10260 SW GREENBURG ROAD STE 800-2 a
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10260 SV: GREENBIJRG ROAD
CITY OF TIG�►RD ___ELECI'RICALPERMIT
PERMIT#: ELC2001-00009
DEVELOPMENT SERVICES DATE= ISSUED: 01/09/2001
13125 SW Hail Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SSV GREENBLIRG RD 800
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT : 014 JURISDICT,ON: TIG
Proiect Description: Installation of seven (7)branch circuits for commercial TI.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LA3EL (10):
_ SERVICEIFEEDER BRANCH CIRCUITS __ ADD'L INSPECTIONS_
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: _
201 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ALD'L BRNCH CIRC: (i IN PLANT:
601 - 1000 amp' _ PIAN REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: � SVCIFDR>=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SPIEKER PROPERTIES WILLAMETTE ELECTPIC NC
10260 SW GREENBURG RD PO BOX 230547
SUITE# IOU TIGARD, OR 97281
PORTLAND, OR 97223
Phone: 892-2500 Phone: 624-3031
Reg M LIC 75059
SUP 1965S
ELE 34-283C
—_ FEES — ,_— Required Inspections
Type By Date Amount Receipt Elect'I Service
PRM T CTR 01/09/2001 $86.75 2720010000( Elect'I Final
5PCT CTR 01/0912001 $6.94 2720010000(
Total — $93.69
This P omit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or If work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notificution Center. Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. 'You may obtain copies of these rules ordirect questions to OUNC at(503)
246-1987 /
PERMITTEE'S SIGNATURE C'� 2p����r9 70A/ GES ISSUED BY;
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _—_,_. DATE:.
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:_
LICENS'7- NO:
Call 639-4175 by 7.00pm for an inspection the next bLIF4iess day
Electrical Permit A pplication
Datcreceived: / O/ Permit no.:E"«�0/_DOC��
City or Tigard Pioject/appi.no.: Expire dale:
Cityq/"rigard Address- 13125 SW )tall I11v(J,T)Ia1N,OR 07223 Dattissued: By:b Receipt no.:
Phone: (503) 639-4171 s---- -- 1
Fax: (503) 598-1960 M�,r+,1'` ' Case file no.: Payment type: J
Land use approval:
U I &2 family dwelling or accessory O Commercial/irdustrial U Mul i-family XTenant improvement
lU New construction U Additioni;uiieratiort/replacement CU Othr r: U Partial
idn 1 t
Job address: /C2 -g , (c. 11 4g.no... Suite no.: 10 'rax map/tax Iot/account no.:
Lot: _ _ Dlock subdivision. _
Project name: 'A/term ego-, 11
1 Description and location of work on premises: 7'4---^--Tj—
Estimated date of completion/inspe.tion: ,. Q
FEF*SU111FDULC
Job no: r . r'r Maz
Dncri tion Qty. (ea.) 1'olal no.ins
Business name.:
New Icsideutial-single or malt(-family per
Address: rd 4, 2 i'6' S dwelling unit.includCSaft.4clredgarage.
City; T,r A"I rState:Cit ZIP: rj 7 / Serviceinclutled:
Phone:
sd; ,1Y-a?' Fax: 1 -2q Email: I(Wsq.ft.or less n
Each additional 300 sq.ftor portion thereof
CCB no.: J 5 p Elec,bus.tic.no: 3 z Limited energy,residential z
City/melic.no.: i Limited energy,non-residential 2
J S_0 / Fach manufactured home or modular dwelling
Si ria are of au rvisln_ ectrician(required) Date Service and/or feeder 2
Sup.elect.name(print), A&I ( ,�� Ucense no: %y 6 S-S Servicesorfeeders-Installation,
alteration or relocation:
t 200 amps of less 2
Name(print): 2111 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address. 601 amps to 1000 amps 2
Citi': Stale: ZIP: Over 1000 amps or volts 2
Phone: Fax: G mail: Reconnecionly I
Owner installation:The installation is being made on property I own Temporary services orfeeden-
which is not intended for sale„lease,rent,or exchange according to Inatrtliatlon,rileratlun,orrelocation:
ORS 447,455,479,670,701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
Name: A Fee foo branch circuits with purchuse of 4
Address:-- service or feeder fee,each branch circuit 1 2
City': - State: ZIP: B. Fee for branch circuits without purchase
— of service or feeder fee,first branch circuit: 2
Phone: t'ax F:trlall: Each additional branch circuit
PLAN REVIEW(riei%e 61teck all that appl�') Mlsc.(.Service—(,,f-dr-not Included):
U Sorvice over 225 amp%-comtnercial U Health-care facility Each pump or irrigation circle 2
U Service over 320 amps-rating of 1&2 U Htuardous location Fach sign or outline lighting 2
family dwellings U Building over 10000 square feet four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nommgl mare residential units in one structure alteration,orextension• 2
U Building over three stories 13 Feeders,400 amps or more *Description:
U Occupar.l fond over 99 persons O Manufactured structures er RV park Each additional inspection over the allowable In any of the above:
U Fgress/liphtingplan U Other
Submit- _-secs of plans with any of the above. Investigation fee _ _ _ _�
71tr above are not applicable to temporary construction service. Other
Nd all jurisdictions accept credit cards,please call jodsdiction for more infoumation. Notice:This permit application Permit fee.....................$
O Visa U MasterCard eupires if a permit is not obtained Plan review(at _ %) $
Credit cud numbet within 190 days atter it has been State surcharge(8%)....$
spire` accepted as complete. TOTAL $
Name d cardholder u own on cm-Fitcad _
l—Cdholder sip-tum Amount F tGI
a 4401615(6i WOM)
S
NONE
WPM
Electrical Permit Fees: Limited Energy Fees:
--�- ---� TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: - - -__
Restricted Energy Fee...................................................... $75.00
Number of Ins actions per permit allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total Check Type of Work Involved:
Residential-per unit
1000 sq.ft or less $145.15 __- q Audio and Stereo Systems
Each additional 500 sq.ft or
p,-Alun thereof $33.40 t E] Burglar Alarm
Lhnitei Energy $75,00
Each Manufd Home or Modular Garage Door Opener'
Dwelling Service or Feeder $90.90
Services or Feeders C] Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 �] Vacuum Systems'
2n1 amps to 400 amps $106.85 2
401 amps to 600 amps _ $160.60 2 n Other
601 amps to 1000 amps $240.60 2 J
Over 1000 amps or volts _ $454.65 _ 2 ----
Reconnect only _ $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relo atiau
200 amps or less $66.85_ 2 Fee for each system.......................................................... $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918-260-260)
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 vuPs, yp
see"b"above.
Audio and Stereo System_
Branch Circuits
New,alteration or ertenslon per Panel L] Boller Gl ntrols
a)The tee for branch c;rcuits
with purchase of service or
feeder lee. Clock Systems
Each branch circuit $6.65 2
b)The fee for branch circuits F-1 Data Telecommunication Installation
without purchase of service
or feeder lee. Fire Alarm Installation
First branch circuit $46.85 r
Each additional branch circuit 6 $6.85 2 9---� F-� HVAC
Miscellaneous
(Service or feeder not Included) Instrumentation
Each pump or irrigation circle _ $53.40
Each sign or outline lighting $53.40 _ 1 Intercom and Paging Systems
Signal circult(s)or a limited energy
panel,alteration or extension $75.00
Minur Labels(10) $12.5.00 ,andscape Irrigation Control'
_ _
Each additional Inspection over Medical
the allowable In any of the above
Per inspection $62.50 Nurse Calls
Per hour $62.50
In Plant $73.75 _
El Outdoor Landscape Lighting'
Fees: ^
Protective Signaling
Enter total of above fees $
S•I [] Other __ __-- _----
8%State Surcharge $ 57
_Ncrrber of Systems
25%Plan Review Fnn
See"Plan Review"section on $ ' No licenses are required, licenses are rege..ed for all othar Installations
front of application
Total Balance Due $ q3 G Fees:
Enter total of above fees $
Trust Account#_
8%State Surcharge S
Total Balance Due $ -_
I\dsls\fonruklc-fees.doc 10/09/00
CITY OF T I G A R D - --- BUILDING PERMIT
PERMIT#: BUP2001-00035
DEVELOPMENT SERVICES DATE ISSUED: 1/2.5/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 1 S'35A8-034p0
SITE ADDRESS: 10260 SW GREENBURG RD 800
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT: 014 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
------- .—_.�_–___—_—
CLASS OF OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: ,f _ PROJECT OPENINGS? _
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 000 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT. sf AREA SEP. RATED:
STOP.: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZ.Z?: _ REQD SETBACKS __ REQUIRED _ _
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DEl
DWELLING UNITS: FRNT: fl REAR: ft FIR ALR.M : HNDICP ACC:
BEDRMS: BATN'�: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Remr_rks: Tenant Improvement- Move 2 Heads Out Of New Wall
Owner: Contractor:
SPIEKER PROPERTIES AFP SYSTEMS INC
10260 SW �_,�EENBURG RD 19435 SW 129TH
SUITE # 1000pp TUALATIN, OR 97062
P Pone N89Z=� gg p07223 Phone: 503-692-92284
Reg#: LIC 00067534
FEES _ REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough-In
PRMT CTR 1/25/01 _ $62..50 27200100000 Sprinkler Final
5PCT CTR 1/25/01 $5.00 27200100000
Total $67.50 �—
i
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 OAP.
952-001-0010 through OAR 952-001-1987 You may obtain a copy of these ruies or direct questions to OUNC by
calling (503) 246-1987.
Pe rm itee
Signature:
Issued By: _„i2�yT'' -------------
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 Recd Ay
13125 SIN HALL BLVD. Date
TIGARD, OR 97 223 Print or Type Date to P.E.
(503) 639-4171, x. 304 IncomDlete or illegibie applications will not be accepted Date to DST
Permit#
Called _ ^-
Job Name of DevelopinenvProject Type of System (Complete A or B as applicable)
�LL,v` -
AddreSS Address r,. 6 r6f� A.) Sprinkler _ Wet { — Dry C1
h
_ � . C, L,). _
Name 4,- Standpipes
Owner Mailing Address g Dp Flazard Group
Nil Additional
ty/ la.to 0 O �Z ZiF Phbne Information Density
Name /�}- Design Area
Occupant Mailing Address awt VOL) K.Factor 5
City/State zip Phone A.1) Sprinkler Project Valuation $ --
Contractor Name (-�- c n� B.) Fire Alarm
(Sprinkieror 11 `� �al.,, ;/ — --
Alarm Company) Mailing Address la Submittal Shall In„Jude Battery Calculations YES❑
Prior to permitI'll 3 j S.W. I-)-,) Individual Component YES❑
issuance,a City/State Zip Phone
copy 'SUI 1.11-91`x`f l Cut Sheets
of all licenses ^�wJ� O K 5)m), B.1) Fire Alarm Project Valuation $
are required if State Const.Cont.Board Lic.# Exp. Date
expired in COT �•�5�y •7_ Project Valuation Subtotal (A & or B) $
database 1
Name /ry - Permit fee based on valuation $
_ (see_chart)
Architect . Mailing Address 9 � 3K0 — — �� 8% Surcharge $
112 L)City/Stale Zip I Phone FLS plan Review 40% of Permit $-_
Describtl work A.)New O Addition O Alteration Bt Repair O TOTAL $
to be done:
B) Modification to sprinkler heads only: ----— -- —
CD 1.1U heads=No plans required Plans requiredi Submit three sets of plans,including a vicinity map arid
the location,of tho nearest hydrant
2 11+=plan review required — -
_ I hereby acknowledge that I have read this application,that the Information given is
Number of sprinkler heads: irrect,that I um the owner or authorized agent of the owner,and that plans submitted
— re In compliance with Oregon State laws
Additional Description of Work !r)AVf
Signal re of Own Agent Date
A.)In Existing Building New Building ❑
Building Contact Person Name Phone
I Cata B.) Commercial IM Residential 0 - -- -
FOR OFFICE USE ONLY:
No.of stories: mat# Map/Tl.#:
�.1
Sq. Ft: Notes
�� Ir
Occupancy Ciess Type of Construction
is\dsts\forms\ftresupr.doc 12/23/99
Valuation of Project Permit fee_ Tax 8% FLS 40% Total
60.00 4.00 20.00 74.00
2,001 - 3,000 59.25 4.74 23.70 _ 87.69
3,001 - 4,000_ _68.50 5.48 27.40 101.38
----_4,001 - 6,000---- 77.75 6.22 31.10 115.07
5,001 - 6,000 87.00 6.96 34.80 128.76
6,001 - 7,000 _ 96.25 7.70 38.50 142.45
7,001 - B4OOA ' 105.50 8.44 42.20 156.14
8,001 - 9,000 w T 114.16 9.18 45.90 169.83
_9,001 - 10,000 124.00_ _9.92 49.60 183.52
10,001 - 11,000 133.25 10.66 53.30 197.21 __
11,001 - 12,000 142.50 11.40 57.00 -210.90
12,001 - 13,000 151.76 12.14 60.70 224.59 _
13,001 - 14,000 161.00 12.88 64.40 236.28
14,001 - 15,000_ 170.26 13.62 68.10 _ 251.97 _
10,001 - 16,000 179.50 14.36 71.80 _ 265.66
16,001 - 17,000 188.75 15.10 75.50 279.35
17,001 - 18,000 _ 198.00 15.84 79.20 293.04
18,001 - 19,000 _ 207.25 16.58 82.90 306.73
19,00,t--20,000 216.50 17.32 86.60 320.42
20,001 - 21,000 225.75 18.06 90.30 334.11��
21,001 - 22,000 235.00 18.80 94.00 347.80
22,001 - 23,000 244.25 19.54 97.70 361.49 _
23,001 - 24,000 253.50 20.28 101.40 375.18
24,001 - 25,000 262.75_ 21.02 :05.10 388.87 _
25,001 - 26,000 269.56 21.56 107.80 308.86 _
26,001 - 27,000 _T 276.26 22.10 110.50_ 408.85
27,001 - 26,000 283.00 22.64 - 11320 418.84 _
~28,001 - 29,000 289.75 23.18 115,90428.83
29,001 - --43-882---30,000 296.50 23.72 118.60 438.82 _
30,001 - 31,000 303.25 24.26 121.30 448.81
31,001 - 32,000 310.00 24.80 124.00 458.80
32,001 - 33,000 318.75 25. 4 126.70 468.79
33,001 -- 34,000 323.50 25.88 129.40 _ 478.78
34,001 - 35,000 330.26 26.42 132.10 488.77^_
35,001 - 36,000337.00 26.96 134.80 498.78
36,001 - 37,000 -. _ 343.75 27.50 137.50 608.75
T7.001'- 38,000 __350.50 28.04 140.20 518.74
38,001 - 39,000 357.25 28.58 142.90 528.73
39,001 - 40,000 364.00 29.12 145.80 538.72
40,001 - 4-0,000 370.75 29.66 148.30 548.71
41,001 - 42-000 _ 377.50 30.20 _151.00 558.70
_42,001 - 43,000 _ 384.25 _30.74_ _ 153.70 _^568.69
43,001 - 44,000 -� 391.00 31.28 166.40 _ 578.68
44,001 - 45,000 397.75 31.82 169.10 688.67
45,001 - 460000 _ 404.50 32.36 161.80 598.66
-46,66f-- 47,000 411.25 32.90 164.60 608.65 _
47,001 - 48,000 __ 418.00 33,44 167.20 618.84-
48,001 - 49,000- 424.75 33.98 169.90 _ 628.83
49,001 50,000 431.50 34.52 172.60 _ _638.62
iAdsts\forms\firesupr.doc 12/23/99 --'�
CITYO F T I G A R D _ PLUMBING PERMIT
I'�RMIT#: P
If
DEVELOPMENT SERVICES 5/01 0002z
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1I25I01
PARCEL: 1 S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 800
SUBDIVISION: LINCOLN TOWER-TOWN OF MET'_GER ZONING: C-P
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 `Y URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WA 7R LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replacement of existing kitchen sink.
r
Owner:
•— Type By -- Date Amount Receipt
SPIEKER PROPERTIES PR�,1T CTR �— 1!25/01 $72.50 27200100000
10260 SW GREENt3URG RD 5PCT CTR 1125101 $5.80 27200100000
SUITE # 100 -- --- --- — —
PORTLAND, OR 97223 Total $7830
Phone 1: 892-2500
Contractor:
MACDONALD MILLER OF OREGON INC
5711 SW HOOD
PORTLAND, OR 97201 REQUIRED INSPECTIONS
Rough-in Insp
Phone 1: 230-8991 Final Inspection
Reg #: LIC 137340
PLM 26-696PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-00b3.
You may obtain copies of these rules or dire,t questions to OUNC by calling (503) 246-19$7.
Issued By: �. `` rte_ _ _ Permittee SignaturetX
Call (503) 639-4175 by 7:00 P.M. for an inspection oeeded the next bd ine 9 day
Plumbing Permit Applicu�"in
7DP�tereceived: 1 ?S 0/ Permitno.:/01 yk" Q/' X0,2City of Tigard r permit no.: Building permit no.:�j1G0_
Address: 13125 SW Hall Blvd,Tigard.OR r17223
City of Tigard phone: (503) 639-4171 Project/appl.no.: Expiredate:
Fax: (503) 598-1960 Date issued: By-
Land
yLand use approval: _ _ Case file no.: Payment type: I
U 1 &t2 family dwelling or accessory Commercial/industrial U Multi-family Tenant improvement
U Nconstruction U Add ition/al terntion/replacenient h1 Food service /U Other.
1611 MIT-INFORNIATION
r
Job address: 11�Civ f' C UesrripUon _ (lts. hcv(ca.) 'q�Mal
Bldg.no.: Suite no.:
OU New 1-and 1-family dwellhtts old
(includes 100 A.for each utility connection)
Tax rraldtax lot/account no.: SFR(1)bath
Lot: Block: Subdivision: SFR(2)bath
Pr:)ject name: °Lto, SFR (3)bath
City/county: ZIP: k - Each additional bath/kitchen _
Description and location of work on premises; /k,/U <'F" Slteutllities:
f_ XlS71"46- i "A- Catch basin/arca drain
Est.date of completiorl/in;pection_ Drywells/leach line/trench drain
;,y Footing drain(no.lin.ft.) _-
Manufactured home utilities
Business name: (� t Manholes
Address: 1 Rain drain connector
City: State: P-.___., ',Rd Sanitary sewer(no,tin.ft.)
Phone: ^ Fax: I E-mail: Storm sewer(no.lin.ft.)
CCB no.: �3 1,344 Q 1 Plumh.bus.reg.no: Water service(no. lin.ft.)
City/metro lie.no.: Fixture or item:
Contractor's representative siemttnre: Absorption valve
_ Back flow preventcr
Print name: a Backwater valve
Basins/lavatory
Name: Clothes washer
-- Dishwasher
AddAddress: — —
State: ZIP: Drinking fountain(s)
CityE'ectors/sump
Phone: Fax: E-mail' Expansion tank --
VAINFixture/sewer cap
Name(print): Floor drains/floor sinks/hub
_: — Garbage disposal
Mailing addre.
(lose bibb
City: State: ZIP: Ice maker
Phone: Fax: E-mail: Interceptor/grease trap _
Owner instellatitan/resjdrntial maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s), ays(s)
Owner's si nature: Date: _ Sum
Tubs/shower/shower pan
Urinll
Name:
—.. - –.-.— Water closet
Address: Water heater
City: State: ZIP: Other:
Phone: Fax: E-mail: Total
Minimum fee................$ --2 5d
Not all}uriKlicuonr.cceM credit Garda,picnic call jurisdiction for rnae inrortrWtan. NrtliCe:This petmi!application U Visa U MasterCard expires if i permit is not obtained Plan review(at _ %) $
Credit cad number .- _ within Igo days iter it has been State surcharge(8%% ....$ S cQr)
c na " -
----- -- p accepted as complete. TOTAL .......................$ '�3' – C�
Narne of cardholder u drown on credit card
_. Cardholder dparme Arnoum 44aik16(M)WOM)
PLUMBING PERMIT FEES:
�- PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES Individual _QTY _dna)_ AMOUNT (Includes all plumbing fixtures in PRICE IOTAL
Sink 16.60 the dwelling and the first100 ft. QrY (ea) AMOUNT
Lavatory --'Y 16.60 for each utilityuonnectlon_) _
One 1 bath $249.20
Tub or Tub/Shower Comb. 16.60 _ _ Two(2)bath $350.00 _ -
Shower Only 16.60 Three(3)bath _ $399.00
1 aer Closet '6,60 SUBTOTAL _
Urinal 16.60 8%STATE SURCHAhGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60 -`-_._- '_TOTAL
Laundry Trey 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 - PLEASE COMPLETE:
4" 16.60
Water Heater O conversion O like kind 16.60 Quantity b Work Performed
Gas piping regi fres r.separate mechanical Fixture Type: New Moved Replaced Removed/
permit Capped
MFG Home NeN Water Service 46.40 Sink
MFG Home Nev-San/Storm Sewer 46.40 Lavatory
Hose Sibs 16 60 Tuh or Tub/Shower
_ Combination _
Roof Drains 16.60 Shower Ong_,
Closet-
Drinking rounlaln 16.60 Water Closet
Urinal
Other Fixtures(Specify) 16.60 Dishwasher
_ _ L
Garbage Disposal _
Laundry Room Tray _
-- Washing Machbie
5.00 Floor Drain/Sink:
Sewer-1st 100' 5
_ _ 3_
Sewer-each additional 100' 46.40 4"
Water Service-1st .00' 55.00 Water Heater _
Water Service-each additional 200' 46.40 Other Fixtures
_ _
(Specify) _
t Storm 8 Rpr^' a(n-1st 100' 55.00
Storm 8 dir,..-Ain-each additional 100' 46.40 _-
Commercial Hack Flow Frevenlion Device 46.40 ---
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60 -
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections - erRtr- COMMENTS REGARDIP.G ABOVE:
Rain Draln,single family dwelling 65.25
Grease Traps Y 16.60 __-�--_---�-.-- -
OUANTITY TOTAL _
Isometric or riser diagram Is required if
Quantity Total is >9
"SUBTOTAL -
8%STATE SURCHARGE -
"PLAN REVIEW 25%OF SLlu'OTAL
Required onlyII fixture qty total is>9
TOTAL $
*Minimum permit fee Is$72:0•8%state surcharge,except Residential Backflow
Prevention Device,which Is$39 25-8%stale surcharge
"All Npw Commarelal Buildings require plans with Isometric or riser diagram and
plan review
i:\dsts\fonns\plm-fees.doc 10/10/00
CITY OF TIGARD P' 'LDING INSPECTION DIVISION
24-Hour Inspection Line: 6- -4175 Business Line: 639-4171 MST --- -
(,� BLIP
Date Requested_ / f,MPM .r BLD
Location z � � Suite
MECi -liG,�r 3 e _
Contact Person Lci r Ph s-L Z-- Pl M
Contractor Ph SVVR
BUILDING - Tenant/Ovfner ELC _
Retaining Wall —`� ELR
Footing Access:
Foundation FPS
rtg Drain --�-- ---
Craurl Drain Inspection Notes SGN
Slab
'3ost&Beam
Ext Sheath/Shear
Int Beath/Shear
- -- --- --
Framing ----- -------
Insulation
Drywall Nailing -------____...------- -_--`--_
Firewall
Fire Sprinkler
Fire Alarm - -- -------- -
Susp'd Calling - ----- ------- - - - ___ ....--- - -
Roo!
Misc:
Final ---------------- --_---
PASS PART FAIL - --- ._.-... - ----- — - -- ----- ---------
PL UMPING - -------_---..----- --
Post&Beam -- -- -- -- - - - --- -._..__-.. - -- ---- ------
Undet-Slab —
TopOut -- - -- --- -- ---- _ - --- -- ------ _----- - --- ----- --
Water Service
Sanitary Sewer
Rain Drains
Final - ---------
�S._ ART FAIL
MECHANW A ------ -- - -
cs earn - -- _._..--- ------ ------- -- - ��._---
Rough In _--------- — ---
Gas Line - _ ----- -- -_
ASPA _ -------------
raspers
RT FAIL
EL TRICAL --
ervica
Rough In - __--
UG/Slab
Low Voltage - --`- -`�
Fire Alarm
Final ---------
PASS PART FAIL -__�_--
Backfill/Grading - ------- --_ -- _�-_-_- __--
Sanitary Sewer
Storm Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW H6II B!vd
Catch Basin
Fire Supply Line ( )Please call for reinspection RE:—, [ ]Unable to inspect-no access
ADA
Approach/Sidewa;k
,ther Date _ Inspector _ Ext
LFinal — -- -
PASS PART FAIL DO NOT REMOVE this inspec'.ion record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line. 639-4175 Business Line: 639-4171
BLIP
.--_.._----_Date Requested_ -3- ` t _ AM...- _PM - BLD �—
Location _ Suite ?C'e i MEC
Contact Person Ph • - /,1, G 3 PLN
Cant ;or �r 7�r �✓r c Ph _ SVvR -_
BUiLliING _ Tenant/Owner ELC _
Retaining Wall ELR &u f -wo-0 3/
Footing Access'
Foundation FPS _
Ftg Dain _ SGN
Crawl Drain Inspection Notes - - --
Slab SIT
Post&Beam
Ext Sheath/Shear _
Int Sheath/Shear J
Framing _^--- -- - - --
Insulation
Drywall Nailing C _-- — = 1
Firewall
Fire Sprinkler
Fire Alarm r _
Susp'd Ceiling
Roof
Misc:
Final r
PASS PART ,TAIL --
PLUMBING
Past& Beam
Under Slab
Tap Out
Water Service
Sanitary Sewer - - -
Rain Drains
Final
PASS PART FAIL _ -
MECi-IANICAL
—�L
Post& Bean --
Rough In
Gas Line
Smoke Dampers
Final
PASS KART FAIL
Service
Rough In
UG/Slab_ -
ow vqllage_
Fire-AMtin _
F1nel
PASS PART FAIL
Backfill/Grading --
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$-•— required b ore next insp tion. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE: DI Unable to inspect-no access
ADA
Approach/Sidewalk - l
Other Date -_ trrspector Ext
Final _
PASS PART FAIL DO NOT REMOVE this inspec*Ion record from the joky site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-1-1� -rr Inspection Line: 639-4175 Business Line: 639-4171 --
� E31:P
Date Requested__" AM PM r-_
_ — B L D
Location G Z GU Suite _ 167&0 _ MEC
Contact Person Lc/w- C v� Ph _7 f'3 _�fi 7 Z_ PLM ' d
Contractor Ph SWR
BUILDING Tenant/Owner _ E'-C
Retaining Walt -�—~ ELR
Footing Access: -
Foundation FPS
Fig Drain _-. SGN
Crawl Drain Inspection Notes: --
Slab -----._._------. _�- _ IT
Post&Beam
Ext Sheath/Shear _
Int Sheath/Shear `
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc.
Final
PASS PART FAIL ---__—. -_-- -
PLU
Post& Beam — --` --"`--
Under Slab
Top Out -- - -- - ---- _, ---- —
Water Service
Sanitary Sewer
iiiia.prains
PART FAIL.
MECHANICAL --.--- _..-- -�-
Post&Beam --- -- ---- - -- r__
Rough In
Gas Line -------
Smoke Dahners
Final
PASS PART FAIL
ELECTRICAL —_—__--
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final --- ------_-- ---
PASS PART rAIL
SITE
Backfill/Grading - --- - - - -
Sanitary Newer
Storm Dain [ J Reinspection fee of$!_ required before next inspection. Pay at City Hall, 13125 SW ball Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspoclian RE: [ J Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date -- -Z 9"4c -- Inspector �'r _ ,Ext
Final —
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
\ --ELECTRICAL PERMIT-
CITY
ITY O F T I G A R D
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2001-00022
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639.4171 DATE ISIZWED: 01/29/2001
SITE ADDRESS: 10260 SW GREENBURG hD 800 PARCEL: 1S135AB-03400
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT: 014 JURISDIC i ION: TIG
Proiect Description. Tenant Improvement
A.RESIDEN FIAL B.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: —�
SPIEKER PROPERTIES rREENLINE INC
10260 SW GREENBURG RD PO BOX 230755
SUITE # 100 TIGARD, OR 97223
PORTLAND, OR 9722.3
Phone: 892-2.500 Phone: 968-1978
Reg #: uc 103033
ELE 34-397CL
FEES i Required Inspections—
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 01/29/2001 $75.00 2720010000 Wall Co.c,
Elect'I Final
5P CT CTR 01/29/2001 $6.00 2720010000
Total $81.00
This ren-nit is issued subject to the regulations contained in the Tigard Municipal Code State of OR Specialty Codes
and ail uiher applicable laws All work will be done in ace,,u--jnce with approved plans This permit will expire if work is
riot started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-0010 through OAR 952.001-0080 You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987
Issued by �= Permittee Signature
OWNER INSTALLATION ONLY
The instailation is being made on property I own which is not intended for sale. lease, or rent.
()WNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N — _ DATE:
LICENSE NO: ---
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
"Datereceived: Peritno.: dpi 00pZy
city of Tigard Project/appl,no.: Expire date: ,—
Ciryq(!'igard Address: 13125 SW Hall Blvd, Tigard,OR 97221 Date issued: By: Receiptno..
Phoud: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: —
TYPE 1
U I &2 fotmily dwelling or accessory Commerciauinduslrial U Nikilti-(artily LI Tenant improvenn^tt
U New constriction U Addition/alterat ion/rrplacerneIII U l)Ihrr U Partial
( SM INFORIVIAT116N
jobaddress: IQ2 _Rb I11dIF r oo Suilc no_ - Tax map/tax lot/account no.:
l.cx: Block: Subdivision:
Project name:/�� —co&jp Description and location of work on prcnus. �AT
Fstimawd(late oi'contj)leti(nt/insl)eclion:
Pee Mat
LAdd
: — Ilrcriplhm Oty. (ea) 'Total no.Insp
ss name: New rssisknlial-sink or tsashi family perss: dwelling unit.Includes atra.-brd fie.
Cit State: zlP:q"j Z set-vice included:
City.
4
Fax . E-mail: 101N)sq fl or less -_- —
Phone: Each additional SIN)sq,ft.or portion thereof _
CCB no.: D3O��j T Elcc.hus.lic.no: Limited energy,residential 2 _
City/metro lie..no.: — Limited en;rgy,non-residential 2
_ —� Each manufactured home or modulur dwelling
Sen tee and/or feeder _ _ 2
tide of supervi g ciccuician(requirul Unto Ser+lcesorfeeders-Installation,
Sup.elect name(print): i(riC License no:ZS alteration or relocation:
WRIII 1 200 an,ns or less _ _ 2
201amps to 4(t0 amps _ 2
Name(print): __ 401 amps to 600 amps 2
Mailing address: _- 601 amps to 1000 Amps 2
City: --- tilalc; 7,11': Over I 0(X)amps or volts — 2
Phone:
I ax; E-mail: Reconneclonly I
Owner installation:The installation is twing made on property I own Temporary services or feeder.-
Ms1alloAn,elleralion,or relocation:
which isnot intruded for sale,lease,rent,or exchange according to 2(p)Amps or less _ _ 2
ORS 447, 6 5,479,670,701. 201 amps to 4(x1 Amps _ 2
Owner's si mature: Dale: _ 401 to f;lxi ams 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits..nh purchase of
Ad,lres., _ service or feeder fee,each branch circuit 2
----- -- It Fee for branch circuits without purchase
I Cit —�Slate: ZIP:
Y - of ger via or feeder fdx,firs)bratch circuit: 2 _
I'ho oto f❑ I?-mail: Bach Additional branch circuit:
Misc.(Service or feeder not Included):
Eech•plrmp or irrigation circle 2
.lcrrru wrr 2.'-S anq• cnnu n rrinl I!ralth d a lartht - Z
U Service over 320amps-tali19of l&2 U llacardouslcAAtion Facltsign oroutline lighting
family dwellings U Building over 10,0(x)square feet four or Signal circuit(s)or a limited energy panel. M
U systentover600 volts nominal more residential units in one structure alteration.orextension• 2
U Buildingoverthreestories U Ft eders,400 anips or more . •srri pion --- --
'a —
U Occupant load over 99 persons U Manufactured structures or RV park la fh aQditlousl inspection over the allowable In any of the above:
U f'.grcss/lightingplat J Other _ -- _ Per inspection _ —
Submit sets of plans with any of the above. Investigation fee —
lhe above are not applicable to temporary construction service. Otber _
-- — Permit fee.....................$ ��$•—
NM all j.n dtctiaru rcep(credit cards,please call jurisdiction for more ird Notice:Titis permit application Plan review(al
U Vis MasterCard :jag�d '
i expires if a permit is not obtained within IRO days after it has been State surcharge(8�f('rrdit card number ___-naccepted as complete TOTAI. .....................Nara ofcardh� .� .town nn credirs
-----_T_ Cardholder siRnsturr Amount 44r)4h15(MX N('Ut,1t
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: -- -
Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved
Residential-per unit
1000 sq It or less $145 15 4 Audio and stereo Systems
Each additional 500 sq It or
portion thereof _ $33.401 Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular n Garage Door Opener'
Dwelling Service or Feeder $90.90 2
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 IJ Vacuum Systems'
201 amps to 400 amps $10685 2
401 amps to 600 amps $16060 _- 2 Other_
601 amps to 1000 amps $24060 _ 2 -- -- ---
Over 106116ktts OrVolts r $454.65 2
Reconnect only _ 166.85 _ _ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONLY
installation,alteration,or relocation Fee for each system.......................................................... $75.00
200 ampj or less _ $06.85_ _ 2 (SEE OAR 918-260-260)
201 amps to 400 amps $10030 2
401 amps to 600 amps $13375 2 Check Type o1011prV Involvecfl
over 600 amps to 1000 volts, . t• •
see•'b"above. Audio and Stereo Systems '
Branch Circuits �j Boiler ConfrolsN~
New,alteration or extension per panel It" _ c ',
a)1 he fee for branch circuits r► •t
with purchase of service orfeedLJ Clock Systems
lee. ----- .
Each br
Each branch circuit $6.65 2 Data Telecommunicatift Installalidh .,� .s.
b)The fee for branch circuits '
without purchase of service 'j• �';"� Fire Alarm Inslal1411W
or feeder fee.
First branch circuit $46.85 _ HVAC
Each additional branch circuit $6.65
Miscellaneous Instrumentation
(Service or feeder not included)
I-ach pump or Irrigation circle $5340 Intercom and Paging Systems
'-ach sign or outline lighting $5340
Signal circuit(s)or a limited energy
panel,alteration or extension _ $75.00 79- Cl Landscape Irrigation Control'
Minor Labels(10) $125.00 �1
Medical
Each additional Inspection ever
l J
the allowable In any of the above Nurse Calls
Per inspection $62.50 _
Per hour _ $62.50 _ ❑
III Plant $73 75 _ Outdoor Landscape Lighting'
FPeS: -1f Protective Signaling
Enter total of above fees $ l/� Other
8%State Surcharge $ _ _`�_._ ____L___Number of Systems
25%Plan Review Fee ' No licenses are required Licenses are required for all other installations
See+149 Review"section on $
front of application
Fees:
Total Balance Due $ �1_
�-7 -- Enter total of above fees $__._
lJ Trust Account# _ ____ 8%State Surcharge S—___ --
Total Balance Due $--
I\dsts\fornta\cic-fees duc 10/09/00
CITYOF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00032
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-41' 1 DATE ISSUED: 1/31/011
1 5135 S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 800
SUBDIVIS*N. 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: 1
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
_�. 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
WOOGAS PRESSURE: 50 + HP: CLO DRYER&
FURN < 100K BTU: _ AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 1
FURN >-100K BTU: <= 10000 cfm: 3
>
GAS OUTLETS:
10000 cfm:
Remarks: Install 3 new VAV boxes and 1 exhaust fan; relocate diffuser.
Owner: _ FEES
SPIEKER PROPERTIES Type By Date Amount Receipt
10260 SW GRErNBURG RD PRMT CTR 1/31/01 $72.50 272001000C
SUITE # 100 PLCK CTR 1/31/01 $18.13 272001000C
PORTLAND, OR 97223 5PC1- CTR 1/31/01 $5.80 2720+110001;
Phone:892-2510 7otal $96':s
Contractor:
MACDONAL.D MILLER OF OREGON
5711 SW HOOD
PORTLAND, OR 97201 REQUIRED INSPECTIONS z� _
Mechanical Insp
Phone:503-230-8991 ict Inspection
Reg #:LIC 137340 anal Inspection
I his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes a,1d all other applicable laws. All work will be done in accordance with approved
plans. This permit wi!I expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. .ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080
YOU may obtain copies of these rules or direct questions to OUNC by calling (503),24�-91 9.
I 1
Issue By: �.�: � y Permittee Signature: -
Call (503)V639-4175 by 7:00 P.M. for inspections needed the next 6 slneis day
I
Meel
Date received: /.7 S v/ Permit
city O! algal u Project/appl.no,: Expire date:
City(if Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By:dl Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.: 6(4407000 - .'W y9 9
U 1 &2 family dwelling or accessory U Multi-I;unjly �d`fenant improvement
U New construction U Addition/alteration/replacement U(Ithcr:
0S01MId
Job address: '• P t Indicate equipment quantities in boxes below. Indicate the dollar
_Bldg. no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tux lot/account no.: profit. Value$ i'�d C�, 60
Lot: Bleck: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit Ice.
City/county: IZIP, 7111
Desert Ii n find location of work on premises: y-uL__;. 1 Koji
J 4�n�( I'l�'(ea.) total
Esl.date of completion/inspection: Ik•sr•ti►tion _ Otl. Rrw.onh Rry.unb
Tenant improvement or change of use: h 20
Is existing space heated or conditioned?U Yes U No Air handling unit a dl�FM _ 'J
Air con itioning(site plan r gwrcd)
Is cxisunf Sparc . .milaled?U Yes U No Alteration o existing AC system
of er compressors
Business name: �y� State boiler permit no.:
-� 1 HP Tons _BTU/II
Address: US ie s—mo a dauct smoke detecttnrs
C - State � euity: mp(steanrqicd
— —
yt')rone:: r Fax: E-mail: _ nsta rep ace furnace/burner BTU/1
Including ductwork/vent liner U Yes U No
0_ no,: .__ ___ Install/replace/relc ocate eaters-suspen ,
e
City/mtro lic.no` �jTp _ wall.or floor mounted
Name(please print): Vent orapplianceother than urnace
e en n:
FM Absorption units- BTIJ/H _
Chillers_ HP
Name: �C'�C:�i1 ,.>L\(�..��1 - —
Address: l� -- Com tressors
n renmentitex rauct an ventllat on:
City: Stale ZIP. - Appliancevent
Phone: r Fax: E-mail: Dryer ex taust _
11 nu s,Type I/res.kjtchc azmaI
hood fire suppression system
Name: C \£J Exhaust fan with single duct(bath fans) -
Mailin r add .s: v
_i �j Exhaust system a cart rom heating or AC
City: �- Stat Zip: �a.3 Fuelpiping andistribution(tip to outlets)
Tylx: LI'C NG _ (til
Phone: - • Fax: E-mail• ue i tin enc a itiona over outlets -_
rocescpiping(schematic required) _
Name: Numbci of outlets
tether 1&le�fi appliance a or equipment:
Address: Decorative fireplace
City: State: ZIP: _Fn sert-type
stove/ficilet stove
Phone: Fax: E-mail:
Applicant's signature: ,, Utile: -C: ter
Name (print): ,` Q
Not all jurisdictions accept credit cant+,please call jundiction tax nwwe infonuatinnPermit fee.....................$ ,
U Visa U MasterCard Notice: Thispe unit application
Minimum fee................$ _
clydit cud number expires if a permit is not obtained— — --L�- Plan review(at _ %) $
r'"spims within 180 days tiller it has been State surcharge(8%)....$
Name of cudholder as shown on cmdit cmd accepted as complete. TOTAL
— -- Cwdholder sist+atare �t'nowl
__ 4.bJ617(yIxYCOMI
MECHANICAL PEPMIT FEES '
COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: _ FEE: ^ Description: Price -Total-
$1.00 to$5,000.00_ Minimum fee$72.,50 Table f a Mechanical Code O1Y (Ea) Amt
1) Furnace to 100,000 BTU
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and Including ducts&vents 1400----
$1.52
400 _$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
fraction thereof,to and including including ducts&vents 1740
$10,000.00. 3) Floor Furnace
$10,0011 A0 t $$25,000.00 $148.50 for the first$10,000.00 and includin vent 14.00 _
$1.54 for each additional$%00.00 or 4) Sued heater,wall�Qater
fraction thereof,to and including 14 00
__ $25.000.00. or floor mounted heater -
Vent not included In avoliar ce permit
$25,001.00 to$50,000 0(l $37� i0 for the first$25,000.00 and �) 6 80
$1.45 for each addit'onal$100.00 or -- - - --
fraction thereof,to and including 6) Repair writs
_ _ $50,000-00. 12_15
$50,001.00 and up $742.00 for the dist$50,000.00 and Check all that apply: Boller Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. footnotes below.
7)<3HP;absorb unit
to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: 8)3.15 HP;absorb
-� Value Total unit I00 to 500k BTU 25.60
Description: Qt Ea Amount ct)15-30 HP;absorb
Furnace to 100,000 BTU,Including 955 unit.5-1 mil BTU 35.00
ducts_&vents - 10)30-50 HP;absorb
Furnace> 100,000 BTU Including 1,170 unit 1.'135 mil BTU 52.20
ducts&vents 11)>50h1p:absorb
Floor furnace Including vent 955 unit>1.75 mil BTU $7.20
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent riot Included In applicance 445 13)Air handling unit 10,000 CFM+
(�omtil 17.20 --
f2epair units _ 805 14)Non-portable evaporate cooler
<3 hp;absorb.Unit, 955 10.00 -to 100k BTU_ _ 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 _ 6.80_
101k to 500k BTU_ 16)Ventilation system not Included In
16-30 hpso
;abrb.unit,501k to 1 2,310 appliance permit 1000
- c1ii.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00
1-1.75 mil.BTU 18)Domestic Incinerators
>50 hp;absorb.unit, 5,725 17.40
>1.75 mill.BTU19)Commercial or industrial type Incinerator
Air handling unit to 10,000 dm 656 Pall ✓ __6995
Air handling unit>10,000 ofm 1,170 20)Other units,Including wood stoves
Non-_ottable evaporate cooler 656 10.00_
`Jentfan connected to a single duct 446_ 21)Gas piping one to four outlets
Vent system not Included in 656 5.40
a ppliance_permit 22)More than 4-per outlet(each)
Hood served b mechanical exhaust 656 _ 1 00
Domestic incinerator _ 1,170 Minimum Permit Fee$72.50 TOTAL:
SUBTOTAL:
Commercial or industrial Incinerator 4,590 _
Other unit,including wood stoves, 656 _ 8-State Surcharge $
Inserts,etc. - �__ __-
Gas piping 1-4 outlets 360 25%Plan Review Fee(of subtotal) $!
Each addltonal outlet 63 Required for ALL commercial permits only
JTOTAL COMMERCIAL -� - 1 TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION: -
Other Ing kglons and Fse
1 Inspections outside of normal business hours(minimum charge-two'iours)
$72 50 per hour
2 Inspections for which no fee r.,specifically indicated (minimum chvrge-half hour)
$72 50 per hour
3 Additional plan review required by changes,additions or re .dons to plans(minimum
charge-one-half hour)$72 50 per hour
'State Contractor Boller Certlncatlon required for units>200k BTU.
"Residential AIC requires she plan showing placernevt of unit.
I.\dsts\formsVne ch-fees doc 10.:11/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - -
BUP
Date Requested— —AM---PM BLD -
L.ocation �1i _ G` Sw e� u�, �u� Suite —iaC' " MEC —_
Contact Person _ T T-_ Ph 2? 3( PLM
Contractor - _ Ph SWR ---
BUIL. .NG - Tenant/Owner ELC
Retaining Wall — ELR--
Footing Access
Foundation FPS _—
Ftg Drain 5GN
Crawl Drain Inspection Notes ---"---"--��-
Slab -- - _ — --- -_ _—�_ - - - -- SIT
Post 8 Beam
Ext
---�-i_-----
Ext Sheath/Shear --
Int Sheath/Shear
Framing
Insulation
Drywall Nailing —_----_.— - ----- -._-_._.___--
Firewall
Fire Sprinkler
Fire Alann
Susp'd Ceiling ---------_-_- --- - —
Roof
Misc: ----
Final
PASS PARI FAIL. --_------- ___ -- -- -
PLUMBING
Dost& Beam -
I hider Slab -
1 op Out
Water Service —
Sanitary Sewer
Rain Drains - — —_- --_----. _-- —_-- --
Final
PASS PART FAIL
MECHANICAL -----.---_-_-._---
F'ost&Beam -------- ----.______ _— -- ---
Rouyn In
GasLine - -----_�___---____--- --- —
Smoke Dampe,s
Final --------- --- --- - .._.—. _—-- - - -----
PASS PART FAIL.
LIG/Slab
Low Voltage
Fire Alarrn _-- _.------.-- ------ ---
m
F�ASS, PART FAIL ----
SIT -
Backfill/Grading -- -- — --
Sanitary Sewer
Storm Drain I J Reinspection fee of$—� required before next inspection. Pay at City Fall, 13125 SV\r Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: J ]Unable to inspect no access
ADA /
Approach/Sidewalk n /
Other Date Z _ Inspector �C-�-� �Ext _ —
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -------
BUP
Date Requested = m AM PM
BLD ,---
Location ZV 2-,i�.�' _S1j-� Qf'- -rJ/7�,r^ 4-, Suite . .� _ MEC
Contact Person Ph PLM
Contractor Ph SWR --
BUILDING — Tenant/Owner ELC
Retaining Well -- -- -� ELR .,Zjp!-r- C � ;
Footing Access
Foundation FPS —
Fig Drain SGN
Crawl Drain Inspection Notes' --- ---
Slab
-.----._._.--------.-- SIT
Post&Beam ----
Ert Sheath/Shear
Int Sheath/Shear --- -
Framing
Insulation
Drywall Nailing -,- --__ ---Firewall
Fire _
Fire SprinklerFire
1 --
Fire Alarm
Susp'd Ceiling
Roof
Mise --- ------ ------- -------- -
Final
PASS PART FAIL `-
-- -- --------- —
PLUMBING �`--- �
Post&Beam ------ ------ -------- — --
Under Slab
Top Out -- -- - ------ ---
Water Service -- ---- - ---------- ------- -
Sanitary Sewer
Rain Drains
- - -- ---------------- --_-- -
Final -
PASS PART FAIL
MECHANICAL
f' ,,. & Seam --- -- -- -- -- --... -- ---- ---- - ----
Rough In
Gas tine -------------- -- -- -
Smoke Dampers
Final - ... --- - --- ------------ --
P FART FAIL
ECT Al- ------
Service
Rough In
UG/Slab
Low Voltage A -
Fi ----- -- - -... - -
Intl
PA§S FART FAIL -- .,-- _--- ---- -.---
Backfill/Grading -- — —'— ----
Sanitary Sewer
Storm Drain i I Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I I Please call for reinspection RF_ --_ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk • -r _ , , /L -� Ext
Other Date c_ / Inspector _----^_. L._--_�_r"-��
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
BUILDING PERMIT
CITY OF TIGARD
PERMIT#: BUP2000-00499
DEVELOPMENT SERVICES DATE ISSUED: 1/3/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL.: 1 S135A13 03400
SITE ADDRESS: 10260 SW GREENBURG RD 800
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: 3: G: +W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR sf N: S_ E: W:
)''CUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCr.UPANCY LOAD: 18 BASEMENT: sf ARES'. SEN. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT'?. MEZZ?: R_E_QD SETBACKS _ _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft HIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y'
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 18,000.00
Remarks: 2325 square feet Commerical TI.
Owner: Contractor:
SPIEKER PROPERTIES C SCHIEWE + ASSOCIATES
10260 SW GREEN BURG RD 1024 NE DAVIS
UpIRTE # 100 PORTLAND, OR 97232
1 Phorle.. OP, 97223 Phone: 234-6617
Reg #: LIC 00054105
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PLCK CTR 12/15/00 $140.47 27200000000 Electrical Pormit Required
Sprinkler Permit Required
FIRE CTR 12/15/00 $8644 27200000000 Framing fnsp
PRMT CTR 1/3/01 $21600 27200100000 Gyp Board Insp
5PCT CTR 1/3/01 $17.29 27200100000 Susp Ceiing Insp
_ Final Inspection
Total $460.20
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�;�TEi�F 10 on law requires you to follow the rules adopted by the Oregon Utility
Notification,�nter. ThQ e rules are et forth in OAR 952-001-0010 through OAR 952-001-1987 You
may obtBif' a copy of the e rules or di ec;t questions to OUNC by calling (503) 246-1987.
Pe rm ite
Signatu —_ --- -- ---
Issued By: ------
T Call 639-4175 by 7 p.m, for an inspection the next business day
Building Permit Application
iw_ Date received: /,,t /S ct Permit no.:
City of Tigard ProjecUappl.no.: 6xpiredate:
CityuJTignrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 — --
Phone: (503) 6394171 Date issued: By:/ Receipt no.
Fax: (503) 598-1960 � Case file n.: Payment type:
1 //y �""
Land USC approval: �(/►' � �� _ I&2 family:Simple Complex:
TYPE OF '
* 1 &2 family dwelling or accessory omrncrcial/industrial U !Multi-family U New construction U Demolition
❑Addition/alteration/repraccment ATenant implawcment U Ftrc sprinUcr/alarm U Other:
JOB ShE INFORMATION
Job address: ?.rc SW C—ee"L.0 Rd , Fbr av,4 CIL, '372'23 Bldg.no.: taws Suiten $OO
Lot: Block: Subdivisio : Tax map/tax IoUaccount no.:
Project name: oNftera Coryoraiov,
Description and location of work on premises/special conditions: TEridvit I►^•wruyernevt —
Name: spiek.er FPey't?cs PTM 114(g_
Mailingaddress: Z(p w—t3•ta. ! �c 00 1 &2 famlly dwelling: r
City: rur��a^c� tate:� LIP: 972 S Valuation of work..................... .... .. .......... _
hone:g92-25ora Fax: E-mail: _ No.of bedrooms/baths.....................
Owner's representative: "Y P_ GL L)lz 'Total number of floors.................................
'LZ •-%,G Fax: 111-mail; New dwelling;area(sq.ft.) ..........................
APPUCANT C3srage/carport area(sq.ft.).........................
Name: GNV Arc I rT tecl l (zaN (k_ til..- Covered porch area(sq.ft.) .........................
-- — `— Dec, area(sq.ft.)
Mailing address: ........
City: State: ZIP: Other structure area(sq.ft.)......................... --
- Fax - Commei•clattindustrial/multi-family.
l'lionc: : C-mail: �� o0
t ' Valuation of work........................................ $1$r—
Gxirdng bldg.ama(sq.R.) .......................... 9.32s sc f{
Business name: G . s eh te►ve CO�stw['{i ov, Nrw bldg.areas ,ft. —
102 t NF s _ t ( q )
i dTir- u� Davis Statc:OK ZIP• �7Z32 __ Tumt,crafstructn.................................... —
• C'it r � �- Type of construction.
(c, Phone: 2 3 4-fnb 17 Fax: E-mail: Occupancy group(s):s Existing:
b
CCB no.• 5 4�v P-�- P y g P( > g:
_ New: d
City/metx,lie.no.: Nonce:All contractors and subcontractors aree required to be
ARCHITECTMIUMIGNEIR licensed with the Oregon Construction Contractors Board under
Name: G13O /+rcN Inc. provisions of ORS 701 and may be required to he licensed in the
—.._._- __.� - --— jurisdiction where work is being performed. If Ole applicant is
Address: '72t) SW 3 Ave"o C = : �c �c,o� _ exempt from licensing,lire following reason applies-
City: rt aw State:CX ZIP: 9-1 17
Contact person: Q xy G1,, flan no.: — - — ---
(=, Fax: E-mail: - -_---
Name: Contact person: Fees due upon application i l
. $ d�o? 1
Address: — Date received: _
City: State: ZIP: _ Amount received .........................................15
Phone: - I'ax. G mail: Please refer to fee schedalc. -
-- —
I hereby certify I have read and examined this application and the Not.rl junsdktkvu arca"�m�c.�,i�at iuri"ctia'ror""xr+nr°°""`t""
attached checklist. All provisions of laws and ordinances governing this o Vis. U Mastercard
work will be complied with,whether specified herein or not. Or&card""mnet ---
ex
Authorized signature:_ Date: ---Naw"(cardpWr u Ow"on email cad---
_i,
Print name: a CARlidea stpum,e
Notice:This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. W4613(6Ax'COr)
%',_Aj
Date Recd:
CITY OF TIGARD Recd By:
COMMERCIAL TENANT IMPROVEMENT
APPLICATIONIPLANS SUBMITTAL REQUIREMENTS
Applicanto: Please complete
APPLICANT
1 . APPLICANT NAME:_ --_,_�_�_---------- PHONE #:_--- ___--�--
7. SITE ADDRESS: -- - --------------- FAX #
1. SITE PLAN (f=ully dimensional, drawn to scale, showing existing parking, accessible route
to building) labeled with:
❑ map & tax lot #, ❑ project name, ❑ site address, ❑ site number,
❑ zoning, ❑ applicant name, ❑ phone number.
A. North Arrow
B. Scale (any standard, architectural or engineering only)
C. Street Names
2. See the 'Commerical Plar, Submittal Requirement Matrix" for number of plans required
based on submittal type (no redlines or tapeons accepted).
SIZE REQUIREMENTS: 2,6" X 36" (ROLLED)
ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS
A. Floor plan(s)
B. Wall details
C. Reflective ce'ling plan
D. Seismic bracing detail for suspended ceiling
E. Specifications & calculations
F. ADA barrier removal worksheet
G. Deposit - based on valuation of project
I ,dStSVonnsWxnbapp doe 10/4/00
ELECTRICAL PERMIT-
CITY OF T I G A R D
RESTRICTED ANERGY
DEVELOPMENT SERVICES PERMIT#: EL.R2001-00031
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/7/01
SITE ADDRESS: 10260 SW GREENBURG RD 800 PARCEL: 1S135AB-03400
SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER ZONING: C-P
BLOCK: LOT: 014 JURISDICTION: TIG
Proiect Description: Installation of restricted energy for access control. Job No. 30-07-10012
A. RESIDENTIAL B.COMMERCIAL __
AUDIO & STEREO: AUDIO & STEREO INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAlTELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: ACCESS COPi X
_ _TOTAL#OF SYSTEMS: 1
Owner: v Contractor:
SPIEKER PROPERTIES RFI ELECTRONICS INC
10260 SW GREENBURG RD 6195 SW 112TH STREET
SUITE # 100 BEAVERTON, OR 97008
PORTLAND, OR 97223
Phone: 892-2500 Phone: 503-626-6387
Reg#: ELE 34-174CLE
SUP 3417JLE
LIC 67147
FEES Required Inspections_ -- _
_Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 217/01 $75.00 2720010000 Elecl'I Final
5PCT CTR 2/7/01 $6.00 2720010000
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 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 suapPndPd 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 10 t ugh OAR 9 --001-0080 You may obtain copies of'liese rules or direct questions to OUNC at (503)
246-1467 � 4 _
Issue by _ _ Permittee :;ignahire�fi1 i clwr
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 — _..------ DATE:------— ------ --
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
u l 1-1 01 PR1 15:35 FAX 503 598 1960 CITY Of, TIGARD Zoo-
Electrical
barElectrical Permit kpplication
-` - -_ - Date received: d �� Permit no ,�L�Qc�De/'pq�3/
City of Tigard \J Project/appl.no.: Expire date:
City of71gard Address: 13125 SW Hall Blvd,� Oltgo Date issued: By: Receipt no..
Phone: (303) 639-4171 C` t � Caen file no.: � Payment
Pax: (503) 598-1960 4�<�, �a�� Y type:
Land use approval:
;.1 t &;familyelling err accessory �Comtt,erclnl/industnal >Multi Caartily U'I'enat�t improvement
J Nen U Adchuurt/aliciati(m/replacement J Other: J Partial
Jon addSW Greenhurt Rd !tld; Suite no.: 800 Turf ntap/tax lot/account no.:
Lot: ack: (Subdivision: Lincoln 'Powers
I1 I tjecl name: _ Al ;:era Description and location of work on premises: Access Cont rnl_
1.',JIIT IV'd date of 1'nmple0on/ins ection (,: ;�; ' -
&m Ell ligilidiLliftil M
loh no: ()()I ' Fie MAX
tfuaillCBa ttaIIlC: F I 17I11I11un1cat l on.,; & Security ,'y5 Description - Qt (ea.) Total nu.hty
11)_SW_ 2 Ve NeHrrAde"tial-slm*orniallifanilvper
Address: dwelling"nft.fnchtdn atbwfwd garage,
City: Beaverton State: MP: o7QON Sersicertrladed: -
Phunr: 503-626-63Ei ax: E-mail rmart i n@rf i . aq fl.nrleaa _ 4
CC'B no.: 67147 f?lec.bus.lic.no: '14--174CLE
Each additional 500 Ill A.or portinn thereof I — '
Limited energy,residential
C'ilylanetro tic.no.: 00004551. Limited energy,non-icsideadal ?
A_ t:6 , , / `.Zt, —_- '/M/01 _ Each manufactured home ormnduludwelling
Service andtor feeder _
Signature of s pervjsing r!ectrlcian(required) Date
_ � , "— Senkesorfeeden--IanalatlatlMn,
Sup.eleciname(prinr): Dean .1, Rea' ce Licenaeno• t)12JLF alieratlonorrelocation:
200 amps or lege 1
Nw1e(print): 201 amps to 4W Amps — 2
--- - - -- 401 amps to 6W amps 2
Mailing address: _ -.- 2
601 amps to 1000 amps _
illy: _ �State: :UP: Over l WO amps or vOil$ 2
kF 'lu,nc r�aX: G-mail Reconnect only
r Owner installation:The installauon is being made on property I own Temporary services orfeeders-
which is not Intended for sale,lease,rent,or exchankc according to hsslnllution,alleralhwt,or relocation:
()RS 447.455,479,670,701. 2W amps t loss
201 Amps to 4W ern s !
I Owners signature; Urate: _ rant to 600 ams 2
Branch circuits-nen,alteration,
or extension per panel:
Name _ _ A. ree for branch circuits iith purchase of
Addrr.m service or feeder fee,each branch circuit
City; State: MP: 8 ree for branch circuits widtout purchase
-- Email of service or feeder tee,first branch circuit: 2
I'llonc: fax Each additional branch nmuit:
Mksc.(Serrlce or feeder not included): i
U Service over 225 amps-commercial U Health-care Will, liach pump or irrigation circle _
Each sign or outline N htin
J Service over 320 amps ruing of 1&2 U Hazardouslocaakn B 8 g
futnilydwellings f]Building over 10,XXI square tees four of Signal circuil(s)or a limited energy panel, -�
I U Syslem over6W volts nunmtnl more residential t nits in one it uctute alteration,orexlension• _ 147 5.Q0 i "110_
.1 Building over duee stoties U Feeders,400 untpi or more 'Desc.iLtiotl: 'xC(Z';=1 C ti l l l I
U i occupant load over 99 persons U Manufactured qtr tctures or BY park Each additional Inspection over the dime aW in any of-twit ve:
U EgreWlightingplan J Other: Per nspection
Sabtnil__.sets of plans with any or the above. Investigation fee
kite abote are not applkable to lemporttry cantotruction aeMee. Other _
- — -— - ---- - -- -- Permit fee.....................S ?.00
N A ail jtuisdicdcau accept credit cards,please call jmlydkuon for atom ini,ameline Notice 'llii3 permit application -—
Visa U MasterCard —^ expires if a permit is not obtained Plan review(at
t•tedd cord number: _L�__ v.ithin 180 days alter it has been Suite surcharge(8%) ....5 X11)
tilp let accepted as complete. 7'OTAL .......................S
Yuri of cardholder s'sh ,T
ownun credit car --
Cardhnldn agnatute Amcott� t4U-•Iti15lN(Il1MOM�