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10565 SW NIMBUS AVENUE STE 100-2 001 3AV SfIRWIN AAS 59SOI 1 g N Q oc: � 10565 SW NIMBUS AVE 100 CITY OF TI G A R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT 1f: BUP2004-00244 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 5/26/2004 PARCEL: 1 S134AD-06200 ZONING: I-P JURISDICTION: TIG SITE ADDRESS: 10565 SW NIMBUS AVE 100 SUBDIVISION: SCHOI_LS BUSINESS PARK BLOCK: LOT: CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 147 TENANT NAME: INOVISE MEDICAL REMARKS: TI:New walls for office space. Owner: _ ROBINSON,CONSTANCE A f * ROBINSON, LYNN+ BELL, KAY ET BYINSIGNIACOMMERCIAL GROUP B Phone TC1069 97008 Contractor: NORWEST GENERAL CONTRACTORS INC PO BOX 25305 PORTLAND, OR 97298-0305 Phone: 503-291-6986 Reg M: LIC 89425 IL a m ui This Certificate issued 7/16/2004 grants occupancy of the above referenced -� building o portion thereof and confirms that the building has been inspected for co " e with a Stat f Oregon Specialty Codes for the group., occupancy, nd s under w is a need permit wa isu d. J BU(L NG INSPECTO BUII_DI Offici L POST IN CONSPICUOUS PLACE r CITY OF TIGARD 24-Hour BUILDING 0 inspection Line: (503)631"175 INSPECTION DIVISION Business Line: (503)639-4171MST Received - Date Requested_ -7 - ___ AM PM kle—fo 8UP Location z C,, �,��4.C� -Suite�d�_ MEG Contact Person Ph(_ _) /O -3_ PLM Con tors Ph SWR — DINO _ Tenant/Owner — ELC — Footing - ELC Foundation Access- Ftg Drain ' ELR -_ Crawl Drain �e � -- Slab Inspection Notes: SIT Post S Beam Shear Anchors - ----Y--------- Ext Sheath/Shear _ Int Shoath/Shear ^- Framing - - ------- - ------- Insulation Drywall Nailing --- - Firewall Fire Sprinkler - - - Fire Alarm Susp'd Ceiling - -- - -- -- Roof &.r.r Ot PASS ART FAIL - - ING _ Post 8 Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains - - — - - Catch Basin/Manhole Storm Drain - - Shower Pan Other: - - Final —PASS PART FAIL ----------.--------- ----- ----------.- MECHANICAL _ Post&Beam Rough-In - 0. Gas Line Smoke Dampers - - - - F- Final N PASS PART FAIL - - - -- ELECTRICAL - -� Service - - - -��--_ m Rough-In Lu UG/Slab a - _j Low Voltage - �- Fire Alarm Final u Reinspeo.on tee of E -required before next inspection. Pay at City Hall, 13125 SW Haii Ovd. PASS PART FAIL SITE F] Please call for reinspection RE: -_ Unable to Inspect-no acepsn Fire Supply Line ADA Approech/Sidewalk Do% - ---- Other: Final DO NOT REMOVE thle Im*oetlon record from the job alb►. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING 0 'nspectioo Lino-,(603)639-4175 10 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP Hece'ved ��! ___ ate Requested_ AM_�.__ _ PM __- BLIP —. ------ _._1 Location `5 Z A)(-V-K J LA, suite 1 QM2 — MEPC Contact Person _ Ph( ) !� �3 � _ PLM Contractor Ph( ) SWR — BUILDING_ Tenant/Owner _._- ELC Footing Foundation ELC Ftg Drain Access: ELR .D Crawl Drain Slab Inspection Notes: SIT Post&Beam �- Shear Anchors - - Ext Shaath/Shear Int Sheath/Shear Framing Insulation - Insulation Drywall Nailing --- ----- -- -- Firewall POW � W Fire Sprinkler ---- � Jl�-'`�'� �1� --------- - --_ Firs Alarm Susp'd Ceiling - - - Roof Other: _-^-- Final PASS PART FAIL - PLUMBING Post&Beam Under Slab Rough-In Water Service --- -- ---- - -- Sanitary Sewar Rain Drains Catch Basin/Manhole Storm Drain --- -- - --_ --- - Shower Pan Other: ------ Final - PASS PART FAIL `MECHANICAL Post _-- Post&Beam Rough-In -- 0. Gas Line a Smoke Dampers - -- ------- --- --------- --- --- Final PASS PART FAIL -- m IfECTIF11 v ce Co Rough-In W UG/Slab a Low Voltage _----__-- - _- - Fi larm al LI Reinspection fee of s.__- _required before next inspection. Flay at City Hall, 13125 SW Hall Blvd. S PART FAIL $ N ❑ Please call for reinspedinn RE:__-_ ❑Unab1A to inPr f ct_.no access Fire Supply Line ADAV Appr��ach/Sidewalk per- � D I-ap / R1lt Other: _ Final DA NOT roe from the job frtllte. PASS PART FAIL CITY OF TIGARD 24-Hour , BUILDING ® Inspection Line: (503)6394175 INSPECTION DIVISION Business Line: (503)639-4171 MST -- — ituP Received Date Requested �7 _ �/ AM PM. BUP Location _.__/L' �_L/a MEC -- Contact person ��.x1'�'C/ _— rah( ) X10 -;a 2- PLM Contractor _ Ph( ) — SWR ----- -----_-.--_ BUILDING _ Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR _1 Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors - Ext Sheath/3hear _ Int Sheath/Shear _ - Framing — — -- --- - Insulation Drywall Wailing Firewall ��/�/� Al Fire Sprinkler - Fire Alarm Susp'd Ceiling - --- - -- Roof Other: -- Final PASS PART FAIL --- ---"-" PLUMBING Post&Beam Under Slab Rough-In Water Service --_-.-- Sanitary Sewer Rain Drains -- -- --- --• Catoh Basin/Manhole Storm Drain - -- --- — - Shower Pan Other: - Final PASS PART FAIL -- MECHANICAL Post A Beam Rough-In Gas Line Smoke Dampers Final U) PASS PART FAIL —-- - - r_ ELECTRICAL— - - ^— . I Service - zo- Rough-In to UG/Slab W Low Voltage Fire Alarm W PART FAIL C1 Reinspection fee of$_ __-required before next Insportion, PRy at City Hall, 13125 SW Nall Blvd. I SW Plea-to call for reinspection RE:__ _ _ ^_ �� Unable to Inspect--no access Fire Supply Line ADA / Approach/Sidit#*'c Date-7 �— — IAspeet r b"Vj&_ 9A Other: Final —--�— DO NOT REMOVE thbIneplCl1011 f'De-"ard fieri the J"WNW6 PASS PART FAIL CITY OF TIIGARD 24-Hour BUILDING Inspection Line: (503)63941175 MST INSPECTION DIVISION Business Line: (503)6394171 �r o�-�� OUP _- Recsived _ —_-Date Requested—�-=� ,,AM.�.�:,.,��PM BUP �— Location ----z v- - �f _Suite—Zv MEC Contact Person r V E _. _ Ph(—) 55 C) Z2 PLM �__--_-_-- Contractor, _ — Ph( ) SWR BUILDING Tenant/Owner (, ( ELC Footing ---� ELC _ Foundation Access: / `�/1 �) / Drain EL CFigr Crawl Drain Slab Inspection Notes: SIT Post& Beam Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear - `" ---- - F-aming _ Irn ulation � Dryv.-.iII Nailing �( Fir I 1 ire larm !tng Roof Other:.. - (na � PASS PART FAIL -- — PLUMBING Post 8 Beam Under Slab _. _ Rough.In Water Service Sanitary Sewer Rain Drains --- -- -• _ Catch Basin/Manhole Storm Drain --- -- _ Shower Pan Other: -— - - --- - Final _-------- PASS PART FAIL --� MECHANICAL Post&Beam a Rough-In Gas Line H Smoke DampersCO) Final PASS PART FAIL --- — �_ ELECTRICAL Service Rough-In — UG/S!ab Low Voltage Fie Alarm PASS PART FArL ❑ Reinspection fe of$ req fired before next Inspection. Flay at City Hall, 13125 SW Hall Blvd. SITE [] Please call for reinspection RE: ._ _ :.nable to inspect-no scorn Fire Supply Line ADA Approach/Sidewalk Other: Final RIO NOT REMOVE this Inst olden record ftroilrr, the,fob site. PASS PART FAIL CITY OF TIGARD BUILDING PERMIT _ DEVELOPMENT SERVICES DATE ISSUED: 6/22/2004 002P4 13125 SW Hall Blvd.,Tlaard.OR 97223 (5031639-4171 PARCEL: 1S134AD-06200 SITE ADDRESS: 10565 SW NIMBUS AVE 100 SUBDIVISION: SCHOLLS BUSINESS PARK ZONING: I-P BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _ RECID 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: $ 1,100.00 Remarks: 10 sprinkler heads. Owner: Conti-actor: ROBINSON, CONSTANCE A + AFP SYSTEMS INC ROBINSON, LYNN + BELL, KAY ET 19435 SW 129TH BYINSIGNIA COMMERCIAL GROUP TUALATIN, OR 97062 BF'hone TON,�l§_6 ;09 11 Phone: FAX-692-1186 Reg#: lliOM92-9ggQ7955 33459 _ FEES LIC REQt71RED INSPEI:.TIONS Description Date Amount Sprinkler Rough-In (BUILD] Permit Fee 6/22/2004 $62.50 Sprinkler Final (TAX]R%State Surchari 6/22/2004 $5.00 Total !$67,50 IL a This permit is issued subject to the regulations contained in ±he 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 100 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law QI requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR (9 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. Issued By: Permittee Signature: Call 639.4175 by 7 p.m.for an Inspection the next business day 03:07PM FROWAutomatic Fire Protection 5036 IAG T-599 P 002/004 F-463 BuUftg Permit Application City of Tigard �� [Jatcrcceived: permit no. Ci o 7"r cord Address. 13125 SW Hall Blvd. 223 Proleevappi•na: Expiredtuo ry ! Phonc: (503) 639-4171 iooh D.teluued: SAO Rftc ptno.: Fax: (503) 39&1960 Lasa Bre Zvi T IGS, D Payment type. ,Land use approval: TY OF '� 1&2 family;Simple I Comp K; C�l dt 2 family dwelling or acccasory O Commercial/inth urial O Multi-fancily O New cc usttucdon 0 Demoption 0 Addirion/altmdordreplacement 0 Tenant improvement O Fin sprinkledalarm O 1)cher. tub address: (C) �. � ._._... I Bldg no.: "Suite no.: Lot; I Block: Subdivision: %"0* Tax t i ApItax lot/account no.: ecu name: na Dewripdon and location of work on ptemL%wzpe:cW Gan 'tions _ %�, RaRDlin— Name: Mallin address: 1 i 2 6tatdly drrteBlai� C State: Z1P: Valuation of work........................................ $ Fax: LE-[nail: No.of bedrotxns/b:s a.......... ..........».... . owner's re ^ntative: .. . Total number of floors................................. New dwelling=a,(sq.R) ......................». GzMelcwpott area(sq.ft,)................. ...„ .. Name: r Ulf- Covered porch area(sq.ft.) ......................... Mailing address: i44CDoak area(sq,ft.)......................................... City. _ State: Z)p: 0(n area .ft).._................ ... Phone: '2 ZJ Fax: 4 •11 F.-mail: drathisil/ inti-f■wair Valuatiok,of work.................----._...............:: Exisdn bld ares sq. ) Bminess 3 ti ( ft) ................»...... Addms: New bldg.urs(aq.ft_)............................... Cit) Stane:6(Z ZlF 7 p Number of stories...................................,... �? _ Phone:( Fax:�� •►1 fi-mall: Type of constrxxloo..............._................ CCB no.: X0"13 - icy group(* Existing- City/metro xisting City/metro lic.no.: _ New: Nedw AA eoatrr MN and subcontractors are regtdred to be licensed with the OmSon Cona me tion Con"=bWS Board tinder Nettie: rT, provisions of ORS 701 and tray be required to,be licensed in the Adtfrsas: 171 Jntiadictfon where work is being performed,If the applicant is raw. ZEF,, exempt from hofs-f ins,the fallowing reaxtn lapplies. t Contact n:` Plan Phone: _ -1 Fax: E-mail: Ip"i Name: —� Contact � Fees due upon appliaat4on..__•...................... Address: Due toceived: W Cl State: ZIP: Atntiunt received .................................. .»..:1 Phone: Pax y &mail Please refer to The schedulle. I hereby certify I have read and examined this application arta the N5UM jw" , MW a m&CM-kr0e 4M�_�om 60 attached checklist.All rgvisions of laws end ordinances govemintR this "a o Masta('ard work will be compli th,w er spooilfed trema or sot. CmPM cmd aaab At,thorized e:_ � r e■ are Print name- Notice- _ Notice_Thf t permit apptieatien expiro if n permit is not ebuined within 190 days after It has been accepted as complete; nir n61!(NoatC»1�1 CITY OF TI ARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: F'_R2004-00181 13125 SW Hell Blvd.. Tigard.OR 97223 (503)639-4171 DATE ISSUED: .i/25/2004 SITE ADDRESS: 10565 SW NIMBUS AVE 100 PARCEL 1S134AD-06200 SUBDIVISION: SCHOLL.S BUSINESS PARK 7OW:'00: I-P BLOCK: LOT: JURISDICTION: TIG Protect Description: Low voltage for Voice& Data. A.RESIDENTIAL B.COMMERCIAL _ AUDIO& STEREO: AUDIO&STEREO: INTERCOM $PAGING: BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC. PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TQTAL#OF,SYSTE 1 Owner: Contractor: ROBINSON, CONSTANCE A + TELECOMM MANAGEMENT INC ROBINSON, LYNN + BELL, KAY E'r '15611 PARTRIDGE DR BY INSIGNIA COMMERCIAL GROUP LAKE OSWEGO. OR 97035-3121 BEAVERTON,OR 97008 Phone: Phone: 503-639-9209 Reg#: ELF 3-463CLE LIC 135355 FEES Required Inspections Description Date Amount _ Low Voltage Inspection [ELPRMT]EL.R Permit 6/25/2004 $75.00 Elect`I Final [TAX] 9%State Surcharl 6/25/2004 $13.00 Total . $81.00 Tils Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all• `►ier applicable laws. All work wall be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, ur if work is suspended for more than 180 days. ATTENTION: Oregon law requires -ou to follow Files adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 p, through OAR 952-001-0100. You may obtain copies of these rules or dined question to OUNC at(503)246-6699. ~m Issued by Permittee Signatur OWNER INSTALLATION ONLY m The Installation is being made on property 1 own which Is not Intended for sale, lease, or rent. t� Ul OWNER'S SIGNATURE: _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M.for an Inspection no �ded the next business day Electrical Permit Applicatioq City of Tigard Rcn -300 f1d PernitNO 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev w C7L] Phone, 503.639.4171 Fax: 503.598.!960 Date/B Clttrer Permit: Inspection Line: 503.639.4175 Date Ready/Dy, —�' lurr 0 See Page 2 tor� Internet: fwww.ci.tigard.or.us Notified/Method _ �y Supple Internet: ."�� x�• .ire s : r: _— ❑New construction ❑Addition/alteration/replacement Please check all that apply. ❑Demolition ❑Other: Ej-#ervice over 225 amps,comm'I ❑Hazardous location UM ❑Service over 320 amps -rating ❑Buildng over 10,000 sq R., of I-and 2-family dwellings 4 or more new residential ❑ 1-•and 2-family dwelling onumcial/industr(al ❑Accessory building []System over 600 volts nominal units in one structure ❑ multi-family ❑Master builder 13 Other: ❑Building over three stories ❑Feeders,400 amps or more []Occupant load over 99 persons []Manufactured structures or ❑Egress lighting plan RV park []Health-care facility ❑Other: Job no.: lob site address: --- Submit-1 sets of plans with any of the above. City/State/ZIP: Ck ? /gyp The above are not applicable to temporary construction service. tit Ids./apt.no.: Project name: p v I St Vii' ' .<r - ,. — DaarrlptMn Q:y. mea. TeUI Cross street/directions to job site: New residential single-or multi-family dwelling unit. Includes attached garage. 1,000 sq.R.or less 145.15 4 Subdivision: i Lot no.: Ea.add'1500 sq ft.a:-portion 33.40 1 Limited energy,residential 75.00 2 Tax Ittap/ptvccl no.: Limited energy,non-residential 75.00 1 2 Each manufactured or modular dwelling,service and/or feeder 90.90 2 Services or feeders Installation,alteration,and/or relocation 200 amps or leas _ 80.30 2 201&trips to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Nom' 601 arms to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 _ 2 Reconnect only 66.85 _ 2 City/State/ZIP: Temporary services or feeders Installation,alteration,and/or Phone: A Fax:( ) relocation El _ 100 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 strips 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 600 arras 133.75 _ 2 Owner aignatute. Date: Branch circalts-new,alteration,or ei tenslon,per panel A.Fee for branch circuits with service or feeder fee,each 6.65 2 Business name: _ branch circuit B.Fee for branch circuits Contact name: — without service or feeder fee, 46.85 2 Address: each branch circuit Each add'I branch circuit 6.65 2 City/State/ZIP: Miscellaneous(service or feeder not Included) Pump or irrigation circle 53.40 2 a Phone:( ) Fax: Pump( ) Sign or outline lighting 53.40 _ 2 E-mail: Signal circuit(s)or limited- energy panel,alteration,or Business name_ Tp�ap extension.[kscribe: Page 2 2 ._ls.. 4_ a1yQ �',W1C'r4, Address: f Q_*1 Each additional Inspection over allowable In any of the above Cit /State/ZIP: - - Perinepectim 62.50 Y JW O !� Investigation per hour(I hr min) 62.50 -'I n9 Phone:((3(j `?g _ (�{Sb Fax:( '"I) gyp' Industrial lane hour 73.75 \ CCB Lit:.: 1353;5- Electrical Lic.: - 3Cl,� Suprv. Lic.: OSS 1.E3 Subtotal Suprv.Electrician signature,required: <' 4!5, Plan review(25%df permit fee) State surcharge(8%of permit fee) Print name: �O 1�w` f,��t } Date: 6��'-bl/ 6 — TOTAL PERMIT FEE 8( 0(] Authorized signature: This permit application expires If a permit Is not obtained aithtn Igo days after It has been accepted as complete Print name: Date: • Fee methodology set by Tri-Comity Building industry Service Bpsrd "— — -- '•Number of impections per permit allowed i\Building\Perrtmr\EL('-PermhApr.doc 12103 u0.461ST(IOMMOMrWF.a Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating,Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: _ Feefor each commercial system....................... 575.n0 (SELF OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems RData Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation Q, ❑ Intercom and Paging Systems R ❑ Landscape Irrigation Control* ❑ Medical _r 00 ❑ Nurse Calls l� uu -a ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations \8�iainl\r�,keLc-rn„*App dm 04/03 1 ELECTRICAL PERMIT- CITYOF 1 I CARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00192 13125 SW Hall Blvd.. Tioaro.OR 97223 (503)639.4171 DATE ISSUED: 6/30/2004 SITE ADDRESS: 10565 SW NIMBUS AVF 100 PARCEL: 1S134AD-08200 SUBDIVISION: SCROLLS BUSINESS PARK ZONING: I-P BLOCK: LOT: JURISDICTION: TIG Prosect Descriptioi: Low voltage for Alarm. A.RESIDENTIAL B.COMMERCIAL AUDIO 8. STEREO: AUDIO&STEREO: INTERCOM&PAGING: BURGLAR ALARM: BOILER: LANDECAPEIIRRIGA T: GARAGE OPENER: CLOCK: MED!CAL- HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF 6-MEM-&— 1 Owner: Contractor: ROBINSON, CONSTANCE A + HONEYWELL INC ROBINSON, LYNN + BELL, KAY ET 15495 SW SEQUOIA BY INSIGNIA COMMERCIAL,GROUP STE 100 BEAVERTON,OR 97008 PORTLAND, OR 97224 Phone: Phone: F-968-3398 Reg#: SQ[I8-330941 LEA LIC 150191 ELE 26-207CLE APP.SAYS Cl _ FEES Required Inspections__ Description Date Amount Elect'I Final A' pt" [['.LPRM'T] ELR Permit 6/30/2004 $75.00 TAX] 8%State Surcharl 6/30/2004 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Manicioal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 1-0100. You may obtain copies of these rules or direct questions to OUNC at(502)246.6699. h N Issued by Permittee Signature-\-- _ OWNER INSTALLATION ONLY The Installation Is tieing made on property I own which t- not Intended for sale,lease, or rent. --r OWNER'S SIGNATURE: DATE: CONTRACTOR!MSTALLATION Q t,Y SIGNATURE OF SUPR. ELEC'N DATE: _ LICENSE NO: Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day 17-3ectrical)'ermit Application ��r� _ nate received Permit no. _ . City of Tigard r�F ! f E�V E - otccvappl.10 rapirc date: Address: 13125 SW Hall Blvd.Tiga 2 c.u�u/''llyard Date issued B),-W no. Phone: 1503)6394171 JUN 2004 fiko.: Fax: 1503)59$•1960 �) ?��a otPayment type. Land use approval: etre car TIGARD Ch n2 all Mthl, O 1 be 2 family dwelling or accessory Commercial/industrial O Multi-family O Tenant improvement O New consinicuon O Addilion/alieratioNreplacemcm O Outer:_ O Partial 1 Job address: (Qyv� Bldg.no.: Suite no.: Tax map/tax lot/accouni no.: — Lot Block: Subdivision: _ Prciiecl name: Descri tion and location of work on premises: r�Estimated date date of completion/inspection: 1 OR APPIAUAI ION oil SCIll M It Far Mn MIM,106 t10: Iknrri rL_ la Taul no.las Business name: HONEYWELL Address: 15495 SW Sequoia Pkwy, 100 nrw'eS onk.Indiall beak a ached Vora"dly.pee dwrNbtp sates.lerMde..n.rMd gutape. City: Portia d Stste:CR ZIP: 97224 Ie►*1 bar d' Phone503-9 8-3304 Fax: 968•-33 E-mail: 1000 sq.h.in leu _ 4 p l q( �— 26-207 G l� Loch additinrul 500 sq,h.of portion thereo' CCB no.: Elect.bus.Ile.no: Limited energy,residential 7 Ci /metro ic.n 4619 Limited enerEy.non-residential 2 Each manufactured homr or modular dwelling Lure of su rvisin electrician Ire uired) Date Service andlor leerier Sup.elect.name(print): Steve Morehouse Licenseno 941 Ile ArrvlevsorMeden-in.ull>,tlon, allocation of relocation: 700 amps or lest 2 Nam(print): tot amps to coo antes 401 amps to 600 amp 2 Mailing address: 601 amps to 1000 amp 2 City: Stale: ZIP: Over 1000 amps w volts —� 2 Phone: Fax: I E-mail: Reconnect only I Owner installation:The installation is being made on property 1 own Iemporory wrvka at ferden- which is not intended for sale,lease,rent.or exchange according to b"ollarlon.liberation,orrelocathsa ORS 447,455,479.670,70). 200 amps or ieu _ _ _ 2 201 amps to 40,ampt - 2 Owner's signaturc: Date: 401 to 60o am 2 Branch eirralts-ars,allocation, or extension per panel: Name: _ _ A. Fee lot blanch circuits with purchase m Address: service of feeder lee,each branch circuit _ 2 City: State: ZIP: B. Fee for branch circuits without purchase ` o1 service or feeder foe,first branch circuit: 2 Phony. Fax: E-mail: Each additional branch circuit: U X nun 13 Mhr.IService,or leder not Inel"rd). O Service ova 225 ampi-conmeedol O Heald(-em facility Each pumror irrigation circle 2 O Service nvee 320 amps-rating of 1!2 O Haniciout location Each sign of outline Iirhting 2 lamilvdwelhngt O Building ova 1011 square reel lour a Sirnal cncuitlO or a limited enagY Vartd. S O Svmm over 600 volts nominal more residential unite in one strunun alietation,_ot extension' ( , d 2 ' O Suildinr met three coria O Feafen.40(1 antes a mop 'Dmri don: O Occupant brad ova 99 penom O Manufarwnxl structnra or RV pad Isch additional his"loo oter rho allowably in any of file above: O L•rressAirhtingplan U other Petmipection _ _L Submit__ sets of plans with ons of the above. _Invatirationfet _ 71it abort are not applicable to ttmpo ar3 tomtrurtion wrrke. (Aber Notice:This permit application Permit its..... .......I.......S •a7_ r:eo VI)urisd�rnnm(cep credn cards,f4uv call)urisdietion to nose mrmtrtMitar. � pp Plan review(al' �) OViso `(MasterCard r expila if a permit is not obtained ------�� — Crydh cnd umbo _ �' �'� _� D within 180 days aher it has been State surcharge 18_%)....$ (�v kxpne' A U12 accepted as utmplet( I OTAI. .......................S r:ara eN Alor y sit ` c dr cod -s � l /' endholdrr torn ore Amount 440-4e1:1 16RgICl7M) CITY OF TIGAR® BUILDING PERMIT DEVELOPMENT SERVICES DATE ISSUED:I6/25/2004 002'2 13125 SW Hall Blvd.. Tiaard.OR 97223 (503)639-4171 PARCEL: 1S134AD-06200 SITE ADDRESS: 10565 SW NIMBUS AVE 100 SUBDIVISION: SCHOLLS DUSINESS PARK ZONING: I-P BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION__ CLASS OF WORK: FPS FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL.AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 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: it REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 3,000.00 Remarks: Fire protection. Owner: Contractor: ROBINSON, CONSTANCE A + FIRE PROTECTION SERVICES ROBINSON, LYNN + BELL, KAY ET 15100 SW 139TH BY INSIGNIA COMMERCIAL GROUP ,'IGARD, OR 97224 BPhone TON, OR 97008 Phone: 509-3732 Reg 0: LIC 121039 _ FEES REQUIRED INSPECTIONS Description Date Amount Fire Alarm Insp [BUILD] Permit Fee 6/11/2004 $72.10 Final Inspection [TAX]8%State Surcharl 6/11/2003 $5.77 [FLS]FLS Pin Rv 6/11/2004 $28.84 Total $106.71 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be Clone 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 p requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR g 952-0 i i OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by Galli (503)246-6699 1-80t)-332-2344. Issue By: _ Permittee 06 Signature: eae—!� Call 639-4175 by 7 p.m.for an Inspection the next business day �osCf S NIn¢vs �/ I odgfPptection System . Building Permit Application Recti City ofTigard EEIVE u"`'B �' od Permit No.4" �•O(„iJd 1'125 SW Hall itivd,Tigard,OR 972 PlonmeGe6, Other Permit: 111nnc 501 619 4171 Fax 503.598.1960 -Date/By: ln�ncction Linc: 5(11.619.4175 I I Due ReadytRy: /� 0 See Pane 2 for lomat www'C1 119ard or,US , . 1 1 20 NotifiedRd (J�ethtd: ` 9applenrat.I Information l Permit fees'are basal on the value work performed. ❑New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all ®Addition/alteration/replacement ❑Othcr: equipment,materials,labor,overhead,and the profit for the work indicated on this application. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: E]Master builder ❑Other: Number of bathroom: Total number of floors: Job site address:10565 SW NIMBUS AVE New dwelling area: square feet ` City.�State/ZlP:Tigard,Or,97224 Garage/carport area: — square feet J Suite/bldg./apt.no.:100 Project name:INOVISE Covered porch area: square fat Cross street/directions to job site:SCHOLLS FERRY RD Deck area: square feet Other structure area: square fat Subdivision: — Lot nv.: Permit fees•arc based on the value of the work performed. Tax map/parcel no.: Indicate the valve(rounded to the nearest dollar)of all equipment,mate–als,labor,overhead,and the profit for the work indicated on this application._ s ADD TO EXISTING FIRE ALARM SYSTEM Valuation: SS3p00.00 i — Existing building area: square feet New building area: 4500 square fe.4 Number of stories: I Name:PMC SIERRA ATTEN DON THIEL Type of construction: Address: Occupancy groups- City/State/ZIP:8555 BAXTER PI.ACC?BARN' r,BC VSA 4V7 C%NADA_ Existing: Phone:(604)2334353 — Fax:( ) New: Business name: All contractors and subcontractors are required to he Contact name: licensed with the Oregon Construction Contractors Board aunder ORS 701 and may be required to be licensed in the e. Address: jurisdiction in which work is being performed.If the 19 NCity/State/ZIP: eppply an!is exempt from licensing,the following reasons Phone:( ) Fax:: — J E-mail: _m 0 W Business name:FIRE PROTECTION SERVICES _1 — Address:18270 SW MOUNTAIN HOME RD — Mrose refer ro jar.scbedrle. City/State/ZIP:SHERWOOD,OR 97140 - - Fes due upon application Phone:(993)590-3732 Fax:(503)628-6214 - I- Amount received CCB lic.:154333 - --- ------ --- Date received: Authorized signature: This permit application expires If a permit Is not obtained _ within I80 days after It has been accepted as complete. Print name:DAVID M PHIPPS — Date:06/11/04 • Fee methodology set by Tri-County Building Ndustry Service Board. ikAuildinx\Permhr\rPS-PennhAppdix IV03 40-013T(I I/02/170M/wEa) �'/) Fire Protection Services Si,'V MOUNTAIN HOME RDDESCRIPTION SHERHERWOOD, O OR 97224 Phone: (503)590-3732 Fax: (503)6288214 INOVISE 9,11-0 6 0 a 0--ts FIRE ALARM DESCRIPTION DESCRIPTION An automat°c fire protection system will be added to utilizing a multi-output NAC The interior horn/strobe will be mounted at 84"to the bottom of the device. All audible devices will sound in the ANSI temporal pattern. All strobe flashes will he synchronized where appiic?hle. Primary power to the panel shall be 110 VAC utility power with a 24VDC 7aH battery back-up. All fire alarm circuit-will be wired with 16 gauge FPLR/CMR red cable with the excerption of NAC circuits,which will be wired with 14 gauge FPLR/CMR red cable. Monitoring will be provided through Alarm Central Station,a U.L.listed monitoring company (503.641.6761) All installation will be done according to N.F.P.A. 72 standard. Work will be performed in a neat and professional manner. All work will be performed according to the timeline set. All equipment will be UL listed and approved for the application. SYSTEM COMPONENTS Silent Knight 5495 NAC power supply Gentex Commander Series Horn Strobes L H Ot! _m E5 W Firepower 5495 Distributed Power Module Supervision Current: Input Firepower 5495 supervises a Standby 75 mA voltage range: 9- 32 VDC, variety of functions including Alarm 175 mA Battery charging • Low AC power. Auxiliary capacity: 33.0 AH • Low battery conditionr power circuii: 1 Ambient Temp.: 32• to 120° F • Earth ground fault Notification 0' *^49" C • Auxiliary output power limit circuits: 4 Mechanical condition. Output Dimensions: 12.25'W x 16" H x • EOL supervision trouble or configuration: 2 Class A(Style Z) 3•V(30.88 cm W power limited condition at an 4 C!paa B (Style Y) x 40.64 cm H x output. ;1 Class A& 7.62 D cm) When a trouble condition occurs, 2 Close 8) Indicator Lights Firepower 5495 creates a trouble condition an thR host control signal Amps per AC power on : Green circuits to which it is connected. outpui circuit: 3.0(6.0 amps total) Battery trouble: Yellow Firepower 5495 still maintains the Notification Ground fault: Yellow ability to be activated by the host circuit output: 20.4 to 27.3 VDC Aux Trouble: Yellow control. In addition, the 5495 C 3.0 amps each, provideq a Fnrm C trouble relay 4.7 kU EOL Output output as an alternative to using resistor required troubles (1-4). Yellow the notification r_ircuit trouble. on each Class B Approvals: Electricsi Specification circuit UL: 864 R 1481 AC Input: 120 VAC at 2 amps No. of inputs 2 NFNA' 72 Output: 24 VDC at 6 amps Input CSFM configuration: 2 Class f3 or 2 Class A Model 5495 Block DiaAraM Signal Circuit Output signal I signal 1 n Distributed Signal Signal CImult Output Signal 2 Power t1. input Module 5495 Signel (Options') IL signal 4 N ----Aux.Power Trouble Output i_ocal Fire Control (Alternative to noWkation cimult trouble.) C --- --- w SILENT KMGH[T 7550 Meridian Circle,Mdpie Grove,MN 553894927 MA11E IIIA AMERICA 600.446-6444 or In Minnesota 783-493-6435 FORW 350395,Rev.OV02 FAX: 783-493.6475 World Wide Web:http./hvww.silentknlght.com Copyright 0 2002 SOW Knight Wiring Diagram GE Series with AVS44 Synchronization Module FAGA �.��� ,e�e...� •,.rwl,r�est.nqutaar ,��.�w �ew,te�net.w.reeer A�..� - atel►eeaartw�ls tAJ�af A♦ Leaera ANI!!N Ai� 1�lr1 rAAe �sI�� auw�a Otaa •e��«I Wall R VOLTAK 1 ANSPE QF 16-�.`V CRA 0 10Ft_ c8A R 10Ft Horn Mode n.r 1M64 Fw LAA64 DC(mA) trWR(mA) de LOW ce 1 v 24v I 33v l6v 24v 33v 16v 24v 33v lLv 24v 3 Temp 3240" 78 &71* 75 77 13 24 i7 37 43 Tem 3 Chi 70' 68" 70' 12 17 1 24 Contirvious2400FIz Bl 78 14 21 28 21 42 Corrtirepus Mechanical BO 76 78 13 16 25 27 37 44 Contuspus Chime Ar68" Ar 1 2 1 1 2400 82 4 '! 'Operating the hom in this mode at this voltage will result in not meeting the minimum UL reverberant sound level required for public mode fire protection service. These settings are acceptable only for private mode fire alarm use. Use the high d6A setting for public mode application(not applicable when using the chime tone.The chime tone is always private mode). Notes:The sound output',,r the temporal 3 tone is rated lower since the time the hom is off is averaged info the round output r8tinq While the hom is producing a tone in the temporal 3 mode its sound pressure is the same as the continuous mode. Architect & Engineering Specifications: The audible and/or visible signal shall be Gentex GE Series or approved equal and shall be listed by Underwriters Laboratories Inc. per UL 1971, UL 1638 and/or UL 464.The notification appliance shall also be listed with the California Stare Fire Marshall(CSFM)and the Bureau of Standards and Appeals(NYC). The notification appliance(combination audible/visible and audible units only)shall produce a peak sound output of 100dBA or greater as measured in an anechoic chamber.The signaling appliance shall also have the capability to,ilence the audible signal while leaving the visible signal energized with the use of a single pglr of power wires. Additionally, the user F fall be able to select either continuous or temporal tone output with the temporal signal having the ability to be synchronized. The audible/visible and visible signaling appliance shall also maintain a minimum flash rate of 1Hz or greater regardless of power input p� voltage. The appliance shall also be capahle of meeting the candela requirements of the ADA (75Cfor the combination listed (UL N 1971/UL 1638) listed models. The appliance shall have an operating current of 63mA or less at 24 VDC for the 15i'75Cd for the strobe circuit. The Popliance shall be polarized to allow for electrical supervision of the system wiring. The unit shall be provided with a mounting J bracket with terminals with barriers for input/output wiring and be able to mount to a single gang or double gang box or double workbox m without the use of an adapter plate.The unit shall have an input voltage range of 16-33 volts with either direct current of full wave rectified 0 power. Tho appliance shall be capable of test supervision without disconnecting wires.Also the appliance shall be capable of mounting w to a surface back box. e GENTEX CORPORATION 24 units per carton 27 pounds per carton Re Protection Products: 41191" .m.otxn _ 10985 Chicago Dr.,Boot 310,Zeeland,M11 49W 818/392-7195 1-800*36M91 FAX:616/392-4219 Centex corporebon reserves the right to make charges to the product dNe sheals s!their discretion r rsrled on Reydsd Paper GFC0e01-5 C I TY OF T I GA R DBUILDING PERMi PERMIT#: BUP2004-00244 DEVELOPMENT SERVICES DATE ISSUED: 5/26/2004 13125 SW Hall Blvd..Tlqard. OR 97223 (503)639-4171 PARCEL: 1S134AD-06200 SITE ADDRESS: 10565 SW NIMBUS AVE 100 SUBDIVISION: I KNOLL BUSINESS CENTER,TIGARD ZONING: I-P BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: ^ sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ _PROJECT OPENINGS? _ TYPE OF CONST: 2FR sf N. S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 Sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 147 BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE. sf OCCU SEP. RATED: BSMTr: MEZZ?: REQD SETBACKS_ _ REQUIRED FLOOR LOAD. psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: PRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 150,000.00 Rgmarks: TI:New walls or office space. Owner: Contractor: ROBINSON, CONSTANCE A + NORWEST GENERAL CONTRACTORS ROBINSON, LYNN + BELL, KAY ET INC BY INSIGNIA COMMERCIAL GROUT' PC) BOX 25305 BVhVER,TON, OR 97008 PORTLAND, OR 97298-0305 one Phone: 291-6986 Reg#: LIC 89425 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require IBt11LD] Permit Fee 5/26/2004 $939.30 Electrical Permit Required (TAXI 8%State Surcharl 5/26/2004- $75.14 Framing Insp RUPPLN Pin Rv 5/26/2004 $610.55 Gyp Board tion nsp l � Final inspection f FLSI FLS Pin Rv 5/26/2004 $375.72. ^ Total �$2,000.71 a (K N this permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law ED requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set frith in OAR ® 952-001-0010 through OAR 952-001-0100. You may obtain a copy of,hese rules or direct questions to OUNC by W calling (503)246-6699^qr 1.800-332-2344. Issued By: c � Permittee Signature: / (jL639-4175 by 7 p.m.for an Inspection the next business day Binding Permit Application City of Tigard R""ved Permit No1 uale/B � '"vo,,-)t/ I t 125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/Br: 2 •Qy J OtherPerrtrit In,pecti(m Line: 503.639.4175 Date Reedy/By: 0 See Attached Checklist for ItitemeC www.ei.tigard.or.us Notified/Method, 1 C Supplemental Information WrARK r „ATA:1'-.A�iD�rFIdV MY DWELLING _ ( ]New construction ❑Demolition Permit fees*are based on the value of the work perfonned. -- Indicate the vclue(rounded to the nearest dollar)of all AdditioNalteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. Valuation. $ 1-and family dwelling ❑Commercial/industrial — —_ — Ac.essory building ❑Multi-family Number of bedrooms: ❑Master builder Q Other; Number of bathrooms: Total number of floors: Job site address: f�� 3 W Al t M 3 v s New dwelling area: square feet City/State/ZIP: 1(71JP_tD Garage/carport area: square feet tai ldg./apt.no.: IV O I Project name: ^/ V[i Covered porch area: square feet Toss street/directions to job site: Deck area: square feet Other structure area: square feet t kECrCL1BT Subdivision: Lot no.: Permit fes'are bash on the value of the work performed Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all ( . equipment,materials,labor,overhead,and the profit for the work indicated on this application. Valuation: S 0 7 ivi4.✓i I/W �'�v rE r✓I —V--!�— Existing building area: IS SUO square feet FNew building area: square feet Num stories: _ _ Name: (���(�1,�/•f J f/ t (��t �Lie- Typ(_of construction: Address: 3:1 J / Q 77 3 Occupancy groups: City/State/ZlP: JA (f4r—A1J(A C-13 CAg Existing: Phone:( ) Fax:( ) ' w q EWE Business name: y S � All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board d under URS 701 and may be required to be licensed in the Address: �� �„s/rpyt} � jurisdiction in which work is being performed.If the City/State/Z1P: f�r~� applicant is exempt from licensing,the following reasons apply: Phone:(�3) Z41 ' _J E-mail: e--44 e 1 d_p�+- y7 z r - W Business name: V J Address: Z S 3v s`— Pleate refer ro jce schedule. City/Slate/ZIP L q Fees due upon application Phone:(9)3 — tV Fax:( — 3 -- Amount received CCH lic.: Date received: Authorized signature: This permit applleatlon expires If a permit Is not obtained within 180 days after It has been accepted as complete. Print name: - Date: ' Fee methodology set by I ri-County Building Industry Service Board. i\Building\Perroiu\BUPPermitAppdoc 12103 440-4613T(IIWCOM/WES) Building Division Plan Submittal Requirement Matrix imercial& Multi-Family - New,Additions or Alterations Qy pf Tigard f Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing(site utilities) 2 Building 1 Fire Protection System 3** Mechanical 2 Plumbing(building fixtures) 2 Electrical 2 IL2 N Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request m additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire &Rescue) W * 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. i:\6uilding\Forrm\COM-PlenSubReq.doc 12/24x'03 r CITY OF TIGARD ELECTRICAL PERMIT Y PERMIT 0: ELC2004-00325 DEVELOPMENT SERVICES DATE ISSUED: 0/8/2004 13125 SW Hall Blvd.,Tinardi.OR 97223 (503)639.4171 PARCEL: 1S134AD--06240 SITE ADDRESS: 10565 SW NIMBUS AVE 100 ZONING. I-P SUBDIVISION: SCHOLLS BUSINESS PARK BLOCK: LOT: JURISDICTION: TIG 13'rojoct Description: Electrical TI,(30)branch circuits. Job No.659 RESIDENTIAL UNIT TEMP ERVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: P - 20C amp: PUMP/IRRIGATION: EACH ADD'l_500SF: 201 - 400 afnp SIGN/OUT LINE LTG: LIMITED ENERGY: 101 - 600 amp: SIGNAUPANEL: MANF HMI SVC/FDR: 601+amps-1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADWL INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O ERVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 29 IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION Ilton*amp/volt: >-4 RES UNITS: >600 VOLT NOMINAL: Reconnect only SVC/FDR>v 225 AMPS: --- CLASS AREA/SPEC OCC: Owner: Contractor: ROBINSON,CONSTANCE A { BOONFS FERRY ELECTRIC INC ROBINSON, LYNN+BELL, KAY ET PO BOX 628 BY INSIGNIA COMMERCIAL GROUP WILSONVILLE,OR 97070 BEAVERTON,OR 97008 Phone: Phone: 682-4936 Reg#: SUP 31705 LIC 88482 FEES _ FL.E 3-2230 Description Date Amount Required Inspection* [f;I,PRMT)EEC Permit 6/8/2004 $239.70 [TAX]8°1,.State Surcharge 6/8/2004 $19.17 Rough-in Final Elecfl F .mm _ nal Total s2 58.87 This Permit is issued subject to the regulations contained in the Tic ard Municipal Code,State of OR Specialty Codes and at ether applicable laws. All work will be done in aocordar^fn with approved plans. This permit will expire if work is not started within 180 days of issuance, or Hwork is suspended for more than 180 drys ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules t forth in_ORR�Q`k2-001-0010 t h O 9 2-001,'1100. You may obtain copies of these rules or direct questions to OUNC at(503) 2 899 or 1 800-332-2344. CL pC I ued By: Permit Signature: H N ' _ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. t7 OWNER'S SIGNATURE: DATE: - W CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:_,_... ,/8s I.iCENSE NO: Cali 639-4175 by 7:00pm for an Inspection the next business day Ekgkical Per n>< t Applications .q Received : . ' City of Tigard Planting Approval > -- Datc/By: Panit No.: 13125 SW H&II Blvd. Plan Review "- Other - ` ---- ® Tigard,(h:igon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Itmview Land use— Internet: www.ci.tiaard.orms Date/By: — -- Cow No.: Contact Jtnu.: tote Page 2 frau 24-hour Inspection Request: 503-639 4175 Narne/Mcthod: Supplemental Inl,rmation. FURN JtEVYE two" LJ New construction _ Service over 225. .. Demolition *�- Health-care facility commercial lburx"m location Addition/alteration/ , IaCement LJ Other: ❑Service over 320 amps-rating of []BuildimR over 10,000 square feet. * :'�A R YJ[V. IJGTf N""'.'• •5,�":" '•' 1&2 family dwellings four or^wire residential u^its in I &2-Family dwelling Commercial/Industrial O S:,stem over 600 volts nominal one structure (]Building over Onrr stories ElFeeders,400 amps or more AeeesSO Buildin _ Multi-Family �]Occupant load ovr,"persons (J Manufactured structures or RV park Master Builder ()cher; ❑Egress/lighting plan ❑Other: '."JOKSITEINFOWKW16RUdl 'ION ? .f Submit _reb of plaar with any of the above. ra The abnot M les construction service. Job site address:/n s 6 s s w Ni fit his above are- Suite W. _�DU Bldg•/A�t#. _p Nimber of in a resit allowel Pr9ject Name: /„p,,, r ,. UHcri Iba�— Qty Fair Tal - — New r"Weatial-41aght or aanit”o lly per Cross street/Directions t0 30b site: dwelling unit.Includes allacbed garage. Servlce locladed: 1000 sq n.or lest 145.15 Each additional SW sq.n.or Irortior,drereor 33.40 Subdivision: _-- [ Ot#: Limited exrergy,residential _ �_ 1 75.00 Limited er�jon residential 75.00 Tax ma &=I#: Each manufactured home or modulo doelk:q `,1i : ::• service and/or feeder 90.90 -- --- Servtres or f edea-hMafttlon, aNerathm or relocation: r - - 200 amp or less -- — 80.30 201�to 400 amp 106.85 401 ornpsto 600 amps- 160.60 PROPERT 601 amps to 1000 amps - - 240.60 Name: Over 222 amps or vohs --- -"45/.65 --- - Reconnect only 66.85 Address: Temporary services or feeder-Installation, Clt �State/Z1 - attention,at.relocation: �; _ 200 amps or less 66.85 Phone: Fax: 201 amp to 400 amps i-- - 100.30 -13 APPLIZ:ANT',;'a I`% 401 to 600 amps 133.75 -' Branch circuits•new,alteration,er Name: extension per panel: -- A Fer for branch circuits with purchase of Address: service or feeder fee,each branch circuit 6.65 City/State/Zip: B Fee for txaruch circuits without purchase of service or feeder feeLftrst branch circuit / 46.85 Phone: Fax: Each additional branch circuit --- 2 6.65 1 = , E-mail: Misc.(Service or feeder not inehnded): - L r. ,'' ' �,.,: Each punp or irrigation circle _ 53.40 2_ Job NO: d Q0 V, Eich signor outline lighting -- 53.40 �— Signal circuit(:)or a limited energy pawl, A Business Name: alteration or extension Page 2 BOO e$ F E 1 e c t r j — Description: - ~ Address: P.O. Box 628 j Each additional lnspeNion aver the allowable In any of the above: Cil /StatC/ZI : Wilsonville OR 97070 Pet ins tion luau min. I horn) 62.50 10 -Phone:682-4936.' Fax: 682-7946 Investigation fee: — - CCB Lic.#:88482 1 Lic-IN: Other: -- Supervising electrician signature aired: --- subtotal S 2-37 Plan Review(25%of PermitFeeel S _ Print Name ,, Herrn Lic.#:S 8 State Surch a 8`iLofPcrmit Fee S TI I _ -— TOTAL PERFEE S i __ • Authorized Notice: This permit application expires If a permit Is not obtained within Signature Date:- 180 days ager It has been accepted as complete. "Fee methodology set by Tri-Coanty Building Industry Service Board- (Please print name) r mosTermit FormsOcPermitApp.doc 01/03 CITY OF T'I G A►R D � ELECTRICAL PERMIT. RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00157 131:5 SW Hall Blvd..Tigard. OR 97223 (503)639.4171 DATE ISSUED: 6/11/2004 PARCEL: '1S134AD-06200 SITE ADDRESS: 10565 MAI NIMBUS AVE 100 SUBDIVISION: SCHOLLS BUSINESS PARK ZONING: I-P BLOCK: LOT: JURISDICTION: TIG Protect Description: Low voltage for fire alarm system. A.RESIDENTIAL B.COMMERCIAL _ AUDIO &STEREO: AUDIO&STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK. MEDICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE: OTHER: HVAC: PROTEr'rIVE SIGNAL: INSTRUMENTATION: OTHER: TQ AL Owner Contractor: ROBINSON, CONSTANCE A + FIRE PROTECTION SERVICES ROBINSON, LYNN + BELL, KAY E T 18270 SW MOUNTAIN HOME RD. BY INSIGNIA COMMERCIAL GROUP SHERWOOD, OR 97140 BEAVERTON,OR 97008 Phone: Phone: 503-590-3732 Reg#: ELF. 34-488CI,F. LK' 154333 FEES _ Required Inspections Description Date Amount Low Voltage Inspection IFI,PRMT) FLR Permit 6/11/2004 $15.00 Eleet'I Final (TAXA 9%State Surcharl 6/11/2004 $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 worts 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 952-001-0010 L through OAR 952-001-0100. You may obtain copies of these rules or direct question-4o OU Cat(50 )246-6699. y xl 2 Issued b Permittee Signatur 3 _ OWNER INSTALLATION ONLY _ 9 The Installation Is being made on property I own which Is not Intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: J - CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ DATE: LICENSE NO: --- Call 6394175 by 7:00 P.M.for an Inspection needed the next business day ,ticaI Permit Applicatiou Rrceive Permit N City of Tigard u1e,,r�� t� 15 13125 SW I lull Filvd,Tigard,OR ` Plus Review Other Permit Phone. 503 639.1171 Fax: .0 S9 �oo DslelB : _ Inspection Line: 503.639. '� �Q ` bate Ready/By: B see Pune 2 for Internet: www.ci.tigard. 1 �?P �O� Notifh"ethod: _ sapplanwatal IaforwaUoa ❑New construction ® r t eration/replacement Please check all that apply: ❑Demolition ❑ ❑Service over 225 amps,comm'I ❑Hazardous location [1Service over 320 amps-rating ❑Buildng over 10,010 sq.n of I-and 2-family dwellings 4 or more new residential ❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building []System over 600 volt-,nominal units in one structure ❑Buildng over three stories ❑Feeders,400 amps or more ❑Multi-family ❑Master builder ❑Other: []Occupant load over 99 persons []Manufactured structures or ❑Egress/lighting plan RV park Job no.: Job site address: 10565 SW NIMBUS 01ealth-care facility ❑Other -- - _ Submit_L sets of plans with any of the above. City/State/ZIP:TIGARD,OR 97224 The above are not applicable to temporary construction service. Suite/bidg./apt.no.: 100 Project name: INOVISE .. ____ peurlptM+ Qtr. Far. I Total Cross street/directions to job site:SHOLLS FERRY RD New Iesidentlal single-or multi-family dwelling unit. -- Includes aitacherd garage. _ _ 1,000 sq.R.or less 145.15 4 Subdivision: Lot no.: Ea.add'I 500 sq.ft.or portion 33.40 _ — --- Limited energy,residential 75.00 _2 Tax map/parcel no.: Limited energy,non-residential 75.00 1. Each rttanufecturcd or modular ADDITION TO EXISTING FIRE ALARM SYSTEM dwelling,service and!or feeder 90.90 2 Services or feeders Installation,alteration,and/or relocation 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name:PMC SIERRA Atten don thiel 601 amps to 1,000 amps 240.60 2 Address:8555 Baxter place Over I,dW amps o volts _ 454.65 2 Reconnect only 66.85 2 City/State/ZIP:Burnaby Canada Temporary services or feeders Iastallatlon,alteration,and/or relocation _ Phone:(604)233-4353 Fax:( ) 200 amps or less 66.85 I Owner Installation:This installation is being made on property that I own which is not 201 amps to 400 snips 100.30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 snips to 600 am _ps 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:Fire Protection Services branch circuit _ B.Fee fo,branch circuits Contact name:David M Phipps without service or feeder fee, 46.85 2 - —` each branch circuit Address: 19270 SW Mountain Home Rd Each add'I branch circuit 6.65 2 City/State/ZIP:Sherwood Or 97140 MlscePaneous(service or feeder not Included) CL Phone:(503)590-3732 Fax: :(503)628-6214 Pump or irrigation circle 53.40 2 Lc _ _ _ _ Sign or outline lighting 53.40 2 1- E-mail:phipps®fpsnw.eom Signal circuits)or limited- energy panel,alteration,or extension.Describe: Page 2 2 Business name: Fire Protection Services J Each additional Inspection over allowable In any of the above m Address: 18270 SW Mountain Home RD Per inspex.,cn 62.50 to City/State/ZIP:Sherwood OR 97140 Investigation per hour(1 In min) 62.50 Phone:(503)590-3732 Fax:(503)628-62U Industrial plant per hour 73.75 CCB Lic.: 154333 Electrical Lic.: 34-488 Suprv.Lic.: 4120102 Subtotal Suprv.Electrician signature,required: Plan review(25%of permit fee) Sate surcharge(9%ofpermit fee) Print name: Date: 06/11/04 TOTAL PERMIT FEE Authorized signature: T7r12 permit sppnratloa expires its perr et is not obtained within 100 ---- - days after It has been accepted n complete Print name: /p i rf J [)ate. 06/11/04 Fee methodology set by TrProunty Building lndosny Service Board ••Number of inspections per permit allowed. 1:lBuildng\Permitlt\EI.C-PermhAppdoc 12103 "0461ST(1002fCOM/w8a CITY OF TIGA,RD RESTRICT 3 ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2004-00163 13125 SW Hall Blvd..Tigard,OR 97223 (5031 '33f#-4171 DATE ISSUED: 6/16/2004 SITE ADDRESS: 10565 SW NIMBUS AVE 100 PARCEL: 1S134AD-06200 SUBDIVISION: SCHOLLS BUSINESS PARK ZONING: I-P BLOCK: LOT: j!)RIS,DTCTION: TIG Protect Description: Low voltage for HVAC A.RESIDENTIAL B.COMMERCIAL AUDIO& STEREO: r AUDIO& STEREO: INTERCOM& PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: zOTAL#OF SYSTEMS: 1 Owner: Contractor: ROBINSON, CONSTANCE A + AVAC INC ROBINSON, LYNN + BELL, KAY ET 5188 SE INTERNATIONAL WAY 6Y INSIGNIA COMMERCIAL GROUP MILWAUKIE, OR 97222 REAVERTON, OR 97008 Phone: phone: 503-462-4822 Reg#: LTC 50897 ELE 26-571CLE FEES Required Ins octions 09scrlption Date Amount Low Voltage Inspection I F.LPRMTj ELR Penni$ 6/16/2004 $75.00 Elect'/ Final I ITAXj 81%9 State Surcharl 6/16/2004 $8.03 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 A-ill 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 fo les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 n thro OAR 95 - 1-0100. You may obtain copies of these rules or di red questions to OUNC at(503)2413-6699. a M Iss ed by Permittee SI nature p rr OWNER INSTALLATION ONLY The Installation Is being made on property 1 own which Is not intended for sale, lease, or rent. W -J OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNA 'URE OF SUPR. ELEC'N _ DATE: _ LICENSE NO: _ Calf 639-4175 by 7:00 P.M.for an Inspection needed the next"iuslness day Electrical Permit Apulicat:On City-of Yo ►ard pDale/H A ---_ Permit No. 13 i 25 SW flail Blvd.,Tigard,OR 97223 Plan Review. Phone: 303.639.4171 Fax: 503.598.1960 Da"Y: other Permit Inspection line: 503.639.4175 tale Ready(By: ewe 0 See Page 2 for Internet: www.ci.tigard.ot.u3 Nolified/Medad: Sa:Ppkmeatallaformsdoa (]New construction ( Addition/ I ratio eplacement Please check all that apply ❑Service over 225 strips,comm'I ❑Ha„rdous location ❑Demolition ❑Other: ❑Service over 320 amps rating ❑Buiking over 10,000 sq.ft., of I-and 2-family dwellings 4 or more new residential (] I-and 2-family dwelling ,omrryr duatrid Acceawry building ❑System over 600 volts nominal units in one structure [IRuitding over three stories ❑Feedcrs,400 amps or more (]Multi-family ❑Master builder ❑Other: (]Occupant load over 99 persons ❑Manufactured structures of ❑Egress/lighting plan RV park , 1l tt ❑Ilealth-care facility L101her Job no.: lob site address: ��j(h r) _Jw Nt_NL1ou Submit_L sets of plans with any of the above. City/State/ZIP: T` EG the shove are not applicable to temporary construction service Suite/bldg./apt.no. Project name: 5E M ---____.___. e_3CHEDULE _ ( f7Q 1 l._ IMcrIPtNe _ Qt r r... ret.t Cross street/directions to job site: New residential single-or multi-ftmily dwelling unit. — Includes attached garage. 1,060 sq R.or less 145.15 4 S ubdivision: s�t no.: _ Ea.add'I 500 sq.ft.or portion 33.40 1 Limited energy,reidential 75.00 2 Tax map/parcel no.: Limited energy,non-residential 75.00 2 I-ach manufactured or modular dweVK C Services or eice and/or(ceder — 90.90 2 _ Services or feeder Installation,alteration,and/or rclocat!on 200 amps or less 80.30 _- 2 201 amps to 400 amps 106.85 2 n^ 401 amps to 600 amps 160.60 Z Name: t3ill�l- ►•\ ICL 601 amps to 1,000 amps _ 240.60 2 Address: Over 1,000 snips or volts_ 454.65 2 -- Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders Installation,alteration,and/or relocation Phone:( ) Fax:( ) 200 amps or les ---- 466,111 1 Owner Installatlon:7 his installation is being made on property that I own which is not 201 r, -s to 400 amps 100.30 2 intended for sale,lease,rent,or exchange,according to URS 447,449,670,and 701. 401 amps l0 600 strips 133.75 2 Ov ner signature: Date: Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with service or feeder fee,each 665 2 Business name: branch circuit _ - — --- P.Fee far branch circuits Contact nrme: without service or feeder fee, ------- — 46.85 2 each branch circuit Address: _ Each&M'l branch circuit 6.65 2 City/State/ZIP: Mlaelianeow(service or feeder not included) Pump or irrigation circle 53.40 2 Phone:( ) - —-- Fax: ( ) Sign or outline lighting 53.40 2 E-mail: Signal circuit(s)or limited- energy panel,alteration,or extension.Describe: Page 2 2 Business name: / C C I - Each additional Inspection over allowable in any of the above l Address: Per inspection _ 62.50 City/State/ZIP: -7 x x a— Investigation pa hour(I hr min) 62.50 1 Phone ) Fax )�555 Indwftial lent hour 73.73 l02-Lf da- CCB Lic.:,5000 7 1 Electrical Lic.: _5.11 MSup"".Lic.:,;W (&P Subtaal �; od Suprv.Electrician signature,required: ,3_ _� _ Plan review(25%of permit fee) _ State surcharge(8%of pemriI fee) ,00 Print name: Ota Date:(0LO TOTAL PERMIT REE Authorized signature: � t rhla permh application etplres If a permit h not obtslned within Iso clays after It has beer accepted as complete Print name: `o C Date:(0/�(0 D ' Fee methodology set by Tri-County Building Induary Service Boat! ••Number of impections per permit allowed. i\RuitdingkPennk-\EEt.C-PamhApp.doc 12101 440•ai1MIoA2X%VWRa Electrical Permit Apulication - City of Tigard � Page 2- Supplemental Information LIMITED EiNEPGY PERMIT FEES: Fee for all residential systems combined........ $75.00 Check Tyne of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Fee for each commercial system....................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation a ❑ Intercom and Paging Systems rn ❑ Landscape Irrigation Control* ❑ Medical ® ❑ Nurse Calls (7 W ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other_ Total number of commercial systems: *No licenses are required. licenses are required for all other installations c-►Q,�rApp eoc 0003 CITY O F T I OA R D MECHANICAL PERMIT DEVELOPMENT Si RVICES PERMIT#: MEC2004-00380 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639.4171 DATE ISSUED: 6/16/2004 PARCEL: 1 S 134AU-06200 SITE ADDRESS: 10565 SW NIMBUS AVE 100 SUBDIVISION: SCHOLLS BUSINESS PARK ZONING: I-P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR TURN: EVAP COOLERS: TYPE OF USE: COM UNIT HE.ATI:RS: VENT FANS: 1 OCCUPANCY GRP: B VENTS W/O APF►L: VENT SYSTEMS: STORIES: BOILERS/COMPRLSSORS HOODS: FUEL TYPES _ 0 - 3 HP: DOMES.INCIN: 3 - 15 HP. COMML. INCIN: IMAX INPUT: BTU 15-30 HP: FIRE DAMPERS?: 30-50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: COD FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: S: F�URN >=100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Installation of split system for computer room,exhaust fan,relocate ducts& grilles. Proiect Value: $7,800. Owner: _ FEES ROBINSON, CONSTANCE A + Description Date Amount ROBINSON, LYNN { BELL, KAY ET IMECH]Permit Fee 6/16/2001 $242.30 BY INS.GNIA COMMERCIAL GROUP [TAX]8%State Sirrcharl 6/16/2001 $19.38 BEAVERTON, OR 97008 "hone _ Total Contractor: HVAC INC 5188 SE INTERNATIONAL WAY MIL WAUK IE, OR 97222 REQUIRED INSPECTIONS Phone: 462-4822 Mechanical InspFinal Inspection Reg#: LIC 50897 IL R J W This permit is issued subject to the regulations contained in the Tigard Municipal Code, State ref Ore. Specialty Codes -� and all other applicable laws. All worts kill be done in accordance with approved plans. Th:n permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than '180 days. A FTEN TION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. ,,hose rules are Set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)2.4 Issued y: Permittee Signature: "AdAg lep Lzed ' Call(503)6394175 by 7:00 P.M.for Inspections needed the next business day Mechanical Permit Application ReceivedMahanicat DsteB : /L Permit No N , City of O'igalyd Planning Ap oval Building Date/By Permit No.: ! 7 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By- Permit No. Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use : Internet: www.ci.tigard.or.us DateTYCase No.:Contact 1,�! See Page 2 for 24-hour Inspection Request 503-6394175 Name/Method S-tpptemental Information. 2y,xv TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLISC New construction Demolition_ Mechanical permit fees*are based on the total value of the work Addition/ erati� placement Other: performed. Indicatt the value(rounded to the nearest dollar)of all CA CORY OF CONSTRUCTION mechanical materiais,equipment,labor,overhead and profit. 1 & 2-Family dwelling omrnercia Industrial Value: s rQ' See Page 2 for Fee Schedule RESIDE _E UIPMENT/SYS17EMS FEE*SCHEDULE Accessory Building Multi-Famil - n I _QtY IE DescriptioFee(ea.j� Total Master Builder Other: _ Heade Conlin ` JOP SITE INFORMATION and LOCATION Furnace-add-on air conditionin •• 14.00 Job site address: I o (�-5 St_u OL IhbuS Gas heat puTp 14.00 +� Suite #: ��_ — Bld ./A t.#: " 5 " Duct work 14.00 Project Name:�. Hydronic hot waters tem 14.00 Cross street/Directions to job site: Residential boiler ffor radiaror or hydropic system) 14.00 Unit heaters(fuel,not electric) in%%all,in duct,suspended,etc.) 1400 Flue/vent for any of above 10.00 Subdivision: Lot#: Re air units 12.15 _ Tax map/parcel #: Water heater Other Fuel AIlanees_ 10.00 DESCRIPTION OF WORK Gas fireplace 10.00 taw isQ & S.4,0-�v 4;W 1'"PtDtTivl Flue vent water heater, asfi lace) 10.00 .- '" Log li ghter as 10.00 Wood/Pellet stove _ 10.00 C diva. C d ( �piy Wood fireplace/insert _ — 10.00 T� Chitnne /liner/flue/vent 10.00 PROPERTY OWNER I 19UNANT Other: 10.00 Name: Environmental Exhaust A Ventilation Address: Range hood/other kitchen equipment 10.00 .— Cit /State/Zip: Clothes dryer exhaust _ 10.00 Single duct exhaust Phone: Fax: _ (bathrooms,toilet compartments, APPLICANT 110 CONTACT PERSON utility rooms) 6.80 Name; A,,&,e w V a Attic/crawl space fans _ 10.00 Address: _T Other: to.00 Cit /State/7_I -- Y Fuel Piping "(53.40 for first 4,51.00 each additional (L Phone: Fax: Funiace,etc.- •• VGas heat pump _ •• E-mail: •• Wall/sus nded/unit heater CONTRACTOR Water heater •• Business Name: }�y/�(► _ Fireplace _ •• --r Address: SE Range •• °p Cit /State/Zi BB •• (� �� E- Clothes dryer(gas) •• Phone:S03 4(0� 48d Fax: ,3-4 _ ;�; Lther: •� CCB Lic. #: r 7 Total: Authorized Mechanical Permit Fen*Signature: I'WO �n Date: k 110 O`-I Subtotal: S Minimum Permit Fee 572.50 S j 1 p Plan Review Fee(25%of Permit Fee) S (Please print name) .� State Surcharge(8%of Permit Fee S s TOTAL PEILMIT FEE $ if Notice: This permit application expires If a permit Is not obtained within •Fee methedolep set by Tri-County Building Industry Seryce hoard. 180 days offer It has been accepted as complete. "Site plan required for exterior A/C nalts. iADsts\Permit Forms\MecPermitApp,doe 01/03 Mechanical Permit Application -City of Tigard Page 2 -Supplemental Information Commercial Fee Schedule: TOTAL VALUATION: — PERMIT FEE: a S I�00 to 52,000.00 Minimum fee S72.50 52,001.00 to S5,000.00 S72.50 for the first S2,000.^0 and 52.30 for each additional 5100.00 or fraction thereof,to andincluding S5,000.00. S5,001.00 to S 10,000.00 S 141.50 for the first 55,000.00 and S 1.80 for [� each additional S 100.110 or fraction thereof,to _ and includingS 10,000.00. S 10,001.00 to S50,000.00 S231.50 for the first 510,000.00 and S 1.35 `:^r each additional S 100.00 or fraction thereof,to Y U and includin S50,000.00. S 50,001.00 to S 100,000.00 5771.50 for the first$50,000.00 and S 1.25 for each additional S100.00 or fraction thereof,to ---- _ and including S 100,000.00. _ S 100,001.00 and up S I,396.50 for the first 5100,000.000 and S 110 for each additional S 100.00 or fraction thereof 4 All New Commercial Buildings require 2 sets Of plans. IL oc h m w VlBuildinglPerrnit FormsWecPermitAppPg2 09-01-03AL M NFPA 72 (1999 Edition) Record of Completion XA Name of Protected ProOVISF. Address 10565 SW NIMBUS SUITE 100 RD,TIGARD Owner's Representative(name/phone TOM MEYERS Authority Having Jurisdiction: TIGARD,OR Address/Phone Number. SAME AS ABOVE I NFPA 72,Chapter 4-3 Proprietary Supervising Station System If Alarms are transmitted to a public fire service communications center or others, indicate location and telephone number of the organization receiving alarm: ALARM CENTRAL STATION BEAV,OR Indicate how alarm is transmitted: PHONE LINES%'IA DIGITAL COMUNICATOR The Prime Contractor FIRE PROTECTION SERVICES TIGARD,OR Proprietary Station Location BEAVERTON OP. Means of transmission signals from the protected premises to the proprietary- statiom X- Digital Alarm Communicator Other Organization NamelPhone Representative Nsrme/Ph:me Installer ___BRAD GORDON Alarm Service Company FIRE PROTECTION SERVICES Location of Record(As-Built)Drawings: ON PROPERTY IN PANEI. Location of Owners Manuals: ON PROPERTY IN PANEL ------___-- Location of Test Reports: ON PROPERTY 1N PANEI. _ A contract, dated 7/02 _ for test and inspection in accordance with NFPA standard(s) No(s) 72 2. Record of System Installation (Fill out after installation is complete and wiring checked for opens, shorts,grrnmd faults,and 0. improper branching,but prior to conducting operational acceptance tests.) co This system has been installed in accrodance with the NFPA standards as shown below,was inspected } by __-DAVID M PHiPPS _ _ on 07/08/02, includes the devices 5 shown below, and has been in service since /__ X NFPA 72, Chapters 3 4 7 (circle all that apply) NFPA 70, National Electrical Code, Article 760 W Manufacturer's Instructions Other ,peci --- Signed: _ Date: C2Z/_[7_ /�_ Organization: �- Q � S�i_v1 Cr_!5_ f 07/14/04 3 Record of System Operation All operational feature7 and functions of thi+system wr,r,tested by DAVID M PI I1PPS- on /_ and found to be operating properly in accordance with the requirements of. X --- NFPA 72,Chapters 1 3 4 5 6 7 (circle all that apply) _ NFPA 70, National Electrical Code, Article 760 Manufartarer's Instructions ---- Other(specify): - _ --- --------- -- Signed: i— Date: `--/-- — Organisation. FIRE PROTECTION SERVICES 4. Alarm-Initiating Devices and Circuits(use blanks to indicate quantity of devices) MANUAL 2 Manual Stations X -Nancoded,Activating _-- -- Transmitters ----Coded AUTOMATIC Coverage Complete Partial. (a) Smoke Detectors _ _ Ion J Photo (b) Duct Detectors _Ion Photo (c) Heat Detectors 194 FT — RR FT/FF RC (d) __.__Sprinkler Waterflow Switches: - Transmitters _ _ Noncoded, Activating Coded (e) Other(list). _---- 5 Supervisory Signal-Initiating Devices and Circuits(use blanks to indicate quantity of devices) SPRINKLER SYSTEM (a) Coded Valve Supervisory Signaling Attachments Valve Supervisory Switches, Activating _ ®,Transmitters (b) Building Temperature Points (c) Site Water Tempetature Points (d) _ Site Water Supply Level Points Electric Fire Pump: (e) __ Fire Pump Power (f) ______, Fire Pump Running (g) Phase Reversal Engine-Driven Fire Pump. (h) - Selector in Auto Position !�) Engine or Control Panel Trouble (j) Fire Pump Running CL Engine-Driven Generator: 97 ik) - - Selector in Auto Position (1) Control Panel Trouble (m) _ -- Transfer Switches (n) Engine Running Other Supervisory Functions(s)(specify). _ 2 07/1004 6 Alarm Notification Appliances and Circuits Quantity of indicating appliance circuits connected to the system: 21 Types and quantities of alarm indicating appliances installed (a) Bells 10" Inch diameter (b) --- Speakers (c) Horns (d) Chimes (e) Other (f) 7__Visual Signals Type: WHEELLOCK _S_ with audible _ 2_w/o audible (g) —L.a;ai Annunciator 7 Signaling Line Circuits Quantity and Style(see NFPA 72,Table 3-6)of signaling line circuits connected to:ystem. Quantity: - 1 Style._8_ 8. System Power Supplies (a) Primary(Main): Nominal Voltage: 1 l0V f Current Rating 8 amps Overcurrent Protection- Type: __BREAKER__-__ :rent Rating:15 amps - Location: PANEL B CIRCUIT 8 Secondary(Standby). _X Storage Battery Amp-Hour Rating 7 amp hour­ --X— our __—x Calculated capacity to drive system, in hours: X (24) (60) Engine-driven generator dedicated to fire alarm system: Location of fuel storage: (b) Emergency or Standby System used as backup to Primary Power Supply, instead of using a Secondary Power Supply: Emergency System described in NFPA 70, Article 700 Legally Required Standby System described in NFPA 70, Article 701 Optional Standby System described in NFPA 70, Article 702,which also meets the performance requirements of Article 700 or 701 9. System Software (a) Operating System Software Revision Level(s): —_-_ 2.45 -- - (b) Application Software Revision Level(s): (c) Revision Completed by: (name) (firm) LL (signed) (title) (date) OC NFrequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s): 'J System deviations from the referenced NFPA;taadard(s)are. w (signed) ---" (title) ------ --(date) Upon completion of the system(s)satisfactory test(s)witnessed by the authority having jurisdiction: (signed)representative of the Authority Having Jurisdiction (title) (date) 3 07/14/04 CITY OF TIGA,RD 24-1-Iour BUILQNG Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639.4171 MST _- _ / BLIP Received _-Date Requested ,�� _ _ AMy PM- BUP f Location -._ Z0 Seo Suite-------�� - MEC L Contact Person - ---_ Ph -) �pe=_-- 'PLM _ Contractor Ph(----_) —_— _ SWR BUILDING Tenant/Owner ELC _ Footing Foundation ILC - Fog Drain CCASB: ELR Crawl Drain - - Slab Inspection Notes: SIT Post&Beam -_- Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear -� Framing - - - _- - ---A---._--- Insulatior Drywall Nailing - Firewall Fire Sprinkler -- --- ---- -- ----- -- - -- Fire Alarm Susp'd Ceilmy - ----- ----- -. - __--_- - -__. Root Other: _ - -- --- --_- _--._--- --- Final _PASS PART FAIL PLUMBING Post&Beam `- -- - - ��----- - Under Slab -- -. - Rough-In Water Service --- --11�ffi_j -- --.__ --- _-- _ Sanitary Sewer Rain Drains -- -- -- - - Catch Basin/Manhole Storm Drain - - -- - Shower Pan Other: - Final PASS PART FAIL - - - MECHANICAL Post&Beam �-__—.' -------- -- --- ------ — Rough-In --- --------- -- - ---- -- — Gas Line Sm ke Dampen -- --- ----- -- .-. _- h- N PART FAIL -- - --- -- - - RICAL - -- - - - -- Service m Rough-In Uta/Slab W Low Voltage J Fire Alarm Final PAPART FAIL Reinspection f e of$_ ...____...___.� required before next inspection. Pay at City Hall, 13125 SW Nall Blvd. SITE - F] Please call for reinspection RE: _- .__-_--- Unaw to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Dab-_ _._ IAspectOft__ ._ _ - _---.__-• --_- Other: Final — - DO NOT REMOVE this Im9c;&* t tawd'hvm the fob sits. PASS PART FAIL CITY OF TIGARD 24-Hour BUI DINT Inspection Line: (503)639--41750 MST _ INSPECTrON ISI©N Busi ess Line: (503)639-4171 BLIP Received —_� _, Date ueste 7 � AM— _PM --_—_ BUP Location __._ �� �' '^'` _.Suite_ MEC _— Contact Person _----_-__ —_— Ph PLM Contractor—__^—_--.-- --_-_— _ Ph( ) _-- SWR _ BUILDING TenanVOwnor _. —� ELC Footing ELC _ Foundation �e�; Ftg Drain ELH _- CrawlOrain - --- Slab Inspection Notes: SIT -- Post&Beam --- __-- ------•---. _._ _ _ Shear Anchors Ext Sheath/Shear -.- Int SheatldSh(jar Framing - ----- - ---- - Insulation Drywall Nailing -- -- ---- --- - - a �Fire Sprinkler - - ------ ------�' Susp'd Ceiling --- - -- ------ ---_--.___ _ Roof Fi QSS ART FAIL --- -�---- ---- - - Post&.Beam - Under Slab -- - -- - Rough-In Water Service - - -- -- - Sanitary Sewer Rain Drains - ,-__-- Catch Basin/Manhole Storm Drain -- --- ------ Shower Pan Other: - Final PASS PART FAIL --' - MECHANICAL _— Post&Beam _ Rough-In -----.__- a Gas Line Ota Smoke Dampers - --- ---- -- -- -�- -- - - F Final rp -_ PASS PART 7AIL --- - - -- - ---- --- - -- - J ELECTRICAL _ _ -- Service Rough-In LU UG/Slab _j I Low Voltage ---- Fire Alarm Final ElReinspection fee of 5--- ._required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PARI FAIL SITE Please call for reinspection RF: _ -_ __ t,eable to inspect-no access Fire Supply Line ADA t DateApproach/Sidewalk - -_ IesPwc a►tr --_--_- -__-.___. - -_b[t Other. Final DO NOT REMOVE this IwApectloe F*00W firo11A Um job SN& PASS PART FAIL CITY OF TIGARD :;.4-Hour BUILDING Inspection Line:,(503)636-6175 p MUT INSPECTION DIVISION Business Line: (503)639.6171 — _J BUP "-I S� — Received -Date Requested_ AM L�PM BUP — Location �� ~�7.�!/!2'���'� --Suite IC�Q_ _— MEC Contact Person I-"- Ph(— ) �eZ " 7i Z.- PLM _ Contractor —__— __— Ph(_ ) . SWR — BUILDING Tenant/Owner _— ___ ELC -- Footing ELC _. Foundation Ftg Drain Cr . 988ELR � Crawl Drain Slab Inspection Notes: UR - — PoRt&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- -- - ation Drywall Drywall Nailing Firewall ��- � M_ FIN Fire Sprinkler Fire Alarm Susp d Ceiling Roof OOther:r. the -� - -- -- - - - Othe - nal PASS PART FAIL - - - i--- - --- PLUMBING --- Post&Beam Under Slab --- -- ----- - Rough-In Water Service Sanitary Sewer Rain Drains -- - Catch Basin/Manhole _ Storm Drain Shower Pan Other: Final _ PASS PART FAIL MECHANICAL Post&Beam Rough-In -- - Gas Line IL Smoke Dampers ------ - rx Final PASS PART FAIL ---- --- ELECTRICAL Service Rough-In --- -- _ — -------- (9 UG/Slab ILI Low Voltage _--- Fire Alarm — © Reinspection fee of$_____ required before next inspectlon. Pay at City Hall, 13125 SW Wall Blvd. PART FAIL r-� I�%PfffPlaase,;ai.'or reinspection RE..- ___-.-__-__ tJ Unable to inspect- no ac",-s Fire Supply Line ADA Approach/Sidewalk p�^ � _._ —�_ Other: _ Final DO NOT REMOVE thle imt+>Malioo .eem from tlw job elft. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Llne: 4503)639-4175 0 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP _ — Received _ _ _Date Requested _ _ AM--- PM BUP 1D — MEC Contact Person Ph :Z PLMContractor Ph Ph( ) ''WR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam _ Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear - Framing Insulation Drywall Nailing Firewall Fire Sprinkler — — ---- _ Fire Alarm Susp'd Ceiling -- - - --- - Roof Other:_____ - - Final PASS PART FAIL PLUMBING Post 8 Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains --- -- - Catch Basin/Manhole Storm Drain -- — --- - Shower Pan Other: Final PASS PART FAIL -- MECHANICAL Post&Beam Rough-In Q. Gas Line Smoko Dampers Final } PASS PART FAIL _ — �T-- ------__—___ 5 ELECTRICAL Service Rough-In — W UG/Slab _t Low Voltage Fire Alarm - SS PART FAIL [] Reinspection fo-of$_ required before next inspection. Pay at Chy Hell, 13125 SW Hall Blvd. $ Please cell far reinspP�tion RE:_ __ __�__ ❑Unable to Inspect-no access Fire Supply Line Approach/Sidewalk Dti11b Other: Final DO NOT REIMME this Insap611AI e r OOM ft^On UW job sit. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING 0 0 inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST SUP ----- Received _ Date Requested___ AM. PM_— BUP Location _ 12 sI, Suite_ 8Q E) MEC Contact Person —_ ____— Ph( ) PLM _ Contractor .-.______---._- ---- Ph(- ) 6 82- — S Q-1 3�_- SWR BUILDING Tenant/Owner ._. _ _�_— ELC Footing --_-- ELC Foundation Access: Fig Drain ELR Crawl Drain _ Slab Inspection Notes: SIT — Post& Beam Shear Anchors - Ext Sheath/Shear _ Int SheAth/Shear ���� V0457 s Framing ---- Insulation � Drywall Nailing --- !' �- ------ ---- Firewall Fire Sprinkler - ------ — --- - Fire Alarm Susp'd Ceiling - --- -- Roof Other: -- —--- --- - Final —- PASS PART FAIL ----`-- --� PLUMBING Post&Beam Under Slab - Rough-In Water Service - -- Sanitary Sewer Rain Drains — -- Catch Basin/Manhole Storm Drain Shower Pan Other- Final ----------- PASS PART FAIL MECHANICAL Post A Beam Rough-In - O. Gas Line Smoke Dampers - — Final PASS PART FAIL - ELECTRICAL — J Service m Rough-In W UG/Slab .� Low Voltage ----- Fire Alarm PART FAIL u Reinspection fee of a -_ required before next inapection. Pay at CRY Hall, 13125 SW Hall Blvd. I-OiAft Please call for reinspection RE:---.___—___ F] Unable to Inspect-no access Fire Supply Line I ADA Daft hnspae ctor14 '✓ 4 Approach/Sidewalk [ . - Other: Final DO NOT REMOVE this Inspection reewd Tr0111 the job eke. PASS PART FAIL