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12909 SW 68TH PARKWAY STE 100-4 1 N LO O �D N N CD Q2 O 0o to Z' En T Ste. O O O O O O 12009 SW 038"' Pkwy #100 �w CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: M18/02 000 i6 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: . ARCEL.: 221012 S101AD-03200 SITE ADDRESS: 12909 SW 68TH PKWY 100 SUBDIVISION. TIGARD OFFICE BUILDING ZONING: MUE BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: BO_ILERS/COMPRESSORS HOODS: FUEL TYPES 0 3 HP: Y DOMES. INCIN: 3 15 HP: 35 COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 0 _ AIR HANDLING UNITS _ OTHER UNiTS: FURN —10GK Bl U: — 10000 cfm:�^ GAS OUTLETS: > 10000 cfm: Remarks: Installation of 35 water source heat pumps Owner: FEES PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt 15350 SW SEQUOIA PKWY #300-WMI PRMT CTR 1/18/02 91,702.00 2720020000 PORTLAND, OR 97224 PLCK CTR 1/18/02 $425.50 2720020000 5PCT CTR 1%18/02 $136.'i6 2720020000 Phone: Total $2,263.66 Contractor: PROTEMP ASSOCIATES ING 807 NE COUCH PORTLAND,OR 97232 REQUIRED INSPECTIONS _ Mechanical Insp Phone:233-15W 1 Final Inspection Refit#:LIC 38868 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. A!1 work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon UtlI% Notification Center. Those rules aro set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copiAs of these rules or direct quer ns to O NC by calling Issue By: _ �� Q _ Permittee Signature: _ �` Call (503 639.4170 by 7:00 P.M. for inspections need .d the nd#t business day Mechanical Permit Application Date received: I_C1 0 i Permit no.J)', City Of Tigard Project/appl.no.: Expire date: City offigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By:u Receipt nu.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no,: Payment type: Land use approval: _ _ Building permit no.: U I &2 family dwelling or accessory mmercial'industrial U Multi-lamily Tenant improvement U New construction U Ac flition/alteration/replacement U Other: 1 Job address: Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.:10p*P w- value of all mechanical material .equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ 3Q'r QO Lot: Block: Subdivision. 'See checklist for important application information and Project name: F- jurisdiction's fee schedule for residential permit fec. City/county: p ZIP: XMma Description and I ation of work orypremises:w.4TcR 305-�fi l 1 t .�r�ehD, 1�/3J DutC ��SRrne�s r i,v _ t el.(ea.) focal Est.date of completion/inspect n: /VV r/Rc'r lC. kxritNicn (py. Rtw.unly Re,.oil Tenant improvement or change of use: Is existing space heated or conditioned?)dYes J No Air handling unit CFM u con iuoning(site plan required) _ Is existing space insulated Yes U No I Alteration of existing IiVAU system oiler compressors Business name: State boiler permit no.: HP Tons BTU/H Address: p?ti�� _ _ Firc/smo a ampers/ uct smo a detectors City: at pump(sue plan required) Phone: Fax .a) E-mail: nsta I rep ace urnac umcr— Including ductwork/vent liner U Yes U No _ CCB no.: Insta rep ac relocate enters-suspended, City/metro lic.no.: wall,or t)oor momded Name(please print): cnt for a lance other than furnace _ Refrigeration: Absorption units. BTU/H Name: 'rcwt/ ,l�,�T Chillers__— HP Address: 7- Com ressors HP rolusenla exhaust a ventilation, City: Slate: 'LIP: 1ppliance vent _ Phone: _ �/ Fax;,Z _ 7 7' E-mail: )ryer ex gust oo s,Type res:kuc er iazmat hood firesuppression system Name: Exhaust fan with single duct(bath fans) �QC T� S r Mailing address: :x tees►s stem a+art tom cat n or C' I State: ZIP: "a p p ng andistribution(up to outlets) City: _- Typc: LPC' NO Oil Phone- .(a,Scei Fax: E-mail: I Fuel pipm 9each a dittona over oar ets Procesm piping(sc ematic required) Numbei(+I outlets Name: t ter 11sled appliance or equipment: — _— Address: _ _ Decorative fireplace City: State: Insert-t _ Phone: Fax: E-mail Woodstov pe et stove Other: Applicant's signature: _ Date: Name(print): Nd VI)tuirrktlau acce{rl cteNt rant,plrtiv call iutitdkaon r+K nwxr infrnmatim Permit fee.....................$ - Notice:This permit application Minimum fee................$ U visa U MasterCard expires if a permit is not obtained Otau card number — __-- — pirev - within 180 daafter it hes been review(at _ %) $ rs days ecce tete. State surcharge(8%)....$ te --- t .r�r t �,� accepted as ys p TOTAL .......................$ — Cedhnider tlpattue Amount 4404617((ATW OW MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 3v�67�r; 1 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION PERMIT FEE: Table 1 ion Price Total 1_Table_1A Mechanical Code _ Oty _(Ea) Amt $1.00 to$5,000.00 Minimum fee W'2.50 1) Furnace to 100,000 HTU - $5,001.00 to$10,000.00 $72.50 for the first$ional 10 and including ducts&vents 14 00 $1.52 for each additional$100.00 or 2�Furnace 100,000 i3TU+ fraction thereof,to and including $10,000.CO. including ducts&vents 17.40 _..� - -- $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace including vent 14 00 --- $1.54 for each additional$100.00 or 4) Suspended heater,wall heater fraction thereof,to and including 14.00 $25r000.00. or floor mounted heater $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or - fraction thereof,to and Including 6) Repair units 12.15 _$50,000.00. _ -- $50,001.00 and up $742.00 for the first$50.000.00 and Check all th a apply: Boiler Heat Air $1.20 for each additional$100.00 rr For items 7-11,see ur Pumo Co:d _ fraction thereof. footnotes beluw. comp 7)<3HP;absorb unit Minimum Permit Fee 572.50 SUBTOTAL: n to 100K BTU - 14.00 8)3-15 HP;absorb - 8Ye State Surcharge $ �3 unit 100k to 500k BTU 25.80 9)15-30 HP;absorb 25%Plan Reew Fee(of subtotal) $ -0 unit.5-1 mil BTU 35.00 vi ____Required for ALL commercial permits onl s! 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEF:: $ -1,6 unit 1-1.75 mil BTU - 52.20 L?U7 11)>50HP;absorb - - - unit>1.75 mil BTU 87.20 12)Air handling unit to 10,000 CFM 10.00 ASSUMED VALUATIONS PER APPLIANCE: Value Total 13)Air handling unit 10,000 CFM+ -Description: Oh Ea Amount - 17.20 Furnace to 100,000 BTII,including 955 14)Non-portable evaporate cooler 10.00 ducts&vents Furnace>100,000 BTII Including 1,170 15)Vent fan connected to a single duct ducts&vents 16)Ventilation system not in _ 6.80 Floor furnace includingvent 955 included Suspende4 heater,wall healer or 955 appliance ermit 10.00 floor mounted heater 17)Hood served by mechanical exhaust Vent not included in ar,plicance 445 - 10.00 permit. - 805 18)Domestic inGr,irators Repair units _ 17.40 - <Shp;abs,,', unit,, 955 19)Commercial or industrial type incinerator to 100k BTU _ 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 500k BTU t0.0u 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU 5.40 30-50 hp;absorb.unit, 3,400 22)More then 4-per outlet(each) 1-1.75 mil.BTU - 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL-: $ >1.75 mil.BTU ____ Air handling unit to 10,000 cfrn 656 ---` a%State Surcharge $ Alr handling snit>10 000 cfm _ 11,1170 Non•pofiable eveptirate cooler _656 -- TOTAL RESIDENTIAL PERMIT FEE: $ Vent tan connected to a single duct 446 - Vent system not Included in 656 - - a Ilence permit - - Other InsoectlM and Fe ea: Hood served by mechanical exhaust Y_656 1 Inspections outside of normal business hours(minimum charge two houru) Domestic Incinerator 1 170 $ez 50 per hour Commerdal or Industrial Incinerator 4,590 2 Inspections for which no tee Is specifically indicated (minimum charge hell hour) Other unit,Including wood stoves, 656 $62 50 per how In!t9�etc, _ -- 3 Additional plan review required by changes,additions or revisions to plans(minimum 3� charge-one-t.alf hour)$02 50 per hour Gas II In 1-4 outlets 83 Ei C additional outlet 'State Contractor Boller Certification required for units�200k BTL1 _ ""Residential AIC requires site plan showing placement of unit. TOTAL COMN!:RCIAL $ VALUATION. All New Commergjel Buildings require 2 sets et plena. i:\dsts\formslmech-fees.don 12/26/01 CITYO F T I GA R D ELECTRICAL PERMIT DEVELOPMENT SERVICES DATE ESS IED: 1/15C 02 2-00016 13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639-4171 PARCEL: 2S10'IAD-03200 SITE ADDRESS: 12909 SW 68TH PKWY 100 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE BLOCK. LOT : JURISDICTION: TIG Proiect Description: Electrical work for tenant improvement. Job No. 8409. RESIDENTIAL_ UNIT TEMP SRVC/FEEDERS__ __ _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:i EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp. SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDERBRANCH CIRCUITS _ _ AD_D'L INSF ECT,, ONS 0 2uO amp: :3 W/SERVICE OR FEEDER: 150 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ _ PLAN_ REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: _ SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: �^ PACIFIC REALTY ASSOCIATES BRIDGETOWN ELECTRIC 15350 SW SEQUOIA PKWY #300-WMI 22732 NW GILLIHAN ROAD PORTLAND, OR 9722.4 PORTLAND, OR 972:31 Phone: Phone: Reg #: W-62fb3t W SUP 41775 ELE 26-887C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMI CTR 1/15/U2 $1,238.40 2720020000( Elect'I Final 5PCT CTR 1/15/02 $99.07 2720020000( Total $1,337.47 L_ _ This Permit is Issued subject to the regulations:.ontained in the Tigard Municipal Code,State of OR. Specialty Codes and all other applicable laws. All work will be done In accordance with approved plans. This permit will expire if work Is not started within 180 days of issuance, or if work Is suspended for more than 180 days. ATTENTION: Oregon law requires you t0 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In 0 R 952-001-0 through OAR 952-001-0060. You may obtain copies of these rules or direct questions to i Permit Signature: �" ^j Issued By: / f OWNER INSTALLATION ONLY The nstallatlon Is being made on property I own which is not Intended for sale, leiase, or rent. O"NER'S SIGNATURE: _ DATE: CONTRACTQR INSTALLATION ONLY _ SIGNA PURE OF SUPR. ELEC'N: ' - _ DATE:Y.__ LICENSE NO: 77 L) Call 639-4175 by 7:00prn for an inspection the next business day /N Electrical Pe \ �-� "Datereceived: / Permit�o.: C j City of Tigard Project/appl.no.: Expire date: C'irvrr(Tigard Address: 13125 SW Hall Blvd,'i1i i,d 1�9�-- Date issued: By: Receipt no.: Phone: (503) 639-4171 iun+W Fax: (503) 598-1960 13ftDINO biv MO rase file no.: Payment type.: Land use approval: _ ____ V t 00 00 e U I &2 fare»ly dwelling or accessory Commercial/industrial U Multi-family U'I'enant improvement U New construction U Addition/alteration/ieplaceme,nt U Other: U Partial 1 Job address: I (p8MQ W lil,lr. nu Snit nu.: j(. i 1 Ilu nuth/I,r,-lntlaccount no.: ----1"--_----- -_ _--- -__--- Lot: Block: Subdivision: _ _ Project name: i�'11 ML4r N' /�1M IW�V Description and location of work on fin rises. c I(fYoeii• Estimated date of completion/inspection: #r. Job no: �S � `: Pee Mat Easiness name: �� ! M(.ti'.� - -{' _ ucsrription _ Qty. (ea.) 7o1n1 no.Im New residrnlLrl +ingk r,r multi-family per Address 3 XA t r dwelling rmit.Incladesattached garage. City:'Pi)p-{' KA State: ZIP:9-1 31 'KV Serviceincluded: Phon . (P 2 '71 L Fa 2l •'114 3 E-mail: (�WW_A ,vtxx)Ry.ft.or less - 4 Each additional 500 sq,ft or portion thereof CCR no.: t�3 Elec.bus,lic.no: al(p _W_7 Limited energy,residential 2 City/me lic.no.: V _ Limited energy,non-residential _ 2 Each manufactured home or modular dwelling S' u rv:smg electrician(rc wired) Date Service and/or feeder - 2 Su elect.name( rint): QI ev1SIIt� License no: 13 Serrlceaorlhedenr-Ittatdlatlon, Sup. p dtentton'or relocation: ? r L' 200 am,s or toes _ J 2 Nems(print): 201 am s to 4O0 amps 2 401 amps u.600 amps Mailing address: _- 601 amps to 1000 amps 2 City: Stale: ZIP: _ Over 1000 amps or volts _ 2 Phone: Fax. E-mail: Reconnect only _ l Owner installation:The installation is being made on property I own Temporary wrvlem or feeders- which is not intended for sale,lease,rent,or exchange accordinE to Installation,alteratIon,orrelova Iion: 200 amps or let% 2 ORS 447,455.479,67O,701. 201 amps to 400 amps 2 ()wner's si nature: Date: —___ 401 to 600 rrn s 2 Branch cirr•ults or vv.alteration, or extension per panel: t Name: _ A. Fee for branch circuits with purchase of Address service or feeder fee,each branch circuit City: State: 17,11, B. Fen for branch circuits without purchase - of service or feeder fee,first branch circuit: 2 Phone: Fax: F.-mail' Eachadditionalbranch-ircuit. Ml c.(.Service or feeder not Included): U Servit'e over 225 amps-commercW U Health-care facility Each pump or irrigation circle _ 2 UServiceover320amps•ratingorIAt2 UHazanlouslocatiorr Fachsign oroutline IighUng 2 family dwellings U Building over 1000)square feet four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,or extension• _ 2 U Building over three stories U Feeders,4110 amps or more 'Description: _ _— U Occupant load over 99 pentons ❑Manufactured structures or RV park fish additional Inspection over the allowable Many of the above: •Egress/lightingplan U Otter: -- -- - perinR ecuon Submit—sets of plaru wNb my of the above. Investigation fee The above are not applicable to temporary construction service. Other ------ Permit fee.....................$ _r 2-3S.`e"i Na all)udutklinns acc�,l emit cards,release call Juriufktitxt far mere infrnmatiixt Notice-This permit application "" U Visa U MasterCard expires if a permit is not obtained Plan review(at .__ 96) $ r credit card number.v_� Lam- within 190 days after it has been State surcharge(896)....$ �7 r•;gyres accepted as complete. --�3 _ TOTAL .......................$ Nerve a n car cralll�— f -- Cidboldrr slgnuuure — Amounr 4404615(60WOM) Electrical Permit Fees: Limited Energy Fees: T'A'PE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: -Restricted Energy Fee..................................................... $75.00 Number of Inspections pei permit allowed (FOR ALL SYSTF_M5) Service included: Items Cost Total s � Checl;Type of Work Involved: Residential-per unit 1000 sq.it or loss $145.15 ` _ _ 4 C_ Audio and Stereo Systems Each additional 500 sq ft ur portion thereof _ $33.40 __^^ 1 ❑ 6w alar Alann Limited Energy $75.00 _ Each Manufd Home or Modular ❑ Garage door opener* Dwelling Service or Feeder _ $90.90 2 Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 ❑ , 201 amps to 400 amps _ $106.85 2 Vacuum Systems 401 amps to 600 amps $160.60 _ 2 501 amps to 1000 amps —_ $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $06.85_ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Ir stallalion,alteration,or relocation Fee for each system............................................... ......... $75.00 200 amps or less _ $66.85 —,_ 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 a 2 401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits E]New,alteration or extension per panel Boiler Controls a)The fee for brant;,circuits with purchase of sen ice or ❑ Clock Systems feeder fee. Each branch circuit $6,65 _ 2 F–] Data Telecommunication Installatinn b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $4685 ___ ❑ Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or Irrigation circle _ $5340 ❑ Each sign or outline lighting -_ $5340 _ Intercom and Paging Systems Signal circult(s)or a limited energy pane,,alteration or extension _ $75.00_ ❑ Landscape Irrigation Control' Minor Labels(10) _ _ $12500 _ Medical Each additional Inspection over ❑ the allowable in any of the above Per inspection $6250 Nurse Calls Per ho.ir __ 567.50 In Plant $73 75 _ ❑ Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ Other 8%State Surcharge $ __ _ _Number of Systems 25%Pian Review Fee See"Plan Review"section on $ � No licenses era required Licenses are required for all older Installations front of applkatlon _ ---- — -- Fees: Total Balance Due $ '-- Enter total of above tees ❑ Trust Account# __. 8%State Surcharge — Total Balance Due i tdsu\fomv\elc-fees doc 104W100 CITY OF TIGAR D ELECTRICAL ENER - RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT #: ELR2002-00008 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 1/15/02 SITE ADDRESS: 12909 SW 68TH PKWY 100 PARCEL: 2S101AD-03200 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE BLOCK: LOT: JURISDICTION: TIG Project Description: Tenant Improvement A. RESIDENTIAL __ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: ' INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OP .NER: CLOCK: MEDICAL_: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS- Owner: ` Contractor: — PACIFIC REALTY ASSOCIATES PROTEMP ASSOCIATES INC 15350 SW SEQUOIA PKWY#300-Wfvtl 807 NE COUCH PORTLAND, OR 97224 PORTLAND, OR 97232 Phone: Phone: 233-6911 Reg #: ELE 26-1063CRE LIC 38868 SUP 2613RET _ FEES Required Inspections— Type By Date Amount Receipt Ceiling Cover `PRMT CTR 1/15/02 $75.00 2720020000 Wall Cover Elect'I Final 5PCT CTR 1/15/02 $6.00 2720020000 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if viork is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or dijVct que to OLJNC at (503) 246-1987. �__ Issued by -- ��y�L� _ Permittee Signature i OWNER INSTALLATION ONLY The installation is being rnade on property I own which Is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'NDATE: LICENSE NO: _---•- ---- -�.__�_ —___ -- ------ -- Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Ap plicatic,'n Date received: 5.p L Permit noAMA49�- City of Tigard Project/appl.no.: Expire date: Cirvn("figard Address: 13125 SW Nall IIlvd,'figard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (303) 598-1960 Case file no.: Payment type: Land use approval: _b oy/-0044I 91111111161MR Oki ❑ I &2 family dwelling or accessory U Commercial/industrial U Multi-family tenant nnpruvrnu•nt 7U New construction U Addition/alteration/replacement U Other: _ U Partial 1l S11TV 1N!MA'1*1ON Job address: Q.c e-a t►!d/ ' Bldg.nu.: _ Suite no.: c�0 Tax map/tax lot/account no.: Lot: I Block: Subdivision:Project name,4 :�, o,,/ F, Description and location of work on premises:^z� Estimated date of completion/inspecti : - 1 I Job nom: reo• ntac Business name: f� S•'(+ IMscriptior' _ Qty. (ea.) lb6d no Inc, Nen ra-Adential single or rnrdtl-famous per Address: dhelling unit.Includes attacheii gar-Age. State: ZIP:97o?3:� Seniceiuchrsled: PE-mail: I ON sq.It.or less 4 CCB 00.: 3g sr Ice.bus tic,no: _ Ench additinral 500 sq.ft.or portion thereof — ' CJP Limited energy.residential 2 Cit /metro lie.no.: e,1-5 � Limited energy,non-residential 12 _ - Q-_ Each manufactured home or m;-dular dweVing Si nature '.u rvising electrician( ulred) ate Smatnp% id/or feeder z Sup.elect.name(print) tJTZi t License n /5f'cr r ferders--Installation, or relocation: r Ilst 2 Name(print): ��,�r • S/ to 4W amps 2 o 6W ams 2 Mailing address: ,IWO an, s 2 City: State: ZIP: Over 100x1 amps or volts 2 Phone ,,ef z 'I Fax: I E-mail: Reconnect only I Owner installation:The installation is being made on property I own Temporarysenicesorfeeden-- which is not intended for sale,lease,rent,or exchange according to indallathm.airrration,orreloontion: ORS 417,455,479 670,701. 200"lops or less _ 2 201 mops to 4W amps 2 Owner's signature: Date: _ 40 i to 6(x1 ams - 2 smich circuits-new,alteration, _Name: br extension per panel: A. ;-ee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: _ - Sinte:- ZIP: B. Fee for branch circuits without purchase Phone: rax- F.-(mall: of service or feeder fee,first Manch circuit: 2 Eaclr additional branch circuit:ON -- Mise.(Service or feeder net Included): J Service over 225 amps-a ouoriv ai I,,,t Health-care facility Each pump or irrigation arc1, 2 O Service over 320 amps-rating of 1&2 U Humdous location Each sl n or outline Ii hang 2 familydwellings U Building over IOAX)square feet four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure altermlon.or extension* 2 U Building over three stories U Feelers,00 amps or more •Desai tion: U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable in any of the above: U F.gressllightingplan U Other Pet insr-ction F--T — ,%bmit_sets of plans with any of the above. Investillationfee The above are not applicable to temporary construction service. Other - --- --- fee............. te. Nor all ptnalicrinas trrcepl credit urtfs,pleas• •all;wi+dicNon far more iNtarnartro� Notice:This permit application Permit f ••••••••S ---1-- _ U visa U MaslerCard expires if a permit is not obtained Plan review(at — %) $cr ss oibown on—credit cord � ,, Credit cod Namme of tmtrr w ,within 180 days after it has been State surcharge(8%1...•$ BTU_ `dor` accepted es complete. TOTAL $ 56 1 - Cardholder sl ure -Amount d4114613(NUYC'QM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: -- --_— - –^ _TYPE Or WORK INVOLVED -RESIDENTIAL ONLY Complete fee Schedule Below: Restricted Energy Fee.......—�.......................... ............ $75.00 Number of Inspections er permit allowed (FOIA ALL SYSTEMS) Service included: Items Cost Total Check Type of Work involved: Residential-per unit 1000 sq ft.or less _ $145 15 _ — '1 Audio and Stereo Systems' Each additional 500 sq.ft or portion thereof $33.40 _ 1 Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular El Garage Door Opener' Dwelling Service or Feeder $9090 Services or Feeders Heating,Ventilation and Air Conditioning System' installation,alloratlon,or relocation 200 amps or less $80.36 2 F-1 Vacuum Systems' 201 amps to 400 apps $10685 _ 2 401 amps to 600 amps $16060 2 Other_ 601 amps to 1000 amps $240.60 _ 2 Over 1000 amps or volts $454.65 _ 2 Reconnect only $66.85 2 Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Temporary rice or relocation Fee for each system.......................................................... $75.00 Installation, S 200 amps or less $66.85 _ (SEE OAR 918-260-260) 201 snips to 400 amps $100.30 Check Type of Work Involved: 401 snips to 600 amps _ $133.75 yp Over 600 amps to 1000 volts, Audio and Stereo Systems see"b"abo,:e. Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch circuits F_� Clock Systems with purchase of service or feeder fee. Each branch circuit $665 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. First branch circuit $4685 f HVAC Each additional branch circuit $6.65 _. Miscellaneous F__j Instrumentation (Service or feeder not included) Each pump or Irrigation circle $53.40 _ u Intercom and Paging Systems Each sign or outline lighting Y $5340 Signal circuits)or a limited energy q75 nn Landscape Irrigation Control' panel,alteration or extension _ Minor Labels(10) — $12500 Medical Each additional Inspection over the allowable In any of the above Nurse Calls Per inspection v $62.50 Per hour $62,50 In Plant $7375 Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of r'•ove fees $ n Other 9%Stpte Surcharge $ - _ Number of Systems 25".Plan Roview Fee No liconses are.required I.Icnnses are required for all other Installetim's See"Plan Review'section on $ front of application - Fees: Total Balance Due $ Enter total of above EJTrust Account n.—_- _ 1 8°:State Surcharge $ � —` -- _�— --- – Total Balance Duce $� All New Commercial Buildings require 2 sets 6f plans. i',iso\rormsklc-fees.doc 08/30/01 BUILDING PERMIT CITY OF TIGARD PERMIT #: BUP2002-00005 DEVELOPMENT SERVICES DATE ISSUED: 2/22/02. 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S101AD-03200 SITE ADDRESS: 12909 SW 681-H PKWY 100 SUBDIVISION: TIGARD OFFICE BUILDIN(- ZONING: MUE BLOCK: LOT: JURISDICTION: TIG F- REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: �- S: E: W: TYPE OF USE: COM SECOND: sf — PROJECT OPENINGS? TYPE OF CONST: i sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED- STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REC1D SETBACKS REQUIRED _— FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 15,850.00 Remarks: Fire sprinkler Owner: Contractor: PACIFIC REALTY ASSOCIATES FIRESTOP CO 15350 SW SEQUOIA PKWY #300 WMI 9384 SW TIGARD ST PORTLAND, OR 97224 TIGARD, OR 97223 Phone: Phone: 620-6140 Reg #: uc 63846 FEES — — REQUIRED INSPECTIONS Type By Date Amount Receipt Sprinkier inspection PRMT CTR 1/10102 $196.90 27200200000 Sprinkler Final 5PCT CTR 1/10/02 $15.75 27200200000 FIRE CTR 1/10/02 $78.76 27200200000 Total $291.41 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable iaw. All work will be done in accordance with approved plans. This permit will expire if work is not started within- 180 days of issuance, or if work is suspended for more than 100 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may ootain a copy or these rules or direct questions to OUNC by calling (50,31) Z46-6699 or 1-800-332-2344. Permittee Signature: Issued6y: Call 639-417.5 by 7 p.m. for in inspection the next business day pf Z-1 00 lJ Building Permit Application Date received --r v -v y Permit no.: r'�5 City of Tigard Project/app!.no.: Expire date: ('tr,t/T'i�rtrrl Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By. Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Lahti use approval: —_ 1&2 family:3imple Complex: o ' U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Addition/alteration/replacement U Tenant improvcnwlll J Fire sprinkler/alarm U Other: JOB SITE INFORMA110N Job address: 12909 'W 68TH PARKWAY Bldg.no.: Suite no.: 10 L.ot: I Block: Subdivision: _ Tax map/tax lot/account no.: Projectnamec AMERICAN FAM? INSURANCE__—_ Description and location of work on premises/special conditions: ADD ST'RINKLER HEADS BELOW SUSPENDED-- CEILING TO ACCOMDATED NEW TENANT, -- 6EN =11111171TMUn 1 411*,solar, 1 1 1 ' ,U SE UIII-XKL1 ST Nancc. IFIC REALTY---- Mailingaddress: 11 &2 family dwelling: City: PORTLAND State:OR ZIP: 97224 Valuation of work........... ............................ Phone: 624-6300 Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: Total number of floors................................. Phone: Fax: E-mail: New dwelling area(sq.ft.) .......................... ---- Garage/carport area(sq.ft.)......................... Name. , RFSTOP CO Covered porch area(sq. ft.) ......................... _ Mailing addressg 3 8 4 sea �I ' Deck area(sq. ft.) . ...................................... --_-- - City: TIGARD State:OR ZIPS 7 2 2 3 Other structure area(sq.R.)......................... Phone _ Fax: _ E-mail Commercial/industrial/multi-family: Valuation of work...................................... . $ 15, 8.5 0 Existing bldg.area(sq. ft.) .......................... -__-�- Busincss name: SAME AS APPLTrANT New bldg.area(sq. ft.) Address: Number nf stories City: State: — ZIP: of construction.................................... -_-_ Phone: Fax. E-mail Tye _ - Occupancy group(s); Existing: - _CCB no.:�8 4 6 _ — New: C'ity/inetro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: JOHN ROMISH provisions of ORS 701 and may be required to be licensed in the Aodr:qs: 2 21 6 SE 2 4th 1� jurisdiction where work is being performed. If the applicant is City: PORTLAND State: 7.IP: g 7 21 4 exempt from licensing,the following reason applies: -- — Contact person: Plan no.: - - Phone: Fax: Email: — - Nance: ('ontact person: Fees due upon application ........................... $ g 1 d t __ Address: Date received: — City: State: ZIP: Amount received ......................................... $__-- --� Phone: Fax: E-mail: - Please refer to tee schedule. hereby certify I have read and examined this application and the Nat all Imiutictions accept credit came,pleme ran)uNuacNm,for mote i.f mnallon attached checklist. All provisions of laws and ordinances governing this U visa U Mastercard work will be complied w h,whether specifi)d herein or not. Credo rad number t(eplre: Authorised signature:_ � Uate: d Q - - Name or crudholdet 1a o wn on credo card — — S Print name:_SCOTT MCLAM �_ _� _--- c r eiin r ---- mount Notice:This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. 440-461.1%taUWOM) Fire Protection Permit Check List j TAS U New _❑ Addition ❑ Alteration_ ❑ Repair B.) Modification to sprinkler heads or ';. !:Describe work to 1. 1-10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads: 2-Is Additional description of work: ADD NEW SPRINKLER PIPE FROM EXISTING PIPING ABOVE CEILING. TO NEW SPRINKLERS BELOW NEW SUSPENDED CEILING. Type of SystemiCom lete A, B or C as_a Ipp icable A. Sprinkler _ Wet Q _ I Dry d Standpipes Additional Hazard Group LIGHTS Information _Density — _Y . 10 Design Area K. Factor 5.6 Sprinkler Pro ect Valuation: $ B. Type I - Hood Fire Suppression System nJa ___ Hood Project Valuation C. Fire Alarm Submittal shall Battery Calculations Yes ❑ Include: Individual Component Yes ❑ _ Cut Sheets —_ Fire Alarm Pro ect Valuation: $ Project Valuation Subtotal (A, B & C):_ $ 1 5_L850 Permijfee based on_valuation see chart): $ 196.90 8% State Surcharge: $ 15.75 _ FLS Plan Review 40% of Permit: $ 78.76 - TOTAL: 1 $ hd9ts\1omis\FPSchedd19t.doc 06/07/01 CITY OF TIGARD BUILDING INSPECTION DIVISI N MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- — BUP --Date Requested_ 3_LSU_ AM _PM BLD _ Location-7 � S Gf�C ✓/�w Suite MEC —_ Contact Person �_— —_ Ph 2,31� PLM Contractor Ph SWR BUILDING Tenan'/OwnerELC Retaining Wall — ELI _ Footing Access: - Foundation FPS Ftg Drain SGN Crawl Drain I Inspection Notes: Siab ^— �� - ---- SIT Post&Beam — --� Ext Sheath/Shear Int Sheath/Shear �V - Framing --.-__._ Insulation Drywall Nailing Firewall f Fire Sprinkler Fire Alarm Susp'dCeiling R rof Mist: -- Final ^� _ PASS PART FAIL ---- - -•— -- -- - Post& Beam Under Slab Top Out __ -• -- — - -- - --- Water Service _ Sanitary Sewer Rain Drains AS PART FAIL_ WMtHANICAL Post& Beam -- - --- -- - ------- --- Rough In Gas Line - - ---- - -- -- - ---- Smoke Dampers Final -- - ------ ----- - -_ PASS PART FAIL ELECTRICAL - - - - - --- S@wire - --- -- Roug In --- UG/Slab Low Voltage Fire Alarm - � - - -- -- _--- --- - ------- Final -/ - PASS PART FAIL /�� SITE Backfill/Grading �r Sanitary Sewer r Storrs Drair ( ]Relr,apectlon fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply I.ine ( J Pleasecall for reinspection RE: ( Unable to Inspect no access ADA Approach/Sldewalk [late 7U � ._. inspector Other; --Q P°C �._—__Ext Fknal PASS PART FAIL no ►VO'T REMOVE this i-ttspection record fe om the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Four Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested_ -3' 2t) AM rQM - BLD Location_ ?,, U Sww - Suite _ !AEC — -- Contact Person Tl-- Ph _ GG G —G 3S✓/� _ PLM Contractor,— _ Ph SWR — BUILDING Tenant/Owner _ ELC __— Retaininy`Nall ELR D Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN _- Slab — SIT Post& Beam — Ext Sheath/Shear Int Sheath/Shear -- Framing __— Insulation Drywall Nailing Fire Firewall ---�`/-J'-- Fire Sprinkler _ �-�� _o -- Fire Alarm Susp'd Ceiling Roof Misr.: -------_. -- —. — - - ----- -- ---- Final PASS PART FA!L PLUMBING � - Post& Beam ---------- __—_—__ _--_—� _--._-- ------- Under S•ab Top Out - --- -- ---- -- ---- —.---- ----- Water Service Sanitary Sewer Rain Drains -------__--____-Final PASS -- ------.—.------ -- ---_-.-- PASS PART FAIL MECiFiANICAL --�_-v- Post$ Beam —.- ------ - -- - _ ------- Rough In ---- (;as Line -- -T_�—.-----_ Smoke Dampers Final — — --- ------ - - --------- — ------- PASS PART FAIL ervice Rough In UG/Slab LowVoltage ---------- -----___._—_ .__----------- - - -- -- Alarm PART FAIL i,ackfill/Grading �— ---. __ _. -- _—•-- --_—_----- -----__-- -- Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, '13125 SW Hall Blvd Catch Basin Fire Supply Lin: I 1 Please call ;or reinspection RE: _ — [ j Unable to inspeci- no access ADA / Approach/Sidewalk -7 Other Dates -,�d a ' =Inspec or _ Ext _ Final PASS PART FAIL DO NOT REMOVE this inspection record from the 196 site. i CITYOF T CARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2001-00461 13'k25 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/28/2001 PARCEL: 2S 101 AD-03 00 ZONING: MUE JURISDICTION: TIG SITE ADDRESS: 12909 SW 68TH PKWY 100 SUBDIVISION: TIGARD OFFICE BUILDING BLOCK: LOT: CLASS OF WORK: ALT TYPE OF USE- COM TYPE OF CONSTR: NONE OCCUPANCY CRP: B OCCUPANCY LOAD: TENANT NAME: AMERICAN FAMILY INSURANCE REMARKS: Tenant improvement to the total first floor and south end of the second floor Owner: PACIFIC REALTY ASSOCIATES -15350 SW SEQUOIA PKWY#300-WMI PORTLAND, OR 97224 Phone: Contractor: hl L GREEN 15350 SVV SEQUOIA BLVD STE 300 TIGARD, OR 97224 Phone: 624-7717 Reg #: LIC 41328 This Certificate issued 3!22/2002 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for complianr o with the State of Oregon Specialty Codpsor the group, occupa cy, and use ndei-vrhich the referenced permit was i7 Bt I DING INSPECTOR _ l3UILD1 G POST IN CONSPICUOUS PLAC►: A � ELECTRICAL PERMIT- CITY OF TIGARD DEVELOPMENT SERVICES ---- RESTRICTED ENERGY 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 066/07/2/07/2 000158 001 SITE ADDRESS: 12909 SW 68TH PKWY 100 PARCEL: 2S101AD-03200 SUBDIVISION:TIGARD OFFICE BUILDING BLOCK: ZONING: MUE LOT: JI;RISDICTION: TIG Proiect Description: Low voltage for Fire Alarm system. [A.RESIDENTIAL _ B.COMMERCIAL AUDIO&STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OFTENER: CLOCK: HVAC: DATAfi ELE COMM: MEDICAL: VACUUM SYSTEM: NURSE CALLS: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: FIRE ALARM X Owner: TOTAL#OF SYSTEMS: 1 PACIFIC REALTY ASSOCIATES Contractor: �--- 15350 SW SEQUOIA PKWY#300-WMI HONEYWELL INC PORTLAND, OR 97224 STE I SW SEQUOIA 100 PORTLAND, OR 97224 Phone: Phone: 968-3300 Reg #: sup 941-JLE LIC 57824 ELE 26-207CLE FEES__ Required Inspectir,:rs _ Type By Date --_Amount— Receipt__ Low Voltaqe Inspection 'RMT CTR 06/07/2001 $75.00 2720010000 Elect'I Final 5PCT C T'R 06/07/2001 $6.00 2720010000 Total $81.00 phis Permit is issued subject to the regula,ions contained in the Tigard Munrdpal Code, State of OR Specialty Codes and all ether applicable laws. All work vAll oe done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or d' ect questiun� ai OUNC at (503) 246-1987 Issued b � y - �� yam/ Permittee Signature ---- — OWNER INSTALLATION ONLY _ The installation is being made on property I own whlcl: is not intended for sale. lea,e, or rent. OWNER'S SIC,NATURE: — - — —__ GATE: CONTRACTOR INLSTALLATION t NLY SIGNATURE E OF SUPFi. FiEC ,�f I� l_ICENSE NO: Call 63t-4175 by 7:00 P.M. for an inspection needed the next business day Sent by: WorkCenter, 250 5039683396 06/05/01 10:38AM Job 102 Page 2/2 64 t-. Electrical Permit Application Datereceived: Cit of Tigard i• Permit nu.: y g ProjecUappl.no.: Expire date: CrpuJTigard Address: 13125 SW Hal] Blvd.Tigard, OR 97223 Dale issued: Iteceiptnn Phone: (503) 639-4171 -_ By: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval t U 1 &2 family dwelling or accessory ommerciallindusttial U Multi-family ❑Tenant improvement U New construction U Addstion/al teration/replacrm,,W U Ocher: 0 Partial T INFORMATION Jub address: 1 Bldg. no Fax ntap/tax IOUilCCtlunt n.•.: LAW Block: Subdivision: '— —�----" Project name Description raid location of work on prerniscs: r itimated date of complelion/inspeetieri Jub uo: �-2 U — ( rL) Total n Mins Business nrune. C)Y"E. LL, INC1 NC Dnrrl tion �r New r"Identlal-sbtRk or rewlti-family per Address: 15495 SW SE OIA PARKWAY #100 doetlingunit.includes artacheclgarage. City: PORTLAND S1atc0R lZjP97224 Service Included; Phone:5039683300 Fax:9683398 6-mail: 1000 sq.ft.or less 4 — _Each aOdidnnal 5561 sq.H.nr poniun lhcrenf - --- c B no.: 5 A24 Elec,bus, lic.no: 26-7.07CLE — Umitedenergy,residential - 2 Cllyl C Ic. O,' _ Untitedenergy,non-residential 2 Each marwhioured horse or modular dwelfinx JeD L4 Signature of sit i1 electriclan(required) Date Serviwnnd/orfeeder _t STEM? iv10RFIXX)SE [.itrnscno 9 1JLE Services or feeders-Installation, ti:p elect name(pnnt) aleratiunor reloration: 200 amps or less 2 Nalne(pool): �y�t: ' 1(_ ` _L v 201 amps to 400arnps _ 2 401 am a to 600 amps — 2 Mailing address: 1 — — 601 amps to 1000 amps _ 2 City: Stale' ZIP'. 2- Over 1000 amps or volts 2 Phune:C.2,4 27 Fax: I F.-mail: Reconnect only — - Owner installation:The installation is b.ing made on property l own Terniscanryarrvlesorfiteelm- which is not intended for sale,lease,lent,or exchange according to Installation,allentIon,orrelomdon: ORS 447,455,479,670,701. 200 un a or leas 201 amps to 400 amps 2 Owner's si nature:. _ ale: 4oi to Allo amps 2 Branch circuits-new,alteratioh, or extenslnn per panel: Name: Y—_ _ _ A fee for brnrt-h circuits with purchase of Address: _ service or .edet roe,each branch circuit 1 City; — State: ZIP: - B. Fee for branch circuits without purchase Phone of service or feeder fee,First branch circuit 2 FnK: F, niuil Each additional branch circuli. R• Mime.(Service or feeder not Included): 0 Service over 225 amps-conuncn n,1 U H� ' ,-uuc facility Each pump or Irrigation circle 7 CJ Service over 1211 amlm nOng of &I U Hazardous locounn Each sign or outline lighting — 7 1n1n11y dwellings 0 Building over 10,000 square feel four or Signal circuit(%)or is limited energyparol, USyslentover 600volt%nominal more residentialuniuinone.structurr alteration,orextenslon' ` U Building over three stories U Feeders,400 amps or more 'DrAcn uou: U occupant load over 99 persons 0 Manufactured structures Fir RV park rich additional Insperflon over the dluwable In any of the shotes O Igress/hghungplan U Other. -----_..-_ Perinspecnon Submit�,_sols of plana with any of the above. Love atiNaLon ter 'tile above are not itipellemble to temporary construction service. other Nast all jurirdn•u s arrept credit cods,plllrcall jurisdiction res n In(Kmatlnn Notice;"is pemilt application Pdtnil fee . .... $..... Vile Bas1eK erd ©Nexpires iI a permit is not obtained Plan review(a( , %) S (I do cod oumtwi 1(1g0 ,S i 60 Z V-2 6 1 1*(D3y State surcharge 14% ss�thin ISO days after It has been ( ) $ r %pins ►�,a car�� accr.pted a%r;rsmplete. TOTAL Co hot er signature r"_Mn 440 4611(I~'uMt ELECTRICAL - CITY OF TIGARD RESTRICTED ENERPERMITGY DEVELOPMENT SERVICES PERMIT#: FLR2001-00183 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 7/2/01 SITE ADDRESS: 12909 SW 68TH PKWY 100 PARCEL: 2S101AD-03200 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE BLOCK: LOT: JURISDICTION: TIG Proiect Description: Installation of card access system. A RESIDENTIAL B.COMMERCIAL AUDIO &STEREO: AUDIO& STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER- CLOCK: MEDICAL: HVAC DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: CARD ACCES X TOTAL#OF SYSTEMS: 1 Owner: Contractor: PACIFIC REALTY ASSOCIATES ENTRANCE CONTROLS INC '15350 SW SEQUOIA PKWY#300-WMI 12606 NE 95TH STREET PORTLAND, OR 97224 SUITE C-100 VANCOUVER, WA 98134 Phone: Phone: 28:'-2�33 Reg #: LC 65581 ELE 37-365CL FEES Required Inspections Type By Date Amount Receipt13c,t'l Final PRMT CTR 7/2/01 $75.00 2720010000 _ 5PCT CTR 7/2/01 $6.00 2720010000 Total $81.00 This Permi+. is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 130 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-008 You may obtain copies of these rules or re quesltions to OUNC at (503) 246-1987 ,� / i Issued by ti 46,r4,_ ��j r Permittee Signatur G OWNER INSTALLATION ONLY The installation is being made on property I own which is riot intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY _ SIGNATURE OF SUPR. ELEC'N 1{_ e-ciy' DATE LICENSE NO _ u_ ) r./ ► ILS' �T Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application t Feceived: Permitna.: 1/ City of Tigard I I��: Project/appl.no.: _ Expire date: -_ City fif Tigard Address: 13125 SW Hall Blvd,Tigard,OR Date issued: Byj Receipt no.: Phone: (503)639-4171 Fax: (503) 598-1960 Case file no.: Paymc tt type: Land use approval: 0 1 &2 family dwelling or accessory Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteraiiun/rcplacenlrnt U tither. U Partial .lob addres Lot: Block: Subdivision: Project nur.tc: t(zI4Dv6L-F Tf r i�h Description and location of work on premises: CA"f b A ec',49A T,_ 1•atimatecl date of completion/inspe•lion: Job no: I e t lax _ Nitcriptlon (jtv. (Co.) Total no.insp Business name: �ANT(R.A V►CC e'Cx:tWbii•fin New rrsldential-dingle or multi-family per Address: /7 t,oZ,, /Uo�7_ -4'4511• 5 v(t j- r'--/DL) dwcllinxunit.includes attached garage. City: U Vl`p 041 Slate: '4 I ZIP: Q Service Included: Phone: Fax:3�' E-mail: I(100 sq.ft.or less of Zf33 Z �S 1 y9N Each additional 500 sq.ft.or portion thereof CCB no.: Elec.bus. lic.no: Limited energy,residential 2 _ City/metro lic.no.: Limited energy,non-residential 2 � L, ��`� 7��/O/ — Each manufactured home or modulnr dwelling 'r4� Service and/or feeder 2 igna urea su rvising electrician(re tired! Date - o I.iccnse no: b bQ SL.Ft Services or feeders-Installation, Sup clect.nnute(prmt) alters I.or relocation: 200 amps or less 2 201 unips to 4011 amps ______2 Name(print): A G`f ✓-a 5 T 401 amps to 6fx)amps 2 _Mailin address: 5 5-U 5(,J 5 e(aL) PKw 601 amps u,1000 amps _ _- - 2 City: VQ-4(A Ld Slate r I ZIP: fit/ Over I(x10 amps or volts _ 2 Phone: 'S( ; C 1 y•L S w I Fax: I Email: Reconnect only I Owner installation:The installadou is being made on property I own Tempora"services cr feeders- which is nInstallation,alteration,orrelocation:ot intended for sole,lease,rear,or exchange according l0 200 amps or leas _ _ 2 ORS 447,455,479,670,701201 ampsw400amps t)tvncr's signature; Date: _— 401 to 600 ams 2 - Branch circuits-ncc,alletatlon. or extension per panel: Nano': _ ___ A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City- - State: LIP: _— B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit 2 Phone: I,tx I'. "tail: Each additional branch circuit lialialifu Misc.(Service orfeeder not Included):-- OService over 22'Sanq,sunnnx•rctnl JlIva lth,aefn„hty Lach pump or irrigallon circle 2 O Service over 120 amps-rating of 1&2 U Hazardous location Each signor outline lighting 2 farnilydwellings U Building over 100)0 square feet four of Signal circuit(s)or a limited energy panel, __ O System over 600 volts nominal more residenlial units in one structure alteration,or extension" /_y_75 2 U Building ever three stories U Feeders.400 amps or more 'Description 0,4 v 0 O Occupant load over 99 persons U Manufacturrxl structures or RV park Fwch additional inspection over the allocable In any of the alcove: O F4 ras/lighting plan U Other. — -------- Perins ctioll --- Submit_,seta of plum citb any of the above. Investigation fee--- "w ee —_The above,are not applicable to►aspt)rlrary construction a-ervice Lother Nd all judedlctiont accept Credit tarda,please call jurisd,Sion fa recce ln6xmadan Notice:This permit application Perr til fee.....................$ _ OVisa UMasterCard p Ix Plan review(at _— 91.) $ -- expires if o emit is not obtained •--�— credu card numher _ _,___—___ L / within Igo days after it has beet: Mate surcharge(996) . ..$ ,— rarn ` actx:ptcd as complete. TOTAL ................. .....$ l --Name nt cardholder se shorn on credit cry--- _ S -- ('ardhd�er dgnsttae _ Amami A" i(blwoM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Enerb;r Fee.................. .....—........................... $75.00 Number of Inspections per plrmit allowed I (FOR ALL.SYS-1 EMS) Service Included: Items Cost Total �� Check Type of V rork Involved: Residential-per unit 1000 sq h or less $145 15 _ 4 L� Audio and Stereo Systems Each addition,,'500 sq.ft.or _1 portion thereof $3340 1 CJ Burglar Alarm Limited Energy $7500 Each Manuf d Home or Modular Garage Door Opener' Dwelling Service or Feeder $90 90 2 Services or Feeders ❑ Heating,Ventilation arid Air Conditioninq System' Installation,alteration,or relocation 2('0 amps or less $80.30 2 Vacuum Systems' 201 ampa to 400 amps _ $1rii.85 2 El 401 amps to 600 amps $160.60 2 Other 601 amps to 1000 amps $240.60 ___ 2 Over 1000 amps or volts $454.65 2 Reconnect only $66 85 TYPE OF WORK INVOLVED -COMMERCIAL ONLY Temporary Services or Feeders Fee for each system......................................................... $75.00 Installation,alteration,or relocation (SEE OAR 918-260 260) 2.00 amps or less $6685 __^ 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps _- $133.75 2 Check Type of Work Involved Over 600 amps to 1000 volts, Audio and Stereo Systems see"b"above. Branch Circuits F-� Boiler Controls New,alteration or extension per panel a)The fee for branch circuits Clock Systems with purchase o/service or feeder lee. Each branch circuit _ $6 65 2 Data 1-elecornmunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. First branch circuit $46 85 C, HVAC Each additional branch circuit $665 Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or Inigation circle $5340 �. ❑ Intercom and Paging Systems Each sign or outline lighting $53,40 Signal circult(s)or a limited energy r Landscape Irrlgatior Control' panel,alteration or extension $75 00 _ Minor Labels(10) _ $125,00 _ Medical Each additional Inspection over the allowable in any of the above CJ Nurse('ails Per inspection $62.50 ____ Per hour —_ $62.50 ElIn Plant $73.75 Outdoor Landscape Llyhting' Fees: ❑ Protective Signaling w S Enter total of above fees $ � Other CA ir�b A`r- -1 -- — 8%State Surcharge $ _1 Number of Systems 25%Plan Review Fee Nn licenses are required Licenses are required for all other installations See"Plan RevieA('section on $ —— front of application Fees: � Total Balance Due Enter total of above fees 3 ElTrust Account M �_ 8'/.State Surcharge =� --"—�- Total Balance Due $ '�` i\dsts\fomv\elc-fees.doc 10/09/00 CITE OF TIC�ARD BUILDING PERMIT PERMIT#• BUP2001-00318 DEVELOPMENT SERVICES DATE ISSUED: 9/12/01 13123 SW Hall Blvd.,Tioard, OR 97223 (503) 639-4171 PARCEL: 2S101AD-03200 SITE ADDRESS: 12909 SW 68TH PKWY 100 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATE j: 3SMT?: MEZ7_?: REQD SETBACKS _ REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR PLRM : HNDICP ACC: F_3EDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 20,850.00 Remarks: Modified Alarm Syatem to includes smoke and heat detectors. Doors will be equipped with magnetic hold-open devices. Owner: Contractor: PACIFIC REALTY ASSOCIATES HON`Y,IVELL 15350 SW SEQUOIA PKWY #300-WMI 15495 SW SEQUOIA PRKY PORTLAND, OR 97224 STE 100 Phone: Pq�2one:TLANp6pAO�7224 Reg #: LSC 00057824 FEES _REQUIRED INSPECTIONS Type�By Date Amount Receipt Fire Alarm Insp PRMT CTR 9/12/01 $244.90 27200100000 Final Inspection 5PCT CTR 9/12/01 $19.59 27200100000 FIRE GTR 9112/01 $97.96 27200100000 -- Total $362.45 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. Permittee Signature: Issued By: � Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit Application \ � Datereceived: 1�14/d/ Pemtit no.:�jUPaGYa/—po?)g City of Tigard � address: 13125 SW I lall Blvd.Tigard,OR 97223 Project/appl.no.: Expire date: (irr.; ;,far;l Y� Receipt Date issued: D tno.: Phone: (503) 639-4171 P Fax: (503) 598-1960 Case file no.: Payment type: Land use approval' — _ I&2 family:Simple Complex: J U I &2 family dwelling or accessory U Commercial/industrial U Multi-family ty New construction U Demolition U Addition'alteratiotVreplacement C]Tenant improvement Fire sprinkler/alarm U Other: �— lob address: _ Bldg.no.: 77Eite no.: / I Block: Subdivision: I f.:x map/tax lot/account no.: Project name: ;�S r—�-�G ()�f�2_ _ _ Description and location of work on irrcmiscs/special conditions: ��L A T r If 1 %1 61��_ r► _ _ Name: r [�t�f ' ' Mailing address: ,$ „t tav 1 &2 family dwelling: City: p/trLAN11 1 5t LIN: Valuation of work.......................... ........... . 'r Phone: j(.241 43W Fax: E-mail: No.of bedroomF/baths................................. Owner's representative: L: �, , ,yam Total number of ft , s................................. Phom. C ;? I ,t� t". mail New dwelling area(sq.ft.) ..................... . i C Garagc/c•arport area(sq.ft.)......................... Name: %' �j16&,A� Wje .— Covered porch area(sq. ft.) ........................ _ Mailing address: f > �/� t l/ C KC �,Gw Deck area(sq. ft.) ........................................ City: w/7 State: 7,IP: Other structure area(sq.ft.)......................... Phone: - 'y2 Fax: E-mail: �� ('ommereial/industrial/multi-family: Valuation of work................... .. ...... $�0 ) Existing hldg.areaft.) ... ,. U....... Business name: ��+ ---- f✓l // New bldg. area(sq.ft.) ...... ..401.0*A0........ Address ' ' �S�b� S'�s City: TZ State — � Number of stories............y....................... Phone: - 'ax: - l:-mail: 'type of construction.................................... — �— � ----- (hcupactcy group(s): Existing: CCB no.: �.2q New: City/metro lie.no.: Notice:All contractors and subcontrat tors are required to be licensed with the Oregon Construction Contractors Board under _N a ire: (I'll z6an (,d ,,Z,e provisions of OkS 701 and mny he required to he licensed in the ress �— t jurisdiction where work is being performed. If the applicant is Add ��' �� W dA exempt from licensing,the following reason applies: City: I State:ort I ZIP: Contact person: Plan no.: — Phone: Name: -- lCmitact person: Fees due .pon application ...... .................... $ --- Address: Date received: City: State: JZIF Amount received ......................................... Phone: I E-mail: Please refer to f'ee schedule. I hereby certify I have read and examined this application and the Not all jurUdictionr accept credit c"q.deme call jurisdiction for mote infnrmallon. attached checklist. All provisions of laws and ordinances governing this U Visa U MasterCard work will fx complied with,whether s4teci ed herein or noott.L Credit card number ��l ' � A uthorized slgna I�'l ate: --Nettie of c older as rhown on c II cord Print name: — — �M'1i` _ c' ard— ol�deri+sneiure -- — $ Amour �!, Notice:Phis permit ap li ion Rxpires if a permit is not obtained within 180 days atler it has been accepted as complete. 440461.11(tiff) COM) 4 Fire Protection Permit Creek List - _�A. ❑ New Ll Addition ❑ Alteration _ ❑ Repair B.) Modification +a sprinkler heads only: Describe work to 1. 1-10 heads: No plan review required. be done: 2. 11+ heads: Pian review required. Number of sprinkler heads:_ —_ P,dditional description of work: Type of System (Complete A, B or C as applicable A. S rinkler Wet ❑ _-- Standpipes --�_-----_---__-.- Additional Hazard Group Information Desicin Area K. Factor _ __ - --- _ --- Sprinkler Project Valuation: _ B� Tie I - Hood Fire Suppression System — -- Hood Project Valuation $ C. Fire Alarm — -- Submittal shall Batterg Calculations_ _ Yes_ Include: Individual Component Yes _ Cut Sheets _Fire Alarm Project Valuation: $ _—Q 1 --____Pro_Ject Valuation Subtotal C,_ _ Perm_ it fee based on valuation see chart 8% State Surcharge: $ �69 FLS Plan Review 40% of Permit: $ 9 r 16 ---- — TOTAL: $ --3 6 2- _--__. l:\dsts\forms\FPSchecklist.doc 06/07101 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST _ BUP _ II Date Requested � '"��-� AM PM — BLD _ Location Suite G MEC Contact Person -_ - , Ph �5 -33 . PLM Contractor Z�Y�ne-e &2A I y,�/c, Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELRf Foundation Access: FPS Fig Drain SGN Crawl Drain Inspection Notes: -- Slab Post&Seam - -- ---- SIT - Ext Sheath/Shear Int Siieath/Shear - Framing Insulation ------ Drywall Nailing - Firewall --Fire Sprinkler Sprinkler Fire Alarm Susp'd Ceiling Roof Misc _-_-.------ ------- -- ------- - Final PASS PART FAIL PLUMBING PoFt&Beam -- _ --- -- - - ------ - Under Slab - � Top Out ---- ---- Water Service Sanitary Sewer -_--- -` --- Rain Drains Final -- PASS PART FAIL MECHANICAL - --------- -- - ---- -___. Post&Beam - - --- -- ---- -- -_-�_____ Rough In Gas Line _._. ___-_ -- '00 - --- -- - Smoke Dampers Final -- -- -_----- - — --- .-....__- SS PA FAIL ELECTRICA , ---------- -- Rough In ---------- - ------------ UG/Slab --_----------- ----- ------ Low Voltage Fire Alarm PASS ART FAIT_ - ------- ---- - -- --------------- -- - Backfill/3rading ---- - ----- --------------- - -..- Sanitary Sewer Storm Drain [ ]Reinspection fee of$-__ _required before n-nvf inspection. Pay at City Hall, 13125 SW Hell Blvd r'atch Basin r ire Supply Line [ ] Please call for reinspection RE:__ - -- [ ] Unable to insp,ct- no access AIM Appioach/Sidewalk Date 9 G� Inspector Ext final final __ - PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 539-4171 — _ Date Requested AM PM BUPBLD 1 �G ` 0-- 'K Suite AD L -- Location MEC Contact Person '�-�--w� �J Ph :2c/ PLM _ Contractor 4,C1yA:LA4i.1-'` Ph _ SWR _`— BUILDING Tenant/Owne ELC _ Retaining Wall ELR Footing Access. Foundation FPS Ftg Drain _ SGN Crawl Drain Inspection Notes: tt �� -- Slab —- SIT Pest&Beam -- Ext SheathiShear Int SheathiShear Framing -_— Insulation Drywall Nailing __---_-_-_- Firewall Fire Sprinkler ---- ----- - --- ------ -- -- ------ - - Fire Alarm Susp'd Ceiling - Roof Misc:_- I --------------- ---— -- ------------ --- --- Final PASS PART FAIL --—._.... -- -- -- -- - ----- ---------- ----- ------------ - PLUMBING Post&Beam ---------------- ---- ----_-_-------_-__._----- Under Slab Tcp Out Water Service Sanitary Sewer ---- ---------- ----- ------ -- -------- --- Rain Drains PinelPASS PART PART FAIL —.-----_-_ -- -------__-._-- - e MECHANICAL Post& 13oam - - ----- -_ ..� — — - ------- ----- Rough In Gas Line -- ---- - ------- - --- ---- ---- Smoke Dampers Final - ---- -- ---.------ -- -------- - -PAR7_ FAIL rviLz p UG/Slab Low Voltage FJteAlarrn — - . -- —--- -- -- --- ---- — n PASS �PR T FAIL - -- --- ----- — ---- ----------------_ _----_-- c,ackfill/Grading -------- - -- —.-- ------ - ---- ----- —.-- Sanitary Sewer Storm Drain ( I Reinspection fee of$ _ , —required before next inspection Pay at City IIaII, 1317 SW flail Blvd Gatch Basin f ire Supply Line ( (Please call for reinspection RE —.— Unable to inspect no access ADA Approach/Sidewalk fi l Qther Date .----� :�// Inspector _. y' - -- Ext - —- f=inal — PASS PART —F=AI1- DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — - � BLIP �,�l -___- Date Requested G seo AM` PM ---- BLD Location- 1,1q 0`7 S Ctj &9 _ MEC Suite - - �'- Contact PP.,son _ Ph — PLM Contractor— —!—_— _ Ph — SWR _ BUILDING Tenant/Owner _ ELC Retaining Wall - -� ELR Fooung Access: Foundation EPS Ftg Drain - -- -- Crawl Drain Inspection Notes SGN _ Slab ----- ------ --- SIT Post& Beam -- --- Ext Sheath/Shear IInt Sheath/Shear - -- - Framing -- _- -_-_. Insulation -- --..- --...------------ ---- ---_ Drywall Nailing Firewall -----_--! �- ----- ��- Fire Sprinkler Fire Alarm u - Susp'd Ceiling ---- ---- - --- - ---------- -- — Roof mi SS PART FAIL _-___-_-... — --- ----. - ---- --__.-- ---- - - PLUMBING Pose& 9eam _-_�_ ----_._ ----- -- ----- ----- ----.__. Under Slab TopOut -_ _ _ -------- ----- ----- -- ---- -----. - Water Service Sanitary Sewer Rain Drains Fina, --- -- ------ PA;S PART FAIL MECHANICAL - - ---------- Post& Beam ----------- -- - - - - - - --- - - --- ----- - Rough In Gas Line ---- ---- - ---- - ----- -- ---- Smoke Dampers Final -- -- -- - --- - -- PASS PART FAIL -� ELECTRICAL - Service Rough !n ----.------ --- -- --------- -_-- -------- -- !UG/Slab — ILow Voltage Fire A!arm Final PASS PART FAIL ----- -- ---- ---- ------ - ----SITE Ii-ackrili/Grading --------- - -- ---- ------ Sanitary Sewer :,corm Drain [ J Reinspection fee of$— rpgr :red before next inspection Pay at City Hall, 13125 SW Hall Blvd Gatch Basin Fire Supply Line [ J Please call for reinspection RE:_ _ -_ [ J Linable to inspect-no access ADA Approach/Sidewalk Date C ` Other �� I a - _-- Inspector _ i9' .�1`_ ---- --- Ext -- F;nal `PASS PART _:AIL DO NOT REMOVE this inspection record' "rom the Job site. '� CITY O F T I G A R D BUILDING PERMIT PERMIT#: BUP2001-00461 DEVELOPMENT SERVICES DATE ISSUED: 12/28/01 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S101AD-03200 SITE ADDRESS: 12909 SW 68TH PKV Y100 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: ALT FIRST: sf N_ S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: NONE sf N: S: E:— W: OCCUPANCY GRP: 8 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: __ READ SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM . HNDICP ACC: SEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 380,000.00 Remarks: Tenant improvement to the total first floor and south end of the second floor Owner: Contractor: PACIFIC REALTY ASSOCIATES H L GREEN 15350 SW SEQUOIA PKW` #300-WMI 15350 SW SEQUOIA PLVD PORTLAND, OR 97224 STE 300 77��1Z Phone: TIt oRne. ��447174 Reg #: LIC 41328 FEF` — REQUIREG NSPECTIONS Type By Date Amount Receipt Electrical Permit Required 5PCT CTP 12/19/01 $146.38 27200100000 Sprinkler Permit Required Plumbing Permit Required PLCK CTR 12/19/01 $1,189.37 2.7200100000 Framing Insp FIRE CTR 12/19/01 $731 92 27200100000 Firewalllnsp PRMT CTR 12/19/01 $1,829.80 27200100000 Gyp Board Insp Susp Ceiing Insp Total $3,597,47 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This pr? mit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law require-, you to follow the rules adopted by the Orag,)n Utility Notification Center. Those rules are set forth in OAR 957-001 -0010 through OAR 952-0 1-1987. You moy o0t3in a copy of these rules or direct questions to OUNC by calling (503)246.6699 or 1-8 52-23 4._ �) Pe rm"tee _ Signoture: E Issued By: J --_ Call 639-4175 by 7 p.m. for an Inspection the next business day I Building PeranitApplTcation City Of Tlga`lJ<'(j Dateieceived:;� /i Q/ pt"rmitna.: l�(! C'/ Address: — Addre13125 SW Hall Blvd,Ti ard,OR 97223 Projec�lappl.no.: Expimdate.: C�}'oJTiBard g Phone: ('503) 63911171 Pate issued: _ _ By: Receipt no.: Fax: (1,03) 598-1960 Case file no.- Payrncnttype: Land use approval: t&2 family:Simple Complex: I &2 family dwelling or accessory El Commercialrr:dustrial C1 Multi-family 0 New construction I?Demolition Addition/alteration/replacement ,C Tenant improvement Q Fire sprinkler/alarm ❑Other. 1 Jab address: _ Bldg.no.: Suite vision: _ no•: ,J 1 Ca• Block: SUbd _ Taz map/tax lot/account no.: Project name.: ,� 77 _ � , JL` Descaptionand � location of work on premise special conditions:. ��- cZ ,11 - _ - 1 Name: Par_Trust loaf" A&IM ?Ziingaddress: 15350 SW Sequoia Pkwy. , #300 1&IfamilydwrUing: City o r t d�— State: O R Z1P_9 7 224 — Valuation of work........................................ $ ( 503 Phune: -624-6300 Faxfi24-775.1 -mail: No.ofbedroomsibaths................................. _ Owner's reputsentative:Den n is Pa n i Total number of floors.............. Phone: S Fax: E-mail: New dwelling area(,sq. ft.) ...................... _ ... _ APPLICANT Garage/carport area(sq. ft)......................... Name: P a c T r u s t M _j_300 Covered porch area(sq.ft) ailing addrrss:l5 3 5 0 S W S e u o i a P k w #3 0 0 Deck area(sq.ft.) ........................................ City., Port t a n d_ state: 0 R 7JP: 9 7 2 2 4 Other suuctur^area(sq. ft)......................... ( 5 0 3 Phone:6 2 4-6 3 0 0 rax 6 2 4-7 7 5 E-marl: l ommerciaUladustrial/multi-family: Valuation of work........................................ Ely-c j� Existing bldg.area(sq. ft.) .......................... _1sT' 'Business name: H. L. Green __ Address: 15 3 5 0 S W S e U 4 1 a Pkw "' New bldg.ares(sq.1'L) ,M#30U — - Number of stones city: ort and state: ZU2 � ........................................ ( 5 0 3 Phone 2 4-7 717 Fax: E ;nail: Type of construction.................................... ��~~ --- Occupancy group(s): Existing: — CCB no.: 41328 city lie.no.: — __ New: _ Notice:All contractors and subcontractors are required to be t licensed with the Cttgon Construction Contractors Board under Name: J oh n Rom i s h provisions of ORS 701 and may be required to be licensed in rhe Address: 15 3 5 0 SW Sequoia Pkw #300 Jurisdiction where work is being performed, If the applicant is exempt t from licensing.th City: Porti-and 7staic:OR ZIP:97224 p g• e following reason applies: t-onvict person: _ Plan no.: (5 0 3 FIhone: 0 0 iFax6 2 4-1 5 E-m ul: •11 =10 _— — --�-ohne@ act us�T-:com as Name: ('ontacr person: --- Fees due upon application ........................... E_ Address: _4__` Date ttccivui: City: State: — Amount received ........ .. E _ Phone: Fax• E-mail: — _ Please refer to fee schedule. I hertbv certify I have read and examined this application and the LCmWI Mu wee"ard1 canis,pleae call 7 nWkuon rfx more iNr�,tw��n utached checklist. All provisions of laws and ordinances governing thusCl Mastercard work will be complied wilt, whether spe ie itUrt�// nn'�Autliriudsignature:Print name: � _ S -_ i:xdndder ntpurure Atnormr Notice: This permit application expires if permit is not obtained within 180 days after it has been accepted as complete. 440.is13 ADWOM) CORIEGON OF TIGARD December 21, 2001 John Romish 15350 SW Sequoia Pkwy 4300 Portland, Oregon 97224 RE: 12909 SW 68"Parkway#100(American Family insurance) The City of Tigard Buildin- Division has reviewed the submitted building plans for the above referenced address in accordance with the Oregon Structural Specialty Code (OSSC), 1998 edition and the Uniform Fire Code, 1997 edition as amended by Tualatin Valley Fire& Rescue. i The following items need to be addressed and are not in comp,'iance with the above mentioned � Codes: First Floor 1) South stairway exit passageway. Openings and penetrations, openin&s in the exit enclosure shall be limited to that necessary for egress from normally Accu ied spaces into the enclosure, and those necessary for the egress from the enclosure. Room 112, (TC Closet). relocate the entrance door outside of the exit passageway. Second Floor 1 ) Room 202 "Training room has an occupant load greater than 50, thus requiring two exits. One exit may go into the hallway (intervening room) and the other shall go into a rated corridor currently, both exits, are served by the same non- rated hallway. 2) Separation ofexit enclosures. Current drawings show exit corridor on the East Side running North li•om the "South" staircase to the center staircase/elevator lobby. Total distant;- is approximately 66 feet. Required separation is 85 feet do to area served. Need (o include the North staircase in the exiting of the second story the center staircase is a convenience staircase not a required exit. 3) Second story pians do not indicate what is being done on the North end of the structure please indicate areas that are not part ofthis application on the working drawings. Due to the items identified as noted above the plan review has peen terminated until the items have been properly addressed. in no way shou!d this partial review be considered as a complete i review. 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD(503)684-2772 - Please submit revised plans showing compliance with codes. If you have any questions regarding this review, please contact me at (503) 369-4171 ext. 392. Si cerely, D�ans J( tWes Examiner C. Hari Watkins,Supervising Inspector Building Inspectors File CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00002 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/9/02 SITE ADDRESS; 12909 SW 68TH PKWY 100 PARCEL: 2S101AD-0300 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE BLOCK: LOT: _ JURISDICTION: TIG TENANT NAME: AMERICAN FAMILY INSURANCE USA NO: FIXTURE UNITS: 9 CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .5 EDU increase. Previous fixture count was 316, this permit added 9 fixture values for a new total of 325 fixture vaiue3 or 2.0.3 EDU's for an increase of.5 EDU's. Owner: _ FEES PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt 15350 SW SEQUOIA PKWY #300-WMI _ PORTLAND, OR 97224 PRMT CTR 1/9/02 $1,380.00 27200200000 Total $1,380.00 Phone: "' Contractor: Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of',hr: Unified Sewage Agency. -he permit expires 180 days from the date issued. The total amount paid will be forfeited if Lhe permit expires The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in ali directions from the distance given. If not so located, the ;nstaller shall purchase a "Tap and Side Sewer" Perm ZIssued by:1/ _ Permittee Slgnature� Jam' Call (503) 639.4175 by 7:00 P.M. for ,n inspection needd the next business ay Accumulative Sewer Tally Tenant!, ;,ie: American Family Insurance This SWR/;2002-00002 Sits Address: 12.909 SW 68th Ave#100 This PLM# 2002-00003 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off#s count # value _ #s values Baptisery/Font 4 0 _ 0 0 0 0 Bath-Tub/Shower _ A _0 0 0 0 0 _ - acuzzi/W h i rl pool 4 0 0 0 0 _Car Wash- Each Stall _ F 0 0 0 _ 0 0 _ - Drive through ` 0 0 _ 0 0 —0— Cuspidor/Water _Cuspidor/Water Aspirator 1 0 0 _ 0 0 0 _Dishwasher-Commercial 4 0 0 _ 0 0 _0 - Domestic 2 0 0 0 0 0 Drinking Fountain _ 1 0 _ _ 0 _ 0 0 0 _�je Wash 1 0 0 0 0 0 Floor Drain/Sin;;-2 inch 2 _0 _ 0 1 2 1 2 3 inch 5 0 0 0 0 _ 0 4 inch 6 0 0 i 0 0 0 Car Wash Drr 6 0 0 0 0 0 Garbage Disposal Domestic(lo 3/4 HP) 16_ 0 0 0 0 0 Commercial(to 5 HP) 32 0 0 0 0 0 Industrial(over 5 HP) _ 48 0 0 _ 0, 0 0 Ice Machine/Refrigerator Drain 1 0 0 1 1 1 1 Oil Se (Gas Station) _6 0` _ 0 0 0 _ 0 Rec.Vehicle Dump station 1 16 0 �0 0 0 1 0 Shower-Gan (per head) 1 0 0 0 _ _ 0_-0_ _ Stall _ 2 ^_ 0 _ 0 0 0 I 0 _Sink -Bar/Lavatory_ 2 0 !_ 0 _ 0 _ 0_ 0 _ Bradly _ 5 U _ U _ — 0 0, 0 _ _ Commercial 3 0 0 _ _ 0 ! 0 0_ -Service 3 - 0 _--- _0 .y— ? 1 6 _ 2 6 _Swimming Pool Filter _ y 1 0 _ 0 _^ �0 _0_ _ 0 _Washer- Clothes 6 _ 0 0 _ 0 _0_ 0 Water Extrartor 6 0 _ 0 0 0 V 0 Water Closet- Toilet 6 0 _ 0 _ _0 0 0 Urinal 6 0 U 0 0 0 Previous EDU Count 19.8 316.8 316.8 Capped EDU Credit 0 TOTALS 1 0 1 316.8 1 0 1 0 1 4 1 9 1 4 325.8 Current Fixture Value 325.8 divided by 16= 20A Current EDU 1 EDU - $2,300 00 Previous Fixture Value 316.8 divided by 16 = 19.8 Previous EDU Change- 9 divided by 16= _ 6.6 over (under) $ 1,380.00 Enter EDU Change Ilere 0.6� HISTORY Note". _ PLM# 2001-0052.5 _ ED_U# 19.8 SWR# 2001-00288 ---- PLM# 2001-00332 EDU# 19.1 +--� SWR# 2001-0022.3 P M# 2001-00302 EDU# 18,8 SWR#2001-00212 N rne: ,� Date 24k, pnature of p son that calculated this tally sheet and date perfromed Is required CITY OF T I GA R D ELECTRICAL PERMIT- RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT ELR2002-00005 13125 SW Hall Blvd.,'Tinard, OR 97223 (503) 639-4171 DATE ISSUED: 1/10/02 SITE ADDRESS: 12909 SW 68TH PKWY 100 PARCEL: 2S101AD-03200 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE BLOCK: LOT: JURISDICTION: TIG Proiect Description: Installation of voice and data cabling. A.RESIDENTIAL _ B.COMMERCIAL AUDIO & STEREO: AUDIO &STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR l_ANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: PACIFIC REALTY ASSOCIATES MOORE COMMUNICATIONS INC 15350 SW SEQUOIA PKWY#300-WMI 20811 NW CORNELL RD PORTLAND, OR 97224 STE 700 HILL-SBORO, OR 97124 Phone: Phone: 617-9800 Reg #: LIC 00076364 ELE 34.356CLE FEES_ Required Inspections -Type By Date _Amount Receipt Low Voltage Inspection PRMT CTR 1/10/02 $75.00 2720020000 Elect'I Final 5PCT CTR 1/10/02 $6.00 2720020000 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans This permit will expire it work is not started within 180 days ' issuance, or if work is suspended for snore than 180 days. ATTENTION Oregon law iecauires you to follow rules adopted by the Oregon Utility Notification Center. Those piles are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. Issued oy !�� ,.L"-61 y Permittee Signature _ OWNER INSTALLATION ONLY The installation Is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ DATE:-- LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day of 10/02 THU 10:18 FAX 503 6179898 Moore Communications Z001 47ovt --c oq(01 Electrical Permitalim �_LRPAI R Unto recelrcti ' _ r- �"." t no.: �J Cfty Of Ti Vwd Rojoct/appl.no.: rmpiradatz: Ciryof7Vard Address: 13125 SW Hall Blvd,Tilrard,OR J)?223 Doteissucd By-_��IRrccipcno.; Phone: (503) 639-4171 --- C Fax: (503) 59&1960 Acuefih no.; P•ymanttype: �:��y ur YxJ �� Land use uppiuval: r� � 71 &2 family dwelling or acct;sort f�f Cotnrnercia1/indusrlia1 O lvr"(ti-family O Tenant improvement rd New eonsituetion ❑Addition✓altcmtiof/replacement Q Other:. � 7 Partial t Job addras6: ( / =wl(��J y Rldl;• tf.'•: Suite no,:�O�� Tk trap/we,lodaeeount no.: Lot: Block: Subdivision: _T —~ _ Pnctjeu name: / `Description tmd locadon of work un pncituses a i„ It t _ �_ -- EstirTia:ed date of cam let iart/in. cction: a Job nor �S n Buairlau name -- 4a, ... .+ Daeriptlou t?ty. (e><) Total nn.irate tVerr tvidnrGod-s(artlie or tnrki•6etdly Ater Addrass: / �.� Sc., arvnlrn�tp,ir f�-ladesatbrl.dpn� Oily: / Starer ZIp - 9unin inclntitrl: I oG 1` �f 7 S 5 E-mail: 1000 tq,ft.nr Icxs f d Each addihen tj 500 sq (L or portion thereof CCB no.: FJec,bus.lie.no: C Li1rt.lted ener •Gs,daactil — City/metier lit,no.: ,S/U ___-- Unnitrd onsersy,tion-reeulantial - 1 Fodt mmttftuteumd home or tnn.lolru dwe!!ih( eWlpyJ "tvi9in elrcvtcl tet�Uilod) `�- 1pT�,L! Service and/us frsder - Z Sup elect,name(1,611t): u .� G r �� Licrc.m nu. Servicre nr feeden-itrsialladoa, tJrmratlen or ttrlocetino: 20Uomptiof 1rss - _ _- -_ 2 Nanrr.(print: lal amps tmp" 1 --�-- 101 antes too 6t'Eva 0 aropti 2 Mailwg addtc6s. jt�� C.! 601 amps to 10na nmpc City. stareZll'; oyer)two amps or VOID a Phone: Fa1t: Frti1.711: Rtconnect—IV 1 Owner inswIlaNun:The ieatailation 1c being made cio property i own T.4"pntury+ ,i—er feedeff- which to not inteudcd for pale,lease,tcrlt_or etc-hanp nccording to insUlMion,operannn,of' rphrrnnn, 200 am ORS 447,455.479,610,701. er400 2 201 am to ln0urops 2 *,awnewes; Fi alUre' Daw: a01SooP - - Rranch dreeits new,alrrnrlan. M otioncrou per psu 1 N;Ad&11c,:'_ : _.. .__�. _ A, Fra for branch cirrow with Purchase of service,or feeder fee,oath branch cucuit stony 71P: l. eefor branch 'rwv without pun-hiom ervice or foe ir•tura,first baarteh circuit:' ii-moil' Roich tiltlandM.rnvhcircuiL 1146W.((lank'•Mfr�MrnotIna )� SrtvicYvver 1:>amo,mmme-mal i)Fitvddremctu';Ihty Hach pump ar irripstion cirr_!r. 2 l:)3etvim utrer 3'0&MrAA tilting nr 1&2 U Harrdeata loration Ent h t n ur outline 11 tin 2_ familydwdlinp* O Building over itiorin sgnmr fen ti�ur or Signal aimutt(a)or a limftod energy panel. / 'r5 i]System"Yt r 00-111S nomlvnl rmrn re5idontlal units in Mr etmcrute: divicatinh,orerstonaion"_-__---.. - ' ,a awoL a uverthrrr tu,rin!, U Peedstrs,400nm,�ormnit "Dart tion:_ {Q Mcu tint load over 99 Persons U Manufactured struct iovs vt RV pink —a.�- p � )1'iafi a4ANfona!irnpaetim neer ihr allotashlr N any r'tbt shoes: :7£.gtrsulightlwT ngpio, O h • ---- --- - perinspcctlon �- 9nbmit—_.__mm afpbmtr tdth any nttb'above. nvatigndontae — 71te pbOve are mot nppUmbla to>•ereriorary eopstruatlon nr.iee, aha NMI all jtu4sdlrtl,aa assent acdt rade,pkaae eu11 ivrista4lon flit gift 1.0. NOhGG:W.permit applit:aM.m Permit fee.....................S �5 A Visa tl MwusrCaard�// l' t' mxpiren if n permit is nol obtained Finn rrwieW(at.__• %) S c..,dir ra.Q pnntxr: A(/) ✓ /U /!�a 79� / L_,., within IWu days nR,r A hot hrnn 110.IC tiutrhlll'XC(b�f)....$ -- __�- a S - .---. 9 r accts tod Re ram lel'. TOTAL................. .... D a J K>2c �; rruZL�tr�u' Q� e0 r r rwdhvidia sa. cru n e a /1hNYrt J 0.14161 S(SNtYCO►t) CPLUMBING PERMIT CITY ®F TIGARD PERMIT#: PLM2002-00003 - DEVELOPMENT SERVICES DATE ISSUED: 1/10/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S101AD-0300 SITE ADDRESS: 12909 SW 68TH PKWY 100 ZONING: MUE SUBDIVISION: TIGARD OFFICE BUILDING JURISDICTION: TIG _ BLOCK: LOT: GARBAGE DISPOSALS: MOBILE HOME SPACES: CLASS OF WORK: ALT WASHING MACH: BACKFLOW PREVNTRS: TYPE OF USE: COM FLOOR DRAINS; 1 TRAPS: OCCUPANCY GRP: B CATCH BASINS: STORIES: WATER HEATERS: 1 SF RAIN DRAINS: FIXTURES LAUNDRY TRAYS: GREASE.i RAE'S: SINKS: 2 URINALS: LAVATORIES- OTHER FIXTURES: 6 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WA;ER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing for 2 break rooms. Other fixtures to include 1 ea Ice Maker, Zea coffee maker water suplies, 2 ea water filter supplies and 1 flow through water heater Owner: — ---- Type By Date _Amount Receipt PACIFIC REALTY ASSOCIATES PP.MT CTR 1/10102 X166.00 27200200000 15350 SW SEQUOIA PKWY' #300-WMI PLCK CTR 1/10/02 $41.50 272002000.10 PORTLAND,OR 97224 ,PCT CTR 1/10/02 $13.20 27200200000 Total $220.78 Prione 1: Contractor: Y DEAN WARREN PLUMBING 3111 SE 13TH PORTLAND, OR 97202 REQUIRED INSPECTIONS _ Rough-in Insp Phone 1: 236-4152 Rough-in Insp Reg a: LIC 172 Final Inspection PLM 26-83PB This permit is issued subject to i'ie regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days c`issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Permittee Signature.4L�L _ •L � Issued By: Carl (503) 639-4175 by 7�0o P.M. for an inspection needed the next business day Plumbing Permit Application Date received: Permit no. City of Tigard ( Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: pa Building Permit no.: City ofTgard Phone: (503) 639-4171 Projectlappl.no.: Expire date: Fax: (503) 598-1960a-Goe'o�L' Date issued: BY:�'' Receiptno.: L nd use approval: ! case file no.: Payment type: U 1 &2 family dwelling or accessory )(CommercialAndustrial U Multi-family U Tenant improvement New construction U Addition/alteration/replacement U Food service C1 Other: Job address: 9 1'riPH;n Ot Fee(ea.) Total Bldg.no.: _ Suite no.: f n�j --- Nen I-and 2-kmlly dwellings only: Tax map/tax lot/ac(ounl no.: - (includes 100 B.for each utility connection) -- __-T SFIt(1)bath Lot: Mock: Sutxlivision: �- --- _ .�_--_-- .-•- - SFR(2)batt) Project name: &, �-�r✓ i( iv`�. SFR(3)bath - _-_HT1 c7","I C - _ City/county: Z.IP: C;-? �0l3 Each additional bath/kitchen N.scnpuoit and location of work on p ises Siteatilitles: Lto a k .s Catch basin/area drain Est.date of completiontinspection: Drywells/leach lineArench drain - Footing drain(no. lin.ft.) Manuf ictured home utilities___ Business name:- v/ gl��L Manhc les _ Address: / Rain drain connector _ City: 10y2T-"Jo- ate: ZIP_ "!2 -- Sanitary sewer(no. lin. ft.) - _ -- Phone: -�.-y Fax: _ Gmail: Stour sewer(no. lin. ft.) CCB no.: Plumb.bus. reg. no. - Water service(no, lin. ft.) - City/metro lic.no : I Fixturr, or Item: o i Contractor's represent Abs presentativc signature: -- on valve Print name: r' �., Date: Back flow reventer _+ - BackwaG?valve Basins/lavatoty -- _Name: �� 1�(�(,rj U._� -_ Clothes washer Address: -- Dishwasher - -- -- Drinking fountains) City: -- - ' State: ZIP: Ejectors/sump —---- -- Phone: Fax: E-mail: Expansion tank _ Fixture/sewer cap Name(print): -'A-C - / R��-- SL.L t T� 3� Floor drains/floor sinks/hub ---+ --- - Garbage disposal — Mailing address: ! 0 SW k -�------ g - Hose bibb Cit r State: --- y' 1� a 9 7_ Ice maker Phone:(-,014- 3 OC] Fax:-� -- --T[-'-.mail: Interco for/gmase trap Owner instal lation/residential maintenance only: The actual installation Prirr--qs) will be matte by me or uie maintenance and repair made by my,egular Roof drb in(commercial) _ employee on the property I own as per ORS Chapter 447. Sink(s) basin(s),las) Owner's signature:_ Date: -7 *Cy Sum Tubs/showcr/shower pan __— - _ Narne: Urinal ---- Water closet _ Address: _ _ _ _ Water heater City: _ _ _State: ZIP: Other:_ - - - --- Phone: - Fax: E-mail:— — Total --'� Infcrm Na dl juriedtttlacc a aegr credit code,plena-,cell iuried4:rim raer marim. Notice:This permit t ppllCallOn Minimum fee................$ � �---- l I Visa U MasterCard Lan review(at _ %) $ _ exnirrs if a permit is not obtained I Credit card mrrrbet _ _ _L 1 State surcharge(8%) ....S within ISO days eller it has been Expir-r accepted as complete. TOTAL .......... ............$ •• _. -- Narne d cardolder sa ehow"m ctedir pard p P S Cardt"der dpWYR Amour"— — - 4101616(6AUR'OM i PLUMBING PERMIT FEES: - PRICE TOTAL New 1 and 2-faml y1 dwellings only: PRICE TOTAL QTY ea) AMOUNT (Includes all plumbing fixtures In OTY (ea) AMOUNT FIXTURES ndivldual 16 60 0 fdwelling and the ct ) ft. Sink _ - for each utllit connection) $249.20 --__------ 16.60 On_11)bath _ - - $350.00 Lavatory -� -16.60 -- Two�2Lbalh -__ -._- - Tub or Tub/ hewer -- - - $399.00 ----- 16.60 Thre�3 ba) th — G,r3wer inly 16.60 --- SUBTOTAL Warn.Closet 16 60 -_-8'/•_STATE SURCHARGE Urinal ---- - 16 60 PLAN REVIEW 25'/.OF SUBTOTAL _ _ __-- TOTAL Dishwasher 1660 —--- -- Garbage Disposal -- 16.60 Laundry Tray 16.60 -- Washing Machine FkxxUreinl—Fborsink z" 16-60 PLEASE 3" COMPLETE: --- 16.60 4" 16.60 - - q_uan_tit b Work Performed O conversion O like kind 16 60 Fixture Type: New Moved Replaced Removed/ Wator Heater Capped Gas piping requires a separate mechanical /G-(Po -_ permit--. 0 4Sink -- MFG Home New Water Service _ Lavatory - --- 46.40 Tub or Tub/Shower MFG Home New SarVStorm Sower _ -- ---- 1660 Combination _ ---- Hose Bib_- ---- - 16 60 Shower Onl Roof Drains Water Gloset -- - - Drinking Fountain 16.60 Urinal_ tn,� -" 16.60 - Dishwasher _ --- --- Other Fixtures(Specffy)XC�r _ Garbage Disposal --- Laundry Room Tra _ - W^A; Washin Machine -- w " F w �&�A.TV - Floor DralNSink. 2" _--- - 55.00 3" _ Sewer-1st 100' -----'- -46.40 - Sewer-each additional 100 5500 - Water Heater — Water Service-1st 100' Other Fixtures 46 40 Specify) Water Service ea— ch additional 200' -_ Storm {n-1st 1(10 _ 55.00 46 40 p Slprm 8 Rein-Dr31n•each additional 100' -_-- -- 46 - .40 �� comma,-C,181 Bar k Flow prevention Device 46.55 --- H Resldentlal Backflow Prevention Device'_ - - - - 16.60 _ -- Catch Basin _ _ ---- call 72 _ COMMENTS REGARDING ABOVE: Inspection,of Exla(in�Plumbing or Spec Y erlhr _ -- Reguested Ins ectkms ---- - 65.25 _------- --- Rain Drain,single 1 tmlw du"'!!ir8 _ _ 1660 Grease Traps ------ --_-- - QUANTITY TOTAL -- -- -- lsometor.or risnr diagram is required 11 ___— •-----` --- �- Ovant Total is >a --- '-SUBTOTAL �G O ------- ^- - - STATE SURCHARGE "— "PLAN REVIEW F SUBTOTAL R uired ON It flxtura rolel I's-'! --- TOTAL 'Minimum Permit he It$72 50•e%state surcharge except Residential Backflow prevention 1)evice,which It $36 25 r a%stain surcharge "All New COmmercist Buildings require Main wnh Isometric or riser diagram and pine review i\dswfonns\plm-fees dos 10/10100 RMIT- CITY OF TIGARD RESTRICELECTRITEDAL NERC RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT M ELR2002-00034 13125 SW Hall Blvd.,Ticiard, OR 97223 (503) 639-4171 DATE ISSUED: 3/8/02 PARCEL: 2S101 AD-03200 SITE ADDRESS: 12909 SW 68TH PKWY 100 SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE j BLOCK: LOT: JURISDICTION: TIG 1 Proiect Description: Job#30.18-20020 Low voltage for 2 access control panels. 3/20/02, adding (2)additional access panels. A. RESIDENTIAL _ B.COMMERCIAL _ AUDIO&STEREO: AUDIO& STEREO: INTERCOM & PAC-;NG: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: ACCESS PAN X _ TOTAL#OF SYSTEMS: 4 _ Owner: Contractor: PACIFIC FEALTY ASSOCIATES RFI COMMUNICATIONS & SECURITY 15350 SW SEQUOIA PKWY #300-WMI 6195 SW 112TH STREET PORTLAND,OR 97224 BEAVERTON, OR 97008 1 Phone: Phone: 503-626-6387 I Reg #: ELE 34-174Ci.E SLIP 3417JLE LIC 67147 FEES Required Inspections Type By Date Amount Receipt Low Voltage Im.oection 5PCT CTR 3/8/02 $12.00 2720020000 Elect'I Final PRMT CTR 3/8/02 $150.00 2720020000 PRMT CTR 3/20/02 $150.00 2720020000 5PCT t'rR 3/20,02 $12..00 2720020000 ( ' _Total $324.00 _ This Permit i7 issued Subject to th-, regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. Th;s permit will expire if work is not started within 180 days of Issuance, or if work is -uspended for more than 180 days. ATTENTION: Oregon law requires_you to follow rules adopted by the Oregon Utility Notification Center. Thosa rules are set forth in OAR 952;061-0010 through OAR 95� You may obtain copies of Mese roles or direct questions to OUNC at (503) 24 -1987 � Issued by ._ Z _ Psrmittee Si-1987 OWNER INSTALLATION ONLY _ The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: _ ____._ DATE:—_ _ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: Call 639-417: by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application -__ r�i 'Ove ived:1 U y Permit no.pa-i ce City Ol Tigard �F;C E V '�U ProjecVappl no.: Expire d-te: City q/Tigard Address: 13W SW hall 131%,1 TgardMR 9-t23 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case rile no.: Payment type: Land use approval:—__Cif Y Uk i tl. AIW t =Ncw dwelling or accessory Wommercial/industrial >Multi-family ❑Tenant improvement iction ❑Addition/alteration replacement ❑Other: ❑Partial JLD address:12909 SW 68th Pkwy Bldg. no.: Suite no.:I00 Tax_map/tax lot/account no.: Lot: Block: I Subdivision: Project name:American Faml7-y—_ __I Descri,tion and location of work on premises: Access itrol Install Estimated date orcompietion/inspection. 3- 02 Jobno: 30-18--20020 I rr<' Max Businessname:M. CartftMications & SecuritY7TY—Stem Dewriplion --� Q11. (ea.) -Iolal no.lnsp — Newresldenllal %Ingle ormulll-fandis per Address: 6195 SW 112th Avenue dwellinRunll.Inrludcssttsched,taxi r. City: Beaverton State: OR 7_iP: 97008Setvkelnclndrd: Phone:503-626-6387 1 Fax:503-626-38 -mail:rmartin(rfi.can low act.A.w less _ _ 4 CCB no.: 67147 Iec.bus.lie.no: 34-174CLE Each additinnal 500 sq.n.or rtion thereof Limited energy. residential 2 City/m o lie.n94. Q0904 I (.,L Limited energy. non-residential 2 _ 3/5/02 Fach manufactured home or modular dwelling Sign rc of supe n.i I electrician, ai-red)A Date Service and/or feeder 2 Sup.clan Home t r Dian hell license no: 102SJ Services or reeders-Installrlion, rllerrtlon or relorrtlon: 2(N)amps or less - _ 2 Name(print): 201 amps to 400 amps 2 - --- 401 am s to 600 Imps 2 Mailing address: 601 ams to IOVJ amps 2 City: --- _ — State: TIP`_ over 1000 acips or Volts — 2 Phone: Fax E-mail: Rcconna.t onl I Owner installation: The instailation is being made on property 1 own Tesrporan serskes or ferder- which is not intended for sale,lease,rent,or exchange according to Irvtallation,allerafion,orrelocallon: ORS 447,455,479,670,701. 2(w ams or Ics — I 2 201 am a to 4(al amps _ _ 2 _ Owner's si nature: Date: 401 to(lx)amps _ 2 -- Branch circults-new,alteration, or exlvoiIon per panel: Name: A. Fee for branch circuits with purchase of Address: service or Feder fee,each branch cinuit _2 City: State: ZIP: B. Fee for branch circuits without purchase - --- of service or feeder fee,first branch circuit: 2 Phone: I,�� is-mail: --- 1'.ach additional branch circuit M Isc.(Service or feeder not Included): U Serviee over 225 amps-commercial 1 I Ialitlt-care i:uthny Each pump or tngahon circle ' I,Servicc over 320 amps-rating of 1&2 J Ilwanlous location finch sign or outline ligh•mg - - flaZy dwellings U Building over 100X)square feet Four of Signal chcuit(s)or a limited energy panel, J System over 600 volts nominal more residential units in one structure alteration,or extensinn -_ __ U Building over three stoics ❑Feeders,400 amps or more •1lcscrl tfo, Access Control pane. S U Occupant toad over 99 persons U Manufactured structures or Rv park I ach�ddltlonsl lnsprcnon oyer the ollorsable Inanyoflheabove: -- U 1.11, n-Aightmg plan U Other'--- - Pct ms 1co it 9nbmlt !rte of plana with any of the above. Invcstigetion fee— -- _ — The above are not applicable to temporary comtruction service. other —---------- Permit fee .•..............o...S 150.45 Na all jurlsdictimts accept credit cards,please call judsdiomn Ln more Infomintino Notice: This permit application U Visa -)MosteWard expires if'a permit is not obtained Plait review(at .-- /o) S Credit card number _,----_ �.1_-- within 180/lays after it has leen State surcharge(8n,40).....S 12.D0_ Expire, ---_—_-- accepted as compleP:. TOTAL.... ...................5 ——162—'00-- Nxute ul'car s cr as s own ml CICJiI cit�i - ---- cordliuldet d nstK ute Joni 440.4615 Ifs Nit I tart I CITY r F TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Linc: 5:. 4175 Business Line: 639-, 1 — - — — J BUP ---___- -Date Requested �4) �O —AL1 _PM BLD Location Suite /&a MEC :o „act Person _ —__--__ Ph :; J- G/ PLM :ontractor - _ — _—_ Ph SWR — -- HUILDING Tenant/Owner _—� — _ ELC — — iRetaining Wall ELR — Footing Access. Foundation FPS — Ftg brain SIGN Crawl Drain I Inspection Notes --- — Slab _ --__ ____--_ _ SIT Post R Be am — Ext Shez hlShear Int Sheath/Shear Framing -- - - - --- ------- Insulation Drywall Nailing Firewall Fire Sprinkler -_----_— Fire Alarm Susp'd Ceiling ---- ---- - --- - --- -- _ - Roof Misc:-- - -- - --- ------- - ---- ------ - - Final PASS PART FAIL __.. ---- - - - - --- �-- ----_ _ ---------- PLURIBING Pwrt R Beam Under Slab Top Out Water Service Sanitary Sewer � in Drains - ----------- _ + --�-- Final j P T FAIL -1T Post& Beam - l2ough In Gas Line -- -- -- - ---- - -- - ---- - --- Smoke Dampers. it _.... ----- -- _ -- - -- ------ -- - ---- SS PART FA!t_ Service - Rough In r_^-- UG/Slab - ---�_. . ---- --- --------- -- ----_ Low Voltage Fire Alarm - - - ----- --------- _r_-. _ Final PASS PART FAIL ---------- --- -- ------- --- ----SITE Backfill/Grading -- ---- - - - Sanitary Sewer Storm Drain ( ) Reinspection fee of$ required before next inspection. Pay at City Hall, 1312.5 SW Hall Blvd Catch Basin Fire Supply Lint, ( J Please call for reinspection RE -_- _ [ ]Unable to inspect- no access ADA Approach/Sidewalk Date �' -��__—InspectorExt Other ----- - -__ -- --�-------- -- Final PASS PART FAIL J1 DO NOT REMOVE this inspecti,)r; record from the job site. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 �2,eice co BUI Received Date Requer+ad � 7, -Z, AMPM —_ BUP ZOO' Z d 4005 Location ' �--` ' `�� Suite G -- MEC _ _— Contact Person __.__— _ fit-�` t Ph PLM Contractor_—._ _ Ph ( ) — _ SWR —__—� ILDING Tenant/Owner __._..- __—_— —_— __ E L C �f ELC r.dation Access: _— Ftq Drain ELR Crawl Drain Slab Inspection Was: SIT Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear _ Framing -- - --- ---------- ---- ---- ------------------- — Insulation Drywall Nailing - ---- -- — ---------- - Firewall Fire Sprinkler - ---- _2 0 U -� --- — - ----------- Fire Alarm Susp'd Ceiling ---- Roos Other: ----- -- -- -- ------ ----- -- --- �14SSPART FAIL Post& Boom Under Slab — _.----5-- ' s --- --- ----- -- Rough-In Water Service - ----— -- ------- ------- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain ----- -- — - — — Shower Pan Other: — Final PASS_PAi1TFAIL ------ ----- -------------- --------•--- •----- --- MECHANICAL__ — Post&Beam Rough-In --- Gas Line Smoke Dampers — --- --- ----- ------- Final PASS PART FAIL — _---- -- — —�- — ELECTRICAL —� Service Rough-In --_-- --_ — — UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL _ SITE _ Please call for reinspection RE:_—. Unabla to inspect-no access Rre Supply Line ADA Approach/Sidewalk Dab __ ..__— ' 4/v-2—Inspector _ _ 'Z'Z�— ____Ext__-- Other: Final DO NOT REMOVE this Inspection record from the Joh site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)539-4175 !DIST INS 'ECTION DIVISION Business Li. e: (503) 639-4171 BLIP Receiwa --.--Date Requested —� AM '/ _—PM 8UP Location _ r __ ��~ K Suite__ 1 MEC Contact Person _— __ Ph(_ ) PLM Contractor —. __-- -- Ph(—�—) ' i _ SWR BUILDING Tenanl'Owner ___ ._._ -n - ELC dZ Footing - ELC Foundation Access: '=tg Drain ELR -- - -- Crawl Drain Slab Inspection Notes: SIT Post& Beam, - --- - ------ _�.--�. -_ _ Shear Anchors Ext Sheath/Shear -- ----- -- -- -- Int Sheath/Shear Framing -- - _ _ - -_ ---- - -- - --- -- Insulation ll ` Drywall Nailing -- - -- F �`� - ------- ---------- --- -- --- Firewall / r) �� f s Fire Sprinkler --� -� -- -- Fire Alarm Susp'd Ceiling ------ -____ -_ _ _ --- ------ --------- - -_ .__- ------ Roof - - - --- -- Final _PASS PART FAIL PLUMBING - — - - _-- ----_ -- . Post& Beam Under Slab Rough-In Water Service -- Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain - -- - - -- - - Show,)r Pan Otner: I Final PASS PART FAIL MECHANICAL Post&Beam Rough-In - - - --- -- - Gas Line Smoke Dampers -- - Final PASS PART FAIL - GLECTRICAL Service Rouah-In UG/S'aL Low Voltage -_ _-- -- -- - FirQ Alarm Reinspection feo of$._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. t-fASS PART _FAIL S ^- �� Please call for reinspectioo RE _- _.-_--_— -_ Unable to inspect--kic access Ffre Supply Line ADA DatcSr d Z� InspectUir - - Ext . - -- Approach/Sidewalk Final nOther:DO NOT REMOVE this Inspection record=fFOMhejob site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MSl` INSPECTION DIVISION Business Line: (503)639-4171 SUP — ----- Received _ — __ Date Requested l --.- AM_—_-- PM-- -- BLIP — t_ocation �' �� _ ___ _Suite__— MEC Contact Person �'��. _._-__— Ph(_�.� PLM ----- -- Contractor_,'�� f'�;��i` .——"---- Ph -- ) - --- SWR -- --- BUILWAG Tenant/Owner _ —.— _—_---- ------ ELC ELC --- -- ---- 1-nundstion Access: ELL Fig Drain Crawl Drain SIT _ Slab Inspection Notes: Pest&Beam — --- - --------------- Shear Anchors Fxt Sheath/Shear --- Int Sheath/Shear — -------- ----`--�— Framing - — - Insulation — Drywall Nailing Firewall Fire Sprinkler — Fire Alarm _ - ------ Susp'd Ceiling Roof - ---— -- Other: — Final -- - - ---- ----- -- PASS _PART FAIL _ — — PLUMBING — --� Post&Beam Under Slab -- -- —T`—I- Rough-In Water Service -- - Sanitary Sewer - Rain Drains Catch Basin/Manhole Storm Drain ----� -- -- Shower Pan — — Other: -----— - -- — ---- — Final - PASS PART FAIL ^---- --- _--- - --- --- MECHANICAL r — Post&Beam Rough-In — Gas Line _-_— Smoke Dampers - - ---- -- --- ------ Final _ —-- PASS PART FAIL ELECTRICAL _-- ----._r----------- —_ Service — v ------- UG/Slab Fire Alarm Final Reinspection fee of$ _.— required before next inspection. Pay at City Hell, 1312.5 SW Hall Blvd. (I,A% PART FAIL S - l no access � Please call for reinspection RE: __— ______r E] Unable to inspect- Fire Supply Line ADA pib �L-�-�" - Inspsat - Kxt Approach/sidewalk , Other. Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Insnecilon Line: (503)539-4175 INSPECTION DIVISION Business Line: (503)539-4171 MST BLIP —__— Received —_--- ate Requested - G' __ AM PM _ BUP �_— Location .1� p _iY� ---- --------.Suite MEC -- --------- Contact Pemon -- ------_-- Ph(—- --) ---- PLM --- ---- -— Contractoro�� L \�'�> ►L i� 1�!:-'- -- Ph(S'- SWR v-- ---------- _BUILDING Tenant/Owner ELC Footing Foundation ---- ELC -. Access: Ftg Drain ELR ayOd o 1?0 Crewl Drain Slab Inspection Notes: SIT Pest& Beam - -- - - - ----- - -- -`)hear Anchors , Ext Sheath/Shear _ Int Sheath/Shear Framing ---------___--- Insulation Drywall Nailing —-- -- -- --- - ---- `--- -- Firewall l-�W � �� / L Fire Sprinkler � ----- - --- Fire Alarm Sucp'd Ceiling - - --- -- - -- -- - w __- Root 1 Other: -- - -------------- Final PASS PART FAIL - - -- -- -- ------ -`— PLUMBING Post& Beam Under Slab --- - -------- ---- Rough-In -- Water Service - --- - ----- - - Sanitary Sewer Pain Drains -- --- Catch Basin/Manhole Storm Drain - - - Shower Pan Other: - - ---- -- -- ------_---- Final SS PARTFAIL MECHANICAL Post& Beam Rough-In -- --- _- Gas line Smoke Dampers Final PASS PART FAIL -- ELECTRICAL Service - -- ------ Rough-In - UG/Slab -- -- - - - 'Volta ---- Fire Alarm cfffffa PART FAIL E] Reinspection fee of$__ - - req -.red before next inspection. Pay at City Hull, 13125 SW Hall Blvd. $� - [� please call for reinspection RE -.—._ _-_____- _ L� Unable it, inspect -no access Fire Supplv I inn ADA Approach/Sidewalk Date _!? Inspecto _ Exit Other- - -- - �---- Finai DO NOT REMOVE this Inspection record from the Job site, PASS PART FAIL