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9225 SW HALL BLVD-1 �- �►'i Ile NEw D1 V0 APProved... !TY..OF. tk W RE(-ALTf*' 0 k ADI)EQ T ;; x .� C..• 1„ 1�,j �J 16, ,;Pi (jtior'a"y•A. " ws ., Oc t 1 0 �E ,�11T ;,�� ork d�',9c`rihld ','..,......,..�' .w. ._.._,_......�.w._. . .,_ See _ - .nN�.IMp•n•FIRM.fR,Rf.twlM.lit!,t1M'AsM'a^•�„+'.+.�.MV•r�R++•..s rr.•..wi�.1. •r.•Mn...+r.:r,..-iw. .- . .. ., ...,� .a..w.,.,......•..`.,.�. ...",...._.,.... � Letter to doll C ��•- �•-•---..,.,,,, ..�,._.._........._..•..... .._. ...._.._....._. � �. - Job Addr A t to c h. .............,j Date `' �� ;��.,-..� �� Z, � b► ��•�. • �� : `�' V �- I S-0 eelf � � Y te)ol A V-v Iq NOTICE. IF THE PRINT t)RTYPE ONANY r � i �T1 � � i � i � t i � i � ili ili � il . ili � r � i � Ir � i r TFT III � r iJi � ( � i ( t tl � tjt int ilt r t ili � � i int tJi SII llr Ali i t� Cpfir llt � i �� t tlt � lilai � � l � � ili ilil � li „ � ,�: :��r� • �..�� I I IMAGE IS NOT AS CLEAR AS THIS NOTICE, l $ 1O Z �.� � 12IT IS DUE TO THE QUALITY OF THE — �� - - - �O No.38 °. ".ro..."" _ __.._ _ ORIGINAL DOCUMENT 8 6 Z 99 L Z 8 Z Z Z E Z ZI � 11111111011 O'111111,11 6 i i 1 6� i • �I'.�III � �,.. II 1i IIII II I I,II III. IIII ILII IIII III (III li.i Illl��lll IIII�IIII ILII III I IIII Illi LIII IIII 1111 ll{i 1111 IIII IIII illl Illlillll 1111 IIII 11111111 IIII Illi fill BILI Lel Lill I!!l 11l�.11.0 �!. L 1.111 lLl Lll t1 11ILI Illlll III it �; ��.. - •... .w..r,.. •.. T.r.MY.Y�. .Y•...R ONY.tH•.I .1...,--n.K:'lY •....... . ...Ir•. . ,, r _ •.. • .. �' �, � I � - ,.� •.�... vw.I W'T,._.ww r•n..M.4T M...—.+...�.. -.yr.T. - I 1 A • • e eA • # i • i # • # s • rb, it e t 11 • a + # I # • a • • C{ ee • ♦ eo a # • � ....�_ 7-777_....__._. _...........T;........Y....W. _. ,� �? t . v . 1,A1 s' r � r AA f y r�l L 4 �" � '' ♦, � r �v r 1 I , 111( _ .•a y�� ee 1 I ` 1 i 1 I ` 1 1111 (t I 1 `� . • . . I . + • • • • • Aeo ` { a 0 0 0 • # : * 00 * # • # 1 10 s + o # • # oa • # e 00 so 0 CITY Of- TIGA`A� 131) • • Approved ---------- - ---------------- dko o r c� (,,9 C F? I/ jnditionally Approvod ......... ........... 1 ] or only +he wok es it.y PERMIT N0- ,V UC•� �► ( � tJ,/� �1 i-l_ 1 oel. C See �..etter to: Follow.------- - Job ,lob Ar cress. Fay: nate- . , date- � ; � t f., +t` s + rsy� a ��° ' �' .r � A c=f �ci r a s } ,'i AF'•�...;,� , i s ;.,. NOTICE: IF THE PRINT OR TYPE ON ANY TT I r I I I III III 11 I I � 1111 I r] 1 1 1�T .1 �� T�� l T 111 '1 ] 111111 1 11111 1 r111 11 1 1 1 1111j1II_I 111111 ] II III r'� I Jill I I f 1 I I l 1 I l 1 1 I -_ - ---- 2 --_ __-3 -- -- -- 4 --__ - --- - _ _ $ _-_ - 1� __ -11 121 ' OG IMAGE IS NOT AS CLEAR AS THIS NOTICE -7 36 IT IS DUE TO THE QUALITY OF THE No. ORIGINAL DOCUMENT -------- --__.-___- _ _. � � _— —___- __.___. .__ --�----_—,_-- ---- --- _ 6r 8Z LZ 9 � 57 d� Z EZ Z tZ OZ 6t $ i LT[ 9t � t Y1: Et Zt tt (l�T F 8 L 9 5 E Z t �la>�w IIII. . it IIII IIII I( I IIII I � , 1►11 IIII lilt iill�lill {I I IIII III IIII IIII !i I III11111 IIII IIII hll Ilii IIII 1111 IIIIIIIII illi Ilii IIII IIII 1111 illi IIII IIII III► Ilii Till Ilii_ ILIIIIII ( �Ill illi ilii ILII 111,1 .1111.1. 111 L1l ill �1 IIIJ Iill�f�lll l w I I 1p N N i r r i i i i 9225 SW HALL BOULEVARD CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 635-4171 — — - j G C�� BUP _ _ __Date Requested—_ l�� d ( AM PM BLD — Location �(.�� t lL P- �� Suite ME(; ��q 7 Contact Person y 60 4 Ph 1 SSI 7--�- PLM Contractor c Ph SWR 61J LDING natzt,�wner � t� �Cr�1��S ELC Retaining Wall ELR _—__— Footing Access. Foundation FPS Ftg Drain - SGN Crawl Drain Inspection Notes: Slab _-_ _—_-- ---- SIT —_-- _ Post&Beam Ext Sheath/Shear I -•-• - ------ Int Sheath/Shear Freming --- — --- - -.--__ -- Insulation Drywall Nailing ---____-- -- --- ----- ---- - — FirewallSp /�� C —tea Fire Sprinkler _— �� _ � � :� ---- Fire Alarm SuspA Ceiling —'=✓-�1-- - --- -- Roof Misc: -- - - --_- -- Final - PASS PART FAIL --- PLUMBING _ Post& Beam � Under Slab — rop Out Water Service — Sanitary Sewer - - _--- Y - Rain Drains ------__-- -__- -. Final --_ PASS PART FAIL.EC A_ ` Post & Beam - ---- - _ ----- Rough In Gas Line - _--- -.— --.-_- Smoke Dampers Fill ---.--- )PART FAIL ELECTRICAL -- Service Rough In UG/Slab _-- - ---- -- -- - --- Low Voltage Fire Alarm - ---- --- ---- -- -------- --- Final PASS PART FAIL ---- --- - --------- -.------ SITE ------ _——- Backfill/Grading - -- --- --- --_- Sanitary Sewer Storm Drain [ 1 Reinspection fee of$ required before next inspection Pty at City Hall, 13125 SW Hall Blvd Catch Basin I Please call for reinspection RE ( )Unable to inspect no access Fire Supply Line ADA Approach/Sidewalk 7 / <. Ext Other Date ��--��[� / .n Inspector --- Fwa! —_ PASS PART FAIL DO NOT REMOVE this inspection record from the job site. ELECTRICAL PERMIT- CITY OF T I GA R D RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00113 13125 SW Hall Blvd.,Tictard, OR 97223 (503) 639-4171 DATE ISSUED: 6/21/02 SITE ADDRESS: 09225 SW HALL BLVD C PARCEL: 1 S126C0-00100 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIC, Proiect Description: Intall alarm system. A. RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO& STEREO: _ INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS:_ 1 Owner: Contractor: MENASHE, R BARRY HONEYWELL INC 621 SW ALDER, STE 605 15495 SW SEQUOIA PORTLAND, OR 97205 STE 100 PORTLAND, OR 97224 Phone: Phone: 968-3300 Reg#: SUP 941-JLE LIC 57824 ELE 26-207CLE FEES ' Required Inspections Type By Date _ Amount Receipt _ Low Voltage Inspection PRMT CTR 6/21/02 $75.00 2720020000 Elect'I Final 5PCT CTR 6/21/02 $6.00 272.0020000 Total $81.00 This Permit is issued sublIc A to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws All work will br 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 P Issued by - �L��_ �-_ y (,L:� Permittee Signature �') ` L 1 �+�r�t�_ 4 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 Kt j / Cx--d) 41S DATE:, _ LICENSE NO: _- LSI Call 639-4175 by 7:00 P.M. for an inspection needed the next business day JUN-14-2002 19:15 HONEYWELL 513 968 3398 P.02iO3 hlectrical Permit Application � - -- '- 1)a1C leceivtxl: G y Pctmir nn ... ('11)' 01 flgal'dProJcct/appl.,,o.: _ Expirrdxre• Cln•u(7rpard Address. 1;1125 Sw Hall rSI�ED 1)utt isxued rdy (S kcceipino.. phnne: 1503) 639-4171 Fax: (503) 5911-1960 Colic file no.- Payment Type: Land use approval: ".moi. , �MVMIJIU1111,411[t --- M U 1 hr 2 family dwelling or accessory �Commcrcial/induslnal JMulti-family D Tenant improvcmrm U New construction Addiuon/ahcratinn/rcpl iccmcnl CJ Otho: __._ U Panial mj[ 11 1 1 aaaLl !pb;rrlrire55: `� j (:'U1-t GL// S)vcj , litlr 11 U.' / lax inf+ /Ittn lot/irccount no.: -- ---- -— r - - i Lot: Bla k' Suhdivt_slon Nru)ecl name:F)rlUri C.aS t; Descnplicn and location of work on premisrs: _-�I-a-r--yr/ '2 Estimated date of cam letinnhrfspcction: fo 2 8 - J a.. — " 1ITE Sit'11MULL Job no: — -1 V7-D/- !ter j(�3 Fee MIKA Business name: HONEYWELL r'"erildion 04 • (M) Tota] no•smv Address: 15495 SW Sequola Pkwy,-#l0o Ne"residential-drtplcottnnhi-Inndlypet e-riling rutin.Inclue.-urr.rf"rnrarr. City: 1'urtlan SI>ttc:(R-'POP 97274 Sorictbtclrrrkd. Phonc503.9968- 04 Fax: 968-3390E-mail: 1000►q_h.or Ices _ _ 4 Each addinnnal SW s h.or gonion thereof CCB na.; 578Elec. bus.11c.no: 26-207CI,.E llmltedener ,rtsidentisl 2 City/metro III no.: 4 619 Hauled energy,non-residential 7 (, -/1/-0- Bch manufactured home or modular dwelling Sipnature of skervisiN aleetrician frequired) Dole Service and/or feeder Sup,elect,Paralt(prinp: Steve Morehouse jLuenmno; 941JLE ISrrnresorlcedeis-iraltalletloh, altrralion or relocation! 1 2W am s or less Name(print): 201 amps to 400 uups 2 - - 401 amps to 6(10 amps 7 Meiling address: hot an,pr in If100amps 7 City: _ Slam: ZIP: (ivu IOW amps or volts 2 Phone; E-mail: Reconnecionly I Owner inslallntlon•The invalladon is being made on propeny I awn Icutporarr serAlea or feeders- which is nc1 intended for Rale,least:,rent,or exchange according to Inaellerion,al,ersimn,orreloeado,e OR 5 447,455,479,670,701- 200 amps or lest _ 2 101 amps Ice 400 amps 2 Owner's signsture: Date; 401 to6Mstrips 2 brahcb circuits-aevv,alteration, or ealension per panel:Name: A. Fee k•branch circuits with purchase of Address,--- __ strvice or feeder tee,each branch circuit 7 City' Slate: 7iti'• B. Fee tot branch citcuiv without purchase Phone Fax: li•mail: -- of service or feeder tee,find branch circuit: e 2 Each additiond brsncif circuit, _ Mht,(. trice or feeder not Included)t Cl Service ova 225 emp#�comoren:ial U llcalth-cmtfacllity Each purt>ir of Irripotion circle 0 service over 320 antpp•tating o1 1&7 Q HmurInut location Each slpn or oullint liphtint, 7 Iamilydwtilingr U Bulldinp over 10,000 syuait feet foul of Slpnal cirtuii(s)o,n linuted energy panel. - Q System over 600 volts nominal more residential units in cat strvciute alicration,at extension' 2 0 auildinp aver three stoner U Feeders.400 amps or marc •r)rscription: U(kcupant load over 99 per%orv, 0 Mrurul'ot-w ecl sinrctutm-or RV pnry yy,h additional inspection over thea Towable in any of the above. 0 F ms/liphtihrplon U other -- Pa h apection (- Submit—sets of Piaui%ith any of the above. Icv�r.upaiinn far 'nit above air not applicable to temporary con oruction service. Na alt toftsdtcaoM arccpr Ltnbt Leith,pknv call prrrxdlenwr for atm tNarmatlat Nance:This(rennet applicAliOn Perniii fee..... .. ............S 0 vise •MasterCard expires if a permit is not obtained Pian".view hat %) S _ roan cat rwmte. -- 140est tT6 00 00�, O 0/ D within IX0 days neer it Inas been State ;urch&rpe(89b)....$ I►►GCG'oy C..tQI S rCNSc, x re► ecccpir.;asromplrir 101 A). - _ .. .__. ►�nrd a hoary endo carr —J� ' [yrAhnlde�,itneiu,r- -�rneiaru' CITY OF T I G A R D _ CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2000-00427 13125 SW Hail Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 11/06/2000 PARCEL: 1 S126C0-00100 ZONING: JURISDICTION: TIG SITE ADDRESS: 09225 SW HALL BLVD E SUBDIVISION: BLOCK: LOT: CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 12 TENANT NAME: HAHIN RASHIDI REMARKS: Commercial TI Owner: MENASHE, R BARRY 6.21 SW AL DEF', STE 605 PORTLAND, Oh 97'05 Phone: Contractor: 1 ENANT Phone: Reg M This Certificate issued 01/12/2001 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Special Codes for the group, occupancy, and use ander which the reference,�l permit was led. BU D G INSPECTOR gUI—FaNG,OFFICIAL POST IN CONSPICUOUS PLACE 1 CITY OF TIGARD BUILDING INSPECTION DIVISION r' M 24-Hour Inspection Line: 63S-4175 Business Line: 639-4171rBU PD --y 77 _ Date Requested___ ?' ' i — _-AM __PM SLD 1.ovation i Z 5 6,/� /� — _ Suite ---_ MEC _ c Contact Person -- Ph S'e- -Sq Contractor _ _ Ph 700 TenanUOwner _ ELC - Retaining_ Wall -� -' ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: — — Slab ------- ---_--- ---- - SIT Pest&Beam - Ext Sheath/Shear _ Int Sheath/Shear A� Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm CJ? Susp'd Cniling _ N. - - Roof Fi PART FAIL - ost& Beam Under Slab Top Out - ---- Water Service Sanitary Sewer f3ajg{jrains c F' )PART FAIL Post& Beam -__--- Rough In Gas Line Smo_ke Darnpers PART FAIL ELITTRICAL Service RoughIn -��-- ----- -------------- - -_...__. ---- UG/Slab Low Voltage Fire Alarm ---_._-._.___. Final � PASS PART FAIL SITE Backfill/Grading ---_�_-.._�_-_-__ ---_-_---- Sanitary Sewer Storm Drain ( i Reinspection fee of$ __ -_ _ required before next inspection. Pay at City Hall, 13125 SW Ha!I Blvd Catch Basin Fire Supply Line ( 1 Please ci'I for reinspection RE:_ __. _ _ ! ] Unable to inspect no access ADA , Approach/Sidewalk Other Date Inspector —__ _—Ext Final ~- PASS PART FAR I DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC1999 00220 DATE ISSUED: 5124/99 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: OSOOOXX-00000 SITE ADDRESS: 09225 SW HALL BLVD SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: CLASS OF WORK: ALT FLOOR FERN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: S2 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 -50 HP: WOODSTOVES: GAS PRESSURE, M 50 + HP: CLO DRYERS: 1 FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Install gas dryer and gas piping for an existing cleaners Owner: FEES _ BARRY R MENASHE ^Type By Date Amount Receipt 621 SWALDER PRMT DST 5/24/99 $25.00 99-315608 SUITE 605 PLCK DST 5/24/99 $6.25 99-315608 PORTLAND, OR 97205 5PCT DST 5/24/99 $1.25 99-315608 Phone: Total $32.50 Contractor: DENNIS PETERSON EQUIPMENT CO 151 FRONT ST WOODBURN, OR 97071 _ REQUIRED INSPECTIONS —_ Gas Line Insp Phone:503-981-4032 Final Inspection Reg M LIC 00084500 ORIGINAL 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 !or more than 180 days ATTENTION. Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-0171-0080. You may obtain copies of these rules or direct questions to OUNC.�(b�y calling (503)2.46-9189 Issue B �>-i �t� Permittee Signature 1�c� I G, C_. Q �- y'mac- Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day CITY OF TIGARD Mechanical Permit Application Plan Check# Ree'd By 13125 SW HALL BLVD. Commercial and Residential Date Recd 3 TIGARD, OR 97223 Date to RE, (503) 639-4171, x304 Date to DST J. 1,;, 1 Print or Type Permit#M�i°f4�1-Q6i�•?� Incomplete or illegible applications will not be accepted Called Name of Development/Project Description l Codeh 1A M Table Mechanical BRONCO CLEANERS TQty Price Amt_ Job Street AddresssuueN - A) Permit Fee 10.00 Address 9225 SW HALL BLVD � 1) Furnace to 100,000 BTU -- including ducts&vents_ see footnote 1,2 6.00 BIdyN Cny/state zip 2) Furnace 100,000 BTU+ TIGARD OR 97223 including ducts&vents see l'ootnote 1,2 7.50 Name(or name of business) 3) Floor Furnace Owner R. BARRY MENASHE including,vent _ _see footnote 1,2 --6,00 Mailing Address ---"- -- 4) Suspended heater,wall heater or floor mounted heater see footnote 1,2 6.00 .521 SWALDER STE 60�Phone �.___ 5) Vent no,:included in appliance permit City/Stale Zip 3.00 _ PORTLAND OR 97.205 'j Check all fiat apply *Boiler Heat Air Name(or name of business) For Items 6-10,see or Pump Cond Qty Price Amt 6P,()0( Q (- LC R�J�t►�S footnotes 1,2 Corn •' Occupant Malang Address 16)<3 P;aosorb unit to 15 �� N LL 13L�U 542Tts L --TU s.00 � �1 7)3-15 HF;absorb unit City/State� ZipPhone 100k to 500k BTU 11.00 - — r<'L•4)�� n 5'��Z3�— B)15 10 HP;absorb— -- - Co_ntractor Name unit.5-. mil BTU 15.00 DENNIS PETERSON EQUIPMENT CO. 9)30-50 HP;absorb 5 __ unit 1-1.75 mil BTU 22.50_ Prior to permit Meiling Address _ 10)>50HP,absorb unit issuance,a copy .15.1 FRONT_ ST _ _ >1 75 mil B1 U _ 37.5_0_ of all licenses CRY/St ete �T ZIP Phone 11)Air handling unit to 10,000 CFM are required if _WOODURN OR_ 970'71 J / `>O S 4.50 expired in COT Oregon Const Cont Board Lic N Exp Date 12)Air handling unit 10,000 CFM+ database 84500 T_ 7/99 _ _ 7.50 Architect Name G ' 13)Non-portae coo Non-portable evaporate tI� , 11 4.50 or Mailing Address ---- 14)Vent fan connected to a single duct _ 3.OU 15)Ventilation system not included in v Engineer Cttyl5late Zlp Phone 9 a pliance ermit _ 4.5_C_ __ribe___ 16)Hood served by mechanical exhaust Descwork to be done i ^� _ _ 4.50_ 171 Domestic incinerators Net D Repair O Replace with like kind Yes O No O _ 7.57_ Residential O Commerri- 18)Commercial or industrial type incinerator 30.00 Additional information or description of work. N 19)Repair units 1>t:fF0, % <' lj1)Kk IQL, ►►,L Te p, 5 LT- r-pUp,, _ 4.50 h 'r _ l h I)t:.L Z'i 1C k f20)Wood stove N — OTE: For&omrr^•,_al projects only;Units over 400 lbs require _ 4.50 structuralQa,=airs_ __ 21)Clothes dryer,etc Type of fuel oil O natural gas 0-LPG electric O — _ ^ _ _ .50 / S 22)Other units - I hereby acknowledge that I have read this application,that the information _ _ _ 4.5_0 given is correct,t')at I am the owner or authorized agent of 23)Gas piping one to four outlets c�0 the owner,that plans submitted are in compliance alith Oregon State laws See footnote_1 200 ______ -- 24)More than 4-per outlet(each) ~^ Signature f Owner/A nc,, !late 50 -y1 7 LJ Minimum Permit Fee$25.00 SUBTOTAL 9 S r Contact Person Name Phone `�{�AR 3 z rJ � .►P RS(,)1�1 L1��7 5%SURCHARGE ( ' PIAN REVIEW 25%OF SUBTOTAL r Foonotes for commercial projects only: Required for ALL commercial P its onty G Provide full schematic of existing and proposed gas line and pressure TOTAL 2 Provide drawings to scale showing existing and proposed mechanical y.Y units 'State Contractor Boiler 6ertificvii,1n required -Resids ntial A/C requires site plan showing placement of Unit I Unechperm.doc rev 02/4/99 OVER-THE-COUNTER (OTC) PERMIT COMMERCIAL MECHANICAL PERMIT CHECK LIST Description of Project: _ Ll r , Class of Work: Floor Furnace: Evap Coolers: — Type of Use: Unit Heaters: Vent Fans: Occupancy Grp: S-7;ZVents w/o Appl: _ Vent Systems: _ Stories: _ _ Boilers/Comprsrs: Hoods: _ Fuel Types - 0 - 3 HP. Repair Units: _ 3 - 15 HP. _ Wood Stoves: Max Input: Btu:_ Air Handling Units CIO Dryer: Fire Dampers:__ < = 10000 cfm: Oth Units: Gas Pressure: H / M / L > 10000 cfm:_ Gas Outlets: No. Of Units: Furn < 100k Btu: Furn >=100k Btu: NOTES: COMMERCIAL. INSPECTION ACTIQNS ' � FEE MENU $ Permit Fee Gas Line Inspection $ z 5' Plan Review Mechanical Inspection $ s' 5% State Surcharge Cooling Unit Inspection $ Additional Permit Fee Shaft Inspection $ Additional Plan Review Fee Hood Inspection 5 Inspection Fee Fire Suppr Inspection $ Miscellaneous Fee Duct Inspection Fire Alarm Inspection Fire Damper Inspection REMARKS: Miscellaneous Inspection Fire Alarm Inspection Final Inspection v FOR OFFICE USE ONLY: TYPE OF USE OPTIONS(COM=commercial;CMS==commercial manufactured structure) CLASS OF WORK OPTIONS FOR ALL PERMITS(NEW-new;ADD=addition;ALT=ateration;ACS=accessory; FMD=foundation;OTH=other,DEM=demolition:REP=repair;FPS=fire protection system.NOTE=USE OTH FOR FENCES, RETAINING WALL,DETACHED DECKS, SIGNS, AWNINGS,CANOPIES) i Novrcntr.doc(dst) 8/97 I SEE 35MM ROLL# 23 FOR LARGE DOCUMENT CITYOF TIGARD PLUMBING PERMIT DENtELOPMENT SERVICES PERMIT#: PLM2001-00590 13125 SW Hnil Blvd.,Tigard, OR 9722 (503) 639-4171 DATE ISSUED: 11/1/01 SITE ADDRESS: 09225 SW HALL. BLVD F PARCEL: 1S126C0-00100 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: M FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURESLAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: [Replacing existing 2. compartment sink with 3 co–mpartment. — Owner: FEESi- --- — "vIENASI IE, R BARRY Type By Date Amount Receipt 621 SW ALDER, STE 605 PRMT CTR 11/1/01 $72.50 27200100000 PORTLAND, OR 97205 5PCT CTR 11/1/01 $5.80 27200100000 _ Total $78.30 Phone 1: Contractor: GVC PLUMBING CO 1700 NE 199TH STREET RIDGEFIELD, WA 98642 REQUIRED INSPECTIONS Phone 1: 503-318-5700 Final Inspection �~ Reg #: LIC 145117 PLM 37-489PB 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 952-0001-0010 through OAR 952-0001-0080. You may ubtair copies of thAse rules or dire(-.t questions to OUNC by calling (503) 246-1987. Issued By: erm Pittee i S y / g .ature:t___ c Call (503) 639-4175 by 7:00 P.M. for an i.,--pe,.tio,i needed the next busfnes4 day r ' Plumbing Permit Application rDatereseived: Permit no.:p City of Tigard TIC-,/ --�L�a'� Sewer permit no.: Building,permit no.: Addresb 13125 SW [fall Blvd,Tigarc, RAZ -- Cirvul7'i�,ur`/ Phone: (503) 639-4171 ProjecUappl.no.: Expire date: Fax: (503) 598-1960 Date issued. By:� Reccipt no.: Land use approval: Case file no.: Payment type: — U I &2 family dwelling or accessory Commercial/industrial U Multi-family 'renant improvement U New construction '>Addition/alteration/replacement U I-ood service CJ Other: Job address: j < Cir �� _ Urwwcription _ Iee(ca.) 7atal -�---�- New I-and 2-family dwellings only: Bldg.no.: _ I Suite no.: Tax map/lax lot/account no.: -- (includes][00 R.for each utility connection) T SFR(1)bath Lot: Block: --jSbdivision: �J T SFR(2)bath Project name: SFR(3)bath — City/county: rL 1. .c� _ ZIP: -;7z'- t — Each additional bath/kitchen— -� - Description and location of work on premises: ' — Siteulillties: �,.� LC,162-e . � _Catch basin/area drain _ Est.date of completion/inspection: Drywells/leach line/trench drain — Fcxriing drain(no. lin.ft.T ness name: y'C. � L[�,t�n Marnafacturod home utilities Busi _ Manholes _ Address: /7f-L+ n,,Z / 1.5 Rain drain connector y v City: -. ,a State:%A)A ZIP: ° e 6 Z Sanitary sewer(no.lin.ft.) Phon S l 3!15.57^ Fax: E-mail: Storm sewer(no.lin. ft.) CCH no.: 1,.t I I,j I Plumb.bus.reg.no. PQ Water service(no.lin.ft) City/metro lic.no.: vcwv 6 5 —` Fixture or Item: Contractor's representative signature: <10r!•-� f�--1 Absotptior,valve Print name: G E0 P- e�*ee�.*! Hack flow pre-venter --L /#� ale: lo-2q-� Backwater valve _ Basins/lavatory Name: r Vit'p u t!;s, S#19 YL- Clothes washer - - Dishwasher Address: Q Z Z S >Lt` V prinking fountain(s) — — City/ Z.ef State: ZIP: 17 1 Ejectors/eump Phone: Fax: F-mail: Expansion tank — Fixture/sewer cap -� Name(print): floor raini7flooi sinks/bub Mailing address: -- — — Garbage disposal _ -- Ilose hibb City: _ State: IZI P: Ice maker — --- —�- Phone: I E-mail: Interceptor/grease trap Owner instal lation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regtilar Roof drain(commercial) — employee on the property I own as per OR,,Chapter 447. Sink(s),basin(s),lays(s) -- - Owner's signature: pate: _Sump Tubs/shower/shower pan Name: L n—al —� ------- - Water closet _ Address: Water healer City: tate: ZIP: Otter: — Phone: Fax: - E-mail: Total Not all juricdictiom accept credit rands.please call iurisdiction for mar inromution. Minimum fee................$ Notice:This permit application plan review(at __ 96 $ U visa U MastetCard ) expires if a permit is not obtained - credit card number:�- __-- -- / / State surcharge(9%)....$ Begins within Itt(1 days atter it has been -- Neme of cardholder as shown on credit rnrd accepted as complete. TOTAL .......................$ _1 3 _ S Cardholder siigmi ue -- Amount 4404616((AWOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURESIndivlduaq QTY ea A_dAOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 16.60 - the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory — ts.so -- for each utility_conn _tion - - One-(j).bath --- ---- - $249.20 ---- Tub or Tub/Shower Comb. !6.60 TwoL21 bath $350.00 Shower Only16,60 Three L3)bath _ $399.00 Waver Closet --� 1660 - - - - SUBTOTAL Urinal �- _ 16608%8%STATE SURCHARGE _ Dishwasher 16,.60 _PLA_N REVIEW 25%OF SUBTOTAL Garbege Disposal - 16.6U - a --TOTAL _ - Laundry Tray -16.60 Washing Machine 16.60 Floor Dra n Jor-%- 2" — 1660 3" 16.60 -- PLEASE COMPLETE: 4" 16.60 --_ - Water Heater G conversion O like kind 16.60 _ Quantic b Work Performed Gas piping requires a separate mechanical Fixture Type: New Mo%ed Replaced Removed/ _coral _ Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46,40 - Lavatory -- -- _ —__-- e_-_— Lib or Tub/Shower Ilose Bibs 16.60 Combination Roof Drains 16.E0 Shower Only _- - --_ Drinking Fountain -- 16.60 Water Closet - Urinal _ Other Fixtures(Specify) 16.60 Ulshwashei Garbage Disposal __- - - LaundyRoom Tray - ----- --- Washing Machine Floor Drain/Sink: 2" Sewer-tsl 100' 55.00 3" Sewer-each additional 100' 4640 4" Water Service-1st 100' — 55.00 Water Heater - _ -- Water Service-each additional 200' -46,40 --- Other Fixtures --_ _ S ecffyd Storm&Rain Drain-1st 100' 55.00 __- Storm&Rain Drain-each zrlditional 100' 46.40 - --- Commercial Back Flow Prevention Device 46.40 -- -- -_- -- Residential Backflow Prevention Davice' 2755 - -- - - Catch Basin — --- 16.60 ---- - - --- Inspection of Existing Plumbing or Specially 7250 Requested Inspections - �er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 1 30 QUANTITY TOTAL Isometric or riser diagram is required if Quant Total Is >9 — — *SUBTOTAL --� -�------ - 8/.STATE SURCHARGE --- - -- - - "PLAN REVIEW 25%OF SUBTOTAL _ Required only If fixtureqty total is>9 —. TOTAL a *Minimum permit I96 is$72 50+11 o state surcharge,except Residential Backflow Preventinn Device,which is$36 25+0'16 state surcharge _ "All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. I:Wsts\fonns\plm-fe,es.doc 08/2grJ1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 C. BU - .---.Date Requested --AM PM __ BLD _ Location 7 ' L2, � Suite MEC �' (�__ _�. Contact Person Ph `>�i _ �_ PLM �- &t Contractor _ _ Ph �— SWR — BUILDING T61hiarNOwner 1 / - - ELC Retaining Wall ELR __ - Footing Access, FPS Foundation - Fig Drain SGN Crawl Drain Inspection Notes: -- --- Slab --_...--__-_—___-- --------—_._..___,-- SIT Post&Beam - Ext Sheath/Shear -- - - - -- --- Int Sheath/Shear y`" Framing --'_ — -_ --- ----- _._ Insulation ''J Drywall Nailing r--- -_-- --. ---- - - .----- - Firewall -� Fire Sprinkler --- ------ - --------- _�_- ------_ Fire Alarm Susp'd Ceiling _ ,_ _- - ----- --- ----- - Roof Final — PASS PART FAIL_ ---- PLUMBING Post&Beam - - - Under Slab Top Out ----_--- -----------_ Water Service _.._- ------_-- _-- _.-_- Sanitary Sewer Ra' Dram : __.-- ---- — ------ —- ----- -- - PART FAIL __ _ - --_---------IfffrHANICAL - - Post& Beam Rough In Gas Line Smoke Dampers Final _-- ------------_._-___- ------ ----_ - ----_ - -- PASS PART FAIL ELECTRICAL Service --- Rough In UG/Slab ______ - - - - ---------- - Low Voltage Fire Alarm -__.__. -- ------___ _._-. -----.__--_- -. Final PASS PART FAIL. --- -------- --- ----- ---_. SITE Backfill/Grading - --- - Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: [ ]Unable to Inspect nn access Fire Supply Line ADA Approach/SidewalkO'' Inspector/, __� ��_-_ Ext Date Other _ _- - ..-. Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITYO F T I OA R D ELECTRICAL. PERMIT PERMIT#: ELC2001-00459 DEVELOPMENT SERVICES DATE ISSUED: 9/17/01 13125 SW Ball Blvd., Tigard, OR 97223 1503) 639-4171 PARCEL: 1S126C0-00100 SITE ADDRESS: 09225 SW HALL. BLVD D SUBDIVISION: ZONING: BLOCK: LOT : JURISDICTION: TIG Proiect Description: Installation of lighting for(3) signs. 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: 3 LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS _ ADD'I_ INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: —PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 40' - 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/FD R >=225 AMPS: _CLASS AREA/SPEC OCC: Owner: Contractor: MEYER SIGN CO OF OREGON 7340 SW LANDMARK LN TIGARD, OR 9722.3 Phone: Phone: 620-8200 Reg #: LIC 64014 SUP 569SIG ELE 20-190CL FEES Required Inspections _ I'ype By Date N Amount Receipt Wall Cover PRMT CTR 9/17/01 $160.20 27200100001 Elect'I Final 5PCT CTR 9/17/01 $12.82 2720010000( �i Total $173.02 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,`state of OR Specialty Codes and all otr.,?r applicable laws. All work will be done in accordance with approved plans. This permit will exrirc if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires ,ou to follow rules adopted by the Oregon Utility Notification Center. Those rules are stat forth in OAR 952-001-0010 through OAR 952-001.0080. You may obtain copies of these rules or direct questions to Permit Signature: Issued By: _A(_ O NER INSTALLATION ONLY T lie installation is being rnade on property I o n Vvhich is not intended for sale, lease, or rent. OWNER'S SIGNATURE, — DATE:---- CONTRACTOR ATE:-_CONTRACTOR INS-rALLATION ONLY SIGNATURE OF SUPR. ELEC'N: LICENSE NO: – Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application - I)atc received:9 /7 O_/ Per mit no.:Lc�zOd/LV X59 City of Tigard Projecl/appl.no.: Expire date; Address: 13125 SW 11xll Blvd, I w:id,OR 97223 bate issued: By.;jjFg Recei31no.: Phone: (503) 639-4171 — — Fax: (503) 598-1960 !, Poo� gyp/ 7d Case file no.: Payment type: Land use approval: U 1 &2 family dwelling or accessory Aff-CoInmercial/industrial U Multi-family U Tenant improvement U New construction U Ad(lition/alteratJon/replitcentent U Othrr U Partial JOB Sl I F 1 Job address: 177 S` WaaaBldg. no.: iNulte no.: ITax map/tax lot/account no.: Lot: Block: ubdivision: _ Project name Description and location of work on premises: � ,�(��t1 S Estimated dale ol'compltrtion/inspection: 1441 SU111111,1111111,11., CON kRAC-1 OR APPLICATION Job no: Pee Max Business name: L��,j a _ Descriptionlo Qty. (en) Total 110.fns — Nc w residential-single or mrrltl-family per Address: c,✓ lseq ct4 V dwelling unit.brclutlesattached gaarep, City: 2 State:e9A I ZIP: 2 Z Service Included: Phone: &zo Fax:627o-, E-mail: I(xx)sq h.or lcsti Each additio,tal5W sq.ft.or potion thereof CCB no.: (LI Elec.bus. lic.no: Z(U-140 C L 5 Limited energy,residential _ _'- City/metro lie.no.: I Limited.nergy,non-residential _:_ , Fach manufactured home or modular dwelling Si nature of supervising electrician(required) _ Date Service and/or feeder Sup elect [);line(print) jI.icenseno:,S69 SLG. Services orfeeden–Installation, alteration or relocation: 200 amps or less _ 2 Nana (Ix'Int): 201 amps to4(l0amps 2 401 amps to 600 amps _ Mauling adthtrs.s: 601 amps to I(NN)amps _ 2 -- — Slate: ZIP: Over 1000 amps or volts _ 2 Phone: — Fax: E-mail It-21nectnnly l owner installation:The installation is heing made on property I own Temporiryservices o►keden- which is not intended for sale,lease,rent,or exchange according to Installatlrrt,alteration,orrelocation: 200 amps orless t)RS 447,45:),479,670,701. 201 amps to 400 4lx)mops _ Owner's si,natur:: _ Daae: 401 to 600 arms Bench cl-culls-new,alteration, or extension per panel: Nam:: A Fee for branch circuits with purchns:(it Address: service or feeder fee,each branch circuit City; State: – ZIP: H. Fee for branch circuits without purchase -- -- of service or feeder fee,first branch circuit: 2 Phone: l a v E snail: Each additionnl branch circuit: Mise.(Service or feedernot included): Each pump or irrigation circle 2 U Scrviceover225mups-rnmmercial U Ilenith-cnre(ecility — U Service over 320 amps-rating of 1&2 U Hauudous location Each sign or outline lighting 2 familydwellings U Huilding over 10,(100 square feet fouror Sigurd circuit(s)or a limited energy panel, USystemriver600volts norrunal more residential units in one structure alteration,or extension* 2 U Building over three stories U I-veders,400 amps or more *Description: -- U Occupant load over(N)persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of tits alcove: U Egress/lightingplan U Other --- Per inspection Submit__sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service, other Not all juriencctiotn accept credit enacts,please call juriMhction for mote information. Notice:'Phis permit application Permit fee.....................$ ¢C a U Visa U MasterCard expires if a permit is not obtained Plan review(at __ %) $ within 1811 days Stale surcharge 8% credo card number:_ - -.....- — ��-- y, otter it has been g . ) ....$ rRpirec accepted as complete I UTAL ...... $ :77T — Nam,Jci older es shown nn c it curd / SD Od S Cardholder dgnetwe --- Amown 440461!(WWOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY _ Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total I Check Type of Work Involved Residential-per unit r, 1000 sq ft or less $-15,15 ^ 4 lJ Audio and Stereo Systems' Each additional',00 sq.ft.or portion thereof $33.40 _ 1 ❑ Burglar Alarm Limited Energy _ $75 00 _ Each ManuTd Home or Modular Dwelling Service or Feeder $90.90 2 Garage Door Opener Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 2 El amps to 400 amps $10685 2 Vacuum Systems" 401 amps to 600 amps $160.60 __ ^_ = ❑ 601 amps to 1000 amps _ $240.60 2. Other Over 1000 amps or volts _ $454,65 2 — Reconnect only _ $6685 _ 2 TYPE OF WORK INVOLVED -COMMERCIAL ONLY Temporary Services or Feeders Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 _ 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel Boller Controls a)The fee for branch circuits with purchase of service or Clock Systems feeder fee. �I Each branch circuit _ $6 65 2 lf�J_ Data Telecommunication Installation h)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. F irst branch circuil _ $46.85 T ❑ Each additional branch circuit $665 — HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $5340 _ Each sign or outline lighting $5340 Interrom and Paging Systems Signal circuit(s)or a limited energy panel,alleration or extension $7500 ❑ Landscape Irrigation Control' Minor Labels(10) $12500 Medical Each additional Inspection over ❑ the allowable In any of the above Per inspection $62.50 Nurse Calls Per i.our $62.50 In Pla it _ $73.75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above tees $ F—] Other�, 9 State Surcharge $ � Number of Systems 25%Plan Review Foe See'vian Review-section on $ No licenses are required Licenses are requirad for all other ins!atletions front of application Fees: Total Balance Due $ — �"— Enter total of above tees $--- Trust _____Trust Account# -- --- 8°i.State Surcharge Tota!Balance Due All Now New Commercial Buildings require 2 sets of pians. i WstsUnmj3\elc-fees.doc 08/30/01 CITY OF TIGARD Electrical Permit Application Plan C!&(;k#- 113-125 SW HALL BLVD. Hec'd By - Date Recd TIGARD OR 97223 Data to P.E. _ Phone (503)639-4171, x304 Date to DST Print or Type ---- Inspection (503) 639-4175 Permit If Fax (503) 6134-7297 Incomplete or illegible will not be accepted called syr oo 17 D 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number or r ispections per permit allowed Name(or name of business) _-_ Service included: Items Cost Sum f�A 4a. Residential-per unit Address Z� � r � ��= � 1000 sq,ft.or less $110.00 4 City/State/Zip T l(W1 2 2-- 3 Each additional 500 sq.ft.or ❑ penton thereof $25.00 _ t Commercial Residential Limited Energy � $25.00 Each Manut'd Home or Module r 2a. Contractor installation only: Dwelling Service or Feeder V $6800 - 2 (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor Installation,alteration,or reiocauon a 200 amps or loss $60.00 - _ 2 Address 7.�yU W-i1i/1,77 �+`�- 201 amps to 400 amps - $80.00 2 city-L 6&A _State e./2- Zip U22 - 401 amps to 600 amps $120.00 __ 2 Phone No. 3 20 - 921)C-) 601 amps to 1000 amps $180.00 2 Over 1000 amps or volts $340.00 2 Job N0. - -- Reconnect only $50.00 �_ 2 Elec.Cont. Lice.No. 70 -f2a c Exp.Date.. ____. OR State CCB Reg. No. L LiQ� Exp.Date /-3,9 _ 4c.Temporary Services or Feeders GOT Business Tax or Metro0._I R y 9 -EXp.Date_-___ Installation,alteration,or relocation -_� 200 amps or less -__ $50.00 2 r. Signature of Su Elec'n y _ 201 amps to 400 amps $75.00 2 g p -- 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, License No. T63 0S-r� Ex _ __.. see"b"above. Phone No. --sv a.. y - ----- -- 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with purchase of service or Print Owner's Name feeder lee. Address _ - Each branch circuit $5.00 _ 2 b)The fee for branch circuits City_ State_^_ Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The Installation is being made on property I own which is not Each additional branch circuit_ $5.00 - 2 intended for sale,lease or rent. 4e.Miscellaneous (Service at feeder not Included) Owner's Signature, -__._. Each pump or Irrigation circle $40.00 Each sign or outline lighting $4000 _ 2 3. Plan Review section (if required):* Signal circu!t(s)or a limited energy - _ panel,alteration or extension $40.00 2 Mina I abels(10) $100.00 _ Please check appropriate Item and enter fee in section 5B. 4 or more residential units in one,tructure 4f.Each additional Inspection over Service and feeder 22.5 amps or more the allowable in any of the above _. System over 600 volts nominal Per inspection $35.00 _ �- _ Classified area or structure containing special occupancy Per hour $55.00 _ as described In N.E.C.Chapter 5 In Plant _- $55.00 Submit 2 sets of plans with application where any of the above apply. 5. Fees: Not required ter temporary construction services. 5a.Enter total of above fees $ - 5%Surcharge(.05 X total fees) $ NOTICE: Subtotal $ -- 5b.Enter 25%of line Sa for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if re Ir (Sec.3) $ - NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. El Trust Account k Total balance Due s -� I10STS\ELC96 APP Rev Mfi n ELECTRICAL PERMIT- CITY OF T I G A R D RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2001-00112 13125 SW Hill Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 04/13/2001 SITE ADDRESS: 09225 SW HALL BLVD G PARCEL: 1 S126C0-00100 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTICN: TIG Proiect Description: Installation of security system. A.RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE. OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM- FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: MENASHE, R BARRY ACTION TECHNOLOGY SYSTEMS 621 SW ALDER, STE 605 835 SE 17TH AVE PORTLAND, OR 97205 PORTLAND, OR 97214 Phone: Phone: 231-1992 Reg #: LIC 79136 ELE 26-7754 FEES Required Inspections Type _ By Date _ Amount Receipt Low Voltage Inspection PRMT CTR` 04/13/2001 $75.00 2720010000 Elect'I Final 5PCT CTR 04/13/2001 $6.00 2720010000 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws All work will be done in accordance with approved plans. This permit w0i expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow 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 � ' , Issued by G� Permittee Signature � � /y 1 �7IZA OWNER INSTALLATION ONLY ` The installation is being made on property I oNm 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 Electrical Permit Application Date received:,/_ _ _�� Permit no.:�� Z ( ;City of Tigard Pro,ect/appl.no. Gxpiredate: Cityolrigard Address: 13125 SW Ball Blvd,Tigard,OR 97223 Dale issued: By: Receipt no.: one: (503) 639-4171 APR 1Qr : (503) 598-1960- Case file no.: Payment type: COMMUNIly gv: Land use approval: TYPE OF PrHNIIT U 1 &2 family dwelling or accessory U Conuorfcial/mclustOal U Multi-family U Tenant improvement U New c-)nstruction U Adchin+n/alteratiotl/replacement U Other: _-� U Partial t SITE INFORMATION _Joh address:9225 SW Hull Blvd _ Bldg. no. Suite no.: G Tax rnap�;ax IoVaccount no.: 1.,tr. Block: Subdivision: — Project name:E, —Description and location of work on premises: IDStB security 9ystefi qj,,� No — Estimated date of completion/inspection: Job no: __ Fer Max Business name: ACT MN TFUTNOLOGY SYSTEMS Description WY. (ea.) Tclal no.insp New rrsiden ial-single or msdlf-family per Address: 835 SE 17th Avenue dwelling unit.Includes atlachedganrRe. City: PORTLAN1.1 State: OR I zip97214 Serocrincluded: Phone: — — E-mail: IWD sq.ft.or less __ 4 Each additional 500 sqft.or portion thereof CCB no.: b Elec,bus.lic.no: Limned energy,residential _ 2 1.City/metro tic.no.: p 02?0 Limited energy,non-residential z Each manufactured horse or modular dwelling Signature o+ supervising electrician(reyu red)iggDate {r-10-�- Service anu.arfeeder I 2 Sup.elect.name(print): + License no: 775 JLE Serriceaorfeeders—Inatallallon, alteration or relocation: 200 amps or less Name(print): 201 amps to 400 amps 2 Malting address: 401 amps to 600 amps bo I amps to 1000 amps 2 City: S;ale: ZIP: _ Over IIN)n amps or volts 2 Phone: Fax: E-mail: — Recom+ecIonly u`-_- -�-- Owner installation:The installation is heing made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation.alteration,or relocation: ORS 447,455,479,670,701. 200 amps or less _ 2 201 amp-to 400 amps 2 Owner's signature: Date: 201 to p.- mans Branch circuits-new,alteration, or extension per panel: NasIse' _ _____. A Fee for hianch circuitsµrth purchase o, Address: __ service or feeder fee.each branch circuit 2 City: State _ Zip: B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail.' Fach additional branch circuit. Misc.(Service or feeder not Included): *Service over 225 amps-commercial U Health-cue facility Fact pump or irrigation circle -_ 2 *Service over 320 amps-rating of I&2 U Harnrdous location Each sign or outline lighting 2 familydwellings U Building over IWXAl square feet four or "ignal circuit(s)or s limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension* __ 2 U Building over three stories U Feeders.400 amps or more •Descri tion: U Occupant loud over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: U Fgies0ightinpplan J Other: - -- - tainspection _ CSS-� Submit cels of plans with any of the above. Investigation fee—, 71he above are not applicable to temporary construction service. Other -- -- ----- -- - Permit fee.................... _L Not all Jun"00ol accept credit cads,please call Jurisdictior+for more udonnation Notice:This permit application U Visa J Mastercard expires if a permit is not obtained Plan review(at __ %) $ -67 MT_Credit cad n,mber — within IRO days alter it has been State surcharge(846)....S xpires accepted as complete. TOTAL S _9r.m Name of cardholder as shown on credit card _ S Cardholder signature Amount 440.4615((iWCOM) CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP �— _—_ _Date Requested_ Cl `� L>> AM_— --PM BLD 7 Location— �- Z_� � Suite MEC ._ Contact Person _ �Y�. Ph PLM — Contractor _ Ph SWR _— BUILDING Tenant/Owner — ELC i�U��iylJ Retaining Wall ELR Footing Access'. Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post& Beam Ext Sheath/Shear — Int Sheath/Shear Framing - iosulation D,ywall Nailing F rewall Fi-eSprinkler Fire Alarm c;usp'd CeilingMisr1117-4r --_------- --,, �/ 1 �� Roof Final -- -� --Ss PASS PART FAIL ---- — --- -- -- -------- ----- PLUMBING Post& Beam -- Under Slab Top Out Water Service Sanitary Sewer Rain Drains " Final PASS PART FAIL MECHANICAL {'c,st R Bean — Rough In W� _-- Gas Line — Smoke Dampers PXn�Ml �j . FAIL ELECTRICAL �'Frrvibe-_—_ _ - Rough In C � UG/Slab ---- Low Voltage Fire Alarm — — 1rASS PART FAIL _—�� ----- - — — -- - TE Backfill/Grading ---i_--��- — —� Sanitary Sewer Storm Drain I ] Reinspection fee of$ rUquired before n spection P at City Hell, 13125 SW Hall Blvd Catch Basin Fire Supply line f ] Please call for reinspection RE: __ [ ] Unable to'nspect no access ADA Approach/Sidewalk Other Date_ _ ^Inspector \�j ��- Ext _ Final PASS PART FAIL_ j DO NOT REMOVE this Inspection record from the job site. +Illtttttttttttt� CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2A-Hour Inspection Line: 639-4176 Business Line: 639-4171 BuP ee) 3l l Date Requested - / 3 AM� PM —--)6:: _ BLD _ !_ocation �� Z 2.�� . '�' SuiteE `Z1OO C ! ?�/�S` Contact Person — ,�,v� _ Ph �( _1 > ,,PLM_ CXJ 1�el 7-- P h - Ph SWR ELC UIL.DI Tenant/Owner _ - — Retaining Wall ELR _ Footing Access: Foundation FPS - Ftg Drain SGN Crawl Drain Inspection Notes SlabSIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall — - - ------- .� ---- -- - — — Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _- Roof FM# PART FAILIN& E3earn - -- - - -� - Under Slab Top Out --_—i- i Water Service - T_ Sanitary Sewer RaJD-Drains '-OASS)i PART FAIL. - - *WS"ANICAL I 4a IL Post& Beam --- Rough In Gas Line ------ ---- .._ — _ Smoke Dampers PART FAIL ICAL Service Rough In UG/Slab - -----------_ _ ---- ----- - - - -- -- Low Voltage Fire Alarm F inal PASS PART FAILSITE Backtill/Grading — Sanitary Sewer Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Nall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ 1 Please call for reinspection RE' [ J Unable to inspectno access ADA Approach/Sidewalk Other _ Date / ' _�__ Inspector � _ �-_- Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the jou site. CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: P'_M2001.00412 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 539-4171 DATE ISSUED: 8/31/01 SITE ADDRESS: 09225 SW HALL BLVD PARCEL: 1S126C0-00100 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW FREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS. TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: —!� SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installalion of(1) sink, (1) lav and (1)water closet. Cap (1) existing sink. — FEES _ Owner: — -- Type By Date Amount Receipt MENASHE, R BARRY PRMT CTR 8/31/01 $72.50 27200100000 621 SW ALDER, STE 605 5PCT CTR 8/31/01 $5.80 27200100000 PORTLAND, OR 97205 _— Total $78.30 Phone 1: Contractor_ MSI MECHANICAL SUSTEMS INC 9655 SW SUNSHINE CT E-700 REQUIRED INSPECTIONS BEAVERTON, OR 97005 — -- Phone 1: 503-642-1234 Top-out Insp Reg #: LIC 00070032 Final Inspection PLM 34-183 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of 013. Specialty Codes and all other applicable laws. All work will be done in accordance with apri oved 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 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. ISloued By: a Permittee Signature:X;L! 5,y Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day f Plumbing Permit Application Marc received: 3, ^) Permit no.:PLn U / CityCit of Tigard 1�a g � Sewer permit no.: Building permit no.: Address: 13125 SW hall Blvd,Tig"OR'97223 City of Tigard Phone.: (503) 639-4171 Projcct/appl.no.: Expire date: Fax: (503) 598-1960 Date issued. By:,,�Z I Receipt no.: Land use approval: — — Case file no.: Payment type: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family e-nant improvement J New construction U Addition/alteration/repl,,cenu•nt U Food service U()(her,: .1011 SI*I F INFORMATION "\FEE SUIIED1[1E(for special Information rise checkilso Job address: nj Z Z j _t.v . X 61114. Description 11Y. Fee(ea.) TOM — ------ -- New I-and 2-family dwellings only: Bldg.no.; Suite no.: ---- --- -- --- (includes 100It.for each utility connection) Tax map/tax lot/account no..: _ _ ,SFR(1)bath Lot: Block: Subdivision: SFR(2)bath Project name: —� SFR(3)bath City/county: ZIP Each additional bath/kitchen Description and location ciwoe on prcmtses: Siteutilities: Id&JA, ,�_ g�.�-_ �— Catch basinfarea drain Est.date of completion/inspection: - Drywclls/leach line/trench drain t Footing drain(no.lin. ft.) -- Manufactured home utilities _ Business name: ` ti- �� _ _ Manholes Address: Z/l Ct S _1U.t J. V'f1 �?Cw}, Rain drain connector _ u 4— City: l� l�Sle0r2n State: ZIP: 9]/LT Sanitary sewer(no.lin.11) Phone:• . Z l Z Fax: .&I f f I E-mail Storni sewer(no.lin. ft.) CCB no.: 7,6o37 1 Plumb.bus.reg.no: 3rL /S3 P6 Water service(no.lin.ft.) Fixture or Item: City/metro lic.no.: noev /L3S - Absorption valve Contractor's representative signature: Back flow preventer Print name: ate: 10-31-Z.+ Backwater valve LIA Basins/lavatory Name: Clothes washer Address. �} Dishwasher - " — Drinking fountain(s) City: State: 'ZIP: Ejectors/sump _ Phone: ,--1-1_ t H Fax: -- Email: Expansion tank -- Fixture/sewer cap _ _Name(print): Aa2 --`.-l� � Floor drains/t'loor sinks/hub — Mailing address: m Z I"b W. Hose disposal -- -- _ Hose bibb City: I State: CA ZIP: Q-1 to C Ice maker Phone: :.t - 46HU Fax: E-mail: Intcrce tor/ re w^trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date: Sump Tubs/shower/shower pan Urinal Name:— _ Water closet v 1 Address: Water heater City: State: ZIP: Other: Phone: Fax: E-mail: Total Na all jurisdiction accept credit cards,please call juris&llon For more Inforrnation Minimum fee................$ Notice:This permit application U visa U MastercardPlan review(at %) $ expires if a permit is not obtained — J credit card namhcr:.-.._ �` __L.�__ State surcharge(8%)....$ within I$0 days atter it has been F e icessU -- p TOTAL .......................$ Nanx of cardholder ashooww n on credit card accepted as complete. -- Cardholder signature Amount 440 4616(r,asv('I)MI t PLUMBING PERMIT FEES: F- PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) _ _QTY _ ea AMOUNT (Includes all plumbing fixtures in PRICE TOTAL Sink 16.60 (1 the dwelling and the first100 fl. QTY (ea) AMOUNT 1660 bath for each utility connection . Lavatory _ _ One 1 $249.20 _ Tub or TubBhower Comb 16.60 Twp 2 bath _ $350.00 -_5� _ -- Three 3 bath $399.00 Shower Only 16.60 �._-__-_.----- - .-.. Water Closet - 16.60 r (� -- - SUBTOTAL Urinal 16.60 BYe STATE SURCHARGE — Dishwasher —� 16.60 PLAN REVIEW 25%OF SUBTOTAL .�_ � TOTAL Garbage DisposalM 16.60 OT - --- Laundry Tray — 16.60 Washing Machine __T6_60 Floor brain/Floor Sink 2'-- 1660 --- PLEASE COMPLETE: 3•• 19.60 4 16.60 _ -- - Quantity b Work Performed _ Water l-leater O conversion O like kind 16.60 Fixture Type: New Moved Replaced Removed/ Gas piping requires a separate mechanical Capped Perm!'. _ _ MFG Home New Water Service 46,40 Sink Lavato -_- 4640 �_ MFG Home New San/Storm Sewer Tub or Tub/Shower 11osa Bibs 16.60 Combination Roof Drains 16.60 Shower Only — Drinking Fountain 16.60 Water Closet Urinal Other Fixtures(Specify) 1660 Dishwasher _ Garbage Disposal _ Laundry Room Tra -- Washing Machine - Floor Drain/Sink 2" _ Sewer-1st 100' -- -- 55,00 3" _ Sewer-—each additional 100' 46 40 4.. _ Water Service-1st 100' - 55.00 Water Heater _ - Other Fixtures Water Service-each additional 200' _ 46.40 S ecf - Storm 8 Rain Drain-1st 100' 55.00 - - Storm8 Rain Dram-each additional 100' 46.40 -- ---- Commercial Bark Flow Prevention Device 4640 ---- -- - Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections __ -__ erRv COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 — Grease Traps -�-- - 16.60 ------ --r� QUANTITY TOTAL -- Isometric or riser diagram Is required If O _ Quantity Total is >9 *SUBTOTAL U - 8%STATE SURCHARGE --- --- - "PLAN REVIEW 25%OF SUBTOTAL �- Required on1iy f fixturo gtY total Is>9 —_ TOTAL $a .Minimum permit fee Is$72 50 4 B%stare surcharge,except Residential Backflow Prevention Device,which Is$36 25 r B%stale surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review i�\dsLs\forms\plm-fees,doc 10/10.100 i A CITY I�� D �_ ELECTRICAL PERMIT / \ PERMIT#: ELC2001-00436 DEVELOPMENT SERVICES DATE ISSUED: 8/30/01 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S126C0-00100 SITE ADDRESS: 09225 SW HALT_ BLVD µ't 1' SUBDIVISION: ZONING: BLOCK: LOT : JURISDICTION: TIG Protect Description: Installation of(8)branch circuits for tenant improvement. Job No. 01-11.50 RESIDENTIAL UNIT TEMP ERVC/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: SIGNALWANEL: MANF HMI SVC/ FDR: 601+gimps - 1000 volts: MINOR LABEL (10): SERVICF/FEEDER _ _ BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 7 IN PLANT: 601 - 1000 amp: __ PLAN REVIEW SECTION _ 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: f Reconnect only: SVC/FDR >= 225 AMPS: _ CLASS AREA/SPEC OCC: Owner: Contractor: i MENASHE, R BARRY KEC ELECTRIC INC G21 SW ALDER, STE 605 1281 NE 25TH AVE UNIT K PORTLAND, OR 97205 HILLSBORO, OR 97124 Phone: Phone: 503-439-0904 Reg#: LIC 99267 SUP 44895 EL-E 34-426c FEES Required Inspections Type 'By Date Amount Receipt Ceiling Cover PRMT CTR 8/30/01 $93.40 2720010000( Wall Cover Elect'I Fina! � 5PCT CTR 8/30/01 $7.48 2720010000( Total $100.88 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 I 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 arP set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to Permit Signature: i f - 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: i �I ``T % �� _ DATE:- LICENSE NO: �—`�y — ------ — ----- -- --� Call 639-4175 by 7:00pm for an Inspection the next business day uo :Hiul nhU III: Id, I-Al SUV 5PS Ifili0 CTTY C)F JICIA kD Eleet:rical 1"ermit Application ._--..— i oii tcccivod: :. Pl'Rrl{t no.. City of Tigard pri 11'!1 Vappl.no.: Expimdatc: rrr•ofrIr•: d Addres&c13125 SNV Hall Blvd,Tigard,OR 97223 now.issucd: By l Rccciptnn Pl jt,c.: (503) 61)-4191 7 Fax' (503) 59f.•1960 lir cJ�'r OC1 Case filonu,t 1>uymanttype: Land use approval; 1 IM' U 1 &2 11utlily dwolling or -'••cssrtty 0111:11tNiulrio;111•.t1tal ,'Auld-faumtly JICT"mill implovcurout ONew ron:i,w'tiurt L-1Additisn/ullriA1W11/rrplacr.mcnL IOilirr t 1 s mi Jnb addre s r' %0 l( ( C1'Idq, no.' uit,. rn, . Tax ms /tax lotlaccount no- l.ut Block, �Suhdtv%.0m: TDercrirtion rind locittion of work art prrnliscs; ei�ft, 1 _ --- orf rr,rnpl�holJinsp�.ction: 1 / 131 1„I,lir /� / - / >Q _ I I („ •t , ihscriplinr, Vtv. t,:l) lur.,l I— m. Ad _ Newmesidlnlurl-sineln nrrnulti•f:unily Peili /��L � 7 V+t,i drrellGrgrmiLlnclnMsallacM-0Gnrispr, Sarriminctudnf; i _1•Xj pq� 1•a+ Cid 3J3 F-mail _ 1000sq.lt oricsa Each nddid.inal.`.00,q,ft or n.r�.;n therwsf'— C'Ck; no.; C' (, ! lrc,bus,lit:,no, - 6 Linke onar residcm,ai City/ ul[o h, nc,. i.Iruilednn,_tit-g non-tesiden(ial ?—� erhmanutntncturedlimneormodwar:;witimig _. �ignaturc ur suptr :,log,Icctr' „(•.quire lj - DJt, _ _yurvi snd/lir reader u --• —T+ — Srrritrs er ret err-rostra at,nn, sup iter, a mr,,,tint• w• .-r. �0 Li uanse no, nitewtlou or rolooNFuhr 1 / 2co,:mp;or letx Name(print) ._... � 201 arnnv In 400 mr,ps -- 40"A I s to 600 ampc 2 Mnilin udJ eas 601 em stn 106oamps — 2 _C'ity: Suite:—�;'IF; _ vnr loon:,nprs or vuiu `— rituuo, Rax. r-mail Reeonnurtutlle _ _ i nwnor inma!Isl on TheinstrdlaUcin is being mtidr on property 1 own fernporarymrvictafir ret derr. Much i.9 lint inn;oded for sale,lease.,rrtlr,or cxrhanl It ucl:ording to IoMliatiotl altumtion,arrelncn"otu 200 nmORS rir less 2 4^'r, z^q,f;7U,701. —�'• - U1 limps to AW ramps 'd` Uwncr's ,, ..r ,i... _ D rte: 4011 to i,uo:u„p X 11,7noh,rlreldW•aeb,olreratinn, er cLIM "I mfou pct peurh A. Fu farnrsnch circuits with purch(ue of szivim er fredet fie,each branch rirrult _ 2� J - state. 7 - li Nrr fnr,,rnrrh rircuirs Without utchatc _ 1 U .�" -._ lt'.� ._... n � •� ~�/6 � �.' J n1'setv:cu or feedur feu,first brmich circuir Yht„• -rax:- G-rntil &-ch nrlditinust bmnah cimia, Mire.(Stmicnu•feedernotIncluded); U Sery rrmrr2i, ,-,,ruucr�,,J ]I1'J qi:2rcGu:il ty Each pump nrimgatirmcirrlc 'J Su','icvnw•rliu,,:,ps rati,ig:f110 M liazurdmesimAthn End IS nuraudinelrghting - family J Nulld,ntf over le.ma itamw u•,!t I'nurur Signal nirruit(s)or a linin.(encrey psnc], rJ SYNtC1111)ve:6L10 volii pon,ioal rnnrarenidanual India inon,wtuernn• altutalinn,nretttanslons J13ui1f1;•1t•nverify"%tirica UIterlim,419)anti.sornlcfr *Dew-i tion: U Occup,n•L•ao,ver 9"P:-tans U hiant,faccurrd of tioures or RV park p tch a nspectithe allo--W.ion orer w.lite(It any of tht+nbnvo: O C'tr., 'h.htu,gpl,,n J Uthx, -�. . _- Pcrina J�`—~ S1lbmlt__sets air pians with any of th s abovo, Invest p-mion ruu t 'Jhe,Ihnvr ,nr, tint npplicnhlc to tvnijjomrl Inns ruction service• Odrar 4(' Permit i,ae. `701 1".••Lch.lu "14X. a•JP ------ •Ir rnnmrion• Notice:'fhfs permit upplicnlion "" 14X ' cxpfrrq if a permit is not obtglimd Plan rcview(at _ rrr) t within 160 dry.after It Nagy been Statu Su1'CI,Nrp..($9(,) i accepwd m complrte, TOTAL $ `_ Cp 1 _rf�llpl ��.m—" _/ fir;,-'VIl •TY."•lI, / CITY OF T I G A R D MECHANICAL PERMIT �1 DEVELOPMENT SERVICES PERMIT#: MEC2001-00315 L 13125 SW Hali Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/6/01 PARCEL: 1 S126C0-00100 SITE ADDRESS: 09225 SW HALL BLVD SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIC; CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: 1 VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES _ 0 3 HP: DOMES. INCIN: �— 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOOD GAS PRESSURE: 50+ HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 2 FURN >=100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: HVAC inprovements. Add (2 supplies and (1) return and (1)exhaust fan. Owner: FEES MENASHE, R BARRY Type By DateAmount Receipt 621 SW ALDER, STE 605 SPCT CTR 9/6/01 $5.80 272001000C PORTLAND, OR 97205 PRMT CTR 9/6/01 $72.50 2720010000 ^ Phone: Total � $78.30 — Contractor: RELIABLE HVAC 5915 NW 78TH ST. VANCOUVER, WA 981365 _ REQUIRED INSPECTIONS Mechanical Insp Phone:360-693-7379 Heating Unt Insp Reg #: I Q5 2 's,q Final Inspection This permit is issued Subject to thO regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 -0080. You may obtain copies of these rules or direct questions to OUNC by c=alling Issue By: =' Permittee Signature: -- Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Dale received y p) Permit no.t1� j .pp�j�0, City of Tigard ��C'� Project/appl.no.: Expire date: City ofTignr•d Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ Building permit no.: U 1 8r 2 family dwelling or accessory C7 Conunercia!/industrial U Multi-family enant improvement U New construction U Addition/alteration/t•epl icement U Other: ------ JOB -- 1 L Job address: Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all meth uical ma—' s,a uipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ I Lot: =Blcxk: Subdivision: *See checklist for important application information and Project name: �' - �' ,�c r Y. jurisdiction's Ice schedule for residential permit fee. City/county Description and location of work on premises: C iq c � 1 2 11Lie 4 t LH- f t A1�uiv!j7 kwi,\� Fee(ea.) Total Est.date of completion/inspection: ` QI Description Qty. Rm.only Res.only Tenant improvement or change of use: U: TNI Is existing space heated or conditioned'? Yes U No Air handling unit t Ali-conditioning(site plan required) Is existing space insulated?2f Yes U No Alteration of existing HVAC system of er compressors - Business name: t State boiler permit no.: I.1 c r�C -_- _ HP Tons BTU/H Address: / i Vire/smoke i ' Tt' ___ amper, uct smo a electors —— City: ( c-�'�' .'r Stale:p 'fl ZIP.'1S l 7 cat pump(site liaan require,' --- --- Phone,�1r 1,jj )3J c. Fax:6•i j J7fj'� E_maiL/t,e N. l'r.'u.tftif/Iff A nstall/rep ace urnacc burner__ T Including duct irk/vent liner !]Yes U No CCB no.: 1 t l ' corr)Q -0' ._ _6-l'tf,rr. n.taII/replace Ire focate- caters-suspended. - -- City/metro lic.no.: wall,or floor mounted Name(please print): .71p 1 t L t Vent For apt lance other than furnace Refrlgeral on: milk, kq woo WE Absorption units -_- BTU/11 Name: Chillers — HI' - — - - Address: Cum ressors III' t -- --- :nv ronmenla ex►gust anwrn,Tat on: City: -- State: ZIP: Apphancc vent Phone: Fax: li-mail: )ryer exhaust_ 0o s,' ype / reg.kitc a wzmat hood fire suppression system Name: _ Exhaust fan with single duct(hath rang) Mailing address: x)aus(s'stem apart from satin or AC Illy: Stale: .'.1P: Fuc p p ng an sl ut on(up to 4 out ets) —._ -Iypc: LI'Ci NG -_ oil Phone: F: E mai:: Fuel piing a ditiona over outlets — rncesspiping(schematicrequirer 1 Number of oullels Name: _ Other listed appliance or equipment: Address: __ Decorative fireplace City: - _ State: _ ZIP: exert-type -- — Phone; — 1::,:I:ux: E-mail; oo stove/pe Ietstove Other: Applicant's signature: Other- Name (print): t ,s ..I,.tL i\ Nor all jurtufictions accept credit cards,please call jurisdiction for mem information. Permit fee. ................$ �� S ❑Visa U MasterCard Notice:'131is permit application Minimum feeee................$ _ / / - expires if a permit is not obtained Plan review(at - %) $ Credit card number_- —_ -- -- Expires within 180 days aller it has been -- State surcharge(89h) ....$ Name of cardholder as shown on c tt 5 S accepted as complete. .7 .3 _ Cardholder signature !^ Amount 440-4617(6AXWOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE - dEDULE: TOTAL VALUATION: PERMIT FEE: Description: _ - Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical C-)de Qty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or includingducts&vents _ 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ $10,00.00. including ducts&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or Including vent 14.00 _ fraction thereof,to and Including 4) Suspended heater,wall heater ___ _ $25,000.00. _ or floor mounted heater 14.00 525,001.00 to$50,000 00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction therecf,to and Including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Alr $1.20 for each additional$100.00 or For Items 7.11,see or Pump Cond traction thereof footnobas below. Comp* " _ 7)<3HP,absorb unit Minimum Permit Fee$72.50 SUBTOTAL: R to 100K BTU 14.00 8)3-15 HP;absorb 8%State Surcharge $ unit 100k to 500k BTL' _ 25.60 _p ______-______- 9)15-30 HI';absorb - -- - 2M/.Plan lie view Fee(of subtotal) 5 unit.5-1 mil BTU _ 35.00 Required for ALL commercial permits on y __ 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU _ 52.20 11)>50HP:absorb --- ----�--� i--� unit>1.75 mil BTU 1 87.20 12)Air handling unit to 10,000 CFM ASSUMED VALUATIONS PER APPLIANCE: 10.00 Value Total 13)Air handling unit 10,000 CFM+ Descr!ptiun: Qty Ea Amount 17.20 Furr ace to 100,000 BTU,including 955 14)Non-portable evaporate cooler ducts&vents __ _ _ 10.00 Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&vents _ 6.80 Floor furnace InrJuding vent 1 955 _ 16)Ventilation system not included in Suspended heater,wall healer or 955 appliance permit 10.0C floor mounted heater 17)Hood served by mechanical exhaust Vent not Included In applicance 445 10.00 - permit 18)Domest!c Incinerators Rehr units 805 i 17.40 <3 hp;absorb.unit, 955 19)Commercial or industri 11 type Incinerator to 100k BTU 6g 95 3.15 hp;absorb.unit, 1,700 _ 20)Other units,including wood stoves 101k to 500k BTU_ _ 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlots mil.BTU_ 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(aach) 1-1.75 mil.BTU _ 100 _ >50 hp;absorb.unit, 5,725 Minimum Permit Fed$72.30 SUBTOTAL: $ >1.75 mil.BTU _ Air handlingunit to 10,000 cfm 656 �- a%o State Surcharge $ Alr handling unit>10,000 cfim 1,170 Nun-portable evaporate cooler 656 _ _ TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct _ 446 Vent system not Included in _ 656 L -.PQgLT - a liance It _ _-�___�. -.- Other Inspections and Feer: Hood served by mechanical exhaust 656 Inspections outside of normal business hours(minimum charge-two hours) Domestic Incinerator 1,170 _ $72 50 per hour Commercial or industrial Incinerator 4 590 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour) Other unit,including wood stoves, 656 $72.50 per hour Inserts,etc. 3 Additional plan review requited by changes.additions or revisions to plans(minimun Gas piping 1-4 outlets 360 charge-one-half hour)$72 50 per hour Each additional Outlet __63 _ 'State Contractor Boller '.r rtlficatlon required for units>200k nTU. _ ___. _ ""Residential AIC requires site plan showing placement o!un+r TOTAL COMMERCIAL VALUATION: is\dsts\fomis\mech-fees.doc 08/00/01 CITYOF T I G A R D _ BUILDING PERMIT PERMIT#: B001-0011. i DEVELOPMENT SERVICES DATE ISSUED: 8/31/1/01 13125 SW Hall Blvd., Tiqard, OR 97223 (.503) 639-4171 SITE ADDRESS. C9225 SW HALL BLVDPARCEL: 1S126C0-001 U0 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJr-:CT OPENINGS? TYPE OF CONST: 5N sf N: S: E: �W: OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 37 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: READ SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: �ft —FiR SPKL: SMOK DF_T: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BFDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: I r Remarks: Tenant improvement- 2875 s f. Owner: Contractor: MENASHE, R BARRY MARKET CONTRACTORS LTD 621 SW ALDER, STE 605 10250 NE MARX ST PORTLAND, OR 97205 PORTLAND, OR 97220 Phone: Phone: 255-0977 Rig#: Lis 62833 M FEES 1 REQUIRED INSPECTIONS Type By Date Amount Receipt Mechanical Permit Require PLCK CTR 8/30/01 $65.59 27200100000 Electrical Permit Required Sprinkler Permit Required FIRE CTR 8/30/01 $40.36 27200100000 Plumbing Permit Required PRMT CTR 8/31;01 $100.90 212.00100000 Framing Insp 5PCT CTR 8/31/01 $8.07 27200100000 Gyp Board Insp _ Susp Ceiing Insp Total $214.92 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This pe-mit will expire if work is not started within 180 days of issuance, or it 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)246-6699 or 1-800-332;234.4., P Permittee SL / Signature: Issued r Call 639-4175 by 7 p.m. for an inspection the next business day Building Perm!#1 Application "Datcreceivedd:: O/ Permit no.: Uf?!50/-G1 Jl Kl City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97213 ProjecUappl.no.: Expire date: cityr�fTignrd Phone: (503) 639-4171 Dale issued: By: Receipt no.: \ A Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: - 1&2 family:Simple Complex: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Ncw construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: JOB SITE IN FORNIA I ION Job address: I,,�. pt�.L _ -,- -- - Bldg.no.: Suite no.: Lol: Blcx k: Sutxlivision: Tax map/t, ,lot/account nu.: Project narac: �� pGIC.. r J. lq q D Desrnptfon and lova ion of work on premises/special conditions: W pA ','fiTl� '_� {�t4.4 � l' �E I:UU"C 4; f 4T I TUR g �s�c�c?�ZV4±RIt_C - Name: k2QY ENASNE (I lotodplai it. Mailing address: LIJ `(2-- , Q kl_ V 1 & 2 family dwelling: Citv: &v LAW 17 State: ZIP: Z C Valuation of work........................................ R Phone: 1i l 4 )kif ail: No.of bedrooms/haths................................. Owner's representative: _ Total number of floors................................. _ -- Phone: Fax: E-mail: New dwelling area(sq.ft.) .......................... Garagc/carport arca(sq,ft.) Name: lZ1GIL Irf-AKlp� IJIV "Dovered porch area(sq.ft.) ......................... Mailing addre r , - t�1� .:J leek area(sq.ft.) ......ss: � r ►.,(- "'...... ......... City: �'CVTL rQ State: L) ' ZIP. 'i �:Z o Other stntcturc area La ft.) __ - . .......... re sUl us riallinulti-famll Phone: �i t 1 Fax; 't 2�,2 ail:r1�k1LIl1i.Y � ,t(c}f a y' / . ll Valuation of�worr ........................................ $`�� . Existing bldg.area(sq. ft.) .. ..................... c ' N'A2k�f Ut-kR.OtC=CLF� — Buslness name: tJ t New bldg.arca(sq. ft.) .......... ..................... _. Address: '� Number of stories........................................ -- City: State: ZIP: }31Z'Cie- - - 'Type of construction.................................... Phone: Fax: —�E mail: — - Occupancy group(s): Existing: CCB no.: -- _ New: _ City/metro lic.no.: c3 orl 57,- Notice:All contractors and subcontractors arc required to be licefsed,�'jth gon Construction Contractors Board under Name: G �r lI:_' J��t�C �R L�^t P 'tM4�s 4.4 01 and may he required to be licensed in the l� k�,, Addrrsss: 7l <, i T jurisdiction where work is being performed. If the applicant is City: ?V15 , State: i, ZIP: � 1 exempt from licensing,the following reason applies: Contact person: 4 ,c "'S.C(Itplan no.: -- — -- _ ---..._---- Phone: ^ A,.3(1,1 11 Fax: ( -ifl 2 l mail: L(",h I p @+ ft-VT - Name: _ Contact person: Fees due upon application ........................... $ - Address: Date received: -- --- _- City State: 'LIP: Amount received ......................................... $----- Phone: Fax: F-mail: Please refer to fee schedule. hereby certify I have read an mined this application and the Not nil Jurisdiction~accept credit cards,please call fuds&-tion for more infixmalion. attached checklist. All rrov' ndlordinances governing this, U visa U MasterCard work will he complied yvith, e s rein or not. creme Cara number,�_— — Es Authorized signal re: _ 13(It, I Name orot t as shown on credit card A ll S Print name: _^ t�'�' At`''�— -crdhoidet signature Amount— Notice:This permit application expires if a permit is not obtained within 180 days atter it has been accepted as complete. 440-4613(fM WOM) COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional plan sets for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). Tota! # of TYPE OF SUBMITTAL Plans KED: Submitted S = Site Work (must include S (New, Add or Alt) 4 location of all accessible park.. d) B (New, Add or Alt) 1* B = Bi;ilding F New, Add or Alt _ 3** F = Fire Protection System M (New, Acid or Alt) 2 M = Mechanical P (New, Add or Alt) 2 P = Plumbing E (New, Add, or Alt) 2 E = Electrical - New = New Building Add = Addition Alt = Alteration to existing building *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" requires that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. !U1sts�tnnnsUnatrrrnm ricer 1N; 'Ittl 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^n altered area may be deemed disproportionate to the overall alteration whan the cost exceeds twenty-five per-cent(25%). VALUATION of all renovation, alteration or modification being done , excluding painting, wallpapering. $ multiply: 25% Barrier removal requirement. .25 BUDGET FOR BARRIER REMOVAL [2]$. 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: ( I (a) Parking $ �' � ��4� {��f.-rl►% (b) An accessible entrance $_ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for $ `'DOU each sax 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 Adsts%ones\access.doc INDEX : A-0 COVER SHE"T H&R BLOCK A 1 PARTITION/ELECTRICAL SHEEP ',. A-2 FURNITURE/EQUIPMENT SHEET E>: 4- fe A - 3 ALTERNATE SHEET (IF NEEDED) LEGEND: GENERAL_ NOTES: DEMO PARIITION 1. CONTRACTOR TO FIELD VEIRFY ALL EXISTING CONDITIONS. NOIIFY DESIGNER OF ANY EXIST. DEMISING PARIITION DISCRE.PENCIES FOUND DURING SITE SURVEY. NEW DEMISING PARTITION 2. ELECTRICAL DEVICES HAVE NOT BEEN FIELD EXISTING PARTITION VERIFIED; RECEPTICLE S AND SWI*ICHFS SHOWN NEW INSULLATFD PARTITION ARE FOR REFERENCE ONLY. CONTRACTOR TO NEW PARTHION PROVIDE NEW ELECTRICAL DEVICES AS INDICATED ON FLAN IF AN EXISTING ELECTRICAL DEVICE IS NOT WITHIN 36° OF DEVICE INDICATED. NEW g00R 3. ALL CHANGES AND REVISIONS MUST BE DIRECTED AND APPROVED BY I-IR BLOCK DESIGNER, � EXISTING DOOR 4, LANDLORD/CONTRACTOR TO PROVIDE FOR d� DUPLEX HECPT. T PHONE SEPERATE HVAC CONTROLS FOR HR BLACK SPACE, IF ADDITIONAL UNITS ARE REQUIRED TO COMPUTER DATA ACCOMPLISH SEPERATE CONTROLS, CONTACT QUADRAPI_EX RECPT, RECEPTACLE W/ DESIGNER. ISOLATED GROUND 40 DEDICATED DUPLEX 5. A SINGLE: JUNCTION BOX TO BE INSTALLED BY K3 FLOOR MOUNTED CONTRACTOR ABOVE DROP CEILING WHERE $ SWITCH DUPLEX LLECTRICAL INDICATED ON F!OOR PLAN. TRACK LIGHT TO BE 1; 3-WAY SWITCH ® FLOOR MOUNTED INSTALLED BY OIHFRS, TF1 FI'HONE/DATA b. DUPLEX OUTLET TO BE INSTALLED Q THERMOSIAT UNDERNEATH FRONT WINDOW WHERE INDICATED EI POWER PULE ON PIAN. IF WINDOW SILL IS FULL TO FLOOR, Q SPEAKER MOUNT ABOVE CEILING TILE. n CF11 IN ON BOX D o ELECT. 7. IF RECEPTION DESK IS NOT PLACED AGAINST PANEL A DEMISING WALL, CONTRACTOR TO INSTALL FLOOR MOUNTED ELECTRICAL AS SHOWN ON 2--LAMP HEAD HOSTAS PLAN. TRACK IIGHT 1-LAMP HEAD TRACK I IG11 T MCAS I RFE I ! NI ��I I �L L�.,I �� ILAIIONS. CITY OF TTo . PAINT .. ... AF ••.... .. ...1 P5- PRAH & LAMBERT #2249 ARROWRO01 pppfoved.......... .. ionelly APProve. .......•... - -- -- -- -- - - --- Condit described- OU + ;ARP' I ;:of only the wol f.- ( 1 PEAM11 NO. C2- PIIII_ADELPIIIA-LYNCHBURG-#65596--SKYLINE rto-.Follow...•~•." ...............( See Leine ............ Attach........... - MAlERIAI 10 HE ORDERED FROM CARPEI&FLOORS t L ¢l Job Address:- OAW: BY CONSOLIDATED INC. CONTACT: PAFFY BFCKFTT � - PHONE: 770 729-2764 1 AX: 770--263 8812 �y..__ ORDER FORM: W_WW.CONSOLIDAIEDCARPE1INC•COM VCT- 4'_VINYL_ COVE BA' T1 -- E31- �.'1 f " "�11 I , ! ' r, 1 t�i►.I �. 1 r`/ ; f'?��fi+ ��- iJ(�tT� of+,.(.l (. OF-I-ICI- ID#: LOCATION ADDRESS: LEASE SQ.FT. 2875 SF _ 9225 SW Hall Blvd ISSUES REVISIONS N0. DATE DESCRIF`l10 96 1-MLS 8/2 Revised Layout I I g U F d, 0 R 9 7 2 3 2-KLS 8/27/01 Room 105/Electrical ' DEMO PA1 i I I ION 1. CONINACTOR IU � CONDITIONS. NOTIFY DESIGNER OF ANY rr_---- r—T EXIST. DEMISING PARTITION DISCREPENCIES FOUND DURING SITE SURVEY. NEW DEMISING PARTITION 2. ELECTRICAL DEVICES HAVE NOT BEEN FIELD EXISTING PARTITION VERIFIED; RFCEPTICLES AND SWITCHES SHOWN NEW INSULLATED PARTITION ARE FOR RFI FRENCE ONLY. CONTRACTOR TO NEW PARTITION PROVIDE N1 W ELECTRICAL DEVICES AS INDICATED ON PLAN IF AN EXISTING ELFCTRICAI DEVICE IS � NEW DOOR NOT WITHIN 36" OF DEVICE INDICATED._- 3. ALL CHANGES AND REVISIONS MUST BE DIRECTED AND APPROVED BY HR BLOCK DESIGNER. EXISTING DOOR 4, I.ANDLORD/CONTRACTOR TO PROVIDE FOR DUPLEX RECPT. T PHONE SEPERATE HVAC CONTROLS FOR HR BLOCK SPACE, IF ADDITIONAL UNITS ARE REQUIRED 10 COMPUTER DATA ACCOMPLISH SEPERATE CONTROLS, CONTACT OUADIZAF LEX RECPT. RECEPTACLE W/ DESIGNER. ISOLATED GROUND(fin DEDICATED DUPLEX 5. A SINGLE JUNCTION BOX TO BE INSTALLED BY ® FLOOR MOUNTED CONTRACTOR ABOVE: DROP CEILING WHERE SWITCI I DUPLEX ELECTRICAL INDICATED ON FLOOR PLAN. TRACK LIGHT TO BE 3 -WAY SWIICII ® FLOOR MOUNIED INSTALLED BY OTHERS. s TILEPIIUNE:/nATA 6. DUPI.EX OUTLET TO BE INSIAP.ED U THERMOSTAT UNDE RNEATI-I I RONT WINDOW WHERE INDICATED �I POWER PULE ON PIAN. IF WINDOW SILL IS I ULL TO FLOOR, (s SPLAKf:R MOUNT ABOVE CEILING TILE, CFII NG 13 N1ED IF LLLCT. 7. IF RECEPTION DESK IS NO] PLACED AGAINST JUN PANEL A DEMISING WALL, CONTRACTOR TO INSTALL FLOOR MOUNTED ELECTRICAL AS SHOWN ON TRACK Y HEADHOSTAS PIAN. RACK ! I(,IIf 1-LAMP HEAD TRACK IIGIIT MICAS TRFF HNISI--I SPLCIFICA-TIONS: Ct.ry OF TIGANd PLAINT ,. . • ` 1: P5--PRALI & LAMBERT Y2249 ARROWROOT Approved...•....... ......... . �ndltionally�►pprcved.scow in:... :ARPE I For only the work as de C)V ........( C2 111111 -LYNCHBURG #65596-SKYLINL pEAMIT NO•F Ilow """ See L.erier 40: "ach.. ( ): MAILNIAI 10 HL ORULRED f I OM CART LI&f LOORS JohAddre�s: �'� pate•_ 4t 13Y CONSOHDATFD INC. CONTACT: TAFFY BFCKETT PHONE: 710 129 2164 FAX: 110 - 263 -8812 BY', ORDIR FORM: WWW.CONS01_IDAIEDCARF'II-IINC.(:OM ---- 4 VINYL COVE yBASE ! rI r 01I (,(,,(A (-P OtI1tff T1 - OFFICE ID#: LOCATION ADDRESS: LEASE SQ.FT. 2875 SF 922.5 SW H(711 E3M.1 _. .ISSUES__REVISIONS ((� [ NO. DATE DESCRIPTION �`I U 1-KL5 8/22./01 Revised Layout T i g t I f"d, OR 9'02 i 2-KLS 8/27/01 Room 105/Electrical - ('01, LIE; I? S TUR1, LY MAR l' IN '{' U ( KKR - - - —� D E SIGN CONS T R U C T I O N D I v I S I 0 N 77 WEST PORT PLAZA SUITE 150 MARYLAND HEIGHIS, MO 6J146 DRAWN BY: KLS EXHIBIT A PHONE: (314) 397 21321 FAX: 392.-2701 _ 314-392-2638 SHEX +..I.. DATE: 8/21/o t /-� �J -- -- 36, CONT + rN . vv 0 WAITING bpt CONF o :- 110 P BREAK U O EflOFFICE PHONE `D 108 i 10 -o" - TOILE [] 'TOILED6 X06 N 107 o 0t `L 0-P,J n � o OPEN - M03 � U OFFICE b MI 104 S -OR rn r 1 PAR VI I NELN .C . F`N N mommummHALF WALL TO BE BUILT rye~ LEASE -SQ. FT . 2875 SF BY CONTRACTOR WITH H&R BLOCK ISSUESV_REVISIONS C OUNTF RS INSTAI.1_FD ON N0. UATE DESC f?IPTION _ LLY , a 14'-6" - WAITING CONF F 101 t-10 BREAK 109 CD "AFF ' �* 69OFFICE o J' 102 FJMONE 4 //gy�pp � CVU ,Y TOILE 1 V'-0n �, iiilll 'TOILET. � +- �6 - D ,�„ t o6 107 0 �a ��,o _ 61- OPEN f)I(Y) r OFFICE cl �,��f STOR mo 105 f�AR� �-ro�� ELEC . �� N HALF WALL TO BE BUILT C°g LEASE SQ. Fl-. 2875 SF- BY CONTRACTOR WITHM&R BLACK ISSUES REVISIONS COUNTERS INSTALLED ON > < NO. DATE RIPTION TOP. WALL AT 48" AFF, '' '' KLS 8/22/01 Revised Layout -0" SWING TO BE OMCE ID#: 96 —KLS §127101. Room 105 Electrical INSTALLED IN NEW WALL. LOCATION ADDRESS: 9225 SW Hall Blvd -- – DRAWN BY: KLS EX'4IBIT A 314-392-2638 r=, Tigard, OR 97223 DATE: 8/21/01 A— CITYOF Ti CARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00249 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/31/01 SITE ADDRESS; 09225 SW HALL BLVD PARCEL: 1S12.6C0-00100 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIG TENANT NAME: H & R BLOCK USA NO: FIXTURE UNITS: CLASS OF WORK- ALT DWELLING UNITS: 1 TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BlJSWR IMPERV SURFACE: Remarks: Increase of .5 EDU's. Previous value count of 87 points, this project adds 8 points for an increase of .5 EDU's Owner: i FEES MENASHE, R BARRY ` 621 SW ALDER, STE 605 Type By Date Amount Receipt PORTLAND, OR 97205 PRMT CTR 8/31/01 $1,150.00 27200100000 Phone: Total $1,150.00 -- Contractor: Phone: Rag#: Required Inspections 1-his Applicant agrees to comply Wth all the rules and regulations of the Unified Sewage Agenq/. The permit expires 180 (lays from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does riot 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" Perm Issue by lRj. Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day i I Accumulative Sewer Tally Tenant Name: _ t�oG' /� /�, This SWR# JZ�� j l g _ Address: `� ,� -- p-f ��^' ! This -LM#: a e:© L Fixture Value Previous Previous Credits Capped Fixtures Fixtures New dotal New # Value Capped off value added# added #s total _ Count off#s count value values Baptistry/Font 4 -- -- Bath-Tub/Shower 4 -Jacuzzi/Whirl ool 4 Car Wash-Each Stall 6 --- -Drive Through 1 f+ ClispidorlWater_ spirator ---- Dishwasher-Commercial 4 _ _ - -Domestic 2 - Drinkina Fountain I —- E e Wash 1 - - Floor Drain/sink-2 inch 2 -- -3 inch 5 - -4 Inch 6 - Car Wash Drn 6 - Garbage Disposal 16 -Domestic to 3/4 HP) - -Commercial to 5 HPI 32 - -Industrisl(over 5 HP 48 - Ice Machine/Refrigerator Drains 1 — Oil S!T(Gas Station) _6i — Rec.Vehicle Dump Station 16 Shower-Gan Pur Head 1 -- -Stall 2 - -- Sink-Bar/Lavatory 2 -Bradley 5 _ - - -Commercial 3 -Service 3 Swimming Poo(Filter 1 - Washer-Clothes 6 - - _Water Extractor _ 6 - - Water Closet-Toilet 6 —1 Urinal _ 6 �. TOTALS Total fixture values:--7,5' divided by 16 =-J- �7 EDU = J I �� a ' '`"� / �o HISTORY PLM# Av6-cvVYY E_DU# .5-.YY SWR# , PLM# EDU#_ SWR# _ PLM# _ !EDU# SWR# PL.M# EDU# SW_R#_� PLM# - EDU# _ SWR# PLM# EDU# SWR# PLM# _ EDU# SWR# PLM# -EDU# SWR# lAdsts\swrtaly.doc CITY OF T I G A R D — ELECTRICAL PERMIT DEVELOPMFNT SERVICES DATE EIS UI /ED: 9 0/0 0100451 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S126C0-00100 SITE ADDRESS: 09221; SW HALL BLVD F SUBDIVISION: ZONING: BLOCK: LOT : JURISDICTION: TIG Proiect Description: [Replace existing 100 amp service with 200 amp service. _ RESIDENTIAL UNIT _ _ TEMP SRVC/FEEDERS _ MISCELLANEOUS 1000 SF OR LESS: _ 0 - 200 amp: PUMP/IRRIGA'',,N: EACH ADD'L- 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): —_ SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 - 200 amp: 1 WiSERVICE OR FEEDER: PEP INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: __ PLAN REVIEW SECTION 1000+ amplvolt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect onlv: SVC/FDR >= 225 AMPS: _ _— CLASS AREA/SPEC OCC: Owner: Contractor: MENASHE, R BARRY AWSEM ELECTRIC LLC 62.1 SW ALDER, STE 605 20315 NE SANDY BLVD PORTLAND, OR 97205 FAIRVIEW, OR 97024 Phone: Phone: 503-890-5562 Reg#: ELE 37-9250; LIC 148:2 SUP 4718S FEES _ Required Inspections Type By Date Amount Receipt Elect'I Service PRMT CTR 9/10/01 $80.31 27200100001 Elect'I Final 5PCT CTR 9/10/01 $6.42 2720010000( Total $86.72 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 f sa�pted by the Oregon Utility Notification Center. Those rules are 7et f in OAR 952-001-0010 through OAR 952-001-0080. ou may obtain gopies of these rules or dhed questions to , Permit Signature: � Issue 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: �-'� _�—. — DATE: 10 LICENSE NO: ._ 7a`"-� — — -- --- - Call 639-4175 by 7:00pm for an Inspection the next business day Electrical Permit Application Date received: Permit no.: City of Tigard Prgjecdappl.no.: Expire date: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 - Fax: (503)598-1960 Case file no.: Payment tvpe: Land use approval: U I &2 family dwelling or accessory C*Commercial/industrial U Multi-f-aily U Tenant improvement U New constniction U Addition/alteration/replacement U Other: U Partial Job address: L.ZS 4 A• Bldg,no.: Suite no.: f' 1 Tux mop/tax luUuccount no.: Lot: Block: Subdivision: _ Project name: Drscripnon and location of work on premises: tC-c Estimated date of com letiotr/ins action: ----- — (,a *'s-H lq t ,lob no: ►OF Aariifvee nfav Business name: r bcscriptiou t)tv. (ca) lotul nu.Ins 49 j5@jM New reddentla, singk or multi-family ps•r Address & „A. t,V dwellingunit.Includrsattached garage. City:FAik VILLA IState#4 ZIP: r*f_ Service included: Phone: y Fnx: E-mail: loons .ft.or less 4 Each additional 5W sq.ft.or onion thereof CCB no.: Y Elec.bus.tic,nae G D-nited energy.residential 2 City/metro lie.no.: Limited energy,non-residential 2 �,... Each manufactured home or modular dwelling Sin re of rvisin electrician(re wired) Date Service and/o, eller 2 Sup,elect,name(primp al License no Services or feeders-installation, atle'atlonor relocation: 21x1 amps or less 2 Name(print): 201 amps to 400 amps ^� 2 Mailing address: 401 amps to 600 amps 2 601 amps to IOW amps 2 1 Slate: ZIPS y_ Over IOW amps or wilts 2 Phone; hax: I E-mail: Reconneclonl Owner installation:The installation is being made on property I own Temporary servicesorfeedenr which is not intended for sale,lease.rent,or exchange according to Installation,alteratIon,orretocatlon: ORS 447,455,479,670,701. 211)amps or less 2201 amps to 4W amps 2 Owner's si nature: __ _ Date: 401 to 600 ams 2 Branch circuits-new,alteration, or extension per panel: Name: A, Fee for branch circuits with purchase of Address: _ service or feeder fee,sas.n oraneh circuit ? City: State:__ ZIP: —` B. Fee for branch circuits without purchase --- - of service or feeder fee,first branch circuit; Phone: L;i E-mail: --- --- Each additional branch circuit: Mbc.(Service or feeder not Included): U Service over 225 ampN conuneictal U Health-care facil.ly Ench pump or i2igalion circle U Service over 320 amps rating of 1&2 U Hazardoushuaann Each sign or outline lighting familydwellinga U Building over 10.000 square feet four or Signal cucuil(s)or a limited energy panel, U System over 6W volts nominal more residential units in one structure aheration.or extension• U Building over three stories U Feeders,4(10 amps or more •lkscri tion: U Occupant load over 91 persons U Manufactured structures or RV parts Each additional Inspection over the allowable In any of the above: U Egres0ightingplan U Other• _ Perinspecuon �'-- Sublall_sets of plans with any of the above. Investigation fee _ The above are not applicable to temporary construction service, Other Not ad jurisdictions accept credit cards,please call jurisdiction for Inure inhamaotxtNotice:'11tis permit application Permit fee.....................$ U Visa U MasterCard expires il•a permit is not obtained Plan review(at _ %) $ _ Credit card number _ _.�—_1 within 190 days atter it has been State surcharge(8%)....$ _ Expires accepted as complete. TOTAL .......................$ Name of c of re�u shown on c it o _ S _ C bottler sijruture — Amount 4404615(6r WOM) ELECTRICAL PERMIT FEES: UWTED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY p Restricted Energy Fee... .......................................... $75.00 Number of Inspections per permit allowed (I )R ALL SYSTEMS) Service included: Items Cost Total Check rype of Work Involved. Residential-per unit 1000 sq ft.or less _ $145 15 — 4 n Audio and Stereo Systems' Each additional 500 sq.ft or portion thereof ___ $33.40 1 ❑ Burglar Alarm Limited Energy $7500 Each Manuf d Home or Modular Dwelling Service or Feeder _ $90.90 — i 2 ❑ Garage Door Opener Services or Feeders n Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 ❑ ) ' r 201 amps to 400 amps _ $106.85 2 Vacuum Systerbs A01 amps to 600 argps $160.60 — 2 601 amps to 100(farnps 111240.60 _ L� Other Over 1000 amps or volts T--� $454.65 -_ 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system..........:.............................................. $75 00 200 amps or less $66.85 _ (SEE OAR 918-2650-260) 201 amps to 400 amps $100.30 7 1 • . 401 amps to 600 amps _ $13375 2 Check Type of Work In-idlved: j Over 600 amps to 1000 volts, see"b"above ❑ Audio and Stereo Systems Branch Circuits O New,alteration or extension per panel Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Fach branch circuit $6.65 2 ❑ Data Telecommynicetion It st4ll4tlon b)The fee for branch circuit- without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 r, Each additional branch circuit $6.65 l__J HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle _ $53 40 _ _ ❑ Each sign or outline lighting _ _ $53.40 Intercom and Paging Systems Signal circult(s)or a limited energy panel,alteration or extension _ _ $75.00 ❑ Landscape Irrigation Control` Minor Labels(10) $125.00 _ Each additional Inspection over ❑ Medical the allowable In any of the above Per inspection _ $62.50 Nurse Calls Per hour _ $62.50 In Plant _ $73.75 ❑ Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ -_ F1 Other 8%State.Surcharge $ - Number of Systems 25%Plan Review Fee See 'Plan Review'section on $ No licenses are required. Licenses are required for all other Installations front of application — — Fees: Total Balance Due $ —"-�" Enter total of above fees $—_ Trust Account# 8%State Surcharge S_, Total Balance Due $-- All New Commercial Buildings require 2 seta of plans. m\dsts\fernts\eic-fees.doc 08/30/01 CITY OF YIGARD BUILDING INSPECTION DIVISION 2' Hour Inspection Line: 639-4175 Business Line: 639-4171 MST BUP Date Requested—/—_ � '_-LL.__AM----- -PM BLD -- -- i Location_- 2 /4zt--. JC ,e Suite �`� MEC - Contact Person ��F'�E- Ph PLM Contractor PhyQ �S(�2_ SWR BUILDING Tenant/Owner _ J J a '1� ,- _ ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain _ Crawl Drain Inspection Notes: SGN Slab Post&Beam --------- ----- _-------------- __-__._._----- --- SIT Ext Sheath/Shear Int Sheath/Shear -"-- Framing Insulation [�-� Drywall Nailing AS/e- s Firewall - Fire Sprinkler Fire Alarm17 Susp'd Ceiling _ ,L�_.� ' -I �;. r��Wt c'�'S, ' � (� _ / Roof — v I y Misc: — Final PASS PART FAIL � PLUMBING . Post&Beam ��_ --.��51. .Z_•--`i _'y --rr--�- Under Slab 1 S, a�i� )/7� �y_� , A Top Out Water �- Service Sanitary Sewer RainDrainsDrains Final PASS PART FAIL is G'�Is �-4 .j�t:i,1..._^�`�C — MECHANICAL Post&Beam '��ty✓► L_ -�t' • , _ J�s�?t1� v�r��^� 1.1`.2 Rough In Gas Line LY14-�-b 2U�. -AEt _ Smoke Dampers Final PASS PART FAIL • w t .� S ELECTRICAL --L! ervi a � Low Voltage --T-i F:re Alarm PART FAIL Backfill/Grading -- -- — ---- -- Sanitary Sewer i Storm Drain ( J Reinspection fee of$ re(�Vired before next inspection. Pay rpt City Nall, 13125 SW Hall Bivd Catch Basin Fire Supply Line ( J Please call for reinspection RE: '�_-__.�! [ J Unaltle to inspect no access ADA Approach/Sidewalk / -other Date C)(4 . . Inspector 4-�t L Ext Final PASS PART FAIL_l 00 NOT REMOVE this inspection record from the job site. CITY O r T I G A R® BUILDING PERMIT PERMIT#: BUP2002-00204 DEVELOPMENT SERVICES DATE ISSUED: 6/3/02 '13125 5W Hall Blvd., Tiqard, OR 97223 (503) C39-4171 PARCEL: 1S126C0-00100 SITE ADDRESS: 09225 SW HALT_ BLVD F SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TI(., REISSUE: FLOOR AREAS _ _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: NONE sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: LEFT SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT. ft KGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,500.00 Remarks: Hood suppression system. Owner: Contractor: MENASHE, R BARRY F.E.S.C. 621 SW ALDER, STE 605 3460 SW 209TH PORTLAND, OR 97205 BEAVERTON, OR 97007 Phone: 503-209-8940 Phone: 503-649-3309 Reg #: LIC 643309 FEES REQUIRED INSP-ECTIONS Type By Date Amount Receipt Sprinkler inspection �_ _ PRMT CTR 5/28/02 $62.50 27200200000 Sprinkler Final 5PCT CTR 5/28/02 $5.00 27200200000 FIRE CTR 5/28/02 $25.00 27200200000 Total $92.50 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) 246-6699 or 1-800-332-2344, Pe rm Ittee Signature: ) "l Issued By: Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit Application 1 -- — Uate received: Per no.: �� T " D j City of Tigard 4ijV E� Address: 13125 SW Hall Qlvd Projecf/appl.no. Expire date: City u/i igard Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 MAY 2W Casc file no.: Payment type: _— Land use approval: r`(e v up a r;:a,w r. 1&2 family:Simple Complex: U I & 2 family dwelling or accessory U Commercial/industrial U Multi-family 6eNew construction U Demolition U Ad(lition/alteration/replacement U•Tenant improvement U Fire sprinkler/alarm U Other: IINFORMATION Job address: 3 Bldg.no,: Suite nZ Lot: Block: , ubdivision: Tax map/tax lot/account no.: Project name t A _ Desc ' tion and locati o orrk un remises/special conditions. -- --� � - ----- r— PT OWNI-N -FOR SPECIAL INFORMATION, Name: Moiling address: (�(. I &2 family dHellinw Eh,�ne �- Stat ZIP: Valuation of work........................................ $ />�Fax: 1 mail: No.of bedrooms/haths.................................wner's representative; / .4(�S Total number of floors........•....•................... Phone ' V I ux: C/'46 E-mail: New dwelling area(sq. ft.) .......................... Garage/carporl area(sq.ft.)................... —_-_ Name: r`/� Covered porch arca(sq. ft.) ....•..••..•. ........... Mailing address: Deck area(sq.ft.)........................................ City. �� 0114d 11=3e Statc: ZIP Other structure arca(s .ft.)....•.•....•............. Phone p Fax: t / E-mail: CommercinUindustrial/multi-family: — Valuation of work................•....................... $ Existing bldg.area(sq. ft.) .......................... _ Business New bldg.area(sq. ft.) ----- -- Address: ..-- — Number of stories City: Plt-� State: LII' Type of construction Phone: Fax: Email: Occupancy group(s): Existing: CCB no.: New: _ City/metro lic.no.,3 aha" Notice:All contractors and subcontractors are required to be t licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be regwred to he licensed in the Address: _ jurisdiction where work is being performed. If the applicant is Cid_ Statc: LIP: exempt from licensing,the following reason applies: Contact person: I flan no.: -- Phone: Fax: E-mail: Name: Contact person: Fees due upon application ........................... $ Address: Date received: _ City; State: ZIP: Amount received ......................................... $ Phone: Fax: I E-mail: Please refer to fee schedule. 1 hereby certify I h read and examined this application and the Not all}udatirtions ccept credit cards,pleme call jurisdiction foi mem information attached checklist. II isio . of ws and ordinances governing this Uvisa OM.aterCard work will be compli 1 h•wh �FI>ecifi herein or n credit card nurnlw: F.Xplres Authorized siig4ture: Date:� � Name of cardholder as shown on credit cert-- ' >— $ Print name:. � Cardholder Nitrtettrrc AmouN Notice:This pemit appf cation expires if a permit is not obtained within 180 days after it has been accepted as complete. 40-461.1(OWnM1 yr-µ/1. -may J -7 u d 1 Fire Protection Permit Check List A.) ❑ New ❑ Addition ❑ Alteration J Repair B.) Modification to sprinkler heads only: Describe work to 1. 1-10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads: Additional description of work: Type of System (_qom_plete A, B or C as applicable A.) Sprinkler Wet ❑ _ D, ry ❑ _ Standpipes — Additional Hazard Inrormation Density____ Design Area _ _ K. Factor Sprinkler Project Valuation: 1 $ B. Type I - Hood Fire Suppression System Hood Project Valuation ;—$ 1000 ,(96 C.) Fire Alarm Submittal shall Battery Calculations _ Yes ❑ Include: Individual Component Yes ❑ _ Cut Sheets Fire Alarm Project Valuation: Project Valuation Subtotal (AB Permit fee based on valuation see chart): $ �-a._�'d 8% State Surcharge: $ _5 (.y FLS Plan Review 40% of Permit: --- _--- ------_ _ - - TOTAL: — Plan review requires a completed application and 3 sets of plans at SUhtnittn . Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. I:\dstsVorms\FPScheckUst.doc 11/21/01 �njQ rir- Z AD D ;��G] h r Z C xnu¢cmrm!urmcmrnca:mmn 2 r .H f O 3 tz -u ;u�2 ;M 7CJf 'o 1, -i n I ,r- r, rye ru r1� ru DW d y Z r r•••• Z-IC S rrr• r -4mM O • • • •r•r• X)CI _ C7 •••••• •.�• C] -- ty • • •r• r•r,•' cn N t:lro 7U N11 •••• • ••r ri t v 11 r ....i D" h•I •• • • • • ••••r. A II G1 8 . r r r .• u L ••••t• rCD W z D •••. r'" LAGI orr,� -CI [rI A r r 'U E4 as _ TT_y tx) rr. . �-4 rzi o ;p ro - - — � mogv m ro X11 N r� � � � Dv DC,. CI —r- !,I"U z� n - n) tj + u. m =lora r Z fUTIF A p U m X 2 I� CT J.• C1 T CI W Nl_ fTl �NC Z Cl CNS C. C7 CA) r1 C 1 D �� W+r 1 Ll 7 DVI r1 D VI C7 H D Z p C`z, *, D CID 0111111lip, n ;u A . .. Agri v J X Z C vri b" D t 1+- CI.D N r �'rt D w it bd < �""♦ �., JD �r....� w D r*I r IrF' r LJ rri~` z O m l A (5. C: 7 M CL N r, t L'' a. UI ty 11 .� o tD tU tD N rr s w G N Ul rh rh tD �`�-- w r• tD ,Ll t.. N rt G. w cU tU rn w rr lu � N rl P� to ao P u tD v n Oft 0n IU 0, I�h A t� tD N � � 0 ZZZZZZ_ m co n 3 m C ' M NN 14 x; at N o w CA to c� ro 0 � o cD rn rno o • O n r � ° o rN* 10 7 K n • • F-� O O p n 4' •V. a O rt N v, to o •: f: O W U,10 a • 0) 0 E • s � an ^ • • • • • • • •Rrv �. W 7 • •• • e rt w � 8 M A N a 10 •• • • • •• •• •• • /n Vl n �1 V l/1 �\ l � n 1 � �) n. � �. �� .... j . T `�,/� � , `� -� ..� . .. . . . , , . . . . , , .. , . , . . , . . . : . . , . . , , . � . , . , � , ; , , . , , , . . , , , . � , . , . , . . . . . . .� ; . . . . . . . . . . . . . . . . . . . , . .• . CITY OF TIGAR vY MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00220 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/3/02 PARCEL: 1 S126C0-00100 SITE ADDRESS: 09225 SW HALL BLVD F SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIG �CLASS OF WORK: FPS FLOOR FURN: EVAP COOLERS: 1 TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: _ BOILERSWOMPRESS_ORS _ HOODS: 1 _ FUEL TYPES _ _ 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 ctm: GAS OUTLETS: > 10000 cfm: Remarks: Install class 1 hood. Owner: _ _FEES MENASHE, R BARRY Type By Date Amount Receipt 621 SW ALDER, STE 605 PRMT CTR 5/28/02 $110.50 2720020000 PORTLAND, OR 97205 PLCK CTFR 5/28/02 $71.83 2720020000 5PC i CTR 5128/02 $8.84 2720020000 Phone: Total $191,17 �~ Contractor: �AT FIRE EXTINGUISHER SF=RVICE PO BOX 1391 BEAVERTON, OR 97075 REQUIRED INSPECTIONS Mechanical Insp Phone:503-643-3309 Mechanical Insp Reg #:LIC 69384 Hood Inspection S.D. Shut-down inspection Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you io follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189. Issue By: Permittee Signature- c Cali (503) 639-4175 by 7:00 P.M. for inspections ne ded the next business day zC0 00 Mechanical Perrnit Application Date received: _ 6'U Permit no.fK City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blv �tIV ED — Phone: (503) 639-4171 ��// Date issued: By:9� 12eceiptno.: — Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: MAY 9 R 2002 Building permit no.: T, , U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U'fenant improvement idNew con,uvctitm U Addition/alteration/n'cplacemen( U Other: t . O' Joh address: I t 9'ti' ( � l� Indicate equipn a t.uantitics in boxes below. Indicate the dollar Bldg.no.: Suite n�_ value of all mcc '�a, �thm.Werials,equipment,hthor,overhead, Tax map/lax lot/account n t o.: profit. Value$ 1 --rU Lot: Block: Subdivision: *See checklist for important application information and Project name: j 1/L: jurisdiction's fee schedule for residential permit fee. City/county &i ZIP: Z�- — l 1p" scription and Mention f work on prennises._ _ l t L- 416i ft lcc(ca.) 7ota1 Est.date of completion/inspection: t Q -- �— Description (py. lies.only Rey.only Tenant improvement or change of use: IIVAC: Air handhigE unit --.-('[:M Is existing space heated or conditioned?IdYes U No _ it conditioning(site plan required) Is existing space insulated"'J 1'r- '_l N" Alteration of existing HVACsystem lioi er compressors State boiler permit no.: $urine , tfrne (�� _ —� -- HP Tons B'fll/11 Address: q4tio �ti�I •tr smo a ampers uctsnnoke etectors City: Stat ZfP: e�)C1 lieu( ume p(sit'- plan requireire—) Phone: 30 Fax:' ( 3(p E-mail: Install/replace furnaceurner TU Including ductwork/vent liner U Yes U No CCB no. nstall/rep ace re;cate heaters-suspended, City/metro lic.no.: wall,or floor mounted _ Name(pleaseprint): Vent for appliance other than furnace e gent on: Absorption units_,.. BTU/H Nam ( / �j Chillers _ HP (lCom ressorsIIP Address: e nv romiac ventilation:n: City Stat ZI . C)� Appliance vent_ hone: Yc>` fAax• J Email Dryer oust on s,Type Il/res. itc en/Mazmal hood fire suppression system - Name: Exhaust fan with single duct(bath fans) Mailin ddress _ - —Exhausts sterna part from heatin orr C Fuel piping en st ut on(up to 4 outlets) Cit State: ZIP $jr �. LPG NG yPe --- y; PI lone: — Fa E-mail: 'tle Mi in r cat 1 a ditiona over 011l Cls rncesspiping(sc ematicrequirc ) Number of outlets Name: _ _ ter d appliance or equipment: Address: —��_ Decorative fireplace (ity_ State: ZIF'__ Insert-type Phone: x: E-mail' oo stove/pe et stove t cr: Applicant's sir alure: - Date: t H; Name(print) ll („5 _ Not all Jurisdictions accept credit cards,pdense cal imisdiction far mate information Permit fee.....................$ U Visa U MasterCard Notice:This permit application Minimum fee.........•.....$ ' expires if a permit is not obtained Plan review(at — 3f) $ Credit card number. --. within 180 days after it has Expires y been State surcharge(R96) ... $ _/��5 —mune of cardholder as shown on c it c - accepted as complete. " TOTAL 9$ -9k—S/ $ - Cardholder riRnaturt —^-- Amount 440-4617(WOWCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.50 _ d Table 1A Mechanical Coda oty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,006.Co and 1) Furnace t 0 BTU $1.52 for each additional$100.00 or including ducctsis&vents _ 14`00 fraction thereof,to and including 2) Furnace 100,000 BTU+ _ $10,000.00. including ducts&vents _ 17.40 $10_,061.0-0t( $25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additiunal$100.00 or including vent 14.00 fraction thereof,to and Including 4) Suspended heater,wall healer $25,000.00. or floor mounted heater 14_00 _ $25,00 r.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance pernlil $1.45 for each additional$100.00 or _ _ __ - 6 80_ fraction thereof,to and including 6) Repair units $50,00900 50__ . 12.15 $ ,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heal Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. footnotes below. CO;'I' Minimum Permit Fee$72.50 T SUBTOTAL: $ 7)<3HP;absorb unit ,Z S-7) to 100K BTU _ 14.00 8%State Surcharge $ 8)3-15 HP;absorb 25.60 Q unit 100k to 500k BTIJ �^ 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb / it.5-1 mil BTi 1 35.00 Required for ALL commercial permits only 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ � � unit 1.1.75 mil 52.20 _ 11)>50HP;absoBTUrb unit>1.75 mil BTU 87.20 12)Air handling unit to 10,000 CFM ASSUMED VALUATIONS PER 'LIANCE: 10.00 - Value Tota 13)Air handling unit 10,000 CFM+ Desai lion:_ Qt Ea Amount 17.20 Furnace to 100,000 BTU,including 955 14)Non-portable evaporate cooler ducts&vents _ 10.00 Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a sinp!a duct ducts&vents 6.80 Floor furnace inciudin�vent _955 16)Ventilation system not included in Suspended heater,wall healer or 955 appliance permit 10.00 floor mounted heater - 17)Hood served by mechanical exhaust Vent not Included in appliance 445 10.00 permit 18)Domestic Incinerators Repair units 805 17.40 <3 hp;absorb.unit, 955 19)Commercial or industrial type incinerator to 100k BTU _ 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves 101k to 500k BTU _ 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU 1.00 >50 hp;absorb.unit, L446 25 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU Air handling unit to 10,000 cfm _ 58 -'^�- 8%State Surcharge $ Air hsndling unit>10,000 cfm 70 Non-portable evaporate c:oole, VeTOTAL RESIDENTIAL PERMIT FEE: $ ntfan connected to a single duct bent system not Included in 56 _ appliance ermlt Hood served by mechan!cal exhaust 858 - Other Inspections pections o and Fees: Domestic InCiner.9tor 1 170 1 Inspections outside of normal business hours(minimu,.i charge-two hours) 562.50 per hour Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour) Other unit,including wood stoves, 858 562 50 per hour Inserts,¢lC. 3 Additional plan review required by changns,additions or revisions to plans(minimum Gas pipin1.4 outlets 380 charge-one-half hour)$82 50 per hour Each additional outlet _ 83 _ 'State Contractor Boller Certification required for units>200k BTU. TOTAL COMMERCIAL _ S "Residential A1C requires site plan showing placement of unit. VALUATION: iL All New Commercial Buildings require 2 sets of plans. IAdsts\formslmech-fees.doc 02111!02 C1TY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00307 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/16/02 PARCEL: 1 S126C0-G0100 SITE ADDRESS. 09225 SW HALL BLVD F SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: FIG CLASS OF WORK: ALT FLOOR TURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL VENT SYSTEMS: STORIES: BOILERSICOMPRESSORS HOODS: _ FUEL TYPES ___ 0 3 HP: DOMES. INCIN: LF'G 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: M 50 -4. HP: CLO DRYERS: FURN < 100K BTU: _ AIR HANDLING UNITSOTHER UNITS: FURN >=100K BTU: <= 10006 Cf m: > 10000 Cf m: GAS OUTLETS: 5 Remarks: Installation of 271 feet of gas piping for existing rooftop unit & new kitchen equipment Owner_ _ _ FEES MENASHE, R BARRY Type By Date Amount Receipt 621 SW ALDER, STE 305 PRMT CTR 7/16/02 $72.50 2720020000 PORTLAND, OR 97205 5PCT CTR 7/115,/02 $5.80 2720020000 Total $78.30 Phone: Contractor: NORTHWEST FIRE INC. 3460 S\N 209'01 BEAVERTON, OR 97007 _ _REQUIRED INSPECTIONS _ Gas Line Insp Phone:503-643-3309 Final Inspection Reg #:LIC 69384 1 his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issid—afice, or if work is suspended for more than 180 days ATTENTION: Oregon law requires y to f4nextrbu ted in the Oregon Utility Notification Center. Those rules are set forth in OAR 052-0 1AR 952-001-0080. YOU may obtain copies of these rules or direct questions to OUNC 6-9189. F Issue By: rL Permittee Signatu .all (50 639-4175 by 7:00 P M. for inspections nee d ay Mechanical'Permit Application Datereceived: Permit no.: ,W0.z City of Tigard Project/appl.no.: � Expire date: �1 City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ Building permit no.: U 1 &2 family dwelling or accessory LI Commercial/industrial _1 Mufti-family U Tenant improvement l^ew construction U Additiotl/alteration/r,-placemcnt U Other COMMERCIAL1 �E Job address: J ; Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.; value of all mechanical mater•ia!s,equipment,labor,overhead, Tax map/tax lot/account no profit. Value$ ._- Lot: I B oc I Subdivision: *See checklist for import- application information and Project name: f 1ri / jurisdiction's fee schedule .or residential permit fie. City/countl ,� �� I ZIP: _ " ae loll skrip4on and cation of wo ,on premix Fee(".) 'Total sl ate of )fupletion/' ction: lk-,crfp(ion (tl). Res,onlr Rvs.only -- IIYAC: Tenant improvement or change of use: Alt handling unit _---CFM Is existing space heated or cond4ioned7 E�Yes U No Air conditioning(site plan required)Is +xistin ..race insulated?U Yes U NoHVA( — -- - — - — Alteration of existing system Hoi er compressors Business na c: State boiler permit no.: --_-- _.. HP Tons BTU/H Address: r Fire/smoke dampers/duct smoke detectors Cit ,_1 -- Slater_ A' 1!'t,r eat pump(site plan required) - - - Pho ( f^tr, t Fax "''r' Email: nst al/replace furnace/burner it P I Including ductwork/vent liner U Yes U No CCB no.: nstalUreplace/re ocale heaters-suspended, City/metro lic.no.: Ia wall,of floor mounted Name(please print). t , V ent appliance other Man furnace t on: n units_--_.-___ BTU/HName: I1 ? -_ HPors HP Address: - enta ex aunt an vent at on:City: Slate: ZIP: e ventPhone: Fax: I:-mail: aunt _ Hoods,Type res, ilchen/aarmat tow hood fire suppression system Name' (- L Exhaust fan with single duct(bath fans) Maili g address: ' 7 - A-/I 1 — :xhatiM system apart lrom eating or AC - L Cllr' / ' Stale' ' r- ZIP:` Fuelpiping and distribution(up to nut ets)y Type: —_-LPG �• NO Oil _ Phone: Fax: E-mail: Puel pi in each a ditional over 4 outlets process p p nt!(sc ematicrequire ) Number of ouilcls _ Name: —_ �— —tither lis teTipjiiiance or equTmenl: _Address: Decorative fireplace City: _ -- — State: ZIP: nsert-rye Phone: Fax: E-mail: oo stov pe et stove er. _ Applicant's sign titre: Name (print)k), t ,�C� _ Mini Nm art Jurisdictions accept credit cards,please call Jurisdiction MA more intommtim. N fee.................. $ .—_. U Viso L3 MasterCard Notice:This permit application Mh1inimum fee................$ Credit card number. _—�__� - expires if o permit is not obtained Plan review(at _ %) $ --_—, expires within 180 days after it has been State surcharge(8%)....$ Name of ear holder as shown on credit card $ accepted as complete. TOTAL .......................$ Cardholdet signature Amount W-417(60DICOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUAT(ON: PERMIT FEE: _ Description: Price Total $1.00 to$5,000.00 Minimum fee$72,50 - Table 1A Mechanical Code _ City (Ea) Amt 1) Furnace t $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and ducts & includingdd 0 BTU ucts&vents 14.00 _ $1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+ fraction thereof,to and including including duras&vents 17.40 _ $10,000.00._ $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnact3 $1.54 for each additional$100.00 or Includingvent 14 00 fraction thereof,to and including 4) Suspended heater,wall heater _ ___ $25,000.00. or floor mounted heater 1400 $25,001.00 to$50,000.00 $379.50 for the firs'$25,000.00 and f 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or -- -- fraction thereof,to and including 6) Repair units _ 12.1' $50,000.00. - $50,001.00 and up $742.00 for the first$50,000.00 and Check all that aF ply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,::ee ar Pump Cond fraction thereof. foot.rotes below, Comp 7)<31-113;absorb unit Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14 00 8%State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 _ ---- - -- 9)15-30 HP:absorb 25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU 35.00 RaqLired for ALL commercial permits only 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: I $ unit 1-1.75 mil BTU _ 5220 11)>50HP;absorb unit X1.75 mil BTU 87.20 12)Air handling unit to 10,000 CFM ' ASSUMED VALUATIONS PER APPLIANCE: 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description: Qt Ea)- Amount 17 20 _ Furnace to 100,000 BTU,including 955 14)Non-portable evaporate cooler ducts&vents _ 10.00 Furnace> 100,000 BTU Including 1,170 15)Vent fan connected to a single duct ducts&_vents 680 Floor furnace Including vent 955 16)Ventilation system not includ(,d In Suspended heater,wall heater or 955 applianctpermit 10.00 floor mounted heater 17)Hood served by mechanical 9xhaust Vent not Included In appliance 445 10.00 Hermit - 18)Domestic incinerators Repair units _ 805 17.40 <3 hp;absorb.unit, 955 19)Commercial or industrial type incinerator to 100k BTU _ _ __ 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves 101k to 500k BTU _._ _ 10.00 _ 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mll.BTU _ _�.._ 5.40 30-50 tip;absorb.unit, 3,400 22)More Than 4-per outlet(each) 1-1.75 mil.BTU__ ___v_ 1.00 >50 hp;absorb unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU - -- _ Air handling unit to 10,000 dm 656 _ - 8%State Surcharge $ Air handling unit>10,000 cfm 1.170 Non-portable evaporate cocler _ 656 - TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct _446 Vent system not included In 656 a Ifance permit -- Other In 'one and Hood served by mechanical exhaust 656i4-� _ 1 170 1 Inspdctlonv outside of normal business hours(minimum charge-Iwo hours) DOmeSIIC inClneretOr $62.50 per hour. Commercial or Industrial Incinerator 4,590 2 Inspections for whic i no fee is specifically indicated (minimum charge-half hour) _ her u Otnit,Incfuding wood stoves, 656 $62 50 per how inserts,etc. 3 Additional plan review required b,changes,additions or revisions to plans(minimum Gas I charge-one-half hour)$62.50 per hour Ing 1-4 outlets 380 Each additional outlet 83 'State Contractor Boiler Certification required for units>200k BTU. " �r Residential A/C requires site plan showing placement o.unit TOTAL COMMERCIAL $ . VALUATION: _ _ All New Commercial Buildings require 2 sots of plans. I:\dsts\forms\rnech-fees.doc 02/11/02 4 Q' d w a, z pal I— 0 L� r, J tt til�M �❑ W d Z+� J LJ 'I ..Li — Z w}Ln t2 J X� `` n� a1 �r r � •z =� CL U o F- Z ri >_Ln 7 Cl L] J u h- V1• d 1 Z vl V F.- aULL '.. Q C Q} p LL I'I rel to L Z 0 d 41) G c1 W 41 CL (t) h >i V 1J � 2 J LJ I 2- u Ir I 111. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received ------ —__ Date Req rested___--__ -r_ 1_ -__-- AM__—_____.-__- PM-----.__- BUP — __-- Loraticn _ �_-— W_�-_---_ __- Suite __.n__.__._ MEC —_ Contact Person _ _----- ---__._ Ph(— ---) �� CCJ PLM Contractor Ph---- -- Ph( -) —� SWR BUILDING Tenant/Owner ELC Footing -- ELC Foundation Access: G Ftg Drain ELR __s.,! 3 Crawl Drain Slab Inspection Notes: SIT — Post& Ream J. _ — -- ---.--- Shear Anchors Fxt Sheath/Shear Int Sheath/Shear Framing ---- - - --- - -- -- ----- -- Insulation Drywall Nailing - - ---- —--- ---- - Firewall Fire Sprinkler ----- -- --- --- - - — _ —. ---- Fire Alarm Susp'd Ceiling - -- --- - _ — --- Roof O'her: -- - -------- F;nal i PASS PART FAIL. PLUMBING Post R Beam Under Slab Hough-In Water Service Sanitary Sewer Rain Drains - -- - Catch Basin/Manhole Stone Drain - - - Shower Pan Other: Final PASS PART FAIL ---- -_ MECHANICAL _ Post& Beam Rough-In --- - - - --- -- - ------- _ Gas Line Smoke Dampers — - - — - -- —- -- - —_-- Final PASS PART FAIL - --- --- -- --_ --- ----------_ ---- --- E[.ECTF�ICAL Secures ----- -�- Rough-In _-- UG/Slab rm PART FAIL [� Reinspection fee of$_— required before next inspection. Pay at City Hall, 1:3125 SW Hall Blvd. `___ i Unable to inspect-no access SITV___, Please cal.for reinspection RE- —__..__ __—_ - � - -- p Fire Supply Line ADA Approach/Sidewalk Dots" _( — Inspector . - Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 ` INSPECTION DIVISION Business Line: (50:3)639-4171 Received __ Bate Requested '1.2 PM Location Contact Person _. Ph Contractor--- ------ - -- - Ph(- ) ----- S'NR _OUILMING Tenant/Owner ---- _ —_ ---- _- — ELC Footing Foundation ACC@SS: EL C Fig Drain EL Crawl Drain _ - -�--- - Slab Inspection Notes: SIT Post& Beam ------ _. - ----- - -- Shear Anchors Ext Sheath/Shear IntSheath/Shear Framing Insulation Drywall Nailing --- - - -- - — - --- -- - Firewall Fire Sprinkler Fire Alarm --- -- ----� Susp'd Ceiling -- -- --- --- —— - --- ---- Roof Other: - -- - ------- _�_�. !aT, -- -- tS -' PART FAIL PLUIiABIN_G ---- -_ - Post& Beam Under Slab - Rough-In Water Service - - -- - - --—---- -�---- Sanitary Sewer I lain Drains Catch Basin i Manhole - 7255'� --- Storm Drain ----- Shower Pan Other. --------- Final - --FinalPAJS& - _ FAIL_ - t'3 earn -- Rough-In - -- - --�_ — —.--_�_ Gas Line ke Dampers - -- S PART FAIL — RICAL service (lough-In UG/Slab I.ow Voltage Fire Alarm F nal Reinspection tee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE I] Please call for reinspection RE: - -_ Unable to inspect--no access Fire Supply Line ADA Approach/Sidewalk Osts _ � � 1 Inspector � Ext Other: Final DO NOT REMOVE this Inspection record from the)ob site. PASS PART FAIL CITYOF TIGARD BUILDING PERMIT PERMIT#: BUP2003-00080 DEVELOPMENT SERVICES DATE ISSUED: 3/3/03 13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 PARCEL: 1S126C0-00100 SITE ADDRESS: 092.25 SW HALL BLVD B SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: — S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: l I"K sf N: S: E: W: OCCUPANCY GRP: E3 TOTAL AREA: 0 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: fl RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 3,000.00 Remarks: Create new TV room in existing E-3 daycare. No change in use or occupant load. Owner: Contractur: MENASHE, R BARRY CONSTRUCTION MANAGEMENT & BUILDERS 621 SW ALDER, STE 605 8375 SW APPLE WAY PORTLAND, OR 97205 UNIT N-302 Phone: PORTLAND, OR 97225 Phone: 503-203-5946 Reg #: LIC 145901 FEES REQUIRED INSPECTIONS Description Date Amount i Electrical Permit Required I 1131IILUJ I'crnnt cc� 3/3/03 $72.10 Frarning Insp Final Inspection I nXj 8%)titan 1,1\ 3/3/03 $5.77 - Total $77.87 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 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)2.46-6699 or 1-800-332-2344. Issued By: L ( <<. Signature Signature: Call 639-4175 by 7 p.m. for an Inspection the next business day Building I Permit App iea_tion Received Uuildin p g BD .� Date/ti it � l O� Petmit No.:P 3-t City O1P Tigard Planning App mval Other 3' g Date/By: _ _ Permit No.: _ 13125 SW Hall Blvd. flan Review — Other - Tigard,Oregon 97223 Date/H : --_- Permit No.: — Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Internet: www.6tigard,or.us Date/By: _.. Case No. g Contact See Page 2 for 24-hour Inspection Request: 503-639-4175 Namc/Method: (01 Submental Information _ TYPE OF WORK _ REQUIR'-D DATA: New construction _ _ Demolition i &2 FAMILY DWELLING Addition/alteration/re lacement Other: --- — 111�0 CATEGORY OF COLNSTRUCTION— Note: Permit Ices*are based on the total value of the work performed, indicate — i &2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, �r uverlmcad and profit for the work indicated on this application. Accessory Building Multi-Family _ --- - -- --- Master Builder ❑Other: valuation.......................... $ - _ No.of bedrooms: No.of baths: JOB SITE INFORMATION and LOCATION - Job site address: W,A$` Total number of floors.................................. New dwelling area(sq.ft.)......................... Suite #: B1d ./A t.#: �_. Garage/carport area(sq.fl.)............................ Project Name: Covered porch area(sq.fl.)............................. Cross street/Directions to job site: Deck area(sq.fl,)............................................ Other structure area(sq.ft.)............................ REQUIRED DATA: 4 COMMERCIAL-USE CHECKLIST Subdivision: ---- Tax map/parcel #: Note: Permit fees*are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, r-- overhead and profit for the work indicated on this application. F Valuation .............................. 4 /1 Existing g ( q ) G�� I , r t f J� New building area(sq, fl. .................. ........... $ �� Number of stories........................................... __T1 —�— PROPERTY O'1VNER_. TENANT type of construction.—................................... Name: Occupancy group(s): Existing: .3 _ -- ---------—- .— ------ —___-- / Address: New: _ Cit /State/Zi � _ � • i �—._ Phone: Fax: NOTICE: All contractors and subcontractors are required to be APPL' ICANT 10 CONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Name: _ jurisdiction where work is being performed. If the applicant is exempt Contact Name: 4 �^ from licensing,the following reason applies: Address: u -- -- ---- Cit /y State/Zip Phone: Fax__ -..______ E-mail: BUILDING PERMIT FEES• L rlease refer to fee schedule. CANT CTOR— -- - — Business Name: VAI 6WOZH ccs due upon application....... Address: K '-7 5 S WG Cit /State/Zi : Cy Amount received............................................. s Phone: y 4 ax: Date received: CCB Lic. #: -- Authorized- 7T� Notice: This permit if a pernili is not obtained within Signature: _ Date:3 180 days after It has been accepted as comiilcte. *Fee methodology let by TH-County Building Industry Service Board. — (Please print name) — r,I:\Dsts%PermitForms\HIdgPermitAnp.doc 01/03 f ' 77' " r One-and Two-Family Dwelling � Building Permit Application Checklist Reference nu.: ,associated permits. City of'I'igurd City of Tigard l7 Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U other: Phone: (503) 639-4171 Fax: (503) 598-1960 THE FOLLOWING 1 FOR PLAN REVIEW Yes No N/A I band use actions completed.tier jurisdiction criteria lin concurrent reviews. -- -- Zoning.Flood plain,solar balance points,se}sriic soils designation,hislom Ir,uict,etc. 3 Verification of approved plat/lot. _ 4 Fire district_—approval required. 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewer permit. 7 Water district approval. 8 Soils report. Must carry original applicable stamp find signature on file or with application. 9 Erosion control U plan U permit required, Include drainage-way protection,silt Fence design and location of catch-hasin protection,etc. 10 3 Complete sets of legible plans.Must be drawn to settle,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on it scparn'^.full-size sheet attached to the plans with cross references between plan location and detail!;. flan review cannot be completed if copyright violations exist. I I Shelplof plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 441.elevation differential,plan must show contour lines at 24t.intervals);location ofeasements and driveway;footprint of'structure(including decks);location of wells/septic s�aeras.utility locations;direction indicator;lot _area;building coverage area;percentage of coverage;impervious area;extsting structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolls,any hold-downs and reinforcing pads,connection details,vent size and location. _ 13 Floor plans.Show all dimensions,rooao identification,window size,location of smoke detectors,water heater, furnace, ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _ 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor heams,headers,joists,sub-floor, wall construction,roof construction. More than one cross section may he required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs. fireplace constriction, thermid insulation,etc. I S Elevation views.Provide elevations for new constriction;minimum of two elevations for additions and remodels. Fxterioi clevalions must reflect the actual grade it the change in grade is greater than tour foot at building envelope. Dull-sire sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for nun-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/root framing.Provide plans for all floors/roof assemblies,indicating int-mber sizing,spacing,and hearing locations.Show attic ventilation. 19 Basement and retaining walls.Provide cross sections and details showing PlarcniL of rebar. For engineered systems,sea:item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of ca6:ulations using current code design values for till beams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load, 20 Manufactured floor/roof truss design details. 21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more appliances. 22 Engineer's caleulations.When required or provided,(i.e..shear wall,roof tnt,;0 shall he stamped by;in engineer or architect licensed in Oregon and shall IV Jw n ti)he apph( able to the Prof,t t +ender review. 23 Five(5)site plans are required for Item I 1 aha�vc. Site plans must he 8-1/2"x I I"m 11"x 17''. 24 Two(2)sets each are required for Items 16, 19,29&22 above. 25 Building plans shall not contain red lines or tape-one. "Mirrored"building plans will he not accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "Drawn to scale" indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 4404614(rrotucoM) i SEE 35MM ROLL# 23 FOR LARGE DOCUMENT ELECTRICAL PERMIT CITY OF TIGARD - _ PERMIT#: ELC21003-00549 DEVELOPMENT SERVICES DATE ISSUED: 9/2/03 13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 1S126120-00100 SITE ADDRESS: 09225 SW HALL_BLVD A ZONING: SUBDIVISION: BLOCK: LOT : .IURISDIcrION: TIG Project Description: (2)each sign lighting. RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ _ MISCELLANEOUS 1000 SF OR LESS: — 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 5GOSF: 201 - 400 amp SIGN/OUT LINE LTG: 2 LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/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: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+amp/volt: —4-RES UNITS: >600 VOLT NOMINAL: Reconnect onl SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC:-- Owner: Contractor: CARLYLE INVESTMENTS MULTI-LIGHT SIGN CO. 621 SW ALDER 809 N E LOMBARD PORTLAND,OR 91223 PORTLAND,OR 97211 Phone: 203.221-4040 Phone: 281-3083 Reg#: LIC 64107 __ ----- SUP 343SIG FEES _ ELE 26-90CLS —� Description Date~ A.nount Required Inspections I I.I'RMT]E.LC Permit 9/2/03 $106.80 -- I AXJ 8%state'rax 9/2,'03 $8.54 Rough in Elect'I Final Total $115.34 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire it work is not started with'n 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 Orr gon 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 to OUNC at(503)246-6699 or 1-800-332-2344. Issued By: /!,� LGL.frit - ( /L" t-,,- Permit Signature: _ OWNER INSTALLATION ONLY _ The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE:_ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:_. LICENSE NO: — Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application RECEIVED _ C Permit no.:�r - tJUJ j� City of Tigard � 1L.CEIVED Project/appl.no.: Expire date: Address: 13125 SW Hal I Blvd,Ti ard,OR 97223 Date issued: B Receipt no.: Ci{yu/'1'ignrd t,• , r Bye P Phone: (503) 639-4171 ,,�� I) ,� 200 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: CITY OF 1 IGARV _ 'ITJ1iT7F . U I &2 family dwelling or accessory ommercial/industrial U Multi-family U Tenant improvement U New constntetion U Addition/alleration/replacement U Other: U Partial .108 SITE INFORMATION ,lob address: zz c �- LV " Bldg.no.: I Suite no.: ax map/tax lot/account no.: Lot: I Block: JSubdivision: Project name: ! ti>A L— Description and location of work on premises: 16 Estimated date of completion/ins ction: CONTRAU'll OR I ION Job no: Per Max -- Description 1(►'. lea.) Totai nip.insp Business name: A.t New resit ential-sinple or m illi-family per Address: :t 'iU doellingunit.Incladmattarhedgarage. City:i6&L j.St1ItqzIP: Service Included: Phone: ?6 Fax: E-mail: I(Nx)sy It nr less ! Each addruunal 500 sq.ft,or portion thereof _ CCH no.: e Glee.bus.tic.no: Z�, C� S lAinitedenergy,residential City/metro tic.no.: 14 7Limit ed energy,non-residential Each mmnufactured home or modular dwelling Signature of supervising electrician(required) Date Service and/or feeder License no: Services or feeder-Installation, Sup.elect.name(print): J/� alteration or relocation: MIMI 2W amps or less 2 Name(print): t —�� - 201 amps to 40()amps 2 401 amps to 600 amps _ 2 Mailing address: (may�_( `�_ 601 amps to 1010 amps 2 Cll 1 Statq.- ZIP: z '�? Over I(xio amps or vnits _-��— - 2 Y_j a�t—C c1n� _— Phone: '7.2- - 'aX: E-mat : Reconnectonl I Owncr installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rens.or exchange according to btstallsit Ion,alteration,orrelocalIon: 200 amps or less 2 URS 447,455,474,670, ?U1• 201 amps it,4011 amps �— 2 Owner's si nature: Date: . _ 401 to(0)arms — 2 Nranch cireuils-new,alteration, or extension per panel: Name: _ A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit _ Oily; Slate: IIP: H Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional brnncr,circuit Misc.(Service or feeder not Included): O Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle —_ 2 n fighting 3 U Service over 320amps-ratingof I&2 U HazuBach sig or outline htin nlouslocatinn g g L ; 140 /a 2 (anti Iydwellings U Budding over l0,(N10 squar feet hour or Signal circuit(s)or a limited energy panel, U System river W)volts nominal more residential units in one structure alteration,or extension' 2 U Buildingoverthree stories U Feeders,400 amps or more •ths�.riplion� U(kcupant load over 99 persons U Manufactured structures or RV pati: Each additional Inspection over the allowable In any of the above: U F.gress/lightingplat U tither' _ Perhupecunn — Submit._._sets of plans with any of the above. Investigation fee• The above are not applicable to temporary construction:ervice. Other — Permit fee.....................$ __L2jhL—.'6 Not all Jurisdictions accept credit cards,please call Jurisdiction for mom in mtontiarl Notice:71tts permit application expires if ennit is not obtained Plan review(at ,_ 9h) $ ex it — U Visa U MasterCard P P credit card number _.-. _.-. —�____ _. 1 within 180 days after it has been Stale surcharge(Sabi....$ �'v• `J_ Exphr, accepted as complete. TOTAL .......................$ _ILL , 4 Name of c a vis shown on credit cid S `— cardholder signature --- — Amount 440 4615(6011COM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Enemy Fee.. .................... Number of Inspections per permit allowed (FOR ALL SYS FMS) Service included: Items Cost Total y Check Type of Work Involved: Residential•per unit 1000 sq ft.or less $145 15 4 Audio and Stereo Systems Each additional 500 sqit or portion thereof $33.40 _ 1 Burglar Aidrm Limited Energy _ $75.00 Fach Manufd Home or Modular Garage Door Opener' Dwelling Service or Feeder $9090 __ 2 Services or Feeders L_J Healing,Ventilation and Air Conditioning System' Installation,alteration,or relocation [00 amps or less $8030 2 Vacuum Systems' 201 amps to 400 amps $106.85_ 401 amps to 600 amps _ $16060 2 r--r 601 amps to 1000 amps $24060 2 Other Over 1000 amps or volts $45465 2 Reconnect only $66.85 � 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Feefor each system.......................................................... $7,5.00 Installation,alteration,or relocation 200 amps or less — $6685 2 (SEE OAR 918-260-260) 201;,nps to 400 amps _ _ _ $100302 2 m 401 amps to 600 aps $133 7.5 � 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service or FjClock Systems feeder fee. f_ach branch circuit $6 65 _ —. 2 �] Data Telecommunication Installation b)The fee for branch circuits without purchase of service CJ Fire Alarm Installation or feeder fee. First branch circuit _ $46.85 n FIVAC Each additional branch circuit $6,65 Miscellaneous Instrumentation (Service or feeder not included) Each pump or irrigation circle $5340 C] intercom and Paging Systems Each sign or outline lighting — $5340 Signal circuits or a limited energy panel,alteration or extension $75.00 w_ Landscape Irrigation Control' Minor Labels j10) _ $125.00 Medical Each additional Inspection over the allowable in any of the above Ej Nurse Calls Per inspection _ $6250 Per hour $6250 F]In Plant v $73.75 Outdoor Landscape Lighting* Fees: Protective Signaling Enter total of above fees $ Ct n Other — p� 8%State Surcharge $ Ej c iJ�i �----Number of Syst»ms 25%Plan Peview Fee No licenses are required. Licenses are required for all other insinuations See"Plan Review"section on $ front of application Fees: Notal Balance Due Enter total of above fees LJ Trust Account# 8%State Surcharge S "^--�+ -- Total Balance Due $—^ i 41sts1formsklc-fecs.doc 10109!00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 —� • BUP Date Requested_ _AM —PM BLD Location U Z Z S ,5L✓ ��y Suite _ MEC _ Contact Person _ Ph �/ ��— _ PI_M --Out/Y Contractor Ph SWR _ BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: ,✓ —�� — Foundation FPS Ftg Drain r_ " SGN Crawl Drain Inspection Notes: - ----- Slab --- -- - -- - - - SIT Post& Beam ---��-- - Ext Sheath/Shear Int Sheath/Shear —�- Framing - Insulation j - Drywall Nailing Firewall Fire Sprinkler Fire Alarm � ousp'd Ceiling _— Roof Final PASS PART FAIL o earn,� Water Service - Sanitary Sewer Fj �PA;Wel PART FAIL �OFCUHRANICAL - _ �- Post& Beam Rough In Gas Line ---- --- - Smoke Dampers Final ---_.-. ---- -- �_ - PASS PART FAIL V ELECTRICAL Service Rough In , i UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain ( I Reinspection fee of$ i required before next inspection Pay at City Hall, '3125 SW Hall Blvd Catch Basin ( I Please call for reinspection RE: [ J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Dante _ Inspector —_ -�Ext - Final PASS PART FAIL DO NOT REMOVE. this inspection record from the job cite.