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10260 SW GREENBURG ROAD STE 710-2 n 1 n a 10260 SW GRFENBURG RD 710 a CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT PERMIT #. . . . . . . . E-UP98-0140, 13125 SW Nall Blvd., Tigard, OR 97223 (503)639.4171 `�] DATE ISSUED: 04/08/98 PORCE:1.: 1 S 135AB-03400 SITE ADDRESS. . . : 1O260 SW GREENBIIRG RD 1t-1_1� S1.IBDIVIsinN. . . . : LINCOLN TOWER-TOWN OF METZGER ZONiNG:C-P BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :O14 JURISDICTION:TIG REISSUE: �j FLOOR AREAS----------- EXTERIOR WALL CONSTRUCTION- CLASS OF' WORK. �t'T �/ i j FIRST. . . . : 0 sf N: S: E: W: TYPE OF USE. . . :COM SECON'). . . : 0 sf PROTECT OPENINGS?---_-__-__ TYPE OF CONST. :2FR . . . . 0 sf N: S: Er W: OCCUPANCY GRP. :B TOTAL-------% 0 sf ROOF CONST: FIRE RET?: OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA SEP. RATED: S'fCR. : 0 HT: b tt GARAGE. . ., : 0 sf OCCU SEP. RATED: BSMT?r, MEZZ?: REDD SETBACKS-___._.____ REQUIRED--.----------------__ FLOOR LOAD. . . . : 0 ps f LEFT: 21 ft RGHT: 0 ft FIR SPKL:Y SMOK DET. . : DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR AL.RM: HNDICP ACC: BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE... $: 0 Remarks : Farsers Insurance fire sprinkler system Owner: --__..______._._____._._______________._________—.--- _-.___ FEES _________—__—_ KNICKERBOCKER PROPUPTIF_S INC type amoi.tnU by date recpt 10300 SW GREENBURS RD PRMT 8 62. 50 .TSD 04/0/98 98-304627 STE 200 SPCT 8 3. 13 JSP 04/02/98 98--304627 TIGARD OR 97223 FIRE $ 23. 00 JaD 04/02/98 98-304627 Phan, 0: 452-5900 Cont Tact u r: FIRE SYSTEMS WEST INC 600 SE MARITIME AVE STE 300 VANCOUVER WA 98661 ----------------------____-----.—__ Phone #s 360-693-9906 $ 90. 63 T TOTAL Reg #. . : OOO497 --REQUIRED ACTIONS or INSPECT?ONS---•- This permit is issued subject to the regulations contained in the Sprinkler RoLigh— Tigard Municipal Code, State of Ore. 5peciaity Codes and all oth?r Sprinkler Final applicable laws. All work will be done in acrurdanre with approved plans. This permit will expire if work is not started within 188 days of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N3tification Center. Those rules are set forth in OAR 952-881-8818 through OAR 9521-#8181987. You many obtain a copy of these rules or direct questiois to O(X, by calling f5831246-1987. [-permittee Signatt.tre : _ N1�f` lssi.ied By: ++++i.+A++++++++++++++++++++++++++++++++4+++++•1-++++++++++++++++++•*+++++++++++i Call 639-4175 by 7:00 p. m. for an inspection needed the next biAsiness day +++++++++++++++++++++++++++++++++++++++++++++++++.++++++++++++++++++++++++++++ i 10 K--O;�C— FLANC.KO Date. APPLICATION FOR PERMIT TO INSTALL FII:E SUPPRESSION SYSTEM BUILDING DIVISION, CITY OF TIGARD 639-4171 DATE: 7, `� Q' \ A% PERMLf # -- tAAValuation: Amt. Paid: `j O �� — _ /'�'� j Permit Fee: C ` ,10% Plan Check Fee: Balance Due: .__ S% State Tax: _ _�' _ ,_.._�—__. -- Plans mast be submitted to the Buii, "ng Division before installation. Three sets of the plot plan, showing the layout and the location of the nearest hydrant is required. New Installation: _ Addition:_ __ Repair:_ Alteration: x Complete:_ ', Partial, Exitway: Basement: Hood & Vent:•__,_._____. Spray Booth: IN EXISTING BUILDING:__ IN NEW BUILDING: f U NUMBER & STREET: (' , r �_, a, r.' C• L�- -�l�v �_r� , NAME OF BUILDING or BUSINESS: 10 y L/L J l �- t..l �-� L•-ti '�-b.N�'r•i. NO, JF STORIES: SIZE OF bL+ILDING: OCCUPIED AS: TYPE OF SYSTEMS: Wet: ,_ Dry: _Combination: _ STANDPIPES: OCC.HAZARD: Light_ ORD.GRP.HAZARD 1— 2— 3_ 4—Extra DENSITY ( o GPM/Ft2 DESIGN AREA ft2 SPRINKLER AREA ft2 SPRINKLER ORIFICE SIZE: t/2" "K" FACTOR S le 'TEMP. RATING I OWNER: ADDRESS: CONTRACTOR: PLANS DRAWN BY:Ft2C —Yy• `A/¢—t"ADDRESS: God *vs. MA21-Nii-t&. 3Do vYdy r��J tn'*'bJ `t'S tow t REMARKS: 'T"r--JdJ-t-• APPROVED permits includes only work described above and/or on plans and specification bearing the same 1/( pe,-mit number and will comply with all applicable codes and ordinances of the City of Tigard. SPRINKLEk COMPANY: PHONE: 3 Lo o-(o 9 3-11 `1 0 SIGNATURE OF APPLICANT: I ® v--.• V4- BUILDING MBUILDING DIVISION: PERMIT VALID FOR 180 DAYS ( /1 h:`,Io4nWttsdlr•perm i CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection !..Inc: 6394175 Business Phone: 639--4171 Date Requested: _ C;-q-. 7A.M. P.M. MST: Location: _d� BUP: Tenant: Suite:7/0 Bldg: NEC: Contractor: . - � L'�-., Phone: �� - --- PLM: / Phone: ELC: I G� ELR: SIT: BUILDING BLDG(coni) PLUMBING MECHANICALE .ECTRICAj__) SITE Site Post/Beam Post/Beam Post/BeamovZ'erl5ervice Sewer/Storm Footing Roo" Undl'I/Slab Rough-ht �et'c"in Water Line Slab Framing Top Chit Gas line '95ugh-In UG Sprinkler Foundation Insulation Sewer Hood/Duct Recop.nect Vault Bsmt Damp Drywall Storm Furnace Temr Service MISC. Masonry Ceiling Rain Drain A/C Ur.)Slab Shear/Sheath Fire Spklr/Alm Crawl/Found lr Ilent Pemtp Low Volt Approval Approved Approved Approved Approved Appr/Sdwlk Not Approved Not Approve) Not.Approve) N-oTWpffiroved Not Approved FINAL FINAL FINAL '—rte FINAL, O Call for reipspe ction r7 Reinspection fee 03 _required before next inspection O Undble to inspect Inspector:_� �� _— Date:_� ' - Cj [ �` Pager--of—-- 6- J CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hoar Inspection Line- 639-4175 Business Phone: 6394171 Date Requested: 5 — q -, qj_ _ A.M. _--_- P.M._T.---- MST: Location: /QeZ C,Q, l - —� BUR Tenant: . Suite: Bldg: NEC: Contractor: li CANJ Phone: _5 7/ �_ PLM: Owner: Phone. _ — ELC: G F.LR: _ _ __ SIT: BUILDING BLDG(coni) _- PLUMBING MECHANICAL ELECTRIC SITE Site Post/Beant Post/Beam Pf.)A/Beam Cover ervice Sewer/Storm Footing Roof UndFl/Slab -Loueb-ln Ceiling Water Line Slab Framing Top Out Gas Line Rough-lu UO Sprinkler Foundation Insulation Sewer i Iood/Duct Rcconnect Vault Bsmt Damp I)ywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Iain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Ur I Teat Pump wVol _ Approved Approved Approved pprovml Approved z Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved FINA1, FINAL, FINAL FINAL )6i k4L- C1 Call for reins O Reinspectio fee of S� required before next i~ -*:ction 0 Unable to inspect Inspector: U ��— / � _ Date: Page __—of_ --- CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 ELECTRICAL PERMIT - RESTRICTED ENERGY PERMIT #: ELR98-0125 DATE ISSUED: 04/29/98 PARCEL: 1S135AB-03400 SITE ADDRESS. . . : 1O26O SW G REENBURG RD #710 SUBDIVISION. . . . :LINCOLN TOWER-TOWN OF METZGER ZONING:C-P BLOCK. . . . . . . . . . .. LCT. . . . . . . . . . . . . =014 JURISDICTN: TIO Project Description: Instr,lling data telecommunications system A. RESIDENTIAL----------- B. COMMERCIAL----------------_--_______________.__-__ .IUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . : BURGLAR ALARM. . . . ; BOILE:P. . . . . . . . . . .. LANDSCAPE/IRRIGAT. . : GARAGE OPENER. . . . : CLOCK. . . . . . . . . . . . MEDICAL.. . . . . . . . . . . . .. HVAC. . . . . . . : DATA/TELE C:OMM. . : X NURSE CALLS. . . . . . . . . VACUUM SYSTEM. . . . : FIRE Al-ARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: : : HVA,.. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : INSTRUMENTATION. : OTHER. . : TOTAL. # OF SYSTEMS: 1. Owner: ------------------------------------------------------- FEES -- --- -- KNICKERBOCKER PROPERTIES INC type amount by date recpt 10300 SW GREENI31JR1 RD PRMT $ 40. 00 B ID4./29/98 98--30537; STE 200 SPCT $ 2. 00 B 04/9/98 98-305373 TIGARD OR 97223 Phone #: 452-5900 Contractor: -____.___....______._.____._.__._.-•----------------------._.__------_._._--.-----___-_ NETWORK CONNECTORS INC $ 42., 00 TOTAL PO BOX 5361 ------ REPUIRED INSPECTIONS ------- OREGON CITY OR '37045 Ceiling Cover Low Voltage Insp Phone #: 550-7748 Wall Cover Elect' l Final Reg #. . . 69942 This permit is issued subject to the riVulations contained in the Tigard Mun,_VAI 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 IN days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule adopfed by the Cregon Utility Notification Canter. Those rules are set forth in OAR 952-01-N10 through OAR 952-901-M. you may obtain cope sot these rules or dir@ek questions to OUNC at (563)246-1987. Tssl.led bY�._'1 "v����.�--�.� Permittee Si gnat `._ ------ -- --------------------OWNER _______ ._-_.-______________OWNER INSTALLATION The installation is being made on property I own which is not intended for wale, lease, or rent. OWNER' S SIGNATURE: DATE: INSTALLATION ONLY --- -- ---------------_______..... S I13NATURE OF SUPR. ELEC' N: DATE: i LICENSE NO: +++i•++++++++++++++.•f+++++++++++++++++++++++++++++++++++++1.........(-+.f-.4............ Call 639-4175 by 7:00 P. M. for an inspection needed the next business day ++++++++-f++++++++++++++-1F++++++•f•++++++++++++++4+++++++++++++++++++++++++++•1•+++++ CITv'OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd btr: 13125 SW HALL BLVD Date Rec'd._ TIGARD OR 91223 PRINT OR TYPE 17 V- 50,13-639-4171 X304 Permit# F- 503-684-7297 INCOMPLETE OR ILLEGIBLE APPI-ICATIOI4S Cust.Call d.-- WILL NOT BF ACCEPTED Name of Development Project e TYPE OF WORK INVOLVt:D RESIDENTIAL ONLY, y. ,/J Restricted Energy Few...'.... .• ......•••• $40.00 L/l`--SL (FOR ALL SYSTEMS) JOB Street Add•ess Ste M rhea Type of Work Invnlvee ADDRESS O�1'e SWC /fbtloi,>t,;it/ Il r, City/at�tttL� t7✓L p tZ3 PhoneM Audicand Stereo Systems - Name �J 0 Burglar Alarm KfJICK�-lZdot Yw;L fit0✓�fi�7i 1+N�L� GsrapeDooropener- OWNER MsilinpAddresis �¢ r r } 'r h✓ 464T 4 OZ Heating VentNa;lan and Air Conditrcning System' fy/State hone N ^„ C,47t4l Vacuum Sysl ams- Irk ms- Niill,vl�� lYlv�jGr IV1�l/ / r-1 ohwr_ -- CONTRACTOR Mailing Address 0 �ox j TYPE OF WORK INVOLVED-COMMERCIAL ONLY (Prior to issuairce,a CNyistate �rip�A'L Phone-1— Fee for each riystem.. ....................................... $40A0 copy or all Irxnsee l "C17y � r ry S5 h (SEE OAR 918-260250) are required N Oregon Contr.Brd Lie N .xp she eyp red in C 0 T, 6A(qikZ - Check Type of Wcrk Involved dare base) Glectrical Contr.Lit.N _ xp.Date 3�3L W 1 6 c7 1:1 Audio end Stereo Systems C O.T or Metro Llc.N Exp. Date O Boller Controls - — — Owner's Name -- T ❑ Clock Systems OWNER- Ma:rig Addle9s APPLICANT 111 Data Telecnrnn,ur.lceticn Installation City/State lip Phone M F,re Alarm Installation Th s permit is Issued uncer OAF 910-320 370 This applicant agrees to make on,y restricted energy nstallations(100 volt amps or lest)under this HVAC permit and to do the roiicw ng InstrumentaU.cn Cnly use e�,!ctresl licensed persons to do Inst,llatlons where required f--1J Certain residential and ogler rransar �•m l ons are erpt from licensing IInterrom and Paging Systems lhase have asterlsKs(') Aft others need licensing, [-- Landscape Irrigation Contrcl' 2 Can far,rspechons when installation under this aerrW are ready for nspec:tic,t at 603.639.41'5; [7, Medical 3. Pwrrtase separate nerr7tks for All Inatalfeticns that are not ready for an Nurse Calls insoeclic n when the nepector is out to Inspect under this permit. 4 Assun•e -espons bility for asswirq that a I corrections rectulred by the Outdoor Landscape Lightirg' inspector-to done,end; ❑ Protectrvs Signaling 5 Aseume,esponsib,lity'or rallirg for a final insGectinn whey all Ythe ❑ correc'lons are co 1pleted ot=ter�, ----,---.. Femlits are non-tronsrerable and non-refundable and syoire if works not stoned wL•hin 180 days of Issuance or if work 1•-usoerded fo•180 days Numhcr cf Systems The parser,signing for this permit must be the applicant or 6 penen Vr Ilrreriw tee required Licensee a•e requited for so ctner installations authorized to bind the applicant ENTER FEES =_ Siva. lure 5%SURCHARGE.(.06 X TOTAL AOOVEI 6 Authority if other than Applicant TOTAL : r`< , i`dsls resole dcc 719? i,U01�] (INy'.)LI, d0 l.l.f.; U461 S65 I:US CFM F.4 'Ul 1131! v6 67 t(1 CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hall Blvd., Tigard, OH 97223 (503)639.4171 RESTRICTED ENERGY PERMIT #: ELR98-0128 DATE ISSUED: 05/06/98 PARCEL!; IS135f)B-03,400 si,rE ADDRESS. . . : 10260 SW GREENBURG RD #710 SUBDIVISION. . . . :LINCOLN TOWER-TOWN OF' METZGER ZONING:C—P BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :014 JURISDICTN: TIG Project Description: Installing additional data telecommunications system 0. RESIDENTIAL---- B. COMMERCIAL-------------------------------------------- AUDIO & STEREO. . . : AUDIO A. STEREO. . : INTERCOM & PAGING. . : BURGLAR A1-..ARM. . . . : BOILER. . . . . . . . . . : LANDSCAPIE/IRRIGAT. . : GARAGE OPENER. . . . - CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . . HVAC.. . . . . . . . . . . . . . DATA/TELE CAIMM. . : X NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . . . : FIRE Al-rRM. . . . . . . OUTDOOR LANDSr- (-.(TE: OTHER: HVAC. . . . . . . . . . . . . PROTECTIVE FIGNPL. . INSTRUMENTATION. : OTHER. . : TOTAL # OF SYSTEMS- I Owner: FEES ----------- NETWORK CONNECTORS INC type amoiknt by date reept PO BOX 5361 PRMT $ 40. 00 DEB 05/06/98 98-305515 OREGON CITY OR 97045 5PCT $ 2. 00 rEB 05/06/98 98-305515 Phone #: 650--'748 Contractor: NETWORK CONNECTORS INC $ 42. 00 'TOTAL PO BOX 5361 REPUIRED 1NSFIECIIONS ------ ORE=GON CITY OR 97045 Ceilinq COV(?V- Low Voltage Insp Phone #- 650-7748 Wall Cover Flect' l Final Reg #. . : 69942 This permit is issued subject to the regulations contained in the Tigard Municipal Code, Sta-;e of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This Hermit 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 rec,uires you to follow rule adopted ty the Oregon Utility Notification Center, Those rules are set forth in OAR 952A*1-0010 through OAR You may obtain copies of these rules pf dirlek questions to OLK at 1503Q4-1987. P e r in i t t 0 e Si 9 r a t U r P I s s i-i e d �4QLo ------------------------------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 INSTALLATION S13NOTURE OF SUPR. ELEC' Ns .)A"rE- LICENSE NO: ..................4....................4.........4-+++4.............................. Call 639-4175 by 7s00 P. M. for an inspection needed the next busines day ++++4-+4.................................4 *+++ 4-++4-++#-44 -1......4..................... CITY OF TIGARD RESTRICTED ENERGY FLECTRICAL APPLICATION Recd by- 13125 y'3125 SW HALL BLVD Date Recd: ^ TIGARD OR 97223 PRINT OR TYPE Permit#: LC,�j' L V- 503-639.4171 X304 F - 503-684-7297 INCOf,APLt.I E OR ILLEGIBLE APPLICATIONS Cus1 CaII'd;—. -_ WILL NOT BF.ACCEFTED Ne , of Development Rrolect TYFE OF WORK INVOLVED -RESIDENTIAL ONLY Rettrictsd Energy Fat....................................... $4v 00 �j/ilrf JJI^ GJ l"S L _— (FOR ALI.SYSTEMS) JOE Street Address Ste M ADDRESS t)J (VO S d �j, �VOU /t L Chock Typo olWork Involved Cit 41110t i 7 Phone N Audio one Stereo Systems — r�ama aurglar Alarm L,1 J /) OWNER tAeilinq Address Garage Door Open!r' City/s!ste Zip Phun�^!i U Heating,Ventoo;lon and Air Condihcninq System' Name I/ vacuum Systems' Other CONTRACTOR MahlegAodres 3(,�I . >( TYPE OF WORK INVOLVED COMMERCIAL ONLY IPnrr 10'stuance a City'sill � Pnene 0 Fee for each system..._............................... ..... $40.00 copy o'sit nxn! t /( f ,�5 (SEE OAR 918.280-280) are fow,ed 11 F Olegon on r rd Lica Exp. Date exp res C O T �.� �� Z Check Type of Work Involved rale base) Electrical Conlr. LIC.N ExF. date 3/ 3C L Audio and Stereo Systems C O T or Melrc Lic.N Exp bate Boller controls Owner's Name Clock systems OWNER- Mb,,n'Address APPLICANT Data Telecommunication installation Cily/5tste Zip Phone x Fire Alarm Inttellat;on Th s permit is issued cancer OAE 918.320.370. This appl,canl agrees to - ❑ make omy restricted energy installations(100 volt amps or res ender this HVAC parmil one to do the follow ng. Q Instrumentation Only ise Pcocel'licersed persons to 90 Installations .+acre required Cenam denttsl and ovier!ranascl ons are exempt fro.-:sensing. 0 tntercom end Paging Systems These +asiensxsl'1 All others need licensing Llndscape irrigation Control' 2 Cali f: .pacMons when,nstalletlon under tris permit are ready for nsaec rn at 603.639-4175; Modl;al 3. Pwcnase soparate porrlsils for all Ins!allalicns that are not ready lot on Nurse Calls inscecl:on when the,nspeator is jut to Inspect under this perm8: 4 Assun'e -esponsib9lty for ossurirg that sa corrections reduked by the Outdoor Landscape Lighting' insoector are done and; Protw,,ive Signaling 5 Assume responslb-Gly for colorg for a Mal inspection when all of the tr;,rectlons are completed. Other re-its are non-usns'erab:e slid ncn-refundable and expire it work is not slar,pn M'h,n 180 days of issuance or If work is susjenced for 180 days. Number of Systems The perscr slgring for this perms must be the appheant 01 a person 4o hearses are required, Licensee a'e rewred for at other instollowt ouiho,-zed to bind the applicant — F l;R55 ENTER PFFS f_ i 5.6 SURCHARGE(05 x TU-,'AL ABOVE) li Aorlty II other than Applicant TOTAL utt• >< �� 'dsls.res(ile dcc 7/IT (u? 01 !)LI. 20 U. 6961 989 COV 0A C9 01 113.e 46:67. to CITY OF TIGARD BUILDING INSPE(17ION DIVISION 24-Hour Inspection. Linc: 6594175 Business Phonc: 6394171 Date Requested: _ S Z;; 2k __-- A.M. -- 1'.M._ — -- MST: Location: /0" U `9r'eaBUP: _ Tenant:_ �,¢Lt,� a �� Z�PSuite: 7/© Bldg: &MC_— Contractor:—� ��__�S�nL4,C�_ Phone: _.6,fO - 774LV PLM: Owner:_ _ — Phone: -- —� ELC: —_--- – ----------- El R: 7 d -0/2 SIT: BtTfi ING BLDG(con't) PLUMBING MECHANICAL 1TIff—TkmlAt SITE Site Post/Beam Post/Beam Post/Beam ice Sewer/Storni Footing Roof tJndFI/Slab Rough-In Ceiling Water Line Slab Framing Top Out Lias line Rough-In 110 Sprinkler Foundation Insulation Sewer Iloud/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Thain A/C DJC;Slab Shear/Sheath Fire Spklr/Alm Crawl/round!r Heal Pump t Approved .— Approved Approved Y /1tM,mved �Approved Appr/Sdwlk Not Approved Not Approved Not Approved �- ved Not Approved w FINAL FINAL FINAL IN FINAL Ice- ' /�►�_` -- Oar/V'I L�,1f 5�--- — C3 Call for reinspec ' /1 C7 RJns 'on fee off-- required before next inspection C3 Unable to inspect Inspector —: / ! Date: S• : CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4971 i - '' BUP -C� Date Requested c l AM PM BLD _ Location ��� ^' �� / Suite ��_ MEC Contact Personf'n,, r Ph i-M tt4 Conr GIGV1,�c�,k,L Ph i .�3t7' : ( SWR BUILf71� Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS — Fig Drain SGN Crawl Drain Inspection Notes: --- Slab ' SIT _ Post&Beam d Ext Sheath/ShearT`^-�� G —_ Int Sheath/Shear Framingming 7 Insulation 9x'& � r Drywall Nailing 1� l Firawall Fire Sprinkler �_1L� '� U ��(; Fire Alarm Susp'd Ceiling _. L_ k Roof Mis : — SS PART FAIL —_¢- VCWBING 1. — A/so / S(7-0-1 Post& Beam Under Slab_ Top Out Water Service Sanitary Sewer �. Rain Drains Finn' PASS PART FAIL MECHANICAL 1 p Post& Beam Rough In �'� �— ] LA_,Q Gas Line Smoke Dampers Final — — PASS PART FAIL ELECTRICAL — —�`- Service ►� �- T``� l_ PIS( " Rough In UG/Slab Low Voltage Fire Alarm -- Final PASS FART FAIL --- SITE LC �� ' � � - - 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 [ ]Please call for reinspection RE:— [ ]Unable to inspect-no access ADA (; Approach/Sidev.alk Date 1� Inspector ► z EXt----� 1"] Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITYOF T I G��R D __.CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP7.003 00053 03 1;125 SW Hall Blvd., Tigard, OP. 97223 (50,)1639-4171 DATE ISSUED: 5A PARCEL: 1 1S1 S1s�A6-03400 ZONING: C-P JURISDICTION: TIG SITE ADDPESS: 10260 SW GREENBURG RD 710 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER BLOCK: LOT:014 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2FR OCCUPANCY GRP: B OCCUPANCY LOAD: 12 TENANT NAME: FARMERS INSURANCE REMARKS: Adding 1256 sq. ft. to existing tenant space. Owner: EOP LINCOLN, LLC 10260 SW GREENBURG f; SUUITi-44 100 pR 972 P Pone NO$92-250t7 23 Contractor: 234-6617 C SCHIEWE+ ASSOCIATES 1024 NE DAVIS PORTLAND, OR 97232. Phone: 234-6617 Reg#: LIC 54105 This Certificate issued 3/1(,/21)04 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliar ce with the State of Oregon Specialty C d_es fort a group, occupancy, and use nder which the referenced permit wa Tr tL BUIL-DING INSPECTOR BUILDING FFICIAL _ POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) F.39-4171of Received`3/� ?t S� Date Requested 3 APA —__ PM _ BLIP _— Location ---- In � �1 QJA � ` uite—�/ - MEC Contact Person _ —_ —__ Ph 03 PLM Contractor Ph f__—) SWR —_ BUILDING Tenant/Owner •ELC Footing � --�-�--�-7`-- ELC Foundation Access: _- C1 �-- Ftg Orr. ELR Crawl Drain ____ Slab Inspection Notes: SIT _ Post& Beam -_—_.__ / 0 Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- Insulation Drywall Nailing -- — -- Firewall Fire Sprinkler - -- — Fire Alarm Susp'd Ceiling --- Root 0 her- Final SS PART FAIL -- -- -- ---L BIN_G st&Beam Under Slab -- —}—- ----- Rough-In I ,/ Water Service _T_ + - Sanitary Sewer Rain Drains _------- Catch Basin/Manhole i Storm Drain ---- - — Shower Pan Final —� FASB PART FAIL -- --" ----__.___ --- ---- MECHANICAL - Post&Beam Rough-In - Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART F;'L SITE ] Please call for reinspection RE: -_—. Unable to Inspect-no access Fire Supply Line ADA Dote_�/ �. Inspector __ �' � Approach/Sidewalk Other: Fina! DO NOT REMOVE this Inspection racord from the Job sits. PASS PART FAIL ITY QF TIGARD 24-Hour BUILDING Inspection line: (503)63 115 I;'JSPLCTiON DIVISIONMST Business Lin is (r03) - - ZatPP requ stedReceived42 BUP Location — Q Suite___ __._ MEC Contact Person Ph(-- -- ) 3y �~ n�S�:�' `LM - -_- ------__--- Contractor _ Ph(_____ ) ___ __._ SWR BUILDING_ Tenant/Owner - � ---- - ELC ---- - Footing - Foundation -- ELC - -- Ftg Drain Access: ELR - Crawl Drair Slab Inspection Notes: �., SIT Post&Beam — -_ Shear Anchors Ext Sheath/Shear -- Int Sheath/Shear Framing - - - - — Insulation Drywall Na;ling - - - -- Fir wall - Fire Sprinkle - - - - — - � RfeTrTr Susp'd Ceiling' -- 719 Roof Final _ r A - S_S PART FAIL -- - -- L NG Post& Beam Undar Slab -- - Rough-In — A - Watei Service ----- -- Sanitary Sewer Rain Drains - - - Catch Basin/Manhole Storm Drain ----- Shower Pan Other:_ __ -- - --- --- ---- _---- Final PASS _PART _FAIL -_---- __ _-__-- - ------__---__ MECHANICAL Post&Beam -- Rough-On - - Gas Line Smoke Dampers -- --- ----- ---- _-._ -_ Final PASS PART FAIL -- - ----- - ..---- - --- ------ -----.-_ ELECTRICAL Service Rough-In rJ(U/Slab ------------- Low Voltage ---� --_—.---- _. .......-------- - Fire Alarm --.-- Final Reinspection fee of$--- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE n Please cull for reinspection RE: _ - __ Unable to inspect -no access Fire Supply Line ADA / f > Approach/Sidnwalk Date _ 1 d Inspector ^ (/ Ext Other. Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TI1.2"ARD 24-Hour, BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Busin Line: (503) 639-4171 BAST '3UP Received 3 3Date Requeste -_IiA_ AM _ PM_ __ _ BUP Location 1 D Z v—..^_ _�_ _Suite _--. MEC __- Contact Person 6-')''� P O _D�_.__ , - PLM ---- --- Contractor_ ---- Ph ( ) _ SWR BUILDING - Tenant/OwnerTLC Footing Foundation Access: �r ELC f tg Drain � -'T'd.l.,c._Q C,.Lo 5� � -H YA I-� c, ��� ELR Crawl Drain Slab Inspection Notes: l/,{� SIT 4 _ Post&Beam -_ �� �Q 3 " / Z-" Z Shear Anchors Ext Sheath/Shear TU Int Sheath/Shear Framing Insulation Drywall Nailing - - --- - _ - - - -- Firewall Fire Sprinkler - - - - - - -- - Fire Alarm Susp'd Ceiling - - 4; --- - - - - Roof Other: - Final _PASS PART FAIL - PLUMBING ___ Post& Beam Under Slab P.ough-In Water Service ---- Sanitary Sewer Rain Drains - - Catch Basin/Manhole Storm Drain --- -- Shower Pan Other: - -- - - - - -- - - - Final PASS PART FAIL MECHANICAL Post J%Beam - Rough-In Gas Line Smoke Damoers Final PASS PART FAIL - ------ -- - - --- ELECTRICAL_ Service - - - - - Rough-In ------ UG/Slab Low Voltage L rn FiniiiL. l Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: Unable to inspect-no access Fire Supply Line �71 ADAApproach/Sidewalk Date -� � Inspecfor � �✓�� �_ Ext__ Other: Final DO NOT REMOVE this inspection record froA the job e. PASS PART FAIT_ CITY OF TIGARD 24-hour BUILDING inspection Line: (503)639-4175 MST' INSPECTION DIVISION Business Line: (503) 639-4171 ���� BUP Received `��-�1 -J__-S�Date Reauested C AM— _.._ PM — e-P ------------ Location --��[� _--_ Suite _ MEC ---- —___ Contact Person —_, / �_� --- -- Ph( ) — / PLM _. Contractor lL[/�-�.0 �'- ---_ Ph(_� -- WR BUILDING Tenant/Owner Footing -- ELC _. Foundation Access: Fig Drain ELR Slab Crawl Drain Inspection Notes: - SIT Post& Beam Shear Anchors Ext Sheath/Shear - Int Sheath/Shear — Framing - --- - - Insulation Drywall Nailing - - - -- Firewall Fire Sprinkldr - -------�._------ Fire Alarm 5ubl.'d Ceding Root Other Final PASS PART FAIL. - Post& Beam Under Slab Rough-In Water Service - - -- -- Sanitary Sewer Rain Drains - --- - - - Catch Basin/Manhole Storm Drain - - - Shower Pan —_— Other: --- Final PASS PART FAIL MECHANICAL - Post& Beam Rough-In Gas Line Smoke Dampers - - -- - Fwal PASS PART FAIL ELECTRICAL ---- Rnrvice Rough-In - - -- - - -- UG,Slab 1 ..w Voltage --- --— ---- --. F nn na Reinspection fee of$_.-_--_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 11170S PART FAIL ----- Please call for reinspection RE: __ Unable to inspect- no access _- - -- - - -- __ 'J Fire Supply Line ADA 3 ./ -� k-71. Ext Approach/Sidewalk Date —. Int�pector - - Other: _ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST ---_-___- _---- INSPECTION DIVISION Business Line: (503)639-4171 BUIP Received - ? P to Requested AM--- _.-_-- PM -_-__-- BUP Location L �2�O�_._____ Suite—__7111_ MEC Contact Person -___._.-_ -J T ��U <'�'h ( , __1�l2-_l PLM Contractor-------- -- - Ph (- ) - — SWR --- - - -- - -- BUILDING Tenant/Owner _- - - --__---- — _- ELC Footing ELC -- ----..__-- Foundation Access: p y Ftq Drain ,rawl Drain Slab Inspection Noles: � SIT Post&Beam ------ '� -� Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ---- Insulation Drywall Nailing -_ -- _— — — ------ - -- -- Firewall Fire Sprinkler — ---•-------- -----------------_- _ Fire Alarm Susp'd Ceiling - ---_ -- -------__- - Roof Other: Final PASS PART FAIL - � PLUMBING -- -- -------- _--- _.. Post&Beam _ Under Slab --- -- ----------- -- -- Rough•In Water Service ---..--- Sanitary Sewer Rain Drains --- - ---_-- ---— Catch Basin/Manhole Storm Drain - -- -- -- - - ---- Shower Pen Other:__ ---- -- - -- - --- Final PASS PART FAIL MECHANICAL_ _ - Post& Beam Rough-in - Gas Line Smoke Dampws, - - - Final PART FAIL TIIL!�CT:0 I —--- - - Rough-Ir. - UG/Slab Low Voltage FWLAIarm al PART FAIL L J Reinspection fee of$ -_required before next inspection. Pay at C!ty Hall, 13125 SW Hall Blvd. Please call for reinspection RE: Unable to inspect-no access Fire Supply Line 1 ADA - Date tta - �z. - - - -- 111spselOr Other Final n0 NOT REMOVE this Inspection record from,he Joh 91to. PASS PART FAIL 1 _ BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2003-00053 DEVELOPMENT SERVICES DATE ISSUED: 2/5/03 13125 S!M Hall Blvd..Tigard, OR 9722.3 (503) 639-4171 PARCEL: 1 S135AB-03400 SrrE ADDRESS: 10260 SW GREENBURG RD 710 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P BLOCK: _ LOT: 014 _ _ JURISDICTION: TIG REISSUE: FLOOR FLOOR_AREAS _ EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST. sf N: _ — S: E: W TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 2FR sf N:u S: E W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 12 BASEMENT: sf AREA SEP. RATED: ;iTOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: R_EQD SETBACKS _ _ REQUIRED_ FLOOR LOAD: nsf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 5}000.')li Remarks: Ac Owner: Contractor: EOP LINCOLN, LI-C C SCHIEWE + ASSOCIATES 102603W GREENBURG RD 1024 NE DAVIS SUITE_ # 100 PORTLAND, OR 97232 PORTLAND, OR 97223 Phone: 892-2500 Phone: 234-6617 Reg #: LIC 54105 FEES i REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require Electrical Permit Required flit ILD] I'ernut Fee 2/5103 $91.30 Framing Insp FAX] 8',,,State Fax 2/5/03 $7.30 Gyp Board InSD IIt JPPLNj 111n Its 2/5/03 $5935 Final Inspection I1:1 S1 FLS Pln 16 2/5/03 $36.52 Total $194.47 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 it work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATT ENTION: 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 952-001-0100. You may obtain a copy of these rules or direct questinns to OUNC by calling (503)246-6699 or 1-800-332-2344. Issued By: — Pe rm ittee Signature: Call 639-4175 by 7 p.m. for an inspection the next business day Builain — r% t A�plieatiun Received Building ^^ - Date/By JA-5—03 �� Perritt N_o.-1 100 3 -00063.1� Of 1 1 and Planning Approval Other City g Date/BY: __ Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No. Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use Dale/B _ Case No. Internet: www.ci.tigard.or.us Contact �� Juris.: N Seepage 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: New construction JDemolition _ 1 Ar 2 f�AMILY DWELLING Addition/alteration/replacement Other: _ CATEGORY OF CONSTRUCTION Note: Permit lees"are based on the total value of the wvrrk performed Indicate 1 &2-Familydwelling Commercial/industrial tht.value(rounded to the nearest dollar!ofall equipment,materials,labor, —_ - ovenccnd and profit for the work indicated on this application. Accessory Building +11 Multi-Family Master Builder Other: valuation............... .... ......................... . _ JOB SITE INFORMATION and LOCATION No.of bedrooms: - No,of baths:_-- Job site address: 10260 SW Gr aen6ur (to Total number of floors.. ............................... .. _ —LW�0 rowel New dwelling area(sq. fl.) ...I.........I......... Suite#: �O Bld ./Apt.#. _ _ WeR' Garage/carport area(sq. ft I Project Name: :V v i r►Sf�l'i1rtC� Covered porch area(sq tl l -......................... Cross sireeUDirections to job site: Deck area(sq. ft.).. . _......•................. Other structure arca try H i _. ..... REQUIRED DA'I A: COMMERCIAL-USE CHECKLIST Subdivision: Lot#: Tax map/pare I #: Note. Permit Ites•are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overheau and profit for the work indicated an this application Valuation...................... ... S.5 000. --- - - - - Existing building area ft.)...... _ v - -- -- —- — New building area(sq. ft.).......... .. . ... . ... S Number of stories..... . ... ......... ...... ......... "r PROPERTY OWNER TENANT Type of construction.......................... ........... Name: EQUITY OFFIG6 P(t, ellt-TIES Occupancy group(s): Existing: _Address: 107.&0oo sW GreeHb ►' �S� 160 New: Cit /State,'Zi ortia►� OF-"' . 9 223 -- ---"�--�-- NOTICE: All contractors and subcontractors are required to be Phone:�3 892-25e0 Fax: licensed with the Oregon Construction Contractors board under APPLICANT I E1 .CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: 6W 1 ,ThG, jurisdiction where work is being performed. If the applicant is exempt Contact Name: F-ay ft- G ur from.icensing,the following reason applies Address: 9'ZOSk-tl Sut1fie ¢t oo - --- - - --------__--- Cit /State/Zi : fort a 0P-. - — Phone:503 2'- -9(o6ta Fax: - -- - __--_--_ BUILDING PERMIT FEES* E-mail: _ Please refer to fee schedule. CONTRACTOR - —— — — -- Business Name: G. S i t,.e, Gov►J Fees due upon application................... Address: (07A. NE Davi.r Xt- Cil /State Zi or PE. 9 2"b2 Amount received..................................... ..... Phone:5a_b ZZ -fofol Fax: _ _ Date received:___— _ CCB Lie. -_--_— Authorized �r Notice: Thts permit application etplres If a permit 13 not obtained selthin Signature Date: '1.9.03 190 dors after It has been accepted as complete. P.. •Fee methodology set by'rrl-('ounh Building Induclry Sen-ice Board. (Please print name) is\Dsts\Perrmt Forrns\llldgPcrmitApp.doc 01/03 avM�vf� �►1sUr�•,c� �J o• , L-.T- 71 C) z9 v 3 i Accessibility: Barrier Removal Improvement Plan �'rl►• u) %Y�urd I 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, lel^phones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations 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 eKA excluding painting, wallpapering. mutt qty;. 25% Barrier removal requirement. _ —25 BUDGET FOR BARRIER REMOVAL [2] $ In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the gioatest access Elements shall be provided in the following order: a- (a) Parking lot►el4ifT4. r;tewQrk-rela�;.�-F, $_ O. — -- acce.r,;41� IJ (b) (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: $ (f) Accessible drinking fountains: and $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL: Shell e_yual line.2 o(_Veluc_Com.puta--tion $ i Asts4omsWccessibiflty dtk OW07102 CITYOF TIGARD _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-00077 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/24/04 PARCEL: 1 S135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 710 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P BLOCK: LOT: 014 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 SY STEMS: STORIES: BOILERS_/COMPRESSORS HOODS: _ FUEL_TYPES0 - 3 HP: Y DOMES. INCIN: I PG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= '10000 cfm: — > GAS OUTLETS: 10000 cfm: Remarks: I IV,1(' nuidifiwnin i _aI) ;uul ranuNc crutis nmc suPhly and relocate grill,,. Value: $4.200 Owner: F Y FEES_Y KNICKERBOCKER PROP, INC XXIV Description Date Amount BY NORRIS, BEGGS + SIMPSON --- — _ 10300 SW GREENBURG RD STE 200 IML:C'IIJ Pcrnnr I cc 2/24/04 $123.10 PORTLAND, OR 97223 TAXI H°i. tilutc SmLlwit 2/24/04 $9.85 Phone: Total __ $132.95 Contractor: AMERICAN HEATING INC 1339 SE GIDEON STE 1 REQUIRED INSPECTIONS _ PORTLAND, OR 51202 v Phone: 239-400o Mechanical Insp Heating Unt Insp Reg#: LIC 33135 Final Inspection This permit is issued subject to the regJations 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'nrill 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 .00 Issued By: G-t��,� LL _CL Permittee Signature: r / Call (503) 639-4175 by 7:00 P.M. for inspections neeAtienekiebusiness day McKhanical Permit APPlic�ltioll IPRceivedPentt Nu.Cit ul"I'E/and r� �: �Y. Fa Da"' y t� 13125 SW Hall Blvd.,Tigard,OR�9'l�t Plan Revie Phone: 503,639.4171 Fax: 503.5598.)960 Date/By: J1hcrPermic Inspection Line: 503.639,4175 r[[ 1 U�h Date Ready/By: Ions ® Sec Page 2 for Internet: www.ci.tigard.nnus [L� Nnlifie"iethod: Supplemental Inrormation AHL tY471eF,`�'116tC7-- COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees are based on the value of the work ❑New construction Addition/alteration/replacement performed. Indicate the value(rounded to the nearest dollar)orull ❑Demolition []Other: mechanical materials,equipment,la overhead,and proftl -- Value:S it�0 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMFNT/SYSTEMS FEES" ❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special inJar•nlruion use checklist ❑M llti-family ❑ Master builder ❑Other: Description Qty. 13a. Total JOB SITE INFORMATION AND LOCATION Hcatin cooling / Air conditioning or h at pump Jobsite:,ddress:zado sw 61- (requires siLe ,planshowing placement) 14.00 City/State/Z1P: Furnace 100,000 BTU(ducts/vents) 14.00 --zr��I d, --- Furnace 100,000+BTU(ducts/vents) 17.90 Suite(bldg./apt.no.: 7/0 Project name:%Tc�f ri> >c'rL Gas heat pump 14.00 Cross sireet/directiont to job site: .,7 i ,:e r ct f,c'G Duct work 14.00 -- Hy dronic hot waters stem 14.00 Residential boiler(radiator or h dronic) 14.00 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 10.00 Flue/vent for any of above 10.00 Subdivision: Lot no.: Other: 10.00 Tax map/parcel no.: Other fuel a rlillances DESCRIPTION OF WORK Water heater 10.00 -� Gas fireplace _ 10.00 c/eor e,n'� -��// _ Flue vent rot water heater or gas fireplace _ 10.00 it rr"e�/� ! ` "�/GI _ ----- Log lighter(gas) 10.00 moll u_�_ T /VfI ✓ w _/rte-u,, Wood/pellet stove 10.00 Wood fire lace/insert 10.00 — C mne /liner/flue/vent 10.00 .'PROPERTY OWNER _�— ❑ TENANT --_ Other: _ I0.00 Name: f�� y� �jT-�,Jroj- /i r Environmental exhaust and ventilation Range hood/other kitchen Address: —�te^ c'0'r?1.1e.1,1111 /It ,/,fit_' a ui rnent — 10.00 City/State/ZIP. /-46", / Clnthes dryer exhaust 10.00 Single-duct exhaust(bathrooms, Phone: 6 7� -d? Fax:(s Z)671_W 7,?7 toilet compartments,utility roams) 6.80 APPLICANT CONTACT PERSON _ Attic/crawls ace fans 10.00 Other, I U.00 Business name: _:;4_1 2 "r_/ r r ,r,,,c t Fuel piping _ Contact name: yg ,1 — $5.40 for Ilrst four;$1.00 for each additional / Fumnce,etc. _ Address: +;`) 1''G ( /c rk CY,, �''T —_ Gas heat pump City/State/ZIP: Well/suspended/unit heater Water heater Phone: r%4( Fax::(.SG �� _" — Fireplace — E-mail: Range CONTRACTOR Barbecue _ Clothes dryer(gas)___ Business name: mfr/e7 a y� Other: Address: ' -�'C C'r, ,, -/ MECHANICAL PERMIT FEES* City/State/ZIP: r' � �f�, %:1 Suhtol■I Q _ Minimum permit fee($72.50) Phone:U?, ��'et- Fax:( �).?3a yl'3'L,' Plan review(25%of permit fee) CCB tic.: ,���/,.; — State surcharge(8%of permit fee) / _ TOTAL PERMIT FEE a r g ���= ,t7�/ .1'Ids permit sppllcatlan expires If a permit Is not obtained within 1R0 Authorize si nature: /5/'T/.�.//t. days after It has been accepted as complete. bate: /�;,,' t. �J e� Fee methodology sal by Ili-County Building,Industry Service Board i\Bullding\Permit+\MEC-PenmitAppdm I1103 440.4617Ttt1'02rC0WWER) --- BUILDING PERMIT CITY OF TIOARD PERMIT#: BUP2004-00067 DEVELOPMENT SERVICES DATE ISSUED: 2/25104 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AU-03400 SITE ADDRESS: 10260 SW GREENBURG RD 710 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P BLOCK: LOT: 014 JURISDICTION: TIG REISSUE: FLOOR: AREAS _ _ EXTERIOR_WALL CONSTRUCTION CLASS OF WORK: FPS �J FIRST: �sf N: S: E: W: 'TYPE OF USE: COM SECOND: sf _ _PROJECT OPENINGS? _ TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD- BASEMENT: sf AREA SEP. RATED: STOR: HT: ft (3 AGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _T:READ SETBACKS _ _REQUIRED_ FLOOR LOAD: psf LEFft RGHT_ ft FIR SPKL: v SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRn CORR: PARKING: VALUE: $ 510.00 Remarks: Relocate 3 and add 1 pendent fire sprinkler Owner: Contractor: EOP LINCOLN, LLC AFP SYSTEMS INC 10260 SW GRE ENBURG RD SUITE 10 19435 SW 129TH PORTLAND, OR 97223 TUALATIN, OR 97062 Phone: Phone: FAX-692-1186 Reg #: S E1F92-906003459 FEES LIC RECIOT $ INSPECTIONS Description Date Amount Sprinkler Rough-In tBUILUj Permit Fee 2/25/04 $62.50 Sprinkler Final 1TANI R State Surcharl 2/25/04 $5.00 Total $67.50 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OIR. 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 Centei. 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 1-800-332-2344. Issued By: Permittee Signature: Call 63 -4175 by 7 p.m. for an inspection the next business clay FEB-23-04 03:29PM FROM-Automatic Fire Protect un 5036921186 T-797 P 003/005 F-483 e e04 hK a UNA K4utig1n2 Permit _ 'on Received Building pate/B C _-Lesmit No.6409DJ40. 7 I City of Tigard Planning Approval Other —j f 1 009 Dat --- Permit CLAUe2DDA,:QQ2S-3 13125 SW Hall Bb d, Plan Review Other i Tigard, Oregon 97223 S ICi( Do WBy. _ Permit No,: � Phone; 503-639.4171 Post-Review Land Use (,rP'r Date/Sy: Case No. Internet: www.ci.tigard,onv*01i.O1 LContact — luns.: Sec Page 2 fur 24-hour Inspection Request; 503-639-4175 Name/method; Su Icmental Information �^ TYPE OF WORK — 'M4 DATA: -- [ New construction -_ ❑Demolition_ I t &2 FAW...Y DWL)LLtNG Additio ter,itio _replacement ❑Other: - — - -- CATEGORY OF CONSTRUCTION Note: Permit fees*ate based on the total value of clic work performed. Indicute �1 LSC r the value(rounded to the nearest dollar)of all equipment,tnateriais,labor, � 2-Family dwehin Conitnezcial dustrial overhead and profit for the work indicated on this epplfcrtfon. 1 "A_ccessory Building Nlulti-Famil [] IMasterBuilder Other: Valuation_ ............................. ................ .. .. s JOB SITE INFORMATION_and LOCA I N - No,of bedrooms No.of baths: Jub site address; 10 — -- Total number of Boors. _ New dwelling area(sq,ft.).............................. _ Suite#: I I O Bld Gartgetcruport area(sq. ft.)............................ L,rCrr_,,01L,e1, ct Name: .0jUV_ ae= �--w�.r . Covered porch area(sq.ft.)............................. sstreet/Dirertions to fob site: f Deck area(sq,ft).. _._ .................................. IC17t,.L1 1rwrlt_=tZ-> z1_1 �,�?�1�•1Q11 Other structure area(sq.it.)„ REQUIRED•DO-A: ;C9MMERC'IAL=USg 16ii0q.I t Subdivision: - Tax=2/parcel#' — Note: Permit fees'are based on the total value�f thv work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,ntatrrials,labor, � overhead androfit for the work it Jicatcd on this a P PPlication. • � 1 1 Valuation............................................ $ ` Existing building area(sq.ft.)......................... ----- -- — - — ---- - — New building area(sq,ft.) —� Number of stories............. �- ROPE TYIIWN•Ltt TEIYAN:T ,: Type of construction,,..,.., — -- Occupancy Rroup(s):,�l Existing: --- New: Address Lp�s„1�aZIA Ci /State/Zi ( Q, 9"I ZS Phone: �+�, NOTICE: All contractors and subcontractors err required to be licensed with the Oregon Construction Contractors Board under =APPLICANT CONTACT PERSON provisions of OILS 701 and may be required to be licensed in the Business Name- � /77 T L.1��1=1— ti,1L. Jurisdiction where work is being performed. If the applicant is exempt a ~ J from licensing,the following reason applies: Contact Name: ? 1 t_ o Address: 19d3S �u1 -- —._--- --- - - - ---- Ci /State/Zip' "� A��1� 97t�6Z - -- -- - -- phone: SDI>-( - E-mail: '(�`^ BtIII:DING•PIi:RMIT.•k'�lyS`• _�l��r i? J 1�J�.L1 I , 'Plea§e.� rWt'o 4e schedule Q U_ CTOR. 1 1 Business Name: A19� -::;r-f fly –el _�*L. ___ I Fees clue upnn application.............................. S Address: 1 .3 �40J_ Ct /State%J1 9 INN Z Amount receiv, S _ r I Phone: -22. 4 Fax: -��11 `p rate received: CCB Lir. #j -- l __- --- Authonzcd �� Nntice, This permit application oxplres if a permit Is not obtained wuhin Signature, _ 1 Date: IRO days after it has been accepted as camplrtr. r)llll �L(,a'a�til 'Fee methodology set by Tri-County Building Industn Service Board. (Please pant name) i\Dsts\Permit Forms191dgPermitApp doc 01103 CITY OF TIGARD 24-Hour BUILDING Inspection ' ' - (503)63x9-4175 MST __ INSPECTION DIVISION Business Line: (503 639-417* -�� —- / 14 BUP Receive7 _Date Requeste ' AM_.___ PM _.__-.____ BUP02& _ Location ---- -- ._ � -- Suite � ME — Contact Person ._ _ _Cldlll _ PI ( ) PLM Contractor - - - - _ ---__._-- - -- - Ph SWR _------ BUILDING Tenant/Owner __- _�s7 � _ _�_ ' ELC -- --_ Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - - - --- ----__ _ Insulation Drywall Nailing __ _----------------- - - - Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling Root Other: Final PASS PART FAIL - PLUPv'tBING Poet& Beam Under SlabRough-In Water Water Service -- --- - - -- - Sanitary Sewer Rain Drains - -- -�-— - -- - Catch Basin/Manhole Storm Drain Shower Pan Other: - Final PASS PART FAIL f -- -- -- -- - - MECHANICAL Post&Beam - Rough-In Dad- Gas Line Dampers ------------ — - -- _._ Final � PART FAIL - --- ------ — --- - -- -- ---- - FL CTRICAL�� -- -- --- Service -- Rough-In -------- ----- --- — -- - UG/Slab Low Voltage -_W.- - - --- - ----- — - — --- ----- Fire Alarm Final F] Reinspection fee of$— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE -- Please call for reinspection RE:.___. _ _.- Unable to inspect- no access Fire Supply Line ADA /1 Approach/Sidewalk Date_ '\/ �____. Inspector Ext Other: Final _ DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD ELECTRICAL - ENER RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00089 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/1/04 SITE ADDRESS: 10260 SW GREENBURG RD 710 PARCEL: 1S135AB-03400 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P BLOCK: LOT: 014 JURISDICTION: TIG Proiect Descrintion: Voice/data cabling install. A.RESIDENTIAL_ _ _ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: 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: J � Contractor: KNICKERBOCKER PROP, INC XXIV DRYER ELECTRIC INC BY NORRIS, BEGGS + SIMPSON PO BOX 86369 10300 SW GREENBURG RD STE 200 PORTLAND, OR 97286 PORTLAND, OR 97223 E(Rl?W1 1C0I_N; %C Phone: 503-771-5667 10260 SW GREENBURG RD Reg #: 11,E 26-1142C SUITE # 100 LIC 153466 PORTLAND, OR 97223 _ SUI' 28765 FEES Y Required Inspections Description Date Amount Low Voltage Inspection IFI]IRMT) FFR Permil 4/1/04 $75.00 Elect'I Final I A X J x Sate Surchaq 4/1/04 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will ba 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 throuc Issued by Per ittee 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'NDATE: _--- I C E N S F N O: I_ - ----__ Call 639-4175 by 7:00 P.M. fur an inspection needed the next business day City of'Tigard Received4 / � L �� Permit No.: 13125 SW Hall Blvd.,Tigard,Oit 9727.3 Date/l): --���-.. — --��,Zp/j�'Ob OPj9 Plan Review llama phone: 503.63 .4171 rax: 503.598.1900 • Other Permit - Inspecl,}•or lane: 503.639.4175 Date Readyflly: ►u,ir E'1 Sec Parc:for ` Internet: www.cl.tigard.orms Nilified/h1ethod: Supplementallnfurnnatiun ---•-- ----_....____,INPE OF WORK PLAN REYIE ' [.�New const uctioo -- De hd(ikon/tiltcrttion/rcpincctncnt ---------- please check all that apply:------ ---- L.I ❑Other: C]Scrn•ice over 225 amps,conun'I LlI laaardaus location Demolition `- []Service over 320 amps rating ❑Huildng over 10,000 sq.n., CA'i'E(,Oitl'.OG,CONS'I'RU TION - - or 1•and 2-family dwelling. 4 or more new residential F1 I and 2-family dwelling Comma ciAlhndustriat nAccessory builoiili), USystem over 600 volts nominal units in one structure [_)building os-cr three stories ❑recders,400 amps or more U Mtdti-lnmily 1]Nljw�irr hl ild r i_�Other: - []Occupant load over 99 persons ❑Manufactured structures or - ---- ---------------- JOB 5111 INFORMATION AND l,OCXHON ❑13gress/lighting plan RV park Jobnu.:OI��S� I JL,hStl udcrr�,:: �CC� S� GRCt�1bv C1Hcalih•carefacility Odicr:. --- _..__. Submit_L sets of plans with any of the Above. Cily/Stale/ZII': r• 04 r 1lie above arc not applicable to temporary construction service. FEE* f,ChIXDULE --- -- Suite/b g./apt.no.: 7r � 'rcnr.t n i�tu: Z• tit - .. Ce.JKYlaltjb+ �_/�.. I►eurlptlmn ----- --�Qly Frc:.J _Told—t.—_. Crass slrceUditectians to job site: • Ncm resltlnulinl shugle-or nnnlli•fnnnily dwelling unit. ------- includes Attached garage. _ 1,000 sq.1l.Or Icss 145.15 Subdivision: l.ot na.: Iia.add'I.500 sq.ft.or portion 33.40 I --- -- - Limited energy,residential - - 75.00 - Z- 1'ax tunp/parccl_no. - - - - Llndted energy,nonresidential 75.00 - 2 [-ach manufactured or modular--- - dwelling.,service and/or feeder 90.90 _ 2 Q4i{`1 _ Set•vicea_or feeders(nstollatlon,alterallon,and/nr rcincation 200 amps or less - - _80.30 -- 2 _--_ -_— _ l> 201 amps to 400 Amps I OG,85 2 o- _ . •L7 J"R(�I'EIi"hl''Kf'IVi�I�:�t„r:t ,` ��� �.`;,. ' -- ---- 401 Amps to 600 amps 160.60 2 -Name: 601 amps to 1,000 amps 2.40.60 2 Address:'-----_.. Over 1,000 amps or volts �--- -_ 454.65 _ 2 -- Zi_........-- -------- - -- Reconnect only 616.85 _ _ 2 City/State/7111: Temporary services or feeders tnslnllatiou,olteratlon,And/o• rax:( ) rrlocatlon ----- __-_-----_---_..____.-- -__-_-- -_----- 200 amps cr kss 66.85 1 Owner instAllAtlon:This institilation is being ninde an property thio i own which is not 201 amps to 400 Amps _ 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 Amps 133.775 --- 2 Owner signature:_ _ _ nate: — _ _-. Branch Hrcuits-new,nitcration,or extension,per panel UAPl'1 ICAN I' ( �Di�TA l�'��� A.pec fir branch circuits wth _ rt - t= service or redder fee,each Ituslncss nantc: branch circuit 6.G5 --------� ---- - - P.pee for branch circuits Contact panic: irithont service or feeder fe -------wlt�--�Ot�¢.�'---_ ---------------- -------------- --- 46.85 , Address: Po �o each branch circuit - --_ _._106-1_ L—.. —.—_____-- Each WWI branch circuit _ 6.65 2- City/stme/71p: panes Z hllscellAneous(service or feeder not lucladcd) t Pump or irrigation circle $3.40 2 S 66 lax: ( Su1 ) 77Y- �pI{(o —` — -- --- — --_----_ � -----_.- --_--_•- ------- _-- ----__._ Sign or outline lighting 53.40 2 I. mail: G'Md�.41 V,.C)f'y_ef' elta+ric . Car, — Signal cir:ult(s)or limited---- - - CONUAL-rOlt energy p•r»l,alteration,or ---------'------ extension.Describe: Page 2 2 Isusiness manic. aR .R 4;f tdC Address: Po (joy YrO 6 I Each additional Inspection over Allowable in Any of the above -- - --------___------------__ ____.__.__-- Per inspection - _ 52.50 City/State/�.II'_ p�Rf(�� OQ `glZ g(, - Investigation per hour(I hr min) _62.50 _ 1 Industrial plan)per hour _ 73.75 Phone-(0) )' I _S66> rax (3v1 )77q -iuYb _- Z;LECI'RICAi. P�Rr1IT rE • - _- M13 Lie.: �Z Metrical Lic.: Su rV.Lic.: 7 - - S3�6��- -- Z I I'1l C�l-----—�{r S _ ---- -- Subtotal -'�- Euprv.Flectrit tan signature,required: _ Pian review(25%of permit fee) +� Date: — State surcharge(8%of permit fee) Print name: —---`,ftp G;6b sL —--- � TOTAL PrRh11T PES f3 I Aul'•)rized Signature: This permit application expires it a permit Is not obtained within 190 days after it has been accepted as complete Print name: Date: • Fee methodology set by TO-Couniv Building Industry Service Hoard •'Number orinspec0ons per permit allowed. InAuindingV'amltsILC•PermitAppdoc I2/03 44M61S1'(I0ro21C0\VWE9 CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd,Tigard,OR 97223 (503)639.4171 CI-RTIFIC'ATE OF CICCJP,ANCY PERMIT #M. . . . . . . i f.+UP')A -N J.O, DATE ISSUED. 07/ 15/98 PORC.M.s 151 '35AP-03400 1 )k. AE)DRESS. . , s 10-:160 SW GREaE14 URB RCS N7 to 3UHbIVISION. . . . sL.INCOLN TOWER.- TOWN OF MFT'ZGER ZONING-C-P 'ILOCK. . . . . . . . . . s _JT. . . . . . . . . . . . . sC�i4 JlIF219DIC:TIONs TIG i i;LASS OF WORK. rfaLT YPE OFF USE:. . . s COM "YPE OF CONSTPr2FR )Cl' LIPANC;Y (-'iRP. r e )(XAjpANCY LOADA 80 +" .NANT NAM%. . . °lema�rl�4ia T) Now wa11s, doers etc. 1,;N11'.KERSUC:KE'.R F>PCPERTIES IIVC IJ NLIRRIS, BEGGS R SIMMON 10300 SW GREE NSURG RD M20v_I r IDARD OR 972'P'.;' 'Ione #Ir "I'DARLAKE GO :iMPLD EUGENE, BOYD t 3;:i !-AGH I N(31'0114 ST )(114CUIUVE R WA 9A660 Ph iiia *4; 360--694--8000 !teq Ohl. . s 0! 144.1 this (';ertific:ate ip-MIA's oCCipakyr'y of the etbovy refer-encect buiIdIng or port or, i-F,nrerif and c:,jnf firms that the I,rui lriing has beer, inspected for r.ompl i otic.e W0,11 I:he CP-.'kte of Ov'pon Specialty C:oclos for the grou , Occ:�u ancy, and ue �� mieler wh tr�h t�ir. r fer enced Kermit; wa3 i uv-ked. t %(J It-1)I NS OFF I C I AL _ F t.1 Y TN CONSPICUOUS' PLACE' CIT` OF TIGARD DEVELOPMENT SERVICES la1.IT1_DTIVG PFRMT'r 13125 5W Hell Blvd., Tigard,OR 9721 1503)639.4171 DA.FE PERMIT SLIER- 03 3/98 -V11 O CiA'fE ISE3l.IF'D: Ol:s/0�,/.-l9 r,ARCF'L..: 1 r;1 3!,AP--013 400 I Tr- nDDP.FS S. , . : t 012,F',0 SW GREEN111_IRG RD #71171 ' AJE11:>IV11,1101M. . . ., : LINCIII-N IC)W-R--1'OWN Ov METZOER 7ONINH:C; C O Y OF TIGARD Commercial Building Permitmeed By. �- Oate Recd - 13125 SW HALL BLVD. Tenant Improvement �.. Dale to P E TIGARD, OR 97223 �- �(y Date to D T (503) 639-4171 y1��� Permit# Print or Type <' D- Related SWR Incomplete or il'�gible applications will not be accepted Called _ Name of Development/Project� Existing Building �g New Building 0 Soo Lincoln Ce+,ter At!aress Street Address — Swle ! Building i rti con Cel��er Io2Fo sw Grt�wtbt)►Jc fid 710 � Cata Bldg# City/State Zip Existing Use of Building or Property: LI Ncc>I.N Qorv� C' -raw�- , 9'1223 Name Property �ickerbc��ke�' ('►ro er"Et'Ps Inc..XX IV Proposed Use of Building or Property Owner Mailing Address Suite C E? r, IO'3G0 SW Greenburg M 2.cj0 h No. Of Stories: L — City/StateZip Phone 12 'tL�elVe j _ Port-lah"Al C)P-•• ')722', ?. 5 0 3q. Ft. Of Project. V Occupant `lame — __7.1- !-7 4"L _ Farmers In Surar ce. Occupancy Clads(es) Name Contractor Cehx['A�-e Const . Co, C Type(s) of Construction Prior to permit Mailing Address Suite _ FF, l issuance.a copy Will this project have a Fire Suppression System? of all licenses Yes ___ Nci 0are required if CdylSlate Zip Phone Americans wlti; Disabilities Act (ADA) 2" /AINT expired bt C O.T. I I� 7 S database Valuation X 2511/0 = $ `� Participation-37 I.31 er Oregon Const,Cont.Board Lic.# Exp.Date — Complete Accessibili orm _ VAu,e 0i 1+4.11 I Project �, Name !- -�-� Valuation _1�.3,2.�7 . Architect &PID {'�rc�titec'�s �n c Plans Required: See Matrix for number of sets to submit Mailing,ddress - st,�le on back 920 SW Ttt i t ANenvt 4 C>O C ----- City/State Zip Phore I hereby acknowledge that I have read this appl:atron,that the information pGr.��,.,• �j� ?,r �j,2� `�(c` v given s correct,toot I am the owner or authorized agent of the owner. and that plans submitted are in compliance with Oregon State Laws. Engineer Name Signature of Owner/Agent Date i Mailing Address ---- Suite / }�• �/3/��j -- Clit ct Perso,i Name Phone City/Slate Zip Phone FOR OFFICE USE ONLY Indicate type of work New O Addition Q Demolition O 1Aap/TL# — Land Use n Accessory Struct r O Foundation Only O Alteration( ' � L1�zkl Repair'J Ot_he-O ^--- Notes: - Desc Iptlon of work: TIF. Tev►av`t 1h�lOrt='vemeN�-- --- - -�J Parks. Eittmated!of Employees - -- Note: Site Work Permit Application must precede or accompany Building Permit Appi,catlon 11COMNEW DOC 'DST) 8/97 5-0 2.0 u �5- b COMMERCIAL PLAN SUBMITTAL �;, o REQUIREMENT MATRIX -1 D JY 1 DISTRIBUTION TO PLANS OUT TO DST _ EXAMINERS (Note a.) TYPE OF SUBMITTAL TOTAL CPF: PPE EPE Cll'f - - PPE _ EP7F- S IT F, �— 1 I -- -- 3 (j,o,u) -- B (New or Add) 1 1 -- -- 3 O,o,w) -- I t New or Add or Alt.) 3 3 -- -- 3 0,o,f) N1 (New or Add. or Alt I 1 -- -- 20,o) -- - B & M (New or Add) 1 l -- -- 3 (j,oy ) -- -- t' (New, Add. or Alt) 2 -- 2 -- -- 201,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j,o.w) 20,o) -- F (New. Add. or Alt) ? -- -- 2 -- 2(j,o) 13 & M & P & F (New. Add) 3 I 1 1 3 (j.o,w) 2(j.o) 20,o) B or B & M (Alt) 1 1. -- -- 20,o) -- -- B & M & P(Alt) 3 1 2 20.o) 2 (j,o) -- H & M & P& F, (Alt) 3 �l 1- 1 2 (j,o) 20,o) 20,o) y()�ES; a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP number of revised plans from applicant, stamps and completes, o == Office M = MEC updates and adds actions. f= Fire P = PLM u = USA E = ELC b. Shaded areas designate ALT subrnittal-.only. w= Wash. Ccunty F = FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. Exception. continue to forward a cope ofapproved fire sprinkler and fire alarm plans with calculations. h Imatnc Doc CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT PERMIT #. . . . . . . : MEC98-0101 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 03/19/98 PARCEL- IS135AB--03400 SITE ADDRESS. . . 10260 SW GREENBURG RD #710 SUBDIVIS)ION. . . . LINCOLN TOWER--'TOWN OF METZGER ZONING: C-P BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :014 JURISDICTION: TIG —----------------- ---------------------------------------------------------------- CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE.. . . . .-COM UNIT HEATE*RS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . -B VENTS W/O APPL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES-- 0-3 HP. . . . 1,71 DOMES. INCIN: 0 3- 15 HP. . . . 0 COMML. INCIN: 0 MAX INPUT; 0 BTU 15-30 11P. . . . 0 REPAIR UNITS: 0 F IRE DAMPERS?. . : 30-50 HP. . . . 0 WOODSTOVEE;. . : 0 GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS---------- A I R HANDLING UNITS OTHER UNITS. : I TURN ( 100K BTU: 0 1.0000 c-fm : 0 GAS OUTLETS. : 0 FURN 1 -100K BTU: 0 i 10000 cfm : 0 Remarks : Relocate rise, grilles and 4 T-stats. Owner-': ---------------------------------------------------------- FEES KNJCKERBOCKER PROPERTTES INC type amoLint by date rpept 10300 SW GREENBURG RD ''RMT $ 25. 00 DLH 03/19/98 98-304251 GTE 200 5PCT s 1. 25 DLH 03/19/98 98-304251 TIGARD AR 97223 Phone #: NORTH PACIFIC HEATING 33700 SE DUUS RD ------------- $ 26. 25 TOTAL ESTACADA OR 97023 Phone #: Rrg #. 0006337 REDUIRED INSPECTIONS This permit is issued subject Vn the regulations contained in the Final "Insciertion 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 by the Oregon Utility Notification Center. Those rules are set firth in OAR 952-901-88I8 through 'OR 952-881-*N. You may obtain copies of these rules or direct questions to ULNC by calling (503)246-9187. B Permittee Signati.tre :_yd�'_J_c A 44 }F......................4........................4-+4..........................44 Call 639--4175 by 7:00 p. m. far~ inspections needed the next business day ...................4-+++ f.......4+4..... ...........4.................4-4......4 Plan Check a CITY of TIGARD Mechanical Permit Application Recd By -1677- 13125 167 —13125 SW HALL BLVD. Commercial and Residential Date Recd TIGARD, QR 97223 Date to P E _ (503) 639-4171, x304 Date to DST Print or Type P e mn 110 A,(- _ Incomplete or illegible applications_will not be accepted Called Na of DeveiopmenuProiecf Description Table to Mechanical Code oTY PRICE AMT Job 9ireer Aaares�i '-- Q 5udee A) Permit Fee - -- 0- -0- 1000 Address S Bldg$ yr5f Zip B) Supplemental Permit 3.00 Name for name of business) 1 ) Furnace to 100.000 BTU 3 00 .I -.1 incl.duds&vents Owner _ M ding Address 1 2.1 Furnace 100.000 BTU+ 7 5U 1:300 'C i incl.ducts&vents Gtvrsiafe� Z Phone 3 1 Floor Furnace 600 L incl_vent_ a name orb m1�►si 4) Suspended heater,wall heater 600 L2fL1b • 'Jt�a,�, ,,� or floor mounted heater — Occupant aibng Addrees i1 5) gent not incl.in 300 appliance permit _- ryr f Phone 6) Boder or comp,heat pump,air Gond 600 e to 3 HP,absorp unit to 100K BTU Nor" _ 7) Boder or comp,heat pump,air Gond. 11,00 3-15 HP;absorp unit to 500K BTU _ Contractor Madrng Address c �' 8 1 Boiler or comp,heat pump,air Gond 1500 'Ll _it 15-30 HP absorp unit 5-1 ml BTU (Prior to CrtyrSfefe Zip Phone 9.) Boder or comp,heat pump,air Gond. 22.50 issuance a copy r. - 1A 30-50 HP,absorp unit 1-1 75 mil BTU _ of all licenses are Oregon Conn Cont'1131+3and Lic a Exp Dere 10.) Boder or comp,heat pump,air Gond 37.50 required d s `xV L7J` >50 HP,absorp unit 1.75 mil BTU ss expired in C O T COT Busineex or Mahn N Eyp Dare 11 ) Air handling unit to 4 50 data base) I Z-/ - ' 10.000 CFM _ �— Archltect Name 12) Air handling unit 7 50 10,000 CTM+ or Mailing Address_ ---� 13) Non portable ~�— 450 evaporate cooler __ _ Engineer CityiSfafe — Zip Phone 14.) Vent fan connected 3 00 _ to a single dud Descnbe work New O Addition O Alteration Repair O r 5) Ventilation system not 450 to be done _Residential O Non-residential O included in appliance permit Additional Description of work 16) Hood served by mechanical exhaust 450 17) Domestic incinerators 750 Existing u�� 18) Commercial or fndustnattype 3000 budding or property _ —� ncnerator - 19 1 Repair units 4 50 Proposed use of 20) Woodstove — 450 building or property_----- — --- 21) Clothes dryer,etc. 4.50 _ Type of fuel oil U natural gas O LPG O -electnc 22) Other units 4 50 I hereby acknowledge that I have read this application,that the 23) Gas piping one to four outlets 2 00 nfoimation given s correct,that I am the owner or authorized agent of _ the owner,that plans submitted are in compliance with Cregon,SStt�ate 24) More than 4-per outlet (each) 50 iaw�s�r"- Signature of Owner/Agent _ Date QTY.SUBTOTAL Contact erson Name Phone 5%SURCHARGE PLAN REVIEW 259'6 CIF SUBTOTAL —�� -- TOTAL — -� --- i�dsnmechpmt doc (rev 7/96) 'Minimum permit fee is S25+5916 surcharge 1f' ✓`S'`^` ccumulative S.1wer Tally Tenant Name- -WR# — Address:- /U2CnG X1-1 -s�,-�._h.-� �c� This PLM#' V IXtUre Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added# added #s total Count off#s count value values -f3aptistr /Font 4 Bath-Tub/Shower — 4 __— Jacuui/Mitlpool 4 Car Wash- Each Stall 6 _ _ __- -� -Drive Through -'6 Cuspidor/Water Aspirator _ 1 Dishwasher_- Commercial 4 -Domestic 2 Dnnkinc Fountain 1 _D_e Wash 1 - Floar Drain/sink-2 inch 2 _ 3 inch 5 4 inch 6 -Car Wash Dun 6 Garbage Disposal 16 _Domestic (to 3/4 HP) — Commercial(to 5 HP) 32 - __- Indust ial(over 5 HP) 48 Ice_Machine/Refrigerator Drains -1 Oil Sep(Gas Station) 6 _— Rec. Vehicle Dump Station 16 Shower- Gang (Per Head) 1 -- __ - Stall Sink -Bar/Lavatory__ 2 Bradley _ 5 — Commercial3 Service 3 - Swimming Pool Filter 1 - Vhasher-Clothes6 Water Extractor Water Closet- Toilet - 6 _.._.. Urinal 6 -__-- -- -- 101 ALS �.- Total fixture value divided by 16= C\ EDU C HISTORY PL M# -o01(c' EDU# L1q SWR# iPLM# 07 -�t EDU# S/-7 SWR# _-15L-M# vW EDU SvVR# PLM# Cj-'J- o PA, EDU#��' SWR# 'i7 0 s _PLM# EDU# SWR# qi -CVV7 PLM#�c't`rc, EDU# PLM# 9 - yyl - EDU# 1 SWR# c-3 PLM# EDU# V ,SW13# \dsts\swrtaly.doc ®F TIGARD ,CITY PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : P11. 1198-006P 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 DATE I SSI..IED: 03/IB/98 PARCEL : 15135AB-03400 '.s I Ti: ADDRL'._S. . . : 10260 SW GREENBURG RD #••710 SUBDIVISION. . . . : LINCOLN TOWER-TOWN OF ME:TZGER ZONING: C-P LOT. , :014 JURISDICTION: TJ(a til._.L7CK. . . . . . . . . . : . . . . . . . . . . , CLASS WORK. . :ALT GARBAGE D 15F"•(JSAI-.S. 0 MOBILE HOME SF'i?CFS. 0 TYI-)E OF USE. . . . :COM WASHING MACH. . . . . . . 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 1 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 1 CATCH BASING. . . . . . . : 0 F I XLAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 1 URINALS. . . . . . . . . . „ 0 GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE= (ft ) . . . : 0 WATER CI._.05ETS. : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . l RAIN DRAIN (ft ) . . . : 0 Remarks : F=armers Insi_trance TI Owner: FE:E; -__-----__----- KNICKERBOCKER PROPERTIES INC type amoo-int by date recpt 10300 5W CREEENBURG RD PRMT $ 36. 00 LEEP 03/t8/98 98--3O4228 'ATE 200 SPCT $ 1.. 80 GEP P"3/18/98 98-304228 f I CARD AR 97C- ;3 Phnne #: RALPH BENSON PLUMBING RALPH S BENSON 1620 19TH ST NE SALEM OR 97303 Phone #: 871--905.4 E 37. 80 TOTAL Reg #. . . 013570 _---_..-.--- REfJL.1TREE.D INSPECTIONS This permit is issued subject to the regulations contained in the yoi.igh-in Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other F'L.M/Underf 1 oor applicable laws. All work will be dane in accordance with Top-oi_it Insp approved plans. This permit will expire if work is not started Final Inspection within 180 days of ;ssuance, or if work is suspended for morethan 180 days. MTTENTION: Oregon law requires you to follow rules — adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-MIAM10 through OAR 952- 001-0080. Yogi may --- obtain copies of these rules or direct questions to Gi1N(: by calling - (503)i 46-1987. Tssi_red B Permittee Signa+, _ire : _ Imo, ++++++++4.......+!+!++++++++++++•++++++++++4++++++++++++I-moi+++++++++++++•4-++*-h++++ Cal 1 639-4175 by 7:00 P. m. for an inspect i on needecl the ne)ct ni.is iness day 4..............4-4-+++4+++ t+++++•4-+++++++++.+.+++.++++............4++++++H+++++++++-++ CITY OF TIGARD Plumbing Application Recd By Y 1312$ SW HALL BLVD. Commercial and Residential Date Recd _ TIGARD, OR 97223 Dale to RE.Date to DST (� (503) 639-4171 Permit Print or Type Related SWR#J`, 7 Dray Incomplete or illegible applications will not be accepted Called rel Name of Development/ProjecttVf- - On back Indicate Work Performed by fixture- Cry i ,w w ,.rT :rtf- Job r,2-60 (Seecii9jo.) FIXTURES Ilndlvldual) QTY PRICE AMT Address Street Address Suite Sink "9.00 �l C Lavatory 9.00 Bldg# City/Slate Lip Tub or Tub/Shower Comb. 9.00 Name - Shower Only 9,00 I A Water Closet 9.00 Owner Mailing Address Suite Dishwasher 9.00 3w &r�" t F Garbage Disposal 9.00 City/Ata t/ e Zip Pho - --- Washing Machine 9.00 i Name --L1�� Floor Drain 2' -- 9.00 o J 1M D G _ 3' 9.00 Occupant Mailing Address Suite 4- - 9.00 N ---:Z L 6 Water Heater 0 conversion O like kind- 9.00 City/SlateZlp PV ne Laundry Room Tray __ :T4_ 9.00 :4� Name rind Urinal 9.00 Other Fixtures(Specify) 9.00 Contractor MallinALCddress Suit 9.00 Prior to permit City/late Zip Phone 9.00 issuance,a copy CL _ 9.00 of all licenses are Oregon Const.Cont.Board Llc.# Exp.Date 9.00 required ifJ 7 ---- .Ewer-1 st 100' 30.00 expired in COT Plumbing Lic.# Exp.Date - --- — database -o I - 19 Io file ---— Sewer-each additional 100' — 25.00 Name - Walm Service- 13t 100' 30.00 ( Watei Service-each additional 200' 2500 .Architect 61- 1 r1 - or Mailing Address Suite Storm 8 Rain Drain-1st 100 30.00- 3t-0 Storm&Rain Drain-each additional 100' 25.00 Engineer CltylState Zip Phone —_ Mobile Home Space 25.00 _l am 2 u 1 Commercial Back Flow Prevention Device or Anti- 25.(10 Describe work New O Addition a Alteration O Repair O Pollution Device _ to be done Residential O Non-residentlal O __ Residential deckflow Prevention Device' 15.00 Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00 Catch Basin _-- 9.00 t 5 �'�✓� Insp.of Existing Plumbing 40.00 per/hr Fxisting use of — Specially Requested Inspections 4000 building or property___- <..,,C _ per/hr Rain Drain,single family dwelling 30 nn Proposed use of Grease Traps 9.00 wilding or property — QUANTITY TOTAL hereby acknowledge that I have read this application,that the Information isometric or riser diagram is required d Quar"Total s ,9 given is correct,that I am the owner or authorized agent of the owner,and •SUBTOTAL that plans submitted are in com liancr -Rh Dregon State Law i SlgfpsttO e-07 er/Age It 5h o SURCHARGE �- ( PLAN REVIEW 25%OF SUBTOTAL Contact P on Name Phone � /. Required only if fixture total is>9 � TOTAL *Minimum permit fee is$25+5%surcharge.except Residential Back ow Prevention Device..which is S15+5%surcharge I WaMplmapp doc 5197 ( L) / `� o l o 2 P4EA5_E CQMP_L_E_IE. Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped -Sink �— Lava iory Taub or 'rub/Shower Combination _ Shower Only -- _ _Water Closet - Dishwasher Garbage Disposal _ - _Wash_ing Machine _ Floor Drain 2" 311 411 Water Heater Laundry Room Tray _ Urinal -- Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I%ftftl sM ooc V CITY OF TIGARD ELF_.C:TRIC:AL PERMIT _ � PERMIT #: ELC98-01 .4 DEVELOPMENT SERVICES DATE" ISSUED: 01-!*P/16/98 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 1 S 135AB-•0::,40(21 !31JE ADDRESS. . . : 10260 SW GREENBURG RD #710 SIJBDIVISI(IN. . . . :LINCOLN TOWER-TOWN OF' MC=TZGER ZC:ININ[3:C-P l:aI-OCK. . . . . . .. . . . . LOT. . . . .. . . . . . . . . :014 JURISDICTION: TIG 11ro J ec,t De scr't pt i on: Add twenty (20) branch circuits to a commercial tenant occpy. - -RESIDENTIAL UNIT---- --------'TEMP SRVC/FEEDERS--------- ------M I SCELLANEOUS------ 1000 SF OR LESS. . . . : 0 0 - 200 afflp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADD' L 500SF. . . : 0 201 - 400 ramp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 I__IMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . : 0 MANE. HM/ SVC/FUR. . : 0 60J.4amps-1000 val.ts. : 0 MINOR LABEL_ ( 10) . . . : 0 ---SE:FVTCE/FE:EDER-•--- ----BRANCH C:IRCUITc;._.---..-. _-_-_AICD' L INSPECTIONS---- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 Ist W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 _ 600 amp. . . . . . : 0 EA ADD" L. BRNCH CIRC: 19 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 -•-----_______.______--F'LAP,I REVIEW SECTION--- --___________. 1000+ amp/vol.t. . . . . : 0 > -4 RES UNITS. . . . . . . . : > 600 VOL..T NOMINAL_. . Reconnect only. . . . . : 0 SVC/FDR > _ 225 AMPS. . : CLASS AREA/SPEC OCC. : 9wner: ___._...__.. _..__.._.._._..____.____._._______._-_--.----_.____________._____._ F'EF_S ------------------ FARMERS INSURANCE type amal_cnt by date rPcpt 10300 SW GREENBURG RD PRMT $ 130. 00 GEO 03/16/98 98-30413_ STE 71 Q CT $ 6. 50 GE:O 03/16/98 98-304133 TIG,ARD OR 972E33 Phone #: Contractor: ------ ---___------ _-_--- --- --------_.____.___.__._____---------____.__ CHR I STENSL,N ELECT R 1(: INC $ 136. 50 TOTAL. 111 SW COLUMBIA STE 480 -- ----- REQUIRED INSPECTIONS ---- PORTLAND OR 97201 Ceiling Cover Undergroi..lnd Cove Phone #: 241--4812 Wall Cover Elect' 1 Service Reg #. . : 000004 Th?s permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Oregon 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 ti follow the rules adopted by the Oregon Utility Notification Center. Those rules a-e set forth in OAR 952-001 0010 through OAA -001-19x7. You may obtain a copy of these rules or direct questions to OW by callin )5031246-1987. i er'mittee SignItI_cr G : /�+ , Issi_ted B 1; INSTALI.-ATION ONLY------________._______--•-_---_.._ __ The installation is being made on prnperty I own which is not intended for ( sale, lease, ar rent. n'ONF R' S SIGNATURE: -�- -�-- -�-. DATE- ------------.------------CONTRACTOR ATE:--------.------------CONTRACTOR INSTALLATION ONLY------------------------------ - e SIGNATURE OF SUPR. ELEC' N: — DATE: LICENSE NO: 4� .. .+++++++++++++•i-++i+++++++-tri+++++++++++++•+++++•`-+++++++++++++++� Call 639-4175 by 7:00 p. m. for ail ii npection needed the next bl.csiness day CITY OF TIGARD Electrical Permit Application Pla IrVC11 Recd B.; 13125 SlfV HALL BLVD. -- TIGARD OR 97223 MIX7d - Phone (503)639-4171, x304 Datc IQ PS' T _ Inspoction (503) 639-4175 Print or Type Permli a - y fs 'C C /.��" Fax (503)684-7297 Incomplete or illegible will not be accepted Called_ 1. Job Address: r 4. Complete Fee Schedule Below: Name of Development__ LINCOLN TOWER Number r•f Inspections per permit allowed Name(or name of business) FARMERS INSURANCE � Service included: Itpms Cost Sum Address 10260 SW GREEENBURG RD SUITE 710 4a. Residential-per unit 1000 sq.it or less $110.00 a City/State/7.ip '..1��'IGARD OR . Each additional 500 sq.It.or portion Commercial ��I Residential ❑ Limited Energy $25.00 Limited Energy - $25.00 Each Manurd Home or Modular FOSS CROSBY DN filling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy oInstallation, f all current licenses) Services Or Feeders Electrical Contractor. CHii tSTENSON ELECTRIC, INC. 200 ampalteration,or relocation - amps or less $60.00 __ 2 Address III SW COLUMBIAaLITTE 480 --.--- 201 amps to 400 amps $80.00 2 City__E(.RT LAND_ State UR Zip_ 9 7 9 n I- _- '401 amps to 600 amps _- $12000 _ 2 Phone No. 241-4812 -_�-_ 601 amps to 1000emps - $180.00 2 Job No. _ Over 1000 amps or volts $340.00 2 _22�X856 Reconnect only $50.00 2 Elea Cont. Lice. No. _2b-_lj L -- Exp.Date-_____.,-. OR State CCB Reg. No._�4 5 R Exp.Date,___ -_ 4c.Temporary Services or Feeders COT Businesses ro No.____Exp.Date Installation,alteration,or relocation 200 amps or less _ $50.00 201 amps to 400 amps $75.00 _ Signature of ; 401 amps to 600 amps $100.00 8 7 3 S over 600 amps to 1000 volts, License Nr _Exp.D3te_ __ see"b"above, Phone N ___ -- -------- 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The fee for bunch circuits with purchase of service or Print Owner's Narne leader fee. Address _ �_ Each branch circuit $5.00 - --_-- b)The fee for branch circuits City - State. _- Zip__ __ without purchase of Phone No. __ _--.-_-_-__ I service or feeder he. 35. 1 wl branch circuit 1 $35.00 2 The Installation is being made on property I own which is not 1 ,n h additional branch circuit_ 19 $1,00 95. _ 2 intended for sale, lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature __ Each pump or Irrigation circle $4000 Each sign or outline lighting $40.00 3. Plan Review section if required):* Signal 1,alt t(s)or Ie tenited energy -! �, panel,alteration or extension ._ $40.00 _ Minor Labels(10) $10000 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above "ystem over 600 volts nominal Per inspection $31,.00 ------ � _ ' lassified area or structure containing special occupancy Per hour ":65 00 -- $55 00 as described in N.E.0 Chapter 5 In Plant ------ Submit --Submit 2 sets of plins with application where arty of the above apply. 5. Fees: 130. Not required for temporary construct+on services. Se.Enter total of above fees $ 5°i Surcharge(05 X total fees) $ -� NOTICE Subtotal $ - ; 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If rtizuir (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY El Trust Account N TIME AFTER WORK IS COMMENCED -- Total balance Due s r�DSTSTLCPB APP Rev s/%