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12540 SW MAIN STREET STE 200 OOZ 31S 1S NIVW MS OKZ I• pop r C! O N O � m cn Q Z a d L cn 0 N O _ m L 7 7 L a cn cn a 1 9 9 N N N N N r r r r r- O O N W H co Z Q N 0 N 12540 SW MAIN ST STE 200 f CITY OF T I G A R D PEBUILDING PERMIT RMIT M BUP1999-00306 DEVELOPMENT SERVICES DATE ISSUED: 05/05/2000 13125 SW Hall Blvd.,Tigard, OR 97223 (F1311639-4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 200 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: 4,900 sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY !SRP: B TOTAL AREA: 4,900.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 44 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: ME7-Z?: REQD SFTRACKS REQUIRED _ FLOOR LOAD: psf LEFT: r GHT: ft FIR SPKL: N SMOK DET:N DWELLING UNITS: FRNT: REAR: fit FIR ALRM : N HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING: VALUE: 6,6,6) Remarks: Commercial tenant improvement for second Floor office space. A-Boy Phase 2. Owner: Contractor: DAN DOLAN GRIGSBY CONSTRUCTION INC 4523 NE DAVIS ST 8114 SW NIMBUS AVE PORTLAND,OR 97213 BEAVERTON, OR 97008 Phone: 225-9009 Phone: 641-7343 Reg#: LIC 4SO73 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing !nsp PLCK DEB 07/08/199E $362.70 99-316678 Framing Insp Gyp Board Insp PRMT DST 09/01/2000 $558 00 0001809 Susp Ceiing Insp 5PCT DST 05/01/2000 $39.06 0001809 Final Inspection FIRE DS1 05/011200C $223.20 0001809 (additional fees not listed here) Total $1,582.96 a a This permit is issued subject to the regulations contained in the 1igard Municipal Code, State of OR. N 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 Not,iication Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You W may obtain a copy of these rules or direct questions to OUNC by calling (503) 246.1987. J 0al-70 Signatur G ^ Issued By: ��-e--- - k7 '00V C-ill 6394175 by 7 p.m.for an insp9ctlon the next business day F TIGARD (Commercial Building Permit Applin Plan,Check R X_ c' 5 SW HALL BLVD. Tenant Improvement Red Date Recd d ARD, OR 97223 Date to e. 3) 639-4171 Date to DST 1'' 1 ' t 71 Print or Type Permit s AuP 19?9 -e�6 Related oWR! _ Incomplete or Illegible applications will not be accepted calms_ '�* Name of Development/Project —' Existing Building New Building O Job Address Street Address Suite Building <iAl P11�fl -1?, �W fri, Data _ Bldg s Clty/stste zip Existing Use-of Building or Property: Name Property J)^ 4 Vo l_Af-1 Proposed Use of Buildin or Property: NAIL bN rl "5T r�00R Owner Mailing Address Sune r7FftCt; J fe/Zo K? I i o ,i4 l �V, Or. No. Of Stories: � Cny/State Zip Phone F(W-rf ANvr rNN `172.x{ 7175'qnrf? Sq. Ft. Of Project: Name — T.T. - %qon -! ^ Occupant — el M L/, Occupancy Class(es) Name ?) Contractor t , Types)of n ruction (_rl I r J�,;.. (.n�J,TYtI/r10IJ _ 1�� Prior to permit Malling Address Suite — Issuance,a copy Will this project have a Fire Suppress;on System? of all licenses 7 T.�flt% �r 09 9P• are required If :ny/State Zip Phone --. Yes NO expired In c O.T, g7b3�j Americans with Disabilities Act(ADA) database L�>�f. n;- r' p 075" Valuation X 25% m. $ _ Participation Oregon Gonst.Cont.Board 1-1,4 Exp.Date Complete Accessibili Farm Project $ Name Valuation If t5 o Architect (' 11M Plans Required: See Matrix for number of sets to submit Melling Address Su!t9 I on back ll y4y' >w wry-, V- zm) - - - clty/state Zip Phone I hereby acknowledge that I have read this application,that the Information fob rt- q 7�I ?l��(�Bf given Is correct,that I sm the owner or authorized agent of the owner,and Name �Y 1 that plans submitted err In comp!ianccr w;+h 11regon State Laws. Engineer (�A SIn ure of Owner/Agent _ Date Mailing Address Suite L i�l��lfj JUl Lt'�yf)j'_r�l. J,� ,ontadPerso a Phone — r City/State Zip Phone .p,,DYf�.11�N 2"0-17-615 'i�1'1i t1►1y ry_ 'fi7201 1��"17_� LAN V --- FOR OFFICE USE ONLY J Indicate type of work: New O Addition O Demolition O MaprrL# _ Land Use: p Accessory Structure O Foundation Only O Alteration O Repair O _ Other feo", r f limes: u Oescrlptlon of work: J.-'C0003 rT�f� dt-�Cl►tl• wlL p.oar- oR r F 1SMVR nit ?rtU Frr+np_ Note: Site Work Permit Application must precede or acco TPOKY Building \ Permit Application !\COMNEWTI DOC (DST) 5/99 F L? 00 I eJ COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan Review is dependent upon submittal :,fiir� lq�Ip a Cts application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review will be conduct After pian review approval, Plans Examiner will contact the applicant to rpqu additional plan seta for distribution purposes. (Copy for Contras Washington,; u Tu11in Valley Fire & e Tti##of TYPE OF SUBMITTAL {glans 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 *B & M & F5 &-E(Alt) • 3 m *B & M & P & E & F(Alt) - 3 w J NOTES: *Shaded areas designate ALT V%dstsVormslmatrxcorn.doc 10/30/98 CITY OF TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT 0: SGN2000-00048 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 03/07/2000 EXPIRATION DATE: BUSINESS NAME: BMDA PARCEL: 2S102AC-0070, SIGN LOCATION: 12540 SW MAIN ST 200 APPLICANT/AGENT: SECURITY SIGNS ZONE: CBD BUSINESS TAX NO: _ _ JURISDICTION: TIG _ SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENISIONS: 4'X 7'8" TOTAL SIGN AREA: 31 sq.ft. WALL AREA: 3,675 sq.ft. WALL FACE(DIRECTION): W SIGN HEIGHT: 29 ft. PROJECTION FROM WALL: 2 In. ILLUMINATION: NON DESCRIPTION OF SIGN: Installing a permanent 31.2 sq. ft.wall sign MATERIALS: STAINLESS ST EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 50.00 C 9 3 6 u a 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. A sign permit shall expire 90 days from approval date. A temporary sign shall expire 30 days from approval date. A balloon sign shall expire 10 tiavc fmm annmval data l� I-.PPROVED BY. PERMITTEE SIGNATURE: D°Yl �1Y1 DATE: 03/07/2000 CITY OF TIGARD ELECTRICAL - ENER RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2000-00016 13125 SW Hall Blvd.,Tioard,OR 97223 (503)639.4171 DATE ISSUED: 01/19/2000 PARCEL: 2S 102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 200 SUBDIVISION: BURNHAM TRACT- ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG Proiect Description: Installation of data telecommunication system. A.RESIDENTIAL B.COMMERCIAL AUDIO& STEREO: AUDIO&STEREO: INTERCOM R PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: DAN DOLAN COMMUNICATIONS INSTALLATION 1919 NW 19TH AVE 8142 SE DURHAM RD PORTLAND, OR 97209 TIGARD, OR 97224 Phone: 225-9009 Phone: 503-670-7721 Reg#: LIC 0111596 ELE 37-686CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DST 01/19/200( $60.00 00-321235 Elect'I Final 5PCT DST 01119/200C $4.80 00-321235 Total $64.80 ORIGINk 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 L requires you to follow rules adopted by the Oregon Utility Notification Center. Those rues are set forth in OAR C 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246-1987. — ---: ` Issued by r _{�. Permittee Signatur� , �� ►i� m 0 OWNER INSTALLATION ONLY The Installation is being made on property I own which Is not Intended for sale. lease,or rent. OWNER'S SIGNATURE: DATE: _ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N /�i �� DATE:_ Z LICENSE NO: Call 639-4175 by 7:00 P.M. for an Inspection needed the next business day tisa� CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by: 13125 SW HALL BLVD Date Recd: _ TtGARD'OR 97223 PRINT OR TYPE V- 503-639-4171 X304 Permit#:fe-g X000-060/to 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 �� Restricted ALL Fo .............l...................... $60.00 FOR AL JOB Street Address Ste# ADDRESS % S yd LpQ Check Type of Work Involved: City/State Zip7Phone# ❑ Audio and Stereo Systems p _ 'ZZ`� _ Nam ❑ Burglar Alarm ❑ OWNER Mailing Address Garage Door Opener. -'� City/State Zip-hone 0 ❑ Heating,Ventilation and Air Conditioning System' Name ❑ Vacuum Systems' C— S ❑ Other CONTRACTOR Mailing Address —� $I'1 Z -, TYPE OF WORK INVOLVED-COMMERCIAL ONLY (Prior to issuance a City/State Zip Phone# _ Fee for each system.............................................. $60.00 copy of all licenses c. c -1 ZX4 (070 33 21 (SEE OAR 918-260-260) are required if Oro$on Contr.Brd Lic.# Exp.Dale expired in C.O T I 1 1 5 Cl(e _ Z-2.13-03 Check Type or Work Involved. data base) Electrical Contr.Lic.# Exp.Date 3'7 Er$ Ll_� t0 -Qt3 ❑ Audio and Stereo Systems C O T.or Metro Lic # Exp.Date ❑ Boiler Controls Owner's Name ❑ Clock Systems OWNER - Mailing Address APPLICANT DFAa Telecommunication Installation City/State Zip Phone# ❑ Fire Alarm Installation This permit is issued under OAE 918-320-370 This applicant agrees to r— make only restricted energy installations(100 volt amps or less)under this ❑ HVAC permit and to do the following. ❑ Instrumentation 1 Only use electrical licensed persons to do installations where required. Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems These have asterisks('). All others need licensing, ❑2 Call for inspections when installation under this permit are ready for Landscape irrigation Control' inspection at 503-639-4175; ❑ Medical 3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Coils inspection when the inspector is out to inspect under this permit, a 4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape 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 woA is not started within 180 days of issuance or if work is suspended for 180 days. __Number of Systems W ._I The person signing for this permit must be the applicant or a person No licenses are required. Licenses are required for all other Installations authorized to bind the applicant. _ w_ FEES: ' ER FEES .`___ Sign ;ce __ - o[ ;SURCHARGE(45 X TOTAL ABOVE) Authority if other than Applicant TOTAL : (� .%,Z)_ ildsts\forms\resele doc 3198 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 dBusiness Linr: 639-4171 BUP Date Requeste/d� (411600 AM_ _ PM BLD Location S ► ' lata /� S� iuite 2tx) MEC Contact Person e. l Ph b-70 " 7 7. Pi.M Contractor On S J Ph . -1-n(Q SWR BUILDING Tenant/Owner _�_I�� ELC Retaining Wall ELR 2X)M -00D Ll Footing Access: Foundation FPS �— Ftg Drain SON Crawl Drain Inspection Noted: — - 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 - - ---- PLUMBING Post$Beam ----- Under Slab Top Out 4 Water Service Sanitary Sewer - — Rain Drains Final PASS PART FAIL - MECHANICAL Post& Beam Rough In Gas Line -- - - --- - - — - - Smoke Dampers Final —� PASS PART FAit. C Service � Rough In — UG/Slab ---- --- -_ -�--. Low Voltage Fire larm ^- 0 in - AS PART F AIL u Backfill/Grading _- - Sanitary Sewer Storm Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for einspection RE: _-_ _ [ j Unable to inspect no access Fire Supply Line App Approach/Sidewalk Other DA Date / Inspector— 1 _Ext Final PASS PART FAIL 0 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2441our Inspection Line: 639-4175 0 Business Line: 639-4171 BUIP –� _ Date Regt.tested AM PM BLD Location 1L c� l�.l ✓! _ MEC Contact Person .'1��S t�Yl Ph - P y /– / PLM Contractor_ Ph SWR �— BUILDING Tenant/Owner f� ELC Retaining Wall �� Footing Access: Foundation IPS Fig Drain SGN Growl Drain Inspection Notes: - Slab — L' � ?�_�_ SIT _ Post&Beam Ext Sheath/Shear _ Int Sheath/Shear Framing -- — Insulatioo Drywall Nailing _ _ — Firewall Fire Sprinkler - -- — Fire Alarm Susp'd Ceiling — -- Roof Misc: ——-- — — — Final PASS PART FAIL —000 -� PLUMBING Post&Beam — Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL — MECHANICAL Poct&Beam -- —^ — —_ Rough In Gas Line -- ----- —_-- --- - Smoke Dampers Final PASS PART FAIL Service u h ~ UG/Slab Low Voltage Fire Alarm PASS PART FAIL - Backfill/Gradin, — Sanitp,r Sewer Storm Drain [ J Reinspection fee of$_— _required before next inspection. Pay at City Hall, 13125 SW Hell Blvd Catch Basin ( J Please call for reinspection RE: [ I Linable to inspect-no access Fire Supply Line — - ADA h Approach/Sidewalk Date (/ ` Inspector -Ext Other -� Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF T I G A R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMITS: BUP1999-00306 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 05/05/2000 PARCEL: 2S 102AC-00700 ZONING: CBD JURISDICTION: TIG SITE ADDRESS: 12540 SW MAIN ST 200 SUBDIVISION: BURNHAM TRACT BLOCK: LOT:001 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 44 TENANT NAME: BMDA REMARKS: Commercial tenant improvement for second floor office space. A•Boy Phase 2. Final Building Inspectior 9x Certificate of Occupancy Approved 3/23/00 by Rick Bolen, Building Inspector Owner: DAN DOLAN 4523 NE DAVIS ST PORTLAND, OR 97213 Phone: 225-9009 Contractor: GRIGSBY CONSTRUCTION INC 8114 SW NIMBUS AVE BEAVERTON, OR 97008 Phone: 641-7343 Reg#: LIC 45073 This Certificate grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Cod for the group, occupancy, and use der w ch the referenced permit was Issued. BUILDING INSPECTOR BUILD OFFICIAL. POST IN CONSPICUOUS PLACE Cc e .. e ry GRIGSBY �T_1115 CONSTRUCTION n pq 1 5 2000 PO PDX 1849 r. LAKE OSWEGO,OR 97035 503 675-8000 FAX 675-8181 April 19, 2000 Mr. Darrel Watkins FILE C Inspection Supervisor City Of Tigard 13125 SW Hall Blvd, Tigard, Oregon, 97223 Dear Mr. Watkins. Regarding the permit for BMDA tenant improvements BUP 1999-00306, 1 would like to make the following comments. It appears the review for this permit was completed in mid August 1999. The Owncr has stated that he was not aware that this was ready Saud therefore did not pay for it at the time. We don't have any record of notification at our office, and since the Owner was purchasing all permits, we assumed that he or the architect had been notified and had picked it up. At any rate, I thought the pennit had been issued and that permit plans were available at the site. The fact that no mention was made of the lack of permit during inspections of the tenant area confirmed this opinion. The job superintendent, Dc-i Athey, thought the second floor tenant work was part of the original building permit. We had all nspcctions perfonned as the work progressed including all of the tenant work. These iras,iections were all completed and signed off with minor corrections noted prior to occupancy. We were issued a Temporary Certificate of Occupancy on 3/24/00 with final pending only minor landscaping work. There was never any mention by either the inspectors or your office that the permit had not been issued for the tenant work. Based on this T.C.O., the BMDA tenant occupied the building the following week. It was not until after occupancy that we were told that the tenant permit had not been paid for. Although the original pennit fee is certainly due and would have been paid when the pennit wa.� originally available, we do not feel the Owner should be penalized with additional fees, when as far as We knew, we were complying with all permit requirements. There was certainly no attempt to avoid paying for the permit or to occupy the building without permission. I think you would agree that, at the very least, there is shared responsibility by the City as well as the construction team for this oversight. Therefore, I would ask that the original permit fee be reinstated. 7 AAP Ven tnih yours. P William F. Ward. P.E. Vice President Cc: Dan Dolan, Dolan & Co. LLC Sensing the Pacific Northwest for Over 50 years CITY OF TIGARD ELECTRICAL ENER - RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR1999-00272 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 11/18/1999 SITE ADDRESS: 12540 SW MAIN ST 200 PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG Prolect Description: Outdoor landscape lighting A.RESIDENTIAL B.COMMERCIAL AUDIO& STEREO: AUDIO&STEREO: INTERCOM &PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: X OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: _ IQTAL#OF SYSTEMS, Owner: Contractor: DOLAN & CO LLC SONITROL PACIFIC 4025 SE BROOKLYN 1975 SW 6TH AVE PORTLAND, OR 97202 PORTLAND, OR 97201 Phone: Phone: 223-5822 Reg#: LIC 00053535 ELE 26370CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT BON 11/18/199E $60.00 99-319873 Elect'I Service 5PCT BON 11/18/199 $4.80 99-319873 Elect'l Final Total $64.80 ORIGINAL This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other :1pplicable laws. All work will be done in accordance with approved plans. This permit will expire if work is p, not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law pL requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR F' 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503) CA C' 246-1987. J Issued by c� Permittee Signature OWNER INSTALLATION ONLY J The Installation Is being made on property I own which is not Intended for sale. lease,or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELE� 'N: _ 1 1 i DATE:_ LICENSE NO: --- Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day CITY OF TIGARD RECENE1ESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by: 13125.FW HALL BLVD Date RAc'd: — - TIGARD OR 97223lQV 151999 PRINT OR TYPE V- 503-639-4171 X30 Permit a ; t '1702 �- F- 503-684-7237 COMMUNIly UEVELOPMOCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.C911'd:_ WILL NOT BE ACCEPTED N me or Development Protect TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Restricted Energy F.................. PM....................... cat3hS 0_%CGt6K1Y1 (FOR ALL SYSTEMS) *60.00 JOB Street A;N #to ADDRESS , i Fr' Check Type of Work Involved: � �Y Clot i e L Zt V Phe N '` ❑ Audio and Stereo Systems Name 'i ❑ Burglar Alarm OWNER M Ilin Add ❑ Garage Door Opener' ❑ Hosting,Ventilation and Air Conditioning System' tyytq 11 1 - Z 7 W7 Phone N Name ❑ Vacuum Systems' ci \1ac - ❑ Other _ CONTRACTOR Malting Addros (Q Ci_ uLSZ _TYPE OF WORK INVOLVED-COMMERCIAL ONLY (Prior to Issuance a ItylSlat� ons M _ Foe for each system.............................................. copy of all licenses \t3.r �\( -D (SEE OAR 918.280-260) /� aro required If Oregon Co tr, id Llc.0 Exp.Date 140.80 expired In C.O.T. _l�711 r_, Check Tyna of Work Involved: data base). Electrical Contr.Lic.N Exp.Date - � ' (j (�-�4�__ ❑ Audio and Stereo Systems C.O.T.or Metro Llc.M Exp.Date ❑ Boller Controls Owner's Name ❑ Clock Systems OWNER- Mailing Address APPLICANT ❑ Data Telecommunication installation City/State Zip Phone 0 ❑ 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: ❑ instrumentation 1. Only use electrical licensed persons to do Installations where required. Certain residential and other transactions are exempt from Ilcensing. ❑ Intercom and Paging Systems These have asterisks('). All others need licensing; 2. Coli for Inspec!lona when Installation under this permit are randy for [, Landscape Irrigation Control* Inspection at 503.83941?6; ❑ Medical 3. Purchase separate permits for el'tnstelletloris that aro not ready for an Nuns Calle a Inspection when the Inspector Is out to Inspect under this permit; 4 Assume responsibility for oes.. ^the#all correc,lons required by the Outdoor Landscape Lighting' F— N Inspector aro done,and; ❑ Protective Signaling 5. Assume responsibility for calling for a ftnsl Inspection when all of the corrections are completed. ❑ Other Permits are non-trensforoble 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 appllcant or a person No licensee are required. Licenses are required for all other Installation• authorized to bird the applicant. Signature ENTER FEES /� _` O "'SURCHARGE( X TOTAL ABOVE) : O Authority If other than Applicant TOTAL 1:1d•bvul•.doo 7101 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639.4171 — .- • BUP _ _ Date Requested_ 4 ?ap loe01-AM PM,*•� _ BLD Location LIy ,/��r l e11 4SUN* :Z-0y MEC e— Contact Person Ph PLM Contractor SL'✓11L Ph SWR BUILDING 9wwner �m_ f� ELC p �y Retaining Wall EL Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: -`— Slab — _ SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear F raming I Insulation Drywall Nailing - - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — - — Roof Misc:_ ---- - Final PASS PART FAIL --- PLUMBING Post R 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 Service --- Rough In UG/Slab -- Low Voltage Fire Alarm —_ -- - n S PART FAILSITE _ Backfill/Grading ------ Sanitary Sewer Storm Drain ( ]Reinspection fee of$_ _required before nex, ,pection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ]Please ca:I for einspection RE: _ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other _ Final PASS PART FAIL D NOT REMOVE this Inspection record from the job site.