Permit CITY O F T I G A R D ELECTRICAL PERMIT
• PERMIT #: ELC1999 - 00628
li DEVE PMENa r S RRVICES ggg���4171 DATE ISSUED: 10/22/99
PARCEL: 1S126DC-04500
SITE ADDRESS: 09575 SW LOCUST ST
SUBDIVISION: LEHMANN ACRE TRACT /G/A/4 C -P
BLOCK: LOT : 007 TIG
TIG
Project Description: Installation of 2 200 amp temporary services.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 2 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
Owner: Contractor:
VIP MOTOR INNS INC CITY ELECTRIC + SUPPLY CO
29757 SW BOONES FERRY RD 8070 SW NIMBUS AVE
WILSONVILLE, OR 97070 BEAVERTON, OR 97008
Phone: 503682 -9284 Phone: 641 -8012
Reg #: SUP 3592S
LIC 42422
ELE 26 -289C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 10/22/99 $100.00 99- 319269 Elect'I Final •
5PCT DEB 10/22/99 $7.00 99- 319269
Total $107:00
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
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules ado. -• bythe Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain co •' -s of these rut- or direct questions to OUNC at (503)
246 -1987. ' al
PERMITTEE'S SIGNATURE ISSU' BY: �/ j
OWNER INSTALLATION ONLY
The installation is being made otroperty 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: 551 �5
Call 639 -4175 by 7:00pm for an inspection the next business day
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. l �� p �
Tigard, OR - 97223- Permit- # E l (.,a�g
/ �� i � li Date Issued /o-619---19 �l�l h�d�l 0 ' { li P hone (503) 639 -4171
- FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 0€ I,( l v v\ Number of Inspections per permit allowed
Address 157 5L) LOCUM ", Service included: Items Cost(ea) Sum
t
City /State /Zip 1 (5a,� q o✓ l `777 4a. Residential - per unit
11 � i _ 1000 sq. ft. or less $110.00 4
Name (or name of business y Clt IX, tuu Each additional 500 sq. ft. or
portion thereof $25.00
Commercial Residential I Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
�i Installation alteration or relocation
Electrica Con > p Le c; br � 20 amps or less $60.00 2 et
Address /" Sts 1 ), 11`1 201 amps to 400 amps $80.00 2
401 amps to 600 amps $120.00 2
Cit State_ Zip ! q / 601 amps to 1000 amps $180.00 2
340.00 2
Phone No. t4 t..-Pi: N 7 Over 1000 amps or volts $ 340.00 2
Job NO. Reconnect only
contractor's license NO. Sib -261C. 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 2. Installation, alteration, or relocation
Signature of Supr. Elec'n 200 amps or less 100.043 2
License No. ?� Phone No. (gip 201 amps to 400 amps $50.00 12 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit $35.00
not intended for sale, lease or rent.
Each additional branch circuit $5.00
. Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: n�yr��
5a. Enter total of above es $ /w•ap
NOTICE 5% Surcharge total fees) $ t.
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal ltlo� $ �l p®
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordre°mdeNeiec- ❑ Trust Account #
$
prm.app
Balance Due $ ! DSW
WASHINGTON COUNTY N O T I C E
9 DEPARTMENT OF LAND USE AND TRANSPORTATION
� / 3 HILLSBORO, OREGON 97123 THIS PERMIT -GUST BE
4 V APPLICATION AND PERMIT TO OCCUPY OR PERFORM OPERATIO S PRESE AT T ALL TIMES
TIR SITE
E
WITHIN THE RIGHT -OF -WAY OF COUNTY AND DEDICATED ROAD- S
APPLICATION
Date 11/09/99 Fee: $ 150
Permit No. 1169I
Name Of Applicant VIPS MOTOR INNS, INC NOTIFY WASHINGTON COUNTY
24 HOURS PRIOR TO START
Address 29757 SW BOONES FERRY RD WILSONVILLE 97070 AND UPON COMPLETION
Phone 682 -9284 Contact STEVEN JOHNSON 846-7647
Applicant hereby applies to the Washington County Department of Land Use and Transportation for
permission to perform the following operations within rights -of -way under Washington County's
jurisdiction. Types of operation and location are as follows:
Type of Work: DRIVEWAY CLOSURE
Address of Work: 9990 SW GREENBURG RD PHOENIX INN
PERMIT
The appropriate General provisions contained in "Washington County, Department of Land Use
and Transportation, Rules and Regulations for Pole Line, Buried Cable, Pipe Line and
miscellaneous operations and /or facility permits" as supplemented and modified by the Standards
and the following special provisions, shall apply to this permit, and by this reference,are made
a part thereof. It shall be the obligation of the applicant to obtain said Standards and Rules
and Regulations from the Department of Land Use and Transportation and to determine which of the
various provisions are applicable before commencement of work under this permit. It shall be the
the applicants responsibility to ensure compliance with Oregon Revised Statutes 209.140 and
209.150 including all subsections, with respect to interference, removal, or destruction of
survey monuments.
SPECIAL PROVISIONS
See attached
This permit is issued by the Department of Land Use and Transportation subject to the terms and
provisions contained herein and /or attached hereto. This permit is accepted and approved by
applicant subject to said terms and provisions.
Maintenance Bond Amount: $ 250 Applicant STEV:/ JOHNSON /
le
Type of Bond [ ] Surety Bond # By /%J /! -
[ ] Cash; Check # Or '�
[ ] Receipt #
Title
Received 11/09/99 Wa�s•' 4•..n County
Expires 11/08/00 D -•a e t •f Land se and T = sp4 on
Nab B \
Rev. 03 -08 -94 Original Permit Office
FORM No. 970 - OUITCLAIM DEED - STATUTORY FORM (Corporate Grantor). STEVENS-NESS LAW PUBLISHING CO.. PORTLAND OR 9T'04
I; NA � �
I
,NA e��‘� QUI TCLAIM DEED — STATUTORY FORM I '
�n1 I
I. ✓1 CORPORATE GRANTOR li
t: u.LP' S..Motar_..Inns.,...Ino , • I
on j. a corporation duly organized and existing under the laws of the State of. Oregon Grantor, H
"� i releases and quitclaims to VIP'S Motor Inns, Inc., an Oregon Corporation li
i ii
•
l
.0 , Grantee, all right, title and interest in and to the following described real property,
(' situated in Washington County, Oregon, to -wit:
Legal description contained in Exhibit A, attached hereto and incorporated by this H
reference as if fully set forth herein.
*NOTE:
The real property in Exhibit A is an assemblage of several parcels of
land acquired in multiple transactions by Grantor /Grantee. This deed
is executed, delivered and recorded in order to comply with City of Tigard
Site Plan Review conditions (SIT #: 99- 00049) that, since the proposed
project site consists of more than one parcel of land, the site must
be consolidated into one parcel so that there is no underlying land division
within the proposed project site.
(IF SPACE INSUFFICIENT, CONTINUE DESCRIPTION ON REVERSE SIDE)
The true ccn°ideration for this conveyance is $..10...00
(Here comply with the requirements of ORS 93.030)
. *iow.ever, the actual consideration consists of or includes other property
_or.__other value given or promised as the whole consideration for this transfer,
the..zQceipt and suffiency of which is hereby acknowledged by Grantor and Grantee.
Done by order of the grantor's board of directors with its corporate seal, if any, affixed on October 21, 1999
THIS INSTRUMENT WILL NOT ALLOW USE OF THE PROPERTY DESCRIBED IN THIS VIP ' S Motor Inns , Inc .
INSTRUMENT IN VIOLATION OF APPLICABLE LAND USE LAWS AND REGULATIONS.
BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON ACQUIRING FEE By S�ipNp),�� President
TITLE TO THE PROPERTY SHOULD CHECK WITH THE APPROPRIATE CITY OR COUNTY
PLANNING DEPARTMENT TO VERIFY APPROVED USES AND TO DETERMINE ANY $ S V. Johnson
LIMITS ON LAWSUITS AGAINST FARMING OR FOREST PRACTICES AS DEFINED IN 3' , Secretary
ORS 30.930.
STATE OF OREGON, County of Clackamas ss.
This instrument was acknowledged before me on October 21, 79 99
by Steuen.V._.. Johnson '
as President
of VIP'S Motor Inns, Inc.
�. :% OFFICIAL SEAL ���� _
' is - 4 NOTARY PUBLIG
4/ ARTHUR E. COYNE
l am - OREGON
\ " ' '� COMMISSION N0.060419 Notary Public for Oregon
MY COMMISSION EXPIRES DEC. 22, 2000 My commission expires v� - *— � — z -- °-- - C="=='
..Y1P'.S._ Inns, Inc. STATE OF OREGON,
__2.9757. Boones Ferry Rd. County of } ss.
._Wi1 QEwille, OR 97070 I certify that the within instrument
Grantor's Name and Address
VIP'S Motor Inns, Inc. was received for record on the day
29757 SW Boones Ferry Rd. of ,19 ,at
Wilsonville, OR 97070 o'clock M.,and recorded in
Grantee's Name and Address SPACE RESERVED book /reel /volume No on page
FOR and /or as fee /file /instru-
After recording return to (Name, Address, Zip): RECORDER'S USE
• VIP'S Motor Inns, Inc. ment /microfilm /reception No ,
29757 SW Boones Ferry Rd. Record of Deeds of said County.
Wilsonville, OR 97070 Witness my hand and seal of
• Until requested otherwise send all tax statements to (Name, Address, Zip): County affixed.
YIP'S Motor Inns, Inc.
_29757 SW Boones Ferry Rd. NAME TITLE
':I . OR 97070 O '
By , Deputy
CASWELL /HERTEL
SURVEYORS, INC. EXHIBIT A
REGISTERED LAND SURVEYOR a 6120 S.W. Lombard Avenue a Telephone 503/644.3179
Oregon - Washington • Idaho Beaverton. Oregon 97008 -4736 FAX 503/644 -3190
October 19, 1999
Job 6087 -50
LEGAL DESCRIPTION
FOR
VIP'S MOTOR INNS, INC.
A PARCEL OF LAND LOCATED IN THE LOTS 6 AND 7 OF BLOCK "C"
"LE.HMANN ACRE TRACTS" IN THE SOUTHEAST QUARTER OF THE SOUTHWEST
QUARTER OF SECTION 26 AND THE NORTHEAST QUARTER OF THE NORTHWEST
QUARTER OF SECTION 35, TOWNSHIP 1 SOUTH, RANGE 1 WEST, WILLAMETTE
MERIDIAN, CITY OF TIGARD, WASHINGTON COUNTY, OREGON, BEING
FURTHER DESCRIBED AS FOLLOWS:
BEGINNING AT THE NORTHWEST CORNER OF SAID LOT 7, BEING A
POINT ON THE SOUTH RIGHT OF WAY LINE OF SW CORAL STREET;
THENCE S88 °51'45 "E, ALONG THE SOUTH LINE OF SAID STREET, A
DISTANCE OF 95.17 FEET; THENCE S01 °05'41 "W, ON THE LINE DIVIDING
THE EAST AND WEST HALVES OF SAID LOT, A DISTANCE OF 176.15 FEET
TO A POINT ON THE SOUTH LINE OF SAID LOT 7; THENCE N88 °54'31"W, A
DISTANCE OF 95.15 FEET TO THE SOUTHERLY CORNER COMMON TO SAID
LOTS .6 AND 7; THENCE CONTINUING N88 °54'31 "W, ON THE SOUTH LINE OF
SAID LOT 6, A DISTANCE OF 201.28 FEET TO THE EAST RIGHT OF WAY
LINE OF SW GREENBURG ROAD (COUNTY ROAD 2472); THENCE N11 °30'56 "E,
ALONG SAID RIGHT OF WAY LINE, A DISTANCE OF 0.31 FEET TO AN ANGLE
POINT IN SAID RIGHT OF WAY LINE, SAID POINT BEING 30.00 FEET
EASTERLY OF, WHEN MEASURED AT RIGHT ANGLE THERETO, THE CENTERLINE
3
OF SAID ROAD; THENCE N15 °42'23 "E, ALONG SAID RIGHT OF WAY LINE, A
DISTANCE OF 99.28 FEET TO THE NORTH LINE OF THAT TRACT OF LAND
DESCRIBED IN DOCUMENT NUMBER 96- 000045 OF THE WASHINGTON COUNTY
i KECORDS; THENCE S88 °51'45 "E, ALONG THE NORTH LINE OF SAID
DEED, A DISTANCE OF 176.15 FEET, TO A POINT ON THE WEST LINE OF
SAID LOT 7; THENCE N01 °05'18 "E, A DISTANCE OF 80.00 FEET TO THE
TRUE POINT OF BEGINNING. THE ABOVE DESCRIBED PARCEL CONTAINS
34,942 SQUARE FEET MORE OR LESS.
END OF EHIBIT A
r `
STATE OF OREGON
SS
• County of Washington
I, Jerry J3.?ifanson,nD1rector, of Assess-
ment and �9a ation'and``Ez- Officio County
Clerk foreaid.dounty; doei Certify that
the withmiristrumenttofwriting was received
and recorded::lra'`b:Q:ok°of.; %records qof said
county. < P
l:. ° i`er•ry R .H4nson,1Director of
t: Assessme'nt'and'Taxation, Ex-
Officio�GourityClerk
Doc : 99120247
Rect: 242489 46.00
10/26/1999 10:53:52am
1