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11565 SW HALL BLVD 01 LYI v� r m r i Ir J.1565 SW HALL BLVD. BUILL,ING P'ER'MIT CITY OF T I GARD PURMIT #. . . . . . . :: OUP96-0330 COM11,1UNITY DEVELOPMENT DEPARTMENT J)ATE ISSUED- 08/05/96 13125 SW Hall 91vd.Tignrd,Oregon 97223*8109 (503)639-4171 P,ARCEL- IS135DD--IZ11800- BITE ADDRE13 11565 SW HALL BLVD 1,0 N I 111G.-C.--P c ;UBI)I V 19 1 ON. . . . P4ETZGER ACRE TRACT. LOI.. . . . . . . . . FLOOR AREAS--- I-EXTERIOR WALL CONSTRUCTION- LLASS OF WORP- :ADD FIRST. . . . ; 95r? S f N; S E I YPE OF U5E. . . :130M SECOND. . . r Q1 S F P,ROTECT Yl,E OF CONET. :5N 0 sf N- S,-. E: W: U R V). .B TOT -*- I - --11RE RET?-. OCCUPIANCY 952 sf ROOF CONST . F OCCAJP'ANCY LOAD: ri BASEMENT. : 0 Sf AREA SEP. RATED: I )GE. . . 0 OCCU SEP. RATED, STOR. ; 0 HT: 0 f t GARP BGMT?-, MEZ Z?: REUD SETBACKS RLQUI FLOOR LOAD. . . . t 0 p,;i f LEFT& 0 ft RGHT: 0 ft F I R SP'KL:Y S11OK 1)1:---T. . DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALR1Y1-.N HNL)ICP' ACC'-'y BEDIRMS: lZI BATHS 1114=, SURFALL-*.: Ili P,RO (-'ORR:Y PARKING: 0 VAL'.JE. 6500O ReMA office V-ks : Addition, t;a dent,11 Own ev-. F ELL hJURRIS & (S1"Et)EN13 type ox m o 1..t n t toy (I ate I-ecpt PILLK $ "..,I-,,. E,0 BON 06/17/9 6 r)6--I--_1 8 LA 6 4 E, 5j?QA SW 6TH F I Rr:-- $ 131. 20 DON 06/17/96 9t,----280646 PUR1LAND OR 97204 SWM i 62. 0b JSD 08/05/96 96-,E,82499 2L'3-3171 Swil $ 3 ij.. z►7 1(,,.;D 08/05/96 96-28c.499 PRM*r s 1.'28. O71 JSD 08/05/96 96--282499 C.ontr-actor: $ 16. 40 JGEf 08/05/16 '36._28&'499 jUW, INC TIF $ E897. 0111 JSD 08/05/96 96-.28E498 , 5932 SE 111TH AVENUE TIF $ j:6-(r.�. 00 .JED 08/05/96 96-28241n PORTLAND OR 97266 f:,viune #- 761-4523 3946. 3i-'., TC TAL ��eg #. . * 091011 REU01RED INSPECTIONS This ptrait is issued subject to the regulation5 contained in the '. 00t/FootriLJ 1115P Tigard Municipal Code, State of Ore. Specialty Codes and all other Framing 11tisp applicable laws. All work will be done in accordance with Inso-klatioll In-,P a.pproveu plan,. This neurit will expire if work is not started Gyp Board ln,p within 180 days of issuance, er if work is suspended for more Susp Ceilliq Insp than 180 mays. Final lnripectiGn ., SsUed Bv : C -39--4175 ,all f ov- inspection 6- Commercial Building Parmit Ap fication , City of Tigard � 13115 SW Hell Blvd. lv v t l. +� �� Tigard, OP { 7223 . LA (503) 63'9-41:'1 �lr����(c � ^I'�� (11,J • � Jobsite Address: ;��/.G Office Use Only 1 ( � Tenant: 4� )�fit�"� �_ Suite # ti r Pianck/Rec # Valuation: A"I — --- - -- --- Permit#Uwner. ..,^ r�� , • Map & TL # Address: 5 7 o i �� __ Approvals Required r Planning Kyvr �' Phone: L ' 1 � l '-- Engineering Other Contractor: G I ype of const: /� f /S 1 Cccupanc:y class: Phone. C 1 L _ Contractor's Licenst l Sp•inklered^ 'fes No # �� L• _ r (attach copy of current Oregon__lu:e __ nse) Sq. ft. of project: Contact name & phone: _ ,._ _._ Story (1st, 2nd, etc.) FA71 6ASa,1-1 ! )UWI APrccosed use: DI- Arch itect/E ng i neer: I-ArchitectJEngineer: ld A LL C h '�',N� Previoi.is use: �d.�/ �R.y i Address' j 10 r� E rIC f rr kt.4A7 NotePlumbing & mechanical plans must be submitted at time cf building permit application. Phone: JOB DESCRIPTION: =a-! �" {. A/[ (,.tJ 1) (* aj Q 'f.`-rr A.--t �- -_ 76�- Appli ant Signature Phone n mer l J Received by: tv i 't <.t- Q '�,n, -- Date Received: P Permit# Account Description Amount Amt. Pd. Bal. Due c07 G—a lr._0 r7 Bldg. Permit (BUILD) • Plumb. Pcrtnit (PLUMB) — Mech. Perniit (MECH) State Tax (TAX) V Bldg: Plumb: Mech: Plan Check (PLANCK) —_ l /X' Z� Bldg: Plumb: Mech: Sewer Connection (SWUSA) � Sewer Inspection ('„NINSP) Parks Dev Charge (r'KSUC) Residenti-I TIF (TIF-R) Mass Tr6nsit TIF (TIF-MT) Commercial TIF (TIF-C) �- - Industrial TIF (TIF-I) Institutional TIF (TIF-IS) i( t Office TIF (TIF-0) t Water Quality (WQUAL) Water Quantity (WQjANT) `17 Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) r Erosion Planck/USA (ERPLAN) L .Erosion Planck/COT (EROSN) -- TOTALS: 1�,4t _ iC ELECTRICAL PERMIT TY OF T � - 0"', A RD DAIE+ISSUED: 06/24/ Con;`l 96 COMMUNITY DEVELOPMENT DEPARTMENT 13125SWHail Blvd.Tigard,Oregon 97223.8199 (503)639-4171 I'ARCEL: 1 S 1�SUD018k"I1� SITE ODDRI . . . : I i ,r, '-)W HkLL P SUBOIV.iS'iION. . . . : ME1216I:R ACRE TRA(_. VS ZONING:C-F' BLOLK. . . . . . . . . . . I.OT. . . . . . . .. . . . . . :26 Project Description: Insta?. ling 11 branch cir•ctiits. -.-__RESIDENTIAL UNIT----•-•_ ----TEMPI SRVC/FE.EDERS------ -- -MISCEL.LANEOUS-_-•-- 1 000 5F= OR LESS. . . . IZI •- c'01Z1 amp. . . . . . . : 0 P,L1MF'/I RR I GAT I ON. . . . : 0 EACH ADD' L 005`. . . : 0 x-:01 - 400 amp. . . . . . . : QI SIGN/OUT LINE LTG. . : 0 LIMITED ENIERBY. . . . . : 0 403. - 600 amla. . . . . . . .. 0 SIGNAL/PANEL. . . . . : 0 MANE, HMS' SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LADE::L ( 10) . . . : 0 _.___-SERV ICE./FEEDER-•_-.__ _..-__._BRANCH (-,IRCUITS----•--- ---ADD' L INSPIECTION(.3-_-.-.--. 0 - 200 amp. . . . . . : 0 W/SERVICE: OR FEEDER: 0 PIER INSPECTION. . . . . : 0 01 400 amp. . . . . . . 17 1st W/O SRVC OR C=DR. : 1 PER HOUR. . . . . . . . . . . . 0 ,rQ11 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 10 IN F'L.AN-C. . . . . . . . . . . .. 0 1,01 - 1000 amp. . . . . • 171 ______.___._____.___FLAN REVIEW SECT 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . s ) 600 VOLT NOMINAL. . : �ec,onnect; only. . . . . : 0 SVC:/FDR > = 225 AMPS. . : CLASS AREO/SPEC OCC. : !..lwner": --.____...____.__..__.__.._____._.__.__.__._..__...__._._._-_---._.___-----___._ FEES - - - -__------- ' [!R. DAVID HUGHES type amol.int by date recpt 11565 SW HALL BLVD F'RM•T $ 85. 00 CJS 06/24/96 96-28091. 5PCT $ 4. 25 CJS 06/24/96 96-:'28091,_ I IGARD OR 9722:3 Phone #: E:::MF'I RE ELECT R►C $ 39. 25 TO I NL 300 SW JOHNSON rREEK BLVD REQUIRED I NSF'E:CT I ONS i-'ORI LAND OR 972,212 Wall Covet-, Elect' I Final Phone #» 503-777-3108 Elect' I Bet-vice Peg #. . : 08614 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore, Specialty Codes and all other Per-mitteeSignatur, applicable laws, All work will be dare in accordance with approved plans. This permit will expire if work is not started 1 within lU days of Eesuance, or if work is suspended for more than 130 days. issued By OWNER IN")'IAL.LATION The installation is belny made on property I own which is not intended for ,sale, lease, or rent. OWNER' S SIGNATURE: INSTAI_L.AT'ION `.1I GNATURE OF SUF'R. ELEC' N: �'Y� .Le°S _ DATE- NO: ATE:NO: Call for inspection - 6 �9-4175 116 Is 91' I6 ,'6 U5111 6S.1 7207 I ITS IF TI(;ARI) ZOO 2;n( 2 Community Devalopment ELECTRICAL PERMIT APPLICATION 13125 5W Hall Blvd, Tigard, OR 97223 Permit 4 c.C-1) Ll 7 _ ------ Uate Issued Phone (5173)E:39-4171 CITY OF fIGARD FAX (503) 684-7297 T170 No (503) 564-2772 Inspection (503) 639-4175 1, Job Address: 4, Complete Fpm Schedule Below: Name of Development DR. DAVID HUGHE,�� Number nr Inxpectrora per rKrmit allo'+md Addresti_-_ 565 SW—t.tp}�._-3�VD _ _ Se vice included Rema Cost(ea) Su r City/5taleiZip ___ TIGARD, OR _-- 4a. Residential -per unit 10(10 ra R a,ieea Name(or name of ousirtess) DR. DAVID HUGHES rmcheddtr0ne1500aq R or ••. Panic"thereof .+_ MOO _. In w R94ldenG�l r_J Limned Energy — — Commar«Iel � Each Mgnurd Home nr ukfduler D*vNllnq Se vkn yr Fee,." fM 00 2a. Contractor installation only. 4b.Servictm e•Feede,It RENNELLS ELECTRIC DBA lnslahation,aiterellon orEMPIRE ELECTRIC CO zoo enrps m loom roi0eetlon _� eloo Electrical Contractor_ ,n1 amps amps $SI0.00 Address 5JUU � EE p VL ttm oo —S D K__L -- — 101 amps to Boo snips - city. POR11AND - __ State QIL. 4-922.22- Bo+acorn to to"o amour x+$000 Phone No o//�I U8 yes r toamps a vnas _ 5}40.00 z Jab NO—:7 3$1�_._. Recvnnectnnly 35000 ___ rontractor.i Ilc"me NO 4c. Temporary Services or Feeder Gontr3etur's 11card Pej No. _ fjq iA- n,tanlJ� marvel"arvel" or wb[etlrni Signature cf Supr Elec'n �7 - 100 empe a,nee 77 r�{{�) tot amps to 400 erre $50 00 2 11rrnse N� 2061S Phone No. 7/ / Q52 all]amps to Bon.cool __._. $75.00 �— r,vw S00 amps to 1000 1049 •,101100 2b. For owner installations: I "" 11aoo ve Ad Branch Circuits Pnnt Owner's Name _ _ crew,migration at e[tenslen per pone Address e)The Lee for Ixanch vocuNs Will 2 -------- -- --- —" purr Mea or service nr hW�r M. City —� .--._ State _ -- Zip —__ Erich branch cecun _ 5500 —, Phone No_ _ _�_ DI rete fee for branch ckfuhe wrthnur 2 The installation is being made on property I own which is pumhai a or eervtre or tieder reg c�tr I9s 00 35 z rlrst Lnwn h e!rcutl not intended fol sale, lease or rent Each add5lonel branch HIM .77E 95 00 ;jj�-2- Owner's Signature4c.Miscellaneous --- — — (Service or ree-4er riot irycludtd) 2 1 .1. Platt Revie- saction 0A required): techpIn,pnrVW11rlIng $4000 Each syn or ovrnMne ugnlnq f40.00 — 2 6'sn9l rirr it(a)w a Ilmaen energy Please check appropriate item And enter tee in section 58. penal alleral"or e119mit on $4000 4 or more r661(lential unira in one Btructure warn uMls(10) I'o1'00 ------ Servics and feeder 225 amps or more 4f.Each addltlonol inspection over System over 600 volts nominal the allowable in any of the above Classt led area or structure co+talning Special eccupiency Per nspeolon $75 OO as descnberl in N E C Chapter 5 Per 1,0v' _R Isis oo — 1n Submit 2 sets of plans with application where any of tfsr above apply Net required for temporary construction services. j. Fees' u. Fnter total of atrove fees NOTICE 5%,Surcharge (05 X loin; f"r.) Subtotal S 1 PERMITS BECOMF VOID IF WORK OR CONSTRUCTION 5ti. Fntei 25%of line A for AUTHORIZED IS NOT COMMCNCED WITHIN 190 DAYS,OR IF Plan Review if required (5!c 3) S CONSTRUCTION OR WORK IS SUSPFNDED OR ABANDONED FOR Subtotal A PERIOD OF 180 DAY,Al ANY TIME AFTER WORK IS COMMENCr-0 wMeM•nrgb• Trust Account N S Balance Uue S r 5 CITY OF TIGARD ELECTRICAL. LEC RICCAL.FPER7?PERMO75�; DEVELOPMENT SERVICES DATE ISSUED: 11/L2-0/97 -�tA,14 13125 SW Hali Blvd., Tigard,OR 97223 (503)639.4171 PARCEL: IS135DD-01800 9ITE ADDRESS'. . . : I1563 SW HALL BL_VU SUBDIVISION. . . . :METZGER ACRE TRACTS ZONING:C_.p BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :026 JURISDICTION: TIU r i.-o )ect De scr^i.pt i on: Adding one lil first branch circuit and three l3i additional branch circuits ---RESIDENT [AL UNIT----- ---TEMP SRVC/FEEDERS------ -----MISCELLANEOUS------- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 500SF. :. : 0 201. - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . . 0 SIGNAL/PANEL. . . . . . . : 0 MANE. HM/ SVC/FDR. . : IC 601+amps-1000 'Jolts. : 0 MINOR LABEL ( 10) . . . 0 -----SERVICE/FEEDER----_ -_---_-BRANCH CIRCLJI'TS_-----.----• -------ADD' L INSPECTIONS-- --- 0 _ C:00 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 i st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 - 600 a;ap. . . . . . .. 0 EA ADD' L BRNCH CIRC: ? JN Pl....ANT. . . . . . . . . . . : 0 601 - 1.000 amp. . . . . : 0 --_----..____...._____---p'l_AN REVIEW SECT I ON---_----- --- -___.__ 1000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : i 600 VOLT NQMINAL. . : Reconnect only. . . . . : 0 SVC/FDR > = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner-: - -- FEES COLUMBIA DENTAL ARTS type amol.rnt by date recpt J. 1565 SSW HALL_ BL VT) PRMT $ 50. 00 TJH 11/1.4/97 97-300949 TIGARD OR 517623 ` PCT $ 2. 50 TJH 11/14/97 97-..1DO949 Phone #: Cantrartor: WILLAMETTE 21-ECTRIC INC f 52. 50 TOTAL._ PO PDX 23O547 _---------- REGU I RED I NSPECT l ONS TIGARD OR 97281 Ceilinq Cover Elect' I Servir..e Phone #: 503-624-3631 Wall Cover Elect' I Final Reg #. . : OOO750 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and ell other applicable laws. All Mork will be done in accordance with approved plans. This permit will expire if work i5 not started within 160 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 sot to h in 'AR 952-001-0010 through CAR 952-001_j9 .� You may obtain a copy of these rales or direct questions toOl by ealiin�Q�2 -1987, t i Permittee S i g n a t 1_i r e : _ I s s i_r e d By - 0 WN y ;OWN I NSTOLLAT I ON The installation is being made on property I own which is not :intended for sale, lease, or rent . OWNER'S SIGNATURE: _ DATE: I _----. -_ _._- ----___--.----------CONTRACTOR INSTALLATION S I[iNATURE OF SUF'R. ELEC' N: . DATE: LICENSE NO: +++++++++++++++++++++++4+++++++++-h+-h++++++++++.I-+++++++i+++++i+-1-++++++++-F+....+++ Call 639--4175 by 7:00 p. m. for an inspPr_tian needed the next bmsi.ness day t-+++ ....... + ++++ ++4. CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Ha11 Blvd., 71gat d,OR 97223 (503)639.4171 J� CITY OF TIGARD Electrical Permit Application Plan Check# _ 11325 SW HALL BLVD. Recd By 777; DataRec'd TIGARD OR 97223I Date to P.E. Pl,one (503)639-4171, x304 Date to DST ` Print or Tvpe Inspection (503) 639-4175 Permit# Fax (503)684-7297 incomplete or illegible will stet be accepted Called _ 7. Job Addres3: 4. Complete Fee Schedule Below: Name of Development _____ Number of Inspections per permit allowed Name(or name of business) C �u.v��+i c� (�_r'.L 1;j An Service included: Ite" s Cost r Sum Address---/! ' L, 5 S L- F(u_l/ f;(� / r__ 4a. Residential-per unit 1000 sq.ft,or lest $11000 4 City/State/Zip 1 ,_ o C)n Each additional 500 sq.ft.or Commercial © Residential ❑ pardon l $25.00 _ 1 Limited Energy � $25.00 Earth Manuf'd Home or Modular Dwelling Service or Feeder $68.0e 2a. Contractor installation only: (Attach copy of all current licensee) �/ 4b.Services or Feeders Electrical C ntractor_ iJ 1 f N�.r if t u er-r-nt! /,% Installation,alteration,or relocation 200 amps or less $60,00 2 Address- , z 3 C t,'4 ? 201 amps to 400 amps $80.00 _._ 2 City_ r _State C 1. _Zlp_'I 7 2 I 401 amps to 600 amps $120.00 2 Phone Nd. t,7!4- '36 5 1 601 amps to 1000 amps $160.00 2 Job No. Zti qC,er 1000 amps or volts _-� $340.00 - 2 Elec.Cont. Lice. No. 34 - Z�3C Exp.Date /G1 -r 1S Recannecl only $50.00 2 OR State CCB Reg. No. I S(_ _Exp.Date -, 4 Y ^2 4c.Temporary Services or Feeders COT Business Tax or Metro No. 5 `�G Exp.Date X- / `RFs Installation,alteration,cr relocation 200 amps or less $5000 --� 201 amps to 400 amps $75.00 Signature of Supr. Elec'n j=am 401 amps to 600 a+hps $1e0.00 _ Over 600 amps to 11:00 volts, License No.__ f17& C S __Exp.Date__� `� F see"b"above. Phone No.__ 1. 2- 1 - ?t."r, r 4d.Branch Circuits New,alteration or extension per panel 2b. For owner Installations: a)The fee for branch circuits with purchase of service or Print Owner's Name feeder fee Address i Each branch circuit $5.00 b)The fee Int branch circuits City State, Zip _ without purchase of Phone No. service or feeder fee. r ' First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch ci-cult_y $5.00 � - 2 Intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not included) Owner's Signature - Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section(if required): Signal linterO or a limit-3d exteennsion anergy panel,alteration or e $40.00 _ 2 - Please check appropriate Item and enter fee in section 5H. $100 oU Minor Labels(10) _4 or more residential units In one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above _ System over 600 volts nominal Por inspection $ 5 00 00 _ Classified area or structure containing special occupancy Per hour $555 as described in N.E.C.Chapter 5 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. Jam. Fees: Not required for temporary construction services. Be.Enter total of above fees $ - 5%SurchF,rge(.05 X total fees) $ NOTTIC Subtotal $ 5b.Enter 25%of line Be for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Re'dew If eau red(Sec.3) $ --- NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtohil IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY t#A '. ccoun TIME AFTER WORK IS COMMENCED. Trus Total bblance Due : i%n9T.WLCg6 APP Rev d96 CITY CF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd,, Tigard,OR 97223 (503)639.4171 'P,? dao of iSflu mtj .. :f ,:ate, A ,_,a Irk+, 7�fgv ,iw 41,16 ty thg orop; 'I'IIit 1 :`.at:n a Copy F,f .0a TEMar�T Cgromerciai Budding Perm�itApp Moel��c�.r ►oN5 C^ of rgaM 171:5 SW Hai- Blvd- r1ganl• OR WM (70.11 d35-4111 Jobsite Address: 5 :5.V.:. f4,4.U.. v QEFNE- .E.DM—Y. Tenant: �p UIQ BJA bLNT&J.- Suite I --- Planck[Rec. ,l Valuation: 11 , -7 E50 _ Permit Map &TL Owner: N6" 1.5NTAc1- royals Required Address: r2r, .t�. (s� Sulu 4Qp Planning Ar Engineering __ Telephone: 22c—,&�4;1 Other 'ontractor. lddress: P- '. 41 � S.W• 9'�rn Gourz� _CI Ci a7uy `1?d(�' D Type of constr: V-N elephone: q 2 6 iO4 V Occupancy Class: .intractor's License N C'D U 3 371 1 Sprinkler? Yes (attach copy of current Oregon license) Sq. Ft. Of Project: '3'�� S•1'�• _,__ 'cntact name & telephone: VAVI D t2(G16X-QW6n Story (1st,(yM, etc.): rchitect b Engineer: tiLG0)1,1 �H.b.1��.. �G� Proposed Use: .I�/••189 "_Ak. ktcVl_ Jdress: tr,_;L._ 63f1x 2.2�-I Previous use: L4ytjyLt-4 ki=h1 T'1 Lx A tZ n tt-DRA, Note: Plumbing & mechanical plans must ephone: _. be submitted at time of building permit application. .0 DESCRIPTION: NTS 3-- pplicant Signature 3 Telephone Number) •eived by: 1\ --.__—_- Date Received: _ _- 1-11.Ccc ;cs-� •ase 'ERMI r x Account Description Amount ' Amt Pd, Balance Cue Building Permit (I ..D) Plumbing Permit (PLUMB) Mechanica.' Permit (MECN) Slate Tax (TAX) Bldg- _ Plumb. Mech. _ Plan Check, (PLANCK) Bldg. Plumb. Mech. Sewer Connection (SWUSA) Sewwr Inspection (SWINSP) Parks Dev Charge (PKSCC) Residential TIF (TIF-R) Mass Transit TIF (T1F-MT) Commercial TIF (TIF-C) Industrial T1F (71F-1) Institutiona: TIF (TIF-IS) Office TIF (i IF-O) Water Quality (WQUAL) Water Quanity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Planck/USA (ERPIAN) Erosion Planck/CBT (EROSN) TOTALS: 1:,cCMTI CCC (.Cs-.) IC/96 OVER-THE-COUNTER (OTC) PERMIT PLAN REVIEW COMMERCIAL ( STRUCTURAL) SUil-DING. PERMIT CHECKLIST DESCRIPTION OF PROJECT: CLASS OF WORK. 1r!k- FLOOR AREAS: '�' ✓ i EXTERIOR WALL CONSTRUCTION _ I I -TYPE OF USE: 0,0 ein _ i FIRST SQ. FT. N: S TYPE OF CONSTR— � _ i SECOND SQ FT i PROTECT OPENINGS? OCCUPANCY GRP: THIRD SQ. FT. hl: S' E: VJ OCCUPANCY LOAD: TOTAL SQ. FT. i ROOF C:ONSTR FIRE RET: STOR: HT: FT. i BSMNT. SQ. FT. AREA SEP RATED: BSMNT?: MEZZ?: i GARAGE: SQ. FT OCCU.SEP.RATED: FIRE FIRE SMOKE HANDICAP SPRINKLER: ALARM' DETECTOR: ACCESS L �COMMERCIAL INSPECTION ACTIONS FEE MENU FOOt/FOLIrld _ PosVBeam $ z Permit Fee Masonry 'Oraming $ (o0 l 3 Plan Review _ Insulation Shear Wall $ " 5% State Surcharge — Firewall Gyp Board $_ � ` FL.S Plan Review Suspended Ceiling Sprinkler Rough-in $_ _ Add'I Permit Fee _—, Sprinkler Fir,,,! Fire Alarm $ Add'I FLS Pln Smoke Detector —_— Approach/Sidewalk $— _ Inspection Miscellaneous Final $ MIS Fee _ 1T _ FOR OFFICE USE:ONLY: TYPE OS USE OPTIONS(COM=commercial; CMS-commercial maaufactured structure) CLASS OF WORK OPTIONS FOR ALL rEPNITS(NEW=new;Add-addition;A.LT=alteration;ACS=accessor),;FND-foundation: OTR=other;DEM=demolition; REP-repair; FPS-fire protection system.NOTE: USE OTR FOR FENCES, RETAINING WALLS, DETACHED DECKS. SIGNS, AWNINGS, CANOPIES) I%ovrcntr2.doc (DST) 4/97 CITY OF TIGARD BUILDING INSP'ECT'ION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 539-4171 ----T--— BUP - ----Date Requested_—_— -- —AM------- -PM ---- BILD -- - ---- ocation _ GJ I _ lj ._ Suite _ MEC Contact Person _ _ Ph PLM Contractor �i/— E� �-�_ ---- Ph SWR —� BUILDING Tenant/Owner 14 ELC Retaining Wal' ELR - — Footing Access. I Foundation FPS Fig Drain L�',-�/'�? l Gu-kI SGN _ Drawl Drain Inspection Notes t -- �'112�'! SIT Slab Post&Ream '"xt Sheath/Sheat int Sheath/Shear Framing ---- ,--- -- ---- Insulation J Drywall Nailing -._ _ �� Firewall -- Fire Sprinkler ------_-_ --- -- _ --_— -. - _-- Fire Alarm Susp'd Ceiling -- ------ -_ - - ---- - - - -- Roof Misc: __ - --- ---- -- - --_ - -__----- -----_. Final - PASS PART FAIL. - ------ _. .- - - ------ -- - PLUMBING Post F Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIT_ MECHANICAL —� Post&Beam I --- -- Rough In Gas Line Smoke Dampers Final -PART- FAIL ELECT - --- Service _ Rough In UG/Slab Low Voltage Fire Alarm --- _ _-- -- - - ---- - --- Final AASt PART FAIL SackfilhGradinp - ---._._----------------- --- -_ -._-- --- -.__------------- Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ -__-_required before next inspr-ction. Pay at City Hall. 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RF - �_- [ ]Unable to inspect- no access ADA Approach/Sidewalk9 Inspector _ �� Ext Other Date _ -. ---- Final PASS PART FAIL- D NO REMOVE this Yiilspection record from the Job site. CITY OF TIGARD SUILDi,;Q INSPECTION NOTICE Inspection Line: 639.4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling �LL Post/Beam Mach. Shear/Sheath Framing Mech. Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: �. Date: _ ._� /��/_ A.M.—P.M. Entry: Address: �L Z � � � Tenant: u-�" -�-s-''_ Ste:---- MST: 6 BLIP. Con/Own:_ �el � �_ _-- MEC- PLM'_,rp�__T ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: In ector: — ---- — Date�� OVED —DISAPPROVED/CALL FOR REINSN. Ur CO C6'Y OF TIGARD BUILDING INSPECTION 140TICE� J Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/Beam Mech. Shear/Sheath Framing Mech. Plbg.Und/Fir/Slab Plbg. Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bld . San. Sewer Gas Line Appr/Sdwlk Reins. Other: Date: W A M. . P.M. Entry: p Address: ---- -- Tenank _-- - - -•- Ste:—_-- MST: _ BUP Con/Own•_,: � 1�__-- y MEC: C 10 PLM: THE FOLL ING COR ECTIONS ARE REQUIRED: ELR: �Inspe�c _ .��� -- --_ Dater —APPROVED _—DISAFIPROVED/CALL FOR REINSP CIF CJ Tigard: Dr. David Hughes First Pian Review LP2A Job No. 96522.046 City No. BLIP 96-0330 MEC 96-0191 July 15, 1996 Dr. David Hughes 11565 SW Hall Blvd. Tigard,OR. 97223 Re: New Addition - 11565 SW Hall Blvd. Floor Area: 910 sq. ft. Construction Type: V-N Occupancy: unknown Occupant Load: 8 Use. Dental Office LP2A(Linhart Peterson Powers Associates)has completed review of the following documents. These documents were reviewed only for their conformance to the City of Tigard building regulations and the State of Oregon Specialty Codes, 1996 Edition. This review does not include plumbing,electrical or Bre sprinkler and tire alarm modifications.These%hall be submitted and reviewed by the City of Tigard. 1. Architectural Drawings, Sheets: 1 -8 2. Engineering Calculations Sealed by Professional Engineer Dale B. Haller. (4) pages 3. Mechanical Drawings. (2)pages LP2A is unable to recommend the issuance of the building permit for this project wail the following items have been satisfactorily addressed. Building/Str tul 1. This addition to an existing dental office will be classified as a health-care center for ambulatory patients receiving outpatient medical care which may render the patient incapable of unassisted self preservation. When the aggregate total number of such patients on the total story of the building ;s more than Eve, it is a Group I Division 1.2 and if the total numher is five or fewer, it is a Group I Division 1.3. The determination of patient count shall be made by the chief licensed health-care practitioner. Please provide written documentation detailing the number of patients that will be rendered incapable of self-preservation at one given time so we may classify this building and complete our review. Section 308 O.S.S.C. 2. Sheet 1, plan scale shows the north wall is approximately 19 feet from the north property line. 1-1.2 and 1-1.3 Occupancies require this wall to be a minimum of I-Hour fire-resistive construction. Please clarify exact measurement from this wall to the property line. Table S-A O.S.S.C. 3. Please submit documentation showing how 25% of the total project cost will lie used to remove existing architectural barriers. Section 1113,1.1 O.S.S.C. toLINHART PETERSEN POWERS ASSOCIATES 3855-3 Wolverine Street NF a Salem,OR 97305 (503)371-2212 •FAX:(503)371-3853 4. The door to the private office shall have a minimum maneuvering clearance of 18 inches from the inside of the office on the strike plate side. Section 1109.9.3,Table 11-E and ADAAG Figure 25. 5. Please submit engineered truss drawings to the City of Tigard prior to installation. Mev-I-140icu, 6. A 120-volt receptacle shall be located within 25 feet of the exterior heat pump for service and maintenance purposes. Section 309.1 O.M.S.C. 7. The heat pump condensate line shall discharge to an approved plumbing fixture of disposal area. Section 301.1 O.M.S.C. 8. The heat pump shall be supported on a concrete slab extending not less than 3 inches above the ground. Section 316.3 O.M.S.C. Response such as,"see plans"or"by others"does not save time or satisfA- requirements. Show or note specifically how compliance is achieved. If you have questions, please contact Gary Lampella at(503) 371-2212. Respectfully, LINIIART PETERSEN POWERS ASSOCIATES G� Gary Lampella Building& Mechanical Inspector'Plans Examiner c: David Scott, Building Official 1 . Tigard: Dr. David Hughes Second Plan Review LP2A Job No.96522.046 City No. BUP 96-0330 MEC 96-0191 July 16, 1996 Dr. David Hughes 11565 SW Hall Blvd. Tigard,OR. 97223 Re: New Addition- 11565 SVS HMI FIhd. Use: Dental Office Floor Area: 952 sq. A. Construction Type: V-N Occupancy: It Occupant Load: 8 11P2A(Linhart Peterson Powers Associates)has completer)review of the following documents. These documents were reviewed only for their conformance to the City of Tigard building regulations and the State of Oregon Specialty Codes, 1996 Edition. This review does not include plumbing,electrical or fire sprinkler and fire alarm modifications. These shall be submitted and reviewed by the City of Tigard. 1. Architectural Drawings, Sheets: 1 -8 2. Engineering Calculations Sealed by Professional Engineer Dale B. Haller, (4) pages 3. Mechanical Drawings,(2) pages LP2A recommends the issuance of the building and mechanical permits for this project subject to the following comments: A 952 SQUARE FOOT DENTAL OFFICE IS BEING ADDED TO AN EXISTING GROUP B DIVISION 2 DENTAL OFFICE OF 8,970 SQUARE FEET. THE TOTAL AREA OF THIS BUILDING WILL BE 9,742 SQUARE FEET. BASED ON THE LETTER FROM DR. DAVID HUGHES, CHIEF LICENSED HEALTH-CARE. PRACTITIONER, THE NITROUS OXIDE IS RARELY USED AND PER ON HIS LETTER, DOES NOT RENDER THE PATIENT INCAPABLE OF SELF-PhESERVATIO"i. BASED ON THIS INFORMATION THE NEW ADDITION IS BEING CLASS11FIED AS A GROUP B, PROFESSIONAL OFFICE. We would recommend that a permanent record be kept that prohibited the use of a general anesthetic in this addition as well as the other occupants of the building. Flu' slitWStruct ter 1 1. This addition to an existing dental office will be classified as a health-care center for ambulatory patients receiving outpatient medical care which may render the patient incapable of unassisted self preservation. When the aggregate total number of such patients on the total story of the building is more than five, it is a Group I Division 1.2 and if the total number is five or fewer, it is a Group I Division 1.3. The determination of patient count shall be made by the chief licensed health-care practitioner. Please provide written documentation detailing the number of patients that will be rendered incapable of self-preservation at one given time so we may classify this building and complete our revie,.. Section 308 O.S.S.C. W.-sponse to this item accepted per the letter from Dr. Da%id Hughes. LIN HART PETERSEN POWERS ASSOCIATES ' 3855-3 Wolverine Street NE • Salem,OR 97305 (503) 371-2212 a FAX(503) 371-3853 'Sheet 1, plan scale shows the north wall is approximately 19 feet from the north property line. 1-1.2 and 1-1.3 Occupancies require this wall to be a minis nim of 1-Hour fire-resistive construction. Please clarify exact measurement from this wall to the propertN line. Table 5-A O.S.S.C. Actual field measurement is 20 feet 10 inches. ;ince this is now a R Occupancy, walls within 20 feet of a property line shall he of not less than 1-I1our tire-resistive construction. � / Please submit documentation showing how 25%of the total project cost will be used to remove L existing architectural harriers. Section 1 1 13.1.1 O.S.S.C. Response accepted (attached) ,Y4 'The door to the private office shall have a ninimmin maneuvering clearance of 18 inches from the inside of the office on the strike plate side. Section 1109.9.3, Table 1 1-E and ADAAG Figure 25. Per the contractor, the 18-inch clearance will be provided. Please submit engineered truss drawings to the City of'Tigard prior to installation. Engineered truss details will be submitted. M c t _is Al 6. A 120-volt receptacle shall be located within 25 feet of the exterior heat pump for service and maintenance purposes. Section 309.1 O.M.S.C. General note. 7. The heat pump condensate line shall discharge to an approved plumbing Fixture of disposal at-ea. Section 301.1 O.M.S.C. General note. 8. The hent pump shall be supported on a concrete slab extending not less than 3 inches above the ground, Section 316.3 O.M.S.C. General note. If we can be of further service to you, please call us at(503)371-2212. Respectfully, HNI IAR I'PETERSEN POWERS ASSOCIATES Gary Lampella Building c& Mechanical InspectorMans F,xaminer c: David Scoff, Building Official i J. C. W INC _ (;EMERAL CONSTRUCTION CONTRACTORS DATE July 16, 1996 To. City of Tigard and Gat y 1.ampella 13125 SW Hall Blvd Tigard OR 97223 RE Dr David Hughes Remode! 11565 SW Hall Blvd Tigard OR 91223 The following is a breakdown of costs associated with removing architectural barriers I Replace existing door& hardware to Business Office S 90000 2 Replace existing Front Desk Reception Counter and Receptionist Work Station 12.050 00 3 Remove existing back drmr to create a 54" Pass Thru to Addition 1,75000 4 Install new Handicap Pa4ing Space to existing parking lot 75000 S Install Handicap lever Hardware to doors Ca Addition 1,00000 6 Install Handicap Accetesible Work Station Cabinetry in Bw iness Office --�-�Q-� TOTAL. $20,25000 Non New dnOr to 3usiness Office to have minimum :d" clear at open side. Please call if you have any Questions Sincerely. Aare S lenquin 5931 SE 111 th,Portland,OR 97266 503 '161-4523 PAX 503-762-1047 1 1400.761-9433 CC RM 91011 DAVID W. HUGHES DMD 59:6©4914: P,01 0�'1Rl).9'36 16:46 5039686309 1?a1►Nk�u_s F�GE �: ki Tend6r( al %L/ 0 � tk f3EN -rAL OFFICE For quality dentlstry dell0r4d gently. July Is, 1990 -� � c Oty ofTigard and fairy Lampella Fax 1-503-.371.3953 'ro City of Tigard and Gary Lampella At no time will any of my den!al patients receive treatment where they will be incapacitated of unassisted self preservation We use mainly local injection anthesia and occasionally NO2 for fearful patients NO2 is conscious sedation and the patient is never"put to sleep"(unconscious sedation) We never uie any method where patients are unconscious. Also. the actual field measurement from the North property line to the proposed addition wall is 20' ICs" Nopefirlly this information will be helpful in your work Sincerely, Dwil ing David W Hughes, D M.D CC Mark 1CW fAX 1.303-767-JV47 W uw awd David W.HuphOe,0.M.11 An**%v H.Kim.0.0.5 71pME, &.9273 Is03)31 tuo.o3ts Rkhard H Axon.a.n.0 A.6twon Singh,0 0.8 tenant Name: �, .r' ~' Accumulative Sewer Tally This SWR#:✓r✓rz `L, O 311 _ Address: This PLM#: Fixture Value Previous d Pre nous Credits Capped Fixtures Fixtures New New Value CLpped oft value added 0 added total Its total Count off #s r-ount vaius values Baptistry/Font 4 Rath - Tub/Shower 4 Jacuz/Whpl 4 Car Wash -Each Stall 6 - Drive Throuqh 16 _ II Cusoidor/Water Aspirator �- 1 1 Dishwasher - Comrner 4 - Domest 2 Drinking Fountain 1 Eve Wash 1 Gloor Drain/sink 2 inch 2 3 inch 5 4 inch 6 Car Wash Dram 6 Garbage Disposal 16 -0 am Ito 3/4 HP) Comm Ito 5 HPI 32 Ind Iry 46 — e� 5 HP 1 IcaJlachirelRefrigerator Drains 1 Oil Sep(Gas Staticn) 6 Recreational Vehicle Durno Station 16 Sho,.ver - Gang (,Per Head) 1 -Stall 2 Sink BauLavatory 2 Bradlev 5 _ Commercial 3 Service 3 Swimming Pool Filter 1 'V-,iLer, Clothes 6 Water Extractor 6 Water Closet, Toilet 6 Urinal _ 6 TOTALS � �t� Total fixture values: divided by 16 = _�_ EDU HISTORY PLM# EDU# J SWRa i PI-M4 _ EDU# SWR# PLM# EDU# SWRa CI% �` PLM# EDU# SWR# PLM# FDU# SWR# PLM# EDU# SWR# Al PLP.1# EDU# SWR# PLM# ED'-)# SWRa ,,ym a•tw•i . OATS PLAAS CHEO(NO.: PROJECT TITLE: j- COUNTYWIDE TR �IC i,�v�1�P•+AC FEE "PUCANT. WORKSHEET 1 �C,�3C MAIUNG ADDRESS: ,G — r•^�r c FOR YOM�iNGLE F-AM .Y USES) �✓''` a� CaTY/71P/PHONE RATE F'ER ( ; ,. l.-,,..r� e. y LAND USE CATIEGCRY TRIP TAX MAP NO.: RESIDENTIAL Sifa.00 BUSINESSAND CCIMMEPCIAL S40.00 SITUS NO.ADDRESS. CcOFPCE $148.00 INDUSTRIAL $153.00 INSTITUTICNAL $66.00 P.AYMa1T METHCO: CAqlj/QJFCK CREDIT NSTTTVTIONAL ONLY' BANCROFT(PROMISSORY NOTE) LANu �'5 LZ c.�TEGURY E' UPTION OF USE EEKCJ►Y AM TRIP RAT WEE1(ENo AVE rwp RATS DEFER TO OCCUPANCY l 'i f 3, /c r•�tjM�,q; aA31S: / _ r ( C ALCULA'iICNS: PRCWR r'Mv OMMA a+: E, T� 1p,S Fft 1`X 3l C,.r c� AMMCNAL NOTES: FCR AC-1-UN-TING PURMSE3 ONLY' _ �EPMEO 3Y: i 7F VOTEEOCK b(� Q CITY OF TIGARD June 24, 1996 \� OREGON J.C.W. Inc ATTN: Marc 5932 SE 111th Portland OR 97266 TRAFFIC IMPACT FEE FOR Dr. David Hughes Addition Enclosed with this letter you will find a calculation sheet showing the computation that has been performed to determine the amount of the Traffic Impact Fee (TIF) to be paid for the project noted above. The amount cf the T'IF is $3,161.00. You have two payment options available to you. The first is to pay the TIF at the time you are issued a building permit. The second is to arrange for payment over tirne by signing a promissory note (if you wish to Exercise this second option please contact me for additional detai!s). Traffic impact fees are subject to an annual increase of up to 6% if not paid or financed pror to July 1 st of each year. Please nate that you may appeal the discretionary decisiors made in determining the appropriate category anc the amount of the fee based on that category. A notice of appeal must be received by the Qjty_RgQQLdar no later than 5.00 p.m. on July 9, 1996 and must be accompanied by the $625.00 appeal fee required by Washington County. Although filed with the City Recorder, an appeal would be heard by the Washington Coun'/ Hearings Officer. If you have any questions. or if I can be of further service, please contact me at 639-4171. Jaynes S. Duckett Development Services Technician c'. TIF file Building file 13125 5W Hall Blvd., Tigard, OR 97223 (503) 639-4171 1DD (503) 684-2712 --- !'.AY-14-�b I Ub 1 U V5 Ntl I l tkSUi� utN I HL r'UK I�iLU r hh NU. I!DW d2edss February 2 1996 (CITY OF TIGARD OREGON Dennis Chun Patterson Dental Co. 7535 NE Ambassador Place, Suite L Portland, OR 91220 I Dear Mr. Chung. This letter is in response to your request for a 9.52 square foot addition to an existing dental office, located at 11565 S'dV Hall Boulevard. This property Is zoned C-P (Professional Commercial) The present use of the site is listed as a permitted use for th s zoning district. The Tigard Community Development Code, Site Development Review Section, states, "if tine requested modification meets any of the major modification criteria, that this request shall be reviewed as a new Site Development review application." This request does not meet any of the eleven (11) approval criteria for qualificatior as a i ma;or r-iod,fcation as listed in Section 18.120 070(81 'This is specified as follows 1.) Dwelling unit density will not be affected since this is a oornmercial use, 2.) A change .n dwelling unit type will not be affected since this is a commercial use. 3 ) This change wil; not increar>e the need for auJitienal on-site park,ng as 49 total spaces are required, while 32 are currently provided. 41 The request will not result in a change in the type of commercial or industrial i structures, 5,) There will not be an increase in building height; 6 ) The request will not result in a change in the type and location of accessways ano parking areas where off-site traffic would be affected; 7 ) This expansion w ll not produce an increase in vehicular traffic of more than twen'y (20) vehicles per day, based upon data submitled by the applicant 8 t The requested building is for approximately 952 squnre feet and i; therefore excluded because it is less than 5,OOU square feet, '3125 SW Pali Blvd., Tlaara. O? 97223 (5031639-4171 TDC 1.503) 684-2772 .-_—_-- r°9AY-14-'1Jb 1 UL l u;uo ;'A f I L?6JN bEN I nL eUK I'4?U h AX NU, i bU3 &t bJJ 9.) The request will not cause a rcriuction of more than ton (1)) percent of the area rsserved for common open space andlor usable open space as there will only be a 4 5'/� reduction, 10.) This request will not cause the elimination of project amenities by more than ten (10) percent: 11 ) The request w11 not modify conditions of approval imposed at the time of Site Developmr--t Review approval. Therefure, th's regi.:est is date mined to be a miner modification to an existing site. The Director's designee hac determined that the proposed minor modification of this existing site will promo,a the general welfare of the City and will not be sig,.ificently detrimental, nor injurious, to srrounding properties provided that dev,.Acipment which occurs after this decision complies with appiicable local, state and feder-11 laws. This request has been app�ovad subject to the following conditi,)ns: 1.) A building permit shal' hne obtained from the Building Department. If you need a:7i'1'onal intorrtiation, or have any questions, please `eel free to c,-411 me at 5034639.4171. Sincerely, 11, C�"ICA; William D'Andrea AsF,ctant Pianner P11oginlcury1nwi khunp itr t K I T 7 G° TO � M { r- - DATE . _V Qj& FROM RF . 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Sparc OLlr or Eeepn DO�anNM One beael Int e'pp,°1 NR of t.mow,•,I r'Met•^1G/1 d Di4hp dngn•1 nd i�� Aelgner Poer+p rnoWFI r to 1016101140"11 eI MWOL-01 neo I/lelwawl onr.Addn,en0r 4mpo,olr beery to rtw••om"aUwrlp condhue-en a v* ..nn..eE01\m IM=10.10.IA010111On01 Oe11r111w6M b'46ry N"0 01000 14ye1V'e 8 0"re60e4lelr of the 12.k"do#",.to,O• Clef 01,IpOnce r SITE WORK CITY OF TIGARD #. . . . . . . PERMI PERMIT #. . . . . I . . .. SIT96­0121141 COMMUNITY DEVELOPMENT DEPARTMENT DOTE ISSUED: 08/05/96 13125 SW Hall Blvd.Tigard,Or*gon 97223e8199 (503)639.4171 PARCEL-. I5135DD-018091 mil_E '. 11565 5W HALL. BLVD SUBDIVISION. . . . , METZGER ACRE TRACTS ZONING: C--P BLUCK. . . . . . . . . . LOT. . . . . . . . . . . . . TYPE OF WORK: COM PAVING''. . . . . . . . . . y RESO. NO. : EXCV VOLUME. 0 Cy GRADING?. . . . . . . . : N VALUE. . . 19014 FILL VOLUME' 0 c-,y LANDSCAPING?. . . . : y ENG FILL?. . . . . . : N SITE PREP .. . . . . . : N SOILS RPT REVD'?: 1\1 STORM DRAINS?. . . : N IMPERV SURFACE: 910 sf Reniar-ks, Site permit for, additiun Owner-: DAVID HUGHES type Amol-tirit by date r-ecpt 11565 SW HALL BLVD 5PCT 1. 55 JSD 08'105/96 105/96 916-26249 LCCLF.'O. 15 JM07/09/96 96--2813BE, TIG14RD OR 97223 EXPIRE15RMT 31. 00 JSD 08/05/96 96-282499 e.,39--9316EROS $ 40. 00 JSD 08/05/96 96--282499 -3 0-0 ERPC $ 13. 00 J 6 1) 08/05/96 96-282499 i.ontr-actot-: $ 1,3. '710 jGD 08/05/96 9 6 JCW, INC 5932, GE 111TH AVENUE ,(JRTLAND OR 97266 ....... oune #c 761-.4523 4 1. 18. '70 TOTAL Reg #. . : 091011 REQUIRL-D INSPEC"TIONS This permit is issued subject to the reg-ilations contained in the Paving Insp Tigard Municipal Code, State of Ore. Specialty Codes and all othsr Stv,m Ura in I n s p applicable laws. All wurk will be done in accordance with Final Inspection approved plans. This permit will expire if work is not started within IBO days of issuance, or if work is suspended for more than 180 days. et ri j.t t e ei q T i a t -A�e4 d LAY1 Call forinspect i on 639-4175 CQmmercial Building Fermit Application City 0 Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 Jobsite Address: /� S 5 '�'�J1 ZZ Office Use Only Tenant: ,— _ Suite# � � PlancWRec # �r q3 Valuation: _ ff Permit# T Owner: 1),6 v 10— �fL:;Zf"f L Map & TL # Address �l S 6 J` S !�f/ �i �r `4'���i Approvals Required _ L _ Planning Phone: S ! s, / �i' — Engineering Other , L to j `fC`tk: wk Contractor: Address: r Type of const: V N Occupancy class: Phone: 761 y5 _ J �Sprinklered? Yes /�Qp Contractor's License # �4 Lrlr�`� ( // (� (atta.h copy of current Oregon liven .) Sq. ft. of project: _ 0 D r Contact name & phone: JQ/113'eCAeX i7�1�." �/S".� 5' Story (1st, 2nd, etc.) Proposed use: _ ArchitecUEnyineer: �Ugh -G' � /f �l/�� ____ ' Previous use: _ A ddress Note: Plumbing & mechanical plans must be submitted at time of building permit application. Phone. ,�, S 5 gs~� JOB DESCRIPTION: /7 �.� /I- �� !✓ ,�7iR�' /�'S-- h ? r� �Applicant`Signature & Phone number Received by- ` 'Y� Date Received: O 06 7C' ___ Permit # Account Description Amount Amt. Pd. Bal. Due Bldg. Permit (BUILD) 1 '�I• %L? Plumb. Permit (PLUMB) _ Mech. Permit (MECH) State Tax (TAX) Bldg: Plumb: ] Mech: x�Plan Check (P64MCK) Bldg: Plumb: Me' Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks jav Charge (PKSDC) Residential TIF (TIF-R) Mass Tiansit TIF (TIF-IVs I-) Commercial TIF (TIF-C) Industrial TIF (TIF-1) _ Institutional TIF TIF-IS) Office TIF (TIF-O) Water quality (WQUi, , Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) f_ $D. OG Erosion Planck/USA (ERPLAN) �?�• /j OU Erosion Planck,COT (EROSN) 37 TOTALS: , i - 1 MECHANILIOL PE RM I T CITY OF TlCARD PERMIT #. . . . . . . . MEC96-0191 IDATE ISSUED: 06/05/96 COMMUNITY DEVELOPMENT DEPARTMENT 13126 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171 FDARCEL; I S I 35DD-01800 S1 TE ADDRESS. . . : I 1565 SW HALL BLVD ZONING: C---P SUBDIVISION. . . . .' METZGER ACRE TRACTS BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :26 CLASS OF WORK. . :ADD I-"I-OOR FURN. 0 'VAP COOLERS: IZ, TYPE OF USL. . . . :COM UNIT HEATERS. 0 VENT FANS— . : 0 OCCUPANCY GRP'. . :B Vf--N']-!-) W/O ADPL: 0 VENT SYSTEMS: I BOILERS/COMPRESSORS HOODS. .. . . . . . : 0 SIORIES. . . . . . . . .. I _I DOMUS. JNClN: 0 FUEL 0-3 HP . . - - : I - /ELE/ 3-15 HP. . . . ' 0 COMML. INCIN: 0 S: NOX I NPUI 15-1-0 HP. . . . ID R-EPAIR UNIT11) FIRE DAMPERS?— : N 30-50 HP— . - 0 WOODs*roVES. . : 0 50+ HP. . . . CLO DRYERS. . : 0 GAS PRESSURE. . . '. OTHEN UNITS. : 0 NO. OF UNIJ S----------- AIR HANDLING UNITS GAS OUT'LETS. : 0 1 i.1p1,4 ( 100K BTU* L71 100016 C f in : 0 1 URN )=100K B*rLJ: 17.1 1.00OL71 C.,fm: 0 Peinat-ks : Piddition to dental of'Fire FEES NORRIS & STEVENS type amount by date w-erpt PRMT $ 25. 0 17, JSD 08,105/96 96-282499 5,:�0 ;;W 6 I'H 51'2' r $ 1. 0.,�,j jSD 08/ib5/96 96-282499 POWILAND OR 97204 PILCK 6. 25 .TSU 08/0C-:,/96 96-28.2'499 Phone #- 223-.31*71 Contractor..: 01-1-161) MECHANli-AL CONT 1.300 NE 48TH AVE STE. 1000 HILLSBORO OR 97124 $ 50 TOTAL I-1-ILIT-le #: PH G93-7553 Reg #. . : 005807 REOUIRED INSPILCTIONS This persit is issued subject to the regulations contained in the Mechanical lnsP Tigard Municipal Code, State of Ore. Specialty Codes and all other f*7 inal Inspection ;pf2l3cable laws. All work will be done in accordance with aoproved plans. This pervit will expire if work is not started --- within 180 days of issuance, or if work is suspended for sore .nan 18@ days. et-mit tee L- Call fov- inspection 639-4175 city of Tigard MECHANICAL ' NICAL PERMIT Planck/Rec. # Le —v`��' 13125 SW Hall Blvd. , KPPLTCATION `Permit # LLi Tigard, OR 97223 E (503) 639-4171 �, G C2Ycl ' (1 escnpt on l __. ��� • U lj I S � to �(� Table 3A Mechanical Code QTY PRICE AMT Job r r s!` .�.� t1J �.: 7 .�- 1) Permit Fee 0- 0- 1000 address rj 11t.t.1 �/ it 2) Supplemental Permit 3.00 •m Iw nun°° ,,, it ( urnar—et o-T7 FnU-MU i 1J�Y✓t 't QI/t K 1) ncl. ducts &vents 600 Y]�, Furnace 100,000 Owner �� p 21 ncl ducts & vents 750 —�ToorFumance �� ��4 <� C_]✓ 3) incl vent _ 600 Suspendedneater, Kai. eater r�r t„ 4) or Floor mounted heater 6.00 Occupant •� °, q°°" Vent not nc. in P i SLI(.) ' ��„ 5) appliance permit 3,00 eparr o eatirg, retng. — ! 6) cooling, absorption unit — _900 boiler or comp heat pump, air con 1 r ����•�-►t/" l' 7) to 3 HP: absorp unit to 100K BTU r 600 ? --goiter or cornp, heat pump, air con-T Contractor r 3D 1.49, - 8) 3-15 HP; absorp unit to 500K BTU —� 1; 00 offer or comp, heat pump, air sono _ 9) 15-30 HP; absorp unit 5-1 and BTU 1500 •I° •p•u.u,n ° . .. of er o�Compal pump, air cono 10) 30.50 HP, absorp unit 1-1 75 and BTU 2250 l'hereoy ac now eage t aTi tT�ave read t s' pp nation, that the Boiler or camp, heat pump, air con -- information given is correct. that I am the owner or authorized 11) , 50 HP; absorp unit 1 75 mil BTU 37 50 agent of the owner. that plans submitted are in compliance with Air handling unit to - -- State laws, that I am registered with the Const,'--,.tion Contractor's 121 10000 CFM ^�4 50 Board, that the number given is correct. (If exempt from State r an ing uni — registration, please give reason below 1 13) 10,000 CTM + '50 Non porta le — 14) evaporate cooler !-_— 4.50 Vent far, connecteo 1 15) to a single duct 300 Ventilation system not 161, included in appliance permit 450 �r .• k. oo, served y z�217) mechanical exhaust 4 50 Describe wor W a dition a t?ratlon repair l_? Commercial or industrial to be done residential O non•res dentia) U 18) type incinerator 30 00 xisting use or ( ---{ t her a woo stove water budding or property 1 jaL a of T G 4 19) heater solar, clothes dryers. etc, 4 50 Proocsed use or - 20) Gas oioing one to four outlets - 200 budding or orocerty r)e,, 10. 1) `�;G -_ 7.1) More than 4-per outlet (each) 2 ro Type of fuel -oil (j natural gas LPG 0 electric Q NOTICE -- - ----h Minimum Fee $25 00 SUBTOTAL PERMITS BECOME VOID IF WORK OR CONSTRUCTION --- --— I AUTHORIZED --- AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 57° SURCHARGE r IF CONSTRUCTION OR WORK IS SUSPENDED OR --- ---- - --- ABANDONED FDR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25°b OF SUBTOTAL lj L AFTER WORK IS COMMENCED TOTAL Sc?C al Cucditicrs —_ ----- -. -- --_-- Date issued ------ b� -- • .. rr�•s.•.Ircror,lr PL.UMBING CITY OF TIGARD i-'-,ER1y1IT` *�. . . . f-,ERMIT. . . : PLM`)C-016 C;7MMUN11-Y DEVELOPMENT DEPARTMENT DATE ISSUED: 1;68/05/96 13 125 SW Poll Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PARCEL. : 1 S 1,3-,-.PDD--01600 SITE — : 11565 SW HALL BLVD SUBDIVISION. . . . : METZGER ACRE TRACTS ZONING., C--P BLOCIi. . . . . . . . . . LOT. . . . . . . . . . . . CLti55 OF WOP1J1- - :ADD GARBAGE DISPOSALU. : 0 MOB ILL HOME SPACES. : 0 TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 6ACKFLOW PREVNrRS. . 1 0 OCCUPANCY GRP. . BR FLOOR DRAINS. . . . . . : Vi T IRPPS. . . . . . . . . . . . . . . 0 STORIES. . . . . . . . WATER HEATERS. . . . . : 671 CATCH BASINS. . . . . . . : 0 FIXTURES-____.___.__....___......_ LAUNDRY TRAYS. . . - - - 0 5F RAIN DRAINS. . . . . : 17' URINALS. . . . .. . . . . . . : 0 GREASE TRAPS. . . . . . . . 0 L AVATORIE'. OTHEIR F=IXTURES. . . . : 0 TUB/SHOWERS. SEWER LINE (ft ) . . . : 0 WATER CLOSETS. . : 0 WATER LINE (ft ) . . - ' 0 DISHWASHERS. . . . RAIN DRAIN (ft) . . . : 0 Rema)--iis- P(Adition to denta'k office (ALL PLANS TObE"THER/ROLLED) Ownev--. FEES MORRIS & STEVENS type Amol-trit by date t'eapt 5�?.o SW 6TH P RMT $ 213. 00 JSD 08/05/96 96-28E'499 5PCT $ 1. 25 JSD 08/@5/')6 9f, 282499 PORTLAND OR 97204 Fah one #'. 223-3171 --'---"'--- 1). P. PLUMBING 904 S. CHEHALEM NEWBURG OR 97132 hone #: TOTAL Reg #. . : L10612REPUIRED INSPECf'1ONS lhis PM'flit is issued subject to the regulations contained in the Roi.tgh-in Irisp Tigard Municipal Code, State of Ore. Specialty Codes and all other P'Llvi/Undev-f loot- applicable laws. All work will be done in accordance with Top-oi.it Insp approvod plans. This perait will expire if work is not started Final Inspel:tiOn within 180 days of issuance. or if Mork is suspended for sore than 180 days. `c , s.- AkAr I 1?v m i L t e e Signati-Ir44 s 1-i e d By fot� irispection 639-4175 (7-114, City of Tigard PLUMBING PERMIT_ APPLICATION Planck/Rec. # 13125 SW Hall Blvd. 6 ) Lr-� Permit # ��•� c��—h res^ Tigard, OR 97223 QV � 503 639-4171 5M __IlaNIMIJM $25.00 PERMIT FEE + ST. SI/�2GHARGE�/ New Single Family Residences 00� y� . 1/�"'"rte ✓�r'�<.!�' _ - � Job � / ! , 1 BATH HOUSE$140.00 2 BATH HOUSE 5195.00 SJ (� ❑ 3 BATH HOUSE 5225.00 Address retrain. zlo Fee includes all plumbing fixtures in the dwelling and the first 100 feet -T; e— -, i of water service, sanitary sewer and storm sewer. See fees below """"°//"•"°°'B`"•" / FIXTURES QTY PRICE AMT i�),Y �rS �f"1 � Sink 9.00 Made g Afters ` N°"• Lavatory 900 Owner J J W Tub or Tub/Shower Comb. 9.00 `"M•'• " Shower Only -- 9.00 �X Water Closet 9.00 Name lar n.m.•1 bumaq Dishwasher 9.00 Occupant �r () Garbage Disposal 900 MA&V/�� / �_ ��/ �/f�^ '*O"d Washing Machine 9.00 _ (� f C Floor Drain 900 r"Y'fl1•'• iD Water Heater 900 (r j%A_Gu ov Laundry Room Tray 9.00 '"• / Urinal 9.00 3 r�f�r- Other Fixtures (Specify; 9.00 Contractor I ladingl. a AMess Pnm. _— 900 n s -'lip Aq 106. s�. --- - - 9.00 zip 900 `1y"J/ Sewer 1st 100' :30.00 s1i11,R1e1/O err•fl N•. C* Is 'a�Na -y-- -_ / Sewer -ea. Addit. 100' 25.00 �,r, � r--� ���- WaterService1st 100' — 30.00 I hereby hcknoyilledge that I have read is application, a VVP%er Service ea Addie. 200' 25.00 information given is correct, that I am theer ownor authorized agent of the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain !st 100' 30.00 I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 2500 number given is correct. (If exempt from State registration, please _ give reason below 1 Mobile Home Space 2500 Back Flow Prevention I1�A /,""kbµ c •� �j- - Device or Anti-Po'lution Device Y9 C0 oats Any T!ap or Waste Not Connected to a Fixture 900 Describe work rew 0 addition ) alteration 0 repair Q _ Catch Basin 90 to be done resiriential 0 nc•-residential O Insp of Ex 1. Plumbing 40001h Specially F Guested Inspections 40,001hr Existing use of 1 (//, -- - hud 'drno or property JC•e'jA �a Q_ Rain Drain, single family dwelling 30.00 Residential backflow prevenbcn devices 15.00 v-crosed nse of hrnlding or property - '(Except residential backflow prevention devices) NOTICE Minimum Fee $25.00 SUBTOTAL PERMITS BECOME VOID IF WORK OR CONSTRUCTION — — AUTI IORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF 5%SURCHARGE CONSTRUCTION OR WORK IS SUSPENDE'- OR ABANCONED —_--- -- FOR A DFRIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED, PLAN REVIEW 25'6 OF SUBTOTAL TOTAL > Soec al Cooddions —-- _ Date issued __ by CITY CSF T1,ARD DEVELOPMENT SERVICES ELECTRICAL. PERMI,r -- 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 RESTRICTED ENERGY PERMIT #: ELR96-0302 DATE ISSUED: 10/07/96 PARCEL: 16135DD-01800 SITE ADDRESS. . . : 11565 SW HALL BLVD SUBDIVISION. . . . : METZGER ACRE' TRACTS ZONING:C—P BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . :26 Project Description: Addition Of AUclio/Stev-eo and Inter-con/paying systems. A. RESIDENTIAL----------- B. AUDIO & STEREO. . . : AUDIO & STEREO. . :X INTERCOM & PAGING. . :X BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . : GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . . 1-1VAC. . . . . a A a . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: HVAC. . . . . . . . . . . . . PROTECTIVE SIGNAL. . : INSTRUMENTATION. : OTHER. . : TOTAL # OF SYSTEMS: 2 Owner-: FEES NORRIS & STEVENS type amoi(nt by date r-eept 51=0 SW ETH PRMT $ 80. 00 JDA 10/07/96 96-282821 5PCT $ 4. 00 JDA 10/07/96. 96-282821 PORTLAND OR 97204 Phone #1 223-31.71 Contractor: EMPIRE ELECTRIC f 84. 00 TOTAL 5300 SW JOHNSON CREEK T3[-VD -------- REOUIRED INSPECTIONS PORTLAND OR 97222 Wall Covet- Flect' l Final Phone #: 503-777--3108 Elect' I Ser-vice Req #. . : 08614 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Plet-mitee Signat i-tv'k- applicable laws. All stork will be done in accordance with approved plans. This permit 6ill expire if work is not started within 180 days of issuance, ir if work is suspended for more than IN days. Issi-ted B INSTALLATTON The installation is being made on property I own which it, not intended for- ,;ale, lease, at, rent. OWNER' S SIGNATURE: DATE: INSTALLATION SIGNATURE OF SUPR. ELECIN: DATE: I-TCENSE NO: <'k I for inspection 639-4175 Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION 1 Hall Blvd. Tigard, ,G `,19f0 Ti ard,OR 97223 PERMIT# Phone(503)639-4171 FAX(503)684-7297 DATE ISSUED_ �A TDD No. (503)684-2772 ` CITY OF TIOARD In4)ection (503)639-4175 ISSUED BY PLEASE COMPLETE ALL SECTIONS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK 11565 SW HALL. BLVD _ Address RESIDENTIAL—Restricted Ene Fee. . . . . . . . . ;igQ.QQ TIGARD OR (FOR ALL SYSTEMS) City State Zip Check Tyne of Work Involved: PERMITS ARE NON-TRANSFERABLE ANU NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK 15 SUSPENDED FOR 180 DAYS. ❑ BurRlar Alarm 2. CONTRACTOR APPLICATION n Garage Door Opener* RENNELLS ELECTRIC DBA ❑ Heating Ventilation and Air Conditioning System' ContractorEMP 1, ELECTRIC CO 4�----------____-- ❑ Vacuum5vsrc;us* ELECTRICAL CONTRACTOR U Uther Address 5300 SE JOHNSON CREEK.BLVD. PORTLAND 97222 --- — Date9-26-96 COMMERCIAL—Fee for each system . . . . . . . . . 140.00 (SEE OAR 418-260-260) Property Owner DR, DAVID HUGHES _ Check Type of Work Involved: Contractor's Board Reg. No. _ 08614 __ Audio and Stereo Systems j Boiler Controls Phone# (503) 777-3108 ❑ Clock Systems 3. OWNER APPLICATION ❑ Data Telecommunication Installations ❑ Fire Alarm Installation ❑ HVAC Print Owner's Name Phone No ❑ Instrumentation Address — CeIntercom and Paging Systems ❑ Landscape Irrigation Control' City State Zip ❑ ".tedical This permit Is issue!ander OAR 918.320.370.This applicant agrees to make only ❑ Nurse Calls restricted energy installations(100 volt amps or le-ssl under this permit and to do the ❑ Outdoor Landscape Lighting' folknving, ❑ Protective Signaling 1 Only use electrical licensed persons to do installations where required.(Certain residential and other transactions are exempt from licensing.These have ❑ Other asterisks(').All others need licensing). - 2. Call for an insp,rctinn when all of the installations under this permit am ready for inspection at 503-639-4175. 17j Number of Systems 3. Purchase separate permits for all installations that are not ready for inspection when the lnspec3or is nut to Inspect under this permit. •No licenses am required. Licenses are required for all other installations. 4 Assume responsibillly for assuring that all corrections required by the inspector are done,and 5. Assume responsibility for calling for a final inspection when all of the 5. FEES corrections are completed. The person signing for this permit must be the applicant or a person a. Enter Fees $ 'D authorized to b the applicant, b. 5%Surcharge(.05 x total above) $ Signature TOTAL $ , 0 el— Authority if other than applicant ENERGARCHP