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9430 SW CORAL STREET STE 200-1 0 co 0 y n 0 0 0 09430 SW CORAL ST 200 CITYOF T I OA R D _CERTIFICATE OF OCCUPANCY 1 DEVELOPMENT SERVICES PERMIT#: bJP2004-00024 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639- 1171 DATE ISSUED: 1/26/2004 PARCEL: 1 S126DC-04400 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 09430 SW , ORAL ST 200 SUBDIVISION: LEHMANN ACRE TRACT" BLOCK: LOT:007 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 15 TENANT NAME: DR DENNIS CLARK REMARKS: Tenant Improvement Owner: MARTIN ROBERT CLARE THELMA M BY JO RENEMMOODHE JRhoe°0p5p08i�`&n71 Contractor: 557-0866 BNK CONSTRUCTION INC 10730 SE HWY 212 PO BOX 66 CLgCK'kMA R 9701 Phone: -1( 85 FA ' 557-f860 Reg #: MEI 00003941 LIC 107555 This Certificate issued 4/8/21104 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 Cgdes for th group, occupancy, ani u e and lich the referenced permit waV i 'Clat, BU DING INSPECTOR BUIL IIN OF CIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING Inspertion Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 0 0 Z S Received _5117-17 Z. ,S Date Reques!ed_7"_� AM PM BUP / U O©Z-•y Location W3 _ _ —_. —Suite MEC Contact Person _ _— Ph(.509 ) PLM Contractor _ Ph( ) _ SWR U -1 Tenant/Owner— 2X ELC Foo ng — Foundation ELC — Ftg Drair, ACCPSS: Crawl Drain 7- ELR — Slab Inspection Notes: ` Sf — JU SIT _ Post 8 Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear - Framing Insulation Drywall Nailing — Firewali Fire Sprinkler - — ---- —.— Fire Alarm Susp'd Ceiling Root WPART FAILNGE Post&Beam — — Under Slab Rough-In Water Service Sanitary Sewer Rain Drains --- — Catch Basin/Manhole Storm Drain - -- ---- _— Shower Pan Other: Final --- --�-- PASS PART FAIL --- -- - MECNANIC_AL Post& Beam — Rough-In Gas Line — §qjokAk Dampers 420 �<' PA PART _FAIL -"-- — — -- ---- -- ELECTRICAL Service --- Rough-In UG/Slab -- - - --- Low Voltage Fire Alarm Final Reinspection fee of$_. required before next ins PASS PART FAIL L� 4 inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE - [—I Please call for reinspection RE: Unable to inspect-no access Fire Supply Lina ADA Approach/Sidewalk UMpNotff — Ext--- Other: _ Final - —� DO NOT REMOVE thle Inopoetlon record from the job olto. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639.4171 MST BUP Received ______ Date Fe nested _-Z-- AM--PM— BUP "�2� 2 s Lcsation _____ Suite ___ MEC Contact Person ` Ph(-----) PLM Contractor Ph(—) _ SWR BUILDING _ Tenant/Owner Ltr �, l" _ ELC Footing Foundation Access: ELC _ Ftg Drain ELR _ Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear / ----� Framing ✓n ✓ __��9' ` Hsulation / r - J Drywall Nailing r `� a 1 A 5! �Q T( d N �.V v ✓r �y.� ,/ C p� Fir�re6vall~`� ✓ t w\ Fire Alarm s �� ( ` � I�"/ .s � f S s_I_�1_ S_r�l� I11 4 � 1� Roo �J Sl ��15 -� Other: VASk .PART FAIL —PLU—MBING Post& Beam Under Slab o�� ✓_—! 14 0 6 � _ Q � r© ✓ Rough-In Water Service --- Sanitary Sewer Gl +0 Vt ( 1 �, �-�,� `C Rain Drains — - Catch Basin/Manhole ��, a V� V Storm Drain I ►V ��=1--�— cn)�(YC' i�( d Showe, Pan t Other: — Final — PASS PART FAIL — MECHANICAL Post& Beam Gas Line Smoke Dampers - _— Final PASS PART FAIL — — - ELECTRICAL Service Rough-In UG/Slab — ----- — -- Low Voltage Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE u Please call for reinspection RE: u Unable to inspect-no access Fire Supply Line /re ADADab �29 "fCc i Approach/Sidewalk Other: Final -� — AO NOT REMOVE thls Inspeotlon record front the job oft. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST SUP _---- Received _ Date Reque;ted - AM PM _ 3UP Location _ y G� a--� Suite a a MEC Contact Person ' -- Ph( U) 7 9 7�5~ PLM _ Contractor __— Ph( ) SWR BUILDING _ Tenant/Owner __ ELC Footing Foundation ELC Access: Fig Drain D�� r / ELR 62a O Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear — Framing _. _ Insulation Drywall Nailing - - - — — Firewall Fire Sprinkler — -- -- -- Fire Alarm — Susp'd Ceiling --- Roof Other: — Final PASS PART FAIL — - PLUMBING Post&Beam ' Under Slab Rough-In Water Service — — Sanitary Sewer Rain Drains — Catch Basin/Manhole Storm Drain — — Shower Pan Other: 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 1�AS PART FAIL F-1 Reinspection fee of$__. required b -e next inspection. Pay at City Hall, 13125 SW Hall Blvd. 3 F] Please call for reinspection RE: Unable to inspect-no access Fire Supply LineADA Approach/Sidewalk In! Ext Other: Final — DO NOT REMOVE this Inspection mord froln the jobli4e- PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP Received 12 ` o Date Requested T �–U 7 AM —PM_ BUP Location __ q44S d Cry a_e r Suite MEC Contact Person — Ph t _) PLM Contractor —� Co��,c -- Ph(sem,, 27^.3 3� SWR BUILDING Tenant/Owner OLC Z Z_ Footing Foundation ELC _ Access: Ftg Drain ELR - Crawl Drain Slab Inspection Notes:�.� — SIT — Post 8 Beam Shear Anchors �� — Ext Sheath/Shear A4' 'lo Int Sheath/Shear Framing - - Insulation Drywall Nailing —Firewall Fire Sprinkler - -- --- -- Fire Alarm Susp'd Ceiling ----- --- ---- -- --- ---_ -- Roof Other. ------ Final -- - PASS PART FAIL ---------- -� PLUMBING Post&Beam -�--- � ----� -- -- --- Under Slab Rough-In Water Service -- --- _- Sanitary Sewer Rain Drains - —- - Catch Basin/Manhole Storm Drain ----- — - - Shower Pan Other: __ _ --- --- -- - ----_- Final PASS PART FAIL — -- -- -- MECHANICAL Post&Beam ---- _--- -- --- ---------- ---- Rough-In --- -.-.-_ — __-- Gas Line Smoke Dampers -- - --- -- —.—_- 1-mal PASS PART FAIL ------ ---- -- — ELECTRICAL Service ----- -- —� Rough-In _— UG/Slab Low Voltage -- larm FinalReins action fee of$ required before next ins PART FAIL p 4 Inspection. Pay at City Hall, 13125 SW Hall Blvd. [] Please call for reinspection RE:---- Unable to Inspect-no access Fire Supply Line ADA _ Approach/Sidewalk Bib �--- Inspector or - Other: Final DO NOT REMOVE Ws Inspootlon record from the Job she. PASS PART FAIL CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MI-C2004-00014 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639,-4171 DATE ISSUED: 1/14/04 PARCEL: 1 S 126DC-04400 SITE ADDRESS: 09430 SW CORAL ST 200 SUBDIVISION: LEHMANN ACRE TRACT 'ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIC ';LASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 3 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: WOODSTOVES: GAS PRESSURE: 5U + HP: CLO DRYERS: FURN < 100K BTI,: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: Air ihstrihutiiu, (ui existing hc;iting& AC system. I r 70 CIM exhuu,,t tanti. Owner:_ FEES MARI-IN, ROBERT CLARE Description Date Amount THEL MA M –—' BY JO RENE M MOOUFIE BVI c III 1'crnut [Cl: 1/14/04 5177.50 SHERWOOD, OR 97140 IA ti titatrtiurrh.ui 1;14;04 X14.20 Phone: L___ _ Total $191.70_ Contractor: OREGON HEATING +A/C INC PO BOX 397 DUNDEE, OR 97115 REQUIRED INSPECTIONS Phone: 538-2953 Mechanical Insp Duct Inspection Reg #: LIC 125,315 This permit is issued subject to the regulation.; contained in the Tigard Municipal Code, State of Ore. Specially, Codes and all other applicable laws. Al l worm will be done in accordance with approved plans. This permit will expire if worts 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 in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued By: ✓ � _�._�_._. � cc&t Permittee Signature: Call (503) 639-4175 by 1:00 P.M. for ins;:pctions needed the next business day Mechanical Permit Application yol; O C'll Ui"11 ilyd Iteccrvcd t Permit Nu J Datc/By: 1 / —L 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: Inspection I ine: 503.639.4175 Date Ready/By: Jura 0 See Page 2 for Internet: www.ci.tigurd.or.us Notined/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST ❑New construction [Addition/alteration/replacement Mechanical permit fees"are based on the value of the work i performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: rnechanical materials,ecluipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:S / ❑ I-end 2--family dwelling ❑Commercial/industrial ❑Accessory building RESIDENTIAL EQUIPMENT SYSTEMS FEES" For special information use checklist. ElMulti-family ❑ Master builder El Other: h Description Qty. Eu. I Total JOB SITE INFORMATION AND LOCATION Heatln coolin Job site address: Air conditioning or heat pump �� 2j� f� (requires site pla i showing placement) 14.00 City/State/ZIP: t/ n /J r't Furnace 100,000 BTU(ducts/vents) 14.00 5uile/bld ./a t.no.: -- Pro ert name: Furnace 100,000+BTU(ducL5wenla 17.90 8 p / J �I�64 z q , Gas heat pump 14.00 _ Cross street/directions to job site: Duct work 14.00 n -- liydronic hot water system _14.00 Residential boiler(radistor or / h dronicl 14.00 _ ---- --- Unit heaters(fuel-type,nut electric), in-wall,in-duct,sus ended,etc 10.00 _ Subdivision: Lot no.: Flue/vent for any of above 10.00 Other: 10.00 Tax map/parcel no,: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 ' Flue vent for water heater or gas fire lace _ 10.00 Lo Iighter_�Pas) 10.00 Wood/pellet stove 1100 Wood fireplace/insert 10.00 ❑ PROPERTY OWNER �ENANT Chi mne /liner/flue/vent 10.00 Other: Name: Environmental exhaust and ventilation Address: Range huod/other kitchen _ equipment 10.00 City/State/Z[P: Clothes dryer exhaust 10.00 ----- Single-duct exhaust(bathrooms, Phone:( ) Fax:( 1 toilet compartments,utility rooms) 6.80 ❑ APPLICANT B 7CONTACT PERSON Attic/crawls ace fens 10.00 Other: 10.0o Business name: Fuel PIpInIti Contact name: $5.40 for nrst four;$1.00 for each additional-- Address: dditional Address: -Furnace,etc. _ -- Gas heal pump City/State/ZIP: Wall/suspended/unit heater _ Fax::( Water heater Phone:( ) (/C� �!�'} Fireplace — -- E-mail: f _ Range CONTRACTOR Barbecue 1 Clothes dryer(gas) Business name: , 4t' Other: _ Address: _ MECHANICAL PERMIT FEES* City/State/ZIP. r971 Subtotal -- Phone:(t.. ) �_. _ Fax:(a ) �- _ _ Minimum permit fee($72.50) Plan review(I5%of permit fee) CCB lic.: /L►- - State surcharge(8%of permit fee) TOTAL PERMIT FEE / v Authorized signetut This permit application expires If a permit is not obtained within I80 days after It has been accepted a complete. Print name. , -- Date: Fee methodology set by Tri-County L 'ing Industry Service Board i'�BuildinpPermiu\MP.(-PennitAl.mdm 12,01 440-4617T(II/02iCOM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: _ r Total Valuation: Permit i.- $1.00 to$2,000.00 Minimun..ee$72.50 $2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30 for each additional$100.00 or fraction thereof,to and including$5,000.00. $5,001.00 to$10,000.00 $141.50 for the first$5,000.00 and $1.80 for each additional$100.00 or fraction t'--reof,to and including _ $10,000.0u. $10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and $1.3.5 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and $1.25 for each additional$100.00 or fraction thereof,to and including _ $100,000.00. $100,000.01 and up $1,396,50 for the first$100,000.00 ind $1.10 for each additional$100.00 or fraction thereof. Note: All new commercial buildings. require 2 sets of plans. isBuilding\Peimits\MEC-PermitApp.doe 12/03 2 PERMI CITY OF TIGARD ELECTRICAL r EENER - STRICT[D ENERGY DEVELOPMENT SERVICES - PERMIT#: ELR2004-00009 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/21/04 SITE ADDRESS: 09430 SW CORAL ST 200 PARCEL: 1S126DC-04400 SUBDIVISION: LEHMANN ACNE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIG Proiect Description: Limited energy for HVAC controls. A.RESILENTIAL __— _ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM- BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: — — — —� Y Connector: MARTIN, ROBERT CLARE OREGON HEATING4AIR GOND THELMA M PO BOX 397 BY JO RENE M N JODHE DUNDEE, OR 97115 SHERWOOD, OF; 97140 Phone: Phone: 503-538-2953 Reg #: ELF. 522LIIlt LIC 175815 FEES Required Inspections —_ Description _Date _ amount Low Voltage Inspection I.I'ItM'I'j 1 I R I'rri rid 1121 04 ----� $75.00 Llect'I Final � FAX 1 8" SIMC Surchvi 1/21/04 $6.00 1 — — Total _ $81.00 II This Permit is issued subject to the regulations contained it tete Tigard Municipal Code, State of OR. Specially Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is riot started within 180 days of'ssuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to fpNcW nabs-adopted by the Oregon Utility Notificat;on Center. Those rules are set forth in OAR 952-001-0010 throuc Is ued by /,� Permittee S'sgnature ..LL t-1 -- OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNFR'S SIGNATURE: DATE: CONTRACTOR !NSTALL.ATION ONLY SIGNATURE OF SUPR FLFC'N — �_-- _ — _ DATE:—_ LICENSE NO: _ —_--- ------- - ---- --- -- — Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Jan 16 04 02: 16p Oregon Heating ar.d Hir 503-537-2172 p. 1 Electrical4wccation —" �AM F3atc received: ; � Pcrmit no.& t �— City of Tigard Project/appl.no.: date: t'iN o/"l'{q�rd Address: 13125 SW Hai Q)ErTA(AR223 Date issued: ey Rcccipt no.: Phonc: (503)639-4171�U�`D�NG DIVISIONFax: (503) 598-1960 Case File no.: Payment typo. _ i_.ancl use approval: G C�U o01, U I &2 family dwelling or accessory ' ommercial/industrial U Multi-family U Tenant improvemem U New construction U Aci(liliun/alteration/replacement U Other: U Partial Job addr^ss: Bldg.no.: Suite no ITax map/tax lot/uccount no.: _ Lot: Block: Subdivision: Project name: Description and location of work on premises: Estimated date of conipletiou/utspection: Job no: Ree Man 1 T Description Qty. a.) Total nu.ias B1191neg8 name: iO(1}'1 lY1 d Al(Z �(� _y, - �_ —N.; Per Address: �C1 ��! dNellinguult.Includes attachedcarage. City: , 11 state: t Z1P: I Serrkeincluded: Phone: 5; '� Fax: 531-___-�_mall: Ia«l ag n.nr les, _ 4 Each additional 500 sq.n.or cion thereof _ CCB no.: E ec.bus.tic.no: Lrmitad energy, rnldanrixl 2 City/ no. y .�,�--- Limited energy, non.teside Ilial 2 _ Each manuroclured home or modular dwelling Ci narur w !A, un eledrfclan(re aired) Datate $![Vi ancVor Carder 2 d--- - -- 9-- — lervicevorfeeders-Irntaitation. Sup, elect. name(print). LicenseRff no: al/cation ertelocation: 200 amps or less _ 2 Nome(print): De 20l amps to 400 amps 2 C 401 em to 6011 strut _ 2 Mailingaddress: ao � _ _ 601 amps to 1000 amps 1 _ City: tate: ZIP: -_ Over (000 amps of Its Phone: Fax: F-mail: Re.nnect only owner installation: The installation is being made on property I own. Temporary senicesorleaders - which is not intended for sale,lease,rent,or exchange according to InstallatIon,slteration.orrelocation: 201 URS 447,455,479,670,701. 201 amps to 40F1 amps Owner's signature: Date: 401 to 600 stns arancbeireutu new,attention, or extension per panel: Name: A. rce for breach rircaits mthi purchase of Address: service or feeder fee,each')ranch circuit _ 2 City: ZI —_- State: P: B. Pee ria broach circuits without purchase 1) �— - of service at feeder fee,first branch circuit: 2 Phone: - — FaX E-mail( Each additional hrnnchdauu. -- Mlse,(Servir etar feeder not Included): U Service over 125 amps•commereiol 0 Flealth care facility Paeh pump or in Wflon clm;e v 2 Li Service over 320 amps-owns of IW 0 ilazardous location Each sign or outline lights- - 2 family dwellings U Building over 10.000 uprwc feet fora ur Signal clradt(s)or a limited energy panel, O System over 600 Volta nominal more residential units in one urwturc alteration, rsr extension* 2- * 0 Building over three stories O Feeders.4x0 amps or mare apescri tion O Occupant kind over 99 persons O Manufactured Ortocturrs or RV park Each additional lots Intel=over the allowable In any ofilmabove: G Egress/lighting plan U tither Per inspection -T -- Sablalt__„_seta of plans with nov of the above. tnvestl Iron fec 'rhe above are not applicable to temporary caa>rtrUtti011 atnit:e. Other Nat all jurisdictions accept credit cards please am ll jurlt llcuon roc nru:ofartration. Notice- 'Mis permit application Permit fee...................... U Visa, U MasterCard expires if a permit is not obtained plan review(at %) s Credit card number _.._ J_.._ within I V days oiler it has been Slate surehgrge(13%).....5 ,__- _uV oi u iFovm on tieaTiaa�- apttas' accepted us complete. TOT4L.................. E `Name of cs�folJ �— — - s --_—._-f iu-ixfiioirlofirpieTre— 7mnsnt 44a.46iSI61001COM) __ —_T CITY O F ' I G,�R D BUILDING PERMIT PERMIT #: BUP2004-00025 DEVELOPMENT SERVICES DATE ISSUED: 1/26/04 13125 SW Full Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S126DC-04400 SITE ADDRESS: 09430 SW CORAL ST 200 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIG REISSUE: FLOOR AREAS_ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: FPS FIRST: Sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 15 BASEMENT: 5f AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RAl ED: BSMT?. MEZZ?: REQD SETBACKS _ _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMCK DET: DWELLING UNITS: FRN'r: ft REAR: ft FIR ALRM - HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,897.00 Remarks: Add 23 heads, remove 1" plugs Owner. Contractor: MARTIN, ROBERT CLARE LARSEN FIRE PROTECTION CO THELMA M LYLE LOUIS LARSEN BY JO RENE M MOODHE 16410 S HIRA.M AVE SHERWOOD, OR 97140 OREGON CITY, OR 97045 Phone: Phone: 655-5456 Reg #: LIC 118596 _ ^v FEES REQUIRED INSPECTIONS Description Date Amount Sprinkler Rough-In VIII !LUj 11rrnur Fee � 1/26/04 $62.50 Sprinkler Final ITAXJ 8 SI;11C Surrhu;) 1/2.6/04 $5.00 113UPPLNI 111n Rv 1/26/04 $2.5.00 Total $92.50 This [x nrmit is issued subject to the regulatinns contained in the Tigard Municipal Code, State of OR Specially 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 OAF 952-001-0100. You may obtain a copy of these rules or direct questions to OLINC by calling (503) 246-6699 or 1-800-332-2344. Issued By: i' Pennittee �� 7 Signature: Call 639-4175 by 7 p.m. for an inspectiL the next business day 12,'10,,2003 15:u3 FAX 5035981960 CIll 01 11(,Axu Fi -e Protection System p-� B_ u ,_ ildina Permit � '"b',-,i Ravived Building Do jy! 0 City of Tigard 1 I PlumIng Approval Other DatdB rertut No.. 13125 SW Had Blvd. ap� < Plan Review other Tigard,Oregon 97223 �� Dat" —, pmnitNo. Phone. 503-639.4171 Fe-i: 503-598-1�C)F Post-Review Lind the lnternet www•ci.tigard.or.us Gt D■w�_ __- — — -Gee No �'t ConflictJuris. 9ee t'a�e 2 for 24-hour Inspection Request: 503.639 Name/Method Supplemental Information bAI New construct on _—_ Dernohtto t r �W1{LLINat; Addition/altthation/re laceme It Other, - Q I, ,( ,; Net Permit fees,art baled on the total value of the work performed Indicate 1 1 &2_ Family dwelling I 1Y.,'lommercial/Industrial the value(rcundcd to the nearest dollar)of all equipment,msI labor, Acccstsory Building Multi-Family overhead and profit for flit work indicated cn this application r _ Master Builder— _ valutUnn _. S Jf�Bi61'itB_r"O 4_ 1110 LO, ►TJON No of bedroor+ts No.of beithr__— Job Site address - C T_ Total number of floors. Suiteb: �__ � New +selling urn(s .tt.-) :.., .;; : � A ........gpq. . .......... . _. Pro)ect Namc_��YJv A/1�_Gr1+ul JL _ Covered porch area(sq.11.)_..................... Cross street/Dtrectitms to fob„ite: Deck area(sq.n.)._ .. ......................._ . N►LL'233 7th Mo � 6-4 a-At Other wvcture area(sq R) ............. . 'Cb t�► Subdivision, _ — Lit ft — --- ------ ax m / Amel N: Note- Permit feer•are based on the total value of iha work performed Indicate l'i {; Y Q ^rr �,y• the value imtmded to the neanat Aonar)of all eiwiprrwrt,matcrials,labor, overhead and profit for the work radiated on Out app'canon Valuation. .... S — _-- — 100ng bulldhtg ma(sa ---- New building area(sq ft) .................. .... Number of stories Type of contiruc ton -- - NAmc: ---- Occupancy group(s) Exr,r g ., Aldi:3s: NOTICE: All contractors and subcontractors are required to be Phone: Fes; ^I, ^, licensed with the Oregon C:onoNcnon ConMv.4ore Hoard under K, -.-��' provisions of ORS 701 and may be required to be licensed in the Business Name: kA�L;f�-� r�n.t` nc s _— _-, _f'� �7��1,/ jtuir.diction+v$ere work is being psriormed. If rhe atxAkstnt is excmpt Contact Name. ,yam ( LJlt rt�- from:iceraing,the followrog reason applies: cies, Address: 16 - C %State%Zip: Phone. >13 105*5_15454, 1_Fax' E-mail Business Name: /,Al Lk- E/Qj //1 r Fces due upon atrplicsrttan S_ Address: _ Ci/State/Zip grsrl G Amount received............................ 6— Phone_ : s� lt� I Fax: C Ia rn G -- Due received'-- - _ LCCB Lic. #: 11 >� —--- --- —--- - - ---- -- Authorized 01 �/ G y—veC�l Ctatt i dra f NeThl+permit ap n capitia If a permit It not abulned within$IgTaaturt 180 dors iDer h At+beenn stria arraPted at complete. - lt�� - tJ Q l�/^�Q� -- _ -Fee methedNotr set by Trl•i.00ntt,DulldlnR ittlostry Servlet Gard. (Please print nart _. i:lDstslPnrndt For+rta�BldgPerrmtApp.doc 0103 IT v � l.; tCIP 12%l0%2003 15:OJ FAC 503598141nu / Fire Protection Permit Check List Describe work to be done: A.) 0 New B.) Modification to Sprinkler heads only: f�Addltlon 0 1-10 heads: No plan review required. C� Alteration G�11+ heads: Plan review required. 0 Repair Number of sprinkler heads:—;2� — Additional description of work: AY) I ov vo rT F rl vwN L,<I G"N I/Ve., {. l N C:/ r � ti ✓[f L l� T pe of S stem fcornelete Ap B C or D as applicable : A. �dMr46 rdii4!SpH6916r --Wet Dr - --- Additional Stand "'.t.3 Information: Hazard Group k i Densi Desi n Area l->c+O K. Factor ;Z�� Sprinkler Project Valuation: $ I cl g,LT�'L =Hood'' lire OwORWIsion" te'tn ' I -- Hood Project Valuatlon: C: aFlt!e..AlarmYess Submittal shall Bett�Calculations Include: Individual Component Yes�] Cut Sheets Fire Alarm Pro ect Valuation: $ ;'t,• ft�>ls1' e�Ytial Sprtnkl6r Starr' A ane System Square Footage Permit Fee: 0 to 2,000 $187.50 �2 001 to 3,500 _ $232.50 3,601 to 7,100 _— — $292.50381.50 --- 7,201 and greater $ — s ft Sprinkler Pro®ct_Sguare_Foota e: Project Valuation Subtotal (A, B_& C): $ Permit fee based on valuation see attached chart : $ _—_ Permit fee bed ons uare foota e D see tees above : $ as - --- State Surcharge 80/6 of Permit Fee: $ FLS Plan Review 40% ofPermit Fee: $_ _. -- - -- - -- TOTAL: $_---- Plan review requires a completed application and 3 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression )gineer, or NICET level "3" technicians. bst9\fOM"\FPS4'.kk11s1 doc 02/2&03 Germ TYCO FIRE PRODUCTS, 7071 5 131h Street,Suite 103 Oak Creek,WI 53154—www 4lemsprmkler com Customer Service/Sales: Tel: (877)436.6926/Fax: (877) 866-9250 Technical Services: Tel (800)381-9312/Fax:(800) 791-5500 PENDENT, RECESSED PENDENT, AND UPRIGHT_SPRINKLERS UNIVERSAL MODEL A _ STANDARD RESPONSE, 5 mm BULB TYPE, 5.6 K-FACTOR, 1/2" NPT** ESCUTCHEON 1;16"It1,1 mm) MODEL F700 PLATE SEATING NOMINAL RECESSED SURFACE= NPT• • MAKEIN ESCUTCHEON DEFLECTOR — - - 6• 7/16" _ 5 23116" (11,1 mm) (55,6 mm) i ` NOMINAL a L MAKE IN t-112" 1 138,1 mm) � _—_ 2.3116" J WRENCH (55,6 mm) i f f FLATS I t SSP DEFLECTOR• — 2.7/8"(73,0 mW DIA 112"NPT •• PENDENT RECESSED PENDENT UPRIGHT CROSS SECTION I Frame 3 Gasketed 4 Bulb 6 Deflector • Temperature rating is indicated on deflector or adjacent to 2 Button Spring 5 Compression orifice seat on frame. Plate Screw •• Pipe thread connections per ISO 7/1 can be provide. special request FIGURE A 5.6 K-FACTOR STANDARD RESPONSE MODEL A PENDENT(SIN G7571) AND UPRIGHT (SIN G7570) SPRINKLERS roslve atmospheres Although war ttAI?NING GENERAL DESCRIPTION and lead coated sprinklers have The 5.6 A"-/ n ror Model A Pendent, The 5.6 K-Factor Standard Response passed the standard corrosion tests of Recessed Pendent, and Upright Universal Model A Pendent,Recessed the applicable approval agencies, the Sprinklers described hereat inust be Pendent, and Upright Sprinklers (Ref. testing is not representative of all pos- insfolled and rnatntc,uied in romph Figure A) are autornatic sprinklers of sible corrosive atmospheres Conse- once with this docutrnent, as well as the"standard response"frangible bulb fluently, it is recommended that the applicable standards of the National type. l hey are "standard spray sprin- end user be consulted with respect to hire Protection Association, in adds• klers"intended for use in fire sprinkler the suitability of these corrosion resis- tion to the standards of city other systems designed in accordance with tant coatings for any given corrosive authorities havtrtgjc,risdirtion. Fail• the standard installation rules recog- environment. The effects of ambient tire to do so inoy impair the integrity nized by the applicable Listing or Ap• temperature, concentration of chemi- of Mese devices. proval agency (e g , UL Listing is cals, and gas/chemical velocity. The uiivier is responsible for emelt based on NFPA 13 requirements).The should be considered, as a minimum. mining their fire protection s%steiq Pendent. Recessed Pendent, and Up- along with the corrosive nature of the and dewces tri proper operating r901- r)ht Sprinklers all produce a hemi- chemical to which the sprinklers will be dition, The installing contractor or spherical water distribution pattern be- exposed manufacturer should be corntarted low the deflector VOTE relative to any questions. The recessed versions of the Model A The interrnediun, lo-t el version of the Installation of Model .i Pendent Sprinkler are obtained by utilizing the Model A Pendent Sprinkler is ob. Sprinklers in recessed escutt-henns Model A Pendent Sprinkler In combi- tat ned by utilizing the Model A Pen- other than the F700 will ioid all nation with the Model F700 Recessed dent Sprinkler(SINC-_;71)ur coinbi• sprinkler warranties, as tuell as pos. Escutcheon (Ret Figures A and 8) nation 14.1111 the Madel Q-67 Shield sibly void the sprinklers Apprnvals The F700 Recessed Escutcheon pro- described in Ternntrol 1)ata Sheet 1?1( lr)r listings. vides 112 inch (12,7 mm) of recessed TU501M aa, .-tmeni or up to 3/4 inch(19.1 mm) of ijastment from the flush pendent TECHNICAL DATA pusition. APPROVALS The 56 K-Factor Model A Pendent Wax and lead coatings are utilized to Laboratory listings and approvals for Recessed Pendent,and Uprignt Sprin- extend the life of copper alloy sprin- the 5.6 K-Factor Model A Pendent klers are rated for use at a maximum klers beyond that which would other- Recessed Pendent,and Upright Spnn service pressure of 175 psi (12,11 bar) wise be obtained when exposed to car- klers are given in Table A and they are available in the tempera Printed in U S A 3 01 1TD5+6M BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2004-00024 DEVELOPMENT SERVICES DATE ISSUED: 1/26/04 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S126DC-04400 SITE ADDRESS: 09430 SW CORAL ST 200 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIG 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: 5N st N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 15 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: 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: $ 82,000.00 Remarks: Tenant Improvement Owner: Contractor: MARTIN, ROBERT CLARE BNK CONSTRUCTION INC I HELMA M 10730 SE HWY 212 HY JO RENE M MOODHE PO BOX 66 SHERWOOD, OR 97140 CLACKAMAS, OR 97015 Phone: Phone: 557-1085 FAX Reg#: bffM866 00705035941 FEES LIC REQ U�REDSINSPECTIONS — Description Date Amount Framing Insp �M II.UJ 1'crnut I-cc 1/26/04 $645.84 Final Inspection I \\1 3'!S Statc Sul Chat 1/26/04 $51.67 10 11111 NJ Pin Its 1/26/04 $419.80 I I'S Pln 16 1/26/04 $258.34 Total $1,375.65 This permit is issued subject to the regulations contained in the Tigard M,.jnicipal 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 Cenier. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of thase rules or direct questions to OUNC by calling (503) 246-6699 or 1-800-332-2344. i Issued By: Permittee ' r Signature: Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit A ve-D •� C Received ��_Gy Permit No, 64'!J. City of Tigard Date/By: 13125 SW Hall Blvd.,Tigard,OR 97223 �� 4 Plan Review Other Permit Phonc, 503.639.4171 Fax 503.598.15 ;� I,i n DatcG . Inspection Line: 503.639 4175 Date Ready/By: Juru ® See Attached Checklist for Inter. www.ci,tigard.or.us Notifiedethod: _ Supplemental Information CITY OF 1 It;ARU M c's' OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING Permit fees*are based on the value o'the work perfornied. Demolition New construction ❑ Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the I work indicated on this application. I1 1r_ 'NM tNt (.%�f'y�'4�. 'y:I\flT•Ma:}41nt{f��L`,,t�)•1ST�[JC'i.� 1,�1� ( � Valuation: $ ❑ 1-and 2-family dwelling XCommercialhndustrial Number of bedrooms: ❑ Accessory building []Multi-family �_- F1 Master builder ❑ Other: Number of bathrooms: �Jv INFORMATJO ��— Total number of floors:SIT�. N AND.LOCATION Job site address: 9 y l 7 W Q/4/!L rJ T New dwelling area: square feet City/State/ZIP: 'f Garage/carport area: square feet Suite/bldg./apt.no.: a00 1 Project name: ` Covered porch area: square feet Cross street/directions to job Lite: eery' l01"/{ t Deck area: square feet Other structure area: square feet ' b ATAi t"UMMERCIAL-USUCHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work perforated. - Indi late the value(rounded to the nearest dollar)of all Tax map/parcel no.: _ equipment,materials,labor,overhead,and the profit for the w OF,WORK work indicated on this application. ; --- Valuation: $ �2 OQQ N r�/ EN��c ®fFsct ------- Existing building area: square feet - — _ New bLilding area: square feet Number of stories: yrs t V./AIL �. TENANT Name: 1Q`L^/�/F y G /��/� Type of construction: '�I 1/i ( y 10, Occupancy groups: Address: City/State/ZIP: ro,� 7LOC Q/t q y� Existing: Phone:( 3 q` Fax:( ) New: �[APPLICANT ❑ C(�l`T MC_PERSON ;., N0,TICS . Business name: _��_—_fly- All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Boer Contact name: ----- under under ORS 701 and may be requited to be licensed in the Address! jurisdiction in which work is being performed.If the -- -- — --- -— applicant is exempt from licensing,the following reasons City/Slate/ZIP: _ apply: Phone:( ) Fax: :( ) E-mail: 4 -.r?A t•.°µ f :'TR".�"t xM :a'. ij�C '71r v fyl�,li+Y:.�. tom,', �, � . .i Business name: �( _v��y _Ti hIJ LDING PERMIT FEES" Address: 0 S _ Please refer tofee schedule. City/State/ZIP: Fees due upon application �4- Phone:( Q 7 0 ` Fax-( 7— 7 _ Amount received CCB lie.: S Date received: Authorized signature: � r This permit application expires If a permit Is not obtained _ within 180 days after it has been accepted as complete. Print name: Date: • Fee methodology set by Tri-County Building hidustry Sen-ice Board. i\Bui1dinaWermlu\8UP•Perr*App doe IV03 110.161`TO I/02)COWWEB) CITY OF TIGARDBUILDING PERMIT PERMIT#: BUP2004-00032 DEVELOPMENT SERVICES DATE ISSUED: 2/2/04 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S126DC-04400 SITE ADDRESS: 09430 SW CORAL ST 200 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIG 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: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 15 BASEMENT: sf AREA SEP. RATED: STOR: 2 HT. It GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: — SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: ' VALUE: $ 800.00 Remarks: Hornstrobe and strobe. Owner: Contractor: MARTIN, ROBERT CLARE T & L COMMUNICATIONS INC 1-HELMA M 4817 COLUMBIA VIEW DRIVE BY JO RENE M MOODHE VANCOUVER. WA 98661 SHERWOOD, OR 97140 Phone: Phone: 360-737-9725 Reg #: LIC 67787 _ Y FEES REQUIRED INSPECTIONS Description Date Amount Final InE pection flit ll.l)J I)Cfnlll I'l'l' 2/2/04 $62.50 PLSJ Fl S' I'In k\ 2/2/04 $25.00 11 AXI 8 titatr SU1C11l111t 2/2/04 $500 Total $92.50 This permit is iss,red subject to the regulations contained in the T igard 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 issuar.ce, or if work is suspended for more than 180 days. ATTENTION: O,egon law i requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. Issued By: ,^.L'u,L� r-'c_z �r c L L�. i Permittee Signature: .c Call 639-4175 by 7 p.m. for an inspection the next business day V,r JY' VV Vim.IV iAA FP- a Protectio fi Bwllding Per�J �+ FEB 02 1004-_- TFUB D -� Ci of Tigard Planning Approval Other DstJEy' Permit trio.: 13125 SW Hall Blvd, CITY OF TIGAM Nan Review _ bother 142u(l,Ozogon 97223Damitz _— PermitNO,: -- vlril' Phone: 503•d'39A171 Fix; -1. PoetRevlew Land Use Interna: www.ci.tigard.or.us !& a___ Case No — conuct 1:rris.. E9 Ser►are 2 for 24- —1 hour Ins ecbon Re oat: 503-63914175 J p Qu - Nam_�Mcthcd: SupplcmeatalInfvrmatbn �• .•�,� +�Q t �., ', i�i4 � .r..,,�4i � h7♦` a� �Y 4'lr No,New construction Demolition Addition/altcmtion/re lacetnent LJ Other: 19MMOther: � rj' ;': 1 ,;,; Note; Ptrntit fe®•ars lased on the total value o.`the work pert'erm d htd,rait 111&2-Family dmercir.Wndusttial the"alta(mundcd to the reamst dollar)of ill equipment,materials,labor, overhead aid profit for the work indicted on fits application. Access Buili-FamilyEl Master Btulder Valuation.................................._................No.of bedrooms:--- No.of baths: Ob-sae SddrCSS a �O S� i C. S row number of Hoon......................I............ Suite, — New dwelling area(sq.ft).. Suit 1t� Bids/Ap Covered potoh area(p.ft}........ t#: _.— Ota-.gelcamon area(sq.ft-) ...... Ct oss str "_- Pro'ec Name: T - -�------ •-- r` ........,........ ._ _-- t:e ilcctlons to job vitt Deck area(sq.ft.)......... .... ........................ _-- Otho otructurc area(sq.t)„ IA Subdivision: Lot#: r3X Mal)/ };i: Note Pet,rut feta arc bawd on the ental+slue of the work prrfotmed Indicate the value(rounded to Cee nearest dollar)of all equipment,materia,%,I.bor n- 1 t��r0�✓r"� �� E It n. ovvhead and profit for the work ind,oaled nn this eppliabon.600 ---- - _" Exining building area(sq.0)... .............. -- _ NOf of stories............... ......... i 1' ,, ,t;l�; Type of construction....................__ .. .... Name: _._ .� (kru -icygiow(s): Bad thl: Address:^�- --- - ---- f Now _�---- ----- C_;it�,'StatGZip: -- --__--- ------ - _ —.__ _._ --- -.�.— Phone: Fix: NOTIM All contractors and st:bcontiactors are required to b: u r + licensed With the Oregon C:onsttucd,)n C cntrac:ors Boats under I provisions of QRS'01 and tray be tcgaired to be licensed in the IiusiAo65 Name_ z_(.-__Lc)N I et t t a a,�y� jurisdiction where work is being peifonned. If rt.e applicant ie exempt Contact Name: ccs L frontlicensing,the following reason applies: Address: _ Ci C t /State/Zi ----- --- - ) 7 ' 1 Fax: E-mail: -L c 0/VI i vt rf-t►t Q t- . C o}-� ; i. - Business Name: r�L.C_C�Lir a'`" Fecs due upon sppli<atlun...... . Address!`V Cit /State%Zip: !/c',')t o y(= Amount received .,....._ Phone:^fir,0'7 210,31 Fax- 3(e C";13 CY [)sitrweived CCB Lief#_- �.z _�rr t4 f r L,ff it'/ Authorizedt�� Moue.: This permit application eiptrol It a permit is slot obtained within 5ignsture 11 t-) Date:��,� lt 190 days after it has been aerepted a+camplrte. 'Fee metbadotegy nt by Tri-Cvant BuikO ng Industry Service Ward. (Aieseprint nattte) i:'Srsu\,Pcmdt Fomwr UldgPer.!utApp.doe 0,M3 ELECTRICAL PERMIT- CITY OF TIGARD — RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00024 13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639-4171 DATE ISSUED: 212/04 SITE ADDRESS:09430 SW CORAL ST 200 PARCEL: 1S126DC-04400 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIG Proiect Descri 3tion: Fire alarm install. A. RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO& STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: _ TOTAL#OF iYSTEMS: 1 Owner: Contractor: MARTIN, ROBERT CLARE T & L COMMUNICATIONS INC THELIVIA M PO BOX 87387 BY JO RENE M MOODHE VANCOUVER, WA 98687-7387 SHERWOOD, OR 97140 Phone: Phone: 300-7 37-9725 Reg#: LI(' 67787 ELE 37-428C LE FEES Required Inspections Description Date Amount Low Voltage Inspection I I l'wm l I I-I.It I'ermii 212/04 $75.00 Flect'I Final I'A N I `t'%o Stan Sui chart 2/2/04 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will 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. ATTENTIONS Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issued by —A< c c c �-e Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY _ SIGNATURE OF SUPR. ELEC'N _ DATE: LICENSE NO: Call 639-4175 by 7:00 F.M. for an inspection needed the next business clay Electrical 'oil Permit N�L , LIDO City of Tl andflaming Approval Sign 13125 SW I1,z Blvd. FEBCU 2 2004 Datday: _-__-- PerrrvlNo flan `— Review Other Tigard,Oregon 97223TY t)d :qT omit No.: Phone: 503.639.4171��1 AWOMON ThGARD Pwppavicw Land Use Internet: WWW,ci.tipM. Datd3 : -- - N� CaaeNo, - contwt 24•hout lnspeztian Request: 503-639.4175 Name/Mes}ud' Jure: Stt Pagt 2 for - �.__ I Supplemental[aformatlen. �..;.;;�', :q s," �' ' •T� I 'Ili 'u. '� i1Nr' is ri"hit; u•,rrind,i� rF ,: .•r' — '�''''�VxE. i!'1 W rAdditionialterikuptnVirepla, construction _ _ _ Demolition Servtoe over 225 amp,- Heilrh care fat lily eommmial Haardous location cemeut Other: r❑Scrvttt aver 320 otrrr�e•ratrng e. Building over 10A00 square feet1,4 2.family dwollinp four or more residential units in Family dwellin COmrrlerciil,/ndusinal ❑System c ta 690 volts rcxninal one aau:tu'c Building oxer&.tee,!crit*, ❑Feeder,,4M amps ur mare ssar Buildin Multi-Famil___Y -_.& - Occupant load over 99 persons ❑Manu`scturcd structures a R.V park er Builder Other: O!greeaIigl,nna p� CJ Other _ :d ,Qlg S T O1V a is Jl!; Submit•_eros of pram with any of the above. -"- The above aro Rot a licable to 101110011`1117YWI1,trYetl n aarVleS, Job site address > 1 t, _ 'rte_+-_ - „ Suite#_---�C)-0 Bld ✓Ap I. _ _ Number of mxMwWtions Der Deraidt allowed — Name.ectsiiet/Name.Direcnons to job bite: r'�� Dacripiloa ort r.a(u) tom Cross New raeldeetial-siaek or ruuld-176111111v per dweBlag Hast,brtlude,attached earaae. \ Service included: C_ ) C 1000, .n o_ rIts A515 —_ 4 _ b � ✓ ` Eachtiocai 5N k R or port{on tl-oo� 3340 1 — — - Li Subdivision: eror r _ 75.00---- 7 Lot#: LimiteC tom.non real tial 15,Op 2 Tax and / arcel#: Each` arMaauf ctutod horse w modulu d lug c�i'•; "i 'I�$ _ :,it*. ;':'r:r: -- l d.•;w." r''ll I service and/or fattier _^ 90.90 2 Services or foodm•InauLatioq c�►� "' �`L s � t�i2 alteration or rtbcaliou 2 -- 201 Amos a+400 since 401p 600 --_ f rlt 101 .r, r�lid ill 601 laws IQ I ON unfit Name: - a 1000amps yr W _ 04.65 _ t ____-- -- -- oartect only 66.95 2 Aflflre3S: Temporary-trviea or%edere-itutaliation, Crit /State/zip: — star■Non,or relocation: --t-_—^-�-- — -- 200 amQt or lap -- ----- — 66 115 1 Phone: _ F 8X: 1I ano at*400=We __— 10030 40110 6M$mat _ - 1)9 75 2 t t'H�'•" ' - '� r Bnneh circuits•cow,alteration,or Name: T`t Vh W� � i,� extension par panel: Address: tJ A.Pee ibrbranch eircahs with purchase of Mervie-or tkedri fee,each branch circuit 6.65 1 2 City t te/ZIr-- ov- LkJ tie 9.Pw far brwcb-circuits without yLuchm of attrAce or fee•Mt trench crcult 46 AS 2 Phone 3 toc7 )3 Fex: _3l-c t ' b`i e - onal branch c wt — W 6.65 , I E-trail: c C a�i h C< ,r Mue.ts�ee at r oda not tnc e�: -- T .�' CI '�" ,a' II '!I`tr,u1�. ;,gid h or e7i on chole _ 73.40 _ch ola7uae . Job No: SiQoal t r ziZU ore btnimrl energy;pastel,— ___ _ _ ---- ahvrou a extension i Pape 2 L 2 Business Name: ,��G�In tFt t l« i� ___ Address: -��!h,� neaeripo�rr: __... CI /StA[C/Zl ( 1 J 1 C --- C' t'\ Euh additional Inspection over the allowsMe In an f the above: �— �- Per coon r hourm n.1 Dull0 Phone: Fax: _C-.e"- s CCB Lic.#: E�"2 7$' ) 1c.# —� — Oder: Supervising electrician 3 -7 8 c r, n ;t �(1— _ 5u6mtal S !� sl turCrEt rGd:— � �lc t--I Pl Review(25%ofPe�Fee) S —� L Print.Name: L,i r -c,/�w{Iq JAC.#:--L c/!L Stete Sure_har a Arr'e of Pmrd'Fee)5 Authonzc+l—` I _ ,TOTAL PERMIT FRE S 41� �� Z _No11to: This permit appiluallos ezplrex if a permit Is not obtplaed within Signature CAh -Y eCaJ Datc<2�Q— IN days after It has bees accepted as complete- G/ — •Fa methodology set by Tri-Cosety Building lndrstry Service Board. _—. (Plle--pm,dam) i •I stpNPtT"It ftv"uL-gcPrnt6tAvv,doc 01M i i IntelllKnightm Model 5808 j Single Loop Addressable Fire Alarm Control System 'rhe convenience of an addressable fire alarm control panel in a cost effective ''' 4-P easy to use package. IntelliKnight Model 5808 is a 127 point class leading single loop t .a addressable fire alarm control/communicator system that provides you with the ievoluhonary value and performance of addressable sensing technology combined with exclusive, built-in digital communication, distributed intelligent power, easy to use interface. Powerful features such as drift compensation and maintenance alert are delivered in this powerful FRCP from Silent Knight For more information about the IntelliKnight system, or to locate your nearest source, please call 1-800-446-6444, or in Minnesota, call 763-493-6435. Description Up or Down load programming, event The IntelliKnight 5808 performs drift history or detector status via remote compensation and calibration checks or direct connection on each M the sensors in the system Built-in RS-232 interface for The basic IntelliKnight 5808 system can programming via PC be enhanced by adding modules such Built-in Form C trouble relay rated at as the Model 5860 Remote 2 5 amps at 24 VDC Annunciator the Model 5824 Two built-in Form C programmable Serial/Parallel Interface(for printing relays rated at 2 5 amps at 24 VDC system reports) and an Intelligent Approvals: Power Module The Model 5808 also UL Listed J NFPA 71 features a powerful built-in dual line fire Central Station communicator that allows for reporting -DACT of all system activity to a rAmote -Local Protective monitoring location Signalling System Features -Water Deluge Up to 127 addressable points Releasing Service • Up to 125 zones and 125 output CSFM Listed 7165-0559 135 groups Specifications • Uses standard wire—no shielded or Primary AC 120 VRMS at 50 160 hz. twisted pair required 2 75A • Built-in digital communicator Total Accessory Load 6A at 24 VDC • Central station reporting by Point or Model 5808 b Zone 6 amps at 24 VDC of power-limited • Supports Class B(S e 4 and Clas notification power Overall Standby Current 206 mA Dimensions A(Style 6 or 7)configuration for SLC y 16"W x 26 4"H x 4 65"C) • Distributed intelligent power Alarm Current 356 mA (40 6 x 67 x 11 8-m) • Drift compensation Notification circuits: 3 amps of power- Weight 28 lbs (12 8 kg) 13 pre-programmed output cadences limited power per circuit at 24 VDC Coicr Red (including ANSI-3 41) and 4 Auxiliary power circuits: 3 amps of Telephone Requirements programmable outputs power-limited power per circuit at 24 FCC: Part 15 and Part 68 approved • Notification circuits can be configured VDC as 2 Class A(Style Z.)or 4 Class B Mechanical Specifications: Type of Jack. RJ31 X itwo required) (Style Y) or auxiliary power for resectable constant or door holder Flush Mount Dimensions power 14 5"W x 24 75'H r 3 5D • Built-in D display nciator with 80-character (36 8W x 62 9H x 8 73D cm) SILENT • R!' 485 bus provides communication KNIGHT to system accessories SLC Sensor Drsvices Model SD500-MIP,4 5865-3 and 5865-4 Model SD50_' APS Mini Dry Contact Input Module.A miniature Remote LEC version of the addressable input module Annunciator Addressable photoelectric smoke detector , r.�uiCh is designed to be used with pull Postures 30 Model SD5C5-AIS stations and other normally open dry contact Pr,grammable LEDs(15 Addressable ionization smoke detector inputs where a smaller size is desired rad and 15 yellow)outputs Model S0505-AHS Model SD500-ARM and piezo sounder The Addressable heat sensor Addressable Relay Module Features 2 5865-4 adds a silence and Model SD505-6AB Form C output relays,designed to mount on reset switch to the a 4 inch square electrical box Provides package Six inch base designed for use with detector indicator LED to show output status and 5883 Relay Board head models SD505-APS,SD505-AIS and comes with a coverplate 05-AHS. Feahrres 10 General purpose Form C SD5 SD 05-AH B Model SD500-LED relays Used with 5880 module An LED driver capable of driving 80 LEDs 5824 Serial/Parallel Gateway Short circuit isolator base for SD505-AHS, through the SLC loop Up to 40 SD500 SD505-APS,and 80505-AIS detectors LEDs can be used per system Module Model SD505-ADH SD500-LIM Has one parallel and one rd IBM- serial poo for connecting any standard IBM-compatible Duct Housu,g Detects smoke in HVAC Addressable short circuit isolator module for printer to the Intellil(nght system.Interfaces ducts Use with SD505-APS or SD505-.AIS. SLC devices with building control system SD505-ADHR/Dl i S-BUS Accessories SKSS Silent Knight Software Addressable Duct smoke detector with buih- The following items listed are devices Thal Suite in relay module detects products or connected to the IntelliKnight's RS-485 Bus combustion present w air moving through an 5860 Remote Fire Annunciator 566G Up Down Load Software HVAC system Provides form C alarm contact.The SD505-ADHR is compatible The 51660 features the same 80 character User rnendly.WindowsTnl software for with the SD505-DTS,which provides remote backlit LCD display keypad and firefighters remote programming of the IntelliKnight annunciation and testing capabilities for the keyswitch as the 5820 The system can be panel using i PC SD505-ADHR Use with SD505-APS or fully programmed and operated from any 5670 Facility Management S0505 AIS remote annunciator 5880 LED/IO Module Software Model 5D500-PS Powerful end-user software allows viewing Addrossable Pull Station with visible LED Features 40 LED outputs 8 normally open of detector status and event history via Intelligent SLC Modules dry contact inputs and one prezo output modem or direct connection Model SD500-AIM 5496 Intelligent Power Module The Model 5496 is a 6 amp.notlffcation Dry Contac!Input Module Designed to used power expander that provides four additional with normally open dry contacts Mounts in a power-limited notification appliance circuit 4 inch square electrical box It features an outputs indicator LED to show alarm status and a coverplate. 1bMJM 01M1R+pP,N gNJH t0101Jp roM,J1» I—-•—— Yy �!»M1M:ro»rwYvl,� t SILENT KNIGHT 7550 Meridian Circle Maple Grove MN 55369-4927 MADE IN AMERICA 800.446-6444 or in Minnesota 763-493-6435 FORM#350386 Rev 05/02 FAX 763493-6475 World Wide Web http 11www silentknight com Copyrghc V 2002 Silent Knight TEIVI SPECTIV,;-*dert series Horns, 1 1 1 Horn Strobes 111,11.1 -711 "1111111 rr Norn/strobe strobe Norn with standard Pirate with:mall Footprint Plata with Atanderd 1,late Features • 24 volt strobe models: 15, 15/75, 30, 75 and 110 candela Universal mounting plate included with each unit • 12 volt strobe models: 15 and 15/75 candela One screw mounting of strobe and horn/strobe to mounting • Horn models operate oil 12 and 24 volts plate • Low current draw: reductions as high as 45% SpectrAlert strobe and hom/strobe take up zero room in the • •ITvo field selectable/reversible horn tones back box. - 3000 hz Interrupted Single gang mounting without the use of a mounting plate -- Electromechanical !horn model only) to Field selectabl4/reversible high-low dBA output on hom Self-contained screw covers (low output on 24 volt models only) Aesthetically pleasing design 101 peak JBA C 10 ;t. high output' Synchronize horn and strobe with Sync•Circuit"module - 96 peak dbA 0 10 It. low output' + Silence horn on horn/strobe over a single pair of wires using • Field selectable i reversible temp 3 pattern or non-temp 3 Sync•Circuit module continuous pattern on hom Sound output varies with tone and output options selected;sound is Hom/strobe can be wired either in tandem or independently levels based upon anechoic-room measurements. Specifications Walk test: SpectrAlen horn/strobe and hom only work on "walk Mounting: 4"x 4"x PH'or tests" with time durations of 4 seconds or greater. 2"x 4"x 1'/6"standard boxes Input terminals: 12 to 18 AWG Indoor operating temperature: 320 to 120° F(01 to 49° C) Dimensions Weatherproof(hom and hom/strobes) Strobe and horn/strobe operating temperature: 320 to 150° F (00 to 66° C) with universal plate: 5"x 51/6"x 211/t6" (outdoor strobe only) -40°F to 158°F (-40°C to 70°C) Strobe and horn/strobe Voltages: 12 or 24 VDC and FWR unfiltered with small footprint plate: 31/6"x 51/6"x 21/t6" Operating voltage range': 12 V, 10.5-17 V;24 V.20-30 V Hom with universal Operating voltage range' (with mounting plate: 5"x 51/6"x 11/16" Sync•Circuit module, MDL): 12 V. 11-17;24 V, 21-30 V Hom without Theo products should be operated Within their rate voltage rinse,UL does hot ew test mounting plate: 211/16"x 5,116"x 11/16" functional tnterty to-10%and -107E of manufacturer s stated ranges Weight,hom only: 7.2 oz. Weight,strobe and �� 1 PM WA hom/strobe: 8.8 oz. DL e approved A.PI"ED rnr listing mfornatton ser"Notes-on hottum of page 6 i General Description System Sensor SpectrAlen Series stro'xc,horns,and combination horn/ selectable features are accomplished with the use of pins and jumpers strobes are UL listed for pnmary signai.nv,n life safety systems and meet located on the back of each SpectrAlen horn and horn/strobe.An accessory ADA public mode visible signaling requirements. module is not needed to make these field selections.The horn un horn/ SpectrAlen products can be connected to the alarm indicating circuit of strobe models will operate on a coded power supply.The horn only model a fire alarm control panel and are compatible with DC line supervision.The designed for coded power supplies(HC12/24)will also operate on a coded SpectrAlerr product line mounts to standard back boxes with the use of a power supply universal mounting plate included with each unit. An optional small ftrobuae footprint mounting plate fits to a single gang box. An accessory back box The ADA compliant SpectrAler strobes are electronic visible warning skin gives a cosmetic fil.ish to a 4"x 4"x 1'/:"or a 1"x 4"x 1'/F"surface signals that flash a; 1 N?over heir operating voltage range.These products mounted back box.All strobe and horn/strobe mounting options require are available in 2,, volt models at 15. 15/75,75 and 110 candela intensities vniv one screw attachment of product to plate. and in 12 volt modois at 15 and 15/75 candela 'ntensities.SpectrAlen These products are designed for 12 and 24 VDC and full wave rectified products feature dramatic reductions in current equlrements. unfiltered power. Full wave rectified operation requires more current than .1C operation. For detailed current draw information,consult the table sync-Circuit Module b41ow.The horn/strobe combination products are factory assembled with The SynceCircuit Module is available for the synchronization of strobes and jumper wires for in-tandem operation.For independent wiring of horn and horns and can synchronize two Style Y(class B)circuits or one Style Z strobe,remove Jumper wires.When wired for independent operation.the (class A)circuit.The module can also generate a synchronized temp 3 tone strobe will continur to run while the horn can be silenced.However,the for System Sensor's Multi-Alert"and PA400 horn products.'The strobe mu i be running for horn to operate. synchronization module allows the SpectrAlen horns on combination horn/ strobes to be silenced on 2-wire systems.SpectrAlen's Sync-Circuit Module Horn can be daisy chained for multiple zone synch-nnizatlon.The Module shall The SpectrAlen Series horns and horn/strobes provide two different field not operate on a coded power supply. selectable/reversible tones,a high-low field selectable/reversible sound output setting(low setting on 24 volt models only)and a field selectable/ 'For Multi-Alert and PA400 Strobes must be wired to a coutinuous source reversible temp 3 pattern or non-temporal continuous pattern.These field of; ewer(non-coded power supply). SpectrAlert Current Draw Table S»obe onl z AVERAGE CURRENT(mA) PEAK CURRENT(mA) IN RUSH CURRENT(mA) ]2V Models 24V Model■ 24V Models Io.5V 12V 1TV 20V 24V 30V 10.5V 12v 1r. 20V 24V I 30V t05V 12V 17V 20V 1 24V 30V ga"ClellOC rwR pC FWR oC FWR oc FWR Dc rwn DC FwR DC I FWR Dc I FwFt oC I rwa Cc I FwR DC I F•NP i CC I FWR DC FWR DC I FwA CC i rwR CC IFYM DC FWR DC I FwR 15 133 159 1+4 157 6+ 1 128 150 61 4.7 00 1 36 80 460 1 460 14501460 t4201480 135 204 135 208 135 105 80 10 92 124 140 190 97 t29 n8 15211A71 198 15175 t 76^ U 17199 1 1505 85 4 u 415201490152014601480t 1 1 0 07 15 19 76 104 88 126 150 165 97 135 tt0 164 147 21t 30 NA NA NA NA NA NA 76 B4 fi7 6 59 72 NA NA NA NA NA NA 193 201 103 219 163 216 NA NA NA HA NA NAI 97 129 116 152 147 196 75 NA NA NA NA NA NA t45 170 123 '59 702 141 NA NA NA NP NA NA 350 440 340 460 330 4B0 NA NA N4 NA NA NA 0 240 230 260 290 360 11 NA NA I NA I NA tNA I NA 1169 122011401 19'11151 174 1 NA I NA I NA I NA INA I NA 460 5601450 570 420 620 NA NA INA NA NA i NA 1190 123012201 290 12901 370 Horn Only: Hort/Strobe 30 cd: AVERAGE CUNRENT(MA) AVERAGE CURRENT(n1A) t2v MOtlele 24111110111111111 High/Low Temp 10.5V 12V I ITV I 20V 24V 1 30V High/Low Temp 20V 24V 30V Tone Volume INO0 DC FWR DC FWR DC FWR DC I FINS I DC I Mr.I CC Fi.n one Volume. Mon DCI FWR Dc I FWR CC FtNR Electro 1-'-gh Temp 10 11 ',0' 10 1 14 ' 14 jig 1 21 25 16 1 29 26 Electro H+gh Terrp 97 105 921 100 07 90 m*rn Non tD i6 t0 t9 to 2G t7 29 23 u 30 42 mech. NOn 95 113 90 116 68 114 Low Tem NA'NA'NA NA NA NA n 12 t3 t3 t7 !S Low _Tem BB 95 BC 95 75 67 Non NA NA NA NA NA NA 12 16 ' 14 19 ' 17 24 Non 90 96 81 101 75 98 3000 Hz High Temp 11 13 11 11 16 16 24 26 2F 23 37 33 3000 Hz High T9m t02 t08 95 105 95 105 Interrupt Non t+ t' 11 2t t4 20 19 14 27 39 5 45 Interrupt n 97 11 94 121 93 117 Low Tem NA NA NA NA NA NA 14 14 +7 15 121 19 Low Tem 92 1, 64 97 79 91 N r NA NA NA NA tNA NA 1 1 t6 2+ 22 5 n 91 100 6 103 80 97 Horn Strobe 15 cd: _AV__ Hom/Strobe 75 ERAGE CURRENT(mAl AVERAGE CURRENT(mA) 12V Models I 24V Models 2iYmadils High/Low Temp 10.5v 12V 17V 20V 24V 30V High/Low Tamp 20V 24V 30V TOM Volume /Non C.; FWR DC�FYM DC FWA DC I FWR OC FWR CC FWR Tone Volume /Non DC FWR DC FWR DC rwR Electro High Tamp 14' 17011241167 95 14; 69 02 58 TT 78 67 87 Electro Minh Temp 164 19t 148 167 131 167 morn Non 143 170 124 167 95 142 67 9C 66 44 66 103 mach _ Non 163 1118 1461 16911321 169 Low Tamp NA NA NA NA NA NA 61 1 73 56 73 55 76 Low Tamp 156 182 1361 162 119 156 Non NA NA NA NAA NA NA 62 17 57 '9 S5 05 Non t57 182 tJ7 182 119 157 3000 flz High Tri AA 172 125 168 97 1" 74 87 71 83 1 75 94 3000 Hx N+gh T ,n 16P 196 151 1%2 139 174 Interrupt N n 1" 173 j.4a 166 1 4f 1 60 95 70 I 73 106 Interrupt Non 164 192 150 +75 t3^ 1^7 Low Tamp NA NA NA NA NA I NA 64 75 60 75 1 S9 00 Low Tam tSf 164 140 +F4 +23 160 Non NA NA NA NA NA I N4 163 1 79 1 59 81 60 86 Non 158 i 166 11391 163 241 162 Horn Strobe 1575 cd: Horn/Strobe 110 cd: AVERAGE CURRENT(mAi AVERAGE CURRENT(mA) 12ILtAgdela 2A1Lmgd6ls 24Y-Ilttleis High/Low Temp 10.5V I 12V 17V 20V 24V I 30V High/Low Tamp 20V 1 24V 1 30V Tan* Volume /Non nr FwR Dc FSR Cc FWA CC FWR CC I rwR Dc rwn Tena Volume 1N2n oG FWA CC FwR DC i MR Eiectro. High Te 1.8 193 152 181 1113 164 75 86 1 741 62 1 73 1 as Electro High Temp 18812411,165 20911-1 200 mein Non 178 193 11521 181 t1; 164 7J 94 72 98 14 104 mech Non 166 236 .63 211 415 202 LOW tem NA. NA NA NA NA NA 67 77 62 i 81 Low Tem 18012321153,1 204 132 169 Non NA NA NA NA NA NA 66 61 63 BJ 61 06 Non_ 161 ZJ2 154 204 132 190 3000 Hz High Tamp '79 195 152 163 115 166 8 1 77 97 61 95 3000 Hz Hgh Temp 193 246 166 214 152 207 Interrupt Nor 79 196 15 163 i'tJ tde ,'S 7 103 107 Interrupt __Nor, 186 242 1671217 150 210 Low Tem NA NA NA NA NA NA 70 79 66 711 BS at Low Tem 183 234 157 206 136 193 Non NA NA NA NA NA N! 81 0 1 8 N n 1 1371 195 Page 2 Engineering Specifications Qenerel Her"/Strobe C mbinatlon SpectrAlert horns,strobes and horn/strobes'shall be capable of Horn/strobe shall be a System Sensor SpectrAlert model mounting to a standard 4"x 4"x 11/2"back box or a single gang 2"x 4" listed to UL 1971 and Ul.464 and shall be approved for fire protective x 1'/,"back box using the universal mounting plate included with each service. Horn/strobe shall be wired as a primary signaling notification SpectrAlert product. Also,SpectrAlert products,when used in appliance and comply with the Americans with Disabilities Act conjunction with the accessory SynceCircuit Module, shall be powered requirements for visible signaling appliances,flashing at 1 Hz over it-, from a non-coded power supply and shall operate on 12 or 24 volts. '2 entire operating Wtage range.The strobe!ight shall consist of a xenon volt rated devices shall have an operating voltage range of 10.5 - 17 flash tube and associat,' lens/reflector system.The horn shall have volts. 24 volt rated devices shall have an operating voltage range of 20- two role options,two audib,..*,, options (at 24 volts) and the option to 30 volts. Spect•Alert products shall have an operating temperature of 32 sv',.:h between a temporal 3 patte., and a non-temporal continuous to 120°F ua ui,:Ate from a regulated DC P wave •ectifie l pattern. Strobes shall be powered independently of the sound-r with unfiltered power supplythe removal of factory installed jumper wires.The horn on horn/strobe models shall operate on a coded or non-coded power supply. Hersr Horn shall be a System nsor SpectrAlen model tpable of Modulo operating at 12 and.74 volts. Horn shall be listed to UL 464 for fire Mod•ile shall be a system ze..3or SynceCircuit model listed protective signi0ing systems.Thp horn shall have two tone options,two to UL.464 and shall be approved for fire protective service.The module audibility options (at 24 volts) and the option to switch between a shall synchronize SpectrAlert strobes at 1 Hz and horns at temporal 3. temporal 3 pattern and a non-temporal continuous pattern.The horn Also,the module shall silence the horns on horn/strobe models,while only model designed for coded power supplies (HC12/24) shall operate ope acing the strobes,over a single pair of wires.The module shall be on a coded power supply, carable of mounting to a 411/te"x 411/ts"x 21/@"back box and shall control two Style Y (class til or one Style Z(class A) circuit. Module Strobe shall bc.,capable of multiple zone synchronization by daisy chaining Strobe shall be a System Sensor SpectrAlert model !isttd to multiple modules together and re-synchronizing each other along the UL 1971 and be approved for fire protective service.The strobe shall be chain.The Module shalt not operate on a vorlon potvcr supply. wired as a primary signaling notification appliance and comply with the Americans with Disabilities Act requirements far visible signaling appliances, flashing at 1 Nz over the strobe's entire operating voltage range.The strobe light shall cuns`,t of a xenon flash tube and associated lens/reflector syst-m. SpectrAlert Dimensions 3 le 21"As't I Is O 5sre" 56/,e" I � / O —moi 15116" F"261, Morn/Strobe with Smalli Footivint Mounting Plate Horn Only (same dimensions for strobe only) r 56/6" 55116~ I o c 1 5' 0 Horn/Strobe with Universal Mourting Plate —_ (same dimensions for strobe only) SynceCircuit Model$* Page 3 / CITY OF TIGARD — PLUMBING PERMIT / DEVELOPMENT SERVICES PERMIT#: PLM2004 00034 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/5/04 SITE ADDRESS: 09430 SW CORAL ST 200 PARCEL: 1S126DC-04400 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: CCM WASHING MACH: 1 BACKFLOW PREVNTRS: 3 OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 7 OTHER FIXTURES: 4 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remar%s: TI plumbing fixtures. Other fixtures: (1)expansion tank, (1) vac pump & (2) p mars. Med gas valuation: $3,147. _ FEES Owner: Description Date Amount MARTIN, ROBERT CLARE THELMA M �I'LUN1111 I'rrmit I-CC 2/5/G4 $477.30 BY JO RENE M MOODHE I'LMI'LN I Ilan Ro ic\\ 2/5/0 $119.33 SHERWOOD, OR 97140 I-I AXl 9 State tiurrhari 2/5/04 $38.19 Phone : Total $634.82 Contractor: WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 REQUIRED INSPECTIONS Phone : 667-1791 Underfloor/Underslab Top-out Insp Reg#: LIE' 23847 Final Inspection 1'I.%1 26.2081113 This permit is issued subject to the regulations contained in the Tigard Mu;licipal 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 stalled within 180 days of issuance, or if work is suspended for more than 180 da-,--z,. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: �Gz- t�G- �x-c.t _ Permittee Signatures_ Call (503)639-4175 by 7:00 P.M. for an inspection needed the next business day CITYOF TI CARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2004-00028 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/5/04 SITE ADDRESS; 09430 SW CORAL ST 200 PARCEL: 1S126DC-04400 SUBDIVISION: I.I-:I IMANN ACIZI:: TRACT ZONING: l'-P BLOCK: LOT: 007 JURISDICTION: I'I(i TENANT NAME: DR. DENNIS CLARK USA NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Ramarks: 1.9 EDU increase Owner: -- _ FEES MARTIN, ROBERT CLARtz Description Date Amount THELMA M BY JO RENE M MOODHE 1SWUS,\1 Sm.Connect 2/5/04 $4,560.00 SHERWOOD, OR 97140 1 SWI.ISA I S\\r Connect 2/5/04 $0.00 Phone: Total $4,560.00 Contractor: Phone: Reg #: Required Inspections I-his Applicant agrees to comply with all the rules and regulatirws of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer Laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm Issued by: Permittee Signature: Call (503) 6394175 by 7:00 P.M. for an Inspection needed the next business day 03/06/01 'ruE 14:41 FAX 503 598 1960 CITY OF TIGARD 2002 o�Q Plumbing Permit A lication I'1 t U Date received:/ (� 04/ Permit no.t)"1� ,0 City of Tigard Sewer permit no.: Building permit no.: Address: 03125 S-4}Tall Blvd,/ it CyR 91� P — City njTiXard phone: (503) 639-4171 '} {ry '�. " LU�+3 ProjecUappl no.: eapircda(e: Fax: (503)598-1960 Date issued: - By(')(' Receipt nn LI TY OF TIGARD ' Land use approval: 3 l) DINT nlvtt;lnti Case file no.: Payment type: U 1 &2 family dwelling or accessory U Commurcial/industrial U Multi-family grenant improvement ❑New construction O Additi(n/alteration/mplacement U Food service U Other: r\ Job address: Deacrl tltw Qty. Fee ea. Total Bldg no.: Sttite no.: ,[j New I-and 2-familly dweftgs only: Tax map/tax loUaccoua!no.: � i / 7 + .-• � r - (tacluder100tl.for each utilityconnection) SFR(1)bath Lot: Block: Subdivision: SFR(2)bath Project name: �,(�, /,kst/,(//S >( SFR(3)bath City/county: -/�!-'�'/� ZIP: Each additional badvkitchen Description and location of work on premises: _ SlteuMlIer Catch basin/area drain D vells/leach line trench drain Est.date of ctsri: letion/ias ection: rY' ooltdrain(no.lin,ft.) Manufactured home utilities : Business name: LLt'/7/`"rGliGf/s/�(/fr� ,TA17NbF49,S Manholes Address: r, " 5 CRtC. 'aifMB�� /( ,�t Rain Broin connectoo City: c/T (_E State:Q'eTiJP: J- Saniiary sewer(no, lin.ft.) Phone:503 /-/lf, Fax: J yj-'�j I E-mail: StortiT wwer(no.lin.ft.) CCB no.: 73! 17 LPlumb.bus.reg.no: �(�-,�T Nater service no. lin. t.) City/metro lie.no.: Z / Fixture or item: ) Coatracwr's representative signature: E!lAtJ- { j��,lLw- Absorption valve Rack now prevenler L ' Print natne: i s z )N?/,j D ue: C Backwater valve Basi vUlavatory Namc: Clothes washer / 14, Gr- DishwasherAdd City: ss: State: :'1P_ Drinking fountains) *u ` City: � _ _ Ejectors/sump Phone: Fax: Email Expansion tank --- i /�� 7 Fixture/sewer caF—CFE � 6MP Name(print): Floor J'rains/floor sinks/hub / Ze Mailing address: —�-- Garbage disposal Hose bibb City: __ Ice maker _ Phone: Fax - E-mail Interceptor/grease trap - Owner installation/residcmial maintenance only: Th( actual installat 11n Primer(s) r� e will he made by mr or the maintenance and repair made by my regular Roof draiin(commercial) -- employee on the property I own as per ORS Chapter 147. Sink(s),basin(s),lays(s) T' Owner's sl nature: Dtte: — Sump Tubs/shower/shower pan _ Name: Urinal ---- Water closet f f Address: _ _ Water heater / (cc 6e City: State:=ZIP: Other: b /41.t.r Phone: Fax: Email: Total Minimum fee............... Nd all jursdictlom accep rnY1it cant,pkase call)uduficdoo for mom in mnuion. NOtIGC:This permit application p r U vise O MasterCard Plan review(at v 9i) $ —L�- expires if a permit not obtained State surcharge(8%)....$ t Gedlt cad camberslier—•— within 180 days it has been ' rainrra ae rc TOTAL $ '' ' n acec led as complete.Naar of ecvd0a10kr at shown on ererar cud p p ___ s —_ cudhnkkrsirrutum Xrrounli 44041616(M000M) 0 AccumulatWE Sewer Tally Parcel# 1S126DC-04400 Tenant Name: Dr, Dennis Clark This SWRA2.004-00028 Site Address 9430 SW Coral St This PLM# 2004-00034 Fixture Value Previous Previous; Credits Capped Fixture Fixture New New # value capped off value added added total total count off#S count # value #s values Baptisery/Font 4 _ 0 _ 0 0 0 0 Bath - Tub/Shower 4 0 0 0 0 0 Jacuzzi/Whirlpool 4 0 0 00 0 _ Car Wash- Each Stall 6 0 0 0 0 0 - Drive through _ 16 0 0 0 _ 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher-Commercial 4 0 0 0 0 0 Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 _ 0 0 0 C _ Eye Wash _ 1 0 0 0 0 0 Floor Drain/Sink- 2 inch 2 Y 0 0 2 4---2 4 3 inch 5 0 0 0 0 0 4 inch 6 0 0 0 0 0 Car Wash Drr 6 0 0 0 _ 0 0 Garbage Disposal Domestic(to 3/4 HP) _ 16 0_ _ 0 0 0 0 Commercial (to 5 HP) 32 0 1 0 0 0 _ 0 _ _=Industrial (over 5 HP) 48 0 0 0 0 0 _ Ice Machine/Refrigerator Drain 1 _ 0 0 0 0 0 Oil Sep (Gas Station) _ 6 0 0 0 0 0 Rec. Vehicle Dump station 16 _ 0 _ 0 0 0 0 Shower-Gang (per head) 1 _ 0 0 0 0 0 - Stall _ 2 0_ 0 _ 0 _ 0 _ 0 Sink - Bar/Lavatory _ 2 0 0 7 14 7 14 Bradley 5 0 0 0 0 0 _ Commercial 3 0_ 0 0 0 _ 0 Service 3 0 0 0 0 0 Swimming Pool Filter _1 0 0 0 0 0 Washer- Clothes 6 0 _ 0 1 6 1 _6 Water Extractor 6 _0_ 0 0 0 0 Water Closet- Toilet 6 _ _ 0 _ 0 1 6 1 6 _ Urinal 6 0 0 0 0 _ 0 _ Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 0 11 30 11 30 Current Fixture Value _ 30 divided by 16 = 1.9 Current EDU 1 EDU - $ 2,400 Previous Fixture Value 0 divided by 16 = __0.0 Previr is EDU Change 30 _ divided by 16= _ 1.9 over (under) _$ 4,560.00_ Enter EDU Change Here 1 9 Notes Si nature:— Date: Q r Buildidq Division Note The property owner scall retain the ORIGINAL sewer tally record. If credits exist, this document will serve i.-.s a voucher hich must be submitted to the City of Tigard Building Division to redeem credits towards futcre system developmen'-harges. 1:\Building\Sewer Tally\SewerTallySheet.xls 11/19/03 ELECTRICAL ENERGY- CITY OF T I G A R D RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00041 13125 SW Hall Blvd., Tiqard, OR 97223 (503)639-4171 DATE ISSUED: 2/19/04 SITE ADDRESS: 09430 SW CORAL ST 200 PARCEL: 1S126DC-04400 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: TIG Project Description: Instaliation of limited energy for intrusion alarm system. Job No. 3566 A.RESIDENTIAL B.COMMERCIAL AUDIO& STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: X INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: MARTIN, ROBERT CLARE ACTION TECHNOLOGY SYSTEMS THELMA M 835 SE 17TH AVE BY JO RENE M MOODHE PORTLAND, OR 97214 SHERWOOD, OR 97140 Phone: Phone: 231-1')92 Reg#: LIC 157030 ELE 26-775('Ll: FEES Required Inspections _Description Date Amount Low Voltage Inspection I I.I'RN1"1 I ELK Permit 2/19/04 $75.00 Elect'I Final "I 1•,� `{ slate Surchari 2/19/04 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordan.)e 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 Utilibt Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issu d by - Permittee Signatures 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 _ v DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 12; 1H ACTION TECHNOLOGY SYSTEMS 503 231 1402 P.01 E_„iectricdl Permit Ali D 11 Sign City of Tigard 13125 SIN RAU Wvd- Per.ee Igo.: TIgucL OMOC 972237v F T 1 A"A rim pw�lcw Phone: $03-639-4171 Fox; 503 LAM Use -1Can No.: Juternst www.cW&ar&cr.U5 sw rar 7 Ric 2s-hour Inspiwficin Repirst 503-639-4175 s wammul I mffw- TYIP%,OF •- L3 Nyrtr lutruGuon DDemolition $O MismQvw M vow I KAzw&xw AdditicirValteration/rcolacement Other psaviceaw M anys-M"U v ol rl sulwins over I 0,0no Kuwl[cc[. Ebur or ime r"kiiiinual wwtm in -ONSTRUCTIOU dw e I &2-Family dv6,cll= I Lcimn=w = Soto I aw Ll CaVlffllual ohm 01 feff&-M oda llominw one sa"M4M Elmillf"ores tae cr more = U Azces!n BuildU -F&Mdv — 9 ovGwent loudvea 99 vvvx% Mups7wam Kv pwt n Masw Builder citba: 0 ft—Aiftat Pw � ,& ON Qtllzls -74(1-"- -- Soikink set obw-*$. J"IL WON- M-1, NO*= "W"M 7%e gbow iimii no appUaW to 111cI Job site addmu. 4-30 5V Coral. m-JIL . -I Suite it: 204 1 BldgJAPI-t- iY erins"d"I Wsvnd I [vim derw PTTjemNamc Dr. Dennis Clark s fts Ifew Cron stvctMn=flons to job site: " - Facer"s"Emsed V"40- sert4n:elder.: lontm ft w ka i 14WIL eddpoeel 50!1 ff pwhm Mastro( t Subdivision: Tax maptpmci N 1 2 X--aj� .�rpr lines _instT tallAion Intrusion Alatm System al WMws*Q w whiftow 2 2 AM 2 4 -,P- 1000 17 Nme-, U FT— 12. Aldmss: T"lliparlilry qw IMMMn hussmatkoll, slawAks.or dm city/statc/ziv: 3w IMM or Ill, Phone: I Fax; -6w!M 1 133.73 I —-:; 1. Ljcrkm per PeNw. Nam: A.Pat N*I ' Omdre wnh wrdmr of --r- awder hr-cich Lq�b dMMI 6.65 Address. VMTM or - - c#y�stpray. Phone- Fax� I Sam w 2 1 U.40 77 Job NO; 3566 -- goal sh"Wil or a HRM4~w P-i- rMLA2 75.00 2 1 Business Narne;AcjLp-n lechnQ10Vf;-t8Ma-llL6- 76;;497 Address- 835 SE 17th Ave.1V .0 Awerowt AMW uselilowsm, ay 0 ts me Abovel t 97214 0-1 L Cit yistwatei v ORT OR Fax:5T3-Z3 1 L7MJV -011`1.26�7�5CLE� Kpervisiri? clike"cl SUbOVdt s` Ls SLIM PrjntNx,r.eF,4W HaLierer _,.�icr7j;T��4L_EN TOTAL R*JF&T ML, 7-- -- FM" met obal"Mcd Owo Mod"I Title pamn't Date:--- too 4M now it ran b.,=scmped as cUppiket FM"M\j.rp-rvuNr*doc VI'05 ELECTRICAL PERMIT CITY OF TIGARD \` PERMIT#: ELC2004-00022 DEVELOPMENT SERVICES DATE ISSUED: 2112/04 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S126DC-04400 SITE ADDRESS: 09430 SW CORAL ST 200 ZONING: C P SUBDIVISION: LEHMANN ACRE TRACT BLOCK: LOT : 007 JURISDICTION: TIG Project Description: Ele(Arical Ti, (23)branch circuits&limited energy for fire alarm. Job No. 540 _ 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: 1 MANF HMI 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: 1 st W/O SRVC OR FDR: 1 F_-R HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 22 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amplvolt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: X Owner: Contractor: MARTIN,ROBERT CLARE WILLAMETTE ELECTRIC INC THELMA M PO BOX 230547 BY JO RENE M MOODHE TIGARD,OR 97281 SHERWOOD,OR 97140 Phone: Phone: 503-624-3631 Reg #: LIC 75059 — SUP 190is FEES _ ELE 4-283(' Description Date Amount jFL1,161l I I I.(' I'crnut 2/12/04 $268 15 I1-:LPL('Kl ELC'Pln Itc\ 2/12/04 $67.04 Ceiling Cover Required Inspections I,AXI8 ~tate Surcharge 2/12/04 $2145 Wall Cover Low Voltage Inspection Total $356.64 Rough-in Elect'I Final 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 H 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 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503)246.6699 or 1-800-332-2344, — — Issued By: Z� ( ,L ��L Permit Signature: l _ 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 SUER EL.EC'N: �— _ _ DATE:-- LICENSE ATE:__LICENSE N O — --- — --- --------— ----- --- - — -- — Call 639-4175 by 7:00pm for an inspection the next business day Kelf NJ W110 0 Electrical Permit A2iftation �te/By: l '/ Electrical t Permit No.:Ge.'o It q Planning Approval Sign City of Ti gar � v� Date/By: Permit No,: 13125 S1 Plan Review Other Tigard,Oregon 97223 \AN 1 �Q N Date/By: Permit No.: Phone: 503-639-4171 Fa##: U I�lSQ Past-Review band Use 10 1%, Date/B : Case No.: _ Internet: www.ci.tigard.or�� QContact — e J See Page 2 for 24-hour Inspection Req -4175 Name/Method: _ / Supplemental Information. kAlcces,o!y w conStTllCtlOtl _Demolition Service over 225 amps- Health-care facility commercial Hazardous location ition/alteration/re lacement Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, tt E U i&2 family dwellings four or more residential units in amidwellin Commercial/Industrial ❑System over 600 volts nominal one structure _ Buildin Multi-Fam11 ❑Building over three atotiea ❑Feeders,400 amps or more Y — __._ ❑Occupant load over 99 persons ❑Manufactured structures or RV park ❑ Master Builder ❑Other: ❑EgressAighting plan Cl Other: R, �0 a$d Submit_sets of plans with any of the above. The above are not a licable to tem orar construction service. Job site address: 3 n r�� r s , ---- r, Suite# ./A t.#: _ Number of Ins ectlonspeer_Qermit allowed Project Name: Ulf. Gla• k Description Qty Fee(ea.) I 'Total Cross street/Directions to job Site: New rn unit.Includes m achemultifgata per dwelling unit.Includes attached Garage. Service Included: 1000 sq.it.or less 145.15 _ Z,•,/ f/v.�i Each additional 500 sq.R•or rtion thereof 33.40 1� I Subdivision: Lot#: Limited energy,residential 75.00 2 Limited energy,non residential Tax map/parcel ##: Each manufactured home or modular dwelling R ll V:,p service and/or feeder 90.90 2 Services or feeders-installation, D en t d G? r P alteration or relocation: 200 am s or less _ 8(1.;0 201 amps to 400 amps IOF.85 2 401 ams to 600 amps 160.60 2 601 amps to 1000 amps 240.60 _ 2 � ---- '� -- '' '�`—- ✓' Over 1000 ams or volts 454.65 ame:-�,�.�J kL, ►-�j{0� � L _ Reconnect only 66.85 Address: yG0 Temporary services or feeders-Installation, -- alteration,or relocation: Cit /State/Z1 _ lrLD (Z 97,Po� 2.00 amps or less — _ 66.85 — 1 Phone: Fax: 201 amps to 400 amps 100.30 2 401 to 600 ams 133.75 2 PPLI `I_ "C 1 1�- �'iC 1S Branch circuits-new,diaration,or � Nanie: extension per panel: _.____ - - ------- ---- - - - A.Fee for branch circuits with purchase of Address: _ service or feeder fee,each branch circait _ 665 2 Cit /State/Zi B.Fee for branch circuits vithoct purchase of {-- ---— --- ---- - — service or feeder fee,first branch circuit 1 46.85 2 Phone: 1 FaX: Each additional branch circuit 2 Z 6.65 2 F-mail: Misc.(Service or feeder not included) Each pump or irrigation circle_ — 53.40 2 Each sign or outline,i htin� 53.40 — 2 All.Fob No: ,j YO Signal circuits)or a limited energy nancl, Business Name: U).ha e t'14 E ler i"i �.,4 . alteration or extension _ _ Pae 2 _ 7-S 2 Description. " , _Address: r , i3.),. 23 d S-`/ i 41,+�Q-L — Cit /State/ZI i r/ 0 P 0172 Each additional inspection over the allowable In anyof the above: Per inspection pet hour min. 1 hour 62.50 Fa : C�3 Phone:7,'3 1` b a CCB Lic. #: ; 'I ' ti I Lic.#: 3 Y 3 Othef Supervising electrician Subtotal S 066 signature required: /L Plan Reviewer 5%of Permit Fee S 6 7. Y Print Name: L1,4, F (e 1). #: /1 S _ State Surcharge(B%of Permit Fee) S Z I TOTAL PFRMIT FEE $ 3,56 -67 Authorized Notice: This permit application expires If it permit is not obtained within Signature: _ Date iR0 days after It has been accepted as complete. *Fee methodology set by Tri-(bunt Building Industry Service Board. (Please print name) i:\Dsts\Pernn t Forms\ElcPermitApp.doc 01/03 Electrical Permit Application -Cety of Tigard Page 2 .Supplemental Information LIMITED ENERGY PERMIT FEES: c RESIDENTIAL,WORK ONLY: Feefor#Ll system.......................—.—.............................. S75.00 Check Type of Work Involved: Audio and Stereo Systenb' Burglar Alarm Garage Door Opener* Heating,Ventilation and Air Conditioning Systetn* Vacuum Sy,tems* Fj Other COMMERCIAL WORK ONLY: Feefor each system.......................................................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: II Audio and Stereo Systems ❑ boiler Controls ❑ Clock Systems 0 Data Telecommunication Installation Fire Alarm Installation HVAC: l-tstrumentation Intarcom and Paging Systems F] Lendscape Irrigation Control* Medical Nurse Calls 0 Outdoor Landscape Lighting* Protective Signaling Other Number of Systems * No licenses are required. Licenses are required for all other installations is\Ds,,s\Petmit Fortes\E1cPermitAppPg2.doc 01/03 01/29/04 THU 31:55 FAX 5030243081 CITY Of TICARD BLDG DEPT (0 001 CITY OF TIGARD OREGON `1 January 29, 2004 � `\,�� J t ,)V \�v \S\ON Dave Fife Willamette Electric Inc. P O Box 230547 Phone: (503)624-3631 Tigard, OR 97281 Fax: (503)624.2938 RE: ELECTRICAL PLANS REVIEW Dear Mr. Fife: Proiect Inform atio Prrmil: ELC 2004-00022 Tenant: Dr. Clark Address: 9430 SW Coral St This plans review is based on the 2002 edition of the National Electrical Code(NEC). The plans received on.lanuary 16,2004 have been reviewed and are not approved as submitted. The following items shall be revised(revisions clouded)on the plans and addressed in a response letter. Two complete sets of the revised plans and the response letter shall be submitted to this office for review and approval prior to issuance of the electrical permit. Please note: Loose pages are not acceptable. 1. Provide the locations of all panels including the low voltage control panel with panel schedules to verify clearances. 2. Provide a complete load calcu,ation. 3. Provide the emergency- and exit lighting. If I can be of any additional assistance, please feel free to contact the at(503)718-2446. Sincereiy, Herb Stabenow Plans Reviewer 13,125 WHWIvd., Tigard. OR 97223(503)639-4171 TDD(.503)68.1-2772 i..�"y Ph (503) 624.3631 • Fax 624.2938 WMLAMETTE ELECTRIC DR. DENNIS CLARK 9430 SW CORAL ST. TICARD, OR 97223 PLAN REVIEW NOTES 1. I'hk k a I'' oc tievalion 111(w xl oral surgeon. i ?. Iaisiint? clu..ill�ui .;w>,I��. 3. .,111 vri-hig in nun paiicni pari.: areas shall cumpl) with tilt:." article 300, #. Ml tvu•ing in pati4nt care :u,.!as shall cumpty with NTC aili�le 517. 5. Pleasc sec revised lighting plan for c.xit lighting. 0. Fire alarm panel is located in the 1" floor electrical room. 7. ?"d floor Mvi transformer is fed from 1\1171' in l°` floor electrical room. P.O. Box 230547 Tigard, Oregon 97281-0547 CUMUUCULr TeflRfit 10pnwellent•Deft"ulld•New Remodel•Parking Lot Ughting•INUl1S711AL.Equipment•Motors•Controls•Trouble Shooting•Electrical Remodeling RRbiDENTIAI. New A Remodel - New Circuits • All Phases of Maintenance A Repair VAT ri I Nv ;7. ~�i_�.• W �0 O i it c � (E) 75 KdA Trin�sforineo, (l) 22,7,4 lzo/Zos tft —4-) IdoA PNL .. , 1 i Ph (503) 6Z4-3631 - Vax 624-2938 WMLAMETTE ELECTRIC 2 771Y80 P N L 2 H 506) 3 b 13 17 I - 21 22 3 RY 25' R 6 Z 4 .03 30 3( qs 3 33 AU 6 c/v/c 3'/ 3i Or C/o,, 36 ,37 S ac c- 5 — 39 0 1oo-1qA,iio Mto 4 PO. Box 230547 1, Tigard, Orogon 9/281-0547 COMMERCIAL Tenant lmrm�cment-DesillitllItflid-Ne-Itemodel-Parkitiq Int 1.1ghtinR*INDUSTRIAL l[quipment-Moron-Controls•TmubleShootinit•Flectri,al Remodeling RFSlDFNTlAl New 6 Remodel - New cirtuit% - All Fliasrs of Maintenance A Repair Ph (503) 624-3631 Fax 624.2938 ;4;00WILELLAMETTT ECTRIC I�0%08 /OA/z- ?L 30 rGld'* r(^ct fee 'ca orCIjI-A PI? X �� rC/dr/r rcrelfaC/rj r Cler/C (A4,Pjy CG/e• y Or L/dr It -e, a t-ad et Or G/r9r/e (.�f /t �y C�k/_ g6 7 Qr Gld//c Trerr f.tlrf___-_y- Or Llar/t (/13 C u L,Irp ar CI9r/C 5Eeril,re'- Qr G/ar/� LL/frato•+,c C/oil-C, 10 Clar/c Cha ,S ^ Qi C/<3.-/t Mode/ re""er --I 13 c u,I.Il t.. r/N, n /y pr cIa•�t x -r2, _ t9 ell PE•ce - aLiP , p.- Clads M ,C21 , �w��e �O �3tin �{es Via.- a 27 pa�lrp t-i e c _ 29 Sjo ac a 30 133 1 3 / 3. 36 2 /3 P.O. Box 230'347 Tigard, Oregon 97281-0547 COMMERCIAL.Tenant Improvemen,•Ilea1Rn/Rulld•New/Remodel•Parking tot 1,10tInR•INDRISTRIAI.:Equipment•Motors•Controls•Trouble Shooting•Electrical Remodeh,R RESIDENTIAL. New Q Remodel • New Circuits • All Phase$of Malntcnince A Repair S i CITY OF TIGARD 24-Hour BUILDING Inspection L;ne: (503)639-4175 INSPECTIGN DIVISION Business Line: (503)639-417". MST - BUP Received -fly r ? Date Re uested _�` AM_ PM ___ BUP _ Location ,��_— _ Suite—�(.,�Q MEC Contact Person Ph( ) — --___ CPy Contractor ph 7 717 al- SWR — BUILDINGTenant/Owner J_— X l U 7 ELC Footing _— —_ Foundation ELC Access: �--- Ftg Drain ELR Crawl Drain --- Slab Inspection Notes: SIT —_ Poli R Beam `hear Anchors ------- ---- _._._...--------------- --- -- --.__—.-- Ext Sheath/Shear Int Sheath/Shear ------ - _ -- Framing ---- --- --- -- Insulation - — Drywall Nailing Firewall — Fire Sprinkler Fire Alarm F,usp'd Coiling — -- — -- F.00f Other: Final ----- �� PASS PART FAIL — - — — PLUM8ING — Post& Beam Under Slab ----- ---- _- -- — Rough-In --- Water Service — —,�_—_— Sanitary Sewer / ---- ---- -- Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Fina; � 2AL T FAILtCHA Post8 Beam --"_- ------ ---------- — ----..._--_—__ -------- R)ugh-I n ---_-- Gas Line -- Smoke Dampers --------- --- ----- ------- Final PASS PART_ FAIL --- -- —�_—__ ELECTRICAL — Service — -- -----_ -_ —_-- —Rough-In UG/Slab UG/Slab --- - --- --- — --- ----- Low Voltage Fire Alarm Final ❑ Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL_ $ITE_ __— Please call for reinspection RE: _. Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date �41 —. Inspector_- �' __—Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL J CITY OF TIGARD 24-Hour 4- 7 -0 BUILDING Inspection Li ,r.: (503)63 -4175 INSPECTION DIVISION Business Line: (503)639-a i" MST Buie Received --- Date Requested _ AM 9;M—__ BUP Location _SuiteMEC _ - Contact Person �� Ph(;fid) _77_3 7 - 7;4- -PLM Contractor— —_ Ph(�___) _ _ SWR BUILDING _ Tenant/Owner ELC _ Footing ELC Foundation Access: ---'----- Ftg Drain ELR Crawl Drain --- Slab Inspection Notes: SIT Post&Beam Shear Anchors -- ----- Ext Sheath/Shear Int Sheath/Shear Framing - --- ------ --- --- Insulation Drywall Nailing -------_----- __- -_ Firewall Fire r -- -- -- - -- ire Alarm SUs—pTUsiling - ---- ----- - ---- - Roof Other: — ---- -- -- --- AS PART -FAIL ------ - -� - -- - BING - Post 8 Beam __.__-- -- - -_--- ---- - .. Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other. _ _ - --- - --- ---- Final - PASS PART FAIL_ - ---- -- MECHANICAL — Post& 9eFleam Rough-In - Gas Line Smoke Dampers -- ----- _ Final PASS PART FAIL ELECTRICAL Service --� - -_-- Rough-In _- LIG/Slab - - Low Voltage _ Fire Alarm Final f , Reinspection fee cr$__ required before next fns PASS PART FAIL U p 4 Inspection. Pay at City Hall, 13125 SW Hell Blvd. 94M___ R Please call for reim,pectfon RE: Unable to inspect-no access Fire Supply Line ADA I. Approach/Sidewalk Dab- ` Inspector Other Final - DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL ELECTRICAL - CITY OF TIGARD RESTRICTED ENRIGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00044 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-41'1 DATE ISSUED: 2/20/04 SITE ADDRESS: 09430 SW CORAL ST 200 PARCEL: 1S126DC-04400 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C-P BLOCK: LOT: 007 JURISDICTION: T iG Proiect Description: Installation of limited energy for data telecommunications system. A.RESIDENTIAL B.COMMERCIAL _ AUDIO& STEREO: AUDIO& STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: MVAC: 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: MARTIN, ROBERT GLARE MERLIN POINTE TECHNOLOGIES THELMA M 10103 NE 180TH CIRCLE BY JO RENE M MOODHE BATTLEGROUND,WA 98604 SHERWOOD, OR 97140 Phone: Phone: 503-312-7714 Reg#: LIC 155924 BLE 37-100CLE FEES Required Inspections Description Date Amount Low Voltage Inspection ITA X I V,, State tiurrh�ut 2!20/04 $6.00 E=lect'I Final I..I.i'kNI l I I I P I'crinit 2/20/04 $75.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started wit -48Q_days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to JKow rules adopted by the gon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Is ued by1�C91 Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property I own which is not Intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR ELEC'N _ DATE: _ LICENSE NO: Call 6394175 by 7:00 P.M. for an inspection needed the next business day �,tUN C 4 411h !1-T/ f � b - / e-R � lectrical Permit Application � Phone: 503-846-3470, Fax: 503-846-3993, InspectionRe nest: 155 N. 1`t AV, Suite 350-12,Hillsboro, OR 97124 www.co.washinmto or.us _ORFGO"' Land Use Approval: Project# Permit#�� TYPE OF WORK PLAN REVIEW ®New construction ❑ Addition/alteration/replacement Please check all that apply ❑Demolition 1-1 Other: ❑Service over 225 amps,comm] ❑Hazardous location _ ❑Srrvlce over 320 amps-rating ❑Buildng over 10,000 sq,n., CATEGORY OF CONSTRUCTION of I•.and 2-family dwellings 4 or more new residential -- ❑System over 600 volts nominal units in one structure ❑ I-and 2-family dwelling 52 Commercial/industrial ❑ Accessory building ❑Bjilding over three stories ❑Feeders,400 amps or more ❑Multi-family ❑ Master builder ❑Other: ❑Occupant load over 90 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOC4TION ❑health/lighting plan RV park _ ❑Iiealth•cere facility ❑Other: Job no.: V Job address �� Submit 2 sets of plans with any of the above. �y The above are notapplicable( temporary const icuon service. CitylState/ZIP jjjc,,�' uy n FEE* SCHEDULE Suite/bldg/apt.no.: Project name: , Deeerlption QN. Fee. Toth �1. New residential single or multi-rarnily - per dwelling unit. Cross street/uirections to job site: Include square footage for attached garage. 1,000 sq.fl.or less _ 150.00 4 Fa.add'I 500 sq.ft_or portion 4200. Subdivision: Lot no.: Limited energy,residential 60.00 2 - Tax map/parcel no. Limited energy,multi-family 66.00 2 / 4,L- 0 C (,; 1, i, (D l Each manufactured or modular L ESCRIPTIONN OF WORK dwelling,service and/or feeder to2.00 2 l -- - -- ------- Services or feeders Installation,alteration,and/or relocation 200 amps or less 90.00 2 201 amps to 400 amps 120.00 2 --[� PROPERTY OWNER401 amps to 600 amps I80.00 2 ❑ TENANT 601 amps to 1,000 amps 270.00 2 Name: Over 1,000 amps or volts 504.00 2 Address: Reconnect only 78.00 1 -- -- --- - - -- Temporary services or feeders installation,alteration,and/or City/State/ZIP: relocation _ Phone:( ) Fax:( ) 200 amps or less 78.00 2 201 am s to 400 a nps 108 00 2 Owner installation:This installation is being made on property that I own,which is not 401 snip to 600 a mps 150.00 2 intended for sale,lease,rent,or exchange. Branch t rcults-new,alteration,or extension,per panel Owner signature.___ Date. A.Fee for ,rar.h circuits with _ ❑ CONTACT PERSON ❑ APPLICANT - srrvice t„ reeder fee,each g so branch circuit 2 Business name: B.Fee for branch circuits wirhout service or feeder fee, 60.00 Contact name: first branch circuit 2 - - Each add'I branch circuit g.so Address: Miscellaneous(service or feeder not Included) City/State/ZIP: Pump or irrigation circle _ 60.00 2 -" ----+ -- Sign or outline lighting 600r 2 Phone:( ) Fax:( ) _ Signal circuit(s)or limited 'C E-mail: -- e - -- - energy panel,alteration,or ✓ extension.Describe: CONTRACTOR _ 2 Business name: Each additional inspection over allowable in any or the above /L' /L�i�T?5' i '�N/1/OLe>t�L`rS Per inspection 9o.tx) Address: ��r� jy �.��ls` _- Investigation fee (S FE COMPLIANCE) City/State/ZIP: Other: -- -eyf m&, V.) (.)A ELECTRICAL PERMIT FEES— Phone: FEES Phone: ax:( • '2 6 Subtotal .0 Li..no.: 3w; 7../X1!4, CCB lic.no.: /115 sS y 2 y Plan review(25%of permit fee) S Supervising electrician signature,required: State surcharge(8%of nermit fee) S Date: �_ G -4 TOTAL PERMIT FEE Sg Print name: ��R 6 ..�uL - a _n t y 0 This permit application expires it a permit Is not obtained Authorized C within 180 days after It has been accepted as complete signature: -•,_� - Fee set by Tri-Counly Bui:ding Industry Senice Board Print name: Date: 'Numher of inspection:allowed per permit 11"-1 - "'��'' C Y 4404615T(7/03!COM/WEB) I