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12540 SW MAIN STREET-3 ' �.. IS NIVW MS 01SZ I• 1 CD o cn CD � N �- ti � W O � m cn Q � t IN a _ r4 40 _ � O O m r'' a+ N a in in a N a N N %4 N C` a � oc z Q 3 J (n m W C14 12540 SW MAIN ST /\ CITY OF TIGARD, ELECTRICAL PERMIT PERMIT 0: ELC2005-00834 DEVELOPMENT SERVICES DATE ISSUED. 10/26/2005 13125 SW Hrdl Blvd.,Tigard,OR 97223 503-639-4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 120 ZONING: CBD SUBDIVISION: BURNHAM TRACT LOT: 001 JURISDICTION: TIG Project Description: sign lighting for(1)sign. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: — PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: 1 LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL: MANF HMr SVC/FOR: 601+amps-1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FOR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>a 225 AMPS: CLASS AREAISPEC OCC: Owner: Contractor: DOLAN+CO LLC SIGNCRAFT LLC BY FLORENCE T DOLAN 9033 SW BURNHAM 4025 SE BROOKLYN TIGARD,OR 972.23 PORTLAND, OR 97202 Phone: 503-225-� 19 Phone: 503-639-4910 FEES Reg 0: LIC 155420 ELE 34-674CLS Description Date Amount SLIP 75SIG [ELPRMT)ELC Permit 10/26/200' $53.40 [TAX]9%State Surcharge 10/26/200' $4.27 REQUIRED ITEMS AND REPORTS Total $57.67 Th:s 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 suspe 'or more then 180 days. ATTENTION: Oregon law,equires you to follow rules adopted by the Oregon Utility Notificatinn':.enter. Those rule are set forth in OAR�952-001- 0 thlouoh OAR 952 001-01 00 You may obtain conies of these rules or direct questions to OLWC at 50 246-6699 r 1-800-332 344 / a Is ed By: h Permittee Signature: -�_ - U) N 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: m — W CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _,f__ __ DATE:__. —_ LICENSE NO: - Call 503-6394175 by 7:00 a.m.for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Apprived plans are required on the job site at the time of each Inspection. S� aW5 — 003 17 Electrical Permit Application City OfTigard v," Nn_� �_ 13125 SW liall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 tyye/Hy 71.,Permit Inspection Linc- 503.639.4175 Dme Ready/k • - 0 See Page 2 for R- 1 Internet: www.ci tigard.or.us Noh---fitWelliel--hc---dttt _ %pplemeetal leformatim _ TYM OR WORK PLAN RZVMW ❑ New construction []Additian/alteration/replacement Please check all that apply: ❑ Demolition [e`()thcr: �� r) I� �} ❑Service over 225 amps,comm'I 0azardous location � -� ❑Service over 320 amts-rating ❑6uildng ova 10,000 sq.ft., _ CAT&C-0 Y OF lirmUCTION _ of I-and 2-family dwellings 4 or more new residential I-(tttd 2-family dwelling ('(xnmercial/industrial rJAccessory building [I system over 600 volts nominal units in one structure ❑Multi-family ❑ Master builder Other: ❑Building ova three stories ❑Feeders,400 amps or more JOS SI E INPORMAT O LOCATION [:]Occupant load ova 99 persons ❑Manufactured structures or _ _ ❑fgress/lighting plan Rpark ❑Iieatth care facility 00tha: Job no.: Jo>fr sits address: ----- �°� Submit sets of plans with any of the above. Oily/State/71P: rzi 6:)p- —� 111Cshove arc not applicable to temporaryconstruction service. Suite/bldg./apt.no.:: Project name:VowG�� a — C"l�i l61 T c..G►1c{� Cross street/directions to job site: New residential single-or multi-family dwelling gait. Includes attacked garage. 1.--- -�- 1,000 sq.0,or less 145.15 4 Suixlivision: I l,�t,,:- F:e.kcal 1300 sq.(1.or portion 33.40 1 —i- Limited energy,residential 73.00 2 s Tax map/parcel no.: _ Limited en _ gy,non-residential 75,00 2 DFAMIMON or WORK _ Each manufactured or modular dwelling,service and/or feeds 1 90.90 2 5 ��->11- - r•�� -llLsrpf-�-�11 Services oc feeders installation,alteration,and/or relotatbn 'nW PX 200 amps or less 80.30 2 p rRoPERTY oWNER -�_-- Q TENAW �_ 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.6(1 2 Name; I�,, ll ala -�, --- 601 EMStn 1.000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 - Reconnect only 1 66.85 2 City/State/ZIP: — Temporary services or feeders Installation,alteration,and/or Phone: �) 22G - rax:( ) relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps_ 100.30 2 inteudcd for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps 133.75 2 Owner signature: _ _Dale: Branch eirerifa-mew,alteradoa,or extension,per panel DAPPLICANT _ OrCOTVTAM PERWN A.Fee fin Manch circuits with Business name: } "� service or fader fee,each 1'� �djI 5 � 4- CWJ-- 1g1n �kr branch circuit 6.65 2 0 `� B.Fee for branch circuits Contact name: 41 5f _ without servile c or fader fee, each Manch circuit 46.85 2 Address: Mach edd'I branch circuit 6.65 2 City/Statc/7.IP: of r,t2- Mbcelhgeass(service or feeder mot Ineladed) _ a Photic:R, J ul7`�:ax:: - Pump o►irrigation circle 53.40 2 ` ) IL% 522 c5D3) 7Z5 J,521 _ Sign(x(wtline lighting 53.40 2 Nf:-mail: Signal circuit(%)or limited- U) energy Panel,alteration,or n � 1 ' extension.Describe: Page 2 2 J Businesv name: pit H ee'trica( _Ad V, L L-C m Address:I p 33-1 ztl I YJ hat h sf-� Each additional Inspection over silo bit In ra Vf flee above 0 -- -- - Per inspection 62.50 J City/StateJ71P:�el at-_ } "72 3 Investigation per hour(I hr min) 62.50 �� - (}L�-/� CF � /1 QGjI Indush nl p1an1 per hour 73.75 Phone:( rax:( "( 6 / '- ELECTRICAL rLRM1T lilt CCB Lic.: (554 Electrical Lic.:� (0�- Sur .Lic.: 1,57 S16- Subtotal Suprv.Electrician si ur ! quired: t e ( D Plan review(23a/e of permit tee) - State surcharge(RSL of permit fee) Print name. � ��d S. will � hate: 6 ,2 � _ ,:iEd (Q -�`� -��' TOTAL PERMIT FEE Authorized signature: 41z- 71Os permit appl!raHnn aspires if a pennN is nM ohtalned whkM Olin days after It has been accepted a.emaplete Print name: [)rete: + Fee mdho&logy set by Tri-County Building Industry Servioe good •'Number of inspections per permit allowed- i%auildinglPermiulFl.('-PWmitApp dos 1" ) 440.4611T(l W72X0WWFR Electrical Permit Application City of' Tigard,- . Page 2 - Supplemental Information ` LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stcreo Systems* [] Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* [J Other: CON MLRCUL WORK ONLY: Fee for each commercial system....................... S75.R49.) (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls [] Clock Systems ❑ Data"Tclecommunication Installation ❑ Fire Alarm Installation ❑ IIVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ I.Andscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i�Puildin A\Pc mitu\F7 f'-PemiiApp dx NMI CITY OF TIGARD 0 BUILDING DIVISION PERMIT#: ELC2005.00034 13125 SW Hall Blvd., Tigard, OR 97223 DATF ISSUED: 10/26/225 Plione: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: TIME: /0.?AM PAGE: 7) SITE ADDRESS- 125,10`tiW MAIN ST 120 CLASS OF WORK: SUBDIVISION: BURNT IAM THAGT LOT #: 00'I TYPE OF USE: PROJECT NNME: POVWLt, PAINT CENTER DESCR PTION: sign lightinq frN (1)sign OWNER: DOLAN + CO LLQ., PHONE #: 503 2259009 CONTRACTOR: `;IGNCRAFT I_LC PHONE #: 503639.4910 Inspection Request O'cheduled For: Date: 1211 i/200!i Pour Time: Code # Inspection Description Confirm # Contact # Message I 0233FA 01 503639.4910 N Corrections/Comments/Instructions: --- -- L J 0 9 U ,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector. _! � 1��--- Date: I Phone #: (503) 718- CITY OF TIGARD a BUILDING DIVISION PERMIT#: ELC2(K)&00834 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2672005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 111212001-) TIME: 7 04AM PAGE: 97 SITE ADDRESS: 12540 SW MAIN ST 120 CLASS OF WORK: SUBDIVISION: BURNHAM'1RAt:T LOT #: 001 TYPE OF USE: PROJECT NAME: POWELL PAINT CENTER DESCRIPTION: cidn lighting for (1)sign. OWNER: DOL AN + CO I LC, PHONE #: 503-225.9009 CONTRACTOR: SIGNCRAFf LLC PHONE #: 503639.4910 Inspection Request Scheduled For: Date: 1 I0200f, Pour Time: Code # Inspection Description Confirm # Contact # Message 199 0leclrn(.al final 014994)01 503 639-4910 N Corrections/Comments/In structions: r a i-sr-- gja ct a A& Pi r e _ ,I The electrical Installation defects noted on this report shall be corrected and an request made within 20 calendar days per OAR 911-0030 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ulpdt- -S�t FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: __`_ ��'� -'� _ Date: 1-,2' 99-C Phone #: (503) 718- CITY OF T I G A R D BUILDING PERMIT PERMIT#: BUP2001-00012 DEVELOPMENT SERVICES DATE ISSUED: 1/10/01 13125 SW Hall Blvd..Tigard. OR 97223 (503)639-4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 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: $ 4,900.00 Remarks: Enclosure of existing stairway and addition of exit door at NE corner of building. No ClIange in Occupant Load Owner: Contractor: DOLAN + CO L.LC GRIGSBY CONSTRUCTION INC BY FLORENCE T DOLAN 5845 JEAN ROAD 40p25 SE BnnROORRKLY77N22DD�� LAKE OSWEGO, OR 97035 P Pone Iv5U625965Zt3 Phone: 503-675-8000 Reg#: LIC 45073 _ FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing Insp PRMT CTR 1/9/01 $91.30 27200100000 Final Inspection 5PCT CTR 119/01 $7.30 27200100000 PLCK CTR 1/9/01 $59.35 27200100000 FIRE CTR 1/9/0' $36.52 27200100000 Total $194.47 CL This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. t•- Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. N 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 requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You m may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987. W J Pe rm itee Signature: Issue By: IP � CaIII394175 by 7 p.m.for an Inspection the next business day Building Permit Applica on t'* Daur reoelvod: q p Permit W.:Akf240 00/a2, h City of Tigard g 1'tnjceUappl.ao.: Ercpiredate: City of7igard Address: 13123 SW hall Blvd.Tigard,OR 97223 — Phone: (503) 6394171 Date issued: ___ By: Receipt no.: Fax: (503)598-1960 Care file no.: Payment type: Land use approval: --_^`-_� 1dc2 family.Simple coml,lex: 1 7I] 1 &2 family dwelling or accessory ommercial/industrial U Multi-family ❑New construction O Demolition Gl Addition/alteration/replacenhent Tenant improvement ❑Dire sprinkler/alarm O Other: Ii S11A INFORMATION X Job address: 1,9> > ��v� c,, 54��t'4' __ Bldg.no.: Suite no.: Lot: Block--_=bdivision: _ _ Tax map/tax lot/account no.: A C pry Project name: /�-�e�,i� _ — .,e• �ne.iD S t•(C �►v.�oy t*� C .S+,n� r��rWt �C car Dewn*rAion and location of work on premises special conditions:__ �n- �_T �� - -�f-�•�-- 1 1 1 1 Name: C)�10., �4 v . I,.i„(� ,r r Mailing address: L W 11 r fie. I &2 family dwelling: City: t,: �c., � S�tate: C)`, ZIP: �n�Lf3`� Valuation of work........................................ S Phone:, '? )e C'`'1 Fax:,4 -t ►t: E-mail: No.of bedrooms/baths................................. Owner's representative: 1PO n ► 1 c'rl Total number of floors................................. Phonc: r-'1 r e y Fax:' -1'1 t 7 E-mail: New dwelling area(sq ft.) .......................... APPLICANT E Garagdcarport area(sq.ft.)......................... Name: cR , 'n `AV,. GLb A Covered porch area(sq.ft.)Dec ......................... Mailing address: ( y,�5 S VJ i r r Te k ama(�1 ft ) - Stale:C�' ZIP: ? �p Other structure area(. .fl.)......................... c City" 1 i °'� Grmmerciabludustrial/multi-family: Phone: Fax Valuation of work........................................ 1 L Existing bldg.area(sq.ft.) .I......: y..... ........... I sib C ' Business name: r W. Cc,.- vt�i 11 New bldg.area(sq.ft.) Address: ri y r c� Number of stories........................................ _- City:t-c•i(f CJ wA State:{ L ZIP: ?i Tytr,of constnwdon.................................... Phone:h 15 $li0 i Fax: '$I X31 E-mail: Occupancy group(s): Existing: CCB no.: t50 ')3 2% n _ - - New: o. La- City/metro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be requited to be licensed in the Name: C 1 Uq jurisdiction where work is being performed.If the applicant is Address: 41 et�- LJ �cr y exempt from licensing,the following reason applies: Cit c � state ij i ZIP:, AL. I Conta^t rson: mac, Plan no.: Phhone' a 1 A5 FAX:,- �� }[' Email: - Name: ( 1 VA Contact person: Fees due upon application ........................... s _ Date received: a-71-oz- Address: -- -TS 19y, v7 City: Statc: ZIP: Amount received ........................................ Phone: Fa;:: E mail: Please refer to fee schedule. I hereby certify I have read and examined this application and die No an Iniad"kM aoat"cmc cards.p� Jmi "" sdi an fm nwx`"'mmodan. attached checklist.All pro 'si of laws and ordinances governing this ov-a QMastercad work will be compli h, died herein or not. Cr"f rd auv0w ex �c - Authorized SlgttalU CG � Date: t+ _ —NNs" arr6older u drown^°eredh red _ $ Print name: Notice:This permit rpplication expires if a permit is not obtained within 190 days after it has been accepted as complete. 440-4613�° t /�a?°i°1-A/ 59, 35 �iS 3d , S� � -7 y� '"A Date Recd: CITY OF TIGARD Recd By: COMMERCIAL TENANT IMPROVEMENT APPLICATION/PLANS SUBMITTAL REQUIREMENTS Applicants: Please complete APPLICANT 1. APPLICANT NAME:-- __ PHONE 2. SITE ADDRESS: _ _ FAX # _ -- 1. SITE PLAN (Fully dimensional, drawn to scale, showing existing parking, accessible route to building) labeled with: ❑ map & tax lot#, ❑ project name, ❑ site address, ❑ site number, ❑ zoning, ❑ applicant name, ❑ phone number. A. North Arrow B. Scale ;any standard, ars iitectural or engineering only) C. Street Names 2. See the "Commerical Plan Submittal Requirement Matrix" for number of plans required based on submittal type (no redlines or tapeons accepted). SIZE REQUIREMENTS: 24" X 36" (ROLLED) ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS A. Floor plan(s) B. Wall details C. Reflective ceiling plan D. Seismic bracing detail for suspended ceiling E. Specifications & calculations F. ADA barrier removal worksheet G. Deposit - based on valuation of project i i:w9t9orortns\oomeaw.dm 10/4= CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)636-4175 Is INSPECTION DIVISION Business Line: (503)636-4171 !�aT BUP Received Date Requested nq AM —PM_ BIP Location 12,590 5W K& n Suit© i MEC Contact Person L L'F'_ Ph(� ) o �y'� t� PLM -- Contractor r i A I f- j Pr fri e -'Xr yi e Ph( . -7)3 ) all -Q _— SWR _ BUILDING Tenant/Owner _71xia P r 1 ncee>5 ELC oting Foundation ELC Ftg Drain Access: ELR Crawl Drain slab Inspection Notes: �:,-� 01 SIT Post&Beam Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing __— Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other. — — --- — — Final PASS PART FAIL. PLUMBII IG _ Post✓3<P eam Under S ab Rough-;n Water E ervice Sanitary Sewer Rain Drains — —_ Catch Basin/Manhole Storm D,vin Shower Pan Other: -- — Fine: PASS PART FAIL — MECHANICAL Post✓f< Beam Rough-In a Gas Line RK Smoke Dampers ---- -- -- _ N Final PASS PART FAIL -- --- ---- — --- J ELECTRICAL Service Rough-In — --� — W UG/Slab --t Low Voltage Fire Alarm Fi Reinspection fee of$T_ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd. ii Please call for reinspection RE: _ L� Unable to Inspect—no access Fire Supply Line ADA Date�. Z Inspector�-� --- Approach/Sidewalk Other: _ Final DO NOT REMOVE this Inspection record from the Job oft. PASS PART FAIL CITY OF TIGARD 24-Hour - &SUI DING Inspection LinG: (503)639-4175 MST INWEC'f-ION DIVISION Business Line: (503)639-4171 �fav '0!9) Received _Date Requested_ A — PM BUIP Location ._ s� � `-�^ Suite _— MEC — Contact Person Ph(_ _) _ PLM _ Contractor— __ Ph(___ — SWR _ 8U DI — Tenant/Owner ELC Footing ELC Foundation Access: Fig Drain ELR —_ Crawl Drain Slab Inspection Notes: SIT Post&Beam _-- —� Shear Anchors Ext Sheath/Shear Int Seath/Shear min Insu ation Drywall Nailing - Firewali Fire Sprinkler -- Fire Alarm Susp'd Ceiling Roof Other:_ - — rn PART FAIL �- _ MBING Post& Beam Under Slab — — Rough-In Water Service — - -- Sanitary Sewer Rain Drains — - Catch Basin/Manhole Storm Drain -- Shower Pan Other: --� Final --- --�_ PASS_ PART FAIL MECHANICAL _ _- Post& Beam Rough-In - ---- - - - Gas Line tZ Smoke Dampers Final U) PASS PART FAIL ---- -- �u ---- ELEC_TRICALv- _-- -- - -- -- _-- J Service m Rough-In - ------- -- ----- (� UG/Slab W Low Voltage Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE G Please call for reinspection RE: Unablo to Inspect-no access Fire Supply Line 13 ADA 11 �J"Y Approach/Sidewalk - � -- �- InspnCtOr Other: _ Final T DO NOT REMOVE this Inspection record from the Job alto. PASS PART FAIL ' A►RD ELECTRICAL PERMIT CITY OF TIG PERMIT M ELC1999-00623 DEVELOPMENT SERVICES DATE ISSUED: 1111/00 13125 SW Hall Blvd.,Tigard.OR 97223 (503)639-4171 PARCEL: 2.S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT : 001 JURISDICTION: TIG Protect Description: Electrical for new commercial building. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS i 1000 SF OR LESS: 0 - 230 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps-1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W/SERVICE OR FEEDER: 40 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: 1 PLAN REVIEW SECTION 1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DOLAN + CO LLC PHOENIX ELECTRIC CO 1919 NW 19TH AVE 7379 SW TECH CENTER DR. PORTLAND,OR 97209 TIGARD, OR 97223 Phone: Phone: 684-3600 Reg#: LIC 00052288 SUP 41405 ELE 34-247C FEES _ Required Inspections Type By Date Amount Receipt _ Ceiling Cover PRMT GEO 1/11/00 $535.00 99-319168 Wall Cover PLCK GEO 1/11/00 $133.75 99-319168 Underground Cover 5PCT GEO 1/11/00 _ $42.80 99-319168 Elect'l Service Elect'I Final A. �. Total $711.55 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 9 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 nbtain copies of these rules or direct questions to OUNC at(503) 246-1987. PERMITTEE'S SIGNATU ISSUED BY- ._,,g _ 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. rELEC'N: DATE: LICENSE NO: �1 y�. S Call 639-4175 by 7:00pm for an inspection the next business day CITY OF•TIGARD Plan Check _ e Electrical Permit Application Recd By :�. 13125'SW HALL BLVD. TIGARD OR 97223 Date Recd 14_ >" Date to P.1E. !D- d Phone(503)639-4171, x304 Ot.,e 4o DST D Inspection (503)639-4175 Forint of Type Permit tr &e-I f -664;0 Fax (503) 5913-1960 Incomplete or illegible will not be accepted Called !O-L,5 D : � 1. Job Address: 4. Complete Fee Schedule Below: Name of Development er,,y Ph4_5e--- _V Number of Insee-aons per permit allowed Name(or name of bu iness) G�I Service Included: Items Coat Sum Address zi o !!51 1"11 2+ 4a. Residential-per unit Cit y/State/ZIp-1�-�-�T'd__Q ' -777-23 1000 sq-R or leas _ S 117.75 4 - Each additional 500 sq.R.or portion thereof S 26.25 1 Commercial Residential ❑ Limited Energy _ A- $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder _ S 71.75 2 (Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders Information for COT ). _ Installation,alteration,or relocation qq Electrical Contras r ` 200 amps or less $ 61.25 �p +J� 2 Address Z CC R, 201 amps to 400 amps $ 85.50 2 �1 CI V-6 State Zi 9722 3 401 amps to 000 amps $ 122.50 2 City-_ �.� p 801 amps to 1000 amps S 192.50 2 Phone No. -3106 Over 1000 amps or volts _ $ 363.75 2 Job No. Reconnect only f 53.50 2 Elec. Cont. Lice. No. ' Exp.Date C 1 D U'V' 4c.Temporary Services or Feeders ' OR State CCB Reg. No.-Zz Exp.Date L 1-3 S Installation,alteration,or relocation COT Business Tax or Metro No. ,� ,, i!_�.Date�- 200 amps or less $ 53.50 7. •- 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps - $ 107.00 2 Over 200 amps to 1000 volts, r.� License No lzUS Exp.Date Io�1 soot see"b"above. Phone Nod _ 4d.Branch Circuits New,alteration or extension per panel a)The fee for branch rircuds 2b. For owner installations: with purchase of servlce or feeder fee. /�►^ Print Owner �/s Name Each branch circuit S 5.35 �,J r 0 2 Address - b)The fee for branch circuits wlthouf purchase of service City State-Zip _ or feeder roe. Phone No First branch circuit $ 37.50 Each additional branch circuit ' $ 5.35 The installation is being made on property I own which is not 4e.Mlacelleueous intended for sale. lease or rent. (Service or feeder not Included) Each pump or irrigation circle _ S 42.75 _ Owner's Signature _ _ _ _ Each sign or ou'line lighting $ 42.75 Signal circuil(s)cr a limited energy panel,alteration or extension $ 60.00 3. Plan Review section (if required):* Minor Labels(10) R 107.00 - Please check appropriate item and enter fee in section 513. 4f.Each additimial Inspection over 4 or more residential units in one structure the allowable In any of the above Service and feeder 225 amps or more Per inspection $ 50.00 --- Per hour � $ 50.00 System over 600 volts nominal In Plant $ 5900 -Classified area or structure containing special occupancy as described in N E C Chapter 5 5. Fees: �M/y Be.Enter total of above fees pr"f0 $ �3S W 'r Submit 2 sets of plans with application where any of the above apply. .59-ISurcharge(05 X total fees) 66 // $ Not required for temporary construction services. Subtotal $ , 5b.Enter 25%of line 5a for t^, NOTICE Plan Review if required(Ser 3) S t PERMITS 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 4 AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ i!(NI ormOelcctric doc CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST 0. OUP --Date Requested j12 bC� AM_ PM _ BLD Location Z —10 'finn ✓� . Suite MEC Contact PersonPh ZCq"33D PLM Contractor Ph SWR BUILDING Tenant/Owner ELC �n Z Retaining Wall ELR —_ Footing Access: Foundation FPS i Ftg Drain SGN Crawl Drain Inspection Notes: --- Slab _ SIT Post&Beam Ext Sheath/Shear M_ Int Sheath/Shear Framing Insulation — - Drywall Nailing — Firewall Fire Sprinkler Fire Alarm Ss up'd Ceiling — — �—.f.•—ft(,L _ Roof Misc: -- J Final PASS PART FAIL - PLUMBING Post& Beam —` -- - Under Slab Top Out — -- --- —• ---�.. Water Service Sanitary Sewer Rain Drains Final I PASS PART FAIL MECHANICAL Post& Beam -- -- — Rough In Gas Line — — -- — --- Smoke Dampers Final '— PASS PART FAIL Service Rough In UG/Slab Low Voltage Fire A _ — II S PART FAIL _ I Backfill/Grading �— ---� --- --` Sanitary Sewer Storm Drain [ ] Reinspection fee of$ required before next Inspection. Pay at City Hall, 1317.5 SW Hall B..,d Catch Basin [ ]Please call for re' +ion RE: Unable to inspect-no accAas Fire Supply Line ADA , Approach/Sidewalk Other Date Inspector ,Ext _ Final PASS PART FAIL j DO/NOT 14EMOVE this Inspection record from the Job site. ' ELECTRICAL PERMIT- CITY OF TIGARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2000-00056 13125 SW Hall Blvd.,Tigard,OR 97223 (503)63+ y1�1 DATE ISSUED: 3/16/00 SITE ADDRESS: 12540 SW MAIN ST /tJ� PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: C01 JURISDICTION: 11G Protect Description: Fire alarm installation. 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: X OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL 9 F M • 1 Owner: Contractor: DOLAN + CO LLC PHILLIPS ELECTRONICS 1919 NW 19TH AVE (DBA FOR MASTER ALARM L.L.C.) PORTLAND, OR 97209 1110 NW FLANDERS PORTLAND,OR 97209 Phone: Phone: 222-5083 Reg#: LIC 00125364 SUP 329JLE ELE 26213CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DEB 3/16/00 $60.00 0000693 Elect'I Final 5PCT DEB 3/16/00 $4.80 0000693 Total $64.90 This Permit is issued sutlect 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 dayu. ATTENTION: Oregon law CL requires to follow rules adopted by the Oregon Utility Notification Center. Those rules ale set forth in OAR F- 952- "0101hrough OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at(503) U) 246- 98764. Issu by Permittee Signature J m OWNER INSTALLATION ONLY WThe Installation Is being made on property I own which Is not Intended for sale. lease,or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day .CIJy OF YIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd &�OO 13 5 SW HALL BLVD �p70Date Rec'd:_ - TIGARD OR 97223 PRINT OR TYPE V- 503-639-4171 X304 Permit F-503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED _ Name of Development Project TYPE OF WORK INVOLVED-RESIDENTIAL ONLY 1 ^i ^o � `.a (FORc ALL EnergySYSTEMS)Fee.. y�l (J- (FOR ALL SYSTEMS) ,pp J013 ores ff ADDRESS lZS' .�itAtiow �-' C!,ec�cryArabt'wbritInwkgtl ':` G it /State Zi Phone# Audio and Stereo Systems I1TQ_ 722,J � QQ% a e Burglar Alarm P OQ E Garage Door Opener' OWNER Mailing Address L1 Heating,Ventilation and Air Conditioning System' /St Zi Phone# Name El vacuum Systems' �lrC Other CONTRA OR Mailing Address 1/10 A1.W. R"_ d ress- " TYPE OF WORK INVOLVED-COMMERCIAL ONLY (Prior to issuance ay/S Zip Phone# Fee for each system.............................................. —00." copy of all licenses 472,ej (SEE OAR 918-280-280) &0.00 are required if Oregon Contr.Ord Lic.# Exp.Date expired in C.O.T. Z, ,36 Check Type of Work Involved: data bash) Ele trical Contr.Lic.# Exp.Date e r', ❑ Audio and Stereo Systems C.O.T.or Metro Lic.# Exp.Date EJ Boiler Controls Owner's Name Clock Systems OWNER- Mailing Address APPLICANT EJ Date Telecc:nmunication Installation City/Slate Zip Phone# �4 Fire Alarm Installation _-Chis 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 licensing. Intercom and Paging Systems These have asterisks('). All others need licensing; 2. Call for inspections when installation under this permit are ready for EJ Landscape Irrigation Control' inspection at 503-8394175; [::] 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; a � 4 Assume responsibility for assuring that all corrections required by the Outdoor Landscape Lighting* f— inspector are done,and; U) Protective Signaling 5 Assume responsibility for calling for a final inspection when all of the +-- — corrections are completed. Other m Permits are non-transferable and non-refundable and expire if work Is not Wstarted within 180 days of issuance or if work is suspended for 180 days. Number of Systems J 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. Fm: --- ------ ----- Signature ENTER FEES $ .oY 0%SURCHARGE(.05 X TOTAL ABOVE) S it Authority if other than Applicant TOTAL : to - i ldstslresele.doc 7/97 _ CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 -- ' Business Line: 639-4171 SUP Date Requested 31;qlego AM�PM BLD Location S Lq le'l,(✓\L Suite MEC _ Contact Person j2S Ph Z72,-�093 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall r8G GMQ— 600 Footing Access: Foundation Ftg Drain Crawl Drain Inspection Notes: Slab _ Post&Beam Ext SheatldShear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler VS_ r �- Fire Alarm Susp'd Ceiling - Roof Misc: Final PASS PART FAIL — PLU16BING 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 ICAC" a Rough In N UG/Slab _ Low Voltage — F' J_ m PASS RT FAIL - W -J Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before n inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line { )Please call for reinspection RE: Unable to Ins____ _ { ] pest no access ADA Approach/Sidewalk Other _ Dat Inspector Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site. PHOEN1 7379 sm. tech center drive tigard, oregon 97223 electric company (503) 694-3600 fax (503) 684-3611 A GroupMAC'" Company 4/18/00 adb EEJ Hap Watkins City Of Tigard 13125 SW Hall Blvd. FILE COPY Tigard Oregon 97223 RE: A-boy Phase II Hap, at the time the shell building permit was issued phoenix electric was already in design for the tenant on the second floor. Phoenix electric submitted complete shell drawing showing the tenant on the second floor and paid fees for the shell tenant combined. The electrical plan examiner approved this and permit was issued. I am sending with this letter a -py of the permit and the review drawings. If there are any problems please let me know. 1 lv Thank You I � Scott Weinbender Project Manager n. s~ m W J CCB #E52288 EC+� City of Tigard Washington County Oregon Voluntary Compliance Agreement To: Don Athey, Superintendent Grigsby Construction 5845 Jean Road FILE Lake Oswego, OR 97035 9 Q r Re: Conditional Certificate of Occupancy do l I, Don Athey, responsible a son fo T ap 1 r2 AC Tax Lot 00700, agree to t oil wi onditi s: A Certificate of Occ a c ill b is d on a conditional basis for a period not t xce fifteen days m his dote, by which time the following co iti n hav e n approved by the City of Tigard: Permit IP 8- 00 must be co pleted and approved, including all tsta d' con ions, corrections, ancillary permits and fees. I ndersta the City will withhold action until April 10, 2000. UpeKcompliance with all above conditions, this case will be closed and the Certificate of Occupancy will become permanent. I further undersand that if these conditions are not complied with fully, I may be ser✓ed with a Summons and Complaint without further notice for a violation of requirements set forth in the Oregon Structural Specialty Code (Final inspection approval required prior to occupancy). m Signed: _ >i Date: 3- 2 4 - J Signed: Date: (Witne CITY OF TK3ARD OREGON April 17, 2000 A-Boy/Second Phase 12540 SW Main Street Tigard OR 97223 Dolan CO LLC By Florence T Dolan 4025 SE Brooklyn Portland OR 97202 Re: BUP98-00070 To whom it may concern: This letter is to certify that all requirements of building permit#BUP98-00070, issued for a building shell, have been completed. The anal inspection was performed and approved on April 10, 2000 by inspectors from the City of Tigard. No tenant spaces are included in this permit, nor shall any tenant improvement be occupied until such time as each space is approved by final inspection of its specific permits, approved for the use intended and provided with a Certificate of Occupancy. The City neither guarantees nor warrants to the owner, occupant or any other person that this letter evidences strict and complete compliance with each and every ordinance or regulation of the City or the State of Oregon affecting the construction or use of said structure or the land upon which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises. This letter certifies only that the work covered under the permit number listed above has been completed. It is not permission to occupy tenant spaces. Sincerely, r Darrel W ins Inspection Supervisor 6 c Don Athey, Grigsby Construction r l.•Bldg/complllr 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 4 CITY OF T I GA R D O MECHANICAL PERMIT - ,L�aDEVELOPMENT SERVICES �/ PERMIT 0: MEC2000-00136 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-416100 DATE ISSUED: 2510 0 SITE ADDRESS: 12540 SW MAIN ST 2 PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT:001 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS: 1 STORIES: _ BOILERS/COMPRESSORS HOODS: FUEL TYPES U - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: FIRE DAMPERS?: 30-50 HP: REPAIR UNITS: GAS PRESSURE: 50+ Hp: WOODSTOVES: C FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN >=100K BTU: <=10000 cfm: OTHER UNITS: > GAS OUTLETS: 10000 cfm: Remarks: Installation of vent fan. Owner: FEES DOLAN + CO LLC Type By Date Amount Receipt BY FLORENCE T DOLAN PRMT DEB 4/19/00 $50.00 0001554 4025 SE BROOKLYN 5PCT DEB 4/19/00 $4.00 0001554 PORTLAND,OR 97202 Phone: Total $54.00 Contractor: HVAC INC 5188 SE INT'L WAY MILWAUKIE,OR 97222 REQUIRED INSPECTIONS Mechanical Insp Phone:462-4822 Final Inspection Reg#:LIC 50897 a a a rn m W This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work .s not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You m obtain pies of thgse r les or direct questions to OUNC by calling (503 246-9189^ Issue y: - Permittee Signature: 42 LV"Q- I'va Call(503)639-4175 by 7:00 P.M.for Inspections needed the next business day CITY OF TIGARD Mechanics I Permit Application Recd By 13125 SMI HALL BLVD. Commercial and Residential Data Recd TIGARD, Oil 97223 Date to P.E. (503) 639-4171, x304o,L44k�� ; �° Date to NtZ �ei�e� "NO' Print or Type 3� Incomplete or illegible a plications will not be accepted Calms Nrne Of Description (>'Cl(I I O G Taft 1A Mechanical Code 07Y PRICE AMT Job $VW Ad&Ma I suiles A) Permit Fee 40- 4 10.00 Address a saga Mw 1.) Fumece to 100.000 STU 6.00 includirig ducts 8 vents Nrr0(or name or a mm") 2.) Fu ;a 100,000 BTU+ 7.50 Owner , %- LA ria dzI 1., i a /' InPhicl p ducts 8 vents / x 3,) Furnace 8.00 C suretq!eg, i:t+an. 4.) Suspended hostler.WON heeler 6.00 7 0� `/7I7�7 "zip or floor mounted heeler Nana(r nrne of twat»") 5.) Vent not included in appNanoe Permit 3.00 Occupant Me"Mont" 6.) Boder or comp.haat pump,ON Gond. 6.00 to 3 HP;absorb tink to 100K BUT- CMyr lata 7.) Boiler or comp,haat pump,air ootid. 11.00 3-15 HP;absorb unit t0 SOCK 8TU" Contractor 'Mn'o 6.) Boder or comp,heat pump,air Gond. 15.00 (Prior to * 15-30 HP;absorb unit5.1 mit BTU- issuance Maatq Aeanaa 9.) Boiler or coo. heat pump,air gond. 22.50 applicant -> l r ,1ct4 30.50 HP;absorb unit 1-1.75mi1 aIU" must provide ON c ZIP Phorle 10.) Boder or comp,haat pump,at con 1. 37.50 contracts It�kw tui(ac Cwa. ` ' 1)i1 4bJ. c 0 a- -o 50 HP;absorb unit 1.75 mit 81U" Ncanse kkprr Canal Cam.sora uta Exp.PM 11.) Air soMMq unk to 10,000 CFM 4.50 Information V U U for COT COT sunaaa T«or Moto• Exp.ons 12.) Air hwxft unit 10,000 CFM 7.50 database). Archfbct N"TM 13.) Non-portable evaporate coolm 4.30 or M*"Adra" 14.) Vent fan corrrrec led to a single duct / 3.00 Engineer Curs"" tip Prion. 15.) Verdistion system not included in 4.50 I -- permit Describe work New O Addition CrANeration O Repair O 16.) Hood served by mechanical exhaust 4.50 to be done Residential O Non-residential O Additional Desciiptior,of work 17.) DOMS8 C incineralas 7.50 16.) Commercial or industi I type 30.00 Existing use of 19.) Repair units 4.30 twilling or property 20.) Wood stove 4.50 Proposed use of 21.) Cblfras dryer,etc. 4.50 building or property IL 22.) Other units 4.50 [Y Type of fuel-oil O natural gas O LPG O electric O 23.) Gas piping one to four outlets 2.00 f- N I hereby acknowledge that I have read this application,that the 24.) More than 4-per outlets(each) .50 infonnadon given is correct,that I am the owner or authorized agent of the owner,that plans submitted are in compliance with Oregon Sate QTY.SUBTOTAL m laws. W Signature of OwnodAgent Dab r l R/� 'SUBTOTAL J 1 1 I% 21 SURCWIRGE y Contact Person Name Phone PIAN REVIEW 25%OF SUBTOTAL TOTAL -- I i:Ast\mechpmtdoc (rev 9 'Minimum pafmit fee is 325+5%surcharge "ResidentailAIC requires aka Plan showing placement of urtk. Y CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00341 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 01/18/2000 SITE ADDRESS: 12540 SW MAIN ST PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING(MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: M FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: 1 GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: 3 TUBISHOWERS: SEWER LINE: 100 ft WATER CLOSETS: 5 WATER LINE: 100 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing-shell for phase 2. SWR1999-00227, 3 EDU's. FEES Owner: Type By Date Amount Receipt DOLAN + CO LLC PRMT GEO 01/18/200C $269.00 00-321183 1919 NW 19TH AVE PLCK GEO 01/18/200C $67.25 00-321183 PORTLAND, OR 97209 5PCT GEO 01/18/200C $21.52 00-321183 Phone 1: Total $357.77 Contractor: C EAGLE PLUMBING ENTERPRISES INC 13801 S FORSYTHE RD OREGON CITY, OR 97045-1219 REQUIRED INSPECTIONS Phone 1: 760-5565 Sewer Inspection Reg#: LIC 00047914 Water Service Insp PLM 3-154PB Top-out Insp Storm Drain Insp Rain Drain Insp Final Inspection ORIGINAL 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 Ut-lity Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rule or direct questions to OUNC by calling (503) 246-1987. Issued By: Permittee Signature: Call(503)639 by 7:00 P.M.for an Inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check 0 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 a - Incomplete or Illegible applications will not be accepted Permit ` 1 Related SWR 0 Zz Called 10-&25, Q e-err ham, or7t1K Name of Development/Project FIXTURES (individual) QTY PRICE AMT Jot) F Rot j G Z-- Sink 11.50 Address Street Ad rens Suite Lavatory 11.50 / 2, O f Vy Mab r( Tub or Tub/Shower Comb. 11.50 Bldg* City/Slate Zip Shower Only 11.50 114 AqW Water Closet/Urinal (Specify) , 11.50 Name rn 4 LC- Dishwasher 11.50 Owner Mailing Address Suite Urinal l 11.50 113-0 ' I� ti f",f( 1 --V, r Garbage Disposal 11.50 Ci /Slate Zip Phone Laundry Tray 11..50 Y LI ryL1 �Hr _ Name Washing Machine/Laundry Tray (Specify) 11.50 Floor Draln/Floor Sink 2" 11.50 Occupant Mailing Address Suite 3- 11.50 4" 11.50 City/State Zip Pho Water Heater O conversion O like kind 11.50 //7��rr1 Name Gas piping rr uires a separate mechanical permit. l MFG Home New Water Service 32.00 L.&- MFG Home New San/Storm Sewer 32.00 Contractor Melling Address Suite _ 1)8 4 Hose Bibs 11.50 Prior to permit City/State Zip Phone Roof Drains 11.50 issuance,a copy n r c-c", OL T 704. tel)'V 7 0 1 Drinking Fountain 11.50 of all licenses are Oregon C �3 Const.Cont.Board LIc.# Exp.Dat , - required If Other Fixtures(Specify) 15.00 expired In COT Plumbing Llc.# Exp.Date 3 miliv-10-A0 database -/S 7 Name Architect GI Dot Sewer-1st 100' - 38.00 Or Mailing Address Suite Sewer-each additional 100' 32.00 j too r-4.% � Water Service-1st 100' 38.00 Engineer City/State Zip Phone Water Service-each additional 200' 32.00 IPIIQ 2u-12. Describe work to be done: Storm 6 Rain Drain-1st 100' 38.00 New ORepair O Replace with like kind: Yes O No O Storm 6 Rain Drain-each additional 100' 32.00 Residential O Commercial Additional description of work: Commercial Back Flow Prevention Device 32.00 -$;Z Residential Backflow Prevention Device' 19.00 _ Catch Basin 11.50 Are you capping,moving or replacing any fixtures? Insp.of Existing Plumbing or Specially Requested 50.00 Yes O Nox Inspections per1hr If yes,see back of form to indicate work performed by Rain Drain,single family dwelling 45.00 l fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL I hereby acknowledge that I have read this application,that the information Isometric or riser diagram Is required it Quart Total is >9 given is cored,that I am the owner or authorized agent of the owner,and - that plans submitted are In compliance with Oregon Slate Laws. 'SUBTOTAL 9 I Signature of Owner/A ent Date 1 g g a11k3-18� 8%SURCHARGE . Contact Person Name Phone "PLAN REVIEW 26'h OF SUBTOTAL / %703 Required only 0 fixture clolet Is>9 G�� 1 BATH HOUSE$170.00 TOTAL 2 BATH HOUSE ""*+ �; ,i r1041 `) 3 BATH HOUSE$1 16.00 (This fit(neludes)all pit ling ina ma 1111sI,; *Minimum permit too Is 150+8%surcharge,except Residential Backflow Prevention 100 feet of•anifaiji sevwr i�iild� c�► � :; Device,wt,4�h Is$25+e%surcharge -All New Commercial Buildings require plans with Isometric or riser diagram and plan review. I kdsislformsipiumapp doc 10/8!99 - - PLEASE COMPLETE: Fixture Type N Sink Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Urinal Garbage Disposal Laundry Room Tray Washing Machine Floor Drain/Floor Sink 2" _ 3" 4" Water Heater Other Fixtures (Specify) _ COMMENTS REGARDING ABOVE: I:WthVamt"m*p doe 9De" �1 FLOOr . To O ►'l J 1 + L .314 !I , t ci ry OF Ti� --- APproved..- �RC Conditionally APprov ... ......... t For only iiIP rk ): FERMI r NO(. as cc'scribt,,d in; See Letter to: F- ollow...-.f.-.0.....�. ..�. �t ..ct ..... ..Job Adddress:4 1 . •.... �•'� . .._._.. ' -----_---_ nate:1Y,--� y 9` A - BOY I,2s'iO MOS W Sr CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 , . Business Line: 639-4171 SUP Date Requester! 3 AM PM BLD Location Suite — M Contact Person Ph (060Ll --L Contractor Ph —•— BUILDING Tenan ilOwner ,l' � �� u r - �— ELC Retaining Wall ELR Footing r1ns ass: FPS Foundation Ftg Drain - SON Crawl Drain Section Notes: Slab SIT Post&Beam Ext Sheath/Shear int Sheath/Shear Framing Insulation Drywall Nailing — Firewall Fire Sprinkler -- Fire Alarm Susp'd Ceiling — Roof Misc: — Final PASS PART FAIL — Post&Beam Under Slab Top Out Water Service _ Sanitary Sewer Rain Drains — — 1 PART FAIL NANICAL Post&Beam Rough In _ Gas Lime Smoke Dampers Final — — PASS PART FAIL ELECTRICAL Service Rough In UG/Slab - Low Voltage Fire Alarm Final PASS PART FAIL --SITE Backfill/Grading Sanitary Sewer Storm Drain ( ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ]Please call for reinspection RE: [ j Unable to inspect-no accPsR Fire Supply Line ADA Approach/Sidewalk Dat 61 Inspector 222 Ext Other Final PASS PART FAIL O NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST IX 24 Hour Inspection Line: 639-4175 Business Line: 639-4171 AUP _� O _ Date Requested il 0� — AM "� PM BLD Location� 0 in suitv9.7Lj-7:- MEC Contact Person /�!� Ph Contractor _ Ph $VVR BUILDING Tenant/Owner--7 ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab _ SIT Post&Beam / Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing _— Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PA ART FAIL Post&Beam r� _ -- Top Out Water Service Sanitary Sewer Rain Drains Fi S PART FAIL METTAWNICAL Post&Beam Rough In Gas Line Smoke Dampers Final —'— PASS PART FAIT. p, ELECTRICAL — -- Service �_ __.� . _—• Rough In UG/Slab Low Voltage _J Fire Alarm _m Final C7 PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RF: _ _ [ ]Unable to Inspect no access ADP, t✓ Approach/Sidewalk Date e ' Inspector Ext Other - Final PASS PART FAIL DO NOT REMOVE this inspection record from the fob site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ' BUP _ Date Reqsted .Z- AM PM BLD Location 2--; b P Cl t yy Suite MEC Contact Person Ph CO S O - 7-7 03 PLM 1999-CQ 32 j Contractor Ph SWR BUILDING Tenant/Owner `r ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SON Craw!Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler ip Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL Post 8 eam / Under Slab V0_63) Wa er Service _ Sanitary Sew Rain Drains — -- — —_ Fi AS PA —� .HANICAL Post& Beam -- Rough In _ Gas Line Smoke Dampers Final —PASS PART PART FAIL _ IL ELECTRICAL – Service _ ----- Rough In W UG/Slab -- -- Low Voltage J Fire Alarm _ -- M Final 0 PASS PART FAIL – -- _j SITE _ Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Inspect-no access Unable to ins Fire Supply Line [ ]Please call for reinspection RE: fNN [ 1 P ADA Approach/Sidewalk1 Other Date � Inspector //� E�ct�_� Final PASS PART FAIL GO NOT REMOVE this Inspection record from the Job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 Business Line: 639.4171 BUP Date Requested 2-0 Q AM PM BLD Location S Suite MEC Contact Person Ph p PLM �'99 'OD �y Contractor � Ph S�2 -ti Ago SWR BUILDING Tenant/Owner Q ,' ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN 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 F MBI Post R Beam Iv Under Slab Water Service Sanitary Sewer Rain Drains :z 15_ Final PASS PA FAIL _ MECHAWAI Post& Beam — -- _ Rough In ' Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL - -- --- a. Service ! _ 011_ Rough In UG/Slab _ Low Voltage J Fire Alarm m Final 0 PASS PART FAIL W SITE 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 Lire [ )Please call for reinspection RE: ! [ ]I.Ingbl-to inspect-nn ncress ADA /rh/Sidewalk Other r (� Ext� Other Date � Inspector Final PASS PART FAIL �0- NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 . Business Line: 639-4171 BUP Date Requested � 3 AM_ PM BLD Location y U f�/1r ' AU✓A Suite MEC Contact Person �cL� Ph CoSo_ 70'3PLM 19q/ —eW Contractor Ph SWR rx, ;« ► BUILDING Tenant/Owner �'''� i�""� ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg 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 Mise _ Final PASS PART FAIL 8 ., Post&Beam Under Slab / Top Out -- Water Service Sanitary Sewer Rain Drains a ' SS PART F IL _ MECHANICAL Post 6 Beam — Rough In Gas Line — Smoke Dampers Final — PASS PART FAIL ELECTRICAL — -- �' Service _ Rough In tq UG/Slab Low Voltage J Fire Alarm ® Final PASS PART FAIL — W SITE Backfill/Grading �– Sanitary Sewer Storm Drain [ ]Reinspection fee of S_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ Please call for reinspection RE:_ [ J UnehIn to!nspect-no access ADA Approach/Sidewalk Other Date Inspectors 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: 639-4176 . . . . Business Line: 639-4171 OUP Date Requested AM PM Location sZG BLD 1 Suite MEC Contact Person _ ( .l Ph COSO - S:203 103�1 Contractor Ph _ SWR BUILDING Tenant/Owner 04 &AA � ELC Retaining Wall �� ELR Footing Access: Foundation FPS Ftg Drain SON Crawl Drain Inspection Notes: Slab SIT Post 6 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 IRLUM11967 Post&Beam Under Slab op i� a er'Service Sanitary Sewer `— Rain Drains aA PART FAIL NICAL Post 8 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 Backfi!I/Grading — Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin please fall fi or reinspection RE: Fire Supply Line [ [ P - — --_.__— [ ]Unable to Inspect no access ADA Approach/Sidewalk Mier Date _Inspector Ext Fina! j Mi PASS PART FAIL DO NOT REMOVE this Inspection recond from the job site. CITYOF TIGA•RD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT M SWR1999-00227 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 01/14/2000 SITE ADDRESS; 12540 SW MAIN ST PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG TENANT NAME: A-BOY USA NO: FIXTURE UNITS: 47 CLASS OF WORK: NEW DWELLING UNITS: 3 TYPE OF USE: COM NO. OF BUILDINGS: 1 INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: Sewer- shell for phase 2. 47 Fixture count=2.94 or 3 EDU's. Owner: FEES DOLAN + CO LLC Type By Date Amount Receipt 1919 NW 19TH AVE PORTLAND,OR 97209 PRMT DST 0 111 41200C $6,900.00 00-321169 INSP DST 01/14/200( $45.00 00-321169 Phone: Total $6,945.00 Contractor: Phone: Reg#: Required Inspections Sewer Inspection L C 4 D This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987. Issued by: , r �� l Permittee Signature: 1 Call(503)639-4175 by 7:00 P.M.for an inspection needed the next business day CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394176 . Business Line: 639-417 Date Requested 0� 0 BU q � AM PM BLD Location L �g1� Suite MEC Contact Person Ph Sig PLM Contractor Phftp _ •1 ' � UIL01 Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SON - Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation ; �" Drywall Nailing l Ae "^ al 4�2v Firewall Fire Sprinkler Fire Alam { _ Susp'd Ceiling �W- Roof Mi sc: G/fJa WaySki �r Final PART FAIL _ PEXIMING Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL �,t�� / MECHANICAL �CG Lam/ 4p,9Le O (/T d v LIE E Post 8 Beam Rough In r Gas Line v/ _ J .S�---�`•�C� fI Smoke Dampers �{ -77UiU Final PASS PART FAIL ELECTRICAL —� IL Service tr Rough In N UG/Slab — Low Voltage Fire Alarm J Final m PASS PART FAIL W J g ( ]Reinspection fee of$_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call fnr reinspection RE:, [ )unable to inspect -no access ADA If Approarh/Sidewalk Other Date loo Inspector _Ext I Final_ PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 j3usinges Line: 639-4171 --- -� / BUP Date Requested �y 2'3��CJ PM BLD Location le;z `�'j7Ct N Suite -{— MEC Contact PersonPh4?6 7G- S d PLM Contractor PhD BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg 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 PASS PART FAIL — -- LUM rugrg Beam Under Slab Top Out — --- Water Service anitary Sew ai rains _ i PASS PART FAIL MECHANICAL Post& Beam — — — --- Rough In Gas Line -- — Smoke Dampers Final -- — PASS PART FAIL ELECTRICAL — - --- L Service 2 Rough In UG/Slab Low Voltage Fire Alarm 3 Final ^ D PASS PART FAIL 9 SITE U 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 rPinspecticn RE: �_ [ ]Unable to Inspect-no access ADA Approach/Sidewalk Date / .L�,1 Inspector Ext 1 `� Other / — — Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. 03/23/00 TQU 13;11 rg 503 884 0984 CARLSON TESTING ia002 AL Arlin Olrrw a.rm 011ie. erect Ofte P.o.Boat 2N14 4080 FA*mi Aw.,NE PA,amt Ma • Tigard.dragon 9 MI MOM ON SMI 11"OR WM Carlson Testing, Inc. mom M, „"�3; W�;mm® Special Inspection FINAL SUMMARY LETTER *"Amended*"March 23, 2000OVA T9802176A City of Tigard 13125 SW Hall Blvd., Tigard, OR 97223-8199 Attn: Building Department Re: A-Boy Phase II 12550 SW Main Street, Tigard, OR Permit No.: BUP98-0070 Dear Sir or Madam: This is to certify that in accordance with Section 1701 of the Uniform Building Code and Chapter 24.20, Title 24,we have performed special inspection of the following item(s)per our inspection reports only: Reinforced Concrete Structural Masonry Structural Steel–Shop and—Field 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 engineers design changes, approvals and vefial Instnrdfans. 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 hositate to contact this office. RespeMfully submitted, CARLSON TESTING, INC. Andrew M. Ewing President cc: Dolan Design–Dan Dolan Grigsby Construction Company CIDA Corporation Architects&Engineers r�wamw�roRrtwwtit�tao•,r.. 03/29/00 THU 13;11 FAX 503 5114 0954 CARLSON TESTING wool Carlson Testing, Inc, Fax TYanemlttel x❑ Tlgw4 Office(Main) ❑ SoWm Branch Offios 8430 SW Hunzlkar 4000 Hudson AvwM.NP Tigard.OR OW $edam.OR WMI Phone:(603)684-3460 Phone:(809 CSA-1262 Fax: (503) 884-0954 Fax (503)589-1309 Date— ��tJ� _ Number of Papel: Odra O&W wifto Please deliver this fax transmittal Information to the following person. If you have reoelved this Information In error, please destroy It. To: �_ � ' — Company: Fax#: G 4z— Telephone #: w From: _ JANET ma. #207 -- — Comments- - L D k*mna*m ow**wd herein in not la be mproduto4.oaotlI I In#A WON"pylar attlhprfuMon 1110m trill dit. N you dd not receive eh Pag"Please=ft d Our OMW Ot your eeafiest www"""' Thank You MAR•21-2000 01:61 FROM-C IDA 10082211170 TWO P.001/002 F-010 4445 SW OAROUR •LVD.. SUITE 200 PORTLAND, ORECON 07701 �0 TEL! 505.220.1255 FAX. 305.220.1070 $-MAW 6dI*al4P9rt.Com March 2Z 2000 City of Tigard Office of Community Development Attention: Hap Wx*k- , Wldrg Inspecmr 13125 SW Haff Blvd. Tigard,Or"on 97223 FAX 624.3681 RE: A-BOY Phase 11 -Reuil Building 122 SW Main Street Tigard,Oregon 97223 Building Permit Number:BUP984)0070 ODA Project Number.97125.07 Dear Mr. Hap W4*irw ODA has reviewed the Carison Testing reports indudin; Stnictural Steel Reinforced Concrete Reinforced Comae Masom Units Rock Compaction at Asphalt Paving To the best of our knowledge,work was satisfactorily completed. Sincerely, AAk Cary Live e,P.E. GO/ a. C w Wua,Gripby Com muccdm 671-t 10I hx H Dan Dorn,A40Y Stws%221-19621be N file C ! J_ _m W F:�f`1A��'7 2!1v.-9d'►2Fn�I4nq�cl.eee IMR-21-2000 00:50 FROMFCKA 110322111f0 1-110 P.101/002 F-011 4445 SW 1Ait M 10MVAUD•SUITE 200 PM AND.OUGON 47201 TR 503.226.1225 FAX:5032MUM F-MAIL:cidAk@"ort.com FAX COVER LETTER Project NI.: 9712S.07 Date:March 23,2000 Project Name: A-BOY II Retail Building Time: 10:00arn Attn: Hap Watkins Fax: 624-3681 Company: City of Tigard Description: Sullding Inapector From: Glen Boyajian Fax N: 503.226.1670 Page 1 of 2 Comments:Final Inspection Letter Cc: Fax At: Originals to Folio:,,:[Yes ®No Confidentiality Notice: nw Warnarbn in this Mar is emfidontial and is irkendrd only for the use of the YbdiridMI or @M;ty M"Wd above If the rwdrr o!this MM-r is Mt Ov inrRnaUdtfq ant ar if rris rfaat wsion WM referred in errs;PAMe notKy 0 P,N,K yat*at 503.226 WS WED GE(DDESIGN , INC . GEOTECHNICAL. ENVIRONMENTAL. AND GEOLOGICAL CONSULTAN r! March 24, 2000 A-Boy Supply Company 1919 NW Nineteenth Avenue Portland, OR 97209 Attention: Mr. Dan Dolatt Geotechnical Letter of Compl e A-Boy Facility Expanxion, has Tigard, Oregon GDI File: A-Boy-4 We are pleased to submit this geotechnical letter of compliance for foundation support for the A-Boy Facility Expansion. Earthwork for the project began in August 1999 and concluded in December. During the construction we observed excavation and construction of plain concrete piers for support of foundations, conducted density testing of underground utility trench backfill, and observed a proof roll of pavement base rock. Our services were provided on a continuous basis during construction of the piers and on an intermittent and on-call basis for the other work. Based on our observations and density testing, it is our opinion that the construction outlined above was prepared in general accordance with the project specifications and the intent of our geotechnical recommendations. Field reports of the site visits ass=ociated with our geotechnical construction monitoring have been provided to you and additional copies can be provided at your request. Sincerely, GeoDe . n I c. 1� /� a Bra u E. N Prcje ti neer �- J cc: Mr. Hap Watkins, City of Tigard g m Mr. Glenn Boyajian, CIDA, Inc. W Mr. Don Athey, Grigsby Construction J BLH:DLR:kt Document ID:A-Boy-4 letter of compliance.doc One copy submitted 17400 SW Upper Boones Ferry Rd., Suite 230 • Portland, Oregon 97224 • Phone(503) 968-8787 • Fax (503) 968-3068 CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES27A LDATPERMIT#: MEC1999-00567 E ISSUED: 12/28/1999 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST ZONING: CBD SUBDIVISION: BURNHAM TRACT .JURISDICTION: TIG BLOCK: LOT:001 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2 OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES _ 0 - 3 HP: 2 DOMES. INCIN: GAS 3 - 15 HP: 1 COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 -50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: CLO DRYERS: FURN <100K BTU: AIR HANDLING UNITS _ OTHER UNITS: FURN >000K BTU: 3 <=10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Mechanical for new commercial bldg. _ Owner: _ FOES DOLAN + CO LLC Type By Date Amount Receipt 1919 NW 19TH AVE PRMT BON 12/28/19f $102.20 99-320713 PORTLAND,OR 97209 PLCK BON 12/28/19 $25.55 99-320713 5PCT BON 12/28/19f $8.18 99-320713 Phone: Total $135.93 Contractor: HVAC INC 815 SE SHERMAN REQUIRED INSPECTIONS PORTLAND, OR 97214 Gas Line Insp Phone:239-4822 Mechanical Insp Iteg#:LIC 50897 Heating Unt Insp Duct Inspection Fire Damper Insp S.D. Shut-down Final Inspection i ORIGINAL i This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may ohtMn copiesf these rules or direct questions to OUNC by calling (50(3�)246-9189. B l' Permittee Signature: �.>z J1 '�� (,'t Iet)l_ Issue y Call(503)639.4175 by 7:00 P.M.for Inspections needed the next business day Plan Check N CITY OF TIGARO Mechanical Permit Application Recd By 1,3125 SW HALL BLVD, Commercial and Residential Date Recd TIGARD, OR 97223y Date to P.E. 3- (503) 639-4171, x304 t 4w� a�OC) Date to DST Print or Type OF Permit 9 — Incomplete or illegible applications will not be accepted Called Nam.Of fO Description>0(- Table to Mechanical Code oty Price Amt Job Sb••t Address r" C, suaaa A) Permit Fee 16.00 Address ov L-,Uj Mw sf 1 1) Furnace to 100,000 BTU tdga Cry/sten• Zip including duds t1 vents 9.65 T, ' %(1 E f?11-3 2) Furnace 100,000 BTU+ �` Nam(OF m na •of busineso Includingducts&vents 12.00 Owner 6 111 D A 3) Floor Furnace i Meting Address including vent 9.65 4Suspended heater,wall heater Cayrsuy Zlp Phony or floor mounted heater 9.65 5 Vent not Included in appliance rmh 4.75 (or of but Check all that apply: 'Boller Hest Air �Q 1- kr2,yp For Items 6-10,see or Pump Cond Oty Price Amt Occupant Aaa footnotes 1,2 Com ~ C/5 W (11cu-tet 6)Repair units Cltyrstme ZIP Phone 8.40 7)c?HP;absorb unit toI Contractor Nam 100K BTJ 9.65 �f 3a (Prior to 0 (-'/1(f i Ty`C.. 8)3-15 to P;absorb BTU unit 17.65 7` issuance A�^� applicant �, S 9)15-30 HP;absorb` SG E"r r Lto-*-1 unit.5-1 mil BTU 24.15 must provide all ayrstms Zip Pna» contractor 0"+(aupU 1� e? / L L- unit 3-1.7 mi absorb 7 3�/��Z unN 1-1.75 m!!BTU 38.00 license OMW COnst Cont Board Lie a F.x .p • information 5 r &, D U 11)>50HP;absorb unit>1.75 mil BTU for COT COT Business Tax or Make a Exp.pay -- 80.15 1 i 10 database). 2)Air handling unit to 0, 00 CFM Architect NOT* 7.00 13)Air handling unit 10,000 CFM+ or Me"Address 11.85 14)Non-portable evaporate cooler Engineer Crty(stme Zip Ptron• 7.00 15)Vent fan connected to a single duct Descrtbe work New O Add tionAg Afferation O Repair O 16)Ventilation system not Included In 4.75 to be done Residential O Non-residential jv a liancem.in 7.00 Additional Description of work 17)Hood served by mechanical exhaust 7.00 18)Domestic In .ierstora 12.00 Existing use of 19 Commercial or induitrfai ) type Incineratorbuilding or property 48.25 20) Other units,Including wood stoves Proposed use of .� {� 7.00 building or property.1/��t "�� (0d_ `i Ov �s2 21)Gas piping one to four outlets ' CL 3.75 22)More then 4-per outlet(each) 75 r j Type cf fuel-oil O natural gas LPG O elednc O Minimum Permit Fes$50.00 SUBTOTAL 8%SURCHARGE I hereby acknowledge that I have read this application,that the PLAN REVIEW 25%OF SUBTOTAL J information given is correct,that I am the owner or authorized agent of Required for ALL commercial permits only 7`7 55 _m the owner,that plans submitted are in compliance with Oregon State - !r7 laws. TOTAL WSignature of Owner/Agent Date Other Inspections and Fees. Pr ( 1. Inspections outside M normal business hours(minimum charge-two hours) $50.00 per hour e�k�ti c b`� 1 `1 I 2. Inspections for which no fee is specifically Indicated (minimum charge-haH hour) Contact Person Name Phone $50 Doperhour 3 Additional plan review required by changes,additions or revisions to plans(minimum charge-one-half hour)$50.00 per hour 'State Contractor Boller Certification required i:Wst4rw&pmt.doc (rev 9 'Minimum permit fe 'Residential A/C requires site plan shaving placement of unit (/l�J CITY OF TIGARD BUILDING INSPECTION DIVISION M8T Hour Inspection Line: 639-4175 Business Line: 639-4171 O�� Date Requested Z O �� PM _ OLD Location 2:�SA D Suite i Contact Person Ph q65;- q35 PLM Contractor Phf"'� SV i WILD II Tenant/Owner '� �'v�-d ELC Retaining Wall ELR Footing Access: Foundation FPS I Fig Drain SGN il Crawl Drain Inspection Notes: — Slab SIT Post&Beam 1_xt Sheath/Shear ZZ Int Sheath/Shear Framing VLFA �� voG OO G Insulation - Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Mi I ASS PART AI — PLUMBING L-oe Post&Beam Under Slab -� — Top Out A . Water Service _ Sanitary Sewer - `^ N Rain Drains _ 1 PA —�f FI PART F CHA LPRIM-Bearn Rough In Gas Line Smoke Dampers - WCTR PART FAIL UG/Slab - CL Service C• S _ Z� S lJ�"�.��-- Rough �• Low Voltage Fire Alarm �fv m Final L PASS PART FAIL w r J SITE _ Vv✓\��/� ( Q_ _ Sanitary Sewer ' Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay a City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: _ ( ]Unable to inspect no access ADA ( ,� Z Approach/Sidewalk Date �� Q U Inspector "'�--^--� Ex Other — ---- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. A FILE COPY January 6, 1999 Dolan and Company, LLC Attn: Dan Dolan 1919 NW 19th Ave. Portland, OR 97209-1735 Re: Permit Extension-A-Boy Phase II, Permit# BUP98-0070 Dear Mr. Dolan, Thank you for you; timely letter requesting extension of the Phase II building permit. Extension is granted for a period of six months. If normal construction begins prior to that time, each approved construction phase will continue the permit for another six months. If I can be of further assi, ice, call me at 639-4171 ext. 416. SincIf r ly, Darrel "Hap" Watkins Inspection Supervisor Z i - t f&z- U) m W J Aug-11-00 12:20P P.O1 Dolan and Company, LLC 1919 NW 19`a Ave. Portland OR 97209-17.1.1 Phone(.10,1)222-9009 t January 5, 1999 Mr.Darrel Watkins City of Tigard 13125 SW Hall Blvd. Tigard OR 9722:1 Re: A-Boy/Dolan Project Phase i1, 1254U SW Main Via FAX 624-3681 Page I of I Dcar M►. Watkins; The Phase I building has been delayed beyond the anticipated completion date. it is necessary to complete this building and move present operations into Ihib building prior to demolition of the existing building and construction of the Phase 11 building. i understand the permit for the second building will expire on)anuary 9, 1999 and hereby request this he extended for three months. Sincerely, Dan Dolan Member a oc c� _J m W J r March 2, 1998 CIDA CITY OF TIGARD 5200 SW Macadam #420 OREGON Portland, OR 97201 RE: A-Boy Phase II Building Plan Review 12540 SW Main Street PC#: 2-31c BUP#: 98-0070 Submittal documents for the above, referenced project have been reviewed for conformance with the applicable Oregon Specialty Codes and other applicable codes and standards. The following comments are noted: SI/TE WORK V Provide a Geo-tech report applicable to Phase II building site. 2! Complete the enclosed Program for Inspection Services form designating the testing laboratory performing the inspections indicated. [ ERGY COMPLIANCE 1, Provide a lighting power budget for the interior and exterior of the building [OSS;;, Section 5310 f(1)(2) and Table 53m]. 1/ Revised plans shall show details and sptcifi ong of exterior wall construction providing a R-19 assembly s specified in 4/A4.0. Provide not less than R4.5 insulation at perimeter of building in accordance with OSSC, Section 5303 (d). FIRE AND LIFE SAFETY a_ 11':" A final building inspection will not be conducted and/or a certificate of occupancy issued until a tenant improvement permit is processed for the office shell area. V Aisles having merchandise on both sides shall not be less than 44 inches wide ao -+I [OSSC, Section 3315 (b)2]. W �> Provide a reflective ceiling plan for each floor with details showing: Retail area 1. Provide exit illumination having an intensity of not less than 1 foot- candle at floor level with an automatic emergency power system, 13125 SW Hall Blvd„ Tigard, OR 97223(503)639-4171 TDD(503)684-2772 A-Boy Phase II Building Plan Review PCM 2-31c BUPM 98.0070 Page#2 such as an on-site power generator or storage batteries, to operate the lighting system in the event the premises wiring system fails [OSSC, Section 1012.1 and 1012.21. When two or more exits are required, internally lighted exits signs shall be provided [OSSC, Section 1013]. Clearly indicate sign locations on the electrical floor plan and provide that E sheet in the revised plans. a. Provide secondary power to one lamp in each fixture [OSSC, Section 1013.41. b. Exit signs shall incorporate an internally illuminated international symbol of access [OSSC, Section 1108.4.12.11. Provide specifications in accordance with OSSC, Section 1109.15.6 within the revised plans. B. Office Shell 1. When two or more exits are required, internally lighted exits signs shall be provided [USSC, Section 1013]. Clearly indicate sign locations on the electrical floor plan and provide that E sheet in the revised plans. a. Provide secondary power to one lamp in each fixture [OSSC, Section 1013.41. b. Exit signs shall incorporate an internally illuminated international symbol of access [OSSC, Section 1108.4.12.11. Provide specifications in accordance with OSSC, Section 1109.15.6 within the revised plans. Suspended acoustical ceiling systems shall comply with the following: 1. Be anchored to resist lateral seismic forces [OSSC, Section 1630.2 and Table 16-0]. Provide suspension wires not smaller than No. 12 gauge spaced at 4" O/C, perimeter wires on terminal ends of cross and main runners at a maximum of 8" from each wall, four No. 12 gauge wires splayed 90 degrees from each other at an angle not exceeding 45 degrees from the plane of the ceiling with a strut centered and extending to the structural members supporting the floor or roof above and spaced 12" on center in both directions starting 6' from each wall, and 2. All lighting fixtures weighing less than 56 lbs, shall be positively attached to the suspended ceiling system [UBC Std., Section 25.213], and 7 3. #12 gauge wires shall be attached to the grid members within 3" of each comer of the fixtures, and 4. Lighting fixtures shall have two No. 12 slack wires connected from the fixture to the structure above, and 5. Ceiling-mounted air terminals or services weighing less than 20 lbs. shall be positively attached to ceiling runners. i. Provide details in the revised plans. 6. T-Bar ceilings shall not be used to support partition walls. A-Boy Phase II Building Plan Review PC#: 2-31c BUP#: 98-0070 Page#3 4' provide Type 2-A fire extinguishers throughout so that the travel distance to an / extinguisher does not exceed 75 feet(UFC Std. 10-1 3.2.11. 6! Provide a key box (Knox) mounted to the exterior wall 10' above finish grade and- adjacent to the right side of the main entry door. The box shall contain keys to gain access as required by the Fire Marshal (UFC 902.41. If you have any questions regarding this requirement, please contact the Fire Marshal at 526- 2502. tl✓ When exit doors are used in pairs, manually-operated edge- or surface-mounted flush bolts are prohibited [OSSC, Section 1004.31. A. Clarify hardware for Door 102A. [Provide revised plans with specifications for automatic flush bolts in accordance with OSSC, Section 1004.3.) The elevator shall meet current requirements of the Oregon Elevator Sper.ialty Code. Provide a copy of the permit application. A. The elevator shall be accessible to persons with diabilities(ANSI 117A, Section 4.101. B. The smoke detector in each lobby shall activate a recall operation. Provide a revised door schedule to include Door#204. �. Store front glazing adjacent to the stairway and landing shall be safety glazing or protected in accordance with OSSC, Section 5406 (d)7. �. No building shall be constructed, altered, enlarged, moved or repaired in a manner that by reason of size, type of construction, number of stories, occupancy, or any combination thereof, creates a need for a fire flow in excess of 3,000 gallons per minute at 20 psi residual or exceeds the available fire flow at the site of the structure (UFC, Section 903.3). A. Provide Fire Flow Testing pursuant to NFPA 291 using the enclosed "Hydrant Flow Test Report Form." a B. Complete the enclosed "Fire Flow Work Sheet" and return a copy to the m City of Tigard, attn. Pians Examiner. Notel These documents shall be on file before a building permit will be issued. co O W STRUCTURAL 1. When special inspection is required by OSSC, Section 1701, the architect or engineer of record shall prepare an inspection program which shall be submitted for approval prior to a building permit being issued [OSSC, Section 106.3.5]. A-Boy Phase II Building Plan Review PCM 2-31c BUP#: 98-0070 Page#4 NKK. Submit an inspection program designating the work requiring special inspection, and the agency who will be responsible for conducting the I inspections [OSSC, Section 106.3.51. li. Complete the enclosed Structural Special Inspection form designating an Approved Testing Laboratory [Line B] and signed by the owner of the project [Line D]. i. The completed form must be returned to this office before a building permit can be issued. ii. Copies of all special inspection reports shall be filed with this office continually during construction. iii. A final signed report must be on file before the occupancy pei mit / will be issued [OSSC, Section 1701.31. i. The building inspection staff will inspect for DF#1 in walls specified on Page D-8 of the engineering. Provide a note in the carpentry category, Sheet S1.0 and on every applicable structural detail. Provide Sheet A4.1 referenced at Line 1, Section 1/A3.0. Engineering for roof beam Line C between Grid 1 and 3 does not correspond with that shown on Sheet S3.0. i W1 Engineering for roof beam #4 is for a 17.5 foot beam, actual size spans 21 feet. Provide correct analysis Sheet R-8. Q' Provide the engineering for determining beam size for drag struts. Engineering for roof framing beam #3 does not include review for cantilevers each end and support of connecting beams. Engineering specifies Simpson HGLBT516 but Keynotes 5 and 6 specify HC2CTA9-7 hinge connectors. (ig The manufacturer's details and specifications for each type of truss and joist must be provided for our review. Submit the engineer's analysis of roof structural members supporting HVAC equipment. �. The attachment of permanent equipment (HVAC) supported by the building's structural components shall be designed to resist the total design seismic forces prescribed in Section 1603.2 of the Structural Specialty Code. 1. Provide an engineer's design specifying attachment requirements [OSSC, Section 106.3.2 and OMSC, Section 304.41. A-Boy Phase II Building Plan Review PCM 2-31c BUP#: 98-0070 Page#5 10J.,/ Determining floor joist size used 100 PSF L.L. + D.I., but only 72 PSF for determining the Glu-lams, Sheet F-3. A. Should the tenant office layout require a fire rated corridor, a floor load factor of 100 PSF is required. Provide the engineering for the lintels on Line A centered on Gild 5 and Line A angled at Grid 7. 1� Engineering for foundation Type W3, Page D-4 specifies different floor loads than in determining floor joist (see page F-2). A. Same with W-4, Grid B. W Same with Column C-2. W. Complete engineering for foundation type F-5, Page D11 and footing type F in Footing Schedule on Sheet S2.0. �1�4J Provide window schedule and specifications within revised plans. Tigard does not recognize the shear wall analysis (APA Report 157) concept proposed in your design. The height of flexible vertical diaphragms shall be measured from horizontal diphragm to horizontal diaphragm. The 1994 OSSC provides no guidance on allowing the height as you have done using APA 157. However, designers have done so, providing calculations for force transfer around openings. The 1997 UBC contains specific guidelines for this approach. Tigard will allow the use of the 1997 UBC as an alternate to the 1994 OSSC. Accordingly, provide design and details for force transfer around openings. 2- Keynote 16, Sheet S3.0 references detail 11/S5.2. Provide a detail that includes requirement for Simpson SSTB anchor. CL 3l Solid blocking and ties similar to that in Detail 8/S5.0 shall be provided to transfer loads for area detailed by 41W.0. Submit engineering and detail. r— rn PLUMBING oJ—p L Provide a drinking fountain on the main floor level [OSSC, Table 5-E). In i LU I addition, provide an accessible drinking fountain in accordance with ANSI-117A _J 4.15. 2v All down spouts shall be a minimum of 4 inches and connected to an approved drainage system. A-Boy Phase II Building Plan Review PC*: 2-31c BUPA: 98-0070 Page 86 MECHANICAL ��. A mechanical permit is required. Submit an application, plans and equipment specifications for review. A. The heat/ventilation system shall provide outside air per occupant in all portions of the building [OSSC, Section7051. 1. Provide outside air specifications on the revised plans. B. Air moving systems (combination of units), supplying air in access of 2000 CFM to enclosed spaces, shall be equipped with an automatic shut- off. [GMSC, Section 608]. C. Each individual roof-mounted HVAC shall be permanently labeled as to the areas it serves [GMSC, Section 305.51. In addition, each unit shall be equipped with a power disconnect. A 120-volt receptacle shall be located within 25' of each unit [GMSC, Section 309.1]. Please submit four copies of revised submittal documents and a letter indicating your response to the above comments for review. Please call me at (503) 639-4171 ext. 390 if you have any questions. Sincerely, Jim Fu PLANS EXAMINER Enclosures c: Doland and Co., Inc. 1919 NE 19th Avenue Portland, OR 97209 CITY OF TIGARD TEMPORARY CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP98-00070 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 07/09/1998 PARCEL: 2S 102AC-00700 ZONING: CBD JURISDICTION: TIG SITE ADDRESS: 12540 SW MAIN ST SUBDIVISION: BURNHAM TRACT BLOCK: LOT:001 CLASS OF WORK: NEW TYPE OF USE: COM OCCUPANCY GRP: B OCCUPANCY LOAD: 250 TENANT NAME: L� REMARKS: TEMPORARY OCCUPANCY FOR /DAYS FROM DATE OF ISSUANCE. Second phase bldg. shell permit and revisions of 5/28/99 adding a hallway and addtional exit to the rear parking lot. Owner: DOLAN + CO LLC 1919 NW 19TH AVE PORTLAND, OR 97209 Phone: 225-9009 Contractor: GRIGSBY CONSTRUCTION INC 8114 SW NIMBUS AVE BEAVERTON, OR 97008 Phone: 641-7343 Reg#: It is understood by the owner/tenant that the issuance of this Temporary Occupancy Pertnit by the City of Tigard forthe use and/or occupancy of the structure located at the site address listed above(hereinafter"structure"), does not grant or convey to the owner or tenant any property right orother protectlole property interest in the use and/or occupancy of the structure for any purpose. It is further understood that this Temporary Occupancy Permit shall only be valid for the number of days from date of Issuance listed above and that the owner/tenant will no longer be authorized to occupy the structure after the period specified,unless 80 until all the conditions of approval imposed under the City's or County's Notice of Decision for the projects land use case(s)issued by the Citys Development Services Department or the County's Department of Land Use and Transportation and/or the Unified Sewerage Agency and all building and rel ed code requirements and any other applicable requirements ave been mplete y fulfil and complied with to the City's or Coo sat' faction. Gid INSPECT INS ION—SOPkRVISOR BUILDING OFFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD DEVELOPMENT SERVICES BUILnING PERMIT 13125 SW Hall Blvd.,Tigard,OR 97223 (503)65x111 PERM I T #. . . . . . . s BUP98-0070 DATE ISSUED: 07/09/98 PARCELS 2SIO2AC-00700 SITE ADDRESS. . . : 12540 SW MAIN ST SUBDIVISION. . . . : BURNHAM "RACT ZONING:CBD BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :OO1 JURISDICTIONSTIG -------------------------------------------------------------------------------- REISSUE: FLOOR AREAS---------- EXTERIOR WALL CONSTRUCTION— CLASS OF WORK. :NEW FIRST. . . . : 5851 sf Ns1HR S: Es WS TYPE OF USE. . . :COM SECOND. . . : 8063 sf PROTECT OPENINGS?---------- TYPE OF CONST. :SN . . . 5 0 sf Ni Ss E: WS OCCUPANCY GRP. sB TOTAL------: 13914 sf ROOF CONST:CFIRE RET?S OCCUPANCY LOADs 250 BASEMENTS 0 sf AREA SEP. RATEDs STOR. S 2 HT: 35 ft GARAGE. . . : 0 sf OCCU SEP. RATED s BSMT?S N MEZ.Z?:N READ SETBACKS-------- REQUIRED--------------------- FLOOR EQUIRED--------------------- FLOOR LOAD. . . . : 100 psf LEFTS 0 ft RGHT: 0 ft FIR SPKL:N SMOK DET. . :N DWELLING UNITS: 0 FRNTS 0 ft REAR: 0 ft FIR ALRM:N HNDICP ACCSY BEDRMSS 0 BATHS: 0 IMP SURFACE: 0 PRO CORRIN PARKING: 0 VALUE. f: _5U653 Remarks: rphase two)of A-boy additions (13,914sq. ft.) Owners ---------------------------------------------- ----- FEES -------------- DOLAN & CO LLC type amount by date recpt 1919 NW 19TH AVE PLCK f 919. 68 JH 02/14/95 95-261695 PORTLAND OR 97209 FIRE f 537. 20 JH 02/14/95 95-261695 PRMT f 1520. 50 B 07/09/98 98-307202 Phone #: 225-9009 SPCT f 76. 03 B 07/09/98 98-307202 PLCK f 68. 65 B 07/09/98 98-307202 Contractor: --------------------------- FIRE f 71. 00 B 07/09/98 98-307202 GRIGSBY CONSTRUCTION INC EROS $ 160. 00 B 07/09/98 98-307202 8114 SW NIMBUS AVE ERPC $ 52. 00 B 07/09/98 98-307202 BEAVERTON OR 97008 Additional fees not shown here. . . . . . . . . ------------------------------------- Phone #: 641-7343 f 28637. 06 TOTAL Reg #. . : 45073 --REQUIRED ACTIONS or INSPECTIONS---- This permit is issued suhject to the regulations contained in the Foot/Found Insp Bolts in concret Tigard Municipal Code, State of Ore. Specialty Codes and all other St ruc Steel Insp Structura1 weld i applicable laws. All work will be done in accordance with Reinf Steel Insp Structural mason approved plans. This permit will expire if work is not started Slab Insp Appr/sdwlk Insp within IN days of issrance, or if work is suspended for more Masonry Insp than 198 days. ATTENTION: Oregon law requires you to follow the Framing Insp rules adopted by the Oregon Utility Notification Center. Those Insulation Insp rules are set forth in OAR 952-881-11818 through OAR 952-"111987. Shear- Wall Insp You many obtain a copy of these rules or direct questions to OUNC Firewall Insp by calling (583)246-1987. Gyp Board Insp Susp Ceitng Insp Reinforced concr Permittee Signature: 6A�Cd_LY ��LNi"� ) Issued By: Call 639-4175 by 7:00 p. m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++.+++++++++++++++++++++++++++++ 2-31� CITY OF TIGARD Commercial Building Permit /� Rec'd By — 1.31 ab>SWIIALL BLVD. New Construction and Additions �1� Date Recd Date to TIGARD, OR 97223 �'1 I 081610 Pq�T - (503) 639-4171 Perrot e(` I IV Print or Type Rallied SWR: Incomplete or illegible applications will not be accepted caftdDZn� V 4 S Name of^-welopmenVmmProject -t- Existing Building'o New B ilding Job '?e rT' -x Address Street Address _ Building 5 yrs I�5 2 ljW I►�1j'-, Data Bldg s City/state Zip Existing Use of Buildin or Prope ZiTioQ(OR R fi �. - Pc, AN, �-f Name Proposed Use ofull ing�r Probe f.� Property VOLP11�t r-0 • t �� -MiL-& r, f t o OF; Owner Mailing Address Suite GV— LO 0 W lart'AAV No. Of Stories: City/Slate Zip Phofie eo R. tmtl E)07 1 ZZS 900 Sq. Ft O Project: Z Occupant "an'• TO 8 F (ZA SEt� Occupancy2lass(es) Name (�7 Contractor 16 KA 5 15"If CON SmcTI e(s) onsjruction , Prior to permit iWiT dress QQ Suite N issuance,a copy SYv NSMN �.. Will this project have a Fire Suppression System? of all licenses Yes 0 No are required if C' /S a Zip P • Americans with Disabilities Act(ADA) expired in C.O T. ��CZ1Tjyi database Gj►�1�1� 1J�t l Valuation X 25% = $ Participation Ore on Const.Cont.Board Lic.s p.Date COm tete Accessibili Form r45 01 2, V�Z Z! Project $ .F L G S 3 Name Valuation ��r r-dG"3 v-#. Architect G I DA �' 3u ' 17 dk-v- Mailing Address Sui Plans Required: See Matrix for number of sets to submit i P2.00 SK) MAA 3 on back i City/State Zi P ne PORTU�1?� �' ZZ 6 (t 1 hereby acknowledge that I have read this application,that the information Name given is correct,that I am the owner or authorized agent of the owner,and Engineer Na IPA plans submitted are in compliance with Oregon State Laws. Mailing Address Suite natu er/Agent Date 5200 NA-MAd ZO o r_ a-'1- w City/State Zip P na ontact Perso ame Phone r (ZTi b oRR� 22fv(z �:, SCP CC, —3 Indicate type of work: New1d Addition O Demolition}i( FOR OFFICE USE ONLY m Accessory Structure O Foundation Only O Alteration O Mapr" Land Use: �- Repair O Other O ".-J A 0 Description of w�o�rkrn p s.� � w T R� 1 p j/'�--� 7C�C �jj(Z � J G PA 0 A tet✓ „0 r� 0AF, r �-rr l U.t/!t ( Notes:' I? ' t G LL- TIF: rp ar�' Estimated s of Em Site Work Permit Application must precede or accomp A�9ullding A Application 1:1COMNEW.DOC (DST) 8197 i COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST EXAMINERS (Note a.) TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 -- -- 3 O,o,u) -- -- B (New or Add) 1 1 -- -- 3 O,o,w) -- -- F (New or Add or Alt.) 3 3 -• -- 36 o,f) M (New or Add. or Alt) 1 I -- -- 20,o) 'B & M (New or Add) 1 1 -- -" 3 O,o,w) -- P(New, Add. or Alt) 2 -- 2 -- "" 26,o) -- B & M & P (New or Add.) 2 1 1 -- 3 O,o,w) 20,o) -- E (New, Add, or. Alt) 2 -- -- 2 -- -- 20,o) B & M & P & E (New, Add) 3 1 1 1 3 O,o,w) 20,o) 20,o) or B&M Alt _ B&M&P;Alt) 3 B&M& P'&F(Alt) 3 N. IF3, KEY. a. Before returning to DST, Plans examiner gets appropriate j =Job B =BUP number of revised plans from applicant, stamps and completes, o=Office M = MEC updates and adds actions. f= Fire P=PLM u=USA E= ELC b. Shaded a�rea�E �'�� k r _ = Wash. County F = FPS w un c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. h Vnatric.Doc l 7 I p� CU G CU .. In N m p N CIL .o :Z - �9 m GGzQ ZEGpt�f1 I HaF- aaWM Ya i UWU > =.. M U crUUCL En z !- Z d E a W I a ° ED W , OW M 1- UI J I 0 w a m r!� w N 1p a a LL N _ I O � mma � a 1 a G .. LL I• p O Q E I a a � ° 1 CL " D o I 1 Cr 3Z 1 z a f 00% W O I a Qi �' G E V,Z u _a .. n. a W z .. mz g j Jv + + + + G fA a I c is J • • ni a I w 5200 SW MACADAM AVENUE, SUITE 420 PORTLAND, OREGON 97201 TEL: 503.216 1285 FAX: 503.226.1670 E-MAIL. OdaOteleport.r om March 12, 1998 City of Tigard Attn.:Jim Funk, Plans Examiner 13125 SW Hall Blvd. Tigard, OR 97223 RE: A-Boy Phase II CIDA Project Number. 97125.01 Dear Jim: This letter is submitted with respect to building permit application for the A-Boy re- development PI-ase 11. Applications for Site Design Review and Building Permits were submitted February 9, 1998, within the time frame specified by the Settlement Agreement The City issued Phase II building plan check comments on March 4, 1998. In order to expedite your review, following is a summary of all the conditions and comments along with the resolution of each. These are also reflected in the accompanying revised permit documents. Phase 11 Pin Check Comments: Site Work. V The Geo-tech report has been expanded to include the building site and is attached. The Program for Inspection Services form is attached, designating Carlson Testing, Inc. as the testing laboratory to perform the inspections Energy Compliance: iJ A lighting power budget for the interior of the building will be submitted with the tenant improvement permit application. Revised plans show details and specifications of the exterior walls with 3-5/8" metal furring at 24"O.C. and R-13 batt insulation,in compliance with Package"B",Table 53-C, IL UBC. p� Revised plans show details and specifications of R-4.5 rigid insulation at perimeter of N building foundation and slab. Firms and Life Safety: V We understand that a final building inspection will not be conducted and a certificate of occupancy will not be issued until the office tenant improvement permit(s) is/are J �� processed. (2J Storage and fixture layouts showing aisle widths will be submitted with the tenant improvement permit application(s). C) deflective ceiling plans have been added to the drawings for the finished spaces-- •ARCHITECTURE elevator lobbies and toilet rooms. •ENGINEERING �B ' Reflected ceiling plan(s) for retail and office spaces will be submitted with the ♦PLANNING ♦LANDSCAPE F:\GENADMIN\PROJECTS\9'\97125\Ph2C,tyResponse.ltrwpd ♦INTERIORS A-Boy Phase II Crty Response March 12, 1998 Page 2 tenant improvement permit application(s). Standard details of suspended ceiling system components have been added to the drawings. Locations of fire extinguishers will be included in drawings submitted with the tenant improvement permit application. A Knox box will be located adjacent to the main entry door, 10' above grade. 0e," Door Schedule/A6.0 has been revised to indicate that automatic flush bolts will be �I provided for Door #102A. r rr lJ When the elevator sub-contractor is selected, he/she will submit an application for an elevator permit. Plans do not indicate Door #204. Clarification of this comment will be required. 9/ Safet glazing will be provided at all locations requiring protection. FI ow: Fire Row Test results are attached, on the "Hydrant Flow Test Report Form". "Fire Flow Work sheet" is attached. Stnictural: I A separate letter is attached. PI bing: 1,1 Two drinking fountains have been added to the drawings at the first floor Lobby. One drinking fountain is handicapped-accessible. �! Detail 6/A5.0 has been revised to state that downspouts shall be 4", minimum. Mechanical: JI When a mechanical sub-contractor is selected, he/she will submit an application for a mechanical permit. Plan Review comments have been forwarded to the contractor. Four copies of revised drawings are attached. Thank you for your assistance in processing these permits. YIrs Truly, Linda C. Wall Architect CL Enclosures N LW\de cc: D. Dolan J.Shonlrweiler m B.Ward,Grigsby Construction M.Roberts,City of Tigard W B.Rager,City of Tigard .J D.Welsh,CIDA G.Livermore,CIDA L.Stout,CIDA F\GE NA DM IN\PROJECTS\9 7\97125\Ph 2 COyResponse.Kr.wpd • .5100 SW MACADAM AVENUE, SUITE 410 PORTLAND, OREGON 97201 TEL: 503.126.1285 FAX: 503.226.1670 E-MAII.: cida@teleport.com March 5, 1998 City of Tigard Attn:Jim Funk 13125 S.W. Hall Blvd. Tigard, OR 97223 RE: Structural Plan Check Comments A-Boy Phase II--12540 S.W. Main Street Project Number. 97125.01 (BUP#: 98-0070) Dear Jim: The following is in response to your structural plan check comments, dated March 2,1998, for the above-captioned project The items below correspond to the numbering in your plan check letter. kA. Refer to attached Special Inspection program on sheet S 1.0. 06. -Refer to attached completed Structural Special inspection form. lY Refer to revised StrucfmW General Notes on sheet S 1.0 and notes on revised drawing sheets S5.0, S5.1 an4 S5.2. This is an architectural item. Refer to architectural response to comments. Beam called out on drawings (8 3/4" x 31,5"glulam) has been upsized from calculated sized of 6 3/4" x 31.5'glulam to match width of beam it frames into to the south--refer to comments on revised calculation sheet R-6. Camber is acceptable as calculated. Refer to attached revised calculations sheet R.-10. Beam size has been revised--refer to roof framing plan for new size. V Refer to attached calculation sheet R-I I and F-I I CL_ Y! Refer to attached revised calculation sheets R-6 and R-7 and new calculation sheets R- N 12 through R-16. !�l Use Simpson HC2CTA9-7. Refer to attached revised calculation sheet R-6. m � r� J9{ Details and specifications for prefabricated wood trusses will be submitted for review and approval prior to fabrication as a deferred submittal, per Oregon Structural Specialty Code, Section 106.3.4.2. ♦ARCHITECTURE 9B Building mechanical is design/build and has not been accomplished at this time. The ♦FNGINEFRING ` - structural support of permanent equipment (HVAC) will be submitted for review and •PLANNING ♦LANDSCAPE F:�GENADhllN\PRgE TS\97\97125\03-OS-98Sov.wpd ♦INTERIORS A-♦oar,Man Check Comment Much 1 I,1998 Par 2 approval as a deferred submittal, per Oregon Structural Specialty Code, Section 106.3.4,2. 110. Floor design live loads have been reduced to 72 PSF for beam design as per 1990 Oregon State Structural Specialty Code,Section 2306. Refer to calculation for live load reduction on calculation sheet F-3. Refer to attached revised calculation sheet F-9, new calculation sheet F-12, revised detail 4/54.0 and new detail 3/S 1.0. The span for the lintel centered on grid line has been reduced to 14'-8" to match the typical lintel (see floor plan for revised dimensions). Calculation sheet F-12 is provided to show the cut-off point for lintels without shear / reinforcing, V The floor loading used for wall W3 on calculation page D-4 matches the design loads use for the floor joists on calculation sheet F-2. The floor dead load is 16 PSF and the floor live load is 100 psf. The tributary areas vary in the designs. I kA. Please refer to comment in item #12. I V Floor design live k ds have been reduced to 72 PSF for the column design as per 1990 Oregon State Structural Specialty Code, Section 2306. M Refer to revised calculation sheet D-I I and revised footing schedule on sheet S2.0. C4) This is an architectural item. Refer to architectural response to comments. SHEAR WALL_ANALYSIS kyRefer to attached calculations. 42- Refer to revised keynote 16 ons sheet 53.0 and revised detail 7/S5,2. $: Refer to revised detail 4/S5.0 and attached calculation sheet L-13. Thank you for your comments. Please call if you require additional information. Sincerely, 3 0A . LUA4A*'/U- Gary MlUrTnore, P.E. J Principal Enclosure cc: David Welsh,CIDA Linda Wall,CIDA File FIGENAD4N\PRQF(707\91125�03-05.98_1ovwpd March 17, 1998 CIDA CITY OF TIGARD 5200 SW Macadam#420 Portland, OR 97201 OREGON RE: A-Boy Phase II Building Plan Review 12540 SW Main St. PC#: 2-31c BUPO: 98-0070 Resubmittal documents for the above referenced project have been reviewed for conformance with the applicable Oregon Specialty Codes and other applicable codes and standards. The following comments aro noted: Some sheets in your resubmittal documents are stamped "preliminary, not for construction." Submit new y construction ready documents. Item 1 of Site Work- nr� A. Complete the enclosed Special Inspection Program for geo-tech inspection recommended by Geo- Tech Design, Inc., in their January 28, 1998 report. 8! Item 1 of Energy requirements and Items 2, 3A, and 3B of the Fire and Life Safety requirements are deferred to the Tenant Improvement Permit. A certificate of occupancy for BLIP 98-0070 will not be issued until all requirements of the Tenant's Permit are completed and approved. J Item 4 of the Fire and Life Safety requirements - the building shell shall have portable fire extinguishers placed throughout the building so that the travel distance to an extinguisher does not exceed 75 feet. t These can be temporarily located until the T.I. Is complete. i �. Items 3 and 14 of Structural requirements were not addressed by the engineer as they are about A-Sheets. Please provide. xThe upper 18 inches of a parapet must have non-combustible faces. See detail 4JA4.0. Fire retardant wood may be used. Please submit three copies of revised submittal documents and a letter indicating your response to the above comments for review. Please call me at(503)6394171 if you have any questions. CL � Sincerely, vA Jim Funk J PLANS EXAMINER m L9 w c: Dolan and Co., Inc. -� 1919 NW 19th Avenue Portland, OR 97209 Enclosure 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 ♦_ COUNTYWIDE TRAFFIC IMPACT FEE APPEAL INFORMATION Attached Is a copy of the Director's decision on this Traffic Impact Fee assec iment or Traffic Impact Fee Credit/Offset request. This decision may be appealed and a public hearing heli by fling a signed petition for review (appeal) within fourteen (14) calendar days of the da en notice Is provided (data male . d) APPEAL PERIOD: Date mailed: to 5:OOPM on 2—Z1-��_. Appeal Due Date A motion for reconsideration also may be fled within seven calendar days of the date written notice of the decision is provided (see Section 208 of the Washington County Community Development Code). A motion for reconsideration does not stop the appeal periods)from running and Is avalable only as an extraordinary remedy for who a -istake of law or fact has occurred. A motion for reconsideration requires a fling fee of$I _. This decision will be final If an appeal Is not fled by the due date(s), and a motion for reconsideration is not granted by the Director. The complete fie is available at tS u _for review. A petition for review (appeal) must contain the following: 1. The name of the applicant and the relevant casefle/building permit/other development permit number; 2. The name and signature of the petitioner fling the petition for review (appeal). If a group consisting of more than one person is fling a single petition for review, one Individual shall be designated as the group's representative for all contacts with the Department. All Department communications regarding the petition, including correspondence, shall be with this representative; 3. A statement of the interest of the petitioner; L 4. The date the notice of decision was sent as specified In the notice; 5. The petition for review (appeal) shall state the relevant facts, applicable ordinance e provisions, and relief sought; and 6. The fee of$625.00 for Director's decisions being appealed to the Washington County 3 Hearings Officer. 0 i U / � l For further appeal Information contact: ` 9 l WWI CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4176 / Business Line: 639-4171 ® _ as 70 Date Requested 4 SL 6y AM PM BLD Location 2A54 Q Suite MEC Contact Person Ph PLM Contractor Ph SWR UILDI Tenant/Owner ELC Rrfflnrn-g Wall —T ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SON Slab — SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear "'� 0 Ssk.� Framing Insulation l� Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: na AFNSS>_PART FAIL PtVMING Post&Beam -- Under Slab Top Out Water Service Sanitary Sewer —— - Rain Drains _ Final — PASS PART FAIL MECHANICAL Post&Beam Rough In Gas Line Smoke Dampers r Final — PASS PART FAIL ELECTRICAL —•-�T - a. Service Rough In -- U) UG/Slab Low Voltage - Fire Alarm CY_ J Final m PASS PART FAIL W SITE "t Backfill/Grading Sanitary Sewer Storm Drain [ )Reinspection fee of$ required before next inspectioo. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( )Please call for reinspection RE: _ [ j Unable to Inspect-no access ADA Approach/Sidewalk 0 6 Other _ Date _ Inspector ExtaA 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: 639-4176 Business Line: 639-4171 —Date Requested Requested �2��U Q � PM BLD Z�'� Location 1177��r `-'V�/\Gw✓�- Suittems ME F i � " S� Contact Person `��-✓�– Ph�G7- �� PLM _ Contractor_ Ph SWR BJUILD_TpTenant/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 � r+�A L Framing y� � Ys Insulation Drywall Nailing IL lk t2 loop Firewall , 0 Fire Sprinkler _ Fire Alarm Susp'd Ceiling - % �— Roof Ph _ Mi in ASS PART At - �— - ----- PLUMBING - -� ---tom Post 8 Beam � � _ Under Slab —�rL-Z.3a41r7C7� ' Top Out Water Service I_ Sanitary Sewer Rain Drains — Final 1 • v k ,f +wry PA PART F I ��i___ —__C+ _ � 'l • /r CHA AL TTUXTeam - Rough In Gas Line Smoke Dampers '— S PART FAIL - =— _- �. TRICAL _ p Service Rough In �:1u'•�..- �r� ^\ �"'-�— UG/Slab Low Voltage � Fire Alarm 1'/ � -- Final PASS PART FAIL — SITE Rackfill/Grading Sanitary Sewer C) d Storm Drain [ ]Reinspecion fee of$_ required before next inspection Pay al City Hall, 13125 SW Hall Blvd Catch Basin reinspection RE: _ I ] P Fire Supply Line [ j Please all for reinsp_A _. Unable to inspect no access ADA VLk _A Approach/Sidewalk Date �J �� b U Inspector -�_ EXt� Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job alts. Elevator Inspection Report Supplemental Inspection Form f 'w Department of Consumer& Business Services Building Codes Division, Elevator Safety Program 1535 Edgewater NW, Salem, OR 97310 (503) 373-1298. Fax: (503) 378-2322,TTY: (503) 373-1358 Inspection date: , 1' Intpeedo�h'Pas Site name: / !•',� _ -� Q Annual �_ Elev. ID no.• Address: _ Bldg. no.: G i&-inspection Phone: _ U Acceptance Ci ST. 1,? . - 7IP:"' r, � � Ref. insp. no.: ,,Construction City: �. . Travel time: - -- hr. U provisional Address irorrectioti! J Yes 01+10 - _ hr. Insp. time: a Special 0 Bill for: _ hr. Same as above C] Inspection results: R/P name: '[.% .l, ; :� � % Wr!(ausfactory: Operation permitted Address: 'i ZV_ /0 A ll' 0 Unsatisfactory: Do not operate(see corrections) Phone: U Inspection requirements: Conditional operation ST:(�' zip:" ~�.�% U Provisional permit;expires: --- I Y_ . a K J Inspector: �. r No: Bill to: Elevator contractor:, Company: Owner/owt1r's rep.: Company: R White-BCD Yellow-Inspector Pink-Elevator contractor Blue-Owner/Oweers's representative 402613(I M OM) Page of