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10500 SW GREENBURG ROAD #200 --3-S-0 GREENBIiRG RD #200 1 OF 1 FILMED 2004 0 0 0 N m m z 03 c G) v N 0 0 • 10500 SW GREENBURG RD 200 CITY OF TIGARD __ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2000-00244 �I DATE ISSUED: 6/19/00 w 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB 01006 SITE ADDRESS: 10500 SW GREENBUR' Ft2_00 I SUBDIVISION: LINCOLN PLAZA ZONING: C-P BLOCK: LOT:002 JURISDICTION: TIG CLASS OF WORK: ALT FLUOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B 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: WOODSTUVES GAS PRESSURE 50 + HP: CLO DRYERS: FURN < 100K BTU: — AIR HANDLING UNITS_ OTHER UNITS: FURN >=100K BTU. <= 10000 cfm: GAS OUTLETS > 10000 cfm. Remarks: Relocate rnisc grilles for new wall lay-out Owner: FEES NORRIS BEGGS & SIMPSON Type By Date Amount Receipt 10300 SW GRE ENBURG RD SPCT DEB 6/19/00 $4 00 0003090 PORTLAND, OR 97223 PRMT DEB 6/19/00 $50 00 00030% Total 554.00 Phone: -- Contractor: iGr•� __- • NORTH PACIFIC HEATING 0 33700 SE DUUS RD ESTACADA. OR 97023 REQUIRED INSPECTIONS Duct Inspection Phone: Final Inspection Reg #: LIC 00063746 Ihis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore Specialty Codes and all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance. or if work is suspended for more than 180 days ATTENTION Oregon law • requires you to follow rules adopted in the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189 Isar.By: _i__ (- It,N1.1k:i Permittee Signature: ' -S�YJ:.�.� . Cell (503) 639-4175 by 7:00 P.M. fnr inspections needed the next business days 1 Plan Check M CITY OF TIGARD Mechanical Permit Application Rec'dBy ' ' 13125 SW HALL BLVD. Commercial and Res _idential Dp'e Rec'd ^.„- TIGARD, OR 97223 Date to P E (503) 639-4171, x304 Date to DST ; `l Print or Type Permit 0_f; rff__3'f(- Incomplete or illegible applications will not be accepted Called F . -__ Nine of 1)evek pmenUProiect ^ Description Nam � 6y1. �%/ �%/ le Mechanical Code Qt Price Amt J,-A.; Address J•1 saner / ermit Fee 16 00 Address 14/6)5 po c,k2)11,11.44,11,4•,00 1) Furnace to 100.000 BTU including ducts&vents 9 65 13100 Crty/State ------- p�� 2) Furnace 100.000 BTU+ A .1� .3 including ducts&vents - - 12 00 ~ Nnne or name of business! 3) Floor Furnace Owner - 7 ....i ,A 4 _ including vent _ 9 65 _— Mailing Address/ I - 4) Suspended heater wall heater 1 or floor mounted heater 9 65 5) Vent not included in a)pliance permit 4 75 -hone Check all(hat apply 'Boiler Heat Air a3 For Items 6-10,see or Pump Cond Qty Price Name for name o business) footnotes 1,2 Comp /.,/�'-� ' 6)Repair units Occupant "siting AA y 8 40- P 7)01113,absorb unit to /0 561-) .'41.21&41 16 !2 100K BTU 9 65 C !State lip 'hone 8)3-15 HP,absorb unit -- 100k to500kBTU 17 65 .. '' . -- 9) 15-30 HP,absorb - -- — COntractor t ame unit 5-1 mil BTU 24 15 I 10)30-50 HP.absorb Prior to permit Mhiiing A _unit 1-1 75 mit BTU _ 36 00 issuance a copy ..?3 11)>50HP,absorb unit>1 75 mil BTU . of all licenses y/s all Zip PCne 60 15 _ are required if " � --` f� : 12)Air handling unit to 10,000 CFM expired in COT Oregon Const Coni Boar a Exp Data 7 00 database N e3 r./�� l-�7 y-G7 , ' 13)Air handling unit 10,000 CFM• Arrhltect �T 1185 14)Non-portable evaporate cooler r.r Mailing Address 7 00 - 15)Vent fan connected to a single duct 4 75 Engineer Clly(State Zip Phone 16)Ventilation system not included in _ _---- ---� -- ap�lience permit /VU Describe work to be done 17)Hood served by mechanical exhaust 7 00 New 0 Repair 0 Replace with like kind Yes 0 No 0 18)Domestic incinerators Residential 0 Commercial it Modification 0 12 00 19)Commercial or industrial type incinerator Addnional information or description of work 48 25 `` dr +' 20) Other units,including wood stoves ��/ 'L -7 2,).4(7 W c4 f - — 7 00 OTE: For Co rdal protects only Units over 400 ., located on the 21)Gas piping one to four outlets roof,require structural talcs Qrepared by licensed engin '_r _ -_- --- 3 75 Type of fuel oil 0 natural gas 0 LPG 0 electric 0 22)More than 4-per outlet(each) 75 pit I hereby acknowledge that I have read this application,that the information ,Minimum Permit Fee S50.00 SUBTOTAL given is correct.that I am the owner or authorized agent of _- 8%SURCHARGE Mr(' PLANorREla 5%Or SUBTOTAL ■ the owner.that plans submitted are in compliance with Oregon State laws Required for ALL commercial permits only Signatureooff OwnerlAt2ant Date TOTAL • U s- _ v, _/4 -QL) _ Other Inspections and Fees------ Contcti Person ame / once ) t Inspections outside of normal business hours(minimum charge two hour,) 850 00 per hour _ _ / /_ 7� q�� 2 Inspections tor which no lies specifically indicated (minimum charge-half tour) Foonotes for c. artist prod is only:LG7 7C/ 2,50 i o al pia r J Additional plan review required by changes additions or revisions to plans(minimum 1 Provide full schematic of ext g and proposed gas line and pressure charge-ono-he hour)850 00 per hour ? Provide drawings to scale showing existing and proposed mechanical 'State Contractor Boiler Certification required units " $ Residential A/C requires site plan showing placement of un I Vnechperm doc rev 11/1(99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour inspection Line: 639-4175 Business Line: 639-4171 BUP -RC 'O oe,A'V `' ' Date Requested 6 AM_ X PM BLD Location l05 1/0 lnr€4i414.1•1 Suite �� - MEC Contact Person 1_ C'Vtni_ Ph 713 - 30.3 PLM _ Contractor Ph SWR Tenant/Owner at, l t ztv-i G-vt S ELC Retaining Wall ELR Footing Access Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN ,— Slab - -- SIT Post A Beam - — Ext Sneath/Shear _ Int Sheath/Shear Framing _-_ _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alann Susp'd Ceiling Roof Misc — — ------ — — let 10114, PART FAIL - — -� — - — BIND Post 8 Beam --- - — --- -- -- — — _ Under Slab Top Out ---------�—_�.------- Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post A Beam _-- Rough In Gas Line Smoke Dampers Final --- — PASS PART FAIL ELECTRICAL ------- - - - Service Rough In _----- -- _ m UG/Slab Low Voltage ----- --— --- --- Fire Alarm Final PASS PART FAIL SITE iBackfill/Grading Sanitary Sewer Storm Drain ( )Reinspection fee of S_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ) Please call for reinspection RF ( )Unable to inspect no access ADA Approach/Sidewalk / ' Other Date 6/ (f Inspector T°1-‘"? J _Ext Final PASS PART FAIL._ DO NOT REMOVE this inspection record from the job site. CITY OF TI G A R DACERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2000 00160 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 05/09/2000 PARCEL: 1 S 135AB-01006 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 10500 SW GREENBURG RD 200 SUBDIVISION: LINCOLN PLAZA BLOCK: LOT:002 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2FR OCCUPANCY GRP: B OCCUPANCY LOAD: TENANT NAME: AMERICAN FAMILY INSURANCE REMARKS: Commeraal TI Owner: KNICKERBOCKER PROP, INC XXIV BY NORRIS, BEGGS + SIMPSON 10300 SW GREENBURG RD STE 200 PORTLAND. OR 97223 Phone: Contractor: PIONEER CONS TRUC1 ION SERVICE PO BOX 68304 MILWAUKIE, OR 97268 Phone. 652-1050 Reg#: l IC 00128689 This Certificate issued 06/29/211110 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under which the referenced permit wa 1r ued. *if rt-...:7 ---- BUILTIING INSPECTOR A,V4iisAd' ) FICIAL POST IN CONSPICUOUS PLACE I _ • _ CITY OF TIGA.RD BUILDING INSPECTION DI`J!2!ON MST 24-Hour Inspection Line: 6394175 Business Line. 639-4171 - —v-- - BUP Date Requested 72 c- _ --,,AMPM BLD V__ — Location I , C OC 1` c ,Y1.b1LAe Suite G MEC __— Contact Person (-4.-1'-" (11t i YAJ Ph () 2 y __3(.�) 3 I PLM _-- Contractor Ph SWR — - __ BUILDING Tenant/Owner ELC 0, UC _- C ; Retaining Wall EL R Footing Access. Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes Slab SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing . — --_ Firewall Fire Sprinkler — -e- ,�11�.1=:_s�y ,:i Fire Alarm — Susp'd Ceiling --___—_ Roof _ Misc —--- Final /f )- PASS PART FAIL. --�/ — ----- PLUMBING ..- Post& Ream --- - Under Slab Top Out ---- ---- -------- Water Service Sanitary Sewer _ .--- — -- -- - _----- Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam --- -- Rough In Gas Line — — Smoke Dampers Final — — --— ---- PASS PART FAIL ELECTRICAL - - - _____ -- - Service Rough In -- --. -- UG/Slab -Low Voltage Fire Alarm ______ _---, -- -- tAS'SWART FAIL Backfill/Grading ------- ------- - -- - i Sanitary Sewer Storm Drain I j Reinspection fee of$ _- required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Supply Line Basin I )Please call f reinspection RF —.— j )Unable to inspect - no access Fire ADA r # ,1 Approach/Sidewalk '7 r: Other Date �' ��. t.1-11_ ;i.;pector __ ,erg - Ext Final PASS PART FAIL 0 NOT REMOVE this inspection record from the job site. 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUFgor Date Requested -�.� AM PM BLD Location �� CSC" ,{1. )1 h(1_'7; Suite 7 (1C) MEC .'7C.Ce C—Ce Vt./ Contact Person Ph PLM Contractor (t*-"�i-- Ph " ? SWR BUILDING I Tenant/Owner r =�'1-L ELC Retaining Wall ELR Footing Access Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes' , ) /�^ / /A fi Slab . Q 1�4- '1'7!� L J� � i,'� SIT Post 8 Beam Ext Sheath/Shear Int Sheath/Shear Framing Inst lation Drywall Nailing Firewall -- --- ------ ------ - Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Mis --- — ' PASS PART FAIL _. -_ _ - G!'=ING est R Beam Under Slab Top Out — — Water Service Sanitary Sewer Rain Drains Fina _PASS PART FAIL MECHANICAL 'post& nem', Rough In Gas Line — — --- Smoke Dampers Final --�... PASS PART FAIL ELECTRICAL — — ----------—----- — -- Service Rough In UG/Slab Low Voltage Fire Alarm _ Final PASS PART FAIL _-- —, SITE Backfill/Grading —" — Sanitary Sewer Storm Drain I J Reinspection fee of$_ required before next inspection Pay at City Hall, t3125 SW Hall Blvd Catch Basin I J Please call for reinspection RE. - j J Unable to inspect-no access Fire Supply Line - ADA Approach/Sidewalk r) Other Date 64/2241_ Inspector / Ext Final PASS PART FAIL_ DO NOT REMOVE this inspection record from the job site. CITY OF TIGARDBUILDING PERMIT PERMIT #: BUP2000-00160 A DEVELOPMENT SERVICES DATE ISSUED: 519100 13125 SW Hall Blvd.. Tigard. OR 97223 15031 639-4171 PARCEL: 1S135AB-01006 SITE ADDRESS: 10500 SW GREENBURG RD 200 SUBDIVISION: LINCOLN PLAZA ZONING: C-P BLOCK: LOT: 002 JURISDICTION: TIC REISSUE: 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 S: E: W: OCCUPANCY GRP: B TOTAL ARE 4: 0 t:u sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMEt%T: sf AREA SEP. RATED: STOR HT: ft GARAGE: sf OCCU SEP. RATED: USMI"r: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT. ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE PRO CORR. PARKING: VALUE: $ 33,600,00 Remarks: Commercial TI. Owner: Contractor: KNICKERBOCKER PROP, INC XXIV PIONEER CONSTRUCTION SERVICE BY NORRIS, BEGGS + SIMPSON PO BOX 68304 10300 SW GREENBURG RD STE 200 MILWAUKIE, OR 97268 picApo, OR 97223 Phone: 652-1050 Reg #: LIC. 00128689 i _ FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing Insp PRMT DEB 5/9/00 $323.50 0002034 GYP Board Insp Susp Ceilng Insp 5PCT DEB 5/9/00 $25 88 0002034 Final Inspection PLCK DEB 5/9/00 $210.28 0002034 ORIGINAL FIRE DEB 5/9/00 $129 40 0002034 ------ Total $689.06 — --- ) This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance. or if work is suspended for more than 180 days ATTENTION- Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987 You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987 Sennitee . �e,— Signature; 7"` (' Issued By: K .( Q'_ yt&. ti- - — - Call 6394175 by 7 p.m. for an Inspection the next business day I CITY.OE T'�ARD Commercial Building Permit Application Plan 13125 SW HALL BLVD. Tenant Improvement Rec' Date Recd TIGARD, OR 97223 Date to P E. — (503) 639-4171 Print or Type 01-C Date to os f /1-7Z Permit• r a i -Odeek9 `..-- Related 3WR• Incomplete or illegible applications will not be accepted Called---.- _ Name of Development/Project I r Existing Building tg. New Building ,lob Lincoln Ce„tkr L iK min Plaza at Address Street Address --! Suit° Building LiKcoth CerZtev 10500 SW ereenbor..5 ZDO Data aidg ri — City/State Zip Existing Use of Building or Property: LiNcooPI_AzAN Portlardl0(�. 9122 Office /Pe-tat\ ' {Name rr Proposed Use of Building or Property Property I"I e6o r=rrupertiei jne.,XXIY Owner Mailing Address Suite C +4-1'02 — — ic' ShJ oreenb, p-4 2.0o No. Of Stories City/State Zip Phone ( I ) eN E Qort)awdr O. 97223 452-49o0 Sq. Ft Of Project Name — ---- 1C, S F Occupant Occupancy Class(es) – Arrtevicar, Fana'lly Insurance — Name Contractor r iorteev- Cor c'bry ct i o n Type sl of Construction Prior to permit Mailing Address Suite V-1`4r� --- issuance.a copy P 0,pox CtSC i- Will this project have a Fire Suppression System? of all licenses __—__ ___ Yes (] No irl — --- ------ ---------- sre required if rny/state Zip Phone Americans with Disabilities Act,ADA) expired in COT M I W a i r!. Oji. 97?.22 Q'Z 1050 r k Valuation X 25% = $ 4.00.° Participation database r � Oregon Const Con! Board l is I Exp.Date _Complete Accessibility Form 12W), 04(02 1` Project $ 33 GOO 00 Name Valuation 1 Architect GIN) Arckl-tects, Inc . Plans Required. See Matrix for number of sets to submit Mailing Address Suite on back 92v S W 3 r'l 40Ofl --— — —— ' City/Stale J Zip Phone I hereby acknowledge that I have read this application,that the inf�rmation ?E rt(avd, C -, 97201' 11.4 -a,r:"SE given is correct,that 1 am the owner or authorized agent of the owner,and that plans submitted are In compliance with Oregon State Laws Engineer Name —__ -- --_-- ��Siignature of Owner/Agent Date �� Mailing Address Suite u. - S • 9 • 00__________ 0---_ Con ct Person Name Phone Cty/State — zip Phone P'-y F.. Gl u r 224 . 965c, _t— --- ---- FOR OF_ FICE USE ONLY _ _ Indicate type of work New 0 Addition 0 Demolition 0 Map/TL• v Land Use Accessory Structure 0 Foundation Only 0 Alteration II( —_ Repair 0 Other 0 —__ Notes Description of work: 1P11Dn-t ti,..rvp`rp►'r.t"it TIF Note' Site Work Permit Application must precede or accompany Building Permit Application 1 1COMNEWTI DOC (DST) 5/98 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MAT RIX upon submittal of BOTH plans AND a COMPLETED Han Review is dependent .l application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review will be conducted. After plan review approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes. (Copy for Contractor, City, Washington County, Tualatin Valley Fire & Rescue) Total# of TYPE OF SUBMITTAL Plans KEY: Submitted S (Private) _ v 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) _~ 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) Building *B orB & M (Alt) --• 1 "BRM & P (Alt) 3 'B & M & P & E(Alt) 3 *B & M & P & E & F(Alt) 3 NOTES *Shaded areas designate ALT submittals only. t 1dslsVolms1n.strxcom doc 10/30/98 I '-yy"'p v l Cil f•411,•,; Iy t t 1 s U Y A N c'e C LINT' PLAZA- uITF 2OQ / 9O a) .9YL.e t ikhel 5 . . 00 SUBJECT: ACCESSIBILITY BARRIER REMOVAL IMPROVEMENT PLAN REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected huildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with 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 (2o%) VALUATION of all enovation, alteration or modification being done excluding painting, wallpapering [11$ 3'ki 600 multiply; 25% Barrier removal requirement .25 BUDGET FOR BARRIER REMOVAL (21$ 6, 41-00 _ In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide Zhe greatest access Elements shall be provided in the following order (a) Parking lot rest�zrrirj ,nes., curs c„tr $ 8. 0• sidewalks, si9►.e5e a.-•d a co.rr;Lie s'trft((r. (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: Stall equal line 2 of Value Computation $ 84-00, oo I Wstslormruc•ess dot I CITY OF r TIGARD _ ELECTRICAL PERMIT PERMIT#: ELC2000.00266 DEVELOPMENT SFRVICES DATE ISSUED: 05/23/2000 z‘ iiii 13125 SW Hall Blvd., Tivard. OR 97223 (503) 639-4171 PARCEL: 1S135AB-01006 SITE ADDRESS: 10500 SW GREENBURG RD 200 SUBDIVISION: LINCOLN PLAZA ZONING: C-P BLOCK: LOT : 002 JURISDICTION: TIG Project Description: Install 7 branch circuits in existing commercial building. _ RESIDENTIAL UNITr TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 200 amp: PUMPIIRRIGATION: EACH ADD'L 5005F: 201 - 400 anru. SIGN/OUT LINE LTG. LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601+amus - 1000 volts: MINOR LABEL 110): SERVICE/FE'iDER ____BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: 0 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 60C amp: EA ADD'L BRNCH CIRC: 6 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC_._i__._ Owner: Contractor: KNICKERBOCKER POPR INC WILLAMETTE ELECTRIC INC 10300 SW GREENBURG RD PO BOX 230547 STE 200 TIGARD, OR 97281 TIGARD, OR 97223 ORIGINAL Phone: Phone: 624-3631 Reg#: LIC 000750 SUP 1965S ELE 34-283C _ FEES _ _ Required Inspections Type By Date Amount Receipt1 �_— Elect'I Service PRMT KJP 05/23/200C $69.60 0002387 Elect'I Final 5PCT KJP 05/23/200( $5 57 0002387 Total $75.17 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 Thus permit will expire if work is not started within 180 days of issuance,or rf work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notrfrcation Center Those rules are set forth in OAR 952.001-0010 through OAR 952-001-0080 You may obtain copes of these rules or direct quesTons to OUNC at(5031 246-1987 P PERMITTEE'S SIGNATURE -y�,t � t k` ISSUED BY: A/ tut„.,..--.0___,, 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: el'‘- C a_6 c-d.�-� DATE: LICENSE NO: _._ ____ / ` 6i ' - Call 639-4175 by 7:00pm for an Inspection the next business day CITY OF TIGARD Electrical Permit Applicp� Plan Check 4 13125 SW HALL BLVD. RCt�tIYEL' Recd By TIGARD OR 97223 Date Rec'd MAY l 1 ?nor Date to P E --_�_ Phone (503)639-4171, x304 Date to DST Inspection (503)639-4175 Print of Type COMMUNITY DEYf1,pPMEAII Permit' (l.L.;Wlw,��_ Fax (503) 598-1960 Incomplete or illegible will not be accepted Called — 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Li r t t f 1, DI6 7 4 L—_ Number of Inspections per permit allowed I Name(or n?n,of business) R Agee,c,.�., wT.a..! j.<<.,,....a Service included: Items Cost Sum 1_ y Address -/e_: $(.� E tie w ter.. ` (sk ci. ;7(4.- 4a. Residential-per unit City/State/Zip 1, A d e,1 / `I) z z 1000 sq ft or less __ $ 117 75 - 4 Y P_ j �j _ Each additional 500 sq ft or portion thereof S 20 75 I Commercial Residential El Limited Energy _ S 60 00 _ Each Manufd Home or Modular — 2a. Contractor installation only: Dwelling Service or Feeder ` S 72 75 2 (Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders information for COT data base). Installation,alteration,or relocation Electrical Contractor L.), l y,...p ._ 2 1-,:->•t,c_-4, — _ 200 amps or less S 64 25 2 201 amps to 400 amps $ R5 50 2 Address f__( A rl,& 7 34) i-4, } -- 401 amps to 600 amps $ 128 50 2 City _f`, it Art State 0,t ZIP t11t1.__ 601 amps to 1000 amps $ 192 502 Phone. NO Sr 2-1/442-1/443L __ - - / _ Over 1000 amps or volts — S 363 75 2 Job No _ 8 el _ Reconnect only S 53 50 _ 2 Elec Cont Lice No P4. 2 bl C.. Exp Date /U• f -c•c 4c.Temporary Services or Feeders OR State CCB Reg No 7)-0 ft/—Exp Date S-I. '0 j Installation.alteration.or relocation COT Business Tax or Metro No /5-p4Exp Date Sr-/ et' 200 amps cr less _ S 53 50 _ _ 2 201 amps to 400 amps S 80 25 2 Signature of Supr Elec'n ' 401 amps to 800 amps _ S 100 00 _a_ 2 Over 600 amps to 1000 volts, see"b"above License No _/ y t f— S Exp Date i d- / • UY 4d.Branch Circuits Phone No _ 6Li_ -3V/ New alteration or extension per panel a)the fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's NameEach branch circuit ----- _`__ S 5 35 __ 2 b)The fee for branch circuits Address without purchase of service City _�._------__-- State Zip _ _ or feeder lee. cl- Phone No brit be arch circuit3/ S 37 50 7 I a,h additional branch circuit Cii S 5 35 7 The installation is being made on property I own which is not 4e Miscellaneous intended for sale. lease or rent (Service or feeder not included) Each pump 0'irrigation circle $ 42 75 Owner's Signature. Each sign or outline lighting _ S 47 75 Signal circuit(s)of a limited energy V4J (if required):* panel,alteration or extension S 60 00 3. Plan Review section Minor Labels(10) S 100 00 Please check appropriate item and enter fee in section 5B 4f.Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more I''''"'sl""r,"' $ 50 00 ---.— r'1`1 '1,111' $ 5000 System over 600 volts nominal In,lant $ 59 00 Classified area or structure containing special occupancy as v described in N F C Chanter 5 5. Fees: 4, 5a.Enter total of at,. I.. , 5 44--1_ Submit 2 sets of plans with application where any of the above apply I R%Surcharge(08 X total fees) $ Not required for temporary construction services Subtotal S Sb.!ore,'25%of hoe 6a for NO1ICE Plan Review 11 required(Sec 3) S PERMITS BECOME VOID IF WORK OR CONS1 RUCTION AUTHORIZED Subtotal S —" — IS NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A F'FRIOO Of 180 DAYS 0 Trust Account M __ C f AT ANY TIME AFTER WORK IS COMMENCED Total balance Due 3aa i ,I-i 'nii ,-I,,in, a., I