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10520 SW NORTH DAKOTA STREET IS ViONVO HIHON MS MU i i �n Q H- oc �v Q � z w J u� O N Ln O 10520 SW NORTH DAKOTA ST CITY O TIGARD ELECTRICAL PERMIT ,IVDEVELOPMENT SERVICES PERMIT #: ELC98-0074 JIM 13125 SW Hall Blvd.. T7gard,OR 97223 (503)639-4171 DATE ISSUED: 0c:17/98 PARCEL: 1S134DP-03300 SITE ADDRESS. . . : 10520 SW NORTH DAKOTA ST SUBDIVISION. . . . : ZONING:R-12 BLOCI;. . LOT. . . JURISDICTION: TIG Project Description: Street Lighting for subdivision -------•- ---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- ------MISCELLANEOUS----- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . .. . . , : 0 PUMP/IRRIGATION. . . . s 0 EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT I__INE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 MANE. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL (10) . . . : 0 ----SERVICE/FEEDER----- -----BRANCH CIRCU'iTS----- ----ADD' L INSPECTIONS---- 0 - 200 amp. . . . . . : 1 W/SERVICE OR FEE.IER: 3 PER INSPECTION. . . . . : 0 201 - 400 amp. . . . . . : 0 1 st W/O SRVC OR F-DR. : 0 PER HOUR. . . . . . . . . . . : 0 401 -- 600 amp. . . . . . : 0 EA ADD' L BRNCH C IRC: 0 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 ------- -------- --F'LaN REVIEW SECTION---------------- 10e0+ amp/volt. . . . . : 0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: ----------------------------------------------------- FEES ----._----•-------_•- BEACON HOMES, INC. type amount by date recpt 9500 S. W. 1.25TH AVENUE PRMT t 75. 00 JDA 02/17/98 98-303340 BEAVERTON OR 97005 5PCT $ 3. 75 JDA 02/17/98 98-.03340 Phone #: Contractor: ---------------------------------------------------------------- R. J. ROUSE ELECTRIC, INC $ 78. 75 TOTAL 16285 SW 85TH #407 ------- REQUIRED INSPECTIONS ---- - TIGARD OR 97221 Rough-in Elect' l Service Phone #: 503-639-5996 Underground Cove Elect' l Final Reg #. . : 90454 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. his permit mill expire if work is not started within 189 days of issuance, or if work is suspended for more than 189 &jys. ATTENTIOM: Oregon law requires you to follow the rules adopted by the Oregon Utility notification Center. Those rules are set forth in OAR 952-91-0919 through MR 952-01-1987. You may obtain a copy of these rules or direct questions to by calling (593)216-1987. Q Permittee Signature: Issued By:� F- N r - _ -------- ---------------- -OWNFR INSTALLATION ONLY— ----------------------- C� The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER' S SIGNATURE: -C� C DATEi UAJ _------------------------CONTRACTOR INSTALLATION ONLY---------------------------- SIGNATURE OF SUPR. ELEC' N: _ ._ DATE: LICENSE NO: +++++*++++++++++++++•*++++++++++++++++i•i-f.+++++++++++++++++++++++++++++++++++++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next business day +++++i•+++++++++++++++++++++++++++-F+++++++++++++++++++++++-F+++++++++++++++++++++ Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Halt Blvd. Tigard, OR 97223 Permit # LC $ ~QQ 1� _ Date Issued et Phone(503)5394171 `'T CRY OF TIGARD FAX (503)684-7297 TDD No. (503)684-2772 Inspection (S03)539-4175 1. Job Address:rel,) 4. Complete Fac Schedule Below.- Name elow.Name of JDevelopment 06!kU r7�—�(✓�Qa �F�J ru1�110'l�ivwj Number of InspectionsInspections �per penallowled rift J /icy 1 (/(A fL, ) f O! Service inclutist Items casino) sum cityisatwzlp-- 1 iuo."-'d 4a. ReNdsndal -per unit 1000 sq.R.r wesl lnoo 4 Name(or name of business) Q k Z • CAMen.r,.I„e 04.R W sum CammeraFal ❑ ( ❑ b ^ •vr m fMAo 2 2a. Contractor installation only. u` ' i` r` I 1 4b.Servicse or Feeders dectrigl ntrsetor rCO (. Yluraraa�aa. «wbare.n "moo U U 2 Address ftooa Mo0 2 cityLL $I== ____ 2 Phone N - '' ^� t"�'r»oo "a m � 2 Job NO. 7cl � .al.ow on ms«ren —� st�oao : contractor's knine NO. A 0 11. fall 98 4e.Temporary Services or Feeders Contractor's Board Reg. NO.. y$ histtsrlec 1 or, M, , Slgnahlre of Supr. Elez n 2W ewe«sr.. 2 MV are,.on 4W..o. sso.00 2 license No. l L/ Phone No. - 401 on"a coo inti. �� moo -- 2 MO 371 - 46 or«IW aw I. o raft 111WOO ------ 2b. For owner Installations. 4d.erandl crncuft Print Owners Name _ Now,w.M%.or Were v«aw» Address .►no be w M.nm eiou t war City Sate_ 23p lifers of M-0..or ft~Am 2 Phone No. EA*�W%ft arena 3 woo (S.U U N IM w 1W Wm lr eraft wlsse■e The irtstallation is being made on property I own which is A of ew%fts or tinea wft 2 sro�Nr not intended for sale. lease or rent RM CNN ftWtA tgllao 2 sfoo Owrrsrs Signmwm 4e AdoeOwoua (Service 0r beth not Wckxbm 3. Plan Review section (if rlequireo: Em"ptsm or 6 6WM (*doSAMOo 2 Q. Early so or a0he 11000 Sam 2 lx PhNne d»ch appropriate Iters and sign las in section So, ager"cra ra "ar a«Mew a+nar � per.l.ewetlen ts.rrbr trea00 N 4 or mora resi Isr,dial wilt in ane stnraum Mnor Lose.(101 Service and seeder 225 amps or mors System over 600 vofts normal 0.Each adeffidn el hsspectim aver _J Ciasseted area or$&UC M aonftinrrrg spatted occupancy the allovwble in any of the above as drsobed in N.E.C. Chapter 5 Pty i ijiean t�.ao W Per noir MOO LUSubmit 2 soft of plana with s"Wocation what a arty of the above In vire s apply. Not rseluhed for teelpm ry constmiction servloss Jr. Fees: NOTICE sae Ender tctat of above foes = --75 00 S%Swdw" (.05 X loW is") PERMITS BECOME V'O(D IF WORK OR CONSTRUCTION subftEnter w d Ins A for $ W AUTHORIZED IS NOT COMMENCED THIN 160 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Pian Revises/ am* (Seem S __ A PEFUM OF 180 DAPS AT ANY TGIF AFTER W ORI(IS SubeAd : COMMENCED. ..+...w.. ❑ That Amu t# fpft . S Balance Due S Q I CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-4171 Date Requested: — 3 -30 -91? AM. P.M. msr I,ocation -�1 `✓'2D - Tenant: n Suite. Bldg: _ MEC:_ Contractor: K Q p_. Phone: h 39 "5� PLM: Owner: _ ELC: 7 -- _ ELR:_r. _ sm _ BUILDING _ 1LDG(con's) PI,ITMBING MECHANICAL_ LECTRIC Srm Site Post/Bea n D'ost/Heam Post/Heam Cover.. ,e Sewer/Stotm Footing Roof UndFI/Slab Rough-in Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UO3 Sprinkler Foundation Insulation Sewer Hood/Duct Re conrmt Vault Hsmt Damp Drywall Storm Hutu Temp Service MLSC. Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Beat Pump Low Volt _ Approved Aplxovecl Approved �- nprov Approved Appr/Sdwlk Not.Approved Not/Approved Not Appmved ved Not Approval FINAL FINAL FINAL FINA FINAL goo a m W O Call for mirspection 11 Reinspection fee of S__ required beton,next inspection D7 Unable to inspect Inspector: �_ Date: . _.= lip_. 9P Page of CITY OF TIGARD DEVELOPMENT SERVICES RESTRICTED 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639. 171 REST R I ELECTRICAL. PERMIT — RCTED ENERGY PERMIT #: ELR98-0196 DATE ISSUED: 07/28/98 PARCEL: iS134DA--03400 SITE ADDRESS. . . : 10250 SW NORTH DAKOTA ST SUBD.'.VISION. . . . : ZONING:R-12 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . JURISDICTN: TIG Project Description a Installation of protective signaling system. 1183-11151-04) ------------------------------------------------------------------------------------ A. RESIDENTIAL--------- B. COMMERCIAL-------------------------------------- AUDIO & STEREO. . . : AUDIO & STEREO. . : INTERCOM & PAOING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : LANDSCAPE/IRRIGAT. . t GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL. . . . . . . . . . . . . HVAC. . . . . . . . . . . . . : DATA/TELE COMM. . : NURSE CALLS. . . . . . . . : VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE: OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . :X INSTRUMENTATION. : OTHER. . : : : 'TOTAL # OF SYSTEMS: 1 Owner: --------------------.----------------------------- --- FEES ---------------- BRITISH STEEL ALLOYS type amc.unt by date r-ecpt 10250 SW NORTH DAKOTA ST PRMT t 40. 00 DEB 07/28/98 98-307747 TIGARD OR 97223 5PCT f 2. 00 DEB 07/28/98 98--307747 Phone #: 620-8810 Contractor; ____.----------------------------.________._.____—__--.----___-- ADT SECURITY ALARMS $ 42. 00 TOTAL_ 703 NE HANCOCK ------ REOUIRED INSPECTIONS ------- PORTLAND OR 97212 Ceiling Cover Low Voltage Insp Phone #: 284-3265 Wall Cover Elect' l Final Reg #. . : 000599 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Cedes and all other applicable laws. All work will be 0+_ne in accordance with approved plans. This permit will expirp if work is not started within 181 days of issuance, or if work is suspended for sore than 188 days. ATTENTION: Oregon law requires you to follow rule adopted by the Oregon Utility Notification Cent.-- rtose rules are set forth in OAR %2-01-WO through OAR %P X11- 181. You say obtain copies of these rules)w-Ti-fftt questions to OUNC at 1583)2WI987. 0. Iss�_�ed by . QD&, �Q Permittee Signature rK INSTALLATION ONLY----------_------ ______________-- The installation is being made on property I own which is not intended for sale, lease, or rent. m OWNER' S SIGNATURE: DATEt W ----------------------------CONTRACTOR INSTALLATION ONLY---------------------------- J SIGNATURE OF SUPR. ELEC' N: DATE: LICENSE NO: ++++++++++++.....++++++++++++++++++++++++++.+++++++++++++++++++++++++++4.....++++ Call 639-4175 by 7:00 P. M. for an inspection needed the next business day ++++++++++++.......... .....t+++t+tt++++t+++t+.....tt+++.........+++++•1......... CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:Qajo A'�f' .3125 3W HALL BLVD /� r 19GARD OR 97223 % ii.J, 7 O 9 S R TYPE Date Recd s-9 >r- _ 0671A�T v 7 V-503-639-4171X304 a$3 U�Ll 1 - 'f Permit# 1ft'4e,9[r-010 F-503-684-7297 INComPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd: WILL NOT BE ACCEPTED Name of Development Project TYPE OF WORK INVOLVED- RESIDENTIAL ONLY Restricted Energy Fee........................................ $40.00 (FOR ALL SYSTE%AS) JOB Street Address Ste A Check Type of Work Involved: ADDRESS U _�v S CL) cawslate / Zi Ph ng 3 wer Audio and Stereo Systems Na (� C E] Burglar Alarm l-/ L_J OWNER Mailing Address Garage Door Opener' City/Slate - Zip Phone fr Heating,Ventilation and Air Conditioning System' -- • � Vacuum Systems' Name Apt SECURI?Y SR�S�f 9 � Other1UXLHAW CONTRACTOR Mailing AddrIp71AND,OR 97212 _ TYPE OF WORK INVOLVED-COMMERCIAL.ONLY 003)J-3265 (Prior to issuance a City/State Zip Phone 0 Fee for each system............................................ $40.00 copy of all licenses (SEE OAR 918-260-260) are required if Oregon Contr.Brd Lic.* Exp.Dale expired in C T //v Check Type of Work Involved data base). Electrical Contr.Lir„0 Exp.Date ^ (P-1;X0 E] Audio and Stereo Systems C.O.T.or Metro Lic.0 Exp.Date Boiler Controls Owner's Name Clock Systems OWNER- Mailing Address APPLICANT Data Telecommunication Installation City/State Zip Phone# O Fire Alarm Installation This permit is issued under OAE 918-320-370.This applicant agrees to make only restricted energy installations(100 volt amps or less)under this ❑ HVAC permit and to do the following 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; 2. Call for inspections when installation under this permit are ready for Landscape Irrigation Control* inspection at 803-639-4176; Medical 3 Purchase separate permits for all installations that aro not ready for an Nurse Cells inspection when the inspector is out to inspect under this permit; � d. Assume responsibility for assuring that all corrections required by the Outdoor Landsnape Lighting' inspector are done,and; Protective Signaling 5. Assume responsibility for calling for a final Inspection when all of the F" corrections are completed. Other P Permits are non-transferable and non-refundable and expire if work Is not ;;J started within 180 days of Issuance or if work is suspended for 180 days. Number of Systems W J The person signing for this permit must be the applicant or it person No licenses are required Licenses are required for all other installationo authorized to bind the applicant. ` t FEES J/�v L� - Signature ENTER FEES n -- 5%SURCHARGE(.05 X TOTAL ABOVE) $ o' r Authority if other than Applicant TOTAL $ &2 i Asts1resele doc 7197 _. _ 0 N1PAiCE 10643 N.E. Simpson I Pcrtknd. Oregon 97220 + i Now krOd►-yorn &AR Conpk/s AmrwkfIln08yeAsrw w��sr�rp.�iw`w� ��,;e+.����• M W&Gft wer�l I fho4efisMfa �a twwia rww0w =s•aa =ww 8q+sclw*CtasrAq t Eevosrsilrq s`enp RldMnweA Conwucdon Ent.,baa, (543) 253-7687 1AL rAMkXftr P.O.a -- Daft_ I I� �-- BOno Name 1;X::j,nr.#.ram nrA _ Addmu PU 4UX 'l6U Job Sl%t her�ood Urt Zip Coda 97140 I Ordered SY Brandon phone#625-6852 Cale 11/10/91 � ,oe Loaaon_, 1i520 Jw north Dakota vc, �p Tigard, (w s..t , e4 Greenbur6 Rd. ) 8arvbe Gk { Labor- Pumpino__eu)ILe—oaf C MISC rAndllkms of tanW[)Intrlbu W Box____ _ TOTAL O."HAFOM 2-26 I Envkodsw M In no way i s- 61- rsr i r4 to sr sspoa tank at of an Mn symwn. TERMS;W 14 d"s.l•IAM pw mono wN be ohrgpd a1 pea vers sosoun1s.11g%pw ajw ee I CAmftrvw's S"turo; 4 �'CYA4"lll A AW-7 i 1 Service Ortver's Slonaturo Tkna DsM I TERMS AND CONO[TMIS REVERSE Noe REDEEMABLE IN WATNOMAH AOLWW + Z0 39Vd 'ONI 9NI O"INOO SA9 9vzz9Z9E89 8t :'7T 866T/98/88 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639.4171 BUP , Date Requested !� �i y AM _PINI BLD Location--/6 % uite , MEC Contact Person .4� Ph S,��{- `1 77 PLM _ Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing [Access: Foundation FPS Fig Drain Crawl Grain ection Notes: SGN ---- ---- Slab SIT Post$Beam —_ / - - �---- Ext Sheath/Shear - Int Sheath/Shear Framing �- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm i �,, Susp'd Ceiling - �' Sr-� �. Lf�� &WS 6Eti t-u ti►r/�yf� Roof Final PAS -'PART FAIL MBING Post$Beam Under Slab Top Out — Water Service Sanitary Sewer - Rain Drains Final ---- --- ---- - _.. PASS PART FAIL - MECHANICAL Post&Beam - - ---- ---_.. Rough In Gas Line ----- -- Smoke Dampers Final PASS PART FAIL ELECTRICAL — Service Rough In --- -- -----. -_� _� _ UG/Slab -- Low Voltage Fire Alarm ___--`- Final PASS PART FAIL SITE _ Backfill/Grading —.--- Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City ball, 13125 SW Nall Blvd Catch Basin Please call for reinspection RE Fire Supply Line [ J p - [ J Unable to inspect-no access ADA Approach/Sidewalk Other Date 8`•� ���V Inspector Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site. CITY OF TIGARD DEVELOPMENT SERVICEES BUTI. DING PERMIT 13125 SW Hall Blvd.,Tlprd,OR 97223 (503)6394171 PERMIT 0. . . „ . . . : 13LJF'':7-4'.'- .':W' DATE' ISSUFD: 11 /06/97 POOR QUALITY ORIGINAL PARt'EL: 1 S 134DA -03300! ITC riDDRESG. . . : 1415T! 5WpN. � 1.113DIVIRION. . . . : ZONING:R.. 1 ' t1CK. . . . . . . . . . . t.OT. . . . . . . . . . . . . c JURI0DICTTON:TIt3 T.S��`LIF: FLOOR AI?CAS•_ . .......... .. - - EXTERTOR WALL. CONSTRUCTION-- �_.ASS OF WORK.O.-DEM, FIRST. . . . : 0 s f N: 94 E; W YPC QF !jsr-. . . t Cr" SECOND. . . : 0 r f PROTECT OPENINGS"_... vPF OF CONST. :5N . , . : 0 s f N: S. F: Wo 'CUP(INrY GRP. :R3 TOTAL- - 0 s f R0f71= CONST s FIRE RET" ^CIJPANCY LDAD; 0 BASEWNT. ; 0 rf ARFA SEP. RATED: ''']R. : Ql iJT: 0 ft; Gf1f1AGI'. . . : 0 ;f cJCCU SEP. RATED "IM`1 . MEZZ7' : REDID SETBACKS_._____._ .. REQIJIRED _..__.___.____. ... . _..-_ ._. .D^'? L=). . . . : 0 p s f LEFT: 0 f t R HT: 0 f f, f-I R SP14L_. SMOV, DET„ . AFI._LING IJNITSs 0 FRNTs 0 ft REAR: 0 ft FIR AL.RM: HNDICP PCC: '-DRMS. 0 PATHS% 0 IMP WRF'ACE: 0 PRO CARR: PARYTNG: 0 "1LL1E. $ : 0 m a r k s : Desolition of existing single fasily residenee. All debris to be loved. Septic tank to be puepe:, filled t itspected, "ACON POMES type c+molant by date recpt 500 SW 125TH AVE & PRMT f 25. 00 GED 11/06/07 37 -30074P 'A'JE'RThN 0R 97000 If 5t1CT $ 1. 25 GEO 11/06/97 97- 30071ie csp ER[Is s '-6. 00 GECI 11/06/97 97—.;32!0740 ,one 1b: 5 )4.. 199969 ERPC t Et. 45 f3F O 1 1/0fsl`77 ';3`'-aP0►''4C FRPr t 8. 45 CEO 11 /OE,/97 97-30071,Q* ;ilt 1"dC tQr VA 'ACJON HOMES O ':;4371 aW 125T!! 9y�/ "AVEF2TDN DR 7702A 524 1919 9 69. 15 TOT Pr 11. „ s 000707 _ _. ....____.. RF-'(;+!ITRF'D. TNspE rTrm—, s persit is issue subject to the regulations contained in the _ _ _ yard M;nicipal Code, State of Ore. Specialty Codes and all other _ ,o�?.�._ � I�7 �Y�L a iplicable laws. All work hill be done in accordance with DC Jiro►ed plans. 'his persit will expire if wore is not started N hair 182 days of issuance, or i` work is suspended for tare an 180 days. ATTENTION: Oregon law requires you to fellow the /NnOnZ _ les adopted by the Oregon Utility Notification Center. Those 7&% its are set forth in OAR 952-081-8810 through BAR 95 . 2-48181987. _[�1� cavy obtain a rcpt of thete rules r direct questions to C'JNC W calling (5011246-1387. /L risitkec SiyTItatI.irdd6 ••I-+++ 4-+++4 f+++++4-+++•e•++•-1-++••f-++++ F•+•4-4-++4++++4 e+++4-+4-4 4 a 4+A i +4 t.4.4.++F+4++ C 11 C_3T. 'a i '� b j 7s00 p. m" Far- An i.Tlspwctimi needed the tiny #-+4ff.4-+-f +4 +++ - -.� - ._':".--`•W�irriw.rrrra+....rrr��.�r■iri�rr ' CITY OF TIGARD Commercial Building Permit R.cd ey -� 13125 SW HALL BLVD. New Construction and Additions Date Recd TIGARD, OR 97223 Date to P.E.Date to DST (503) 639-4171 Permit s /7l ti`'/ Print or Type Related SWR a Incomplete or illegible applications will not be accepted called Name of Development/Prood Existing Building ❑ New Building❑ Job DAKOTA MEADOWS Address Street Address Suite Building 10520 SW N. Dako f a Data Bldgs City/State zip Existing Use of Building or Property: Tigard, OR 97.223 Name rProperty BEACON HOMES, INC. Proposed Use of Building or Property: Owner Mailing Address Suite 9500 SW 125th Avenue No. Of Stories: City/Slate zip Phone Beaverton, 970081524-1999 Sq. Ft. Of Project: Occupant Name Occupancy Class(es) Name Contractor BEACON HOMES, INC. Type(s)of Construction Prior to peg•, - Moiling Address Suite _ Issuance,a corny 9500 SW 125th Avenue Will this project have a Fire Suppression System? of all licensee _ Yes [1 No are required if city/state zip Phone Americans with Disabilities Act ADA explredmC.or. Beaverton, 97008 9124-1999 (ADA) database Valuation X 25 0�,=S _Participation Oregon Const.Cont.Board Lir,.! Exp.Date Complete Access ility Form JU 7 11P Project Project $ Name Valuation Architect Mailing Address Suite Plans Required: See Matrix for number of sets to submit on back City/Slate Zip Phone - I hereby acknowledge that I have read this application,that the information Name given Is correct,that I am the owner or authorized agent of the owner,and Engineer that plans submitted are In compliance with Oregon State Laws. Meiling Address Suite Signature o er/Age Dat - IL City+State zip Phone Contact Person N Phone Peter Kusyk I� 524-1999 _y Indicate type of work: New O Addition O Demolition o FOR OFFICE USE ONLY Accessory Structure O Foundation Only O Alteration O Prn c --- J _ Repair O Other O Ma o Land Use: lescriptlon or work: ,J DEMOLITION TIF: Parks: Estimated 0 of Employees Note: Site Work Permit Application must precede or accompany Building Permit Appllcatron I:ICOMNEW.LIOC (DST) M7 COMMERCIAL PIAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST EXAMINERS (Nobe a.) TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 -- -- 3 0,0,u) -- -- B (New or Add) 1 1 -- -- 3 (j,o,w) -- -- F (New or Add or Alt.) 3 3 -- -- (j,o,) M (New or Add. or Alt) 1 1 -- -- 20,o) -- -- B & M (New or Add) 1 1 -- - 3 6,o,w) -- -- P (New, Add. or Alt) 2 2 -- -- 20,o) -- B& M& P (New or Add.) 2 1 1 -- 3 O,o,w) 20,o) -- E (New, Add, or Alt) 2 -- - 2 -- -- 26,o) B & M & P & E (New, Add) 3 1 1 3 O,o,w) 20,o) 20,o) B or B &M (Alt) 1 (j,n} -. B &M&P(Alt) 3 1 - 2 2 (ho) 26,o) B&:M&.,P E(Alt) 3 1 1 2 (i,o) 2(f,o) 17U > ) NOTE-So KEY: a. Before returning to DST, Plans examiner ets appropriate j =Job B = BUP number of revised plans from applicant, tamps and completes, o-Office M =MEC updates and adds actions. f= Fire P = PLM u=USA E=ELC h "Shaded area^'desir► ite ,''°'�# � w= Wash. Coun F =FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. 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