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7035 SW HAMPTON STREET-1 x f �I { 1 I 1 7035 SVS' HAMPTON ST CITYOFY I G A R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BIJf 2004-00255 13125 SW Nall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 6/3/2004 PARCEL: 2S 101 AC-01100 ZONING: MUE JURISDICTION: TIG SITE ADDRESS: 07035 SW HAMPTON ST SUBDIVISION: BEVELAND NO. 2 BLOCK: LOT:017 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 18 TENANT NAFIF• AFT-OREGON REMARKS: New roof, accessible ramp and interior remodel. Ower: AFT"- OREGON 10725 SW BARBUH BLVD STE 50 PORTLAND, OR 97219 Phone: 503-245-9815 Contractor: 646 123 YORKE + CURTIS 4480 SW 101ST AVE BEAVERTON, OR 97005 Phone: FAX 643-5531 646-2123 Reg #: MET 00001990 LIC 55644 This C--rtificate issuer] 0/30/2014 grants occupancy of the above referenced building of portion thereof and confirms that the building has keen inspeeteir" for compiiar�ce With thf State of Oregon Specialty Codes for the g.-oup, occupancy, and use 4nq& which the referenced permit wa Issu d. BUILDING INSPECTOR BUILD FFICIAL�A. I a POST IN CONSPICUOUS PLACE CITY O F TI CARD OCCUPANCY TEMPORARY I IFICATE OF OCCUPANCY DEVELOPMENT SERVICES - PERMIT#: BUP2004-00256 '13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PERMIT ISSUED: 6/3/2004 PARCEL: 2S 101 AC-01100 ZONING: MUE JURISDICTION: TIG SITE ADDRESS: 07035 SW HAMPTON ST SUBDIVISION: BEVELAND NO. 2 BLOCK: LOT: 017 CLASS OF WORK: ALT TYPE OF USE: COM OCCUPANCY GRP: B OCCUPANCY LOAD: 18 TENANT NAME: REMARKS: TEMPORARY OCCUPANCY FOR,�� DAYS FROM (GJ New roof, accessible ramp and interior remodel. Owner: AFT - OREGON 10725 SW BARBUR BLVD STE 50 PORTLAND, OR 97219 Phone: 503-245-9815 Contractor: _ —s YORKE + CURTIS 4480 SW 101 ST AVE BEAVERTON, OR 97005 Phone: 646-2123 Reg #: I W 55644 It is understood by the owner/tenant that the issuance of this Temporary Occupancy Permit by the City of Tigard for the use and/or occupancy of the structure located at the site address listed above(hereinafter"structure"), does not grant or convey to the owner or tenant any property right or other protectible property interest In the use and/or occupancy of the structure for any purpose. It Is further understood that this Temporary Occupancy Permit shall only be valid for the number of days from date of issuance listed above and that the owner/tenant will no longer be authorized to occupy the structure after the period specified, unless and u iii II the conditions of approval imposed under the City's or County s Notice of Decision for the project's land use caseis)issued by the Cit,'s Development Services Department or the County's Department of Land Use and Transportation and/or the Clean Water Services and all b (ding and re aced code requirements and any other applicable requirementsLkLl n cfilled and compiled with to the it 's or C ou ty's satisfacti Y BUILDING INSPECTOR BUILDING 6IFFICIAL 1 POST IN CONSPICUOUS PLACE CITY O F T�C A R® __ ELECTRICAL PERMIT PERMIT#: ELC2004-00347 DEVELOPMENT SERVICES DATE ISSUED: 6/11/2004 13125 SW Hall Blvd.,Ticiard, OR 91223 (503) 639-4171 PARCEL: 2S101AC-01100 SITE ADDRESS: 07035 SW HAMPTON ST ZONING: NNE SUBDIVISION: BEVELAND NO.2 BLOCK: LOT : 017 JURISDICTION: TIG Project Description: Electrical TI,(10)branch circuits. Job No.62211 _ RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL./PANEL: M',NF HMI SVCI FDR: 601+amps- 1000 volts: MINOR LABEL (10): SER%IICE/FLEDER BRANCH CIRCUITS — ADD'L INSPECTIONS _ 0 201 amp: W/SERVICE OR FEEDER: PER INSPECTION: I 201 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 1011 - 600 amp: FA 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: AFT-OREGON FRAHLER ELECTRIC CO 10725 SW BARBUR BLVD STE 50 11860 SW GREENBURG RD PORTLAND, OR 97219 TIGARD,OR 97223 Phone: 503-245-9815 Phone: FX 639-4673 Reg 0: W9-4627 37410 -- SUP 18165 FUES _ ELE 34-13C Description Date Amount Required Inspections (ELPRMT) ELC Permit 6/11/2004 $106.701 — — — (Tnxj R",Statc Surcharge 6/11/2004 $8.53 Rough in Elect'I Final Toted $115.23 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, Stets of OR. Specialty Codes and all other applicable laws. All work w+!!be done in accordance with approved plans. This permit will expire if work is iot started within 180 days of issuance, or V work is suspendad foL=re than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rulered set forth in R 952-001-0010 through OAR 952-001-0100. You may obtain copios of these rules or direct questions to OUNC at(503) 246 or 1-000-332- 44. r ,, ��, I IssBy: �C ( -j1�lX%J� Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sa!t. lease, or rent. OWNER'S SIGNATURE: _ —_—_� —__._—_�_ DATE: CONTRACTOR IN TALLATION_ONLY SIGNATURE OF SUPR. ELEC'N: _ _ �_ _ DATE: T— C LICENSE N O: __—_ — __ �.- -- -- --------— Call 639-4175 by 7.00pm for an inspection the next business day Electrical Permit Application e City of Tigard i Received �� ( Permit No � t 1312.5 SW ball Blvd.,Tigard,OR 97223 Date/Bplan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: Inspection Line: 503.639.4175 Date Ready/By. ]-is 7 0 See Page 2 for Internet: www.ci.tigard.or.us blmified/Method -Supplemental Information TYPE:OF WORX �^_ — — PLAN RIEVM ❑New construction [I Addition/alteration/replacement Please check all that apply: ❑ DemolitIOn ❑Other: CService over 225 amps,comm'l []Hazardous location — ❑Service over 320 strips—rating ❑Buildng over 10.000 sq.ft., JC AT960ikV`OP'CONSTRUCTION _ of 1-and 2-family dwellings 4 or more new residential ❑ i-and 2-family dwelling ❑Commercial/industrial ❑Accessory building []System over 600 volts nominal units in one structure ❑ ❑ Multi-family Master builder El Other: Building over three stories ❑Feeders,400 amps or more []Occupant load over 99 persons ❑Manufactured structures or JOB.SITE I:NFORMA�I(& AND LOCATION RV ark --— — ..... . . i ,,__ � ., ----__.. _ �.. �..: ❑Egress/lighting plan P Job no.: Job site address: [31 -care facility Other: 6 2 211 7035 SW HAMP'J ON Submit 2 sets of plans with any of the above. City/State/ZIP: TIGARD r OREGON The above are not applicable to temporary construction servic- —_.__ — ,:-. .;,..: it r;r •- �. Suite/bldg./apt.no.: Project name: AFT — OREGON Description Qty. Fea_ Toul Cross street/directions to job site: New residential single-or multi-family dwelling unit. — Includes attached garage. _ _ 1,000 sq.ft.or less 145.15 4 Subdivision: Lot no.: Ea.add'1 500 sq.ft,or portion 33.40 l Tax map/parcel no. -- — Limited energy,residential 75.00 2 Limited encrby,non-residential 75.00 2 'y ESCRIP'rION OF WORK — Each manufactured or modular — JREMODEL EXISTING OFFICE dwelling,service and/or feeder 90.90 2 __.._-- __.—. Services or feeders Installation,alteration,and/or relocation 200 amps or less 80.30 2 — PR 201 amps to 400 amps 106.85 2 TENAN f ❑ P1LR t�f U. ❑ .. ----- �". ----- \ ------_--- 401 amps to 600 amps 160.60 2 Name /i /- f �;(� n p v i i i',T / n 601 amps to 1,000 amps 240.60 1 Address: 'a/ Over 1,000 amps or volts 454.65 2 / Reconnect only 66.85 2 City/State/ZIP: 11 A ' 7 P '7 J Temporary services or feeders Installation,alteration,and/or relocation Phone: J,45- 3/ Fax: , ) 200 amps or less 66.85 1 owner installation:This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel ❑ APPI WANT [ ❑ (' tNTA T PERSON A.Fee for branch circuits with ---- -- ---- -- --- service or feeder fee,each 6,65 2 Business name: FRAnER ELECTRIC COMPANY branch circuit --� B.Fee for branch circuits Contact name: ,JOHN BARNES without service or feeder fee, Address: 11860 SW GREENBURG ROAD each branch circuit 1 46.65 46.85 2 Each add']branch circuit 9 6.65 59.852 City/State/ZIP: TIGARD OR 97223 Miscellaneous(service or feeder not Included) Phone: Fax: : Pump or i,rigation circle _ 53.40 2 (503 ) 639_4627 (503 ) 639-4673 Sign or outline lighting _ 5340 2 E-mail: Signal circuit(s)or limited- --- energy panel,alteration,or extension.Describe Page 2 2 Business name: SEE ABOVE_ Address: Each additional Inspection over allowable in any of the above P.r inspection 1 _62.50 City/State/ZIP: Investigation per hour(I hr titin) 62.50 [ Phone:( ) Fax ( ) Industrial plant pet hour 73.75 CCB L'c.: 37410 Electrical Lie.: 34—L3C Suprv.Lic.: 2334S Subtotal 106.7_0__ Suprv.Electrician signature,required: Plan review(25%of permit fee) Print name: Date: lam, State surcharge(8%of permit fee) 8.53 MIKE WAGNER 06/1? TOTAL PERMIT FEE 115.23 Authorized signature: This permit application expires If a permit Is nog obtained within 180 days after It hike been accepted as complete Print name: Date: • Fee methodology set by Tri-County Building Industry Servir-e Board ••Number of inspections per permit allowed. I\Buildina\Perndu\BLC-PetmnAppdoc 12/03 440.4615T(I0IO2/C0WWEB l Electrical Permit Aimlication - City of Tigard Page 2 -Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL W6A !NIJy: ; Fee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COM1VIl�;lt�1<A�,Wb)�tih:�U1VLY: ''�'•;G, � " .;, Fee for each commercial system....................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls FJ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other 'rotul number of commercial systems: *No licenses are required. Licenses are required for all other installations i«fuilding\Pernt$TLC.PernitAppdoc 04In1 t / CITY OF T I OA R D _ __._ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2004-00267 13125 S"' Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/15/2004 (1711 , SITE ADDRESS: �� SV'J HAMPTON ST PARCEL: 2S101AC-01100 SUBDIVISION: BEVELAND NO. 2 ZONING: MUE BLOCK: LOT: 017 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 4 URINALS: 1 GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Interior fixtures: Relocate 1 garbage disposer and 2 sinks, 2 sinks replace existing, 1 sink cap. 1 toilet relocate, 2 replace existing. Add 1 urinal and cap 1 shower,. Owner: __ FEES AFT - OREGON Description Date Amount 10725 SW BARBUR BLVD STE 50 [PLUMB] Permit Fee 6/15/2004 $149.40 PORTLAND, OR 97219 [TAX] 8%State Surcharl 6/15/2004 $11.96 Total $161.36 Phone ; 503-245-9815 Contractor: POWER PLUMBING CO P O BOX 19418 PORTLAND, OR 97?80 REQUIRED INSPECTIONS Phone: 503-244-1900 Rough-In Insp Top-outlnsp Reg#: LIC 52378 Final Inspection PLM 34-150PB 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 Notitication Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246.6699. Issued B s Permittee Signature:y Gl-til - !L 9 f7� Call (503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day Accumulative Sewer Tally Parcel# 2S101AC-01100 Tenant'•1ame: AFT-Greyon — This SWRA none required Site Address: 7U35 SW Hampto,; Thir PLM# 2004-00267 Fixture V�Wln Previous Previous Credits Capped Fixture Fixture New New # value capped off value added addod total total count riff#s count _ # value _#s values BaptiserylFont 4 0---- 0 0 -0 0 Bath-Tub/Shower 4 0 0 0 0 0 -- -Jacuzzi/Whirlpool 4— 0 0 0 0 0�—_ Car Wash- Each Stall 6 _ 0 0 _ 0 _ 0 _ 0 - Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator _1 — 0 — — 0 0 0 — 0 Dishwasher-Commercial 4 0 — 0 0 — 0 0--- - Domestic 2 0 _ 0_ 0 0 _ 0 Drinking Fountain — 1 0 0 0 0 0 - Eye Wash 1� 0 0 ---0 0 —0 r Floor Drain/Sink-2 inch 2 0 — 0 _ 0 0 — 0 3 inch 5 0 -----o — 0 0 0 -- 4 inch -6 0 0 U 0 0 --- Car Wash Orr 6 0 0 — 0 0 �0 Garbage Disposal -- Domestic(to 3/4 HP) _ 16 —_ 0 — 0 — 0 0 -_ 0 _ Commercial(to 5 HP) 32_ _ _ 0 — 0 0 0 0 _ Industrial(ovrr 5 HP) 48 _0 0 _ 0 _ 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 U Oil Sep (Gas Sta ion) _ 6 —^0 0 — 0 _ 0 _ 0 Rec.Vehicle Dump station 16 0 0 0 0 -0 -- Shower-Gang(per head) 1 0 —_0 0 0 0 _ -Stall 2 U 1 2 —_ 0 - -1 -2 -- Sink- Bar/Lavatory2 0 1 2 — _ 0 -1 -2 Bradley — 5 0 0 0 0 _ 0 Commercial 3.----0--. 0 — 0 _ 0---- 0 Service 3 _ 0 _-- 0 — 0 — 0 0 Swimming Pool Filter 1 0 0 —_ 0 0 0 Washer-Clothes 6 0 ---0 0 0 0 Wafer Extractor 6 0 — 0 0 0 0 _Water Closet-Toilet 6 0 0 _ 0 0 0 Urinal — 6 _ 0 0 —_ 0 _ 0 0 Previous EDU COUnt I 0 0 Capped EDU Credit 0 TOTALS 0 0 2 1 d 1 0 1 0 1 -2 4 Current Fixture Value -4 divided by 16= —_-0.3 _Current LDlJ 1 EDU = $ 2,400 Previous Fixture Value 0 divided by 16= 0.0 Previous EDU Change -4 divided by 16 = -0.3 over (under) $ (720.00) Enter EDU Change Here -0.3 Notes: Name: G�1`��^�G / Date: Building Division Note The property owner shall retain this record for sewer credit purposes. In the event of a credit, this document stamped"ORIGINAL" shall serve as a credit voucher and must be submitted to the C'ty of i and Building Division to redeem credit towares future system development charges. ___ Jun 11 20114 G: 33AM HP LASERJET 3200 P 1 00/10/2004 18.50 FAX 503SA81960 CITY OF TIGARD f�002 •:2414' 10 2004 1 . 52PM HP LASERJET 320U P• f P,jy��tbi��e�rtnit A onlfic4t dn Ciry o! > Ti py T �� Ihtaart 1?12S SW Hag Blvd.,lVard,OR 971.73 Pituna50-1V9.4171 Fax5U,998."m 24-Hour hoprotiw Li°s Sp .619.6175 I �Dayyy��,Ry. OdrPa�fttc, bNarad enesctddb orNt M I 1f eaPago — _J bttetaAtiOi []Nc,taommadtln ❑Dsmdllim Pbrrlrcfffo/ alrrctNs 1flAtltraAtlttrtioahrylttesttlmAo< ❑ow": ari- -- enM" Kttw i-2-hlo(ly dartIDnO(lnelydq 100 Ktar-°�06 utility exavrodnnl 9FR(1)bad% �el,io (] 1•and 2•feaily d%etting CaSnmt:f hays bmial $PR(2)belt ❑Arceoacry tntildin0 _ Q MAItLfasliT M SSR(37 6sdt 399.DC - U MUM buildet F,vA additlwtd bubAdtchen 45,00 ❑Othdt'i � Pineprbtklar(�_fo R.) Pacc ,vl skit atiiitln '----- Job fits addltst, ?G 3 �� -I't( c.wt.c Id ti Z ��huin a�c'rnle L . I i.60 - city/3tnJl IP ff D G 7 orywcll,Iwo,,Ikw,w t manoh drVin 16.F4 BnitrJbld6./qn.nc,: vrejaat oases: �F r -FO K. _�___ it z par Nar>duartadbttdteuflllow 110.00 CroSaftrecvrlirtctinrr:Do i0A fns: -- — OAIn dtala romecAm 16.60 3mb9 k*cr(no.WON R:_� Pad•2 Storm wwv(no.Ilan;ft;=U==L- Pala 2 snbdivifirm. T --- Lm no.. �yaear ft"ift(00.61PAW � pW 2 -' Tut trta4t/ya cet res _. _. Altorydus•rttfri _ 16.60 own _ Pape 2 _ 06.0 _1— Clomas wfahar 1660 (oWab -- --- - (660 Name. 16.60 Wok — Exprstt•°n Ad*xu CRy/StrrlZfF 1 Z�Lj ^y mss' Floor ginWoo°rtlnk%ub --- 0hoac:(5 Q) Pax (--L--) CIat3,t6e dirpaai -- / 16.6q NO"bib-a - 16.60 (ce anfkp 6ualomf name -- ---- lnttme uprme trw 16.60 COCIM nano: PjA fll AsldMKS: PMaer _16.60 -- "Ity1SMroldmin(cereatarelA 16,6D •� ( 1 ,�---F16,6D 0 I11bAllo+heVAhoMrPoo Ib.6D ^uil' - 1 F6.60 •�, base mule,; 'pb W'(A f^Van t?f R1(r Weer ttealn'— - 16.60 CII, -_O�trtcfLiP� ��r�y -� cmhw�_ -- ! Fax(S+S.) _Mknlo%mpeltbe: %77,50' A y y_' Y 8 d Rmirdantlal btwq!E-ntinW-n Permit flr k561.5 CCB Lia: ar J ? 7 Pluntbinj Lie,m:3Jf-{SQ Plan tvrvirr (34*Apar otwk�l - - - Audtorttedflpottrr • � ,, � StrrnfureAattir(tlioRparwdfiltl TQ'TALMRMITPEE - -- �Prfalrwmc.t 1 / +5 Darr. 4-10 .BIN aaler ltbms bees+arpuanptt rd f■r tong eal n wl a •1 en methgrlatuty out by W-County 9WISInd IrdwnY Swvim Board nW'IasVerwJvJl1(hnwllN�dlr ILO7 �/hIIIR(fflldlOWtT'fit) I ELECTRICAL PERMIT- CITY ERMIT- CITY OF T I GA R D RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00158 I 1312.5 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 DATE ISSUED: 6/14/2004 SITE ADDRESS: 07035 SW HAMPTON ST PARCEL.: 2S 101 AC-01100 SUBDIVISION: BEVELAND NO. 2 ZONING: MUE BLOCK: LOT: 017 JURISDICTION: TIG Proiec:, i►ascription: Data telecomPlUnication cabling. A.RESIDENTIAL_ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING- BURGLAR ALARM: BOILER: LANDSCAPE/IRRIG.AT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DA rfA/TELE COMM: X NURSE: CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: AFT- OREGON A-REBS CONIMIINICATIONS INC 10725 SW BARBUR BLVD STE 50 5855 SW TARAI_YNN AVE PORTLAND, OR 97219 BEAVERTON, OR 97005 Phone: 503-245-9815 Phone: 520-0625 Reg #: ELE 34-558CLE LIC 86096 SUP 2340RET FEES Required Inspections Description Date Amount Low Voltage Inspection (I;.LPRM'I'j ELR Permit 6/14/2004 $75.00 Elect'I Final ITA X1 Wo State Sarchari 6i14/2004 $6.00 !� Total $81.00 J This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions toOUNC at(503)246-6699. Issued by', �i ;�� Permittee Signature;Kr? OWNER INSTALLATION ONLY The installation is being made on property I own which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ — —__ — DATE: _ LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit A 1 lica!if)q � CitN of'.T igard Received Date/By- Permit No / 13125 SV;Nall 131vd,,Tigard,OR 97223 --- ----- --/ Phone- 503.639.4171 Fax: 503.598.1960 Plan Review Other Perim Date/By _ Inspection Line: 503.639.4175 Date Ready/By 7wu ® see Page 2 for Internet* WWW ci.tigard.or.us Nutifie"ethod Supplemental Information TYPE•+OF WOFtYC ------__�� - . PLAN ItEVIEh� ❑New construction Addition,'alter,thon%replacement Please check all that apply, ❑Demolition ❑Other []Service over 225 amps,comm') ❑Elazardous location F, ,; - ❑Service over 320 amps-rating ❑Baildng over 10,000 sq.A., ti �CATEGnRY'OF CnN$TIt(1CTION of 1-and 2-family dwellings 4 or more new residential ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal unite in one structure ❑ Multi-family ❑Building over three scot' ❑Feeders,400 amps or more ❑ Ma to builder ❑Other: -JOB SITE INPOR ,-"- 1k. ❑Occupant load over 99, •o as [ Manufactured structures or --- -__._-_ _-- __- --Nhip :+ ;(p,LOCATION ❑Egress/lightingplen RV park Job no.. - Job site address: `7035 5�J []Health-care facility ❑Other: NAM rU61 __ _ Submit�sets of plans with any of the above City/State/ZIP: TI .0 6R. 97 ZZ 3 The ahove a:e not;mplicahle to temporary construction service Suite/bldg./apt.no.: Project name: Q, - a'+ _ _ I_6N," SCHEDPLE Deecrlptlan I Qty, I Fee, I Total Cross street/directions to Job site: New residential Single-or multi-family dwelling unit. Includes attached garage. _ 1,000 sq.R.or less 145.15 _ 4 Subdivision: Lot no. Eaadd'1500 sq.R.or portion 33.40 1 Tax map/p imel no: -- Limited energy,residential 75.00 2 ,. ,.. _:,• , .,n, },�*• ------ Limited energy,non-residential 75.00 2 Ilk �a�.4t ra.'t�� TI "'Off -,�1 tai Each manufactured or modular ! dwelling,service and/or feeder 90.90 2 �'-', UO +� L TA r vA ck _ - v 1vC CA Cl Services or[ceders Installation,alteration,and/ort 1ocation 200 amps or less 80.30 2 []'PROPEItY OWNER, `� �E(VANT 201 amps to 400 amps 106.85 2 . -- " - —'�- -- — ---- - 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps_ 240,GG 2 Address: Over 1,000 amps or volts 454.65 2 - -- - Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders Installation,alteration,and/or Phone:( ) Fax.( ) relocation_ Owner Installation:This installation is being made on property that[own which is not 200 strips or less --F--66857— amps to 400 amps _ 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps __+ 133.75 2 Owner signature: _ Date: Branch circuits-new,alteration,or extension,per panel ', I• A.Fee for branch circuits with service or feeder fee,each Business name: branch circuit 6.65 2 Contact name: B,Fee for branch circuits without service or feeder fee, 46 R5 2 Address: each branch circuit -ach add'i branch circuit 6.65 2 City/State/ZIP: Miscellaneous(service or feeder not Included) Phone: Fex: Pump or irrigation circle 53.40 2 ( ) :( ) -- E-mail: Sign or outline lighting 5340 2 Signal circuit(s)or limited• E "'A y energy panel,alteration,or Business name: extension.Describe Page 2 2 _ _ Address: Each addltlonal Inspection over allowable In any of the above " 61�n►ru ,a v� — - - Per inspection 62.50 City/State/ZIP: �rAVE U 9 700 5 Investigation per hour(I hr min) 62 50 Phone:(SL30(,L5 Fax:(5o3 ) (oy/. 5Llfa ,t Industrial plantper hour 73.75 CCB Lic.: trical Lic.:CLF 3`fprv.Lic.: VY LC3 ' -7 5WSubtotal Suprv. Electrician signature,required: 4e_ Plan rev.-w(25%of permit fee) Print name: 'hr-RL�'`� Date:�b State surcharge(8%of permit fee) 1�L_ ��t - O Y Authorized signature: TOTAL PERMIT FEEThis permit application expires Ifs permit is not obtained within Igo days after It has been accepted as complete Print name: Date: • Fee methodology set by Tri-County Building Indartry Service Board ••Number of Inspections per permit allowed. i'9uildinaTPormha\FLC.PemtitAppex IV03 44()4615-r(10/n2iC0WWEn Electrical Pet mit Application .. City of Tigard Page 2 -Supplvmental Information LIMITED ENERGY PERMIT FEES: R0S'1DFNTIA1s Wnitk'0A;Y: Fee for all residential systems combined........ $75.00 Check'type of Work Involved: ❑ Audio and Stereo Systems* F] Burglar Alarm ❑ Gsrage Door Opener* ❑ Heating,Ventilation and Air Conditioning System* ❑ Vacuum Systems* Other: -ILA yW Fee for each commercial system....................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems OData Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse falls ❑ Outbor Landscape Lighting* ❑ Protective Signaling ❑ Otlo!r Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i\Building\PermiMOLC.Pmn tApp doc 04103 t /n w �� BUILDING PERMIT \ (v- PERMIT#: BUP2004-00256 DEVELOPMENT SERVICES DATE ISSUED: 6/3/2004 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S101AC-01100 SITE ADDRESS: 07035 SW HAMPTON ST SUBDIVISION: BEVELAND NO. 2 ZONING: MUE BLOCK: LOT: 017 JURISDICTION: TIG REISSUE: _ FLOOR AREAS EXTF.R_IOR WALL CONSTRUCTION _ CLASS OF WORK: ALT r FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONS(: 5N sf N: S. E: W: OCCUPANCY GRP: B TOTAL. ARF4: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 18 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: 1'q 4/' 1'60-DO Remarks: New roof, accessible ramp and interior remodel Owner: Contractor: AFT- OREGON YORKE + CURTIS 10725 SW BARBUR BLVD STE 50 4480 SW 101 ST AVE PORTLAND, OR 97219 BEAVERTON, OR 97005 Phone: 503-245-9815 Phone: 646-2123 Reg #: MET 000�g0gg011990 FEES LIC REQUIRED INSPECTIONS Description Date Amount Electrical Permit Required BUILD] Permit Fee 6/3/2004 $837.90 Plumbing Permit Required BUPPLN Phi Rv 6/3/2004 $544.64 Framing Insp f 1 Gyp Board Insp t].S J FLS Pln Rv 6/3/2004 $335.16 Dryrot ager tear-off I'!AX] R'!s,State Surcharl 6/3/2004 $67.03 Final Inspection - ------1 Total $1,784.73 -] I 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 rule are set forth in OAR 952-001-0010 Vough OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (5 46-6699 1-800-3 344 Issue By (/ Permittee --_ --'"-- Signature: Call 639-4175 by 7 p.m- for an inspection the next business day Building Permit Application Received //__ City of Tigard Date/Hy C-1 O Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 303.639.4171 Fax: 503.598.19.3 Date/By: -Q f Otter Permit. B Inspection Line: 503.639.4175 Date Ready/By: uric ® See Attached Checklist Tor Internet: www.ci.tigard.oeus Notified/Method: _I Supplemenud Information TYPE OF WORK REQUIRED DATA:r-AND 2-FAMILY DWELLING ❑New construction — ❑Demolition Permit fees*are based in the vaiuc of the work performed. --- ---- Indicate the value tri aided to the nearest dollar)of all Addition alteration/replacement ❑Othec equipment,materials,labor,overhead,and the profit for t',e CATEGORY OF CONSTRUCTION — work indicated on this application. ❑ 1-and 2-family dwelling [9 Commercial/inoestria' -- Valuation: S-- __ []Accesoory building~, J ❑Multi-femily� Number of bedrooms: ❑Master huildet - _-_ ❑Other. — --- Nurnb:.r Jr1'dthrooms: JOEL SITE INFORMATION AND LOCATION Total number of floors: Job site address: 3S' $w t,,. #V\ New dwelling area: square feet City/State/ZIP: -R 7 2,17 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: F- - Covered porch area: square feet Cross street/directions to job site: 7 01 l "k Deck area: square feet Other structure area: square feet ,;REQUIREII)DATA:COMMERCIAL-USE CHECKLIST S0division: Lot no.: Permit fees'are bas(J on the value of the work performed Indicate the value(rounded to the nearest dollar)of all LTa> map/parcel no.:- . _.._ equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indlcatel_on this application. _ Valuation s a 000, Existing building area_ square feet New building area: square feet [9 PROPERTY OWNER, ❑ TENANT Number of stories: Narne: AFT- rfj—d-1 _nn_ — Type ofconstruction: Address: (� t1_ -C3 �a'AtA.t (R(V K fit, Occupancy groups: City/State/ZIP:� � e — _ ur L•. l p 7 .11 _ Existing: Phone: ) a 4S- ST.5' Fax:( )) L 4 V-- RAY New: J[] APPLICAN i [] CONTACT.PERSON --- — --__ NOTICE Business name: YC) — t• 6_Lv.. t S _ _ All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: [ S4,kL � under ORS 701 and may be required to be licensed in the Address: L4, ;,'J �� `A _ jurisdiction in which work is being performed.If the City/State/ZIP: �? applicant is exempt from licensing,the following reasons I�t-x V-4 U - — apply: Phone ( ) is Y '1 :. / Fax: :(SA E-mail: !_0 A .S d ell � (yt,r _i (dOA -- q CONTRAt"rOR - Business name: r �' ' - BUILDING PERMIT FEES'' Address: �+�_ t p -- ------ Please refer to fee schedule. CiryJState/Z[P_. ? QU �___-- Phone: ) � 2 _ Fax:( j _ �� / Fees due upon application — CCB ✓-"!� Amount received Date received: Authorized signature: This permit application expires If a permit Is not obtained -- within 180 days after It has been accepted as complete. Print name �,c Date:6 3--Qy/ • t:ee-iethodoio' set by Tri-County Building Industry St, +ce Board. I MuildinOU'ernUu\RIJP.PemitApp doe 12103 440.46137(1 POVCOM/W98) t Building Division Plan Submittal Requirement Matrix Commercial & Multi-Family •- New, Additions or Alterations Ci o ward ----- -- --- --- -- Type of Submittai #of Plans (Includes new,additions and alterations.) Required at Submittal i Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing(site utilities) 2 Building 1 Fire Protection System 3** Mechanical i Plumbing(building fixtures) 2 Electrical Plan rcvie.% is dependent upon submittal oi'a completed application and plans. After pian review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Fescue) * For over-the-counter commercial tenant improvements,submit 2 sets of plans. ** "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "Y technicians. iABuilding\Forms\COM-Plan SubReq.doc 12/24/03 CITY OF TIGARD 24-Hour BUILDIN a inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received — Date R ested_ 4 Am 11� PM_ BLIP Location 0 Suite -__ MEC Contact Person – Ph( ) PLM J /1 Contractor _ Ph ) yU SWR _ BUILDING _ Tenant/Owner ELC Footing ELC Foundation Access•. Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Beam Shear Anchors _.— Ext Sheath/Shear Int Sheath/Shear Framing - ------ - --- Insulation Drywall Nailing - -- -- -- - Firewall Fire Sprinkler -- - ------ - - Fire Alarm Susp'a Ceiling -- - -- -- — __- Roof Other: -- - - ----- - --- -- ---- Final _PASS—PART FAIL — PLUMBING _ ------- -------- - -- Post& Beam _ Under Slab -- ---------------Rough-In Water Service _.._- _--- -_- _-- - - -- - --____-- Sanitary Sewer Rain Da-ins - --- --- — - -- ------ - Catch Basin/Manhole Storm Drain Shower Pan Other: - -- --_-. 1�` _ PART_ FAIL ---- ------- ------------------ —_----__ --------- ANICAL Post&Beam Rough-In - — ------------.----__�-__ Gas Line Smoke Dampers -- -------- -�-- --------- - - Final PASS PART FAIL - ---- --- ELECTRICAL — ...------------ Service — - --- ---------- --------------- Rough-In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$____ Action.i re ured oefore next ins. Pa q P Vat City Hell, 13125 SW Hall Blvd. PASS PART FAIL SITE _ Please call for reinspection RE:_-__ Unable to inspect-no access Fire Supply Line L ADA Approach/Sidewalk Data Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP _-- -___-- Heceived _ ___ Date`Requested.- equested._____�_�___ _'_ AM PM ' BUP __- LocationSuite MEC —_ JLr---- s�0 (n �s _ Contect Person �_ Ph(___—__) PLM — Contractor_ __._ —__— Ph(—) SWR __— BUILDING Tenant/Owner _- -__-__-__-_-____— _ ELC Footing ELC p� Foundation Access: c �U s0 Ftg Drain ELR Crawl Drain _— Slab Inspection Notes: SIT _ Post& Bears Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - - -- ._.-. _ ----- --- ---- --— -- ------ Insulation Drywall Nailing - - - -i--- -----Firewall Fire Fire Sprinkler -- - -- --_ -- Fire Alarm Susp'd Ceiling _ - — .,�-- Roof Other: -- -- - Final - PASS PART FAIL PLUMBIN_g_ __--- ----_-- _ Post&Beam Under Slab --- - Hough-In Water Service -- - - - - - -- Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain - -- - - -- Shower Pen Other: --- - 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 F' Alarm i Reinspection too,.f f required before next inspection Pay at City Hall, 13125 SW Hall Blvd. PAW PART FAIL --- i ffm l'Ie ase gall t Unable to inspect-nn access L- Fire Supply Line . ADA ,/ 5 Approach/Sidewalk D>lte Inspector - ��s►'t _-- y Ext Other: _ Final DO NOT REMOVE this InspeGtlon record from the job site. PASS PART FAIL CITY OF TIOARD 24-Hour BUILDING Inspertion Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 lBLIP/ ^ /Date Re, asted—�� AM— _PM_ BUP _ Received r� _-- Location l L�- !�if�'Tl'1ti 1�-� Suite ___ MEC -- Contact Person Ph(_ —) C'3�= �` � PLM Contractor __. —_ _ _ Ph (_ ) — -- SWR _ BUILDING Tenant/Owner — _ _- ELC 4-? Footing - - -------- ELC _--� Foundation Access: Ftg Drain ELR Crawl Drain - SIT Slab Inspection Notes: - Post&Beam -- - - --- -- _.. Shear Anchors Ext Sheath/Shear - ---- Int Sheath/Shear Framing --- Insulation Prywall Nailing --— - --- -- Firewall Fire Sprinkler Y — Fire Alarm Susp'd Ceiling Roof Other: _ -- -- Final -- PASS PART FAIL PL_UM_BING -- Post& Beam Under Slab ---___ -- ------ - Rough-In Water Service Sanitary Sewer Rain Drains - -- -- - Catch Basin/Manhole _ Storm Drain T--- Shower Pan Other: Final __ - - --- - -- PASS PART FAIL _ MECHANICAL - - - - - --- Post& Beam Rough-In -- —-- -....- —---- — Gas Line Smoke Dampers --- Final PAU PART FAIL - LECTRIC ----- — — Service Rough-In --- --- -- ------ --- LIG/Slab Low Voltage ,U�+' —_ ----- ----- ----- �� - - Fire Alarm 1 nA�SSART FAIL U Reinspection fee of$—_ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd. Please call for reinspection RE: Unable to inspect-no access Fire Supply Line— ADA Date_,__ L �-- Insperctor "` ---- Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inopectlon record from the job site, PASS PART FAIL I CITY OF TIGARD 24-Hour BUILDING Inspection Line: (5 9-4175 INSPECTION DIVISION Business Line: (5Z 639-4171 M� ST� ----t -- U t� ReceivAd Requested 156Date ____. AM —_ PM—__.__ BUP __— Location __ 7 SC cJ ---Suite------ MEC Contact Person _ O Ph( —) �� f PLM Contractor __- __ _— Ph( ) � � SWR BUILDI G Tenant/Owner . ____ __ ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT ....... .._...._. ..... Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -------- - - --- --- -- Insulation Drywall Nailing - Firewall Fire Sprinkler -- - Fire Alarm Susp'd Ceiling - - - -- - ------ Roof / ---- -t PART FAILNG _ -- -- - Post& Beam Under Slab —_-- Rough-In Water Service - Sanitary Sewer Rain Drains ---- - - - Catch Basin/Manhole -� Storm Drain -- - - - Shower Pan Other: _ - ------- ------------- - Final PASS PART FAIL -- MECHANICAL _ Post&Beam Hough-In - Gas Line Smoke Dampers Final --- � PASS PART FAIL - ,-- -- - --- -- - -- - - ELECTRICAL ServiceRough-In LIG/Slab UG/Slab - - — — - --- Low Voltage Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PASS PART FAIL SITE --� H Please call for reinspection RE:� �� Unable to inspect-Bio access Fire Supply Line r/ ADA 'j O/C7 ( �� Approach/Sidewalk �� - -. Inspector --_c_ Ext Other. __-- Final DO NOT REMOVE this Inspection record from the lob site. PASS FART FAIL �