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7350 SW LANDMARK LANE STE 120 J W O �i r. r 0 CITYOF TIGARD CERTIFICATE OF OCCUPANCY` DEVELOPMENT SERVICES PERMIT#: BUP2002-00511 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/25/02 PARCEL: 2S112AB-00300 ZONING: I-H JURISDICTION: TIG SITE L'DDRES: 07350 SW LANDMARK LN 120 SUBDIVISIOI BLOCI _OT: CLASS OF WORI ALT ^! ^— TYPE OF USL. COP" TYPE OF CONSTR: 0rr1_1pANCY GRP: O,;CUPANCY LOAD: TENANT NAME: hiCmS REMARKS, Add (2) restrooms and build wall Owner: HICKS, PRENTISS C PO BOX 23633 TIGARD, OR 9722.3 Phone: Contractor: DAVE COX 12115 SW SPRINGHILL RD. GAS ON, OR 97119 Phone: X03-475-3180 Reg #: IN 129661 This Certificate issuers 6/12/03 g. ants occupancy of the above referenced building or portion Clereof and confirms that the building has been inspected for compli�fice with the Statprof, Oregon Specialty forles for the group, occupancy, and us undv�r which th@r'rreferenced permit was issued. BUILDING INSPEC r0►2 BUILDING OFFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour Inspection Line, ?C-G BUILDING (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 �(v SUP Received __ ____ nate Requested Location -_—_. 316 '��1� LQ — Suite, Contact Person — -- ----- Ph Contractor Ph — _-- I -----) -------------___ SWR 1U2WG Tenant/Owner --_�-_._-------- -------- ELC Foundation Access: ELC Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing --- - -- Insulation Drywall Nailing - - Firewall Fre Sprinkler ---- --- -- ----- ----- - Fire Alarm Susp'd Ceiling - --- - Root Other: -- - — _ UMBING RT FAIL ------ --- �--- _ _-- _ - --- - L _ � eam Under Slab - - -_ — Rough-In Weer Service - _ - -- Sanitary Sewr,r Hain Drains - - ..-_ - ---- - Catch Bap;n/Manhold Storm Drain - -, Shower Pan Other: AAS ' PART_ FAIL M ANIC _ — eam Rough-In Gas Line Smoke Dampers Fi _ PART_FAIL lem-R-1—CAL Service - Rough-In UG!Slab ---- - - _ Low Voltage Fire Alarm Final Fl Reinspection fee of$� - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL .'t—ITE —� Please call for reinspriction RE:------, F] Unable to inspect--no access Fire Supply t no ADA � Approach/Sidewalk Date _ - __ Inspector _ __ -_ Ext Other Final DO NOT REMOVE this Inspection record from the jab site. PASS PART FAIL CITY OF TIGARD BUILDING PERMIT PERMIT#: BUP2002.00511 DEVELOPMENT SERVICES r,ATE ISSUED: 11/25/02 13125 SW Ha" Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S112AB-00300 SITE ADDRESS: 07350 SSV LANDMARK LN 120 SUBDIVISIC:'V: ZONING: I-H BLOCK. LOT: JURISDICTION: TIG REISSUE: 'FLOOR AREAS EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: ALT FIRST: sf N: S: E: _ W: TYPE OF U:'E: COM SECOND: sf _ _PROJECT OPI_NINGS? TYPE OF CONST: sf N: S: E: W. OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?. MEZZ?: REQ_D SETBACKS REQUIRED FLOOR LOAD: p5f LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 8,000.00 Remarks: Add (2)restrooms and build wall. Owner: Contractor: HICKS, PRENTISS C OWNER PO BOX 23633 TIGARD, OR 97223 Phone: Phone: Reg #: FEES REQUIRED INSPECTIONS _ Description Date Amount Electrical Permit Required [BUILD] Permit l ee , 11/25/02 $120.10 Plumbing Permit Required t3UPPLN Pin Rv 11/25/02 $78.07 Framing Insp CPLs FLS Pin Rv 11/25/02 $48.04 Gyp Board Insp [FLS] Susp Ceiing Insp (TAXI R State'i'ax 11/25/02 $9.61 Final Inspection Total $255.82 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 rule3 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 1+52-001-0010 through CAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. Issued By:( �'( e�' c �L�b'� Permittee ' J Signature: ----------- Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit Application PDatc received: Gj_ Pcrmitno.: ' ,) -W6 / City of Tigard Project/appl.no.: Expire date: City q(Tigard Address: 13125 SW Kali Blvd,Tigard,OR 97223 Date issued: Ry: �% Receipt no.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: I&2 family:Sininle Complex: Land use approval: -- Em U I &2 family dwelling or accessory U Commercial/industrial U Multi-flmily U New construction U Demolition U Additiun/alleration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: Bldg.no.: I Suite no.: 21b Job address: 73 ID'O { I"�� ' — �ax map/tax lot/account no.: Lot: Block: Subdivision: Project name: - 4 A T I O - K�� W Q f{QA-�� Description and location of work on premises/special conditions: R'NUTt?��C t M11,115120111 Nil r�Na�me�* VilIT l � IL k`�esa: Ij�Tj 3 1 &2 family dwelling: � Stale:f� ZIP: [ Valuation ofwork ............ .......................... $t -�-12L Fax: Vi I I$q5 E-mail: No.of hedrooms/baths. Owner's representative: Total number of floors......................... Phone: Fax: E-mail: New dwelling area(sq.ft.) ..................•..,•,•. Garage/carport area(sq.ft.)......................... APPLICANT 1�MEW-(� zI_ . �r , Covrred porch area(sq.ft.) ......................... Name: t = _,�.�;. Deck area(sq.ft.)Mailing address: Other structure area(s . ft.)......................... City: State: ZIP:1?-mail: ('ffnrmerciallindustriallmulti-family:Phouoc: Valuation of work $ Existing bldg.area(sq.ft.) .......................... Business name: f tJN ; S 1, G7 A�G�_�i New bldg.area(sq.ft.) ................................ Address: Number of stories........................................ — - ---- City: State: ZIP: Type of construction.................................... Phone: Fax: E-mail: Occupancy group(s): Existing: CCB no.: - --- _ —.---- New: City/metro lie..no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may he required to be licensed in the Name: ------ jurisdiction where work is being performed.If the applicant is Address: - exempt from licensing,the following reason applies: City: Stale. ZIP: — — _ Contact person: Plan no.: --_ — Phone: I,,, E-mail: Name: Contact person: Fees due upon application ........................... $_ - Date received: Address: ... $ city: State: ZIP: Amount received ...................................... —�- -_ phare: Fax: E-mail: Please refer to fee schedule. Not all Jurisdictions eccep credit cards,please call jurisdiction for more informa"n" I hereby certify ave read and examined this application and the U Visa ❑Mastercard attached checkli t.All provisions of laws and ordinances governing this Cre card rw,nber: work will be com ied with,whether s f d herein or not. =xpifeL Date: Nurse or c Ider as shown on cre It card S Authorized signaturY. - Print name:__- -j>s Cardholder signature Amount Notice:This permit application expires if a permit is not obtained within I go da%,after it has been accepted as complete. 440461)I60l/C'UM1 Commercial Plan Submittal Requirc>tnent Matrix City of Tigard TYPE OF SUBMITTAL_ # of Plans (Includes New, Addi,ions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing Site Utilities 2 Building 1 i Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and 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 & Rescue). *Far over-the-counter comms:?rcial 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 NICE level "3" technicians. 0dsts\forms\C0M-mathx.doc 9/24101 13'8' i. of 1 /1 1 F � � t �y^ 0/1111 C� • i -\ •11.1 •�1 1 1 I t t 4 1 1 d, ••••• 1 1 1 / S1 F f � � o a. 3 ~' w x 3 D N C T w CD n m U7 �� m c ( x -D > C CD (D 0 � C a _ r 3 ' Q° -I Z �� (Ds a . D o0 LI' aof. (D Z aJD n ( z __� 0 m 0N33 w Z ° v1 LD: A v m v n - m Tj o -TN j WC W -OC) D N ro(DMR G b (? O m O� 1 o n o h cl ( y a C r1 " CL -� = N n CHAP.11 DIV.IV ADAAG MURE 30 1"7 UNIFORM BUILDING CODE II •••./ e • 1. •.••. •••11. Ar 1 doof N t 1 ' rOOf W41 top •//t r I . 1 • ! t I � /i • t . 1 I I t 1 1• • S 1 1 1 1 1 1 N^ .Yr �� •1;••• • 1 tr. I CL� F 1 1 7 1. t••• I t I � • ,trte 0 I t S 1 s Rii" maii jnmmi.0 M,C. N 70 42 mtn latch 59..mia��Ilt .1,«,.,I.e VC. Approach-v;A 1.00 other approaches (�) 48 min 5 -fd Sall . 36 rlw, 91S I � 1 1 a ♦ I char \ ( Iba 1 I .pK. 11 4 rJ6m,n w..II,UI. "'4y.+�tQ r r NIO 5�w1 M 1. (�11 slaftfAm Scan («rd a row ADAAG FIGURE 30--TOILET STALLS 1-134AO 1997 UilIFORM BUILDING CODE ADAAAQ Aau�2 ADAAG FIGURE 32 .•.r , , ssc ; •rf . o 4--^� f• i N$ n 9 ...r. • s ware ' 71b Ir,• cl••r•ntrr krs�• 8m' Cie rem*,V_ min {•p.h ai0 ADAAG FIGURE 31—LAVATORY CLEARANCES 17min r430 .....,_.............. ...... . c tloa E Glow r ---1 O M O .............. .... 19 mix IGS 48 n►1� 1220 ADAA3 FIGURE 32---CLEAR FLOOR SPACE AT LAVATORIES 1-134.53 CHAR 11,1XV.IV 1997 UNIFORM BUU.DINO CODE ADAAG FIGURE:A a YrYYte 36 m1n , 91536 wn 12 min 12 min Y • ' ' tttYe • � r y/�6 3aS 30 •t.t Y• • [ . •• t/ Y� 1e •YYYY 1 Y Y Y !o a Y I t*3 o Bads Wall 54 min 1370 12 42 min 165 tolltl paper c Lil. C7C Z (b) Side Wall eA[jAAU hlt3Uf4t!Y—(ARjAu a--n.S!T WATER CLOSETS 1-134.49 1ti CITY O F T I G A R D T MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00537 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 02 PARCEL: 221S11217_AB-00300 SITE ADDRESS: 07350 SW LANDMARK LN 120 SUBDIVISION: ZONING: I-H BOCK: LOT: JURISDICTION: TIG CLAS:'. OF WORK: ALT FLOOR FLIRN: E JAP COOLERS- T' PE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS WIO APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL TYPES _ 0 3 HP: DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS,. 30 - 50 HP: WOODSTOVES: I GAS PRESSURE: — 50 HP: CLO DF',YERS: AI FURN < 100K BTU: R_HANDLING UNITS OTHER 0NITS: FLIRN >=100K BTU: 1 <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Tenant Improvement - replace unit heater Owner: _— FEES - ---- HICKS, PRENTISS C Description Date Amount PO BOX 23633 IN,%(111 I'crniir I re 11/27/02 $72.50 TIGARD, OR 97223 j'IA\j 8"., titcucl.0 11/27/02 $580 Total $78.30 Phone: Contractor- ARROW MECHANICAL 10330 SW TUALATIN RD TUALATIN, OR 97062 REQUIRED INSPECTIONS Mechanical Insp Phone: 692-1565 Final Im',pection Reg #: LIC 5193 This permit is, issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. /All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center 1 hose rules are set fort-i in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rL les or direct questions to OUNC by calling (503)246-6699. Issued By: _ �1 �) 39��O Permittee Signature: Call (5P.M. for inspections needed the next business day Mechanical Permit Application City ,1 — rDatcreceived: Permit nd.Jl r _a, :1, , City of Tigard Prc�jecUappLno.: Expire date: CitynfTigard Address: 13125 SW hall ilivJ,"fipitol, t)Il 'i7:? Phone: (503) 639-4171 Date issued: By: I Receipt no.: Fax: (503) 598-1960 Case file no _ Payment type: Land use approval: _.. Building permit no.: U I &2 family dwelling or accessory U Commercial/indw-'tial U Multi-family 'b'enant improvement U New contitnI-tionNddition,'al(cra(ion/replacernent U Other: MIN 0 Job address: 7 S w' i )hlr > Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all tnech• I it materials,equipment,labor,overhead, Tax map/lax lot/account no.: profit. Value$ _ Lot: Block: Subdivision: *See checklist for important application information and Project name: j(5` jurisdiction's lice schedule for residential permit fee. City/county: >fj S) Z1P: ('2-1 Description and location of work on premises: I _ 1 y frc(ca.) dotal Est.date of completion/inspection: Ik-stri tion Qcp. Rcr.onlr Res.(Ird) Tenant improvement or change of use: a Is existing space heated or conditioned?Ayes U No Air handling unit __--_ (JI'M Air conditioning(site plan required) Is existing space insulated? es U No A tern[To—nof existing system or er compressors - _- Business name: yl 1 State boiler permit no.: Address: HP Tons BTU/H �' LJ 1 i ire smoke dampers/duct smoke detectors Cit s: TIN Slate ZIP: X-71)&]L eat pump(site plan require ) - Phone - - Fa AjU-mail: Instnl l/repl ace furnacr urner' CCB no: _ Cf 3 Including due[work/vent liner U Yes U No nsta"re ac relocate eaters-suspended, Cily/metro lic.no.: 7 4-]I:^ _ wall,or floor mounted Name(please tint): it Vent fits art lance of cr t an furnatc� efr geraUon: Absorption units_ BTI1/H Nan": �TI L �/ITYZ LC(G ('hitters.---� HP Address: ) Com tressors— IIP (L{ ��L �lv )L_Ir City: L i Fitate 1 . IIP: Environmental ez east.n vent etictn: —1 �- 1 �:(� 1.� Appliance vent Phone: 4Z2 l ,,v E-mail: )ryerexhaust Hoods,Type 17 res.kilclieRfiazmat Name: hood fire suppression system - I _ Exhaust fan with single duct(hath fans) Mailing address 1 zExhausts stem a art from heating or AC I City: 7 Slat . k! p ping and disirlbution(up to 4 outlets) 1'ypc: __1-116 _ NG Oil Phon Fax: E-mail' Fuelpiping eachadditional over out ets — - Process p p ng It schematic require ) Name: Nunthei til outfe s UI er pp nice or equipment., Addtes, _ ct�Dccorativeftreplace City: State: j ZIP: Insert-type —_--_ Phone: I Fax: E-mail: oo stov pellet stove -" Applicant's signature (h er. -7 Dalair -Z 'c- t Name(print): �; } Nd all Jurisdiction wv pl crew:^udi,pleats call}tvidlcaon for mae infamuicni Permit fee..................... Notice:This permit application ❑Vita UMasutCerJ Minimum fee............... $ expires if a permit is not obtained Plan revit w(at _, 96) $ Crtdit cad numha! within IRO days ager it has been State surcharge(896)....$ Name arc der at shown on c t cod $ accepted e9 complete. TOTAL _ ......I................. —""--"— Crtdltolder tlputtae Attnwm � 4141617(tiVaR'OM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FL SCHEDULE: _ _ -0 --- Price Total -T-0 TOTAL VALUATION: PERMIT FEE: Description: i.U0 to$E.000.00 Minimum fee$72.50 Table 1A Mechanical Code Oty (Ea) Amt 1) Furnace to 100,000 BTU $5,001.00 to 510,000.00 $72.50 for the first$5,000.00 and including ducts&vents _ 1400 $1.52.for each additional$100.00 or 2) Furnace 100,000 BTU+ fraction thereof,to and Including Including ducts&vents 17.40 _ _ $10 000.00, 3) Floor urnace I $10,001.00 to$25,000.00 $148..50 for the first$10,000.00 and Includina vent 14.00 $1.54 for each additional$100.00 or 4 Suspended heater,wall heater fraction thereof,to and Including ) or floor mounted heater 14.00 _ $25,000,00. _ $25,001.00 to$50,000.00 $379.50 for the first$25,000,00 and 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or fraction thereof,to and including 6) Repair units 12.15 _ $50,000.00. $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Hcy, Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond Comp fraction thereof. footnotes below. _ - 7)<3HP;absorb unit 1400 Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU ------- $ 8)3-15 HP;absorb 25 60 8%State Surcharge unit 100k to 500k BTU -- _ $ 9)15-30 HP;absorb 35.00 - 25Y.Plan Review Fee(of subtotal) unit.5-1 mil BTU - Reguired for ALL commercial permits only 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.26 - 11)>50HP;absorb 87,20 -- - -_-- - -- --- unit>1.75 mil BTU 12)Air han'ling unit to 10,000 CFM 10.00 [ SSUMED VALUATIONS PER APPLIANCE: r-- Value Total 13)Air handling unit 10,000 CFM+ Desai lion: Qt Ea Amount 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler 10.00 ducts&vents Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a single duct 6.80 ducts&vents Floor furnace Including vent 955 16)Ventilation system not included in Suspended heater,wall heater or 955 appliance permit 10.00 floor mounted heater 17)Hood served by mechanical exhaust Vent not included In applicance 445 10.00 ermit --- 18)Domestic Incinerators Reps805 ir units 17.40 <3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator to 100k BTU __ 89.95 3-15 hp;absorb.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 outsets mil.BTU _ _ 5.40 r_ 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU 1.00 - >50 hp;absorb.vnit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.i 5 mil.r1T'j _ Aif r,I,nQ unit to 10,000 Cfm 858 8%State Surcharge $ Air handling unit>10,000 cfm - 1,170 Non-portable evaporate coolel 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not included it 656 ---.--.__--- a Ilance armit --- Other Inspecilons end Fees: Hood served by mechanical exhaust 656 1 Inspections outside of normal business hours(minimum charge-twe hours) Domestic incinerator1 170 - $62 50 per hour Commerd31 or Industrial Incinerator 1:-4 590 _ 2 Inspections for which no fee is specifically indicated (minimum charge-hall hour) Other Unit,including wood stoves, 656 $62 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum Inserts etc. -----36-0 tc. harge-one-half hour)$62 50 per hour Gas I In 1.4 outle+s - 363 Eadl additional outlet - _ 'Stale Contractor Boller Certification required for units>200k BTU. "Residential AIC regnires site plan showing placement of unit. TOTAL COMMERCIAL $ VALUATION: All New Commercial Buildings require 2 sets of plans. lAdstsVormsVnech-fees doc 12/26/01 2 CITYOF TIGARD BUILDING PERMIT PERMIT#: BUP2002-00542 DEVELOPMENT SERVICES DATE ISSUED: 12/18/02 13125 SW Hall Blvd., Tiqard, OR 97223 1503) 639-4171 PARCEL: 2S112AB-00300 SITE ADDRESS: 07350 SW LANDMARK LN 120 SUBDIVISION: ZONING: I-H BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS _ _ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _ P_,_E_Q_D 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: $ 500.00 Remarks: Addition of 4 sprinkler heads in 2 restrooms. Owner: Contractor: HICKS, PRENTISS C WYATT FIRE PROTECTION INC. PO BOX 236:33 9095 SW BURNHAM TIGARD, OR 97223 TIGARD, OR 97223 Phone: Phone: 684-2928 Reg #: MET 8000044593 ^FEES _ LIC REQN6iII INSPECTIONS Description Date Amount Sprinkler Final 1111111 DI PCIIIIII FCC 12/18/02 $62.50 "TAX! 8%Slab I a\ 12/18/02 $5.00 -- Total $67.50 i _J 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 Ole Oregon Utility Notification Center. Those rules arE. set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2.344. Issued By: y Permittee Signature: __..- Call 639-4175 by 7 p.m. for an inspection the next business day Fire Protection System Building Permit Application City of Tigard 7..j�m. ed: ' _��.c a- Permit no.:r o,_pV 41.P- Address: 13125 SW Hall Plvd,Tigard,OR 97223 l.no.: Expire date: City of Tigard Phone: (503) 639-4171 : Hy:� Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: r1&2 family:Simple Complex: U I &2 family dwelling or accessory Wommercial/industrial U Multi-family U New constnlction U Demolition U Addition/al teratioft/replace ment 21.Tenant improvement jilFire sprinkler/alarm U Other: JOB SITE INFORMATION Job address: 'a.,-I Il4,r1 NZK W Bldg. no.: Suite no.: Lot: Block: Subdivision: - Tax map/tax lot/account no.: Project name: ---_ _ ---— -- Description and location of work on premises/special conditions: (Floodplain,septic capacily,solar,etc.) .—�� OWNI31 1-011 SPECIAL INFOHNIA"I ION, USE' ( 11LUKLIS I Mailing address: f~ 3 1 &2 family dwelling: City: z -) Statc:CIZ_ ZIP: C Z Valuation of work........................................ $ __-- Phone: Fax: E-mail: No.of hedrewms/baths....................... . ._. .. Owner's representative: Total number of floors....................... Phone: Fax: E-mail: New dwelling arca(sq. ft.) .......................... Garage/carport area(sq.ft.) Name: 5 F [L��j tti. R1 G'�- Covered porch area(sq. ft.) ......................... Mailing address: Deck area(sq. ft.) ........................................ City: _ Slate: ZIP: Other struclurc area(sq.ft.)......................... Phone: Fax: E-mail• Commercial/industria l/nmltl-family: Valuation of work........................................ $ Business name: ��;� � I t '- )�� I � Existing bldg.arca(sq.ft.) .......................... - - �-- New bldg.area(sq.ft.) Address: 0 � cJ � ................................ - - Number of stories. City: • r Slate: ZIP: 6 - Phone: 11 a Fax: .o �(-" E-mail: Type(if construction.................................... -- Occupancy group(s): Existing: CCB no.: - - -- _ New: City/metro tic.no: '? Noliee: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 Address: jurisdiction where work is being performed.If the applicant is City: Slatc: ZIP: — exempt from licensing,the following reason applies. Contact person: _ Plan no.: - Phone: Fax: E-mail Name: _ Contact person: Fees due upon application ...................... .... $-_ Address: Date received: — City: Statc: ZIP: Amount received ......................................... $ Phone: I E-mail Please refer to fee schedule. hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please call,iii-Miction for mete information attached checklist. All provisions of laws and ordinances governing this U visa U MasterCard work will be complied with, Iscificti herein or not. credit card nurntwf _ ____ __ . 1—/ _ Lspires Authorized signature: --- Date: Name of cardhnider as shown on credit card — Print name: 7 i� Cardholder sippnaturr�'-- --- S-Amount Notice:This permit application expires if a permit is not obtained within 180 days alter it has been accepted as complete. c.ar.a,1 3 tnaxucoM) Fire Protection Permit Check List A. U New ❑ Addition ❑ Alteration ❑ Repair B.) Modification to sprinkler heads only: Describe work to 1. 1-10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads:_ 4 Additional description of wurk: �n� IS @ 1� t120p�b1 S Type of System Complete A, B or C as applicable): A. S rinkler Wet Dry ❑ _-__._ Standpipes Additional Hazard Group —_ Information Density Design Area K. Factor _ Sprinkler Project Valuation: $ S(JC B. Type I - Hood Fire_S_upgession System Hood Pro ect Valuation $ C. Fire Alarm_ Submi+tal shall Batte Calculations _ Yes _❑ include: Individual Component Yes ❑ Cut Sheets Fire Alarm Pro ectValuation: $ _ Project Valuation Subtotal (A,B AL C : $ Permit fee based on_ valuation (see chart : 8% State Surchar e: $ FLS Plan Review 40%a of Permit: $ -- --- .--TOTAL: $ -- Plan review requires a completed application and 3 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians 1Adsts\torms\FPScheck11s1.doc 11/21/01 CITY OF TIGARD PLUMBING PERMIT PERMIT#: PLM?_002 00462 DEVELOPMENT SERVICES DATE ISSUED: 1213/02 —2w OIL 13125 SW Hall Blvd., Tigard, OR 37223 (503) 639-4171 PARCEL: 25112AB-00300 SITE ADDRESS: 07350 SW LANDMARK LN 12.0 SUBDIVISION: ZONING: I H BLOCK: LOT: JURISDICTION: TIG rLASS OF WORK: Al_T GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS•. GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 4 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Building fixtures: 4 lays and 4 toilets FEES Owner: Description Date Amount HICKS, PRENTISS r II'1.11N11ij 1'ernut Fee 12/3/02 $132.80 PO BOX 23633 1 AN State]a\ 1213/02 $10.62 TIGARD, OR 972.23 Total $143.42 Phone Contractor: WOODBURN PLUMBING LELAND FOSTER PO BOX 252 REQUIRED INSPECTIONS WOODBURN, OR 97071 — —� Rough•in Insp Phone : I)X I-405; Top-out Insp Reg#: MET t)()()()1769 Final Inspection I'lu 51140 I'I.M '.1-15a1'It 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 Issued By �, (� tlirye/ J . Permittee Signature: -- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Fixtures Plumbing Permit Application Date received:/ -0.7-- Permit no.?-AaW City of Tigard Sewer permit no.: - Building permit no,: - Address: 13125 SW Ifall lik(1,Tigard,OR 97223 city of T(gard Phone: (503) 639-4171 Project/appl. no.: Expire date: Fax: (503) 598-1960 bate issued: By: eceipt no.: Land use approval: case file no.: payment type: OF PERMIT 0 I &2 family dwelling or accessory J Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food service lJ Other: JOIR SITF INFORMATIONSCHEDULE lob address: 7350 S ty C/1 Hl ►'�4 ek.- M 6/C family dwel Qty. Fec(ea.) Tota Bldg. no.: Suite no.:j 2Q h't'w I-and 2-family dwellings only: --- ---- (includes 100ft.foreach uliliO connection) Tax map/tax lot/account no.: _ _SFR(1)bath _ Lot: Block: Subdivision: SFR(2)bath _ _ Project name: SFR(3)bath i Cit /county: _ ZIP: Each additional bath/kitchen Description and location of work on premises: Siteutilities: Catch basin/area drain Est.date orcompletion/inspection: Drywells/leach line/trench drain _ looting drain(no. lin.ft.) PLUMBING CONTRACTOR Manu!'actured home utilities _ Business name: r/ 1k t- Manholes Manholes Address: ).0. X Rain drain connector _ —_--_ City: StatWV ?_IP: a Sanitary sewer(no.lin.il_) Phone- 81.�(U$ Fax: E-mail: Storm sewer(no, lin, ll.) CCB no.: -5//yL) _ ;bus t• ,no: �'><./SG7F� Water service n: lin. fl. City/metro tic,no.: Flxtureorltem Contractor's 1 epresentative signature: Abso tion valve _ --- - - Back flow preventer Print name F 1 ' l�'k �_ I>it'' Backwater valve _ PERSONCONTAff Basins/lavatory Name _ Clothes washer Dishwasher Address: Drinking fountain(s) (� City: - - I tii, i /II': - Ejectors/sump Phone: lax: I in,iil Expansion tank IOWNER Fixture/sewer cap _ fJFloor drains/floor sinks/hub Name(print): L�(Q ( (CK S Garba a is osal (� Mailing address: t)K 3�3 C 3 3 Klose bib City__ /Qz— State: IX— ZIP:q 7`S (__. ice maker _ Phone: ZQZ-(e22(. I Fax: I E-mail Interceptor/grease trap _ Owner instal lation/residential maintenance only: The actual installation Primer(s) r will be made by 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 ays ) Owner's signature:_ [' 'p Sump _ Tubs/shower'shower pan Urinal Name: _ Water closet _ iW A2 Address: Water heater City: 1 ti1a1e. ZIP: other: Phone: Fax: E-mail, Total JIL Not VlaaurisdiO MasterCard expires credit cards,please call junso,,iwn for mare informNotice: This permi ation. Minimum fee................ $ 1 t application Plan review lar � %) $ _ expires if a permit is not obtained State review (surcharge(8% $ Credit cad number _— within 180 days after it has been )"" —�— �r — Name o ar of er a s own on credit ar — accepted as complete. TOTAL.................... ... $ 3. S _ ca of er sisnatura Amount 440-4616(6i00WOMI 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 1660 the dwelling and the first100 ft. QTY (e8) AMOUNT _- -- -- for each utility con_nectlon __ Lavatory 16.60 One 1 bath, _ _ $249.20 Tub or Tub/Shower Comb, 16.60 Two 2 bath $350.00 Shower Only 16.60 Three(3)bath _ $399.00 Water Closet _ 16.60 - -- SUBTOTAL _ Urinal J 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _ Garbage Disposal 16.60 TOTAL 9 p _ Laundry Tray 16.60 Washing Machine 16.60 Floor DrainfFloorSink 2" -� 16.60 3 16.60 PLEASE COMPLETE: -� - 4" -- -- 16.60 _ _ -- --- - - Water Heater O conversion O like kind 16.60 QuantltY b Work Performed Gas piping requires a separate mechanical Fixture Type: New Mnved Replaced Removed/ permit. MFG Home New Water Service 46A0 Sink MFG Home New San/Storm 4nwar 46.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fixtures(Specify) 16.60 Dishwasher _ Garbage Disposal -" Laundry Room Tray _ Washing Machine _ Floor Drain/Sink: 2" - __-- Sewer-1st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1 st 100' 55.00 Water Heater _ Water Service-each additional 200' 46.40 Other Fixtures S eci Storm 6 Rain Drain-1st 100' 55.00 _�- Storm 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Pre%sntlon Device 46.40 - - --- - Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 - Inspection of Existing Plumbing or Specially 62.50 Requested Inspections perthr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 -- --------- - ------ - -- QUANTITY TOTAL --- Isometric or riser diagram Is required If Ouentity Total Is �,g -- *SUBTOTAL - - --. --- -- - - 8%STATE SURCHARGE �- - "PLAN REVIEW 25%OF SUBTOTAL __ R�urred only it fixture qty totalI_�>9 - _ TOTAL E *Minimum permit fee is$72 50+8%state surcharge,except Residential Backflow Prevention Device,which Is$36 25•8%state surcharge **All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review iAdsts\forms\pirn-feP,s.doc 12/26/01 u 14'.4 112" ---. �37- 112"+�-I 74-112.. '• r, _L r m I ; W CU _ C -18 55- l r2" 1 55- 112" O 3 � Q7 X c D --1 v I _ (D (0 + CD -n = w 37- 112'+1 __-_� ' x T X O N C n mV D Q CCD v m �a n - S. c � Z W L r CD cn W N0Q03 > � v 3 ON imp v 5 D o0 m v N Z D - N D I 1T p m � -no Cl ro c R0Z ;u D Fn' CD D 0 Z CD �n c Z n1 1 � 1 � CD CL i Q O a O N L f1 n / + MECHANICAL PERMIT CITY OF TIGARD DEVELOPMENT SERVICES PERMIT#: MEC2002 00526 DATE ISSUED: 11/25/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S112AB-00300 SITE ADDRESS: 07350 SW LANDMARK LN 120 SUBDIVISION: ZONING: I-H BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: ,TORIES: BOILERSlCOMPRESSORS _ 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 FHP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: TI inside East Warehouse area Owner: _ _ — FEES HICKS, PRENTISS C Description _ Date Amount PO I30X 23633 [MI.( Ill l'crnut Fee 11/25/02 $72.50 TIGARD, OR 97223 1MLclII Permit Fee 11/25/02 $0.00 I'l Ax) 8%)State]ax 11/25/02 $5.80 Phone: IA N I M%,StateTax 11/25/02. $0.00 Contractor: — _ ___ Total $78.30 l'jzL) .F1LTU �Z REQUIRED INSPECTIONS _ Mechanical Insp Phone: Heating Unt Insp Reg #: This permit is issued subject to the regulations contained in the Tigard Munic,oal Code: State of Ore. Specialty Codes and all other applicable laws. All work will be done in accor&,nce with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNG by calling (503)246-6699. �' Issued By: J L {�, t.. /�i Permittee Signature: — Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Datereceived: ^ 5j_p ermitno.: City of Tigard Pmjecdappl.no.: Expiredate: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date ir3ued: By . Receipt no.: 51 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: —---- — Building perms no.: --- U I &2 family dwelling or accessory U Cornmercial/industrial U Multi-family U'fenant iniprovenlent U New construction U A(I(Ijtion/alteration/replacemcnl U Other: .100 SITE INF0111MA-tION COMMERCIAL VAIA 1A I ION SCI I I Dl 111', Joh address: amu) L A N DA4 4 Rl2- LAML LAMIndicate equipment quantities in boxes below. Indicate_the dollar Bldg.no.: I Suite no.: value of all mechanical material ,equipment,labor,overhead, Tax map/tax lot/account no.: prol it, Value$ ��L)N y Lot: Block: Subdivision: 'See checklist for important application information and Project name: 'BA'jl-((2CLWj1jS jurisdiction's fee schedule for residential permit fee. City/county: "T I CAP 0 ZIP: C, -7 ZZ cDWELLING PERMIT FEE S('IIIFDtfl,E Description and location of work on premises: t INSri_ i<AST Lk) A(2F_Hc) ,SE Est.date of completion/inspection: 2- U,; OZ Descriptio QI . Ret.only Res.nnly Tenant improvement or change of use: 11VC: Is existing space heated or conditioned'?JA Yes U No Air handling unit CFM -- Air con itioning(site plan required) Is existing space insulated?J21i Yes ❑No tcrauon of existing HVAC system 1101 LILi ffffilk'l I= Boiler/compressors - - - -- Business name: State boiler permit no.: ---- I IP Tons _BTUM Address: - -- tie smo c dampers/duct uct smo ce electors City: _ State: ZIP: Meat pump(site plan required)- - - nsta re furnaceburner — — Phone: Fax: E-mail: 7 Pace Including ductwork/vent liner U Yes U No CCB no.: _ nsla rep ace relocate eaters-suspen ed, — - --- City/metro lic.no.: wall,or floor mounted Name(please print) entfor al liance other than furnace - - -_ rf gerat on: A' urptionunils BTU/li Name: Ch llers_ lip --- Cum ressors HP Address: — - - - Environmental ex oust an vent At on: City: Slate: "ZIP: - - Appliancevent Phone: Fax: E-mail: )ryerex aunt - -- - i loo s, Type /res. jtc ten/hazmat hood fire suppression system Name: e L N T C k S Exhaust fan with single duct(hath fans) Mailing address: 0 A d-3 lv 37, xhaust system n art from ►eatT tin ur AC- - - Fuelpiping an stns abut on(up to ou,,e,$) City: ( 2U State: �1L- ZIP: 172,, T LIKJ Nc; oil Phone: ;aqZ-(,,-2Z(- Fax: 2'31 1 Y rl( E-mail: i til t p,,T-r, c i lin•each additional over 4 outlets - -- 'rocessp p ng(schematicrequire t - — ----- --- utleName: Numbero offer limid applianceance o-r-q_upmet: -_-- _- Address' Decorative fireplace Cily: Slate: ZIP: nT sort- type _ —Phone -- Fax: E-mail: - -- - oo stov pe et stove other: — Applicant's signature: ,. Date: i 1 a'Z _ ter: Name (print): C jq7- H( - -- Nit all jurisdiction%accept credit card.please call jurisdiction fur route information NotPermit fee.....................$ O Visa ❑MasterCard expire:if a permit application Minimum fee................ expires if A permit is not obtained Credit card soother .__ __ __4�R�-- within 180 days atter it has been Plan review(at _ %) $ State surcharge(8%)....$ _ Name of c o t as on credit c s accepted as complete. TOTAL $ Cardholder signartAe — � — M41611(6A]atCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Oty (Ea) Amt $5,001,00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or Including ducts&vents 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ _ $10,000.00. including ducts&vents _ 17.40 $_10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 14 00 fraction thereof,to and Including 4) Suspended heater,wall healer 525,000.00. _ or floor mounted heater 1400 $25,001.00 to$50,000.00 $379.50 for the fist$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 (3) Repair units _ $50,000.00. _ 1715 $50,001,00 and up �! $742.00 for the first$50,000.00 and Check all that apply: Boiler HcaI Air $1.20 fur each additional$100.00 or For Items 7.11,see or Pump Corid fraction thereof. footnotes below. Conip Minimum Permit Fee$72.50 SUBTOTAL: $ to 1100K 7) 00K absorb unit BTU 14.00 8%State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU _ 25.60 25'/.Plan Revltw FFee(of subtotal) $ 9)15-30 HP;absorb Required for ALL commercial permits only l unit.L 1 mil BTU 36.00 -- - - - 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 roil BTU 52.20 11)>50HP;absorb unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM - _ 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description: Qt Ea Amount _17,20 _ Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents _ 10.00 Furnace>100,000 9TU Including 1,170 15)Vent fan connected to a single duct ducts&vents 6.80 _ Floor furnace Inclu ftvent 1 955 16)Ventilation system not included in Suspended heater,wall heater or 955 appliance permit 10.00 1 _ floor mounted treater 17)Hood served by mechanical exhaust Vent not Included in appliance 445 10.00 permit 18)Domestic Incinerators Repair units 805 17.40 <3 hp;absorb.unit, 955 19)Commercial or Industrial type incinerator to 100k BTU _ 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 500k BTU 15-30 hp;absorb.unit,501k to 1 _ 2,310 10.00 mil.BTU 21)Gas piping one to four outlets 5.40 _ 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1.1.75 mil.BTU _ 1.00 >50 hp;absorb.unit, 5,725 >1,75 will.BTU Minimum Perndt Fee$72.50 SUBTOTAL: $ _ Air handling unit to 10,000 cfm 656 8%State Surcharge $ Air handling unit>10,000 cfm 1,170 Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE $ Vent fan connected to a single duct 446 Vent system not Included in 656 _______��_- a Iiance permit Hood served by mechanical exhaust 656 1 n pections o and Fees: Domestic Incinerator 1,170 1 Inspections outside of normal business hours(minimum charge-two hours) $62 50 per hour Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee is specifically Indicated (minimum charge-hell hour) Other unit,Including wood stoves, 656 $6260 pot h-)ur IrlSeft9,.elC. 3 Additional plan review required by changes.additions or revisions to plans(minimum Gas i Ip ng 1-4 outlets _ _ 360 charge-0ne-half hour)$62 50 per hour Each additional outlet 63 *State Contractor Boller Certification required for units>200k BTU. TOTAL COMMERCIAL $ Residential A/C requires sit-plan showing placement of unit VALUATION: All New Commercial Buildings require 2 sets of plans. I:\dsts\forms\mech-fees doc 021111n? CITY OF TIGARD _ ELECTRICAL PERMIT PERMIT#: ELC2002-00621 DEVELOPMENT SERVICES DATE ISSUED: 11/27/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 6::'s 4171 PARCEL: 2S112AB 00300 SITE ADDRESS: 07350 SW LANDMARK LN 120 ZONING: I-H SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: Install 2 branch circuits. RESIDENTIAL UNIT_ TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMPhRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 6014-amps - 1000 volts: MINOR LABEL (10): SERVICEWEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: list W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION_ 1000+amplvolt: -4 RES UNITS: > F00 VOLT NOMINAL_: Reconnect only: SVC/FDR—225 AMPS: CLASS AREA/SPEC OCL:: — Owner: Contractor: HICKS,PREN'ISS C TRIPLE S ELECTRIC PO BOX 23633 3581 7TH STREET TIGARD,OR-N7-M' •J&3_1 HUBBARD,OR 97032 Phone: Phone: 981-8448 Reg#: LIC 111812 -- SUP41275 FEESE L E 24-1490 Description Date Amount Required Inspections (ILI'fthfI I.Lc'I'cnnu I I '_ r�'` $5;5.50 --- --- I'AX 181/6 Statc Tax I I _"n' $4.28 Rough-in F Elect'l Final Total $57.78 rhis Permit is issued subject to the regulations oontained 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 6 work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utiiity Notification Centei. Those rules are se', forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or ditect questions to OUNC at(503)246-6699 or 1-800-332-2344. ! Issued B : ) r " Permit Signature: OWNER INSTALLATION ONLY — The installation is being made on property I own which is riot intended for sale, lease, or rent OWNER'S SIGNATURE: _. _ DATE: _ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:_-___ _ LICENSE NO: -- - / --� __ -- - — -- - ------- -- - -- ------ — — Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application k- Phone: ved: ; i Pcrmitno._ t 'tr" -Zvo city of Tigard oject/appl.no.: Expire date: Address: 13125 SW flall Blvd,Tigard,OR 97223 nteissued: By:.r Rcceiptno.: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: - U 1 &2 family dwelling or accessory Commercial/industrial U Multi-iamily U Tenant improvement U New construction U Addition/alteralion/replaccme.nt U Other: U Partial I.INFORMATION Job address: 3,S-C) L/ p IMAX LAI I Bldg.no.: I Suite no.:IAO JTax map/tax lot/account no.: •fir. Rkwk saldm". rnr— Project name: ADescription and location(f work on premises: Estimated date of completion/inspccrion: Job no: _ Fee *In% Business name: �t� Descri tion Qty. (ea l lalal 110.111%1) New residenlial-single or multi-family per Address: dwellingunk.Includes attached garage. City: "If State: dr 7..IP: %-� fisnlcrhlclutled: Phone: ! �� / ,2t/; E-mail 1(xx)sq.ft.or less 4 eCtJ no.; ��T � .bus. tic.no: ^ L `� - L Eaci1 additional SW sq.ft.Of Lnrtion thereof Lunited energy,residential 2 Cil. elf i .no,: UPPtedcite tgy,nou-residential 2 Jeac Finch manufactured home or modular dwelling ig tature of su rvlsl electrician(required) Ante Service and/or feeder 2 Sup.elect.Pane(print): c n ", )n License no: Serrlces orfeederr-installation, alteration or relocation: 21x1 amps or less 2 Name(print): t'('_i-a(? t1 f C_K S 2201 amps to 400 amps — 2 Mailing address: 401 amps to 609 amps 2 601 amps a)I lox)amps 2 City: `Y'l coA n o State: 1)Q. ZIP: 4 7 za I Over I(W amps or voles _ 2 Phone: ?c)2_471( Fax: �1 0-011,r E-mail: Reconneclonly I Owner installation:The installation is being made on property I own Temporary services orteeden which is not intended for sale,lease,rent.or exchange according to Inoallalton,alteration,orrelocation: ORS 447,455,479,670,701. 2(x)maps ar less 2 201 maps to 4(x1 amps 2 Owner's si mature: Date: 401 to 6(xl ants 2 Branch circ•ulk-new,alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 - -----2222-- City: Sla(t•. ZIP. B Fee for branch circuits without purchase - -- — Phone: E-mail: - of service.,r(ceder fee,first branch circuit: I ax: �� -- Fach additional branch circuit PLAN 110 N I I %I (Please check all glint appl.i I Mise.(Cerslce or feeder not Included): U Service over 225 amps-commercial U Healthcare facility ):ach pump or irrigation circle - 2 U Service over 326 amps-rating of 1&2 U Hazardous location Each sign or outline lighting _ family dwellings U Building over 10 010 square feel tour or Signal circuit(s)of a Iimitrd energy panel, U System over 600 volts nominal more residential units in one smiciure alitration,orextension* 2 U Building over three stori,:s U Feeders,400 amps or more *Nscritinm U occupant loud over 99 pemmis U Manufactured structures or RV park t'' ch additional bupectlon over the allowable In any of the above: U HFrrss/liphtingplan U other -- -- Pet inspection Submit__sets of plans with any of the above. Investigation tee The above are not applicable to temporary col!struction service. I Other Nd al'Jurlsdictiom accept credit ca"h,please call haisdicuon for rrrnrr mfoons ino Notice:'this permit application Permit fee.....................$ U visa U MasterCard expires ifa permit is nol obtained Plan review lot _ %) $ Credit card number — ._ __ __L[ within 180 days after it has been State surcharge(8%)....$ expiry% T'OTA1. . . $ 7 7 nrccpted as complete. . .................... Nerne of rardhulder u shown on credo card Cardholder siprature Amounr 440.4615(&UWOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY p Restricted Energy Fee.................................... ......... ..._.. $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq it or less _ $145 15 4 ❑ Audio and Stereo Systems' Each additional 500 sq it or portion thereof _ $3340 1 ❑ Burglar Alarm Limited Energy —_ $7500 Each Manufd Home nr Modular F—]Dwelling Service or Feeder $9090 2 Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $8030 2 ❑ 201 amps to 400 amps $106.85 l Vacuum Systems' 401 amps to 600 amps _ _ $160.170 _ _ 2 _ 601 amps to 1000 amps —_ $240 60 Over 1000 amps or volts _ $45465 _ 2 Reconnect only $6685 _ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY P ry Installation,alteration,or relocation Fee for each system...................... ................. ................. $75.00 200 amps or less $66,85 _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100 30 2 amps mps to 600 amps $133 75 ^� 2 Check Type of Work Involved Over 600 amps to 1000 volts, see"b"above. �� Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit — $6.65 _ 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. I First branch circuit $46.85 Each additional branch circuit $6.65 /, ( ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $5340 — _- ❑ Intercom and Paging Systems Each sign or outline lighting _ _ $5340 ---_ Signal circuit(s)or a limited energy panel,alteration or extension $7500 _ ❑ Landscape Irrigation Control' Minor Labels(10) $125 00— ❑ Medical Each additional Inspection over the allowable in any of the above Per inspection — $6250 ❑ rlurse Calls Per hour $6250 In Plant $73 75 v ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ Other 8°i.State Surcharge $ ,7 ) Number of Systems 25%Plan ReviewFcr Sea'Plgn <eview section on $ ' No licenses are required Licenses are required for all other installations front of application -- Fees: Total Balance Due $ --" Enter total of above fees $ ❑ Trust Account A — I 8%State Surcharge $ _ — Total Balance Due $� All New Commercial Buildings require 2 sets of plans r fists forms sic-fees doc 09 V)W Building Division Request for Check Refund Cry d_� - - - -- ----- --- --__j This form is used liar refund requests by check. Appropriate reccilits, documcnti,,ion anLI the ahhlicant"s written requc: t for the refund must be attached to this form. Refund requests must he submitted to the 'I Remark systepi administrator by no later than Friday at 5:00 PM for processing the following Monday. Approved request is due by Monday at 5:00 PNi to Accounts Payahle for checks by Friday (week opposite payroll only). VENDOR NO.: _ DATE: December 2, 2002 PAYA13LE TO .Prentiss C. Hicks REQUESTED BY: Dianna Howse P.O. Box 23633 Tigard, OR 97281-3633 C11FCK REFUND: _Date Description, Invoice No.,etc. Revenue Account No. $Amount Receipt#: 2002-4532 -- �----- �-Case#:#: ELC2002-00621 Site Address: 7350 SW Landmark Ln. #120 Project Name: Hicks Explanation: Overpayment of permit fees Over/Short 100-0000-101000 $10.00 TOTAL APPROVALS: (IF UNDER $50) Section Manager/Professional Staff _ (IF UNDER $2500) Division Manager (IF UNDER$7500) Department Manager (I1-UNDER $25000) City Manager _ (IF OVER$25000) Local Contract Review Board is\Dsts\Refunds\RequestCheckkefund.doc 12/02/02 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 SUP Received Date Requested AM PM SUP Location lc--60 Suite MEC Contact Person Ph PLM C'ontractor - Ph SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Fig r)rain ELR Crawi Orain ------- slat.) Inspection Notes: SIT Post& Bearti Shom Anchors F_xt Shoath/Shear j Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL --PLUMBING Post& Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drain.,: Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL - MECHANICAL Post&Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL -- Service Rough-In UG/Slab Low Voltage Fire Alarm L111101111, 11-7-21-NN- - [-1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd S'MAPART FAIL T Please call for reinspection RE----. ----, Unable to inspect no access q9" Fire Supply Line ADA Approach/Sidewalk CG Inspector L-2,qxYj Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP .2- Received -_ Date Request d-__ Ja _ AM __- PM_ SUP -__ Location __ ---- 50 Suite-.,�2.��'!�T_ 2- 6) MEC _ Contact Person ___ ` � -- Ph( .____) Sr?�_ �'CL PLM Contractor __-----__--- -- _ - Ph(_-- ) - SWR _---- - - BUILDING Tenant/Owner _._. ELC Footing Foundation �- ELC Ftg Drain Access: A - ELR _ (;rawl Drain — -- slab Inspection Not SIT Frost& Beam - - - - -- - -. . ----- Shoar Anchors F-xt Sheath/Shear Int Sheath/Shear -- ---- - _ - - Framing - ---- - Insulation -� Drywall Nailing --- -- Firewall f tr6rinilsf -- - ------ _._._--- -- Fire Alarm Susp'd Ceiling goof Other:--- -- / / - _ F. PART FAIL -- -PT MBING _-7Z Post& Beam - ------ Under Slab __---_ -- - Rough-In Water Service Sanitary Sewer , Rain Drains Catch Basin/Manhole Storm Drain - - --- Shower Pan Other: - -- - 7< -- - -- Final PASS PART FAIL -- - ---- ----- MECHANICAL Post 8 Beam -----^ —_ Rough-In Gas Line Smoke Dampers - - Final PASS PART FAIL _-- - -- - --- -- ELECTF46AL Y ------- . Service -- --- - - — Rough-In UG/Slab - ---- �--- - Low Voltage _ Fire Alarm —� Final L? Reinspection fee of$�_- required he-fore next inspection. Pay at City Hall, 13125 SW Hall Blvd. _PASS PART_ FAIL SITE Please call for reinspection RE: A.__ __ Unable to inspect no access Fire Supply Line / Date // �/ l/_ 3 Inspector 1 ADA / Approach/Sidewalk �f - P -.- -- - Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00323 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/3/02 SITE ADDRESS; 07350 SW LANDMARK LN 120 PARCEL, 2S112AB-00300 SUBDIVISION: ZONING: I-ii BLOCK: LOT: JURISDICTION: "I lc, TENANT NAME: PRENTICE HICKS USA NO: FIXTURE UNITS: 32 CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR MPERV SURFACE: Remarks: 2 EDU increase. Previous EDU=2 for a total of 32 fixture values. Addition of 32 fixture values, for a new total of 64 fixture values=4 current EDU's. Owner: — FEES HICKS, PRENTISS C PO BOX 23633 Description Date Amount TIGARD, OR 97223 ISWUSAISwrC'onncct 12/3/02 $4,600.00 1SWUSAI Swr Connect 12/3/02 $0.00 Phone: - Total $4,600.00 Contractor. Phone: Reg #: Required Inspections 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 the accuracy of the side se41er laterals If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not located, the installer shall purchase a "Tap and Side Sewer' Perm Issued b / _ y� % Permittee Si nature: %L,V`y- '/ Call (503)639-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally 1 enant Nnr,ie: Prentice Hicks This SWRA 2002-00323 _ Site Address: 7350 SW Landmark Lane STE. 120 This PI_M# 2002-00462 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off#s count # value _ #s values Ba ptise /Font 4 _ 0 0 0 _ 0 0— Bath- rub/Shower 4 0 0 _ 0 0 0 -Jacuzzi/Whirlpool 4 0 0 0 _ 0 0 Car Wash- Each Stall 6 0 0 q — 0 0 -Drive through 16 0 - _ 0 - 0 0 _ 0 - Cuspidor/Water Aspirator - 1 0 0 _ 0 _ 0 0 _ Dishwasher-Commercial -4 0 A 0 0 0 0 -Domestic 2 0 0 -� 0_ 0 0 Drinking Fountain I -0 - 0 0 0 0 - Eye Wash _ _ 1 _ _0 0 -�- 0 0 0 Floor Drain/Sink -2 inch 2 0 0 0 _ 0 0 3 inch 5 _ 0 0 0 0 0 4 inch 6 0 0 _ __0 0 0 _ Car Wash Drr 6 0 0 0 0 0 Garbage Di.;posal _ __ - - — ------ _- Do,neslic(to 3/4 HP) 16 _ 0 0 0 0 0^_ Commercial (to 5 HP) - - 32 0 0 - 0 0 0 Industrial (over 5 HP) 48 0_ _ 0 --0 0 0 -_ Ice Machine/Refrigerator Drain 1 0 0 0 ^ 0 ----0 _ Oil Sep(Ga5 Stations 6 0 _ 0 0 0 0 Rec.Vehicle Dump station 16 0 0 00 0 Shower-Gang (per head) _ _1 0-----0 0 — -0 0 -Stall 2 0 0 0 y 0 0 — Sink __Sink- Bar/Lavatory - 2__ _- 0 - 0 �- 8 4 8 Bradley _ 5 0 0 0 0 0 _ Commercial 3 0_ 0 _ 0 0 0 Service 3 0 0 0---0 - 0 -- Swimming Pool Filter_ 1 - 0 0 _ — 0 0 _ 0-- Wosher-Clothes 6 _ '0 ---0 0 0 0 _ Water Extractor _ s 0 0 0 _ 0 - - 0 Water Closet-Toilet 6 _ 0 0_ 4 24 _4 - 24--- Urinal -Js ---.--o 0 - 0_ 0 -_ 0 Previous EDU Count 2 - 32 32 Capped EDU Cred'.t 0 TOTALS 0 32 0 0 8 32 8 1 64 Current Fixture Value_ 64 _ divided by 16 = _ 4.0 Current EDU 1 FDU - $2,30000 Previous Fixture Value 32 divided by 16 = _ 2.0 Previous EDU Change 32 divided by 16 = 2.0 over (under) $ 4,600.00 Enter EDU Change Here 2 HISTORY Noles_:Current EDU of 2 t.-n PLM# EDU# SWR# -~ Carol in water dept. PLM# _ __ EDU#^ SWR# PLM# ED/U# SWR# - Name:, = 1;t Q ��,f/:�T� Date: squired Signature of person irhat calculated this tally sheet and date perfromed Is►