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6900 SW HAINES ST BLDG �_
CITY OF TIOARD
tilmping A Better Community
MEMORANDUM
CITY OF TIGARD
13125 SW Hall Blvd.
Tigard, OR 97223
Phone 503-6394171
Fax: 503-684-7297
TO Address distribution list
FROM: Kit Church
DATE: 02/08/00
SUBJECT: Change of address
Please correct your records to indicate the following change of address for the Oregon
Education Association building at the corner of SW Atlanta and SW Haines St.
NEW ADDRESS OLD ADDRESS
6900 SW Atlanta St. 6900 SW Haines St.
If you have any questions please contact me by calling 639-4171 x377.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hou- Inspection Line: 639-4175 Business Line: 639-4171
C q BL
Date Requested f r3 9 f AMPM _ BLD /
Location e oy sco 'K�`'° Suite �C v� MEC
�U- 7rF5� PLM nG' 3
Contact Person - Ph )
ContU::ctor _ Ph SWR _
B IL. N Tenant/Owner LLC
DS _
Retaining Wall ELR
Footing Access. ,f
Foundation PS
Fig Drain
Crawl Drain Inspect' n Notes: S
CG// o�2 �L� role.,
Slab - SIT
Post& Beam -
Ext Sheath/Shear �G/t!^► ��/V(
Int Sheath/Shear
Framing - - - - -
Insulation
Drywall Nailing -
Firewa!I
Fire S rinkler - -- ------ ---- -----------_--
Fre Alar �—
Roof 1-2 51eC)A
Ina
as PART FAIL /S _
81NG e7410
Post& Beam
Under Slab
Top Out ---------
Water Service _
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL.
MECHANICAL q�r Z 7 - ,r •� -- -
Post&Beam --_-.�-
Rough In
Gas Line -
Smoke Dampers
rr
PASS PART FAIL
ELECTRICAL ----
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm ------- - -�---- -- - -- -
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain ( ]Reirspection fee,-if$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( j Please call for reinspection RE: _ ( J Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date 1 r Inspector `Z'� Ext
Other - ---- -
Final
PASS PART FAIL Dn NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 635-4175 usiness Line: 639-4171 MST _
euP 7`l-CZ% t nim
Date Requested_ AM PM _
// � / Q� BLD _
Location c�Cl t h�Ce,��1^ S Suite YJ< <� MEC
Contact Person _ Pe� _ Ph PLM
CQa4iRetQr Ph SWR
UILDING Tena;riiOwner ELC
Retaining Wall ELR
Footing rAccess: /� tin_ �`K S�f'L9 Lk enc._. —.
Foundation FPS
Fig Drain .� +-u� ��..��•,��v ,Fitt 1.* GJ-r� SGN
Crawl Drain Inspection Notes: - ----
Slab
Post&Beam SIT
Ex:Sheath/Shear
Int Sheath/Shear - —�—-
Framing
Insulation --- ---_- - - `'
Drywall Nailing
CFi all _ 2�
ie — —
Fire Alarm
Susp'd Ceiling
Roof _
Misc:
,PASS_)- PART FAIL --------- _—_ _
ING
Post$ Beam - --- - ---- -----
Under Slab
Top Out ---- --
Water Service
Sanitary Sewer
Rain Drains
1 inal - -
PASS PART FAIL -- -
MECHANICAL
Post& Beam
Roug'i In
Gas Line - -- - -----
Smoke Dampers
Final -- -- - - --- --- --- --
PASS _PART FAIL
ELECTRICAL - - -
Service N I
--- -- -- -- - ------- — - -- -- -- -
Rough In jb
UG/Slab
Low Voltage _._� -----------—------
Fire Alarm
Final -----------
PASS PART FAIL
SITE
Backfill/Grading - - - -- --- --- --
Sanitary Sewer
Storm Drain ; j Reinspe.:tion fee of$ _ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd
Catch Basin Please call for reinspection RE:
Fire Supply Line ( i p ----___ ( Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date tq Inspector / . —_ Ext
Final
PASS PART FAIL 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
4 �
ADate Requested I ��( 11/ —AM NM BtJPBLD _
location Suite MEC _
Contact Person _ Ph PLM —
Contractor �QpPh` ) � SWR
%SGL, " l� lJ�(1c<<.r-�,`
BUILDING- ant/owner Z �e `ELC
en
Retaining Wall ELR
Footing -------- ---
Foundation Access:
FPS
Fig Drain
Crawl Drain Inspection Notes , SGN
--
Slab '
Post&Bearn - - SIT
Ext Sheath/Shear
Int Sheath/Shear ---_---- -` -
Framing
Insulation ---
Drywall Nailing -------
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof — ----- --- -
PA PART FAIL _
PLUMBING
Post& Beam ---_.__----—_-_
Under Slab
Top Out -- -- -
Water Service
Sanitary Sewer -
Rain Drains
Final --
PASS PART FAIL_
MECHANICAL
Post& Bean ----- -- ---
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Servicr
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading ----- —
Sanitary Sewer
Slz)rm Drain ( )Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Plvd
Catch Basin Please call for reinspection RE
Fire Supply Line I ) P ___ ( ) Unable to inspect-no access
ADA
Approach/Sidewalk /
Other Date Inspectr- / (� Ext -
Final if
PASS PART FAIL 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 �p
BUP (q q 9—
Date Requested /dI/sI9 AM PM BLD
Location 061 SW i`kttw S Suite MEC -----
Contact Person lk)_A (j1A.) gyp,/✓� Sok... Ph Sl 9- l 9 7 PLM
C�aek�r Ph SWR
'/BUILDING _ Tenant/Owner ELC
all � ELR
Foo ing Access:
Foundation FPS _
Ftg 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 -_---
Roof
SS 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
ELECTRICAL _ _-- - __. -_
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 RE:reinspection f
Please call or reins
Fire Supply Line ( p [ J Unable to inspect no access
ADA
Approach/Sidewalk
Other Date Inspector._ Ext
Final
PASS PART_ FAIL 00 NOT REMOVE this inspection record from the job rate.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 �------
f / BUP
_ —Date Requestgd, ��I (�I L� AM PM BLD
Location (oc -V >v) ��l 'x-�� Suite aMEC
Contact Person Ph �)>Ci `-7k PLM —
Contractor` Ph SWR _
BUILDING Tenant/Owner ELC p
Retaining Wall ELR
Footing Access: �r
Foundation FPS _
tg 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 - - -- --
Roof
Mise - - — —
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 T
PASS PART FAIL
ELECTRICAL �- —
Service
Rough In
UG/Slab
r ow V0-11,W)
Alarm
411s_
PART FAIL -
Backfill/Grading —
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$_— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection F;F _ L I j Unable to inspect no arces�,
ADA
Approach/Sidewalk /
Cate
OtherInspector - _ Ext
Final !!!
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line:;639-4`171 MST
Date Requested It I 4/ AM: ,-� PM BLD _
Location (r9� �e r Suite '
- L MEC
Contact Person ( ?L_ ei, � S fC Ph ��3`>< �� Y C L PLM
Contractor Ph SWR
BUILDING — Tenant/Owner EI._C 4`?`r- 0 5�
Retaining Wall ELR
Footing Access:
Foundation FPS
Fig Drain - -
Crawl Drain Inspection Notes: SGN
Slab
Post& Beam - SI'r —
Fxt Sheath/Shear
Int Sheath/Shear -
Framing
Insulation --- - -
Drywall Nailing
Firewall - — l-
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: --- -- - --- ---- ----- - -
Final
PASS PART FAIL
PLUMBING
Post& Hearn --- - ---- -- -- -_
Under Slab
Top Out -
- - - —
Water Service
Sanitary Sewer —
Rain Drains
Final - -_
PASS PART FAIL.
MECHANICAL
Post& Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS _+MT FAIL
LECTRI
�;ervice
Rough In
UG/Slab
Low Voltage
E Alarm
SS PART FAIL
Backfill/Grading -
Sanitary Sewer
Storm Drain ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catchlease call for reinspection RE: _ ( )
Fire Supplypply PUnable to inspect-no access Line ) ) p -_- _ �.
ADA
Approach/Sidewalk
Date / Inspector t -.. Q
Other -�(�-_- --�-_.� P - -- - - -- Ext
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the joky site.
' �4 R D BUILDING PERMIT
CITY O F T I G
PERMIT#: BUP1999-00493
DEVELOPMENT SERVICES DATE ISSUED: 11/30/1999
13125 SW Hall Blvd., T;gard, OR 97223 (503) 639-4171 PARCEL: 1S136DA-02301
SITE ADDRESS: 06900 SW HAINES ST BLDG2
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
REISSUE: /(, FLOOR AREAS_ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: / T 1 FIRST: sf N: S E: W:
TYPE OF USE: COM SECOND: sfPROJECT OPENINGS?
TYPE OF CONST: 5N sf N_ S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf r,%-,-CU 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 20,000 00
Remarks: Fire protection system -This system is a non-required alarm system - Inspect in accordance with approved plans.
Owner: Contractor:
OREGON EDUCATION ASSOCIATION ADAMS ELECTRIG CO INC
6900 SW HAINES ST 2340 SE CLATSOP
TIGARD, OR 97223 PORTLAND, OR 97202
Phone: 684-3300 Phone: 234-9651
Reg #: LIC 00596
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Fire Alarm Insp
FIRE GEO 11/19/199 Final Inspection$86.60 99-319807
PRMT GEO 11/19/199E $216.50 99-319807
5PCT^—GEO 11/19/199E $17.32 99-319807 -- ORIGINAL
Total $320.42.
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 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
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987.
Pennitee 1 I�
Signature: 'a11
1 � (
Issued By: ,�C'l LL1v
Call 639-4175 by 7 p.m. for an inspection the next business day
Fire Protection Permit Application
CITY OF TIGARD Plan Chec
Commercial or Residential RecdBy
3125 SW HALL BLVD. Date Recd
-
I-IGARD, OR 97223 Print or Type Date to P E.
,503) 639-4171 Ext. 304 Incomplete or illegible applications will not be accepted Date to DST-,
Permit#
Called _ �� 'IfA
Name of DevelopmenVProiect Type of System (Complete A or Q as applicable)
Job (JCA ai Alki
Address Ad ress ) ��� A.)Sprinkler Wet Dry El
Name Standpipes
X11<�C1GN �rft.r�.4Ti .J�L S j n _
Owner Marling Address Hazard Group _
�AM e) Sf
Additional
City/State Zip Ph�tne n oimDensity
Y
J230 d
Na e qk) Design Area
Factor
Occupant Mailing Address K.
City/State zip Phone - A.1) Sprinkler Project Valuation $
COT Business Tax or Metro# Exp Date B.) Fire Aldrm
Contractor Name, Submittal Shall Include Battery Calculations _ YES —
---
(Sprinklercr (!55__L
. 0- RI�,,Z,��r — Individual Component YES
M
Alarm Company) ailing Address _ Cut Sheets
(Prior to peit Cf�e +�
�ssuence app6c ll itylState Zip Phone Fl,1) Fire Alarm Project Valuation $
i•y
must prowde all 1Gt i
�;(ZITIA00 (AIL q?ZUL Project Valuation Subtotal (A & a B) $ �i
contrnators incense tate Const. Cont. Board Lic.# Exp. Date _-
rntormar.on for
�)r6- on valuation Permit fee based $
COT dntsbasel. COT Business Tax or Metro# Exp.Date
_ (see chart on back) .
NaSurcharge $ 17,:51%
16LtLO
Architect Mailing Address — ,_FLS Plan Review 40% of Permit
-- ----- -- - y
CitylState Zip Phone TOTAL 4 $ .� 7 n'
Describe work A.)New O Addition O Alteration O Repair O Plans required Submit three sets of plans, including a vicinity map and
to be done the location of the nearest hydrant
B.) Basement O HoodNent O Spray Booth 0
Complete O Partial O Exitway O _
1 hereby acknowledge that I have read'rn:application that the information given is__
Additional Description of Work correct.that I am the owner or author:ed agent of the owner,and that plans submitted
are in compliance with Oregon State la ws
---------- Signal. ouFd f OwnerlAgent Date
A.)In Existing Building pT New Budding E /
Building _ `f�
Data B.) Commercial Residential Cod ct Person Name Phoqe
L_J-)C'6Z,e;-_ /,,;-Y _ �'fz��'�� A /Oi:�
FOR OFFICE USE ONLY:
No of stories
i L Plat# ---�-'— MaplrL#: _
Sq. Ft
— Or_cupancy=IassT�p_e of CoAstruction Notes ryt N y
w�c( ,.r
I\rIRESUPR DOC (DST) 8195 l
CITY F T1
BQIILDING PERMIT FEES
TOTAL
STATE BUILDING
VALUATION OF PERMIT F.L.S. TAX PERMIT
PROJECT FEES (40%) (5%) FEES
1-1500 25.00 10.00 1.25 36.25
1,501-1600 26.50 10.60 1.33 3843
1,601-1,700 2300 11.20 1.40 40.60
1,701-1,800 29.50 11.80 1.48 42.78
1,801-1,900 31.00 12.40 1.55 44.95
1,901-2,000 32.50 13.00 1.63 47.13
2,001-3,000 38.50 15.40 1.93 55.83
3,001-4,000 44.50 17.80 2.23 64.53
4,001-5,000 50.50 20.20 2.53 73.23
5,001-6,000 56.50 2.2.60 2.83 81.93
6,001-7,000 62.50 25.00 3.13 9063
7,001-8,000 08.50 27.40 3.43 99.33
8,001-9,000 74.50 29.80 3.73 108.03
9,001-10,000 60.50 32.20 4.03 116.73
10,001-11,000 86.50 34.60 4.33 125.43
11,001-12,000 92.50 37.00 463 134.13
12,001-13,000 98.50 39.40 4.93 142.83
13,001-14,000 104.50 41.80 5.23 151.53
14,001-15,000 110.50 44.20 5.53 160.23
15,001-16,000 116.50 46.60 5.83 168.93
16,001-17,000 12250 49.00 6.13 177.63
17,001-18,000 128.50 51.40 6.43 186.33
18,001-19,000 134.50 53.80 6.73 195.73
19,001-20,000 140.50 56.20 7.03 203.73
20,001-2.1,000 146.50 58.60 7.33 212.43
21,001-22,000 15250 61.00 7.63 22.1.13
22, 01-23,000 158.50 63.40 7.93 229.83
23,001-24,000 16450 65.80 8.23 238.53
24,001-25,000 17050 68.20 8.53 247.23
25,001-26,000 175.00 70.00 8.75 253.75
26,001-27,000 17950 71.80 8.98 260.28
27,001-28,000 184.00 73.60 9.20 266.80
2.8,001-29,000 188.50 75.40 9.43 2.73.33
29,001-30,000 193.00 77.20 9.65 279.85
30,001-31,000 197.50 79.00 9.88 286.38
31,001-32,000 202.00 80.80 10.10 292.90
32,001-33,000 2.06.50 82.60 10.33 29943
33,001-34,000 211.00 8440 10.55 305.95
34,001-35,000 215.50 86.20 10.78 312.48
35,001-36,000 220.00 88.00 1100 319.00
36,001-37,000 22450 89.80 11 23 325.53
37.001-38,000 229.00 91.60 11.45 332 05
I +FIRESUPR DOC (DST) 8196
H-113
CPX-751 and SDX-751
�J N GTI F1 E R® Low-Profile Intelligent
A Pittway Company Plug-in Smoke Detectors
Section: IntelligenVAddressable Devic^s August 21, 1997
u
GENERAL t ,�� California State Fire
The NOTIFIER SOX-75' (photo) and CPX-751 (ion) are a � ,+��
Marshal
analog, addressable, low-profile (height measures only 7272-0028:171
1.66") smoke detectors designed for the AM2020, S1115 CS308 (CPX-751)
AFP1010,AFP-400,AFF'-300,AFP-200,and System 5000 (SDX-751A,CPX-751A) 7272-0028:172
(when equipped with an AIM-200 module). n A CG� 328-94•E (CPX-551. (SOX-751)
Because the SDX-'751 and CPX••751 are addressable, the 1 V 1 SDX-551, &B71OLP)
control panel can provide fire fighters with a pinpoint de-
427-91-E (8501, B501BH)
scription of where the fire is located. The SDX-751 and BASES separately listed.
CPX-751 are also analog devices. The control panel is Contact factory. F iM
capable of not only knowing,he detector's location but ex- Optional SMOKE GUARD is
actly how much smoke is in the chamber of the detector. UL listed with the SDX-751. OX5A5.AY
The detector may be sit for different sensitivity settings
appropriate to the environment of its location.
Analog devices continually send obscuration values to the '
control panel. These values may be gathered so as to '4t
allow the control panel to determine if a detector has accu-
mulated an excessive amount of dirt or dust. A "mainte-
nance" required indication allows the installer to clean the
smoke detector before an unwanted false alarm occurs.!
The CPX-751 Intelligent Ionization Sensor incorporates a
unique single-source chamfer design to respond quickly
and dependably to a broad range of fires.
The SDX-751 Intelligent Photoelectric Sensor's unique op- SDX-751 with WIMP base
tical sensing chamber i; designed with superior signal to
noise ratio. The optical chamber is engineered to sensor- ---
the presence of smoke produced by a wide range of com-
bustion
om bustion sources.
FEATURES
• Sleek, low-profile design (height only 1.66 inches).
• Common base for both photo and ion detectors.
• Compatible with current SDX-551 and GPX-551.
• Addressable-analog communication. SDX-751 with 8501 base
• Stable communication technique with noise immunity.
• Low standby current. SPECIFICATIONS
• Rotary decade 01 to 99 address switches. Size: 1.66" (42.164 mm)high x 4.1" (104.140 mm)dia.
• Optional remote, single-gang LED accessory (RA40OZ.). Shipping woight: 3.6 oz. (104 g).
• Dual LED design provides 360° viewing angle. Operating temperature: 0°C to 49"C (32"F to 120°F).
• Visible LEDs blink every time the detector is addressed, Ul_listed velocity range: ION: 0-1500 fpm. PHOTO: 0
and illuminate steady on alarm(LED blink is optional on - 4000 fpm
the AM2020, AFP1010, AFP-400, AFP-300 and AFP- Relative humidity: 100%-93% non-condensing
200). ELECTRICAL SPECIFICATIONS:
• Built-in functions!test switch activated by external mag- Voltage range: 15- 32 volts DC peak.
net. Standby current ION: 200 pA @ 24 VDC(without com-
• Optional relay, isolator, or sounder bases. munication); 300 pA @ 24 VDC (one communication ev-
• Listed 13 UL 268 ery 5 seconds with LED enabled).
t This dor ument is not intended to be used for installation purposes We try to keep our
produr-t information up-to-date and accurate We rannol cover all specific applications or ISO-910I s
an'icipa.e all requirements All specifications ars subject to change without notice. For Engineering and Macafactunng
more information,contact NOTIFIER. Phone (203)484-7161 FAX, (203)484-7118 Quality System Certified to
N OTI FI E R• 12 Clintonville Road.Northford,Connecticut 06472 International Standard 1S0-9001 Made In the U s A
DN-4762 --- Pape 1 Of:
Standby current—PHOTO: 230 pA @ 24 VDC(without ORDERING INFORMATION
communication); 330 pA @ 24 VDC (one communication Model Description
every F seconds with LED enabled).
LED current(max.): 6.5 mA @ 24 VDC ("ON"). CPX-751' Low-profile intelligent ionization sensor. Must
he mounted to one of the bases listed below.
BASES AVAILABLE: SDX-751' Low-profile intelligent photoelectronlc sensor.
B71OLP: 6.2" (157.48 mm)diameter. Must be mounted to one of the bases listed be-
B501: 4.0" (101.6 rem)diameter. low.
B501BH: Sounder base assembly. Includes B501 base. BASIS:
8224RB Relay Base: Screw terminals: up to 14 AWG. B71OLP Standard U.S. Low-Profile base.
Relay type: Form-C. Rating: 2.0 A @ 30 VDC resistive; 8501 Standard European ftangPless base.
0.3 A Cu> 110 VDC, inductive, 1.0 A @ 30 VDC inductive. B501 BH Sounder base, includes B501 base above.
Dimensions: 6.2" (157.48 mm)x 1.2"(30.48 mm).
B524BI Isolator Base: Dimensions: 6.2"(157.48 mm)x B224RB Intelligent relay base.
1.7."(30.48 mm) Maximum: 25 devices between isolator B224BI Intelligent isolator base. Isola'- 5'_C:from loop
bases. shorts.
ACCESSORIES:
INSTALLATIONSDG-7 13 Smoke Detector Guard. For use with SDX-
The CPX-751 and SGA-''51 plug-ill detectors use a sepa- 751 only.
rate base to simplify installation,service,and maintenance. F110 Retrofit replacement flange for B501 B base.
A special tool allows maintenance personnel to plug in and
remove detectors without using a ladder. RA400Z"" Remote LED annunciator. 3 -- 32 VDC. Fits
Mount base on a box wh ch is at least 1.5"deep. Suitable U.S. single-gang electrical box.
mounting base boxes include: MOD40OR Detector sensitivity test tool. Use with most
analog or digital multimeters. Satisfies require-
3-1/2"
equire-
4-inch square box. ment of NFPA 72 for sensitivity testing.
• 3 1/2"or 4"octagonal box. SMK400 Surface mounting kit provides for entry of stir-
Single-gang box (except relay or isolator base). face wiring conduit. For use with 8501 base
SMOKE GUARD only.
Cover: 16 gauge perforated steel(3/16"(4.7625 mm)dia. M02-04-01 Test magnet.
perforations on 1/4" (6.35 mrn) staggered centers). 51% XR-2 Detector removal tool. Allows installation and/
open. SDG-773 is 3" (76.2 mm)deep by 7"(177.8)wide. or removal of 700 Series detector heads from
Frame: 3/4"x 3/4"angle, 14 gauge solid steel. base in high ceiling installations.
XP-4 Extension pole for XR-2. Comes in three five-
All guards are supplied with the following: foot sections.
1) Guards fasten to mounting frame with No. 10/24 x 3/8" *Order suffix "A"for Canadian(ULC)approved devices
long Allen-head screws (10/24 spanner-head screws and .-Supported by 871OLP and 8501 bases only,
tool option at extra cost).
2) Standard finish: "Cool Tan" baked enamel. REMOTE ANNUNCIATOR
OPTIONAL
SDG-773 Smoke Guard -------
I
1 '
I
Listed /
cum"fible
CONTROL 3 / 3 2 1
PANEL ( 1
1
'rr• \ I 1
I 1
I
1
1
1
V I
I I
_--------------
----------------OPTTORETURNLOOP
------------------
7-
..................
-----------
iI
'•
--•----•••-••.... ....................•-•---
♦
y� WIRING DIAGRAM
(standard ba_saJ
3-
MODEL No MOUNTING DIAGRAM
SDG-773 ' �SDCs-T1sJ
Pqp 2 of 2 — DN-4762
r
ENGINEERING SPECIFICATIONS Horn/Strobe Combination—Horn/strobe shall bea
Geacrai—SpectrAlert horns,strobes and horn/strobes shall System Sensor SpectrAlert model listed to UL 1971
be capable of mounting to a standard 4"x 4"x 1-1/2"backbox or and UL 464 and shall be approved for fire protective service,
a single-gang 2"x 4"x 1-1/2"backbox using the universal mount- Horn/strobe shall be wired as a primary signaling notification ap-
ing plate included with each SpectrAlert product. Also, pliance and comply with the Americans with Disabilities Act re-
SpectrAlert products,when used in conjunction with the acces- quirements for visible signaling appliances,flashing at 1 Hz over
sory Sync-Circuit Module,shall be powered from a non-coded its entire operating voltage range. The strobe iigi t shall consist
power supply and shall operate on 12 or 24 volts. 12-volt rated cf a xenon flash tube and associated lens/reflector system. The
devices shall have an operating voltage range of 10.5-17 volts. horn shall have two tone options,two audibility options(at 24
24-volt rated devices shall have an operating voltage range of 20 volts)and the option to switch between a temporal 3 pattern and
-30 volts. SpectrAlert products shall have an operating tempera- a non-temporal continuous pattern. Strobes shall be powered
lure of 32'F to 120°F and operate from a regulated DC or full- independently of the sounder with the removal of factory-installed
wave rectified,unfiltered power supply, jumper wires. The hom on hom/strobe models shall operate on a
Horn— Horn shall be a System Sensor SpectrAlert model coded or non-coded power supply.
__capable of operating at 12 and 24 volts. !-tom shall be Module—Module shall be a System Sensor Sync-Circuit model
listed to UL 464 for fire protective signaling systems. The horn listed to UL.464 and shall be approved for fire protec-
shall have two tone options,two audibility options(at 24 volts) tive service. ThP module shall synchronize SpectrAlert strobes
and the option to switch between a remporal 3 pattern and a non- at 1 Hz and horns at+emporal 3. Also,the module shall silence
temporal continuous pattern. The hom-only model shall 140T )p- the horns on horn/strobe models,while operating the strobes,
erate on a coded power supply, over a single pair of wires. The module shall be capable of mount-
ing to a 4-11/16"x 4-11/16"x 2-1/8"backbox and shall control
Strobe—Strobe shall be a System Sensor SpectrAlert model two Style Y(class 6)or one Style Z(class A)circ.it. Module
listed to UL 1971 and be approved for fire protective shall be capable of multiple zone synchronization by daisy-chain-
service. The strobe shall be wired as a primary signaling notifi- ing multiple modules together and resynchronizing each other
cation appliance and comply with the Americans with Disabilities along the chain. The Module shall NOT opera!e on a coded power
Act requirements for visible signaling appliances,flashing at 1 Hz supply. (Sync-Circuit Module available July,1997.)
over the strobe's entire ope,ating voltage range. The strobe light
shall consist of a xenon flash tube and associated lens/reflector
system. 2.15/15' -+' 15116'
(74.6125 mm) (23.8125 mm)f• l
DIMENSIONS — —
00
3-318' --
(85 725 mm) 5.5/16•
(134.9375 mm)
5 518' J
(142.875 mm) L!
1.5116"
(33.3375 mm)'
UPPER LEFT: Hom!Ftrobe with Small Footprint Mounting Plate
(same dimensions fo-strobe only).
14- 2.5116• LOWER LEFT: Ham/Strobe with Universal Mounting Plate(same
(58 7375 mm) dimensions for strobe only).
UPPER RIGHT: Horn only.
LOWER RIGHT: Synr-Cirouit Module.
2-15116-
74.6125 mm)� 2'
)I
-C- — --- --- 5-1/4"(133 35 mm) (50.8 mm
�
o —
OUTER: 5.518' o p
(142.875 mm)
INNER: 5-5116' 5.114'
(134 9375 inn,) (133 35 mm)
O n
--
1 5'
( 27 (58 7375 mm)
mm) l�- 2-5116" ----- -._ _—.
DN-5939 — Page 3 of 6
MOUNTING DIAGRAMS 4"(101.6 mm) Horn Surface Mount
backbox BBS with accessory
,„amu
Backbox Skirt
�a
2"(50.8 mm) _ ®
backbox
Horn Direct Mount
D-MP Horn with Universal Mounting Plate
(included with each product)
O O mri ♦ 2"(50.8 mm)
backbox S-MP
Strobe or Horn!Strobe with - 1
Ov Universal Mounting Plate l
O QO (included with each product)
Strobe or Horn/Strobe
�1 with accessory
\ Small Footprint
° o
o Mounting Plate
4-11/16'x 4-11116"x 2-1/C" /
(119.0625 x 119.0625 x 53.975 mm)
backbox
v �
Strobe or Horn/Strobe Surface Mount
SyncrCircuit Module Direct Mount with accessory Backbox Skirt
SOUND OUTPUT GUIDE (dBA)
UL Reverberant Room dBA @ Volts DC Anechoic Room Peak dBA @ 10 ft.NDC
10.5 12 17 20 24 1 30 10.51 12 1 17 20 24 30
LOW Electromechanical NA NA NA 75 75 79 NA NA NA 94 96 98
TONE 3000 Hz Interrupted NA NA NA .5 79 79 NA NA NA 94 96 98
Temporal
HIGH Electromechanical 75 75 79 82 82 82 94 1 95 98 100 101 102
TOIJE 3000 It Interrupted 75 75 79 82 b5 85 94 1 95 98 100 1 101 102
LOW Electromechanical NA NA NA 79 82 85 NA NA NA 94 96 98
TONE 3000 It InterrLpted NA NA NA 82 82 85 NA NA NA 94 96 98
Temporal HIGH Electromechanical 79 79 85 85 88 88 94 95 98 100 101 102
Tem
TONE 3000 tt Ii 82 85 88 88 90 93 95 98 100 101 102
Page 4,)16 — DN-5939
October 1, 1997 J-89A
ONOTIFIER" MDL & MDLW Sync Modules
f
A Pittway Company o use with the SpectrAlert Series
Section: AudiorViisual Appliances
GENERAL
System Sensor's MDt- Sync Module is designed to work �� M
with the SpectrAlert series of horns, strobes, and horn/ a
strobes to provide a means of: synchronizing the tempo-
ral-coded horns, synchronizing the one-second flash tim- S4011 ONA7
ing of the strobe,and silencing the horns of the horn/strobe
combination over a two-wire circuit while leaving the strobes
active.
MODULE CONFIGURATION
Each MDL module has the capability of connecting two
Style Y (Class B)circuits or one Style Z (Class A)circuit.
The NAC output(s) from the panel are connected to the
zone inputs of the MDL mcdule and the zone output(s)from
the MDL module are connected to the notification loop(s). �,-
Supervision is accomplished in the module by a direct KR
connection between the zone input and the zone output of
each of the two zone circuits connected to the normal end-
of-line device. The FACP "sees"the EOL device through
the MDL module. When either or both outputs(zones 1 &
2)from the module are wired to the SpectrAlert products,
the horns and strobes in both zones will be synchronized.
The MDL module can be configured so that more than two
zones can be synchronized by the interconnection of the
slave input and output (see Application Examples).
SPECIAL CONSIDERATIONS
A latching Form-C contact is provided in case the synchro-
nizing signal to the notification devices is interrupted. The
output can be wired so that a trouble signal will be annun-
ciated at the panel. If the synchronization pulse fails In the
MDL module, the strobes will shut off.
NOTE: The MDL Module is factory-set with the trouble ,ontacts
in the open state. These contacts may close during shipping.
Approximately two seconds off�r power-up, timer .ontacts will
open. The MDL Modu1R
SPECIFICATIONS
Voltage range: DC or full-wave-rectified; 11 to 30 volts.
NOTE: Supply voltage range at 12 volts, 11 to 17 VDC;at 24
volts, 21 to 30 VDC.
Maximum load on lour 3 amps. Average Peak In-Rush
Current: chart at right. Voftage
Operating temperature: 0°C to 49'C DC FWR DC FWR DC FWR
(32°F to 120°F). 12 V 10 mA 12 mA 30 mA 31 mA 87 mA 122 mA
24 V 11 mA 15 mA 35 mA 37 mA 198 mA 262 mA
This document is not intended to be used for installation purposes We try to keep our
prcduct mfonnafion up-to-date and accurate We cannot cover ill specific applications or ISO-9t)01
anbripate all requirements All specifications ere subject to change without notice For Engineering ani Manutactunng
mn/r�r inlnrrnation,contact NOTIFIER. Phone (203)484-7161 FAX (203)484-7118 Quality System Certified to
1 J N OTI FI E 1111V 12 Clintonville Rood,Northford Connecticut 06472 Intemational Standard ISO-9001 Msae In the Us a
ON-6066 — Page 1 of 4
APPLICATION EXAMPLES MODULE_ 1
Temporal Coding on
Multi-Alert and PA400 , ACP O1 HORN ZONE1 f,lj �---->
J CONTROL OUT l`
(Non-SpectrAlert Horns) FACP �Multi-Alert TO NEXT
IILor PAQ0 DEVICE
• Program module to provide temporal coding -- oHom ONLY OR EOL
�. ZONE t
ZONE 2 ,.,
by inserting jumper plug per instructions. MAC 1 IN OUT �'
• Connect only sounders producing a continu•
ous tone to the module zone output(s). O
NAC 2 A
ZONE:2 TROUBLE
OCAur 0 IN {o DMulfi-Alert TO NEXT
orPA4DOStrobes cannot be used on a module pro- NL DEVISE
viding temporal coding to horns! Strobes oo NLY OR EOL
i., SLAVE SLAVE �.+
must be wired for Independent operation. O IN . • OUT O Homs will be temporal-coded
NOTE: Temporal jurnper should be inserted across _ —- - and in sync.
both pins only on non-SpectrAlert products that are TEMP.JUMPER ON
to be powered for temporal sound output.
Synchronize SpectrAlert Horns and Strobes
ZONE 1 INPUT This input powers the MDL Module. This input must have voltage present from the
FACP before anything will work. This also supplies voltage to Zone 1 output.
ZONE 2 INPUT This input only supplies voltage to 7bne 2 output. NOTE: If Zone 1 input is not
powered,the notification devices attached to the Zone 2 output Nill not be allonod.
HORN CONTROL This input enables the horns on the SpectrAlert notification appliances. Voltage
present means hams are enabled. No voltage present means tx ms are disabled.
SLAVE IN Connects to Master MDL Module slave out.
SLAVE OUT Connects to Slave MDL slave in
MODULE 1 Synchronize SpectrAlert
Horns and Strobes
HORN 70NE 1 f,.i (+) > Each module can power two
FACP CONTROL OUT b TO NEXT three-amp circuits wired in
DEVICE Class B, or one three-amp
ZOOR EOL
NAC 1
NE t ZONE 2 f,.� circuit powered as Class A.
IN OUT ' (,) _. • Each module will synchronize
2 CLASS B two zones.
,.� ZONE 2 ` (+) > Additional modules can be
NAC 2 ,., IN TROUBLE
o TO NEXT added and may be synchro-
DEVICE nized to all other modules by
,01 OR EOL interconnecting the "slave'
SLAVE SLAVE f,'
o IN OUT1`' (_)� _, input and output termin is
between modules.
ALL SpectrAlert homs,
hon✓stmbes,and strobe-only
devices will operate In sync.
- \ TEMP JUMPER.OFF
Configured as: ,,l HORN ZONE 1 f,., (q ---- -
Style 7-Gass A ' CONTROL OUT
TO NEXT
DEVICE
N��3 OUT(+) ,.1 ZONE t ZONE 2{0—,. OR EOL
OUT O '''JrIN OUT t
O
1 CLASS A
RETURN(+) (O ♦ -- --
NAC 4 i i ZONE 2 TPOUBLE(1:i
RETURN O , IN O TO NEXT
-- -- DEVICE
SLAVE SIAVE f' OR EOL
' IN - - OUTI ()
MODULE 2 — ---�-�-u1 ----`--- NOTE: Class A configuration
TEMP.JUMPER OFF requires a special panel
Consult with panel manufacturer
Page 2 of 4 - DN 6066
CITY OF TIGARD BUILDING PERMIT
I� AH � PERMIT#: BUP1999-00265
DEVELOPMENT SERVICES ATE ISSUED: 7/16/99
13125 SW Hall Blvd..Tioard. OR 97223 (503) 639-4171 PARCEL: 1S136DA-02301
SITE ADDRESS: 06900 SW HAINES ST BLDG2
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
REISSUE: _ FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP FIRST: 6.000 sf N: S: E: W:
TYPE OF USE: COM SECOND: 6.000 sf PROJECT OPENINGS? _
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 2 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:N
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: * JAG7010vo
Remarks: Fire refurbishment. - No C of 0 required - No change in occupant load
Owner: Contractor:
OREGON EDUCATION ASSOCIATION COOPER CONSTRUCT;ON CO
6900 SW HAINES ST 2305 SE 9TH
TIGARD, OR 97223 PORTLAND, OR 97412
Phone: 684-3300 Phone: 232-3121
Reg#: LIC 0';008587
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PLCK DEB 6/22./99 $1,337.70 99-316333 Electrical Permit Required
Sprinkler Permit Required
FIRE DEB 6/22199 $823.00 99-316333 Plumping Permit Required
CDCB GEO 7/16/99 $125.00 99.316927 Plumb Top Out
CDCP GEO 7/16/99 $125.00 99.316927 Framing Insp
Insulation Insp
(additional fees not listed here) Gyp Board Insp
Total — Susp Ceiing Insp
$4,9 54.80 Final Ins 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 permit will expire if work is
not started within 180 days of issuance, or if worts 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) 246-1987.
Permitee h
Signature: [ -
Issued By:
Call 639-417,5'by 7 p.m. for an inspection the next business day
CITY OF TIOARD Commercial Building Permit Application Re( d By �
t Date Recd ^� �_/
13125 Sfi HALL BLVD. Tenant Improvement Dale to P E -
TIGARD, OR 97223 Date to DST 1—
(503) 639-4171 Permit
Print or Type Related SWR#
Incomplete or illegible applications will not be accepted Calledj�'/�:7ff� -
Name of Develo ment/PrYect -' - _ Existing Building ew NBuilding 0
Job Oregon Education Assoc.
_Fire Refurbis
Address Street Address Suite Building
900 SW Haines St. -- Data _ _
Bog#Ur City/State -Zip Existing Use of Building or Property
i�
Tard, OR 97223, g Business
-- -- Name- --Property Oregon Education Assoc. Proposed Use of Building or Property:
p KY _
Owner Mailing Address—-- Suite -- Same
6900 SW Haines St. _ No Of Stories: 2
City/State Zip — Phone
Tigard, OR 97223 684-3300 Sq. Ft. Of Project
�—_ 12 ,000
Occupant Name
Oregon Education Assoc. Occupancy Classes) B
Name
Contramtor Cooper Construction Ca. Type(s) ofConstructlon V-N
Prior to permit Mailing Address Suite _
Issuance,a copy 2305 ;E lith Ave. ---- Will this project have a Fire Suppression System?
of all licenses Yes { No E
are required if City/Slate Zip Phone --
expired In C.O 7Po t land Americans with Disabilities Act(ADA)
database , OR 9 7 21 2 3 2-3121 Valuation X 25% = $ 18 7 . 5 K Participation
Oregon Const Cont Board Lic# Exp Date Complete Accessibility Form
088587 7/1/99 Project $ _
-� Mame Valuation 750 ,000
Architect GBD Architect-q-,--. , - Plans Required. See Matrix for number of sets to submit
Mailing Address Suite - on back
920 SW 3rd 4000
----- -- — --
City/State — Zip Phone I hereby acknowledge that I have read this application,that the information
Port 1 a nd, OR 9 72 0 224-9656 given is correct,that I am the owner or authorized agent of the owner,and
_ —_—_—
Engineer Name that plans submitted are in compliance with Oregon State Laws
——
SigDoom o Owner//Agent Date
Mailing Address Suite
Pe�8n1.itea�h — Phone
City/Shite Zip -- Phone GBD Architects 224-9656
- --- - --� FOR OFFICE USE ONLY
Indicate type of work New O Addition O Demolition O MaprTL# Land Use:
Accessory Structure n Foundation Only O Alteration O
_ RepajDCR Other O Notes —
Uoscrlpllon of work:
Fire Refurbishment TIF tb2 o I
'Curl- Lti 1
Note. Site Work Permit Application must precede or accompany Building
re s v
Permit Application
I\COMNEWTI DOC (DST) 5198
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
V__A_L__U_ATION_ of all renovation, alteration or modification being done 750 ,000
excluding painting, wallpapering (11 $
multiply: 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2] $ _18 7 ,0 0 0
In choosing which accessible elements to provide under this section, priority shall be given to those
elements that will provide the greatest access Elements shall be provided in the following order
(a) Parking $ ----- 750 ----
(b) An accessible entrance $ -0-
(c) An accessible route to the altered area $ 17 ,750
(d) At least one accessibie restroom for $_ 33 ,500
each sex or a single unisex restroom
(e) Accessible telephones $ 4-0-
(f) Accessible drinking fountains and $ 4 ,700
(g) When possible, additional accessible
elements such as storage and alarms $ _ -0
g �P s
TOTAL: Shall equal line 2 of Value Co utatfon_ $ 56 ,700
I i t„rms`,ncccss doc
' BUILDING PERMIT
CITY OF TIGARD
PERMIT#: BUP1999-00411
DEVELOPMENT SERVICES DATE ISSUED: 09/23/1999
nl�Ilk 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136DA-02301
SITE ADDRESS: 06900 SW HAINES ST BLDG2
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION _
CLASS OF WORK: ALT FIRST: 4,280 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: 24 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 49,500.00
Remarks: Tenant improvement- Oregon Medical Evaluation
Owner: Contractor:
OREGON EDUCATION ASSOCIATION COOPER CONSTRUCTION CO
6900 SW HAINES 2305 SE 9TH
TIGARD, OR 97223 PORTLAND, OR 97412
Phone: Phone: 232-3121
Reg#: uc 00008587
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT BON 09/23/1995 $431.50 99-318575 Gyp Board Insp
5PCT BON 09/2311995 $30.21 99-318575 Final Inspection
FIRE BON 09/23/1995 $172.60 99-318575
PLCK BON 09/23/1995 $280.48 99-318575 1 , ' A
Total $914.79
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 wil! 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 snore 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
952-00'1-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-1987.
Pe nn iter -
Signature:
Issued By:
Call 639-4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Application Plan Check 71)('
\13125 SW HALL_ BLVD. Tenant Improvement Recd By
TIGARD, OR 97223 Date Recd
(503) 639-417'1 Date to DST A !�
Print or Type V Pemdt# )
Related SWR#
Incomplete or illegible applications will not be accepted called
Name of Development/Project Existing Building P( New Building Li,
Job } eq tr
Address Ttreet AdWess Suite Building
s H Data
'Bldg# City/State Zip Existing Use of Building or Property:
Q
Name C 3 e
Property ^d� � Proposed Use of Building or Property:
Cwner Mailing dress Suite Q
c S No. Of Stories:
City/State Zip Phone
7� cls Sq. Ft. Of Project:
Occupant 4T me _ }
G A (u 11c Occupancy Class(es)
Na B
Contractor rM-4Rpey*1
)of Construction
Prior to permit Mailing Address n� Suite 6 <QYr `
issuance,a copy 17 Will this project have a Fire Suppression System?
of all licenses Yes No EJ
are required if CllylStale Zip Phone
expired in C O T Americans with Disabilities Act(ADA)
database Valuation X25% = $ Participation
Oregon Const,Cont Board Llc.# Exp.Dale Complete Accessibilityity o
_ Project - $ L 0 a,C,
Namee Valuation
Architect Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
` -SU) 3� 1100o
RtylState Zip Phone I hereby acknowledge that I Crave read this application,that the information
_ 9fven is correct,that I am the owner or authorized agent of the owner,and
Engineer
that plans submitted are in compliance with Oregon Sta',3 Laws.
Si natureOwn r/A nt Date
Malling Address SuitetMIT _ -. ]3--'5` C
Contact Person Name Phone vc�-'-9`-Y
CftylState lip Phone ; -
FOR OFFICE USE ONLY
Indicate type of work: New O Addition O Demolition O Map/TL# Land Use:
Accessory Structure O roundalion Only O AiterationA
Repair O Other O _— Notes.
Description of work:
TIF 4
Note: Site Work Permit Application must precede or accompany Building
Permit Application
I\COMNEWTI DOC (DST) 5198
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED
application. For an electrical submittal,the application must contain the
signature of ths- aupervising 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)
Total# of
TYPE OF SUBMITTAL Plans KEY:
Submitted
S (Private) 1 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
I E (New, Add, 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
*g & M & P & E(Ait) 3
*B & M & P & E & F(Alt) 3
NOTES:
*Shaded areas designate ALT submittals only.
I\dstsVorms\matrxcom doc 10130198
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISL.1, STATUTE (ORS)447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportiunate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION of all renovation, altera`ion or modification being done
excluding painting, wallpapering. [1)$ 14 9,.�
multiply_ 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2]$ 1TSt
In choosing which accessible eleme its to provide under this section, priority shall be given to those
elements that will provide the greate,-t access. Elements shall be provided in the following order:
(a) Parking $ L/ 0•��
(b) An accessible entrance: $
(c) An accessible route to the altered area: $ 1_&t L/t 4
(d) At least one accessible restroom for $ (z)CC)
each sex or a single unisex restroom:
(e) Accessible telephones- $
(f) Accessible drinking fountains: and $
(g) When possible, additional accessible
elements such as storage and alarms: $
TOTAL; Shall equal line 2 of Value Computation $
i.\dsis\fours\access doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 630-A4171 —
BUP _
—_ Date Requested AM ���,,,/// PM BLD _
Location Suite&I oqfw. MEC
Contact Person Ph r PLM _
Contractor Ph �- y�s � SWR
BUILDING Tenant/Owner ELC 777
1 +
Retaining Wall � ELR �&S-15
_
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Nates: —
Slab — -- SIT
Post& Beam /�
Ext Sheath/Shear 1��� S/r ,✓�q C_Cr R E�7Z A/
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -- --- --- --.---- ----..- -
Roof
Mi s c --- - ----- ------- -
Final
PASS PART FAIL -- - ---- - _— --
PLUMBING
Post& Beam —_---
Under Slab
TopOut ---------.._..�-__----------- ------- --
Water Service
Sanitary Sewer --�___----------------- - — ---------------
Rain Drains
Final --.-_.-
PASS PART FAIL
MECHANICAL
Post& Beam ---- - ----- --- -—--------- - - -----
Rough In
Gas Line - ------- __.�--- ----- -------- -
Smoke Dampers
Fmal - -- -- ----_.- - ---------------- -- ---
p o-�T _FAIL
ervrce
RoughIn -- --- _ ---- -- - ---------____-._ _—..___- -------- -
UG/Slab
Low Voltage VIS
Fire Alarm _--.�_---
Fin '
S ART FML -- ----- -- - -- -- - ---- -- - - ---_-
Backfill/Grading - -- ------.__-__-�_-_-- —_ ---
Sanita,y Sewer
Storm Drain [ ]Reinspection fee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
r'atch Fiasin
Fire Supply Line [ ]Please call for reinspection RE ____. __ - _ [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Date ate I
_ _ — nspector_ _,�� �Fxt
Find
PASS PART_ FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR1999-00196
13125 SW Hall Blvd.,Tioard, OR 97223 (50311639-4171 DATE ISSUED: 8/18/99
SITE ADDRESS: 06900 SW HAINES ST BLDG2 PARCEL: 1S136DA-02301
SUBDIVISION: ZONING: MUE
BLOCK: LUT: 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: FiRF_ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS: 1
Owner: Contractor:
OREGON EDUCATION ASSOCIATION HIBBARD CONTROL WIRING LI-C
6900 SW HAINES ST 1455 N MAPLE ST
TIGARD, OR 97223 CANBY, OR 97013
Phone: 684-3300 Phone: 503-263-2331
Reg#: LIC 1342.02
ELE 3-456C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT DST 8/18/99 $60.00 99-317731 Elect'I Final
5PCT DST 8/18/99 $4.20 99-317731
Total $64.20 ORIGINAL
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 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 direct questions to OUNC at (503)
246-1987. 7t
L
Issued b --1 °�____ Permittee Signaturo�
OWNER INSTALLATION ONLY _
The installation is being made on property ; 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 OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:
13125 SW HALL BLVD Date Rec'd:_
TIGARD OR 97223 PRINT OR TYPE
V - .503-639-4171 X304 Permit#: vcy/y
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
Restricted Energy Fee....................................... $60.00
�('e �•� �e�,wca�/o,,a SStlk�"* (FOR ALL SYSTEMS)
JOB Street Address Ste# Check Type of Work Involved
ADDRESS 61Q0 Sw h'04 1116. /d
—__
City/State ip7��3 P hon6W Audio and Stereo Systems
Name — ❑ Burglar Alarm
OWNER Mailing Address ❑ Garage Door Opener'
City/State 7_lp—� Phone# � 2 Heating,Ventilation and An Conditioning System'
--------- �-- - ❑
Name Vacuum Systems-
� �, frpl G�if/Not �-.�, ❑ Other_ - ----
CONTRACTOR Mailing Address
X, /'ha P(e S r _ _TYPE OF WORK INVOLVED -COP iMERCIAL ONLY
iPrior to issuance a City/State Zip Phone# Fee for each system............................................. $60.OQ
copy of all licenses 0.F,Li O 9�o I «-1.)39 � (SEE OAR 918-260-260)
are required if Ore on ontr Brd Lic #
expired C 0 T u p �p P Check Type of Work Involved
data base) Electrical Contr L c # Exp Date
/ -1. ❑ Audio and Stereo Systems
C 0 T or Metro Lic # Exp Date
❑ Boiler Controls
Owner's Name
Clock Systems
OWNER- Mailing Address
APPLICANT ❑ Data Telecommunication Installation
City/State Zip Phone# ❑
Firs 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. L� Intercom and Paging Systems
These have asterisks(') All others need licensing,
❑ Landscape Irrigation Control'
2 Call for inspections when installation under this permitare ready for
inspection at 503-639-4175; ❑ Medical
3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this permit,
4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspector are done,and,
Protective Siranaling
5 Assume responsibility for calling for a final inspection when all of the
corrections are completed C] Other
Perm-ts 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 this permit must be the appliAnl or p?rson No licenses are required Licenses are required for an other installations
authorized to bind the applicant _.
FEES: r.�------
Signature Ef TER FEES $
V10 SURCHARGE(.05 X TOTAL ABOVE) $
Authority if other than Applicant - TOTAL $
i+dstslforms+resele doc 3,98
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM1999-00232
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/11/99
SITE ADDRESS: 06900 SW HAINES ST BLDG2 PARCEL: 1S136DA-02301
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 3
OCCUPANCY GRP: B FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: 1 GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing TI - building#2.
FEES
Owner: --'
Type By Date Amount Receipt
OREGON EDUCATION ASSOCIATION PRMT DST 8/11/99 $176.50 99-317570
6900 SW HAINES ST 5PCT DST 8/11/99 $12.36 99-317570
TIGARD, OR 97223
Total $188.06
Phone 1:
Contractor:
WATSON PLUMBING CO
7935 E BURNSIDE ST
PORTLAND, OR 97215 REQUIRED INSPECTIONS
Phone 1: 256-3720 Top-out Insp
Re #: LIC 111855 RP/Backflow Preventer
Reg Final Inspection
PLM 26-602PB
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. Ali wofb 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, i'hose 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.
Issued B �
Permittee Signature:
Y � � 1✓ lvizu�__ 9
Call (503) 639-4175 by 7:00 P.M. for an inspection r:eded the next business day
CITY OF TIGARD Plumbing Permit Application Plan Check#
13125 O-W HALL BLVD. Commercial and Residential Recd By C —�
TIGARD, OR 97223 Date Recd ;R_
(503) 639-4171 Dale to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit#Pc M fY-�, - Crz 7-
Related S -7
Called
Name of Development/ProjectFIXTURES (individual) QTY PRICE AMT
Job Ifs �l I /i ((� + 1 Sink _ 11.50
Address ret4AdS�esFl _ 5uite� Lavatory 11.50 %,,ry'
ll.• (( �� Tub or Tub/Shower Comb 11.50
Bldg# Clty/State Zip Shower Only
�� 11.50
Name Water Closet `w 11,50
Dishwasher 11.50
Owner ailt edruss Suite 1 Garbage Disposal 11.50
t (- Washing Machine 11.50
City/State Zip Phone — _
Floor Drain/Floor Sink 2" 11.50
m 3" 1150
C, GN 4" 11.50
Occupant mail' Address Suite
p JJ `, Water Heater O conversion O like kind 11.50
S u-) G r 11\,4 C-� Gas pi ing requires a separate mechanical pormit
,itylState Zip Phone Laundry Room Tray 11.50
— —----- Nam Urinal 1//VIfl O�t I L 11.50
VIA bl I\ Other Fixtures(Specify) 1500
Contractor .....ailing Address Suite (1 L A-LEft 71:9
L> ( V�+✓
S / rJ E
Prior to permit ri�y/State l LL L) •f: LD') (7'
Phone
]�jo / —
issuance,a copy �' )/ u/� ! 7J l S 9 StQ-SV,!�) EX l .S
of all licenses are Oregon Const Cont.P,oard Lic.# Exp.Date - L UC,/'cJ
required if -S -7
expired In COT P m ng Lic xp date
database - - �;
U 3 Sewer-1st 100' 138.00
Name Sewer-each additional 100' 3200
Architect Water Service- 1st 100' 3800
Or Mailing Address Suite Water Service-each additional 200' 3200
Engineer CilylStale Zip Phone Storm 6 Rain Drain-1st 100' 38.00
9�
Storm 8 Rain Drain-each additional 100' 3200
Describe work to be done Mobile Home Space 32.00
New O Repair Replace with like kind Yes No O Commercial Back Flow Prevention Device 32,00
Residential Commercial Residential Backflow Prevention Device
Additional description of work Rid '
"- _Cv 19.00
atch Basin 11 50
_...— Insp.of Existing Plumbing 50.00
Are you capping,moving or replacing any fixtures? _ per/hr
Yes O No O Specially Requested Inspections 5000
If yes,see back of form to ir.r!;cate work performed by per/hr
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain,single family dwelling 45.00
WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50
I hereby acknowledge that I have read this application,that the information QUANTITY TOTAL
given is correct,that I am;he owner or authorised agent of the owner,and
Isometric or riser diagram is required d Quantity Total is >9
that plans submitted are in co pfian .with Oregon State laws --
Si tura of O / ge91
p 'SUBTOTAL ,
SURit J D
�n act Person Name Phone 7% CHARGE
"PLAN REVIEW 27%OF SUBTOTAL
1 BATH HOUSE$1.'18.00 Required only it fixture gly total is>9
2 BATH HOUSE$2.ri0,G- TOTAL
3 BATH HOUSE$286.00
(This fee includes all plumbing ftxture3 in the dwelling and the first
100 feet of unitary sewer storm sewer and water service) Mlnlmum permit fee is$50+7%surcharge,except Residential Backflow Prevention
Uewce which is$25.7%surcharge
Al Naw Commercial Buildings require plans with isometric or riser diagram and
plan review
1%dslsl!ormsiplu,,app doc 719199
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher__
Garbage Disposal
Washing Machine
Floor Drain/Floor Sink 2"
-3„
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I\ds1sk1orrns%p1umapp doc 119199
OA
. ` c umutative Sewer Tallyyy
Tenant Name. 4 ('GC1�t(Y AV*), �� y This SWR#` —_
Address: ![c — This PLM#:
Fixture Value Previous Previous Credits Capped
7Fixturesxtures New total New
# Value Capped off value dded #s total
Count off#s countalue values
Baptisty/Fonl 4 —
Bath- Tub/Shower 4 --_ -- — - -
-JacuzziWiidpool 4 --
Car Wash-Each Stall -
-Drive Through 16 —
Cuspidor/Water Aspirator 1 — — -- ---
_Dishwasher -Commercial 4 ---
_ Domestic 2 _— -- — — —
Drinking -
1-rhe Wash _-- —1 ---- — —
_Floor Drain/sink- 2 inch 2 --� —
3 inch 5.4 inch 6 ---
~— Car Wash Drn 6 _ — --
Garbage Disposal ` 16
Domestic(lo 3/4 IIP) __--- — --
Commercial(to 5 HP) _32 _ ---
Industrial(over 5 HP) 48 ---
Ice Machine/Refrigerator Drains 1 _ -- ----- --
Oil Sep(Gas Station) __— 6
Rec. Vehicle Dump Station _ 16
Shower-Gang(Per Head) 1 _
-Stall 2 ---
Sink - Bar/Lavatory _ 2 _ -
-_
Bradley—_ — 5
Commercial — 3
--_-
Service 3 ---
Swimming Pool Filter 1 —
_Washer-Clothes_
Water Extractor 6 _ —
Water Closet-Toilet 6
Urinal �6 _�— --- -
—
TOTALS (�
Total fixture values: _divided by 16 - ��' EDU ' y`
HISTORY _ _
PLM# I , N EDU# !� SWR# _ PLM# EDU# _ SWR#
PLM# EDU# �_SWR# _PLM# EDU# SWR#
EDU# — SW_R# PLM# EDU# SWR#
PLM#___- --- —- EDU# ----SWR# — -- PLM# —.--- EDU# SWR#
I\dstskswrialy[fou.
CITYOF TI GARD SEWER CONNECTION PERMIT
-} DEVELOPMENT SERVICES PERMIT#: S -00157
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/110/990/99
SITE ADDRESS; 06900 SW HAINES ST BLDG2 PARCEL: 1S136DA-02301
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME: OREGON EDUCATION ASSOCIATIO14
USA NO: FIXTURE UNITS: 20
CLASS Or WORK: ALT DWELLING UNITS: 1
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Plumbing TI - adding fixtures for two new ADA restroorns. Re-installing previously capped urinal.
Owner: FEES
OREGON EDUCATION ASSOCIATION Type By Date Amo,int Receipt
6900 SW HAINES ST
TIGARD, OR 9713 PRMT DEB 8/10/99 $2,300.00 99-317529
Total $2,300.00
Phone:
Contractor:
Phone: OWGNAL
Reg M
Required Inspections
1 his Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from she date issued The total amount paid will be forfeited if the 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 all directions from the distance given If not so located, the installer shall purchase a"Tap and
Side Sewer' Permit and the Agency will install a lateral. 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 direct questions to OUNC by calling (503) 246-1987
� n �
/^ / / — --
Issued hCIt , J Permittee Signature: _
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
D� � BUILDING PERMIT
CITY OF TIGAR
PERMIT#: BUP1999-00489
DEVELOPMENT SERVICES DATE ISSUED: 11/18/1999
13125 SW Hall Blvd..Tioard. OR 97223 (503) 639-4171 PARCEL: 1S136DA-02301
SITE ADDRESS: 06900 SW HAINES ST BLDG2
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: CCM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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 : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 4,600.00
Remarks: Re-roof
Owner: Contractor:
OREGON EDUCATION ASSOCIATION SNYDER ROOFING + SHEET METAL
6900 SW HAINES ST PO BOX 23819
rIGARD, OR 97223 TIGARD, OR 97281
Phone: Phone: 620-5252
Reg #: uc 158
_ FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Misc. Inspection
PRMT BON 11/18/1990 $77.75 99-319869 Final Inspection
5PCT BON 11118/1990 $6.22 99-319869 ORIGINAL
Total $83.97
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 ')e 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 may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-1987.
Pe rm itee
Signature:
Issued By:
Call 639-4175 by 7 p.m. for an inspection the next business day
11./17/99 WED 17: 40 FAX 503 598 1960 CITY OF TIGARD 002
CITY OF TIGARD Plan Check#:
13125 SW HALL BLVD Recd By
TIGARD OR 97223 RE-ROOFING PERMIT APPLICATION Date Recd
V- 503-639-4171 X304 Date to PE.-]ME
F-503-598-1960 Date to DS i':
Permit# �
Incomplete or illegible applications will not be accepted Called.
Name of lDevelopment/Business �' EV�I>RQ,�EIN�sASSEMBL-Y
10 rq �r.Ma 1 t Tifi�'ffljlloJl�U�C' ''e'n fx+,15 ,a; t� -f •;:sem,
r�treW"eld4dre!"st-_ Ste# Please RII out applicable section and attach copy of roofing
Job Site 4W RvN04Zvspe h i
Blda tt -GtyrState Zip s epi setnbly- -:Circle°8>,Camplebe!A;-Wb.CC)_3L;:
A•
Name r 1. Specification# -73II , 95 X75'1
Applicant -MaililigAddress 2. Manufacturer: MA►1V ILLt=_r _
Z a ��A
ty/ tate Zip Phone •3a UL Classification:
Roofing Na e Listed UL Building Materials Directory Page# _
Contractor (OR)
(Prior to issuance ding Address '3b ldamock Hersey
applicant must
provide a copy of 'City/State zip Listed Warnock Hersey Directory Page#
all contractor 'COPY OF ASSEMBL'i REQUIRED
licenses if Pho e# Fax#
expired in COTB. ICBO Research #
database) State Constr.Cortr. Board# •Exp Date
DATED:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
Building - Type Of Use: (circle one) (review required by plans examiner)
SF SFA CCDM MF _
Building - Type of Construction: VALUATION OF PROJECT $L `�
V" I� — _ sq. ft. of roof area
Existing Deck Type: Permit fee based on valuation"
Combustible Non-Combustible ) • see chart on back I S /r 7'�
°I3 DEN 1AL_T4IDNLYiyIiii§b_itly ork,:311Eetatio _ = �VG11St?4o61y WACU "
'� REPAIR (MAJOR) (review required by plans ex er) F"r'($UIC�)
PeLrnit required ONLY when spaced sheat is covered by /
solid sheathing. Changes to roof line . uire Building Permit 8% State Surcharge S C! l
Application. City Use oply,l �� 1N�ACO f _
SUBMIT TWO S OF NS SPECIFYING.
A. Roof area & neares et. 'Required for major repairs of
Residential
B Attic vents - rovide 1 sq. ft. for h 150 sq. ft. of attic or'C" above ' 65% Plan Review S
space,Yks shall be located in the u 1/3 of the roof >✓_ity tit?;Only "i WACO
Prpv�de 1 sq, ft. for each 300 sq. ft when eav ttic ( WFPLNJ'_ .,. _ _ _(Ur3UP(_N
venting is provided
TOTAL $
SIP 1 = ti
AME
RriAL,s' 0�1CY-•'� f��l I acknowledge that I have read this a lication and that the
= was . - PP
Ca§S�3f Wpt kf7epalr �3• � �'T�'a. �`_
information given is correct: th-t I am the owner or authorized
Describe work to be done (check appropriate box) agent of the owner, and that the plans (If applicable) are in
O RE-ROOF (circle A ,8 or C) compliance with Oregon State law.
A. Existing built-up roof covering to be REMOVED and deck I
repaired Signature o er/Tin',
Date
B Existing built-up roof covering to REMAIN: note applicant 1 1 .I
mus' submit an engineer's review of the roof structural �!>�.��r 1.11.•
elements Review shad bear the seal (or stamp) of the
architect or engineer licensed n Oregon. Contact Person Name Telephone
C. or wood Asphalt shingle/shake
p
(PROCEED TO S l EP 2)
dsts\forms`,roof.res.doc
Fr26/99
SLQUOIA k' ANIS
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Sage Green Blend Cedar Blend
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Charcoal Blend Nlesa Brown Blend
lD
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Slate Blend Weathered Wood Blend
It is difficult to reproduce the color clarity and actual color blends of these products.
Before selecting your color, please ask to see several full-size shingles.Nei ill as I
s
a
t
7Cuiranules...have a multifaceted design and light
ction that adds dimension and depth In the shingle ,r/t SpecSelerl Grading Svslem...assures the use of
rotects against damaging sunlight.which improv/ the fines)quality asphalt which will improve
d extends the life of the shingle weathering in harsh conditions.
� t
gator for f"Ceramic. Firing
onge...melntalns the a
Into color of the shingle longer.
FiberTechT"Components...
incorporate fibers that are non.
Dura Grip'"Adhesive...Ira•ks n. �7 _ _ combustible,providing a UL Class A fire rating
the shingles in place nn the roof. — _ Micro Wraver"Core...offers a superior strength
gripping tight er en in strong gale fone winds. foundalnm that resists cracking and splitting
SPECIFICATIONS' 1
�1 7
Grand SeS yuok Rfa(a Storter,Str 54in s Tim6erRIDtGE°Ridy Cop Skala .
1 I
Ill(op Piecet/Bundle 12 Ridge(ap Pieces/Bundb SO
Starter Ship Sheet/Bundle 18 Uneor Ft.Pel Bundle(Ridge(up) 33.3 �.
Linear Ft.Per Bundle(Ridge(ap) 33.3 (Approx.)Nails Per Pc(Ridge(ap) 2
(Approx)Noik Per ter Ill(ap) 2 Exposure B' FATER ,A(
Exposure S' BundleciPallel 24 ROOH NG SYSOTEIM EP,
Bundles/Pager 36 8undks/7rurk 612 is d
Bundle-0rurk 120 Pnllet0rurk 20 ;
Pa0eh/ltwk 70 (Avainble in 8'and 10°widths)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 BusinessLin 39-4171 —
� ql � . BUP
Date Requ stedy (, AM-. PM BLD
Location4>�1G� U��f� �' Suite Oe4 �� MEC _
Contact PersonPh "��J��v���'KIPLM `
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS
Fig Drain SGN
Crawl Drain Drain I s ection Notes: t — —
Slab 5 C Cre-0�-L'Ylt. t 14 -FG CSIT
Post&Beam �i-�- S G_ . c pe-x0-'t-f� 5.6 <[1 ►c�.� --
Fxt Sheath/Shear _
hit Sheath/Shear
F rarring
Insulation
Urywall Nailing
Firewall
Fire Sprinkler
Fire Alarm_
SuspA Ceiling (, - ------- _ -- - ---
---------------------
Roo -
Misc _- - - --------
S ART FAIL --- - -- _"KWB
Post& Beam ---- - -- -- -
Under Slab
Top Out - -
Water Service
Sanitary Sewer - -- - - -- ---- -
Rain Drains I
Final -
PASS PARI FAIT_
MECHANICAL
Post& Beam
Rough In
Gas Line --- - - - __
Srr0e Dampers
SS PART FAIL
E' TRICAL - - -- -- --�__ ---- -
Service
Rough In
UG/Slab
Low Voltage _ --- — --- --�--- ----
Fire Alarm
Final
PASS PART FAIL ------_-_.-.-_---.__---.-_---------.-__ -------- --------SITE
Backfill/Grath,ig -------------- - --_ ---- --
Sanitary Sewer
Storrn Drain ( ] Reinspection fee of g_ , required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ] Pleaae call for reinspection PF _ — r Unable to inspect no acr.esc
ADA
Approach/Sidewalk Date I _ 1 �_
Other _ �� 1 _ Inspector _ Ext
Final �-
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 / ysi�ss Line: 639-4171 1 yy3
BUP
Date Requested CCS AM PM BLD
Location (,, Pe-C I A•-'6 MEC
C,.),-,.tact Person Ph PLM
Contractor Ph SWR _
BUILD! n 'FenanUOwner ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS _
Ftq Drain , C SGN
crawl Drain Inspection Notes
SlabSIT
Post& Beam -
Ext Sheath/Shear C �tz�
Int Sheath/Shear
Framing -- ---------- — —
Insulation
Drywall Nailing —_--
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ------ - -- ---- ---. —�-___
Roof
S PART FAIL ----- ------------- ---- ------
P_ BING
I lost& 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
ELECTRICAL - - - - - - - -- - ------
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm _.._._.. - .
Final
PASS PART FAIL - ---- ---- -- - --------_
SITE - _� ---------- - —. -- — -
Backfdl/Grading -
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection Pay at Citv Hall, 13125 SW Hall Blvd
Catch Basin
F ire Supply L ine [ ; Please call for reinspection RE' _ [ J Linable to inspect no access
ADA `_�l
Approach/Sidewalk
Other _---- Date 710� Inspectcr Ext
_-_
Final _
L PASS PART FAIL. DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD 1 _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC1999-00278
13125 SW Hall Blvd.,Tigard, OR 97223 (5U31 630,4111' DATE ISSUED: 7/15/99PARCEL: 1S136DA-02301
SITE ADDRESS: 06900 SW HAINES ST BLDG2 r4*4 M-
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: REP FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2
OCCUPANCY GRP: B VENTS WIO APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS i HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 15 HP: COMML. INC!N:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 23
FURN >=100K BTU: <= 10000 cfm: 1 GAS OUTLETS:
> 10000 cfm:
Remarks: Mechanical work for fire refurbishment
Owner: _ FEES
OREGON EDUCATION ASSOCIATION Type By Date Amount Receipt
6900 SW HAINES ST PLCK DST 7/15199 $48.38 99-316902
TIGARD, OR 97223 PRMT DST 7!15/99 $193.50 99-316902
5PCT DST 7/15/99 $9.68 99-316902
Phone:684-3300 Total $251.56
Contractor- _
INTERSTATE MECHANICAL INC
2609 SE 6TH AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS _
Mechanical Insp
Phone:233-7171 Mechanical Insp
Reg#:LIC 00055190 Duct Inspection
PLM 26-43PB S.D. Shut-down
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 Notification Center. ThoF- rules 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 by
calling (503)246-9189. � _ 1
Issue By: 11_7 Permittee Signature:
--
Call (503) 39-4175 by 7:00 P.M. for inspections needed the next business day
Plan Ch "
CITY CSF TIGARD Mechanical Permit Application Recd ZY _
13125 SW HALL BLVD. Commercial and Residential DateRec'd /e
TIGARD, OR 97 223 Date to P.E. -
(503) 639-4171, X304 Date to DST
Print or Type Permit# 1 fC ( -ON i 9'
Incomplete or illegible a plications will not be accepted _ c led "�s"'
_ w
Name of Development/Project Description
Oregon Education Assoc. Table 1A Mechanical Code Q Price Amt
Job Street Address Suite p A) Permit Fee 16.00
Address 6900 SW Maines St. 1) Furnace to100,000BTU
—includingducts&vents see footnote 1,2 9.65
Bldva City/state zip 2) Furnace 100,000 BTU+
"I3" I'i ga rd, OR 9722 including ducts R vents see footnote 1,2 12.00
Name(or name of business) 3) Floor Furnace -
Owner Oregon Education Assoc. including vent see footnote 11,2 9.65
Mailing Address 4) Suspended heater,wall heater
or floor mounted heater see footnote 1,2 9.65
6900 SW Haines S t. 5) Vent not included in appliance ermit 475
Chyrstate zipPhone Check all that apply. *Boiler Heat Air
Tigard, OR 97223 For Items 6-10,see or Pump Cond Qty Price Amt
Name(or name of business) footnotes 1.,2 Com
6)<3HP;absorb unit to
Oregon Education Assoc. 100KBTU 0W 9.65
3L.—pant Mailing Address 7)3-15 HP;absorb unit
6900 SW Haines St. 100k to 500k BTU _ _ 17.65
City/State _ Zip I Phone 8) 1530 HP,absorb
P i a r it, OR 97 2 2 3 unit.5-1 mil BTU _ 24.15 -
Name 9)30-50 HP;absorb
contractor unit 1-1 75 mil BTU 36.00
Interstate Mechanical 10)>50HP;absorb unit
Prior to permit Mallinq Address >1.75 mil BTU 60.15 _
issuance,a copy 26!)9 SE 6th Ave. 11 Air handling unit to 10,000 CFM
of all licenses chylstate zzi111/7/99
Ph oqqy _ _ 7,00 N
are required if i'�=L"t l and, OR U 71L S S-7 1 �1 12)Air handling unit 10,000 CFM+
expired in COT Oregon Cost Cont Board Llc p Exp Dale 11.75 _
database__ 55190 13)Non-portable evaporate cooler
Architect Name 7.00
GBD Architects , Inc. 14)Vent fan connected to a single duct ,QCs
or Mailing Address _ S 4.75 1
920 ;W 3rd Ave. 15)Ventilation system not included in
appliance permit 7.00
Engineer CRY/Slate zipPhone 16)Hood served by mechanical exhaust
n ;
PortlaL , OR 97'04 "224-965 _ 7.00
Describe work to be done 17)Domestic incinerators
12.00
New O Repair IN Replace with like kind Yes O No O 18)Commercial or induotrial type incinerator
Residential O Commercial ti 48.25
19)Repair units W
Additional information or description of work 8.40
Vire damage refurbishment 20)Wood stove/gas FP/other units/clothe dryer/etc �3I�
7.00
NOTE. For Commercial projects only,Units over 400 lbs require 21)Gas piping ore to four outlets
_ structural gas talcs See footnote 1 3.75
Type of fuel oil O natural ga*(X LPG O electric O 22)More than 4-per olftlet(eac 75
10
Minimum Permit Fee$50.00 SUATA
1 hereby acknowledge that I h-r:,e read this application,thal the information 5916 Le
z�
given is correct,that i am the owner or a,-1horized agent of PLAN REVIEW 25%Od
the owner,that plans submitted ate in compiiance with Oregon State laws Required for ALL comrnerclaiS n reof ent bate
( �-� 6/21/9 9 Other Inspections and Fees:
1. Inspections outside of normal business hours(mininum charge-two
Contact Person ame phone hours) $50.00 per hour
S t e V e Ebme Yrs r 233-7171 2. Inspections for which no fee Is specifically Indicated (minimum
charge-half hour) $60.00 per hour
Foonotes for commercial prolects only: 3. Additional pian review required by changes,additions or revisions to
L11) Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
Provide drawings to scale showing existing and proposed mecharical
'State Contractor Boiler Certification required
"Residential PJC requires site plan showing placement of unit
I lmechperm doc rev 02/11/99
CITYOF T I G A R DELECTRICAL PERMIT
1 Ir DEVELOPMENT SERVICES DATE ES UIED: 8,20/99 9-00515
13125 SW Hall Blvd., Tipard,OR 97223 (503)639-4171 PARCEL: 1S136DA-02301
SITE ADDRESS: 06900 SW HAINES ST BLDG2
SUBDIVISION: ZONING: MUE
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Add three (3) signal circuits or limited energy panels.
_ RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: 3
MANF HMI SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
- ADD'L INSPECTIONS
0 - 200 amp: W!SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1 st 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.
OREGON EDUCATION ASSOCIATION ADAMS ELECTRIC CO INC
6900 SW HAINES ST 7980 SE 17TH AVE
1 IGARD, OR 97223 PORTLAND, OR 97202
Phone: 684-3300 Phone: 234-9651
Reg#: LIC 00000596
SUP 2056s
ELE ''6-5C
FEES � Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT GEO 8/20199 $180.00 99-317796 Elect'I Final
5PCT GEO 8/20/99 $12.60 99-317796 ORIGINAL
Total $192.60
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 work is not started within 180 days of issuance,or if work is
suspended for more than 180 days ATTENTIO!" 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 direct questions to OUNC at(503)
2146-1987
Permit Signature: `? Ar Issued By:
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: _ �'� _ DA 17 ir aC1 �7
LICENSE NO: ______ — Ow6JG"
Call 639-4175 by 7:00pm for an inspection the next business day
06121 i99 MON 13, 10 FAX 503 598 1960 CITY OR 'I'IGARD 002
Ci-('Y OF TIGARD Electrical Permit Application Plan check*_
13125 SW HALL BLVD. RECTI\/Fn Rec'dBy
TIGARD OR 97223 Date Recd_, _
Phone(503)639-4171, x304 AUG ,� lqr; Date to P F
Date to DST _
Inspection(503)639-4175 Print of Type Permit k E_�a✓�
Fax(503) 508-1960 COMMUNITY OF 61 litpl1lite or illegible will not be accepted called
1. Job Address: n 4. Complete Fee Schedule Below:
Name of Development_ � - 1, G(c�_, Number of Inspections per nnit allowed
Name(or name of business) Service Included: Iterris Cost Sum
Address U:tt'(' S LA-- A ti 4s Residential-per unit
7 Z Z 3 1000 34.11.of less _ $ 117.75 4
City/Statelzip ,��ArCp_ CY � Eich eddlllonal 500 art If or
T� portion thereof $ 26.26 1
Cornmercialo Residential❑ Limited Fnargy _ $ 60.00
Eeeh Manut d Hone of Modular
2a. Contractor installation only: Dwelling Servlca or Feeder $ 72.75 2
(Prior to penTait Issuance,appllca►ts roust provide contractor license 4b.Services or Feeders
Information for COT data eo). 1 Inslanauon.anorallon,or relowoun
Electrical Contractor LL`,.G Aio Tic; 2co amps or less $ 6426 2
Add s J� ((•�'?_� Lr�- 201 amps to 400 amps , $ 65.50 2
__! !.7_ _ 7.__ /� L I _ 401 amps l0 6110 amps $ 126.50 2
City 1;;1;TLAIOQ State _j�,i2- Zip c7 1).D 2 601 amps to 1000 amps -��$ 19250 _ - 2
Phone No. ! �.! Over 1000 amps or voila $ 363.15 __ 2
Job No. i�Lrf f{ Reconnect only J`$ 53.50 2.
Elec.Cont. Lice. No._ �-Exp.Date It) I 4c.Temporary services or Feeder
OR State CCR Hag No. _ Exp.Date -t 7 `alt installation,alteration,or reiumh-m
C0 t Business I ax or Metro No.L9-7.�_ Exp.Date-1-:j J 20n amps or I"% $ 53.50 � 2
201 amps lu 400 amps $ 00.25 2
40'amps to 600 amps $ 1n7 00 2
Signature of Supr. Elec It f �� � yLry��, Over 600 amps In 1000 volts,
see vb^above.
License No. c-70`°; 6 S Exp.Dale h -7" U,,_ 4d.Branch"tronas
Phone No. New,alteration or extension per panel
a)The fee for branch circulls
?b. For owner Installations: with purcheso of service or
feeder fee.
Print Owner's Nslrne Loch branch circuit $ 5.35 _ 2
Address b)The fee for blanch circuits
without purchase of eoorvlcs
City�- --f Slate_____Zip _ or feeder fee.
Phom No. First branch cirruh $ 3750
-- Each additional branch circuit _ $ 5.35
The instal'ation is being made on property I own which Is not 411.Miscellaneous
Intended for sale lease or rent (Clervice of feeder not included)
Each pump or Irrigation circle $ 42.75 _
Owner's Slgnpture _ Each sign or outline lighting $ 42.75
cirmit!c)or c I-n!ted eaergv
3. Plan Review section(if required):*:* panel, els(1 ion or extension S 60.00 f(J
�. Q � M1'gnor Labels(10) � $ 10740
Please check appropriate iteral and enter fee in section 5B. 4f.Each additional Inspection over
4 or more residential units In one structure the allowable In any of the above
Service and feeder 225 amps or more Per Inspection $ 50.00
-- - F'er hour _ ^ $ 50.00
System over 600 volts nominal In Plait S 5900
�Classifrvf area or s•nlrt irn containing special occupancy as
described In N F C Chapter 5 5. Fees: ,j may, i
ba.Enter total o1 sbove fees $ SIX
" Submit 2 sets of plans with application where any of the above apply. 4",Surcharge(9tuc total fees) 7S S� JL. ,(f
Not required for temporary construction sorvices. Subtotal S
6b.Ente,25%of line 6s for
NOTICE Plan Review 111!LreAulted ISec 3) $_
PCRMITS BECOME VOID IF WORK OR CONSTRUCI ION AUTHORIZED Subtotal $
IS NOT COMMENCED WTI HIN 180 t]AYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD Or 160 DAYS ❑ Tnlst Acrolrnt>r
AT ANY TIME AFTFR WORK IS COMMENCED. -- - Total balance Due
i 1d;L:Nfmms\electric.dac 2/` � � ca� �'�` �f- � (( � ,/1,