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10220 SW GREENBURG ROAD STE 310-1 a A N N O M m m z G M G� Cl) m w a O I i ii I Ii f �i 10220 SW GREENBURG RD , STE. 310 1999 SAVE - Hi5'rORICAL INFORMATION BUILDINGS) NAME CHANGE PER KIT CHURCH, ENGINEERING 10220 GREENBURG RCS, LINCOLN II r,\1ORTH CHANGEr) TO 10220 GREENBURG RIS, LINCOLN :CII 10220 GREENBURG RD, LINCOLN II SOUTH CHr'•N&PO TO 10220 GREENBURG hn. LINCOLN 11 30 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspcction Linc: 639-4175 Business Phone: 639-4171 Date Requested: /0 '_-3 l' / 7 _ - A.M. — P.M._ MST: —_ Location: Z2 LIAJC BUP: _ Tenant: INSURA E b Suite: /Bldg: _ 2 MEC: Contractor:_ _ Phone: Z2Z —q41i PLM: — Owner: Phone: U ELC: —Qw (0_ ----- — ELR: L� SIT: BUILDL IG BLDG(con't) PLUMBING MECHANICAL % ELECTRICAL SITE Site Post/Beam Post/Beam Post/Beamoval,%rvtl. Sewer/Storm Footing Roof UndFUSlab Rough-In Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG S Shcar/Sheath Fire Spklr/Alin Crawl/Found Dr Heat Pump ow of t _ Approved Approved Approvedec Approved Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved FINAL. FINAL FINAL FINAL FINAL Z, 41 ,, ---�--- r' ----- 4-, - - - - 0 Call for reinspection fieinxx1ion f • required before next inspection n ' to inspect Irrapaanr ,_ Date:-T/"" � ����_9 _ Page— CITY OF TIGARD DEVELOPMENT BT #. . . .LDING PERMIT NT SEPVICES -<°•..,, PERMIT T #. . . . . . . : BUF'9 7--0 X60 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 12/31 /97 PARCEL: 15135AB-01004 13I TE ADDRESS. . . : 102:4'0 SW GREF_NBURG RD #S310 ":RUBD I V I S I ON. . . . : Z ON I hIG:C-F' BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . . . JURISDICTION:TIG REISSUE: FLOOR AREAS---------•---- EXTERIOR WALL CONSTRUCTION- CLASS OF WORK. :ALT FIRST. . . . : 0 sf N: S: E: W: T'(PE OF USE. . . :COM SECOND. . . : 0 sf PROTECT OPENINGS'?--------- - TYPE OF (:ONST. :2FR . . . : 2 178 sf' N: S: E: W: OCCUPANCY GRP. :B TOTAL --- - 2:178 sf ROOF CONST: FIRE RET') : OCCUPANCY LOAD: ter' BASEMENT. : 0 sf AREA SEP. RATED: STOR. : 0 [AT: 0 ft GORAGE. . . : 0 sf OCCU SEP. RATED: BSMT? : MEZZ.?: REOD SETBACKS-------__ REG!UIREU----_------ -�- --- FLOOR LOAD. . . . ,Z; psf LEFT: 0 ft RGHT: 0 ft FIR SP VL. MOI'. DET. . DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: 18E.DRMS: 0 PATHS: 0 IMP SURF-ACF:: 0 PRO CORR: PARKING: 0 VALUE. $ : 11'200 Remarks : Tenant improvement - Fire sprinkler, electrical 6 mechanical permits are required. OwT,er: ____.__.._.____.__-_____.__._________..----------------_-_-_____._-- FE:ES KNICKERBOCKER PROPERTIES INC type amot.int by date recpt 10300 SW GRFENBURG ROAD PRMT f 98. 50 GEO 12/31 /97 97-302200 SUITE 2,00 SPCT f 4. 93 GEO 1.2/31/97 97--302200 TIGARI) OR 97223-0000 PL.CK f 64. 03 GEO 12/31/97 97--3,02200 Phone #: 452--5900 FIRE f 39. 40 GEO 12/31/97 97-302200 Contractor: _____.__- ---------•--------_....._ COMMERCIAL CONTRACTORS :NC 25610 SW 41ST AVE RIDGEFIELD WA 98642 Ph o n o #: 2:27-4440 f 206. LIX8 1 OTA1_ Ren #. . : 123729 --- ---- REQUIRED INSPECTIONS -----This permit is issued subject to the regulations contained in the Framing Insp Tiqard Municipal Code, State of Are. Specialty Codes and all other Gyp Board I n sr applicable i iws. All work will be done in accordance with Si_h s n C e i 1 n q T n s p approvea plans. This permit will expire if work is net started within 198 days of issuance, or if work is suspended for more than 198 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in NIR through OAR 952-88181997, You many obtain a copy of these rules or direct questions to (INC by callrnq (583)246-1997. Permittee S+gnath.treL ) y Issl_hed By- 4 y• -_-. +++++f•+++++1+++++++-I +++.f+++++++++ ++++++++++++++fi.+++++++++++V9 +++++ i 4-+++ Call. 639-4175 by 7:00 p. m. for inspection needed the next bi_isiness day +++++++++• +++++++++++--+++a ++++++++++++++++•1 ' f•+++++•h+++++++++4-+ +++++++++++++++ f CITY OF TICARD Commercial Buildinc Per it Rec'd By �� 1 Date Recd 13125 SW !-CALL BLVD. Tenant Improvemel,t � y ti"`� v Date to P E� 1-5 ) TIGARD, OR 97223 7' �'L-?� (503 6'�3-4171 I �� ' ��� Date to DST Permit f Print or Type Related SWR ativ Incomplete or illegible applications will not be accepted Called_— v."__—.__ Name of Development/Project Existing Building X New E gilding .Job Lj►1co�v� C,•tn'E.'ev-� Address street Address Sure — u Building �,jr�COI:� �'PK (pZ2_0 3W G►�3'eKw% fid �1�_— Data -- - Bldg 0 City/State Zip Existing Use of building or Propei y. _Iwo PCA O 9-7 Z2'b 0 JCA CAP- Name AzName Property Kn'%Ckey�ocKer Fwe+tee T1c. XXIV Proposed Use of Building or Ptrtpelty. Owner Mailing Address Suite ` �' C-e 1nl,tD SW Gree,,6oy�►Rel, T OD i , Of Stories: City/State Zip Phone Sq. Ft. Of Pr jest: — --- — Occupant Name _ � -L F, Pah Occupancy Class(es) Name ^` V) Contractor (otntr,flr� I; (-,J" .-f it"W,J I N r Type(s) of Construction Prior to peril Mailing Address Suite issuance.a copy rt KiII this project have a Fire Suppression System of all licenses NW Yes ❑ No I] are r?gwred if City/State Zip Phone Americans with Disabilities Act(ADA) —wedinCO.T pp ( talabase I I e ,e(d wA ?27-iq- t-, Valuation X 25% $ -' C- ` " Participation ore—g&Const.Cbnt.Board Lica Exp.Date Complete Acces!;ii ility Form _ 12 ,7-2Project $ Name Valuation 12 r`�� �� Architect Gf�P ArcL140ec-�r I►ncc r trd't�,c{ Plans Required:- See Matrix for number of sets to su_bmii�� Mailing Addresg Suite on back 920 SW 1 a NeAve AGO — -- 1 City/State i Zip Phone I hereby acknowledge that I have read this application.that the infurmation Qor'{- 9(,5 given is correct,that I am the owner or authorized agent of the owner,and that plans submitted are in compliance with Oregon State Laws. Engineer Name Signature of Owner/Agent Date Mailing Address Suite ` �� I '�2-97 — Cont 16 Person Name Phore Gty,'Slate Zip Phone ay Glor ---- -- --_ FOR OFFICE USE USE ONLY T Indicate type of work: New G Addition O Demolition O Map/TL# _ Land Use: Accessory Structure G Foundation Only O Alteration K Repair G Other O —_ _ Notes: Description of work: 1 TQY�aVt` 1W��wv�htEtl l TIF -- Parks Estimated r of Employees -- — NL. Site Work Permit Application precede or accompany Builr4ing Permit Application I\COMNF'J'1 DOC (DST) 8/97 COMMERCIAL PLA"'T SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST _ EXAMINERS _ (Note a.) TYPE OF SUBMITTAL r IO� TAL, CPE PPE =F-P CPE —i Pr'E l EPE —1 SITE 1 - -- 3 O,o,u) -- B (New or Add) 1 1 -- -- 3 O,o,w) F (New or Add or Alt.) 3 3 -- -- 3 (j,o.f) M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- '- B & M (New or Add) i 1 -- -- 3 (j,o,w) -- -- P (New, Add. or Alt) 2 -- 2 -- -- 2(j,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) ( -- E (New, Add, or Alt) - -' -" "" 20,o) B & M & P & E (New, Add) ? l 1 l 3 (j,o,w) Z(j.u) 20,o) B or B & M (Alt) 1 1 -- -- 20,o) -_ B & M& P(Alt) 3 1 2 -- 2 (j.o) 20,o) -- B & M & P& E (Alt) 3 1 1 1 20,o) 20,0) 2 (j,o) NOTES: a. Before returning to DST,Plans examiner gets appropriate j =Job B = BUP number of'revised plans from applicant. stamps and completes, o= Office M = MEC updates and adds actions. f= Fire P = PLM u= USA E= ELC b. Shaded areas designate ALT submittals only. w= Wash. County F = FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and R.escue no longer require,- a set of approved plans to be forwarded to their office. Exception, continue to forward a copy of approved fire sprinkler and lire alarm plans with calculations. h�n Anc.Doc 12/22/97 MON 10:39 FAX 503 244 4400 NnRRIS BEGGS GBOARCH [tjo Pan American Bank • Two Lincoln, Suite 310 AVER THS Gtr NTEf�IO1Q) (attachment to Submittal Criteria) SUBJECT, ACCESSIBILXry BARRIER REMOVAL IMPROVEMENT PLAN REQUIREMENT: OREGON RMsEri STATUTE IoRS)447.241. (1) Every project for renovation,aperstion or modi8catlon to affected bulklUvdi and related facilities shall be made to hilt"that the path of travel to the a'lared area and the resrroorn telephones and drinking fountains are readily acooWbie to individuate with disabilities,unless such alterations ure disproportionate b the 0w'14 eeerallons In terrns of cost and scofwe (2) Alterations made to the path of travel to or,altered area may be deemed diaproportlonals to the overall alteration when the cost exceeds twenty-five per-cent(25X). THEREFORE; Each submittal for a building permit shall Include this form providing the following Information. (Excluding re-roofing,mechanical and electrical permit applications] VALUATION of all renovation, alteration or modification being done excluding painting,wallpapering. 12,200.00 lZluff1ply,; 25% Garriet removal requirenwint. BUDGET FOR BARRIER REMOVAL ]2] $ 3,050.00 The dollar amount of the BUD-M. established on-line (2) In the computation above shall ba spent providing the accessible elements In the following order. 1- An accessible route connecting the building to accessible pedestrian walkways, and the public way. ; finrJuding but not IinUted to-,rub rumps,dolomble warnings, — mark4d crossings,ramps handrails and findings). 2 Not less than one accessible parking space. S ('including but not limited to ediecent aceeas aisle,signs and curb ramp conrecsing"th the sca essrble retrial. 3. Accessible entry or entries, $ flnctudkv but rat t rA"to ramps,handrails.landings. �— door ail helgl%do.,!width and door herrmare). 4. An accessible Interior route to the altered are.A. S__ Ikrcluding but not irrrRed tc doer-weya,manouvsrkrtl cbarancas,door hardware srld slairweys). 5. At least one axessible restroom for each sex. S 6. At least one accessible telephone where public phones are provided. $ __^�-- 7. When drinking fountalns are required, filly percent but not less than one shall be accessiblb. a Additional accessible elements such as storage, reach ranges, alarms. etc.. cabinetry, hardware, siKnae ; 3,050.00 TSLTAL; t aft t:auaf ffne Z of Vafue CQniglita)i, S 3,050.00 is/owd.doc(DST) CITY OF TIGARD EL.EC:TRICAL PERMIT DEVELOPMENT SERVICES FERMI-r #: ELC96-0009 13125 5W Nall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 01 /07/98 PARCEL: 1S135AB-01004 SITE ADDRESS. . . : 10,220 SW GREENBURG RD #5310 SUBDIVISION. . . . : ZONING:C-PI BLOCK. . . . . . . . . . . LCT. . . . . . . . . . . . . . JURISDICTION: TIG Pr•o J ect Description : Add four (4) brench circuits to an existing cossercial tenant. - -RESIUE.NTIAL_ UNIT----- ---TEMP SRVC/FL.CriERS----- - ---MISCELL.ANEOUS----_ 1000 SF OR L.ESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP'/IRRIGATION. . . . : 0 FACH ADD' L 500SF. . . : 0 201. - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 1 TMITED ENERGY. . . . . : 0 401 -- 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FUR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL. ( 10) . . . 0 - ---5. RVICE/FEEDE:R----- -----BRANCH CIRCUITS-------- ----ADD' L INSPECTIONS----__. 0 - 200 ,amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INSPECTION. . . . . r 0 201 - 400 amp. . . . . . : 0 1st W/0 SRVC OR FDR. : 1 PIER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : 0 EA RDD' L BRNCH CIRC: ?, IN P'L_ANT. . . . . . . . . . . . 0 601 1000 amp. . . . . : 0 ---- --------•_-.- _._.__RICAN REVIEW c,ECTICIN- ---- --_.___.__-. 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Rer.unnec:•t only. . . . . : 0 SVC/FDR ) = 225 AMP'S. . : CLASS AREA/SPIE:C OCC. : Owner.. __._______--------.--------- -------_-___._______.________-- FEE' :i PIAN AMERICAN BANK type amol.int by date r^eept 10c'20 SW GREC'NBUR(3 ROAD PIRM1 50. 00 GEO 01/07/98 98-'023 'O SUITE .310 5PICT $ 2. 50 GEO 01 /07/98 98-30231:0 TIGARD OR 97223--0000 Phone #: Contr,actor: $ 52. 50 TOTAL -------- REQUIRED INSPECTIONS --- Ceiling --Cei1ing Cover Undergrotmd CovF, FIhone #: Wall Cover- Elect' 1 Ser-•vir_e Rpq #. . . This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All North will be done in accordance with approved plans. This permit will expire if work is not started within 188 days of issuance, or if work is suspended for more than 18N days. ATTENTIGN: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR W-401-00W through OAR 952-01-1997. You say obtain a copy f these rules or direct questions to RX, by calling 1593)246-1987. 7 (.� Permittee Signatitr�p: Iss'_ied By • _._-----------------__...____._---0!JNER TNSTFIL.LATION The installation is being made on proper-ty I own which is not intended for- sale, orsale, lease, or, rent. r1WNER' S SIGNATURE: DATE : ----------------------CONTRACTOR INSTALLATION ONLY---------------_--___-_-_-- - _ S I GhiATURE OF SUP'R. ELEC' N: _ C`}' v cJ -I DATE: -- -_LICENSE NO• +++++tt+4++f+++++++-++++.....++.*.............+...+•1-....-Fi•+•F........ •+i•+........ Call F,39-4175) by 7:00 p. in. for- an inspection needed the next bl-tsiTress day CITY OF TIGARD Electrical Permit Application Plan Check# 13125 SW HALL BL.VD. Recd By TIGARD OR 97223 Date Recd Phone (503)639-4171, x304 Date to P.E. Print or Type Date to DST Inspection (503)tb39-4175 Incomplete or illegible will not be accepted Permit# f Fax (503)684-7297 C2iled 1. Job Address: V�^ 4. Complete Fee Schedule Below: Name of Development C. •w� t', I �� � Number of Inspections per permit allowed Name(or name of business)_ I^e_„i ire-n,re - �. .� ��' Service incluc'ed: Items Cost Sum Address /� C' S� beA���cr s, he I t 4a. Residential-peg •,mr City/State/Zip + ,, ) '17_ ' 1000 sq.ft.or less ,-- $1 Ci ryS / pI 1,iIL� 9 1 Each additional 500 sq.ft.or 77 portion thereof $ 5.00 Commercial ® Residential CI Limited Energy $25.00 _ Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2a. Contractor installation only: - -- - (mach copy of all current licenses) 4b.Services or Feeders Electrical Contractor L i;at ,r �/r t(wc f�1r�-. �� c__ Installation,alteration,or relocation 200 amps or less Address $60.00 �! �.=- ti�-Y_� 201 amps to 4G0 amps $60.00 City State :L Zip `)7 21r/ 401 amps to 600 amps _ $120.00 Phone N6. 4 14 �. L 601 amps to 1000 amps $180.00 �. Job No. C Over IOM amps or volts $340.00 Elea.Cont. Lice. No.,2_q__:�� C Exp.Drate_,_ u f - (d Reconnect only $50.00 OR State CCB Reg. No. '7i� Exp.Date 6 C/ 4c.Temporary Services or Feeders COT Business Tax or Metro No-Ai-ki-Exp. ate Installation,alteration,or relocatior / 200 amps or less $50.00 _ Signature of Supr. Elec'n_ 201 amps to 400 amps $75.00 �L 401 amps to 600 amps i $100.00 Over 600 amps to 1000 volts, License No. /4, s S Exp.Date /V i y f see"b"above. Phone No. Z 4 r i - 3t 14 4d.Branch Circuits Now,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with purchase of service or Print Owner's Name__ _ feeder fee. Address Each branch circuit $5.00 R b)The lee for branch circuits City_ State Zip without purchase of Phone No. _ service or feeder fee. 7 -� First branch circuit $35.00 7 2 The installation is being made on property I own which is not Each additional branch circuit_ $5.00 z intended for sale, lease or rent. 4e.Miscellaneous Owner's Signature (Service or feeder not Included) g -_ Each pump or irrigation circle $40,00 _ Each sign or outline lighting $40.00 3. Plan Review section (if required):' Signal circuit(s)or a limited energy panel,alteration or extAnsion $40,00 _ Please checkappropriate item and enter fee in section 58. Minor Labels(10) $100.00 4 or more residential units in one structure 41.Each additional Inspectlon over _Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $3500 Classified area or structure containing special occupancy Per hour - $55 00 as described in N.F.C.Chapter 5 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. 5. Fees: Not required for temporary construction services So.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ ' NOTICE Subtotal $ Sb.Enter 25%o1 line So for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review It reauired(Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account N S TIME AFTER WORK IS COMMENCED. Total balance Due : I%DSTMELC48 APP nev ares CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT 13125 SW Hell Blvd.,Ti9prd,OR 97223 (503)639.4171 RESTRICTED ENERGY PERMIT #: EL.R98-0014 DATE ISSUED: 01/29/98 PARCEL.: 1S135AP-01004 SITE ADDRESS. . . : 10'L::'20 3W GREENBURG RD #5310 SUBDIVISION. . . . : ZONING:C—P BL.00K. . . . . . . . . . 1. LOT. . . . . . . . . . . . . . JURISDICTN: TIG Flv-n j ect De sct-i pt i on: Miscellaneous: signal circuit or a limited enerqy panel, alteration or extension to an existinq tenant occpy. A. RE91 CENTI AL 3. AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAGING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . : GARAGE. OPENER. . . . , CLOC 3K. . . . . . . . . . . : MEDICAL. . . . . . . . . . . . : HVAC. . . . DATA/TEL-E COMM. . : NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . . . : FI RE At-ARM. . . . . . : OUTDOOR L.ANDSC L.ITE: OTHER: PIVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL.. . : Jf-_!STRUMENTATIONI. : OTHER. . :LIM ENERGY: : X TOTAL. # OF SYSTEMS: I Owner,. -------------------------------------------------------- Fc ES — - -------------_ PAN AMERICAN BANK type amol-knt by date rerpt 1 1 -19/98 98-302877 0POO SW GREENBURG ROAD PRMT $ 40. 00 GEO 011C. SUITE 310 5PCT t '. 00 GEO 01 /29/98 98-302877 TIGARD OR 97223-0000 Phone #: contractor-: AL.LEN/FALK INC $ 42. 00 TOTAL, 9020 SW GEMINI DR ------ REQUIRED INSPECTIONS ------- BEAVERTON OR 97008 Low Voltage Iosp Phone #: 646-0533 Elect' l Final .. ........ Reg #. . : 000472 This permit is issued subject to the regulations contained in the Tigard Municipal Cod,.,, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is su;opnded for more than 18e days, ATTENTION: Oregon law requires you to follow rule adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952.--8@I-Nl@ through OAR 952-01-*60. You may obtain copies of these rules or direcA quest ns to,,IfXK at 1503)246--1967. Permittee SjqnAti.ire Issi.ted b —_____--_OWNER INSTALLATION The installation i being made on property I own which is not intended for- salel lease, or- vent. OWNERIS SIGNATURE- DATE r ____._._—__.--_—.-----------CONTRACTOR INSTALLATION ONL.Y-------------------------------- SIGNATURE OF SUPR. ELECIN: DATE L-ICENSE NO: ..............4.......................4...4.........i............................4-4 1 Call 639--4175 by 7:00 P. M. for- an inspection needed the next bi-tsiness day ...................4............................ ..............................4.+4 CITY OF TIGARD Electrical Permit Application Plan Check# 13125 SW HAIL BLVD. Recd By TIGARD OR 972.23 Date Recd Dale to P.E. Phone (503)639-4171, x304 Inspection (503) 639-4175 Print or Type Date to DSl'L Incomplete or illegible will not be accepted Permit# > -3'-04<</ Fax(503)684-7297 Called_ ( 1. Job Address: j - 4. Complete Fee Schedule Below: Name of Development L if 1 ul"i, Number of Inspections per parrnit allowed Name(or name of business) ) ���L1 L Service included: Items Cost Sum Address , 4a. Residentfaf- ,),jr unit Ci /State/Zi i� �2 1000 sq.ft.or less $110.00 ry p Each additional 900 sq,ft.or portion thereof $25.00 Commercial Residential Limited Energy $25.00 Each Manul'd Home or Modular 2a. Contractor installation only: Dwellinq Service or Feeder $68.00 (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor rr Installation,alteration,or relocation Address , 200 amps or less $6c.00 2 201 amps to 400 amps $80.00 2 City- tate _Zip CM n A 401 amps to 600 amps $120.00 2 Phone No.`& - 601 amps to 1000 amps $160.00 2 Job Nc. 'l 3S9 Over +000 amps or volts $340.00 2 Elec.Cont. Lice. No. Exp.Date q, q5F Reconnect only $50.00 2 OR State CCB Reg. No (_LL) Exp.Date (1 4c.Temporary Services or Feeders COT Business Tax or Metr Exp.Date_jjInstallation,alteration,or relocation 200 amps or less $50.00 Signature of Supr. Elec'n ,,,_ ; 201 amps to 400 amps $75.00 401 amps to 600 amps $100.00 �✓ 1 G ' Over 600 amps to 1000 volts, License No. :2M alb Exp.Dete_ /��9 see"b"above. Phone No. (pia-,(L3 _ 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The tee for branch circuits with purchase of service or Print Owner's Name___ feeder fee. Address Each branch circuit $5.00 b)The fee for branch circuits City _ State Zip �.._ I without purchase of Phone No. _ service or feeder fee. First branch circuit $35.00 The installation is being made on property I own which is not Each additional branch circuit i $5.00 intended for sale,lease or rent. 4e.Mlscellaneous Owner's Signature (Serviva or feeder not Included) 9 _ Each pump or Irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan RE tai%u-v section (if required):' Signal anel,ilimited energy alteration orextensi n � $40.00 2 Please check appropriate item and enter fee in section 58. Minor Labels(10) 5100.00-- 4 or more residential units in one structure 4f.Each additional Inspection over Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per Inspection _ $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described In N.E.C.Chapter 5 In Plant _ $55.00 *Submit 2 sets of plans with application where any of the above apply. S. Fees: 40Not required for temporary construction services. So.Enter total of above tees $ _��/,,,__- 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enter 25%of line Se for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if rVgui (Sec.3) $ ----- --- NOT COMMENCED WITHIN 180 DAYb,OR IF CONSTRUCTION OR WORK Subtotal $ ----- IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIMF AFTER WORK IS COMMENCED ❑ Trust Account it Total balance Due s I\DSMELC96 Air nev WN - CITE( OF TIGARD ikDEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 CERTIFICATE OF� OCCUPANCY PE F01 T M.. . . . . . . a BUF197-02560 DATE I SSUE D c 03/15/98 PAPCEL c 1 .13'5AP--01 i'e)04 T TE~ ADDRESS. . . c 1SW GREENSUPG RD ks310 I.IBD.IVISION. . . . TWO LINCOLN — TOWN OF METZGER ZONINGcC P . . . . . . . . . . LOT a LOT. . . . . . . . . . . . . c _ UR113DI("T TO i 16 LAGS OF WORK. -FLT YPE OF USE. . . s COM YPE OF: CONS T R s,.F R -LUPANG"Y GPP. 0 G C,t.)PANC Y 1—OAD. ; ENANT NOME. . . ;PAN AMERICAN BAW, I. rkse Tenant i.mprovemeiit wnerc __. _... _..... ...__......._.____......__._..___..__.__.. ____._....__ _. NI CKERBOCKE"R PROPERTIES, 11,47, 10 NORR I Fa, '9EGGS & S I MPGON 0 300 SW GREENFURG RD 0200 WARD OR 97r--'23 hnne Mc OMMEft'LIAL. CONTRACI'ORS INC 3610 SW 41ST AVE I U©Ez.F I EL_D WA c�66u ! i`►une #1 ' ?T-4440 itis Certi.firarte gr amts u2cLipanr�y of the a.bovw referenced building or portion hev-0f and confirms that the br,ra. IJIny has been fnal:ye(-ted for compliance witf he State of Organ Specialty Codes for thegro , aceta pan y, and use lir►r,er, tlic:h the referenced permit was issued. j ��r11_.DINC�� NLiEa CTOR BUil_ �Nr OF'F 1C1AL_...._ .... PUS-f IN CONSPICUOUS E=LACE 0�{�3 CITY OF FIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Linc: 6394175 Business Phone: 6394171 Date Requested: f /U A M 1'M. MST: Location: ��,��-C.J . ----- BDP: Tenant: L -Y O�� Suite: 'C) Bldg: MEC: Contractor: r ^ Phone: PLM: / r Owner:_ Phone: ELC:,Ci L ELR: SFT: BUILDING BLDG(con's) PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam F'osl/Beam Post/Beam 1 ooting Root UndrI/Slab Rough-In Ceiling C' Water Line gh !�� (—Ceiling U'V�'�`. Water Line Slab Framinh Top Out Gas Line '1FougTiTn -` - UG Sprinkler Foundation lnsulatio.l Sewer Hood/Duct Reconnect Vault Bsmt Demp Drywall Stonn Furnace Temp Service MISC. Masonry Ceiling Rain[rain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt _ Approved Approved ApprovedApproved Approved Appr/Sdwlk Not Approved Not Approved Not Approved roved Not Approved FINAL FITi'AL FINAL FINAh, FINAL Ztllt-15'Lel Aq ss -- - 1�Al- /.X. _o —_-- .�. D Call for reinspectio 17 Reinspection fee of S—�—required before next inspection D Unable to inspect Inspector 1 _,—� ��_ Date:Z— A �-.- Page_ of _ CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 6394171 Date Requested: t'1 % _ A.M P.M.— - MST: l.oc:ation: (J1 , av v�� G I f 1�� ��,. �i BL'P: Tenant:—�� I �, �L t SuitC-:�aBldg: _ MEC: Contractor:� _ !V —p^_ i Phone: - `.'�j PLM. Owner _ _ Phonc: _ EI C: EIR SIT: _ BUILDING BLDG(con't) PLUMBING MECHANICALELECTRICA SITE ^v Site Post/Bearn Post/Beam Post/Beam ovc tee Sewer/Storm footing Roof UndfUSlab Rough-In Ceiling Water Line Slab Prmning Top Out Gas Line Rough-In I IG Sprinkler Foundalion Insulation Sewer Ilo(xl/I)uct Reconnect Vault Bsmt Damp Drywall Ston) I urnace 'Temp Service misc. Masonry Ceiling Rain Irmo A/C W;Slab Shear/Sheath fire Spklr/Ahn Crawl/Found DT I leat Pump I 11 Approved Approved Approved Approved Approved Appr/Sdwlk Not Approved Not Approved Not Approved o pproved Not Approved FINAL, FINAL FINAL FINAL FINAL ❑Call for reinspection fl 1 slrcGon tee of 4 required before next inspection 0 unable to inspect Inspector Hale Page_____—_.- of