The URL can be used to link to this page

10260 SW GREENBURG ROAD STE 1150-1 r N O� O z e� r 1 1 2 1 1 1 1 1 I j s f, j �'aF :r d i i 10360 3W GREENBtJRG RD IISO i CITY OF T I G A R D ELECTRIC PERMIT PERMIT#: ELC2000-00422 DEVELOPMENT SERVICES DATE ISSUED: 07/27/2000 13125 SW Hall Blvd.. Tigard OR 97323 (503) 639-4171 PARCEL: 1S135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 1150 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P BLOCK: LOT : 014 .JURISDICTION: TIG Proiect Description: Installation of 10 branch circuits. F--RESIDENTIAL UNIT TEMP SRVC/FEEDERS __MISCELLANEOUS _ 1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION: F"ACH ADD'L 5GOSF: 2.01 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL 00): SERVICE/FEEDER _— BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: '4V/SERVICE OR FEEDER: PER INSPECTION: l 201 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC 9 IN PLANT: 601 1000 amp: _ _ PLAN REVIEW SECTION 1000+ amp/volt- -- >-4 RES UNITS: — > 600 VOLT NOMINAL: Reconnect only: _SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCG: Owner: Contractor: KNICKERBOCKER PROP, INC XXIV CHRISTENSON ELECTRIC INC BY NORRIS, BEGGS + SIMPSON 111 SW COLUMBIA 10300 SW GREENBURG RD STE 200 STE 480 PORTLAND, OR 97223 PORTLAND, OR 97201 Phone: Phone: 241-4812 Reg #: LIC 000458 SUP 3289S PLM 2468S ELE 26-34C FEES Required Inspections —�— Type By _ Date — Amount Receipt Ceiling Cover PRMT DLH 07/27/200C $85.65 0004038 Wall Cover 5PCT DLH 07/27/200( $6.85 0004038 Elect'I Final Total $92.50 This Permit is issued sub,ect to the regulations contained in the Tigard Municipal Code, State of OR Spedalty 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 or direct questions to OUNC at(503) 246-1987 PERMITTEE'S SIGNATURE /r;?,4iI F, _ — ISSUED BY: Z � 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 INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N LICENSE NO: —_ ----- --...------- _�-- -- — — Call 639-4175 by 7:001)m for an inspection the next business day Sent by: CHRISTENSON FIFCIPIC 5032056721 ; 0712410n q:1 /AM;jejrjijL-N5/0;P39e CITY OF TIGARD Electrical Permit Application Plan Check 4_ -_-- 13125 SW MALL BLVD_ Rrscd Cy TIGARD OR 97223 [)att,Recd -- - -- Date to P F Phone(503)639 4171 x304 Uale to DST �M Irlcpuction (503)639-1175 print of TypN Permit# Fax (503) 598-1960 Incomplete or illegible will not be accepted Called__ --- 1. Jan Address: 4. Complete Fee Schedule Below: Name of Development LINCOLN CENTRE f LINCOLN TLWI.R. Number of h.xpe tions per pom.0 aPsswgd Name(or name of business)STATE FARM INSURANCI,_ Service included: Items Cost Sum Address 10260 SW GREENBURG RD SUITE 1 150 _ 4a Residential-icier unit - Ct TIGARD OR I OOU sq n or lass r I I 1 15 -- 4 ty;Stats Zp Each additional 5DC A.R or pIf _ 2, y Comrtlerdal® Residential❑ Limited Fnyirgy $ 60 UU MALIBU PACIFIC QUESTIONS7CONTACT ROSS r•I o Wilich Manufd Horne or Modular 2a. Contractor installation only: 245-1965 Dwelling Service or Feeder — ! 72 7b 7 (Prior to permit issuance,appllcavtts must provide contraelw 11cense 4b.Servicas or Feeders into►mation for COT dab baso). installation,an traUon,or relocation FlectmealContr cto.rCliR1STENSON ELECTRIC INC. 200 amps or less $ 54,25 __ 2 Address L 11 SW CO1.liMBIA,SllITE 80 201 amps to 400 amps $ 115.50 2 PORTLAND _ State OR 2) 966 4131 amps lu 600 amps _ s 128.50 ___^ 2 City r_ zip601 amps to IGuo amps 3 192.50 e N Phono� 24 1-48� 12 over 1000 amps or volts 5 363.75 t Job No. 6 2-14 366 Heconneci only _ _ ti 5350 2 V ler_, Cont. Uce. No. 26-34 C Exp.Date 10/l/.00 4c,Temporary Services or Feeders OR State CCB Reg. No 458 _Ecp,na 503 Installation,sheratior,or relocation COT 8usines4.Tax or Metro No. 5 �13 )2/31- 0 200 amps dr less $ 5350 2 201 amps to 400 amps $ 80.25 2 401 amps to 600 amps $ 107.00 2 Signature of Supr Llee'n y. Over 600 amps to 10(jo Vohs, C / age"b"above. License No. i ._ F.,Date _I 0/1/01 503 241-4612 4d.Branch Circuits Phone No. New, allerabon or extension per parcel a)The fee for brancrt circ:utts 2b. For owner installations: with purchase of service or feeder fee Print Owner's NameEach branch circuit $ 5.36 2 - - - o b)Thr fee for branch circuits Address _ -_ - without purthose orse►mse city -- State ._ZIP� _ or feeder fee. 1 Phone No, _ First brand,circuit $ 3750 37.50 Earn additional branch circuit _$ 5.36 The instai!ation is being rnsde on property I own which is not M.Mlsgsllansoua Intended for sale, lease or rent (Service or feeder not included) Each pump or irrigation cirrtle $ 42,75 tOwnef 5 Signature _ _— _ �i_ Ea4 h sign or outline lighting = 42.75 - Signal circuit(s)or a limited energy " panel,altersUor or extension $ 60.00 3. Plan Review section (if required): Minor Labels(10) $ 10100 Please check appropriate Item and aintur fee In se.ttion 5B. 4f.Each addfbonal Inspection over 4 or more residential untU in one�tiudurP the allowable in arty of the above --- Per inspection $ 5o o0 Serrice and feeder 725 amps tit more Per hour $ 5000 System over 50D volts nominal In Plant S 59 00 Clas0wd area or structure containing special occupancy as descnbed in N E C Chapter 5 5. Fees: Ss.Enter total of above fees ti 85.65 " 9ubirnll 2 sets of plans with i-,ppilandon o4wrw any of the above apply 5%Surcharge(o5 x total reesi 82 s i685 Not required for temporary constructicn services. Subtotal 8b•Enter 23%of fine Sa for NOS,(-E Plan Review If req Ir (Sec 7) S PERMITS BECOME VOID IF WORK OR CONSTRUCT ION AUTHORIZED I Subtotal $ IS NOT COMMENCEU WTHIN 180 PAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR AUANUUNED FOR A PERIOD OF 160 DAYS Trust Account M _ (92.50) AT ANY T1ME AFTER WORK IS COMMENCED Total balance Due $ -0- \601ormCclectric doc � CITY �� BUILDING PERMIT PERMIT#: BUP2000-00275 DEVELOPMENT SERVICES DATE ISSUED: 7120100 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: lS135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 1150 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P BLOCK: LOT: 014 JURISDICTION: TIG REISSUE: FLOOR_AREAS _ — EXTERIOR WALL CONSTRUCTION— CLASS OF WORK: ALT FIRST: sf N. S: E: J W. TYPE OF USE: COM SECOND: sf _ — PROJECT OPENINGS_? TYPE OF CONST: 2FR sf N:� S_- E: W: OCCUPANCY GRP: B TOTAL AREA: 0 0() sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 42 BASEMENT: sf AREA SEP. RATED: STOR: HY: ft GARAGE: sf OCCU SEP. RATED: 1 HR PSMT?: MEZZ?: REQD SETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:Y DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 39,000.00 Remarks: Tenant improvement - Note - There will be a one hour separation in t .is unit - Same tenant- see plans Owner: Contractor: KNICKERBOCKER PROP, INC XXIV MALIBU PACIFIC BY NORRIS, BEGGS + SIMPSON 735 NE JACKSON SCHOOL ROAD 10300 SW GREENBURG RD STE 200 HILLSBORO. OR 97124 P9Pone:TLff.. OR 97223 Phone: 693-9797 Reg #: LIC 059045 _ FEES _— REQUIRED INSPECTIONS _- Type By —Date Amount Receipt Mechanical Permit Require PRMT DEB 7120100 $364.00 0003831 Electrical Permit Required Sprinkler Permit Required 5PCT DEB 7120100 $29.12 0003831 Fire Alarm Permit Requirec PLCK DEB 7120100 $236.60 0003831 Framing Insp FIRE DEB ?/20100 $145.60 0003831 GYP Board Insp _ Susp Ceiing Insp Total` $775,32 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987 Pe mi ltee 8igg'ature: i Iss ed By: Call 639-4175 by 7 p m. for an Inspection the next business day CITY Or: TIGARD Commercial Building Permit Application PlAnCheck# C' 1 s1 25 SW HALL BLVD. Tenant Improvement RecdBy�4k Date Rec'`d 7 — 1'7-cX) f IGARD, OR 97223 Date to P.E. _ !50?) 639-4171 /-' Date to DST 7 lg - Print or Type �'' Permit it Related SWR# Incomplete or illegible applications will not be accepted called_ Name of Development/Proi,.r-t f Existing Building X New Building ❑ .lob (_incoly% C-C-rrber I Lioc..lr Towcv ai Address Street Address ' Suite Building 1o2too Sw cmenbuy� F-A. 1150 Data i�co�� C.e►.`l ev fTldy# i_ City/State — zip Existing Use of Building or Property. LINC-0ELJ Pcrt�QvK {�t�. 972?.3 Uf f(ce 'LoWEP— �•1 _ Name Property -- �kerb X�IV I Proposed Use of Building or Property Kni o er Pyo e�►�ies,T►'ti� _ -- Owner Mailing Address Suite I o-f�f t e �— I()JC0 3W C"*W,4L)r�j I� 2Gv No. Of Stories City/Slate Zip Phone I'L� Forjand, tOf-, 9722 52.5900 Sq. Ft. Of Project Occupant Name. ---- ,StA7 ,c Farm Oc[cuupancy Class(es) ---- Name Contractor _Malibu Par-41C Type.(s)FffConstruction Prior .�permit Mailing Address suue -- -- - is-�uance,a copy7 NE �ao�cson sc�ta'�I �a� Will this project have a Fire Suppression System? of all licenses ,-, Yes No [- _ are required if City/State Zip Phone Americans with Disabilities Act(ADA) Pxplred!n . I N'11A-ry I CP,• 9712.4' (093-9'197 Valuation X 25% $8,7d2,5O Participation databacOregon Const.Cont.Board Lir.* Exp.Date Complete Accessibility Form - 0590+15 by Project —v $ J9100,�C,0 Name — `Z� O�, Valuation__ — — — Architect C7� fly c�ltec` r InC Plans Required. See Matrix for number of sets to submit Mailinddress - salla On back g A City/State Zip Phone I hereby acknowledge that I have rend this application,that the information PoY,-tl aKA (-1 •, '3-7204, TVt�9F5� given Is correct,that I am the owner or authorized agent of the owner,and I _ that plans submitted are I^compliance with Oregon State laws. Engineer Name Signature of Owner/Agent Date Mailing Address Suite _ 1/be _,d�^Y 7 It-(z) Con �t Person Name Phone f'--.. City/State Zip Phone a P-. Glu 22��9 - --" FOR OFFICE USE ONLY Indicate type of work. Now O Addition O Demolition O Map/TL# Accessory Structure O Foundation Only 0 Alleration)K[ -- Repair O Other O Notes. Description of work: Tewi) IrAprove"nt TIF. Note: Site Work Permit Application must precr.de or accompany Building Permit Application _,y I1COMNFWf1 DOC (DST) 5/98 ,;7 �/ COMMERCIAL PLAN SUBMITTAL_ REQUIREMENT MATRIX clan Review is dependent upon submittal of BOTH pians AND a COMPLETED application. For an electrical submittal, the application mast contain the signature of the supervising electrician before plan review will be conducted. After plan reviow approval, Plans Examiner will contact the applicant to request additional plan sets for distributioo purposes. (Copy for Contractor, City, Washington Cow iiy, Tualatin V,,lley Fire & Resr,Ue) Total # of TYPE OF SUBMITTAL Plans KEY- Submitted --- S (Private) :1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = F=ire Protection System PA (New or.Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) E = Electrical B & M & P (New or Add) 2W 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 *8 & M & P (Alt) 3 *B & M & P & E(Alt) 3 (Alt) 3 NOTES. *Shaded areas designate ALT submittals only. 1Ads1sVomisvnatrxcom.doc 10/30/98 SUBJECT: ACCESSIBILITY BARRIER REMOVAL IMPROVEMENT PLAN REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected huildings 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 disab0ities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alts,,rations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five per-cent(25%). VALUATION_ of all renovation, alteration or modification being done excluding painting, wallpapering multiply_ 25% Barrier removal requirement. _. .25 ^ BUDGET FOR BARRIER REMOVAL [2] $ 81'7c)'?- In r7cb2In choosing which accessible elements to provide under this section, priority snail be given to those elements that will provide the greatest access. Elements shall be provided in the following order (a) Parking lot restr��piK9, ne.w cvrb cats, $ ni�eWa�ks , si9>1a�a a��d pccassib(r staIlJ. (b) 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: $ (0 Accessible drinking fountains: and $. (g) When possible, additional accessible elements such as storage and alarms $ TOTAL: Shall equal line 2 of Value Commutatiorti $_ , / 02 •5 0 i Adsts\rorms\access.doc __ _ BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2000-00302 DEVELOPMENT SERVICES DATE ISSUED: 7/31/00 13125 SW Ball Blvd.. Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-03400 Si'rE ADDRESS: 10260 SW GREENBIJRG RD 1150 SUBDIVISION: LINCOLN TOWER-YOB`/N OF MFTZGER -ZONING: C-P BLOCK: LOT: 014 JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS — FIPST: sf N: �S: E W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 0 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?: RE_QD SETBACKS _ _ REQUIRED_ FLOOR LOAD: psf LEFTS ft RGHT: It FIR SPKL: SMOK DET: DWELLING UNITS: FRNT- ft ;SEAR: ft FIR ALRM : HNDIrP ACC: BEDRMS: BA'rHS: IMP SURFACE: PRO CORR. PARKING: VALUE: $ 1,820.00 Remarks: Fire Sprinkler Owner: Contractor: KNICKERBOCI:ER PROP, iNC XXIV FIRES TOP CO BY NORRIS, BEC."iS + SIMPSON 9384 SW TIGARD S) 10300 SW GREENBURG RD STE 200 TIGARD, OR 97223 PPhr?rie ND, OR 9722.3 Phone: 620-6140 Reg#: LIC 00063846 _ F9ES w _ _ REQUIRED INSPECTIONS Type By Date Amount Receipt Sprinkler Rough-In PRMT JMT 7/31/00 $50.00 0004100 Sprinklei Final 5PCT JMT 7/31/00 $4.00 0004100 Total $54.00 — �--_-- _ _J This permit is issued subject 'to the rtN. ulations contained in the Tigard Municipal Code, Sta o'OR Specialty Codes and all other applicable law. All work will he done in accnrdance 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 bV calling (503) 246-1987. Pe rm itee Signature Issued By: Call 639-4175 by 7 p.m. for an inspection the next business day Fire Protection Permit Application , Plan Check# CITY OF TIGARD Commercial or Residential � � Rec'd By 13125 SW HALL BLVD. ®� I} "bate Recd TIGARD, OR 97223 Print or Type E� tk Date to P E. (503) 639-4171, x. 304 Incomplete or illegible applications will not be accep ed Data to DST Psrmit#��u. o7dn�'r70 C Called Job Name of Development/Pro)ect Type of System (Complete A or B as applicable) Address AddressL ` A.) Sprinkler Wet [] Dry Nnn��e �7 Standpipes Owner Mailing AddreSb Additional Hazard Group Gty/:tate Zlp Phone Information Density - ---- . _ - N" Design Area Occupant MailingAddresj- K Factor it)L,140 « /jilt I I.— _ Qty/State—^ zipI Phone A. 1) Sprinkler Project Valuation $ Contractor Name B.) Fire Alarm (Sprinkler or Fv Alarm Company) fling Address Submittal Shall Include Battery Calculations YES ❑ Prior to permit '3 . tiL11 I ( ,a-- _ issuance,a City/State Zip Phone Individual Component YES ❑ copy �y /I Cut Sheets of all licenses (e 02 -I Rl--; to U U B.1) Fire Alarm Project Valuation $ are required if State Const.Cont.Board Lic.tk Exp.Dote expired in COTr''` Z" I Project Valuation Subtotal (A & or B) $ database (C4 tom_ 4 _ _ 1 Namet Permit fee based on valuation $ C I - \2 t'N►7�r T 1ti (see chart nn lJack� — ArchitectA@ailing Address ----- `1 �� Surcharge $ TkiilZ6 GV qty/State \ Zip I Phone FLS Plan Review 40%of Permit $ P. ' Describe work A.)New O Addition O Alteration 9k Repair O T AL $ v to be done: B.) Modification to sprinkler heads only: -� - —=--- --TOTAL - 1. 1-10 heads=No plans required Plans reo!lired: Submit three sets of plans,including a vicinity map a.nd the location of the nearhydrant. 2. 11+=pia i review required -est 'Lrant. - _ I hereby acknowledge that I have read this application,that the information given is Number of sprinkler heads I I corTect that I am the owner or authorized egenl of the owner,and that plans s e are in compliance with Oregon Stale laws . Additional Description of Work: SI iature of s gent Date A.)M Existing' Ing ❑ New Building (] � �r•(p11C Building Cpn t PeI Name Ph ne 1 Data B.) Commercial Residential— �' .\� w" C�1 -- � FOR OFFICE USE ONLY: _ No of stories: — -- Plat# Mapr r,--#' —� Sq. Ft: --- Notes Occupancy Class Type of Construction is\dsts\fonns\firesupr.doc 7/2/99 Valuation of Project Permit fee_ Tax 8% FLS 40% F � Total 1 - 2,000 50.00 4.00 20.00 74.00 2,001 - 3,000 59.25 4.74 23.70 87.69 3,001 - 4,000 _ 68.50 _6+.48 27.40 101.38 4,001 - 5,000 '17.75 6.22 31.10 _ 115.07 4 _ 5,001 -16,000 87.00 6.96 34.80 T128.76 6,001 -17,000 v 96.25 7.70 38.50 142.45 J 7,001 -18,000 105.50 8.44 42.20 - 156.14 1001 - 9,000 114.75 9.18 45.90 _ 169.83 9,0011- 10,000 124.00 _ 9.92 49.60- J _ 183.52 _ 10,001 - 11,000 -- 133.25 _10.66 53.30 _107.21 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 64.40 238.2$ - 14,001 - 15,000_ 170.25 13.62 68.10 251.97 _ 15,001 - 16,000 _ 179.50 14.38 71.80 265.66 ,T 16,001 - 17,000 188.75 15.10 75.50 279.35 17,001 - 18,000 198.00 1 15.84 79.20 293.04 18,001 - 19,000 207.25 16.58 82.90 306.73 19,001 - 20,000 216.50 17.32 _86.60 32_0.42 20,001 -121,000 225.75 18.06 90.30_ 334.11 21,001 - 22,000 _235.00 18.80 94.00 _ 347.80 22,001 - 23,000 _244.26 19.64 _ 97.70 361.49 23,001 - 24,000 _ 253.50 20.28 101.40 375.18 24,001 - 25,000 262.75 21.02 105.10 388.87 _ 25,001 - 26000 269.50 21.56 107.80 398.80_ ' 26,00' - 27,000 276.25 22.10 110.50 408.85 27,0011-128,000 283.00 22.64 113.20 418.84 28,001]T- 29-,000 289.75 23.18_ 115.90 428.83 �- 29,001 - 30,000 296.50 2_3.72 118.60 438.82 30,001 - 31,000 303.25 _ 24.26 _121.30 448.81 31,001 - 32,000 _310.00 24.80 124.00 _ _454.60_ I---'--j-2,OOl - 33,000 316.75 25.34 126.70 - 468.79 33,001 134 ,000_____ 323.50 25.88 129.40 478.78 34,001 ,000 _ _ 330.25 20.42 132.10 . 488.77 35,001 ,000 337.00 26.96 134.80 498.76 36,001 ,000 343.75 27 50137.50 508.75 V,001 ,000 __ 350.50 28.04 140.20 518.74 38,001 ,000 357.25 28.58 142.90 528.73 W8- 39,001 ,000 364.00 29.12 145.60538.7240,00', ,000 37036 29.66 148.30 548.71 41,001- 42,000^ 377.50_ 30.20 151.00 558.70 42,001 - 43,000 384.25 30.74 153.70 568.69 _ 43,001 1-447,6_00 _ _ 391.00 31.28 156.40 578.68 44,001 -"43,000 397.75 31.82 159.10 588.67 _ 45,001 - 46,000 -404.50 32.36 161.80 598.66 46,001 - T7,60-6-----_ 411.25 32.90 164.50 608.65 47,001 - 48,000 418.00 3344 4_ J 167.20 618.0 48,601 - 49,000 - 424.75 33.98 169.90 628.63 49,001 50,00043ff.50 34.52 ,172.60- 838.82 fists\forms\firesupr.doc 12/23/99 CITYOF T I G A R MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2.000-00312 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 08/02/2000 PARCEL: 1 S135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 1 150 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-F BLOCK: LOT: 014 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS. TYPE OF USE: COM UNIT HEATERS: VEN r FANS: OCCUPANCY GRP: B VENTS WiO APPL: VENT SYSTEMS: STORIES: BOILERSICOMPRESSORS _ 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. GAS PRESSURE: 5() + HP: CLO DRYERS: SODS : FURN < 100K BTU: _Ali, HANDLING UNITS TYFR FURN >=100K BTU: <= 10000 cfm: OI!I! R UNITS: 4 > 10000 cfm: GAS OUTLETS: Remarks: Install three fire smoke dampers and one 6"VAV box. Owner:_ _ _ FEES NORRIS, BEGGS & SIMPSON Type By nate Amount Receipt 10300 SW GREENBURG RD PRMT JMT 08/02/20( $50.00 HAND TIGARD, OR 9722.3 5PCT JMT 08/02/20( $4 00 HAND Total $54.00 Phone: --- Contractor: NORTH PACIFIC HEATING 33700 SE DUOS RD ESTACADA,OR 97023 REQUIRED INSPECTIONS Mechanical Insp Phone: S.D. Shut-down inspection Reg'.Y:LIC 00063746 Final Inspection 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 f(:!!-w rules adopt9d in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189. Issue By: , Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next busines�•tiay Plan Che CITY OF.TIGARD Mechanical Permit Appiication Recd B, 13125 SW HALL_ BLVD. Commercial and Residential Date Fec'd TIGARD, OR 9722:) yJ Date to P E. (503) 639-4171, x304 � 401" Date to DST_= Print or Type 1j,o Permit# r��C 2 �Do3la Called --__ Incomplete or illegible applications will not be accepted I�GNisme of D«ve opment/Projecl Description — _ Table 1A Mechanical Code QTY PRICE AMT Job 5lreet Address 5141 ex A) Permit Fee 0- 0- 10.00 Address > >� /4 cb T,# y# ty t A Ip 1 Furnace to 100,000 BTU 6 00 _ .L CY 7JU _ ncluding ducts&vents Name(or name of business) 2) Furnace 100.000 BTU+ Owner / / including duds&vents Meiling Addr ss ( �- 3) Floor Furnace 600 Sincluding vent tylStato9115 Phone 4) Suspended heater.wall heater 600 or Floor mounted heater iamename mess ) 5) Vent not,rtcluded in appliance permit 300 Occupant -Wailing-Address 6 1 Boder or camp,heat pump,air cond 6,00 to 3 HP,absorb unit to 100K BUT }I y creta Lip hone 7) Boder or comp,heat pump,air cond 11 00 _ 3.15 HP;absorb unit to 500K BTU" _ Contractor Name 8 1 Boder or comp,heat pump,air cond. 1500 %7 ? dz '5-30 HP:absorb unit 5-1 and BTU" _ Prior to permit Mailing Andress 9) Boiler jr comp,heat pump,air cond. 22 50 issuance, a copy �ii�, ,�, _ 30-50 HP:absorb unit 1-1.75mil BTU" _ of all licenses Crryrs Zip hone 10) Boder or comp,heat pump,air cond. 37 50 are required if expired in COT Oregon Const Cont adard Lic$0 >_50 HP:absorb unit 1.75 and PTU" � 11 ) Air handling unit to 10.000 CFM 4 50 j Exp eta database -'- 7 � _ -„Z Architect flame 13) Non-portable evaporate cooler 450 rir Mailing Address 14) Vent fan connected to a single dud 300 Engineer I city%state ZIP Phone 15) Ventilation system not Included in 4.50 L __ appliance permit Describe work New O Addition O Alteration O Repair O 16) i•iood served by mechanical exha.st 4 50 to be doneResidential O Non-residential O Additional Qescnptjon of woorr�k/: 17 i Domestic incinerators 7 50 LlL� �/ x 18 i Commercial or industrial type 3000 Incinerator Existing use'uf 19 I Repair unds V — 4 50 building or property 20 1 Wood stove 4 50 Proposed use of 21 ) Clothes dryer,etc. 4 50 budding or property _ 22) Other units - V 41115 Type of fuel-oil O natural gas O LPG O electric O 23! Gas piping one to four outlets 200 I hereby acknowledge that I have read this application that the 24 I More than 4-per outlets(each) 50 info.-nation given is correct,that I am the owner or authorized agent of the owner that plans submitted are in compliance w-th Oregon State QTY SUBTOTAL n o laws Signature of Owner/Agent Date 'SUBTOTAL 1 �. 0� 54t"'URCHARGE . / _ 0 ,J Contact Person am Phone --Pl�1N REVIEW 25'/o OF SUBTOTAL Y I _ _— TOTAL ' .1G i Vnechpmt.doc irev q 'Minimum permit fee is;?5+5116 surcharge / V tr ' "Residential.AIC equires silo plan showing placement of unit d A \ CITY ®F T I G A R D _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00280 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/1/00 SITE ADDRESS: 10260 SW GREENBURG RQ 1150 PARCEL: ,S135AB-03400 SUBDIVISION: LINCOLN TOWER-(OWN OF METZGER ZONING: C-P BLOCK: LOT: 014 JURISDICTION: TIG C' ASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: CUM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES_._ .y LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATuRIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft. WATER CLOSETS: WATER LINE: ft DISHWASHERS; 1 RAIN DRAIN: ft Remarks: Rrplace/relocate two sinks and one dishwasher. No additional fixtures, no change in EDU count. _Owner: _ FEES -- KNICKERBOCKER PROPERTIES Type By Date _Amount Receipt 10300 SW GREENBURG RD PRM7 DEB 8/1/00 $50.00 0004155 TIGARD, OR 97223 5PCT. DEB 8/1/00 $4.00 0004155 - Total T$54.00 Phone 1: Contractor: DE TEMPLE CO INC 1951 NW OVERTON ST PORTLAND, OR 97209 REQUIRED INSPECTIONS Phone 1: 503-227-2641 Top-outlnspFinal Inspection Reg #: LIC 00002510 I PLM 26-25PB I I This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codos and all other applicable laws. All work will be done in accordance with approved plans. This permit wil'i expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAFS 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Is4veu By: �CXm_. GSL - _. Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Applica Mail Che�F� 13125 Su'' HALL BLVD. Commercial and Reside Racd B� TIGARD, OR 97223 �� 7% Date Recd �" ^ (503) 639-4171 �t6 Ey��"�� Dato to 1�� P.E Date to Print or Type permit# Incomplete or illegible applications will�cn�c�� accepted Related SWR V' Called I ,4 w + i / ffNarne of Development/Project e FIXTURES (individual) QTY PRICE AMT I---�-i`- Sink - � Job l_�y)(t,I(\Towe� 11.50--- - -- =-1 Address Street Address Suit,: Lavatory -` _- 11.50 I 0 21P 0 Sint C-treetel bu r i50 _ Tub or Tub/Shower Comb. 11.50 Bldg# CitylSlate Zi Shower Only^ 11,50 WaterCloset 11,50 Namel �j --- --- 6,'c-t�pr', r r� ��eS Urinal ------ 11.50 Owner Mailing Address � Suite Dishwasher 11.50 5 1 Sa 0 UL) A) rLr (A _ _ Garbage Disposal — 11.50 City/State Zip Phone Laundry Tray — 11.50 --1� -- -- Washing Machine/LaundiY Tiay— 11.50 - Na�ner�� A I N,,,LJ Q�1 I�`I1v I(� Floor Drain/Floor Sink 2" 11 50 Occupant Mailing Address/ \ Suite 3" V 11.50 I -2(00 �,w Cif1�j 1150 4 11 50 City/State Zip Phone _ - � - Z Z 3 Water Heater O conversion O like kind 11.50 Name — Gas piping requires a separate mechanical permit. MFG Nome New Water Service 32.00 _ MFG Home New San/Storm Sewer 32.00 Contractor Mailing Address ��/ Suite —� N W 6V l°;I Hose Bibs 11.50 Prior to permit City/State Zip Phone - Root Drains — 11.50 Issuance,a copy t (a-ry CK q jMPI Z Z1•Z(Qy I —' 11.50 Drinking Fountain of all licenses are Oregon Const Cont Board Lic# Exp.Date required If 2- ';t Q I Other Fixtures(Specify) 1500 expired In COT Plumbing Lic # Exp Data — database 2- cP 2_S Name 3800 Sewer-1st 100' , Architect _��-_ _ Or Mailing Address Suite Sewer-each additional 100' 32.00 Water Service- 1 st 100' 36.00 City/State Zip Phone Engineer Water Service-each additional 200' — 32.00 Descnb work to be done / Storm&Rain Drain-1st 100' 38.00 New 19 Repair O Re^:ace with like kind. Yes 0 No O Storm&Rein Drain-each additional 100' — :,2.00 Residential O Commercial -- ---- Commercial Back Flow�reventlon Device 3200. Additional description of work: / � Residential BarkOow Prevention Device' 1900. 16)Cll r� Qom. ��/ �W � � - Catch Basin 11.50 _ Are you cappl^g,moving or replacing any fixtures? Insp of Existing Plumb,n j or Specialty Requested 50 00 Yes-* No O Inspections ---_ _ per/hr If yes,sie back of form to indicate work perfomled by Rain Drain,single family dwelling 4500 fixture. 'AILURE TO ACCURATELY REPORT FIXTURE Grease Traps tt50 vv()RK_CDIJLD RESULT IN INCREASED SEWER FEES. -- ,eby acknowledge that I have read this app,ration,that he information QUANTITY TOTAL Isometric or riser diagram is required N Ouanyty Totalis >9 given is correct,that I am the ownpr or authorized agent o1 thr owner,and 'SUBTOTAL. 1 t fans submitted are in compliance with Oregon State taws. _ V Ig ur of Owner/Agent bate --- -- 8% SURCHARGE G 1�.6 ontact Person Name Phone -- — 1-t OLc) �.��y! **PLAN REVIEW 26% OF SUBTOTAL 1_ Required onl H fixlTegty total rs -9 _ 1 BATH HOUSE=178.00 - TOTAL c.) 2 BATH HOUSE$250.00 3 BATH HOUSE$285.00 (This fee Includes all plumbing fixtures In the dviAling and the first 'Minimum Permit fee is$50+0%surcharge,except Residential Backflow Prevention Ion feet of canitary sewer storrr sewer and wator service) Device.which is$25+RIA surcharge —All New Commercial BuiidlnCs require plans with isometric or riser diagram and pian review I WstsUormslpiumappdoc 11/19/99 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped _Sink _ _� _ _ 1 :I_ Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Urinal Dishwasher _Garbage Disposal Laundry Room Tray Washing Machine Flour Drain/=1oor Sink 2" Water Heater__ _ — Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I%dsts\lormslplumepp doe 11/18/99 PLEASE COMPLETE: Fixture Type _ Quantity by Work Performed New Moved Replaced Removed/Capped Sink Lavatory ---- ---_ -_ - - -- _— _ _`-- T_ub or Tub/Shower Combination -Shower Only _Water Closet Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain/Floor Sink 2" Water _Heater Ot _ 6—h e- (Specify) — COMMENTS REGARDING ABOVE: I Vh18%'' M5\Pk"Opp doc 11,18!99 CITY OF *rIGARD (BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 6394175 Business Line: 639-4171 — BJP Date Requested G' _ AM PM , BLD _ Location iC v _S w ( �ser /, ' Suite 1/Sy MEC Contact Person Ph T_3 s` o / PLM _ Contractor _ Ph SWR BUILDING Tenant/Owner i ELC z---- Retaining Wall ELR Footing Access: — Foundation FPS _ Ftg Drain SGN Crawl Drain Inspection Notes. — Slab -- —_-----�_r�_- SIT Post& Beam Ext Sheath/Shea,- Int heath/Shea Int Sheath/Shear Framing Insulation ----� Drywall Nailing Firewall --._- Fire Sprinkler Fire Alarm Susp'd Ceiling - Roof misc Final PASS PART FAIL. PLUMBING Post& Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final _ PASS PART FAIL MECHANICAL Post 6 Beam Rough In Gas Line -- — Smoke Dampers Final — -- --- - PA PART FAIL LECTRICA - —" --- -_ Sery ce Rough In UG/Slab Low Voltage Fiie Alarm in SS PART FAIL Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd Catch Basin Fire Supply Line f ]Please call for reins-.:ction RE:_ ]Unable to Inspect-no access ADA Approach/Sidewalk Other Date % Inspector Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITYOF TIGARD CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2000-00275 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 0712012000 PARCEL: 1 S135AB-03400 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 10260 SW GREENBURG RD 1150 SUBDIVISION: LINCOLN TOWER-TOWN OF MFTZGER BLOCK: LOT:014 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2FR OCCUPANCY GRP: B OCCUPANCY LOAD: 42 TENANT NAME, REMARKS: Tenant improvement- Note -There will be a one hour separation in this unit- Same tenant - see plans Owner: KNICKERBOCKER PROP, INC XXIV BY NORRIS, BEGGS + SIMPSON 10300 5W GRFFNBt1RG RD STE 200 PORTLAND, OR 97223 Phone: Contractor: MALIBU PACIFIC 735 NE JACKSON SCHOOL ROAD HILLSBORO, OR 97124 Phone: 693-9797 Reg#: LIC 059045 This Certificate issued 09/20/2000 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of O gon Specialty Codes for the group, occupancy, and use under which the refers c ermit was issued. BUILDING INSPECTOR BUILDI G OFFI IAL POST IN CONSPICUOUS PLACE 'ITY OF TIGARD BUILDING INSPECTION DIVISION ' MST _ ..our Insnection Line. 639-4175 Business Li e. 639-4171 — —/� ' UP, s —Gly 2 7 a _Date Requested AM _PM BLD I oca.lon Z.0 2 6, G J C.v 44, u Y i Suite _ //,T-V Contact Person _ Ph 7 YCi—y 7- PLM/ — Contr Ph SWR UIL DIN Tenant/Owner ELC _ Relaining Wall ELR Footing Access: Foundation EPS Fig Drain - Crawl Drain Inspection Notes: SGN Slab Post 8 Beam ---� � ----- --- -- SIT Ext Sheath/Shear - Int Sheath/Shear -- Framing Insulation --- --- Drywall Nailing J Firewall ✓ , Fire Sprinkler Fire Alarm -7----' Susp'd Ceiling Roof — --- inall� PART FAIL ------- ---- ---__— -- --- --- --- -- ---PLIAIBING Post&Beam - - - --- ------- - --- --- ------ --- - Under Slab Top Out Water Servic,a Sanitary Sewer - - -- --- ---- ----- Rain Drains Final - -- PASS PART FAIL WWI Post&Beam - - Rough In Gas Line - - - Smoke Dampers h PART FAIL. RICAL - - --- - Service / V Rough In UG/Slab Low Voltage - _- -— Fire Alarm ------------- Final -- PASS PART FAIT-SITE Backfill/Grading -- -- Sanitary Sewer Storm Drain I )Reinspection fee of$ _ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ 1 Please call for reinspection RE: —_ _ [ ]Unable to inspect-no access ADA \ A Approach/Sidewalk Date I <X)�'Other _InspectoryC� c_Z - EX5 t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job sita. i CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639.4175 Business Line: 639-4171 SUP Date Requested �� - 'AM_ PM BLD I-ocation �� r sy 5� r��4, ` 1-tk_ Suite MEC Contact Person _ — `U Ph �'PLM� UD Contractor Ph SWR (BUILDING Tenant/Owner ELC _ Retaining Wall ELR Fooling Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes SsN _ Slab - ---- ..---- ` r l.�y��j- C / IW SIT Post&Beam ---� --- F.xt Sheath/Shear Int Sheath/Shear Framing ----------- Insulation Drywall Nailing Firewall -- Fire Sprinkler Fire Alarm Susp'd Ceiling -- _ -------.___.-------- -- ___ Roof Misc: ---- -- Final PASS PART FAIL Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains 'nsS PART FAIL �AWCfAANICAL Pobt&Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service _ Rough In UG/Slab Low Voltage fire AlarmFinal PASS PASS PART FAILSITE Backfill/Grading -- '— Sanitary Sewer Storm Drain ( Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( J Please cell for reinspeNion FSE: ___ _� ( Unable to inspect no access ADA Approach/Sidewalk Date ` _( � Ext Inspector. `�_ Other _. _ Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION % `� MST 24-Hour Inspection Line: 639-4175 Busi-iess Line: 639-4171 —_ Date Requested �`7 AM PM/o�''v iUr�J ZoU6 '.�Da 7 S Location /Q Ai�(' `� _S��'`'``�'t 6w' Q� _ Suite /I 5- _ MEC Contact Person �'r& Pn PLM Contractor _ Ph —_ SWR i BUILnING `— Tenant/Owner /v� -� d ELC — Retaining Wall FLR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: —�— Slab _.. - -- SIT Post&Beam \ Ext Sheath/Shear ----=--- - Int Sheath/Shear _ , r Framing '1 l Insulation ►rJ' >> Drywall Nailing �� Firew" Fire Sprin� F �Am Misc: _ - na S PART FAIL Dost& Beam M Under Slab Top Out Water Service Sanitary Sewer Ra;-i Drains 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 Final PASS PART FAIL -.. - ----- - -- —_--SITE _ Backfill/Grading Sanitary Sewer Storm Drain [ j Reinsp,3ction fee of$ - ____required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I 1 Please call for reinspection RE: �_ _ ____ ; ]Unable to inspect no access ADA ��' Approach/Sidewalk Date '-7 (.� U hispector �` EXtT I Other Final PASS PANT__FAIL] 00 NOT REMOVE this inspection record from the jolt site. ELECTRICAL PERMIT- CITY OF T I GA R D RESTRICTED -- ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2000-00198 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 8/23/00 SITE ADDRESS: 102G0 SW GREENBURG RD 1150 PARCEL: 1S13F .0 03400 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P BLOCK: LOT: 014 JURISDICTION: TIG Prosect Description: Installation of data telecommunication system. A.RESIDENTIAL 3.COMMERCIAL AUDIO&STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: KNICKERBOCKER PROP BETTS TELCOM INC BY NORRIS BEGGS & SIMPSON 6815 N RICHMOND AVE 10:300 SW GREENBURG RD STE 200 PORTLAND, OR 97203 TIGARD, OR 97223 Phone: Phone: 735-4123 Reg #: LIC 125312 ELE 26-969CL FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 8/23/00 $60.00 2720000000 Elect'I f=inal 5PCT CTR 8/23/00 $4.80 2720000000 Total $64.80 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 adopte; by th a 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 di t uestions to OUNC at (503) 246-1987. l - "1 Issued by %' A 6'(�� l� _ Permittee Signature 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 INSTALLATION ONLif SIGNATURE_ OF SUPR. EL.EC'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day i CITY OFC G RESTRICTED ENERGY ELECTRICAL APPLICATION I�AF,D 13125 SW HALL BLVD Date Recd / - �— TIGARD OR 97223 PRINT OR TYPE ;rmit V- 503-639 4171 X304 F - 503-598-1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust Call'd_ WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Restricted Energy Fee........................................ $60.00 S p r�� •� (FOR ALL SYSTEMS) JOB Street Address Ste#� Check Type of Work Involved ADDRESS �Qt,5 C. 12 fid. ( � C. State ip Phone# Audio and Stereo Systems aLldOf7 IVa e a Burglar Alarm FJ Garage Door Opener- OWNER Mailing Address r City/State_ �Zip PL]hune# Heating,Ventilation and Air Conditioning System' ---.---I--- E Vacuum Systerns' Name C,/I( �iVll___— Other -- -- — ----- CONTRACTORng"Addr ss Co Q Ve TYPE OF WORK INVOLVED - COMMERCIAL ONLY Prior to issuance a ,�Y/St tf / Zip 7 Phone# Fee for each system.............................................. $60.00 copy of all licenses �� -/ a I t]I,1)� ! �5 Nf_�� (SEE OAR 918-260-260) are required if Oregon Co_ntr Brd Lic.# Ex Date expired in C O T 9„t c'C Check type of�' *Involved data base). Electrical Con r Lic # xp 15ate j Crr- f[ f pC Audio and Stereo Systems C.O.T.or Metro Lic # Exp Date Boiler Controls Owner's Name Clock systems OWNER - Mailing Address APPLICANT Data Telecommunication Installation City/State 7_i Phone# ❑ p l Fire Alarm Installation This permit is issued under CAE 918-320-370 This app—licantntJagrees toHVAC make only restricted energy installations(100 volt amps or less)under this permit and to do the following Instrumentation 1 Only use electrical licensed persons to do installations where required. Certain residential and other transactions are exempt from licensing intercom and Paging Systems These have asterisks(') All others need licensing; Landscape Irrigation Control' 2 Call for inspections when installation under this permit are ready for inspection at 603.639-4176; F'� Medical 3 Purchase separate permits for all installations that are not ready for an Nurse Calls inspec0on when the inspector is out to inspect under this permit, 4 Assume responsibility for assuring that all corrections required by the Outdoor Landscape Lighting' inspector are done,and. ❑ Protective Signaling 5 Assume responsibility for calling for a final inspection when all of the ❑ corrections are completed Other _ Permits are non-transferable and non-refundable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days —_Number of Systems The person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other installations authorized to bin e applicant. n FEES: 0 ENI ER FEES Signature �/ F � 8%SURCHARGE(.08X TOTAL ABOVE) Authority if other than Applicant TOTAL r\dsts\forms\reSde doc 3198