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CITY
f TY O F I I GA R D _ CERTIFICATE OF OCCUPANCY
DEVELOPMENT :SERVICES PERMIT#: BUP2005-00090
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 3/9/2005
PARCEL: 1 S134AA-01800
ZONING: I-P
JURISDICTION: TIG
SITE ADDRESS: 10220 SW NIMBUS AVE K-2
SUBDIVISION: SCHOLLS BUSINESS CENTER
BLOCK.- LOT:002
CLASS OF WORK: ALT
.YPE OF USE- COM
TYPE OF CONSTR: 3N
OCCUPANCY GRP: B
OCCUPANCY LOA-: 39
TENANT NAME: CASHCO
REMAFI . TI Partition walls.
Owner:
ROBINSON, CONSTANCF A +
ROBINSON, LYNN + BELL, KAY ET
BYYgINSIGNIA
NCOMMERCIAL GROUP
B Phdne TO&30 8 008
Contractor:
GUILD CONSTRUCTION
PO BOX 874
BEAVERTON, OR 97008
Phone: 788-7778
Reg#: LIC 109116
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This Certificate issued 4/18/2005 grants occupancy of the above referenced
buildingg�6r portion thereof and confirms that the building has been inspected for
compliance ith the Sta Oegon Specialty Co es for the group, occupancy,
d ' _e and r h r enced permit was d
D G INSPECT BUILDING
POST IN CONSPICUOUS PLACE
CITY OF TIGARD
BUILDING- DIV1510N PERMIT#: BUP200500090
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/!12005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/18/2005 TIME: 7:14AM PA43E: 46
SITE ADDRESS: 10220 SW NIMBUS AVE:K-2 CLASS OF WORK:
SUBDIVISION: SCHOLLS BU`4NESS CENTER LOT k: 002 TYPE OF USE:
PROJECT NAME: CASHCO
DESCRIPTION: TI Partition walls.
OWNER: ROBINSON. CONSIANCE A +, PHONE N:
CONTRACTOR: GUILD CONSTRUCTION PHONE M: 788-7778
Inspeci;on Request Scheduled For: Date: 4/16/2005 Pour Time:
Code N Inspection Description Confirm # Contact to Message
299 Final inspection 04472501 503957-1180 N
Correcti ans/Comments/Instructions:
I
H
0'3
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a
;Ass ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCJESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED
Inspector: -- Date: 4-/1 ✓ Phoney 0• j503) 718_
CITY OF TIGARD* �
BUILDING DIVISION PERMIT 0: PL.M200&000%
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3114/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/1W'2005 TIME: T09AM PAGE: 32
SITE ADDRESS: 10220 SW NIMBUS AVE K-2 CLASS OF WORK:
SUBDIVISION: SCHOL LS WU ANESS CENTER LOT 0: 002 TYPE OF USE:
PROJECT NAME: CASHC O
DESCRIPTION: Roplac�,ment fixtures
OWNER: ROUNSON, C0NSTANCF A +, PHONE #:
CONTRACTOR: BE=AVERTON PLUMBING INC PHONE #: 5643-7619
Inspection Request Scheduled For: Date: 411212Q05 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing fine) 004305.01 +503957-1190 Y
Corrections/Comments/Instructions:
it .9 dAll
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w -- -- -
`A4SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION (] ADDITIONAL FEES ASSESSED
Inspector: �� " Date: Phone 0: (503) 718-
CITY OF TIGARD
BUILDING DIVIISION PERMIT#: f,C2DD&()D139
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 311 JIM
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR BATE: 4/8/2005 TIME: T 10AM PAGE: 83
SITE.ADDRESS: 10220 SW NIMBUS AVE K-2 CLASS OF WORK: '
SUBDIVISION: SCROLLS BUEANESS CENTER LOT#: Q02 TYPE OF USE: I
PROJECT NAME: CASHCO
DESCRIPTION: 7 branch circuits.
OWNER: ROBINSON. CONSTANCE A a, PHONE C
CONTRACTOR: GUILD ELECTRIC INC PHONE#: 503-957-117'?
Inspection Request Scheduled For: Date: 4/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 ElwArical fin;A 00410601 503750.3109 N
Corrections/Comments/instructions:
60 Vk
c�
J -- -- -----— - ----
PASS ❑ PARTIAL APPROVAL. ❑ CANCEL ❑ NO ACCESS
F1 FAIL ❑ CALL FOR INSPECTION [] ADDITIONAL FETES ASSESSED
Inspector: _ / '}S_>(ir�� Date: Phone #: (503) 718- _
r
CITY O F T I GA R D _ ELECTRICAL PERMIT-
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2005-00046
13125 SW Hail Blvd.. T'Igard. OR 97223 (503)639-4171 DATE ISSUED: 3/9/2005
PARCEL: 1 S 134AA-01300
SITE ADDRESS: 10220 SW NIMBUS AVE K-2
SUBDIVISION: SCHOLLS BUSINESS PARK ZONING: I-P
BLOCK: LOT: 002 JURISDICTION: TIG
Prosect Description: Data telecommunication.
A.RESIDENTIAL _ B.COMMERCIAL
AUDIO& STEREO: AUDIO a STEREO: 11'TERCOM& 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 S 5 MS: 1 _
Owner: Contractor:
ROBINSON, CONSTANCE A + CUSTOM TELCOM
ROBINSON, LYNN + PELL, KAY ET 4785 TEX-fRUM CT. SE
BY INSIGNIA COMMERCIAL GROUP SALEM, OR 97302
BEAVERTON, OR 97008
Phone: Phone: 503-580-7500
Reg#: F.LE 24-397CLE
_
LIC 127754
_ FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMTj ELR Permit 3/9/2005 $75.00
13'AX] 9%State Surcharl 3/9/2.005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon taw requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010
through OAR 9 -001-0100. You may obtain copies of these rules or direct que bon to OUNC at(503)246-6699.
4. Issued by �.i Permlttae Signature A/k- e
N _ OWNER INSTALLATION ONLY _
The Installation Is being made on property I own which Is not Intended for sale, tease,or rent.
C0 OWNER'S SIGNATURE: q DATE:
F3
CONTRACTOR INSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC"N _ DATE:_
LICENSE NO:
Call 6394175 by 7:00 P.M.for an Inspection needed the next bu3iness day.
This permit card shall be kept In a conspicuous place on the job site until completion of ft project.
Approved plans are required on the job site at the time of each Inspection.
o a pg)
Electrical-Perm tlip
oll E D
City of Tigard' IAA� 0 9 2005 Received By al-
13125 remelt No.
9�t2 Plan Ry:
SW Nall Blvd.,Tigard,OR PiauRevie
Phone: 503.639 4171 'Pax: 503.598.1960 D,tdBy: Other Permit
ins ection Line: 503.639.417 I: TIG ARD Date Read re : iwtc — ® Sae lase 1 for
Internet: www.ci.hgard.or.us�ITY U Notifwd/Method: SuppbmantNinformation
E]New construction Addition/altefation/Mlacement Please check all that apply:
El Demcatlon ❑Other ❑Service over 225 amps,comm'I ❑Hazardous location
❑Service over 320 emps-rating ❑Buildng over 10,000 sq.ft.,
of 1-and 2-family dwellings 4 or more new rejidential
❑ 1-and 2-family dwelling ornmerciaVindustrial ❑Accessorybuilding ❑System over 600 volts nominr: units in one stru ture
❑Multi-famil ❑Master builder ❑Other: ❑Buildin8 ever three stories ❑Faders,400 ams or more
[]Occupant load over 99 persons ❑Manufactured structures or
❑Egresstlighting plan RV park
Job no.: Job site address: ❑Health-care facility ❑Other:
/U W Ab P7?�7�l3 Submit 1 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg./apt.no.: Project name: 0157 A!'D
lrescrlPu.a natal
Cross street/directions to job site: New residential single-or multi-family dwelling unit.
includes attached garage. _
_ 1,000 sq ft_or less — 145.15 4
Subdivision: Lot no. Ea.add']500 sq.ft.or portion 33.40 1
---- -- — Limited energy,residential 75.00 2
Tax ttlap/parcel no.: Limited energy,non-residential 75.00 2
Each manufactured or modular
dwelling,service and/or feeder 90.90 2
/ rte.
Viol /tom' Services or feeders Installation,alteration,and/or relocation
2_00 amps or less 80.30 2
201 amps to 400 stripe 106.85 2
401&trips to 600 amps �— 160.60 2
Name: ("'d-_-.1 rnes 601 amps to 1,000 amps 240.60 2
Address: , / Over 1,000 straps or volb 454.65 2
'
/L �'�/ C � '2 N/m �`5 �� Reconnect only _ _ 66.85 2
City/State/ZIP: ! O r /� 9 7;? _ Temporary services or feeders Installation,atteratlor.,and/or
Phone:Q5Z3) J/p —i9ra f Fax:( ) relocation
1 200 amps or less 66.85 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 arrq!s 100.30 _ 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600&mps 133.75 2
Owner signature: Date:_ Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
service or feeder fee,each 6.65 2
Business name: �u S } .� / r>7 branch circuit
B.Fee for branch circuits
Contact name: ��' A5 yam. without service or feeder fee, 46.35 2
�� s� each branch circuit_
Address:
7 9— _ /-P X f h'1 �- Each add'I brslich_circuit _ 6.65 2
City/State/LIP: (,e r;,? Miscellaneous(service or feeder not included)
IL
Ph...-. `'�).S�D — 7��04 Fax::f03) -39rf Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
�. Signal circuit(s)or limited-
4f1 energy panel,alteration,or
extension.Drscribe Page 2 2
5 f� Business name 0
(� Address: Each additional inspection over allowable In any of the above
Per inspection 62.50
W Citv/Stete/ZIP: _ Investigation per harm(I N min) _ 62.50
J Phone:( ) Fax:( ) Industrial plant per hour 73.75
CCB Lic.: 'T 7<j Electrical Li ;j _3 7 Suprv.I.ic.: Subtotal
Suprv.Electrician signature,required: CLE Plan review(25%of permit fee)
Print name: Date: 3 (JS State surcharge(8%of permit fee)
�/� r� A s TOTAL PERMfT FEE
Authorized signake: This permll application exptr"it+permit Is not obtained within 180
days after it has bete screpted as complete
Print name: _ Date: _ Fee methodology se!by Td-County Building Industry Service Board
Number of imtpectiom per penuit allowed.
i\Building\Pexmin\BLC-PerrnkAppdoc IV03 /40461MIaION00116' IM
Electrical Permit Application - City of Tigard '
Page 2 -Supplemi al Information
LIMITED ENERGY PERMIT FEES:
Fee for A residential systems combincid........ $75.00
Check'Type of Work Involved:
❑ Audio and Stereo Systems*
[] Burglar Alarm
❑ Garage Door Opener*
❑ Heating,Ventilation and Air Conditioning
System*
[] Vacuum System%*
❑ Other:
Fee for each commercial system....................... $75.00
(SFE OAR 918-260-260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication[siallation
❑ Fire Alarm Installation
❑ HVAC
E] Instrumentation
I. ❑ Intercom and Paging Systems
OC
��- ❑ Landscape Irrigation Control*
J ❑ Medical
m ❑ Nurse Calls
13
W
A ❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses ere required
for all other installations
+:\Ro11einteffwv0MC-rarndtnpp doe rero+
% BUILDING PERMIT
CITY OF TIGARD PERMIT#: BUP2005-
00090
DEVELOPMENT SERVICES DATE ISSUED: 3/9/2005
13125 SW Hall Blvd..Tigard.OR 97223 (503)639-4171 PARCEL: 1S134AA-01800
SITE ADDRESS: 10220 SW NIMBUS AVE K-2
SUBDIVISION: SCHOLLS BUSINESS PARK ZONING: I-P
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS _ EXTERIOR`HALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 39 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: K PEAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 30,900.00
Remarks: TI Partition walls.
Owner: Contractor:
ROBINSON, CONSTF NCE A + GUILD CONSTRUCTION
ROBINSON, LYNN + BELL, KAY ET PO BOX b74
BY INSIGNIA COMMERCIAL GROUP BEAVERTON, OR 97008
%AVERTON, OR 97008
one: Phone: 788.7778
FEES Reg#: LIC 109116
Description _ Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/9/2005 $328.30
[TAX] 8%State Surchart 3/9i2005 $26.26
[BUPPLN]Pln Rv 3/9/2005 $213.40
[FLS] FLS Pin Rv 3/9/2005 $131.32
—� —- Total $699.28
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
N 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
m 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by
W
calling(503)246-669 1-800-332-2344.
J
Issued By:
Permittee f
Signature: 'x/
Call 6394175 by 7:00 p.m.for an inspeci:,+n th9 next business day.
This pern,lt card shall be kept in a conspicuous plane on the job Ote until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
r �w.
Building Permit Applicati®n
((''``C'`,�n( Date received: Permit no.:
City of TiTv�rngac .
City of Tigard
Address: 13125 S I a ; Projec�/appl.no.:� Ltxpircdate:
Phone: (503) 639-4171 Date iaaued: By: Receipt no.:
Fax: (503) 598-1960 MAR 0 9 2005 Case file ro.. �Y Payment type:
Land use apprt►ft•V*) 1&2 family:Simp:e Complex:
U 1 &2 family dwelligg or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Addition/alteration/replacement $Tenant improvement U Fire sprinkler/alarm U Other:
NMIW"o1b) dress: Z �bN u�— _ _ Bldg.no.: K_ ISuite no.:9 'f
Black: Subdivisior: Tax map/tax lot/account no.:
Project name: AS
C _ ---�—
Descri ton d location of work on pmmises/special conditions: �!M�17 /JClf1 D Wit 5 /Vek) WSZ&Ld
4- r V
Name: U y_p littltt5 k4,rwt
Mailin address: 0Z U) I Nt aS I&2 fondly dwellIeV
t
City: H HIstatez aluation of work........................................ S
Phone: -S V'- ax: bI-1j -mail: No.of bedroomstbaths.................................
Owner's representative: At, deij�_ S _ Total number of floors.................................
"Name:
Fax: E-mail: Ncw dwelling area(sq.ft.) ..........................
dullilwya Garage/carport area(sq.ft.).........................
Covered porch area(sq.ft.).........................
—vDeck area(sq.ft.)
Mailing address: ........................................
City: State: ZIP: Other structure area(sq.ft). _
Phone: Fax: E-mail: Commercial/indrfriallio lt6-ta>mBy:
Valuation of work........................................ $ Q
Business name: U t J TExisting bldg.area(sq.R.) .......................... �
AddresS.-PD. onif k7 V
New bldg.area(sq.ft.)................................ _
City: u State: ZIP: p t Number of stories........................................ �
Phone:0 3as _ Fax: _ mail: Type of construction....................................
CCB no.: - Occupancy group(s): Existing:
New:
City/metro lie.no.: No—lice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in We
Address: `—— jurisdiction where irk is being performed.If the applicant is
L City: State: ZIP: exempt from licensing,the following reason applies:
Contact person: — Plan no.: _ —
Phone: r;"- Email: --
�* .
J
m Name: Contact person: Fees due upon application ...........................$
( Address: Date received:
_j City: State: ZIP: _ Amount received ......................................... $
Phone: Fax: I E-mail: V Plcasc refer to fee schedule.
I hereby certify I have read and examined this application anti the Nat all Odukikm accept crr&t cart*,pleme am rtrisdktlnn for mote Information.
attached checklist.All provisions of laws and ordinances govt ming this o Visa U MasterC■rd
work will be complied wi whethers cified herein or not. Cmdlt cmd nomhrr-
P.x res
Authorized signature: J, Date: 3' Nww of cudhotder u Om"on ctMft card
Print name: Z U 1 w k06-e i/ -- — S
_Cedholder rlputore AnaaM r
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. mo-*13(e tacaM)
At
Commercial Plan Submittal
Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL
(Includes New, / dd tions b!` 41tet2l
Site Work 4
(must Include location o4 all accessible pa Ring)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3*'
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
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N Pian review is dependent upon submittal of a completed application fnd plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
is Washington County, and Tualatin Valley Fire & Rescue).
c7
J
*For over-the-counter commercial tenant improvements, submit 2 sets of plans.
**"New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
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CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: P 14/200 -00095
13125 SW Hall Blvd.,Tigard, OR 97223 503-639-4171 DATE ISSUED:PARCEL: 1 S 13 1513 005
4AA-01800
SITE ADDRESS: 10220 SW NIMBUS AVE K-2 ZONING: I-P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: 002 JURISDICTION: TIG
Project Description: Replacement fixtures
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: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ROBINSON, CONSTANCE A + Description Date Amount
ROBINSON, LYNN + BELL, KAY ET
BY INSIGNIA COMMERCIAL GROUP [PLUMB] Permit Fee 3114/2005 $72.50
BEAVERTON, OR 97008 ITAX]8%State Surcharl 3/14/2005 $5.80
Phore: Total $78.30
Contractor:
BEAVERTON PLUMBING INC
13980 SW TUALATIN VALLEY HWY REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97005
Phone: 641-7619
Reg#: LIC 128892
PLM 34-4PB
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Fu This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
0 and all other applicable laws. All work will be done in accordance with approved plans. This permit Gill expire if work is
Lu 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 952-0001.0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503-246 9 or 1-800-332-2,14y ��
Issued By: ��u�.. _ Permittee Slgriature: ;i:- c--- _-
Call 503-639.4175 by 7:00 a.m.for an inspection that business day.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans am required on the job site at the time of each Inspection.
Plumbing Pe lication
City of Tigard if 1?ate receive) /t Permit
Address: 13123 SW Hall Blvd,I*M,OR 9 Sewer permit no.: Buildin77---7
City-f nga►d Phone- (503) 639A 171 /111' Pmject/appl.no.: Expire
Fax: (503) 598-1960 CI I Y Date issued: B
UI ilV
Land use approval: F3UIIDING Case rile no. Payme
U 1 At:2 family dwelling or accessory U Commercial/industrial U Multi-family Wfenant improvement
U New construction U Addition/alteration/replacement U I-ood service Cl Other:
Job address: C�22G 5,�J. kjus Dose IItN1 dee a. Tolial
BI no. New 1- y o yr
Bldg. _ Suite no.: `- (IocMatles 1N11.for ttraelttttslyeattueetllion)
Tax ma -tax lot/account no.: SFR(1)bath
La: Block: Subdivision. SFR(2)bath -4--
Pr Iml name: - SFR O bath
Cit /count : zip: Eac additional at itc en
Description and location of work on premises: ____ _� S'itetdilNles:
C•dtch basin/area drain
Est.date ofcutnpietionlins ction: D welis/leachline/trench drain
ooti_ng drainfT)-
Manufactured home utilities
Business name: g v�, ;y., he . Manholes
Address: 18G Rain drain connector
StatA ZIP:9 Ano 4- Sanitary sewer(no.lin.A.)
Phone: Email Storm sewer(no.lin.ft.)
CCB no.:017-70'Q Plumb.bus.reg.no: y�y F1 Water service(no.lin.ft.
City/metro BIC,
no.:/fay Fixture orltew:
Contractor's representative sinature- - - Absorption valve
Back flow reventer
Print name: y Dete. o DS Backwater valve
Basins/lavalory
Natne: Clothes washer _
Address: Dishwasher
rinkin fou
4
City: _ State: ;LIP: ntain(.)Ejectors/sump
Phone: Fax: E-mail: Exansion lank
Fixture/sewer cap
Name(print): Floor drains/lloor sinks/hub
Mailing.addrcae � Garbe a is sal
-- Hose bibb
Cil :_ _ State: ZIP: -
-- --- _ _ leemaker
E-
Phone:_ Fax: J - mail: Interceptor/grease trap _--
Owner instRilation/residerrtial maintenance only: The actual installation Primer(s)
will be nude by me or the maintenance and repair made by my regular Roof rain(commercial) L
OIL employee on the property i own as per QRS Chapter 447. Sink(s),
C ( ),basin(s),levs(s) `, I
I- Owner's si nature: Date: Sum - - -
N Tubs/shower/shower pan
Name: Urinal
Address: Watercloset
m Water eater
City: State: ZIP: Other_-� -- -
WPhone: i Fax:_ Email: ota --
J - r
Not Nljsrldlctlees accryN eteda arida,please call jurisdiction for mart{ea+trnntlnn_ Minimum fee..........sees.. S
Notice: This pemi application
U vim p MtugerCard Plan review(at
expires it a ptxrrtit is not obtained
Credit mrd number: _ — within I RO days after it has been State surcharge(R%).... S s
ap{res
Name or c.rdisotear w shown os credit card _. accepted as complete. TOTAI..... .. ........... .... .fi
Cerdboltkr sl�ature Amwrm
440-4616(NOWCOM)
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT 0: ELC2005-00139
'DEVELOPMENT SERVICES DATE ISSUED: 3/11/2005
13125 SW Hall Blvd.,Tigard.OR 97223 (503)6394171 PARCFL: 1S134AA-01800
SITE ADDRESS 10220 SW NIMBUS AVE K-2 ZONING: I-P
SUBDIVISION. SCHOLLS BUSINESS PARK
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: 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 HMI SVC/FDR: 601+amps-1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 6 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >n4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/FDR>-225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ROBINSON,CONSTANCE A+ GUILD ELECTRIC INC
ROBINSON,LYNN+ BELL, KAY ET PO BOX 674
BY INSIGNIA COMMERCIAL GROUP BEAVERTON,OR 97075
B EAVE RTON,OR 97008
Phone: Phone: 503-957-1173
FEES Reg*: L;C 109116
SUP 38685
Description Date Amount ELE C21
IFLPRMT]F.LC Permit 3/11/2005 $86.7
iTAX]8%State Surcharge 3/11/2005 $6.94 REQUIRED ITEMS AND REPORTS
Total $93.69
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and at other applicable laws.
All work will be done in acc;ordanoe with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspends ,teFrrr. ththan 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cen'Ar. Those
riles set forth in ORR 952- 1-0010 through OAR 952-001 0100 You may obtain copies of these rules or direct questions to OUNC at(503)
246 99 or 1 )0-332-2" h
IL Iss d By: Permittee Signature: � ✓&-111— '�t aL__
iK
N —� OWNER INSTALLATION ONLY
The installation is being made on property I own wh',ch is not intended for sale, lease, or rent.
J
m OWNER'S SIGNATURE: _ __--_ DATE:
F3
!a CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: �� �`�_�_ ,!''�1 =` DATE:
LICENSE NO:
Call 6394175 by 7:00pm for an inspection the next business day.
This permit card shall be kept in a conspicuotis place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Electrical Permit Application
-- ---, - Received] � Electrical , Y� /3
RECEIVE oa�8 Ap `�! Sign No
Cit of Tigard
Planning Approal Sign
City g [>ateley: Permit No.:
13125 SW Hall 131vd. Plan Review other
Tigard,Oregon 97223 � � �oo� DOWDY: _ Permit No -
Phone: 503-639-4171 Fax: 1 6 Post-Review Land Use
Date/B : _ Case No..
Internet: www.ci.tigard.or• Contact )uris..
W-A "k 1 1.1 See Page 2 for
24-hour inspection Reques . +G39[ Jk1l Norm/Method: _6 Supplemental information.
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW(PIEiltl ttitkk all Chit gobq
El New construction _ _ 10 Demolition Service over 223 amps- tieshh-care facility
commercial ❑Hazardous location
Addition/al teration/replaccrnentOther: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet.
CATEGORY OF CONSTRUCTION 1&2 family dwellings four or tore residential units in
I &2-Family dwelling Commercial/Industrial ❑System over 630 volts nominal one structure
❑Building over three stories ❑Feeders,400 amps or more
Accessory Building _ Multi-Family ❑Occupant load over 99 persons ❑Manufactured structures or RV park
Master Builder Other: ❑Fgressnighting plan ❑Other:
JOB SITE INFORMATION oy2d LOCATION Submit__Acts of plans with any of the above.
The above are not applicable to tem ra construction service.
Job site address: J 1 r
Suite#: L Bld ./A t.#: - Number of las lectioas per pcrmit allowed
Aro ect Nam : Desert tion ----�— Qty Pone(ea.) Tour
--�---- - -" New residentla"ingle or multi-family per
Cross street/Directions to job site: dwelling unit.Includes attached garage.
Service Included:
1000 s9,ft.or less 145.15 4
Each additional 500 sq.ft.or portion thereof 33.40 1
Subdivision: _ Lot#:
Limited ener residential 75.00 2
Limited ener ,non rmidential _ 75.00 2
Jax map/parcel #: Gch manufactured home or modular dwelling
_
DESCRIPTION OF WORK service and/or feeder 90.90 2
��j Services or feeders-Installation,
✓'R/ T� �(� 15r / r u, alteration or relocation:
L! 'A 1 ' ,d -- 200 amps leas 80.30 2
WilW 201 am to to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
'OWNER TENANT 601 amps to 1000 amps 240.60 2
-- Over 1000 amps or vola 454.65 2
Name: C 4/ Nv k+a Reconnect my - 66-85 z
Address: W w �e 1'3 Temporary services or feeders-Installation,
City/State/Zip: Y _ _ 21teration,or 00 amps or lessalnsatlon:
".85 !
Phone:X03-5-9 Sr-'?qko Fax:,!5-03 5 q�f- 'V' - 201 amps to 400 amps 100.30 2
APPLI T CONTACTPERSON 401 to 600 am 133.75 2
Branch circuits-new,alteration,or
Name: C pq's extension per panel:
-- A.Fee for branch circuits with purchase of
Address: til �__� service or feeder fee,each branch circuit 6.65 _ 2
City/State/Zip: B.Fee for branch circuits without purchase of
- — Fax:
service or feeder fret branch circuit 46.85 2
Phone: � Fax: Each additional bootchh circuit � Ln 6.65 2
i E-mail: Misc.(Servicc or feeder not included)
a �J CONTRACTOR Each pump or irri tion circle _ 53.40 2
Each sip or outline lighting _ 53.40 2
J ppt/ Signal circuit(q)or a limited energy panel,
b NO: —
SName: ! — alteration,or extension Page 2 2
Bb No:usinc2
ikscription: -----
? Address:
" Each additional ins rctlon over the allowable In any of the above:
Clt State/Zip:OnqvevI�vv Per inspection per hour min.I hour) 62.50
t7 Phone: 5 - / Z) Fax: /- s ?�- Investigation fee: _
CCB Lic. #: I Lie. #: other -
Y:
.wm -
Supervising electricia �• _ Subtotal $
signature required: ?-� /0-/•O3 Plan Review 25%of Permit FeeL S
Print Name: e Lic. #: g $' $ State Surcharge(8%of Permit Fee S
TOTAL PERMIT'FEE S -st.
Atilt rued Notice: This permit
%«/1J ✓'� .- c'�-'�-/JS application expires If a permit Is not obtained within
Signature: Date:_-- 180 days after It has been accepted as complete.
O(ftee methodology set by Tri-County Building industry Service Board.
/` (/l ►tel `(�5 Gf/ l
(Please print name) ,�0 3 •• J 73-
is\Dsts\Permit Forms\ElcPerrmtApp.doc 01/03
Electrical Permit Application -City of Tigard
Page 2 - Supplemental Information ;
LIMITED ENERGY PERMIT FEES:
RESIDEN'T'IAL WORK ONLY: _
Fee for aff systems........................................................... $75.00
Check Type of Work Involved:
ElAudio and Stereo Systems*
Burglar Alarm
�J
Garage Door Opener*
ElHeating,Ventilation and Air Conditioning System*
EJVacuum Systems*
DOther - ---
c�
t
('OMMERCIAL WORK ONLY:
Fee for fain system.......................................................... $75.00
(SI-T.OAR 916-260-260)
['heck Type of Work Involved:
.Audio and Stereo Systems
(� Boiler Controls
I� Clock Systems
flatn Telecommunication Installation
Firc \term Installation
HVAC
EjInstrumentation
ElIntercom and Paging Systems
ElLandscape Irrigation Control*
Medical
IL [--j Nurse Calls
H El Outdoor Landscopc Lightitfg*
N
Protective Signaling
OD E] Other _!
F _ Number of Systems
J
* No licenses are required. Licenses are required for all
other installations
e �
i:\Dsts\Permit Fortns\ElcPerrnitAppPg2.doc 1)1/03
CITY OF TIGARrD
BUILDING'-DIVISION PERMIT#: ELR2005-00046
13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 3/9/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/1/2006 TIME: 7:10M PAGE: 79
SITE ADDRESS: 10220 SW NIMBUS AVE K-2 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUEANESS CENTER L.)'T C 002 'TYPE OF USE:
PROJECT NAME: CASHCO
DESCRIPTION: nata telecommunication.
OWNER: ROBINSON, CONSTANCE A+, PHONE #:
CONTRACTOR- CUSTOM TFA.COM PHONE N: 503.51 7500
Inspection Request. Scheduled For: Date: 4/1/2005 Pour Time:
Code # ispection Description Confirm # Contact # Message
135 !nw voltwr 00349801 503-518117500 N
Corrections/Comments/Instructions:
Lx
I r
IL
U)
m
w
PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL _ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ` Q Phone #: (503) 718-