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10300 SW GREENBURG ROAD STE 420-2 0 � n 1 r x C'1 N O a I 10300 SW GREENBURG RD 420 CITYOF T I G A R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2003-00158 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-417'. DATE ISSUED: 4/4/03 PARCEL: 1 S135AB-01003 ZONING: C-P JURISDICTION: TIG SITE Atr:)RESS: 10300 SW GREENBURG RD 420 SUBDIVI.;ION: LINCOLN ONE/RED LOBSTER/CASA L BLOCK: LOT: CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2FR OCCUPANCY GRP: B OCCUPANCY LOAD: 10 TENANT NAME: G J. PACIFIC CORPORATION REMARKS: TI New office and counter. Owner: EOP LINCOLN, LLC 10260 SW GREENBURG RD SUITE 100 'J'06 e'ID2WOF' Contractor: C SCHIEWE +ASSOCIATES 1024 NE DAMS PORTLAND, OR 97232 Phone: 234-6617 Reg#: LIC 54105 This Certificate issued 4/30/01 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and u � uMder whi/ch "r erenced permit w is led BUILDING INSPECTOR BUIL Nu FFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (oo2l)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 Received Date Requested 3y AM__-____PM BUP Location — u� �/7-2-2", GJ' c� — Suite//!! — M hoc' `0`, Z Z Contact Person �f' Ph( ) �X g � _ PLM 25 Contractor __ _ Ph( —) _— _ SWR MIA Tenant/Owner _ ELC Footing - -- ELC Foundation A-cess: �. Fig Drain ELR Crawl Drain N Slab Inspection Notes: � r r SIT _-__- Post&Beam Shear Anchors - --- --- - -- _ _ ._._— Ext Sheath/Shear Int Sheath/Shear Framing -- Insuiation Drywall Nailing — Firewall Fire Sprinkler - - - --- — -- �^ Fire Alarm / Susp'd Ceiling Roof Other: - --- — --� — aA S,AS _ FART FAIL-- BING Post& Be-im — -- _ Unde;Slau -- --- — Rough-I Water ServicA Sanitary Sewer Rain Drains ---- - - ----� _—__ — - Catch Basin/Manhole Storm Drain -�— Shower Pan Other. i Final -- PASS PART FAIL MECHANIC_AL Pu-t R Rearn Rough-In - Gas Lina Smoke Dampers Final PASS PARTPAIL ELItrCT_RICAI_—— Service_----- - _ Rough-In - UG/Slab Low Voltage — Fire Alarm Final ❑ Reinspection fee of$_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART _FAIL SITE ❑ Please call for reinspection RE: Unable to inspect-no access Fire Supply Lina ADP. A pproactvSiduw:�lk I2,1,C) �- Inspodor Ext _ Oth _ Final AO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGA.RD 24-Hour �, ��✓� �`y� `' Inspecron Line: (5031639-4175 BUILDING s-s 7.2-.- MST _---- INSPECTIC" DIVISION Business Line: (503) 639-4171 BUP .. - - --- - ...- Rareivea _- Date Requested..- AM.____ PM_. BUP Location - - . 10300 -- Suite—_.. a0 MEC PLM Contact Person - -- ----- (— // - - Contractor 1 T r_�'�'�{�� 'fvy Ph ( of y SWR BUILDING Tenant/Owner - ___ _ ELC _— Footing ELC Foundation Access: ELR Ft.1 Drain Crawl Drain Slab inspection Notes: ,, It SIT Post&Beam -------- -. -_ =---/ � Shear Anchors � � L Ext Sheath/Shear - Int Sheath/Shear Framing ---- - " Insulation Drywall hdiling — Firewall _ Fire Sprinkler -- Fire Alarm Susp'd Ceiling - --- - Roof Other:^-- - - - - Final PASS 'ART FAIL --~ -'-- -- PLUMBING _ — Post& Beam Under Slab - Rough-In Water Service - -- - - - ------ ---- - Sanitary Sewer Rain Drains -- -- Catch Basin/Manhole Storm Drain - --�- -------- — Shower Pan --- Final - �— PASS PART FAIL _MECHANICAL -- - _ --- Post&Beam ---- Rough-In - Gas Line Smoke Dampers Final PASS PART FAIL -- f.L,FScT� Service Rough-In U jelarm [] Reinspection fee of$ required before next Inspection, Pay at City Hall, 13125 SW Hall Blvd. S ART FAIL --�� [ Please for reinspection RE: _— [] Unable to inspect-no access Fire Supply LineADA - ease c Approach/Sidewalk Date Inspect r - Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hoi r BUILDING Inspcetion Line: (503) 639-1175 - MST - -- - INSPECTION DIVISION Busi•,iess Lime: (503)639-4171 BLIP -_ - ----- - Received 15 3 Date Requested G '-3y AM__-_ PM BUP __ --- Location .--�� 3D ` � 'i'`Ga'^ Suite dy MEC -_----__-- --_- Contact Person Ph( 5t 27 ) 3 I 07-73 C PLM ��1 Contractor_ —�lG��i��a- Ph( ) - - SWR --- BUILDING __ Tenant/Owner _—._ ELC Footing ELC __- Foundation Access: Ftg Drain ELF! - 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 - Root Other._ Final PASS PART FAIL r er Slab Rough In Water Service ! Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Ot _APART FAIL NICAL Post&Beam Rough-In Gas Line Smoke Dampers Final PASS PART__FAIL IC �- ELECTRAL Service Rough-In - --- - UG/Slab ------ ---- Low Voltage Fire Alarm Final ASS Reinspection tee of$. _ required before nex� 3pection. Pay at City Wall, 13125 SW Hall Blvd. _P_ PART FAIL SITE _ E] Please call for reinspection RE:_ -- _ Unable to inspect-no access Fire Supply LineADA ` ? Approach/Sidewalk Dnb- / 3 010 J Inspector Ext— -- Other _ ____- _ Final DO NOT REMOVE this Inspection record front the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST _— INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received _ _._____ Date Requested— _-- AM _-- —--___ PM _ BLIP ___-- -- -- � te MECw `Location L/"L% PLM _ ` Contact Person - - - Ph( 1 �- Contractor_ - -- _ Ph( ► --_ - _ SWR _— — BUILDING fenant/Owner _— - _ _-- ELC •1 s Fooling - - ELC Foundation Access: ELR Ftg Drain ----- Crawl Drain C _�"r`�.' SIT Slab Inspection Notes: - --- _ Post&Beam Shear Anchors Ext Sheath/Shear -- -- Int Sheath/Shear Framing -- Insulation it L Drywall NailingFirewall -- - -- Fire Sprinkler Fire Alarm Susp'd Ceiling -------- Roof _ Other: Final — _PA_SS PART FAIL PLUMBING Post& Beam Under Slab -- --- ---� — Rough-In Water Service ----- - Sanitary Sewer Rain Drains —" Catch Basin/Manhole Storm Drain -- - Shower Pan Other: �— Final PASS PART FAIL MECHANICAL - -- -- Post& Beam Hough-In Gas Line Smoke Dampers - - Final PASS PART FAIL -- ----- —— - --- C RIC Service Rough-In _ -- --- -- UG/Slab i Low Voltage -- Fire Awflil Reinspection fee of$_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. AS PART_FAIL SITE Please call for reinspecjihn RE [� Unable to Inspect-no access Fire Supply Line ADA Date Approach/Sidewalk .-�U. S� Inspector / Other: Final DO"NOT REMOVE this Inspection record from thr job site, PASS PART FAIL CITY OF T I C A R Q ELECTRICAL PERMIT PERMIT#: ELC2003-00205 DEVELOPMENT SERVICES DATE ISSUED: 4/9/03 13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003 SITE ADDRESS: 10300 SW GREENBURG RD 420 ZONING: C-P SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical tenant improvement, (2)branch circuits. Job No. 3392 RESIDENTIAL UNIT TEMP SRVG/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 ramp: SIGNAL/PANEL: MANE HM/ SVC/ FOR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS. 0 300 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 arnp: 'Ist W/O SRVC OR FOR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: -4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: — SVC/FDR >-225 AMPS: CLASS AREA/SPEC OCC: J Owner: Contractor: EOP LINCOLN,LLC WILLAMETTE ELECTRIC INC 10260 SW GREENBURG RD PO BOX 230547 SUITE 100 TIGARD,OR 97281 PORTLAND,OR 97223 Phone: Phone: 624-2938 FAX ReU #: M4-3631 75059 -- stir 19655 _ FEES _ 111 14-2810 Description Date Amount Required Inspections I I TRM'I) 1A.0 Permit $53.50 -- —�— AX 18",,State Tux d 'iii! $4.28 Rough in Elect'I Final Total $57.78 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 suupended for mor #*t1ZBQ days_ ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set fort •iii OAR 952 001-001dfl�rough OAR 9 2 001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)2466699 or 1 00-332-2344. \\ Issued By: A — Permit Signature: OWNER INSTALLATION ONLY The ins a a ion is tieing mad9 on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE:_—.--.. CO TRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'hl: __/�_. _ DATE: LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: l,i Permit no.: (' City of Tigard I'roject/appl.no.: Expire date: Cm,of Iigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.. Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ TVOV OF PERMIT U I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family W Tenant improvement U New construction U Addition/alteration/replacement U Other: _ U Partial 11 SITE INFORMATION Job address: ;n u Bldg.no.: / Suite no.: 2c, I Tax map/tax lot/account no.: Lot: 181ock: Subdiv' ion: Project name: C'J 9,11 A c (cin a I Description and location of work on premises: Estimated date of completion/inspecti n: 1 1 Job no: r?—97- l(c nicer Business name: 11 - -�1 ,(� Description QW (ea.) 'fund no.Ina t New rrshkntial-slnRk or multi-fandly per Address: e) dwellingunit.Incltulesaltncll(•dg:tra�c. City: Ir,4 A 4 1 Slate: Or. 1 ZIP: `/.)1 J ►— Scnicrinclude(I: Phone: .7641(- TA 3, IF= Ery-tti E-mail: 1000 sq.ft.or less 4 Fach additional 500 sq.ft.or 1-ition thereof CCB no.: 7 o cI I Clec.bus•lic.no: dj-26 L- Limited anergy,residential 2 City/metro lie.no.: c,: Limited a lergy,non•residentinl _ 2 racrvred home or modular dwelling Signature of supervisingectr i an a wired► pole Service and/or feeder 2 Sup elect.nm»r(print): License no: /Q� \ y Serrationvices feedersloctiInstallation, A�lalteration or relocation: 1 1 200 amps or less 2 Name(print): 201 amps to 401 amps 2 401 amps to 600 amps 2 Mailing address: -- 601 amps to 1000 amps 2 City; Stale: ZIP: over 1UWamps orvolts 2 Phone: `_ Fax: I E-mail: Reconnectonly I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocallon: ORS 447,455,479,670,701. 21N)pnlpx or less 2 201 amps l0 4011 maps 2 owner's signature: I);iIC: __ aol to600am s - - 2 Branch circults-new.alteration, ur cxtenslun per panel: Ntlme: A. Fee for branch circuits with purchese of AddrCSs: seryice or feeder fee,each branch if? 2 Cit ; State: 2,11' B. Fee for branch circuits without pur'aase v_ City - — — - of service or feeder fee,first branch circuit: I y S `14 S 2 Phone: I ,i Email Eachaddiuonplbranch circuiC L Misc.(Service or feeder not Included): U Service over 225 amps•conmicicial U Health-cmc facility Each pump or irrigation circle 2 U Service ower 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 ramilydwellings U Building over IOAK)square feet four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders,41x)amps or mote Ilh:scri lion: ___ J()ccupaml load over 99 persons U Manufactured structures or RV park finch additional inspection over the allnwshle In any of the alcove: .J h.gres-Aightingplan U Other Perins ection Submit__.sets of plana with any of the above. Investigation fee The above Etre not applicable to temporary construction service. Other ---- Hol all Judadtctlona accept credit cants,please call)uriulicri:u(f:x noxa in6xnmtiar. NOIiCC:'11115 permit application Permit fee.....................$ L]visa U MasterCard expires it'a permit is not obtained Plan review(at _ 91) $ Credit card number: within 190 days after it has been State surcharge(8%)....$ I apina accepted as complete. TOTAL $ S Name of of c of r s own no credit ear-- "0 r si6neturc s Amount IIOJ611(tiltltllCOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FECES. 'rYPE OF WORK INVOLVED -RESIDENTIAL ONLY rn Colete Fee Schedule Below: -- ---�— -- /� Restricted Energy Fee..................................................... $75.00 pe Number of Insctions per perr•�it allowed (FOR ALL SYSTEMS) Service included. Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less $145 15 . 4 Audio and Stereo Systerns' Each additional 50u sq.ft.or portion thereof _ $33 41' 1 C7 Burglar Alarm Limited Energy $75 r^ Each Manurd Home ,.Modular n�ener' D,n Garage Dwelling Service or Feeder — $9o90 g ,, Services or Feeders ❑ Heating,Vbntll:tiun and Ali Curjitioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 Vacuum Systems' 401 amps to 600 amps _ $160.60 2 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts _ $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL. ONLY Installation,alteration,or relocation Fee for each system.................................................. .... .. :e75.00 200 amps or less $66.85 2 (SEE OAR 918-260.260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or Irrigation circle $53.40 Intercom and Paging Systems Each sign or outline lighting $53.40 ❑ Signal circult(s)or a limited energy panel,alteration or extension $75.00_ _ ❑ Landscape Irrigation Control Minor Labels(10) $125.00_ Medical Each additional Inspection over v� ❑ the allowable in any of the above ❑ Nurse Calls Per inspection $62.50 Per hour $62.50 _ In Plant $73.75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ _ ❑ Other 8%State Surcharge $ _ -------Number of Systems 25%Plan Review Fee See"Plan Review'section on $ No licenses are required Licenses are required for all other Installations front of application. _- Fees: Total Balance nue $ '- - Enter fetal of above fees ❑ Trust Account#-_—__ 8".Slate Surcharge $__ Total Balance Oue $—_ All — AII New Commercial Buildings roquire 2 sets of plans. i:\dsts\formLs\elc-fees.doc 08/70/01 CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PI.M2003-00157 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/29/03 SITE ADDRESS: 10300 SW GREENBURG RU 420 PARCEL: 1 S 135AB-01003 SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS. MOBILE HOME SPACES: TYPE OF USE: CONI WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES _ _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE- V DISHWASHERS- RAIN DRAIN: ft Remarks: Rf!plac:e 1 water heater, 1 sink to be moved and add 1 3" hub Owner: — FEES---� — ----- — _--- -- —_- - --- -- Description Date Amount 102 60 SW GREENBUSZG RD LINCOLN, LLC ,I'LL)MBI Permit Fee 4/24/03 $72.50 102 SUITE 100 11 ANI r"'; Statc Tax 4/24/03 $5.80 PORTLAND, OR 97223 Total $78.30 Phone : _--'-- —.- --- Contractor: MCKINSTRY CO 5400 t Ir COLUMBIA BLVD PORTLAND, OR 97218 REQUIRED INSPECTIONS Phone : 331-11_'34 Rough-in Insp Top-out Insp Reg#: MET 00001 171 Final Inspection LIC 40991 1'LM 37-2211B This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires -ju to follow rules adopted by the Oregon Iss d By: r(t (n4 14 Permittee Signature. Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 1 Plumbing Permit Application Date received: Permit no.: ,/thl(arj?,-r; I - Cit of Tigard — ' �' � Sewer permit no.. Building permit no.: Address: 13125 SW Ball Blvd,Tigard,OR 97223 t Ir' °l 1i)'"'`/ Phone: (503) 09-4171 Projcct/appl.no.: Expire date: \ Fax: (503) 598-1960 Date issued: By: Receipt no.: n Land use appi oval: Case file no. Payment type: LV J I &2 family dwelling or accessory JCommercialiindustrial J Multi-family XTenant improvement <� J Ncw construction J Addition/alteration/replacement J I taut service -J Other:— Jobaddress: Description Qty. Fee(ea.) Total �} 1 O Sv�l. J u ' --- New 1-and 2-family dwellings only: (� Bldg. no.: Suite no.: Tax ma (lax lot/account rto.: (includes 100 ft.for each utility connection) � P _ SFR I I)bath _ Lot: Block: Subdivision: _ SFR(2)bath ----- __ — ' Project name: C_-i, T->) 1Fcc. SFR(1)bath -- c City/county: pt,¢.tc.n_._i_ ZIP: 91 Each additional b-athi itches Description and location of work on premises: T,'.I . PWITIt LAC, Site utilities: _- oc2, tL pk 1at't• �1C7� Catch basin/area drain _-- -- — Drywells/leac line/trene drain Est date ol'complelion,inspection; Footing drain(no. lin. ft.) Manufactured home utilities Business name: Mc.K1N`sjy_j CU —_ Manholes Address: S44ja 14 c.)uAm t►> Qy>»vv. Rain drain connector City: p012Tl1aNU State:C)} 7.IP t �t _ Sanitary sewer(no.lin. ft.) Phone:gall cfa�,A Fax::zA (pr(a(o I E-mail: Storm sewer(no.Tin. R.) CCB no.: yU cl�,1 Plumb. bus,reg.no: 11Water service(no.lin. t1.) City/metro lie.no.: I I q _ Fixture or item: AbsoContractor's representative signature• Back tion valve �s-�C� _— — Back flow preventer Print name: " Backwater valve asins/avatory Name: C1,►1= lIAzJZt.c.� _ - Clothes washer -- Address: Dishwasher �-) _S�t 1 ' +lt� Drinking ountainIsl City: j22?(j.'LL-wo State:r.*— ZI11_q-(2116 Ejectors/sump — Phone:qUA Fax:t • Email: Expansion tan i Fixture/sewer cap Name(print): Floor drains/floor nk. tub 1 Mailing address: Oarba a disposal _ _ (lose hi b t'ity: _ State: ZIP: _ Ice maker I'hune: — ax: E-mail: Inlerceptorigrease trap (h%ner Installauon,residential maintenance only: The , ,tual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property I own as per ORS Chapter 447. Sink(s).basin(s),lays(s) 1 Owner's siunature: Date: Sump RN IN 0 0 u srshower/shower pan Urinal ---- �;uncWater closet -- - �tld;ess• ate—heater 1 �State: "ZIP _--Water I'hlate: Fax: I E-mail: _ _ ota _ Minimum lee................ $ -7Z ( Not all unsdtctlom a,cept credit tarda.please call jurisdiction for more inhumation Notice: This permit application t J\lsa J MosierCurd expires if a permit is not obtained Plan review i al n ' o) $ — Ctrdu card number � $tate surcharge 18�n).... S �• —_.-_.___ .___ within 181)days atler it has been , Frptra — -- accepted as complete. TOTAL........................ $ — Name al cardholder a..,,hien on credit card S � --— -_ Cardhlder%tgnsttute^ ----- — \mount 440-4616 WOO COW CITYOF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00130 13125 SW Hall Blvd., Tigard, OR 97223 (303) C39-4171 DATE ISSUED: 4/29/03 SITE ADDRESS; 10300 SW GREENBURG RD 420 PARCEL: 1S135AB-01003 SUBDIVISION: I INCGLN ONE/Rt--D LOBSTER/CASA I. ZONING: C-P BLOCK: LOT: JURISDICTION: Ill TENANT NAME: C.J. PACIFIC USA NO: FIXTURE UNITS: 1 CLASS OF WORK: ALT DWELLING UNITS: IYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .3 EDU increase. Previous EDU = 50.6 for a total of 809.6 fixture values. Addition of 5 fixtutu values, tot a new total of 814.6 fixture values = 50.9 current EDU's. Previous ($460.00)credit applied. Total fees $690.00 less $460.00 = fees due $230.00. Owner: FEES EOP LINCOLN, LLC Description Date Amount 102.60 SW GREENBURG RD _ - - SUITE 100 SWUSAI SwrConnect 4/29/03 $230.00 PORTLAND, OR 97223 JSWUSAJ Swr Connect 4/29/03 $0.00 Phone: Total $230.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. Tte 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 SiOe Sewer" Perm ssued by: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally Tenant Nan e: C.J. Pacific _ This SWRA 2003-00130 Address: 10300 SW Greenhurg Rd. Ste.420 This PLM# 2003-00157 Fixture velae 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 v 0 0_ 0 0 _ - Jacuzzi/Whirlpool 4 0 0 I 0 0 0 Car Wash - Each Stall _ 6 0_ 0 _ C _0 0 - Drive through 16 _ 0__ — 0 0 0 0 Cuspidor/Water Aspirator 1 0 _ 0 0 0 _ 0 Dishwasher-Commercial 4 0 V 0 0 V O --0-- - Domestic 2 �0 __ 0 0 0 _ 0 Drinking Fountain 1 0 0 i 0 0 _ 0 Eye Wash _ 1 0 0 0 0 0 Floor Drain/Sink-2 inch 2 _0 __ 0 0 0 _ 0 3 inch 5 0 0 1 v 5 1 5 4 inch _ 6 _ 0 0 _ 0 0 0_ — Car Wash Drri 6 0 0 0 0 0 Garbage Disposal_____,______ _ —_-- Domestic(to 3/4 11P1 16 0 _ 0 _ 0 0 0— Commercial (to 5 HP) 32 0 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 V_ 0_ _- 0 0 0 Stall _ �2 0 0 0 0 0 Sink- Bar/Lavatory _ 2 0 0 0 _ 0— 0 Bradley 5 0 0 0 0 C_— 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 0 0 0 _Water Extractor 6 0 _ 0 _ 0_ v 0 _ 0 Water Closet-Toilet 6 0 0 0- _ 0 0 Uriva_I _ 6 _ 0 0 0 0 ^ 0 Previous EDU Count 50.6 809.6 809.6 Capped EDU Credit 0 1 OTAI S 1 0 1 809.6 0 0 1 5 1 814.6 Current Fixture Value 814.6_ divided by 16= 50.9 Current EDU 1 EDU = $2.300.00 Previous Fixture Value 809.6 divided by 16 = _50.6 Previous EDU Change 5� divided by 16 = 0.3 over (under) $ —690.00_ Enter EDU Change Here 0.3 i{Io(t.Cny�R.E3t1�. Balance fwd. ($460.00) PLM# EDU# _ SWR# ,is credit used for this tally. 4-25-c 3 Pt-M# ___ E D U# _ SWR# PL.M# EDU# SWR# Name:� '-���� =�`� �`�- Date: ,5 - —C Signature of person that calculated this r-Ily sheet and date perfronted is required CITYOF TIGARD _ MECHANICAL PERMIT [DEVELOPMENT SERVICES PERMIT#: MEC2003-00211 13125 SV Hall Blvd., T'3ard, OR 97223 (503) 639.4171 DATE ISSUED: 4/24/03 PARCEL: 1 S135A8-01003 SITE ADDRESS: 10300 SW GREENBURG RD 420 SUBDIVISION: l_iNCOI_N ONE/RELY LOBSTER/CASA I_ ZONING: C-P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT _ FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: b VENTS W/O APPL: VENC- SYSTEMS: STORIES: BOILERS/COMPRESSQRS HOODS: _ FUELTYPES 0 - 3 HP: DOMES. INCIN: I_PG — 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 Hp: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: VJOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDL ING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfrn: GAS OUy', TS: > 100000n: Remarks: I IVAC Grilles and VAV boxes. supply(lillu. rti;mil dtict��olk. Value$892.nn Owner: FEES EOP LINCOLN, LLC Description Date Amount 10260 SW GREENBURG RD \ll c III SUITE 100 I'rrnu1 I cr 4/24/03 $72.50 PORTLAND, OR 97223 I_I:\ 4/24/03 5,80 Phone: — Total — $78.30 JI Contractor: _ MCKINSTRY CO 5400 NE COLUMBIA BLVD PORTLAND, OR 97218 _REQUIRED INSPECTIONS_______ _ Phone: 131-11214 Mechanical Insp Duct Inspection Reg#: LIC 40981 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty ;,odes rand all other applicable laws. All work will be dore in accordanrr. with approved plans. This permit will expire if we,a1 1s not started within 180 days of issuance, or it woo\is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow n1les adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued By Permittee Signature: G _ Call (503) 639-4'175 by 7:00 P.M. for inspections needed the next business day ...riaaa�..a�aat Mechanical Pern it Application -� -- - - - -- Date received: -al-03 Permit no.:Mf,4L ~ ' City of Tigard Projcct/appl.no.: Expire date: Cavof Tigard Address: 13125 SW Haff 1W,d.Tigard,OR 97222 ey: �� Receipt no.: Phone: (503) 539-4171 Date issued: - Fax: (503) 598-1960 Case file no.: Payment type: Laild tlse approval: L Building permit no.. J I &2 family dwelling or accessory UCommercial/industrial J Multi-family .Tenant improvement J New com.truction J Addition/alteration/replacement J()Ther: Job address: (Lj TUU -_Akj Ll .IGkA(24 � — Indicate equipment quantities in boxes below. Indicate the dollar Bldg. rte.: Suite no.: 2 value of all mechanical materials,equipment,labor,overhead. Tax map/tax lot/account no.: _ profit.Value$ �r��>__ Lot: —Block: I Subdivision: *See checklist for important application infimnation and Project name: -`„�, V)f4 jurisdiction's fee schedule for res,idential permit fee. City/county: poV_,ji, eya ZIP: ��2.•Z'� Description and location of work on remises: T.Z, V-9t�fUq�l. i L.d�:a_—VA v 1: 0 At`� Fee(ea.) Total Uta.date of completion ms ection: Description Qty. Ree.only Rett enly Tenant improvement or change of use _ � Air handling unit _ChM Is existing space heated or conditioned'3 Yes ]No Air conditioning(site plan required) Is existing space insulated';r9 Yes J Iteration of existing VA�_stem Boi er/compressors — Businessname: State boiler permit no.: Fac K tnl'� lzy Lo HP,—Tons BTU41 _ Address: p t4 _(:OL_� nip �- --- Fire/smoke dampers/duct smoke etectors City: v_-Tl.r ov 181L jState: Q�JZIP t I'Z( eat pump(site plan require ) — Phone: Fax: E-mail: nsteiT rcp ace furnaceumer ���r''� - �'tiD Including ductwork/vent liner U Yes U No _ CCH no.: O�� —_ - _— nsta '_. Lace.r�catet-Te-iters-suspen c City/rnetro lie.no.: _�� _ wall,or floor mounted Namel, !ease rint)* � cot I'or appliance other than furnace e t Rest nn. Ahsotl'inrnr units BTUM Name. Ca ,�_ - �'htllcr; --- HP Compressors HP Address: OU c. A u. Environmental ex-liaust and ventilation: City:�R, �t�t� _ State:op_ ZIP: cj1 Llta, Appliance vent Phone: ' Fax: wninl E-mail: rver11 aunt Hoods,Type I/II/res. it- cC hen haintat — hood fire suppression system ""n, Exhaust fan with single duct ihath fans) \1mlmu address: Exhaust syslem a art from heatinq or AC -- -- Fuelpiping adistribution(up to outlets) �tit ttr: - ZIP: T%pe _ LPG NG Oil Thune I ,tx. I mail f ucl alma.carTa t ona over outlets rocess piping(schematic require ) 11110 Number of outlets erlwi-e-r p rote or equipment: \ddress: _ Decorative tireFlacc i t. itv: 'stair ZIP _ - nsert type --- --- I'none: -mail oo stove pe vt stove +Tree -- \l+plicant's signature_ y Date: ter: �,unc tpnr�tl ------ �� — -- - - Not,dl nmmm� y +ma.cein ctedu suds p—w.ail iumclicuon tot mute inioro morn Permit fee ..................... $ 7 _ _ J Via& J MasterCard Notice: This permit application Minimum fee................ $ Credit card nunrner expires if a permit is not obtained plan review tat — a4+) $ _ -__---. LL_ within 190 days after it has been G Expires of ---.- --,---- __--- --_-- Mate surcharge(8,al.... $ Name of cardholder ns shown on credit card accepted as complete. "0-41ei7t&MAO\tr 1511� rn Z � r m Z T � r? r) --j � z o x (n rn G) -- - -- � -_ I —-- -0o � KTn mMOc -a ° ;Uo - v D Z '< z Nm DCS n I D ? Irl O 1'" �+- DRI o ; IT 3 0N c1� A w N � (/) rn 0 D D ;I7 Z1 O p n n CD cD 'D 7 0 °0 0 w O CO m o V I I rIn p c 7r A0 n N j (D _ - Sm CID < N ------ -- -- _ c a n -- - ------ cn !z r- a ° X 16 CJ Pacific Corporation n !`' Lincoln One - Suite 420 � k ` 10300 S W. Greenberg Rd � �c',, Portland, Oregon 97223 q° CITY OF TIGARD ELECTRICAL - ENER RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00123 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/1/03 PARCEL: 1 S135AB-01003 SITE ADDRESS: 10300 S11V GREENBURG RD 420 SUBDIVISION: LINCOLN ONE!RED LOBSTER/CASA L ZONING: C-P BLOCK: LOT: JURISDICTION: TIG Proiect Description: Installation of data/telecommunications system. A.RESIDENTIAL B.COMMERCIAL _ _ —�— AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS: 1 Owner: Contractor: EOP LINCOLN, LLC RICHARDSON COMMUNICAJ IONS 10260 SW GREENBURG RD 15875 SE 114TH SUITE 100 CLACKAMAS, OR 97015 PORTLAND, OR 97223 Phone: Phone: 503-650-28 14 Reg #: LIC 137396 ELE 3-390CEP SUP 1977LEA FEES Required Inspections _Description _ Date Amount_ Low Voltage Insp ;tion �1�.1.PkM-11 FLR Permit 5/1/03 "075.00 Elect'I Final ITA`i j 8%fl State Tax 5/1/03 $6.00 Total $81.00 i his Pennit is issued subject to the regulations contained in the Tigard Municipal Code, Stale 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 issuance,or if worts is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification �,,nter. Those pules are set forth in OAR 952-001-0010 throuc Issued by 111 �� _ Permittee Signature �f-�'�— OWNER INSTALLATION ONLY T he 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 _,cf�,<----'_y _„ DATE: LICENSE NO: _ _-- — -- Call 639-417.5 by 7:00 P.M. for an inspection needed the next business day FOR OFFICE USE ONLY Electrical Permit Application ;received ,� Electrical e ,4 Date/By: i nom-' Pcrmit No.-"� 0 Planning Approval Sign City of Tigard pale/B : Permit No.. 13125 SW Hall Blvd. Plan Review Other 'i'igard,Otegon 97223 Date/By: _ Permit No.:Post-Rev Use Phone: 503-639-4171 Fax: 503-598-1960 Date/8 y: land Case No.:Date/By: Internet: www.ci.tigard.or.us Contact Juris. Sec Page 2 for 24-hour inspection Request: 503-6394175 L Name/Mt.thod: n Supplemental Information. TYPE OF WORK _PLAN REVIEW Please check all that apply) New construction_ Demolition Service over 225 amps- I icalth care facility commercial ❑Ilazardous location _FEAddition/alteration/replacemett _ Olht r: ❑Service over 320 amps-rating of ❑Building over 10.000 square feet, CATEGORY OF CONSTRUCTION I&2 family dwellings four or more residential units in 1 &2-Family dwelling 171Commercial/Industrial ❑System over 600 volts nominal one structure ❑Building over three stories ❑Feeders,400 amps or more Accessog Building Multi-Famil ❑Occupant load over 99 persons ❑Manufactt -ed structures or RV park Master Builder Other: ❑r•.gmss/lighting plan ❑Other: _ Submit__sets of plans with any of the above. _ JOB SITE INFORMATION and LOCATION The above are not applicable to temporary construction service. Job site address: 5L,J 6�'-n burr1l"D FEE*SCHEDULE _ Suite#: 9ZU Bld ./Art.#: Number of Ins colons ter PC mit allowed Description Qty Fcc(Co.) 'roue Pro'ect Name: �-.S. '�� �� `- New reside nrial-%/ogle or multi-family per Cross street/Directions to job site: dwelling unit.Includes aitached garage. Service Included: Iow sq.ft.or less 145.15 4 Each additional 50( 33.40te1 --- — Limited energy,residential 75.00 1 2 Subdivision: Lot#: Limited energy,non residential 7S•oo �� 2 Tax pg/parcel arcel#: Each manufactured home or modular dwelling service and/or feeder 90.90 2 _ DESCRIPTION OF W�ORK--�---- Services or feeders-installation, N-�St►./,••yt alteration or relocation: 2UU amps of less 80.30 2 2U1 am s w 40ti amps _ 106.85 2 401 amps to 600 ams 160.60 2 pROPF,RTY OWNER TENANT _ 601 amps to 1000 amps _ 240.60 2 _— .� --- Over 1000 ams or volts _ 454.65 2 Name: _ _ Reconnect only 66.85 2 Address: rentporary services or feeders-installation, alteration.or relocation: City/State/Zip: _ 21N)amps or less _ 66.R5 I 201 amps to 400 ams 100.30 2 Phone: _Pax: 401 to 600 ams 133.75 2 APPLICANT _ CONTACT PERSON Branch circuits-new,alteration,or Name: — extension per panel: A.Fee for branch circuit.%with purchase of 6.65 2 Address: _ service or feeder fee,each branch circuit Cit /State/Zip: �_ B.Fee for branch circuits without purchase of service or feeder fee,first branch circuit _46.R5 2 Phone: FAX: Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): Each pump or itti ation circle 53.4U _ CONTRACTOR Each sign or outline lighting 53.40 2 Job No: Signal circuit(s)or a limited energy panel, alteration or extension _ Pae 2 2 Business Name: 12 ft 14J9_rLDescription: _Address: Vs — Each additional Inspection over the allowable In env of the above: Clt ;State/Zip: C.L.f1Cw/3m 3 OR l701S, Pet ins coon perhour(min. Ihour 62.50 Phone: S�& & y-a ?�Y/ Fax: Investigationfee:Other: CCB Lic. #: 3 J : 0Jr '10' Electrical PSupervising electrician- o_� _ Subtotal S '75 oz signature required: . k d'^''"� Plan Review(25%of Permit Fee 1 LiC. #: 19 7 7. State Surchar a 8%of Permit Fee S _ Pring Name:lit a rs k Yaa r- — TOTAL PERMIT FEE S _ / . Authorized t Is not obtained within Notice: This permit apt.oration expire%ff a Pi' rnd Signature: �— Date:s 180 days after It has been accepted as complete. �`'"— *Fee methodology'set by Trl-County Building Industry Service Board. (Please print name) iADsts\Permit Forms\FlePet•mitAppAoc 01/03 CITYOF T I GA R D -- BUILDING PERMIT PERMIT #: BUP2003-00158 DEVELOPMENT SERVICES DATE ISSUED: 4/4/03 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-01003 SITE ADDRESS: 10300 SW GREENBURG RD 420 SUBDIVISION: LINCOLN ONE/RED LOBSTER/CASA L ZONING: C-P 3LOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: Al-I' FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2FR sf 14: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 10 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: F.SMT?: MEZZ?: _ READ 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: ARKINGVALUE: $ 10,000.00 Remarks: TI New office and counter. Owner: Contractor: EUP LINCOLN, LLC C SCHIEWE + ASSOCIATES 10260 SW GREENBURG RD 1024 NE DAVIS SUITE 100 PORTLAND, OR 97232 PORI LAND, OR 97223 Phone: Phone: 234-6617 Reg #: LIC 54105 _ — FEES — — REQUIRED INSPECTIONS Description Date — Amount Electrical Permit Required 1131-111,D] 11crnur I cc 4/4/03 - $139.30 Plumbing Permit Required I'AXj 8%Stale Tax 4/4/03 $11.14 Framing Insp Gyp Board Insp It1 PPLN] I'In R\ 4/4/03 $90.55 Susp Ceiing Insp I I til 11's 11111 R4/4/03 $55 72 Final Inspection Total $296.71 - -- ----- L- -- --- 1 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. 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: CLA-6, Permittee �> > Signature: Call 639-1175 by 7 p m for an inspection the next business day Buiidxag Permit Alication ' -- Received [SuildinK Datc/B U r Permit No.:C city O1F�rl dPti Planning Approval Other y K Date/By: Permit No.: 13125 SW Hall Blvd. Plan ReviewH _� 03 ash Other Tigard,Oregon 97223 Dale/B , _— Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use te/13y _____ Case No. Internet: www.ci.tigard.or,us DaContact )uric ED Sec Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method LSu elemental Information _ TYPE OF WORK REQUIRED DATA: kA ew construction _ DemolitionI &2 FAMILY DWELLING ddition/alteration/re lacement I Ll Other: -- -�---- — ---- CAT_EGORY OF CONSTRUCTION Note. Permit fees'are based on the total value of the work performed Indicate &2.-Family dwellingCommercial/hidustrlal the value(rounded to the nearest dollar)ofall cquipnrent,materials,labor, - overhead and profit for the work indicated on this application. Accessory Building—_- Multi-Family — Master Builder Other: Valuation......... ..................... .... ... ..... .......... JOB SITE INFORMATION and LOCATION No.of bedrooms: _ No.of baths:__ Job site address: I 300 sw Gr tbur (w Total number of floors......... ..... ...... ............ --� New dwelling area(sq, fl.)-................. .......... Suite#: 420 Bld►./Apt.#one ( jmo n Garage/carport area(sq. fl.)........ ................... Project Name CnJ, aC( t e Cor• Covered porch area(sq. ft.).., . ........ .. .... Cross street/Directions to job site: Deck area(sq. fl)........ ............ . . .. . ..._ __. _ o Jf E AiTilUc H� MPI° Of Other structure area(sq. fl.)...... ._.. ..... .. ._. L I N c o L N C REQUIRED DATAt COMMERCIAL-USE CHECKLIST Subdivision: _ _ Lot#: — — Tax map/parcel#: ___ v Note: Permit lets'are based on the total value ofthc Hark performed. Indicate CR DESIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application Tey►ant_ Irn roverheh --- ------- Valuation. _......, ............................................ S�Q GDO - Existing building area(sq.ft.)......................... -Allio-_V - ------ ----- - _ --- ----- New building area(sq fl.).......... .. ........ .. ..... Number of stories.... . ... .... ........ .. .... LV(' - PROPERTY OWNER -� 'TENANT — Type of construction., ................ .. ..... .......... Name: EOWITY CFFIGE PRoFE -TIE-s Occupancy group(s): Existing: Address: JOU60 SW Gre_er►bur Sur'te 11coo New: 0 Cit y/State/Zi or-tl2i OP,, 9 223 Phone:66'6 892-2900 Fax: NOTICE: All contractors and subcontractors are required to be ISAPPLICANT _ CON7�:�'T PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Name: GpD A�' �h4. jurisdiction where work is being performed. If the applicant is exempt Contact Name: �Qy (L. Glut' from licensing,the following reason applies: Address: 112.0 NW C.ouel% St,. Stam 3U') - - - - - Cit /State/Zi Porta o -- - - - ---- - Phone:503 2119<o1 & I Fax: _ — -- ------- E-mail: BUILDING PERMIT FEES* Pleasi rifer to fee schedule. CONTRACTOR -- -- — Business Name: 0, S-WteW e C-,,A . Fees due upon application............................. 5 _ Address: 1p?,+ WE Dayis d`t.. t^e( 01Z. 232 Amount received............................................. S City/State/Zip: JQVLI; Phone5o$ 234 CAA Fax:__--A Date received:- _ CCB Lic. #: 5g-10e —_ — - - -- - - Authorized Notice: 'rhls permit application expires If a prrmil 1%not obtained i0hin Signature. Daterf'03 IAO day%alter:t hat been accepted a%complete. p., Glue •Fee methodology set by'i'rf-('ounty Building Indo%hy Scrvlce Board. (Please print name) t\t)sts\Pctmit FormsBldgPerrnttApp.doc 01103 Buildla Permit Application ' �_—_� ��__ .. ReCllVea Bui;ding Deta'By: 'U Permit No.. CityCit of Tigard Planning Approval Other g Date/By: Permit No.: 13125 SW Hall Blvd. Plan ReviewS6 Other Tigard,Oregon 97223 DatdB "�-03 a Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use Date/By Case No Internet: www.ci.tigard,or.us Contact Juns tier Page 2 for -- 24-hour Inspection Request: 503-639-4175 Name/Method tiupplcmcntal Infarmatlo. -- -- __ TYPE OF WORK ---- REQUIRED DATA: - —- New construction �� D� emolition t & z FAMILY DwEt.EINC Addition/alteration/re lacement _7ther: -- - - ----- - ------ —-- - _ CATEGORY OF CONSTRUCTION Note: Permit fees*ere based on the total value of the work p.,rl'ormed. Indicate I & 2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all^quipment,materials,labor, --- overhead and profit for the work indicated on this application. _ Accessory Buildipy,_ Multi-Family Master BuilderH Other: — Valuation.............................. ....................... JOB SITE INFORMATION and LOCATION No.of bedrooms: No.of baths:—_ - - Job site address: 10 300 5W C"raW16Ur � Total number offloors............................ ........ New dwelling area(sq.ft,). ............................ Suite#: 2.0 Bld ./A t.#One 11nco h _ Garage/carport area(sq. ft.)............................ Project Name: W. pacif It e Care. Covered porch area(sq. fl.)... ...._ .................. (Toss street/Directions to job site: Deck area(sq. ft)................... . ................... o --k E AT-rp<MC-P MAIo cT Other structure area(sq.ft.)................ ... ..... L 10 cot_N cerTTGA- REQUIRED DA'T'A: _ COMMERCIAL-USE CHECKLIST Subdivision: _ Lot#: _ ---- T'ax map/parcel #: Note: Permit fees*are based on the total value of the N•nrk performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, 1Getn�n't Irh ro�en►�h overhead.and profit fur the work indicated on this application. --- Valuation... ............. ............................... ...... $ Q 000 ---- -' Existing building area(sq.ft.).. .... ................. �b -- ------- --- --- New building area(sq. ft.)............ . Number of stories...... ................... .......... ...... Ve_ PROPERTY OWNER__1 TENANT Type of construction............... ....... .............. _ N_am_e:_E_MU'ITY �FFI�E PROpEp.TIES Occupancy group(s): Existing: New: Address_ 167-GO SW Greem6oN +_e 1160 City/State/Zip: t `�ora+%d cf-. 9104 Pllone:�'+ 892-25ao Fax: NOTICE: All contractors and subcontractors are required to be APPLICANT _ CONTACT PERSON licensed with the Oregon'-instruction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Name: 1271bD P+►'r itee 6YnG, jurisdiction where work is being performed, if the applicant is exempt Contact Name: F-ay I'-. Glor from licensing,the following reason applies: Address: 11 2.d NW Cour► at. SLAC 300 -- - -- - Cit !State/7_ip: oP-. _ _ - - ---— - -- Phone:5o3 22 966& Fax: — --�i - ------ BUILDING PERMIT FIFES* ' E-mail: _ Pleasi titter to fee schedule. CONTRACTOR -- -- Business Name: G. 3- lie-we Cc",sl . tees due upon application.............................. $ Address: —10Z�+NE Davit J"t.. City/State/Zi �, '�►�^d-,01Z-- °) I Amount received............................................ $ Phone503 21 6 17 I-Pax: [Date received:-_ CCB Lic. #. 5+ 051 - - - - - Authorized 16e— /� Notice: t hk permit application espiros if a permit Is not obtained Allhin Signature: - __ Date:-03 180 days after It has liven screlrted as complete, 1.. Glut __— *Fee mrthodolog_v set by'I ri-County Building Industry Son lee Board. (Please print name) i\lkts\Permit Fomu\BldgPermitAppdoc 01iO3 CITY OF TIGA►RD DEVELOPMENT SERVICES 13125 SW Hall Bird., Tigard,OR 97223 (503)639-4171 CERTIFICATE` op OCCUPANCY PERMIT #. . . . . . . i BLIP97-04tB DATE ISS'UEElc 10/10/97 PARCEL.1 1 S1 35AB- 01003 ADDRESS. . . : 1V1300 SW GRECNBUPG RD #4 2'0 1)1 V I S I ON. . . . : ZONING e C.-P (A'K. . . . . . . . . . : LOT. . . . . . . . . . . . . a JURiSDICTION; TIG 1:1- ASS OF WORK. vOLT I f F,E OF USE. . . i COM I (PE OF CONSiTP-.21­14 f)(J.'UPANCY GRP. ig (I(XUPANCY LOAD: 1 I.WANT NAIY,'E. . . sCOMMONWEAL TH M(.)RTGAGF--* 1-emar-ksv Tenant lmprovF.sment Ownerl (A)MMONWEALTH MOPTGAGE (C'MOC) 10300 SW GREENDURG RD STE 4c!O I'MARD OR '372E3 Phone #2 , untt-i-ictort PIONEER CONSTRUCTION SERV ICES Pf) BOX 683014 M11-WOUKIE OR 97009 , 7268 Phone #3 652- 1050 Peg #. . 1 001197 This Certificate qv-*Ilts occupancy of the above reforenced building or portit..• t!--terecif and confirms that the building has been inspected for compliance wifl-, Cite State of Orqolt Spec.:ialty Codfoa for the grol.1p, OCCLIPAInCy, and 1-ise under, which the v,eferenced permit was issued. MULD1 0 R BUIL MG OFFICIA& P3ST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 6394171 Orate Requented: / _ A.M. K MST: Location' _ I /�y L, �� l _ T IIIJP: 9 7-0 c/ ) C: I enant ._ _ uite:�.. ,� Bldg: MF Phone: _-70 2' O��Q_� PL, 0 7 0%vner. _ _ Phone- ELC: ------ -� �� ---- „ ELR: _— _� SIT: BUILDING — CB1.D,C,, -� PLUMBING — MECHANICAL — ELECTRICAL SITE Site 110st/13cam PostAleam Post/Beam Cover/Service Sewer/Stonn Footing Roof UndFl/Slab Rough-In Ceiling Water line Slab Framing Top out (ins Line Rough-In UG Sprinkler Foundation Insulation Sewer Ilood/Ihict Reconnect Vault Bsmt Damp Drywall Slomi Furnace Temp Service MISC. Masonry Ceiling Rain I)rain A/C UG Slab Shear/Sheath Fire Spkh/Alm Crawl/Found Dr i lent Pump Low Volt - pprove Approved Approved Approved Approved Appr/Sdwlko pproved Not App oved Not Approved Not Approved Not Approved 1 rmA! FINA►. FINAL FINAL FINAL O Call for reinspection 0 Reinspection fee of Srequired before next inspection 13 lJnable to inspect Inspector: /��"� _ Date-��U_-/ a` G Page__of---- CIT` OF TIGARD DEVELOPMENT SERVICES PLUMBING F'r�.RM I T T ##.. .. . .. PERMIT . . . F'LM97-0370 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 09/09/97 I-'ARCEL: 1S135AB-01003 I IF: ADDRESS. . . : 10300 SW GREENBURG RD #4clh SUBDIVISION. . . . .. ZONING: C-F' BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG CLASSOF WORK. . :ALT Al_T - -GARBAIC'E DISPOSALS. .- 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLOW PRE.VNTRS. . : 0. OCCUPAI:CY GRP. . :8 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES . . . . . . . : 0 WATER HEATERS. . . . . : 1 CATCH BASINS. . . . . . . : 0 FIXTURES-------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 1 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 WATER CLOSET'S. : 0 WATER LINE (ft ) - - - : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Tenant improvement for Commonwealth Mortgage Owner: __ _ ___ _ ___..-----.------._____________._--____-- FEES ___-------__.-.-- NORRIS BEGGS-& SIMPSON -- type amoi_rnt by date recpt 10300 SW GREENBURG RD PRMT ffi 25. 00 GEO 09/05/97 97-298985 ST'E 230 SPCT E ] . �'S GE:O 09/05/97 97-498985 T'I GARD OR 97223 Phone #: Contractor---------------.------------------ MYERS A. SONS PLUMBING 602+ SW JEAN RD, BLDG F I...AKE OSWEGO OR 97035 ------------------------------------------ Phone -------------_-_--_----------_---__-_._Fhone #: 684-6602 # 26. 25 TOTAL. Reg #. . : 000403' ---------- REQUIRED I NSF'EGT I ONS ---------- This permit is issued subject to th;+ regulations conta,ned in the Top.-oi_rt Insp Tigard Municipal Code, State of Ore. Specialty Codes ar.d all other Final Inspection applicable laws. All work 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 188 days. ATTENTION: Oregon law requires you to follow rules - adopted by the Oregnn utility Notification Center. Those rules are --- set forth in OAR 952 9881 8818 through OAR 952-8881-*W, You may --- obtain copies of these rules or direct questions to OLK by calling i 4 � ) Issi.red By: C,Gt_Ict'u'L-4 � Permittee Signat�_rre :�l'� 111 ++++++++f+++++++ ++++++++++++++++++++++++++++++++++++++++++-+++-+i-++•+++++++++++++ Call 639-4175 by 6:00 P. m. for an inspection needed the next bt.rsiness day +++++++++++++++4-+++4+++++++++++++++++++++++++++++++++++4+++++++++++++++++++++++ :ITY OF TIGARD Plumbing Application Recd By 3125 SW HALL BLVD. Commercial and Residential 0410 Recd_ IGARD, OR 97223 Oste to P E. 703) 639•-4171 Data to DST Permit! Print or Type Related SWR!v Incomplete or illegible applications will not be accepted caned Name of Development/Protect .F MKt:Z0 jindlvldual0 %�Ct '�i;lt�t2(�tb r t lta lA:eA�i!Riil Job ti i&' 'O L (iFIL"'�C"e Sok 9.110 wit(t Address Street Addreu 7 Suite Lavatory 900 ( vC� E i rtI ��2C) Tuo or TuWShower Camp. 9 Bb9! .00 tylstate Zlp Shower Only 9.00 l< k t'; „?.;1-:j Water Ctoset Name 9.00 o ys,'/l1F�n�rJ 2 v/r Olahwasher 9.00 Owner Madk+g Atldreaa Scats Garbage Disposal 9.00 Waahing Machine9.00 City/State Zip Phone Floor Dram -1, —900 3" 9.00 �` �IC/l•k'PQf/ 10t �c {c �� 9.00 occupant Ma"Address Su aWrMr Heals. - ' 0(1 (� reCivlh,t 2 ��(� Laundry Room Tray _ 9-00 .-ghtstate ZIp phpM 9.00 r(1,7 O/Z 1 ZZ 3 unreal "9.00 —' Na,R�fy / Other Fotttres(Spray) 9.00 9.00 .ontractor Masin9 rasa scat. -- 9 ii !EASE COMPLETE AS APER PRIATE TO PROJfM: Fixtures to be capped, moved or replaced Qty . Sink Lavatory _ Tub or Tub/Shower Combination Shower Only i Water Closet M _ Dishwasher Garbage Disposal Washing Machine Floor Drain 2" _ 4" Water Heater Laundry Room Tray _ Urinal _ Other Fixtures (Specify) OMMENTS REGARDING ABOVE: I:\plmapp.doc 11.96 'dst) CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: -ATG9 DATE ISSUEDD:: 09/0�/?7 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PARCEL: 1S1.35AB-01003 SITE ADDRESS. . . : 10300 SW GREENBURO RU #4.'0 SUBDIVISION. . . . : ZONING:C--F' BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: TIG i'r•o j ect Descr•i pt i ori : Add ten (10) branch circuits to existing tennant. --- RESIDENTIAL UNI1'—— ---TEMP SRVC/FEEDERS----• -----MISCELLANEOUS----- 1000 bF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 'UMP/IRRIGATION. . . . : 0 EACH ADD' L- _-OOSF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 -- 600 amp. . . . . .. . : 0 SIGNAL/PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps--1000 volts. : 0 MINOR LABEL ( 10) . . . : 0 .----SERVICE/FEEDER---- ----.-BRANCH CIRCUITS------ ---ADU7 L INSPECTIONS—- 0 - 200 amp. . . . . . : 0 W/SERVICE OR. FEEDER: 0 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : 0 EA ADD' L- BRNCH CIRC: S IN PLANT.. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 -___---_________.---FLAN FcVIEW --_------- -- 1000+ amp/volt. . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL.. . Reconnert only. . . . . : 0 SVC/FUR > = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner.: _.______------------------------------------.._________ FEES COMMONWEALTH MORTGAGE (CMAC) type amoi.rnt by date recpt 10300 SW GREENBURG RD STE 420 PRMT t 80. 00 GEO 09/03/97 97-298914 TIGARD OR 97223 5PCT $ 4. O0 GEO 09/03/97 97-298914 Phone #: Cont r-actor,: ---------- --__ -_-------- - --- - --- --- -- ---___ -_ -___ -__- _---_ - CHRISTENSON ELECTRIC INC t 84. 00 TOTAL, 111 SW COLUMBIA STE 480 ------- REQUIRED INSPECTIONS - -- -- PORTLAND OR 97201 Ceiling Cover Llndergrol.md Cove Phone #: 241- '+812 Wall Cover-, Flect' l Service Rey #. . : OOOC1O4 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 work will be done in accordance with approved plans. This permit will expire if work is not started within 199 days of issuance, or if work is suspended for more than IN days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-01-NIO through OAR 952-Wl-1047. You may obtain a copy of these rules or direct questions to OUNC by calling (,59)246-1987. Pf-r•mitte2 Signatl.rr•e : _ Issi ed By :jl _� r INSTALLATION l]Nl_Y- -------- - - ----- - -- ------- _.._ rhe-installation is being made on property I own which is riot intended for salr,, leAse, or rent. OwNFR' S SIGNATURE: DATE: --_..-____._----_---•---___-.-CONTRACTOR INSTAI_.l_ATION ONI_.Y------ ----- --�-- --- ---- ` -- L;I GNATURE OF SUPR. ELEC' N: _ h.� d DATE: d�/ t� • , __ v r l_I LENSE NO: _ 1:k 3 +++++++++++++++.++++++++++++ +-4 r++++++++-++-` ++++4+++++•r+++++++.++++•r••++++++++++++++ Call 639-4175 by 6:00 p. m. for an inspection needed the next birsiness day ++++•++++++++++++++++++++++++++•++++++++++++++++++++++++++++++.I•++++++++++•+•++++++•+ CITY OF TIGARD Electrical Permit Application Plan Check q__ 13125 SW HALL BLVD. Recd By Date Recd TIGARD OR 97223 Date to P.E. _ Phone (503)639-4171, x304 Date to DST_ Inspection (503) 639-4175 F'rint or Type Perrr,ll a EG•C Fax(503)684-7297 Incomplete or illegible will not be accepted Called— 1. Job Address: 4. Complete Fee Schedule Below: Name of Development LINCOLN I SUITE 420 _ Number of Inspections per permit allowed Name(or name of business) C.M.A.C. Service included: Items Cost Sum Address 10300 SW GREENBURG RD - 4s. Residential-per unit 1000 sq.it or less $1 In(w 4 City/State/Zip TIGARD OR Each additional 500 sq.it or portion thereof $�- (t1) -- I CommerciaKU Residential❑ Limned Energy $25.00 ROSS CROSBY Each Manufd Home or Modular Dwelling Service or Feeder $69.00 - 2A. Contractor installation only: 4b.Services or Feeders (Attach copy of all current licenses) Installation,alteration,or relocation Electrical Contractor CHRISTENSON ELECTRIC, INC. _ - 11 S.W. COSUITE 480 200 amps or less $60.00 2 Address 1COLUMBIA, ---_ 201 amps to 400 amps $80.00 2 City_PORTLAND} State_QK, 7_ip 97201-5886 __ 401 amps to 600 amps $120.00 Phone N0. - _ 601 amps to 1000 amps $160.00 2 _ Over 1000 amps or volts $340.00 __- 2 Job No. -- Reconnect only $50.00 Elec.Cont. Lice. No. 26-34C--- _Exp.Date OR State CCB Reg. No. (1(1458 Exp.Date_ . 4c.Temporary Services or Feeders COT Business Tax or Metro No. 5246 Exp.Date--__ Installation,alteration,or relocation 200 amps or less $50.00 ---__ 2 - -,J 2.01 amps to 400 amps $75.00 2 Signatur4af 8u�r.1elQCrf1 ,]I _ - 401 amps to 600 amps $100.00 2 "pec- �--- over 600 amps to 1000 volts, License No. 8735 _____---Exp.Date" _ see"b"above. PhoneNo. 50�_�4I-481_ _.__._--._.----- -- - 4d.Branch Circuits New,altera ion or extension pot panol 2b. For owner installations: a)The tee for branch circuits with purchase o!service or Print Owner's Name_, feeder tee. - ----- -- --T-- Each branch circuit $500 -_-- _- Address --------- b)The fee for branch circuits City _ State IIp-_ __ _.. without purchase of Phone No. _ _ service or feeder fee. First branch circuit 1 $35.00 35. The installation is being made on property I own which is not Each additional branch circuit_9 $5.00 ��-- intended for sale, lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature__ _ Each pump or Irrigation circle $40.00 _. $4000 Each sign or outline lighting $AO(10 Signal eircuit(s)or a limited energy 3. °lar, Review section (if required): panel,alteration or extension $40.00 Minor Labels(10) __ $100.00 Please check appropriate Item and enter fee in section 5B. _4 or more residential units in one structure 4V.Each additional Inspection over Service and feeder 225 amps or more the allowable in any of the above $35 00 System over 600 volts nominal 1'hr insperhrm $55.00 Classified area or structure containing special occupancy I'er h'Iu _ Li I'Innt $55.00 as described in N.E.C.Chapter 5 -- Submit 2 sets of piens with applicati n where any of the above apply 5. Fees: $0, Not required for temporary construction s ervlces. 5a.Enter l of above fees $ _-�-- 5%Surcharge(.05 X total fees) $ - NOTICE Subtotal $ 84 5b.Enter 2591.of line 59 for PERMITS BECOME VOID IF WORK nr;CONSTRUCTION AUTHOnIZED IS Plan Review If recuir (Sec.3) $ $ NOT COMMENCED WITHIN!18U DAYS, )R IF CONSTRUCTION OR WORK Subtotal - �I IS SUSPENDED OR ABANDONED FOR A PERIOD OF 190 DAYS AT ANY Trust Account 11_ TIME AFTEr;WORK IS COMMENCED. 3 Total balance Due R�� I IDSTSTI.C9li.AFT nev 9195 RECEIVED SEP 0 3 1997 COMMUNITY OEVELOWNI CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT F'ERMI'T #. . . . . . . BUF'97-0418 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 08,128/97 PARCEL: 1S135AB-01.003 SITE ADDRESS. . . : 10300 SW C_rREENBURG RD #420 SUBDIVISION. . . . : ZONING:C-P BLOCK. . . . . . . . . . . 1_0 T. . . . . . . . . . . . . .IUR T SD I C'T'1 ON:T I i3 -------------- REISSUE: FLOOR AREAS---------- EXTERIOR WALL CONSTRUCTION- CL-ASS OF WORK. :ALT FIRST. . . . : 1380 s f N: S: E: W: TYPE OF USE. . . :COM SECOND. . . : 0 sf PROTECT OPEN"'dGS?-----____-___ TYPE OF CONST. :2FR . . . . 0 sf N: S: E: W: OCCUPANCY GRr.,. :B TOTAL-------: .1:.380 s f ROOF CONST: FIRE RET ) : OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA SEP. RATED: STOR. : 0 HT: 0 ft GARAGE=. . . : 0 s f OCCU SEP. RATED: NSMT?: ME.Z Z? : REDD SETBACKS-------- REQUIRED- ----- --- --- FL.00R "_OAD. . . . : 0 las f LEFT: 0 ft RGHT: 0 ft F I R SPKL: SMOK DET. . : DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: BEDRMS: 0 BATHS: 0 IMP SURFACE-: 0 PRO CORR: PARKING: 0 VALUE. $: 6900 Remarks- Tenant improvement for Commonwealth Mortgage Owner: ------------------------ - - ...._ -- _._... -- ------- --- FEES COMMONWEALTH MORTGAGE (CMAC) type amount by date recpt 10300 SW GREENBLIRG RD STE 420 PRMT $ 62. 50 DRA 08/28/97 97-298760 TIGARD OR 97223 5F'CT $ 1::; DRA 08/28/97 97-2'38760 PLCK $ 40. 63 DRA 08/28/97 97--298760 Phone #: 684-8990 FIRE $ C-5. 00 DRA 08/28/97 97-29876 Cort-actor: PIONEER CONSTRUCTION SERVICES F'0 BOX 68304 MILWAUKIE OR 97009-7268 652-1050 f 131. 26 TOTAL ------ REQUIRED INSPECTIONS --- --- - Thi4 permit is Issued subject to the regulations contained in the Framing Insp _ Tigard Municipal Coae, State of Ore. Specialty Codes and all other Gyp Board Insp applicable laws. All Mork will be done in accordance with S u s p C e i 1 n g n s p approved plans. This perait will expire if work is not started within 188 -ays of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you tc follow the rules adopted by the Oregon Utility Notification Center. fhose rules are set forth in OAR 952 BBl-BBIB through OAR 952-88181987, You many obtain a copy of these rules or direct questions to Ol$IC by calling (583)246-1987. Permittee Signati-ire : `� Issued By : .....+-s- r+++++++++++++++++++++++++++++++++++++++++++++++++.+-+++++++++++++++++++ Call 639-4175 by 6:00 p. m. for an inspection needed the next business day ++++++++++++++..........+++++++++++++++++++++++.++++++++++++..... ....++++++++ -I 08,27'97 WED 12:11 FAX 503 598 1980 CITY OF TIGARD 004___,–., Kid By ,�? CITY OF TIGARD Commercial Building Permit Dare Recd x, 13125 SW HALL BLVD. Tenant Improvement TIGARD, OR 97223 r Date to P.E. bate to DST (503) 639-4171 Permit to L- Print or Type Related SWR: -_- Incomplete or illegible applications will not be accepted Called___ JOb - Name of Uevelopmr .tJProjed -- — Lincoln Ceilt:er r� l:xiisting Building a New Building Address Street Address T Suite 10300 SW Greenburg R 420 Bldg City/8tate ZipBuilding One 1,portland, OR 97223 Data I,[ncoln Center Property NameX 1 Existing Use of Building or Property Knickerhoc-kr,r Propertie!; [tie. , Owner r M�d57s(',reenburp Rc SIIB200 Office cily/state rep Phcna Proposed 'Jse of Building or Property: P(( rtland OR 97223 452-5900 Office Name (:Omnmnweal th Mortgage (CMAC) No- Of Stories: Occupant Meiling Address I-Ruda F ivc' 10 300 SW t;reenburg Rc . / 420 — Sq. Ft Of Project; CIry�S�retid, OR 223 PV-8990 1 ,380 IName Occupancy Clasa(e Pioneer Construction, Dave Riede Contractor Ma ng Address sungryFe(s)of Construction 1'() Box 68304 1 ry�i State p�,r,�,•f11� --- ---- ------ �`Il�fw,ii4lc , OR 97-22 0r��-10.10 -_ J"loi to issuance Qisgan Const-Cont,Bawd Fic-A Exp.Data VY(II this project have a Fire Suppression System's a copy of all 1 19 765 I / 1 /98 Yes ('] No Iltxnses are orogen Const.Cont.Board Lic.0 Exp.Dam (1 auired if rxpiied in GOT Business Tax of Metro 7R F.xp.Data Project valuation $ 6,900.00 O.T.dsia base) -- Name------ — Americans with Disabilities Act(ADA) Architect Robert Becker -_' Valuation X 25% = $1 ,75.00 ___Participation Mailing Address suite Complete Accessibility Form 9660 SW Eagle Court -- city/state ZIP Phare Plans Required: See Matrix for number of sets to submit cave OR 91008 646-1812 _ on back of submittal requirement sheet Engineer Name - 1 hereby acknowledge that I have reed this application,that the information Mailing Address Suite given is comet,that 1 am the owner or authorized agent of the owner, and that plans submitted are in compliance with Oregon State Laws Ciry/staln -- Lip -- Phone T _ _ xwoi;� f Oat�/�,"7 Indicate type of work: New O Addltinn O Demolition O -- ; ACWSSary Sinictltre O Fou ndatian Only O Alteration O C nW.:r erson Name Phone AAW --�.— Rcpair O Qlhei O - — i C7cscrlptlon of work: FOR OFFICE SE ONLY .LL!I;lnt lmuroverncnt_'s-.CMAC-- Mapfrt-0 Land Use, -� TIF: � - ------^------. i,-arks: Estimated a of Employees N,�t-.- Site Work Permit Application must precede nr accompany Building F'rrtnit ADpllctlort .('OMMA.PP DOC IDST) 10r9A OVER-THE-COUNTER (OTC) PERMIT COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST DESCRIPTION OF PROJECT: CLASS OF'VVORK: — 'r — FLOOR AREAS: t u EXTERIOR WALL CONSTRUCTION TYPE OF USE: C...ym FIRST SQ. FT. N: S: E: W: TYPE OF -- —_ CONSTR: 'Z F SECOND SQ. FT PROTECT OPENINGS?: OCCUPANCY GRP: THIRD SQ. FT. i N' S: E W: OCCUPANCY LOAD: ( � TOTAL SQ. FT, ROOF CONSTR FIRE RFT: STOR: HT: FT: BSMNT: SQ. FT. i AREA SEP. RATED: BSMNT?: MEZZ?: i GARAGE: SQ. FT. i OCCU.SEP RATED: FIRE FIRE SMOKE HANDIC),P SPRINKLER: ALARM: DETECTOR: ACCESS: — COMMERCIAL- INSPECTION ACTIONS —,— _-- _ FEE MENU J Foot/Found Post/Beam $ (9LPermit Fee i3 �— Masonry -- Framing $ Plan Review 1� —_ Insulation Shear Wall $ _5% State Surcharge —_ Firewall — Gyp Board $ FLS Plan Review Suspended Ceiling _ Sprinkler Rougo-in $ Add'I Permit Fee _ Sprinkler Final — Fire Alarm $— —Add'I FLS Pln Smoke Detector Approach/Sidewalk $ Inspectiun Miscellaneous �/ Firal $ MIS Fee FOR OFFICE USE ONLY: — — TYPE OS USE OPTIONS(COM-commercial: CMS=commercial manufactured structure) CLASS OF WORK OPTIONS FOR ALL PERMITS(NEW-new; Add=addition; ALT=alteration; ACS-accessory;FND-foundation: OTR=other; DEM77clernolition; REP-repair; FPS--fire protection system. NOTE: USE OTR FOR FENCES. RETAINING WALLS, DETACHED DECKS. SIGNS, AWNINGS, CANOPIES) I\ovre.tr2 doe ,,UST) 4197 118.27.97 WED 12.11 FAX 509 598 1980 CITY OF TIGARD Q003 CMAC #420 One Lincoln 9/28/97 (attachment to Submittal Criteria) SUBJECT: ACCESSIBILITY BARRIER REMOVAL IMPROVEMENT PLAN REQUIREMENT: OREGON REVISED STATUTE(ORS)447.241. (1) Every project tut renovation,alteration or modification to affected buildings and related facilities shall be made to insure that the pati of travel to the altered area and the restroom, telephones and drinking fountains are rear,ly accessible to individuals with disabilities,unless such alterations are disproportionate to the overall alterations in terms of cost and scope (2.) Alterations made to the path of travel to nn altered arra may be deemed disproportionate to the overall alteration when the coat exceeds twenty five percent(25%). THEREFORE; Each submittal fnr a building permit shall include this farm providing the following information. [Excluding riaroofing, mechanical and electrical permit applications] V�t,lUAT]l of all renovation, alteration or modification being done excluding painting, wallpapenng. [1J S 0 ,900.00 MtiltwRly: 25% Barrier removal requirement —.25— BUDGET .25_BUDGET FOR BARRIER REMOVAL [2] S 1 ,725.00 The dollar amount of the BUDQf'T established on line (2) In the computation above shall be spent, providing the accessible elements in the following order 1. An accessible route connecting the building to accessible pedestrian walkways, and the public way. $ � (including but not limited to curb ramps,detectable wamings, marked crossings,ramps handrails and landings). 2 Not less than one accessible parking space. $ (iicluding but not limited to adjacent access aisle,signs and curb ramp connecting with the accessible route). 3. Accessible entry or entries (includinq but not limited to ramps,handrails,landings, door sill height,door width and door hardware). 4. An accosslble interior route to the altered area. $ _ (including but not limited to doorways,maneuvering clearances,door hardware and stairways). S At least one accessible restroom for each sex. $ 6. At least one accessible telephone where public phones are provided $ T When drinking fountains are required, fifty percent but not less than one shall be accessible. $ a. Additional accfossible�em�ents su% s 9�oSage, reach ranges, alarms, etc.. ever ar wa�'e 555 ii. V $ 1 , 7.'5.00 Cabinetry $1 ,215.60 TOTAL" jhM Ay_gI line 2 of Value Com t ton_ $ 1 ,725.00 i:!otc4.doc(DST) �-ERM IT ELC96 -0096 CITY OF TIGARD DnTE ISSUED: 02'/14/96 COMMUNITY DEVELOPMENT DEPARTMENT I TL 13125 SW Hall Blvd.Tigard,.0 1.regon'r9722398199 (503)e39-41171 ZONING:C'—P' SUBDIVISION. . . . LALOCI... . . . . . . . . . . LOT. . . . . . . . . . . . . . Project Description: Run Tonkin UNIT--- -- --TEMP 3RVG/FEr__DERS______ ---------MI1.12CELLANEOU,5 1000 SF OR LESS. . . . : 0 .— 20k't) amp. . . . . . . : 0 P,UMP/I RR I GAT I ON. . . . ["ACki ADD` L IJ00SF. . . : 0 201 400 amp. . . . . . . : 0 SIGI,,I/OUT LINE LTC. . MITED ENERGY. . . . . : 0 401 -- 60121 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . iNF. HM/ GVL/FDFR. . t 0 601+ampti - 1000 Volts. : 0 MINOR LABEL ( 10) . . . --SE RV ICE/FEEDER—.--..-. CIRCUITS INSPECTICJNI 12100 amp. . . . . . W/3ERVICE OR 1E.EDER. Fil PLR INSPECTION. . . . . . 400 amp. . . . . . n 0 1st WID SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 GOV) amp. . . . . . : 0 EA ADV„ 1. DRNCH CIRC : 'A IN PLANT . . . . . . . . . . .. it 1000 amp. . . . . : 0 REVIEW 3ECT I 1004 anlip/yolt. . . . . . 0 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : .,connect only. . . . . ! 0 '0VC/Fl),q > = 225 AMPS. . . CLASS AREA/SPEC �r­', -ill el': — . - - - ­.. — .— . ­­. ... .­­ ..­I . .. .. - _. - _­ ­_­1 " ­...­ _ ... FELS - - - ;.JN TONKIN typf, -amount by date 1'eL P Y'100 SW GREC.NDURG RD STE 42@ PRMT $ 40, 00 JSD OL/14/96 ')6-- 5PCT $ 2. 00 JSD 121,2J14/96 96- 27"' GA 1:'Q OR 97223 ,one 0; I I t t-a c t o LE N,'FALK INC # 42'. 111 Q'i T 0 T'(- L G.,lb SW GL�MINI DR REQUIRED INSPECTIONS .0VERTON OR 9'7000 Ceiling Lovei, E1 ec:t I r- on e #s Wal I Covet- g is persi; is issued subject to the regulations .-ontaineu in the :yard Municipal Code, State of Ore. Specialty Codes and all other Pler mitt ev -_.plicabje laws. All wark will be done in accordance with .,proved clans. This permit will expire if work is not started ;thin 180 days of issuance, or if work is suspe-ded for sore .an Is@ days. ssueu INSTALLATI N ONLY- -le installation is being made on pr-operty I own whici is not intended for, ale, lelkse, or, rent. ANE:RIG SIUNPTURE: DATE : IN5rALLATION L-7 i--4HiLJRE OF 5UPR. ELF LINi: DATL (LLNIE Call for int-,pection -- 639-4175 02/12/96 :4: 40 IMS03 689 7297 CITY OF TIGARD 19002/002 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # L— Permit # PNine (503) 639-4171 Date Issued C� FAX (503) 684-7297 Issued b �_ 21- CITY OF TIGARD _. TDD No. (503) 684-2772 Y Inspection (503) 639-4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development U I 1c Number of Inspections per psrrrtil allowed Addrr-ssU Set rine included: Items Cosl(Qa) Sun, City/state/zip � ' n), 4a. ResHential-per unit ' 1000 aq A or%so 111,0.00 �—' too aeldilienl W r h s/ Nam• (or name of business)- PORW,tnrfaat 1121;oo ' Commercial® Residential ElEEWA Srrraf SUM ad1 Mar>tA'd Mohr w Moditen 2 DwelCsy tiararn ar Faador a6H.00 28. Contractor Installation only: 4b,Services or readers Insulation,abrawn.or;atooation Flectrical Contractor �Ilr r�('' I I rY _ 2W wr4m or Ia• sm 00 2 201 ami400 nwo 00 2 Address mt r-1 I hr. N L,dr i Gt l 2 SOI amPs to e0o amp. $ (,IState feta- -' Zip r ` EAt ampf o to 1000 amps 111160 00 2 ] C)vor IUM amps or vohc $340.00 2 Phone No. �9L,�O`�.� ----- r Facarv,od Dory 11b0 00 Contractor's License No. -s1U•a CG '"— Contractor's Board Reg. No. ac Temporary Service*or Feeders �r Iretallation,"brawn or rabcolton 2 i' 1160 tt0 Signature of Supr. Elec'n �_ . ��, i00ar'°"or lass 2— 2 �it ense No. Phone No. 701�'F@ 1O 400 amps 106.00 501 amfla r 500 amps :100.00 Ovar am ami to I ow voles 2b. For owner installations: aae b' 4d.Branch Circuits Print Owner's Name Mwr,alrnalon of estemmn per parr) Address __— a)The to for bramt,aralte wiM pumh"e of aanks or lrala r. 2 City State __ Zip— too Mrd+arcun 116.00 Phone No. _ b)The Iw for Manch comuhs rrlrhmd 2 Tho installation is being made On property ! own which is rruramso N Wfvke or boder M.Fast wench araail 113500 2 not intended for sale, lease or rent. Emch additrrad branan ortuh 56 a, Owner's Signature Miscetlansous 2 (Servios or leader not Included)FAch 2 3. Plan Review section (if required): each u"°a'Alwo Q on'�' --- '"p°Q fJd,aipn ar nAlna iwht-V ._ �rro 00 84"nT„h(q or a lirnAed srrrpr pteses check spprop►ime Item wW sntsr far in wmicn SB. parol,sh.rrllrin r.i narrbn 4 or more residential units in one structure MAW Label(10) $100 00 M'--Service and feeder 226 amps or more all.Koch additiorw Inspection over System over 6010 volts nominal 1h•allowable In any of the above Classified area or stnMure containing spacial occupancy Por impectwn53640 ruw as descrAwd in N.E.C. Chaptor 5 Per rr 556.00 _ In Plana W 00 submh 2 rite of piano with appiieatlon wrr»re any of the above apply. Not required for temporary construction sat rhes. s, Fees: tie Enter total of abo us toot S NOTICE SX 5urchargc 1 05 X total less) subtotw PERMIT'S BECOME VOID IF V00AK OR CONSTRUCT" •b,Enter 25%of the A for AUTHOPIZED IS NOT COMMENCED WITHIN 160 DAYS,OR IF plc, Review If required(Sec.3) CONSTRUCTION OP WORK IS S USP ENDED OR ADANDCNJED FOR iubtoral s PEMCD OF Ise DAYS AT ANY TIME AFTER WORK IS ICOMMFNCFD ❑ Trust ACC011nt Of g Halanev Dur $ 1 ' -c k) CITY OF TIGARD BUII ►Ifs' -i INSPECTION DIVISION MST 24-Hour Inspection Line: 634-41, . Business Line: 639-4171 / BUR (date Requested� � � , AM PM BLD Lccation_ L/ 7 C _� Suite MEC Contact Person L Ph /C/ PLM — Contractor Ph 7c y—7,)-3 ,j0WR rnrn BUILDING Tenant/Owner SEA-AVIAC i 'l /� dA Retaining Wall a;1'45 - 5 t� /`cz�c rN c�Q�. EL2 Footing Foundation Access: �-� � )��`-�� C��C , FPS J Ftg Drain LJ J �` O SGN Crawl Drain Inspection Notes: — Slab - SIT Post&Beam •-� 7 ��Z/,r J Ext Sheath/Shear G Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler -- - - -_ ------ -- ---- --- - - - ..------------- Fire Alarm Susp'd Ceiling ----- — ----- Roof Misc: Final — PASS PART FAIL ---------- -- ---- - --- -- -- ._._- PL.UMBING Post&Beam _ . -- - - --- Under Slab Top Out Water Service Sanitary Sewor -- - - --- ---- Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam Rough In Gas Line - - -- - Smoke Dampers Final —— —.._�—- ---- ---------- - P At1K FAIL Service Rough In - - -- -- - UG/Slab L162W—lage Fire Alarm ------ -- -..- - - - - . .. PASS PART FAIL i - - -------- _ -_. - - Backfill/Grading ---_ _.-- .__ _. _--.----------_-------__�.___ ._-_--- Sanitary Sewer Storm Drain I j Reinspection fee of$ required before next inspection Pay at City Hali, 13125 SW Hall Blvd Catch Basin I j Please call for reinspection RF - __ Unable to inspect-no access Fire Supply Line _ ADA / Approach/Sidewalk Other Gate I - _-- Inspector _ _ Ext'` �l Final PASS PARI FAIL r o NO'T REMOVE this inspection record from the job site. CITY CF TIGARD DEVELOPMENT SERVICES ELFCTRICAt_ PERMIT - 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 RESTR I C'TE D ENERGY PERMIT # : EL R98—O '60 DATE ISSUED: 12119,1J7/9P, PARCEL : 1 S 1 35nB-•0'1001 r !-E ADDRE S O. . . : 1.O300 9W GREENBURG RD #4i'LI'� !BD I V 1 S 1 ON. . . . : RF 17 LOBSTER / CASA LUP I TA -L ON I N0:C—P Or-K. « . . . . . . . L_OT. . . . . . . . . . . . . „ !(11�IODICTN: TIG a j ect« De scr^i p1. i on: Cossonvealth Mo-t gage TI RESIDENT IAL-.____._...___._. S. U)MMERCIP1 _-.__.._....__._-_._.._.....___._........._._......___._.___..___ ....__. ..___.__... AUDIO & STERFn. . . : AUD I n & S'TE:_REO. . : I NTERCOM R PAC31 NO. . s BURGLAR AI...ARI'd. ^ . . : BOILER. . . . . . . . . . : I..f11,1DSCAPE/IRRI(3A'T. . : CARAGF. OPENFR. . . . . C:L.00k. . . . . . . . . . . . MEDICAL.. . . . . . . . . . . : HVAC. . . . . . . . . . . . . . DATA/'TE'I...E C:nMM. . : X NURSE CALLS. . . . . . . . . VACUUM SYr;TF:M. , . . : FIRE nl_f1RM. . . . . . : OUTDOOR L_ANDSC LITE: OTHER: . . HVAC. . . . . . . . . . . . : PROTf CT T.VE S I GNAT_.. . I NSTRUME'NT'AT 1.0N. : DTHF R. . : s TOTAL. # OF LSYSTEM5: 1 -__ _-.__ ._. _ _.._..._._.._._...._....- FEFl 1.')RRIS BEG13S SIMPSON type amount by date rept h12,2O SW CREFNBURG RTS STE t:25 PRMT $ 40. 1110 .JSD 09/1. 7/98 98-3O92' r CARD OR 97-23 5PCT $ P. 091 JSD 09/17/98 1.38--309; �nne #: 5900 ' 1RISTE N': ON E•I_.F:CTRIC TIVC 42. 1110 Tnl'vii ! 1 SW COL LIMBI A FE=: 480 — ^— RE=C,1'.11 RFT) I NSF'IECT I ONS - - — !1RTL.AND OR 97E'01 Cf*iI irig Cover Lo4v Voltage Inap hnne #: 55'41 4f3] �' Wall Cover EElert' I Final O00458 '`'is persit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plane. This per•sit will expire if work is not star-te within 160 days of issuance, or if work is suspended for sore than 180 days, ATTENTION: Drpgon law requires you to follow rule ed by the !lrpgon Utility Notification Center, se rules are set forth in DAR 954 061-01010 through DAR 952-001-0886. `lou y twin ies of `pse rules or direct questions at (503)246-1987. 1 stied try r �,._- Perr•mitthe Sign t OWNER INSTAI A_ATION 0141 Y ' ,'' installation is being madf? nn proprprty 1 own whish is riot. intenHed fm ,le, lease, or, i^Qnt. ONER' 5 S I GNAT1.IRF : � DATE: __.._.__ .........._.. ._.-._ ..._..__.._,._-...__, ..U)NTR,`)!"TC:R IWTAI_l_ATTON nNl_v _ .._..._ ._.._ _-.-_ ..... ..... (3NATI.IRF OF SUPR. ELFC' N: DATE: !CENSE NO: ++++.1-++++ ++++++++++++++.4++ 4.++++++.+++++4-+++++++++++++++++++++.}+•h+++++.+++++++++4 Call 639 41.75 by 7:14:111 P. M. fn)• an inspe7tion ner1lle+c1 the next 1,1_rsinpss Hly +4++++4 ++4-+•++++++++++ f+ f-+•++++++•+4-++++++•+•++++++++++++++++.+-+++-+++++++++-1•++4.f+ CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd C)5�s _:rte 13125 SW HALL BLVD Date Rec'd`'_6L,:_��f. TIGARD OR 91223 j �G `J PRINT OR TYPE (� V-503-639-4171 X304 Permit#:.0 F-503-684-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd JOB:509-6675 WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL ONLY LINCOLN CENTER Restricted Energy Fee........................................ $40.00 C M A C (FOR ALL SYSTEMS) JOB Street Address Ste# ADDRESS 10300 SW GREENBURG RD 4'2O Check Type of Work Involved City/State Zip Phnne u Aurhn and Stereo Systems PORTLAND OR 97/_21 Name LJ Burglar Alarm NORRIS BEGGS SIMPSON REALTORS Garage Door Opener' OWNER Mailing Address 1020 SW GREENBIJRG RD SUITE 225 Cit /State Z.ip Phone Heating,Ventilation and Air Conditioning System' I'(�R'fLAND OR 452–g90 QUESTIONS:? Name Vacuum Systems' CONTACT RANDT CHRISTENSON ELECTRIC, INC. ❑ Other___ _.-.– GROSS M aA�d CONTRACTOR 5w dG6tUMBIA SUITE 480 TYPE OF WORK INVOLVED -COMMERCIAL ONLY (Prior to Issuance a City/State Zip Phone# Fee for each system.............................................. $40.00 copy of all licenses PORTLAND 197201-5896 241-4 12 (SEE OAR 918-2.60-260) are required if Ore on Contr Brd Lic # Exp, Date expired in C.0 T. 458 Check Type of Work Involved data base). I ctr I Contr.Lic.# Exp.Date gc -C Audio and Stereo Systems C O.T.or Metro Lic.N Exp.Date a 5246 Boiler Controls Owner's Name Clock Systems OWNER - Mailing Address APPLICANT X}X® Data Telecommunication Installation City/State Zip Phone# r-1 lJ Fire Alarm Installation This permit is issued under OAE 918-320-370.This applicant agrees to HVAC make only restricted energy installations(100 volt amps or less)under this permit and to do the following L� L Instrumentation 1. Only use electrical licensed persons to do installations where required Certain residential and other transactions are exempt from licensing intercom and Paging Systems These have asterisks(') All others need licensing, Landscape Irrigation Control' 2. Call for Inspections when installation under this permit are ready for inspection at 503.639-4175; Medical 3 Purchase separate permits for all installations that are not ready for an I__J Nurse Calls inspection when the inspector is out to inspect under this permit; 4 Assume responsibility for assuring that all corrections required by the Outdoor Landscape Lighting' inspector are done,and; r–I LJ Protective Signaling 5 Assume responsibility for calling for a final inspection when all of the corrections are completed Other Permits are non-transferable and non-refundable and expire If work Is not started within 180 days of issuance or if work is suspended for 180 days. Number of Systems The person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other installations aut�lz1 to bind the applicant. FEES: ENTER FEES $_40. 9/15/98 2 5%SURCHARGE(.05 X TOTAL ABOVE) $_ Authority if other than Applicant TOTAL $ 42• _— i tdstskreseie doc 7197 --