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12571 SW MAIN STREET-1 IS NIVW MS I L9Z6 T lid 1' I N N a z r� _ e— m 0 N W r" 12571 SW MAIN ST CITY OF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2005-00103 24, 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: •4/51/2005 PARCEL: 2S 102AC-00900 ZONING: CBG JURISDICTION: TIG SITE ADDRESS: 12 i71 SW MAI 11 ST SUBDIVISION: BLOCK: LOT: CLASS OF WORK: ADD TYPE OF USE: COM TYPE OF CONSTR.- 5N OCCUPANCY GRP: S2 OCCUPANCY LOAD: 1 TENANT NAME: AVES LAB ADDITION REMARKS: 150 square foot storage room addition. Owner: GARY CIMENT 11607 SW 27TH AVE PORTLAND, OR 97219 Phone: 503-598-8766 Contractor: ARCHITECTURAL INVESTMENTS 10324 NE HALSEY#2 PORTLAND, OR 97220 Phone: 503-761-9700 Reg#: LIC 158906 IL oc f- r) t J_ to WThis Certificate issued 6/13/2005 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with t e Stat f Oregon Speclaltft Codes fo the group, occupancy, a nd r h r r n d permit ed. BU MPECTCYR BUILDI G FFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING DIVISION PERMIT#: El-C2005.00316 13125 SW Hall Blvd., Tigard, OR 97223 MATE ISSUED: 511712005 Phone: (503) 639-4171 Inspection Requests (24 Hr,.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6/3/2005 TIME: 7:09AM PAGE: 57 SITE ADDRESS: 11571 SW MAIN ST CLASS OF WORK: SUBDIVISICIN: LOT N: TYPE OF USE: PROJECT NAME: AVES LAB ADDITION DESCRIPTION: (3)branch circuits. OWNER: CIMENT, GARY PHONE C 503-596.8766 CONTRACTOR: PERFORMANCE ELECTRIC PHONE #: 503 1680 Inspection Request Scheduled For: Date: 6/3/7005 Pour Tim,): Code # Inspection Description Confirm # Contact # Message 1,49 Electrical final 008331-01 5036581680 Y Corrections/Comments/Instructions: a L.�-0 L a J_ m W J L. PASS ❑ PARTIAL APPROVAL_ ❑ CANCEL NO ACCESS AIL [_] CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _:- ; �-' . Date: —L.5 Phone #: (503) 718- Y DELECTRICAL PERMIT CITY OF TIGARD PERMIT A: ELC2005-00316 DEVELOPMENT SERVICES DATE ISSUED: 5/12/2005 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171 PARCEL: 2S102AC-00900 SITE ADDRESS: 12571 SW MAIN ST ZONING: CBD SUBDIVISION: LOT: JURISDICTION: TIG Project Description: (3)branch circuits. RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMPIIR . EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL: MANF HM/SVC/FDR: 601+amps-1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: WiSERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amp/volt: —4 RES UNI S: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>■225 AMPS: CLASS AREAISPEC OCC: Owner: Contractor: GARY CIMENT PERFORMANCE ELECTRIC 11607 SW 27TH AVE 14674 SW SUNNYSIDE Rb#170 PORTLAND,OR 97219 CLACKAMAS,OR 97015 Phone: 503-598-8766 Phone: 503-658-1680 FEES Reg#: LIC 161535 ELE 3-582C Description Date Amount SUP 4210S (ELPRM'1'1 ELS'Permit 5/12/2005 $60.15 (TAX] 8%State Surcharge 5/12/2005 $4.81 REQUIRED ITEMS AND REPORTS Total $64.96 I l-_ J 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 18P ays. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-uJ1-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at 503-246-6699 or 1-800-332-2344. IL Issued By: ifs f Permittee Signature: OWNER INSTALLATION ONLY U) The The installation is being made on property I own which is not intended for sale, lease,or rent. OWNER'S SIGNATURE: DATE: m U' CONTRACTOR INSTALLATION ONLY W -- — J SIGNATURE OF SUPR. ELEC'N: _ DATE: LICENSE NO: Ca►I 503-639-4175 by 7:00 a.m.for an Inspection that business day. This permit card shall be kept in a conspicuous plate on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. MAY 12,2005 12:40 PERFORMANCE ELECTRIC 503-558-1949 Page 1 12,2C,•2004 17:11, (lutlt1I)"Ntlll(l 6E ill Eltcteical Pcrgnit ApRlicsltion C ity of Tigard !1 Or 11125 SW 11eI1 Hlv/, I ryrJ,(Ill V77.'.iAi - �`- Ilrlr Vacwn pfi ele tin 1614 a 171 ray ?U.I 57r.1'1GIl —. 1w - latpo"In IM � Ill,1a14 4115 r 1' Intnrrtt www aLllpl.d ur u� "� ..-+-' IWleY.le/e. TYR ON wow PLAN usvt�wr _ C] New cunrtrtrttern talilirrnrWlleroliuNrtpinCetnMN - -^ Ail aw opp�L)%wv oe liver 2n at"."awn'l rjl lesardrru.lf)cnl,rn ❑tk mohulal -�]<Xher: --- _ ❑%mvkx ava 310 emru-rating 1311wIIdnll(ca(II.IIUI)vy a -_»•. CA _Y_OF IJpO7lllClttnlll .. „r 1-few 2 lardy dwellmit. 4,»rru.rc rKw rgilemul ❑�yaletn mrr lip)vote nunNrtrl rant in 44K etnwlun []I-Wild 2-linnly Jwellinp nmrtlerclWinJlnlriWl ❑A(1�llFtwV IwIWinR ❑I�rejeta,61tDompa,a'I"t � []11ui1r1irrlw two dxK Mr.elr. 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I llh,tl� �Ot1rfRTM 401 armps Lu W Nor IMI MI 2 ^lemt• a' _�. v'v�.2 r)'V- 60 .n -d10.Armia— Addres-; �J rw�I.00ae�rN..�alw _ awe _-- -__ --_ It .~nilly Ih1 I t+x " 2 ClIN/`;lege!/.I I> Temporary rer•vim o►twiers MnriY�Ww slfenMnn.e.drri "Amde. Mom 1 1 — TFWc I I _ Mo)arrest or Itst _ x.Jl� I (IeY.M INull.tl0.:Thia ilw,x1111Mtion le being rude on pruperry rhu 1 own whie.it la nett 2111 Wltlpa M�Wn Wil +— IIMI.lII 7 inteMlcd Inr%mic.Icx%c.milt,lw cKillanKe,.Coarding to Opti 447,4419,6V Will 701. Ion W_601)MR* Own��ei flullnro - - _ —__- I hue: - - 1)1Woeb elrr.lrr-.ew.tdknqu.r or eete.eltrW� purl [] A"[W-Altf T - � ❑ CMTACF I MW it Fee mit-M�cicuMe n -'-- a im M Ibaler tragi,via. � - h bi 1 Hrtuner,s nWmt: hrt.lclr t-Im.it _—. fir hind criumm t'nlllet:l Fiume: wirlkt.t"nim tK IEeder iee• '/C•X 1 Ad•Utty _- Vach UN'1 Manch cirael ul 6ir+ � �— 1'ity'tisetc//11' -- MMerMrnMwfear-fear-AM lw IllaMvat ct iWt4.Aed-1 ......_. 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'� -- 1'hn micw l25%ont petmo tcul Supty 1:kttnuan agnrture rctiuin -- __ --_ .., ....__`----_' tilgrl eu►dlWeee 1�of •inn In:I i' -� "M nine. \ I91, ��•- -. t� Si4nl'AI.M:N941TFIT CD AIAlI1rH�ed riiinw:Il:r-- . . l„ _ ._,�. � �.� �p�t�taeir■Iw.ipfrr�-p't.I'�..t-.rt.w1.�-iii .{ / ••rat nrMtYrk er eu ry'rr►l:nlrray nwbrrq In1�.Ir.4•• rwaca J prim nantc. t K W�LI i►w rr r' 7A 44 l 0.1 , ....._... ...�a.�i� =•s`•= ._ -S .• NaMNMin,rcUnntewenrnnMkMwl .de�►4�,)..NYlI 1'\feal.il•r•1.v I,/r1r aUF�aI�l111W]At1aVM7T ur•fi 26_`00a t0: to W.NNINW; !)17NAL1) 0000000000 I>ng 1 CITY OF T I G A R D SITE WORK PERMIT DEVELOPMENT SERVICES PERMIT# : SIT2005-OOOu6 13125 SW Hall Blvd.,Tigard, OR 97223 503-639-4171 DATE ISSUED : 4/11/2005 PARCEL: 2S102AC--00900 SITE ADDRESS: 12571 SW MAIN ST ZONING : CBD SUBDIVISION: LOT: JURISDICTION : TIG Project Description: Site work for 150 square foot addition. CLASS OF WORK: ADD PAVING ?: N RESO. NO: TYPE OF USE: COM GRADING ?: Y VALUE: 1,200.00 EXCV VOLUME: 8 cy LANDSCAPING?: N FILL VOLUME_: 0 cy SITE PREP ?: U ENG FILL?: N STORM DRAINS?: U SOILS RPT REQD?: N IMPERV SURFACE: 150 sf Owner: FEES GARY CIMENT Description Date Amount 11607 SW 27TH AVE [1311PI11,N) Pin('k-Valu 3/17/2005 $40.63 PORTLAND. OR 97219 [FLS] FLS Pln RN. 3/17/2005 $25.00 [BUIL,)] Prmt Fre-Valu 4/11/2005 $62.50 Phone: 503-598-8766 [TAX] Valu 8%,State Surcharg 4/11/2005 $5.00 Total $133.13 Contractor: ARCHITECTURAL INVESTMENTS 10324 NE HALSEY#2 PORTLAND, OR 97220 Phone: 503-761-9700 REQUIRED ITEMS AND REPORTS Reg#: LIC 158906 IL oc U) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and J all other applicable laws A1 work will be done in accordance with approved plans. This permit will expire if work is not m started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION: Oregon law requires t9 I you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001.0100. You may obtain copies of these rules or direct questions to OUNC by calling 503-246-6699 or 1-800-332-2344. Issued By: #-Lj _ Permittee Signature: U Call 503-639-4175 by 7:00 a.m.for an inspection that business day. This permit card shall be kept in a conspicuous place on the jcb site until completion of the project. Approved plans are required on the job site at the time of each Inspection. P 7 air Site Work. .� E:l�r�—C' V I\ /ED -e (, r Building Permit Applicgt on City of TigardA / ( 1 "7 ? Received Permit No 1317.5 SW Ifall Blvd..Tigard,OR 97123 ��N11 Plan Revie Phone: 503.639.4171 Fax: 503.599 1960 1hIr1By. Other Permit Inspection line: 503.639 4175 111 i '��' Date Ready/By ) 0 !lee Pose 3 for Internet: www.ci.tiprd.or.us ' NcRi ethrxl t3rppleosralldar�aMaa TYPE OF WORK R461,11111111W DATAt t•AM 2.11PAM1LY_ID*UA QIIG ❑New construction ❑Demolition Permit fees*are basod on the value of the work performed. -- -- Indicate the value(rounded to the nearest dollar)of all Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF cON917RUCTION work indicated on this application. ❑ I-and 2-family Dwelling (Commercial/industrial _Valuation: S ❑Accessory building ❑Multi family Number of bedtooms: ❑Master builder ❑Other: Number of bathrooms: JOB 81TE INFORMATION AND LOCATION Taal number of floors: Job site address: 12 j 7 I e New dwelling area: square feel City/State/71P: ) C �- L 2 3 Garage/carport area: square fat Sui4ve�l L,4-6 -,,'`/)/77e Covered porch area: square feet Cross street/directions to job site: Deck area: J square feet C/" Al^ J-j Other structure area: square feet -- RQQUtRED DATAt COMMERCIAU4111112 CHECKLIST Subdivision: I,ot no.: Permit fees'are based on the value of the work performed. Tax map/parcel no: Indicate the%,nine(rounded to the nearest dollar)of all —_—_ equipment,materials,labor,overhead,and the profit for the Cyt oFscRIPTION OFF`W�O`RK� indicated on this application. --� �y S•�- G+;��o�l 77 Q� nation: _ S� - Existing building area square foci New building area: A square fat PROPERTY OWNER -� ❑ TENANT Number of storier _ Name: re !C' Type e of construction: � vo?vt,'I' — -- -- Address: / 2 et `Yl Occupancy groups: City/State/71P: Tti elk--,,r{ D R -1-7 ZZ Existing: Phone: �(-7 N G Fax:( ) — New. _ 14 APPLICANT ❑ CONTACT Damm NOTICE Business name: Q u All contractors and subcontractors are required to be Contact name: gG(a j'f P e�._ licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the L Address: S s 3 j I � f 2 Qy� — — jurisdiction in which work is being performed. If the City/state/7'113: J ti, t �� applicant is exempt from licensing,the following reasons e1rE!Y_:_ Phone:( ) Z CSS Fax: lyln E-mail: �5 cC j -- 9 Business name: G —�dc�� t�e- t kL v �/1 cj P ae )(-s PERMIT FEW J Address: L 5G!/1itPleasr�. refer to jee.tebrdwlr. City/State//.IP` dy ( o� ej�-7 Z 2- 6 Fees due upon application -�—u— Phone:;jS >) /V -cl W D Fax.( ) Amount received ('CH lie.: ✓7 �� Date received. Authorized signature: 6 �; This permit application expires If a permit M not obtained within I89 days after It has leen accepted as complete. Print name: ` FQ Date: DS _ • Fee methodology'�^ � 7 gy set by Tri-County Building Industry Service tiroard i\nuildinp\Permits\SIT-Pe milApp dnc 12/03 /164613T(11/02/C0M/WFR) or r � City of Tigard: Site Work Permit Checklist Page 2 -Supplemental Information Commercial. Multi-Family and One-and Two-Family Dwellings: No permit is required if fill is less than 50 yards(5 uurrp truck loads),or less than 3 feet deep and will not be supporting a structure. If building will be constructed on the fill, it must be engineered Fill. If fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review (SLR). Please complete all items below, unless otherwise noted. Excavation Volume: _ �{. cu. yds. Grading Volume: Soils report required for>5,000 cu. ds. cu, yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90%of maximum densith.�) a cu. ds. Retaining structure? (Check one) ❑ Rock G0ticRd-z?- W6-A0 Pdtt2 ❑ CMU F u Concrete �SHN�4 L?7 �jJ 1,ert�TD C ❑ Other: *Total new impervious area including all buildings, sidewalks, and paving: sq. ft. Site Utilities Plumbing Work: Complete the Plumbing Permit Application for site utilities plumbing work. Plans Required: See"Site Work Permit Application - Plan Submittal Requirements" attached. The following must accompany this aplication: Site Plan with Vicinity Map showing L1 *Parking(including ADA)and ADA compliance _ L' hong PlanN Li _ Grading Plan and details *Landscaping Plan Erosion Control Plan and details TI[�_,_)ils Report if required) _ _T Retaining Structures *Does not apply to One- and Two-family dwellings. a 0 SMU TYPE OF SUBMITTAL Req*hvd at rn Inchides_New,Additions or Alterations lubyibW GO Commercial 2 W J Multi-Family R-i Occupancy 2 Once- & Two-Family Dwelling 2 i:\Rtiilding\FormslclT-PerrnitApp.doc 1/13/04 2 April 8,2005 Design Intelligence CITY OF TIGARD Bob Steele 15532 Jantzen Ave OREGON Portland, OR 97217 RE: AVES LAB STORAGE ROOM ADDITION—SITE REVIEW Pr-qiect Information Site Permit: SIT2005-00006 Construction Type: V-B Tenant Name: Aves Lab Occupancy Type: S2 Address: 12571 SW Main St Occupant Load: 1 Area: 150 sq. R. Stories: I The plan review was performed under the State of Oregon Structural Specialty Code (OSSC)2004 edition; and the Tualatin Valley Fire& Rescue Fire&Life Safety t Requirements for Fire Department Access and Water Supplies(Based on the 2003 International Fire Code as amended by TVF&R). The submitted plans are approved subject to the following. EROSION Erosion control measures shall be in place prior to excavation or grading. ACCESSIBILITY Accessible walkways and routes shall not exceed a running slope of 1 unit vertical in 20 units horizontal (5% slope). Cross slopes shall not exceed I unit vertical in 50 units horizontal (2% slope). Approved Plaps: 1 set of approved plans, bearing the City of Tigard approval stamp, shall be maintained on the jobsite. The plans shall be available to the Building Division inspectors throughout all phases of construction. 106.4.2 OSSC L Premises Identification: Approved numbers or addresses shall be provided for all new K buildings in such a position as to be plainly visible and legible from the street or road fronting the property. 3 When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City U of Tigard in tracking and processing the documents. J lke I� 'Val Henzel,Semor Plans Examiner 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 February 8, 2005 RECEIVED ` MAP, 't 7 2005 CITY OF TIGARD Design Intelligence CITY OF TIOARC OREGON Attn: Bob Steele BUILDING DIVISION 15532 Jantzen Avenue Portland, OR 97217 Dear Mr. Steele: This letter is in response to your request for Minor Modification (MMD2005-00001) approval to construct a 154 square foot addition to the existing building located a. 12571 SW Main Street/Aves Lab Addition, WCTM 2S102AC, Tax Lot 00900. The Tigard Community Development Code, Site Development Review Section, states; "if the requested modification meets any of the major modification criteria, that the request shall be reviewed as a new Site Development Review appliration." Section 18.330.020.B.2 states that the Director gha1i determine that a major modification(s) has resulted if one (1) or more of the changes listed below have been proposed: 1. An increase in dwelling unit density or lot coverage for residential development. The proposal does not involve residential property. Therefore, this standard does not apply. 2. A change in the ratio or number of different types of dwelling units. This criterion is not applicable, as this request does not involve a residential development. 3. A change that requires additional on-site parking in accordance with Chapter 18765. Additional on-site parking is not required as a result of this proposal. Based on the use associated with thesubJ.ect site, the total number of required parking stalls for the site is five. There are a total of five parking stalls, all of which are located on-site. There` :re, this standard has been met. 4. A change in the type of commercial or industrial structures as defined by the Uniform Building Code. No change in the structural occupancy type of the building is proposed. Therefore, this criterion is not applicable. 5. An increase in the height of the building(s) by more than 20 percent. The building ..� height will not be increased as a result of this proposal. m W 6. A change in the type and location of accessways and parking areas where off-site _J traffic would be affected. This request wi!I not require a change in accessways or parking areas where off-site traffic would be affected. Therefore, this criterion does not apply. 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD (503)684-2772 Page 1 of 2 7. An increase in vehicular traffic to and from the site and the increase can be expected to exceed 100 vehicles per day. This modification will not generate more than 100 additional vehicle trips per day according to the 5 h edition of the ITE Handbook. Therefore, this criterion does not apply. 8. An increase in the floor areas proposed for a non-residential use by more than ten percent excluding expansions under 5,000 square feet. The proposed expansion is 154 square feet. Therefore, this standard does not apply. 9. A reduction in the area reserved for common open space and/or usable open space that reduces the open space area below the minimum required by the code or reduces the open space areas by more than ten percent. The modification will not affect landscaping or open space. 10. A reduction of project amenities (recreational facilities, screening; and/or, landscaping provisions) below the minimum established by the code or by more than ten percent where specified in the site plan. The change of use will not reduce project amenities. 11. A modification to the conditions imposed at the time of Site Development Review approval that is not the subject of criteria (B). 1 through 10 above. Staff conducted + a search of City records and found no original land-use approval associated with this property. Therefore, this standard does not apply. THIS REQUEST HAS BEEN APPROVED. PLEASE SUBMIT A COPY OF THIS LETTER WITH YOUR PROPOSED MODIFICATIONS TO THE BUILDING DEPARTMENT. This request is determined to be a minor modification to an existing site. The Director's designee has determined that the proposed minor modification of this existing site will continue to promote the general welfare of the City and will not be significantly detrimental, nor injurious to surrounding properties provided that, development which occurs after this decision complies with all applicable local, state, and federal laws. If you need additional information or have any questions, please feel free to call me at (503) 639-4171, ext. 2437. a Sincerely, 01m Mat ew S'cfiieideg er W Associate Planner J I\curpin\mathew m1nmod\mmd2005-00001.dec c: MMD2005-00001 Page 2 of 2 SUMMARY: ��`h '- DESIGN ') 0'-F3"X 14'-0"ADDITION FOR STORAGE STORAGE ROOM ADDITION FOR: R��' r r INTELLIGENCE ' OCCUPANCY: 'B' , SCIENTIFIC LAB AVES LABS ROBERT STEELT 12571 SW MAIN ST. 17 2005 CONSTRUCTION TYPE: 5 --1 (WEST WALL) PSI Z TIGARD OR 97223 MAR 1553 N.jantUm Aur. • • 5 - N SOUTH WALL ADDITION = 150 SQ '7FT. ( � 0V �` Portland, OR 97217 BUILDING SQ FT W/ADDITION: 2241 (�G7 �1 1 / o -2r4e 13U ILOINL' D1 503-247-3073 42- I ZI SFr 41(.04 P A R K I k cc X .a 3 Row Is►�vsp,�AR _ P,c s s��A✓,g ry rr�-rPAN PA-D`�s --—�- 2T C��`-'''ya� -- CITY OF TIOA D P PAVE D �-�� z. �, Fete P�4n' � � Approved..........�..�.................... ..r..(��: t `� ........... 4' rim Conditionally Approved................. ..................( ) For only _ L.4-Iv DSG,�rP�` hREA ____. - — v the ►11�.�L12�-- � QC2G�.—._.. ` � --..- _ _ --.--�.__. __ _ _ PERMIT NO.. _ See letter to:Follow..•................... . ..........,,....( ): 479-A Job Ad a ' �- J ' Ft �c N yi��/�- ''----- OFFICE COPY � C� A N _ BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2005-00103 DEVELOPMENT SERVICES DATE ISSUED: 4/11/2005 13125 SW Hall Blvd., Tigard, OR 97223 503-639-4171 PARCEL: 2S102AC-00900 SITE ADDRESS: 12571 SW MAIN ST ZONING: CBD SUBDIVISION. LOT: JURISDICTION: '1-IG Project Description: 150 square foot storage room addition. REISSUE: FLOOR AREAS LXTERIOR WALT_CONSTRUCTION CLASS OF'WORK: ADD FIRST: 0 sf N: NR S: NR E: 1 HR W: NR TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N 0 sf N: N S: N E: Y W: N OCCUPANCY GRP: S2 TOTAL AREA: 0 sf ROOF CONST: B FIRE RET? N OCCUPANCY LOAD: 1 BASEMENT: sl AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REOD SETBACKS REQUIRED FLOOR LOAD: 50 psf LEFT: ft RGHT: ft FIR SPKL: N SMOK DET:N DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING: VALUE: $ 15,000.00 Owner: Contractor: GARY CIMENT ARCHITECTURAL. INVESTMENTS 11607 SW 271 H AVE 10324 NE HALSEY#2 PORTLAND, OR 97219 PORTLAND, OR 97220 Phone: 503-598-8766 Phone: 503-761-9700 FEES Reg#: LIC 158906 Description Date Amount REQUIRED ITEMS AND REPORTS 11311PPLNj Illi Rv 3/17/2005 $121.75 I Bolts in concrete FLS] FLS 1'In R� 3;17/2005 $74.92 I Special inspection (see pla (HUILDj Permit Fcc 4/11/2005 $187.30 TAXI 9"', Slate Surchm 4/11/2005 $14.98 Total $398.95 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes t and all other applicable law. All work will be done in accordance with approved plans. This hermit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENT!ON: Oregon law i requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are s1�t forth in OAR 952-001-0010 through OAR 952-001-0100. Yot• may obtain a copy of these rules or direct questions to OUNC by calling 503-246-6699 or 1-800-332-2344. t Issued By�;r� Pern Signature: Call 503-639-4175 by 7:00 a.m. for an inspection thai business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inrapection. tk /957/ S w mi,, s� Building Permitns v ED City of Tigard Dat y PermitNo.: 13125 SW liall Blvd.,Tigard,OR 97223 1 ^I Plan Review Phonc: 503.639.4171 Fax: 503.5981*,, I I Date/By: yr Other Permit: Inspection Line: 503.639.4175 Date Reedy/By: 1uri� ® Nee Page 2 for Internet: www.ci,tigard.or.es (iA� Nolitied/Method: // ��. Supplemental Information it Ail/ WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. - Indicate the value(rounded to the nearest dollar)of all Additiontalicration/replaccment ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. _ ❑ I-and 2-family dwelling 0 Commercial/industrial Vaivation: S ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: I S 7/ s kJ ` ,-f-f /-) 55'T New dwelling area: - square feet City/State/ZIP: __/l 4110- 0 WE 9 7 ZZ 3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: A(/L,;S Covered porch area. square feet Cross street/directions to job site: Deck area: square feet w 4-11-J 1/ IT 9 - Other structure area: square feet REQUW,,D DATA:COMMERCIAL-USE CHECKLIST _ Subdivision: 77- Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. /�/ Valuation: S s Glp!7 Existing building area:2C-R/ square feet New building area: ye/ square feet I PROPERTY OWNER ❑ TENANT Number of stories: Name: —� W-i J C;( ayv*f _ Type of construction: _ ,S Address: 1 -2s -71 S V'J Occupancy groups: R Cit,/State/ZIP: -T( a-1101 Q /z 9"� ti L ] Existing: Phone:(Vo j) y 17 - 7 7 Fax:( ) New: J4 APPLICANT ❑ CONTACT PERSON NOTICE Business name: [35/!N -7-ti!7ZE-2-4-I Cay/t/GtE- All contractors and subcontractors are required to be Contact name: 2�3EZ?- ��- SLG licensed with the Oregon Construction Contractors Board under Oki 701 and may be required to be licensed in the IL Address: S's" 3 Z N j'Z�/ jurisdiction in which work is being performed.If the it - applicant is exempt from licensing,the following reasons N City/State/ZIP: a,a 7-Z-f- b D R 4.7 2-/ "7 , apply: Phone:(1;-o3) LGf /A/ J E-mail m CONTRACTOR --// W Business name: T'ec�t+v✓ay��JUPS7/Y! _ BUILDING PERMIT FEES* Address: /0 3 2 q N cx-- f f a�St L Y -- Please refer to fie schedule- City/State/ZIP: 111�' Qn e -7 2'72- a — Fees due upon application Phone:(bbl) I - - - — Amount received CCB lic.: 174 -73 / // Date received: Authorized signature: W This permit application expires If a permit Is not obtained within 190 days after It has been accepted as complete. Print name: ,bGr S 'pt Pe Dater - / '� ^ D • Fee methodology set by Tri-County Auilding Industry Service Board. i\auilding�PrrtiulSIT-PermBAppdoc 11103 440.4613T(IIM21COM/wE6) City of Tigard: Site Work Permit Checklist Page 2-Supplemental Information ' Commercial,Multi-Family and One-and Two-Family Dwellinss!s: No permit is require if fill is less than 50 yards(5 dump truck loads),or less than 3 feet deep and will not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If 611 is in a flood plain,drainage way,or wetlanj, the applicant must apply for a sensitive lands review(SLR). Please complete all items below, unless otherwise noted. Excavation Volume: _ �, cu. yds. Grading Volume: (Soils report required for>5,000 cu. yds.) _ cu. yds. Fill Volume: (Fill exceeding 12"in depth shall be compacted to 90%of maximum density) 0 cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete _ ❑ Other: _ *Total new impervious area including all gbgWilidi"nsdewalks,and avin : b s . ft. Site Utilities Plumbing Work: i Complete the Plumbing Permit Application for site utilities plumbing work. Plans Required: See"Site Work Permit Application-Plan Submittal Requirements" attached. The following must accompany this aplication: Site Plan with Vicinity Map showing El *Parking(including ADA) and ADA compliance Lightiny Plan El -Grading Plan and details f7F *Landscaping Plan 17 Erosion Control Plan and details Soils Report if required) Retaining Structures *Does not apply to One- and Two-family dwellings. a #of Plans U) OA Mbiliftd. J Commercial 2 m J Multi-Family R-1 Occtnancy 2 One- &Two-Family Dwelling 2 i:\BuildineFom\SIT-Checklist.doc 12/29/03 CITY OF TIGARD BUILDING DIVISION PERMIT#: 9t1P200000103 13125 &A'Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 4/11/2005 Phone: (503) 639-4171 Inspection Requests (24 Hr )• (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6113/2005 TIME: 7:08AM PAGE: 22 SITE ADDRESS: 'I 2F471 SW MAIN ST CLASS OF WORK: SUBDIVISION: LOT C TYPE OF USE: PROJECT NAME: AVES LAB ADDITION DESCRIPTION: 150 square foot storage room sddition. OWNER: CIMENT, GARY PHONE #: 503-598.8766 CONTRACTOR: ARCHITECTURAL INVESTMENTS PHONE •: Inspection Request Scheduled For: Date: 6113/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 009093.01 971-5703894 Y (� Corrections Comments Instructions: B�A a o� U) - m W J PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL F INSPECTION [] AD AL FE S ASSESSED Inspector: _ Date: ✓Phone #: (503) 718- r DESIGN INTELLIGENCE' 13.53 N.Jantun Acv. Portland,OR 97217 r• � 303-247-3073 MSN Hotmail - page 1 of 1 MS/111 Hotmail" _ riverbobehotmaq.com Prised:FeAmr,lira_10,200510:13 PM Hera: wbat meek<ArNbob6holo ilAom> IM: Friday,Jana 10,2005 W.U PM Th. a: dvorbobehatn:all.com subject: Avea tab To Tigard Building Dept RE:Aves Lab,12571 SW Main St,Tigard BUP 2005-103 As the designer of this project,R is my opinion that no special MtspeetdBli Is ngttlted 1br the WWI earaieelbn betwW the aatslq vat and the aow well. This Is not an engineered joint with arty spKMMd deMpn value. Bb amorait Of IMaa bob waa spKrAK but R Is my t:aMw,dttdbq 1Mt M" were Installed at kest X oc. Portlier,the plan cast fbr a doped paved ramp to the now atm lo;damn. This amp Y not an ADA aoi:bement as owe are atasady two ssdd111tg exbe*4 doors with amp aaess. This was put In on my part assuntta 04 owner wa-to R but M does net. The amp Is tlwybr net required. Regards,Robert Steele,Designer Design Intelligence 503-247-7075 Cir IG'`" IL oc U) m C7 W CITY OF TIGARD BUILDING DIVISION PERMIT#: 3rTaddS-o�aob 13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6 _3 — t7 S TIME: PAGE: SITE ADDRESS: t a S 7( M dl-*'t 41 CLASS OF WORK: SUBDIVISION: LOT#: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE#: y-71- s74.-3g1 Inspection Request Scheduled For: Date: Pour Time: Code # y�l q Inspection Description Confirm # Contact # Message Corrections om�r sniff/Instructions: N d !�-�,. t/� C'� a oe m _ c� W PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION [] ADDITIONAL FEES ASSESSED Inspector: _ 1 Date: v3/6 Phone #: (503) 718- April 8, 2005 Design Intelligence CITY OF TIGARD Bob Steele 15532 Jantzen Ave OREGON Portland,OR 97217 RE:AVES LAB STORAGE ROOM ADDITIO*:-REVIEW rE9j'ect Information Site Permit: BUP2005-00103 Conduction Type: V-B Tenant Name: P -es Lab Occupancy Type: S2 Address: 12571 SW Main St Occupant Load: I Area: 150 sq. ft. Stories: l The plan review was performed under the State of Oregon Structural Specialty Code(OSSC) 2004 edition;and the Tualatin Valley Fire&Rescue 2003 edition.The submitted plans are approved subject to the following conditions. 1. All exit doors shall be openable from the inside without the use of a key or any special knowledge or effort. 1008.l.8 OSSC 2. Special Inspection: Special inspection is required for item listed on sheet 2.The special inspection agency shall furnish inspection reports to the Contractor of Record, Architectural Investments and the City of Tigard, Building Division,att?ation Hap Watkins. All discrepancies shall be brought to the immediate attention of the general contractor for correction.The special inspector shall submit a final signed report stating whether the work requiring special inspection was,to the best of the inspector's knowledge, in conformance with the approved plans and specifications and the applicable workmanship provisions of the code. 1704 OSSC 3. American with Disabilities Act(ADA): It shall be the responsibility of the Architect, Engineer, Designer,Contractor, Owner and Lessee to research the applicability of the ADA requirements for the structure.The City of Tigard reviews the plans and inspects the structure only for compliance with Chapter 11 of the OSSC,which may not include all of the requirements of the ADA. a oc ' t` rn Approved Plans: l set of approved plans,bearing the City of Tigard approval stamp,shall be maintained on the jobsite. The plans shall be available to the Building Division inspectors J throughout all phases of construction. 106.3.1 OSSC _m 0 When submitting revised drawings or additional information,please attach a copy of the enclosed W -J City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Resp di�or V Henze Plans Examiner 13125 Sb Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684.2772 SUMMARY: DESIGN 10'-8"X 14'-0"ADDITION FOR STORAGE STORAGE ROOM ADDITION FOR: INTELLIGENCE OCCUPANCY: 'B' , SCIENTIFIC LAB AVES LABS 12571 SW MAIN ST. ROaERT ST�ELC CONSTRUCTION TYPE: 5 -1 (WEST WALL) �i 1 TIGARD OR 97223 1553 N Jantzen Ave. • • 5-N (SOUTH WALL) Portland, OR 97217 ADDITION = 150 SQ FT. OR 503-247-3073 • BUILDING SQ FT W/ADDITION: 2241 q� 1 � ,✓ cf �Olt, loos rA i IN ZO 0 11 NI�N t 3 N D � RowPAVEW -L4ND-W At r • . PAVED -'; , 2 r F LAmD.Sc•AP1 ^ AREA _ o �",�Y oiQAR cpb: 9 Approved...�� •� Gondhlenelly Loved....................................( ) For only the a In: PERMIT'NO• l e Lefty to:ft flow..................... ........--•. .l A all, P�AN --� OFFICE COPY _ _. Y N LAB - ONE STORY CONNECT FRAMED WALL TO CMU W/10"THREADED ROD LAB _ TWO STORY THRU STUD,EPDXYED INTOCMU WALL,NUT&WASHER ON STUD END ZEXIST11 BLOCK WALLS-3 9oee END STUD PT' ADDITION - STORAGE CONCRETE FLOOR 9'CLG Jf �y ` —� CONNECT FRAMED WALL TO CONTINUOUSLY SHEATHED 'a PAHD42 WALL, 100% FULL HT HDRS HLDOWK CMU W/10"THREADED ROD SHEATHING. NAIL 8d 6"OC ' THRU STUD, PDXYED,.INTOCMU CADET TR F� ON STUD 4 PANEL EDGES, 12 OC PAHD42 WALL,NUT d.W/A�iER r FIELD HLDOWN ) (220V) �c /END 4020 9068 IEND STUD PT 4M e04e 1-9 3/ki LI _.__ CONTINUOUSLY SHEATHED L �— - 28'-0" — WALL, 60%FULL HT SLOPE ASPHALT SHEATHING. NAIL 8d 8"OC UP TO DOORSILL PANEL EDGES, 12"OC FIELD FLOOR PLAN W/ ELECTRICAL E'G � SCALE: 1/4"m l'-V I I I I _ _EXISTING FOUNDATION FOR �- BLOCK WALL CONSTR. CONNECT SLAB TO CMU WALL W/04 REBAR 12"INTO SLAB, IMORTAR 6"INTO CMU a 2'OC _ I i i 1/2"X10 AB®4'OC MONOLITHIC SLAB/ FDN/ FTG d PAHD42 ALL CONCRETE 2500 PSI R HLDOWN N PAHD42 �. i (2) 1/2"X10 AS HLDOWN� L - _ _ - _ - _ - - - - - VI (2) 1/2"X10 AS R 7.5 RIGID INS SLAB (1) +./2"X10 AS EDGE, SEE DETAIL B/5 FOUNDATION PLAN SCALE: 1/4" =- 1'-0" woo X�"SwPE New foo F CsuT781- x- 4 T 1 m 7b'P��_ �r - 3cVrIKU \dALL \. \ 4\ H Aao► PLA+ W sp 4 NoPE AcIPHal.rr Th DF- bp- So L. RO-NIOer-XVAl000lON (6oUfH) �� v PPS tau Ln, j i hod F.SLOPE �- N1 c•rpL � R N e� „y ' con r czurtte 2-511) 1 _ }1+4RD1-pli4tlft �Dc _ t,c� 9'PJMI-fyP _ --__4DI)lTION MONOLITHIC SLAB ;INSULATION QT-5 TYPICAL SLAB WITH NO RADON SOURCE CONTROL RIS SILL SEAL/CAPILLARY BREAK 4" CONCRETE SLAB FLASHING aM(L- No( PROTECTION RADON/MOISTURE BARRIER BOARD OR e e IF APPLICABLE COATING REQUIRED COMPACTED EARTH INSTALL 1 ftVIIQ� 6-- REWIRED R—VALUE (� M -,q L ►20o rr' • '7.5 13-s Poo r--oft.Eaw1%/ -CLA; MI N a Z'oc- I N� FIRrU��4�L PER IZ 19 �)NS �Fi20tiJT aFl� IA-5a 720.I Cs-) Is-/, WAI,� 5 -IfON 140DI PLA1411- st;* VL1 GYP5VM 514ft "H L MdrAk1 WAtL- 711V 0SB SNL-r41" Zx1 QVr> V/AWA-IG"OC- R IS F4-tf I Ns u I,- W, .W, Do (INS 1 D I9, •Goty N er-S L-46 EDGE ntn--C.M.J--wAU. *'4 P.D 1k� 31N- RAE 411SLAR ItM7 cMU GM Z�o�- C� D FIRE-RESISTANCE-RATED CONSTRUCTION TABLE 720.1(2y–continued RATED FIRE-RESISTANCE PERIODS FOR VARIOUS WALLS AND PARTITIONS 4,0,P r- MINIMUM FINISHED THICKNESS FACE-TO-FACE° ITEM inches MATERIAL NUMBER CONSTRUCTION 4 hour 3 hour 2 hour 1 hour 2"x 4"wood studs 16"on center with two layers of'/s"regular gypsum wallboard'each side,4c1 cooler"or wallboard"nails at 8"on center first layer,5d 14-1.1''"'cooler"or wallboard"nails at 8"on center second layer with laminating — -- — 5 compound between layers,joints staggered.First layer applied full length vertically,second layer applied horizontally or vertically 2"x 4"wood studs 16"on center with two layers'/z"regular gypsum wallboard° 14-1.21 m applied vertically or horizontally each side',joints staggered.Nail base layer _ 51/2 with 5d cooler"or wallboard"nails at 8"on center face layer with 8d cooler"or wallboard"nails at 8"on center. 2"x 4"wood studs 24"on center with s/s"Type X gypsum wallboard'applied 14 Wood 14-1.31-1 vertically or horizontally nailed with 6d cooler"or wallboard"nails at 7"on studs—interior center with end joints on nailing members.Stagger joints each side._ partition with 2"x 4"fire-retardant-treated wood studs spaced 24"on center with one layer of gypsums/g"Type X gypsum wallboard`applied with face paper grain(long dimension) _ wallboard 14-1.4 parallel to studs.Wallboard attached with 6d cooler"or wallboard"nails at 7"on — _ 4/'n each side center. 2"x 4"wood studs 16"on center with two layers s/s"Type X gypsum wallboard' each side.Base layers applied vertically and nailed with 6d cooler"or wallboard" 14-1.5'm nails at 9"on center.Face layer applied vertically or horizontally and nailed with _ 6 8d ccoiler" or wallboard"nails at 7"on center.For nail-adhesive application, _ — base layers are nailed 6"on center.Face layers applied with coating of approved ' wallboard adhesive and nailed 12"on center. 2"x 1"fire-retardant-treated wood studs spaced 24"on center with one layer of 14-1,61 s/" Type X gypsum wallboard'applied with face paper grain(long dimension) 35/d at right angles to studs.Wallboard attached with 6d cement-coated box nails — spaced 7"on center. Exterior surface with'/a"drop siding over'/;"gypsum sheathing on 2"x 4" wood studs at 16"on center,interior surface treatment as required for — 15-1.1'm 1-hour-rated exterior or interior 2"x 4"wood stud partitions.Gypsum sheathing Varies nailed with 1'/4"by No. 1 I gage by 7/1(,'head galvanized nails at 8"on center. Sidr7g nailed with 7d galvanized smooth box nails. 2"x 4"wood studs 16"on center with metal lath and'/,"cement plaster on each 15-1.21.m side.La:h attached with 6d common nails 7"on center driven to I"minimum _ penetration and bent over.Plaster mix 1:4 for scratch coat and 1:5 for brown 15.Exterior or coat,by volume,cement to sand. _ interior walls 2"x 4"wood studs 16"on center with 7/8"cement plaster(measured from the I S-I.;' m face of studs)on the exterior surface with interior surface treatment as required for interior wood stud partitions in this table.Plaster mix 1:4 for scratch coat and — — Varies d. 1:5 for brown coat,by volume,cement to sand. Nis/N"No. 16 gage noncombustible studs 16"on center with cement plaster (measured from the face of the studs)on the exterior surface with interior i — sC.. 15-1.4 surface treatment as required for interior,nonbearing,noncombustible stud Varies' J partitions in this table.Plaster mix 1:4 for scratch coat and 1:5 for brown coat, m by volume,cement to sand. _ W (continued) J 118 2003 INTERNATIONAL BUILDING CODE@ RcbF S 6 iU N PRoviV9 (z) (ZvlLBJ. Roof o ALMU(V, GLA% B 91A P06 Rot or v>uy GDK f PIL"N CD 4 IN FRA� LFPf Si DE ADD?,C e`oc.K►wG �pRjcovC> � -IRgRe.) MrCTS Sfat. 7ey.� crq Be'Twec� r9ltS t x IL.-+ JKa a -L'oG td� al) 44"If LuS110 H4QS Rlq �� V� Nal'Bs I*-, -ul ---RrPP� o W� SLoPe 1'a F u Pee-A.- Pd�� @ 2'oc b F' EA btx i 5�. Fp 1 A!A s A t 6 41ROSS V�T�t►� o V�'� LL c�j 115 u1.- a ' . A SSE Der a_a c� Ul - = r �� CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00103 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 3/27/02 SITE ADDRESS: 12571 SW MAIN ST PARCEL: 2S102AC-00900 SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: B FLOOR DRAINS. TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of commercial backflow prevention device. FEES Owner: Type By Date Amount Receipt DAVIS, EUGENE L+ VIVIAN M PRMT CTR 3/27/02 $72.50 27200200000 10875 SW 89TH AVE 5PCT CTR 3/27/02 $5.80 27200200000 TIGARD, OR 97223 Total $78.30 Phone 1: Contractor: KENNEDY PLUMBING 13985 SW FARN.;::GTON RD BEAVERTON, OR 97005 REQUIRED INSPECTIONS Phone 1: 643-5535 RP/Backflow Preventer Reg#: LIC 10967 Final Inspection PLM 34-42PB C 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. U This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-1987. _ (k' Issued � � ) Permittee Signature: Call (503)6394Viby 7:00 P.M.for an Inspection needed the next business day Plumbing Permit Application Date received:3 91 1';; Permit no.:, WI-0 City Of Tigard Sewer permit no.: Building permit Address: 13125 SW Hall Blvd,'I'igard,OR 97223 CirvnfTigard phone: (503) 639-4171 Projcct/appl.no.: Expire date: Fax: (503)598-1960 Date issued: By: Receipt no.: Land use approval' Case rile no.: Payment type: U I alt 2 family dwelling or accessory WCommemlaUindustrial ❑Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: Job address:I ` 1 I 5 tz (n(i PLUMBING PERMIT FEES: - PRICE TOTAL Now 1 and 246mily dwellings only: FIXTURES ndlvldual QTY ea AMOUNT precludes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and Nee flrah00 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility Connection) Onto 1 bath $249.20 _ Tub or Tub/Shower Comb. 16.60 Two 2 bath_ $350.00 Shower Only 16.60 Three(3)bsth $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _ Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" -,- 16.60 PLEASE COMPLETE: 4" 16.60 Water Healer O conversion O like kind 16.60 uantity by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped- MFG ap edMFG Home New Water Service 46.40 Sink MFG Home New Sart/SIorm Sewer 46.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 1x.60 Water Closet Other Fixtures(Specify) 16.60 Urinal Dishwasher _ Garbage Disposal Laundry Room T.-3y Washing Machine Floe,Drain/Sink: 2" Sewer-1 st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.0J Water Heater Water Service-each additional 200' 46.40 Other Fixtures (Specify) Storrs 8 Rain Drain-1st 100' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 - QUANTITY TOTAL t1 Isometric or riser diagram Is required If Quantity Total Is >9 - 'SUBTOTAL } 8%STATE SURCHARGE H J "PLAN REVIEW 25%OF SUBTOTAL m Required onlilk fixturegt total Is>9 W TOTAL $ "Minimum permit hs is$72.50+8%state surcharge,except Residential Backilow Prevention Device,which Is$36 25+8%stale surcharge ""All New Commercial Buildings require plans with Isometric or riser diagram and plan review i:\dstsNorms\plm-fees doc 10/10/00 CITY OF TIGARD 24-Hour BUILDING • Inspection Line: (503)6394175 . MST INSPECTION DIVISION Business Line: (503)639.4171 _ BUP r Received . _Date Requested�_--1— —�' AM PM — BUP Location S 71 A: .5, Suite MEC Contact Person _—__ Ph 3 S—,_�_357* PLM W Z Contractor Ph( ) SWR BUILDING TenantOwner —_ ELC Footing ELC Foundation Access: Fig Drain ELR _ Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/8hear Framing ---- _ Insulation Drywall Nailing Firewall Fire Sprinkler -- -- — Fire Alarm c Susp'd Ceiling — - --- Roof Other: -- Final _PASS PART FAI PLUMBING _ Post R Beam — Under Slab _— Rough-In Water Service ------ — — - Sanitary Sewer Rain Drains ----- Catch Basin/Manhole Storm Drain ------ — Shower Pan Othet— PART FAIL — HANICAL _ Post&Beam Rough-In — - - -- Gas Line Smoke Dampers — Final U) PASS PART FAIL ---- — — ELECTRICAL - J service m Rough-In —_ t; UG/Slab W Low Voltage Fire Alarm Final I1 Reinspection fee of° required before next inspection. Pay at City Hall, 13125 SW Hell Blvd. PASS PART_ FAIL SITE I'leasn cart for reinspection RE:_______ __ Unable to inspect-no access Fire Supply Line nn ADA Date 'S V Z- Inspector Approach/Sidewalk -- Other- Final DO NOT REMOVE this Inspection record frons the fob site. PASS PART FAIL CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT 0: SWR2001-00224 La 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 8/9/01 SITE ADDRESS; 12571 SW MAIN ST PARCEL: 2S102AC-00900 SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG TENANT NAME: AVIES LAB USA NO: FIXTURE UNITS: 1 CLASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: IMPERV SURFACE: Remarks: .1 EDU increase. Previous fixture units was 32. Capping(4)units and adding(5)units for the increase of.1 EDU's. Owner: FEES GARY CIMENT Type By Date Amount Receipt 11607 SW 27TH AVE/ PORTLAND,OR 97219 PRMT CTR 8/9/01 $230.00 27200100000 Phone: 503-245-3497 Total $230.00 Contractor: Phone: Reg#: Required Inspections _ CL ac N J m This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 0 180 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 gr direct questions to OUNC by calling(503) 246-1987. i Issued by Permittee Signature: Call(503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00375 13125 SW Hall Blvd.,Tigard,OR 97223 (303)639-4171 DATE ISSUED: 8/9/01 SITE ADDRESS: 12571 SW MAIN ST PARCEL: 2S102AC-00900 SUBDIVISION: ZONING: CBD BLOCK: LAT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: CUM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 3 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Installation of plumbing fixtures (1)hose bibb. FEES Owner: Type By Date Amount Receipt GARY CIMENT PRMT CTR 8/9/01 $116.20 27200100000 11607 SW 27TH AVE/ 5PCT CTR 8/9/01 $9.30 27200100000 PORTLAND,OR 97219 Total $125.50 Phone 1: 503-245-3497 Contractor: RAYBORN'S PLUMBING INC PO BOX 69 TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone 1: 503-692-4139 Rough,in Insp Re #: LIC 87852 Top-out Insp Reg Final Inspection PLM 34-166PB IL oc 1— ca J This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. F5 Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. WThis permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules at 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: 1f 1_— Permittee Signature:. Call(503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day i i'prlbing PermitApplication f data received: 9 /0 1 p,mitno.:`1 1f7 W -t City of Tigard t') Sower Permit No. Buildinn Permit No.�__ 13125,SW Hall Blvd. Tigard.OR 97223 Proioct/Appl.No. Expire date Phone:503 6394171,Fax 503 598-1960 Date issued By Remitrt No. _ Laid Use Amwoval Case Filo No. Payment Typo J I &2 Familv dwelling,or accessory ComrnerciaVindustrial J Multi-family O Tenant imrm,vemenh J New construction Addition/alteration/replacemer-it U Food service 1(3 Other: is USEEM Job address: 12571 Main Street Description Qt Fee Total New 1&2 family dwelling only:/+100 It Bldg. No.: Suite no.: SFR 1 Bath $249.20 0 Tax map/tax lot/account nu.: SFR(2)Bath $350 0 Lot: Block: Subdivision : SFR(3)Bat' $399 0 Each additional bath/kitchen $ (> Project name: Aviec Lab Site Utilities:Catch basin/area drain $16.60 0 Citv/county : Zip: Ihay.wells/leach line/trench drian S 0 Feting drain(no.Lin.ft) S 0 Description and Location of work: Tenant Improvement Manufactured Borne utilities-each $46.40 0 Date of Completion/inspection: Manholes _ $ 0 Rain drain connector _ $ 0 Sanitwy Sever(no,of linear feet)100` $55.00 0 Business name : RAYBORN'S PLUMBING Stern Sew,:rr (no.of linear feet)100' $55.00 0 Address : P.O. BOX 69 Water Service (no.of linear feet)100' $55.00 0 City : ,rUALATIN State:OR Zip: 97062 Fixture or Item: Abse ion valve $16.60 0 Phone - 503 6924139 Fax : 503 691-2328 Back flow preventer $27.55 0 E Mail Address : Wayne(aRayborns.com Backwater valve $16.60 0 Basins/Laval 1 $16.60 16.6 CCB no. : 87852 Plumb.Bus. No. : 34-166PB Clothes Washer $16.60 0 City/Metro Lic. No.: 001806 Dishwasher 1 $16.60 16.6 Contractor's signature : ( sU Drinking Fountain(s) $16.60 0 Ejector/sump $16.60 0 Print name: Wayne Siebold Date :8/8/01 Expansion Tank $16.60 0 Fixture/sewer ca $16.60 0 Floor drains/floor sinks/Hub $16.60 (1 Name: Garbage 1 �aposal _ $16.60 0 Address: Hose Bibb 1 $16.60 16.6 Ice maker _ $16.60 0 nn }� Interceptor/Crrcase trap $16.60 0 Primer $16.60 0 PLUMBINGs INC. Roof drain(cornmerical) $16.60 0 Sinks(s),Basin(s),Lav(s) 1. $lfi.(d) 33.2 it sacisf(ythy A9 J yer.r ylu• i"li suds at„re 1977. t obtained Sum 516.60 0 fn License R34-166Pe • CC13 097852 • Metro (11806 Tubs/shower/shower pan $16.60 0 Ride Rayborn Urinal $16.60 0 19990 SW Cipole Rd. (503) 692-4139 Water Closet 1 516.60 16.6 m Tualatin, OR 97062 FAX 691-23213- Water heater 1 $16.60 16.6 w r 39"9 Other: $16.60 0 "J TOTAL 116.2 Minimun Fee$50 116.20 Tigard still doesn't Plan review .301/a SIGNATURE Amount$ State char a.08% 9.30 Total 125.50 10/13,/00 FR I 10:48 FAT 503 588 1860 ('111' OF 'I'I GARD Q003 PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2- mlly dwellings only: FIXTURES indlvldual) QTY ea AMOUNT (includes all plumbing fh4t 'es In PRICE TOTAL Sink 16.60 the dwelling and the 116114100 ft. i2TY (iia) AMOUNT 16.60 for each utility connection) Lavatory One 01)bath $248.20 Tub or Tub/Shower Comb. 16.60 'Two 2 bath __ $350.00 Shower Only 16.60 ThreeS�Lbolh $399.00 Water Closet 16.60 SUBTOTAL, Urinal — _-- 16.6n - - 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25•/.OF SU9TOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 2 1660 Washing Machine 1660 Floor Drain/Floor Sink 2" - 18-50 - PLEASE COMPLETE: 3•• 16.60 4~ 16.60 — --_ Water floater O conversion IP like kind 16.60 Quanllt b Work Pb olmed I Gas piping requires a separate mechanical I Fixture Type: New Moved Rep Is cod Removed/ permit. _ I Capped MFG Home New Water Service 46.40 Sink _ MFG Home New San/Slonn Sewer 46.40 Lavato _ Tub or Tub/Shower I lose Bibs 16.60 Cnmbinatlon Roel Drains 16.60 SDower Only Drinking Fountain 16.0 Water Closet _ 16 60 Urinal C11her Fixtures(SpecKy) _ _ Dishwasher T Garbage Disposal - — - — Laundry Room Troy --- Washing Machine -- Floor Drain/Sink: 2" Saw • 1st 100' 5500 3., --- Se Ner-each additional 100' 4640 4" Water Service-1st i00' 55-00 Water Heater 1 Water Service-each ad!Plonal 200' 46.40 Other Fixtures S ecl Storm&—Rain Drain- 1st 100' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 Commercial nick Flow Prevention Device 46.40 - Residential Backflow Prevention Device' 27 55 --- Calrh Do-sin 16.60 Inspection of Fxlsling Plumbing or Specially 72.50 Requested Ins ectlons ler/hr CnMMENTS REGARDING ABOVE: tL Rain Drain,single family dwelling 65.25 F.. Grease Traps 16.60 -- -- QUANTITY TOTAL _ Isomolric or riser diagram Is required 11 ouantlty Total Is >8 *SUBTOTAL 8%STATE SURCHARGE --- — W "PLAN REVIEW 2541.OF SUBTOTAL Reguired only Iffixture.total Is>0 TOTAL "Minimum permit fee Is$72 50+8%state surcharge,except Resklentiol Bact low Prevention Device,which Is f30 25+8°Y state eurcnarge. "All New Commercial Buildings require plans with Isometric or deer diagram and plan review. A , CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2001-00375 DEVELOPMENT SERVICES DATE ISSUED: 07/24/2001 13125 SW Hall Blvd..Tinard.OR 97223 (503)639.4171 PARCEL: 2S-102AC-00900 SITE ADDRESS: 12571 SW MAIN ST SUBDIVISION: ZONING: CBD BLOCK: L07 . JURISDICTION: TIG Prolect Description: installation of(1)service/feeder and(12)branch circuits. Job#01.122 RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/GUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+amps-1000 volts: MINOR LABEL (10): SERVICEIFEEDER BRANCH CIRCUITS AVD'L INSPECTIONS 0 - 200 amp: 1 W/SERVICE OR FEEDER: 12 PER INSPECTION: 201 - 400 amp: tat W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIF'C: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amplvolt: >=4 RES UNIT'S: >600 VOLT NOMINAL: Reconnect only: SVC FDR>=225 AMPS: _ LASS AREA/SPEC OCC: Owner: Contractor: GARY CIMENT CORPORATE ELECTRIC 11607 SW 27TH AVE/ 8040 SW BONITA RD PORTLAND,OR 97219 TIGARD, OR 97224 Phone: 503-245-3497 Phone: 503-997-2081 Reg#: LIC 143114 ELE 34-541C SUP 4075S FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 07/24/2001 $160.10 2720010000( Elect'I Service Elect'I Final 5PCT CTR 07/24/2001 $12.812720010000( Total $172.91 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 1 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those IL 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 at(503) 246 6699 or 1-800-332-2344. rn Permit Signature: Issued By: J M OWNER INSTALLATION ONLY 0 The installation is being made on property I own which is not intended for sale, lease, or rent. W J OWNER'S SIGNATURE: _ DATE- CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUUPPR. ELEC'N: C-2 2 6ti-gd - DATE: LICENSE NO: �1L Call 639-4175 by 7:00pm for an Inspection the next business day Electrical Permit Aj 'cation 1 Ratereceived:1" Permit no. -,V37'? City of Tigard Pruject/appl.no.: Expire date: 01yu(Tigu;A Address: 13125 SW Hall Blvd,Ti�r ,_/()R 97223 Date issued: By:(119 Receiptno.: Phone: (503) 639-4171 — Fax: 1503) 598-1960 Case file no.: Payment type: Land use approval: ME ;UNcw &2 family dwelling or accessory omrnercial/industrial U Multi-family U Tenant improvement construction U Addition/alteration/replacement U Other: U Partial dress: a.�� Bldg.no.: Suite no.: Tax map/tax lot/account no.: LCC I Block: Subdivision: Pr-oject name: Description and location of work on premises: p�C..._� Estimated date of com letion/ins •ction: IF .lob no: O ., z 2. Fee Max Desert Hon er Qty. oa TOW no.Im Business nameJrr oraraNl- 1� New reddnslMl- Address: �' sc� dwek Wally t Ilirytladl.I seMdtsdinctrtdfpntge. City Qn,m.! Stater ZIP: 177?xjr, Servicelncbded Phone: 6 Fax , I(x)0 sq.ft.or less _ 4 Each additional 500 .ft.or portion thereof CCB no.: !,/ t�/� py Glee.bus.lie.no: 3 t(—SY( ! � Limited energy,residential 2 City metro lic.no.: - Limited energy,non-residential 2 -4,ad 4 Each manufactured home or modular dwelling Si aturc of sac ry icing electrician(required) ate Service and/or feeder 2 Sup.elect.name(print): jjj;j;=WLicense no: o FS Services or feeden-Installation, alteration or relocation: BB 200 amps or less W, 2 Name(print): z /,,. ��(�� g f� �lt T _ 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City; State ZIP: �I Over 1000 amps or volts 2 Phone: Fax: Email: Reconnectonl I Owner installation:The installation is being made on property I own Temporary aervicesorfeetite which is not intended for sale,lease,rent,or exchange according to hatal1AHota,alteration,orrelocation: 200 amps or leas 2 ORS 447,455,479,670,701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 ams 2 Branch circalb-new,alteration, U or extension per panel: r� Name: A. Fee for branch circuits with purchase of Address: cervix or`seder fee,each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase CL - of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional branch6rcuit: H Misc.(Service or feeder not hrchded): NU Service over 225 amps-commercial U Health-cafacility Each pump or irrigation circle 2 Health-cam U Service over 320 amps-rating of I X42 Cl Hazardous location Each sign or outline lighting 2 J family dwellings; U Building over 10,030 square feel four or Signal circuit(s)nr a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension' 2 100 U Building over three stories U Feedets,400 amps or more *Desai tion: F3 W U Occupant load ever 99 persons U Manufactured structures or RV park Each additional Inspection over Use allowaMe In any of Use above; J U EgmssAighting-plan U Other — Perinspection Sabath__sets of plant;with may of the above. Investigation fee _ The above are not applicable to temporary constractlon SmIce. other _ Na all Jurisdictiura recap credit cards,pkau call jrnisdktian far mare information. Notice:This permit application Permit fee.....................$ ](nO.10 U Vi%a U MasterCard expires if a permit is not obtained Plan review(at 96) $ Credit card number:J_ �_�— within 190 days after it has been State surcharge(8%)....$ Expires accepted as complete. TOTAL .......................$ I-I a,.011 Name or caidboider as shown on croail card f C'rdholder siV wore Amoom W-MIS(6rOOICOM) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Restricted EnwW Fee....................................................... $78.00 Number of Ins ecHons 1w permit allowed (FOR ALL SYSTEMS) Service Included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.fl.or less $145.15— 4 Ej Audio and Stereo Systems Each additional 500 sq.ft.or portion thereof $33.40 1 Burglar Alarm Limited Energy $75.00 Each Ma-iufd Home or Modular Garage Door Opener' Dwelling Serve or Feeder $90.90 2 Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation O� 200 amps or less $80sZ 2 Vacuum.iystems' 201 amps to 400 amps _ $1 85` 401 amps to 600 amps $160.80 2Other 601 amps to 1000 amps $240.60 2 ❑ Over 1000 amps or volts $454.65 2 Reconnect only $88.85_ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONLY Installation,alteration,or Feed on Fee for each system.......................................................... $78.00 200 amps or less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Wort 11111�dvfol_vY Over 600 amps to 1000 volts, Audio attd StttKeo Sy:titems see"b"above. F " . E anch Circuits Boller Controls New,alteration or extension per panel a)The fee for branch circuits ❑ with purchase of service or Clods Systems feeder fee. Each branch circuit $6.65 2 Data Telecommunication Installation b)The fee fry branch circuits ,1 ems`\ without purchase o/service Fire Alarm Installation or feeder fee. First branch circuit $46.85HVAC , Each additional branch circuit $6.65 �� Miscellaneous Instrumentation (Service or feeder not Included) Each pump or irrigation circle _ $53.40Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuh(s)or a limited energy Landscape Irrigation Control' panel,alteration or extension $75.00 Minor Labels(10) $125.00 EJ Medical Each additional Inspection over the allowable in any of the above Nurse Calls Per Inspection _ $62.50 Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting' a Fees: Protective Signaling a Enter total of above fees $ Other F– 8%State Surcharge $ Number of Systems 25%Plan Review Fee No licenses are required. r.loenses ere required for all other Ins`allations See-Plan Review"section on $ front of application. Fees: J i Total Balance Due $ - Enter total of above fees $ ❑ Trust Account 0_ 8%State Surcharge $_ Total Balance Due $ i-\dsts\forms\elc-fees.doc 10/09/00 CITY OF T I G A R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2001-00302 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 08/23/2001 PARCEL: 2S 102AC-00900 SITE ADDRESS: 12571 SW MAIN ST SUBDIVISION: ZONING: CBD BLOCK: LOT: .JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: 1 STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: GAS 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 -50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: CLO DRYERS: FURN <100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Install new exterior a/c unit and replace existing gas furnace with like kind. Owner: FEES GARY CIMENT Type By Date Amount Receipt 11607 SW 27TH AVE/ PRMT CTR 08/21/20( $84.66 2720010000 PORTLAND,OR 97219 PLCK CTR 08/7.1/20( $21.17 2720010000 5PCT CTR 08/21/20( $6.77 2720010000 Phone:503-245-3497 Total $112.60 Contractor: A-1 AIR CONDITIONING CO INC 2038 NW HILLSBORO,OR 97i23 REQUIRED INSPECTIONS Gas Line Insp Phone:503-652-5900 Mechanical Insp Reg#:LIC 62102 Cooling Unt Inst, Duct Inspection Final Inspection IL F2 F- r� t FD W This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. -� Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189. Issue By: Permittee Signature: d)l Call (503)639-4175 by 7:00 P.M.for Inspectlo.is needed the next business day f-ori H FAX NO. 6507435 Pk-&q. 20 2001 04:07PM P1 'cal�PermitA Q'\ Mecha>ru Application -- "Dwocolved: permit no.: _ -o City of Tigard Project/sppl.no,: Clew ofTlNard Address: 13123 SW Hall l31vd,Tigud,OR 97223 Date iasued: Ry; Receipt no.; Phone: (303) 639-4171 Paymeuc type Fax: (503) 599-1960 Casc Ma no.: Land use approval: Building permitno.: D 1 2 fancily dwulling or aeeeaaory O Commetcialrnduattial O Multi-family O Tenant improvement ❑New construction ❑Addition/alterationheplacement O Other: ikilaimiLs�Simms job address: / S Indicate equipment quantities in boxes below. Indicate the dollar Did$.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, fax ma /tax lodsov')unt no.: profit.Value S �rtt AMe —�--_- Bltrck_ Subdivision- *Sm checklist for important application Information and I.ot � ! _ Ptvjec.t name' jurisdiction's fee schedule for residential permit fee. LME City/county` Description and location of work on premises: QtV.- �'. rire(ea.) Total est.date of wmplelioNinsl+rctlun. _ lit— Aw ouir Tcnnnt improverneut or change of use: AirhandUa unit CPM _ Is existing space heated or conditioned?C]Yes U No r con otun s an tags Ts existing space ias-Iatcd?D Yes ❑No Alteration of exisUng HVAC s stem o er cumpressots Stere bollcr permit no.: Business nams�^ti s J" HP Tons BT7 Address= erne a ani uct emo a e,ectcr - City: State: ZIP: eat um s tc an r u r Phone: Nax — mail nsta rep sec m CCB no.: _ e � Inclttdin la deal van leer O Yes n No f _ este rep ae ales lora-suspen Cit /metto lic.no.: well,or floor mountwi Name( leaseprint): encoralliance of as mace Absottl0on units BTV/H Name: Chillers HP Addreea - Cu bacon HP near • on: City: . 5trs: Z[P: _ Ap llancevent — Phone: F1tx: E-mall: ca exhaust i.kitchenthaunat hood fire suppreaaion system _ Narr►a :�.n �tw..w�.T Exhr•:Itu fan wirer sht=le due_t_(path fans) Mailing addrees:�l(trR_Z _-�r� Ebdsuets tWtn mom- na n or�� — Ch _T� State: ZTP:�rFees (.Pt3 NOPto outlets) Phone: Fen: L?mail: e o nl each a4dittional over 4 outlets •a sc emat c required) Number of outlets Name: t or a4r pee r - Addross: Decerativaf late CYry:_ -- Starr.: ZIP: nsert- _ phone: Pax: Woodallovatpellet stove tar. A�i.canfss aiRnatu—_ ) _ - �.,•.t,. rt, ��f'+�. - t — - Name (print): CL Na atl ud t c4ntr,�Iw�.y1 Iarldkt n.r elate Permit fee.................... $ gym_ Notice:This permit application Minimum fee................$ taws am expires if a permit is not obtained Plan review(at r_T%) $ C 1-4 aIle' within 180 days after It has been N tam or m n t accepted as complete. State surcharge(896)...,$ s/12.Ao TgTI'AI. ........... ...........$ L!Z - - _— r sljtstum Atnaartt 44t416 17(6rtxvoom) _J ,m V W J FROM R FAX NO. 6907435 Rug• 20 2001 04:12PM P1 ot l� �p►40 r �� fy aP�� i SO s o*A\ N �t, 7_'4 ci i IZS71 sw MJ'a 160 •�'r'2 T _ FROM : R FRX NO. 6907435 Aug. 20 2001 04:12PM P2 i ------------------- J 100 Tt a T'♦s��v f��.r�-- C 3 0 a u FROM H FAX N0. : 5907435 Aug. 20 2001 04:13PM P3 BEFORE PURCHASING THIS APPLIANCE, READ IMPORTANT ENEROY COST AND EFFICIENCY INFORMATION AVAILABLE FROM YOUR RETAILER. PHYSICAL DATA AND SPECIFICATIONS-UPFLRW MODELS U.S. and Canadian Model: , Iffifti*' 11111KIM1. I, ._ ! 0 �'' <` •`;�/1,L; 1NOA0• 10MiM' 111111..•. i>tNiAJ• hiout•9T11/Hr Ik*j m as 000 80000 76,000 76,000 78,000 00 000 to 000 106.000 1pS 000 120,000 120,000 1?i,1e 11.68 21.98 21.911 21.98 2497 zd.37 30.77 SO:rr 136.1735.17) Hos2np achy 42 o00 56 000 70.000 70000 70000 81000 64000 97,0011 pr 100 113.01)(1 1 13,000 BTUhh N 151 19,41 20.61 2db1 24,51 11.91 21,81 28.43 zd.13 33.12 33.12 High Altitude npvt 40,500 54,000 67,100 67 600 67,600 61000 61000 94 600 94,600 106,000 106.00 fkWl CD 11.67 15.83) 19.76 111,78 19.79 4,73 zi73 21,70 21.70 31.69 31,81 h N61uee Oullrul 37.600 90 400 83,000 63 000 63.000 7e ppp 16,000 87,600 67100 100.000 100,000 C d kW m 11.07 11.77 (18.46 111.46 18,44 2217 22.27 204.841 (2d+041 129.31129.31 Blowu(DxW) 11x1 11X7 11x7 12x7 - 12X7 12x11 12x11 12x11 11x11 11x10 11x10 mm 1279 x 176 270 x 178 279 v 176 305 x 1781 306 x 178 305 X 219 306 x 279 305 x 279 306 x 270 [279 x 2S4 '1270x2541 Motor H,P.1W1 1/2(3731 1121373) 1/2 13'31 12I373J 3/1 1669) 1/21373) 3/1 659) 12[373) 3/1 fs691 1213731 3/4 1660) 9 0s 4-RSC 3 C 3• 3 C 3 C 3. SC 3 3-PSC 9 C 3 SC 3- Motor Fob Load Amps 6,8 6.8 6.8 8.0 9.5 6.0 Iib 8.0 _ 9.5 so 9.5 Headng Speed _ med-low Low Med Med Low Med Lav Med Law Med Low Cooling Speed H h 1-14h h H h fth 11411 HIlIh High Host Fd.Static Presswe In.W.C. kPa 10(.0251 .12(.0291 .12(.029) 12(.029] 12(.0291 1S Lo37J 16 IA371 .201.0491 901.0491 .20I.040) .201.0491 I. Ext.SUtic Rreoslrn ( W,C, kf4 .50[,121 ,501.12) .60[.121 .501,12) .501.121 .501.111 .501.121 .601.121 .501.121 .501.121 .501.121 In _ _ H1AItlrq C.F,M.0 1 1.049 kPa1 86514171 84513981 1050[496] 1275(6001 1276(8001 149616911 146516011 1116(6821 1449 Ii621 168)17451 1500(746) W.C,E.B.P. LAt rn0 C,BM.O.6'1.124 kPa] 1175[5641 11001619) 111015241 144016791 154017251 1SW 461 1910 9011 1640(727 1510 864 1890 783 1"0(897 w,c.E.6.P. I7 1 1 1 1 I l I Temperature Rise 30-60 40-S 45-75 40-70 40.70 3586 36.65 50-0 Range IF I'CI_ 15,7-33.3 22.2-39.9 2x•41.7 22.2-38.9 2-38.9 10.436,1( 19.4-.16.1 27,844.1 127.8-44.41 117.8x.41 (21.d-44.41 ReturnAir Cabinets(Opt.) RXGR- C178 C178 C179 C219 C218 C210 C218 C218 0218 0216 C240 FOler Size 2)12'x IIr 2 It 116' 2 12'x 18 1)12'X 20 2 12'x 20' (2)t1'x 16' T 12'x 16' (2)12'm 16' 21 12'x 15 2 24'x 16' 2 24'x 18' mm 306 x 406 �O6 x 406 34 X 408 306 x 506 �x 5508 306 x 406 x 4 305 x 405 �00 x 406 y�09 x 406 Approx.Isgl Shipping Weight 111(50.31 111153.11 123156.81 123166.81 123(66.8) 146167.11 148(87.1) 161168.91 162186.9] 160[72.61 160172.61 AFUE 0920%_ X0% 92,0% 920% 92.11 92-11% 92.0% 02.0% 92.0% N14orn4 Seeso�- 61.ryx 66,44% 67.18% 96.1611 $916% 86.9611 85,96% 86.93% 1011.011% 67.11rx 87.57% NOTES: All models are 115V,BOHZ,19.(386 connection she for 048 modeh 1e 1/2'[13 mmJ N.P.T. 'Designates"S"for U,S.,"S"for Canadian Models. m See Conversion X11 Index Form No.92-21519.52(U.S.)or 92-21519-53(Canadian)for high shitude dente. m Canadian models only. ®In srtvrdance vMh D.Q.E.trM procedures. MODEL IDENTIFICATION R 13 R J - 07E M A _ E S Rheem Gas Upilow Design Heating Input Flower Site Variations Heamool Fuel Code Fumare Condensing Series Do0analion 1111-110 A A Std. Designation 3 e U 5.Natural Gas Gas Furnaoe Hot Surface 1279 x 178 mmJ S=Wide E.1100-1300 CFM 8•Cenedlan IL Not Surface 1 nfllon-- Input A "11 x 10 Cawnat (519-613.5 U9) Natural Gas Ignition Nd,r Models BT (279 x 254 mm) Q•1500-1700 CFM F- 2 - 2 x 11 707.9.802.3 Us] N 04E 04N 45,000 13 ] 118E OBN 00,000 17.6 kV x 279 mm) J . 900 2100 CFM y 2 x 7 (898,7.991.1 us) 07E 07N 75,000 20.5 kWj INS x 178 mm) 09E 0" 90,000 26,4 kkW WE ION 106,000 3V kW) 12E 12N 120,000 311.2 kW] W -j [ )Designates Metric Corverslone ' BUILDING PERMIT CITY OF T I GAR D PERMIT#: BUP2001-00246 DEVELOPMENT SERVICES DATE ISSUED: 7/17/01 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARCEL: 2S102AC-00900 SITE ADDRESS: 12571 S`.:'Ml!IN ST SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: of N: S: E: W: TYPE OF USE: COM SECOND: of PROJECT OPENINGS? TYPE OF CONST: 5N of N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0.00 of ROOF CONST: FIRE RET? OCCUPANCY LOAD: 20 BASEMENT: of AREA SEP. RATED: STOR: HT: ft GARAGE: of OCCU SEP. RATED: BSMT?: MEZZ?: REGID SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FROT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 4,255.00 Remarks: Commercial TI - 2370 S.F. Owner: Contractor: GARY CIMENT THOMAS A. SCHIRLE 11607 SW 27TH AVE/ 11545 SW 27TH AVE. PORTLAND, OR 97219 PORTLAND,OR 97219 Phone: Phone: 503-816-5256 Reg#: LIC 93545 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Electrical Permit Required PRMT CTR 7/17/01 $91.30 27200100000 Framing Insp Gyp Board Insp 5rCT CTR 7/17/01 $7.30 27200100000 Final Inspection PLCK CTR 7/5/01 $53.11 27200100000 FIRE CTR 7/5/01 $32.68 27200100000 Total $184.39 k This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR U 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246 99 cr 1- -332-2344. Pe rrn lttee Signature: Issued By: �Y2�� v Call 639-4175 by 7 p.m.for an Inspection the next business day Building Permit Appli "Dalrecrived: Permitno.: City of Tigard City of fignrd Address: 13125 SW[fall Biv<I,Tigard,ORC21 2S Prolect/appl.no.: Expire date: Phone: (503) 639-4171 Date issued: — _ fly: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: 7\ Land use approval lec2 termly:Simple Complex: U I &7 family dwelling or accessory bmmercial/industrial U Multi-family U New construction U Demolition U Ad ditton/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: Job addtrti�: / � ! r Bldg.no.: Suite no.: Lot: -- -^ Blcxk: _ Subdivision: Z. Tax map/tax lot/account no.: _ Project name: --- DescriptiorLond locatio99,,gf work on premises/speci conditions: j✓G-� r Name: _ - Mailing address: Q p2 1 Q 2 bmily dwellhsg: L� City: p d- te:(� Vztp�' ?/I Valuation of work........................................ $ f PhoncL0j- `3 Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: iy,t Total number of floors................................. "ame: dm - 'Z Fax: E-mail: -- - New dwelling area(sq.ft.) .......................... Garage/carport area(sq.ft.)......................... _ r� Covered porch area(sq.ft.) ........... ............. Mailing address:_11SYrDeck arca(sq.ft.) .................... . ................. City: State: ZIPS ( Other structure area(sq.ft.)........................ Phone _ L Fax: I E-mail: CoenesercissUiodsrtrlaUtttntdH-flu�lrs UU Valuationof work....................................... $ 7 SS Existing bldg.area(sq.ft.) .......................... ,2 370 — Business name: /it( t alt 4R� New bldg.area(sq.ft.) — Address: /1.y� 7-- .......... .. ......... City: Stat ZIP.. Number of stories..................... ....... -- Type.of,qconstruction.................................... _ Phone: �P.4- ;?d •ax: E-mail: p�v Occupancy group(s): Existing: CCB New: sre; / City/metro lic. no �Cd WO o � Notice:All contractors and subcontractors are required to be licensed with The Oregon Construction Contractors Board under Name: provisions of ORS 701 and may he required to be licensed in the Address: jurisdiction when^1vort ;r ieing performed.If the applicant is d City: d State: ZI exempt from licensing,the, stowing reason applies: �'ontact person: Plan no.: U) Phone: ax: E-mail: H _3 Name: Contact person: Fees due upon application ........................... $_ M Address: _ Date received: _ F9 City: State:E-mZIP: _ Amount received ......................................... $ U1 -t Phone: Fax: ail: --� Please refer to fee schedule. I hereby certify I have read and examined this application and the Nd Wt jurls&&ne wcW c"i cw&.Plme eWl knis&fien her mm tetammstian. attached checklist.Allrov. .ms of laws and ordinances governing this t]visa 0 MasterCard work will he.-omplied wi hcther ed rein or not. ensu card number: -- _ r1 / Authorized Si at C Date: .�_ � Name of cudioltiff as drown on«.dk card �nt name:T til �!' /✓ _. _— C.eeuier dtnan.e - Amotmt Notice:This permit application expires if a permit is not obtained within 180 days it has been accepted as complete. 4404613(60D)COM) �L,ep . �8 Fps �3a M , COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan review is dependent upon submittal of a completed application an plans. After plan review approval, the Plans Examiner will contact the applicant to request additional plan sets for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). Total#of TYPE OF SUbIlA"AL P191'8 6th. S = Site Work (must include S (New, Add or AK) 4 location of all accessible parking) B (New, Add or Alt) --r^I* B = Building F (New, Add or Alt) 3** F = Fire Protection System M (New, Add or Alt) 2 M = Mechanical P (New, Add or Alt) 2 P = Plumbing E (New, Add, or Alt) 2 E = Electrical New = New Bulliding Add = Addition Alt = Alteration to existing building a *For over-the-c3unter commercial tenant improvements, submit 2 sets of plans. oc t-- ""New" requires that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. m w I:\dats\forms\mstrxwm.doc 10/27/00 r x x I-0rxx �' x At lab area it x t)'-e• F- 14'-10" 24•x s'-e• x 2'46"-*-2'.7.4 All 8"walls constructed concrete block + 4`'• � k x b 6 31-01 x 6' 6'4r x NY --2A'-0•— — til /-Proposed changes to j interior partition walls CIl Y OF TIGARD with dropped Tbar jApproved..........................................................(,,p Condition A ✓,' Ceiling by pPnvee. ...................................( ): For only the worts as de:cribed In: PERMIT NO._ aLf See Letter to: Folk)w._... .—� Attach ....... — Job Address: I k?�,1(//f��_rr_��_ By:,- Daae: k M lab area y 3'-0"x 0'-a" , H Heti A ;. tion area 3-0"x 0'48" 31-0"x Q=�_ 6-0"x_T'TIL N Existing m floorplan J CITY OF TIGARD _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#* MEC2001-00273 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 7/27/01 PARCEL: 2S 102AC-00900 SITE ADDRESS: 12571 SW MAIN ST SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APDL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS _ HOODS: FUEL TYPES _ 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15.30 HP: REPAIR UNITS: FIRE DAMPERS?- 30-50 HP: WOODSTOVES: GAS PRESSURE. 50+ HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN>=100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: 1 Remarks: Installation of new gas piping for an existing furnace. Ownov: _ FEES _ GARY CIMENT Type By Date Amount Receipt 11607 SW 27TH AVE I PRMT CTR 7/27/01 $72.50 2720010000 PORTLAND,OR 97219 5PCT CTI? 1/27/01 $5.80 272001000_0 Phone:503-245-3497 — Total $78.30 . Contractor: RITE-WAY PEATING+ A/C INC PO BOX 1815 HILLSBORO,OR 97123 REQUIRED INSPECTIONS Gas Line Insp Phone:503-693-3161 Final Inspection Reg#:LIC 00071242 PLM 34-236 a oc t`- J_ m W This permit is issued subject to::ie regulations contained in the Tigard Municipal Code,State of Ore.Specialty Co,+es and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is not started within 130 days of issuance, or if wort; is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow+Liles ad%led in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00Y-0DIG through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by call (503)246-9189. Iss a By: 0 Permittee Signature: Call(503 39-4175 by 7:00 P.M.for Inspections needed the next business day Mechanical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expiredatc: City of liptird Address: I1125 SW Hall Blvd,Tigard,OR 97223 pate issued: By: Recei tno.: Phone: (503) 639-4171 y p Fax (501) 596-1960 Case file no.: Payment type: Land USC approval: Building pennit no.: ❑ I &2 family dwelling or accessory 13 C< mercial/industrial LJ Multi-family U Tenant improvement ❑New construction �d'Addition/alteration/replacement ❑Other: Rl"M N 10 ELM all 11111MIN Mill ll Job address: C 1 21 _ Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: va' t.cf all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. `.value$ Lot: Block: Subdivision: `See checklist for important application information and Project name: jurisdictie^'s fee schedule for residential permit fee. City/county: ZIP: Description and Ick tion of work on premises: ('l A rirt�L _ Fee(en.) Total Es ,date of completion/inspection; Demipilkiin Qt . Res.oul Res.001 Tenant improvement or change of use: Air handling unit 16126-0 Is existing space heated or conditioned?VYes LI No Air con momng(site p an required) Is existing space insulated?Q Yes U No teratlon u emitingRUC system I Kill I RIO Lai Kam I oiler compressors Business name: () 9 State boiler permit no.: HP Tons BTU/H Address:PC) lir smoke dampers/duct smoke detectors City: s State: R ZIP: G IH cat pump(site p an require ) Phone(C,� Le Fax: E-mail: Instal t1repl aceurnace/bum r Including ductwork/vent liner 0 Yes O No CCB no.: `t12 2 nsta rep ac re ocate heaters-suspended, City/metro lie.no.: 1 12(- wall,or floor mounted Name(please print): - ` ant fora iance other than furnace c . Absorption units_ BTU/H Name: Chillers HP Address: -0 SLk) "►� Com rossors HP Cit State:'1 �!P: C ,m ronareeta ex Illi a •ant ton: Y_r CSYt !Z �� Appliance vent Phone:. - CA Fax: E-mail: T)ryerex aunt 0o s, ype res.kitchen azmat hood fire suppression system Name: GeAAt_ �C�V 1 S Exhaust fan with singJe duct(bath fans) Mailing address: �►�. xhaust system a art from heatingor t1 Fuelp p eg a st on up to outlets) ^Q, City: _ Stale: ZIP: C Type; LPC. t/-NG Oil Phone: Fax: E-mail: Fuel pipin;each additional over 4 out ets } roce"piping(sc ematic required) ~ Name: Number of outlets 3 appliance or equipment: m Address: Decorative fireplace 0 City: State: ZIP: nsert-ty W Phone: Fax: I E-mail: sty ooa ovelpellet stove IOther: Applicant's signature: Date: t l \ ter: Name(print): Not all jurisdictions accept credit cords.please call jurisdiction for mare information, Permit fee.....................$ _ ' O visa U MasterCard Notice:this permit application Minimum fee................$ Credit card number _ expires if a permit is not obtained / / Plan review(at 96) $ Expires within 180 days after it has been State surcharge(8%)....$ ..�' — Name of cardholder as shown on credit card accepted as complete. TOTAL . $ Cardholder signature Amount 41[-1617(60"M) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL.VALUATION:_ FEE: s Description: Price Total $1.00 to$5,000.00 _ Mlnimim fee$72.50 Table 1A Mechanical Code _ City (Ee) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to cls&v BTU $1.52 for each additional$100.00 or Including ducts 6 vents _ 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ $10 000.00. including duds 8 vents 17.40 $10,001.00 to$25,000.00 $149.50 for the first$10,000.00 and 3) Fl(,.!Furnace $1.54 for each additional$100.00 or Irntudli:v vent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater _ _ _ $25,000.00. or floor mounted heater 14.00 $25,001 00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included In appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and Including 6) Repair units $50.000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. footnotes below. Com " 7)<3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00 8)3-15 HP;absorb Value Total unit 100k to 500k BTU 25.60--- Description: 5.80 _Description:_ _ Ot _JE� Amount 9)15-30 HP;absorb Furnace to 100,000 BTU,Including / 955 unit.5-1 mil BTU 35.00 ducts 8 vents --- 10)30-50 HP;abs.wb Furnace> 100,000 BTU including 1,170 unit 1-1.75 mil BTU 52.20 ducts&vents - 11)>50HP:absorb Floor furnace Including vent 955 unit>1.75 trill BTU 87.20 Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM floor mounted heater _ _ 10.00 Vent not Included In applicance 445 13)Air handling unit 10,000 CFM+ -permit _ 17.20 Repair units 805 14)Non-portable evaporate cooler <3 hp;absorb.unit,�_-- -- --955 __- 10.00 to t00k BTU 15)Vent fan connected to a single dud 3-15 hp;absorb.unit, 1,700 6.80 101k to 500k BTU 16)Ventilation system not Included in 15-30 hp;absorb.unit,501k to 1 2,310 appliance partnit 10.00 mil.BTU --- 17)Hood sen ad by mechanical exhaust 30-50 hp;absorb.unit, Y 3,400 1Q.00 1-1.75 mil.BTU --- 18)Domestic Incinerators >50 hp;absorb.unit, 5,725 17.40 >1.75 mil.BTU 19)Commercial or Industrial type incinerator Air handlingunit to 10,000 ctm 656 69.95 Air handling unit>10,000 cfm _ 1,170 __. 20)Other units,Including wood stoves ter 656 Non-portable evaporate coa - 10,00 Vent fan connected to a stele duct - 446 21)Gas piping one to four outlets Vent system not Included in 656 5.40 appliance permit _ 22)More than 4-per outlet(each) Hood served by mechanical exhaust _ _ 656 1.00 Domestic incinerator 1,170 _ Minimum Permit Fee$72.50 SUBTOTAL: $ �- Commercial or industrial incinerator 4,590 _ a Other unit,including wood stoves, 656 8%State Surcharge $ t' Inserts etc. N Gas��1-4 outlets i in - 360 _ h ^_ - L _ �-- 23 Plan Review Fee(of subtotal) $ Each additional outlet 63 Required for ALL commercial permits only m TOTAL COMMERCIAL S TOTAL RESIDENTIAL PERMIT FEE: f VALUATIONS T __ W Other Inspections and Fees: 1. Inspections outside of normal business hours(minimum charge-two hours) $72.50 per hour. 2. Inspections for which no fee Is specifically indicated (rninimum chargefialf hour) $72.50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum charge-ane-half hour)$72.50 per hour "Slate Contractor Boller Certification required for units>200k BTU. "Ree:dentlai AIC requires site plan showing placement of unit i:\dstskforms\rnech-fees.doc 10/11/017 I v CITY OF TIGARD BUILVING INSPECTION DIVISION MST _ —244iour Inspection Line: 639-4175 Business Line: 639-4171 -- BUP _Date Requested �-- q _AM PM BLD _— Location 5 -71 r'1 Suite MEC Contact Person Ph 3 3(o PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS _ Fig Drain SON Crawl Drain Inspection Notes: — Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing — Firewall Fire Sprinkler _ Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL — PLUMBING Post&Beam -- Under Slab Top Out Water Service Sanitary Sewer Rain Drains _ Final PASS PART FAIL MECHANICAL Post&Beam Rough In Gas Line Smoke Dampers Final ASS P FAIL ELECTRICAL (L 'ce Rough In UG/Slab _ fn Low Voltage Fig _ J m PASS ART FAIL � ITE J Rackfill/Grading — -- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Please call for reinspection RE: Unable to ins Fire Supply Line [ ] p — 4 [ 1 pact no access ADA Approach/Sidewalk Other Date(� , !v Inspectors __-Ext 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: 6394M75 Business Line: 639-4171 BUP _Date Requested— AM PM BLD Location Suite MEC Q0/ 49Q 30 Contact Person Ph x 4/ 0-7 PLM Contractor Ph SWR _ BUILDING Tenant/Owner EL.0 Retaining Wall ELR Footing Access: Foundation FPS _ Fig Drain SIGN 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 Misr,:_ — -- Final PASS PART FAIL PLUMBING Post&Beam Under Slab Top Out Water Service _ Sanitary Sewer Rain Grains Final P FAIL _ �GECHANIQAQ Smoke Dampers 2PART FAIL 1TRICAL' Service _ LL Rough In OC UG/Slab Low Voltage Fire Alarm Final –� PASS PART FAIL W SITE Backfill/Grading -� Sanitary Sewer Storm Drain [ ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ l Please call for reinspection RE: _ [ ]Unable to inspect no access ADA Approach/Sidewalk q q Date Inspector �� V11 Ext Othe# Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 / BUP Date Requested 0 — T AM PM BLD — Location / ;S 7 1 040.s.� S"�— Suite _ MEC Contact Person �T�YY\ _ Ph I Co S-I SIP PLM 2-Z)01 00375 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing _ Firewall Fire Sprinkler _ Fire Alarm r Susp'd Ceiling — Roof Misc._ —— Final --- PASS PART FA L PLUMBING Post&Beam Under Slab Top Out Water Service _ Sanitary Sewer Rain Drains i PART FAIL ANICAL Post R Beam Rough In Gas Line — Smokq Dampers Final PASS PART FAIL ELECTRICAL --- Service P.ough In UG/Slab _ Low Voltage Fire Alarm —_ Final ] PASS PART FAIL _ SITE a Backfill/Grading — —'— Sanitary Sewer Storm Drain ( ]Reinspection fee of$_ requi.ed before next inspection. Pay at City Hall, 13123 SW Hall Blvd Catch Basin [ )Please call for reinspection RE: [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk - Date Inspector q��Q . Ext Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site, CITY MJF TIGARD DEVELOPMENT SERVICESBUILDING PERMIT PERMIT #. . . . . . . s BUP98-0022 Ail 13125 SW Hill Blvd.,77gard,OR 97223 (503)W4171 DATE I SSUED a 01/15/98 PARCEL: 2S102AC-00900 SITE ADDRESS. . . : 12571 SW MAIN ST SUBDIVISION. . . . : ZONINGsCBD BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : JURISDICTION:TIG ---------------------------------------------------------------------------------- REISSUE: FLOOR AREAS----------- EXTERIOR WALL CONSTRUCTION— CLASS OF WORK. :ADD FIRST. . . . : 0 sf Ne S: E: We TYPE OF USE. . . :COM SECOND. . . : 0 sf PROTECT OPENINGS?---------- TYPE OF C0NST. :5N . . . : 0 sf Na Se E: W: OCCUPANCY GRP. -.B TOTAL------: 0 sf ROOF CONST: FIRE RET?s OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA SEP. RATEDe STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATEDe BSMT?: ME.ZZ? : REQD SETBACKS-------- REQUIRED------------------- FLOOR L.OAD. . . . : 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET. . : DWELLING UNITS: 0 FRNT: 0 ft REARe 0 ft FIR ALRM: HNDICP ACCs BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORRs PARKINGs 0 VALUE. $: 2000 Remarks : Add new exterior stairs - No CFlange in Occupant Load - No C of 0 required Owner: ---------------------------------------------------- FEES -------------- GF_NE DAVIS type amount by date recpt 10875 SW 89TH AVE PLCK $ 20. 13 JSD 01/14/98 98-302448 TIGARD OR 97223 FIRE $ 13. 00 JSni 01/14/98 98-302448 PRMT $ 32. 50 B 01/15/98 98-302519 Phone #: 246-5862 SPCT $ 1. 63 B 01/15/98 98-302519 Contractor: -------------------------- • OWNER --------------------------------------- Phone #: $ 67. 26 TOTAL Reg #. . : 000000 ------- REQUIRED INSPECTIONS -- ----- This permit is issued subject to the regulations contained in the Framing Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with L approved plans. This permit will expire if work is not started C within 181 days of issuance, or if work is suspended for more _ than 181 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utilitv Notification Center. Those - rules are set forth in 0118 952-$I1-N11 through OAR 952-$1111987. 3 You many obtain a copy of these rules or direct questions to Ol1NC by calling 15131246-1987. 9 U -- J — Permittee Signa{1_:re : ' Issued By:X /W7 I-. +f++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next business day +++i-++++++++++++++++++++++++++++++•t+++++++++++++++++++++++++++++++++++++++++++ i__ �IIT`ir OP TIGARD Commercial Building Permit Recd By !3125 SW HALL BLVD. Tenant Improvement Date Recd Q Date to P.E. 1 TIGARD, OR 97223 Date (503) 639-4171 Pamto DST t Pits 1' ��'-2 Print or Type Related SWR Incomplete or illegible applications will not be accepted called I- I�--Tj Name of Nvelopmeni/Project Existing Building;K New Building p Job 'A ^�}, L'c'�tP;nub C Address street Address Suite Building S Data I a _ Bldg kCity/State ZIP Existing Use of Building or Property: _ o k 97223 Name Property Proposed Use of Building or Property: Owner Mailing Address Suite U,fe1:/1Ay 0 XfhNo. Of Stories: Z City/State ZIP Phone(So;� _ T1 _ z44-Sa Z Sq. Ft. Of Project: Occupant Ne '' // llOccupancy Class(es) V ct CQ bA Name Contractor C W Type(s)of Construction Prior to permit Mailing Address Suite _ Issuance,a copy Will this project have a Fire Suppression ystem? of all licenses Yea IJ Nom aro required if Ciry/State zip Phone Americans with Disabilities Act(ADA) expired in C.O.T. ) database Valuation X 25%=$ _Participation Oregon Const.Cont.Board Lic.! Exp.Date Complete Accessibili Form Project $ o00 Name Valuation —44*14694_ ly),44— � Plans Required: See Matrix for number of sets to submit Mallirg Address Suite on back ` Cit /State Zip 9 7,+Pl j Phone I hereby acknowledge that I have road this application,that the information -6 Y-fivry �' 7��-1 c�¢�, given is correct,that I am the owner or authorized agent of the owner,and Engineer Name that olans submitted are in compliance with Oregon State Laws. Sig roof�er/Ant � Date Mailing Address Suite Contact Perso iV me Phone L City/State Zip Phone f'n v, CFO�3296- 2 FOR OFFICE USE ONLY -_ Indicate type of work: New O Addition O Demolition O Map/TLsitn Land Use: J Accessory Structure A Foundation Only O Alteration O a�S�(��q(�-C' [ � — _0 Repair O Other O Notes: Description of work: U Ne') Its it.) �ecCnt� IfJe�. TIF: Perks: Estimeted x of Employees ---- / — - Note: Site Work Permit Application must precede or accompany Building C L Pcrmrt Application r 13 2 L51 J 1.%COMNEW.DOC (DST) 8/97 dip fir 13. Au.dhwn ARE To 6#.OPE AWAY MOM'.HE INJL n v 1.�1. K 0ONC14ETF 9LW TO HAVE CONTROL. "MTS AT 26 FT (MAX^ :IVQ r... NIMAI S FA WAY. 3 S KMMAIi. . fool VV MOM= � r + ALL exTERga WALL oPs S KAwr+t3 WALL OPENINIa6 TO HAVE A►M X r 7 HFADFR9~98 OTHENWI,9E NdTEC. DUMN AM h 6 UNAM SPECNLNt: l MM W NAFTIM: No i oom.FIR ode 4#44the D.Slur.PLAM,fk.K*A. ~� apma".ETC•. NO 3 0000.FIR 1 E.SUM STUD GRAVE Of. Ok +rn `ref F.PLYWO."A'dF*WA-' `�'CUX FLY.WIG Job 4reac• T. 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