Loading...
12090 SW MAIN STREET-2 IS NIVW MS 060ZI, cn z rx a g (n co o rn � o N m � W J I 12090 SW MAIN ST CITY OF'TIGARD 24-Hour BUIf_DING i Inspection; Line: (303)639-4175 i� MST h.SPFC 1 X011 DIVISION� Business Line: (503)639-4171 ` 9 7 r BUP J_----- 0 0 Received __ / �pDate Requested AM BLIP Location ��1_�__L/L)L__ _44"A .—�—Suitte.p MEC Contact Person _-- _nom, __ __ _ _ Ph PLM Contractor _ Ph( _) _ SWR DI _ ena caner . a. ELC Footing ELC — Foundation Access: Ftg Drain ELR _ Crawl Drain Slab I spectiolI Not�1S. � SIT Post&Beam Shear Anchors 40 64441 ' Ext Sheath/Shear Int Sheath/Shear Framing --- Insulation t-G L l Aj%L TGs T Drywall Nailing -- Firewall — Fire Sprinkler Fire Alarm Susp'd C ling - — -- Roof /Y Other: --�-- - - - Fi ASS PART FAIL — , -- BING Post&Beam Under Slab — — Rough-In Water Service Sanitary Sewer Rain Drains L - Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post&Beam Rough-In _ 4. Gas Line Smoke Dampers — ---- f Final PASS PART FAIL - - — ELECTRICAL _— J Service _ CO Rough-In _ W UG/Slab — Low Voltage Fire Alarm Final F-] Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ F] Please call for reinspection RE: �. �� Unable to inspect-no access Fire Supply LineADA Approach/Sidewalk Dab -I -D- Inspectofl � A 0ue-��_ Other: Final DO NOT REMOVE this Inspection rvmrd from the job alts. PASS PART FAIL ft C� BUILDING PERMIT CITY O F T I G A PERMIT#: BUP2003-00149 DEVELOPMENT SEWCONZS DATE ISSUED: 4/23/03 13125 SW Hall Blvd..Tigard, OR 97223 (503)639-4171 PARCEL: 2S102AA-00903 SITE ADDRESS: 12090 SW MAIN ST SUBDIVISION: PAYLESS SHOPPING CENTER ZONING: CBD BLOCK: LOT: 004 JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPF OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: A3 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: ft RGHT ft FIR SPKL: SMOK D'T: DWELLING UNIT: FRNT: ft REAR: ft FIR ALRM : HNP-ICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,300.00 17—a rks: Upgrade fire suppression system to LJL300 standard Owner: Contractor: MCDONALD'S CORP 036/0041 SANDERSON SAFETY SUPPLY CO. PO BOX 66207 1101 SE 3RD AVE AMF O'HARE PORTLAND,OR 97214 CHICAGO, IL 60666 Phonc Phone: 2.38-5700 Reg#: MET 0000008044715 FEES LTJ REQUIRED INSPECTIONS Description Date Amount Final Inspe;tion BUILD] Permit Pee 4/1/03 $62.50 [TAX] 8%,State Tax 4/1/03 $5.00 JFLS] FIS Pln Rv 4/1/03 $25.00 Total $92.50 L r This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is J not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law p requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0 1--GOIG through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by U cal' g (503)246-6699 or 1-800-332-2344. J 1 IS ed By: AAV -- P@Write Signature: Call 639-4175 by 7 p.m. for an inspection the next business day Re Protllfon System i Tu L — B.uildin. Nxmit Applie E I VE eceived Bu iu:rg )ater :3 Prrrnit Ne. Planning Approval other City of Tigard MQ 1 1003 Date/fly: ate/ly -- Permit No 13125 SW Hall Blvd. Plan Review �7 Other "Tigard,Oregon 97223 Cl F ARD Uate'-6 ���i (Permit No.: Post-RcviewLand Use Phone: 503-639-4171 Fax: 503-598-1960$-(J SIO nate/By: Case No. Inlcrnet� www.ci.tigard.or.us Contact — –-- Juris: N See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method Supplemental Information 4 _ 'TYPE OF WORK _--� REQUIRED DATA: ONew constnlctionDemolition I &2 FAMILY DWELLING ri-"`ddition/alteration/replacement Other: CATEGORY OF CONSTRUCTION Note: Permit fees'are based on the total value of the work performed Indicate 1 &2-Family dwellintrf ommercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. Accessory Building _ Multi-Family _ _ Master Builder Other: Valuation...................... .................................. S I — - and No.of bedrooms:--- No.of baths: I .iC3 SITE INFORMATION and LOCATION --- 'Total number of floors..................................... Job site address: /Z''(t) G. New dwellingarca s fl. _ Bid ./A t.#: (,q. ).............................. Suite#: - � _ _ Garage/carport area(sq. fl.)............................ —Project Name: /V(t o.��r� A�_ _ Covered porch area(sq.fl.)............................. —_ _ Cross street/Directions to job site: Deck arca tur area ............................ Other structure area(sq.fl.)............................ REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivisions -- -� Lot#: 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. - -- Valuation................... V Existing building area(sq.fl.)........................ _ New building area(sq.fl.)............................... _ Number of stories............................................ 12:PROPERTY Os'✓NER TENANT 'Type of construction....................................... Naar' Occupancy group(s): Existing: -- -- - -- _ New: _ Address: —City/State/zip: . NOTICE: All contractors and subcontractors are required to be Phone: Fax' licensed with the Oregon Construction Contractors Board under APPLICANT I U CONTAC'Tf PEP.SON provisions of ORS 701 and may be required to be licensed in the Business Name: n,,.c�0 JOW✓- Sa y jurisdiction where work is being performed. If the applicant is exempt Contact Name: N from licensing,the following reason applies: CL Address: 1101 _5L_ top Cit /State/Zip: c I` N Phone: '; f 70v Fax: _o j - `✓u T BUILDING PERMIT ItIS` y E-mail: Please Irefer to fee scheddle. J CONTRACTOR m � yv Business Name: �P Fees due upon application............... ............. ; _ -_� Address: Amount received...................._....................... S Cit /State/Zi : //0 / -- Phone: Fax: Date received:---,__^ CCB_. #: 496 !j _-s--- -- - Authorl7ed 3 Notice: Thi.Permit application expires If a permit Is not obtained within Signature: ------ Date:_. Q) 190 days after It has been accepted as complete. 'Fee methodology set by Trl-('aunty Building Industry Service Board. (( lease print name) is\I)sts\Pernit Forms\BldgPernitApp.doe 01103 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: � f 64 e Toto _Type of System Complete A, B or C as a -ca-- A.) Sprinkler Wet ❑ D ❑ _ Stand�i�es Additional Hazard Group Information Densitv Design Area K. Factor __ Sprinkler Project Valuation: $ B. Type I - Hood Fire Suppression System _ Hood Project Valuation — C.) Fire Alarm Submittal shall Batted Calculations Yes ❑ Include: Individual Component Yes ❑ lCutSheets Fire Alarm Project Valuation: $ a Pro ect Valuation Subtotal (A, B & C): $ Permit fee based on valuation see chart : $ 8% State Surchar e: $ FLS Plan Review 40% of Permit: $ t— op TOTAL: $ Plan review requires a completed application and 3 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal c f an Oregon licensed fire suppression engineer, or NICET level "3" technicians. iAdsts\forrnsTPScheckllst.doc 11/21/01 � G GodIr April 18, 2003 CITY CSF 71GARD Michael Bowman OREGON Sanderso i safety 7 I ]()] SE 3rd Port land, OR 9`7214 RI : MCDONALDS, FIRE SUPPRFSSION SYSTEM Pro'ect Information l3iiilding Permit: BUP2003-00149 Construction"Type: VN Tenant Name: McDonalds Occupancy Type: A3 Address: 12090 SW Main Street Occupant Load: NA Area: NA Stories: 1 Sprinkled: NA Alarms: NA The plan review was performed under the State of Oregon Mechanical Specialty Code (OMSC) 2002 edition; and the Tualatin Valley Fire&. Rescue Ordinance 99-01 (TVFR99- 01) 1999 edition. The submitted plans are approved subject to the following. w The automatic fire suppression system shall be interconnected to the fuel or current supply for the cooking equipment and arranged to automatically shut off all equipment under the hood when the suppression system is activated. Shut off valves or switches shall be of a type that requires manual operation to reset. 509.5 OMSC • A readily accessible manual activation device shall be located at or near a means of egress from the cooking area, a minimum of 10 feet and a maximum of 20 feet from IL the kitchen exhaust system. The manual activation device shall be located a minimum of 4 '/2 feet and a maximum of 5 feet above th% finished floor. Instructions for N operating the fire suppression system shall be posted adjacent to manual activation device. 509.4 OMSC 00 • An approved K-type portable fire extinguisher shall be installed within 30 feet of the W cooking equipment, as measured along an unobstructed path of travel. 1006.2.7 -J TVFR99-01 • Extinguishing systems shall be ser✓iiced at least every s K months. 1006.2.8 TVFR99- 01 13125 S%N Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 CITY OF TIGARD OREGON Approved Plans: I set of approved plans, bearing the City of Tigard approval stamp, shall be maintained on the Jobsitc. The plans shall be available to the Building Division inspectors throughout all phases ofconstructica. 106.4.2 OSSC Premises Identification: Approved numbers or addresses shall be provided for all new buildings in such a position as to be plainly visible and legible from the street or road fronting the property. When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittni. The letter of transmittal assists the City of Tigard in tracking and processing the documents. P.esbcctf, i. Bro lalock, Senior Plans Examiner r J U J 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2172 � PIN, �� �a�'j0 So f o&" FI( HAUST HOOD TYPE - 1 EXHAUST DUCT I�it 1 r ks�.e►t �oo� 19 ►o"„ao" RECEIVED MAR 31 2003 CITY OF TIGARD BUILDING DIVISION 0 - 0 0 1 1 1 3-G�.S CITY OF TIGARD Approved.......................................................... (}C�: Conditionally Approved..................................... For only the wgrk as de�fibed into s PERMI i N0._ See Letter to:Follow............................... ..........( Attach............ ...........................�: R- 102 RESTAURANT Job Address�4°pa— tA) FIRE SUPPRESSION SYSTEM aStandard UL 300 Listed) AJ_L PIPING SCH. 40 - BLACK IRON ALL FITTINGS- STANDARD BLACK )RON - 150# INSULEX Low pH Liquid Fire Suppressant NOZZLES S FLOW � q m _ W SL1. R-102 -� AL GLON-U1. 300 I UCT -2W L E NUM - I N 1 :"'OZZLE FLOW # PLLANCE - IN DETECTOR @.) 300 UEC. _ PLIANCE - 230 G _7UE L SHUT-OFF VALVEPLLANCE 245 - CONTACTS FOR SHUT-DOWN_ ~ - IR.E.MOTE PULL STATION APPLIANCE 260 LT . 20 . R CART. PLLANCE 290 LT - 30 • R CART. APPLIANCE PLIANCE - IFN (DOUBLE CART APPLIANCE I W T1 -- Ff F, 2120 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 SUP Date Requested_" U AM PM BLD Location_ Y) Suite MEC Cuntact Person _ Ph _ PLM Contractor ®®Ph SWR BUILDING TCngpt`Owner L,r[ ELC Retaining Wall ELR Footing Foundation NOT REQUESTED FPS Ftg Drain FOUND DURING RESEARCH Crawl Drain I NO INSPE("I'ION(s) IN FII,E SGN Slab � SIT Post&Beam Ext Sheath/Shear _ Int Sheath/Shear F-aming Insulation Drywall Nailing _ Firewall ! Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final P ART FAIL — — - — -- --- LUMBIN Post& Barri �— Under Slab Top Out - Water Service Sanitary Sewer Rain Drains ' PART FAIL Post& Bean) -- -- — —-- Rough In Gas Line ------- — — Smoke Dampers Final PASS PART FAIL 4. ELECTRICAL— Service Rough In UG/Slab Low Voltage ,J Fire Alarm m Final j PASS PART FAIL -- w SITE Backfill/Grading — -- — -� Sanitary Sewer Storm Drain [ 1 Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ Please call for reinspection RE _ —_ _�. [ )Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk '� /Date Inspector LY Other Ext Final PASS PART FAIL DO 14OT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 Date Reqs pasted OW AM PM RLD Location 211 (:! r Suite /- MEC _ Contact Person _ ( _ Ph �x Olk PLM Contractor_ __ Ph �'9'" g c`'. 3 SWR f LD erELC — Retaming Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: — — Slab SIT Post Beam Ext Sheath/Shear NO J/' Int Sheath/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susl�d Ceiling �v °�_� !J–�2 _ / S T –_ (ZT_ y 5–V���f'--� PART FAIL - LING Po.;t& Beam - `-- Under Slab Top Out – Water Service Sanitary Sewer Rain Drains _ Final — PASS PART FAIL MECHANICAL [lost& Beam ––-- ----- -- Rough In Gas Line -------- — _ ,– Smoke Dampers Final ---- PASS PART FAIL ELECTRICAL. -- �— "�-- EL Service pa.. Rough In – N UG/Slab G Low Voltage J Fire Alarm Final PASS PAPT FAIL – �_– ---- –. W SITE BackfilllGrtading --– — –" – --- Sanitary Sewer Storm Drain [ )Reinspection fee of$ _ _ requircd before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: _ [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk "3 / -71 / 00 ' ' !! ll Other Date CJ Inspector Ext Final PASS PART FAIL DO NOT REMOVE this nspection recor, frrl,m the Job site. • CITY OF T I G A R D - BUILDING PERMIT _ PERMIT#: BUP2000-00094 DEVELOPMENT SERVICES ORIGINALE ISSUED: 3/28/00 13125 SW Hall Blvd.,Tiqard, OR 97223 (503)639-4171 PARCEL: 2S102AA-00903 SITE ADDRESS: 12090 SW MAIN ST SUBDIVISION: PAYLESS SHOPPING CENTER ZONING: CBD BLOCK: LOT: 004 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: LINK sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP, RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ff, FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 6,980 00 Remarks: Reroof of existing building, built-up roof covering to remain. Owner: Contractor: MCDONALD'S CORP 036/0041 ABC ROOFING CO INC PO BOX 66207 10123 SE BRITTANY CT AMF O'HARE CLACKAMAS, OR 97015-6670 C�hCone, It. 60666 Phone: 503-786-0616 Reg#: uc 427 _ FEES REQUIRED INSPECTIONS _ Type By Date Amount Receipt Misc. Inspection kf--1u5Pfe-r PQ;,r - fc. 0-,JE2 PRMT DEB 3/28/00 $96.25 HAND RCPT Final Inspection 5PCT DEB 3/28/00 $7.70 HAND RCPT Total $10195s This permit is issued subject to the regUiations contained in the Tigard Municipal Code, State of OR. Specialty Codes and a:l 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 i Notification Center. Those rules are set forth in OAR 952-001-00'10 through OAR 952-001-1987. You j may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987. i Pe r"It ee i ) SiJn(ature: Iscukd By: / -1 Call 6394175 by 7 p.m.for an Inspection the next business day CITY OF TIGARD Planeck 13125 SW HALL BL.'D. Recd y: 16 - TIGARD OR 97223 RE-R©VFING PERMIT APPLICATION DateRec'd: V.-503-639-4171 X304 Date to PE: F-50-598-1Permit#.. � 960 Date T: / Permit ' Incomplete or Illegible applications will not be accepted Called: Name of /DevelopsI/Business VO /,7n Street Address Ste# Please till out applicable section and attach copy of roofing Job Site ;L C} v specifications. Bldg# City/Statedd Zip Name 1.Specification#: N 6y Applicant Mailing Address T—� 2. Manufacturer: f City/State Zi Phone "3a UL Classification: X./. ,,, . 'l 70/5 7y6 606 Roofing N Listed UL Building Materials Directory Page Contractor t} 0. (OR) (Prior to issuance Mailing Address I "3b Warnock Hersey : applicant mus: ' r_ �_ _ provide a copy of City/Stf to r, Zfr Listed Warnook Hersey Directory Page#: all contractor /c. ..a !J C l`� "COPY OF ASSEMBLY REQUIRED licenses if Phone# Fax# axpired in COT 4/(. ) .0 6_11L B. ICBO Research#: database) State Constr.Contr.Board# Ex .nate U a q DATED: WW'IRWN C. SPECIAL PURPOSE ROOFING WOOD SHAKES Building-Type Of Use: (circle one) (review required by plans examiner) SF SFA MF Building- Type of Construction: VALUATION OF PROJECT $ sq.ft.7OU of roof area � 9 Q OC Existing Deck Type: Permit fee based on valuation' /,,, Combustible ( ) Non-Combustible ( ) 'see chart on back $ ZO "] City use only: WACO: U REPAIR(MAJOR)(review required by plans examiner) (BUILD) UBUILD) _ Permit required ONLY when spaced sheathing is covered by —7 solid sheathing. Changes to roof line require Building Permit 6%State Surcharge $ /, 76) Application. City use ohly: WA 0: SUBI_11T Tt,'VO(2)SETS OF PLANS SPECIFYING. (TAX) (UTA)() A. Roof area&nearest street. "Required for major repairs of Residential B. Attic vents-Provide 1 sq. ft.for each 150 sq.ft. of attic or"C" above ' 65% Plan Review $ space. Vents shall be located in the upper 1/3 of the roof. City use only: WACO:' L Provide 1 sq.ft.for each 300 sq. ft. when eave&attic BUPPLN) I— (usuPLN C venting is provided. _ TOTAL $ I acknowledge that I have read this application and that the information given is correct; that I am the owner or authorized 0 Describe work to be done:(check appropriate box) agent of the owner, and that the plans(if applicable)are in LJ RE-ROOF (circle A,B or C) compliance with Oregon State law. U A. Existing built-up roof covering to be REMOVED and deck - repaired- Signature of OwnerfAgent Date Existing built-up roof covering to REMAIN: note applicant c_�re must submit an engineer's review of the roof structural elements. Review shall bP the seal(or stamp)of the architect or engineer lia:nsed in Oregon. Contact Person Name Telephone / C. Asphalt or wood shingIv/shake (PROCEED TO STEP 2) _ T' I:dsts\forms\roof.res.doc 8/26/99 _ . Sent By: WRG DESIGN INC; 503 603 9944; Mar-28-00 10:04AM; Page 1/1 [�R t N C. March 28, 2000 Tom Bolt ABC ROOFING COMPANY 10123 SE Brittany Court Clackamas, Oregon 9701.5 RE: McDonalds Restaurant Building-Tigard Structural Review-Proposed Roof System Dear Tom As you requested,we have reviewed the information on the existing and proposed root system and inspected the roof system for the existing roof on the McDonakis Bulkirng at 10290 SW Main Street in Tigard, Oregon. The information supplied to us on the existing roof system and the proposed roof system and the approximate weights are as follows. Existing Roof: Based on the Information given to us, the existing building has the following weights. Fiberglass Base Sheet -0 28 lb/s 2 plies of 11 Ib ply sheet -0 16 Ib/sf Fiberglass mineral sheet -0 72 Ib/sf 3-Asphalt moppings between shts -—UM" I" Total Existing Roof Weight 191 Ib/sf Proposed Roofing: The weights of the proposers roof system is as follows Fiberglass Base Shcet -0.18 Ibis 2 plies of 11 Ib ply sheet -0 16 Ib/sf Fiberglass mineral sheet -0.72 Ib/sf 3-Asphalt moppings between skits _5u5jw5-f Total Proposed Root Weight - 191 Ib/sl This proposed roof system to be placed on the structure will be the second roof placed The existing roof is to remain in place with some cleaning Therefore, the new roof system will have a weight of approximately 3 82 IWO The existing roof structure appears to be in good condition with no noticeable cracks,deformations or failures. The structure is a fairly new wood'rame structure with plywood decking. IL HIt is my opinion, after Inspecting the building and'he structural soundness of the roof system.and based on W the information giver,to me,that thin roof system Is adequate to support the proposed roof eget m. If you C have any questions, please feel h,A@ to give me a call Sincerely, "��► m -MG Design, Inc. / low J arren M Welborn, P F_ _ 4►s,� Principal r'IANNEf1S a FNGINEERS ■ LANDS(-APE AQ(:-HIT[(-TS a IU450 5W Nimhus Ave . Po,tlrino OR 97223 1 (503) 603-94:3" (fox) 603-9944 O BUILDING PERMIT CITY OF TICARD DEVELOPMENT SERVICES 3/3/0 PERMIT#: 000 00071 DATE ISSUED: 313/00 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 /1 PARCEL: 2S102AA-00903 SITE ADDRESS: 12.090 SW MAIN ST �J SUBDIVISION: PAYLESS SHOPPING CENTER ZONING: CBD BLOCK: LOT: 004 .iURISDICTION: TIG REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: 3f PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET? OC-;UPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: It GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKSREQUIRED FLOOR LOAD: psf LEFT: ft RGHT_ift FIR SPKL: SMOK[DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 11,800.00 Remarks: Remove existing shake roof and replace with sheet metal roof. Owner: Contractor: MCDONALD'S CORP 036/0041 PORTLAND SHEET METAL PO BOX 66207 10101 SE BRITTANY CT AMF O'HARE CLACKAMAS, OR 97015 CWQG0, IL 60666 Phone: 654-8582 one: Reg#: LIC 55412 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Final Inspection PRMT DEB 3/3/00 $142.50 0000425 5PCT DEB 3/3/00 $11.40 0000425 Total $153.90 This permit is issued subject to the regulations contai, in the igard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordar,ce 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. Thnse rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You I may obtain a copy of th.rse rules or direct questions to OUNC by calling (503) 246-1987. t i Pe nn itee Signatury: Issue! By: ,Q1�—�)- f Call 6394175 by 7 p.m.for an inspection the next business day CITY OF TIGARD Plan C c ._ '`- 13125 SW HALL BLVD. Recd TIGARD OR 97223 RE-ROOFING PERMIT APPLICATION Date Rec' :,3•_3-ao V-503-639-4171 X304 Date to PE: F-503-598-1960 Date to DST: Permit#: 7/ Incomplete or illegible applications will not be accepted Called: Name of Development/Busoess Street Address Ste* Please fill out applicable sec on and attach copy of roofing Job Site -10 0 w IM t t,,110 r• cificatlons. Bldg# 1 City/State Zip 14%5l,.WZV3 c_i-1Z1,'y �.. Name 1.Specification#: . Applicant Mailing Address 2 Manufacturer: C(3 — 1 0 O WV, City/S'ate Zip Phone • a UL Classification: lrl L, Roofing Name Listed UL Building Materials Directory Page#: Contractor _YS)Vz-t yN"v1 s""oy VAz–A,&V4.. (OR) (Prior to issuanc,- Mailing Address `3b Warnock Hersey:_ applicant must to 1 0 1 vzt e—T provide a copy of City/State Listed Warnock Hersey Directory Page#: all contractor ,,L "COPY OF ASSEMBLY REQUIRED licenses if Phone ak Fax# expired in COT 65 19 B. ICBO Research#: dntatase) State Constr.Contr.Board# Exp.Date 5 4 ?2 •0 1- IA-to( DATED: C. SPECIAL PURPOSE ROOFING: WOOD SHAKES Building-Type Of Use: (circle one) (review required by plans examiner) SF SFA COT` MF Building- Type of Construction: VALUATION OF PROJECT $ e_ .ft. of roof area Existing Deck Type Permit fee based on valuation" Combustible ( ) Non-Combu"ble ( ) •see chart on back $ City J.d ,ly: WAC \t � ❑ REPAIR(MAJOR)(review required by plans examiner) ( ILD m 11BUILb x� Permit requirsd ONLY when spaced sheathing Is covered by �d solid sheathing. Changes to roof line require Building Permit 8%State Sureha e $ Application. City use dh : Ws1 O:' SUBMIT TWO(2) SETS OF PLANS SPECIFYING. �'/!�( JUfA)C :y A. Roof area&nearest street. *Required for major repairs of Residential B. Attic vents-Provide 1 sq.fl.for each 150 sq,ft.of attic or"C"above "65%Plan Review $ space. Vents shall be located in the upper 1/3 of the roof. City use Only: ti Provide 1 sq.fl,for each 300 sq ft.when eave 8 attic BUPPLN r:. R venting is provided. N TOTAL O I ackr:owledge that I have read this application and that the i< . . information given is correct; that I am the owner or a• `orized -� D scribe work to be done:(deck appropriate box) agent of the owner,and that the plans(if applicable)at.:in CD 0 RE-ROOF (circle A,B oro compliance with Oregon State law. w A.Existing built-up roof covering to be REMOVED and deck repaired- Signature of Owner(Agent Date 6. Existing built-up roof covering to REMAIN:note applicant must submit an engineers review of the roof structural 3 / 17 elements. Review shall bear the seal(or stamp)of the Y C architect or engineer licensed in Oregon. Contau.t Person Name Wephone Asphalt or wood shingletshake (PROCEED TO STEP 2) i l:dsts\forms\roof.res.doc Ae—Yv1&`L E- .1" 8/26/99 4 "u-- �I L� `�•`` � . j CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMITS: PLM1999-00435 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 12/16/1999 SITE ADDRESS: 12090 SW MAIN ST PARCEL: 2S102AA-00903 SUBDIVISION- PAYLESS SHOPPING CENTER ZONING: CBU BLOCK- LOT: 004 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2 OCCUPANCY GRP: FLOOR DRAINS. TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS- LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of two(2)commercial backflow prevention devices. FEES Owner: Type By Date Amount Receipt MCDONALDS CORPORATION PRMT DST 12/16/1995 $64.00 99-320479 5000 SW MEADOWS RD#200 5PCT DST 12/16/1995 $5.12 99-320479 LAKE OSWEGO, OR 97035 Total :89.12 Phone 1: Contractor: ROCK CONSTRUCTION + PLUMBING P 0 BOX 8507 BEND, OR 97708 REQUIRED INSPECTIONS Phone 1: 541-317-2944 RP/Backfiow Preventer Reg#: LIC 00112770 Final Inspection PLM 9-184PB ORIGINAL. IL a N 0o This permit is i,asued subject to the regulations contained in the Tigard Municipal Code, State of OR. W 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 obtain copies of these rules cr ,,' rect questions to OUNC by calling (503) 246-1987. Issued By: �l rmittee Signature: % ^v Call(503)639-4175 by 7:00 P.M. for an Inspection need d the nevt business day CITY OF TIGARD Plumbing Permit Application Plan Check• 13125 SW HALL BLVD. Commercial and Residential Recd By TIGARD, OR 97223 Date Recd (503) 639-4171 Dale to P.E. Print or Type Date to DST r-- Incomplete or illegible applications will not be accepted Purmitqe A� _a Related SWR 0 _ Called _ -- Name of Development/Project FIXTURES (individual) QTY PRICE AMT Sink 11.50 Jobroc - Address Street Address uite Lavatory _ - 11.50 ,.A-o'i C) q _ Tub or Tub/Shower Comb. 11.50 Bldg 0 City/Stale Zip Shower Only 11.50 Water Closet/Urinal (Specify) 11.50 N pi Dishwasher 11.50 Owner Mailing Addressuite Urinal 11.50 Garbage Disposal 11.50 City/State zip Phone Laundry Tray 11.50 Name � Washing Machine/Laundry Tray (Specify) 11.50 C lJ-..a J C� Floor Drain/Floor Sink 2" 11.50 Occupant Mailing Address Suite 3" 11.50 4" 11.50 City/State Zip Phone Water Healer O conversion O like kind 11.50 Gas pipin4 requites a separate n_ec'anicalpermit. Na MFG Home New Vlater Service 28.00 or~ Contractor Mailing Address Suite MFG Home New San Storm Sewer 28.00 JEs-b 1 Hose Bibs 1110 Prior to permit Cl /Slate Zip Phone Roof Drains 11.50 Issuance,a copy OC- I Drinking Fountain 11.50 of all licenses are Oregon Const Cont.Board Lic.# Exp.Date Other Fixtures(Specify) 15.00 required if expired In COT Plumbing Lic.0 Exp.Date database Name Architect Sewer 1st 100' 38.00 Or Mailing Address Suite Sewer-each additional 100' 32.00 Water Service-1 st 100' 38.00 Engineer City/State Zip Phone 9 Water Service-eacit additional 200' 32.00 Describe work to be done: Storm 6 Rain Drain-1st 100' _ 38.00 New rW Repair O Replace with like kind: Y-)s O No O Storm 3 Rain Drain-each additional 100' 32.00 Resien ial O Commercial Commercial Back Flow Prevention Device 32.00 Additional description of work: Residential Backflow Prevention Device' 19.00 Catch Basin 11.50 a Are you capping,moving or replacing any fixtures? Insp.of Existing Plumbing or Specially Requested 50.00 Yes O No X Inspections perthr If yes,see back of form to Indicate work performed by Rain Drain,single family dwelling 45.00 in in fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 I,;- WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL -_I I hereby acknowledge that I have read this application,that the information given is correct,that I am the owner or authorized agent o"the owner,and Isometric or riser diagram la required M Quantity Total la >9 to -SUBTOTAL. 0 that plans s bmitted are In compliance with Oregon State Laws. ir/ W Slgnatu Jer ,gen _ Dire 8%SURCHARGE r C to Pe on Name Phone C $�3_�ao I7.�5- "PLAN REVIEW 76%OF SUBTOTAL 1 BA HOUSE.$178.00• . T Required on fixture Is=s TOTAL p 2 BATH HOUSE 060.00 3 BATH HOUSE$280.00 r t o (This tea Includes all plumbing flxtufas In the dih*lllrrg and the A •kllnimum p m,lt faa is ileo+s%surcharge,except Residential SwJdlow Prevention 100 fast co jiAnar'je"r itotim strwair ind water i4Ivics) v(p 1 Device,which Is$25+e%surcharge "Alf New commercial Buildings requke plans with isometric or riser diagram and plan review I ldsislfonnslpiumapp doc 1011199 err PLEASE COMPLETE: Fixture Type uanti b Work Performed New Moved Replaced Removed/Capped ;pink Lavatory Tub or Tub/Shower Combination Shower Only Water Closet _ Dishwasher _ Urinal Garbage Disposal Laundry Room Tray I.Jashing Machine _ Floor Drain/Floor Sink 2" 3„ 411 Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: a a — - - _J m C7 W J I%dstsVorms%phxnapp doe 10/1199 - - LaCITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMITS: PLM1999-00110 13125 SW Hall Blvd.,Tigard,OR 972'23 (503)639.4171 DATE ISSUED: 4/15199 PARCEL: 2S 102AA-Ol`903 SITE ADDRESS: 12090 SW MAIN ST SUBDIVISION: PAYLESS SHOPPING CENTER ZONING: CBD BLOCK: LOT: 004 JURISDICTION: TIG CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: M FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTUF.ES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES. OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replacement of water heater with like kind. FEES Owner: Type By Date Amount Receipt MCDONALDS CORPORATION PRMT DRA 4/15/99 $25.00 99-314554 5000 SW MEADOWS RD #200 MISC DRA 4/15/99 $1.25 99-314554 LAKE OSWEGO, OR 97035 Total $26.25 Phone 1: Contractor: GEORGE MORLAN PLUMBING + APLIANCES 9806 SW TIGARD STREET CCB (EXP 6/2002) RUQUIRED INSPECTIONS TIGARD, OR 97223 Misc. Inspection Phone 1: 624-6895 Final Inspection Reg#: LIC 000027 PLM 026-60PB C J This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 0 g 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 jmy obtain copies of these ru!es or direct questions to OUNC by calling (503) 246-1987. Is ed By: _ �� �� L"P. �") Permittee Signature: 14 ld)zo Call (503) 639-4175 by 7:00 P.M.for an Inspection needed the next bus ass day APR-08-1999 13:25 gjL Nec o Y OF TIGARO RECF, Plumbing Application pets Recd - 25 SW HALL BLVD. Commercial and Residential G,Ite to P 6 iARD, OR 97223 APR ] ri 1yU�. "it 4 T 54t h Penna e 3) 639-4171 CUMMUNIIr ULVEWI'Mi ll, Print or Type Rood SWR a 'Incomplete or illegible applications will not be accepted called f XT�JRES (Inelvldwl) OTY PRICE AMT Nm ae at evewtpmenuProma Sim l.00 F00 J O b lavatory :eet Ad rocs rue a Tubrsnower Come. so 0 AddressMO y,00 Shower Only tag a Ci ,state ZiP2.00 Water Clesal 9 00 olenwesner r900 G;aroags Disposal tlresa Su" Was""Macrtwte 2.00 Owner � ��. ,� I Floor onin -.nrst t. zip Pma"e 9.00 r• 9.00 W Wow�w 9.00 MaAirq Address Sudo l.OG O:CUpant LatMtory Roem Tray 9.00 " CiryrStsa 110 Phone urinal Omer Fixtures ISM") 2.00 9.00 N 2.00 Contractor "�dfe� �Strt)�Ti I l.ao Prior to issuance Ci 19tate P 3P;iicani must d r- 9.00 arav�de all Orel Corel.cont.Boars L1c.s txa, ata 9.00 corttrac:ors WoorinSerer-1 st 100- license PlurttEkq t "p. ate 2D.Q0 ! nformation — Sewer•each additional 100' waW Servtae-tat 100 ]0.00 for COT COT Buatneaa or Me1r0• �. a ! oata0asel. Nater Service•sacra switionat 200• 25.00 Name storm 6 Rain grain•1st 100 �3.00 Architect stain&Ra;;Orin•sae"add*ortal 100 z ! MMUM Address Suite 29.00or Moat.Home Spaoe Commercial 9aca Flow Proven"I'l CevwA Or Ana- 25.00 I G estate 7.p Prone 1 Engineer ty Pollution Device 15.00 ResIdep"al 9aekflow arevenuon Device" .escnbe work New v Adattan O Alteration O Reach O9,00 o_e none. Retlwlenbai O Non-residenual O Any Trap or Was,'NCI Connet~!o to a�ntture I I 900 I , •cac:onal dt7cnouon of wont CalCn 3asm a l��oL�-e r he lo.�t dry trop.of wsun0 i umoing +0.00 1,1.�tL ��l�f� goner N 1`' QX1 Q�1��► SoWsiy Requested Inspeaans I a0.00 I oerrttr U) ;an;nq use of , 30.30 .,ic:nq or property �.,7T T Rawl Cram.singt!family dwelruiq J 9,C0 Grease Traps m acuse of QUANTITY TOTAL ( I I od inreg q oO r 9M1l roP JIrenoae x riser^�s1n,s n!eyres 1 GuanTr Total a it _ -,a .ou caoeing. moving or replacing tiny fixtures, rh r No:I SUBTOTAL I ,if.es see back of form) - ,;,any acknowledge Incl l nave read tea application.Utat one Informaoon fiX SURCF4AaGE f ;von's correct.that I am'fie owner or auMenied agent of:He Owner,Dred err Diana wommed an ^ =1111of.ancill wiM Canon State o'an PLAN REVIEW 25•.OF SUBTOTAL i ger afar• Ownw/Agent — I xseveea orifi I**"ter e�ai s t 9 _-, _ TOTAL i it 1 0l—.)I Phone •Mlnimwm Permit Ne,i alit"�'.StMClar2e.*xcsol Rexa antlal flaGtllew �, ct person Nerve - prevention Device.wn,cn is SIS-3'f;wrenuge rJ�r i:`tlsts'.pintapp.doc&me TOTAL P.01 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 Business Line: 639.4171 Date Requested "Oe �� AM PM SUP BLD Location 12- U Irl Q -6 � Suite MEC Contact Person Ph ��� �- PLM Contractor Ph SWR BUILDING Tenant/Owner L a ELC Retaining Wall ELR Footing Access: Foundation FPS Fig Drain SON Slab Crawl Drain Inspection Notes: Lot r Post&Beam SIT Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler _ Fire Alarm Susp'd Ceiling Roof Misc: _ Final PA T FAIL � IN Post&Beam Under Slab Top Out - Water Service Saniiary Sewer — R a_ iaLrains - - ��T T AM T FAIL NIMANICAL Post&Beam Rough In Gas Line Smoke Dampers Final — PASS PART FAIL ELECTRICAL Service C Rough In Il UG/Slab Low VoltaSe JFire Alarm 0 Final 9 PASS PART FAIL _ U SITE Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE — — ' ]Unable to Inspect-no access ADA Approach/Sidewalk Other Date _Inspector _Ext " Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639.4171 tsup Date Requested '�-x /- ? _ -AM PM BLD Location MrA64L,,—"J&4Suite MEC Contact Person / Ph PLM _ Contractor h rl C 2 ��� r C Ph SWR BUILDING Tenant/Owner ELC ! - (.b4 to 3 Retaining Wall ELR Footing Access: ` Foundation FPS Fig Drain -T— SON I Crawl Drain Inspection Notes: Slab / J C Gl w2a SIT Post&Beam y,� I r Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall ll J Fire Sprinkler �� Gy0Y K Ct�Tde.Jo ►"S D Co>� � & uZ Y�A Fire Alarm Susp'd Ceiling Roof / Misc: — Final PASS PART FAIL PLUMBING Past&Beam Under Slab Top Out Water service Sanitary Sewer Rain Drains Final t PASS PART FAIL MECHANICAL Post&Beam o Rough In Gas Line Smoke Dampers Final YASS,PART FAIL ELECTRICAL L Serv- 2 Rough In UG/Slab Low Voltage Fire—Alarm _ J i 0 S PART FAIL 7 U J Backfill/Grading — — Sanitary Sewer Storm Drain [ J Reinspection fee of S required before next inspection. Pay at City Hall, 13125 SW Hall Blvd C nIch Basin [ ]Please call for reinspection RE: F [ )Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date L � Inspector Ext Other - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD `Aw d DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hall Blvd.,Tigard,OR 97223 (S03)6394171 PERMIT #:DATE ISSUED: 0/0663 : 110/17/96 PARCEL: 2S102AA-00903 SITE ADDRESS. . . : 12090 SW MAIN ST SUBDIVISION. . . . : PAYLESS SHOPPING CENTER ZONING:CBD BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . :4 11roJect Description: REPAIR STOP LIGHT FROM CONSTRUCTION DAMAGE AT CORNER OF MAI N & SUFFINS - MCDONAI_D'',, CORNER -----•--•-----.------ -------------------------------------------------------- -----RESIDENTIAL UNIT----- -----TEMP SRVC/FEEDERS---- -----MISCELLANEOUS----- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' I__ 5009F. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 -----SERVICE/FEEDER----- ----BRANCH CIRCUITS----- ----ADD' L INSPECTIONS--- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDERi 0 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. s 1 PER HOUR. . . . . . . . . . . : 0 401 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 601. - 1000 amp. . . . . : 0 -------------------PLAN REVIEW SECTION---------------- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR ) = 22:5 AMPS. . : CLASS AREA/SPEC OCC. : Owner: - -- - __._ _.._._______ .__.._...__._____.._______.___________.--_---------_ FEES -••_-------------- CITY OF TIGARD type Amount by date r•eept 1.3125 SW HALL BLVD PRMT $ 35. 00 TAT 10/17/96 96-265322 5PCT $ 1. 75 TAT 10/17/96 96-265322 TIGARD OR 97223 Phone #: E,39-4171 Contractor: -_------------------------.—_—_---------------------------------_---- C:ONTRACTOR NOT ON FILE $ 3G. 75 TOTAL --- --- REQUIRED INSPECTIONS -------- Elect' l Final Phone #. Rey This permit is issued subject to the regulations contained in the — l� Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t� S i gnat ur applicable laws. All work will be done in accordance with y approved plans. This permit will expire if work is not started D within 168 days of issuance, or if Mork is suspended for more than 168 days. I s sued 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: __-_--------------------------CONTP.ACTOR INSTALLATION ONLY----------_--_------------- SIGNATURE OF SIJPR. EL_EC' N. _ DATE: _ LICENSE NO: Call for inspection -- 639-4175 c Community Development ELECTRICAL PERM APPUCA71ON 13125 SW Had Blvd. Tigard, OR 97223 Permit EL CR1' Date Issued �i<Q Phone(503)639-4171 '"-- CITY OF TiC3ARD FAX(503)684-7297 TDO No. (503)684-2772 Inspection (503)639-4175 1. Jolp Addie jsos:: D a L e:D� 1011419 P 41. Complete Fee Schedule Below:eii�ie?�C �o, oJ� mQ�nJ Name of C i t y o f i p a r d Nunbsr of hrpspion per psmtit allowed Addre" Main and S c o f f i n s (S E Corner) Sarna,rteMrded Nsns Ca,p(Mt Bran City/$teCs/Dp Tigard, OR 4a. RaMdsrrtisl -per u It 1000 aq.R ar tw 3110.00 4 Name (or name of business) E.drarsr resod. it or rra+�e�r.s trim t Commercial ® Residential ❑ ue+.iSoul �" am= **Traffic Signal** 00MwairdHoomarUse" sss.ao 2 2a. Contractor installation only: Aw+++3 a.Me..t*spew 4t1.Swvkn or Feeders a+r.arrw+..r.r`r rslxaaan E1eCfl ) (:OnfhCtOr L i n n r o ( 1 r t r jr C'n 700 arN r err t3a es ! Address PO Box 92', 201 sime to 400 COs iso 00 2 City Aany State OR Zip 97321 .ot""r""am "'d' Phone No. (541) 926-4266 MMen a=0&,gwover 11W 3ts00o _ WIWI Job NO. 62143-01 rtwrwr.d�«� Saco 2 contracoWs kertse NO. 22-15C 4o Twoponary servkM or Fsadsrs Contractors '^•nerd Reg. No.4 9 43 Ztnaas+tal.asrwlmr a r�beabn Signatixe of Supr. Elez n 200 arks W bn 2 License No3 2 5 7 S phone No. (541)__926-426(` 2w a'"1x'00`4% W.os 401 ev"ns cos asps 31!100 2 Ovr em arks ra 1000 sets 3t0aA0 2b. For owner installaty�ans: :Vsbwja 46 Brand:Circuits Print Owners Name Mat.a mien r.s.Man w►Paw Ack.f.cress ")1M M 1w Warm dmu t"wM C••' State /rte""Isovde""►Ib�drA�a = Phare No. EMA buck atm woo N no he 1r tresnh diart.0400W The ir>stalladw is2 being made on property I own which is /rssArs of sa•Nss sr 11ndr ha not intended for sate, lease or vent. tAral hs"dl desats 1 roam 35.00 2 emm maftr---.arm s m OwnerA Signstua 44.Nbcalerwoun (Se vim or heder not ildtrded) 3. Plan Review section (if required): &"purm a aryl°"dmm $am 2 4. Ead'or r aeerr or" ^� Sam (� Please shseir apprvpeiabfr turn and soft fee in section 58 a . S w `aatst"1r s cease m 2 wl tlwMsr r aawrsar 310,00 4 or more residential units in one structure M"W crew(101 x100.00 U) S*Mm and I 'a 225 amps or mors System over 600 vote n x.- 4f.Each additional inspection over J CLss4led area or structure containing special ocapsnq the snug wable In arty of the abave m as described in N.E.C. Chapter 5 Per I P W, 83LOO Pr rev 11KOO in Woo W SWw*2 sets of phrra with appilimdon where any of the sbme J apply. Not raquft for temporary construction saiivices. S, Fees: NOTICE Ss.Enter Oft of stove hes s 35.00 5%Sueharge (.tis X total lass) _PERMITS BECOME BECOME NOIR rF VMRK OR CONSTRUCTION �1 d s .&,75 . AUTHORQED tS NOT COM IENCE��WITHIN ISS r)AYS.OR F Plan Review i �� C DNSTRl1CT10N OR WORK IS SUSPENDED OR ABANDONED FOR $ A PER10D OF 180 DAPS AT ANY TIME AFTER WORK tS subta w s -- COMMENCED. ❑ Trust A=unt dl Balance Due $ 36.75 Y C ^, C C r a a a a X000 0 os 8 8 8 0 os �, CL 0 0 CD `- H 1002 n a a •� a a :r n a � IL t; m CL 77 0 (D M to 0 R to O Q a r Q d d R a n- 8 . N g U E 0 x N r O ri o o cr cn (j) (1) co � 12 0 � a C" W g (1) LL LL LL N a A C3 = h U m H r .g 10- H � m a ,o o � a N V Q � m L LL1 M Q. p E 5 8 F LL O M a € 0Ir a c m O O Q Q 2 ll LL lL O (D $ N v8 v o r- $ o c� .r w w w w w w w w a U U Ui W a Z Y M 4 oww � a EL w a � o 0 M c v 0 C NO X O N 8i ro 0 _ a0 CL d � Q h 00 g N tND CJf Ol Ql 8 $ <G a a U ` Off QU > > = U D > CO m m m 03 m m m CO m m m it a a a a v� =J Q� O d a 4 0 cc IL Sn GoLL a a K c r- 0 212 .- VCQ f0 �- 0 3 v a � 0 3 N N � O V M T C O V Q C Q C o W Q Q CL CL ` LL FL o co .Q c c E m m c C N c a a LL ii o N v O a s n a m m m m m m m m m i f i 2 ti 0o cm 4 C) r L. d CL 0 w cr 212 U H N V Q � a rc ti U) _J m J > LE 0 N 0 00 to a R N d 8 vgv U UU gU U U U U U W W W W