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14150 SW MILTON COURT-7 13 NO1lIW MS O94b6 i Q z a 0 h � J N cn W ..1 14'150 SW MILTON CT / �' BUILDING PERMIT CI O TZAAR4 4D PERMIT #: BUP2004-00070 DEVELOPMENT SERVICES DATE ISSUED: 4/19/2004 13125 SW Hall Blvd..Tlqard, OR 97223 (5%3)639-4171 PARCEL: 2S112AB-02300 SITE ADDRESS: 14150 SW MILTON CT SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: !-L BLOCK: LOT: 005— JURISDICTION: TIG RE:SSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: AI-T FIRST: sf N: S: E. W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE qF-T? OCCUPANCY LOAD: BASEMENT: sf AREA SFR. u.ATED: STOR: HT: ft GARAGE: sf OCCU SE.P. RATED: BSMT?. MEZZ?: REQ7 SETBACKS REQUIRED FLOOR LOAD: psf LEFT: �ft RGHT: it FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRn' : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 700,000.00 Remarks: TI existing building with rack storage& minor site modificatio.is. Owner: Contractor: SHEININ.-MENDENHALL LLC I SD DEACON ENTERPRI INC(77875) 12725 SW 66TH AVE#202 PO BOX 25392 PORTLAND, OR 97223 PORTLAND, OR 97298-0392 Phone: Phone: 297-8791 Reg#: LIC 77875 FEES _ — REQUIRED INSPECTIONS Description Date Amount Mechanical Permit RequirE Insulation In:p �13UPPLNJ Pin Rv 2125/2004 $1,968.07 Electrical Permit Required Shear Wall Insp Sprinkler Permit Required Shear Wall Insp [FLS]FLS Pin Rv 2/25/2004 $1,211.12 Plumbing Permit Required FFrewall Insp 1 13UILD]Pennit Fee 4/19/2004 $3,027.80 Foot/Found Insp Gyp Board Insp (TAX]R%State Surchari 4/19/2004 $242.22 Struc Steel Insp Gyp Board Insp (additional fees not listed here) Framing Insp Gyp Board Insp Framing Insp Gyp Board Insp Total $6,574.21 I Framing Insp Susp Ceiing Insp ------ - -- I Framing Insp Reinforced concrete final r 0. OG CO) 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. T)is permit will expire if work is not siarted within 180 days of issuance,or if work is suspenriod for more than 180 days. ATTENTION:: Oi-egon law m requires you to follow the rules adopted by ',e Cregon Utility Notification Center. Those rules are set forth it OAR t j 952-001-0010 through OAP.952-001-0100. You may obtain a copy of these rules or direct questions to OUP C by J calling(503)246-6699 or 1-800-332-2344. Issued By: Permittee S'gnaiarc: Call 639-4175 by 7 p.m.for an Inspection the next business day IS"o `S a l7 I 7-0 Al c r" H tgTT TRI-COUIITY SERVICE CENTER BuRd'ing Permit Application 1`1 Jurisdiction: City of Tualatin �'�7 Date received: Permit no.: 'I Address: 18880 SV1'Ma li V 062 Pmject/appl.no.: Ex ire date: Phone: (503)691-30441xP6ef4YI Date issued: D eceipt no.: Clackamas Internet address: www.ci.tualaMultnomah ft � 5 2004 Case file no.: ayment type: � lkashing,ton C o u N br r s Land use approval: elf Y Or 'FIGAF77 W family:Simple Complex: ❑ 1 &2 family dwelling or accessory O Commercial/industrial O Multi-family J New construction U Demolition CJ Addition/alteration/replacement Tenant imps ovement Cl Fire sprin''cr/alarm ❑Other: Joh address: 4W Bldg.no.: Suite no.: Lot: Block Subdivision: I Tax map/tax lot/account no.:Z � Project name:JJ NMAL!! • _101AM7 1lW*M1EAr Description and location of work on premises/special conditions:TW,4MAMMIA"r drIlff--Mt�l� Name: Mailing address: AA lie 1 &2 family dwelling: City: State: ZIP: Valuatiotr of work......................................... S Phone: — Fax: I E-mail: No.of bedmoms/baths.................................. _ Owmcr's representative:W.AAW00 91111ADl -' Total number of floors.................................. Phone: Fax: [:-mail O New dwelling area!sq. ft.)................. Garage/carport anoa(sq. ft.).......................... Name: Covered porch a ca,sq.ft.) .......................... Mailing address: Deck area(so PL )..... .................................... City: State 7_IP: Other structurt area(sq. ft.).......................... Phone: I : F m;til CommereiaUtndt strlaUmulti-famlly: Valuation of work......................................... S ��d Existi Business namng bldg.area(sq.ft.)............................ `(�_ — e � �- New bldg.area(sq.ft.) Address Q"�� t�hf - - — Number of stories....... .................................. City: State • ZIP: r Phone: ax E-mail: Type of constniction.................................... CCB no.: - - --L_-_- — ncy goup(s): Existing: • New: w City/metro lic.no. Notfce: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the 4 Address: (10 6W2ft jursdiction where work is being performed.If the applicant is F -�Cit State: ZIexempt from licensing,the following reason applies: �j P: ca Contact Plan no.: Phone: qW 11.ax2W. Name: Contact te•t,on �7Date due upon application.............................S � •U7 �_ _ P PP — Address: received:State ZIP unt received...........................................S --_ Phone•^ F tx -mail:99AWNPlease refer to fee schedWk �-- i� - I hereby certify I have read and examined this application and the No,all turisdinionswe"tctedircuds,plemcall iwisdiclimhrmmetnrormtion. attached checklist.All s ns of laws and ordinances govemin his Cl Visa O MasterCard work will he complie d herein or not. Cmtii card n mW: •pins Authori:ed signature --_ Date: Name of cardholder as.no"on crWit card 6s Print name. Caidboldersisnuum Antoum Notice:This permit application expires(fa permit is not obtained ovithin 180 dors after it hos been accepter as complete 440 4 13(6A*X'OM) ELECTRICAL PERMIT CITY OF TIGARD RES RICTEDENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00151 13125 SW Hall Blvd.. Tigard,OR 97223 (503)639-4171 DATE ISSUED: 6/9/2004 SITE ADDRESS: 14150 SW MILTON CT PARCEL: 2S112AB-02300 SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: I-L BLOCK: LOT: 005 JURISDICTION: TIC Prosect Description:T.-stats. A.RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: AUDIO&STEREO: INTERCOM &PAGING: BURGLAR ALARM: BOILER: LANDSCA1OE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COW: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL,#OE SY T ' 1 Owner: Contractor: SHEIN114-MENDENHALL LLC I PROTEMP ASSOCIATES ING 12725 SW 66TH AVE#202 807 NE COUCH PORTLAND, OR 97223 PORTLAND, OR 97232 Phone: Phone: 233-6911 Reg#: ELE 26-1063CRE LIC 38868 SUP 2613LEP Fr==, FEES Re uired Ins ections escription Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 6/9/2004 $75.00 Elect'l Final TAX]8%Siate Surcharl 6/9/2004 $6.00 Total $81.00 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 worts is quspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregor Utility Notification Center. Those rules are set forth in OAR 952-001-0010 a through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(5)3)246-6699. Issued by ,(� Permittee Signature _ OWNER INSTALLATION ONLY m The Installation Is being made on property I own which Is not Intended for sale, lease, or rent. -i OWNER'S SIGNATURE: DATE: CONTRACTO( L.TSN ONI—Y SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an Inspection needed the next business day Electrical Permit Application MIS mmme City of Tigard ReceivedD."yL4� Permit No Q 13125 SW Hall Blvd.,Tigard,OR 97Plus Revie Other Permit. Phony 503.639.4171 Fax: 503.598' ECi,/ Date/By: _ Inspection Line: 503.639.4175 v Date Ready/By tem I ® see Paee t for 0, Internet: www.ci tigard.or.ua iNl I Notified/Method 3upplemenul Information Please check all that apply FC]Demo construction ❑/ t�o��ltaftiopreplacetrtertt ❑ mp !ai�n Service over 225 a s corrtm'I ❑Hazardous location ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.f1, of I-and 2-family dwellings 4 or,note new residential d 2-fair ily dwelling ❑Cominereial/industrial ❑Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories ❑Feeder;,400 arms or more i-family ❑Master builder ❑Other: C7Manufactured structures or ❑Occupant load over 99 persons RV ark� []Egress/ P Job n-m Job site address: I' �' r► 01 -care facility ❑Other: /yIS� .�iby Submit 2 sets of plans with any of the above. City/State/ZIP: Q The above are not applicable to temporary construction sci%Ice Suite/bldg./apt.no.: eeerlptlen Qty. Ree. Tmu� Cross street/directions to job site: _ New residential single-or multi-family dwelling unit. 1 --- Includes attached garage. 1,000 sq.ft.or less 145.15 4 Subdivision: Lot no.: Ea.add'1500 sq.ft.or portion 33.40 1 I.imi:ed rnagy,residential 75.00 2 Tax map/parcel no.: Limited energy,non-residential 75.00 2 Each manufactured or modular dwelling,sery ce and/or feeder 90.90 _ 2 Services or feeders Installation,alteration,and/or relocation 200 amps or less 80.30 2 201 amps to 400 amps _ _ 106.85 2 t ---- 4o1 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps _ 240.60 2 Address: --- _- Over 1,000 anV.,,or volts 454.65 2 --- Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or - - relocation Phone:( )_ Fax:( ) 200 amps or less 66351 Owner Installsitlen:This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 _ 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps _ 133.75 2 Own!tr signature: Date: Branch circuits--new,alteration,or extension,per panel A.Fee for branch circuits with service or feeder fee,each 6.65 2 Business name: branch circuit B.Fe-for branch circuits Contact name: without service w feeder fee, each branch cir,lit 46.8 2 Address: Each add'I branch circuit L6.65 2 City/State/Z[P: Miscellaneous(service or feeder act ladadad) tl Phone:( ) Fax: :( ) Pump or irrigation circle 53.40 _ 2 Sign or outline lighting 53.40 2 F- E-mail: Signal circuit(s)or limited- energy panel,alteration,or extension.Describe Page 2 2 JR tsiness name: m Address: S� f '� Each additional Inspection over allowable in any of the above 9 2'r 81Per inspection 1 1 62.50 WCity/State/ZIP: ! T& t?A96?Z Investigation per hour(I hr ntin) 62.50 Phone:(S?4y) I Fax_. ) ,tit - 9 � Industrial plant hour 73.75 CCB Lic.: Electrical Lic.: Su rv. Lic.: /ems P __id'rl' Zr)30 Subtotal S �� Suprv.Electrician signature,required: an review(25%of permit fee) Print name: Date: State surcharge(9%of permit fee) i - TOTAL PERMf r FEE Authorized Slgnah're: This ramie application expires if a pere,ft Is not obtained within leo dayr after It has been accepted to complets Print name: .Aefg r Date: Fee mnhodology vet by Tri-County ituilding Indtotry Service Roard •'Number of inspections per pemtit Allowed. i.\Building\Pem,itiTLC.PerfmAppdoc IV03 4404615T(1'0VC0M/wC8 Electrical Permit Application - City of Tigard Page 2 -Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all resid tial systerns combined........ $75.00 Check Type of Wo Involved: ❑ Audio and Stcr Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating,Ventilation dnd Ai onditioning System* ❑ vacuum Systema* [] Other: Fee for each commercial system....................... S7.. 0 (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation 4. ❑ Intercom and Paging Systems y ❑ Landscape Irrigation Control* C1 Medical J ❑ Nurse Calls J ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total nurr ber of cc,mmercial systems: *No licenses are required. Licenses are required for all other installations i\Building\P r iu\P.LC-PmmtApp dm 04101 CITY OF TI GARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-00354 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 6/9/2004 PARCEL: 2S112AB-02300 SITE ADDRESS: 14150 SW MILTON CT SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: I-L BLOCK: L OT:005 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 5 OCCUPANCY GRP: B VENTS W/O APPL.: VENT SYSTEMS: STORIES: 2 BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 0 DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-?0 HP: REPAIR UNITS: FIRE DAMPERS?: 30-50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS FURN >=109K BTU: 4 <=10000 cfrn: 1 _ OTHER UNITS: GAS OUTLETS: 4 > 10000 cfm: Remarks: (4)new rooftop units and tenant ductwork. Value: $40,000 Electrical permit required. OwnRr: FEES SHEININ-MENDENHALL LLC I Description Date Amount 12725 SW 66TH AVE#202 1MECH)Permit Fee 6/9/2004 $636.50 PORI LAND, OR 97223 [MECPLN) Plan Rev 6/9/2004 $159.13 [TALC]8%State Surcharl 6/9/2004 $50.92 Phone: �Totalr :846.55 Contractor: PROTEMP ASSOCIATES INC 9788 SE 17TH AVE PORTLAND, OR 97222 r_ REQUIRED INSPECTIONS Phone: 233-691' Gas Line Insp Mechanical Insp Reg#: LIC 38868 Duct Inspection Fire Damper Insp Misc. Inspection Final Inspection a a m t7 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes UJ� and all other applicable laws. All work will Li done in accordance wi,h approved plans. This permit wil!expire if work is nol —arted within 180 days of issuance, or i' ', is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oi Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. 1 iay obtain copies of these rules or direct questions to OUNC by calling (503)246.6699 Issued By: Permittee Signature: ' Call (503)639-4175 by 7:00 P.M.for Inspections needed t e nent'business day Me_ chat/ cal Permit Application City of Tigard RecDate/By �Per.nmtNo 13125 SW Hall Blvd,Tigard,OR 9'/223 Pan Refti Plan Revie Phone: 503.639.4171 Fax: 50ROPmE 1 1! E D D&W'By Other Permit Inspection Line: 503.639.4175 �P Date Ready/By Jura fd See Pr`e 1 for — Internet: www.ci.tigard.or.us Notified/Method: supplementallnformatio•r fON t — ❑New construction rAdIgibohNfWkin/replacernent' 7For Fcrmn fees'are based on the value ofthe work 1Pf DIVISION ndicate the value(rounded to the nearest dollar)of all ❑Demolition materials,equipment,labor,overhead,and profit a'tt. ; Value 5 .11 TUL EQUIPMENt7/SYSTEMS FEES' ❑ 1-and 2-family dwelling �, ' -oreial/industrial ❑Accessary building L__Multi-famil special information use chrcklist. ❑ y [ f builder ❑Other: Description Qty. Ea Total Head" cooling _ Job site addr-,s: I�'�— �� C - Air conditioning or heat pump —� r t (requires site plan sbowing placement) 14.00 City/State/ZIP: / R D dq Furnace 100,000 BTU(ducts/vents 14.00 L s! go, Suitelbldg./apt.no.: Project name:AJW/Ijfa1G4jL Furnace 100,000+BTU ducts vents 1790 Gas heat pump 14.00 Cross street/directions to jol•,rte: Duct work 14.00 H-dronic hot waters stem 14.00 Residential boiler(radiator cr h dronic' 14.00 Unit beaters(fuel-type,not electric), in-wall,in duct,suspended,etc 10.00 Subdivision: Lot no.: i Flue/vent for any of above 10.00 -- _Other: Tax maprparcel no.: Other fuel appliances h ... + t} Water heater _ 10.00 ' G:s fire lap ce _Y 10.00 AAEOV /p1' 3r 1�{d/ � r,L j w AL/C I _ Flue ver,for water heater or gas rZo L_ X a�— L lace 10.00 � �� 7 rJ�r t `� Lo It hter jE.sj_—__ _ 10.00 '_C45 p)101!.K' woodJjellet stove _ 10.00 Wood fireplace/insert 10.00 Chi rnne /liner/CueJvent _ IO.W Other: 10.00 Naw e: Environmental exhaust a ventilation Address: Range hood/other kitchen equipment 10.00 _ City/State/ZIP: Clothes dryer exhat-st 10.00 Fuc: — Phone:( Single-duct exhaust(bathrooms, ( ) toilet co artments,utility rooms 6.80 Attic/crawlspace fans 10.00 Business name: Other: 10.00 Fuel piag Contact name: 55.40 for first four;$1.00 for each additional n' Address: Furnace,etc. — (!lti -- -- Gas heat ump NCity/State/ZIP: Wall/suspended/unit heater Phone:( ) Fax: .! ) -- Water heater Fireplace J E-mail: Range m Barbecue JBusiness name aWAA Clothes d as Andress: 7►'ft Other: _ 97�t� �1� •ave _ __ __ C'itl,/State/ZIP n L4N� '� a� _ Subtotal Minimum permit fee($72.50) Phone:(!.3)—m-C.91 i I Fax: S3� �x7I Plan review(25%of permit fee) CCB lie.: �g`�"6�' State surcharge(8%of permit fee) Q — -- ----- TOTAL PERMIT FEE This permit application expires If a permit 1*not obtained within 110 Authorized signature: _ days after It has been accepted as complete. rPrint name: ��,y1�~� Date: Fee methodnlogy set by Tri-County Building Industry Service Board i\Building\PerrnftjWFC-PerndtApydo-, 12103 —� uo-alai(ro2Jc0WweB) M hanical Permit Application - City of Tigard Page - Supplemental Information Comm cial Fee Schedule: S 1.00 to$2. .00 Minimum fee$72.50 $2,001.00 to. ,000.00 S72.50 for the first$2,000.00 and$2.30 L9 60 for each additional$100.00 or fraction , thereof,to and including$5,000.00. G! $5,001.00 to$10, 0.00 $141.50 for the first$5,000.00 and � �( $1.80 for each additional$100.00 or S fraction thereof,to and including $10,000.00. S 10_,001.00 to$50,000.00 $231.50 for the first$10,000.00 and ?.�` Q ' $1.35 for each additional$100.00 or kiob fraction thereof,to and including 0,000.00. $50,001.00 to$100,000.00 $ 1.50 for the first$50,000.00 and $1. for each additional$100.00 or fractithereof,to and including -- $100,00 00. _ $100,000.01 and up $1,396.50 r the first$100,000.00 and $1.10 for ea additional$100.00 or fraction thereo Note: All new commercial buildings requi 2 sets of plans. CL co L- J_ m W ,J i:\Building\Permits\MEC-PermitApp.doc 12/03 2 _ FILE COPY April 9, 2004 CITY OF TIGARD OREGON Christine Mckeivev Group Mackenzie 0690 SW Bancroft Street Portland, OR 97201 RE: TENANT IMPROVEMENT W/NEW EXTERIOR OPENINGS Project Information Building Permit: BIJP2004-00070 Occupancy Tyne. B/S-I Tenant Name: Northwest Medical Teams Construction 7 ype: VN Address: /1150 SW Milton Court Occupant Load: NA Area: 60,300 Sq Ft Stories: 2 The plan review was performed under the State of Oregon Structural Specialty Code(OSSC) 1998 edition; and the Tualatin Valley Fire& Rescue Ordinance 99-01 (TVFR99-01) 1999 edition. The submitted plans are approved subject to the following conditions. • Exit signs shall be Nominated at all times and shall be provided with a second source of power that will provide 1 '/2 hour s of illumination in case of primary power"_oss. 1003.2.8.5 OSSC 40 The means of egress shall be provided with illumination of not less than 1 foot candle at the floor level anytime the building is occupied. The means of egress illumination shall be provided with a second source of power in case of primary power loss. 1003.2.9.2 OSSC e Provide 2-A rated fire extinguishers so that no usable space has a distance greater than 75 feet to the extinguisher. Standard 10-1, Chapter 3 TVFR99-01. a • Deferred subm;ttals such as Fire Alarm, Fire Sprinkler, Truss Joist Shop Drawings, Nctc, will be charged a deferred submittal fee based on the valuation of the portion of cathe work being deferred. The minimum fee shall be $200.00. J �p Special Inspection: Special inspection is required for Concrete& Reinforcing Steel, LU Expansion Bolts, Epoxy Bolts, high-Strength Bolts & Structural Welding. The special .J inspection agency of record shall furnish inspection reports to the Engineer of Record, Timothy L. Schweitzer, the General Contractor, SD Deacon and the City of Tigard, Building Division, attention Rap Watkins. all discrepancies shall be brought to the immediate attention of the general contractor for correction. The special inspector shall submit a final signed ►eport stating whether the work requiring special inspection was, to the 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 best of the inspector's knowledge, in conformance with the approved plans and specifications and the applicable workmanship provisions of the code, 1701.3 OSSC 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 stricture. 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. Live Loads Posted: The live loads for which each floor has been designed shall be conspicuously posted by the owner in that part of each story in which they apply, using durable metal signs, and it shall be unlawful to remove or deface such notices. The occupant of the building shall be responsible for keeping the actual load below the allowable limits. 1607.31.5 OSSC Approved Plans: 1 set of approved plans, bearing the City of Tigard approval sta-np, shall be maintained on the jobsit The plans shall be available to the Building Division inspectors throughout all phases of construction. 106.4.2 OSSC Certificate 6 Occupancy: No building or structure shall be used or occupied until the Building Oficial has issued a certificate of occupancy 109.1 OSSC Premises Identification: Approved numbers or addresses shall be provided for all new buildings in such a position as to be plainly visible and legible from the street or road fronting the property. 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 of Tigard in tracking and processing the documents. Respectfully, IL ran B c H Se ' lans Examiner 0) _J (a W J OFFICE COPY RECEIVED MAR 3 0 2004 CITY OF TIGAHD BUILDING DIVISION March 29, 2004 City of Tigard Attenti(m: Brian Blalock, Senior Plans Examiner 13125 SW Hall Blvd. Tigard,OR 97223 Re: Northwest N.'edical Teams Building Pe?n.it:BUP2004-0070 Plan Check Response M Project Number 2000358.05 Q H O 01 eD r Dear Brian: n � o• c o The following is Group Mackenzie's response to the City of Tigard's Fire&Life Safety and E Structu•-al Plans Examination. Our responses below correspond to the items in your letter o dated Ma,-ch 10, 2004. 0 Y V T E FIRE & LIFE SAFETY ca U�- 1. See revised details: 3,4, and 6/Cl.l. 0 3 N d IF"2. Detail 1/A 1.1 has been added to reflect Shan Table for Metal Studs 1 IG- 3. See revised door schedule on Sheet A9.1. Door 1298 and 220B shall be 20-minute rated assemblies and doer 123A will not be a rated assembly. Mo 01 F 0(L 4. See revised door schedule. Door 221 was added to the schedule. 1L 5. See revised ceiling plan on Sheet A6.2 and new Fire Rated Corridor Section on Detail 18/A8.2. Group Mackenzie, 0 K-6. See revised plan on Sheet A2.2. Hallway-120 is now identified as Corridor-120. a Incorporated De 7. See revised plan on Sheet A2.3. A 30"x43" area of rescue assistance with two-way U) communication has been provided in the existing stairwell. Group 1*) 8. See revised plans: A6.1,A6.2,A6.3. Illuminated exit signage has been provided. m Mackenzie Engineering. 9. Energy code and lighting budget will be deferred pending selection of design-build W Incorporated .J electrical contractor. STRUCTURAL /t� 10. See attached calculation. fhe rradit!on of V Markenve Engineerrno.md Maekenrre,Satto FI:\PRO.IEC'rS\00035805\WP\4c2311,doc ronLnuea. City of Tigard Northwest Medical Teams Project Number 2000358.05 March 29. 2004 Page 2 0(-11. See attached plan with panel numbers and locations. 0-12. Calculations had been revised to show a two.bolt connection. See attached page C5 of calculations. 0 X13. See attached footing calculation and revised detail 91A.8.4. 6(t-114. See attached calculation page Cu. 5. See attached cut sheets. Please let us know if there are any furthor questions. nccr e 13 1 o, AIA~.. Timothy L. Schweitz^.r, S.E. roje Manager Structural Engineer C'T M/mpd Enclosures a oc ..a m t� W J H^,PROD EC TS100035805\WrAc2311.dae 1 March 10, 2004 CITY A OF IGARa OREGON Christine Mckelvey Group Mackenzie 0690 SW Bancroft Street Portland, OR.97201 RE: TENANT IMPROVEMENT W/NEW EXTERIOR OPENINGS Project Information Building Permit: BIJP2004-00070 Occupancy Type: B/S-1 Tenant Name: Northwest Medieval Teams Construction'Type: VN Address: 4150 SW Milton Court Occupant Load: NA Area: 60,300 Sq Ft Stories: 2 The plan review was performed under the State of Oregon Structural Specialty Code(OSSC) 1998 edition, and the Tualatin Vallee Fire& Rescue Ordinance 99-01 (TVFR99-01) 1999 edition. The following information is required prior to the issuance of a Building Permit. FIRE -& LIFE-SAFETY 1. 4/C 1.1 indicates truncated domes for 24 inches. Section 1103.2.3.2, OSSC, requires a .� 36 inch boundary. Revise detail. 2. Provide detail 1/Al.1 3. Door 129B& 220B shall be 20 minute rated assemblies to maintain the integrity cif the corridor identified as 123. Door 123 A is not required to be rated. Revise door schedule. 4. Door 221 is not on the door schedule. 5. Clarify rated ceiling construction forth(.;corridor. Provide details. J6. "Hallway" identified as 120 should be renamed as Corridor. E C7 7. Provide an area of rescue assistance on the second floor. J 8. Indicate illuminated (xit signs on the Reflected Ceiling plan. 9. Provide an energy code, lighting budget. 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 v STRUCTURAL. 10. Section 1914.3.7 OSSC requires 2 # 5's to e.,tend past the openings in concrete walls.The 245's are in addition to the reinforcement required for other required loads. The proposed openings in panels 17& 18 will not be provided with the required 2. #5"s. Propose an altertipte method as permitted in section 104.2.8 OSSC. 11. Calculations refer to a numeric designation for the concrete panels. Provide a plan that indicates the panels as they are located on the site. 12. Detail 7/A8.4 requires 4 bolts per calculations. Revise detail. 13. Provide a calculation for detail 9/A8.4. 14. Detail 8/A8.4 indicates a joist supported on another joist. Provide a calculation that indicates the uniform load as well as the paint load as shown in the detail. 15. Provide Manufacturers cut sheet(s) for the metal deck and any tables that wiil indicate tl r load capacity of the product. • Please provide an item by item ;espon: When subrnitting 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 of Tigard in tracking and pro sling the documents. Respect .00 ian , Seni ans Examiner a rY U) m W June 16, 2004 CITY OF TIGARD OREGON Western States Fire Protection 13896 Fir Street, Suite B Oregon City, OR 97045 RE: MODIFICATIONS TO FIRE SPRINKLER SYSTEM Protect Information Building Permit: BUP2004-00229 Occupancy Type: B/S-1 Tenant Name: Northwest Medical Teams Construction Type: VN Address: 14150 SW Milton Court Occupant Load: NA Area: 60,300 Sq Ft Stories: 2 Hazard: Light/Ordinary Group I Commodity: IV The plan review was performed under the State of Oregon Structural Specialty Code(OSSC) 1998 edition; and the Tualatin Valley Fire & Rescue Ordinance 99-01 (TVFR99-01) 1999 edition. The submitted plans are approved subject to the following. I. A key box shall be installed within 20 feet of the riser room entrance. The bottom of the key box shall be not less than 8 feet nor more than 10 feet above the walking surface unless approved by the Fire Chief. 902.4.2 TVFR99-01 Contact TVF&R for keybox at 503-612-7010 An existing keybox is acceptable. 2. A supply of spare sprinklers(never less than F) shall be maintained on the premises so that any sprinklers that have operated or been damaged in any way can be promptly replaced. These sprinklers shall correspond to the types and temperature ratings of the sprinklers it the property. Standard 9-1, section 2-2.7.1 OSSC IL 3. A special sprinkler wrench shall be provided and kept in the cabinet along with the, spare sprinklers to be used in the removal and installation of sprinklers. Standard 9-S, section 2-2.7.2 OSSC 4. A minimum of 18 inches shall be maintained between top of storage ano -.eiling sprinkler deflectors. Standard 9-1, section 4-4.1.6 and 4-4.3.2 OSSA LU 5. Sidewall sprinkler deflectors shall be located not more than 5 inches or less tr inches from walls and ceilings. Standard 9-1, sectian 4-4.2.3.3 03SC 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(6G3)684-2772 6. Clearances shall be provided around all piping extending through wails, floors, platforms,and foundations. Minimum clearance for pipe sizes I inch Rough 3 "/: inches shall be not less than 1 inch. Minimum clearance for pipes 4 inches end larger shall be 2 inches. Standard 9-1, section 4-.5.4.3.4 7. Monitoring, Section 904.3.1 OSSC All valves controlling the water supply shall be electr-A, :4y monitored. 8. An approved audible sprinkler flow alarm shall be provided on the exterior of the building in an approved location. An approved audible sprinkler flow alarm to alert the occupants shall be provided in the interior of the building in a nonrAly occupied location. 904.3.2 OSSC Approved Plans: 1 set of approved plans, bearing the City of Tigard approval stamp, shall be maintained on the iobsite. The plans shall be available to the Building Division inspectors throughout all phases of construction. 106.4.2 OSSC 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 of Tigard in tracking and processing the documents. Respectful ria clock, Senior Plans Examiner IL OC m C9 W J CITY OF TIGARD ELECTRICAL - ENER RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00201 13125 SW Hall Blvd.,Tlqard.OR 97223 (503)639-4171 DATE ISSUED: 7/12/2004 SITE ADDRESS: 14150 SW MILTON CT PARCEL: 2S112AB-02300 SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: I-L BLOCK: LOT: 005 JURISDICTION: TIG Prolect Description: Low voltage for fire alarm. A.RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: AUDIO& STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: SHEININ-MENDENHALL LLC I TEAM ELECTRIC CO 12725 SW 66TH AVE#202 9400 SE CLACKAMAS RD PORTLAND, OR 97223 CLACKAMAS, OR 97015 Phone: Phone: 557-7180 Reg#: LIC 47336 SUP 44165 _ ELE 3-225C FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 7/12/2004 $75.00 Elecl'I Final [TAX]8%State Surcharl 7/12/2004 $6.00 Total $81.00 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 wir!:,C done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspeoded for more than 180 days. ATTENTION: Oregon law requires YOU to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 a, through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)243-6699. y Issued by ,� u�J C/,eJ Permittee Signature � _Cj�-�_ OWNER INSTALLATION ONLY CO The Installation Is being made on property I own which Is not Intended for sale, lease, or rent. 0 UJ OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: -1--Call 639-4175 639-4175 by 7:00 P.M.for an Inspection needed the next business day JUL. B.2004 2:24PM TEAM ELECTRIC NO.229 , Eleetricai Permit A�lic_ t= W City of Tigard J� �' i t- 4' PW=ftNc•; —00.W/ [3125 SW Hall Blvd.,Ttgud,OR 97223 pr peva Phone- 503,639.4111 Fax_ 503.596.1960 Other P`xdL Inspection Line,: 503.639.4175 Jill Dara 4W Fir 3 Gr Interest: wwa.ci.dgard_or.ns New t:olattrnatim ❑AddlFlew dw&W tw apgr: DCt1101ition ❑ ❑Service ova 225 amps,oomm'l ❑kltmdous location ElService over 320 amps-ming ❑8niidttt over 10,000 q.A., of 1-sad 2-fitatily dwellings 4 or more asvv reridordial M 1-and 2-ihm1ly do'elling ❑Commetc3AUiadtutriel—0 Accessory building ❑system over 600 volts nord1w uniu In one structure 0 Multi-fam4y Mester Wider 0 Outer; ❑Badding aver thea stories ❑Feedae,400 amps or mora ❑Oocum,load over 99 persons E1MUU#9turW etruetures or 13EF'ecsllialtin6 pion RV pRrk : �� Job site Wilma: ❑Aatth•-care ac" ❑Other: Job no _ I�b W s Submit_I sets otplaar with any o1 the above. City/State/ZIP: �. �'`� The above an na applicable to tempowy construction stsvioe. Suite/bldg./tgtt.no.: Project name: N IIT --� +--= t .. -- -- - N n. •s g9 Cross stroet/directiona to job site: Now reddeimisll dgoe-or,multi-hw2y dweilling IMIL — Ineludea attac 1,000 M-tZ or la.•g _ 145.15 4 Subdivision: ~W jpt tto.: Ea.ad4'1500jq�itor`portion 33.40 1 1`ax map/perael t10: -- Limited!!arty,residerttfal 75.00 2 _ Limited en ana-residential 75.00 2 Each MISM1111011UM OF modular dwelip_thtAedsr 0.90 2 - Sery1p or ae/Stuhatl dtenstloo,amd/er rebeatle.v t N ` 200 antes or lap 9030 2 � � 201 to 400 mp106.115 2 401 to 6001mW 160.60 _ 2 Name: 601 amps to 1 240.60 2. Address. Over 1 000 amps or volts 454.65 _ 2 Reoonna0tnal 66.95 2 City/State/zlp: TeMPMU7 se or raises MsalhHs a, raNaa,u Vor Phone: 2%wrip alas _ i6.95 l Owner iestallaftn:This Inst Hndon is being made on property that I own which L+not 201 wAp ro400 m,!pe 100 30 2 intended for sale lextse,rent,nr exchange,according to ORS"7.449,670,and 701. 401 !0600 am 133.15 12 Owner signattat: Date: Brsatc6 tdt eaNs-Deur apstytlen or extraefa'e,per A.Fee ft branch circuits wM - se vloe err fbeder fast each 6 65 2 Busir>esa nem 1e-ai�� _ _T dt i! F B.res fianui circuits Contact nrmc: %Whord envkx or tads fee, 46.95 2 Address: drouM Eaob add'I broft oirmit 6,65 2 City"State p: MbceSaaeous arfiee or heeler not bsrleded) —— Pump or kd circle 53.40 2 Q. Phone:( ) FaX::( ) s or ondime lighthg 5310 2 F-mail: Slane)cfrcuft(s)or limked- 7 777 enemy pond,ahaition,or C-� --_ exfeneina.Desexlbe: ! Page 2 2 >titleineas name: _ Address: 9 4 p O S�. r t�4��4s1� � [� ,� �VeetinaddidonsO Gapsctba m�sr allowable ism of the obe►.e Sam-FEZ- PQ,tap�inn 62.50 - - City/State/ZEN Q/j Ivveatiption per hoar(i I<r min) 62.50 J Phone ?,) �� (� Fax:( 615 S AZO Industrial Plant per hem 73.75 ` CCB Lia: Electrical Lic.: sltptw.'ii0.- , Suprv.Electrician sloature.,regained: -'_ _ _Pian review(25%ofpamtt Ike) T e eurcbstac(94 of perm_ l3 146) Print restos t `c -pa _- "' I�j�^ T" StatTOTAL .Al►tl'i PF paE � Authmi2edsignaure- Thb neRpeR+6taparer anee•Haloed sempMb Print name: j Date- — ••Yes aedtaMlogy on by 1tl.Coo ty IAdb W lademy service rend ,� �--/� tt��of Yttfat<ans ex oaeadr eRewed V ELECTRICAL PERMIT- CITY OF TIGARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT M ELR2004-00230 13125 SW Hall Blvd., Tlpard,OR 97223 (503)639.4171 DATE ISSUED: 7/26/2004 SITE ADDRESS: 14150 SW MILTON CT PARCEL: 2S112AB-02300 SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: I-L BLOCK: LOT: 005 JURISDICTION: TIG Prosect Descrintlon: Burgler alarm install. A.RESIDENTIAL B.COMMERCIAL _ AUDIO&STEREO: AUDIO&STEREO: INTERCOM R PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL#OF SYSTEM Owner: Contractor: SHEININ-MENDENHALL LLC I FIRST RESPONSE SYSTEMS GROUP BY PARROTT PARTNERHIP 4970 SW GRIFFITH DR 12725 SW 66TH AVE#202 BEAVERTON,OR 97005 PORTLAND, OR 97223 Phone: Phone: 503-207-5301 Reg#: L303-2074930(]3 ELF 26-956CL FEES Required Inspections Description Date Amount_ IF.I.PRMT] ELR Permit 7/26/2004 $75.00 TAX] 90%,State Surchari 7/26/2004. $6.00 Total E81.00� This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 a through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699. N Issued by � ,� _ Permittee Signature L N. } OWNER INSTALLATION ONLY J -- ® The Installation Is being made on property I own which Is not Intended for sale, lease, or rent. w OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M.for an Inspection needed -fig next business day U7/:JI-IL.?6.200419 1:05PM1598FIRGT RESPONSE INC' OF TIGAn NO.970 P.INUua i Q S Elects cal Permit Apt&cltf City of Tigard Pan 111x5 SW Hall Blvd.,Tipp,OA 97213 ;0 1 rMUVdaw Q:,r Phona: 303.639.4171 Fuc 503,5981960 ir kupsatioo Line: 503439.dt73 c� Nom, a hp I b,for,node" hweer www.ei.tiW.or.or ti> ,. ;�.. Now eonatruedon Addition/ol assent Oe ohWV SE OW Vie ly ❑DemolitionOder: ❑SCM=ova 213 VMS.oorret'l ❑Iiuudoua loeat oft ❑suvioe ow 320 auras-raeinS (]BWWn8 over 10.000 sq,ft, ! of 1-sod 2-amay dlweilinp 4 or nom new ruidmtkl I-and 2.f>vally d Accessorybttild{a[f []System ova 600 vola tloutWi —te im oat fttttawra Messrs-l�tm1 �]MaRei builder p� [j>luilding over thew ateritr [(Feedras,800 aatpa a them Qoccq mt toad over 99 persotu QManuschm atrnc.M$or ❑sweso d nsplin RV,pluk Job no.:X.27-/0 3 job site umrea: /y/$o SW l Gt rJ�.-cue fec,uty ODS' _-- -- Subadt.L scot of plass atilt trtty of ills ateve. Cit3o'Statr/Z@: - C>iZ q 7 7 be abova at not appF.cable to totrlpanry C0011114011Wv1V-�. 5tlicetbldgJept no.: proaacc a:tam-/�,J�t,i �i � •�•ii4�,.,�,', - - _- � lautry0ee Zw hYl Cross stroWdirecdons m job titc: irew ruldatttT" di pe-or mold-b r dwomax usit. -- Indusia aenaked ra s• 1,000%t1.or Mss 145.11• 4 Subdirhdob - - T.at na.: la•.addl SOO n.&a! onion 33.40 1 Undted EM taid0al ea75.00 tt2 Tax u e d no,. � l i�ted c,t�nna4uidw" 75.00 1 t�rstut`tttan�ar servi=iutd/orbedet 90.90 2 Ser,teaa or Mam Instalhdon,alta atfoa,aodtor ralooydan 200 oW or tat 1030 2 201 sap to 400 106:95 V 2 401 mWe to 600 150.60 -- 2 Name: 601 to 1,000 240.60 2 Address- Over 1,000 ams or volts 450.63 A Rec mtect only 66.85 2 Teaaporary services or feeden IAatallatiatt,alteradoo,ea or Phone ( ) Fat::( ) rdecidOA - 10 a rx lea b6.B5 1 Owner hiMile loo;Ibis installarion is being mMe on pmpeM tbAr 1 own which isnot 201 m 400 amps 100.30 2 intatdad fbr sale,lewc,tear,or e=)mmg%sccotrang to ORS 441,449,d70,and 701. 401 to 600 lamps 133.73 2 Otvttet agasiztre: _ Date; drauclt cirraitt mea,adtaratMR w oRavim,per pend A.Fee for bnmeb circuits+Hth Business ttatt!er /''�.-� cattle9 orlseder fee,cath 6.65 Z +^drcah Coi7a►ce tltmte J vs3� Far br braocb eitcua -lthout service or f xdcr fee, 46.fl5 A omit Addrau: q� Sw Grp '; 1��. /�j r :�ta»un Sub add'1 brach cireoie 6,63 2 city/Stmerm: Bq+^ Ole, CPMMbrcaltanaeua(mdse or*War fast ladndW) a Phone(5;o3 ) 2-jc)7-5 3 0c) Fax::(503 ) 7.07• 57-361 Nn or W den thele $3.40 1 2 Sign or oudhtc ughthe 53.40 2 H E,-�utill 9iBaa1 eirctrit(a)a N enew panel,altetadoat.or r cxtuWcn,Deters"": / Ftja 2 15 2 Bucmesc:patne: Addrm: I+alf additktsal inspIM63 ever 2I Rtrsbte in aay artle above ---— Perinapacdon+ 62.30 77-m lL City statelZEN `---- lytvasd om hole^ k 62.50 -j Phase:( ) Pax:( ) laid laat bout 73.75 MEOW x, CM Li:.: //i7/ $lectrieal Lie.:26-1 5, sem'.Uc., /�, �Submad 7-6 Snpty.V ctrician sWaftm rMdm, ---- Plea Nview 3%of pcern(t ierl - y L y sacs tuvettse�e(aa aipletrtit ue) Printout i'�! i%Ca- /7 fj/�o Hate: TOTALPZRMT)M)t 8 f Atitiletj2ed 9tQTlatnI't:: '�^ah p•rrnh opr[kagoa wYptr•e R rtsAit iw nwr_ nlwd www.too eayr a11ar R W bast/anon a enerplaa Pont asttne: s� Dald7 tr..�odobp an er M•�ehn8 taatrslr!+tubo lord ••Kaaba of k WdMW par tam*Man-'et. 13M3 �.eaeratttoaarOtaawa CITY OF TlGARD BUILDING PERMIT — PERMIT#: BUP2004-00229 DEVELOPMENT SERVICES DATE ISSUED: 7/7/2004 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARCEL: 2S112.AB-02300 SITE ADDRESS: 14150 SW MILTON CT SUBDIVISION: BONITA INDUSTRIAL PARK ,ZONING: I-L BLOCK: LOT: 005 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: of N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? 1 OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE_: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 10,800.00 Remarks: fire potection. Owner: Contractor: SHEININ-MENDENHALL LLC I WESTERN STATES FIRE PROTECTION 12725 SW 66TH AVE#202 13896 FIR ST STE B PORTLAND, OR 97223 OREGON CITY, OR 97045 Phone: Phone: 503-657-5155 Reg#: LIC 104570 FEES REQUIRED INSPECTIONS Description Date Amount Sprinkler Rough-In [BUILD]Permit Fee 5/19/2004 $148.90 Sprinkler Final [TAX)8%State Surchart 5/1912004 $11.91 [FLS] FLS Pin Rv 5/19/2004 $59.56 Total $220.37 CL This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR m 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by w� calling (503)246-6699 or 1-800-332-2344. Issued By: Permittee Signature: kX 4A / Call 639-4175 by 7 p.m.for an Inspection the next business day Rection S stem AdM 4- Built inY el-M > >lication CC CC City of'Tigard HECEI I gate 7ived `q�►/ , I'cnnil Nr. /1�lly-Opp 13125 SW I lall Blvd., Fward,OR 97223 flan Revie f �lLLL (nha 1'rmn1: Phone: 503.639.4171 Fax 503.598.1%0Mea" Date/d : —, Inspection Line 503.639.4175 /i I Datr Ready/Rv' �" ® ser Page 2 for Internet www.ci.tigard.or.us Notified/Methlal -^ Supplementallnformaflon --- 41 GITY OF TAG _ TYPE wG DIVISION REQUIRE?DATA:1•AND VFAM!lUY,DW14M1t+L1h1Ci ❑New construction ❑ Del-1111on PCrinu(ees'are based on the value of the work per')rnted. -- hxlicetc the value(rounded to the nearest dollar)of all Addilirn✓allcralinn/rcplaccnleni ❑(),her equipment,materials,labor,overhead.and the profit for the CATEGORV OF CON8TRUCT1ON work indicated on this application. Valuation: S ❑ I-and 2.family dwelling ❑Cotmncicial/indostrlal ❑Mulu family Number of bedrooms, El Accessory building _ ❑Other: Number of bathrooms: ' r-1Maslcr builder � -- JOB SITE INFORMATION AND LOCATION Total number of floors: - • lop site address: r y�5o S w �) f01, �UU! + New dwelling area: square feet City/Stale/ZIP: T e4o r--J q7�;k Z?y Garage/carport area: square feet ` - _ 4 Suite/bldg.lapt.no.: 11rojeci name,()W fiYf al /Ff)n7$ Covered porch area: - square feet - Cross streethlirections to joh Ste: � i >`ca ��1/O�i�L�u r-1 Deck area: square feet ; Other structure area: + y square feet x subdivision: Lot no.: Permit fees'arc based on the vnlue of the work performed. Indicate the value(roundel to the nearest dollar)of all Tax inap/parcel no.: equipment,materials,labor,overhead,and the profit for►1 DESCRIPTION OF WORK work indicated on this application. - -f-� E Valuation: S fit, Opp j flf r:lf��5 � Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER �— ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) pax:( 1 New: APPLICANT � CONTACT PERSON � NOTICE Business name: U4,j;-X, `,n J ia' A-7 fon CC) All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact mune: /I F&I'l - under ORS 701 and may he required to he licensed in the IL Address: � � Jr"f j LL; f y jurisdiction in which work is being performed. If the i applicant is exempt from licensing,the following reasons R (-ity/State/ZIP (^ Q� 97015 apply: U) Phone:(7,;/13) ,57-S 155 Fax :(503) 65 7 -5/8a P-(nail: e) IO ('� W CaNTRAc-roR F9 Business name: BUILDING BUiLD1NG P)aRMIT.')�BE9* 'J Address: Please refer ro jee schedule. City/Stale/ZIP: Fees due upon application Phone:I l Fax:( ) Amount received CCB tic.: J, — --- - - __ _- j� nate received: Authorized signature: r �J� ThiN permit appliention expires If a permit Is not obtained Within Igo days after It has been accepted as complete. Print namC: ��/1R ` ��/T Date:vQv y�� Fee methodology set by Tri-County Building Industry Service Board. I gmnildmppennns\FPS-Pemi1App 1111 1210 440.461 IT(I IM2/COMfwnin CITY OF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2004-00070 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 DATE ISSUED: 04/19/2004 PARCEL: 2S 112AB-02300 ZONING: I-L JURISDICTION: TIG SITE ADDRESS: 14150 SW MILTON CT SUBDIVISION: BONITA INDUSTRIAL PARK BLOCK: LOT:005 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: TENANT NAME: REMARKS: TI of existing building with rack storage&minor site modifications. Owner: NORTHWEST MEDICAL TEAMS 14150 SW MILTON CT TIGARD, OR 97223 Phone: 297-8791 Contractor: SD DEACON ENTERPRI INC(77875) PO BOX 25392 PORTLAND, OR 97298-0392 Phone: 297-8791 Reg#: LIC 77875 IL oc U) _J m W -" This Certificate issued 08/25/2004 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty qodes for the group, occupancy, and unde hich the referenced permit w u r j.� UILDIN INSPwc+' BUIL N FFICIAL `� POST IN CONSPICUOUS PLACE CITY OF TIGARD TEMPORARY CERTIFICATE OF DEVELOPMENT SERVICES OCCUPANCY 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 PERMIT#: BUP2004-00070 PERMIT ISSUED: 4/19/2004 PARCEL: 2S1 12AB-02300 ZONING: I-L JURISDICTION: TIG SITE ADDRESS: 14150 SW MILTON CT SUBDIVISION: BONITA INDUSTRIAL PARK BLOCK: LOT: 005 CLASS OF WORK: ALT TYPE OF USE: COM OCCUPANCY GRP: B OCCUPANCYLOAD: TENANT NAME: REMARKS: TEMPORARY OCCUPANCY FOR30 DAYS FROM TI of existing building with rack storage&minor site modifications. Owner: SHEININ-MENDENHALL LLC 1 12725 SW 66TH AVE#202 PORTLAND, OR 97223 Phone: Contractor: SD DEACON ENTERPRI INC(77875) PO BOX 25392 PORTLAND, OR 97298-0392 Phone: 297-9791 Reg#: LIC 77975 a_ F— It is understood by the owner/tenant that the issuance of this Temporary Occupancy Permit by the City of Tigard for the use and/or occupancy of the structure located at the site address listed above(hereinafter"structure"), does riot grant or convey to the owner or ' tenant any property right or other protectible property interest in the use and/or occupancy of the structure for any purpose. It Is further ._� understood that this Temporary Occupancy Permit shall only be valid for the number of days from date of issuance listed above and that the owner/tenant will no longer be authorized to occupy the structure after the period specified,unless and until all the conditions 0 of approval imposed under the City's or County's Notice of Decision for the project's land use case(s)issued by the City's Development -J Services Department or the County's Department of Land Use and Transportation and/or the Clean Water Services and ai, building and related code requirements and any other applicable requirements ha n Gamplet y fulfilled and complied with to the Ci 's or nt 's a sf ction. I/ Y Tl�tn L��j�i.-� UILDING INSPECTOR BUILDIN FFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING Inspection.Line: (503)639-4176 INSPECTION DIVISION Business Line: (503)639-4171 MST Q SUP _ Received _ c I 1' Date Requested U_. �� AM_ PM_-- _ BUP — Location �L _ — Suite — MEC _ Contact Person Ph( ) 9_35- e- 9s,e- PLM Contractor __— Ph( ) SWR BUILDING _ Tenant/Owner — i_ !�, 0 _ ELC 40 Footing ELC _ Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Past&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear _ Framing — Insulation o�� / � Fb� Drywall Nailing �[— — Firewall Fire Sprinkler -- Fire Alarm Susp'd Ceiling — --- --- Roof Other: — Final — PASS PART FAIL --- PLUMBING Post&Beam-- — — — Under Slab Rough-In Water Service Sanitary Sewer Rain Drains ------ — — Catch Basin/Manhole Storm Drain -- Shower Pan Other: — Final `--- �— PASS PART FAIL --- - - lk.ECHANICAL Post& Beam — -- Rough-In Gas Line Smoke Dampers — p� Final CO) PASS PART FAIL �- -- ELECTRICAL— J Service Rough-In _— ----- —__ ----- UG/Slab — W Low Voltage Fire Alarm r��77 _ AS PART FAIL 1__I Heinspection fee of$ required before next inspection. Pay at City Hall. 11312t;SW Hall Blvd. SITE F] Please call for reinspection RE:_. _ —_ Unable to inspect-no access Fire Supply Line ADA 8 - 2.61 _ Approach/Sidewalk Date_ _ -� Inspector Other: Final 00 NOT REMOVE this Inspection record from the job sits° PASS PART FAIL Mein Office Salem Office Band Office P.O.Box 23814 4060 Hudson Ave.,NE P.O.Box 7914 Tigard,Oregon 97281 Salem,OR 97301 Bend,OR 97708 Carlson Testin Inc. Phone(503)684-3460 Phone(503)589-1252 Phone(541)330-9155 g� FAX(503)684-0954 FAX(503)589-1309 FAX(541)330-9163 Special Inspection FINAL SUMMARY LETTER July 28, 2004 1.0405547 City of Tigard FILE COPY 13125 SW Hall Blvd., Tigard, OR 07223-8199 Attn: Building Department Re: NW Medical Teams 14150 SW Milton Court-Tigard, OR Permit No.: BUP2004-00070 Dear Sir or Madam: This is to certify that in accordance with Section 1701 of the Uniform Building Code, Title 24, we have performed special inspection of the following item(s) per our inspection reports only: Reinforced Concrete Installation of Adhesive Anchors S Wedge Anchors Structural Steel- Fabrication & Erection, *x:k-*9 wwaaw x wpwm avrc,a,,.WW vroMdum and melerlM cerlNlcaeo�e All im4pections and tests were performed and reported according to the requirements of Projod Documerrts and, to the best of our knowledge, the work was in conformance with the approved plans and specifications, approved change orders and applicable workmanship provisions of the State Building Code and Standards, as well as the structural engineer's design changes, approvals and verbal instructions. Our reports pertain to the material tested/inspected only. Information contained herein is not to be reproduced, except in full, without prior authorization from this office. If there a any further questions regarding this matter, please do not hesitate to contact this office. Respe fly submitted, a CARL N TESTING, INC. i J F. Hietpas rations Manager t9 a JFH/ks cc: SD Deacon Corporation Gnu¢Mw*enzie n IWORMWPORTWORMT CITY OF TIGARD 24-Hour BUILDING i Inspection Line: (603)639-4175 MST _22? INSPECTION DIVISION Business Line: (603)639-4171 -7/ 7 K p � BUP Received _� Date ues d_ — AM�' PM_ _ BUP Location ,�-_--�__-- �Suite MEC , Contaca Person Ph( ) 7O9'' ''� PLM _ Contractor_ Ph( —_) SWR _ UILD! Tenant/Owner _ ELC _ Foundation ELC Access: Ftg Drain ELR Craw!Drain Slab Inspection Notes: ( D --- SIT — Post&Beam N Shear Anchors - Ey'Sheath/Shear Int Sheath/Shear ---' Framing _ Insulation Drywall Nailingi — Firow L qZre Sprinkl Fire arm Susp'd Ceiling — Roof - PASS PART F IL Post& Bearn A Under Slab Rough-In Water Service _ _ —_— Sanitary Sewer Rain Drains — --Catch Basin Basin/Manhole Storm Drain _-- Shower Pan Other: ---— — Final PASS PART FAIL —`- MECHANICAL _ --�_ _— -- ------.__-_---- --- -- -- — Post&Beam Rough-In —_--_.__- —_------ —._.. _ 9L Gas Line Smoke Dampers — _--------- -- ---_ — -- N- Final PASS PART FAIL — -—- --- -- -- -- �— ELECTRICAL -� -J Service i+ Lo Rough-In 0 UG/Slab ——` W Low Voltage V Fire Alarm �_..--- Final Reinspection fee of$ r uired before nAxt ins PASS PART FAIL P inspection. aay at City Hall, 1St 25 SW Hall Blvd. SITE _ Please call for reinspection RE:._______� .___� _____�—_— _ Unable to inspect -no access Fl,,,)Supply Line ADA Appreach/Sidewalk D>rlte Other: Final _ DO NOT REMOVE this Inspeaden rkord from Ow job silo. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING 0 Inspection Line: (503)639"175 6 INSPECTION DIVISION Business Line: (5Az)639-4171 MST _ OUP f;r,ceived _Date Requested_._�__ AM—_ PM BUP location �_— S�7J �- —Suite—_. d ME _ —tom Contact Person _ Ph( ) .��l '—L� 7 PLM Contractor Ph SWR ( -) — BUILDING Tenant/Owner _ iJ ELC _ Footing — — Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post 8 Beam Shear Anchors - - - Ext Sheath/Shear Int Sheath/Shear Framing -_- - --- --_-_- y Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof Other:- - --_ - - — _ Final -- — PASS PART FAIL PLUMBING �--� Post A Beam - - Under Slr.j ,-- Water Service -----— _ —_ Sanitary Sewer "f Rain Drains — ------- _- _ Catch Basin/Manhole i Storm Drain - -_ Shower Pan Other: -- -- Final _ PASS PART FAIL - -- MECHANICAL Post 8 Beam- — - —' (lough-In Gas Line- d Sm ampere -- -------- - — _ — - i N SS PART FAIL - -- — — __ _ RICAL — J Service -- m Rough-In UG/f,lab - W Low Voltage Fire Alarm - Final Reinspection fee of$_--_ . _- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL - SITE Please ceil for reinspection RE: _--.- _ n Unable to inspect-no aceeyss Fire Supply Line ADA Approach/Sidewalk Dane - Other: Final DO NOT REMOVE this Inspection record from the hb slb. PASS PART FAIL i CITY OF TIGARD 24-Hour BUILDING • Inspection Line: (5503)631"175 MST INSPECTION DIVISION Business Line: (503)639-4171171 SUP Received DateyReequesteed� 7 7 AM__ PM __ SUP � —r Location 7 .�—_�_1 �.X.d. _ Suite __._ MEC Contact Person __ Ph PLM Contractor— Ph(_ ) SWR BUILDING Tenant/Owner l.l� ELC _ Footing Foundation ELC Ftg Drain Access: ELR X40 -00/ Crawl Drain Slab Inspection Notes: SIT — — Post S seam Shoar Anchors — Ext Sheath/Shear Int Sheath/Shear Framing ---- — _ Insulation Drywall Nailing PYW Fig.— .— Firawall Fire Sprinkler — Fire Alar Susp'd Ceiling — - Roof Other: Final _PASS PART FAIL —`�— PLUMI3ING Post 8 Beam — --�� `_--- --� Under Slab rinugh-In Water Service — Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain — Shower Pan Other: Final PASS PART FAIL -- - MECHANICAL Post& Beam Rough-in Cas Line IL Smoke Dampers — -- QC Final F- N PASS PART FAIL -- --- ELECTRICAL —_ Servine mRough-In ---��-- —__�� U UG/Slab r Low Voltage FffkAlarm 1 1-1 Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL _ ❑ Please call for reinspection RE:___ _ a._ ____._..�.—. Ej Unable to inspect--no Across Fire Supply Line ADA Approach/Sidewalk fAsb Other: Final DO NOT REMOVE this 111spectlon rscord from the job she. PASS PART FAIL CITY OF TIGAR© 24-Hour BUILDING 0 Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 M4T /� SUP — Recsived _ Date Requested____)-1Z ---- AM— PM BUP —�— _-- Location /. —_ ___—.Suite MEC — Contact Person ,. Ph ��!2 PLM Contractor__ Ph(_ ) _--_ SWR BUILDING Tenant/Owner — ��- ELC — Footing Foundation ELC ACCASS: Ftg Drain SLR -- Crawl Drain Slab Inspection Notes: SIT — Post&Beam Shear Anchors Ext Sheath/Shear Int Shea!n/Shear Framing _ �_----- -- -- -- - Insulation Drywall Nailing -- Firc wall Fire Sprinkler -- - - - Fire Alarm Susp'd Ceiling -- - Roof Other: '- ---- — Final -�--��-- PAS3 PART FAIL -` - ��- --- -- PLUMBING Postst8 Beam Under Slab Rough-Ise Water Service — Sanitary Sewer Rain Drains - Catch Basin/Manhole Storm Drain - --- - - --- ---- Shower Pan Other: - - ------- — - ,TTA-§j PART FAIL - ---� -- ---- - - " MECHANICAL -- Post&Beam Rough-In a Gas Line Smoke Dampers - — Final PASS PART FAIL - - -- -- - ELECTRICAL — SerJce --`— -- Rough-In - -- _----_-- -` — W UG/Slab _j Low Voltage ^— Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE_ -_ ❑ Please call for reinspection RE:—_ _. _ l l"Rhle to inspect-no access Fire Supply Line ADA Approach/Sidewalk Dab -- - Inspector_— Other: Final DO NOT REMOVE;;hls Inspection rmmrd from the job alto. PASS PART FAIL t S P"'E' C T Ra-Mgqert Selectable 1 1 be W.5TEM 1 Horn/$trobes SENSOR Models Available Strobes _ Y, `• PIU4MC ttan/tiuebe Red White FIRE Ys S1224MC S1224MCW • S1224MCP S1224MCPYJ S1224MCK ?t= S1224MCSP Mom/Strobes " ;.,,•per Red White rS �1. P1224MC P1.224MCW P1224MCP P1224MCPW P1224MCK P1224MCSP Homs •v ' Red White H12/24 H12/24W H12/24K Product Overvlow Operates on either 12V or 24V SpectrAlert"Selectable Output Homs, Strobl*,&W Hom/St►obee War enhanced fear Widest range of candela options: tures that Include the widest range of enndels options available and the capability to 12V: 15 and 15/75 candela recognize and self-adjust for either 12 or 24 volt operation. With an overall feature 24V: 15, 15/75, 30, '15. 110 candela set that combines performapce, Installation ease, flexibility, and a consistent, aesthetically pleasing appearance, the SpectrAlert Selectable Output devices Easy candela selection provide both the Innovation and efficiency synonymous wtth the SpectrAlert name. Lower current draw Performance. SpectrAlert selectable output wall-mount horns,strobes,and horn/strobes Easy DIP switch selection for horn offer key performance features long associated with the SpectrAlert name.The select- optlonn able candela strobes and horn/strobes offer average current draws that are not only lower than conventional fixed-candela SpectrAlert products,but also lower than similar Eat,y mountIn4 with QulekCllek'*' selectable candela products. By consuming less current,the ability to connect even more Synchronlzable with MDL devices per loop is possible,resulting in a lower installed cost. Syne•Clrcult'41 module Installation. SpectrAlert selectable output horns,strobes,and horn/strobes offer the IL Meets 111-1971, NFPA72, and ADA same installation-friendly features synonymous with the SpectrAlert name,such as the signaling requirements option of?- and 4-wire operation;the ability to use standard size backboxes with no r/a All strobe and horn/strobe models Incorporate a encroachment into the box;and universal mounting incorporating the labor-saving new patent-pending-oltage booster design that QuickClickn,feature.Such labor-savings features make wire connections simple and fast, has a more consistent flash bulb voltage over further reducing installed cost. the range of candela selections. The benefit to Flexibility. SpectrAlert selectable output strobes and hornistrobes offer the broadest the customer is a high quality strobe device. Wrange of candela options.In addition,the selectable output strobes and horn/strobes can operate on either 12V or 24V,with no setting required;the device recognizes and self-adjusts to the correct current automatically.Temporal 3 or Continuous tone options o �C continue to be available,in either an Electromechanical or 3kHz pattern. LSM s<s17 css.weor+K37rJ4 Aesthetics. SpectrAlert selectable output horns, strobes,and horn/strobes incorporate s.o11 `�'�ovto2NM13rm the same stylish,low profile design of the conventional SpectrAlert products,for a con- ® A sistent and aesthetically pleasing appearance across the entire product line. r M 6P�v" ,1751M9 222 112424 71331709223 3014150 126024 En;9neei g SpoelRcatlons General fire protective service. Horn/strobe shall be wired as a primary SpectrAler horns,strobes and horn/strobes shall be capable of signaling notification appliance and comply with the Americans mounting to a standard 4" x 4"x I Yz" back box or a single gang with Disabilities Act requiremew i for visible signaling appliances, 2" x 4" x 1'/s" back box using the universal mounting plate flashing at 1Hz over the strobe's entire operating voltage range. included with each SpectrAlert product. Also, SpectrAlert prod- The strobe light shall consist of a xenon flash tube and associated ucts. when used in conjunction with the accessory SynceCircuit lens/reflector system.The horn shall have two tone options,two Module,shad be powered from a non-coded power supply audibility options(at 24 volts)and the option to switch between and shall operate on 12 or 24 volts. 12 volt rated devices shall a temporal 3 pattern and a non-temporal continuous pattern. have an operating voltage range of 9-17.5 volts. 24-volt r;--ed Strobes shall be powered independently of the sounder with the devices shall have an operating voltage range or 17-33 volts. removal of factory installed jumper wires.The horn on horn/ SpectrAlert products shall have an operating temperature of strobe models shall operate on a coded or non-coded power sup- 32'to 120°F and operate from a regulated DC or full wave ply(the strobe must be powered continuously). rectified, unfiltered power supply. Synchronlzatlon Module Strobe Module shall be a System Sensor SynreCircuit listed Strobe shall be a System Sensor SpectrAlert Model to UL 464 and shall be approved for fire protective service.The listed to UL 1971 and be approved for fire protective service.The module shall synchronize SpectrAlert strobes at lHz and horns strobe shall be wired as a primary signaling notification appliance at temporal 3. Also,the modrde shall silence the horns on horn/ and comply with the Americana with Disabilities Act require- strobe models,while operating the strobes,over a single pair of ments for visible signaling appliances,flashing at 1Hz over the wires.The module shall he capable of mounting in a 41r/rF" x strobe's entire operating voltage range.The strobe light shall con- 411hs"x VW back box and shall control rwo Style Y(class R)or sist of a xenon flash tube and associated lens/reflector system. one Style Z(class A)circuit. Module shall be capable of multiple zone sym:hronization by daisy chaining multiple modules together Horn/Strobe Combination and re-synchronizing each other along the chain.The module Horn/Strobe shall be a System Sensor SpectrAlert Model shall not operate on a coded power supply. listed to UL 1971 and UL 464 and shall be approved for Speelf4catlons Walk Test Weight, strobe and horn/strobe Operating voltage range" SpectrAlert horn/strobe and horn only 8.8 oz. 12V: 8-17.5V; 24V: 16-33V work on "walk tests" with time dura- Mounting Operating voltage range* (with tions of 4 seconds or greater 4" u 4" x i'/i" or 2" x 4" x 1'/a" Syrc•Circuit module, MDL) Input Terminal, standard boxes 12V: 9-17.5V; 24V: 17-33V 12 to 18 AWG Indoor Operating Temperature 'Note for Strobes: Do not 3xceed; 1) a Dimensions — 32°F to 120°F (0°C to 49°C) 16--33 or(1-17.5 voltage range limit; Strobe and horn/strobe with universal -- —Maximum humidity 2) maximum number o!70 strobe lights plate when connecting the MDI_Sync module 5" Y 55/e" x 215/1e" 959 as tested per IJL464 with a maximum line Impedance of 4 Strrbe and horn/strobe with small Operating Temperature ohms per loop and; 3) maximum llrie =, footprint plate Weatherproof(horn and horn/strobes) impedance as required ty the fire alarm 33/s" x 55/s" x 25/1x" 32°F to 1507(0"C to 66•C) control manufacturer W Horn with universal mounting plate (outdoor strobe only) U.S. Patent Numbers 5" x 56/s" x 15/16" -40°F to 158°F(-40"C to 70°C) 5,593,569 Horn without mounting plate ULC Canadian Models 5,914,665 2161/16" x 55/Se" x t5/r6" -40°C to 69°C 6,049,446 %Vu,ight. horn rmly----- �--�_,- Voltages - - 7.2 oz. 12 or 24VDC and FWR unfiltered SKUPO.-Imert 11N., SYSTEM Module Models Available MDL(Red) MDLW (White) Canadian Models MDLA (Red) MDLWA (White) Product Overview Two wire operation from module Technology. The Sync-Circuit module synchronizes SpectrAlert'strobes at to the devices 1 Hz and horns at temporal 3 over a single pair of wires. Pat_lated module tech- Silences horns over a two wire loop nology also allows the silencing of horns on horn/strobe models over a pair of wires. Synchronizes strobes at 1 Hz Synchronizes horns to temporal Application Flexibility. The Sync-Circuit module is designed to power and syn- 3 pattern chronize either two 3-amp circuits wired in Class B or one 3-amp circuit powered as Class A. Should more than two zones require synchronization, Patented technology additional modules can be added by interconnecting the "slave" input and Allows slave module operation output terminals between modules. Generates synchronized temporal 3 Additional Capabilities, The SynL-Circuit module is also designed to generate tem- tone for Multl-Alert"and PA400 poral 3 tone for System Sensor's Multi-Alert and PA400 Mini-Alert sounders. horn products Existing installations can be upgraded to comply with NFPA 72. IL Engineering Specifications l]f Synchronization Circuit Module si;cll be a System Sensor Sync-Circuit Model _ listed to UL464 and shall be i pproved for fire protective service.The mod,de shall synchronize SpectrAlert strobes at 1 Hz and horns at temporal 3. m Also, the module shall be capable of silencing the horns on horn/strobe models, while operating the strobes, over a single pair of wires.The module shall be _j capable of mounting to a 4"/4"x 411/."x 21/r" back box and shall control two �C Style Y (class B) or one Style Z (class A) circuit.The module shall be capable LIM casui5.e ,5512 of multiple zone synchronization by connecting multiple modules together via a slave-in/slave-out arrangement and re-synchronizing each other along the chain. Note: The module shall not operate opt a coded power, supply. FM > KA 'IM 1209 1 OOMfav a1N'/b generalgeel8 ac Ions__ f . �., Mo"nting Indoor Operating Temperature 5'A'L.5 A-w 414. x241'back box 32'to 120'F(0'to 49'C) Operating Specifications Ooerat,ng Vcnage 0petA4ng Voltage Range(12 V) Maximum Load on Loop 12 or 24 VDC and FWR unfiltered 9 to 17.9 VOC 3 Amps/zone Ociet.IUng Vottage Range(24 VI t7.S.Paten? Nos 17 to 33 VDC 5.596.139 5.650.178 Homs Sllewed Over Two-Wire Circuit 1-Any mix of Horn/Strobes or Strobe only devices is acceptable 2.Horn control connects to Interruptible power source lwTtn YOOMI r YAys NWNAA FACP M PAP Sit t x•rw ear, I a xsrn ?ere -> t.l IIOI canxoL evr toNm ; aex+wo� TOMW "Act w4KTRUW" SMCTRALWT an on Rot at— ttavlcR art NACI r re•s�t eel AxC2 ----;r ?-i NAC$ fox•r •rxe .'� foci tare r ---o « ria 1 « sx#ox /PR�CTRALLT11rr 1-1 !Pict�* rye 02%%10" ttavtea oft l r" KA sn Jib" Ra O/f -^� A8peo� • • TTM• hornMrob Strobes Nda operate In sync. Tamp 3 Coding of Multi-Alert and PA400 Sounders Strobes must he powered from non coded supply rY1l > _(otmtolewrt ..... to NbtT "C" Q+ MNICR on ROl NACI v i•r r tp!•t in drr iOrrx r e (tJ > NACI r.w• TO JAM ORVICR an KAVI SLAVS ROL of our • • Nem•will be Tanperal TRW.JUWRA ON ee4ed end 1,•yne. Ordering Informatlon/Current Draw a Average Current(mA) ( Peak Current(mA) In-rush Current(mA) _ Model No.(Red) Model No.(White) Voltage tic FWR DCr*R DC_ FWR N MDL, MDLW. 12 10 12 30 31 at - 122 MD(A(Canadian) MDLWA(Canadian) 24 11 15 35 37 198 262 _J fY1 W System Sensor Sales and Service System Sensor Headquarters System Sensor Canada System Sensor In China System Sensor-Far East System Sensor-India 3825 Ohio Avenue Ph:905.812 0767 Ph:88.29.524.8253 Ph:85.22 191.9003 Ph:91.124.237.1770 x..2700 St.Charles.IL 60174 rx 905.812.0771 Fx:86.29.524.6259 Fr:85.22.736.6580 Fx:91.124.237.3118 Ph:800/SENSOR2 System Sensor Europe System Senna In Singapore System Semler-Australia System Sensor-Rusela Fx:630/377-6495 Ph:441403.891920 Ph:85.6273.2230 Ph:613.54,281 142 Ph:70.95.931.7982 Documents-on-Demand rx 44 1403,891021 Fx:65,6773.2610 F. 813.54281172 rx, 7095.937.7983 800/736-7672 x3 www.sysrr,n,ensor com 0 2004 System Senses.The Company reserves the right to Cherie#product speCiscetMns without notice. A00-1007.001•9/Os.a12S7 BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2004-00348 DEVELOPMENT SERVICES DATE ISSUED: 7/21/2004 13125 SW Hall Blvd..Tigard.OR 97223 (503)639-4171 PARCEL: 2S112AB-02300 SITE ADDRESS: 14150 SW MILTON CT SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: I-L BLOCK: LOT: 005 JURISDICTION: 1 IG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: of N: S: E: W: TYPE OF USE: COM SECOND: of _ PROJECT OPENINGS? _ TYPE OF CONST: 5N of N: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 of ROOF CONST: FIRE RET? 0(,-UPANCY LOAD: BASEMENT: of AREA SEP. RATED: STOR: HT: ft GARAGE: of OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 4,000.00 Remarks: Fire alarm, strobes, pull station &smoke dectectors. Owner: Contractor: SHEININ-MENDENHALL LLC I FIRE SYSTEMS WEST INC 12725 SW 66TH AVE#202 600 SE MARITIME AVE#300 PORTLAND, OR 97223 VANCOUVER, WA 98661 Phone: Phone: 360-693-9906 Reg#: LIC 49732 FEES REQUIRED INSPECTIONS Description Date Amount Electrical Permit Required [BUILD] Permit Fee 7/21/2004 $81.70 Fire Alarm Insp Final Inspection [TAX]8%State Surcharl 1/21/2004 $6.54 IFLSj FLS Pin Rv 7/21/2004 $32.68 Total $120.J2 a ac N 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 susper, !ed for more than 180 days. ATTENTION: Oregun law "J requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR W 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct nuestions to OUNC by F3 calling (503)246-6699 or 1-800-332-2344. Issued By: _ Permittee Signature: �� Call 639 175 by 7 p.m.for an inspection the next business day Fire Protection System BOilding Permit Application Received (� City of'I':,u_ard Datettty 7 2/ C/ )1 " Pe.rmit No.7SLA3, 11125 SW Hall I)lv�.Tigard,OR 97223 Plan Review J /. Other Permit {'hone 503.639.417( Fax: 503.59A.19(><) Date/By: I `Z� �r► � S Inspection Line: 503.639.4175 Date Ready/By. lurk QI tie!Pqe 2 Por Inlrrncl. www.ci.tigard.or.us Notifted/Method: _ 3uppk�eentall�ormation TYPE OF WORK RBQUIRID DiATAr I•AM'"AMY DWALLM ❑N-w construction ❑Demolition Permit fees*tue hased on the vaiue of the work performed. --- -- Indicate the value(rounded to the nearest dollar)of all Additian/alleration/replice ment ❑01hcr: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. --� ""--- Valuation: $ ElI-and 2-family dwelling Commercial/industrial ❑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: 1416'0 6W New dwelling area: square feet City/State/LIP: T Qo e),Q, 97-91- _ Garage/carport area: square feet Suite/bldg./apt.no.: — Project name: M K(s . Covered porch area: square fat Cross street/directions to job site: 3cK t l� (� ��-�}� Deck area: _ square feet Other structure lues: square feet Subdivision: — l of no.: i Permit fees'sae based on the value of the work pr:rformed. 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 ap Ip!cation. — Valuation ow,cc Exi<ting building area: JBCW square feet w New building area: CW square feet r ❑ PROPERTY OWNER eTENANT Number of stories: Name: N4w1n/L✓ES'f' /ar�7,�lC NL /C�ritS Type of construction_ Address: 141-"o '5tJ /J7r,k'X (2r, Occupancy groups: City/Slalc/ZIP: _1/el*J(_'3' 0/2. Existing: --v— Phone:( I Fax:1 ) New: ❑ APPLICANT ❑ CONTACT PERSON 1 Business name: _ All contractors and subcontractors are required to be Contact name: — licensed with the Oregon Construction Contractors Board -- under ORS 701 and may be required to he licensed in the Address: jurisdiction in which work is being performed.If the IL ---� ---J City/State/ZIP: applicant is exempt from licensing,the following reasons � aPP1Y_-- U) Phone: E-mail: -1 CONTRACTOR W 5 Business name: _J Address: &00 �. /'U4.l7'j.f y JC � - Pimm refer to fee schedub. City/State/ZIP: L/KeLO�� -� [� _ Ld13G Fres due upon application Phone:l �� ) (r9.3 19•'li Fax:(5o3) W9 ' �g - --�— -- Amount received CCR tic: V�� 719ZN -- Date received: Authorized signatnrr' ��;t This permit application expires If a permit Is not obtained W thin 1 R0 days after it has been accepted ae complete. Prin[name: FC iC k � Date ��— * Fer mei;i;oology set by Tri-County Building Industry Service Board. i\Buiklinp\Pcmau\1VS.PrrmeAPP,L w I2A3 440-M1311I I/M&(W/WEB, July 12, 2904 CITY OF TIG,ARD OREGON Bruce Murdy SD Deacon PO Box 25392 Portland, OR 97296 RE: RACK STORAGE @ NW MEDICAL Project Information Building P.-rmit: BUP2004-00070 Construction Type: VN Tenant Name: Northwest Medical Occupancy Type: B Address: 14150 SW Milton Court Occupant Load: NA Commodity: C!ass III The plan review was performed under the State of Oregon Structural Specialty Code (OSSC) 1998 edition, and the Tualatin Valley Fire & Rescue Ordinance 99-01 (TVFR99-01) 1999 edition. The submitted plans are approved subject to the following conditions. Loads Posted: The racks shall display in one or more conspicuous locations a permanent plaque not less than 50 square inches in area, showing the maximum permissible unit load in clear legible print. Approved Plana: 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 throughout all}teases of construction. 106.4.2 OSSC 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 of Tigard in tracking and processing the documents. IL ZSenior cti U k, J Rxaminer m a W 13125 SW Nall Blvd., Tigard, OR 97223 (503)639-4171 TDD(503)684-2772 i Vj lel it hh 1 s>tv�5 , I a , w 1 • e , I I � rt • CITY OF TIGARD 24-Hour BUILDING . Inspection.111-int: (503)639.4175 INSPECTION DIVISION Business Linc (503)1439-4171 MST SUP Received — Date Requested AM— PM_ SUP Location — il t J —--Z4 -- __ ____ Suite____ MEC Contact Person �_ Ph(_.—__) __�.�L_`- PLM Contractor T Ph( ) .�_ SWR —, BUILDING _ Tenant/Owner _ � ELC Footing ELC Foundation Access: — Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT --__ Post R Beam — Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation �p Drywall Nailing ---A?�rw _ Firewall Fire Sprinkler -- --------- — — FireAlarm Sus Susp'd Ceiling --- Roof Other: — — -- — Final — PASS PART FAIL — PLUMBING Poet&Beam -- Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Stnrm Drain — — -- Shnw9r Pan UthPr ----- ---- — — Fina! -- PASS PART FAIL --MECHANICAL Post R Beam — — Rough-In — _-- Gas Line IL Smoke Dampers — -- OC Final PASS PART FAIL — --- — — — ELECTRICAL — J Service m Rough-In — UG/Slab — — W Low Voltage tIFIrGrm PART FAIL E] Rai,ispection!se of s._. ____. _ . required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinspection RF: Unable to inspect—no eco- Fire Supply Line ADA ApproachiSirlew�lk Dab — — Inspe�t� Ext----- Other: Final DO NOT REMOVE this In8111" Jon r000rd fibllfl Um job*ft. PAb! PAR FAIL ` ELECTRICAL PERMIT- CITY OF TIGARD ' RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00126 13125 SW Hall Blvd.,Tlaard, OR 97223 (503)639-4171 DATE ISSUED: 5/14/2004 PARCEL: 2S112AB-02300 SITE ADDRESS: 14150 SW MILTON CT SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: I-L BLOCK: LOT: 005 JURISDICTION: TIG Prosect Description: Data/telecommunications low voltage. A.RESIDENTIAL B.COMMERCIAL _ AUDIO& STEREO: AUDIO&STEREO: INTERCOM& PAGING: BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: _ TOTAL# 21UMSTEMS: 1 Owner: Contractor: SHEININ-MENDENHALL LLC I CHRISTENSON TECHNOLOGY SERVICES 12725 SW 66TH AVE#202 1631 NW -HURMAN ST. 2ND. Fl— PORTLAND, OR 97223 PORTLAND, OR 97209 Phone: Phone: 503-419-3600 Reg#: LIC 64137 FILE 26-1174C _ SUP 19945 FEES Required Inspections Descript!on Date Amount _ Low Voltage Inspection IFI_PRMT] F?1.11 Permit 5/14/2004 $75.00 Elect'I Final [TAXI R%State Surchaq 5/14/2004 $6.00 Total $81.00 This Permit 15 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 worts is not started within 180 days of issuance, or if work is suspended for more than 190 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 a through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699. v1 Issued by Permittee Signature ILIOWNER INSTALLATION INSTALLATION ONLY m The Installation Is being made on property I own which Is not Intended for sale, lease, or rent. Lu OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO* - Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day MAY-12-404 WED 02.57 PM CHRIST'ENSON CORPORATION FAX N0, 503 419 3636 P. 01/02 �ert�r cal P�rr�itLAn011jWWV E D Received( Iee�le.l City of Tigard Mi�`� 2001+ Plaening ' o sign t No;ps !��42 13125 SW Hall Blvd. Plan Review CIT'>' C, \F1L Plan REview other" Tigard,(kegon 97223 11t.D1 G f!' jitP t No.: Phone: 503-639-4171 FAx: 503-59S-1961 Post-Review`— Landwa Internet. www.ci.tigard.or.u9 DeedBy' Case No 24-hour frispection Request: 503-639.4175 Contact lura,.; , Ssa pare 2 for Naltx/Method; Suneilement2l Gsformariea. New c.on -- Additit�n/a1wratiol/re iacement Other: comrnieitial Hazardous location [�Service over 320 amps-rating of Building over 10,000 squ--rc feet, t' I&2 firmly dwellings tour or "Or,residential units in 1 &2-Fa>�dwelling Cottlmercial/lndustrial _ S)'vem over boa volts nomtnai One IdUCtuh Accessorv_ButlditlK _ Multi-Family Building mer three suxties Ll Feeder,400 Rmpa or mora Occupant load over 99 pertons' �]Manufactured structures or RV park Muster Builder Other: figress/lighungplan Other; vI I Submitits of plans with nay of the above. Job site address: 14150 SW MILTON CT (T) 97223 eaboveare nota licaba otem rat. con■ tiopser.ica Suite#: - Bldg./Apt, ; � Number of the eedoa Per Permit allowed Pr2iect Name. Dcactf on � -- ---- — Fri Qty et.(ea) Tastl g &t t?� �0 7�tQ t�" New rnldeotle-Angle or multf Ei eyr pe► J011 TE°°C61�'e N CHR} b IONEs(503)62 4-1000 dwelling uok.includes attached garali Seryke kttluded: 1000 sq jt.or{au _ 145,15 4 Each additional x00o�_�or— n o _ i Subdivision: _ _ Lot#: t " �fIIt1d°e=l.._ 75.00 z Lurtated cher identitl 7 , 2 Tax tea / drCel#: Each manufa a or modular dw1eTlurj service VW_ Qr feeder 90.90 2 OW VQLT_A_GW1_=A1TE ServA:es or feeders-lartallatloo, 0 I alteration or relocation- smos R,� last. _ 60.30 2 UESTIOWCONTACT J Y G. 503 19- 4 1an' 106.95 -J 2 401160.60 601000 am 240.60 2 Name: Ont.toxo arp tp or vote _ 4s—s z Donees only _ 6. 5 _ 2 A.ddIe9S: M Temporary services or feeders-lastellation, OtY/State/Zip� alteration,or relocation: 200 artgr oT ieg 66.95 I Phone: Fax' zot 4nips to 400a�_ _79._30 -- 2 amp 401 to 600 am133.73_ 2 Branch circuits-new,atteratlon, Name: extension _ per pend: 1�dClreSS: _ A-Fee for brattch circuits with purchase of aerv�ea a feeder fee_each bunch circuit 6.65 2 city/state/Z..— —^ A.Fee for tench circuits without puiritf_ of Phone: service or heeler to branch ebwh 2 Fax' Bach additional h uit 2 IL E-mail: - i�:s<.iserYi"a �m anomae�: ie or uri�uion c{rcle _ s7.40 4411,91 qurlftte li do 53 2 W Job No: 43-001 _ signal circuit(s)or a limited energy panel Business Name:CHRISTENSON TECHNOLOGY SERVICe.S r�aclto°,ct°"tension 1 pa 2 75, a Address: 163! NW THURMAN ST 2ND FL �� DAT�n� 1:LECOMMUNICATION m Cit /Sy tate/zl, rORTUND, ach eddttaooat les fettep pvar the allow tble Ilay of the above: Pa h_wMtlon hours I ftoyr) W pet PhonC:(503)419-3bUU Fax: 503 419-3636 _� vgta on fee: T CCB Lic. #: 64137 Lic.#: 26-�117_4C Supervising electrici ahmwniim 11 signature required: 1 Subtotal S �_ 4 ! 5 IL2/C4]4 flan Review 25%ot'Pmmit Fee S Print Name ROBERT A. AXT Lic, #: 1 State Surcharge(8%of?ertnit Fee 5�---V. Authorized TOTAL PERmf h 9 Notice: This permit applicatlon expires If a permit is o cirtained witbin `�igitature: _ Dtte: 180 days after it her been accepted a complete****' V2SA******* 'Fee methodology set by Tri-County Building Industry Service Hoard, lease pent name) a 1Dsts\Permit Ieotmt\Elc?e rnitApp.doc 01/03 CITY OF TIGARD 24-Hour BUILDING • Inspection-L%eL4503)635-4175 MST INSPECTION DIVISION Business Line: (503)635-4171 BUP Received ___—_ _Date Requested,./ —Z� AM_—__.PM—__.—__ BUP _ Location _.—_� �� M�t'!'�"F _ Suite_ ____ MEC -- Contact Person — Ph( ) _.__--__ PLM Contractor —___--___—_ Ph SWR _. _BUILDING _ Tenant/Ownor — ELC — Footing Foundation ELC - Fig Drain Access: ELR 2o6q 00 .2-'s o _ Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Fr,ming - --- ----�. _- _ Insulation Drywall Nailing — ------ ------ - - -- - Firewall Fire Sprinkler --- - - -- -------------- --- Fire Alarm Susp'd Ceiling - -- --- -- `- --- -- Roof Other: ---- - ---- �_�-_-_ _- _ ---- Final _�------- PA33 PART FAIL ------T__--- -- ___-�-- - PLUMBING Post&Beam Under Slab - - -- --- Rough-In Water Service - -- - Sonitary Sewer Rain Drains ---- Catch Basin/Manhole Storm Drain -- --- Shower Pan Other: _ -- Final PASS PARI FAIL _ME_CHA*i!^r! --- -- -- -- --- Post&Beam Rough-In - - - -- ----Q. Gas Line Smoke Dampers - - --- -- - - i F- Final U) _PASS PART FAIL - - - ELECTRICAL05 _ Service - - - -�-- - Rough-In UG/Slab �- _j Low Voltage _ _ __---- ----�--- - --- - -- - - Fire Alarm Fi - 0 Reinspection fee of$ _-_ required b0ore next inspection. Pay at Clty Hall, 13125 SW Hall Blvd. PAS PART FAIL SUE Please tail for reinspQction RF - _ ----_.- _--. Unable to inspect--r,-)access Fire Supply Line / ADA 14 - 16A, Approach/Sidewalk Dab r Z p- Iwspectotr -- -Ext_---- Other: Final DO NOT REMOVE this Initpsdbn Iroaolyd from the job sib. PASS PART FAIL CITY OF TIGARD 24-Hour BUII DING Inspection Line: (503)639-4175 INSPECTIN " DIVISION Business Line. (503)639.4171 MST _�._._ BU^ -- Received _--_Date Requested_� Z.p_AM — PM_—_-- BUP Location1_4U.5-0 '��/L — Suite —.___— MEC — __— Contact Porson _ __ _ ___—_ Ph(_—) _ PLM Contractor_e — Ph(---) SWR BUILDING Tenant/Owner _._ -- ELC Footing Foundation Access: ELG Ftg Drain ELR 00 2 T Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing ---- ----- — -- - -- Insulation Drywall Nailing --- - — Firewall Fire Sprinkler Fire Alarm Susp'd CP'',ng — - — Roof Ot',er: _ -- --- -- ---- —___ Final _ _PASS PART FAIL -- - — PLUMBING -.Post 8 Beam - -- ---- --- Under Slab Rough-In Water Service Sanitary Sewer Rain Drains --- rntch Basin/Manhole Sto m Drain — Shower Pan Other: -- Final PASS PART FAIL — MECHANICAL Post& Beam Rough-In — Gas Une CL Smoke Dampers -----w Final N PASS PART FAIL -- --- ELECTRICAL — J Service m (lough-In -- - ---------- — UG/Slab uj Low Voltage F' larm r F] Reinspection fee of$ ^_requirr 1 before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL sm 0 Please cv.:,fog einspection RE _ _ Unable to i""M nn access Fare Supply Line ADA g �'l �' .+� y Approach/Sidewalk Dab I _—.._ hnegmeter---1�— - �—Ext Other: Final DO NOT REMOV:this Inspoetion Irm*rrd from So fob sib. PASS PART FAIL CITY OF TIGARD ELECTRICAL PERMIT PERMIT 0: ELC2004-00235 DEVELOPMENT SERVICES DATE ISSUED: 5/21/2004 13125 SW Hall Blvd..Tigard,OR 97223 1503)635-1171 PARCEL: 25112AB-02300 SITE ADDRESS: 14150 SW MILTON CT ZONING: I-L SUBDIVISION: BONITA INDUSTRIAL PARK BLOCK: LOT: 005 JURISDICTION: TIG Project Description: Electrical TI Job No. 9029---- RESIDENTIAL 029 __RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 6 - 200 amp: PUMP/IRRIGATION: EACH ADD't.500SF: 201 - 400 amp: !�tGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FOR: 601+amps-1000 volts: MINOR LABEL (10): 0-RVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 2b0 amp: 6 W/SERVICE OR FEEDER: 129 PER INSPECTION: 201 - 400 amp: 1 1st W/O SRVC OR FOR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amp/volt: 1 >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect onty _ ',/FDR>=225 AMPS: _ CLASS AREAISPEC OCC: Owner: Contractor: SHEININ-MENDENHALL LLC I TEAM ELECTRIC GJ 12725 SW66TH AVE#202 9400 SE CLACKAMAS RD PORTLAND, OR 97223 CLACKAMAS, OR 97015 Phone: Phone: 557-7180 Reg#: LIC 47336 SUP 4416S FEES ELF 3-2250 DescriptionV Date �Amount Required Inspections [ELPRMTj ELC Pem:it 5/6/211114 $787.15 [TAX]8%State Surcharre 5/6/2104 $62,97 Rding n Ceiling JELPLCK] EI.0 Pln Rev 5/6/2104 $196.78 (additional foes not listed here) Wall Cover Rough-in Total $2,528.54 Elect'l Final 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 aprroved plans. This permit will expire if work is not started within 180 days of issuance, or 4work is suspended for more than 180 days ATTEN i iON Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules a OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these riles or d'ect questions to OUNC at(503) 24W99 or 1800-3 3 CL Is ued By: ¢ Permit Signature: N OWNER INSTALLATION ONLY The installation is being made on prope�I own which is not intended for sale, lease, or rent. _J m OWNER'S SIGNATURE: DATE: W / i CO RACTOR INSTALLATION ONLY _ SIGNATURE OF SUPR. ELEC'N: _- "r '�-L� DATE:— LICENSE NO: q Call 639-4175 by 7:00pm for an inspection the next business day Electrical,Permit Applicati Q City Of Tigard - "Rewi%vd Permit Ne13126 SW Ifall Blvd.,Tigard, QQ� 1 alar Nernst. Phone: 303.639.4171 Fax: ' i' 0 �_ Inspection Line 303.639.4173 PO Ixrs Ready/By: / ill gee Page 1 far Internet www ci Hgard.or.us ��GP Nofill"WItW �:n t s■pple..mt.t ImNrt•aha _ E)New oonstruexictn A tentient/roplaexmertt Please c�all that apply: ❑Service over 223 amps,comm'I ❑Ilaardous location ❑ Demolition ❑Ci'er: [--]Service over 320 amps-rating ❑Building over 10,000 sq W, u` ? of I-and 2-hmily dwellings 4 or more new residential ❑ I-and 2-family dwelling-MCommcrcialAndutstrial ❑Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories El Feeders,400 amps or more ❑ Multi-family ❑Master builder ❑odw: I []Occupant load over 99 persons ❑Menu66ctured structures or I ! ❑F.gresallightind plan RV part JOB 61'I'li'}(!il"QfIWA'1'(Q'�.1��•. ❑Healthcare faci0ty ❑Other:— - Job no.: ) 3 W OW aw Submit_I acts of plan..•ith any ot'thc above -_--- City/StatdZlF:_---r-•, q Z" � The above are not applicil to tempnnry construction%mice. WIN SuiteJbidg./apt.no.: -�� I Project name: . t tr.r,yn.a at, r.ay Tsar •. Cross strrt:t/directions to job site: New residential slgk-or salts-fecally dwelling well. - Includes attill garage. _ 1,000 Mg.ft.or less 143.13 4 Subdivision: TL; rp, Ea.add'I 300 sq.ft or portion 33.40 1 Limited energy,residential 75.00 ---2 - Tax map/parcel no.: Limited enemy,non rosidetttial - 75.00 2 a^' Each manuhdured or modular dwelling,serviceand/or feeder 90.9(1 2 9ervleea or feeders Installatloa,aNeratlon,all relocation~ 200 amps or less 80.30 2 2C 1 amps to 400 amps 106.83 2 ❑ PRO"Xff p .: -1 401 amps to 600 amps 160.60 2 Name: 60{antgto I,000amq 240.60 2 Address: T Over 1,000 aTps or volts r 434.63 2 Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders{astallstlou,alteration,and/or -- — relocation _ Phone:( ) Fax:( ) 200 air or less 66.83 I (tanner histallstioo:This installwilion is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for We,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 amps 133.73 2 Chs net signature: _Date: Breach circuits--new,alterstlon,or e:teusloo,per panel 13 A?yJlCMf i A Fee for bmncti circuits with service a fader fee,each 6.63 2 2 Business name: 1"A _��- branch circuit B.Fee for Manch circuits Contact name, �r5 � �� _ without armee cx feeder fee, 46 p5 2 Address: q q OQ�e� — each bench circuit ��/) Each add'I branch circuit 6.65 2 City/StatelIZIP: �� ),/y,I �,� /1 u! 9720 !' Miacellaucows(service or texekr not Included) F nil ' 1L11�c- Pump or irrigation circle 33.40 2 IL Phone:(5p ) !C�`�__"1�7W Pte::(J Z 6 2- Sign or outline lighting 33.40 2 ail: Signal circuit(s)or limited- el,t r"'' 1(,!:•CtOMWu-'lOR ': 'rO' r energy panel,alteration,or � ' extension.Describe: Page 2 2 re Business name: J 't r' Elicit additional la�eetlom over allowable In an of the above LI m Address: q O Qpk-qq�,,1�� Per i on 62.30 City/State/ZIP: � c 51J�_�L�^ Investiption per hrur(I hr min) 62.30 _L r,,,, Industrial lent err,+stun 73.75 �� Phone: ) (DU _j�¢lL� SAKMs CCB Lic.: L41 Electrical Lie.: ? ` Suprv.Lie.: y� _ Subtotal Sttprv.Electrician signature rryuircd: ` Plan review(23%of permit lice) jZ _ — C` �� State urcharge(11%of permit fee) z. q Pont name. Date: J-- ---� — --- TOTAL.PERMIT FEE lw.�t) Authorized signature: Tile permit application expires It a peraslt is mot obtdeed within I s0 days atirr It has been accepted a complete Print name: — /ate: - - Fee mothod lor•all by Tri-County Buildir.e Industry Service Board ••Nrenbar of inspections ver nemuit Wowed. r V May 11, 2004 Michael Trusheim Team Electric 9400 SE Clackamas RD. Phone: (503) 557-7180 Clackamas, OR 9/0 15 Fax: (503) 557-8201 RE: ELECTRICAL PLANS REVIEW Dear Mr. Trusheim: Project Information Permit: ELC 2004-00235 Tenant: N.W. MEDICAL TEAM Address: 9430 SW Coral St This plans review is based on the 2002 edition of the National Electrical Code (NEC). The plans received on May 11, 2004 have been reviewed and are not approved as submitted. The following items shall be revised (revisions clouded)on the plans and addressed in a response letter. Two complete sets of the revised plans and the response letter shall be submitted to this office for review and approval prior to issuance of the electrical permit. Please note: Loose Dozes are not acceptable. 1. Provide complete set(s)of plans with all information in legible form. (I must be able to a read all information.) 2. Sheet E-11 ONE-LINE information for the Main Distribution Panel. Provide MDS label N (name), Voltage, Phase, Ampacity and Fault Current at the Main Service Disconnect. 3. Provide correct locations for all panelboards, switchboards, transformers, etc. J 4. Revise the one-line diagram to show grounding of all separately derived systems per ap Article 250. (Transformers, panelboards, etc.) 0 5. Provide fixture schedule for all lighting fixtures. Include Type Designation, Voltage, Uj Ampacity, Number and type of Lamps for all florescent fixtures. 6. Coordinate fixture schedule with fixtures shown on the plans. All lighting fixture must be labeled per the lighting schedule. 7. Show egress lighting and provide method for emergency power for 1 1/2 hours of light. 8. Show exit lights and method for emergency power for 1 1/2 hours. 9. Provide rating for all AC and UH units including voltage, current in amps, phase, wire size and overcurrent rating. 10. Identify all electrical equipment on the plans as new or existing. May 11, 2004 Page 2 If I can be of any additional assistance, please feel free to contact me at (503) 718-2446. Sincerely, Gary Noble Plans Reviewer A04 01:4TPM FRW-PGE LANDSCAPE 6026704461 T-204 P.002/002 F-T12 ' �.._ PoANnd o«wM e.anc C,xnrwry� �••f MEMORANDUM r !� r,I TO: CONTACT: TEAM ELECTRIC-DAVE ALEXANDER I, PHONE* 503 557-7180 CUSTOMER NAME: N.W. MEDICAL TEAM ►;: ADDRESS. 14150 SW MILTON CT.,TIGARD OR FROM: PGE ENGR: KEN DUTIERREZ sn3-570.4412 -- .r' •1 i rr ' ". SUBJECT: 3- S_Fe �, NPARY LINE-LINE ' T QRRENT18M�1 jf FORMER_DATA 3.1 'Ye RADIAL NETWORK XFmR Impedance( ): ' XFMR 7 NO TRANSFORMER 8ME ' 1000 KVA � Secondary VOLTAGE(L to L); 4s0 v WYE c°fl;' VAULT Pole SECO Y —> or Pole --> p Secondary Wire LENGTH: 0 Feet WIRE SIZE Jill X11: Number of SECONDARY RUNS: 1 Run(s)at: q`d Secowlary WIRE Pasistance R: 0.0773 Ohms/1000' 1 '' Seconds WIRE Reactance X: 0.0258 Ohms/1000' PANEL SE„Q^ D NARY for Sac Dr021 040 '�t '' VAUL�or Poled �> Service Wire LENGTH: 100 Feet WIRE SrM S1f A �!: Numter of Service RUNS: 4 Run(a)of: 960(�(U© Service WIRE=Resistance R: 0.0600 Ohms/1000' 1'Ir —Service W1RF Reactance X: 0.0330 OhMS/1000' FAULT CURRENT: 279105 AMPS „ (or SHORT CIRCUIT CURRENT) AMS SYrtM0h (or INTERRUPTING CURRENT) Based on a panel size of: 1200 amps Jill UJI To Print This Page: 'Ctrl M"and moose."Print 3-Phase.Date" ;Y *AMwxk n CoEIM yWcd{o ft*Oy ACW011,slew 1/isiom `�' Terr •w W l ,�r , i,„•+:;�'lf.l!'! �A;.iii.1::'?it�ni�'+�.'•i'�11+�1 �+`'r� ''•' :!•. A, vPLAQN �v1L��NG a CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT PLM2004-00189 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 5/18/2004 SITE ADDRESS: 14150 SW MILTON CT PARCEL: 2S 1 12AB-02300 SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: I-L BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKF LOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS: STORIES: WATER HEATERS: .1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 3 URINALS: 1 GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: 1 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 3 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Building plumbing: other fixture is drinking fountain. _ FEES Owner: — Description Date Amount SHEININ %AENDENHALL LLC I 66TH #202 [PLUMB] Permit Fee 5/18/2004 $249.00 12725 SW 66 PORTLAND, TH AVEVE# [PLMPLN] Plan Review 5/18/2004 $62.25 (TAXI 8%State Surcharl 5/18/2004 $19.92 Phone: Total $331.17 Contractor: PMSI LLC 21195 NW EVERGREEN PKWY STE 20 HILLSBORO, OR 97124 REQUIRED INSPECTIONS Phone: 503-466-2222 Rough-in Insp Underfloor/Underslab Reg#: LIC 158286 Top-out Insp PLM 34-434PB Final Inspection a ac J This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. m Specialty Codes and all other applicable laws. All work will be done in accordance vVith Pnproved Wplans. 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 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. —--- Issued By: Permittee Signature: Call(503)Z39-4175 by 7:00 P.M.for an Inspection needs the next business day f SEWER CONNECT'ON PERMIT CITY O F T I G A R D DEVELOPMENT SERVICES PERMIT#: SWR2004-00130 13125 SW Hall Blvd., Tigard, OR 97223 (503)6394171 DATE ISSUED: 5/18/2004 SITE ADDRESS; 14150 SW MILTON CT PARCEL: 2S112AB-02300 SUBDIVISION: BONITA INDUSTRIAL PARK ZONING: 1-1. BLOCK: LOT: 005 JURISDICTION: TIG TENANT NAME: NORTHWEST MEDICAL TEAMS USA NO: FIXTURE UNITS: 46 CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: 2.9 EDU increase Owner: FEES SHEININ-MENDENHAI-L LLC I -- 12725 SW 66TH AVE#202 Description Date Amount PORTLAND, DR 97223 [SWIJSA]Swr Connecti( 5/18/2004 $6.960.00 ISWUSA]Swr Connecti( 5/18/2004 $9.00 Phone: — — - --- Total $6,960.00 Contractor: Phone: Reg#: Required Inspections CL LIC M N J_ m This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee tu the accuracy of the side sewer laterals. If the sewer is not located at the measurament given, the installer shall prospect 3 feet in all directions from the distance niven. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a Idteral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-6699. Issued by: —z __ Permittee Signature: Call(5d)639-4175 by 7:00 P.M.for an Inspection needed the next business day Accumulative Shwer Tally PArfRI# 2S1,2AB-02300 'T'enant Name: NW Medical Teams This SWRE2004-00130 Site Address: 14150 SW Milton Ct This PLM# 2004-00189 Fixture Value Previous Previous Cred!!s Capped Fixture Fixture New New # value capped off value added added total total count off#s count # value #s values_ Bgtlse /Font 4 0 _ 0 0 0 0 _ Bath-Tub/Shower 4 0 _ 0 0 0 0 -Jacuzzi/Whirlpool 4 0 ' 1 0_ 0 0 0 Car Wash-Each Stall 6 _ 0 0 0 0 0 _ -Drive;hrou h 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 0 _ 0 0 0 Dishwasher-Commercial 4 0 0 0 0 0 _ -Domestic_ 2 0 0 0 0 0 Drinking F4 ountain 1 0 0 1 1 1 1 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink-2 inch 2 0 0 2 4 2 4 3 inch 5 0 1 0 0 0 0 4 inch 6 0 0 0 0 0 Car Wash Drr 6 0 0 0 0 0 Garbage Disposal _ _ Domestic(to 3/4 HP) 16 0 0 0_ 0 0 Commercial to 5 HP 32 1 0 0 0 0 Industrial(over 5 HP) 48 0 0 0 0 0 Ice Mach ine/Refrigerato r_Drain 1 0 6 0 0 0 Oil Se Gas Station 6 0 0 0 0 0 Rec.Vehicie Dump station 16 0 0 0 0 0 Shower-Gang(per head) 1 0 0 0 0 0 -Stall 2 0 0 0 0 0 Sink-Bar/Lavatory 2 0 _ 0 4 8 4 8 Bradley _ 5 0 0 0 0 _ 0 Commercial 3 0 0 3 9 3 9 Service 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 —0 0 Washer- Clothes 6 0 0 0 0 0 Water Extractor 6 0 1 0 1 0 0 0 Water Closet-Toilet 6 0 0 3 18 3 18 4. Urinal 6 0 0 1 6 1 6 Previous EDU Count 0 0 Capped EDU Credit 0 rTOTALS 0 0 0 0 14 46 14 1 46 ED Current Fixture Value 46 divided by 16= 2.9 Current EDU 1 EDU= $ 2,400 0 Previous Fixture Value 0 divided by 16= 0.0 Prev;ous EDU W Change 46 divided by 16= 2.9 over (under) $ 6,960.00 J Friter EDU Change Here 2.9 Notes: _-- SI nature: Date: Building Division Note: The property o or-ehaTf retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher hich must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:\Building\Sewer Tally\SewerTallySheet.xls 11/19/03 �'�it:rrll�'Ing�ertnit A licatl City of Tigard Dae received: �� o Permit nv. Address: 13125 SW Hall Blvd,Tigard.OR 97221 Sewer permit cat.: — fluilding permit no.: City n/Tisrrrrl Phone: (503) 639A171 1UU4 Ajay/app) no.: date: Fax. (503) 598-106() CITY Or TIGARD Dace issued: _�. B Recetiptno.: Land use approval: RI)ILDING DIVISION can file no.: Payment type: U I &2 family dwelling or accessory U Commercial/industrial U Multi-fonily U -nant improvement U New construction U Addition/alteration/replacetnent U Food service U Other: Job address: NOV S W 1111 t t O N a IMP . Fee ea. Told Bldg.no.: _ Suite no... New " (ladnies INN far ere!er Tax map/tax lol/account no.: day caaateaI-s SFR(i)bath _ Lot: Block:_— Subdivision: — SFR x)bat Project name: - _ SFR(3)bath -- - Cr icoun : �16AW5 L K ZIP. Each tional batlthitchen -- - Description and location of work on premises: _ _ Shesallrs: C-*-'•basin/area drain _ Est.date A�couTletion/inspection: wells/leach lineltrench drain Fowtin drain no.lin.ft.) — Manufactured home utilities Bushmu narue: /rl•51 ( ) Manholes Address:_o2/1 N k(r reedX 4 d 4 Rain drain connector C_tty�i�, sigic state:01K ZIP: -11Sani sewer(no. i- Phone:Z]lpG o?,9.2#1 Fax: (r•j,),9/1 E-mail: Storm sewer(no,lin.fl. CCB no.: 156ab Plumb.bus.reg.no: -yj y p, Wates service no.lin.ft.) — City/metrolic.no.: A f — FIxt ur a or Item: Conhactm'etepresenlativeaignature: QE7a ,� Absorption valve. Backflow ter — Print name: n eW 1)IA�S't�> D f i tt} e: -til C Backwater valve — Basirw/lavatory ---' Name: -Clothes washer Address: 111q,5 N t.! ev reel) Plot 't' .3K aC/ __._ oishw iwiff Drill"fountain(s!--— Ci 16L.S OIO State:QR ZIP: Hit E'e:ctora/eturtp Phone: (i/i''c(�.�7 Fax: �(I '��11 E-mg_I: — ion tank NOW&WAM cap Name(print): Floor dre, oor sinka/hub Mailing address: _ _ a sal ---- Hose bibb State:_ 7.IP: Ice maker Phone: F'ax: F mail: _ Inl tor/ ase tra Owner inrtallationlresidential maintenance only: The actual installatirnur Prirnet(s) will be made by me or the maintenance and repair made by my regular jimfdrain c 9L employee on the property I own as per ORS Chapter 447. Si ,basin(s), eves Y- iJ (p, Owncr's si lure: Date: — Tubs/shower/shower pan Name: Urinal _ Address: -- —" Water closet —_ pj — -- Water heater �* City: Stats ZIP: Other: — - ul Phone: _ Fax: E-mail__ T0111111 Not ell Jurisdiction sceert credit cards.please call Jurisdiction Ihr mom hrfamstion. Minimum fee .............. Notice: This ptnret application L)Vim o Maaetcard Plan review Crede card number expires if a permit +a not Obtained -- within 180 da s after it has been State surcharge(8%)....$ rxpires Y Name of cardholder as shown on irat ead accepted as complete. TOTAL........................ C'udholder a40nttae Amount -. - -- - --- 4404616(6iDNCOM)