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ELECTRICAL PERMIT-
CIT'Y OF T'IGARD RESTRICTED ENERGY
DEVELOPMENT SERV) � PERMIT#: ELR1999-00214
13125 SW Hall Blvd., Tiqard, OR 97� 9-4171 DA'T'E ISSUED: 9/13/99
SITE ADDRESS: 11481 SW HALL BLVD 102 'x/� PARCEL: 1S135DA 03500
SUBDIVISION: Y ZONING: C-P
BLOCK: LOT: r, JURISDICTION: TIG
Proiect Description: Installation of a HVAC 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: X PRO i ECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS: 1
Owner: Contractor: —
LN PROPERTIES, LLC D L HOWARD CO
11481 SW HALL BLVD 5340 SW DOVER LN
SUITE 100 PORTLAND, OR 97225
TIGARD, OR 97223
Phone: Phone: 246-6764
Reg #: LIC 00082769
ELE 165JDA
_ FEES Required Inspections _
Type By Date Amount_ Receipt Low Voltage Inspection
PRMT DEB 9/13/99 $60.00 99-318258 Elect'I Final
5PCT DEB 9/13/99 $4.20 99-318258
Total $64.20
This Permit is issued subject to the regulations container .., the Tigard Municipal Code, State of OR. Specialty Coles
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance. or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0p- ough OAR 952-001-0080. You may obtain copies of these rules or ' ec4 tions to OUN t (503)
246-1 87.
Issue by L 9,6LU"JJ _ Permittee Signatur
OWNER INSTALLATION ONLY
The installation is being made on proper.y I own which is not intended for sale. lease, or rent. _
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC'N DATE:
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next Business day
CITY 01= TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by
1 7.125 SSV HALL BLVD Date Rec'd:
TIGARD OR 97223 PRINT OR TYPE Permit ermit
V- 503-639-4171 X304 #:
F - 503-598-1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:��—��
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED RESIDENTIAL ONLY
,7 Restricted Energy Fee........................................ 560.00
(FOR ALL SYSTEMS)
JOB Street Address Ste#
ADDRESS �4 ,Pry /ALL Check Type of Work Involved
Lity/StZip Phone# Audio and Stereo Systems
Nam h — Burglar Alarm
z,,V. �n 17f Tf BS �,.L ❑ Garage Door Opener'
OWNER Mailjng,H.01, ss
!/��`� e d. ❑ Heating,Ventilation and Air Conditioning S,stem'
r'1WState ip I Phone#
(�$SI �C# Vacuum Systems'
Name T- 7
Other -- ---
CONTRACTOR Mailing Address TYPE OF WORK INVOLVED -COMMERCIAL ONLY
& ---
(Prior to issuance a /StateZip
Phone# Fee for each system.............................................. $60.00—
copy of all licensesO i L,��� c7 (SEE OAR 918-260-260)
are required if Oregon C— Contr.Brd Lic # Exp. Da
expired in C.O T CC 6 g "7(o� S�OQ Ch
Type of Work Involved:
data base) Electrical Contr.Lia# Exp a
__Z_(O —/O ZO CKF` d / ❑ Audio and Stereo Systems
C.O.T or Metro Lic # xp.O to
2Z (o Z �'7/ ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/State Zip I Phone# ❑
Fire Alarm Installation
This permit is issued under OAE 918-320-370 This applicant agrees to
make only restricted energy installations(100 volt amps or less)under this HVAC
permit and to do the following ❑
Instrumentation
1 Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems
These have asterisks(') All others need licensing;
❑ landscape Irrigation Control*
2 Call for inspections when installation unde-this permit are ready for
inspection at 503-639-4175; ❑ Medical
3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection whet.the inspector is out to inspect under thio permit;
4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspector are done,and; ❑
Protective Signaling
5 Assume responsibility fcr calling for a final inspection when all of the ❑
corrections are completed Other
Permits are non-transferable and non-refundable and expire if work Is not
started within 180 days of issuance or if work is suspended for 180 days _Number of Systems
The person signing for thi permit must he the pplicant or a person No licenses are required Licenses are required for all other installations
authorize/to/bit --
FEES:
ENTER FEES S��
Signature
7%SURCHARGE(.05 X TOTAL ABOVE) $
Authority if other than Applicant TOTAL
I ldststformsvesele doc 3198
CITYOF Y I G e R D 0 MECHANICAL PERMIT
DEVELOPMENT SERVICES 9z I DATE ISSUED: 9/13/99
PERMIT#: MEC1999-00367
13'125 SW Hall Blvd., Tigard, OR 97223 (503) 639-417 4 r I/ PARCEL: 1S135DA-03500
SITE ADDRESS: 11481 SW HALL BLVD 102 ' l�
SUBDIVISION: ZONING: C-P
BLOCK: LOT: JURISDIC,rION: 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: BOILERS/COMPRESSORS HOODS:
_
FUEL TYPES0 - 3 NP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN•
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE- 50 + HP:
FURN < 100K BTU: _ AIR HANDLING U"JITS CLO DRYERS:
OTHER UNIT- 1
FURN >=100K BTU: <= 10000 cfm: -- �---
n 10000 cfr.i: GAS OUTLETS:
Remarks. Mechanical for tenant improvement. (Dr Brolinstein)
Owner: 'y FEES
LN PROPERTIES, LLC Type By Date Amount Receipt
11481 SW HALL BLVD PRM T DEB 9/13/99 $50.00 99-318258
SUITE 100 PLCK DEB 9/13/99 $12.50 99-318258
TIGARD, OR 97223 5PCT DEB 9/13/99 $3.50 99-318258
F-hons' Total $66.00 v_
Contractor:
D L HOWARD CO INC
5340 SW DOVER LN
PORTLAND, OR 97225 REQUIRED INSPECTIONS
Mechanical Insp
Phone:246-6764 Duct Inspection
Reg #: LIC 82769 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Care.
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 to follow rules adopted in the Oregon
Utility N
ot Center. Those rules are set forth in OAR 952-001-001Q through OAR 952-0 1-0080.
You mc pieL f these rules or direct questions to OUNC by g ( 3)2�� 1 '
Issue _� fla,�4.q.�j Permittee Signature: —
Call (503) 639-4175 by 7.00 P.M. for inspections nee ed the next business day
CITY OF TIGARD Mechanical Permit Application Plan Check# 7
Rema By
13125 SW HALL BLVD. Commercial and Residential Date Rer'd
TIGARD, OR 97223 Date to P E
(503) 639-4171, x304 Date to DIT___
Print or Type Permit# r3(•�
Incomplete or illegible applications will not be accepted Called
NaW,04tDevelop trprolect^ Description
LL 14Table 1A Mechanical Code Oty Price Amt
lob Street Address - Sude# - A) Permit Fee - A �`:.. 16.00
9�/ �a" /0 1) Furnace to 100,000 BTU
Address ( � including ducts&vents _ see footnote 1,2 9 65
Bldg# I CnyrState Zip 2) Furnace 100,000 BTU+
16*AAZL> including ducts&vents_ see footnote 1,2 12.00
Ne (or nnan)°of bus ss) 3) Floor Furnace
Owner les L(. _ including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater,wall heater
or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance ermit _ 4.75
City/state ZIP Phone Check all that apply: 'Boiler Heat Air
7&4A 971 Z �,o(j' SC�(!�, For Items 6-10,see or Pump Cond Qty Price Amt
y�- -- footnotes 1,2 Com
Name(or n9 a o1 business)
6)<3HP;absorb unit to
20L-)A-)ST.9I/J 100KBTU 9.65
Occupant Melting Address 7)3-15 HP;absorb unit
100k to 500k BTU 17.65
GtyfStateZip Phone 8) 15.30 HP;absorb
unit.5-1 mil BTU 24.15
--- 9)30-50 HP;absorb
COntraCtOr Name unit 1-1.75 mil BTU 36.00
-h'• r /�4J/1t�J� 1-�-►6, 10)>50HP;absorb unit
Prior to permit Mailing Address / >1.75 mil BTU 60.15
Issuance,a copy 5-3a (,�o Z ra L 11 Air handling unit to 10,000 CFM
of all licenses c�y/State ZipPhone _ 7.00
are required if Q M- 6- 7 12)Air handling unit 10,000 CFM+
expired in COTC;!Q Co st Cant Board Llc# Exp Date _ 11.85 _
database C i�/� 13)Non-portable evaporate cooler
Architect Nam , 7.00
� A i)DLE 51 G N _w H-r.cT- 14)Vent fan connected to a single duct
or Mailing Address 4.7_5
a16)Ventilation system not included In
appliance pel-mit _ 7.00
Engineer CnyrState zip Phone 16)Hood served by mechanical exhaust
ZZI-ZCa3 7.00
Describe work to be done: 17)Domestic Incinerators
12.00
New V Repair O Replace with like kind: Yes O No O 18)Commercial or InOistrial type incinerator
Residential Commerclal,Af 48.25
19)Repair units
Additional information or description of work: 8.40
20)Wood stove/gas FP/other units/clothe dryer/eta /
_ 7.00
NOTE: For Commercial projects only;Units over 400 lbs require 21)Gas piping one to four outlets
_ structural has caics. _ _ See footnote 1 -_ 3.75
Type of fuel oil O natural gas O LPG 0 electric O 22)More than 4-per outlet(each) 75
Minimum Permit Fee$60.00 SUBTOTAL
I hereby acknowledge that I have read this application,that the information 7%SURCHARGE
given is correct,that I am the owner&authorized agent of PLAN REVIEW 25%OF SUBTOTAL
Required for ALL.commercial permits and A 1'
the o I s su in compliance with Oregon tate laws ---- TOTAI
/ „.
3tgn nt
of Owner/ gent -_�--�
_ ��41ry Other Inspections and Fees:
_� W�L 5 0,� G�-� 1. Inspections outside of normal business hours(mininum charge-two
Contact Person Name Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically Indicated (minimum
charge-half hour) $50.00 per hour
Foonotes for commercial projects only:V 3. Additional plan review required by changes,additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
2 Provide drawings to scale showing existing and proposed mechanical
units. 'State Contractor Boller Certification required
'�" "Residential A/C requires site plan showing placement of unit
I\mechperrn doc rev 7/19/99
ASMRAE Standard 62-1989 Multiple Space Equation
U.L. Howard Company August 1999
Nall Park Office Building
Dr. Brounstein RTU-1 First Floor
Block Occupancy Occupancy
Number Terminal Zone Area -S ace Air Factor Load
Tenant Unit Use sq ft Flow cfrr) Table 10-A People
Dr E3rounstein Office FPB 1 4 Office~ 140 850 �100 _1
Office New VAV _ Office 120 100 —1710 1
Work lNewAV__ Lunch 1_45 100 —1070-- 1
Waith, New VAV Lobb 120 200 15 8
Column Totals 525 1250 12
Equipment List
FPB 1A Existing 850 cfm
New VAV Trane VCEE06, no heat 550 cfrn
POO
0
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6N ,
21, %
t�
aQ
Table 12-A Average Zone Z New Zone
OA er Occupancy OA Using OA Flow
erson Factor cfm Block Load cfm
,,0 _
0.5 14 — 0.02 118 T-_-
-- 20 _ - 0 5 -- 12 - 0.12 _ 14
20 0 515 - 0.15 14
20 0.5 80 0.40 28
121 0.40 173 cfm
X= 0.10
Previously ::alculated Ouside Air Volume 3972 cfm
Y- 0.14
RTU-1 New Total Outside Air Volume 4145 cfm
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I�`S �� �'���� ELECTR.ICAL PERMIT
�i T - _
PERMIT#: EI_C1999-00570
�y DEVELOPMENT SERViICESDATE ISSUED: 9/21/99
13125 SW Hall Blvd.,Tigard. OR 97223 (503) 639-2 R 61
��,,77/�/� PARCEL: 1S135DA-03500
SITE ADDRESS: 11481 SW HALL BLVD 102 � y
SUBDIVISION: Z014ING: C-P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of 3 branch circuits.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _ MISCELLANEOUS
_
1000 SF OR LESS: 0 - 200 amp: _ PUMP/IRRIGATION:
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/FEEDER A BRANCH CIRCUITS
-- _ _ _ _ _ ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN_REVIEW SECTION __
1000+ arrrp/volt: _ >=4 RES UNITS: > 600 VOLT NOMINAL: _
Reconnect only: SVC/FDR >=225 AMPS: _ CLASS AREA/SPEC OCC: Y
Owner: Contractor:
LN PROPERTIES, LLC RC COSTELLO
11481 SW HALL BLVD 1439 SE 12TH LOOP
SUITE 100 CANBY• OR 97013
TIGARD, OP 97223
Phone: Phone: 266-8433
Reg #: LIC 87402
EI E 3-3440
SUP 3934S
FEES Required_ Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT DEB 9/21/99 $48.20 99-318497 Elect'I Final
5PCT DEB 9/21/99 $3.37 99-318497
Total $51.57
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specia ty Codes hnd all uther 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 0 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 copiesofthese rules or direct questions to OUNC at(503)
246-1987
PERMITTEE'S SIGNATURE r- -- ISUED BY: / r
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: _ = - '' _—� DATE: Gl k I let 1
LICENSE NO:
i
Call 639-4175 by 7:00pm for an inspection the next business day
Y OF TIGARD Electrical Permit application Plan chr
125 ',;W HALL BLVD. Recd
TIGARD OR 97223Date
. .
Phone(503)639-4171, x304 Date to PE
(� q'b Date to DST ---" _
Inspection (503)639-4175 print of Type 1 i)( f Permit#_ z_e l
Fax (503) 598-1960 Incompr-te or illegible will not be accepted Called
1. Job Address: 'f F/i Complete Fee Schedule Below:
Name of Development_!" Number of Inspections per permit allowed
Name(or name of buslnass) ' 7e I, Service included: Items Cost Slim
Address rA vK/ 4a. Residential-per unit
1000 sq It or less $ 117 75 4
City/State/Zip ------
Each additional 500 sq.ft.or
portion thereof $ 26.7 t
Commercial LJ Residential ❑ Limif,d Energy _ $ 6000 _
Each Manurd Home or Modular
2a. Contractcr 1175tallatlon only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
information for COT data ba 7 � Installation,alteration,or relocation
Electrical Con r cjor 1 200 amps of icbo $ 64.25 2
Addre -_1l4 S`' l�"YM -/0 201 amps to 400 amps $ 85.50 _ 2
401 amps to 600 amps $ 128.50 2
City 5 State Zip 4- U
, 601 amps l0 1000 amps _ $ 192.02
Phone No._ t( Over 1000 amps or volts $ 363.75 2
Job N0. _ Reconnect only _ $ 53.50 2
Elec Cont. Lice. No. _Exp,Date Cu 4c.Temporey Services or Fenders
OR State CCB Reg. No Exp Date rr installation,alteration,or relocation
COT Business Tax o Metro No 0 Exp.Date 200 amps or loss $ 53.50 _- 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'nJ Jam`' 401 amps to 600 amps _ $ 107.00 2
-- Over 600 amps to 1000 volts,
/ soe"b"above.
License No. ����' - _Exp.Date �{�//�CJ�
�, 4d.Branch Circuits
Phone No. _� New,alteration or extension per panel
a)The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address h)The fee for branch circuits
without purchase of service
City State _ _,Zip or feeder fee.
Phone No _ _ _ First branch cr,cuit $ 37.50 -7
Each additional branch circuit $ 5.35
The installation is being made on property I own which;s not 4e.Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 4275 _
Owner's Signature _ Each sign or outline lighting $ 42.75
Signal circuit(s)or a limited energy
* panel,alteration or extension $ 60.00
3. Plan Review section (if required): Minor labels(10) $ 107.00 ---
:'lease check appropriate item and enter fee in section 5B. 4f.Each additional Inspection over
4 or moie residential units in one structure the allowable in any of the above
_Service and feeder 225 amps or more Per inspection _ $ 50.00
Systemover 600 volts nominal Per hour $ 50.00In Plant $ %00
Classified area or structure containing special occupancy as
described in N E C.Chapter 5 Jr. Fees:
Be.Enter total of above fees $
Submit 2 sets of plans with application where any of the above apply. 1 ;ib Surcharge(.05 X total fees) $
Not required for temporary construction services. Subtotal $
Sb.Enter 25%of line So for
NOTICE Plan Review if required(Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 DAYS ❑ Trust Account# _
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ '
I d:,4 li�rms�cicctric.dnc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Businjss Line: 639-4171 y
�j BLIP
-E)ate Requested j��� � ' l AM PM — BLD
_ t , `t 1 � , 61 �� Suite 102-
Location MEC
Contact Person f Ph PLM
Contractor w_ Ph SWR Q _
BUIL 6ING Tenant/Owner �� ELC !-1�
Retaining Wall _. .... EL.R
Footing Access: M•,
Foundation FPS
Fig Drain SGN
Crawl Drain Inspection Notes -
Slab _.._ _�-�_-------_�_-�- — ----.__.._.- SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing .�,
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - - - - - -
0-0
Roof
Misc: --- - - _
Final
PASS PART FAIL --_.- -
PLUMBING
Post& beam _ --_------• --.— —_���
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL —
MECHANICAL
Post&Beam
Rough In
Gas Line - ---- —
Smoke Dampers
Final - ---- - - __-
PASS PART FAIL.
BL!—?C—,f- - - ---- _..--
Service _
Rough In
UG/Slab
Low Voltage
Fire Alarm<;w _—
PART FAIL _
SME
Backfill/Grading _ -
Sanitary Sewer
Storm Drain j Reinspection fee of$ required befcre next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( j Please call for reinspection RF: ( J Unable to inspect-no access
Fire Supply Lira
ADA
Approach/Sidewalk-` Date Inspector �ee- Ext
Other -- •-- -
Final
PASS PART FAIL DO KOT REMOVE this inspection record from the job site.
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CITY OF TIGARD --BUILDING PERMIT
PERMIT M BUP1999-00412
DEVELOPMENT SERVICES DATE IzjSUED: 09/24/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135DA-03500
SITE ADDRESS: 11481 SW HALL BLVD 102
SUBDIVISION: ZONING: C-P
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:
OCCUPANCv GRP: TOTAL AREA: st ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: R_EQD 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: $ 400.00
Remarks: Installation of six (6)sprinkler heads.
Owner: Contractor:
L N PROPERTIES A + R FIRE PROTECTION CO
11481 SW HALL BLVD PO BOX 459
SUITE 100 NORTH PLAINS, OR 97133
TI"AP,
onD OR 97223 Phone: 503-647-2468
e'.
Reg #: LIC 65938
FEES REQUIRED INSPECTIONS _
Type By Date Amount Raceipt Sprinkler inspection
PRM'r GEO 09/24/15,9 Final$25.00 99-318612 Sprinkler In
Sprinkler Final
5PCT GEO 09/24/199E $1.75 99-318612 Final Inspection
FIRE GEO 09/24/199 $10.00 99-318612 ORIGINAL
Total $36.75
This permit is issued subject to (he 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
not 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 NOW cation 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)246-1987.
Pe mi itee
Signature:
Issued By:
Call 639-4175 by 7 p.m. for an inspection the next business day
Fire Protection. Permit Application Plan Check#
CI1Y OF TIGARD Commercial or Residential Recd By
13125 SW HALL BLVD. Date Recd
TIGARD, OR 97223 Print or Type Date to P.E. _
(503) 639-4171, X. 304 Incomplete or iNegible applications will not be accepted Date to DST
Permit#J�,tf1rll�" n �.
Called_
Jpb — Name of Development/Project Type of System (Complete A or B as applicable)
1 ALL- PAfZ ►+t_ _
Address Address '—
5 �,� L` Q V p A.) Sprinkler Wet Dry ❑
Name Standpipes
Owner Mailing Address Hazard Group
S W 14 A�� I r` .� _ l o o Additional L i o"T
City/State Lip :-1holiel. Information Density -�-
Name :resign Area
54 3; k d1 0 s rs _ ! Sa o
Occupant Mailing Address K Factor
//` I SW NALL gLJP 10Z
ity/State Zi Phone A.1) Sprinkler Project Valuation
Contractor Name r� �^ B.) Fire Alarm —
016
(Sprinkler or A-4 !�� Fit iF_rB-o-y _ _ -
Alarm Company) g 'an
�� Submittal Shall Include Battery Calculations YFS
Wo
❑
Prior to permit �Y
issuance,a City/Slate Zip Phone Individual Component YES❑
copy AI D C2. ?3'7JCut Sheets_
or au licenses 'Y i ti.�� .J.e Z Z 7 Z :_3�� B 1) hire Alarm Project Valuation $
are required if State Const. Cont Board t.ic.# Exp, Date
expired in COT iF � � / Project Valuation Subtotal (A 8r or B) $
database � _.____ / O
Name Permit fee based on valuation $
Mailing (see chart on bac
Architect g Address k)7%Surcharge $
City/State zip Phone FLS Plan Review 40% of Permit $ i
Describe work A.)New O Addition• Alteration O Repair O TOTAL $
to be done:
B) Modification to sprinkler heads only
1 1-10 heads=No plans required Plans required Submit three sets of plans,including a vicinity map and
2. 11+=Pian review required the location of the nearest hydrant.
I hereby acknowledge that I have read this application,that the information given Is
_Number of Sprinllerfieads correct,that I am the owner or authorized agent of the owner,and that plans submitted
are In mpllanca with Oregon State laws
Additional Description of Work ^ r
Signature of Owner/Agent Date — -� -
A.)In Existing Building New Buildingr ^�
❑ '�C.3_�
Building Contact Person Name Phor,c g U
Data B•) Ccrnmercisl Residential ❑ —Z 2
FOR OFFICE USE ONLY: _
No.of stories Plat# MaprfL#:
Sq. Ft _
Notes
Occupancy Class
Tyye•gf Construction- -
is\dsts\forms\firesupr.doc 7!2/99
CITYOF TIGARD CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: B /25/1999
99-00376
13125 SW Hall Blvd., Tigard, OR 972.23 (503j639-4171 DATE ISSUED: 1 S1 5 DA-
PARCEL: 1 S135DA-03500
ZONING: C-P
JURISDICTION: TIG
SITE ADDRESS: 11481 SW HALL BLVD 102W�_
— y
SUBDIVISION: FILE
BLOCK: LOT:
CLASS OF WORK: ALT
TYPE OF USE: COM
TYPE OF CONSTR: 5N
OCCUPANCY GRP: B
OCCUPANCY LOAD: 9
TENANT NAME: BB & S PSYCHOLOGISTS
REMARKS: Tenant improvement
Final Building Inspection and Certificate of Occupancy Approved
10115199 by Tom Plescher, Building Inspector
Owner:
L N PROPERTIES, LLC
11481 SW HALL BLVD
SUITE 100
PORTLAND, OR 97223
Phone: 684-5066 219
Contractor:
PACIFIC CREST STRUCTURES INC
7301 SW KABLE LANE STE 700
PORTLAND, OR 97224
Phone: 503-968-8949
Reg #: LIC 006691
This Certificate grants occupancy of the above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the State of Oregon
Specialty Qodes for the group, occupancy, and lase under whi h the referenced permit was
ISSLIP.'�.
---
44 7-
BUILDING INSPECT BUILDIN OFFICIAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
r �r+JP
Date Requested AM_ PM CO
Location Suite U MEC ci 2 1 nC>.3(,- T
Contact Person Ph 5 �C-�" � PLM
Contractor Ph SWR
-
t3UILDING� Tenant/owner ELC_- � -
Retaining a;l ELR __-
1 noting Access:
Foundation FPS —
Ftg Drain SGN
Crawl Drain Inspection Notes: —
Slab _ __ _ — _ SIT
Post R Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing J - - -- - -------- --
Insulation 51\Drywall Nailing 4
- _ -- -- --- —
F firewall,_-_
Fire Sprinkls►% ------- - -- -- - �------- -------In Alarm
Susp'd Ceiling _..�----- --- _-.. - ---- -- --- - -----
Roof
[Misc.
5._
'PPA.-", PART FAIL - - --- -- --.... -------- - —--------
PE-U-911BING
Post&Beam
Under Slab ---------- - -- _ _ -- - ----
Top Out ------ _.__
Water Service
Sanitary Sewer
Rain Drains
Final
PASS FART FAIL
ECHANICAL
Pos emm - - - -- -- --- _ _ ----- - ---
Gas Line
Smoke Dampers
"TAS PART FAIL
NLITUICAL _------ --- --------__.._------___---------_ _ ---------------- - -- --
Service
Rough In ---
UG/Slab
Low Voltage
Fire Alarm _. - ----- ------- - ------
Final
PASS PART FAIL - --_- - ----- -�_--_ __ -SITE
Backfill/Grading -
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Unable to inspect-no access
Fire Supply Line [ ] Please call for reinspection RE:- —__ ( 1 P
ADA
Approach/Sidewalk Date /11� InspectorT7 Ext
Other _ -�#-1- ---11�---���-----���- �- —_
Final
PA., PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYOF T I GA R D _ BUILDING PERMIT _
PERMIT M BUP1999-00376
DEVELOPMENT SERVICES DATE ISSUED: 8/2.5/99
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135DA-03500
SITE ADDRESS: 11481 SW HALL_ BLVD 102
SUBDIVISION: ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION_
CLASS OF WORK: ALT FIRST: 1,175 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 9 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : FINDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 12,290.00
Remarks: Tenant improvement
Owner: Contractor:
L N PROPE=RTIES, LLC PACIFIC CREST STRUCTURES INC
1 1481 SW HALL BLVD 7301 SW KABLE LANE STE 700
SUITE 100 PORTLAND, OR 97224
h Phone ND, OR 97223 Phone: 503-968-8949
Reg #: LIC 006691
FEES REQUIRED INSPECTIONS
Type By Date i Amount Receipt Framing Insp
PRMT BUN 8/25199 $151.75 99-31797.8
-- Gyp Board Insp
5Final Inss PCT BON 8/25/99 $10.62 99-317928 Susp Ceg Insp
pection
PLCK BON 8/25/99 $98.64 99-317928
—FIRE BON _— 8/25/99 $60.70 99-317928 ORIGINAI-
This
Total $321.71 permit is iss,.led subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes anu all other applicable law. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987 You
nlay obtain a copy of these rules or direct questions to OUNC by calling (503) 2461-1987,
pennitee
Signature: t
Issued By: (�
Call 639--4175 by 7 p.m. for an inspection the next business day
CITY OF lGARD Commercial Building Permit Application Plan Check�lr
13125 SW HALL BLVD. New Construction and Additions Recd By
T.IGAFZD, OR 97223 Date Recd -
Date to P.E.
(503) 639-4171 Date to DST - k
Print or Type Permit# I ��!
Incomplete or illegible applications will not be accepted Related SWR#__
Called_
-� Name of Development/Project
Job �- ,t� LGtL. �l�< .'
.� Existing Building New Building [j—_7
Address Street Address Suite
I i iii Building
---- Bldg City/State, zip j Z Data ��
. ?z Z ) Existing Use of Building or Property.
Name i
�, f �
Property [- V V �� �--, &.
Owner !Nailing Addresr. Suite Proposed Use of Building or Property:
5vx) l�}'a- _/d c:' D j� GCe
city/State Zip Phone _
1 6, 7 ZZ j No. Of Stories
f `( -SZr,
Occupant Name` Sq. Ft. Of Projec :
Name Occupancy Class(es)
Contractor
Prior to permit Mailing Aiddress Suite
Type(s)of Construption
Issuance,a copy `` ` - /��
of all licenses
are required If City/State Zip Phone Will this project have a Fire Suppression System?
expired In C.O T. Yes _ NO []
database c7' "f� ------�-
Oregon Cons.Cont.Board Lic.# Exp Dale Americans with Isabilities Act(ADA) r-A
Valuation X 25% K($ -z— Participation
(��►' ( l v ?Q'�� Complete Accessibility Form
Name t Project $
Architect We � fa-C�1(.c Valuation
Mailing Address suite
III 7o0 Sit) Plans Required. See Matrix for number of sets t0 submit
City/State / Zip Phone t' on back
Engineer Name I hereby acknowledge that I have read this application,that the Information
given is correct,that I am the owner or authorized agent of the owner,and
Mailing Address Suite that pl ns submitted are in compliance with Oregon State Laws
S of Ow r/Ag nt Date
City/State ___ ZIP Phone `/�,q �.
cot t Per on Name ' , Phon ,
Indicate type of work. New* Addition O Demolition O �f jrf -��
Accessory Sliurture O Foundation Only O Alteration 7T
Repair o Other o FOR OFFICE USE ONLY
Description of work: 01r 4 d v>fvv Map/TL# Land Use -
—
/
Parks: Estimated#of Employees -----------.--____
TIF.
If the above figure Is not supplied at the time of application,the city will
calculate the fee based upon the number otparking spaces.
Note: Site Work Permit Application must precede or accompany Building
Perm!t Application
i\fists\forms\comnew.doc 5/10/99
J
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent jpon submittal of BOTH plans AND a COMPLETED
application. For an electrical submittal, the application must contain the
signature of the supervising electrician before plan review will be conducted.
After plan review approval, Plans Examiner will contact the applicant to request
additional plan sets for distribution purposes. (Copy for Contractor, City,
Washington County, Tualatin Valley Fire & Rescue)
TYPE OF SUBMITTAL Plans KEY_
Submitted
S (Private) �u1 S = Site Work
B (New or Add) 1 B = Building
F (New or Add or Alt) 3 F = Fire Protection System
M (New or Add or Alt) 1 M = Mechanical
B & M (New or Add) _ 1 P = Plumbing
P (New, Add, or Alt) 2 E = Electrical
B & M & P (New or Add) " 2 New = New Building
E_(N eWA d-d, or Alt) 2 Add = Addition
B & F & M & P & E 3 Alt = Alternation to Existing
(New , Add) Building
*B or B & M (Alt) 1
`B & M & P (Alt) 3
"B & M & P & F(Alt) _. 3
'B & M & P & E & F(Alt) 3
NOTES:
'Shaded areas designate ALT submittals only.
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