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12540 SW MAIN STREET STE 120 l OZ6 31S 1S NIVW MS OVSZ6 c Cb lu ui r: LL' m cn ' z L CO O O N O U) a Cl) (1) a Ln a A a t N N N N N G N r W a cr ac U) z_ _J Q W U) J N 12540 SW MAIN ST STE: 120 J CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 � Date RequestedAM PM BLD _ Location Z [/mow !yl G/h sure �-- Contact Person Ph — < J o PLM _ Contractor Ph SWR UILDI Tenant/Owner 1T FLC RetaTn-TMTWall ELR Footing Access: Foundation FPS _ Ftg Drain SGN Crawl Drain Inspection Notes: Slab Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall b� 1 ► 11 ,11�n!� �, Q � 2 (� � 1! I � �„ � �_ Fire Sprinkler Fire AlarmC L�� Qi/L„1 ZG•l 00 Susp'd Ceiling l — 1 Roof f Z0 a�VA ) S Misc: a l final — S PART FAIL - PLUMBING Post& Beam Under Slab Top Out /i Water Service —_ V L 2,610- p 0 -2— 2_ Sanitary Sewer Rain Drains Final PJANk RT' FAIL ` Cf✓k4 Al. .lam�tnn Post&Beam - Rough In Gas Line e Dampers in -- -- --- - — PART FAIL ELIMICAL d Service Rough In UG/Slab —_ -- Low Voltage Fire Alarm -� Final M PASS PART FAIL — O w SITE -j Backfill/Grading ---_-- ------- Sanitary Sewei Storm Drain [ J Reinspection fee of$ __ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: [ J Unable to inspect-no access Fire Supply Line - --- ADA Approach/Sidewalk Other Date Q (� 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 Bur Date Requested AM PM BLD Location l2 i4 b Sw Mi r 5 Suite . I' v MEC _ Contact Person Ph 9.3 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Fig Drain SGN Slab wl Drain Inspention Notes: CACI — SIT Post& Beam Ext Sheath/Shear Int Sheath/vhear Framing � Insulation Drywall Nailing Firewall Fire Sprinkler __ vy Fi 00 Misc. C Lir.,-A- FinalLa PASS PART FAIL -- _-- PLUMBING Post& Beane Under Slab _ Top Out -- Water Service Sanitary Sewer Frain Drains _ Final _ r PASS PART FAIL ��- —_ u � MECHANICAL Post&Beam - - - Rough In Gas Line — Smoke Dampers Final — - — - -- -- PASS PART FAIL ELECTRICAL — a Service Rough In -- y UG/Slab I-ow Voltage —i -- m J ina b SS PART FAIL W J Backfillft trading -- —�—` — --- - Sanitary Sewer Storm Drain [ ] Reinspection fee of$ ^required before inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Ling [ ]Please tail for reinspection RE: I ]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. BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2000-00188 DEVELOPMENT SERVICES DATE ISSUED: 05/24/2000 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 120 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0.00 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: $ 30,000.00 Remarks: Commercial TI Owner: Contractor: DOLAN + CO LLC GRIGSBY CONSTRUCTION INC BY FLORENCE T DOLAN 8114 SW NIMBUS AVE NIGINAL 4025 SE BROOKLYN BEAVERTON, OR 97008 PgpoTneAND,OR 97202 Phone: 641-7343 Reg#: LIC 45073 _ FEES REQUIRED INSPECTIONS _ Type By Date Amount Receipt Framing Insp PLCK KJP —05/24/2000 $192.73 0002427 Gyp Board Insp Susp Ceiing Insp PRMT KJP 05/24/2000 $296.50 0002427 Final Inspection 513CT KJP 05/24/200C $23.72 0002427 FIRE KJP 05/24/200C $118.60 0002427 -- — Total $63155 L a a This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes rn and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is �- not started within 180 days of issuance, or if worts is suspended for more than 180 days. ATTENTION: Oregon law J requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR m 952_-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by W calling (503)246-1987. Pe rm It ee Signature:Issued By: By: �QQ� Call 6394175 by 7 p.m.for an Inspection the next business day CITY OF TIGARD Commercial Building Permit Application PtanChocks 13125 SW HALL BLVD. Tenant Improvement Recd ey— Date Recd TIGARD, OR 97223 --" Date to P.E. (503) 639-4171Date to DST 711 r Z�- Print or Type U Penni" Related SWR t Incomplete or illegible applications will not be accepted Called_ _. Name of Development/Project Existing BuildinggyNew Building❑ Job TX. Fog TAtt A-4oti Address Ttreet Address fUlTE 12p rune Building 125+10 YW MAM1 ST. 1 s,T Fc Data Bldg r — City/State Zip Existing Use of Building or Property: :Irid'MAD., 0A 9^1 Z3 R{TA/L o cs Name --- pe�� Proposer. Use of Building or Property: Property p e I L* FLoofl.' RF`TMa Owner Mailing Address Sui!e 7.++o Flet& - eFFie_e )9 jQ nit✓ /9 ll�A ^vE No. Of Stories: City/State Trp --- Phone — _ 2 �RTI,•M� oR q'7U1 2,16-10eq Sq. Ft. Of Project: -- ------ T-Z- 2r ol'R S.F. Occupant Name .-- S'cRAP/TAtc. Occupancy Class(es) Name— Contractor 64t/6s6Y ev^u1R✓GT1e-JTypes)of Construction Prior to permit Mailing Address Sulte Issuance,a copy5�,y5 Rd Will this project have a Fire Suppression System? of all licenses _Yes n No are required If City/State — Zip Phone expired in C.O.TAmericans with Disabilities Act(ADA) . �1tC database 1'4kE 0Etre,0t17035 _ Valuation X 25%=$!_ Participation N A Oregon Const.Cont.Board l.1c.t ; .Dat Complete Access ility Form Wo r7 g 1 ay1 D� Project $ 3 c o 0 0 Name Valuation _ Architect e-IDA Plans Required: ;see Matrix for number of sets to submit Maillnd Address Suite _ on back *N5 Sw M Br a BLVD 2 o a _--_ CIty/&-;te Zip Phone I hereby acknowledge that 1 have read this application,that the information fii*1 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 Wme —' C I DA D �W ature of Owner/Agent Date Mailing Address Suite �, J;/16?f a a L HyYS fes• • �'d A aPerson Name Phone C City/State Zip Phone JOIJA Tf4, d PILO/M Z Z6 a 114s PoQrc,M-O�oR T72e(_ iib- 129 FOR OFFICE USE ONLY Indicate type of work: New O :Addition O Demolition O Map1TLN land Use: Accessory Structure O Foundation Only 0 Altera Jon O a Repair O Other fp TP �_)p ay T. Notes: _ Description of work: RET)9 t W/Tr/ OFF/4t' SUA-0-DL4- TIF Note: Site Work Permit Application must precede or accompany Building Permit Application lACOMNEWTI DOC (DST) 5198 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX rian l evlew is p i�+ eri#"up rt submittal nf' t' TH plans ANt a GCS IIBL`ETED application. For an electrical submittal, the application must contain the signature of the supervising electriciali 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) 'dotal# TYPE OF-SUBMITTAL Plans k' EY. 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 6 & 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 *B or B &'M (,alt) 1 a *B 8&M & P (Alt) µ3 } *B & M & P & E(Alt) 3W !83& M & P & E & F(Alt) 3CU � w NOTES: *Shadli areas deslgnite'1 `' fiml :-' P :v.. 11dstWorriMmatrxcom.doc 10/30/98 CELECTRICAL PERMIT CITY OF TIGARD PERMIT M ELC2000-00286 DEVELOPMENT SERVICES DATE ISSUED: 06/01/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 120 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG Proiect Description: Install a 200 AMP seravice/feeder, 12 branch circuits and 2 sign or outline lighting for tenant improvements. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: 2 LIMITED ENERGY: 401 - 600 amp: IIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps-1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS —� ADD'L INSPECTIONS 0 - 200 amp: 1 W/SERVICE OR FEEDER: 12 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amn: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amp/volt: >=4 RES UNITS: > 600 7OLT NOMINAL: Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DOLAN PHOENIX ELECTRIC CO A-BOYS 7379 SW TECH CENTER DR. 12.540 SW MAIN ST TIGARD, OR 97223 TIGARD, OR 97223 Phone: Phone: 684-3600 Reg#: LIC 00052288 SUP 4140S EL.E 34-247C FEES Required Inspections Type By Date Amount Receip' Ceiling Cover PRMT GEO 06/01/200C $213.95 0002621 Wall Cover 5PCT GEO 06/01/200C $17.12 0002621 Underground Cover Elect'I Service Total $231.07 Elect'l Final ORIGINAL CL This Permit is issued subiect to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will eypinr if work is not started within 160 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-0010 through OAR 952-001-0080. You may obtain copies of these rules ordirect questions to OUNC at(503) 246-1987 J m PERMITTEE'S SIGNATOR ISSUED BY: L7 — a _ OW ERINSTALLATION ON Y 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 SU"R. ELEC'N: 6'_Ij DATE; LICENSE NO: 6Y/W Call 639-4175 by 7:00pm for an Inspection the next business day CITY OF TIGARD Electrical Permit Application Plan Check ,1312WSW HALL BLVD. Recd By _ TIGARD OR 97223 Date Recd Date to P.E. Phone(503)639-4171, x304 Date to DST_ Inspection (503)639-4175 Print of Type PermitX WMW-d0R Fax (503) 598-1960 Incomplete or illegible will not be accepted Called_ 1. Job Address: 5c°jegPjTyr-e- 4. Complete Fee Schedule Below: Name of Development��c.��_ 6 11 Number of Ins ons r rmtt allowed Name(or name of business) Service included: Items Cost Sum Address /,Aa Y O JL.J M4 r a tj i Z 4a. Residential-per unit 1000 sq fl.or less S 117.75 4 City/State/Zip_ 'r, � �71Z _ Each additional 500 sq ft.or portion thereof $ 26.45 1 Commercial ❑ Residential❑ limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder � S 72.75 2 (Prior to permit Issuance,applicants must provide contractor license 4b.Services or Feeders Information for COT data base). Installation,alteration,or relocation Electrical Contractor_�1.c�•a;� E/��>1�;�_ 200 amps or less _� $ 64.25 �. 2 p 201 amps to 400 amps $ 85.50 2 Address_^23 2,y J�•> i tyl. Lc. 401 amps to 600 amps $ 126.50 _ 2 City It y State mt __Zip `})11.3 601 amps to 1000 amps $ 192.50 2 Phone T o �L'1~Y CX Y Over 1000 amps or volts $ 363.75 2 Jot No R//� - Reconnect only __ S 53.50 _ 2 Elec. Cont. Lice. No. �7 Y-a YZC Exp.Date i 4c.Temporary Servicer or Feeders OR State CCB Reg. No. -c2z.r fl Exp.Date Installation.alteration,or relocation COT Business Tax or Metro No. Exp.Date 200 amps or less _ $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 ampo to 600 amps S 107.00 2 Over 6011 c!rnps to 1700 volts, y License Os _ Exp.Date %se"b"above. 4d.Branch Circuits Phone No. i_ New,alteration or extension per panel a)The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5.35 6�.a o 2 Address b)The fee for branch circuits -- - - without purchase of service City State Zip _ or feeder fee. Phone No First branch circuit $ 3750 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e.Miscellaneous intended for sale, lease or rent. (Service or feeder not Included) Each pump or irrigation circle $ 42.75 Owner's Signature _ Each sign or ou"Ine lighting _ $ 42.75 _ Signal circult(s)or a limited energy (f required):* panel, elsalterallun or extension - $ 60.00 3. Plan Review section i 1 Minor Labels(10) __ $ -4Afif)b Please check appropriate Item and enter fee in section 5B. 4f.Each additional Inspection over /Ao.00 I 4 or more residential units in one structure the allowable In any of the above • Service and feeder 225 amps or more Per inspection S 50.00 Per hour $ 50.00 CI System over 600 volts nominal In Plant _ $ 59.00 iClassified area or structure containing special occupancy as f described in N.E.C.Chapter 5 5. Fees: l 6a.Enter total of above fees S 3``f " Submit 2 sets of plans with application where any of the above apply. Surcharge(45-x total fees) $ / L Not required for temporary construction services. Subtotal •0 r $ _�3 j O 6b.Enter 25%of line 6s for NOTICE Plan Review if required(Sec 3) $ PFRMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account i!_ AT ANY TIME AFTER WORM,IS COMMENCED Total balance Due $ d31 - 0 i:)dstslrnrmsNeIectric.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 74-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested _AM PM BLD _ Location �'CDL-, d S T- Suite �1 MEC _ Contact Person —__n Y72 PLM Contractor Ph SWR BUILDING TenanUOwner ELC 1,000 CO Z R Retaining Wall ELR Footing Foundation ACCESS: FPS Fig Drain Slab Crawl Drain Inspection Notes: �� SGN Post 8 Beam SIT - 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 - PASS PART FAIL _ �— MECHANICAL Post& Beam - ------ �_- Rough In Gas Line --- - - —-- — __ Smoke Dampers Final ---- -- -- - --- — d PASS P T FAIL RIC __-------- ------ _ ., ___ - ery oug SIn --- 1` UG/Slab Low Voltage Fire Alarm 'j Fi -- - m PART FAIL W J 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 reinstion RE: ( ]Unable to Inspect-no access ADA Approach/Sidewalk Other Date �9 Inspector. Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site. CITYOF TIGARD SEWER CONNECTION PERMIT f� DEVELOPMENT SERVICES PERMIT#: SWR2000-00131 13125 SW Ball Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 06/20/2000 SITE ADDRESS; 12540 SW MAIN ST 120 PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CDD BLOCK: LOT: 001 JURISDICTION: TIG TENANT NAME: SCRAPITALL USA NO: !-;XTURE UNITS: 65 CLASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: Tenant improvement: Install 2 sinks, 2 water closets and a water heater. Current fixture count is 47 add 18 =65 or 4 EDU's. This adds 1 to the EDU count. Owner: FEES _ DOLAN & CO LLC Type By Date Amount Receipt BY FLORENCE DOLAN 1919 NE 19TH PRMT DST 06/20/200C $2,300.00 0003135 PORTLAND, OR 97209 Total $2,300.00 Phone: Contractor: Phone: Reg#: Required Inspections a ORIGINAL N J_ _m This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires Uj 180 days from the date issued. The!otal amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Ne;ification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain espies ese rules or direct questions to OUNC by calling (503) 246-1987. Y Issued b l �-Z- -- Permittee Sign ature• Call (503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 Business Line: 639-4171 OUP Date Requested AM PM BLD Location 2 S 0 MEC _ Contact Person ��f,�Tl�_ Ph (9SO -9203 (liki, 29 W't;e2O3 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab _ - SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Misc: — Final PASS PART FAIL - — — B Post&Beam - -- — -- - Under Slab op u) - — a er Seryice Sanitary Sewer — Rain Drains Fi PART FAIL HANICAL Post& Beam --- - -- -- Rough In Gas Line --- - — — --- Smoke Dampers Final — ------ —— PASS PART FAIL ELECTRICAL -- Service Rough In — — UG/Slab Low Voltage Fire Alarm Final PASS PART FAIT_SITE Backfill/Grading — Sanitary Sewer Storm Drain ( ] Reinspection fee of$ _ reo red before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ]Please II for reinspection RE: Fire Supply Line —_ _ ( ]Unable to inspect no access ADA 7 i Approach/Sidewalk Other Dat ,Inspector Ext J`J Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITYOF T I GA R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT 0: MEC2000-00262 S10 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: '2000 PARCEL.: 2 2S 102AC-OQ700 SITE ADDRESS: 12540 SW MAIN ST 120 SUBDIVISION: BURNHAM TRACT ZONING: CB0 BLOCK: LOT:001 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2 OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS _ NGOUS: FUELTYPES 0 - 3 HP: 1 DOMES. INCIN: GAS 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 -50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: Commercial TI Owner: _ _ FEES DOLAN & CO LLC Type By Date Amount Receipt 4025 SE BROOKLYN PRMT DST 06/28/20( $50.00 0003335 PICK DST 06/28/20( $12.50 0003335 5PCT DST 06/28/20( $4.00 0003335 Phone: Total _ $66.50 Contractor: HVAC INC 5188 SE INT'L WAY MILWAUKIE,OR 97222 REQUIRED INSPECTIONS Gas Line Insp Phone:462-4822 Mechanical Insp Reg#:LIC 50897 Cooling Unt Insp Duct Inspection Final Inspection ORIGINAL This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be Jane in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than '180 days. ATTENTION. Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through,_0�R 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246.918 ) - Issue By: -��''`��' �",-� Permittee Signature: IZN V1, Call (503) 6394175 by 7:00 P.M.for Inspections needeJ the next business day Plan Check# CITY OF TIGARD Mechanical Permit Application Recd By 13125 SW BALL BLVD. Commercial and Residential Date Recd � D TIGARD, OR 972231 Date to P.E. (503) 639-4171, x304 gc`+,l* Date to DST Print or Type 60P,?DOCS -C7U 1Z5' Permit# Met .ecu PCalledy'/1(• e►_ Incomplete or HIA i1bie a plications will not be accepted 1—Name of 0evelopment/Protecf i5 ss_ 1phon Table to Mechanical Code _ _ Ot Price Amt ,.:. 16.00 _JCt Street Address Sun N A) Permit Fee +• �' Job ?o?� 1) Furnace to 100,000 BTU Address �a�rIU �W fl1a-ut 9.65 ` including ducts 8 vents Bldg# C /Staten ZIP 2) Furnace 100,000 BTU4 Includ g ducts&vents 12.00 -^ Name(or name o1 busmen 3) Floor Furnace ^• �� includin vent 9.65 _ Owner , Melling Address 4) Suspended heater,wall heater _ J se1� u�� or floor mounted heater 9.65 I-� 5) Vent not included Ina Dplianrepermit_ 4.75 i ny/State Zip Phone 'Boiler Heat Air tv t �� Check all that apply: �A For Items 6-10,see or Pump Cond Qty Price Amt Name(or name of usiness) footnotes 1 2 LC 6)Repair units �4 8.40 Occupant Maninp Add s 7)<3HP;absorb unit to 100K BTU 1 9.65 City/State zip Phone 8)3-15 HP;absorb unit look to 500k BTU 17.6' Contractor Name 9)15-30 HP;absorb unit.5-1 mil BTU 24.15 10)30-50 HP;absorb Prior to permit Mailing Ad res unit 1-1.75 mil BTU 36.00 Issuance,a copy 4) se TA -- 11)>50HP;absorb unit>1.75 mil BTU of all licenses City/State Zip hone 60.15 are required if �I UQ+r-�I �1� �� /{ ' 4,2)Air handling unit to 10,000 CFM expired In COT Oregon const.cont.Board Lic.a Exp )aiF 7.00 database �� 0 13)Air handling unit 10,000 CFM+ — Architect Name _ 11.65 14)Non-portable evaporate cooler 7.00 or Mailing Address 15)Vent fan connected to a single duct � n 4_75 '1 Engineer cny/state zip Phone —i C)Ventilation system not Included in appliance permit_ 7.00 Desc dbe work to be done: 17)Hood served by mechanical exhaust 7.00 New O Repair O Replace with like kind: Yes O No O 18)Domestic incinerators Residential O Commercial Modification 0.( 12.0_0 _ _ 19)Commercial or Industrial type Incinerator Additional information or description of work: 48.25 20) Other units,Including wood stoves _ 7.00 _ NOTE: For Commei sal proje is only;Units over 400 lbs.,located on the 21)Gas piping one to four outlets / ? d roof,require structural talcs.prep#red by licensed engineer. _ _ :3.75 (� Type of fuel: oil O nal, -%I gas O L.PG O electric O 22)More than 4-per pullet(each) .75 F- - N I hereby acknowledge that I have read this application,that the information Minimum Permit Fee$50.00 SUBTOTAL given is rnrrecl,that I am the owner or authorized agent of 8%SURCHARGE :4. u' PLAN REVIEW 25%OF SUBTOTAL .j the owner,that plans submitted are In compliance with Oreg n Sla laves Required for ALL commercial permits only F0 SI tulUof Ow�genttDateTOTAL r W .�- Contact Person Name Phone Other Inspections and Fees Z 1 Inspections outside of normal business hours(minimum charge-two hours) SSo.00 Per hou e Q 2 Inspections for which no fee Is specifically indicated (minimum charge-heti hour) Foonotes for co merc al projects only: W 00perhour 1. Provide full schematic of existing and proposed gas line and pressure. 3 Additional plan review required by changes,additions or revisions to plans(minimum charge-one-half hour)$50 00 per hour 2. Provide drawings to scale showing existing and proposed mechanical 'State Contractor Boiler Certification required units. "Residential A/C requires site plan showing placement of unit I:\mechperm.doc rev 11/1/99 OVER-THE-COUNTER (OTC) PERMIT i COMMERCIAL MECHANICAL PERMIT CHECK LIST Description of Project: L 1 Class of Work: 66;r- Floor Furnace: _ _ Evap Coolers: _ Type of Use: _-- - ►'i Unit Heaters: Vent Fans: —Z� Occupancy Grp: — �— Vents w/o Appl: Vent Systems: Stories: Boilers/Comprsrs: _ Hoods: -- Fuel Types - e� 0 - 3 HP. t_.� Repair Units: 3 - 15 HP. — _ Wood Stoves: Max Input: - Btu: Air Handling Units Glo Dryer: Fire Dampers: s 10000 cfm: Oth Units: (�— Gas Pressure: H / M / L > 10000 cfm: —_ Gas Outlets: — No. Of Units: _ — Furn < 100k Btu: t Furn >_ 100k Btu: — NOTES: --- — COMMERCIAL INSP►?CTION ACTIONS FEE MENU_ Ga e 1 mon $ Permit Fee _ bchanir�ll $ 5�v Plan Review _ oo mg nit Inspection $ 8% State Surcharge _ Sh'a Inspection $ — Additional Permit Fee E Additional Plan Review Fee Hood Inspection Lection $ Inspection Fee spection $ Miscellaneous Fee Fire Alarm Inspection REMARKS: Fire Damper Inspection Miscellaneous Inspection — -- Fire Alarm Inspection — Final I spection - C Wdst/rorms/otcmech.doc 9/99 i Adsts\forms\otc-mech.doc9/99 CITY O F T I GA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00203 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 06/20/2000 SITE ADDRESS: 12540 SW MAIN ST 120 PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Tenant improvements: Install two(2)sinks, two(2)water closets and a water heater. _ FEES Owner: Type By Date Amount Receipt DOLAN & CO LLC PRMT GEO 06/20/200C $57.50 0003146 BY FLORENCE DOLAN 5PCT GEO 06/20/200C $4.60 0003146 1919 NE 19TH PORTLAND,OR 97209 Total $62.10 Phone 1: Contractor: EAGLE PLUMBING 13801 S FORSYTHE RD OREGON CITY, OR 97008 REQUIRED INSPECTIONS Phone 1: 503-650-8703 Rk dh-in Insp Reg#: LIC 47914 derfloor/Underslab - PTop-out Insp LM 3-154PB Final Inspection ORIGINAL 2 J This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. o Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. 9 P tY PP � PP � This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: Permittee Slgnature� Call(503)639-465 by 7:00 P.M.for an Inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check 0 :j--900- 13125 SW HALL BLVD. Commercial and Residential Recd By -- � TIGARD, OR 97223 Date Recd (503) 639-4171 Date to P.E. _- Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit# iye-hl ASN-�R� Related SWR e�� called 3 G AI SNf Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job Sink 1150 Addresq Street Address Suite Lavatory 11.50 1 W rL&A111 Tub or Tub/Shower Comb. 11.50 Bldg a City/State Zip Shower Only 11.50 I T1 t' Water Closeu (Specify) Z 11.50 Do LAa 4 CZ Name LLG Dishwasher _ 11.50 Owner Mailing Address Suite Urinal 11.50 I H M Garbage Disposal 11.50 CkylState Zip Phone �' O� �.7 Laundry Tray 11.50 Name Washing Machine/Laundry Tray (Specify) 11.50 Floor Draln/Flecr Sink 2" 11.50 Occupant Mailing Address Ate 3" 11.50 4" 11.50 CitylState Zip Phone Water Heater O conversion O like kind I 11.50 Gas piping requires a separate mechanical permit. Name MFG Home New Water Service 32.00 0VOL-: P Lam Contractor Mailing Address Suite MFG Home New San/Storm Sewer 32.00 Hose Bibs 11.50 Prior to permit City/State Zip _ Phone Roof Drains 11.50 issuance,a copy 6AZcAl, C-L 5 65D Drinking Fountain 11.50 of all licenses are Oregon Const Cont.Board Lic lr Exp.Date required If - -OI Other Fixtures(Specify) 15.00 expired In COT Plumbing Lic.0' :xp.Date database -3 _I`j,1 tib y-30-O Name Architect C 1 A Sewer-1st 100' 38.00 Or Mailing Address(09 O Suite Sewer-each additional 100' Water Service-1st 100' 38.00 Engineer City/Stale Zip Phone I 5 7 LO Water Service•each additional 200' 32.00 ` Describe work to be done: Storm 6 Rain Drain-1st 100' 38.00 New Repair O Replace with like kind Yes 0. No O Storm d Rain Drairh-each additional 100' 32.00 Residential O Commercial Commercial Back Flow Prevention Device 32.00 Additional description of work: Residential Backflow Prevention Device' 19.00 Catch Basin 11.50 4 Are you capping,moving or replacing any fixtures? Insp.of Existing Plumbing or Specially Requested 50.00 Yes O No 0 Inspectionsh�er/hr If yes,see back of form to Indicate work performed by Rain Drain,single family dwelling _ 45.00 N fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 H WORK COULD RESULT IN INCREASED SEWER FEES. ----- I hereby acknowledge that I have read this application,that the information QUANTITY TOTAL J given is correct,that I am the owner or authorized agent of the owner,and Isometric or riser diagram Is required it Quentily Total Is >9 that plans submitted are in compliance with Oregon State Laws. 'SUBTOTAL 0 Signature of Ownar/A ent Date W 9 C C ^� 8%SURCHARGE C ntact Pe Name Phone AFotw 9LC (iJ0-S�7Q3 '"PLAN REVIEW 26%OF SUBTOTAL 1 BATH OUSE=178.00 l) Required only It fixture qty total is>9 2 HATH HOUSE$280.00 .• TOTAL 3 BATH HOUSE,=288.00 --- (This fat includes;all plumbing fWums In the drvelllnn and the firs! r1 'Minimum permit fee Is 950+8%surcharge,except Residential Backflow Prevention 100 feet bf iasewer storm sewer and wadi•e#rvIce) ;+ +` ryteDevice,which Is$25.e%sur&arge -All New Commercial Buildings require plans with Isometric or riser diagram and plan review I hd315110rma1plumapp doC 10/8199 - - PLEASE COMPLETE: Fixture Type Quantl , Wdf, ' . o bd' New Moved Repli dead Removed/Capped Sink Lavatory 2 Tub or Tub/Shower Combination _ Shower Only Water Closet _ Dishwasher Urinal Garbage Disposal Laundry Room Tray Washing Machine _ Floor Drain/Floor Sink 2" 3" 4" Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: a _J m W J I Wtt%%formA\o%lmepp dot 1018199 _ _ City of Tigard Washington County, Oregon Voluntary Compliance Agreement anCY OF Temporary Certificate of Occupancy OREGON To: Don Athey, Superintendent, Grigsby Construction 5845 Jean Road Lake Oswego, OR 97035 Re: Temporary Certificate of Occupancy FILE COPY I, Don Athey, as responsible person for 12540 SW main St,--:W126 Tax Map 2S102AC, Tax Lot 00700, agree to the following: This temporary Certificate of Occupancy is hei aby issued on a conditional basis for a period not to exceed fifteen days from this date, by which time the following conditions must have been met and approved by inspection by the City of Tigard Building DeQartment: Permit BUP2000-00188 must be completed and approved, including all outstanding corrections, ancillary permits and fees. Specifically, the restrooms will be completed and final inspection approved. I understand the City will withhold action until February 25, 2000. Upon compliance with all above conditions, this case will be closed and the permanent Certificate of Occupancy will be issued. I further understand that if these conditions are not complied with fully, I may be served with a Summons and Complaint without further notice for violation of requirements set forth in the Oregon Structural Specialty Code (Final approval required prior t occupancy). roJ Signed: Date: 7 — 7— 0,0 _ Approved: `/ Date: 7— 06 (Inspection ervisor) 1-7 13125 SW Hall Blvd., Tigard, OR 97223(503)6394171 TDD(503)684-2772 Customer Receipt CITY OF TIGARD Printed:07/07/2000 12:00 User:front Station: 02 Operator: GEO Rcpt No: 0003540 Date: 07/07/2000 Customer No:000000 Amount Due: 90.00 Name: GRIGSBY Cash: 0.00 Address: PO BOX 1849 Check: 90.00 LAKE OSWEGO, OR 97035 N/A 0.00 Change: 0.00 Jyps Description Amount BUILD Building Permit 90.00 10 - pc)/i7 7) GK apld r 0 U CITY OF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2000-00188 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 DATE ISSUED: 05/24/2000 PARCEL: 2S 102AC-0070A ZONING: CBD JURISDICTION: TIG SITE ADDRESS: 12540 SW MAIN ST 120 SUBDIVISION: BURNHANI TRACT BLOCK: LOT:001 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCYLOAD: TENANT NAME: SCRAPITALL REMARKS: Commercial TI Owner: DOLAN + CO LLC BY FLORENCE T DOLAN 4025 SE BROOKLYN PORTLAND,OR 97202 Phone: Contractor: GRIGSBY CONSTRUCTION INC 8114 SW NIMBUS AVE BEAVERTON, OR 97008 Phone: 641-7343 Reg#: LIC 45073 This Certificate Issued 09/21/2000 grants occupancy of the above referenced building or portion thereof and confirms that the building has been Inspected for compliance with the State of O on Specialty Codes for the group, occupa cy, and u e under which the refErence rmit was Issued. BUILDING INSPECTOR BUILDING ICIAL POST IN CONSPICUOUS PLACE 's CITY OF TIGARD BUILDING INSPECTION DIVISION MS -'24 dour Inspection Line: 639-4176 Business Line: 639-4171 r8-4-kqa d Date Requested A d _AM PM BLD �, O Location��---'r7� (�'�'..�' 1210 MEC _ Contact Person Ph PLM o00 00209 Contractor P SWR BUILDING Tenant/Owner - v f ,ELC Retaining Wall ELR Footing Access: Foundation FPS Fig Drain SON 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 LZ !�o z s — Final PART FAIL GING Por Beam Under lab y� Top Out Water Se a \I Sanitary Se r�G�I� rains !Final S PART AIL MECHANICAL Post& Beam - Rough In _ Gas Line -- Smoke Dampers Final PASS PART FAIL ELECTRICAL a Service _ Rough In N UG/Slab _ Low Voltage — Fire Alarm m Final PASS PART FAIL W 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 Date Q61 Inspector - `-�� Ext -� Other — Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. j CITY OF TIGARD BUILDING INSPECTION DIVISION . 24.41our Inspection Line: 639-4175 Business Line: 639.4171 MUT Z9d _ BUV' _ / —Date Requested //1C:;L/ 40 AM PM BLD Location /�54 i/7A4-� <Suit MEC Contact Person Ph ��?� Contractor P SWR BUILDING Tenant/Owner CAI- - (� " �ELC Retaining Wall ELR Footing Access: Foundation FPS Fig Drain SON 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 Misc: _ — Final P!Lj.X4T FAIL LUMBI Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains _ SSPART FAIL ANICAL Post& Beam Rough In Gas Line Smoke Dampers Final — PASS PART FAIL ELECTRICAL Service _ Rough In I UG/Slab _ Low Voltage j Fire Alarm j Final j PASS PART FAIL -- I SITE I Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Halt, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call foi reinspection RE: _ [ ]Unable to inspect no access ADA Approach/Sidewalk Date /2 __Inspector Ext Other 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 _ �A _ � AM PM BUD ate Requested BLD Location Suite I.A© MEC Contact Person Ph `' PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR -DD IV Footing Access: Foundation FPS Ftg Drain SON Crawl Drain Inspection Notes: --- Slab SIT&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 PASS PART FAIL MECHANICAL Post&Beam --- - Rough In Gas Line -- Smoke Dampers Final PASS PART FAIL T IC L — Tervice _ Rough In UG/Slab Low Voltage Fire Al :L) PART FAIL Backfill/Grading — Sanitary Sewer Storm Drain [ ]Reinspection fee of$-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please; reinspection RE: _ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other - — -- Final PASS PART FAIL DO NOT REMOVE this inspectiooll record from the job slte. y ELECTRICAL PERMIT- CITY OF TIGARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMITM ELR2000-00191 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 DATE ISSUED: 8/17/00 SITE ADDRESS: 12540 SW MAIN ST 120 PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG Prolect Description:Tenant Improvement A.RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: AUDIO 3 STEREO: X INTERCOM a PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC- DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHEP: TOTAL 0 QF SYSTEMS: Owner: Contractor: MUZAK LLC 12402 NE MARX PORTLAND,OR 97230 Phone: Phone: 254-7400 Reg#: LIC 142760 ELE 26-1055CLE FEES Required Inspections Type By Date Amount Receipt Elect'l Final PRMT RCP 8/17/00 $60,00 0004543 5PCT RCP 8/17/00 $4.80 0004543 Total $64.80 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR a' 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. N Issued by �_� 3,rn Permittee Signature ✓"- J OWNER INSTALLATION ONLY m The Installation Is being made on property I own which Is not Intended for sale. lease,or rent. W J OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY _ SIGNATURE OF SUPR. ELEC'N _ DATE: LICENSE NO: Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recdby 1317.5 SW HALL BLVD Date Rec' ._g= 2—C TIGARD OR 97223 PRINT OR TYPE V -503-639-4171 X304 Permit#: Ep"t'a -000 -001q, F - 503-598-1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED-RESIDENTIAL ONLY SeMAP-n A Restdctsd Enerpy Feu.............................-..�. 60.00 ` I{"ALL (FOR ALL SYSTEMS) .10E Street Address Ste ADDRESS _ 124P Sw ST. 120 Check Type of work Involved: -- Cily/V7 R Zjp7213 hone 0 C] Audio and Stereo Systems Name Q ❑ Burglar Alarm OWNER Mailing Address — ❑ Garage Door Opener* City/State Zip Phone N ❑ Heating.Ventilation and Air Conditioning System' Name ❑ Vacuum Systems' MUM, `L (pQrA D) ❑ Other CONTRACTOR Mailing Address 12492 Nf MANX sr. TYPE OF WORK INVOLVED-COMMERCIAL ONLY (Prior to issuance a Ti Q e Fee for each system.............................................. =80.00 copy of all licenses 0� (SEE OAR 918.280-260) are required N Oregon Contr.Brd Llc.0��•�!O p Da expired in C O T. /b (1. Z Check Type of Work Involved; data base) Electrical Contr.LIc.0 26-f 0%elf VIDSA X Audio and Stereo Systems COT.or Metro Llc.#,v�/11yg00G/34 E".a ❑ Boller Controls Owner's Name OWNER - Marling Address ❑ Clock Systems APPLICANT ❑ Data Telecommunication installation City/State Zip Phone It r� LJ Fire Alarm Installation This permit is issued under OAE 918.320-370 This applicant agrees to make only restricted energy Installations(100 volt amps or less)under this ❑ HVAC permit and to do the following. 1. Only use electrical licensed persons to do Installations where required. instrumentation Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems These have asterisks('). A8 others need licensing; ❑ 2 Call for inspections when Installation under this permit aro rowdy for Landscape Irrigation Control" Inspection at 503-639-4176; ❑ Medical 3 Purchase separate permits for all installations that are not ready for an Nurse Calls inspection when the Inspector is out to Inspect under this permit; 4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Lanoecape Lighting" Inspector are done,and; Protective Signaling 5 Assume responsibility for calling for a final inspection when all of the corrections are completed. Other_ Permits are non-transferable and non-refundable and expire if work Is not ' started within 180 days of issuance or if work Is suspended for 180 days. Number of Systems The person signing for this permit must be the applicant or a person No lieenses are required Licenses are required for all other installations authorized to bind the ap Iicant. FEES: Sian to — - ENTER FEES 8%SURCHARGE(.08X TOTAL ABOVE) $ Authority if other than Applicant TOTAL : 4.90 _ i Ws!sNormsVessre.doe 3108 Z00 a (MVD11 do U10 00111t 962 CO2 2V& 60:90 an 00/ct/fo /3f /7-- CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Lino: 639-4171 BUP Date Requested 1�2 AM PM � BLD , Location �`�' ' Suite MEC Contact Person r� �j C r� �r�-s 5 Ph �.�— 7�� PLM 4Relf V 4V-20.3 Contractor Ph SWR — BUILDING Tenant/Owner ELC Retaining Wail ELR _ Footing Access: Foundation FPS rtg Drain SON Crawl Drain Inspection Notes: Sinb SIT Post&Beam Ext Sheath/Shear i Int Sheath/Shear Framing Insulation Drywall Nailing _ 6-!�/0 vs Firewall ! Q— Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final ca fF 7't-,1- ,L PART FAIL — PIJ4NIIIN Post&Beam UpOut Cwkrservice Sanitary Sewer rains IMPART FAIL _. ANICAL Post&Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service -- Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Plense call for reinspection RE: i _ [ ]Unable to inspect-no acxess Fire Supply Line ADA / .-- Approach/Sidewalk Date Inspector / 41 Ext Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.