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12100 SW SCHOLLS FERRY ROAD 12100 SW SCROLLS PERRY ROAD CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUIP Received __ _.._ Date Requested �� _ AM—-- - PM SUP Location _____ 1 (JU -��!� Suite___ MEC Contact Person Ph( ) — __.__._.._-___ PLM - Contractor '' - _ Ph SWR BUILDING Tenant/Owner ( ELC ._�2 cz Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain ---�— Slab Inspection Notes: 517 — Post&Beam -------- Shear ---_Shear Anchors 1 Ext Sheath/Shear Int She-ith/Shear Framing Insulation Drywall Nailing Firewall A SS Fire Sprinkler —� —T Fire Alerm S.jp'd Ceiling - -- — -- - --- - -- -- Roof Other: -- Final PASS PART FAIL --- PLUMBINGI Post&Beam Under Slab Rough-In Water Service — -------------- -- _ __ -- --- Sanitary Sewer Rain Drains — ---------- ---- - Catch Basin/Manhole Storm Drain _--- -- — --- -- Shower Pan Other: Final -- PASS PART FAIL MECHANIr,AL Post&Beam Rough-In Gas Line Smoke Dampers -___-- Final PASS PART FAIL —��------ - -- ----- ELECTRICAL Service -- Rough-In _� ------ -- — ---------- ----- --- UG/Slab Low Vnitage - --------_—_ _.�---A_. _ Fire Alarm F]F'FA'�3S PART_ FAIL u Reinspection fee of$___—��_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. gi Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA ~" - Approach/Sidewalk Date ! I __�'-L-1MSpectOr _---___ d" _. _____ut__— Other: Final 00 NOT RIEMIVE this Inspection record from th6 job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 Hour Inspection Line: 639-4175 Business Line: 639-4171 --- — z Bl1P --__ Date Requested ___AM ___PM --__— BLD _ Location -S '� �%-O(Gll yry,.- •z Suite _ MEC Contact PerFon _ Ph V PI_M Contractor Ph SWR (BUILDING Tenant/Owner ELC —_ Retaining Wall !— EI_R Footing Access' -— Foundation FPS Ftg Drain — AGN Crawl Drain Inspection Notes: — - -- -- Slab - ------- ----- --- — -— -- ----- - - SIT Post&Beam ---------_._.____� Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall - - - - Fire Sprinkler ---_- _-. 042 - Fire Alanr, )N 5 Susp'd Ceiling � _ _ Roof Misc: Final PA PART FAIL ------ — _ Pl. Post& Bearn Under Slab Top Out - — — Water Service Sanitary Sewer R reins — ASS j PART FAIL NIC_AL _ Post& Beam Rough In 'Gas Line (Smoke Dampers Final - --- — PASS PART FAIL. ELECTRICAL Service _ Rough In UG/Slab Low Voltage - _ — Fire Alarm Final PASS PART FAIT_ -_ SITE Hackfill/Grading ---------- - --- - ---- -- — — Sanitary Sewer Storm Drain ( ]Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: a. ( ]Unable to inspect- no access ADA lc� Approach/Sidewalk Uate � G) Inspector ( Ext Other —L_ ---- - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF T! ` A R ELECTRICAL PERMIT � (V= _ PERMIT #: ELC2002-00494 ►ry� DEVELOPMENT SERVICEES DATE ISSUED: 9/20/02 J1� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134BC-00100 SITE ADDRESS: 12100 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: C-G BLOCK: LOT : JURISDICTION: TIG Proiect Description: Job No. 31017 131018 Ice machine and timer box ' RESIDENTIAL UNIT TEMP SRVCIFEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601 4-amos - 1000 volts: MINOR LABEL (10): _ SERVICE/FEEDER _ _BRANCI' CIRCUITS _ ADD'L INSPECTIONS__ - 0 200 amp: W/SERVICE OR FEEDER: — PER INSPECTION: 201 400 amp: 1st W/0 SRVC OR FD12: 1 PER HOUR: 401 600 amp: EA ADD'L BRNCH CIRC: ? IN PLANT: 601 - 1000 amp: PLANREV_IEW SECTION 1000+ amp/volt: _ >=4 RES UNITS: —^ > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >=225 AMPS CLASS AREA/SPEC UCC,—_—_.__ Owner: Contractor: 1-ELEVEN BECK ELECTRIC INC 9318 SE CHURCH ST CLACKAMAS, OR 97015 Phone: Phone: 656-7396 Reg #: SUP 1326S LIC 00002629 ELE 3-5C FEES _ Required Inspec►ions Type By _ Date Amount Receipt Rough-in l Wall Cover CAAI r: PRMT CTR 9/20l02� $53.50 2720020000( Elect'I Final A" 5PCT CTR 9120/02 $4.28 2720020000( Total $57.78 This Permit Is issued subject to the regulations contained In the Tigard Municipal Code,State of OR.Specially 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 tollow rules adopted by the Oregon Utility Notificatbn Center. Those pules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may cbWn copies of these rules or direct questions to OUNC at(503)2466699 or 1-800-332.2344. Permit Signature: ---'- Issued By: v. OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ _ DATE- _ CONTRACTOR INS AL LATI )N ONLY SIGNATURE OF SUPR. ELEC'N: ___._—-- -----.-------------- -- --- DATE:---- -�_. LICENSE N O: _.�,-------- --- ---- ---- — ---- ---------- Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: Pennitno.: -&v City Of Tigard^ "I` d .Lt Ni Project/appl.no.: Expire date: CityujTigard Address: 13125 SW Hall Blvd�'1'IgMard,OR 97223 Date issued: By: I Receipt no.: Phone: (503) 639-4171 ( — Fax: (503) 598-1960 csEP 1 { �D(11 Case file no.: Payment type: Land use approval: _ 111111111,111 W OKI]a 0 1 &2 family dwelling or accessory It CommerciaUindustnal 0 Multi-family 0 Tenant imirroveinent U New construction U Add ition/alteration/replacement 0 Other: 0 Partial JOITSITE INFORMATION !ob address: 12.-1 O 5 j,.c_k P�,(A. I Bldg. no.; 17Suite no.: Tax map/tax lot/account no.: Lot: 131uck: Subdivision: Project name.: Description and location of work on premises: {GST f�r'r•,',i 4a�r x tr Jet � Tir�c,'rZ �cyL Estimated date of compietion/inspection: CONIRACFOR APPLICAT ION1 Job no: %I t I" /L!/ 'e { ice vt�r Business nano': Y , (rC t, Desert tlou rry• (ca► Total no.Ins, New residential-single or multi-famliv per Address: 1`-' 'at L-k'LtVCV_ dwelling unit.Includes attached garage. City: C.0.0rhVW1C Slater Z1P: �j..7d1 service Included: Phone:�,:�h I i Fax: .*y r i 7 L-mail r I(xxl s ft.or less Each additional Ssq. .or portion thereof CCB no.: i' Eler,bus.tic.no. 3 a� W ft Limited energy,residential Cit /metro lic.no.: Limited energy, al _ It 110 C -V Each manufactured home m modular dwelling Signature f4 su rvZin ctrtc an(required) Date Service and/or feeder Services or feeders-Installation, Sup,elect name(pnnp: n, ,�1 r, i, Uv License no: 1 (0 a Iteration or relocation: 200 am s or less 2 Name(print): 201 amps to 400 trope 2 401 amps to 600 furring Mailing address: _ 601 amps to 1000 ams _ City: State: ZIP: ove, I(HH)amps or volts _ Phone: z` p 1 1.71r;ax: E-mail: Reconnect only Owner installation:The installation is being made on property 1 own Temporary services or ferden- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,670,701. 1 200 amps ur less 201 amps to 4W amps 2 Owner's signature: _ Date: I 4111 to 60(1 ams v v - F Branch circuits-new,alteration, or extension prr panel: Nanta: A. Fee fur branch circuits with purchase tit Address: service or feeder fee,each brunch circuit - c'j(y; Stale: ZII': Y N Fee for branch circuits without purchase -- - — -- of service or feeder fee,first branch circuit: y�,j' _ 2 Phone: I .t v Ei-(nail: Each additional branch circuit: / rmrgml Misc.(Service or feeder not Included): 0 Service over 225 amps-conmietcial J Health-care facility Each pump or irrigation circle _ lJ Service over 320 amps-rating of 1&2 ❑HuArdous location Each si�tn nr,-utline lighting _ '- fanulydwellings U Building over MAW square feet four or Signal cin 7uit(s)or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration.or extension* '- 0 Building over three stories ❑Feeders.4lx)amps ormore •Dee scnouun _ 0 Occupant load over 99 persons Ll Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above: 0 Fgtess/lightingplai J Other , Per inspection Submit_sets of plans with any orthe Above. Investigation fee The above are not applicable to temporary cotMruction service. Other x Na 1111 iurirdicilons accept credit cards,please call jurisdiction for more Information. Notice:1'llis permit application Permit fee.....................$ Cl visa O MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit cod number- ._—---_ 1_/ within 180 days after it ha:,been State surcharge(8%) ....S Expires accepted as complete. TOTAL • ...$ / 7 Name crf cudhohkt u t rwn-on� t- 1-ncard -- Cardholder signature —� v Amount 440461.1(ISMICOM) i Electrical Permit Fees: Lin;ited Energy Fees: -- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee............ ..................... $75.00 Number of Inspections per pennit allowed (FOR ALL SYSTEMS) Service included: Items Cost Tctal Check Type of Work Involved: Residential•per unit 1000 sq.ft.or less $145 15 4 Audio and Stereo Systems Each additional 500 sq,ft.or portion thereof $33.40 1 Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Garage Door Opener' DNelling Service or Feeder $00.90 2 :urvices or Feeders Heating,ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80302 Vacuum Systems' 201 amps to 400 amps $106.85 _ 2 401 amps to 600 amps $16060 2 601 amps to 1000 amps i $24060 _ 2 Other Over 1000 amps or volts $45465 2 N y yr can or r $66.85 _ 2 Reconnect ors TYPE OF WORK INVOLVED -COMMERCIAL ONLY TemFee for each system................. ' Installation,alteration, r relocation Sr 5.00 200 amps or less _ $6685 2 (SEE OAR 918-260-2601 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps $133 '5 2 Check Type of Work Involved: Over 600 amps to 1000 volts. ❑ see"b"above. Audio and Stereo Systems Branch Circuits Boller Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service or Clock Systems reader fee. Each branch circuit $665 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. First branch circuit / $46.85 HVAC Each additional branch circuit / $6.65 Mlscellanenus Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Intercom and Paging Systems Each sign or outline lighting $53.40 _ Signal circuit($)or a limited energy panel,alteration or extension $75.00 __ Landscape Irrigation Control' Minor Labels(10) _ $125.00 __. El Medical Each additional Inspection over the altowabis It,any of the above Nurse Calls Per inspection $62.50 Per hour _ _ $62.50 _ In Plant _ $73 '5 U OutJuur Landscape Lighting' Fees: Prolective Signaling Enter total of above fees $ `7�' �I Other - 8%State Surcharge $ �� Number of Systems 25%Plan Review Fee No licenses are required Licenses are required lir all other installations See"Plan Review"section on S front of application (� Fees: Total Balance Due $ 7' O Enter total of above fees $ ❑ Trust Account#---- 8%State Surcharge $ Total Balance Due $ 0dsts\forru\elc-ftes.doc 10/09/00 \ CITY �� ®� �� ELECTRICAL PERMIT PERMIT#: ELC2002-00073 DEVELOPMENT SERVICES DATE ISSUED: 212'110? 13125 SW Hall Blvd.,Tipard. OR 97223 1'503) 639-4171 PARCEL: 1 S134BC-00100 SITE ADDRESS: 12100 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: �: G BLOCK: LOT : JURISDICTION: TIG Proiect�Description: Install 2 branch circuits to slurpee machine. I RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _ _—. MISCELLANEOUS —_ 1000 SF CR LESS 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 600 amp: SIGNALIPANEL: MANF HMI SVC/ FDR: 601•4-amos - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER _ _ BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: 0 PER INSPECTION. 201 400 amp: list W/O SRVC OR FOR: 1 PER HOUR: 401 - 600 amp: EA ADDT. BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: �_ PLAN REVIEW SECTION 1000+ amp/volt.: >=4 RES UNITS: _ > 60n v NOMINAL: Reconnect only__. SVC/FDR 225 AMPS: CLASS ',PEC_OCC: Owner: Contractor: SAUNDERS, WILLIAM W TRUSTEE ROSE CrrY ELECTRIC CO INC 2155 KALAKAUA AVE STE b00 4012 NE CULLY BLVD HONOLULU, HI 96815 PORTLAND, OR 97213 Phone: Phone: Reg #: 807-644t7S LIC 3567 ELE 26-1130 FEES Required Inspections Type By Date Amount Receipt Wall Cover Rough-in PRMT CTR 2/21/02 $53.50 2720020000( Elect'I Final 5PCT CTR 2/21/02 $4.28 2720020000( Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or 9 work is suspended for more then 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001.0080. You may obtain copies of these rules or direct questions to OUNC at(503) 246-6699 or 1-800-332-2344. Permit Signature: 1 � / ` issued By: OWNER INSTALLNTION ONLY The Installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: __--__ _ __—____ _ DATE:_—__ CONTRACI OR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:-------.— LICENSE ATE:_ ___LICENSE NO: ---- -- ----- - Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application —' Datercceived: � '. Permit no.: :' Cl of Tigard!)ar Pro ect/a I.no: Expire date Addie s: K3 _&W_- ,�gE,�ja 1 PP P Ciry. ,aidDateissued: By:'t Receiptno.: Phone: (5 Fax: (50360" Case file no.: Hyment type: Land use approval: LA Y OF 1 K iAjU) _ t ' U I &2 family dwelling or accct;sory U Commercial/indusuial OMulti-family U Tenant improvement U New constniction U Addition/alterabon/replacement U Other. 0 Partial Job address: � , BIOS.no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: Project name: I Description and location of wnrk on premises: t Estimated date of completion/inspection: 1 ' irn S( 1 Job no: _ Fee Max Business name: ROSE CTTY FLECTRIC CO TNC Description Qty. (ea.) Total no.las Address: New resNienWl-singk or multi-family per () 2 N V dwelingunit.Includes attached garage. City. PORTLAND State:OR. IZEP7213 Smicebsciuded: PW_-_@ 2 7 61 h 1�alrcl 3 282 ®ail: IOW sq.ft.or less _ _ 4 CCB no.: Elec.bus.lic.no: 6 113C r-ach additional 5W sq.ft.or ponnm thercot --- Limited energy,residential 2 City/916 tly/r r, O.: _ Limited energy,non-residential 2 1" r Each manufactured home or...odular dwelling Signet eo supervising eleevician(rc uirod) Oete Service and/or feeder 2 Sup.elect name(prinq: ot1SII1 License no: 212770, Services or feeders-Installation, alteration or relocation: 210 amps or less 2 Name(print): 201 amps to 400 amps 2 Mailing address: — 401 amps to 600 amps 2 601 amps to 1006 amps _ 2 City: Slate: ZIP: _ Over 1000 amps or volts 2 phone: Fax: E-mail: Reconnectonly I Owner installation:The installation is being made on property I own Temporary cervices or feeders- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: ORS 447,455,479,670,701. 200 amps or less _ 2 201 amps to 4(x1 amps 2 Owner's signature: Date: 401 to eW amps 2 NOX"Ll 10Bench circulis-new,alteration, or -Duper panel: Name: _ A. Fee for branch circuits with purchase of Address: _ service or feeder fee,each brach circuit 2 City: State: ZIP: B. Fee for bench circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: Mise.(Service or feeder not Included): ❑Service over 225 amps-commercial O Health-care fectllty Each pump or irtiWon circle 2 O Service over 320 amps-rating of 1 U O Hazardous location Each sign or outline lighting 2 family dwellings 13 Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. •System over 600 volts nominal more residential units in one structure alteration,or extension* 2 •Building over three stories U FeWent,400 amps or more •Desciri tion:-- - _ I]Occupant load over 99 persons U Manufactured structums or RV park Each additional Inspection over the allowable In any or the above: U Egmss/lightingplan O Other Perins on Submit_sets of plans vvkh any of the above. Investigation fee —! The above are not applicable to tapoaary courtractlon service. Other Na allhat*rc'uom accept aedlr cads,pkae atali hrtadktioa ku inane+afom+.r!«G Notice:This permit application Permit Pee.....................S ---�-=�- ` U Visa O MasterCard expires if a permit is not obtained Plan review(at _- %) $ credit cad number _ —�—j_ within Igo days after it has been State surcharge(8%)....$ „� Name or ldri ar dsoc o oa credit cad�— Fapt'rev accepted as complete. TOTAL .......................$ Cardhdder dpuruae Auoea•t 4404615(600000M) Electrical Permit l=ees: Limited Energy Fees: -------�- --�- -"- TYPE OF WORK INVOLVED_-RESIDENTIAL ONLY _ Complete Fee Schedule Below: –Restricted Energy Fee................. $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost )tal I Check Type of WorK Involved: Residential-per unit Audio and Stereo Systems 1000 sq.It or less $14u.15 4 .� Each additional 500 sq.it.or 1 G Burglar Alarm portion thereof $33.40 _ Limited Energy $75.u0 Each Manufd Home or Modular Garage Door Opener' Dwelling Service or Feeder $90 90 [j Healing,Ventilation and Air Conditioning System' Services or Feeders installation,alteration,or relocation 2 _ 200 amps or less $80.30 �� Vacuum Systems' $106.85 2 201 amps to 400 amps 401 amps to 600 amps $160.60 2 $240.60 2 ❑ Othe 601 amps to 1000 amps – 2 Over 1000 amps or volts _ $454.65 2 Reconnect orly $66.85 TYPE OF WORK INVOLVED -COMMERCIAL ONLY "temporary Ser✓Ices or Feeders ree for each system.......................................................... a'S on Installation,alteration,or relocation 2 (SEE OAR 918-260-260) 200 amps or less $66.85 $100.30 2 201 amps to 400 amps $133.75 2 Check Type of Work Involved: 401 amps to 600 amp:. Over 600 amps to 10'0 volts, Audio and Stereo Systems see"b"above. Branch Circuits U Boiler Controls Prow,alteration or extension per panel a)The fee for branch circuits Clock systems with purchaso of service or feeder fee. Q Each branch circuit $G.65 Data Telecommunication Installation b)The fee for branch circuits without purchase of service I E] Fire Alarm Installation or feeder fee. First branch circuit $46.85 E] HVAC Each additional branch circuit $6.65 _ Miscellaneous Instrumentation (Service or feeder riot included) . Each pump or irrigation circle $5340 — Intercom and Paging Systems Each sign or outline lighting $53.40 _ Signal circuits)or a limited energy Landscape Irrigation Control' panel,alteration or extension $75.00 Minor Labels(10) ___._ $125.00 _ Medical Each additional inspection over the allowable in any of the above $62 50 Nurse Calls Per inspection Per hour $62.50 I r-3 tS7^75 I_J Outdoor Landscape Lighting* In Plant --- Fees: Protective Signaling Enter total of above.fees $ Other 8%State Surcharge $ _____IJumber of Systems 25%Plan Review Fee $ No licenses are required Llcen:;es are required for all other installations See"Plan Review"section on front of application -- Fees: rTotal Balance Due $ -- Enter total of above fres $------ L 1 Trust Account ff 8%State Surcharge $ – -- _s - -- Total Ealanre DUE $------ i:\dsts\fomu\elc-fees.doc 10/109/00 CITYOF T I G P9 R D _ __MECIi/-`,NICAL PERMIT DEVELOPMENT SERVICES PERMIT#: M15/02 -00064 13125 SW Hall Blvd., Tigard, OR 97223 (503) 633-4171 DATE ISSUED: PARCEL_: 1 1513 2 S134BC-00100 SITE ADDRESS: 12100 SW SCHOLLS FERRY RD —7_ E&w&i, SUBDIVISION: ZONING: C-G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM LIMIT HEATERS. VENT FANS: OCCUPANCY GRP: M VENTS W/O APPL.: VENT SYSTEMS: STORIES: BO_ ILE_RS/COMPRESSORS HOODS: FUEL_ TYPES ^^0 3 HP: DOMES. INCIN: ---_ —!— 3 15 HP COMML. INCIN- MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS v OTHER UNITS. :i FURN :>=100K BTU: <= 10000 cfrn: GAS OUTLETS: > 10000 cfm: Remarks: Install 3 each condensing units on roof and run line sets. Owner: ----FEES ---- -------- _ SAUNDERS, WILLIAM W TRUSTEE Type By Date Amount Receipt 2155 KALAKAUA AVE STE 500 PRMT CTR 2/15/02 _ $72.50 2720020000 HONOLULU, HI 96815 5PCT CTR 2/15/02 $5.80 2720020000 Total $78.30 Phone: Contractor: VAN AIR CONTROLS 13327 S GL ENN DR. MULINO, OR 97042 REQUIRED INSPECTIONS Mechanical Insp 0hone:503-632-5991 Final Inspection Reg #:LIC 119125 EXPIRED This permit is issued subject to tt ,- regulations contained in the -Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in a.,cor(!ance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTIONS Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189. Issue By: -,_ zc-a , l/ Permittee Signature: t.t Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day 1 �17 Mechanical Permit Applica ' L/ -- — Dale received c"J Permit no.:/;`L •k .c r `� / City Of Tigard , Project/appl.no.: Expire date: Cirvr,�7ig;nrd Address: 13125 SW Hall Blvd O t� �a Date issued: By: lkcceiptnn.: Phone: (503) 639-4171 Fax: (503)598-1960 Case filen.: Pay!renttype: Y_ Land use approval Building permit no.: U 1 &2 family dwelling or accessoryCommcroial/industnal UMulti-family U T enant improvement U New construction J A(I(li(imrt/altcritioti/replacement U Other: INFORMATfONt r o a Job address: f�� indicate equipment yunnuties in boxc t,low. Indicate the(loll. (��Si1' `� �� --� value of,-Ail mech nicnl materials,equipment,labor,overhead, Bldg.no.: e trt.: -- ✓� Bld no.: r o Tax map_/lax h,tiaccount no.: profit. Valve$ ��,�Q- . hat: I31ock: Sulxtivision: •See checklist in; important appliention Information and I Z_ urisditlion'S I'e( hedule for residential permit fee Project name: 7TC-� I City/county: r %I t ' r r ► r Description an cx:atiun of ork op premises: �'(L` t_+.ni -,t Fee(ca.) Total USL date of completion/inspection; _ Ut�c(r)ptlon QI • >k�•o��' Kms•only Tenant improvement or change of use: UA Air handling unit Is existing space heated or conditioned?U Yes U No it cont i oningIsite plan rcqo re ) Is existing space insulated"J Yes ❑No I Altteratlon o cxisung l A(.systemMECHANICAL CONTRACTOR lot er compressors State boiler permit no.: Business name: (n. o S ___ _ .- HI' Tons RTU/H _ Address: ��p n^ V_r• it smn e Itmhcrsh uct Brno- ko e� lectors City: 'n Slate:Q 7.DP: cat pump(a to p nn requic�c�j City: 110 %3 Email: ns►a rep—ac e I urnace/burner0/1 Including;duetwork/vent liner ❑Yes U No CCH no.: nsrep eDea: eaters-suspen e , City/metro lic.no.: Qod 9 �_L wall,or Moor mounted etoante oder than furnace Name(please printI. c gerat on: CONTACt.PERSON 1111r. Absorption units Name: n J, Chillers_...-_ - _ IIF' -- - - _ H�t.1� -- -- -_ Com ressots_ __ HI' _ Address: + - V\ -Env ronmenta exhatwt and vent ton: City: `. _ State ) 'lll' �� Appliancevent � - Pfunz tc:U - 1-19_ Fax _ r mail: TtycrrxtausI - t -Ao,,(&;Type U IUre3.kitchertAititzmat hood fire suppression system Name: [� _ Exhaust I'm with single duct(bath tans) Mailing addn 5s: v -77 isx�t x stern n art from heating or AC Furl piping an tut on(up In 4 outlets) Cit State:_ LIY: y� —_ T.�_ •rype� ______t.Pe) Nr ou Mow- I .t I tpml _` ueliiunFeae a iuona over Aou s -- 'roceVtp p ng(sc cmaticrcqutred) 19 W Number of outlets rdd ter app ance of eq pment: _ Decorative fireplace _ .. State: 1.%IP: 75-1-61-1—tyle _ 0 SIOVE/pC CtSIOVe _ _ Phone: - -- Fax. r-mail: Other. - Applicant's signature: - hate: ------- I Other. - -_ Name (print): --- - ----- --- Permit fee.....................$ r _ - rN(M dI)UfitAlta(tw lCttpt cm at cani1,rlraer call Ittrimlictinn r(x rmre i11rM WIM Notice:Tills permit application n Mast � pp Minimum fee................$ - x� ex fires if a permit is not obtained plan review(at — 9h) $ -_-.-_ t_t it rJ r'll � within ISn days at)er it has been P�tpirc+ State surcharge(8%)....$ t aITRKWWO o'a a r.,f r 30 accepted Ac camplete. '30 S- mmtH EXPIRE'' t teusetTttu!rvtrxt: •d GL98-i?E9-F.US awwep ueA 2aig dT0 :E0 RD 21 qaA CITYO�" T I G /� R® __- MECHANICAL PERMIT PERMIT#: MEC2001-00457 DEVELOPMENT SERVICES -'` DATE ISSUED: 12/14/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134BC-00100 SITE ADDRESS: 12100 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: C G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: CONI UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL. VENT SYSTEMS: STORIES: BOILERS_/COMPRESSORS HOODS: FUEL TYPES _ _ T� 0 3 HP: 2 DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS. FURN < 100K BTU: _AIR HANDLING_UNITSOTHER UNITS: FURN >=100K r3TU: <= 10000 cfm:` GAS OUTLETS: > 10000 cfm: Remarks: Replacing (2)freezer units Owner: _.__- ------ FEES SAUNDERS, WILLIAM W 'TRUSTEE Type By Date Amount Receipt 2155 KALAKAUA AVE STE 500 PRMT CTR 12/14/01 $148.50 2720010000 HONOLULU, HI 96815 1 9PCT CTR 12114/01 $11,88 272001000C Total $160.38 Phone: Contractor: SOURCE REFRIGERATION& HVAC IN 800 E ORANGETHORFE AVE. ANAHEIM, CA 92801 REQUIREU INSPECTIONS Mechanical Insp Phone:714-578-2300 Final Inspection Reg#:LIC 149200 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001.0010 through OAR 952-001-0080. Ypu may obtain copies of these rules or direct questlrins to OUNC by calling ren,AwAs-al R9 Issue By: �� _ �c�y _ _ _%r Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Datereceived:l -�' - Permit no.: (t ''UCJ C) City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issue(!: B Receipt no.; Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: ❑ I i family dwelling or accessory �Commercial/industrial ❑Multi-family ❑Tenant improvement ❑New construction U Addifinn/altcngicm/rcplaccmrnl U Other: .1011 SUIT 1 Job address: • Ot _ Indicate equipment quantities in boxes heiuw. Indicate the dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ 0,--y-o Lot: Block: I Subdivision; _ *See checklist for important application information and Project name: 7 // jurisdiction's fee schedule for residential permit rec. City/county: ,' a,- z1P: 9 7 .3 Description and location of work on premises:_.Z'n�ra// yc;-eeze,-5 -_ 1'ec(tm.) 11WAI Est.date of co:npletionhnspection: i�j_ _o t Description (Ay. Rei.only ites.only Tenant improvement or change of use: Is existing space heated or conditioned?UKcs ❑No Air handling unit CFM Air conditioning(siteplanrequired) Is existing space insulated?E�Yes C]No Alteration of exfsuns _system _ of er compressors Business name:15o r-c (-}u ct C_ .1.yt c. State holler permit no.: `} J' HP --Tons BTL'/H Address: .5 Sd (� S r vr% r.tj it smo a dampers/duct smo a etectors City: r uState:QR I'LIP: 11cat pump(site plan reau re ) Phone:S�3 �,y� SEIu Fax: E-mail: nsta repace umac .urncr CCB no.:/WY9o2 wn Including ductwork vent liner V Yea❑No _ osis replac relocate heuters-suspen e , City/metro f ic.no.: 6 9,9 7 _ wall,or floor mounted Name( lease print):41 H R K Fl c?-r' Vent ora lance other than furnace 1Refrigeration: Absorption units—__ HTU/H Name:/-* C'hillcrs-___ HP Corn ressors HP Address: a - _ ar<icdta w n4ronmental eithaust and vent ton: City: r,fa�, ,' State:o ZIP: �/J �1„� Appliance vent Phone:r3 Sbd Fax: I E-mail Dryerexhaust — - - o s,' ype res. itc a azmat hood fire suppression system 7"" _ Exhaust fan with single duct(bath fans) —IW,ss: — x ousts stem a art from heatingor AC "Plill"Ic ue p p ng an ton(up to out els) Slate: l.IP:ilType __LPG NG Oil l a. I mail: ur. ripin each additions over outlets rocesspiping(schematicrequitec) Name: Number of outlets Address: ter listedappliance or equipment: _____-___ _ _ _ Decorative fireplace City: State: ZIP: Tnsert-type Phone: Fax: E-mailrxn stov�pe et stove T _ Other: Applicant's signature 'r: , v ` tT— Name(print): j X,-k NM all Jurisdictions accept ctedii cants,pleav call)urfedicrion fm nnae informau m Permit fee.....................$ ) O Visa U MasterCard Notice:'This permit application Minimum fee................$ _ /-.� expires if a permit isnot obtained Plan review(at _ %) $ I%phes within 180 days after it has been State surcharge(8%) ....$ Man*of caciltioldrr as sMwn on radii card $ accepted as complete. TOTAL .......................$ . --- ('ar�hulJer sf�nitwe —_ -Amount — 4104617(NOOK OM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCI17DULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 ML,imum fee$72.50 Table 1A Mechanical Code Ot (Ea) Amt $5,Ouf-0-05 6$10,OC,OCO $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTLI $1.52'or each additional$100.00 or including ducts&vents 14.00 fraction'hereof,to and Including 2) Furnace 100,000 BTU+ _ ___ $10,000.1.: T/4,_ 50 includingducts&vents 17.40 $10,001 AO to$25,000.00 $148.50 for b.,:first$111,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 1 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $2_5,000.00. or floor mounted healer 14.00 $25,001.00 to$50,000.00 $379,50 for the first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units _ $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof, _ footnotes below. Com ' " 7)<3HP;absorb unit Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14.00 8)3-15 HP;absorb �8'/.State Surcharge $ unit 100k to 500k BTU 25.60 25%Plan Review Fee(of subtotal) 9)'t 5-30 HP;absorb Y $ unit.5-1 mil BTU 35.00 _ Re fired for ALL commercial permits only 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20 11)>50HP:absorb -"�- - unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 121 Air handling unit to 10,000 CFM 10.00 Value Total 13)Air handlinq unit 10,000 CFM+ Description: 4 Ea Amount 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&vents 6.80 Floor furnace Inducing vent 955 16)Ventilation system not Included in Suspended heater,wall heater or 955 appliance permit 10.00 Boor mounted heater 17)Hood served by mechanical exhaust Vent not Included in applicance 445 10.00 _ permit __ 18)Domestic Incinerators Repair uni'z 805 17.40 <3 hp;ab-sorb.unit, 955 19)Commercial or Industrial type Incinerator to 100k B1'U 69.95 3-15 hp;abborb.unit, 1,700 20)Other units,including wood stoves 101k to 500k BTU _ 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU _ 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.7F rAl.BTU _ 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mll.BTU _ _A6 handling unit to 10, fm 656 8%State Surcharge $ AIr handling unit>10,0c., 1 1,170 _ Non-portable evaporate _ der 656TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 _ Vent system not Included In 656 appliance permitInseections and Fees: Hood served b4 mechanical exhaust 656 _ 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic incinerator 1,170 $72.50 per hour. Commercial or Industrial Incinerator 41590 2 Inspections for which no iee is specifically indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 5 per hour Inserts,etc. 3 Additidltianal plan review required by changes,addltiona or revisions to plans(minimum charge-one-half hour)$72 50 per hour Gas piping 1-4 outlets 360 _.. Each additional oy let _ 63 'State Contractor Boller Certificaticn required for units>20ok BTU. "Residentlal/VC requires site plan showing placement of unit. TOTAL COMMERCIAL S VALUATION: I:klstsUnrmsUnech-fees,doc 08/06/01 CITYOF T I GA R D __ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00071 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/12/01 SITE ADDRESS: 12100 SW SCROLLS FERRY RD PARCEL: 1 S134BC-00100 SUBDIVISION: ZONING: C-G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: M FLOOR DRAINS: 2 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY 1 RAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES. TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replace rotted out inte for drain lines. Remove and replace tw floor sinks. FEES Owner: —_------ _�_--� --- — - Type By Date Amount Receipt SAUNDERS, WILLIAM W TRUSTEE 2155 KALAKAUA AVE STE 500 PRMT CTR 3/12/01 $72.50 27200100000 HONOLULU HI 96815 5PCT CTR 3/12101 $5.80 27200100000 Total $78.30 Phone 1: Contractor: 3 MOUNTAINS PLUMBING PO BOX 386 SHERWOOD, OR 97140 REQUIRED INSPECTIONS Phone 1: 503-925-1342 Rough-in Insp Reg#: LIC 141187 Ton-out Insp PLM 34-368PB Final Inspection I his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialtv 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 withir 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By' �. ;, _ Permittee Signature: Call (503) 639-4175 by 7:00 P M. for an inspection needed the next business day Plumbing Permit Application Uatereaived: Permitno.: Ci of Tigard `� g Sewer permit no.: Budding pernut no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 —'— City(if Tigard phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receiptno.: Land use approval: " case file no.: Payment type: U I &2 farnilY dwelling or accessory f`Commerc:iaUindustnal U Multi-fancily G Tenant improvement Cl New construction U Addition/alterntion/replacemcttt U Food service U Other: INFORMATION Job address: /LCA 1)escriptfou _ (?tv. Fee(ea.) 11 'f'Wit Bldg.no.: _ rSuite no.: New 1-and 2-family dwellings( y: -- (includes 100 ft.for each utility connection) Tax map/tax lot/account no. SFR (I)bath Lot: Block: Subdivision: SFR(2)bath - --"-- --^ ----- Project name: 7- ► I SFR(3)bath City/county: �/ ,.��1H. ZIP: -L-t 3, Each additionalbath/kitchen Description and location of work on premises: -t n I-L.,e RCt'1r7 Siteutilitles: o-T t „ L ,��— _ _ Catch basin/area drain -- Est.date of completion/inspection: — Drywells/leach line/trench drain111.1 N1111ING CONTRACTOR I _ Pouting drain(no. lin.ft.) Manufactured home utilities _ Business name: 3 41 1�t „ �� t r C Manholes _ Address: fl t,,p -1 y (, Rain drain connector City: lr u�t>/ _ State:o(z ZIP: 9-7 iy t -Sanitary sewer(no.lin. ft.) -- Phone: Fax: t S 9 IV L/ E••mail: 14_ _14,j Sturm sewer(no.lin.ft.) CCB no.: 1 If)I -) Plumb.bus.reg.no: Water service(no.lin.ft.) _ City/metro tic.no.: U C cr Fixture or Item: Absorption valve Contractor's representative signature: Back flow reverter Printa ki t j L � Date:—N l vi Backwater valve Basins/lavatory Name: Clothes washer Address: _ Dishwasher Drinking fountain(s) — City: State: ZIP: _-- E'ectors/sum _ Phone: Fax: E-mail: Expansion rank iature/sewer cap Name(print): S t; , t`L,I Ikwr drains/floor sinks/hub s Mailing address: Garbage ddisp�sal Hose Bibb City: State: ZIP: Ice maker --_ Phone: I E-mail: Interce for/gre_ase trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made'y me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's si nature: Date.: Sump _ Tubs/shower/shower pan _ Urinal Name: _ _--- — Water closet Address: _ Water heater City_ State: ZIP: Other: -- Phone: Faxes E-mail:_ — _-- _ Total —_�— Nd all jurisdictions erverx credit c",please call jurisdiction fix mcmwr infontwnon Notice:"11ns pcnnit npplication Plan re ret fee (( $ a!................ _ 0 Visa t7 MasterCard expires if a permit is not obtained Plan re Credit card number —__ _--- ___ 1-- within I80 days alter it has been State surcharge(8%)....$ F,xpires ----- - accepted as complete. TUTAL .......................$ Now of cudhcldrr as,Iwvvn on credit cant _ S __ Cardholder siyuttat -- - - "-A,nount 440461616+XWOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: -- FIXTURES(individual)_— QTY ea AMOUNT (Includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT –lavatory 16.60 for each utility connection —__ One(1)bath ____ _ $249.20 Tub or Tub/Shower Comb. _ -_ — 16.60 Two 2)bath _ _ $350.00 Shower Only 16.6(1 Three 3)bath _—_ $399.00 Water Closet -_ 16.60 -- _SUBTOTAL Urinal 16.60 i _ 8%STATE SURCHARGE Dishwasher J 16.60 PLAN REVIEW_25%OF SUBTOTAL Garbage Disposal 1660 __ _ _- TOTAL _! Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" — 1660 3" -- 16.60 PLEASE COMPLETE: 4----- 16.60 -- _ Water Healer O conversion O like kind 16,60 Uuantit�/h Work Performed _ Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. _ --- Capped MFG Home New Water Service 46.40 Sink _ _ MFG Home Ne,-.San/Storm Sewer 46.40 — Lavatory Tub or Tub/Shower Flow Bibs 16.60_ _ Combination Roof Drains - —� 16 6U Shower Only Drinking Fountain 1660 Water Closet Other Fixtures(Specify) v — 16.60 -- Urinal_ _ - __— — Dishwasher _ Garbage Disposal _ — Laundry Room Tray _ --" Washing Machine Floor Drain/Sink. 2" Sewer-1st 100' — .95003„ --- er-each additional 100' 46.40 4- -- V�urdr Service-list 100' i 55.00 _Wafer Heater Water Service-each additional 200 46.40 Other Fixtures —_ Storm&Rain Drain-1st 100' 55.00 (Specify) —�— Storm 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 -- Residential Backtiow Prevention Device'-- — 27.55 ---- -- Catch Basin 1660 -- Inspection of Existing Plumbing or Specially 72.50 Requested Inspections — per/hr _ _ COMMENTS REGARDING ABOVE. Rain Drain,single family dwelling 65.25 Grease Traps--^ — - 16.60 QUANTITY TOTAL ----- - Isometric or riser dlagrae,la required if -- — -- — -- _Quantity Total Is >9 ------ --� _ "SUBTOTAL 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only It fixtureqty, is>9 TOTAL $ Minimum permit fee Is$72 rxt.a%state surcharge,except Residential Backllow Prevention Device,which Is$ae 25+AW state surcharge ""All New commercial Buildings require pians with Isometric or riser diagram and plan review is\dsts\forms\plm-fees.doc 10/10/00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP — Date Requested k– AM —_PM BLD Location z 1 C/U I., 5(-It CIHs Suite MEC Contact Person Ph U)-/ PLM ;,2Gy✓'liL�,2 ? Contractor Ph SWR BUILDING Tenant/OwnerELC Retaining Wall _ ELR _ Footing Access. Foundation FPS - Ftg Drain SGN Crawl Drain Inspection Notes: ---- - -- Slab -- -- ---- ---- -- SIT Post&Beam - ------ - .-._--- Ext Sheath/Shear Int Sheath/Shear — Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof _ r Misc. —.._ 44-42 Final —-- - ✓ - t i P� 5 PART FAIL PLUMBING' Post& Beam — — Under Slab Top Out - Water Servic ("� Sanitary Sewer -- — ---- - ----___ ___—__--_ Rain Drains ,f�tPART FAIL 'MECHANICAL Post& Beare ---------- Rough In Gas Line - ----- ------- -- ---------- -- Smoke Dampers Final -- ---------- __---- -- ----- --- -- PASS PART FAIL ELECTRICAL - Service Rough In ---- UG/Slab _- Low Voltage F)rq Alarm Finai PASS PART FAIL SITE Backfill/Grading -- Sanitary Sewer Sto m Drain [ Reinspection fee of$ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd Catch Basin [ j please call for reinspection RE: —,- [ Unable to inspect-no access Fire Supply Line ADA Q 1 Approach/Sidewalk Date L� inspector i Ext 5 Other _ - Final It PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITYOF T I GA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00277 13125 SW Hall Blvd , Tigard, OR 972.23 (503) 639-4171 DATE ISSUED: SITE ADDRESS: 12100 SW SCHOLLS FERRY RD PARCEL: 1S134BC-00100 SUBDIVISION: ZONING: C-G BLOCK_ LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN ')RAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES. OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of commercial back flow prevention device. Located on side of 7-11 store & next to RP in cement vault. Owner: _A_.— FEES Type By Date Amount Receipt SAUNDERS, WILLIAM W TRUSTEE ---- — -- 2155 KAIAKAUA AVE S7E 500 PRMT JMT 07/28/200C $50.00 0004071 HONOLULU, HI %815 CT JM1 07/28/2000 $4.00 0004071 Total $54.00 Phone 1: Contractor: TEUFEL NURSERY INC 12345 NV/ BARNES RD PORTLAND, OR 97269 REQUIRED INSPECTIONS Phone 1: 646-1111 RP/Backflow Preventer Reg #: LIC 00005133 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 riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080 You may obtain copies of these rules or direct questions to OUNC by (-Wling (503) 246-1987. Issuod 9y• Permittee Signature: Call (508) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY O!" TIG/1R1 Plumbing Permit Application Plan Check# 13125 SW HALL BLVD. Commercial and Residential Recd By TIGARD, OR 97223 Date Recd r --3-�-� (503) 639-4971 ` ( �,r/ Date to P.E. Print or -type 1 j Date to DST �{u i Incomplete or illegible applications will not be accepted Permit SDI `�' Cie j Related SWR# w1 e e6 � �-// lv 'e �??tf.�� Called Name ofDevelopment/Project 1 FIXTURES (individual) QTY PRICE AMT Job (4 U ,4 �wn �e�i eti/ sink - 11 50 Address Street Address D I Suite Lavatory 11.50 Z j dry o j ` V lt '`d Tub or Tub/Shower Comb. 11.50 Bldg# City/State ZIP Shower Only 11.50 Name Water Closet 11.50 Urinal 11.50 Owner Mailing Address Suite Dishwasher 11.50 Garbage Disposal 11.50 City/State Zip Phone _ Laundry Tray s 11.50 ---------- ----- - Namp - Washing Machine/Laundry Tray 11.50 Floor Drain/Floor Sink 2" 11.50 Occupant Mailing Address Suite 3" 11.50 City/State Zip Phone _ 4 11.50 Water Heater O conversion O like kind 11.50 Name Gas piping requires a separate mechanical permit, Tr ► L St MFG Home New Water Service 32.00 Contractor Ming Address Suite MFG Home New San/Storm Sewer 32.00 I 345 Nw Paotrne Hose Bibs 11.50 Prior to permit City/State Zip Phone im I IT Roof Drains 11.50 Issuance,a copy v ,Z2q 503 of all licenses are Oregon Const.Cont.Board Lic.# Ex ate Drinking Fountain 11.50 required if �,e- L �. Other Fixtures(Specify) 15.00 expired In COT Plumbing --�� 77 E ,Da - -'database xpe� Name �j awl Architect �' j Sewer-1st 100' - 38.00 or Mailing Address uite Sewer-each additional 100' 32.00 Engineer CitylState ZIP Phone Water Service-1st 100' 38.00 _ Water Service-each additional 200' 32.00 Describe work to be done: Storm&Rain Drain-1st 100' 38.00 New p( Repair O Replace with like kind: Yes O No O Storm&Rain Drain-each additional 100' 32.00 Residential O Commercial )Y Additional description of work: Commercial Back Flow Prevention Device 3200 7 Z` Residential Backflow Prevention Device" 19.00 ` UL �D t✓ �p�p��'�/, _ Catch Basin 11.50 Are you capping, moving or replacirIg any fixtures? Insp of Existing Plumbing or Specially Requested 50.00 Yrs O No 0 Inspections er/hr If yes, see back of form to indicate work performed by Rain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 1150 WORK COULD RESULT IN INCREASED SEWER FEES._ I hereby acknowledge that I have read this application,that the Information QUANTITY TOTAL given is correct,that I am the owner or authorized agent of the owner,and Isometric or riser diagram is required ff Duant,ty Totals ,s that plans submitted are In compliance with Oregon State Laws "SUBTOTAL Signature of Owner/Agent Date _ _ (7 11 8%SURCHARGE Contact Person Name Phone _ "PLAN REVIEW 26% OF SUBTOTAL _ 1 BATH HOUSE:178.00 - I ke uired only d fixture qty total is 1 2 BATH HOUSE$250.00 TOTAL Sri 3 BATH 14OUSE$285.00 (This fee Includes all plumbing fixtures In the dwolling and the first •Mlnlmum Permit lee is$50+8%surcharge,except Residential Backflow Prevention 100 foot of sanhary sewer sterrn sower and water service) Device which is$25+8%surcharge "All New Commercial Buildings require plans wMh Isometric or riser diagram and plan review PLEASE COMPLETE: Fixture Type Quantity by Work_Performed__ New Moved Replaced Removed/Capped Sink Lavatory_---- — -- -- --- --- Tub or TubiShower Combination Shower Only -- -- --- --- -- --- -- ---- Water Closet Urinal---------- ------ _ - — Dishwasher ___-- Garbage Disposal Laundry Froom Tray Washing Machine Floor Drain/'Floor Sink 2" Water Heater _Other Fixtures (Spo'cify) COMMENTS REGARDING ABOVE: I%d2t1%f0rM 1P1•.lmaPP dOt t I/I BM9 rr / CITY OF TlO�►.F?D ELECTRICAL PERMIT PERMIT#: ELC1999-00203 DEVELOPMENT' 'SERVICES DATE ISSUED: 4/8/99 13125 SW Hall Blvd..Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S134BC-00100 SITE ADCRESS: 12100 SW ECHOLLS FERRY RD SUBDIVISION: C-G OLOCK: LOT : JURISDICTION: TIG Proiect Description: Instal!�ng one branch circuit RESIDENTIAL UNIT TEMP SRVCIFEEDERS i MISCELLANEOUS _ 1000 SF OR LESS 0 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 400 amp: SIGNIOUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER_ __ -----BRANCH CIRCUITS_ ADD'L INSPECTIONS 0 200 amp: WISERVICE OR FEEDER: PER INSPECTION: 201 400 amp 1st W/O SRVC OR FDR: 1 PER HOUR: 401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION _ 1000+ amplvolt: >=4 RES UNITS: �> 600 VOLT NOMINAL: Reconnect onl SVC/FDR >= 225 AMPS:_ CLASS AREA/SPEC OCC: Owner: Contractor: 19-e SAUNDERS, WILLIAM W TRUST 15P Ce_ ,`ret` 2155 KALAKAUA �/u HONOLULU, HI 96815 ej lXt kGWlll S OC T7M_ Phone: Phone: (j c;� ^"1,31(O Reg #: LSD 2- FEES _ ect'I SRequired Inspections Elervice Type By Date Amount Receipt Elect'I Final SPCT BON 4/8/99 $1.75 99-313342 PRMT BON 4/8!99 $35.00 99-313342 :_ Total $36.75 This Permit is issued subject to the regulations contained in the Tigard Muniapal Code,State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 248-1987 Permit Signature: Leh p`7Gc —� Issued By: ,��! OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE:--- CONTRACTOR ATE:CONTRACTOR INSTALLATION ONLY^ SIGNATURE OF SUPR. ELEC'N: DATE:--- LICENSE ATE: —_LICENSE NO: ----- -- - Calll 639-4175 by 7:00pm for an inspection the next business day RECEIVIEV community Development ELECTRICAL PERMIT APPLICATION 13125 5W Hal' Blvd. Planck/Re(. # - - l� R i f 8 1999 Tigard, OR 97223 - Permit # _ LCI "` I:LOPMENIphone (503) 639-4171 Date Issued 4-$�I FAX (503)(503) 684-7297 Issued by �i I 4m)/ CITY OF TIGAUD TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address: _ 4. Complete Fee Schedule Below: Name of Development—_,f / Number of inspection* per permit allowod — Address /o7�U� `Jt l� �t'�O �t1 Service included. Itttims Co qoa) FA)In 4a. Rmidential - per unit 4 City/State/Zip 71-4oed — st to cn --7— 1000 sq ,t or I*sa ---- L rN Each arlde,orall 500 sq h.or Name (or name of business) ��"��'� 7 y� portion shared _—_ G0 ---- Limited EnergyV 5 0G Commercial Residential ❑ Each AAand'd Homs or Moduar --- Dwaang Servant;or Feeder —� $68 DO 2a. Contractor installation only: 4b. Services or Feeders /J retallatwn al,araLon,or rebeat on ` Electrical Contractor P C_k & I C, _ 200 ammo or to" �0 00 00 AddresQ312' _ 201 amoe io aoo amps 00 y=- 401 amD*to 800*mite City_ L /j c.Kgr->- cr.S State_ Zlp`17uI sot amps to 1000 ammo $18000 Over 1000 amt's or Von* S0a7 o0 _ 2 Phone No. U510 739/e _ _._ �- only &W 00 � *connetionly Contractor's Ucense No. C, tractor's Board Reg. No. 4c. Temporary Services or Feeders 1�'1 — Ir*,a14l,on,alteration,or Tek anon $5000 ` uV 200 amp*or leas c'n 201 amps to Ano ampa f75oo Signature of Supr. Ele Lcense No. 13-2G' =� Ph,a No. 401 $100 00 ---- Over 800 amps In 1000.ons 2b. For owner installations: e"W aWye 4d. Branch Circuits Print Owner's Name i— anarat on or arterwon per pants Address h*'awr_ a'or brh 0rauta ARM _-_ purchaM of service or fea,,W W. 2 City State Zip wort branch crcua S5 Phone No. 91 The w for brarch arcurts mthour S, The installation is being made on properrpurchase of*,'Nita or Marl,vr be. %/ I own which is Ffst branch wcud _� 13500 x ->. not intended for sale, lease or rent. Eac+additional brans+artud $600 Owners` j -a 4e. Miscellaneous (Ser,,wa or feeder not included) 2 F-ad+Dump or irngiman arch $4000 2 3. Plein F?eview sectrc.n (if required): W00 _ Each sign or uAlina IgMmg J. Signal un:uMa)or a limited RnarQy Please r:hec:k appropriate item and miter fee in section 58. Dual, vtarstan or a>nena-on Sul 00 _4 or more rustdentral units in one structure u.nor tarn a(10) Service and feeder 225 amps or more 4f. Each additional inspection over System over 600 molts nominal the allowable in any of the above C;asstfied area or structure containing special occupancy Per nsoarion say a as described in N E.C. Chapter 5 per hour f55:o In Plant S5530 Submit Z sets of planta with application where any of the above apply. Not required for temporary construction services. 5. Fees 5a. Enter total of above fees s NOTICE 5%Surcharge 05 X total feesl $ Subtotal $ _ PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b, Enter 25%of line A for AUTHCRIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review If required ISec 3) CCNSTRUCTICN OR WORK IS SUSPENDED OR ABANDONED FCR Subtotal $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS CCMMENCED 1 ! 'rust A,:::runt�1 $ - t e 111r,ca� c�A s 3 co. IJ ...ya*.e�..r•an�sA CITY O F TIGARD Pt-UMBING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : PI-1197-0511 13125 SIN Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 12/01./,7 PARCEL.: IS134BC-00100 SITE ADDRESS_ : 12100 SW SCHOLLS FERRY RD SUBDIVISION. . . . : ZONING: C—G BI-OCK. . . . . . . . . . : LOT. . . . . . . . . . . . . JURISDICTION: TIG ---------------------------------------------------------------------------------- CLASS OF' WORK. . :AL.T GARBAGE DISPOS 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :COM WASHING MACH. . . 0 BACKFLOW PREVNTRS. . : I OCCUPANCY GRP. . .-B FLOOR DRAINS. . . I TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . .. 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0 FIXTURES--------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . : 0 URINAL.S. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 1. TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 WATER CLOSETS. : 0 WATER LINE (ft ) . . . v 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Install. ing I hot f1lish system, 1 -211 floor-- drain, 1 commercial backflow prevention device. Owner: FEES 7—:11 type amol.int by date recpt 12100 SW SCHOL-LS FERRY RD 'RMT s 43. 00 DRA 12/01/97 9 7—3 Q,Ice 6 TIGARD OR 97223 5PCT $ 2. 15 DRA 12/01/97 97-301263 Phone #: Cant ract a MICHAEL & CO PLUMBING P 0 BOX 23008 TIGARD OR 97281 Phone #c 639-3189 $ 45. 15 TOTAL Reg #. . : 000678 -------- REQUIRED INSPEc*rIONS This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other RP/Backflow Prev applicable laws. All work will be done in accordance with Final Inspection approved plans. This permit will expire if work is not started within IN days of issuance, or if work is suspended for more than IN days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in DA 952-MI-010 through DAR 952-0001-0080, you may obtain copies of these rules or direct questions t, OUK by calling (53)246-1967. Ltkd By Permittee Si gnat i-tre :j. "-Pt) 4.......*.........................4.4-++++4-++-1+++++++++++++i++++++++++++++++++•+-++ Call 639-4175 by 7:00 p. m. for an inspection needed the next blASiness day ........1-4...........................4........4..............4............4•......... Tenant Name: 7- J/ Accumulative Sewer Tally This Swag: �_;� ACdrt3ss: ra,u ft'i This PUNIC• NU-f Fixture Value Prevrotrs 0 Preva= Credits Capped Fixtures R.-tures New New Value Capped off value added Q added total #s total Count off#s count value values Raptistry/Font 4 !— Hath - Tub/Shower 4 Jacuz/Whpl 4 L.Car Wash- Each Stall ` g - Drive Through 16 Cusnidor/Water Asuiretor Dishwasher - Cammer 4 - Domast 2 Drinking Fountain 1 Eye Wash 1 Floor Orain/sink. 2 inch 2 3 inch 5 4 inch y _ Ca_ r _Wash Drain 8 arpomaye Disposal 16 — — •Dom Ito 3/4 HPI Comm (tn 5 HFI 32 Ind lover 5 HPI 48 Ice Machine/Rnfrigerator Drains Oil Seo IGas Station) g Recreational Vehicle Dumo Station 16 Shower- Ganq(Per Heed) 1 _ Stall 2 Sink - 8a./Lavatory 2 I _ Bradley 5 Commercial 3 Service 3 — — Swimmrnq Pool Riler _ 1 '+ Washer, Cluthns g Water Extractor g Water Clo-at. Toilet g Urinal g - LTOTALS Total fixture values: _ —� divided by 16 – 1 r^ EDU 1 HISTORY Pt M# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# _ FLM# EDU# SWR# PLM# EDUO SWR# PLM# EDU# SWR` _— --_ r'LA1# EDU# SWR# PLfv1# EDLP# °WR/ `ITY OF TIGaRD Plumbing Application Recd Btu 3125 SW HALL BLVD. Commercial and Residential Date Recd IGARD, OR 97223 Date to P E. 503) 639-4171 Date to DST " Permit• r Print or Type Related SWR tt Q9 -o i 7 Incomplete or illegible applications will not be accepted Called _ Name of DevelopmenUProlect FIXTURES (Individual) QTY PRICE AMT Job _ .`link - 9 U0 Street Lavatory 900 Address suite 1 Z.I C'1, S n.1c L o 1 S /' dcC',/ Tub or Tub/Shower Cumb 900 Bldg k CitylSlate Zip I Shower Only 900 T 19• • A �-77-7,z2 3 Water Closet 900 Name / 7_ 1( _ __ �-hl ee r t (C,r�..• 1 r t t, D,attvater 900 Owner Mailing Address Suite Garbage Disposal 900 0 bZ c t i..irea-it- o _ L[ 7 O Washing Marhme 900 CctylStale Zip Ph-o-nne- I Floor Drain 2' 9.00 Name 900 900 Occupant Mailing Address Suite Water Healer 400 Z 10( 1 w 1C L,LLaundry Room Tray 9.00 Cdy,Slate Zip Phone Urinal 1900 1,5, , / C'" 2 71 Name Other Fixtures(Specify) 900 /'1 It 1,..e ( f �� u../} ^1 _ NUS r IulL, jbi TCfl\ 900 .—pc ,ontractor adingAddress Suite hC�,I�r r 9A0 rI,O S ao City'State Zit, one one 9 0U Oregon const Cunt board Lic 0 p Date _ �9 00 --� >ttach Copy of 1 'I, �— - ,�_ 900 Current Plumbing Lic 0 E Date Sewer• 1 s 100" JO 00 Licenses Z G ell �-t v q y Sewer-each adddfonal 100' 2500 COT Business Tax or Metro 0 Exp Date _ Water Service- 1st 100' 3000 Name --- Water Service each additional 200' 250 Architect Storm R Rain Drain-1st 100 30 00 or Mailing Address Suite Storm 8 Rain Drain-each additional u& 25 00 Mobile Home Space 2500 Engineer Cdy Slate Zip Phone Commeraal Back Flow Prevention Device or Anti- , 2 00 Pollution Device ZS u01 )escnbe work New Addition O Alteration O Repair O Residential Backflow Prevention Device' 1500 'd be done Residential O Non-residential O Any Trap or Waste Not Connected to a Fixture I 9 00 Additional description of work 1'h S T,11 ha+ /�u 1 /��'�S Catch Basin 900 lijAer wrjl! Cr"I C (�s�;/ .� Insp a PxisfingPlu',ibing 4000 , l nn(h, C0 �,1(� (C' __ per/hr casting use of Requesled Inspections 4000 ddin roe _� penhr g or p p �'�-� -- -- - Rain Drain,sinal-family dwelling 3000 -oposed use of Griase Traps 900 ,riding or property_ ___---- _ QUAN i ITY TOTAL e you capping, moving or replacing any flxtt,esl Yes O No❑ Isometne c:nser diagram is re_nuired d duanity Totals >9 If yes see back of form) _ *SUBTOTAL 43 o •iereby acknowledge that I have read this.aoldication that;`,e information ___�__Y yen is c t,that l am the owner of authon.ed agent of the owner,and 5% SURCHARGE 2 r S / Ala submrtI are�in�Fom�p;i�an�w�ith Jregon State Laws _ _ - C gnatu of Owner/Ag" ' i — Date PLAN REVIEW 25°16 OF SUBTOTAL Y /r_ r), ,/ 7. Required only d fixture 7ty total is>9 TOTAL ,:intact Parson Name Phone -- ' �� , 'Minimum permit fee is$25 - 5%surcharge,except Rer,dential Backflow f,r 5 �. 1 p-,�_ O t Prevention Device,which is S15+5%Surcharge tdstMplmapp doc 8,98 PLEASE CQMPLETE ASAPPROPRIATE TO PROJECT: Fixtures to be capped, moved or replaced Oty Sink _ Lavatory Tub or 'T'ub/Shower Combination Shower Only Water Closet Dishwasher_ Garbage Disposal Washing_Machine Floor Drain 2" 3" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) -- COMMENTS REGARDING ABOVE: 4 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour inspection Line: 639-4175 Business Phone: 639-4171 Date Requested: _ s A.M. P.M. MS'I Location: !.21io( �,t i (,(/nom_ – BUR Tenant: _ urate: Bldg: Contractor: Phone: _!� l x.51 I I Owncr ---- Phone: ELC: ELR: BUILDING BLDG(con's) — PLUMBING — SIT: MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beane Post/Beam Cover/Service Sewer/Storm Footing Roof IJndFI/Slab Rough-In Ceiling Water Line Slab Framing Top(hit Gas Line Rough-In IJO Sprinkler I,oundation Insulation Sewer Ilood/Duct Reconnect Vault 13smt Diunp Drywall Storm Furtiace 'Temp Service MISC. Masonry Ceiling Rain Thain A/C UG Slab Shear/Sheath Fire Spklr/Alm Caowl/l ound Ur I feat Pump Low Volt Approved k.. Approvi4 - Approved Approved Approved APer/Sdwlk Not Approved NotApproved Not Approved Not Approved Not Approved FINAL1+'IN ` FINAL FINAL FINAL D Call for reinspection 0 Reinspection fire of S__ required before next inspection 0 Unnble to inspect Page of 1 Inspector: L ��_J ----- — - I t..� ---- CITY OF TIiGAR® -- BUILDING PERMIT PERMIT#: BUP2002-00127 DEVELOPMENT SERVICES DATE ISSUED: 4/23/02 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S13413C-00100 SITE ADDRESS: 12100 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: C-G BLOCK: LOT: JURISDICTION: TIG REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: NONE sf N: S: E: W: OCCUPANCY GRP: NONE TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OC^.UPANCY LOAD: BASEMENT- sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: ME,L'Z?: ----READ SETBACKS _ REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT. ft _ FIR SPKL: SMOK DET: — DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BA'rHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 12,000.00 Remarks: Install new freestanding sign, approximately 17 feet high, on corner of SW 121 st Ave and SW Scholls Ferry Rd. Owner: Contractor: GRAYCO TUBE ART 531 SW MACADAM AVE PO BOX 34333 PORTLAND, OR 07201 SEATTLE,WA 98124 Phone: Phone: 503-653-1133 Reg #: LIC 70956 FEES REQUIRED INSPECTIONS Type By Date — Amount Receipt Foot/Found Insp PLCK CTR — 4/10/02 �— $103.03 27200200000 Final Inspection FIRE GTR 4/10/02 $63.40 27200200000 PRMT CTR 4/23/02 $158.50 27200200000 5PCT CTR 4/23/02 $12.68 27200200000 Total $337.61 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 952-001-0010 th�b4�gh OAR 952-001,,71987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-66 or 1-800-33 -24. Permittee ' ` / — Signature: l � Issued By: ( �� I `r ,, Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit Application ' -- ! .,,(_., � Date receivedmino.: : � /D /I% Pert City of Tigard City of Tigard Address-.'13125 SW Hall Blvd,Tigard,OR 97223 !'rojecUappl.no.: date: Phone: (503) 639-4171 Date issued: -Byt-2jjReceipt no.: Fax: (503) 598-1960 (.l! Y ( i>c a.K.ii U Case file no.: Payment type: Land use approval: � �r�GUU. - t - 1&2 family:Simple Complex: -R JA I'M 11111111 U I &2 family dwelling or accessory U Commercial/industrial U Multi-family I:tNcw construction J Demolition `f� U Atltliti,m/alteration/replacement LI Tenant improvement J Fire sprinkler/alarm U Other: INFORMATIONJOB SITE Job address: A 5WT-je, Bldg.no.: tiuilc no.: Lot: Block: Subdivision; Tax map/tux lot/account no.: --- Proiect name: �" _- - - ----�- �� Description and location of work premises/special co ditions: 1 Name: 911111 Mailing address: �• ��'¢fs,/� - F X 2 femat. dNellint": City: Stale: T :Tll�-P: - Valuation of work........................... .... .. ... M G,� � - - Phone: Fax: E-mail: No.of bedrooms/haths............ .................... Owner's representative: Ac-' - 'total number o1'floors....................I........ ... Phone: Fnx: Fs-mail: New dwelling area(sq. ft.) .......................... APPLICANT Garage/carport area(sq. Il.) Name: Covered porch area(sq. ft.) ......................... Mailing address: I hrck area(sq. fl.) ... .... City: State:_ ZIP: t nitrr structure arca 1 ml f).).................. ...... Phone: Fax: I I mail: Cnmmerclal/L�lustrial/multi-fantil�: -- — Vuluaoon of work........................................ L Existing bldg.area(sq. ft.) .......................... _ Business name: � /,� New bldg.arca(sq. ft.)Address: - 6 MA- ' City: I state-- 7.IP: Number of stones........................................ _ --- - Type of construction................................ Phon 3 / Fax: j�Email: _ ..:Occupancy T- -- group(s): Existing ('C'B nit.: New: --- f'ityh irtrC)tic.no.: Notice.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 Addresi: ---- jurisdiction where work is being performed. If the applicant is City: State: "LIP: exempt from licensing,the following reason applies: Contact person: _ I'lan no.: _ -- - Phone: v Fax: Name: -' � t' i utct pers m: p Fees due upon application ....................... ... $_ Address: Date received: _ City: State• '-,iP:e kZ Amount received ......................................... $_ --- Phone A994M Fax: _ E-mail: Please refer to fee schedule. I hereby certify I ha" n n examined this application and the Not all jurisdictions accela unlit canis.please call jurisdiction foi mlmmummn attached checklist. All revisions oEwsand ordinances governing this U visa U MasleWardwork will be complied h,wt t rificd herein or not. t'redlt��+number -__1_1 tSspires Authorized sig re: / Dite: --—Name of cardholder as shown on credit,and Print name: Cardhoidet slxrtautre $ Amount Notice:This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. 440.1613(baarCOM) Commercial Plan Submittal } requirement Matrix City o/'Ti, lird TYPE OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must Include location of all accessible parking) Plumbing - Site Utilities 2 i Building �* Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 1 Electrical 2 Pian review is dependent upon submittal of a completed application al"d plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescuel. *For over-the-counter commercial tenant improvements, submit 2 sets of plans **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. I:klsts\f0nns\COM-mstrlx.1oc 9/24101 4 ZTec ENGINEERS, IN JOB—J Z� 3737 SE 8th Avenue SHEET NO OF— PORTLAND, OREGON 97202.3761 (503) 235.8795 CALCULATED By _ DATE-- CHECKED BY-- DA rE_W_ SCALE _ - pax 424:�'A l W IU�JATUAL. wa4 AILWA04E, �2,T2 oZ cfTY or TIiARD Approved.......... . ......... ... ..-.. ....,....... . . CondltlonellyApproved... . ....... ...................... ( ). For only thew as de- 0-' "' ERm NO 7. See oit r to:F Ilow 8C ....... ... y. ....)). .. ( )" J EXPIRED RECEIVED UlILGOId BVI-DTNG MWSION l 19� JOB ZTec ENGINEERS, INC. — 3737 SE 8th Avenue SHEET NO __ OF___- PORTLAND, OREGON 97202.3761 (503) 235-8795 CALCULATED BY-_ � DArr CHECKED BY ___.-_ _..___ ____ DATE SCALE I - /-4� -HOZ !•off/��) �/4,�,�-= � +/i i' _- jp9 /x4 =41 i,(c`1110 of�a � Ii 13-/-/�vz = x•43 w►� ---�--_-- __ ____.,.. 6 =(4) r `qtr)( 41-2)z Xz ZTec ENGINEERS, INC. Joe - 3737 SE 8th Avenue SHEET NO PORTLAND, OREGON 97202 3761 (503) 235.8795 CALCULATED BV__ _ DAM _- CHECKED By_._ DATE. SCALE 9334 I 0 EG0 r J , I 'yq��22. ,CI :%0. .► I ✓ G�rJGn 40 �\B SES�1e P1 Pei b)-U45t4l i 10 I Gil ' _� 71= _ .alio' 47fL Wl - -�"' _. p 4j„Gil 0 pp0^u[" gm CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-flour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Reauested_� /` _AM PM ;EC , LD Location_ LL Suite . Contact Person t-J --,') Ph 4�Cl PLM Contracto, _ _ Ph SWR f ( ELC BUILDING Tenant/Owner _l Retaining Wall Ct-S — Footing ACCipss: AJU ( , ' FPS Foundation '' - Fig Drain f k7t Ste'`` SGN Crawl Drain Inspection Notes ,(7 57 e>��.� Lam,� � Slab SIT Post&Beam �— Ext Sheath/Shear - Int Sheath/Shear Framing --- - - - -- - Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - Roof Misc:- - ------ ------ - Final PASS PART FAIL ---- -�- PLUMBING mac---— Post&Beam Under Slab - - - Top Out / Water Service - - Sanitary Sewer / Rain Drains -- - Final P PART FAIL - -- -- M[=C-NANI Rh I ikTRICAL - pers - ART FAIL Service _ Rough In UG/Slab --- -- Low Voltage Fire Alarm - Final PASS PART FAIL - ----- --- SITEBackfill/Grading — - Sanitary Sewer Storm Drain ( 1 Reinspection fee of$-.—_i_required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( j Please call for reinspection RE: - ( j Unable to inspect-no access Fire Supply Line ADA ' r Approach/Sidewalk I Irtsltf�r for 'w v �Xt�_- Other Date _ Final PASS PART FAIL DO NOT REMOVE this irispectior record from the job site.