10260 SW GREENBURG ROAD STE 110-2 NU I E
Sc q�c DATE
®E.XISTI^!C. 15;'o �J G ,&, CQNCCAItPENDENT r
SPIES t R PROPERTIES ys : tV, 9 -15-a:)
A0 HEAO AtJGCO FROM6x% ebT1Nv 14ep* ie. PLu
� � � b SUITE 110
c e x l S'T" 1 N G !-i E ak O RE• L-O C A-c t
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"7 t rte......ALL PI PE SCH y0 P O P\ TL A IVC O R .
LINCOLN
D A
ALL too R K F Ek N F A Loc�L A�rr*o&vTy TOWER l3 L O G ,
CITY F TIGAR .... �'.
Approved...... . Pd ... ............. .�
itionally Pprov
For only the` vjork a5 described in: A ?' `1�57"FNIS, Y�VG
l �� tet✓„p Ij,I�ti� ___ - -----------' A 170 MATIC F7jK �R071EL?ION
KEY PLAN F-ER _____” P ........... ........ ( »435 SW 1-4 fhh Am
See Letter to: Fo1ow.......... . .��*... 1 ��011 VVQ
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IMAGE IS NOT AS CLEAR AS THIS NOTICE,
J _ _— _—� 7 10 —IT IS Dl;c TO THE QUALITY OF THE No.36
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10260 3W GREENBURG RU#110
CITYOF TIGARD PLUMBING ,'ERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00375
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/20/02
SITEADDRESS: 10260 SW GREENBUP,G RD 110 PARCEL: 1S135AB-03400
SUBDIVISION: LINCOLN TOWER-TOWN OF MET7_GER ZONING: C-P
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Tenant Improvement - replace fixtures
FEES
Owner:
-- - —
Type By Date Amount Receipt
EOP LINCOLN, LLC PRMT CTR 9/20/02 $72.50 27200200000
10260 SW GREENBURG RD 5PCT CTR 9x20/02 $5.80 27200200000
SUITE # 100 _ - -
PORTLAND, OR 97223 Total $78.30
Phone 1: 892-2500
Contractor:
POWER PLUM3ING CO
PO BOX 23144
TIGARD, OR 97281 REQUIRED INSPECTIONS
Phone 1: 244-1900 Rough-in Insp
Top-out Insp
Reg #: LIC 52378
PLM 34-150PB Finallnsper,'ion
This permit is issued subject to the regulations contained in the Tigard Mt:,ricipal Code, State of OR.
Specialty Codes and all other applicable laws. All v,,ork will be done in accordance with approved plans.
This permit w0 expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 day ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: _ �� ,� �_ _ Permittee Signature:_ GGCLLtfYt
Call (503 639-4175 by 7:00 P.M r nn inspection needed the next busi a day
!;IV, IH 2002 10: 40RM HP LASERJET 3200 P 1
+ l
._ rllumbrig•I'ermit A►pph• on ..
,t i c o$torecctva fi ' Ptairiit
City of Tigard Scwrrpermltno tluildfngpamilno.:
Address. 13125 SW Hall BIv�,;T��,,�vR 97 —
City°�g°rd Phone: (503) 639-417L , c� ProjecV>tppl.no_ -_- ---- Brcpiredatc: -
Fax: (503)598-1960 - +J h+ ! Daelssu'_d: - By: Rccelptno.:
Land use approval: case file no.: _ Payment type:
J 1 dt=familylling or accessary U Gmimemiallindustiial U Multi-family U Tenant improvement
O NeU Add itionfaltr_atinn/rrplacct.rnenl U F<xx1 sr.rvic:e U Other. - _-
1 1EU=4l I I DIMMMMM '
Dmer{pt;on Qty. Fee eo. Total
Job address: New 11-a.nd t-family dwellings only:
Bldg.no.: Stucc no` s (includes IDOB.tureach mWit7 rtmuecliou)
Taz tnap/tar.IoVaccount no.: �! __-- -- SFR(1)bath
Lot; Block: Subdi�.ritiion: SFR(2)bath
Project name - SIR(3 bath _
--- —
Ci /stunt* /- ZTP:- _ C Each additional batl9kitchen _
tY Y:� Siteutilttiex
Descriptio and lcx:alion 1 work on prtr ises:
- � d Catch basinlarea drain
— -"- Urywclls/Icach lincitrrmch drain
Est.date of completion/inspection: F•outinz drain(no.lin.ft_)
Mauufac urtxl barite utiliUca _ -
ausiness nano; olcs
Rain Fmin onnnuctor
Sanitary sewer(no.lin.it)
— —
Cit : i Stare: QY'�Z1P: - Y —
Fax: I3 rani!: toren Sew er(tx�. lin_ft-)
°�: _Water service Din lin.IL)
CCB no.: Plumb.bits.reg.no: FbttrQr.or Item:
_City/metro lic.no.: �tAz Ahso on valve
Contractor's tepresentative signa•ure: BPCk flow paeventerf
Pont name— S Date: U e_' [lackwater valve
Y_
Name: - _--
Name:_ s was es
Address. brinki_t f°�untain(s)J
-Address. _ State- ZIl' E ectots/swn� —
Plionc: Fax: )email: Exvansiun tank —
FixhnrJsewex cap �.-- -
Hloor dmimmillcxn sinksthub
Nam(print): ( -_ .L_Q.- Gazfi a di ►osal - -
Mailing addrus. �&4 S 6 Nose bibb
City: I
late:
-- ---
Phone - U Fax: _ &mail: trite -� ase trap __ -- ---�
Owner instFltalion/residential maintemnce only: 1'he actual installation Primer(s)will he made by me or the maintenance and repair made by my mgular Roof drain(commercial)
employee on the properry I own as per ORS Chapter 447. Si (s),basin(s)_ays(s)
Owner's signature: Dale: _ umTH _-
't'ubs/ wcr/shower an
Urinal
Name: - stet c oset
Address: _ WaterTieater ,ti!r
City: State: _ Other: ----
Phone: --P TFax: E-mail: o ---
Minimum fee................
Na all jari+dictinaa.qt eedit earda.j4.eau Jmbdtctioo tar more trta<matioo Notice:'Ilcis penuit application Plan review(at _ %) $ -
U vita t]MasterCard ext,ims if a putnit is not obtained State surcharge(8%)
within 190 days after it bass been U
acceptai nc complete. TOTAL ..................... $ /11L3
Nurse:ofiatd6o u a on t and
$
�.adholdereiRouue ATOWt 4404616(601-C l� AI
SLP 1H 2002 10: 40AM :lP LASERJET 3200 p. 2
4' 1. d. AZ•
Sink _
16.60 , r
Lavatory — 18.60 One Ih _ " 124920 v
Tub or Tub/Shower Cvmb. �--- 16.60 _ 2 tl1 -- 5350.00
ShovwrOnly �- 16.60 — Throe 3 bath 5399.00
Water Closet ..i 16.60 , 4 ,. . .SUBTOTAL r" F: T---
Urine �:• 8'/°STATE SURCHARGE '
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
TOTAI
fill
GarbDisposal 18.60
_ �4 !' t
18.e0r .i ti n'
Laundry Tray
WashinyMaUlino � ?16.110- � •'" . A,
f luorl ralNFk)ol Rink r 18'60 PLEASE COMPLETE ''
3- 16.60. 3
18.80 1h:
Water Heater U Co-fl vnrslrxt iW kind �f, •,
x;aa Piping requires a separate echani(;Al
�rertth --
MFG40,11 e New'.Va1er Sorvico 46 40 Sink
-46A0 --"--- _Lavator _
MFG Homo Now SaNStorm SewerTub or Tu,',Mower
I foss Bibs _ - - 16.60 _ Combination _
Flout tains 16.60 — Shower Onlyh.,
75jV D 16.M Nater Closet
Fountain Urinal
cb')
Other Fbduros(SPO —^_ --16.80 Dishwasher _
Garbage Dls�osal -.
- —
t-aundry Room TMy _-
-- --' Werhlnp Machina
Floor Drain%Sirik Z' _
Sewer-1st 100' 66.00 -
�' ler-each edditiorel 100' —T - 48.40 4' 77
56.00 Wator Heater
Water Service-let 100' Other Fixtures
Water Service-each 13ddhlonal 200', 46.40 S WYE
55.00...,
Storm 4 Rain Drain-,1 st 100'
Storm&Rnln Main•earh addhional 100' _- 46.40
Commercial BArk Flow Prove Devoe MAO - —
Residentlal Baddiow Preverhtkxh[hwlce' 27.65
Catch Baslu J .� — 16.60
Inspr�etlon of Exir lap Plumbins)or Sperially 72.50 '` •
11t1f
Ru�vettad las ions COMMENTS REGARrIIN(IABOVE
Int alngleIamly,dwelling -
G mase+Traps -- 16.60 --��--- — ---—-- --
- - QUANTITY TOTAL
Isorrmtrtc orrlsar dlatlran is renulrnd M -- —_- --- .--•——-- -
,
Qy.ntky ToW lS r p
SUBTOTAL P °'r112 5D
_ — —. _�__ --- ------ ------
8%STATE SURCHARGE C- - -" -'--- - -
"PLAN REVIEW 259/6OF EFT—SU -Of ALOT
Requlrod aNy tl Ilxwre rpt .RNa,Is e
- TOTAL
}Minimum permit Ice In$72.6)- 6`Y"t surchaW."C"I ReslaeMtal Kadtllw
prEvlrrlla,Dnvloe,which It$3x).26+01%SWIR Wrdwrpe t
"All Nov.Commerelel ouedlnpa mgjire pluu with istitnelric a rher diagram and
plan review
I ldstS"nTtalUlm-fees.d,x: 10/10/00
1
12/30/2003 15: 18 503-443-370ti TM RIPPEY PAGE 02
'TA4 RIPPEY 76.50 SW Beveland Street,Suitt 300
Tigard,OR 97223CONSLJLTJNG GNGINp.ERS
Phone:(503)W-3900
/ Fax• (503)443-??pp
December 30, 2003 ` a O
—A61� Jualn
City of Tigard - Building Deparhnent
Attention: Building Official
13125 SW Hall Blvd.
Tigard.Oregon 97.223-8199 rILE
COPY
Rc: One Lincoln Center- Tower Link
Project Number: 2S I I
Permit Number: DUP2003-00297
Dear Sir or Madam:
In accordance with the provisions of the State Building Code, Section 1701.2 and City
Administrative 1% 'Ip structural observations for the following areas Of work were pri-vided byour
office.
1• Gencral Steel Framing Observation.
All work observed appeared to be in conformance with the project documents. Please reference the
attached Field Report for the general steel framing observation,
If ynu have any questions, please do not hesitate to call.
Sincercly,
Brent Cornelison, P,F.
Project Managet M7931PR
[:nc(osure ry 011=0111
13 7
cc: Vince Sheridan, Equity Office Properties
Barbara Anderson, Collins Woerman Atc1litects _�--
Don Erickson, C. Schiewe &Associates
CITYOF TIGARD PLUMBING PERMIT _
DEVELOPMENT SERVICES PERMIT#: PLM2000-00339
LM 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/12100
SITE ADDRESS: 10260 SW GREENBURG RD 110
PARCEL: 1 S 135AB-03400
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREV14TRS:
OCCUPANCY GRP: FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: I CATCH BASINS:
_ F!XTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER I !NE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN- ft
Remarks: Tenant Improvement
four fixtures added, one fixture capped off, no change in current EDU count
FEES
Owner: - - -
Type By Date Amount Receipt
KNICKERBOCKER PROP, INC XXIV PRMT CTR 9/12/00 $66.40 27200000000
BY NORRIS, BEGGS + SIMPSON 5PCT CTR 9/12/00 $5.31 27200000000
10300 SW GREENBURG RD STE 200 _
PORTLAND, OR 97223 Total $71.71
Phone 1:
Contractor:
ASSOCIATED PLUMBING CO
P O BOX 301362
PORTLAND, OR 97230 REQUIRED INSPECTIONS
Phone 1: 331-0582 Top-out Insp
Reg #: LIC 00057890 Final InspectiCn
PLM 26-412PB
1"his pennit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR
`specialty Codes and al: other applicable laws. All work will be done in accordance with approved plans
I'his 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 Idw 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 (43)639-4175 by 7:00 P.M. for an inspection needed the next busines4day
CITY OF TIGARD Plumbing Permit Application Plan Check
13125 SW HALT_ BLVD. Commercial and Residential Recd BY--e
TIGARD, OR 97223 Date Reed
Date to P.E.
(503) 639-4171 Date to DST
Print or Type Permit#�C
Incomplete or illegible applications will not be accepted Relater.SWR#
Called_,,-----.--
Name of Developrnen Project ` FIXTURES (individual) - QTY PRICE AMT
Job �rnco�„ �e� it, - L,. torr` Tow(r Sink _ s ` -
Street Address Suite Lavatory 11.50
Address - -- —
4 ,� p Sw Grti_�b;•� l IQ Tub or Tub/Shower Comb 11,50
Bldg Water Closet Shower Only 11 50
---- L-nol,1 Towt� . 4rJ p.Q W1111 — 1150
_
Name F —"— 1150
5 t t- Pr ti w T;is Urinal
Marling Address n� Suite Dishwasher 11.50 L%
Owner ,49, 1 SW fyltA�oaiJ, Pd. �`c Garbage Disposal 11 50
City/State Zip Phone Laundry Tray 11.50
La110)�V10 o(L `j jU)5 69q 51:- Washing Machine/Laundry Tray 11 50
Name �" 1 11 50
t lctr, P'u ff r �S Floor Drain/Floor Sink 2"
Occupant Mailing Address ,�,1 f Suite 3" 11.50
401 sw Mcal?A 1J X6`'
CitylState Zip Phone
Water Heater O conversion O like kind 44~ I
�
_ -_ -- rias Pipin requires a sPparate_mechanical ermit.
Name I MFG Home New Water Service 3200.
S$O('ate �I�Yn�' N MFG Home New San/Storm Sewer 32.00
Contractor Mallin Address Suite _ --
(10 CA 30i 34A Hose Bibs 11.50
Prior to permit
city/ t to / Zip P hone Roof Drains 11.50
issuance,a copy Po. Q 1UR �111.5d HJ6l 31 05e k 11 50
_ Drinking Fountain
of all licenses are Oregon Const Cont Board Lic# Ex Date(l -o Other Fixtures(Specify) 15.00
required if 5 1 I W 0 ✓I
expired in COT Plumbing)_ic # Exp.Date 14u b _-----
database (, -418 Pd 10-31 - 2 0
Name 1 I
Architect 68D Art`,.�ctf� Sewer-1s1100' J 3800
Or Mailing Address Suite Sewer each additional 100' 3200
50 3, Water Service-1 st 100' 38.00
Engineer Cit I t le 7i Pit Water Service-each additional 200' 3200.
Po- �a� A_97?0 �� -951.
Describe work to be done.
Storm&Rain Drain-1st 100' 38.00
New O Repair O Replace with like kind Yes O No O Storm&Rain Drain-each additional 100' ,3200
Residential O Commercial _ (,OmmerClal Back Flow Prevention Device 32.00
Additional desclription of work1 Residential Backflow Prevention Device' 19.00
1 QnilM f .r/►� /��r r'YtL�I Catch Basin 11,50
Are you capping,moving or replacing any fixtures? Insp of Existing Plumbing or Specially Requested 50 00
Yes)4 No 0 Inspections -- perlhr
If yes,see back of form to indicate work performed by Rain Drain,single family dwelling 4500
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. — QUANTITY TOTAL
I hereby acknowledge that I have read this application,that the information Isometric or riser diagram is required if Quantity Total is >9
given is correct.that I am the owner or authorized agent of the owner,and "SUBTOTAL
that Plans submitted are in compliance_with Oregon State Laws- _ r��
Signature of Owner/Agent Date 8% SURCHARGE
r I
Contact Person Name Phone
*'LAN REVIEW 25%OF SUBTOTAL
_ Re uired only H fixture qty total is__9
1 BATH HOUSE 5118.00 TOTAL
2 BATH HOUSE$250.00
3 BATH HOUSE$285.00
(This fee Includes all plumbing fixtures In the dwelling and the first 'Minimum permit fee is$50 r 8%surcharge,except Residential Backflow Prevention
100 feet of sanitary sewer storm sewer and water service) Dev1,6 surciricirge
—All Now Commercial Buildings require plans%1h isometric or riser diagram and
plan review
I hdstslfonnshprumapp doc 11118/99
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed —
New Moved Replaced Removed/Capped
Sink ---------- — I -- --Lavatory__________
Tub or Tub/Shower Combination �~
_Shower Only
Water Closet
Urinal
Dishwasher
Garbaga Disposal
Laundry Room 1-ray
Washing_Machine —
Floor Drain/Floor Sink 2" __ M
311
Water Heater
I Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I uIglsvormMplumapp tloc 1,1,&99
Accumulative Sewer Tally
Q ) This SWR#
Tenant Name: > L
Address' (nD /, l i�_; This PLM#�!nnr Q J
. /0= .I�,l r�'I' � �. r~�. _.
N
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added# added #s total
Count off#s count value values
Baptistry/Font 4
Bath - Tub/Shower 4
Jacuzzi/ Whirlpool 4 --
Car'Nash - Each Stall 6 --
Drive Through 16 _ _ --
CuspidorANater Aspirator 1
Dishwasher -Commercial 4 ---
Domestic 2 — -- —
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink - 2 inch 2
3 inch 5
4 inch 6 — — -- -- -- .
- Car`Nosh Drn 6 —
Garbage Disposal^ 16
CGomestic(to 3/4 HP -- --
Commercial Ito 5 HP) 32 ----
Industrial (over 5 HP) 48 ---
Ice Machine/Refrigerator Drains 1 — _ — --- — — —
Oil Sep (Gas Station) 6
_Rec. Vehicle Dumb Station 16 —
_Shower-Gang (Per Head) 1 _ — -
- Stall 2 - —
Sink - Bar/Lavatory 2 ---
Bradley -----5 — ---
Commercial 3 J —
_ • Service --
Swimming P-)ol Filter —
Washer - Clothes _ _ 6 — — —
'JVater Extractor 6 — ---
Water Closet - Toilet __ 6
Urinal 6 --- —
TOTALS
i �/ . 2
Total fixture values — divided by 16 = L EDU
TJ �'c� lzi1FN'
HISTORY
_
PLM#` EDU# SWR# �LM# I i I c� << ; EDU# y SWR# /r i- —OLZ
i
_ � OGS- --
PLM#�ac� EDU# SWR# I P_LM# ,meq-n(: r -EDU# y q SWR# 1rj
c r_ , EDU# ( SWR#, r PLM# - nc,plrg EDU# , _SWR# 'd- -cc- y-
rLNi,. 1891 ft .j L
L� EDU# -) SWR#rl yL PLM# g_ opo 41 EDU# ,ia SWR# y,?- co0 1/
rWf-'L n,. t :,� ( ( r / —L� , �,_< t (U
stsbwrtaly.daC
CITYOF TI GA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00375
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/22/00
SITE ADDRESS: 10260 SW GREENBURG RD 110 PARCEL: 1 S135AB-03400
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF U:'.E: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GUP: B VENTS W/O ADPL: VENT SYSTEMS:
STORIES: _BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN':
3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + Hp: WOODSTOVES:
FURN < 100K BTU. AIR HANDLING_ UNITS CLO DRYERS:
>-
FURN 100K BTU: <= 10000 cfm OTHER UNITS: 3
> 10000 cfm: GAS OUTLETS:
Remarks: Mechanical work associated with commercial 71.
Owner:
FEES
KNICKERBOCKER PROP, INC; XXIV Type By Date Amount Receipt
BY NORRIS, BEGGS + SIMPSON PRMT CTR 9/22/00 T $72.50 2.720000000
'0300 SW GREENBURG RD STE 200 PLCK CTR 9/22/00 $18.13 2720000000
PORTLAND, OR 97223 5PCT CTR 9/22/00 $5.80 272000000C
Phone: - _ --
Total $96.43
Contractor: ----
AMERICAN HEATING
1339 SW GIDEON ST,
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Mechanical Insp
Phone:239-4600 Final Inspection
Reg #:LIC 00033135
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is -Suspended
for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by i;zalling3)246-9189.
Issue By: _ Permittee Signature—Call (5 3) 639-4175 by 7:00 P.M. for inspections nee ne business day
Roc'd
CITY OF TIGARD Mechanil Plan C ck#
_
13125 SW HALL BLVD. Comm- Date Recd
TIGARD, OR 97223 Date to P,E. 2-1k-
(503) 639-4171, x304 Dale to DST
Print or Type Permit#
-e"o cto op�7S-
Incomlete or illegible a plications will not be accepted_ Called ` k_)
Na rpe of Develo�mrnUPiojed Description
Table 1A Mechanical Code City Price _Amt
Job Street Address suite# A) Permit Fee _ 16.00
Address 47,irrn
�Gr'q i) Furnace to 100,000 BTU
Bldg# Coy/State Zip including ducts&vents _ — _ 9.65
2) Furnace 100,000 BTU+
,y _ j including ducts&vents —i 12.00
Name(pr name of business 3) Floor Furnace
Owner ,� ice' �fC, L� , including vent9 65
Maill Address ! 4) Suspended heater,wall heater
or floor mounted heater _ 9.65 _
City/State Zip Pr1efC 5) Vent not Included in appliance ermit 4.75
Check all that apply: 'Boiler Heat Air
For Items 6-10,see or Pump Cond Qty Price Amt
Name for name of business) footnotes 1,2 Com _
6)Repair units
Occupant Mailing Address 8.40
P — 7)<3HP;absorb unit to
_ 100K BTU 9.65
City/Slate Zip Phone1. --
0)3-15 HI ,absorb unit
100k to 500k BTU 17.65
Contractor Name 9)15-30 HP;absorb
unit.5-1 mil BTU 24.15
Prior to permit Mailing Ad re s __-7 10)30-50 HP;absorb
unit 1 1.75 mil BTU 36.00
issuance,a copy •L i �',y" —
of all licenses /State Zlp Phone 11)>50HP;absorb unit>1.75 mil BTU
?/State
required if !/ __ _ �_ 60.15
expired in COT Oregon Const.Cont Board Lic# Exp.Dale 12)Air handling unit to 10,000 CFM
database -'& /?�� 7.00 _
Architect Name 13)Air handling unit 10,000 CFM+ 11.85
14)Non-portable evaporate cooler
or Mailing Address 7(in
15)Vent fan connected to a single duct
Engineer City/State Zip Phone 4.75
16)Ventilation system not included in
�_�_ appliance permit 7.00
Describe work to be done: 17)Hood served by mechanical exhaust
New O Repair O Replace with like kind: Yrs O No O 18)Domestic:Incinerators
Residential O Commercial )/ Modification O _ 12.00 _
19)Commercial or industrial type incinerator
Additional information or description of work: 48.25 _
20} Other units,including wood stoves ,.�
7.00
NOTE: For Commercial projects only;Units over 400 lbs.,located on the 21)Gas piping one to four outlets
roof,require structural calcs.prepared by licensed engineer. _ 3.75
Type of fuel: oil O natural gas O LPG O electric O 22)More than 4-per outlet(each) .75
I hereby acknowledge that I have read this appiication,that the i,formation Minimum Permit Fee$50.00 SUBTOTAL
-4�
given is correct,that'am the owner or authorized agent of _ 8%SURCHARGE
the owner,that plans submitted are in compliance with Orene,i State laws. PLAN REVIEW 25%OF SUBTOTAL
Required for ALL commercial permits only
Signature off Owner/Agent Date TOTAL '�
Contact Pelson Name Phone Other Inspections and Fees
/ / 1 Inspections outside of normal business hours(minimum c
yb("e.— harge-two hours) $50 00 per holo
2 Inspections for which no fee is specifically indicated (minimum charge-halt hour)
Foonotes for commercial projects only: $50 00perhour
1 Provide full schematic of existing and proposed gas line and pressure 3 Additional plan review required by changes,additions or revisions to plans(minimum
Provide dr2wings to scale showing existing and proposed merttanical charge-one-half hour)S50 00 per hour
units. 'Stale Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I Imechperrn doc. rev 11/1/99
CITYOF T I G A R D ELECTRICAL PERMIT
PERMIT#: ELC2000-00530
DEVELOPMENT SERVICES DATE ISSUED: 9/6/00
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S13 5AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 110
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT : 014 JURISDICTION: TIG
Proiect Description: Installation of 9 branch circuits. Job No. 864
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS_
1000 S1= OR LESS: 48 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+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS AUD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 8 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
L Reconnect only: _ SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KNICKERBOCKER PROP, INC XXIV WILLAMETTE ELECTRIC INC
BY NORRIS, BEGGS + SIS/IPSON PO BOX 230547
10300 SW GREENBURG RD STE 200 TIGARD, OR 97281
PORTLAND, OR 9723
Phone: Phone: 624-3631
Reg#: LIC 000750
RIP 1gR5S
ELE 34-283C
FEES Required Inspections _
Type By Date Amount Receipt
Elect'I Service
PRMT CTR 9/6/00 $100.05 2720000000( Elect'I Final
5PCI CTR 9/6/00 $8.00 2720000000(
Total $108.05
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or if work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules ordirect questions to OUNC at(503)
)46-1987
PERMITTEE'S SIGNATURE ;` '"` ISSUEb 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 NO:
Call 639-4175 by 7:00pm for an inspection the next '3usiness day
CITY OF TIGARDPlan C eck _
Electrical Permit Application Recd 17 ______
13125 SW HALL BLVD. Date Recde.
T'IGARD OR 97223 Date to P.E.
Phone (503)639-4171, x304 Date to DST
Inspection (503)6394175 Print of Type Permit#
Fax(503) 598.1960 Incomplete or iller;We will net be accepted called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development
L 1 N 41 Iw' I✓•vt IL Number of Inspections per permit allowed
Name(or name of business) S trT 1 Service included: Items Cost Sum
Address !u Z Sv I 1 t' 4a. Residential-per unit a
1000 sq ff.or less $ 117 75
City/State/Zip ��n V A cf .� Each additional 500 sq.ft.or
portion thereof $ 26 75 1
Commercial Residential ❑ Limited Energy $ 6000
Each Manufd Home or Modular
Dwelling Service or Feeder $ 72.75
2a. Contractor installation only:
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
information for COT data base). Installation,alteration,or relocation
Cles
200 amps or s $ 6425 _ 2
Electrical Contractor_ ��� )�+Mrhv hY Z�tc rn�c �� /C-- 201 amps to les amps $ 85.50 2
Address � 23C ? 401 amps to 600 amps $ 12850 2
City_ Ta v� State.�dZip�}?b t 601 amps to 1000 amps $ 192 50 2
Phone No -6 ty �_ Over 1000 amps or volts $ 36375 2
Job No _ Sb Reconnect only _ $ 5350 2
Elec. Cont. Lic�_ y ��Exp.Date /0 / ~n'✓ 4c.Temporary Services or Feeders
OR State CCB Reg. No._'#$�� Exp.Date &-4 V/ Installation,alteration,or relocation
COT Business Tax or Metro No �l� E Date d 200 amps or less $ 53.50
AAA 201 amps to 400 amps $ 80.25
401 amps to 600 amps _ $ 10000 2
Signature of Supr. Elec'n Over 600 amps to 1000 volts,
see"b"above.
License No. ���+ S _ _ -Exp.Date L�'_ !__ - 4d.Branch Circuits
Phone No `a (v LY,'4_9 New,altoratinn or extension per panel
I a)The fee for branch circulls
2b. For owner installations: with purchase or service or
feeder fee.
Each branch circuit _ $ 5.35
Print Owner's Name_. - b)The fee for branch circuits /
Address - - without purchase of service
city Stilts 7it� - __ or feeder fee.
- $
Phone No. First branch circuit
- -- Each additional branch circuit $ `
The installation is being made on property I own which is not 4e.Miscellaneous (0 k
intended for sale,lease or rent. (Service or feeder not Included)
5ach pump or irrigation circle $ 42.75
Each sign or outline lighting $ 4275
_
Owner's Signature -_ — Signal circull(s)or a limited energy
panel,alteration or extension $ 60.00 — -
3. Plan Review section (if required):* Minor Labels(10) $ 100.00
Please check appropriate item and enter fee in.%pcf cin 58. 4f.Each additional inspection o ter
the allowable in any of the above
4 or more residential units In one structure Per inspection $ 50.00 _
Service end feeder 225 amps or more Per hour $ 50.00
System over 600 volts nominal In Plant _ $ 59.00
Classified area or structure containing special occupancy as 5. Fees: 0
described in N E.0 Chapter 5 0 .
5a.Enter total of above foes $
� G� v _
' Submit 2 sets of plans with applicati(n where any of the above apply, 8%Surcharge(.08 X total fees) a e $
Subtotal D $
Not required for temporary construction services. 51).Enter 2514,of line 6a for
NOTICE Plan Review if re uired(Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
Subtotal $ -_--- ----
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR ❑ 1 rust Account# s
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS /C�r $ J ✓
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due
I
65)
i.tdsts\litmts\cicctric.doc iJ
CITYOF T I G A R DBUILDING PERMIT
PERMIT#: BUP2000-00360
. A DEVELOPMENT SERVICES DATE ISSUED: 8/31/00
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 110
SUBDIVISION: 'INCOI_N TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT: 014 JURISDICTION: TIG
REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FP sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 31 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 75,000.00
Remarks: Commercin.I TI - 3809 Square feet
Owner: Contractor:
KNICKERBOCKER PROP, INC XXIV C SCHIEWE i ASSOCIATES
BY NORRIS, BEGGS + SIMPSON 1024 NE DAVIS
10003RR00 SW GREENBURG RD STF_ 200 PORTLAND, OR 97232
PPhone ND, OR 97223 Phone: 234-6617
Reg#: LIG 00054105
FEES u REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PLCK CTP 8/25/00 $356.04 27200000000 Electrical Permit Required
FIRE CTR 8/25/00 $219.10 27200000000 Sprinkler Permit Required
Framing Insp
Pi?MT CTR 8/31/00 $547,75 27200000000 Susp Ceiing Insp
5PG I CTR 8/31/00 $43.82 27200000000 Fir;:,l Inspection
Total $1,166.71
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 perrni',will expire it 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 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-1987.
Permitee
Signature: Af -
Issued By: `j2�_„X
Call 639-4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Application Plank#
13125 SW HALL BLVD. Tenant Improvement Rec,iey. ��kDate Recd_
,IGARD, OR 97223 Date to P.E G tJ5
X503) 639-4171 Date to D
Print or Type Permit# ew_N _- __iv/v
Related SWR#
Incomplete or illegible applications will not be accepted called b ACC ra
-- Name of Development/Project Existing Building New Building
Job L Ihcai, Ce--tev j n C of n Tota evr �t
Address Street Address Suite Ouilding ) Ce t e,r
;bZlbo SW Gree►�irg 110 — I Lata �-Ihco n H
Bldg# -- CitylState Zip _ _ I Existing Use of Building or Property:
LL.)N Cowj
Cf-. _ 97223
Name
Property Nicks o e Piro or [nc, XIV Proposed Use of Building or Property:
Owner Mailing Address Suite 4-�Fi Ce
10 SW G✓reeN60T M, 200 No. Of Stories:
City/State Zip Phone C12) TWeye'
_ PortiaNd� -. 97223 14g2-59O� Sq. Ft. Of Project
Occupant Name
Spjekee proetY-��eS Occupancy Class(es)
- Name 1, __�
Con S�c�i�V) Type(s) of Construction
Contractor G. Scat l et,ve _ ,
Prior to permit Mailing Address Suite IL ___
issuanc
---.issuance,a copy10'Z+ NE Davis St. Vtliil this project have a Fire Suppression System?
of all licenses Yes Igy No ❑ _ _
are required if City/State Zip Pr.)ne Americans with Disabilities Act(ADA)
expired In C O.Tp �
database 1 Or��and)O�• 9722 234��C°17 Valuation X 25% = $�?5D Participation
Oregon Const.Cont.Board Lic# Exp Date Complete Accessibility Form_
-54105 8/02,/'>1 Project $ — ,/ ao
--- - Name �—-- Valuation 75)"• __
Archt,�ct Gad �re�'teAS, IrIc . Plans Required: � See Matrix for number of sets to submit
Mailing Address Suite on back
920 SW 3 w enoe J-c)60 — --�
CitylS1tate _ ZIp Phone I hereby acknowledge that I have read this application,that the ir,iormation
`)720 22 _9(oSro given is correct,that I am the owner or authorized agent of the owner,and
that plans submitted are in compliance with Oregon Stale Lav s
Engineer Name _ — Y
Signature of Owner/Agent Date
Mailing Address Suite 2
Ccofart Person Name Phone
CitylState Zip Phone �r'.a _P�,. Glor 2Z 4'9656
- ---� FOR OFFICE USE ONLY _
Indlcate type of work New G Addition O Demolition O MaprTL# r Land Use: —
Accessory Structure U Foundation Orly O Alteration 10 �`���.5��-� ���e� s
Repair O Other O Notes.
Description of work:
Tenant ly►,rrvVeMCvik TIF ----{I
�
°
Note Site Work Permit Application must precede or acccmpany Building ���s• Y
Permit Application
I q.'CrMNEVVTI DOC (DST) 5/98
r
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED
application. For an electrical submittal, the application must contain the
signature of the supervising electrician before plan review will be conducted.
After plan review approval, Pians Examiner will contact the applicant to request
additional plan sets for distribution purposes. (Copy for Contractor, City,
Washington County, Tualatin Valley Fire & Rescue)
r^ Total # of
TYPE OF SUBMITTAL Plans KEY:
Submitted
S (Private) 1 S = Site Work
B (New or Add) _ 1 B = Building
(New or Add or Alt) 3 F = Fire Protection System
M (New or Add or Alt) 1 M = Mechanical
B & M (New or Add) 1 P = Plumbing
P (New, .odd, or Alt) � 2 E = Electrical
B & M & P (New or Add) 2 i New = New Building
E (New, Add, or Alt) 2 Add = Addition
B & F & M & P & E �3 Alt = Alternation to Existing
(New , Add) Building
*B or B & M (Alt) 1
*B & M & P (Alt) 3
*B & M & P & E & F(Alt) � 3
NOTES:
*Shaded areas designate ALT submittals only.
I\dsts'.,ormsVnatrxcom doc 10/30/98
SPI�EfZ �I��PC-IQ-TIES
(a Lips TM-E7L STE NO
8.25-bD
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REViSED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in te,ms of cost and scope.
(2) A,terations made to the path o"travel to an altered area may be deemed disproportionate to
the overall alteration when tho cost exceeds twe qty-five per-cent(25%).
VALUATION of all renovation, alteration or modification being done dp
excluding painting, wallpapering. $
multiply: 25% Ba,rier removal requirement. — .25
BUDGET FOR BARRIER REMOVAL [21 $1 Z50
In cnoosing which accessible ele,nents to provide under this section, priority shall be given to those
elements that will provide the grr atest access. Elements shall be provided in the following order:
CamLxs Wide
(a) „P�rking impwve�en Crest►'ilOrirq -dor access;ble $ 18 ]5U �b
'514ewalks , curb �J/{1 and fat►,
t-j 3 s.
(b) I An accessible entrance $
(c) An accessible route to the altered area: $ _
(d) At least one accessible restroom for $
each sex or a single unisex restroom:
(e) Accessible telephones $
(f) Accessible drinking fountains: and $
(g) When possible, additional E ccessible
elements such as storage a id alarms. $
TOTAL: Shall equal line 2 of Value Commutation $ �.� �o
i\dsiriornWacccss doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4176 Business tine: 639-4171 BUP
-Date Requested_ q 2 AM PM BLD
— , 0 < —`—r` `. Suite �lUy MEC —
Location
Ph PLM
Contact Person
�
Ph — __ SWR
Contractor ELC _
BUILDING Tenant/o�^rror —
ELR
Retaining Wall -
Footing Access. FPS
Foundation SGN
Ftg Drain
Crawl Drain Inspection Notes — SIT
Slab ---- ------ -- —._—-
Post&Beam --
Ext Sheath/Shear ,
Int Sheath/Shear
Framing
Insulation -
Drywall Nailing ---------
Firewal wkie
- -
ire
Fire Alarm - - - -
Susp'd Ceiling _ -
Roof - -. —
Mis
ART FAIL. — — --
-
L
fust& Beam
Under Slab -
Top Out — - -
Water Service
Sanitary Sewer
Rain Drains -
Final
PASS PART FAIL - - -
MEr HANICAL —
Post&Beam - -
Rough In —
Gas Line -_w
Smoke Dampers -
Final _
PASS PART FAIL ---
ELECTRICAL
Service -
Rough In ----- - -
UG/Slab —�---
I_ow Voltage -
Fire Alarm -- —.—_—.----_- -----
Final - -
PASS PART FAIL -------- --TJ--
SITE
Hackfill/Grading
Sanitary Sewer required before next inspection Pay at City Hall, 13125 SW Hall Blvcl
Storm Drain ( J Reinspection fee of$_ _— �—_
Unable to inspect no access
Catch Basin
( ]Please call for reinspecm,n RE
Fire Supply Line
ADA a InspectorExt
Approach/Sidewalk pate ` _ _ �"- ---- -
Other ---
Final D0 NOT REMOVE this inspection rec and from the job site.
PASS PART FAIL
CITY OF TIGARDBUILDING PERMIT
PERMIT#: BUP2000-00389
DEVELOPMENT SERVICES DATE ISSUED: 9/21/00
13125 SW Hall Blvd., Tiaard, OR 97223 (503) 639-4171 PARCEL: 1 S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 110
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT: 014 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 OPEN!NGS?
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?: REQD SETBACKS _ REQUIRED
FLOOR LOAD: psf 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: $ 1,700.00
Remarks: Modification of fire protection system associated with commercial TI.
Owne;: Contractor:
KNICKERBOCKER PRCO INC XX!V AFP SYSTEMS INC
BY NORRIS, BEGGS a `�IMPSON 19435 SW 129TH
10300 SWrrGREf_NBUR'3 RD STE 200 TUALATIN OR 97062
h a
P� ne N51 987' 4 Phone: 503-692-9284
Reg#: uc 000675'34
FEES REQUIRED INSPECTIONS _
Type By Date Amount Receipt Sorinkler Rough-In !
PRMT CTR 9/1;,/00 $62.50 27200000000 Sprinkler Final 1
5PCT CTR 9/15100 $5.00 27200000000
FIRE CTR 9/15/00 $25.00 27200000000
Total $92.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other a;;plicable 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 through OAR 952-001-1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987.
Pe rm!tee
Signature: ��lucl- r_
� 7
Issood By: � /, ?� C
Call 639-4175 by 7 p.m. for an inspection the next business day
Fire Protection Permit Application Plan(hye
ck
CITY OF7IGARD Commercial or Residential Recd
13125 SW HALL BLVD. Date Rac'd - C�
TIGARD, OR 97223 Print or Type Date to P.E. 5 ��
(503) 639-4"71, x. 304Incomplete or illegible applications will not be accepted Date IoD
Permit p
Called 71v
Job Name of Development/Project Type of System (Complete A or B as applicable)
—
Address Ares A.)Sprinkler Wet Dry
—�� Name Standpipes
5rIC E le PROPEI F-ji, _.
Owner Mailing Address 0501 ret Hazard Group
It 7,1'1 S.I.J. Mt' Additional Li6NY ptz,
City/State zip I Phone_ Information Density '10115-00
Name , sign Are
Dea
af'rF' I� ol° 6 T/tS It-Jb�
Q
PrQ 1 ---22-
Occupant Mailing Address Sv,>•r- IID K Factor
Rip
City/State zip Phone A.1) Sprinkler Project Valuation $
� -,I _ _ 1700,°0
Contractor Name B.) Fire Alarm
(Sprinkler or I
J-11-1 T 1 S TN.)(. —
Alarm Company) Mailing Address ,ta Submittal Shall Include Battery Calculations YES ❑
Prior to permit I),('7�" "� (.) I�'j rN V C, Individual Component YES ❑ —
issuance,a City/State Zip Phone
copy _ Cut Sheets
of all licenses UP,L1,,t� OF I lt'" t 92" B.1) Fire Alarm Project Valuation $
are required if State Const.Cont Board Lic.# Exp. Date
expired in COT j 3 l( r� ,.� Project Valuation Subtotal(A & or B) $
database _
Name r Permit fee based on valuation $
7 U (see charts �)
Architect Mailing ress 3�0 B% Surcharge $ ,c)U
City/State zip I Phone— FLS Plan Review 40%of Permlt $ Q nU
Describe work v A.)New O Addition O Alteration 0 Repair O TOT ALr�
to be done $
B) Modification to sprinkler heads only --
1 1-10 heads=No plans required Plans required Submit thrersets of plans,including a vicinity map and
2 11—Plar review required the location of the nearest hydrant.
----- I hereby acknowledge that I have read this application,that the Information given is
_ Number of sprinkler heads: correct,that I am the owner or authorized agent of the owner,and that plans submitted
are in compliance with Oregon State laws
Additional Description of Work
Slanature of Owner/Agent Date
— A.)In Existing Building FZ New Building Jnr C� S C)o
Building
Contact PerrpA� PV
Name Phone
it V11 'tS
Data B.) Commercial Residential ❑ -s _
FOR OFFIf3E USE ONLY:
No of stories — Plat# MapfTL#:
Notes
Occupancy Class Type of Construction
i:\dsts\forms\firesupr.doc 12/23/99
Valuation of Project Permit fee Tax 8% FLS 40% Total -
1 - 2,000 50.00 4.00 20.00 74.00
_ 2,001 - .i,000 59.25 4.74 23.70 87.69
3,001 - 4,000 68.50 5.48 27.40 101.38
4,001 -15,000 77.75 6.22 31.10 115.07
6,000 87.00 6.96 34.80 128.76
6,001 - 7,000 96.25 7.70 38.50 142.45
7,001 - 8,000 _ 105.50 8.44 42.20 156.14
_ -_8,001 - 4,000 114.75 9.18 45.9_0 169.83
9,001 - 10,000 124.00 9.92 49.60 _183.52
10,001 - 11,000 133.25 10.66 53.30 - 197.21
11,001 - 12,000 142.50 _11.40 57.00 210.90
12,001 - 13,000 151.75 12.14 60.70 224.59
13,001 - 14,000 161.00 12.88 64.40 238.28
14,06-1 -. -i5,000 17U.25 13.62 68.10 251.97
15,001 - 16,000 179.50 14.36 71.80 _265.66
16,001 - 17,000 _ 188.75 15.10 75.50 279.35
17,001 - 18,000 198.00 15.84 _ 79.20 293.04
_ 18,001 - 19,000 -207.2516.58 82.90 306.73-
19,001 - 20,000 216.50 _ 17.32 _86.60 320.42
20,001 - 21,000 225.75_ 18.06 90.30 334.11
_ _21,001 - 22,000 235 00 18.80 94.00 347.80
22,001 - 23,000 244.25 19.x.497.70 361.49
23,001 - 24,000 i 253.50_ 20.28 101.40 375.18
24,001 - 25,000 262.7_5 21.02 105.10 .388.87
25,001 - 26,000 269.50 21.56 107.60 398.86
26,001 - 27,000 _ 276.25 22.10 110.50 408.85
27,001 - 28,000 283.00 22.64 113.20 418.84 _
~28,001 - 29,000 289.75 23.18 115.90 428.83`
--279,0-01 - 30,000 296.50 23.72 118.60 438.82
30,001 - 31,000 1 303.25 24.26 121.,0 448.81
31,001 - 32,000 310.00 24.80 124.00 458.80
32,001 - 33,000 _ 316.75 25.34 126.70 468.79
33,001 - 34,000 323.50 25.88 129.40 478.78 -
34,001 - 35,000 330.25 26.42 132,10 r 488.77 _
35,001 - 36,000 337.00 2.6.96 134.80 498.7F3
36,001 - 37,000 343.75 27.50 137.50 -, 508.75
37,001 - .38,000 350.50 28.04 140.20 518.74
_ 38,001 - 39,000 357.25 28.58 142.90 528.73
39,00_1 - 40,000 _ 364.00 29.12 145.60 _ 538.72
40,001 - 41,000 370.75 29.66 148.30 548.71
41,001 - 42,000 377.50 30.20 151.00 558.70
42,001 - 43,000 384.25 30.74 153.70 568.89
43,001 - 44,000 391.00 31.28 156.40-----
----44,001
56.40 ,____44,001 - 45,000 397.75 31.82 159.10 588.67_
45,001 - 46,000 404.50 32."5 161.80 598.66
46,001 - 47,000 411.25 32.90 164.50 608.65 '
47,001 - 48,000 418.00 33.44 167.20_ 618.64
_ 48,001 - 49,000 424.75 33.98 169.90 _628.63
49,00150,000 431.50 34.52 172.60 638.62
is\dsts\forms\firesup,.doc 12/23/99
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