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12460 SW MAIN STREET-2 IS NIVW MS 09VZ6 r cn IL Z U 3 m � ca � W J 12460 SW MAIN ST CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT M PLM2004-00481 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/21/2004 SITE ADDRESS: 12460 SW MAIN ST PARCEL: 2S102AB-04800 SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing TI, install backflow prevention device,water supply for coffee maker, (1)new sink and move(1)sink. FEES Owner: – Description Date Amount CAPISTRANO, NICOLAS N + CHRIST IN —' —� 6646 SW 35TH AVE [PLUMB] Permit I�ee 10/21/2004 $96.20 PORTLAND, OR 97221 [TAX]8%State Sureharl 10/21/2004 $7.70 Total $103.90 Phone : Contractor: ABC PEMODELING & HANDYMAN SERVICES PO BOX 1144 TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone : 503-887-2413 Rough-in Insp Top-out Insp Reg#: PLM 26-7691111 Final Inspection LIQ' 161073 a a� m =' This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. m 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, o► if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules aft-- >ted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-00DJ -fL100. You may obtain copies of these rules or direct questions to OUNC 93 246 699. Issu d By: 4• Permittee Signature. Call (5081639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TI GARD ^ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2004-00308 1312.5 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 10/21/2004 SITL ADDRESS; 12460 SW MAIN ST PARCEL: 2S i02AB-04800 SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: T16 TENANT NAME: MARSHAL JAMES USA NO: FIXTURE UNITS: 3 CLASS OF WORK: ADD DWELLING UNITS: TYPE OF USE: COM NC. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .2 EDU increase, Oviner� FEES CAPISTRANO, NICOLAS N + CHRISTIN Description Date Amount 6646 SW 35TH AVE PORTLAND, OR 97221 [SWUSA]Swr Connecti( 10/21/2004 $500.00 [SWUSAI Swr Connecti( 10/21/2004 $0.00 Phone: — — Total $500.00 Contractor: w Ph-one: Peg#: Required Inspections IL ti UI J_ m This Applicant agrees to comply with all the rules and regulations of the Clean Water S vices. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR -010 . You may obcopies�f hese rules or direct questions to OUNC by calling(503) 2.46-6699. /� r Issue by: _ Permittee Signature: -"all 7:00 P.M. for an Inspection needod the next business day Building Fixtures Plumbing Permit Application City of Tigard �,;��D Pernut No. LN 13125 S W Hall Blvd,Tigard,OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Plan Re Other Permit No 24-Hour Inspection Line: 503.639.4175 '6 nate Ready/By Ir See Page 2 for— Internet: www.ci tigatd.or.us Notified/Method: tt� Supplemental lnfarmatlon IDY TYPE UY New construction ❑Demolition F_o_ -neclal in-formation use checkHsL _ � y--t� Fa.-r Total ddition/alteration/repla.ement ❑Other New I-2-family d••.Ilings(includes 100 ft.for each utility connection) -- -�, C �UEGORY OF CONSTRI ICT ON .` ,. •,.• r- SFR(1)bath - 249.20 - ❑ I-and 2-family dwelling W-rmercial/industrial SFR(2)bath 350.00 ❑Accessiry buildingSFR(3)bath 399.00 (_]Multi-fami'.y - - -- EL ch additional bath/kitchen 45.00 ❑Master builder ❑Other - __ Fire sprinkler(--sq,R,) Page 2 JUB SPUN INF(iRMATION AND LOCATION � Site utilities - Job site address: S Caton basin or area drain 16.60 ^ City/State/ZIP: s �I �?,V. '� �?�Z'� Drywall,leach lino,or trench drain 16.60 o Suite/bldg./apt.no. Project 4-( VVI-1Footing drain linear R.:_J Page 2 MManufacturedhhome utilities 11000 Cross street/directions tojob site: -- -� Manholes 16.60 13(..L y-AA, Gl A bets 4 0,11,A,ir J _- Rain drain connector 16.60 Sanitary sewer(no.linear R.:_J Page 2 Storm sewer(no.linear fl.:_) Page 2 Subdivision: v— Lot no.: Water service(no.linear fl.:_) Page 2 Fixture or Item Tax map/parcel no. f IT7/ -- - Absctption valve 16.60 LIS ' to+ ;'• �" r .1 4 Backflow preventer Page 2 A,4( Backwater valve _ 16.60 Clothes washer _ 1660 — Dishw:-her 16.60 Drinking fountain 16.60 Ejectors/sump 16.60 Name: "i A I t$h ham- "��y. a Expansion tank 16.60 Address: !t((� G J- JA4 4,f Al' 5 tFixture/sewer cap — 16.60 City/State/ZIP: 1:L('5;/I—d G- `9 3 Floor drain/fl00r sink/hub 16.60 (. /3G ��t/O Garbage disposal 16.60 Phone: Fax:( ) qct"t r, ;�, rs' z.�. w Hose bib � 16.60 CU 16110 Business name: Interceptor grease trap _ 16.60 Contact name: Ic _1 CIL E'- 'LUL Medical gas(value:S ) Page 2 Address: - L Primer 16.60 N City/State/ZIP: -*Zl A� G''V le Z Roof drain(commercial) 16.60 �";/shower/shower Phone_ 'f�_ G( / Fax: :l - n asin/lavatory 16.60 pan 16.60 1 �J E-mail: Urinal 16,60 Water closet 16.60 WBusiness name: - _ Water heater 16.60 Address: Other: - - Subtotal City/State/ZIP: -- Minimum permit fee: 571.50 p Fhone:( ) F :( ) Residential backflow minimum permit Cee: $36.25 e --- CCB Lic.: 'G 0 Plumbing Lic. Plan review (25%of permit fee) State surcharge(f!%of permit fee) 0 �tn sign <' -_ TOTAL PERMIT FEE � (s, Date: �u This permit application expires If a permit Is not obtained within �- 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board i�Building'P,rmin'PLMF-PemtitAppdnc 12101 "0-4616'.(10/021C0WWEB) Plumbing PermittA Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: S1�itr UtiliCies- ,.�y �q i i ;, , ,.,��_ � '��'Foti,>t� : ��' � ee• Footing drain- I"I(X)' 55.00 0 to 2,000 _— $1 15,00 Footing digin-each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 _ $220.00 Sewer-1st 100' 55.00 7,201 and greater $309.00 Sewer-each additional 100' 46.40 Water Service-1st 100' 55.00 _ Medical Gas Systems: Water Set vice-each additional It1U' 46.40 µ, l�lll�t e,' ' Storm&Rain Drain-Ist 100' 55.00 + $1,00 to$5,000.00 Minimum fee$72.50 Storm&Rain Thain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72 50 for the first$5,000.00 and 51,52 for each additional$100.00 or fraction thereof,to and includigS10,000.00, Commercial Back Flow Prevention Device 46.40 510,001.00 to$25,000.00 5148.50 for the first 510,000.00 and 51.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee 536.25 2T55 and including$25,000.00. Rain Drain,single family dwelling 65.25 525,001.00 to 550,000 00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Ir,spection of existing plumbing or and including$50,000.00. specially requested inspections-pei hour 72.50 550,001.00 and up $742.00 for the first 550,000.00 and 51.20 for Subtotal: each additional 5100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures? If "yes",please Indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. uaintlt;b Fixtare VVar Flxhtr�Type: Rtplace Neto l+i"Yet sxtsnng Capped Comments regarding fixture work: Baptistry/Font Bath -Tub/Shower -lacurzi/Whir( 001 --- —M Car Wash -Each Stall -Drive Thru -- Cu idor/Wattt — Dishwasher -Commercial _- -Domestic -- Drinking Fountain Eye Wash Floor Chain/sink .2" d Car Wash Drain Garbage -Domestic NDisposal commercial *Note: If the fix ure work under this permit results in an Ice Mach./Ref-inalhaial increase of sewer EDUs,a sewer permit will be issued and Oil s orator Gas station fees assessed for tete sewer increase must be paid before the m Rec.vehicle Dump Station plumbing permit can be issued. Shower -Gang W -Stall —a Sink -Bar/Lavatory Quanti y Total -Bradley Isometric or riser diagram is required If fixture quantity -Commercial -- total is>9. -Service Swimming Pool Filter _ Washer-Clothes Water Extractor Plan Review Water Closet-Toilet Plan review is required if fixture quantity total is>9. Urinal _ Other Fixtures: imBuildinamPe iismPLM-PetMftAppdnc 7/03 Accumulative Sewer Tall/ Parcel# 2S1t12AB-04800 Tenant Name: MArshal James _ This SWRA2004-308 �1 _ Site Address: 12460 SW Main.St This PLM# 2004-00481 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off#s count # value #s values 8aptisery/Font 4 0 0 �0 0 0 Bath-Tub/Shower 4 0 1 1 0 0 0 0 r - Jacuzzi/Whirlpool 1 4 0 0 0 0 0 Car Wash-Each Stall 6 G _ 0 0 0 0 -Drive through 16_ 0 0 0 0 0 -Cuspidor/Water Aspirator i 1 0 _0 0 0 0 Dishwasher-Commercial 4 _ _ 0 0 0 0 0 _ -Domestic _2 0 0 0 0 0 Drinking Fountain 1 0 0 0 — 0 0 Eye Wash 1 0 0 0 0 0 Floor Craln/Sink-2 inch 2 0 0 _ 0 0 0 3 inch 5 _~ 0 _ 0 0 0 0 4 inch 6 _ 0 0 M 0 0 0 Car Wash Drr 6 0 0 _ 0 0 0 Garbage Disposal _ Y Domestic(to 3/4 HP) 16 0 0 0 0 0 -Commercial(to 5 HP) 32 0 0 0 0 0 Industrial(over 5 HP) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Oil Sep(Gas Station) 6 0 0 _ 0 0 0 _ Rec.Vehicle Dump station 16 0 0 0 0 0 Shower-Gang(per head) 1 0 0 0 00 -Stall 2 0 0 �0 0 — 0 _ Sink-gar/Lavatory 2 0 0 0 0 0 Bradley 5 0 0 00 0 _ Commercial 3 0 0 0 _ 0 0 Service 3 0 0 1 3 _ 1 3 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 0 0 0 _ �- Urinal 6 0 0 _ 0 0 0 ir Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 0 1 3 1 3 J Current Fixture Value_ 3 divided by 16= .0.2 Current EDU 1 EDU= $ 2,500 �j Previous Fixture Value 0 divided by 16= 0.0 Previous EDU LU Change 3 divided by 16 = 0.2 over (under) $ 500.00 J Enter EDU Change Here ~02 Notes: �\ r --- gnature: ^_ - Date:�d 1-1 BtAding Division / Note: The property own hall retain the ORIGINAL sewer tally recnrd. If credits exist, this document will serve as a voucher hich must be submitted to the Cid of Tigard Building Division to redeem credits towards future system development charges. L\Building\Sewer Tally\SewerTallySheet.xl.s 7/1/04 A CITY OF T!GAFtD ELECTRICAL PERMIT \ PERMIT AI: ELC2004-00677 DEVELOPMENT SERVICES DATE ISSUED: 10/25/2004 13125 SW Hail Blvd.,Tigard.OR 9722:3 (503)6394171 PARCEL: 2S102AB-04800 SITE ADDRESS: 12460 SW MAIN ST ,ZONING: CBD SUBDIVISION: BLOCK: LOT: JURISDICTION: TIG Project Description: Verify circuits,add&relocate. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 St'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 HM/SVC/FDR: 601+a,Ytps-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: 1 PER HOUR: 401 • 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT: 601 - 1000 amp: _PLAN REVIEW SECTION 1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only. SVC/FDR>r 225 AMPS: CLASS AREA/SPEC OCC•, Owner: Contractor: CAPISTRANO,NICOLAS N+CHRISTIN SHARP ELECTRIC 6646 SW 35TH AVE 2856 NE 65TH AVE#E PORTLAND, OR 97221 VANCOUVER,WA 98661 Phone: Phone: 360-695-8015 Reg#: LIC 156982 ELE 37-101 IC _ FEES SUP 48935 Description Date Amount Required Inspections IF.I.PRMT1 ELC Permit 10/25/200 $66.80 [TAX]8%State Surcharge 10/25/201, $5.34 Rough-in F Elect'l Final Total $72.14 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 amordance with approved plans This permit will expire if work is not started within 180 days of issuanoe, or if work is suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503) a 246-6699 or 1-800-332-23447 at Issued By: - '- Permit Signature:, _ W OWNER INSTALLATION ONLY a The installation is being made on property I own which is not intended for sale, lease, or rent. ED (D OWNER'S SIGNATURE: DATE_ W J CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: __ ___ DATE: _ LICENSE NO: -- Call 639-4175 by 7:00pm for an inspection the next business day _� 10/18'2004 14:69 FAIL 505981960 CITY OF TIG,ARD lkjQctrlcal FerMlt AR Leatfu IEP / T City of Tigard *'ei1`ed ' 1 13125 SW H.D Blvd.,'IStartl,dR 97223 'j lA ti thbarPoonk Phone; 503.639A171 Pax: 503.594.1960 1 16 softie 3 --- (nspecdan Liar 503.639.4175 1 I! 1We��ty,s Internet Www.ci.tL1wd.x.m — _ -�-aAL _�. TYTit OF WORK PLAN REVIEW Y ❑New oonstruetitllt Additi00/alttxat 0n/replaoeUx" Plater Ace all Q+D1Y ❑Service tmtt 225 amps,oolrmo1 [7H12701100 location ❑ —DMO IItion G odm. __—- — OServics over 320 amps-taring Dawma6 ever 10.000 aq.B_, CAI ORY OF CONFTROCTION of I-and 2-fhm;iy dwo-inp 4 at more nen maldesUal. mud2-family dorellint (amrpC�CillRnduatrial E)Accessory building (]SYatem over 6(10 voint aotn4nal Vertu in one ammo t 0&tildl>u aver tbdee trtorlas Ol'aed�y'WO At mom 1iltr-fsmi Master bwda [a Other: _ []0mWgmt load over 99 perMw ❑Manu&-nod emunxres of TOB SrM INFORMATION AND LOCATION DE rrs 11WVitag ptao RV park yy Oth- HAdave faoilhy Q�10r. .: ----- Job n lob site Address: geo t // _e Babrrrit-1 Bata of piam with any of the Allow. city/stater-'it, Jim nbe a am Dot applicable to ternoporary oonswotion oervim 1►EIE" 3CHLDULE Suite/bldgJapt no.: Project name, ,. Cross street/dimtiaay to job sitz: Now radde-otlal dude-or raait4hmity dwagtag unit. Iacledes atrschad urate. 1,000 ars.A.or keg 145.11 4 3tlbtiivisigs Lot mo.: fn sdd'1300 s9 R tx�hoa 33.40 1 Lurited www,retidea Ml 7.4.00 2 Tax zn4vVend no.: _ --- Umltsd afterp,e06gwldsmtlsl 75.00 2 Lp)<B RWnON OF WORK SW msuullm or at0dulur yyd=� - �Q �� Banka_r2 fbed1m insaMtl lon,skeratta:.and/or r�tldoa 200 Tr or loss g0 30 2 ❑ >f+1 oplm TY OWNER TINAN•T201 amps to 400 scups 10645 , 2 401 w 600 160.60 2 Ntmoa M/�Q.�µ,q-i, Tq M ES 601 to I,000 240.60 2 Addross: 24 U t>� ��,.` !, Over 1,000MUK volts 454.63 2 I"' Recomssot only 66.85 2 t:1ty'/statem. t ep^-QT> 2 97;)-9-3 Temgarary an vim or fenden last flotknr,a tentles,sad/or ri,one 5-16 q Fax:( ) 2(10 or Its 6485 — f Otrmar(//t1111Nb xs:This installation is being trade on property tlutt I own which is not 201 stnr to 400 amp 100]0 2 }nt nlded ft ale.km,root,or exchange,according to M 447,449,670,and 701. 401 amps to 600 amp I I 133.75 1 2 Owner sigaawre. Date: Branch elrealts-enw,alssratlou,or arztension, d ❑ APPLICANT ❑ COM .FosACT PERSON At b cirtruts with — service of lbeder he.swD 6.63 2 8tainm OAfne: bench dzwtt '— B.Fee%r branch cireaha contaCt name: wrthow aervice or fiWer tae. d 46 i3 f 2 each bran Addmm: Boob Wd'1 branch tdreuit 6 65 2 City/9t1maw; Mtacallaneeaa(service or tbodw not ludad puert pr gni oar Ahnle_ 53.40 2 phone.( ) Ft1a::( ) or outline hodq 53.40 2 B-rittll: — Signal timWt(s)ar Hedged_ — CONTRACTOR energy panel,altrxdwm er I'A oxtcnviaa.Describe: Pate 2 2 R susine.a Warne I` N A&hse: Ne t C- C Each additionsi t e►as�edoa ever atlo" is u of the above C G Pa 62.50 City/3tatow: V19j CCuU - � 6 / tion hour(I ire mfn 62 30 rltvaA:(V) 5 Ba 15 - 77(6FAtc:4Mo! 57�/ ''�""��'®`ELEpor cr>9ticcAtr PERMIT F�is$� eau Cn \ ccs Lie.: B1tet1trleAl Lic.: 7-/01/ swv.Lio.: — sabwW f . J SWv.S1eeMeian siplatare,required*v` —/ - �/ Plan review(21%of patrdr fee) aSa surcharge(8%0fpermi!P;] Prier Duk: TOTALPEMT Aux aignanmr Torr pertait yplkslb�aspane tf■penast u aM ebuMea trit[W 1 Print Date: • Fee tsomoly vat by I*C*Uzdy bel bdus"swvlta Bard name: —_ ew+•Numbrr of i++tp«ttae.pee parteit apoVsd. IMu(kMlt�atbldt.C'1' rnpP dor, 12roa Me•MIrT(10d CITY OF TIGAIRD 24-Hour BUILDING 0 Inspection Line: (503)639-4175 is INSPECTION DIVISION Business Line: ` (503)639-4171 MST BUP Received Date Requested �� --AM PM _ OUP Location .- �i-I17L 1 : _ Suits- — MEC Contact Person — �11r1�J1�S�l _— Ph Xe _ _14P PLM 02012 !UQ Y I Contractor _^._ _ Ph(__) SWR _ BUILDING Tenant/Owner ELC _ Footing in-LC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Nates: SIT Post&Beam _ Shear Anchors -- Ex;Sheath/Shear - Int Sheath/Shear Framing ---- -- - -— Insulation Drywail N Hing ---------------- Firewall Fire Sprinki �r Fire Alarm Susp'd Ceiling "-- Roof Other' —- - - - - - -- Final PASS PART FAIL - PLUMBING Post 8 Beam Under Slab ---- ----- - --- Rough-In Water Service -- ----- ---_ -- - - ------- __-.. Sanitary Sewer Rain Drains - -- —_------- - -- - Catch Basin!Manhole Storm Drain Shower Pan PA PART FAIL — MECHANICAL Post&Beam - Rough-in --- - ---- Ras Line Q. Smoke Dampers - ---- - LX Final PASS PART _FAIL -- �- ELECTRICAL Service m Rough-In UG/Slab tea Low Voltage _� -____��__----.--------------_ _- -_-_ - -t Fire Alarm Final Reinspection tee of$ _ _-_required before next inspection. Pay at City Hail, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection Q Unable to inspect-no access Fire Supply Line ADA 1 A"w' Approach/Sidewalk -��/CI` Ins�ctor_ Other: _ Final _- -� DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 _ MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received _ —Date Request d AM PM OUP a`-{C��' Location ��1/�.1— Suite _ MEC Contact PersonPh( ) _ PLM _.. Contractor_. — Ph( ) — SWR - BUILDING Tenant/Owner _. _ _ --_ ELC e Footing v ELC Foundation Access: Ftg Diain ELR M� - - Crawl Drain Slab Inspectior, Notes: SIT — -- Post&Beam Shear Anchors - Ext Sheath/Shear _ - Int Sheath/Shear Framing — Insulation Drywall Nailing - -- — - Firewall Fire Sprinkler - Fire Alarm Susp'dCeiling -- Roof Other: --_--------� -t -- - -- Final _ PASS PART FAIL PLUMBING _ - - Post&Beam Under Slab - Rough-In Water Service — Sanitary Sewer Rain Drains Catch Basin/Manhole _ Storm Drain Shower Pan Other: Final PASS PART FAIL — MECHANICAL — - — Post&Beam Rough-In - — a. Gas Line Smoke Dampers -- -- — -- _ -— H Final N FAIL -- ECTRI — m Rough-In — UG/Slab W Low Voltage _ _ �- -------- -- -- Fire Alarm SS PART FAIL F1 Reinspection fee of$ _required befr•,(e next inspection. Pay at City Hall, 13125 SW Hall blvd. SITE Please call for reinspection RE:_ ____- Q Unable to Inspect-no access Fire Supply Line ADA Date / IAsp�ctos ��-��"`� Ext _ Approach/Sidewalk Other: _--� Final DO NOT REMOVE this Inspection record m the johe. PASS PART FAIL ANU OMIM Si/Nm Office Bond Office P.O.Box 23814 4080 Htxloon Ave.,NE P.O.Box 7918 TlpfdCarlson Testing, I n C Phone,503)68 -346 Salem, 3) 89-12 Bend, 97708 Phone(503)884-x480 Phyte(503)589-1252 Phone(541)330-9155 FAX(503)884-0954 FAX(503)589-1309 FAX(541)330-9183 Special Inspection FINAL SUMMARY L.EIFTER --_� """Amended**' April 20, 2000 APR � 4 #99-1470 2000 City of Tigard L31 13125 SW Hall Blvd, Tigard, OR 97223-8199 Attn: Building Department Re: Maria Cristina Building—Seismic Upgrade 12460 SW Main Street, Tigard, OR Permit No.: PUP99-0049 Dear Sir or Madam: This is to certify that in accordance with Chapter 17 of the Uniform Building Code, we have performed special inspection of the following item(s) per our inspection reports only: Installp':on of Epoxy Anchors Stru;tura) Steel-- Shop **"Structural Steel—Field, see attached Engineer's acceptance letter All inspections and tests were performed and reported according to the requirements of Project Documents and, to the best of our knowledge, the work was in conformance with the approved plans and specifications, approved change orders and applicable workmanship provisions of the State Building Code and Standards, as well as the structural engineer's design changes, approvals and vernal instructions. Our reports pertain to the material tested/inspected only. Information contained herein is not to be reproduced, except in full, without prior authorization from this office. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respectyjlly submitted, o' J.jdk TESTING, INC. a ti rn m ietpas LU ( urance Manager cc: Robert GrayPartners Nicoli Engineering—Jim Andrews P WOR MR(POF I`l(M4 iR\MI.1170 F P,n ill,:ItI El IG IIIEEPII6 FW 110. 'FA3 60.4 3636 Apr. 0 -'tXXi 11:4'k1-1 R_ t .- - 4 and Construction Services, Inc. Street Address. 9025 Southwest Center Strewt Mailing Address: P.O. Box 23784-Tigard. Oregon 97291 (503)620-2086 - FAX (503)694.3636 December 17, 1999 City of Tigard Building Depai tinent 13125 SW Hall Blvd. Tigard, OR 9'%`.:2,3 1TTN: Hap Watkins George Stecl PP, Marin Cristina Building - Seismic Upgrade 12460 SW Main Street Tigard, OR 97223 BUP 99-0049 Job #99-1107 (wntlemen: Thank you for meeting onsite earlier last month and establishing a punch list for the above-mentioned project. Subsequent to our meeting, we have complered the outstanding items. The following comments address each of the ro•maining issues and their resolution. • Hir Strength Bolting (A325) a s A bolt strength of A325 was required per the construction documents, but not as a structural necessity. A bolt strength of A307 would have been all that was required structurally. Therefore, a special inspection is m rig t required for this connection. c.7 W The threaded rods and bolts were installed to the satisfaction of this office. E"r' •.' I i I-11 S U:,I t IEER I1 U:, FHX I In. : r5ol hR4 36731__� Hpr.. _XI 2000 1 1:41�14-I P7 • Field Wald Inspections All field welds were required to be inspected. This was apparently not hrrformed by the testing agency. Response: Nicoli Engineering met with The Carlson Testing Inspector at ; the site and reviewed the field welds of the frames at the "storefront" openings (report enclosed). Approximately '.0'/, of the welds were undersized. The size and locations of the undersized welds are located in an area which will not jeopardize the structural design and is acceptable to this office. We believe that the outstanding iteins have been resolved for the seismic upgrade of the building. I1 you have any further questions or concerns, please do not hesitate to contact me... Sincerely, �LP,FO PR or ��" ~ , I N ,James R. Nicoli, P.E. I.IRN/clb RRG IN Enclosures � q^f , 17 5 R N IL m W r ft WASHINGTON COUNTY A OREGON . �. , RFFvH; f' TD July 18, 200L0 JUi- 1 9 2000 L;Y: Judy Anderson 1415 SW 199'Court Aloha, OR 97006 RE; Worth on Earth Energy Center 12460 SW Main Street Tigard,OR 97223 Dear Mrs. Anderson: The Washington County Department of Health and Human Services has obtained the revised plans f'or the proposed Juice Bar to be located at 12460 SW Main Street in Tigard, Oregon. The revised plans are approved provided that the faucet reaches each compartment of your three- compartment sink. Please contact Chad P 'ursen at 846-8722 at least one week prior to anticipated opelation to schedule a pre-opening inspection. Sincerely, DEPARTME.{NTI OF HEALTH AND HUMAN SERVICES CL `l tCciv�cd 1 y Toby Harris, R.S., M.P.H., Supervisor Environmental Health and Sanitation n TH:eoc (7 w cc: City of Tigard Chad Petersen Department of Health &Human Services 155 N First Avenue. MS 5, Hillsboro.OR 97124-3072 WIC Nulrftlon Plan:15031 846-3555 Administration R Planning:15031 846-4402 'PTY.(5031846 880i 1fralth Services:15031846-8881 Fax:Cllnlr 15031846-4522/Administration(5031846-4490 Environmental Health:(503)846-8722 CITY OF TIGARD ----.BUILDING PERMIT PERMIT M BUP1999-00484 DEVELOPMENT SERVICES DATE ISSUED: 1111911999 13125 SW Hall Blvd.,Tigard.OR 97223 (503 PARCEL:PARCEL: 2S102AB-04800 SITE ADDRESS: 12460 SW MAIN ST INA L SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS --EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: 4.455 sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: �ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRdAS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 4,400.00 Remarks: Install suspended ceiling system. No Certificate of Occupancy required, no change in occupant load. Owner. Contractor: NICK CAPISTRANO OWNER 6646 SW 35TH AVE OWNER RESPONS FORM SIGNED PORTLAND, OR 97221 Phone: Phone: Reg#: _ FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Misc. Inspection FIRE GEO 11/17/199 $31.10 99-319745 Fina! Inspection PLCK GEO 11/17/199 $50.54 99-319745 PRMT DST 11/19/199 $71.75 99-319909 5PCT DST 11/19/199£ $6.22 99-319909 Total $165.61 a This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. � Pe 1 9 9 P I- Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more J than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility m' Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtai a copy of these rules or direct questio a OUNC by calling (503) 246-1987. J Perm ltgo- Sig ture: Iss ed By: Call -4175 by 7 p.m. for an Inspection the next business day OF TIGARD Commercial Building Permit Application Plan Check 15 SW HALL BLVD. Tenant Improvement Recd 11 . T!GARD, OR 97223 Date Rer•'d Date to P.E. [ (503) 6394171 Date to DST Print or Type Perm"a� fT� 7 p'� Related SWR# _ Incomplete or illegible applications will not be accepted Called- Name of Development/Prolect Existing Building K New Building p .lob MAJEIA 61ZI4oT1,h1A eW . Address Street Address Suite Building 17_At(v0 U.MAN 5�-- Data _ Bldg# City/State Zip Existing Use of Building or Property: _ 11160�� CP 8122NIA.3 .e. Mr Name Property Ir;K- •ta t Proposed Use of Building or Property: (�GlhT�,dh�D Owner Mailing Address Suite d t'S L 2'S`i' C S, *t-. No. Of Stories: City/State Zip Phne r (o9 Sq. Ft. Of Project: p Name -+l' � 45_'. Occu ent � VA V-1p40 ,N �� `� nµG Occupancy Class(es) Name Contractor G W N P #z. Types)of Construction Prior to permit Mailing Address Suite - Issuance,a copy Will this project have a Fire Suppression System? of elf licenses _ _ Yes Nt7 are required If City/State -� Zip Phone Americans with Disabilities Act(ADA) �xp datlred abase O T _ Valuation X 25% =$ Participation Oregon Const.Cont,Board Lic.tt Exp.Date^ Complete Accessibili�L Folin Project $ Name — '- Valuation Architect Plans Required: See Matrix for number of sets to submit Mailing Address Suite on back CitylState ZIP Phone�^ I hereby acknowledge that I have road this application,that the Information given is correct,that I am the owner or authorized agent of the owner,and _ _ that plans submitted are in compliance with Oregon State Laws. Engineer Name ltm I bk Skmature of Owner/Agent Date Mailing MAdSuite tT �' a t 1 1 a f?p, ^2� 4 rt Person Name. Phone U) CitylState+e, Zip Phone I?.. 116AVJO Of7 °t-(1 m b 1a-2. FOR OFFICE USE ONLY _ co Indicate type of work: New O Additinn O Demolition O Ma R # El Accessory Structure O Fcundation On!y O Alteration O p �(��--r im Repair O Other '(-&hg Notes: —t Description of work: tN.'Pt`XW 4Lk"oMN0?--0 (%F-tUwbt ev-Yt4IrM TIF:--` Note: Site Work Permit Application must precede or accompany Building t- Permit Application lACOMNEWT1 DOC (DST) 5198 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan Review isdependent upon sut mlttail"a5f'Bt i"Oita"ns AND, CI IIV!} L application. For an electrical submittal, the application must conts signature of the supervising electrician before plan review will be -After plan review approval, Plans Examiner will contact the applicant to )additional plan sets for distribution purposes. Washington.County, i'ualatln Palley Fire Res Total of TYPE OF SUBMITTAL Plans KEY: >Su. S (Private) 1 S = Site Work B (New or Add) 1 B - Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) _ Bu'llding a *B or'B& M (Alt) 1 a *B & M & t (Aft) ��. µ 3 . *B & M & P &�E(Alt) _ . 3 00 *B & M & P & E �& F(Alt) 3 � _ W NOTES: '`....We,d areas 4"Ign. ALT submittals only. 1:ldstslforms\matrxcom.doe 10/30/98 _ . CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP rr Date Requested 4-7- "u AM PM - BLD Location ( , `-1 _ ( j4 Suite MEC Contact Person Ph PLM Contractor Ph $WR BUILDING _ Tenant/Owner ELC Retaining Wall ELR Footing rInspfection Foundation / ( FPS Fig Drain 1 SGN Crawl Drain Notes: Slab .4 - T Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- Roof Misc: - Final PASS PART FAIL --- - - PLUMBING Post& Beam -- Under Slab Top Out Water Service Sanitary Sewer -- — — -- Rain Drains Final ----- -- - - - - — FAIL _-_ ^-_-- -- --- —--- -- - - MECHA Rough In Gas Line __- Smoke Dampers PART FAIL CL =RICAL p� Service -- --- - -----.--.-__ Rough In U) UG/Slab -- Low Voltage ..I Fire Alann -- -- M Final 0 PASS PART FAIL SITE Backfill/Grading -- Sanitary Sewer Stone Drain [ J Reinspection fee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply I-ine [ )Please call for reinspection RE: _ - [ J Unable to inspect no access ADA ApproPch/Sidewalk Date 2 nspector /1�� AqExt Other -- Final PASS PART FAIL DO NOT REMOVE this Inspection recoc,d from the job site. CITY OF TIGARDBUILDING PERMIT PERMIT M BUP1999-00525 DEVELOPMENT SERVICES DATE ISSUED: 12/28/1999 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 PARCEL: 2S102AB-04800 SITEwbDRESS: 12460 SW MAIN ST SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: 238 sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? _ TYPE OF CONST: NONE of N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 7,700.00 Remarks: Installation of 5 awnings over windows and entrances. Owner: Contractor: NICK CAPISTRANO GRAPHIC AWNING,+ SIGN 6646 SW 35TIl AVE PO BOX 301038 PORTLAND, OR 97221 PORTLAND, OR 97294 Phone: Phone: 256-3938 ORIGINAL Reg#: LIC 000636 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Final Inspection PLCK DEB 12/20/199£ $68.58 99-320156 FIRE DEB 12/20/199E $42.20 99-320156 PRMT KJP 12/28/199 $105.50 99-320705 5PCT KJP 12/28/199 $8.44 99-320705 Total $224,72 aThis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility m Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987. Permitee Signature: Issued By: Call 629-4175 by 7 p.m. for an Inspection the next business day CITY OF'TIGARD Commercial Building Permit Application plan(,N C 13125 SW HALL BLVD. New Construction and Additions Recd By _ TIGARD, OR 57223 Date Recd LJ3 Date to N.E. (503) 639-4171 Date to DST49,k8 Print or Type Permit$ Px�Pi r^ - r Incomplete or illegible applications will not be accepted Related swRIII Called-1-1--3 1 No np of DevelopmentlProiect Job ftA.,geA tA C4_4,1Lt%TIr44 �u,Lor,uG Existing Building X New Building O Address Street Address Suite w. 41r I 1 Building Bldg! Clty/State Zip` Data Existing Use of Building or Property: Na Property Lt4_`> SAA/a�/� K to_-w L Owner Mailing Address Suite — Proposed Use of Building or Property: G" zeto as _ R�-T�-,� Ity/State Zip Phone No, Of Stories: Occupant Name Sq. Ft. Of Project: Name-- ��— Occupancy Class(es) Contractor t�l4_w&(rnt& 4, C1�jc,.,.�4 'nor to permit Mailing Address Suite Type(s)of Construction Ir suance,a copy o of all licenses k3 oIC3g are required if City/State Zip Phone - Will this project have a Fire Suppression System? expired In C.O.T. �(� v o j Yes NO L] database 2 e,T�_��'112�4 Americans with Disabilities Act(ADA) Oregon Const.Co t.Board Llc.>Y Exp.Datil Valuation X 25% =$_ Participation Complete Accessibili Form Name Project $ -- Architect _ Valuation Mailing Address Suite Plans Required: See Matrix for number of sets to submit City/State Zip Phone on back Engineer Name I hereby acknowledge that I have read this application,that the information given is correct,that i am the owner or authorized agent of the owner,and Mailing Address Suite that plans submitted are In compliance with Oregon State Laws aI Signatipir, of Owner/Agent Date (L' City/State Zip Phone t~ {U) Contact Person Name Phone 2 J Indicate type of work: New O Addition O Demolition O t_(�1�� VV() z` Z a m Accessory Structure O Foundation Only O Alteration O _ Repair O Other o FOR OFFICE USE ONLY O Description of work: J 1�W/�l n( L, OV►F� Wt^4 O Q W S Map/TL#t Land Use: Mntes: Parks: Estimated 0 of Employees TIF; If the above figure Is not supplied at the time of application,the city will calculate the fee based upon the number of parking spaces. Note: Site Work Permit Application must precede or accompany Building Permit Application a�.• , i\dsts\forms\comnew.doc 5/10/99 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plain Review is ddpe6dent upon submitt#':' b- fTH plans AND a C0MPL b application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review will be conducted. After plan review approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes, (Copy for Contractor, City, Washington County, Ioalatin;)/alley Fire �Rsctte) Total# of TYPE OF SUBMITTAL flans KEY_: Submitted S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) Building *BorB & M (Alt) 1` 0- *13 & M & P (Alt) � � 3 N ~'B & M & P & :(Alt) 3 'B & M &P E & F(Alt) - 3 m W NOTES: 'Shaded areas designate ALT submittals only,* 1Ads1sVormslmatrxcom.doc 10/30/98 CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC1999-00437 13125 SW Hall Blvd.,Tigard,OR 97223 (503��IM DATE ISSUED: 15102 9 �� PARCEL: 2S10210/21/99 SITE ADDRESS: 12460 SW MAIN ST SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: 1 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: 50+ HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1 FURN —100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 Cf.11: Remarks: Mechanical TI -add 12 supply grilles, 4 return grilles and ductwork. Owner: _ FEES NICK CAPISTRANO Type By Date Amount Receipt 6646 SW 351'f1 AVE PRMT DEB 10/21/99 $50.00 99-319249 PORTLAND, OR 97221 PLCK DEB 10/21/99 $12.50 99-319249 5PCT DEB 10/21/99 $4.00 99-319249 hone: Total $66.50 Contractor: ARROW MECHANICAL 10330 SW TUALATIN RD TUALATIN, OR 97062 REQUIRED INSPECTIONS Duct Inspection Phone:692-1565 Final Inspection Reg#:LIC 000051 ELE 34-47CLE IL oc _J m uThis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-r(503)246-91819. 0 througR R 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by callin Iss _ Permittee Signature: _ Call(503) 6394175 by 7:00 P.M.for Inspections needed the next business day CITY OF TIGARD Mechanical Permit Application Plan edc �� PP Recd ' 13125 $W "TALL BLVD. Commercial and Residential Date Rec'd1 TtGARD, OR 97223 Date to P.E (503) 639-4171, x304 Date to DST /d�� i Print or Type Permit 0 r1c ( 113 7 _ Incomplete or illegible applications will not be accepted�ca°ed Ner,.s of DevelopmentlPro)ed Description Table 1A Mechanical Code a Price Amt Job Street Address Sidle# A) Permit Fee 16.00 c 1) Furnace to 100,000 BTU Address Bldg* r 0 , r CRY/state�� z — Includingduds 3 vents see footnote 1,2 9.65 tP 2) Furnace 100,000 BTU+ 171601D O ") ? ' including duds&vents see footnote 1,2 12.00 (or nems i akMts) -` Floor Furnace im Owner me —P includingventvent sae footnote 1,2 9.65 ►w{edingAl „ 4) Suspended heater,wall heater / Io or floor mounted heater see footnote 1,2 9.65 l G�Le, i ZC� 5) Vent not Included in a liance ermit 4.75 nyrstele p Phone Check all that apply: •Boiler Heat Air For Items 6-10,see or Pump Cond City Price, Amt Name(or name of business) footnotes 1,2 Comp '•_ _ 5)<3HP;a sorb unit to Occupant Mailing Address OOK BTU _ 9.65 A ,t 7)3-15 HP;absorb unit i (D 0 100k to 500k BTU 17.65 CRY/State Zip 8)15-30 HP;absorb 7l6 0 Q G17z� unit.5 1 mil BTU 24.15 1larne - 9)30-50 HP;absorb contractor unit 1-1,1 d mil BTU 36.00 6l i?o L-) M a !✓ ( 10)>50HP;absorb unit Prior to permit Mailing Address >1.75 mil BTU bO.15 Issuan(e,a copy /0330 i(J , 1 A D 11 Air handling unit to 10,000 CFM of all licenses CNylt3late zip PrtoM _ _ 7.00 are required if /, 6 1-706714q1- an 1 12)Air handling unit 10,000 CFM+ expired in COT Drepm Const.COK Board Lie.$ Exp.Dale 11.85 database !� e,, 13)Non-portable evaporate cooler Architect Ner1e 7.00_ /,1i,, r, ) C 14)Vent fan connected to a single duct Or Mailing Address 4.75 15)Ventilation system not included in JO r 3r) Lj R 1 appliance permit 7.00 Engineer Cltymate ZIP Phone 16)Hood served by mechanical exhaust ri1r)ry1/AI 0 J IUG2_ 612 -156S 7.00 Describe work to be done: 1 y)Domestic incinerators 12.00 New O Repair 91 Replace with like kind: Yes O No O 18)Commercial or Industrial type incinerator Residential O Commercial fit 48.25_ 19)Repair units Additional Information or description of work: E)U)� I 8.40 rs 20)Wood stove/gas FP/other units/clothe dryer/etc 1 7.00 n• NOTE: For Commercial projects only;Units over 400 lbs.require 21)Gas piping one to four outlets astructural gas calcs. _ See footnote 1 3.75 W Type of fuel. oil O natural gas 0 LPG O electric O 22)More than 4-per outlet(each) _ 75 } Minimum Permit Fee$50.00 _ SUBTOTAL f— I hereby acknowledge that i have read this appli ration,that the information 7%SURCHARGE given is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL m the owner,that plans submitted are in compliance with Oregon State laws. _ Required for ALL commercial permits ons (9 TOTP L W Signat re of Agent i� Date Other Inspections and Fees: / 1. Inspections outside of normal business hours(mininum charge-two Contact Person Name Phone hours) $60.00 per hour 2. Inspections for whist,no fee is specifically Indicated (minimum charge-half dour) $50.00 per hour Foonotes for commercial projects only: '. Additional plan review required by changes,additions or revisions to 1. Provide full schematic of existing and proposed gas line and pressure. plans(minimum charge-one-half hour)$50.00 per hour ?. Provide drawings to scale showing existing and proposed mechanical units. J 'State Contractor Boiler Certification required "Residential AJC requires site Ian showing pi cement of unit 1:Vnechperm.doc rev 7/19/99 �z A e5xf�r CITY OAF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT PERMIT #. . . . . . . : SUP99-0049 13125 S W Hall Blvd., 71gard,OR97223(503)6.39.4171 DATE ISSUED: 03/08/99 PARCEL: 2S102AB-04800 SITE ADDRESS. . . : 12460 SW MAIN ST SUBDIVISION. . . . : ZONING:CBD BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . JURISDICTION:TIG REISSUE: FLOOR AREAS ---- -- --- EXTERIOR WALL. CONSTRUCTION— CLASS OF WORK. :ALT FIRST. . . . : 4.390 sf N: S: E: W: TYPE OF USE. . . :COM SECOND • 0 s f PROTECT OPENINGS?---------- TYFE OF' CONST. :5N . . . . 0 sf N: S: E: W.- OCCUPANCY :OCCUPANCY GRP. :M TOTAL--------: 4390 sf ROOF CONST: FIRE RET?: OCCUPANCY LOAD: 130 BASEMEN';. : 0 sf AREA SEP. RATED: STOR. : 1 HT: 0 ft GARAGE- -. . 0 sf OCCU SEP. RATED: BSMT?: MEZZ?: REOD SETBACKS—._____.__— REQUIRED---------.-------------- F LOOR LOAD. . . . : 0 p s f LEFT: 0 ft R13;4z: 0 ft FIR SPKL:N SMOK DET. . :N DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:N HNDICP ACC:Y BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR:N PARKING: 0 VALUE. $ : 50000 R e m a rl4 s : Remove brick veneer, construct new opening in exterior wall. Install new store front windows. Seismic upgrade on 2 walls and ADA upgrade. Owner: -____ --------------------------------- FEES -------------- NICK CAPISTRANO type amoi.int by date r,ecpt 12370 SW MAIN ST PLCK f 183. 95 BON 02/08/99 99-312760 TIGARD OR 97223 FIRE f 113. 20 BON 02/08/99 99-312760 PRMT f 283. 00 B 03/08/99 99-313504 Phone #: 639--8375 5PCT $ 14. 15 B 03/08/99 99-313504 Contractor: ---------------------------- ROBERT GRAY PARTNERS INC PO BOX 1016 SHERWOOD OR 97140 --------------------------------------- Phone #: 692-4675 $ 594. 30 TOTAL Reg #. . : 000654 - -REQUIRED ACTIONS or INSPECTIONS------- This NSPECTIONS--------- This permit is is5ued subject to the regulations contained in the Framing I n s p Tigard Municipal Code, State of Ore. Specialty Codes and all other High strength bo applicable laws. All work will be done in accordance with Misc. Inspect ion approved plans. This permit will expire if work is not started -� N within 188 days of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the ._� rules adopted by the Oregon Utility Notification Center. Those _ ID rules are set forth in OAR 952-881-8918 through OAR 952--88181987. 0 You many obtain a copy of these rules or direct questions to O(K —_ W by calling (503)246-1987. F'Er,mi.ttee Si nat�lr-e: Issmed By: "_ --k ++....++t+++++f++++++..... ....+++++++++++++++++.... .....++++++++++++4+++++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next business day +++++++++++++.f++++++++++++++++++++++++++++++.+++++++++++++++++++++++++++++++++ CITY OF TIGARD Commercial Building Permit Application Rete ByDate 13125 SW HALL BLVD. New Construction and Additions Date o P,E. A--1/' TIGARD, OR 97223 Uate to DS/�T,_A"� (503) 639-4171 Permit! 1�11. _ Print or Type Related SWR 0 ' Incomplete or illegible applications will not be accepted Called •�=�� - Name of UW,eiopmenVProject tali Job NtAWh CAPM IRA BultrbII' , Existing Building New Building Address Street Address Suite ' 124160 s•W. MAtly 5T. Building t Bldg 0 City/State Zip Data I ` iTi6AV-0, Olt. 'T'1LL3 Existing Use of Building or Property: Name Property (f p15T')ZA J0 Yp`c o,mT Owner Mailing Address Suite Propr ed Use of Building or Property: I-151b S.y1,MAIN LAVA V-WW1`4 City/State Zip Phone — •rt6A� O� °I'i L�3 `31 r&315 No. Of Stories: 1 Occupant NameI Sq. Ft. Of Project: NoT. APPULABL�F_ Al, ct b Name )T,V rA 7tf It t rrdl Occupancy Class(es) Contractor la N kNOW4 • TH%� -rime- Prior IMEPrior to permit Mailing Address Suite Type(s)of Construction issuance,a copy or all licenses - N are required if City/Stale Zip Phone - Will this project have a Fire Suppression System? expired in C.O.T. Yes 0 NO database Americans with Disabilities Act(ADA) Oregon Const.Cont.Board LIc./ Exp.Dale Valuation X 25%= $ Participation Complete Accessibili Form Name Project $ _ v Architect Valuation ejO000059- Mailing Address Suite Plans Required: See Matrix for number of sets to submit City/Stag ^ Zip Phone on back Engineer Name {. I hereby acknowledge that I have read this application,that the information N I LOW GK6,1M6 r,IAK ILI given Is correct,that I am the owner or authorized agent of the owner,and Mailing Address Suite that plans submitted are in compliance with Oregon State Laws. d .o. 601k Z -7 Signatt f Owner/Agent.p Date City/State -. 8Zip Phone rn _ T< ?_ 9lZb1 (02U-2,00(o C ct Person Name Phone Indicate type of work: '•ar. 7 Addition O Demolition C!/ JIM NILdLI ZD Zf78 Accessory Structure O Foundation Only O Afleratic^ 011 m Repair cY Other O FOR OFFICE USE ONLY U' Description of work: RENaVG eUJI (:1G1G VIREMMIL G6t49rI1 t r.T MaprTLall Land Use: Nt W 0M"IWj t.N P'XTEGIUR WAI,t.. IN�T#►Ll- NIC- 7Top.EF Nr WlNuorJy 5rlyMlc I.Ipa¢,ws. oN Tiow Notes: o n 0 r- Parks: Eat i sled M of Employees TIF: If the above figure Is not supplied at the time of application,the city will calculate the fee based upon the number cf park!q spaces. —— Note: Site Work Permit Application must precede or accompany Building Permit Application 1.1COMNEW.DOC (DST) 5198 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan Review is dependent upon submittal'Of'90TH plans AND a COMP LETED application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review will be conducted. After plan review approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes. (Copy for Contractor, City, Washington County, Tualatin Valley Fire & Rescue) ToJ # of TYPE OF SUBMITTAL Plans KEY: Submitted S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) I P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) Building *13 or B & M (Alt) 1 F *B & M & P (Alt) 3 N *B & M & P & E(Alt) 3 m •B & M & P & E & F(Alt) 3 W NOTES: *Shaded areas designate ALT submittals L\dsts\forms\matrxcom doc 10/29/98 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 I 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 individuiwls with disabilities,unless such alterations are disproportionate to the overall alterations In terms of cost and scope. (2)Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five percent (25%). VALUATION of all renovation, alteration or modification being done _ excluding painting, wallpapering. [1 J $ 60, 000 mulLtiplyz 25% Barrier removal requirement. _ .25 BUDGET FOR BARRIER REMOVAL [2[ $ 500 In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b)An accessible entrance: On `imol (c) An accessible route to the altered area: $*k, bOp°' l t (' Imo, (d) At least one accessible restroom for F'd-VRkA6P each sex or a single unisex restroom: $ US I* 5_Fii', ''% It (e) Accessible telephones: �t� (f) Accessible drinking fountains: and (g) When possible, additional accessible elements such as storage and alarms: a m TOTAL: Shall equal line 2 of value computation X12 F]Dd w E i I I M - 4�. I I—� ----------- A Id _ — Erg and Construction Services, Inc. Street Address: 9025 Southwest Center Street Mailing Address: P.O. Box 23784 •Tigard, Oregon 97281 (503)620-2086• FAX (503) 684-3636 City of Tigard Building Department Attn.: Bob Poskins, CBO Re.: Maria Cristina Building 12460 S.W. Main Street Tigard, Oregon BUP 99-0049 Mr. Poskins, The work to be performed water the above noted permit is complete. Field observations/ inspections where performed by Nicoli Engineering and the v ork performed was found to be in compliance with the permit documents. The contractor was directed by this office to perform certain tasks as field conditions arose. This work .--as performed to the satisfaction of this office. The contractor is requesting a final inspection by the city( if required) for their portion of work. To the best of our knowledge, all work performed was per the permit documents and per the O.S.S.C. requirements. If you have any questions please fee) tree to contact us. Sincerely, Nicoli Engineering Ca .w....�... _a -- a rn James D. Andrews Project Manager m 0 J FROM N I COL 1 EKri I NEER I NG FAX NO. 503 684 3636 Apr. 05 1999 02:24PM P2 T_17Till III 1 1111 and Construction Services, Inc. 9025 Southwest Center Street P.O. Box 23784-Tigard, Oregon 97223 (503)620-2056-FAX (503)684-3636 April 1, 1999 City of Tigard Building Department Attn.: Bob Poskins Re.: Maria Cristina Building 12460 SW Main Street Tigard, Oregon 97223 Permit No.: BUP 99-0049 Job No.: 97-0416 Mr. Poskins, The approved documents required (2) '/4" diameter anchor bolts be used to connect the T.S. column base plate io the concrete footing(see details 1,2/5.1). We have apprcved the use Ul epoxy set bolts in lieu of the anchor bolts at all locations except for the diagonal bracing connections(detail 2/5.1) to footings. The epoxy anchors shall be 5/8" diameter all thread Huth 5" minimum embedment set in epoxy(9 'A for Simpson system). The contractor can use Simpson ET Adhesive or Hilt! HVA Adhesive System. Testing agency shall inspect hole diameter and depth_ Reports shall be submitted to the City of Tigard and Nicoll Engineering. If ycu have any questions please do not hesitate to call. a N Sincerely ��D pRd'7� / w W ftF�;CiN ..J James D. Andrews ,,}; '!r 17. ' �� Project Manager SFS , JDA:lmh 12-31 enclosuresXPlRES: 2a40 CITY OF TIGARD BUILDING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : BUP98-0123 13 IPS SWHaliBlvd.,17gard,10A9W3 (303)839 171 DATE ISSUEED: 03/27/98 PARCEL: 2S102AB-04800 SI E ADDRESS. . . : 12460 SW MAIN ST S DIVISION. . . . : ZONING:CBD B CK. . . . . . . . . . : LOT. . . . . . . . . . . . . . JURISDICTION:TIG --- --------------------------- -------------------------------------------------- REISSUE: FLOOR AREAS------------ EXTERIOR WALL CONSTRUCTION— CL_ASS OF WORK. -.ALT FIRST. . . . : 4400 sf N: 1 HR S: E: W: 'TYPE OF USE. . . :COM SECOND. . . : 0 sf PROTECT OPENINGS?----------- TYPE OF CONST. :5N . . . . 0 sf N: S: E: W: OCCUPANCY GRP. :B TOTAL------ ! 4400 sf ROOF CONST: FIRE RET?: OCCUPANCY LOAD: 106 BASEMENT. : 0 sf AREA SEP. RATED: STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED: BSMT?: MEZZ? : READ SETBACKS-------- REQUIRED--------------------- FLOOR LOAD. . . . : 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET. . : DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:Y BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ : 8500 Remarks : Tenant improvement of restrooms and exit, ADA upgrade and parking. Owner: -------------------------------------------------------- F EES --------.------ NICK CAPISTRANO type amount by date recpt 12370 SW MAIN STREET PRMT $ 74. 50 DEB 03/27/98 98--304452 TIGARD OR 97223 5PCT $ 3. 73 DEB 03/27/98 98-304452 ML_CK $ 48. 43 DEB 03/27/98 98-304452 Phone #: FIRE $ 29. 80 DEB 03/27/98 98-304452 Contractor: OWNER ----- Phone #: $ 156. 46 TOTAL Reg #. . : 000000 --REQUIRED ACTIONS or INSPECTIONS---- This permit is issued subject to the regulations contained in the Framing Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other G p Board I n s p d. applicable laws. All work will be done in accordance with ZJM, 1 LP- approved plans. This permit will expire if work is not started �— within 189 days of issuance, or if work is suspended for more N than 189 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- 91-9910 through OAR 952-99191987. M You many obtain a copy of these rules or direct questions to OtINC _ 0by calling 15931246-1987. W _-- _ J _ Permittee mittee Si9nature : Issued B ��_�_�—✓ ++++++t-+++++++++++++++++++++++++aa++++++++++++++++++++•!-+++++++++++++•r+++++++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next busi�iess day ++++++++++i++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++* CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERMIT 13125 SW Had Blvd., Tigard,OR 91223 (503)6394111 PERMIT #. . .DATE ISSUED::. . . :05/13/98/98 —0134 PARCEL: 2SI02AB-04800 SITE. ADDRESS. . . : 12460 SW MAIN ST SUBDIVISION. . . . : ZONING: CBD BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . JURISDICTION: TIG ------------------------------------------------------------------------------------ CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 'T'YPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 1 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0 FIXTURES------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . : 1 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . : 0 LAVATORIES. . . . : 2 OTHER FIXTURES. . . . : 1 TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : 0 WATER CLOSETS. : 2 WATER LINE (ft ) . . . : 100 DISHWASHERS. . . . ; 0 RAIN DRAIN (ft) . . . : 0 Remarks : Plumbing tenant improvement of restrooms and exit, ADA upgrade and parking. Owner: ----------------------------------------------------- FEES -------- NICHOLAS CAPISTRANO type amount by date recpt 12370 SW MAIN ST PRMT f 93. 00 B 05;13/98 98-305713 T I GARD OR 97223 5PCT 1 4. 65 1; 05/13/98 98-305713 Phone #: Contractor-------------------------------- WENDALL CONSTRUCTION 5555 SE 119TH PORTLAND OR 97266 ----------------_-----___---__----_.-- Phone #: 761-5220 S 97. 65 TOTAL Reg #. . : 57615 ------- REDI..)I RED I NSPECT I DNS ------- This permit is issued subject to the regulations contained in the Water Service In Tigard Municipal Code, State of Ore. Specialty Codes and all other Rough—in I n s p _ applicable laws. All work will be done in accordance with Top—out Insp a approved plans. This permit will expire if work is not started Mi sc. Inspection within 180 days of issuance, or if work is suspended for more Final Inspection _ N than 188 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notificatiun Center. Those rules are _ set forth in OAR 952AWI-W1e through OAR 952-A181-M, You may obtain copies of these rules or direct questions to 01K by calling _ m (593)245-1987. '. _ a i s s u e d By : t � 6L-11 Permittee .,r.g n a t u r e. -�]Ql.l✓'L- ++++++++++++++++++++++++++++++++++++++++++++++++.....+ ++++ L+++++++......+++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ CITY OF TIGARD Plumbing Permit Application Plan Check8(� -37 13125 SW HALL BLVD. Commercial and Residential Recd By _C-7T- TIGARD, OR 97223 Date Roc'd (503) 639-4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be -accepted Permit#`L Related W• - d Called _1 Name of Development/Project ` On back Indicate Work Performed by fixture, .lob L q io'l__51 1 A tV0 CJ�(� kiXTUREIVirld.IvIdini) QN&Z aWf" PRICE; Address S r et dress —� Suit Sink X5.0,1 /77At goo ��q Lavatory Bldg/ G1iylSlatQ Zi 'rub or Tub/Shower Comb. 8.00 � a�f e 1 Shower Only 9.00 1`t C<YL- % �-�%5 •-ry, 0 l7 Water Closet �l_ goo � Owner Mailing Address Ito Dishwasher 9 t)0 ( � Io -'� mac`"" Garbage Disposal 900 ,jty/State Zip Phone * C, c�2� 1 Washing Machine 9.00 Name &/A/ 7 � Floor Drain 2" 800 C�C G U,4)1 e- 3" 9.00 Occupant Mailing Address r Suite 4. — 9.00 CMy/State Zip Phone Water Heater O conversion O like kind 9.00 Laundry Room Tray 9.00 Nam tA_Je k--,J't! ' ` Otv Urinal g.00 _ Other Fixtures(Specify) � r , 9.00 Contractor Mailing Address/ Li'l �SuiM _ 9.00 Prior to permit Ci tate ZIp Phone 9 00 issuance,a copy 111 f,d r 761•— Sewer-1st 100' 30.00 of all licenses areregen onst.Cons oard Lic.# Exp.D`te �,i Sewer-each additlonal 100' 25.00 required if lbs / / f 11 Water Service-1st 100' exp!red in COT Plumb g ic. Exp.Dato 30 00 ?�� databas� XWater Service-each additional 200 _ 25.00 Name 0 , ' Storm&Rain Drain-1st 100' 30.00 Architect / (;) 16 V1 Iry P Storm 6 Rain Drain-each additional 100' - 25.00 Or ailing dross Suite Mobile Horne Space 28.00 {rr' Commercial Back Flow Prevention Device or Anil- 25.00 Engineer Qty/State ZiD Phone Pollution Devic _ 090-,q08(4 Residential Backflow Preven!!on Device' 15.00 Describe work New}O Addition O Alteration IS Repair O Any Trap or Waste Net Connected to a Fixture 9.00 to be done: Residential O Non-residential Jr' Catch Basin 9,00 Additional des peveal n of work: Insp.of Existing Plumbing 40,00 NeM 4E 1<e51fV0t-1 _ rRtt Specialty Requested Inspections 40,00 fl _ r/hr Rain Drain,single family dwelling 30.00 �= Existing use of A _ Nbuilding or property / Grease Traps 9.00 r Proposed use of QUANTITY TOTAL4v. 1 g H # building or property !xxnsalc a riser d is required M Quantity Taal Is >9'SUBTOTAL I hereby acknowledge that I have read this application,that the informationW ghan is correct,that!am the owner or authorized agent of the owner,and 5%SURCHARGE that lans submittare in com li ce with Ore on State Laws. gn of r/Agent Dste "FLAN REVIEW 2dX OF SUBTOTAL R red on K fbxaw total Is>9r TOTAL F� S C B t Pe n N a Phone / f q *Minimum perrnft fes Is$25+5%surcharge,except Residential Backilow, Prevention Device,which Is$15+5%surcharge All New Commercial Buildings require plans with Isometric or riser diagram It/ 767115 �s l 9S and plan review I%ditMi mbW dw 5151116 PLEASE COMPLETE: Fixture Type Quantity by Work Performed • New Moved Replaced Removed/Capped Sink Lavatory Tub or Tub/Shower Combination Shower Only _ Water Closet Dishwasher _ Garbage Disposal _ Washing Machine Floor Drain 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: 00 W 'e,MpkrnhWp doe&&" CITY OF TIGARD FI FrTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: EL.C98-0537 93125 SW Hatt BIvd., Tigard,OR 97223(503)639.4111 DATE ISSUED: 09/10/98 PARCEL: 2SI02AB-04800 SITE ADDRESS. . : : 12460 SW MAIN ST yUBDIVISION. . . . . ZONING:CBD BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG Project De seri pt ion: Installation of 12 branch circuits. ---RESIDENTIAL UNIT---- -----TEMP SRVC/FEEDERS---- -------MISCELLANEOUS-- ------- 1000 ------MISCELLANEOUS-- --- -- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EAf'H ADD' L 500SF. . . : 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 6014amps-1.000 volts. : 0 MINOR LABEL_ (10) . . . : 0 ---SERVICE/FEEDER---- -----BRANCH CIRCUITS----- ---ADD' L INSPECTIONS--- 0 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PES INSPECTION. . . . . : 0 201 �F00 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 FrR HOUR. . . . . . . . . . . : 0 401 - 1300 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1. 1 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : (A -.----------------PLAN RI=1.1iEW SECTION-- -------- ------- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR )= 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner-: --.-------_------_-.------------------------------------ FEES -----------_ _.....__ DE LA ROSA ELECTRIC CO type amount by date recpt 3452 NE PACIFIC ST PRMT $ 90. 00 DEB 09/10/98 98-30903E PORTI_.AND OR 97232 5PC:T $ 4. S;M DEB 09/10/98 98--3090.:2 Phone #: Cortractor: ----------------------------- DEL_A ROSA ELECTRIC CO $ 94. 50 TOTAL 3452 NW PACIFIC ST REON]I RE'D I NSPECT I ONc3 --_-- PORTLAND OR 97232 Ceiling Cover Elect' 1 Service Phone #: Wall Cover Elect' l Final Reg #. . : 48856 `his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. PH work will be done in accordance with approved plans. This permit will exrire if work is not started within 188 days of issuancp, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-01-8818 oug R 952-881-1987. You may obtain a copy of these rules or direct questions to DUNG b ling (583)24Ey1 Permittee Signature : / ssued I ------___----OWNER INSTALLATION ONLY----------------- --- Theinstallationis being made an property I own which is not intended for -� sale, lease, or renis. R OWNER' S SIGNATURE: DATE: (D _w _ - _------------------------CONTRAf.'TPI._.I_ N ONLY------_---_--------_------- _..__. a p 5I GNATURE OF SUPR. FL F_.r' N: �'_- Q,C- DATE: I IFENSE NO: /6 +++•+-++#-F+++++++++i++++++++-h++++i+++++++++++++i++++•+-+++•f++++++++++++++++++++++++ Call 639--4175 by 7:00 p. m. for an inspection needed the next business day ++++++++++++++++++++++++++++•+++++++++++++++++++++++++++++++++++++++++++++++++++ CITY OF TIGARD Electrical Permit Application Plan;Rec'd4&T 13125 SW HALL. BLVD. Dat TIGARD OR 97223 Date Date to P.F. Phone (503)639-4171, x304 Date to DST -+ Print or Type Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit«-EU Fax(503)684-7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development MARIA CR I ST I N A BUILDING Number of Inspections par permit allowed Name(or name of business) 12460 SW MAIN SREET Service Included: Items Cost Sum Address BURNHAM,TIGARD,OR. 97223 4a. Residential-per unit �- 1000 sq.0.or less $110.00 4 City/State/Zip Each additional 500 sq.tt.or Commercial lXI Residential❑ portion thereof $25.00 1 Limited Energy $25.00 Each Manul'd Home or Modular 2a. Contractor Installation only: Dwelling Service or Feeder $68.00 2 (Attach copy o c r nt s) 4b.Services or Feeders Electrical Contractor R�T ELECTRIC CO. Installation,alteration,or relocation Address__ Strept 200 amps or less $60.00 2 201 amps to 400 amps $80.00 2 City Portland -State 0 r. _Zip 97232 401 amps to 600 amps $120.00 2 Phone No. ( 903) L16-012-R 601 amps to 1000 amps $180.00 _ 2 Job NO. Over 1000 amps or volts $340.00 2 Elec.Cant. Lice. No. 26-891C Exp.Date 10-01-98 Rec wined only $50.00 2 OR State CCB Reg. No. 4 8 8 S 6 Exp.Date 097217979 4c.Temporary Services or Feeders COT Business Tax or Metro No. E p. te Installation,alteration,or relocation- - 200 amps or less $50.00 2 Signature of Su r. Eler,'n ,1�+ ` 201 amps to 400 amps _. $75.00 _ 2 p 401 amps to 600 amps $100.00 _ 2 Over 600 amps to 1000 volts, License No. 1.67 S Exp.Date 10-01-98 see"b"above. Phone No. -0 3 2 8 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 W. Address Each branch circuit $5.00 2 b)The fee for branch circuits CityState lip without purchase of co Phone No. _ service or feeder tee. First branch circuit 1 $35.00 s 2 The installation is being mado on property,own which is not Each additional branch circuit tL $5.00 2 Intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's SlgnatureX , _ Each pump or irrigation circle $40.00 2 Each sign or outline lighting _ $40.00 _ 2 CL 3. Plan Review section (if roquire d):* Signal circutt(s)or a limited energy- panel,alteration or extension $40.00 _ 2 Minor Labels(10) $100.00 Please check appropriate Item and enter fee In section 58. 4 or more residential units in one structure 411.Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per inspection __ $35.00 m Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C.Chapter 5 In Plant $55.00 W _j "Submit 2 sets of plans with application where any of the above apply. Jr. Fees: Not required for temporary construction services. So.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ - 5b.Enter 25%of line So for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHCRIZED IS Plan Review if reguir (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. Trust Account Total balance Due : t IDST",AR C96 API' no 9/Qf, CITY OF TIGARD BUILDING INSPECTION DIVISION DUP 24-Hour Inspection Line: 639-4176 Business Line: 639-4171Z Date Requested �d AMo PM Location, Suite MEC _ Contact Person ,' �/ -1�YL Ph PLM _ Contract nL.,,�•__ lof Ph SWR UILDING Tenant/Owner ELC Retaining Wall ELR Footing JAEccess:Foundation FPS Ftg Drain sGN Crawl Drain Notes: - Slab SIT Post&Beam y Ext Sheath/Shear Int Sheath/Shear , Framing _ Insulation Drywall Nailing Firewall �1 so o�`- 1 n e%co 21 9 _ T Fire Sprinkler r'J L ! Fire Alarm Suso'd Ceiling Roof M sc: LaiZ (PAWS_ ')PART FAIT. - - P BING Post&Beam Under Slab Top Out \� ' Water Service - Sanitary Sewer - - - Rain Drains Final J� PASS PART FAIL MECHANICAL Post& Beam -- ---- Rough In Gas Line - - -- - Smuke Dampers Final -- PASS PART FAIL ELECTRICAL — n' Service Rough In U) UG/Slab Low Voltage J Fire Alarm — m Final PASS PART FAIL - —_ LU SITE J Backfill/Grading -� -- -- Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd Catch Basin [ ]Please call for reinspection RE: _ i [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other pate / 4 O d' Inspector Ext t Final PASS PART tA!Lj DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT 13125 SW Hell Blvd., Tigard,OR 97223 (503)6394171 PERMIT #. . . . . . . .. BUP98-0295 DATE ISSUED: 07/31/98 PARCEL.: 2S 102AB-04800 STiE ADDRESS. . . : 12460 SW MAIN ST SIJBD I V I S I ON. . . ., : ZONING:CBD BI_..00K. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTIONsTIG ------------------------------------------------------------------------------------- REISSUE: FLOOR AREAS----------- EXTERIOR WALL CONSTRUCTION— CLASS OF WORK. :ALT FIRST. . . . : 4048 sf N: S: E: W: TYPE OF USE. . . :COM SECOND. . ., : 0 sf PROTECT OPENINGS?---------- TYPE OF CONST. :5N . . . : 0 sf N: S. E: W: OCCUPANCY GRP. :M TOTAL------: 4048 sf ROOF CONST: FIRE RET?: OCCUPANCY LOAD: 0 BASEMENT. ; 0 sf AREA SEP. RATED: STCLR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED: BSMT?: MEZZ?: REDD SETBACKS-------- REQUIRED---.----------------- FLOOR..LOAD. . . . : 0 p s f LEFT: 0 ft RGHT: 0 ft FIR SPKL.: SMOK DET. . : DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ % 3000 Remarks-. Commercial tenant improvement: Installation of insulation and Gyp board only. Electrical permit is reouired. Owner: -------------------------------------------------------- FEES NICOLAS CAPISTRANO type amount by date recpt 6646 SW 35TII AVE PRMT f 38. 50 JSD 07/31/98 98-307885 PORTLAND OR 97221 5PCT f 1. 93 JSD 07/31/98 98-307885 PLCK $ 25. 03 JSD 07/31/98 98-307885 Phone #: FIRE f 15. 40 JSD 07/31 .;8 98-307885 Contractor: --------------------------- OWNER -------------------------------------- Phone #: 8 80. 86 TOTAL. Reg #. . : 000000 --RED.L.I I RED ACTIONS or INSPECTIONS—— This permit is issued subject to the regulations contained in the Insulation Insp Q. Tigard Municipal Code, State of Ore. Specialty Codes and all other Gyp Board Ins p p� applicable laws. All work will be done in accordance with F' approved plans. This permit will expire if work isnot started _ within 188 days of issuance, or if work is suspended for more _ than IN days. ATTENTION: Oregon law requires you to follow the J rules adopted by the Oregon Utility Notification Center. Those _ m rules are set forth in OAR 952-11-0018 through OAR 952-81181987. W You many obtain a copy of these rules or direct qutstions to DUNG J i by calling (583)246-1987. Permittee Signature: Issued By : ++++++++++++++++++++++ ++++++++++++++++++++i.+++++++++++++++ +*+++++++++++++++ Call 639-4175 by 7:0 p. m. for an inspection needed the new business day +++++++++++++++i-+++++++++++++++++++++++++++++++++++++�-++++++++++++++++++++++++ CH, 7-103(_.. ATY OF TIGARD Commercial Building Permit Application t R _17'_17'Dae 3125 SW HALL BLVD. Tenant Improvement Date Redd_ p Date to P.E. ]GARD, OR 97223 Date to DST 503) 639-4171 Permit N P__..'U/' —O 5 Print or Type Related SWR e Incomplete or illegible applications will not be accepted cam� Name of Development/Project Existing Building❑ New rluilding p Job /Z 4-6 4 S. Address Street Address suite Building 7 r- Data _ aldg s Cny/State Do Existing Use of Building or Property: ® -^-- Name Building ti/ Proposed Use of Property G�pl S--2Pr••o 445S p 9 or Property: Owner Mailing Address Suite No. Of Stories: City/Stale Zip Phone Sq. Ft. Of Project: Occupant Name Occupancy Class(es) - Name O N_ / _— Contractor Ow kie 2 o ��er / �, Type(s)of Construction Prior to permit Mailing Address SUN$ / -- — issuance,a copy Will this project have a Fire Suppression System? of all licenses Yes IJ No 0 are required if City/State Z.ip Phone Americans with Disabilities Act(ADA) expired in C.O.T. database Valuation X 25%= $ Participation Oregon Const.Cont.BoDate Complete Accessibili Form _ Project $ Name Valuation d / Architect Plans Required: See Matrix for number of sets to submit Mailing Address Suite on back City/State Zip Phone I hereby acknowledge that I have read this application,that the information given Is correct,that I am the owner or authorized agent of the owner,and _ that plans submitted are in compliance with Oregon State Laws. Engineer Name y#I /Ir�L IpE u/ N/Ga t-/ ��it/�� /E t 2/N Ca Signature of OwnenAgent Dale Mailing Address Suite OA4-2'.t„1 f b MA Pd L3 7 ¢ Contact er n N r Phone Q. City/State Zip Phone \� ��^�'�� -I v Q: E,Zo-?tee U) >_ -- — FOR O FILE USE ONLY Ir.dlcate type of work. New O Addition O Demolition O Map/TL* Land Use: Accessory Structure O Foundation Only O Alteration _m Repair O — Other O _ Notts: F3 Oescrlptlon of work: J //�/S tJ L Ar[ S�4 f=bF-r� TIF: --- -- � P��s Note: Site Work Permit Application must precede or accompany Building Permit Application 1:1COMNEWTLDOC (DST) 5198 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 9 BUP _ Date Requested rq / �AM PM - BLD Location [ ?�yCQ� l�''►Cu/� 1r� Suite MEC Contact Person Ph PLM Contractor Ph SWVR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Foundation Access: e FPS Fig Drain ` '�Yh'l _ Crawl Drain Inspection Notes: SGN _ Slab _ Post&Beam — - SR Ext Sheath/Shear Int Sheath/Shear Framing Insulation ---_- --- Drywall Nailing Firewall Fire Sprinkler Fire Alarm - Susp'd Ceiling Roof Misc: _ Final PASS PART FAIL PosBeam Under Slab Top Out L L_ Water Service Sanitary Sewer — Rain Drains rCAS PART FAIL ANICAL — Post&Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL - — Q. Service Rough In —- f. UG/Slab N Low Voltage -" Fire Alarm — — — J Final 0] PASS PART FAIL —_ 5 SITE W Backfill/Grading - ---- —- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basir Fire Supply Line [ ]Please call for reinspection RE:_ [ ]Unt;ble to inspect-no access ADA Approach/Sidewalk Other Date Inspect - _Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITYOF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Insuection Line: 639-4175 Business Line: 639-4171 — _ Date Requested BUP / AM _PM BLD A^ t ocation ( 2 (l�— / cam( A . Suite MEG Contact Person _ Ph X070- Z�DB'<O PLM Contractor Ph SWR BUILDING Tenant/Owners Retaining Wall ELR _ Footing Access: Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: ' Slab 0 SIT Post&Beam Ext Sheath/Shear _ Int Sheath/Shear Framing _-- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final - PASS PART FAIL PLUMBING Post& Beam Under Slab Top Out -- Water Service Sanitary Sewer —" — Rain Drains Fina! ----- ��- v- PASS PART FAIL -- MECHANICAL Post R Beam Rough In Gas Line — -------- ------ --- Smoke Dampers Final ------ — -- — - PASS PART FAIL HService --- — -- --- - N Rough In UG/Slab Low Voltage J Fire Alarm _M PASS RT FAIL W - — - --- J Backfill/Grading - -- Sanitary Sewer Storm Drain [ )Reinspection fee of$ ^�required before next inspection. Pa at City Hall, 13125 SW Hall Blvd Gatch Basin Fire Supply Line I )Please call for reinspection RE- [ Unable to inspect-no access ADA Approach/Sidewalk Other Date Inspector11,4-- ,,,Axt _ Final PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site. CITU OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 *� 6 �fJ � BUP Dat a uested_J� ' AM 'J� PM f —� �Yf Location._ ) C �w Suite _ Contact Person Ph PLM ContractorIver c—' Ph (J lf � ;— SWR --c BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Diain SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing ( _ �— Insulation Drywall Nailing Firewall - Fire Sprinkler Fire Alarm Susp'd Ceiling Roof t t�TFAILNG Post&Beam `-- -- ---- -- -_ — Under Slab Top Out Water Service - Sanitary Sewer Rain Drains Final _ PASS PART FAIL MECHANICAL V Post& Beam -- --- --- Rough In Gas Line ------ -__ __� - Smoke Dampers Final ------- -_��,. — __fIv _. r PASS PART FAIL CL ELECTRICAL --- �`— - Service � Rough In N UG/Slab Low Voltage Fire Alarm -----_ — - -- -- _� m 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 Mvd Catch Basin Fire Supply Line ( ]Please callfor reinspection RE. ___ __ i [ ]Unr�Me to Inspect-no accQss ADA ,r^� Approach/Sidewalk Date �yInspector Ext Other -----_ -- —_— Final PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site.