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10115 SW NIMBUS AVENUE STE 500 N �l J C• 10115 SW Nimbus Ave #500 CITY OF TIGARD 24-Hour B:'- .71NG Inspection Line: (503)639-4175ST 41up , !NSPECTION DIVISION Business Line: (503)639-4171 Received — Date Requested AM 22` _.PM SUP Location ___—�t' ( / `-a__lt`� c�►���-- :L' Suite MEC _ Contact Person T )a Ph( ) + ��5 -L PLM _ Contractor — Ph( ) -- SWR BUILDING Tenant/Owner ___ "' ��� `-'3^ f� ELC Footing --- ELC _ Foundation Access: , Fig Drain ELR Crawl Drain SIT Slab Inspection Notes: Post&Beam r Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- - ---- - Insulation Drywall Nailing ----- -- Firewall ,Sprinkler --- -- -- - e Alarm j 9uap'd Ceiling - Roof Other: . - ---- -- - -- SS PART FAIL -�-- - — i _BING __ _ ------ -- - - -- — Post&Beam Under Slab Rough-In Water Service --- - - —`-- Sanitary Sewer Rain Drains ------T -- - -- Catch Basin/Manhole -- Storm Drain - - -- -- -- Shower Pan ---- Other: --- Final ---- PASS PART FAIL - MECHANICAL _--___-. ----__--.- -- - ---- __-_ —_---- Post&Beam - Hough-In ___--- Gas Line Smoke Dampers - --- -- -- -v- Final PASS PART_ FAIL - -- __._ - ---------- -- ELECTRICAL - -- ---- --- Service Rough-In -----_._ __ -- --- - -- -- -- -- UG/Slab Low Voltag'' ---- -- _----- - --- - Fire Alarm Final FJ 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 Line - �i �j / ADADde-`�`►-`� C..; A;,proach/Sidewalk Iesp�ctOt F thEr.nal DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST SUP _> -- Received Date Requested. -� =� AM __. PM BUP Location 1L,-- ,�1 _��Ju.,.i— Suite Contact Persen --- -"`�`'►'� _ Ph( C— Contractor _ - — =" Ph( ) 5 =.�'l-S SWR BUILDING Tenant/Ownpr ELC Footing Foundation Acce3S: ELC Ftg Drain X Crawl Drain �'e a c�ty ELR - - -- Slab Inspection Notes: SIT Post&Beam Shear Anchors' - Ext Sheath/Shear Int Sheath/Shear --- Framing � -_�LJZ�„r ��`� ---- -- Insulation - Drywall Nailing - Firewall G�� �'YIG- Fire Sprinkler - ,// 62=�' — Fire Alarm Susp'd Ceiling - -- - - Roof Other: - Final PASS PART FAIL PLU_MBINd _— o� Arm- I Post 8 Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains— Q=e4=.9- - Catch Basin/Manhole Sto.m Drain - Shower Pan Other: _ -— -- - Final I PASS PART FAIL MECHANICAL -- � — Post 8 Beam Rough-Inr Gas Line Smoke Dampers -- — t PART _ Ah - ------- -- -•- - - _ s E CTRICAL / Service Rough-In UG Slab ^.v Voltage -- Fire Alarm Final lj�Relnsogdon fee of$ • , V requir /"t�efore next inspection. Pay at City Hail, 13125 SW Hall Blvd. PASS PART FAIL SITE -- - Please call for �a _ �_ � Unable to inspect- no access Fire Supply Line ADA Date apretor0 'Z�- �� Approach/Sidewalk -- ------ � Other: Final DO NOT REMOVE tivis inspection recoA f'rorn the)oh site. PASS PART FAIL CERTIFICATE OF OCCUPANCY CITY OF TIGAR DEVELOPMENT SERVICES PERMIT#: BUP2002 00091 DATE ISSUED: 3/1.5/2002 13125 SW Hall Bivd.. Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134AA-01900 ZONING: C-G JURISDICTION: TIG SITE ADDRESS: 1011x, SW NIMBUS AVE 500 Sut3DIVISIGN: 1 KOLL BUSINESS CENTER TIGARD BLOCK: LOT:001 CLASS OF WORK: ALT TYPE OF USE: CUM TYPE OF CONSTR: LINK OCCUPANCY GRP: B OCCUPANCY LOAD, 40 TENANT NAME: "T'AE KWON DO REMARKS: Exercise room 2000 sf with bathroom Owner: NIMBUS CENTER ASSOCIATES 811 NW 19TH AVENUE PORTLAND, OR 97209 Phone: 503-227-042: Contractor: NORWEST GENERAL CONTRACTORS INC PO BOX 25305 PORTLAND, OR 97298-0305 Phone: 291-6986 Reg#: 'LIC °0425 This Certificate issued 4/3/211112 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under which the referenced ir�nit was issued. BUILDING INSPECTOR 15U NG OFF .I. POST IN CONSPICUOUS PLACE CITY OF T:GARD 24-Hour BUILDING Inspection Line: (503) 639-4175 ST y INSPECTION DIVISION Business I ine: (503) 639-4171 *U M; 3 `�!�JCc�a 0069S Received —_Date Requested �!_— AM_-_ __ PIA BLIP —__ _�_ Location . D `� - '�-� Suited _ MEC Contact Person -________._.. __'3'L���- Ph 1� �'1�� PLM Contractor_ Ph( ) SWR BUILDING Tenant/Owner _._ .... ELC Footing ELC Foundation Access: Ftg Drain ELF! Crawl Drain _ Slab Inspection Notes: s; Post&Beam L Shear Anchors Ext Sheath/Shear Int Sheath/Shear •,}.-vim �� �W� Framing 1 - — Insulation Drywall Nailing Firewall I ue S — --- Fire Alarm Susp'd Ce nyny � ------ ------ - Roof Other.;-----. — -- ASS PART FAIL P V BING Post&Beam Under Slab --- ------ - — Rough-In Water Service -- ------- ---- -- 4 Sanitary Sewer ' Rain Drains ---- --------- — - -- Catch Basin/Manhole Storm Drain - ---- Shower Pan Other: -- Final PASS PART FAIL — — MECHANICAL _ — _— Post&Beam Rough-In — - - -- Gas Line Smoke Dampers — Final PASS PART FAIL --- - ELECTRICAL Service Rough-In — UG/Slab Low Voltage — Fiie Alarm Final -- -- Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL Please call foi reinspection RE:__ _— __ - Unable to inspect-no access Fire Supply Line l ` ADA Date __ L _a Inspector Approach/Sidewalk Other: Final 90 NOT REMOVE this Inspection record from the Job site. PASS PART FAIL ccumulative Sewer Tally Tenant Name: TAE w�►o. -� This SWR# Address:�n I f ,�- s�� �,�„!r? t� ) This PLM#:— D - F!xture Value Previous Previous Credits Capped Fixtu,es Fixtures Nev, -tal New # Value Capped off value add(;d# added #s total Count off#s count value values Ba tilt /Font 4 -- Bath-Tub/Shower 4 - -Jacuzzi/Whirlpool 4 _ Car Wash-Each Stall 6 -Drive Throu h 16 _ —Cuspidor/Water Asirator 1 N �_ Dishwasher-Commercial _ 4 - - Domestic 2 - Drinking Fountain 1 —Eye Wash 1 — — _Floor Drain/sink-2 inch 2 - _— 3Inch 5 - - -- _ -4 Inch 6 _ -Car Wash Drn 6 — -- Garbage Diaposal 16 Domestic(to 3/4 HP) Commercial to 5 HP 32 _ Industrial over 5 HP 42 Ice Machine/Refri orator Drains 1 QII Se Gas Station 6 Rec.Vehicle Dump Station 16 -- - Shower_Gan Per Head _ 1 — _ -Stall _ _2 - - Sink-Bar/Lavator�i ---2-- - -Bradley _ 5 _ -Commercial V 3 - _ -Service 3 -- Swimming Pool Filter 1 - _Washer-Clothes _ 6 _ - Water Extractor 6 _ — Water Closet-Toilet 6 Urinal 6 TOTALS Total fixture values:---------------divided by 16 = __EDU HISTORY - PLM# EDU# SW_R# _ PLM# EDU# SWR## PLM# EDU# _SWR# r.".M# EDU# SWR# PLM# EDU# SWR# PLM# _ _ EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR## i:\dsts\swrtaly.doc BUILDING CITY OF TIGARD PERMIT#: BUP2002-00095 DEVELOPMENT SERVICES DATE ISSUED: 3/15/02 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCFL: 1S134AA-01900 SITE ADDRESS' 10115 SW NIMBUS AVE i;n SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD ZONING: C-G BLOCK: LOT: 001 JURISDICTION: TIG ^'REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRU_CTIO_N, CLASS OF WORK: FPS FIRS. sf N. v S: E- 1 YPE OF USE: COM SECOND: sf PROJECT OPENING_ TYPE OF CONST: UNK sf N: S: F: Vv: OCCUPANCY GRP: B TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: GARAGE: sf OCCU SEP. RATED: STOR: HT: ft BSMT?: MEZZ?: REQD SETBACKS — _ REQUIRED _ LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR- PARKING: VALUE: $ 200.00 Remarks: Install 1 head and add 1 pendent sprinkler head. Owner: Contractor: ROBINSON, WILLIAM R/CONSTANCE AFP SYSTEMS INC ROBINSON, LYNN+ BELL, KAY ET 19435 SW 129TH BY ELLIOTT ASSOC TUALATIN, OR 97062 P�pone:TLAND, OR 97204 Phone: 503-692-9284 Reg #: LIC 67534 FEES _ _ REQUIRLD INSPECTIONS Type By Date Amount Receipt Sprinkler inspection Sprinkler rival PRMT CTR 3/15/02 $62.50 27200200000 Final Inspection 5PCT CTR 3/15/02 $5.00 27200200000 Total $67.50 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spacialty 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 52-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246 6699 or h 0-332-2344. Permittee Signature: Issued By: -- Call b35-4175 by 7 p.m. for an inspection the next business day Building Permit Application �., ✓ Ferula no.: '� C�' � City of Tigard Date received: Address: 13125 SW Hall Blvd,Tigard,OR 97223 {1l Project/appl.no.: Expire date: C'iryu/!};nd Phone: (503) 639-4171 (, r�. y• Receipt I -, Z ' Date issued: N i no.: Fax: (503) 598-1960 I (/ Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: 7Addifio��ra�tot ily dwelling or accessory Cnm�(•si- ndustrial U Multi-family U New construction U Demolition rcplacenmrnt 'I'cnant improvement 4f lit-7Pnn ' /alarm U Other:.1011 SITE INFORMATION Joh address: IpsIS. ti -) _ Bldg.no.: Suite no.: I(S), LA: I Block: Suhdivision: :1 ax map/lax lot/account no.: Project name: - .TS Description and location of work on premiseticspecial conditions:T1 OWNER I OR SPIECIAIL INFORMATION, Name: 1� NOW ("oodplatifil septic capachly,soll'ar,itc.) Mailin address: &IJ 1 &2 family dwelling: City: — State:t`J1Z ZIP: 9,1115:1 Valuation of work................................ .. Phone: -OAZ'�) I Fax: E-mail: No.of bedrooms/baths............................... ._-- Ov ner's representative: LA,, C- ," m_� Total number of floors................................. Phone: Fax: E-mail: New dwelling area(sq. ft.) .......................... Garage/carport area(sq. ft.)............ ............Cove Name: _ c 1�` Deck area porch area(sq. ft.) ......................... --- — Deck arca(sq. ft.) ................... .................... Marling address: � rj- �. I = --Other_ — City: State: ZIP: �p(o SJnmcture arca(s .f.)....... c� t ._ ._.. _ Phone: - Fax:(a 7 I� E-mail: C['nmmere Ulndutst.In"multi-lamllyt 1]CNNfilufflillValuation of work........................................ $ 7c _ — Y Existing bldg.area"(sc ft.) .......................... I.lam"P Business name: lS�,-� (SIL Address: i- � New bldg.area(sq.f' ................................ " Number of stories........................................ Stutc: pit ZIP: City' Type of construction...... Phone: Fax: �c92•I I E-mail: _ ........... _ ���� - Occupancy group(s): Existing: C CCB no.: G� � �'� - - ------. New: City/metro lic.no.: Notice:All contractors and subcontractors are required to he r licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may he required to Ek licensed in 1,,e Address: jurisdiction where work is being performed. If the applicant is City: Slate- ZIP. exempt from licensing,the following reason applies: Contact person: I'l.ol no.: _— I'hone: 1 I, Name: I1 ­w,u t person: Fees due upon appllcation ........................... $ Address: Date received: —3.1 S-C;L - City: State: LIP: Amount received ......................................... $-.( I -S Phone: _ Fax: E-mail Please rel'er to tee schedule. hereby certify I have read and examined this application and the NM all jurisdioiram wcepr crelir cants.please call jurisdiction for nlore Information attached checklist. AllLith, ic f laws and ord;nanees governing this U visa u Mastercard work will he comt,r,edwile specified herein or not. t'redir card number _-. -- -- (—L- 3-I� 1'.xpires 3i Authorized ture: Date: Name of cardholdet as shown on credit card Print name: Cardholder sijnarurc Amounr— Notice:This permit application expires if a permit is not obtained within 190 days after it has teen accepted as complete. W-4613(f>+(IWOMr Fire Protection Permit Check list A,) U New ❑ Addition 1 Alteration ❑ Repair_ B.) Modification to sprinkler heads only: Describe work to 1. 1-10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads: Additional description of work: Type ofS stem Com lete A or B as applicable : _- - - --- A.) Sprinkler Wet 14 D _ 0 Standpipes Additional Hazard Group _ Information DensityDesian Area K. Factor - Sprinkler Project Valuation: Bi-Fire Alarm Submittal shall Batt ry Calculations Yes ❑ _�__ include: Individual Component Yes ❑ Cut Sheets Fire Alarm Project Valuation: $ _ Project Valuation Subtotal (A & B $ 26t.� — Permit fee based on valuation see chart : $ Cry _ Sa/o State Surcharge: $ FLS Plan Review 40% of Permit:- $ -- _^---------- -TOTAL: $ (x-1.5 lAdele\fom. .oackllel.doc 10/04/0. ^ CITY I�� �� �I���® ELECTRICAL PERMIT PERMIT#: ELC2002-00112 DEVELOPMENT SERVICES DATE ISSUED: 3/18i02 13125 SVI' Hall Blvd., Tiqard, OR 97223 (5U3) 639-4171 PARCEL: 1S134AA-01900 SITE ADDRESS: 10 15 SW NIMBUS AVF 410 �,_Z> SUBDIVISION: 1 KOL, BUSINESS CENTER TIGARD ZONING: C-G BLOCK: LOT : 001 JURISDICTION: TIG Proiect Description: TI Insf�-,ll 7 branch circuits. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 600 amp: SIGNAL/PANEL: MANF HM/SVCi FDR: 60' +amps - 1000 volts: MINOR LABEL (10): _ SEF'VICE/FEEDER _ _ _ BRANCH CIRCUITS — _ ADD'L INSPECTIONS ___ 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:—� 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW_ SECTION 1000+ amp/volt: s -- >=4 RES UNITS: > 600 VOLT NOMINAL. Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: ROBINSON, WILLIAM R/CONSTANCE COMMERCIAL EI.ECTRIC CORP ROBINSON, LYNN+ BELL, KAY ET 1904 5E OCHOCO BY ELLIOTT ASSOC MILWAUKIE, OR 972.22 PORTLAND,OR 97204 Phone: Phone: 503-462-5201 Reg#: LIC 6145 SUP 1940S ELE 26-33C FEES Required Inspections Type �By Date Amount Receipt Wall Cover PRMT CTR 3/18/02 $86.75 20020000( RoughFi 72 Elect'I Final 5PCT CTR 3/18/02 $6.94 2720020000( Total $93.69 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 ii work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-6699 or 1-800-332-2344 / Permit Signature: Issued By: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: —_ DATE: — CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: �'l DATE: _- LICENSE NO: _—.- — — --- ------ -- ---- Call 639-4175 by 7:00pm for an inspection the next L usiness day 09/18/02 MON 10:44 FAX 5098594968 THE STONER GROUP frfi Electrical Permil-A_ .ppXlicat_ion buerccCfvcd�! D 7a.yy, no. .0011 City of Tigard -D PwjecUappl.no_ ' C'irpr�(rignrd Address: 13125 SW Hall 91 ` D�rcissuut RecciptnoPhone: (503) 639.4171Fax- (503) 599-196U C3scCilcno.: e: Land use approval e I tl U I &2 family dwelling or accessory Com merclal/industrial J Multi-family O Tenant improvement `J Ncw construction Addition/alteralirrrt/rrplaccmrnr I Othcr. J Partial 1 1 1 Joh address: !�/! 1ryJ bldg. no.: Suite no T rna tax loNacrount no. Lot Block. 5uhdivisionr � -- Fro;rct name::&&� f�L;J4rMDescription and location of work on premises: WrRE je,e NL'W ?cam%f�T Fsumatrd date of compiriion/inspccuon Job 11w— j ttx Bias C?eserfption m) TYGtI no,tarp fiirtiil1C55narrlC:�a��M7PC.fc- -e'--LT _�..`.- Ne"to+identwl-single ornwhi-farnilyper Address �0�0 _ _.- d"cllirtt;wtit.tncl,relm.rinclydgaraCe. CIty;IWeStatexl< ZII'. +7zz� Servirsineiuded Phoncib,y. G.2 SZv/ Fax�l9G6 E-mail:' 1000 sq.n.or less 4 _...-- -- - — -__- -- Fadi additlonal 500 i .k or portJon thereof CCB no.: Gi�/5' Elec.bus.lic.no: Z63j umllad;nergy,retldaf 2 _ Cite retro lie.iso; 2od4 umltedenergy,non-residential 2 --- - —11C•1L�_ Etch manufactured home or modular dwilli_ng S cr+urc or sup:rvising electrician(required) Due Serviceandforfeeder 2 Sup e.iact.name(pnaifj�„vs�sj�,, Uam"no:/'r+40SY ser-ices or reeders-instillation, 1 nUoo or relocation: mg a s ur leas 2 Name(print): attapa l0 400 ami2 Mailing address. amps to 600 amps 2 ams w 1000 am 2 CIt;.: State: ZQ': Oval amps or volts7M7:N Phon.: Fax S mail; Reeonnectonly _ I 0%­.-_-r installation-The installation is being made on property I own Temporaryserrimorfeederrt %%II"It Is not Intended for sale,lease,rent.or exchange according to insuWoo,alteragon,orrelocatlon: 0R, 1.17.455,479,670.701. 200 amps or las 2 201 amps to 400 anipt 2 Utt:rt r'S si nature; _ Date: 401 to Goo ams 2 a w lit g Branch circuits-nett,elleratlon, orexterulon per panel: Nartrr �__ A Mo fir brnneh clrtnru,vith rurehare erf service or feeder fee,each branch circuit 2 Crr_� 5talC: ZIP: B. Fee for branch circuits without purchase f r. T� Feu: -ntall: of service or feeder lee.first branch circuit — fach additional btar.6 circuit. t 1ltisc.(Service or recd;:notIncluded); n �. --ice over 225 amps-commercial Cl Heal d) fuci6ty Each pump or irrigation cimis J ice over 320 amps-rating of I&2 Cl Hvardous location fysch n p or oulhnc nrlcdwellings 13Ruddingover 10,000square feet(out or Signilcimult(s)ora limited energ>panel J :rem over 600 volts nonunal more residential units in one stricture aneration,orcttcntion• CJFecdcrs.400imp ormore 'Desert don J acunam Inad over99 persons C❑Manufactured structurm or RV-:it p �� '- ----- Each eddhleml Ir•Irectlon osc r the dlosrrbl;In any of the t+lWre: J I erv,Aichunfplan O Other. Per nspeedon Submit—sels of plant Nith may of the above. Invssngati0n fee _ L_-The above are bol applicable Io tenlporaty construct Ion strice. Oder Not alt junsdicuons araept credit ends.pleats call Jurisdiction for moa Inraaunon Notice This permit application Permit fee.. _ .. ... .... Its 0 Slasterrard ecpires if a permit is not obtained Plan review(at _ r+1 4 _ Credit cart)number ___ __. _-� __--4_y It ithln 190 clays after it has bean State sureltarge(8t7F) P ret/ $ t �7 rTOTAL .. accepted u complete, S arra n car rare Yon creditcard— _ -- S _ ardnoldereltiturture — —« AnwYnl� 4fll-rl11IHOOrCUAt) / \ CITY OF TI Y A R D _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00099 HATE ISSUED: 3/12/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134AA-01900 L SITE .ADDRESS: 10115 SW NIMBIJS AVE-699- �." z, SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD ZONING: C-G BLOCK: LOT:001 JURISDICTION: TIG CLASS OF WORK: CTR FLOOR FURN: EVAP COOLERS: TYPE OF :JSE: CUM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: UNK VENTS WiO APPL: VENT SYSTEMS: STORIES: BO_!LERS/COMPRESSORSHOODS: _ FUEL TYPES �0�- 3 HP: _-� DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP CLO DRYERS: FURN < 100K BTU: AIR_HANDLING UNITS OTHER UNE'`�: 3 FURN >=100K BTU: <- 10000 cfm: -- > 10000 cfm: GAS OUTLETS: Remarks: Relocate (3)grilles/diffusers Owner: _ FEES ROBINSON, WILLIAM R/CONSTANCE Type By Date Arnount Receipt ROBINSON, LYNN+ BELL, KAY ET 5PCT CTR 3/12/02 $5.80 272002000C BY ELLIOTT ASSOC PRMT CTR 3/12/02 $72.50 272002000C PORTLAND,OR 97204 — Total $78., 0 Phone: Contractor: OREGON HEATING + A/C INC PO BOX 397 DUNDEE, OR 97115 REQUIRED INSPECTIONS Mechanical Insp Phone:538-2953 Final Inspection Reg#:LIC 125815 This permit is issued subject to the regulations contained in the Tigard �Aunicipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-961-0080. You may obtain copies of these rules or direct question tc - UNC45y-calling (�n� AA-q1 4 � l Iss a By: ' '� J Permittee Signature: \4 - - Call (503) 639-4175 by 7:00 P.M.for inspections needed the next business day Mechanical Permit Application Date received: li CC, Permit no.:1(F_ , pee 79 City of Tigard Project/appl.no.: Expire date: (lryn/7i�nrd Addreft: 13125 SVS' 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: ltuildingpermit no.: ❑ 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family I&Tcnant improvement U New construction 'J Addition/alteration/replacement J Other: Job address: J it ! - C/r Indicate egllllMlll'llt lIthilull es In boxes below. Indicate Il.e dollar Bldg.no.: Suite no.: ai value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value Lot: Block: Subdivision: *See checklist for important application information and Project name: Do jarisdiction's fee sc•hodule for residenliul permit fee. City/county: ZIP: ALUM I Description and location of work on premises {,. f l t t t ? n__k�,l C_ I,% Fee(es.) total Est.date of cumpletion/inspiection: IMuri�rllorf Qty. Res.only Res.only Tenant improvement or change of use: ace hrated or conditioned?A Yes O No Air handling unit _ CPM Is existing space Aircon rtioning(sitepanlcyulrc—�-- _ Is existing space insulated?l'Yes U No Alteration of existing HVAC system zoi er compressors State boiler permit no.: Business name; ©!l f(.c�t� I'f f}7 ( ,L C= IIP —Tons—BTU/11 Address: Q �� 1r smoke dampers/duct smo1,detectors City: Slatc:W 7..1 P: C eat pump(site plan requited) -- Phone: r,37-- : 95 Fax: E-mail: insta rp ace furnace umer j — - In1tiding ductwork/vent liner U Yes U No CCB no.: 5-%-1 -- �_ _ G sk al I rep ace/re locate heaters--suspen ec. City/metro lic.no.: L4 ),-7 _ wall,^r flour mounted Name( lease pant 1: vent fora.o ranee of er than furnace , r Rest un: Absun(,uonunits� _ BTU/H Name: "lillel' _- _. HP Address— —__. --_ Compressors HP rev ronmenta exhaust en vent ton: City: Stele: ZIP`+ _ Appliance vent _ Phone: - Fax: rl ne)il )ryerex aust Hoods.Type re.s.TcitchlTat hood fire suppression system _Name: m �( �� e� 'r� / Exha.lst fan with single duct(bath fans) Mailing a ress: 0-/ 1 lyj /�' Exhaust s stem a art tom {acerin or AC ('it C f State: Z[P: 2: 7>e-'P ue p itng an distribution(up to outlets) YType: _ LJ'G NG Oil Phone: Fess E-mail; Fucl i in cac additional over out els rmm piping(sc emauc require ) Name: Number of outlets — O#Pr IWIR app anceor equipment: Address: _ Decorative fireplace City: State: ZIP: Insert- ype Phone: F E-mail: on, sFive7pellctstove Other: t 1 L5 Applicant's signature: ;=' Date: - C,.,- then _ Name (print): ! _ Not all jurisdictiow wxvo reedit cards,ptetue call jurisdiction f,x mere inrottmtion. Permit fee.....................$ ❑visa ❑MasterCard Notice:This permit application Minimum fee............ ... Credit csd numtw: _ ___ / / expires if a permit is not obtained Plan review(at _ 96) S --- Esplres within 180 days after it has been State surcharge(896)....$ fc me Naof cuilho r N shown on ci;% card -- $ accepted as completes -� TOTAL, .......................$ , Cr al�nattrre Atnomr 440-417(t XYCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 _ minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU 1400 $1.52 for each additional$100.00 or Including ducts&vents fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000.00, including ducts&vents 17 40 $10,001,00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or Includingvent 14.00 _ fraction thereof,to and Including 4) Suspended heater,wall heater 14.00 $25,000.00. _ or floor mounted heater $25,001,00 to$50,000W $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or fraction thereof,to and Including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Hoal Air $1.20 for each additional$100.00 or For items 7.11,see or Comp Pump Cond fraction thereof. footnotes below. $ 7)<3HP;absorb unit Minimum Permit Fee$72.50 SUBTOTAL: to 100K BTU 14.00 8'/•State Surcharge 8)3-15 HP;absorb $ 25.60 unit 100k to 500k BTU _ 25%Plan Review Fee(of subtotal) $ - 9)15-30 HP;absorb unit.5-1 mil BTU 35.00 _Required for ALL commercial permits onl - 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU _ 52.20_ 11)>50HP;absorb unit>1.75 mil 131 U 81.20 _ ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 1000 Value Total 13)Air handling unit 10,000 CFM+ Description: at Ea Amount 1720 _ Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents - 10.00 Furnace>100,000 BTU Including 1,170 15)Vent fan corn acted to a single duct ducts&vents6.80 Floor furnace Including vent `955 16)Ventilation system not Included in Suspended heater,wall healer or 955 oppliance permit 10.00 floor mounted heater _ 17)Hood served by mechanical exhaust Vent not Included In applicance 10.00 etmit _ 18)Domestic Incinerators 17.40 Re air units <3 hp;absorb.unit, 9b5 19)Commercial or Industrial type incinerator to look BTU 69.95 3.15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 500k BTU 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas pips ig one to four outlets mil.BTU 5.40 30.50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU _ Air handllnug nit to 10,000 aim 656 ------ 8%State Surcharge $ Alr handling unit>10,000 ctm 1,170 _ Non- )rtable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not included in 656 -- a Ilance ermlt Other Inspections and Fees: Hood served by mechanical exhaust 656 1 Inspections outside of normal business hours!minimum charge-two hours) Domestic Incinerator _ 1,170 $62 5o per hour Commercial or Industrial incinerator 41591) 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) Other unit,including wood stoves, 656 $62 50 per hour Inserts etc. 3 Additional pian review required by changes,additions or revisions to plans(minimum Gas piping 1-4 outlets 380 _ charge-ono-half hour)$62 5o per hour Each additional outlet _ 83 Slate Contractor Boller Certification required for units>200k BTU. TOTAL COMMERCIAL $ "Residential AIC requires site plan showing placement of unit. VALUATION: All New Commercial Buildings require 2 sets of plans. Wstalfon;a mech-fees doc 12/26/01 CITY OF TIGARD 24-Hour BUILDING bispection Line: (503.)639-4175 MSr INSPECTION DIVISION Business Line: (503)639-4171 BLIP ------ Heceived _._Date RequestedAM-_.- . _ _ PM_ -_ --- BLIP Location _-�Q�_1��_ yS Suite. -14__'Q__. MEC ----- -- _ Contact Person _-- -- --- _ Ph( _) . ------- --_- PLM --- - - Contractor -------- - Ph( ) ---- - -._..- ._ SWR - - - BUILDING Teriant/Owner -_-__ ---- -_ E L C s� -•� Footing ELC Foundation Access: Fig Drain EL.R Crawl Drain __----_-- --- -_ Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear - - Framing - —--- _ Insulation (��� Drywall Nailing - I; — --- -- ---_-____ Firawall Fire Sprinkler - ►"� -- -- - Fire Alarm Susp'd Ceiling ---— -- -- Roof �----Other: Final PASS PART FA II_ —� PLUMBING__ Post&Beam Under Slab _ Roush-in Water Service _- Sanitary Sewer Rain Drains -- - Catch Basin/Manhole Storm Drain Shower Pan Other:_ Final -PASS PART_ FAIL - M_ECHA_NIC_AL _ Post&Beam Rough-In Gas Line ---- --- -__� _. Smoke Dampers Final PASS PART FAIL ---�- - - ------ ----- --- - ELECTRICAL. Service -- -- ------- --__-._-____ _-_- ---�_ Rough-In UG,'Slab — — Low Voltage --- - ------- - - --- -- - ---- 11,%F'rplarm PART_FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE:.__ -_ �� Unable to inspect-no access Fire Supply Line ADA _ Approach/Sidewalk ppb f - �-�` Inepecfor - _ _ lit Other: Final —'— DO NOT REMOVE this Inspection record from the site. PASS PART FAIL CITYO F T I G A R D _ PLUMBING PERMIT [DEVELOPMENT SERVICES PERMIT #: PL.M2002-00088 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/15/02 SITE ADDRESS: 10115 SW NIMBUS AVE 40 ' '� I PARCEL: 1S134AA 01900 SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD ZONING: C-G BLOCK: LOT: 001 JURISDICTION: TIG _ CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 0 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: 2 TUB/SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: 1 WATER LINE- 100 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Cap 1 ea. toilet and lav, add 1 ea. ADA toilet and la\,, install 100'each water and sewer line. FEES Owner_ ---- Type B'• Date Amount Receipt ROBINSON, WILLIAM P./CONSTANCE PRMT CTR 3/15102 $176.40 27200200000 ROBINSON, LYNN + BELL, KAY F7 5PC1 CTR 3/15/02 $14 12 27200200000 BY ELLIOTT ASSOC --- — — PORTLAND, OR 97204 Total $190.52 Phone 1: Contractor: — DP PLUMBING 904 S CHEHALEM NEWBERG, OR 97132 REQUIRED INSPECTIONS Phone 1: Sewer Inspection Water Line Insp Reg #: PLM 110612 Rough-in Insp LIC 36-70PB UnderflooriUnderslab Top-out Insp Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code State of OR. Specialty Codes and all other applicable laws. All work will be clone in accordance with appr(,ved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080 You may obtain copies of these rules or direct questions to OUNC cy c i ig (503) 244'-1987 Issued By: �' 1 ,'�(� Permi!tee Signature �. t s�z�r ,/�Z 9 — Call (503) 639-4175 by 7:00 P.M. for an i,isoection needed the next buiZess day 1 Plumbing Permit Application Now, =MWIM _ i),111!rcccncrl >>> Permit nu dont-Q &S.O C 1t y of Tigard Srwer Ixtrnit no` Building permit no.: Wdress 1.112> ';\\ 11,,11 223 Tigard,OR 97223 _--- ('rn rr!1'r,4wJ Phone. (503) 639-4171 I'roject/aPPI u,, -- - Expire date Fax: (503) 598-1960 bate issued B :yM I Rceript no.: Land use approvil: Case file Ill- Payment type: JI &2familvdwelling oraccessory J( 11111111CIC1,11ln(lu,tn,,l JMult-famlk )(Tenantinuprovcment J New construction J Add ition/alteration replacemcnt J Food service J()thea .108 SI'VIK. INFORmMION FEEvISUIll-IMILF,(for special Information use flieckilait) .lob address. 10111$ SW rN101,1160S AVitr Description Qty. hce(ela.) total - Bltl1gg.-no Suite no . New I mid 2-Tamil}dtrell nks only: --- -- - - -- -- - �� (int•lude%1111111.for eat•h utlllh connectlnn) Tax mill tax lot account no.: __ SFR(I)b;111 Lal: rrliluck: Subdivision: SIR(2)bath - --- L--- - _71111cct n,nm "�'A - --- SFR(3)bath ( ttv county ,'140. LII' q 722A Each additional bath kill IIC•n nescillttion and location of work on premise, C1) ,<1"--AQUA. Siteutllitlev: Tpt#66•T --- Catch basin/arca drain - F,,i.date of completion ll — Drywclls//leach line/trench drain t tIt• hooting drain(no.lin.ft.) -Manufactured home utilities Blts,ncss�,amc pP__Ptilks �-.54-- _..___---- Manholes - AddI ss: p , Lam► A Rain drain connector (1tv 5talc:pR, Z.II Sanitarys ewer lno. lin. R.► Phone fly- -144 I nr E-mail:it- Storm sewer too In, ti l ('( I( Ill, (IAyI lPluml,.bus.reg.no: `'7oP¢ Water scnILC(M)1111. It ( Ilin,ru he no -- ,�„ Fixture or iteln: - ' / Abso tion taltr ('Douai I�u'•.rrplrsrntalitc,ll!natttc: AA r; .. . . . _....- Back tloa prev enter Ill int n;unrate: - C; iackwater valve MAIN1171 him=611h: Basins/lavatory _-- -- --- ---- - - - Nanu ('lollies washer Adthcs•; -- Dishwasher Drinking fountains) Cn� Awn Q W.._ Static o(t L.lv-at ; jcclors'sump Phone: g I (-yo I nisil I,+,}woti n tank _ 1 txtur .ewer cap N,nnr I prnit I • Dor drains floor sinks/hub —_ Garbage disposal M,Itllnl•,ul,l eb t ( +s�[ Ilose bibb 14101Ic 217,04LI Iax: h.-mail: Intc:ceptor/grease trap — ()\vne, a+st,lllatl,u,residenual maintenance only: The actual installation Primer(s) ,t Ill be made h% me^C ntal c• repair made by my regular --Roof irain(commercial) - cmplovrc(111 the pr pert" V.11 ,,<11, 5 Chapter 147, Sink(s),basin(s),lays(s) - Owner's S11'natlne I .I, Sump -- Tu s/shower/shower pan Urinal Name: --xj]A -. Water closet Address: _ _ _ _ Water heater - City: _ state: 71P: Other: ---^ - Phone: Fax: Email: lata -- ---- Minimtnn fee $ Not all turlsdtelions accept credit cards,please call jurisdictionm for ore mn foraintlo """""""" Notice This permit application Uviiin UMamerc'ard eshnc, if a lxnnd is not obtained ev Plan rtaw 0,(at _ ,o) $ _-- or crrdil cord mrmher State surcharge IB 01.- $ _ .__.L_._,._ - nttlnn I`((1 d:n,after it has been � t.ld,e. 4 /- - - _-- ---- _-- - accepted t,Complete 7 o TAL. ........ .. .... ll2 Name of cardholder as shu,sn un c,edit card l:erdhuldm srynalure Amount Wit Alf.11,if,141((IMI EL PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES jindividual ^ - _ _ QTY - ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 1600 the dwelling and the first100 ft. QTY (es) AMOUNT Lavatory 16.60 for each utility connection_ Tub or Tub/Shower Comb _ 16.60 One(1)bath $24926 Two 2 bath_ $350.00 Shower Only 16,60 Three bath $399.00 Water Closet 16.60 __ SUBTOTAL Urinal 16,60 8%STATE SURCHARGE Dishwasher iG,60 PLAN REVIEW 25%OF SUBTOTAL _ Garbage Disposal 16,60 TOTAL Laundry Tray 16.60 Washing Machine 16,60 Floor Drain/Floor Sink 2" 16,60 3" - 16.60 PLEASE COMPLETE: 4" - - 16.60 Water Healer O conversion O like kind 16.60 Quantiy b t Work Performed__ _ Gas piping requires a separate mechanical Fixture Type New Moved Replaced Removed/ permit, _ Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory — Tub or Tub/Shower Hose Bibs 1660 Combination _ Roof Drains 1660 Shower Only _ Drinking Fountain 10.60 Water Closet — - Other Fixtures(Specify) r Z 16,60 Urinal �l1 Dishwasher _ Garbage Disposal Laundry Room Tray Washing Machine Sewer-lot 100' 55.00 Floor Drain/Sink 2" i- 3" _ Sewer-each additional 100 46.40 4 Water Service-1st 100' 5500 Other Heater _ Water Service-each additional 200' 46.40 Other Fixtures (Specify) Storm 8 Rain Drain-1st 100' 5500 — Sloan 8 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 4640 Residential Backflow Prevention Device' 27.55 -- Catch Basin 1660 -- Inspection of Existing Plumbing or Specially 62 50 — Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rein Drein,single family dwelling 65.25 Grease Traps 1660 QUANTITY TOTAL: - Isometric or nsor dlagrrun i•ri•iiuu n'1 if Quantity Total Is >'1 it•r 7l- -- 'SURTOTAL 8%STATE SURCHARGE: _ i� "PLAN REVIEW 25%OF SUBTOTAL: Requited only II li wo,illy total is,9 TOTAL PERMIT FEE: 'Minimum permit he Is$72 50 r a%orate surcharge except Residential Backflow Prevention novice,which Is$36 25+a%state surcharge ""Alt New Commercial Buildings require 2 seta of plans with Isometric or riser diagram for plan review I 1dsl0formslplm-fees doc 02/05102 '� --- BUILDING PERMIT CITY OF T I G A R PERMIT#: BUP2002-00091 DEVELOPMENT SERVICL r DATE ISSUED: 3/15/02 13125 SW Hall Blvd., Tigard, OR 972n.(F-j 639-4171 PARCEL: 1S134AA 01900 SITE ADDRESS: 10115 SW NIMBUS AVE,400 '), SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD ZONING: C-G BLOCK: LOT: 001 JURISDICTION: TIG ___--_— REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: ALT FIRST: sf f.: S: E: W.- TYPE :TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? ______ TYPE OF CONST UNK sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 40 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQ_D 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: $ 21,000.00 Remarks: Exercise room 2000 sf. with bathroom Owner: Contractor: ROBINSON, WILLIAM R/CONSTANCF_ NORWFST GENERAL CONTRACTORS ROBINSON, LYNN + BELL, KAY ET INC BY ELLIOTT ASSOC PO BOX 25C�30�5R c� P Pone NDPhRone , OR 97204 P NZLJ1=7698672.98-0305 Reg #: sic 89425 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing Insp PRMT CTR 3/15/02 $254.50 27200200000 Gyp Board Insp Final Inspection 5PCT CTR 3/15/02 $20.36 27200200000 PLCK CTR 3/15/02 $165.43 27200200000 FIRE CTR 3/15/02 $101 80 27200200000 Tctal $542.09 This permit is issued ,ubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-699 or 1-800-33'-21344. Permittee Signature: Issued By Call 639-4175 by 7 p.m. for an inspection the noxt business day Ruilding Permit ApplicationOFFICE USE ONLY Date received� . /y Pernm no f'�'�r _ ( �� Citi'of Tigard 'iga rd — _� � Proy:cvappl. no.: Expire date .-r htt'Il l Address: 13125 \\ Kill Ithd,Tigard.OR 'I'.' — --- _. Phone: (503) 639.4171 Date Issued -^_ ey J I Receipt no -- Z11- Fax: Fax: (503) 598-1960 ease file no. - _ Payment type. - 1J Land use approval: 1&2 family Smgllc Complex C J I & 2 fan.ily dwelling or accessory U Commercial/industrial O Multi-family U New construction r i Demolition J J \ddltion/alteration/replaceincnt JI Tenant improvement _1 1 t- prinkler/alarm O Other: _ - - 1 : SiTE INFORMA11101"i lob address: 0111S SLj yI, Ayt FBIdg.no.: Suirc no.: I ,I Block: Subdivision: u Tax map/tax lotiaccount no.: I'' ,'ct name: MAL Kwod % I i Itomn and location of work on prcmiseslspecial conditions /Jvl-1 S7AktF2l�4�►���21*t0� Nh01s�s����1�L11 a AOS BATt>♦RDofN. ____-OWNER- Name X11M as AU&z.4A i!L s - Moding address: igi l NW c14ft Aq T 1 &2 family ds-welling: � ( 1n >>1s D� State:A& I"LII': q'Zf%6 4q Valuation of work .......... ...... 1'Inalc I E-mail: No.of bedrooms/baths.................................. - ()\\ner's representative: t0 KillialitiAllij Total number of floors .................................. I'htme. 121"11- 111111411 lFax:tt7' 71 F-mail New dwelling area(sq. ft.)............................ ��---_-_— Garage/carport area(sq.ft.) ......................... - Name. Dj%Jklo13 O0SKA Covered porch area(sq.ft.) .......................... - -_--- -- —� Det.k area(s Mailing address: 101,415,_ S. NA6d►Tl ural �_ q. ft.).......................................... --- -- -- Other structure nren ,, . R. C111'...2J�+_._^s�_ SlatC:Q� ZIP: q�2L4_ (. )..................... .... ---_ Phone I I 11.7fI E-mail: f'ommerciallindustriallmulti-family: Valuation of work ......................................... S Business name: Existing bldg.area(sq.fl.)............................ --- -_ Qi .rMt;.�Nltj ------ New hid Address b 0 B.area(s q. fl.)............................... - -- _>�..,_�r 0-.�- -- -- Nurnlwr of stories ..................................... state: eajilP q�s1• ----- _-- --- Type of construction ................................ Thune' 11 I-i9 S�I Fax:'j,1•'JO E-mail c fi no.` ��"` -- Occupancy group(s): Existing lio. ��'� 1 0�' New. lits• u�truhr nit ®;'�� Is OZ --- Notice:All contractors and subcontractors are required to he t licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Name: /JOfl,-it"j S T PLIL 41 s loo -DILS IC tJ Address I o .� S si„1 TV^641tld lis jurisdiction where work is being performed.If the applicant is City State Q ILI/.11' q,7 2.L4 exempt from licensing,the futlttwing reason applies: ---- Contact person: 0 Plan lit, --- - - -- - - ('honc Pati fi-mall - 1`11�61t 111.703` ENGINEER OFFICE USE 1 Nanic: /A Contact person Fees due upon application...- _ g \dtlrr.ti: Date received: I In State: IIP: Amount received................. .. Phony Fax: E-mail: _ Please refer to fee schedule. _ 111001% certify I have read and examine his application and the No,all Iurluhcnnna arcept credit cardf,plearr.all Iurivieconn for mmr information natached checklist. AllproJisions Q nd ordln:uucs governing this U vim J MaaferC'ard ll trfk 1.1111 be complie with.whet hC lied hereto of ool. f redn taid numbrr -_____ Y I.por. Attilikiti,red signalut( -- -- D + �/ ate: Nalmor t of cardholder as shorn o„credit card --------------- CardholAe: +IIrMNrt Ammnn N..ntr I Ills penllit appheatlon erpile,; II ;I lxllllif N iint ohimned within 190 days altef II h•N t,een accepted as complete - - - -- - -"0JnI I If,1,91 [All Over-The-Counter (OTC) Building Permit Building Check List CLUr of Tigard Description of Project: -_- _[ G Zoo SRS. �� iczn—..----_----- -V —� GENERAL INFORMATION _ ClassMor* k:* Floor Areas(sq.ftp: _ _ _ Exterior Wall Construction: T e -- First floor: N 5: W Type of Construction: Second floor: E W Occu am Group: _ �� Third floor:_ _ -Openings Protected Y/N7: _ Occupancy Load: Total sq_f . _ N: S: Stories: Note: Combine total floor area for E: E: Height: _ all floors ahovc third floor and Roof Construction: Floor Load: _ add to the third floors . ft. Fire Retardant: Basement: Basement: Area Separation Rated: Mezzanine: Garage: Occu.Separation Rated: — RE UIRED ITEMS Firesprinkler: _— _ Handicap access: Smoke detector: Protected corridors: Fire alarm: _ Parking spaces(#): Notcs: — a,I - INSPECTIONS _� FEES DUE _ _ Footing/foundation __ Firewall _$ ;TeTq, S'D _ Permit Fee Post/beam structural Smoke detector $ Z9, -4 4,_ _ State Surcharge Shear wall _ Misc. inspection _$ I f 4.3— Plan Review Fee _ Masonry _ Approach/sidewalk $ I0� . 8Q FLS Plan Review Fee - - Framing _$ Additional Permit Fee Insulation Sprinkler rough-in $ ___ Additional flan Review Fee Gyp board —�_ Fire alarm $ Investigation Fee _ Suspended ceiling Sprinkler final $ Misc.Fee Final inspection $ _ Hourly Rate Fee -- $ Hourly Rate State Surcharge Total Fees Due *OPTIONS: T� TYPF OF USE: CUM=commercial;CHIS=commercial manufactured structure. CLASS OF WORK: ACS=accessory;ADD=addition;ALT=alteration,M, =foundation;DEM=demo; FND=foundation;FPS=flre protection system;NEW=new,OTR=other(use for fences,decks,retaining walls,signs, awnings or canopies);REP=repair. ,\dsts\fomis\0TC-®UP.doc 01/03/02