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15940 SW 72ND AVENUE BLDG 17 15940 SW 72ND AVE B-17 r I TY O F T'GA R n _ CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2003-00289 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/15/2.003 PARCEL: 2S 112DD-00400 ZONING: I-L JUP.ISDICTION: TIG SITE ADDRESS: 15940 SW 721JD AVE B-17 SUBDIVISION: OREGON BUSINESS PARK 1 BLOCK: LOT:017 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 33 TENANT NAME: ENGINEERED STZUCI UPES REMARKS: TI: New offices, upgrade rt:strooms Owner: KAUFMAN, LOTTIE L + SLIBOTNICK, RUTH ET AL BY PACIFIC REALTY 2 ASSOCIATES P Phone ND624-7�717 24 Contractor: H L. GREEN, HL CO INC 15350 SW SEQUOIA BLVD STE 300 TIQjA nD. OR 97 224 Rnneg#: LIC 41328 This Certificate issued 6/27/2003 grants occupancy of the above referenced building or portion there,,r and confirms than the building has been inspected for compliance with the Sta a of Oregon Specialty Codes for the group, occupancy, and use under which thF ryf eftced permit wi,� u 1'L --- - -- ---- BUILDING INSPEC fOR BUILDING ILIAL POST IN CONS"ICUOUS PLACE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639 4171 MST BUP Received _Date Requested _.= _ ANI_—___. PM __ __ BUP _ Location ___ l____�S y •-�� �SuitP _. MEC Contact Person >� _ Ph(__—__) _��� 3 _ PLM — Cortractor- ----- - -- - — — Ph(--- ) --- SWR BUILDING Tenant/Owner _ 1r � . `— ELC ELC Foundation Access: 1 _ Ftg 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&Beam Under Slab i -- -- Rough-In Water Service - -- ----- - ---- -- Sanitary Sewer Rain Drains -- - -- - Catch Basin/Manhole Storm Drain - -- - - Shower Pen Other: -- Final PASS PART FAIL MECHANICAL Pos(& Beam — Rough-In --___-- Ras Line Smoke Dampers ---- -- I F�,ial PASS PART FAIL. -- ELECTRICAL Service-----_ - ---.. Rough-In UG/Slab Low Voltage Fire Alarm -_- -- ------- nal L_] Reinspection fee of$ required before next inspection. Pay at Cit, Hall, 13125 SW Hall Blvd. PASS PART FAIL Please call for reinspection RE —_ L Unable to inspect-no access Fire Supply Line / /, ADA '1 L c% �:�C�s --moi' Approach/Sidewalk pa�' -- lnsptict0 �_"'� _ Ext _ Other: Final DO NOT REMOVE this Inspection (record from the Job site. PASS PART FAIL CITY OF T"IGiARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 13UP Received // _Date Requested -,;L_ AM_—__._� PM BUP Location _Lst a Suiie MEC — Contact Person Ph( ) �S "ate✓ PLM Contractor— _ Ph( ) SWR BUILDING Tenant/Owner __ _ _ 'u –�_— ELC Footing Foundation ELS ACCESS: Fig Drain ELR Crawl Drain Slab I Inspection Notes! SIT -_--- Post&Beam ------------------------------------ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- — Insulation Drywall Nailing - -- --- Firewall Fire Sprinkler - - ---- — --- -- — Fire Alarm Susp'd Craling -- - - -- - Roof t _PART FAIL BING Post 8 Beam ^-.------_ - - - - Under Slab -- — - Water Service -— - - -- -- -- Sanitary Sewer Rain Drains - --- ----- Catch Basin/Manhole Storm Drain _ Shower Pan Other:..--- Final ther: __Final PASS PART FAIL MECHANICAL P6 A&Beam Rough-In - _--- --- — Gas Line Smoke Dampers — --- Final PASS PART FAIL --- ELECTRICAL Service Rough-In - - - - ---__--- - UG/Slab Low Voltage Fire Alarm Final �_ I Reinspection fee of$_ -required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ [� Please call for reinspection RE:_-____ — _ l Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Date- _ _..__/'" / Inspector ��►'��*-�„�.-- Ext--_ Other: `' ---- - ------- FinRl _ OO NOT REMOVE this Inspection record from the job alto. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received Date Requested AM---PM Location 7 oL Suite MEC PLM Contact Person Ph Contractor Ph SINR BUILDING Tenant/Owner ELC Foi3fj_ng­ ELC Foundation Access: ELR Ftg Drain Crawl Drain SIT Slab Inspection Notes: Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall fIre Sprinkler Fire Alarrr Susp'd Cailin 3 Root ------- Othpi ltb PART F7AIL PLUMBING Post& Beam Under Slab Rough-In Water Service Sanitary sewer Rain Drains rAtch Basin/Manhol© Storm Drain Shower Pan Other: Final PASS P,1 FIT FAIL Xk-k"—,C;—L Post& Beam Rough-In Gas Lino Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm 3 Final Reinspoction fee of reauired before next inspection. Pay at City Hall, 13125 SW Hall I lvd. PASS PART FAIL F] unable to inspect--no access -N—TE Please call for reinspection Fire,'ijoply Line ADA Date__L /2 7/0 Ext Apptoach/Sidnvya!k Other: Final DO NOT REMOVE this n spection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION BLisiness Line: (503)639-4171 MST BUP Received —__. _ Date Requested— 60 °Z _ AM-----__ PM __ _ BUP ' i_ocation --_--����'� --lc� .'j1. - -Suite--- —. MEC - Contact Person ----------- -- -- Pti ----- ) 2-�-0= �1 �E.. PLM, 3 -'U Contrector --- ---- -- — - Ph(---)T----- — SWR — BUILDING _ Tenant/Owner ��� - �-�� - _ — ELC Fo�tinq ELC Foundatiun ------ ----- --- Access: Ftg Drain ELR --- Crawl Drain _ Slab Inspection Notes: SIT Post&Beam - --- Shear Anchors - -- --- Ext Sheath/Shear IntSheath/Shear Framing - Insulation -- ------ ------------ Drywall Nailing -- -- -_ -- - _ Firewall — Fite Sprinkler - - -- - Fire Alarm Susp'd Ceiling - - ----- Root ---- Other. - - - Final PASS PART FAIL _ - PLUMBING - Post& Beam -- Under Slab Rough-In l Water Service - Sanitary Sewer Rain Drains i - -— - _. -- --- _._ Latch Basin/Manhole Storrs Drain — --- Shower Pan Otr:--- -- - PAPART FAIL -- - - - __ .._...----- ---- H_ANICAL Post A Beam Rough-In Gas Line - �-------- Smoke Dampers Final PASS PART FAIL --- --- - ELECTRICAL Service _-'_— ---- -------- --- Rough-In UG/Slab — ---------- ---- --..... Low Voltage -_-- —_ — ---_-._---_---_�. Fire Alarm — — Final Reinspection fee of$ -_required before next inspection. Pay at City Hall, 13125 SW I tLll Blvd. PASS PART FAIL SITE ; ) Pre&se call for rel spection RE:--,. Unable to inspect-no access Fire Supply Line i ADA � / Approach/Sidewalk iDate _ Inspector �:� / _- Ext Other: Final DO NCT REMOVE this Nspection record from the job site. PASS PART FAIL CITY O F T!GA R D _ ELECTRICAL PERMIT PEI. IIT#: ELC2003-00303 DEVELOPMENT SERVICES DATE ISSUED: 5/29/03 13125 .9W Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S112DD-00400 SITE ADDRESS: 15940 SW 72ND AVE B-17 ZONING: i-L SUBDIVISION: OREGON BUSINESS PARK 1 BLOCK: LOT . 017 JURISDICTION: TIG Project Description: Install(6)branch c'-cuits. I RESIDENTIAL UNIT _TEMP SRVC/FEEDERS MISCELLANEOUS_ 1009 SF OR LESS: 0 206 amp: PUMP/!RPIGATION: `I EACH ADD'L 5003F: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp SIGNALIPANEL. MANE HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPEC'rIONS 0 - 200 amp: WISERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ _PLAN REVIEW SECTION 1000+ ampivolt: ­4 RES UNITS: >605 VOLT NOMINAL: Reconnect only: SVC/FDR—225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: KAUFMAN,LOTTIE L+ JOHANSEN ELECTRIC INC SUBOTNICK,RUTH ET AL 10948 SE VALLEY VIEW TERR BY PACIFIC REALTY ASSOCIATES CLACKAMAS,OR 97015-000 PORTLAND,OR 97224 Phone: Phone: 503-698-3417 Reg#: LIC 51539 SUP 2053S FEES _ J ELF 3-243C Description Date Amount Required Inspections [ELPRMTJ ELC Pcrnm 5!29/03 $80.10 — -"-- [TAX]814j State Tax 5 w n3 $6.4 i Rough-in _ Elect'I Final Total $86.51 This Permit Is Issued subject to the regulaticns contained In the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or 9 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 952-001-9010 through OAR 952-001-0100. You may obtain cooiss of these rules or direct questions to OUNC at(503)246.6699 or 1-800-332-2344. Issued By: + �_ L(:'c, Permit Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE-.--, CONTRACTOR INSTALLATION CVLY SIGNATURE OF SUPR. ELEC'N: DATE:___ LICENSE NO: Call 639-4175 by 7.00pm for an inspection the next business day F'r.:,m Charlyo� 'Sen To City of Tigard Date:5/27/2003 Time:11:18:20 AM Nage 2 of 3 1 Electrical p spit. r2tion _ Date rca ivedrJ ."r,.;. Permit no.j City of Tigard P(oject/a pl.no.: _ Expire.dale: If in,of Tigard Adt;ars . 131.25 SW hall 131y(iAlligl1d90>5UP23 pate Tsar ed Ry1� Receipt no.: Phone: (503) 639-4171 Fax: (503) 598.1960 CITY OF TIGARD Can file no.: Payment type: Land use approval:3UI1 DING DIVISION U I &2 family dwelling or accessory Z1 Commercial/induRtrtel :3 Multi-family O•Tenant itaprovement lJ New construction ]Addition/alteratitm/replacement ❑Other: ___ ____U Partial Joh address: 15940 SW 72nd Bldg.no.: Sufic no,: Tax map/tax lot/account no.: Lot: - — Block: Subdivision-- Project ubdivision:Project name: Englneered Structures_ Description and locatio,l ofwork on ptemisea: Tenant Improvement Estimated date ofcom letion/inspectiow 5/30/03 _ Job No.- 8215 Far Mom Business name: Johansen_Electric Inc. Description I Qty. (as.) retail n..).s Address: 10948 SE Valley View Terr, _ ._ Burd"gs ook.l.dcirsaelar-WoerraerY•ebll pin.w. r city: Clackamas _ State:OR ZIP:97015 B�brrerctaAed. Phone:503-698-3417Fsx:503-P5S-2488 B-tllail:•bhenserel��l�gnr,l�r,n iNX,sit r.,r lea, 4 GCB no.:51539 Elec,bus.lic.no: 3-243C Pack!tLfiocul 5011 eq.ff_m pmrlion thereof 4896Ltrtrueel wrcrgy, rusidmWal - ± limited anmgy, noo•rrsidenflal 2 5/27.10• Fate menufremred home nr modvla dwellinK Siamature or sudirisina electrician (mquired) --_ t)rte Service rr/or fooder —v T A clad.name(print). Carl K. Johansen LAr>eme eo: 2063S Sardcaearfboden-lemnodaa, altersdass or reMtatior. 2111 amps ex less _ 2 Name(print), 2111 amps In coli amps 401 am on 61111 amps 2 Mailing address: -- - - --- --- ----- ------- 601 amps to 1000 amps 2 City: Sten:: 7.IP:� trio I(xxl a r m volts 2.- -fir --- - Phone: I Pax: I r.-M- atl' aeamnoct only -- I Owner inditUatlon:The installation is b^ing made on property I own lhspermysanleeeerfmiers- which is not intended for sale,lease,rent or exchange according to 1WAd 't6a,aNwaM",ar"ohm dos: _ _ _ ORS 447,455,479,670,7�I 2011 amps or les, 2. 7.111 amps to 400 amps 2 C1W)tt's RI nan rr... Date: 401 Io 60o amps 2 nrsach ttrenhe-mew,aNanttoa, Nance. m atleasba t"panels A. Fee ria 1.acre circuits wA purchase of A-dr7ria, service or feeder fee,aacb hnmch cmmit _ 2 pity: (State: ZIP' n. Fee fin brant circuits wNhut purehue - Phone: I;n h-mail of service.no reedy roe,caamdn nt lectrouir 1 46 11x, do R!, 2 Each additicmal branch cimurt� _ errs ri r, alMe.(Bente.w IeNneel lae9ede/!s 0 Savin ma 225 cart faulmy Fah itmF in irrisation rimle _ 2 U 15svlon twee 320 amps-smarm of 1d.2 U Hrrrdous localism loch u , ou0unc b frog _ 2 family dwellsras U Budding ovm HOW squsm Abd700elcripline, Sittaal dteuigsl or n limiled enemy panel, U System over 6M volh neaninal mrer residential unk In sac sumAlteration, or eatlrmstara 2 U Bidlding over three suxim O Feakn.4M ani or more U(Iravpam bwl over 99 persons U Ma sufadrrmd dsrAmm or kV pelt -� FJrJ ddlfloaal I0,11rr16n6-nee fAr anaaahk In any"(do abuser U higm vliglring plan U Other --- Per Trap,taxi ftbou sale of pbm am my"ISO dove. InreauKdm; f �- JU Tan tee Asan apptleaNe ft te"pnsrry eartahtactlloo W Ike. Olbcr Niw�a1rrMsewawry ctedrf es",plans call)urudfew,a rer near.:�(umemn. Nouns: 'Mix permit applicafiaa Permit fee............. S �— U via U Masweard expires if a permit is no obtained Plan review(at-- ab) S - within 180 da s after it has peen State lurch e 11'161,,...5 _b tlsdn esnl number: —_--.- —L_L-- y w ( wfn�io M061dw a s i­c_MRWaM Capes accepted as complele TOTAL.........................S 86.51 5 mina) seci r CITY OF TIGARDBUILDING PERMIT L PERMIT#: BUP2003-0 1307 DEVELOPMENT SERVICES DATE. ISSUED: 5/29/03 13125 SIN Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S1 12DD-0,1400 SITE ADDRESS. 15940 SW 7 2ND AVE B-17 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I-L BLOCK: _ LOT: 017 JUR!SDICTION: 1-IG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCT!ON__ CLASS OF WORK: FPS Y 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?: REQV SE'rBACKS REQ_UIREC FLOOR LOAD. psf LEFY. fl RGHT: ft FIR SPKL: Y ` SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHi: IMP SURFACE_: PRO CORR: PARKING: VALUE: - 0 U Remarks: Add (2) new sprinkler heads and relocate (2)sprinkler heads. Ov,ner: Contractor: KAUFMAN, LOTTIE L + FIRESTOP CO �UBOTNICK, RUTH ET AL 9384 SW TIGARD ST BY PACIFIC REALTY ASSOCIATE=S TIGARD, OR 97223 PORTLAND, OR 97224 Phone: Phone: 620-6140 Reg #: LIC 63846 FEES _ REQUIRED INSPECTIONS Description Date Amount Sprinkler Rough-In Iti 11 Ill Pemw Fee 5/29/03 $62.50 Sprinkler Final I:A\I W'i,State"fax 5/29/03 $5.00 Total $67.50 -- This permit is Issued subject to the regulr•tions contained in the l igard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire If work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the 01-)gon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-6699 or 1-800-332-2344. Issued By: PemrIttee Signature: call 43 175 by 7 p.m.for an Inspection the next business day Building Permit Application City Of Tigard RECEIVED Datereceiveds22 91t7 7 Permit noaC{�PX,�7)S Projecdappl.no Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 I'tione: (503) 639-4171 MAY 2 8 1063 Date issued: _-� 13 Receipt no.. Fax: (503)598-1960 CITY OF TIGAFU Case file no.: Payment type: - ---- — — Land use approval: 1&2 family:Simple Complex: t , U 1 &2 family dwelling or accessory Commercial/industrial U Multi lamily L New constructi.m U Demolition )4 Addition/alteration/replacement ATeriant improvement aj Dire sprinkler/;harm U Other: . !ob address: Z 3 tiLJ `7 'W YI Aye (,U _ Bldg.no.: ,Suite no.: Lot: Block: Subdivision: _ Tax map/tax lot/account no.: Project name: G 7.je U -LL2 e:_-, j W C, �-- -- Descr;ption and location of work on premises/special ;onditions:_Ad_ 11 - tL"As FOR SPECIAL IN1.01(hIA-1 ION, t SE ('11ECKLIST Name: __ (1--jo!dfiltiln,sepillecapaelly.,solar,etc.) Mailing address: ( c >i/ W 1 &2 family dwelling: City: rid IStatc4NLIZIP: 7 Valuation of work........................................ $ Phone: , 'ax E-mail: No.of bedrooms/baths................................. _— Owner's representative: __ Total number of floors................................ _ Phone: Fax: E-mail: New dwelling area tsq.ft.) .......................... _ Garage/carport area(sq.ft.)......................... Name: - Covered porch area(sq.ft.) ......................... Mailing address: C y _ — .A A Deck area(sq.fr.)........................................ City: !l it S te: ZIP: 47'Z23 Other structure arca(sq.ft.)... ............ Phone Fax: ?j,� i E-mail: CommerciaUlndmtrial/multi-family. Valuationof work........................................ $ f.;xisting bldg.area(sq.ft.) .......................... _ Business name: C, =� Address• 7 <' � �_ New bldg.area(sq.it.)................................ Cit State: ZIP: 'JZ x Number of stories........................................ City: Type of construction............................... .... Pl1one i Fax• i .-Jlij/ E-mail: Occupancy group(s): Existing: CCB no.: �(4 New: _ Ci metro ic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Nnme: provisions of ORS 701 and may be required to be licensed in the Address: / l —� .jurisdiction where work is being performed.If the applicant is Cit stet Iet, State ZIP:c IZ Z!r exempt from lica:rsing,the following reason applies: Contact person: Plan no.: -- — Phone: Fax: I E-mail: - -- — Name: _ Contact person: Fees due upor,application ........................... Address: Date received: _ City: State: Z1P: Amount received ......................................... $— Phone: - — Fax:E-mail: YY Please refer to fee schedule. I hereby certify 1 heve read and examined this application and the Not all ludedkuam wrW credit cards.phew •sit iudedktion N mm inromution attached checklist. AH provisions of laws and ordinances governing this U Visa U MasterCard work will he complied ''t,Whither apecif hteio or not. r ctreu cad somber Authorized signature: [ — (/�— Name ciadhR--oot u shown on credit card l� FSP _ _ s Print name: �.. � .---- c.rdhatdei:�n.twe Amount Notim:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. ivi- 1 A 00")Mi Fire Protection Permit Check List ----.- - - A. ❑ New Addition _Alteration _ Repair B.) Modific:tion to sprinkler heads only: Describe work to 1. 1-10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads: LIG _ 2- - Aadit�onal description of work: T e_of Systemtgogplete A. B or C as lip TbleA I Sprrinkler Wet �Additional Hazard Groin___-Information Dense - - Desi n Area --- K. Factor_ _ _ Sprinkler Pro ect Valuation• Hood Fire Su od sc ect Valuation Ho C Fire Alarm -� Submittal shall Battery Calculations _Yes ❑ I Individual Component Yes ❑ Cut Sheets ------ --- Fire Alarm Project Valuatlon: _ Project Valuation Subtotal A B 8 C : i_ Permit fee based o_n valuation (see chart : $ - 8% State Surchar e: $ tea' FLS Plan Review 40% of Permit: $ TOTAL: $_ 2 � 1Adet9\torma\FPScheck119t.doc 06/07101 CITY OF TIG ® RD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00219 13125 SW Mall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/27/03 SITE ADDRESS: 15940 SVV 72ND AVE 8-17 PARCEL: 2S 112DD-00400 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I-L BLOCK: LOT: 017 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS, TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURESLAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: TUB/SHOWERS: SEWEZ LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: R&R 2 toilets and 2 lays. Relocate breakroom sink. _ FEES Owner: =-------- —" — O -- -- Description Date Amount KAUFMAN, LOTTIE L + SUBOTNICK, RUTH ET Al. IPLUMBJ Permit Fee 5/27I03 $83.00 BY PACIFIC REALTY ASSOCIATES ITAXJ 8%Statc Tax 5/27/03 $6.64 PORTLAND, OR 97224 Total $89.64 Phone : Contractor: ADDISON PLUMBING 17506 SE RIVER RD. MIL WAUKIE, OR 97267 REQUIRED INSPECTIONS Phone : 503-785-1840 Rough-in Insp Final Inspection Reg#: LIC 151754 PLM 3-348PB This permit is issued subject to the regulations contained in the Tigard Municipal C,.le, 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, of if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rifles adopted by the Oregon Issued By: Wil_,. L/./ , r ,��. �� Permittee Signature�/,Z' Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day Builicl tng r fixtures Plumbing Permit Apiplicntion Received 't, ' Datc/By: )1`O� �� I'crmit No.: i-11 ':'� _Icyca/r Cl of Tigard Planning Approval Sewcr `, g Date/By: Permit No.: 13125 SMr Hall Blvd. Plan Review Other Tigard,Oregon 97223 Datae/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Dale/By: Case No.: Internet: www.ci.tigard.or.us contact Jtuis.:- I M See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Melhod: Su rJilcmcnial Information. TYPE OF WORK — FEE*SCHEDULE(for special Information use checklist) Fj New construction _— Demolition _— aescriPtiun _ Qty• _fee(ea•i Total LJ Addition/alteration/rep]acement Other: New 1-e�or each lu dwellings CATEGORY OF CONSTRUCTION (Includes 100 Vit.for each uttlity connection SFR I 249.20 1 &2-Family dwellin _ Commercial/Industrial bath SFR 2 bath 350.00 Accessory Building 71 Multi-Farnily _- SFR 3 bath 399.00 Master Builder ❑Other: — Each additional bath/kitchen 45.00 —_ JOB SITE INFORMATION and LOCATION Firesprinkler-sq. 0.: Pa c 2 Job site address: y�,. �c, >w 7 z.,.A v Site Utilities Suite#: Bld ./A t.#: Catch basin/arca drain__ 16.60 Project Name: £r.. D ell/leach line/trench drain 16.60 Footing drain(no.linear ft) —� Pae 2 Cross street/Directions to job site: 9 Mpnufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 _ Sanitary sewer no.linear ft. — IPa 2 Subdivision: _ _ Lot#: Storm sewer(no.linear ft.) 4 2 Tax map/parcel #: —_ Water service no. linear ft. 2 DESCRIPTION OF WORK Fixture or Item —_ Absorption valve 16.60 _ w t - wc- .�....� L L, J � Backflow prcventcr _ Pae 2 Backwater valve —W _ 16.60 — Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 PROPERTY OWNER TENANT Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: - Fixture/sewer cap 16.60 C�It�/State/Zl�_ _ Floor drain/floor sink/hub 16.60 Garbage disposal 16.60 Phone: Fax: Hose bib _ 16.60 LIGAN — CON i A_CT PERSON _ Ice maker 16.60 — Name: Interceptot/grease trap 16.60 _ Address: Medical gas-value: S Pae 2 - Primer 16.60 Cit /State/Zi p:— —�— -- --- Roof drain commercial 16.60 Phone: —� 'ax: _ -- — Sinkbasin/lavator l 16.60 4 E-mail: Tub/shower/shower pan _ 16.60 — CONTRACTOR Urinal 16.60 LL Business Name: P kek . ;�..-� .,. �� Water closet L 1660 -- ---- Water heater 1636 Addresa: cc 1�.,,vtf po- Other: Cit /State/Zip: T",.\,44cm%.,.%-- - C-V- <(-,Lam, Other: �- Phone: . Hwy -�titio Fax: Plumbing Permit Fees* Subtotal $ CCB L,ic. #: ist-7 sy — Pianib. LicA 3 -wiq rE Minimum Permit Fee$72.50 S Authorized Residential Backflow Minimum Fee$36.25 Signature: ��ata Date: 21-x•3 Plan Review(25%of Permit Fee) S 1-- a�� �a t p State Surcharge(850 of Permit Fee $ 47 (Please print namc) TOTAL PERMIT FEE I Notice: Thk permit application expires if a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or ISO day+of vi it lin+liven accepted is complete. riser diaaram for plan review. 'Fec meihodolog� sei by Trl-(ounh Building Industry Service Board. i:\Dsts\Pamit Form&\PlmPermitApp.doc 01,10 i'Sl� Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Stippression S stems: _ Site Utilities Qty. Fee(on) Total Square Footage: Permit Fee: _ I'ooting drain- I"100' 55.00 0 to 7000 $115.00 Footing drain-cash additional 100' 46.40 2,001 to 3,600 — $160.00 — -- 3,601 to 7,200 _ $220.00 Sewer-lst I W - 55.00 7,201 and greater $309.00 - - - Sewer-each additional 100' 46.40 Water Service-Ist 100' 55.00 Medical Cas S Stems:_ Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain Thain- Ist 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 4640 $5,001.00 to$10.000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and _ Fixture or Item Qty. Fee(ca) Total _ including VO,OC'.00. _ Conunctctal[lack flow Prevention Device 46.40 _ $IO,00I.00 to$25,000.00 $148.50 for the first$10,1100.00 and$1.54 for Residential n,•:kflow Prevention Device each additional$100.00 ur fraction thereof,to (minimum permit fee$36.25) 27.55 and including$25,000.00. _ Rain Drain.single family dwelling 65.25 $254911.00 to$50,000.00 $379.50 for the first S25,0W.00 and$1.45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or and including$50,000.00. specially requested inspections- •r hour _72.50 $50,001.00 and up $742.00 for the first$50,000.(91 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes",please indicate«ork perforated by fixture. Failure to accuratre+(rt (Mures could result in increased sewer fees*. uaulily Fixture):''ark Performed Comments regarding fixture work: Fixture Type: Re cc� _ New Mored Ealsting Cxl)ped --- ----- --- -------- l3a visa-,'onl Bath -Tub/Shower - _-Jacuzzi/Whirl of - - ------ --------- ------- Car Wash -Each Stall -Drive Thru Cuspidor/Watcr As irator Dshwasher -Commercial Domestic -- - - -- --- -- - -- Drinkin Fountain E c Wash v r►rain/sink -2" - -- - - - --- — - - - ----— ----- 3^ ----- --�--_ - --------- 4„ - Car Wash brain *Note: li the fixture«or k under This ►erntil results in an Oarbage -Domestic Disposal -Commercial increase of sewer EDUs,a sewer per•ntit %sill he k%ijed and -Industrial fees assessed for the sewer increase must be paid before the Ice Mach./Refri .Drains _— plumbing permit can be issued. Oil Se rator Gas Station Ree,Vehicle Durnp Station Shower -clang Stall —- Sink -Bar/Lavatory -Bradley _ -Commercia; -Service _ Swimming fool Filtcr _ Washer-Clothes — Water Extractor - -- Water Closet I oilet _ Urinal Other Fixtures -- — OD.itAPermil For•ms\PlmPermi1AppPg2.doc 01103 BUILDING PERMIT CITY OF T I C Q R C PERMIT#: BUP2003-00280 DEVELOPP ENT SERVICES DATE ISSUED: 5/15/03 13125 SW Nail Blvd.,Ti4ard, OR 97223 (503) 639-4171 PARCEL: 2S112DD-00400 SITE ADDRESS: 15940 SW 72ND AVE B-17 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I•L r BLOCK: LOT: 017 JURISDICTION: TIG I REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: ALT _ FIRST: 3.475 sf N: S: E: W: TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: v E: W: OCCUPANCY GRP: B TOTAL AREA: 3,475 sf ROOF CLAST: FIRE RET? OCCUPANCY LOAD: 33 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: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATItS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 13,025.00 Remarks: TI: New offices, upgrade restrooms. Owner: Contractor: KAUFMAN, LOTTIE I_ + H L GREEN, HL CO INC. SUBOTNICK, RUTH ET AL 15350 SW SEQUOIA BLVD BY PACIFIC REALTY ASSOCIATES STE 300 PORTLAND, OR 97224 TIGARD, OR 97224 Phone: Phone: 624-7717 Reg #: LIC 41328 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require IlIILUJ I'crnut I ce 5!15/03 $177 70 Electrical Permit Required 13 WAX] 8'%stair Tax 5115103 $14.22 Sprinkler Permit Required Plumbing Permit Required ILS)FLS Pln It\ 5/15/03 $71.08 Frarning Insp 113UPP1,NJ Pin Itc 5/15/03 $115.50 Gyp Board Insp Total $378.50 Susp Ceiing Insp Final Inspection This permit is ,.,sued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952.001-0100. You may obtain a copy of these rules or airer3 questions to OUNC by calling (1,03) 246-6699 or 1-800-332-2344. Issued By: Pe rm it tee Signature: _ 4 Call 639-4175 by 7 p.m. for an inspection the next business day ---- � Building Perndt ApplicationMOE""" Datereceived: Permit no.: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Prola:dappl.no.: apirrdate: City of Tigard Phone: (503) 639-4171 Date issued: By:., tna: Fax: (503) 598-1960 Case file no.: I ayment type: Land use approval: —_— — 1&2 family:Simple 1 Complex: TYPE OF PiRMIT ❑ 1 &2 family dwelling or accessory ❑CDinmerciallindustrial ❑Multi-family 0 New construction ❑Demolition 0 Addition/alteration/repla,xment enant improvement ❑Fire sprinkler/alarm ❑Other.--` JOB SITE 1 Job address: Bldgvno.: Suite no.:— -- Lot Block: Subdivision: Tax tnap/taz lot/account no.: Prajectname T-ALL, Description and locatt�on premiseslspecial conditions: / G - � L?U c"e,v)_t_.11_14_ - ---- Jsp— OWNER - -- - - 1 INFORMATION. (Floodpjain, Name: PiiCTrust Mailing a_ddress: 15350 SW Sequoia Pkwy. , #300 1 &2 family dw�eWng- City: T o r t T a-n d State: 0 R zlP: 9 7 2 2 4 Valuation of work...... ................................ $ _-- 503 Phone:`624-6300 iax524-773 C-mail: No.of ................................. -- Ownces represcntative:D e n n i s P a r!i Total number of floors................................. _ Phone: Same — Fax: gIl E-i tail: — New dwelling area(sq.R) .......................... Garage/carport area(sq.ft.)......................... — - Name: P a c T r u s t _ _ Covered porch area(sq.ft) ......................... --_ #30U Deck ....................................... Mailing address.15350 SW Sequoia Pkwy, city; Portland — I State: 0 R zip: 97224 Other structure area(sq.ft.)......................... -- -'- "--- Commercial/industrial/multi-famil - �03 Phonc:624-6300 F 624-775 E-mail: y: 1 Valuation of work............... " Existing bldg.arca(sq.ft.) .......................... Business name: H.L. G r e e n _ - -- New bldg.arra(sq.f.)................................ ill, Address: SW Sequoia Pkwy. Y300 Number of stories........................................ Cy: —orta—tom— � 5 State: ZIP: 9 - --- -- Type of constr.tction.................................... � iO3Phoneb_2_4-1711 Fax__ E-mail: - - r Occupancy group(s): Existing: CCi3 no 41328 New: _ City/metro lic.no.: Notice:All contractors and subcontractors are requited to be licensed with the Oregon Constriction Contractors Board under rNamc:dohn Romish provisions ofORS 701 and may be requirrd to be licensed in the ress:15 3 5 0 S W S egu o i a Pkwy. #3 00 eximpt iro where work is being ung r aso a the appliuutt is exempt from licensing,the following reason applies: : Portland State: O R :1P.9 7 2 2.4 act person: Plan no.:103e:6�- 0 Fax{2 4-7 7 5 E-tttai l:'o h n r@ act u s lET . t m- ------ —___ Name: Contact person:--- Fees due upon application ........................... $ Address -- - -- Date receival: — City: State. 7.IP: _ Amount received .................... .................... S _---------- Phone: Fax: E-mail — Please refer to fee, schedule. I hereby certify I have read and examired this application and the Not all inrisdictitrn accept credit cartes,please cati puisit a,for;;; attached checklist. All provi sof s ordinances grivetning this a visa ❑MasterCard work will be complied w' e r spr_ct herein or not. Credit card number _— __r__— ,1.-J__ rspiru Authorized signal -f Date: 3 Name of cardholder as shown on credit cud 1'nnt name'-- -- ms s -- cudhdder druture s Atttcuat— Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 41 MUMC-'OM) I �crL1MITCITY OF TIGARD PE.MIT44 ,� ! C16-0171) COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 0:3/2£3/16 13125 SW Hall Blvd.Tigard,Oregon i'223•61N0 (503)630-4171 _ 7 PARC r L. ADDR D 5. . . . 151)40 '3W 7�M AVE AM-1-0, _'r_'PIVI SION. . . . . ZONING: I-;_ . . . . . . . . . . . LOT. ,, . . . . . . . . . . . . Ject Description : Install twe branch circuits. RESIDENTIAL UNIT__......_._ _..-TEMP r)RVC/FEEDERS- _._-MISCEt..LANECtUC 000 Or OR LESS. . . . : 0 0 ZOO =amp. . . . . . . : 0 PUMP/IRRI0A'r1ON. . „ . : ACH ^flT)II.. 50h2101". . . : 01 1:01 '400 amp. . . . . . . : 0 SIGN/GUT L14NE LTG. . 71`7-7- .-. 7" Y. . . . . . 0 4el CO.," e.mp. . . . . . . 0 SJ'f3NnL_/r(-)N1~L. . . . . . . . rh 'AN '. Hill/ QVC;1708. . : 0 601+amps- 1000 Volts. : 0 MINOR LABEL Sr f7 ICI"/fwCDC'R ZRnNC1-i Cir' - 200 amp. . . . . . : 0 W/SERVICC OR r7'- "^: 0 PEI INSPECTION. . . . . : ' 110-110 amp. . . . . . 0 i srt W/0 n1,Vr np, - �^. . 1 !^1 R Hour, , . . . . . . 60101 amp. . . . . . : 0 1-ri ADD' L BRN04 C•I RC.: f 1N r'LANT. . . . . . . . . . 01 100+0 camp. . . . . .. 0 . . {''I__Gll�: ', r'�I E W SC.CTION..._ _ ;100+ a^1p/vrs1•t.. . . . . . 0 > ::tF RES UNITC. . . . . . . . ) L00 VOLT NOMIr,"' oconnect I�nly. . . . . . 0 L`7 (VI!r'S' CL..^St- Ar!'A/"rrr YPCR TCCA IN',- r /i r 1.17 t:t by 1.., 7140 OW 72'!x'1) f1VE: Prim" 1 40. 00 CJ"; :� ''•70�f.. 9t, ;'; :1�RL Or 07C1"_ ")One #: 110CNIX CLCCTR',1- ("0 � !ice. 00 TOTAL I " s 71 SW TECH CONTE; DR REQUIRED I N"Pr—T 1C MARD OP 07""4 C Wall CoVer. F- ec.+.• • , irlal #z Elect' 1 !e, -'v:ic:e' is pereit is issued subject to the reyulatimis contained in the .jar; Municipal Codt, State of Ore. specialty Codes and all other plicable laws. All work will be done in accordance with ,proved plane. fits persit will expire if wads is not started / thin 188 days J iss.:arse, at- if wc4 is suspended for sort ;8S da)'. I4,s;.seci Ity OWNER INSTALLATION ONL." 'e iristailrztiVrl 1 ; , d made On property I awn whi.'A, i ; 1, ir,t�ncJrta Eales Isia�" , or ,'ern'.. . _. . . GHTRr-CTOR IW! ,11...i-OTIC1,1 01, . „-R1A'r!iRl_ Of- �Ur'R, CLEC+ N: _._..1Q17__. lr��.f�arl____ _._�_ Dn'TE: _ 3_arf- 96 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Halt Blvd. Tigard, OR 97223 Permit # �Zifqb- D 179 Date Issued b 9 3 ,A7- 96, 61 Phone (503) 639-4171 CITY OF TIGA�2D FAX (503) 684-7297 TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address: 4 Complete Fee Schedule Below: Name of Development - + _ Number of Inspections per permit allowed Address ggQ_ 7jj1d .-1 —_--._ Service included Items Cost(ea) Sum CitylState/Zipp 0r_j � 4a. Residential per unit — � 1000 sq. `t or less $11000 4 Name (or name of business).Qr('•1\�l�[`rti.� — Each add thereofanal 500 sq fl or $2500 portion thereol Limited Energy $25 UO 1 Commercial Residential �� --- Each Menurd Home or Modular DwAlling Service or Felder $6800 2 2a. Contractor installation only: �� 4b. Services or Feeders Installation,alteration,or relocation Electrical r—j tra tor?� ___. 200 amps or less $6000 1�i � 201 amps to 400 amps $8000 z Address ja LL — __ $12000 Cit 401 amps to 000 amps �—— 2 City —�_ tate r Zip 601 amps 10 1000 amps $14000 140 00 Phone Wo. oZ,� ,] over ioo0 amps or von% — l40 00 2 Job NO _ I __— Reconnect only $.io 00 contractor's license NO 4c. Temporary Services or Feeders Contractor's Board Reg No installation.alteration or relocation 2 Signature of Supr. Elec'n200 amps or less�.s � —_ _ - 1 p 201 amps to 400 amps $5000 1 ICerISe N0.��� ne Lt — 401 amps to 600 amps $7500 Over 600 amps to 1000 Vona $10000 2b. For owner installations: see"b"above. 4d. Branch Circuits Print Owner's Name _.-_ New,alteration or extension per pane Address a)The fee for branch clrcults with - — purchase or service or Nader he. City _ Stat@_ ZI!JEach brsneh circuit $S 00 Phone No. _ �__ __ b)The fee for branch circuits without �o J The installation is being made on property ! own which is purchueofservice orfeeder M./ ?67 not intended for sale, lease or rent Eac branchnalbr $�500 Each additional branch circuli $500 Owner's Signature _ _ 4e. Miscellaneous (Service or feeder not Included) 3. Plan Review section ('if required): Eachpumpor outline lighting $4000 Each sign or outtline lighting $40 00 Signal circuit(%)or a limited energy Please check appropriate Iterr.and enter fee in section !if) panel,alteration or extenslon $4n DO 4 or more residential units In one structure Minor Labels oo) $10000 Service and feeder 225 amps or more 4f Each additional Inspection over System over 6oC volts nominal the allowable in any of the above Classified area or structure cnrtdining special occupancy Per inspection $0500 as described In N E C Chapter 5 Per hour $5500 — In Plant $51100 T_ Subrnit 2 seta of pians with application where any of th,t above apply. Not required for temporary construction services 5. Fees: a NOTICE 8a. Enter total of above fees $ !V J 5%Surcharge (05 X total teas) $ — _ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $5b. Enter 25% of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR ,F Plan Review if required (Sec 3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. .arm rme.r.�, I Trust Account M $ FM Soo Ba;ance Due E A CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/Beam Mech Shear/Sheath Framing -Meth. Plbg.Und/Fh/Slab Plbg.Top Out Insulation lect� Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg San. Sewer Gas Line Appr/Sdwlk Reins. Other. -- —- - - -- - --- Date: ��' A.M. PK -- Entry.-,__ Address' Tenant: _ _ . _- Ste:_-- MST: c BLIP: — - -- Con/Own _ �_h�0--�/1(S ` MEC:_— PLM: ELC: _ THE FOLLOWING CORRECTIONS ARE REQUIRED ELR: or, oe oft Inspector: 1t_LDeter-" ,APPROVED --.DISAPPROVED/CALL FOR REINSP SCF CO i i TUAI,ATIN VALLEY FIRE & RESCUE AND BEAVERTON FIRE DEYARI MENT Oil 4755 S.W. Griffith Drive• P.C. Box 475.5 • Beaverton, OR 97076• (�23) 526-2469• FAX 526-2538 September.' 10, 1992 John H. Romish 2216 S. E. 24th Avenue Portland, Oregon 97214 Re: Cyber-Tech, Inc. Oregon Business Park X17 15940 S.W. 72nd Avenue 6190D-135-006 Dear Mr. Romish: This is a Fire and Life Safety Plan Review and is based on the 3.988 editions of the Uniform Fire Code (UFC) and those s,:ctions of the Uniform Building Code (UBC) and Uniform Mechanical Code (UMC) specifically referencing the fire department, and other local ordinances and regulations. Plans are conditionally approved subject to Tigard Building Department requirements and the following items: 1 . The tenant space number must be prominently displayed on the street front where it is readily visible to drivers and officers of responding fire apparatus and other emergency vehicles. UFC Sec. 10. 208 2 . Not less than one (1) approved fire extinguisher(s) with a rating of not lets than (*) shall be provided for each (**) square foot of floor area or fraction thereof. The travel distance to an extinguisher from any portion of the building, shall not exceed 75 feet. UFC Sec. 10. 303 (*) ?I,J.OB: C - Light and Ordinary Hazard 4A10B: C - Extra Hazard ( **) 3 , 000 - Li.gl t Hazard 1 , 500 - Ordinary Hazard 1 , 000 - Extra Hazard "Nbrking-Smoke Detectors Cave Lives John H. Famish September 10, 1992 Page 2 Note: Where flammable or combustible liquids are used, "B', ratings of extinguishers may need to be higher and travel distances shorter. See requirements in National Fire Protection Association Standard 10-1. 3 . Plans referred to and examined by this office contain no provisions for the alteration or installation of automatic sprinkler system. Not less than three sets of plans for the installation shall be submitted to this office for approval prior to installation. UBC 302 (b) 4 . One set of approved plans bearing the stamps of the building department issuing the construction permit and this office must be maintained on the project site throughout all phases of c�,,:struction and must be made available to building and fixe inspectors for reference durin•! required coristructi.on Inspections. UBC Se( . 303 5 . Upon completion of this project and prior t : asking for building permits for ccnstructior. this office shall be contacted for a field inspection to review compliance with fire code requirements. A final letter will be issued to the Planning Department stating compliance, with fire code requirements. Approval of submitted }-,laps is not an approval of omissions or oversights by this office or of non-compliance with any applicable regulations of local government . If I can be of any further assistance to you, please feel free to contact me at 562-2469 . Sincerely , h Bradley N. Wanamaker Deputy Fire Marshal BNW: kw cc! Jim Jaqua ✓ Tigard Building Department iylECHANICAL PERIvil T' CITY OF TIGA RD LIZ CITYOFTM - IMMUNITY DEVELOPMENT DE0AhTAk4r 01"M RD -//f 13125 SIN Hall Blvd. P.O.BW 23397,Tt",OrMPn 97223(603)6364175 1 -j)l) 0 0 LA 0 #F11 Ill SUBDIVISION— . - ZON11\16. I---L- bLOCK. . . . . . . . . . : i-O f.. . . . . . . . . . . . . 9 ---------------------------------------- CLASS OF WORK. . :ALT FLOOR FURN. . . . . EVAP COOLERS: TYPE OF USE. . . . :LOM UNIT HEATERS. . : VENT FANS. . . : 1 UCCUPANG'Y GRP- - :B2 VENTS W/O APDL: VENT SYSTEMS: STORIES. . . . . . . . : 1 BOILERS/COMPRESSORS HOODS. . . . . . . .. FUEL TYPES----------.---- 0-3 HP. DOMES. INCIN: . /GAS/ 3-15 HP. (:Olrli'rlL. INCIN: MAX INPUT: STU 15-30 HP. REPAIR UNITS: FIRE DAMPERS?. . : 30-50 HP. . .. ,. -. WOODSTOVES. . : GAS PRESSURE. . . :L 50+ lip,. . . . : CLO DRYERS. . : NO. OF UNITS----------- AIR HANDLING UN 1 -15 OTHF,r'. UNITS. i FURN ( 100K BTU: 10000 cfal : GAS OUTLETS. % 1 1- URN )=iOOK BTU: 7 1000171 (-A-m : Remarks: Tenant Impr- Cyber-Tech, Inc. , offices & waretiotise. 2. 5 ton GaSpack, I vent fan Owner- FEES 11-4K f'RUS r type amount by date rec pt PRMT $ 25. 00 BCR 09/14/92 - PLCK $ 6. 25 BCR 09/14/92 - 5PCT $ 1. 25 BCR 09/14/92 - Phant. #i Contractor: PROTEMP ASSOCIATES INC. aQA7 N. E. COUGH PORTLAND OR 97232 Phone #: 233-6911 32. 50 TOTAL How #. . : 38868 REWIRED INSPECTIONS This permit is issued sub'iect to the regulations contained in the Gas Line Insp Tigard Municipal Lode, State of Urp. Specialty Codes and all other, lylec-hanir-al Insp applicable laws, 1111 work will be done in accordance with Heating Unt Insp approved plans. This permit will expire if work -.s not started Cool my Unt Insp within 180 days of issuance, or if work is Rusprided for more Duct Inspection than 180 days. Final Inspection Permittee Signati.ire: z 6e I S S'.'I e d B y Call for inspec:t -.tori 15 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/Beam Mach. Shear/Sheath Framing -Mech. Plbg.Und/Flr/Slab Plbg. Top Out Insulation lec . Post/Beam Struct, Mech. Rough-in Gyp. Bd. T Idg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: Date:QY^� q�- A.M. P.M.__ Ent Address: ­7 Tenant: r7 Tenant _ Std:.__.-.._ MST: Con/Own: BUP. MEC: PLM: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR - --- - - CM) Inspector /t f- 1 -e f.0 _ Date: KAPPROVED __DISAPPROVED/CALL FOR REINSP ,F ^•O a7YOFTIFARD " CffYOFTM COMMUNITY DEVELOPMENT DEPARTMENT 0iRD PLLJIvJJATJ\IG PERMIT11100N 13125 SW HWI apyd. P.O.Box 23397,TqW,Or*gDn VM(5W)&W4175 PERMIT #. . . . . . . : 639 4171 DATE ISSUED: 09/15/92 SITE ADDRESS. . . : 15940 SW 72ND AVE #BLDI / PARCEL: 2SI12DD-00500 SUBDIVISION. . . . : ZONING: I-L BLUCP . . . . . . . . . . : LOI.. . . . . . . . . . . . . . CLASS OF WORK. . :ALT' GARBAGE DJS''"'OSALS. . : MOBILE-HOME: SPOCES. . TYPE OF USE. . . . :COM WASHING MACH. . . . . . . :: SACKFLOW F-'REVI\ITRS. . : OCCUPANCY 6RD. . :BE FLOOR DRAINS. . . . . . . : T*RAF'S : STORI1--S. . . . . . . . .. I WATER HEATERS. . . . , . - I CATCH BASINS. . • • . • • . F I X T'URES--- LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . SINKS. . . . . . . ^ I URINALS. . . . . . . . . . . . : (3HEAGE 1-RAPS. . LAVATORIES. . . . . .. I OTHER FIXTURES. . . . . : TUB/SHOWERS....: SEWER LINE (ft) . . . . : WP-r'[--Fq LLOSETS. . WATER LINE (ft ) . . . . DISHWASHERS. . . . RAIN DRAIN ( ft ) . . . . kemark5: Tenant Impr: Cyber.-Jecl-), Inc. , oiiicL-5 & ware.lioi.ts e. Owner: FEES PHCTRUbT type amount by date reept PRIvIT $ 30- 0111 JH 09/15/92, PLCK $ 7. 50 JH 09/15, 92 I-fione 5PC F $ 1. 50 JH 09/15/92 (-ant ract at-: ---_---____-____________________ JOHN REINHARDT PLUMBING 1 , u BUX 129 NEWBERU OR 97132 Phone #- 538---9464 $ 39. 00 TOTAL keg #. . : 01870 REQUIRED INSPECT IONS ------- ]his permit is issued subject to the requiations contained in the Ro�-Igli-in Insp Tigard Municipal Code, State of Ure. Specialty Codes and all other. lop-ol.it Insp applicable laws. All work will be done in accordance with Final Inspection approved plans. This permit will expire if work is not started within IN days of issuance, or if work is suspended for more than i3J days. Ist;l.ted By : Lail tot, inspection 639-,4115 JINN f. RUNIIAND" PLUM54NGI INC. 610 South Center P.O. Box 129 Newberg, Oregon 97132 620.3754 / 538-9464 ZIA-'-E' 9-//- 9 Z FAX-(503)684-5762 8 y : D. 6v#6cLape 7-o,6 : C Y6EjZ--r G H 46d: /s940 SW 7z 6tal rX I ST 179: v Sia lip 3� PQ,ok)E �X �J�N JOAN L REINNARDT MUM, INC. 610 Sout.� Center P.O. Box 129 Newberg, Oregon 97132 620-3754 /538.9464 �A T� 19—//— c1 Z i AX-(503)684.5762 J c•6 "C' /s5w 7Z4d!( Exi'Fr IKG oew Ej ED I k�r i r 1 Y2 3 1.6 �t� �2 �•T. �.�1`J�� ` J Yf Z ��oC_, 3' / /:.,TSG � Fx IST v�C , LAV (. SA NE Lc L'14T-/r _ LAV) �raK , CITY Ur• TiGARU PWMBING PERMIT 13125 SW HALL BLVD. P. O. BOX 2339; Applicants must hold ( -gas ReglsUation to conduct a plumbing TIGARD, OR 97223 business or must be property owner/operator not hiring outside help. Name of ftveknpment (5 0 3}639-4175 CYBER-'F H INC.--- Plumbing Permit No. Address Doscription --� 15940 S.W. 72NI), TTGARD _ ORS 614-21-6 10 OUAN. PRICE AMT, Job Tax Lot Map.No. Address -- _-- FIXTURES Inl Block St.birelsion 7.50 � - anse or name a bi iSiriess __ Lavatory—�_ ( 7.50 - 7.50 C NERAL .PEN COMPANY, TN(' Tt,.taTubfShowerComb--- —__.- 7.50 1R�a'T���e� 7.SO C NTRACTOR 15115 S.W. SEQUOIA PARKWAY,STE#2O( Stiavor Only- --- -- -- -- Owner CRY/State zip walerCloset -- 1 _ .7.50- 7.50 110VITAiND, ORFCON 97224 Dkshwasher ^— -_ --_ — 7.-() —-A Phone Garbage Disposal 7.50 _—_-- 624-7717 Washing Machine �.__. - - - 7.50 - -- Name Floor Drain ,- 7.50 ai uig ress Ptx" Water Healer 7.50 --- Laundry Room Tray 1 7.50-- 7. Occupant C;ty/Stale ---- LP - - --- --_--- 50- Unnal 7'jO Name -`—Fthorie Othef FnAures(Specify)-- - 7.50 J011N 1:. REINIIAR1',F PLUMb1N(',, INC. --- — Tu-v 1Cdaress --- t'Ixxse 750 1'.0. 13OX 129 538-9464 Contractor Ory/Stab —._ ZJp ---- - -- �- 7.50 L N 'W13 R ' OR}' ON971_ i2 MISCELLANEOUS _ City Die Tax NO Sewef 191100' _ 3000 t tele — � Sewefea.Addd.100--- ---- --- 15.00 -- -- (Rt sdaidial) - #01870 1 ,70 Water ServMx I st 100' 70.00 - 1 hereby acknoedge that I have read Ibis appiicstlon,that ttw inlomsatbn water Service ea Addi1' ' -- 15.00 wl --- given is conact,that I ern registered wills the State Builders Board•and also Storm,%Rain Drain I st.1 Do' 70.00 twee r`,'tate PkxnbbV license that the rwxrtbws given are eor*ect.that all - -- -- pkm bwtg wrA will be done in et�oonl -oce with apprc-able pruvi6icxns of rlre- Ston i Pyn Drain Addit_100' - 1500 gon Revised Stables Chapters 447 cad 6..93 cad appllcabM codes and hat Mobile Home Space 25.00 no help wN be empbyee unless licensed under ORS 683.(lt exempl from ---- -- State registration please g^ro feascn below). Bar*Flow Proveotion f 10MEONMCRS-•1 hm"ow ify tial I am the own-v of the pnsperty M- Device or MO-Pdlutia,Device - 7.50 aenbed aNwe,N~location I propoas a make a ptvnlAng InSIARation for Any Trap or Wavle Not my own,c.e a:-A cis prop"Is not benq oonstructed for sake,tease or rent. Connu!ed loa FxWm - C,"':Basks 750 Insp.of Fidel.Pkxr"N X0.00 Pec He - -- Specialty Requer.ted Inspectons - _ 40.00 Per Hi. — 1 _ Rain Drain, 15.00 Single Pam_ Dwlq. _ AUTFiORIZED SIGNATURE Deis -- - -- --- 1le6cnbs work new(] edditionN afterntion[] repalt tQ be done residential F-1 non-reeklentiel --- ----- - -- -- --- ----- FdVktO uve of MINIM11M PERMIT NES 25.00 orPfOp*rty----- — - ----_�— _ -------- SUB-TOTAL 3 uu_- t�U"cA ----- 5% SURCHARGE a PApwty-- -- 25% P LAN REVIEW 7 TMs pemit b000mon null and rad f/wort or oonevu-Aw autrwxtsed Is not aom TOTAL menOad wMhln 160davasw K cesndn.tlort or work is Mnpervlerl or abardrxned kx a packet of 100 dM at any flora ;%w wrxk 1s onnvrwv*,ad ORin bst,r►A --..- -- by �pSIN vq� TUALATIN VALLEY FIRE & RESCUE AND BEAVERTON FIRE DEPARTMENT FIRE MARSHALS OFFICE 'Oi,9F (503) 526-2469POSTED; d OCCUPANT' ' CONTRACTOR ') L 6, eay ___—i _`BLDG. PER1,1IT It_ PROJECT NAME PLAN REVIEW Ik ;.00ATION JURISDICTION; 1= Be. 2= Du, 9= K. �T�L, S= Tu. 6= Sh. 7= Wi, 8= CC 9= WC 0= PiC COVERj Ia SPECIAL FOLLOW-UP/REINSPECTION ATTEMPTED FINAL Framing Separation Walls Sprinkler System Shaft El Fire Dampers (Overhead/Underground) Alarm System F] Hood Extng Systems Conference Spray Booth Ceiling C(\•,�r Other AOL) i� ��° .� c I� f� iurjc — -- F �• bn-r1� P..v I �Y G��� b w� / ems► �� V, 5� � '�. Cep cafe: , �. Lnsl,ect.ort 8/d9 / 7 IJV t F 1 ED SEWERAGE AGENCY OF "SH 1 r1GT0N C XATI-f F I XTU E; UN i T RAT t rigs 159/2 JIS930 /5940 /-5 I59-54 TOTAL TOTAL F 1 XTURE VALUE 7�h/in P Ra olo bec-Teth. NumaER NUM-mm RAPT 1 STRY/FC7NT /. BATH - TU13/S"DWER 4 - JACUZ/L:MM 4 CUSPIDOR/WATER ASP 1 D 1 SMASiHER - C33f44 ER 4 - DOMEST 2 DR1W1NG FOUNTAIN 1 FL OM MA 1 N - 2 INCH 2 1Z - 3 1 NCH S - 4 1 NOH 6 C.ARSA E DISPOSAL - DOM CTO 3/4 M") 16 - Comm (TO x HP) 32 - IND(OVER S HP) 48 OIL SEP (GAS STA) 6 ---. SLHDQER - .ANC: 1 STALL S 1 M - .BAR 2 14 - WADLEY S - COI*dCRC I AL 3 __ e-47tV 1 LIE 3 J / WASHER.CLOTHES 6 / WATER EJ(T 6 WATER n ostcT c ,Z/// /!Z Z/, . i,R t NAL_ c �eaadl 4.5 13 66114 ,S2 S �8 s - � 9/ MTE2Z2T/ (ISP C TOTAL nS 1 NE55 OHP I S/L� L7 E°" U _ ADME SS ,e�[/ //�� /� � TTAXMAP J LG /L J t t�1 /2042 G��QOC> Ccx>rrrED FROM 8�d9 / 7 CSB P / 1x11 F 1 M SE1fERAGE AGENCY OF WASH I NG ION COINTY /__l F i 201M UN i T RAT I l�IC;S ZZZZ ,2 /.S9/ /593'0 /.5990 /s /X9.5 4 TOTAL TOTAL FIXTIM VALUE TcKblint� Ra /Q0 6,.-Tr[h Sl•nCo /VW InC. 1` +sem NUMBER RAPT I STRZY/FOfdT l BATH - TVA/SHOWER 1. - JACUZ/%HPl- ! —� CLISPIDOR/WATER ASP I D 1 SHWASFIER - ODMNER t - DOW-ST 2 UR I NIC I NG FOUNTA I N 1 FLOOR DRAIN - 2 INCH 2 f `a - 3 INCH 3 4 1 NC}I 6 \' GARBAGE DISPOSAL - V - 0016 (FO 3,ft HP) 16 - Gomm (ro 3 IIP') 32 � - INO(OVE t S HP) IA OIL SE,P (GAS STA) 6 5*40WER - GANG 1 STALL 2 S I IBC - BAR 2 �_� z 14 3! z,14 2 4 - BRADLEY S - COFAWRC 1 AL 3 - SFJrr I CE 3 J /3 ► 3 WIaSHER. CLOTHES 6 I pgTER f.X.T 6 URINAL 6 ISLI- ;2-71.Z ;Zl// l6%1 16i1 _ :�1�LTszf��_ 1 4-5/3 66114 6A15 8 L4 -5 -� 9/ 7- WSA _ rmi i DATE._��._ 1 NSP (. - TOT*t. RI)SINESS OHP- 1 /UQ Z7 Erlu �-'- ADDR[SS &2 - -5' 9C�/ �.W 7Zacl PFJi1/lT P,". -- TAX MAP/LOTz LL GOUNT'EA FR01A CERTIFICATE OF CITY OF T I GARD OCCUPANCY COMMUNITY DEVELOPMENT DEPARtMkkT PERMIT *. . . . . . . % BUP92-0266 13125 SW Hall Blvd.Tigard,Oregon 97223*8160 (60y,#30.4171 DATE ISSUED: 05/21/93 SITE ADDRESS. . . : 15940 SW 7211,1D AVE 1#31-1)17 P(4RCrz.'I-.- 2S I 121)D-00500 SUED IVISION. . . . : ZONING: 1--L BLOCK. . . . . . . . . . t LOT. . . . . . . . . . . . . GLASS OF WORK. :AL.T TYPE OF USE. . . i COM OCCUPANCY GRP. *B2 OCCUPANCY LGqDt33 TENANT NAME. . . -CYSER--TECH, INC Remar-lis.- 'Tenant Impr.- Cyber- Tec.,h, Inc. , officeri war-etiou%p. Owner: PACTRUST 15115 SW 3EQUOTA PKWY SUITE 200 TI6qRI) OR 97224 Phone #1 Contractoro H. L. GREEN .15115 SW SEQUOIA BLVD, SUITE 200 TIGARD OR 9 722 4 Phone #t 624--7717 reg f#. . 1 41328 11ccupency of the above refev-encpd bulldin!j is hereby given, and cert ifip he compliance with the 9)tkt@ Of Orprjon Specialty Codes for, ti-,@ gr-oup, C 1A I)CY, dEe under which the i-efet-enced per-omit weis issued. DEPARTMENT E DIN IN�,i-,ECJOR S JIL I G OF!'FICIAL POST IN CONSPICUOUS PLACE llISPECfION NOTICU City of Tigard quildinq 13125 Sit Hall Blvd. Tigard,Inspection Line Rec-0- 2'iPhone): 639-417 se Ph e: 670k.11 InePerctlon•_-_ �/Y,��Gf2�j '�S/ —.- Footing P1bg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gan Line F.'.NAL: Poet/Beam Struct. San. Sewer Framing -Bldg, Pust/Beam Mech. Rein Drain Ins•jlatlon -Plumb, Plbq. Underfloor Water Line ///see GYP• Bd. -Mach. Date Requested: /�7' _��' � i- 7'„ AM PN Address:__.������) %� /��/ }} _-- PBrmit it Builder: THE FOLLOWING CORRFCTIONd'ARE REQUIRED: _ ---��_�—��J'/ 1 _,��� Tse%/ �� • inspector: / L Date: _APPROVED --_-- DISAPP D APPROVED SUBJECT TO ABOVE. —✓ -C411 For Reinsp. CITYOFTIOrARD LI/ CffYOFTWAPD BUILDING PER1Y1IT COMMUNITY DEVELOPMENT DEPARTMENT 0"Oft PLR01IT # 13125 SW Hidl Blvd. .3.0.Box 23397,TOM,Or"m 97273 (603)639-4176 C7 639--4171 DATE ISSUED: 09/10/92 SIIE ADDRES5. 15940 SW 72ND i4k)[E- #i.�! .D 17 PARCEL- 25112DD-00500 SUBDIVISION. . . . : ZONIiNG: 'r -L BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . REISSUE: FLOOR FXTERIOR WALL CONSTRUCTION - Lt_f�SS OF WORK. :ALA F I RST. . . . :3 3 7 2' sf N: S E W: TYPE OF USE. . . :COM SECOND_ : s f PROTECT -I Y'PE Of CONST. :3H THIRD. . . . : sf N: 5: E W: OCCUPANCY GRP. :B2 : 3372 sf ROOF CONST:B FIRE RE'T*'? : ,( OCCUPANCY LOAD:34"" BASEMENT. : sf AREA SEP. RATED: STOR. : 1 HT. :i::14 ft GARA13E. . . : sf OCCU SEP. RATED: BS1v1T'?.N IYIE Z Z? :1\1 REDD SETBACKS-.._.__-_-__ REQUIRED_.___.-•--_•---__._____.__ .. FLUOR ETBAL;KS------------ FLOOR '­(_1AD. . . . :50 psf LEFT: ft RGHTg ft FIR SPKL: Y S01OK DET. . iN DWLL.LJNL7 UNITS: FRNT: ft REAR: ft FIR ALRII:Y HNDICP ACCsY BLDRMS: EAAf'HS: INP SURFACE; PRO CORR:11 PARKING VALUE. $- 40000 Remarks: Tenant Impi,: Cyber-Tech, Inc. , offices & warehouse. Owner: FEES PACTRUST type amount by date reept 15115 SW SEQUOIA PKWY PRNIT $ 238. 00 JH 09/ 10/9c­' SUITE LOO PLCK $ 154. 70 JLH 09/01/92 C'31157 TIGARD OR 97224 5PCT $ 11. 90 JH 09/ 10/92 Phone #v Contractor: -------------------------------- H. L. GREEN 15115 SW SEDUDIA BLVD, SUITE 200 TIGARD OR 97224 Phnne #. 624-771 .', $ 404. 60 TOTAL Reg #. . : 41326 REQUIRED INSPECTIONS - )his permit is issued subject to the reg,ilations contained in the Framing Insp Tigard Municipal Code, State Cf UFF. Specialty Codes and all other Insulation Insp applicable laws. All work will be done in accordance with Gyp Board Insp approved plans. This permit will expire if work is not started Smsp Leilng Insp within 180 days of issuance, or if work is suspended for more Final Inspection than 180 ON i -ermittee 5l gnature : Issued Bye Call for inspection 639-4175 13125 SW i1aU BW& PLNCK/RECT # — CITY O TIGAR 1O Box 23397 P ERM I T # COMMUNITY DEVELOPMENT DEPARTMENT Tiprd,Oregon97223 (503)639-4171 DATE ISSUED -- JOB ADDRESS: �,' � s�i"• %•N.� _ TAX MAP/LOT SUB: LOT: LAND USE:VALUATION: � OWNER SPECIAL n T"`�c,,,�JE �# NAME: _ Pacific Realty Associates, L.P. L'acTrust REISSUE ADDRESS: 15115 S.W. Sequoia Parkway, Suite 200 LAST REISSUE: __— Portland, OR 97224 _ i _ FLOOD PLAIN/ PRONE: _ 624-6300 SENSITIVE LAND: CONTRACTOR APPROVALS f,t9UIRED NAME: H.L. Company_ Pl_$-NNING: -- ADDRESS: _ 15115 S.W. Sequoia Parkway, Suite 200 ENGINEERING: _ Portland, OR 977.24 --__ FIRE DEPT: - -- PHONE: 624-7717 — —_ OTHER: " -- CONTR. BOARD #: 41328 EXP DATE: ITEMS RE UIRED SUBCONTRACTORS: PLUMB: _ _ LIST/SUBCONTRACTORS: —_— MECH: _ BLS TAX: ARCH ENGINEER CALCULATIONS: NAME: John H. Romish_` - TRUSS DETAILS: - ---- ADDRESS: 2216 SSE, 24th Avenue _—__ -i___ OTHER: --_ — --- Portland, OR ^7214_----- PHONE: 14 -__-- - PHONE: 236-6306 -- PROPOSED BLDG. USE: -- COMMENTS: APICANT SIGN F e - ceived B1� _----- -- --- Date Received: By. ;. . . c PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 10-432 00 Building Permit Fees 10-431 00 Plumbing Permit Fees 10.431 01 Mechanical Permit Fees _ 10-230 01 State BuilJing Tar (5%) - /A C/o Building —_ Plumbing _ Mechai,:cal 10-433 00 Plans Check Fee L �-- Building _ Plumbing _ Mechanical 10-230 06 Fire --- ---�� 30-202 00 Sewer Connection ----- 30-444 00 Sewer- Inspection _ — 25-448-02 Commercial TIF Fees ---. ----- --- 25-448-04 Industrial TIF Fees 25-448-06 Institutional TIF Fees - 25-448-03 Office TIF Fees --- -- 25-448•-01 Residential Traffic Fees — 25--448-05 Mass Transit TIF Fees - — 52-449 00 Parks System Dev Charge (PDC) --.— --- 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) -J 24-445-01 Water Quality (Fee in lieu of) - 24-445-02 Water Quantity (Fee in lieu of) �C, TOTAL �5 - nm/3581P.WPF CITY OF TIGARD r-i _.rTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: EL_(797-021.5 13125 SW Nall Blvd.,Tigard,OR 97223 (503)639-0171 DATE ISSUED: 04/17/97 PARCEL: 2S112DD•-00500 S T TE' ADDRESS. . . :: 15940 SW 72110 AVE. #BI__1)]. SURD IVISIOh1. . . . : ZONTNG: I-L BLOCK. . . . . . . . . . . L_OT.. . . . . . . . . . . . . . JURISL ACTION: TIG Project Description: instl ! branch circuit ---RESIDENTIAL LJNIT------- -----TEMP 5RVC/FFrDERS----- -----MISCEL..LANEOUS----- t000 SF OR LESS. . . . : 0 0 - 2LAO amp. . . . . . . : 0 PUMP/IRRICATTON. . . . : 0 EACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 STEN/OUT LINE L.TG. . : 0 I_T M I TF'D ENERGY. . . . . : 0 401 - 600 amp. . . . . . . . 0 S I GNAT_/PANEL.. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 6014-amps--1000 volts. : 0 MINOR I_AREL_ ( 1.0) . . . : 0 -- --SER!%ICE:/FEEDER-- -- -----BRANCH CTRCUITS-------• ----ADD' L INSPECTIONS---- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 ='0] 4017, amp. . . . . . : 0 j.st. W/O SRV(: OR FDP,. . 1 PER HOUR. . . . . . . . . . . . '71 F�00 Amp. ,. : 0 EA ADD' L BRNCH CIRC: 0 IN PL.ANT. . . . . . . . . . . . 0 1000 amp. . . . . . 0 - _-- - -----------PL.AN REVIEW SECT TON- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . .. . . . . : ) 600 VOLT NOMINAL,_. . pp(-.nnriPrt only. . ., . . : 0 SVC/FDR > =225 AMPS— : CLASS AREA/SPEC OCC. Owner-: ---------------------- ----- --- ---- ---- _ _ -_ __ PEES --......_.__. _.. -_------ - rIRFGON BUSINESS PARK type amount by date rer_pt 15940 SW 72ND ST PRMT $ 35. 00 TAT 04/11/97 97- '`73].66 T TGARD OR 972;='.7 5PCT $ 1_ 75 75 TAT 04/11/97 97-293166 Phone #: Contir..tar. -----•-•-------------------------'-_._._-------------_-.-.---__-__-_-.-----.____ JOHANSEN ELECTRIC INC $ 36. 75 TOTAL 1130 N7 174TH ------- REQU T RF'D INSPECTIONS PORTLAND OR 97230 Ceiling Cover Under^grot_md Cove PI-ione #: 503--'c'52--4881 Wall Cover Fleet' l Ser^vire Reg #. . : 000515 Thi, p4rait is issued subject to the regulations rantained in the Tigard M-micipal Code, State of Ore. Specialty Codes and all other Permit ,^,i gnats-it applicable lases. P11 work will be done in accordance with approved plans. This pereit will expire if work �s not started within 18N days of issuanre, or if work is suspended for eor! is _ than 188 days. Isled By Y - --- - ---- --nWNER INS'fAL_1-ATION ONLY---- 'The* installation is heing marle on property I own whic-h is not intended for sale, leasf-, or- rent. OWNER' S SIGNATURE: DATE: TNSTAL-L�ATTON ONLY----------- ----------------- RIGNA'Tl1RF OF SUMEl_.EC' Ns / .� �� _ nATEe _Y�-Z_4 - C � ICFNSF NOa -a.. Call for inspection - 639-4175 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # �—�� Date Issued __- Phone (503) 639-4171 FAX (503) 684-7297 CITY Of TIGARD TCD No. (503) 684-2772 Inspection (503) 639-4175 r 1. Job Address: 0 ( 4. Complete Fee Schedule Below: Name of Development 4� �T-�"Tt`� ' Number of Inspections per permit allowed Address "1 `tr�U ' Service included Items Cost(ea) Sum City'State/Zip___ � a,/i _ 4a. Residential -per unit — 1000 sq. ft. or less $11000 Name (or name of business) Ir t C b]� ILS. Each additional 500 sq ft at $25 00 portion thereof 1 Commercial �tesidential ❑ Limited Energy _ $2500 Each Manurd Home or Modular Dwelling Service or Feeder $6800 _ _ ' 2a. Contractor installation only: 4b. Services or Feeders 1 installation,alteration,or relocation 2 Eleetricai Contractor t I� �' _ 200 amps or less $6000 2 Address � � u 201 amps to 400 amps —_— $8000 .�J L --� 401 amps to 600 amps $12000 City �1 Statues Zip q 7„� 601 amps to 1000 amps $lop 00 2 Phone No. 2 � > � " Q J� Over 1000 amps or volts $34000 � 2 Job NO Reconnect only $5000 _ contractur's license NO._f ;7 �._� 4c. Temporary services or Feeders Contractor's Board Reg. No. Installation,alteration,or relocation 2 200 amps or less Signature of Sypr. E12c'n_ _ -- 2 `l 201 amps to 400 amps _ $5000 License No _�[ CPhone �`�i - 401 amps to 600 amps $7500 7 over 600 amps to 1000 volts $100 00 -- 2b. For owner installations: see"b"above 4d. Branch Circuits Print Owner's Name ____ r1ew,e'leretion or extension per pane Address a)The fee for branch circuits with CityState Zip purchase of service or feeder fes Each branch circuit _ $5 00 Phone No. _ _^_ _ _ b)The fee or branch circuits without The installation is being made on property I own which is purchase nf service or feeder fee. First branch circuit —A_ $3500 i no: intended for sale, lease or rent Each additional branch circuit $500 nwnpr's Sig:ature v._ 4e. Miscellaneous (Service or feeder not Included) Foch pump or Aline circle -- $4000 _ _ 3. Plan Review section (if required): -- Fech sign or cutlie lighting S40 00 _ I Signal cirrrarj)or a limited energy Please check appropriate item and enter fee in section 56. panel utteration or extension $4000 4 or more residential units in one structure Minor Labels(to) $10000 Service and feeder 225 amps or more 4f. Each additional Inspection over System over 600 volts nominal the allowable in arty of the above Classified area or structure containing special occupancy Per Inspection $3500 as described in N E C. Chapter 5 Per hour - $',50o In plant 355 00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5- Fees: 5a Enter total of above fees $ NOTICE 50h Surcharge (.OB X total fees) $ � Subtotal _ PERMITS BECOME VOID IF WORK OR CONSTRUCTION Mr AUTHORIZED IS NOT COMMENCED WITHIN 180 5b. Enter Subtutal DAYS, OR IF plan Review If required of line A $ for (Sec.3) S CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS CnMMENCED T=°� .M, Trust Account M S wm wit '� Balance Due 411, —3— ELECTRICAL - CITOF TIGARD RESTRIC EDPI 1 ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00161 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 LATE ISSUED: 6/16/03 SITE ADDRESS: 15940 SW 72ND AVE B-17 PARCEL: 2S112DD-00400 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I-L BLOCK: LOT: 017 JURISDICTION: TIG Proiect Description: Low voltage for voice/data cabling. A.RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: - INTERCOM & PAGING- BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/FELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS: Owner: Contractor: —� KAUFMAN, LOTTIE L + BROADWAY ELECTRIC LOCHRAN INC SUB')-rNICK, RUTH ET AL 626 SE MAIN BY PACIFIC REALTY ASSOCIATES PORTLAND, OR 9721,d PORTLAND. OR 97224 Phone: Phone: FAX-238-2098 R:a#: LIG4-65600072942 SUP 34475 _ ELE 37-546C _ FEES 1 Required Inspections Description _ Date — Amount Lcw Voltage Inspection 11 1 HI MTJ ELR Permit 6/16/03 $75.00 Elect'I Final 1'i A X J 8",4,4tatr Tax G/16/03 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigarc Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Qregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set fft A"2-001-0010 throuc 7 Issued by � n �� ��, ,t _ Permittee Signatur - i OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent, OWNER'S SIGNATURE: _ —_ _ DATE:__— CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N —_ _ DATE:-_­_ LICENSE NO. Call 639-4175 by 7:00 P.M. for an inspection needed the next business day PlectricM Permit Application Date received . Qom` Permit no.: City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW flail Bivd,Tigard,OR 97223 1%teissued: H Phone: (503) 639-4171 Receipt no.: Lax: (503) 598-1960 Case file no.: Payment type: Land use approval: -- -------- - t U 1 & 2 family dv clling or accessory fsi Commcrr ial/indu.'i wl U Multi-family U Tenatu improvement U New construction ement U Other: U Partial JOB SITEINFORMATION Job address: 0 _ lA) ~' ►/t Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: I Block: Subdivisicm: Project name: rmill4vtlergA • [)ascription and location of work un premises: O�r� Estimated date of ct mpletion/inspection: - CON I 1 I Job no: 01Fee Max Business name: 19 f A^ A ,/ i Description Qty. (ca.) Total nn.lusp _ �C,rl L __ _ New r residential single or mrdll42mily per— Address: 1r /�'l�r r _ dwelling will.hu lad.s altadnvl l mage. City: 01 a ti State: ZIP: Q 7 Z/ Service included: Phone: ?.71-494 Fax: •U 111'I E-mail: --- 1000 sq.ft.or leas 4 Each additional 500 sq.fl.or portion thereof CCB no.: - _7- q�J Elec.bus.lic.no: ] -S Limited enc y,residential _ 2 City/meta kc. o.: r ,.+ -J t 7 J I Limited energy,non-residential 2 Each manufactured home or modular dwelling Signature of supervisi C electrician(required) Date Service and/or feeder 2 Su elect. Servlcesorfeeders-Installation, Sup �e �� License no: alteration or relocation: 200 amps or less Name(print): 201 amps to 400 amps _ 2 401 amps to 600 amps 2 Mailing address: --- -- ----- ---- 601 amps to 1000 amps _ 2 City: Slate:._ ZIP: — Over 1000 amps or volts _ 2 Phone: Fax: E-mail: Rxonnectonl —� I Owner installation:'Ilse installation is being made on property I own Temporary services oriisti6n- which is not intended for sale, lease,rent,or exchange according to InstallaUan,alteration,orrelocauon: ORS 447,455,479,670,701. 20(1 amps or leas 2 201 amps to 400 amps 2 1)wner's signature: Date: 401 u,600 amp 2 Branch circuits-new,alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: _ service or feeder fee,eaa.h branch circuit 2 City: Steele: ZIP: B. Fee for branch circuits without purchase — — _ --- of service or feeder fee,first branch circuit: 2 Phone:---�Fax..... E-mail: Each additional branch circuit _ W1 I Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Health-Lam facility Each pump or irrigation circle 2 U Service over 320 amps-rating of I&2 U Har rdous location Each sign or outline lighting _ _ _ 2 `amity dwellings U Building over 10,000 square feet n ar or Signal circuit(s)or a limited energy panel. I 7�as S~ 2 U System over 600 volts nominal more residential units in one structure alteration,or extension- _ U Building over three stories U Feeders.400 amps or mote "Description: _ U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspn1ion over the allowable In any of the six re.: U Egres0ightingplan U Other. --_ Per inspection Submit._sets of plant with any of the above. Investigation fee The alcove are not applicable to temporary construction service. Other I to all judsdlctiau accept credit cards,please call jud"ction for more.Infonnauion. Notice:This permit application Permit fee....................$ U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit card number: __—_ _ within 180 days after it has been State surcharge(8%)....$ -- `''""' accepted as complete, TOTAL. .......................$ _ ure of can$ol i u sbown on credit car S ^ Car holder signature --�- Amount 4dU 4615(~'OM) CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4i7a MST INSPECTION DIVISION Business Line: (503)639-4171 SUP Receive) _—__ Date Requested O_—__ AM_ — PM__ __ BUP Location -___ 0;-'F yG) _--A__ -- Suite — MEC ___-- Contact Person — _ _ Ph PLM — Contractor— -- - Ph(-----} --- -- — SWR --- — BUILDING Tenant/Owner __. _--_ __--__._ �_ --_._ ELC __-- Footing ELC Foundation Access: Fig Drain Eli' Crawl Drain _ Slab Insp,ction Notes: SIT Post&Beare ----- -- ----- -__ --- --- _ _ 1-aar Anchors Ext Sheath/Shear -_ Int Sheath/Shear Framing -------- Insulation -Insulation Drywall Nailing ---- - - ....--- ----------- --- Firewall Fire Sprinkler --- - - - _—_--- Fire Alarm Susp'd Ceilin_ ---- -__ -- - - - - _ - - - -------- Roof -- -------- Other: Final PASS PART FAIT_ — Post&Beam Under Slab --- - - - - - - --- - _ Rough-In Water Service - - -- - - -- - - - -- rnitary Gower Rain Drains - - - -- ---- - - Catch Basin/Manhole Storm Drain - - -- -- - -_ Shower Pan Other: - - - --- - - - Final - - _ - - - - PAS5 PART FAIL. Post&Beam Rough-In ------ Gas Line Smoke Dampers - - - Final PASS PART FAlL -- ELECTRICAL F rvice Houyn gh-In Slab L� Fire Alarm PART FAIL L-1 iiib OI—E Reinspection fee of$ _ . __--_._ . requirad before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS - Please call'or reinspection RE:__ -- -.______ , Unable to inspe -non-cess ------ Fire Supply Line � •-- ADA Data'` j Inspector 4- "� a Approach/Sidewalk t{'�=- Other:_---- Finsf DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITYOF TICARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00293 ---� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/4/03 PARCEL: 2S112DD-00400 SITE ADDRESS: 15940 SW 72ND AVE B-17 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I-L BLOCK: LOT: 017 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: 0 BOILERS/COMPRESSORS HOODS: _ FUEL TYPES _ 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING_ UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Relocate ducts&grille~ fm tenant 1111pl-m rmriit. Owner: — _ --- FElS KAUFMAN, LOTTIE L 4- Description Date Amount SUBOTNICK, RUTH ET AL %IFC'H) Permit I cc 6/4/03 $72.50 BY PACIFIC REALTY ASSOCIATES PORTLAND, OR 97224 I_f.�k1 R Slaw l;i . -- 6/4/03 $5.80 Phone: — Total $78.30 Contractor: PROTEMP ASSOCIATES INC 9788 SE 17TH AVE PORTLAND, OR 97222 REQUIRED INSPECTIONS Phone: I I Duct Inspection Misc. Inspection Reg #: LIC 35868 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty C d,3s 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 ATTt- (TION: Oregon law requires you to follow rules ador.ted in the Oregon Utility Notification Center. Those rales are set forth in OAR 952-001-00 Issu d Sy: 1 Permittee Signature. call (50) 6. ••4175 by 7:00 b P.M. for inspections needed the nex uslness day ( ) r Mechanili al Permit A1' Neation ' 1N� Received NLY Mcchanira ��ll Date/13 : dc3 Permit No.: HE14oe�9-00 a4 3 City of Tigard Planning Approval Building - Y g Date/By: Permit No.: �� 13125 SW Hall Blvd. Plan Review Other - 'rigard,Oregon 97223 Date/By: Permit No.: _ Phone: 503-639-4171 Fax: 503-598-1960 Post-Revicw Land Use Date/By: Case No.: Internet: www.ci.tigard.or.us Contact Juyy'ss See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: r101 su lemental Informati m. TYPE OF WOL2_K _ COMMERCIAL FEE'SCHEDULE-USE CHECKLIST New construction Demolition Mechanical permit fees*arc based on the total value of the work i performed. Indicate the value(ro+tnded to the nearest dollar)of all AddiUotJalteration,1e�lacemcnt 1_n Other- CATEGORY OF CONSTRUCTION mechanical materials,equipment labor,overhead and profit. EJi Value: S See Page 2 for Fee Schpdule 1 &2-Family dwelling �mmerciaL Industrial RESIDEN 7AL EQUIPMENT/SYSTEMS FEE'SCHEDULE Accessory Buildt—�_ M_ulti-Family _ Description - I (1ty Fec ca. Total Master Builder ❑ Other: tfeatin Conlin JOB SITE INFORMATION and LOCATION Furnace-add-on air conditioning" 14.00 -� Job site address: ;�-qy c �• .,,,�-i ✓) Gas heat pump — 14.00 _Suite#: _ I Bldg./ t.#: ! 7 Duct work 14.00 Pr_o'ec� t Name: c' i �,Cn,KE H dronic hot waters stem 14.00 Residential boiler — Cross street/Directio s to job site: for radiator or hydropics stem 14.00 Unit heaters(fuel,not electric) in wall in-duct,suspended,etc. 14.00 Flue/vent Sfor any of above 10.00 Subdivision: Lot#:_ Repair units 12.15 -- Other Fuel Appliances Tax map/parcel __ _Water heater 10.00 _DESCRIPTION OF WORK _•_ Gas fireplace _ 10.00 Flue vent(water heater/ as fire lace 10.00 L�hter as 10.00 Ott- ------ ----- ---- Wood/Pelletstove_ 10.00 Wood fireplace/insert 10.00 _ Chimney/liner/flue/vent 10.00 OPERTY OWNER TE)S ANT_ Other 10.00 Environmental Exhaust&Ventilation Name: .. __ Address: Range hood/other kitchen equipment 10.00 — - - - --•� Clothes dryer exhaust 10.00 City./State/Zit: -__ Single duct cyhaust Phone: _ Fax: (bathrooms,toilet compartments, APPLICANT CONTACT PERSON utility roomsL — 6.80 Nance: Attic/crawl space fans — __ I 10.00 Address: Other: 10.00 Fuel PipingCity/State/Zip: __ _—.155.40 for first 4.$1.00 each additional' Phone: pax";��' Furnace,etc. •� _ - ---_I_ -- Gas heat pump _ •• E-mail: _ — Wall/suspended/unit heater •' _ CONTRACTOR Water heater _ •' Business Name: oy�.-yh�U_Ld t . - le.� Fireplace " Address: � <,e /)� Qty _ — Range •� ��, BBr1 .. Cid 5��//L/State/Zi : -rL u r ,r Clothes dryer(gas) - •* Phone: Fax: 7 . -7 Other: _ .. CCB Lic. #: 32 Mechanical_ cal Permit Fees' Authorized — Signature: Date:-� —`— — Subtotal $ _ Minimum Permit Fee 572.50_ s 5-0 -T _Plan Review Fee 25%of Permit Fec s _ (Ple.s print name) State Sure h_ar a 8%of Permit Fee) S 5. 90 TOTAL PERMIT FEF, S -,-17_& , 3Cj Notice: This pennFt application esplres if a permll h not obtained within *Fee methodology set by Tri-County Building Industry Service Board. IAO days after it lus been accepted as cmnplete, "Site plan required for exterior A/C units. is\Dsts\Permit Fortm9\MecPcrrrutApp doc 01/03 Mechanical_Permit_Annlication - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: _ Total Valuation Permit Fee: $1.00 to$5 000.00 Minimum fee$72.50 55,001.00.o$I0,W,J.00 $72 50 Cc-the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and including$10,000.00. _ $10,001.00 to$25,000.00 $148 50 for the first$10,000.00 and $1.54 for each additional$100.(x)or fraction thereof,to and including $25,000.00.__ _ $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additiona!$100.00 or fraction thereof',to and including $50,000.00. _ $50,001.00 and up $742.00 for the first$50,000.00 and I $1.20 for each additional$100.00 or fraction thereof'. _T Assumed Valuations Per All lian:e: Value Total Description: La Amount _ Furnace to 100,000 BTU,including 955 ducts&vents _ Fumacc>100,00013TUincluding ducts 1,170 &vents _ Floor furnace including vert 955 Suspended heater,wall heate-or floor 955 mounted heater _ Vent not included in appliance permit 445 Repair units 805 <3 hp;absorb.unit, 955 to 100k BTU 3-15 hp;absorb.unit, 1,700 101k to 500k BTU 15-30 hp;absorb.unit,501k to I mil 2.310 BTU -- 30-50 hp;absorb.unit, 3,400 1-1.75 mil.BTU >50 hp;absorb.unit, 5,725 >1,75 mil.BTU Air handhn tg mit to I0L000 cfm 656 Nit handling_unit>10,000cfm 1,170 Non,portable evaporate cooler 656 'vent fan connected to a single duct 446 Vent system not included in appliance 656 �ctmit _ I hood served by mechanical exhaust 656 Domestic incinerator _ 1,170 __`__ Commercial or industrial incinerator 4,590 t)then unit,including wood stoves, 656 inserts,cte. (insi ing 1-4outlets �_ 300 _ Bach additional outlet 63 TOTAL COMMERCIAL $ VALUATION: ODsts\Permit Forms\MecPermitAppPg2 doc 01/03 ELECTRICAL - CITY OF TIGARD RESTRICTED N RIGY DEVELOPMENT SERVICES FERMIT#: ELR2003-00153 13125 SW Ha4l Blvd., Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 6/4/03 SITE ADDRESS: 15940 ",'V 72ND AVE B-17 PARCEL: 2S112DD-00400 SUBDIVISION: ORE,-,ON BUSINESS PARK 1 ZONING: I-L BLOCK: LOT: 017 JURISDICTION: TIG Proiect Description: Limited energy for HVAC. A._RESIDENTIAL B.COMMERCIAL !— AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANOSC LITE: OTHER: HVAC: X PROTECTIVE JiGN'AL: INSTRUMENTATIC.o: OTHER: Owner. -- — TOTAL#OF SYSTEMS: 1 Contractor: _— KAUFMAN, LOT i IE L + FROTEM'J ASSOCIATES INC SUBOTNICK, RUTH ET AL 807 NE COUCH BY PACIFIC REALTY ASSOCIATES PORTLAND, OR 97232 PORTLAND, OR 97224 Phone: Phone: 2.13-6911 Reg #: ELE 26-I063C'RE LIC 38868 'vl FT 000045% FEES — —_ til'I' F464MOA Inspections _ Description —_ Date Amount Low Voltage Inspection — I Lr'KNTI I ki,R I'crniit 6/4/03 $75.00 Eleci'I Final i rAXj 8%State Tax 6/4/03 $6.00 Total— $81.00 This Pe nit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be. done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires YO!, to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 i 0 throuc Issued by -�� ,,¢ Permittee Signature OWNER INSTALLATION_ONLY The installation is being made on property I own which Is not intended for sale, lease. or rent. OWNER'S SIGNATURE. __-- —_ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: t_ICENSE NO: — -- --- ------- — — — -- Call 639-4175 by 7:00 P.M. for an Inspection needed the next business day _ Electrical Permit Application Received Electrical Date/By: Y Permit No.: fir'Jr Planning Approval Sign City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.:Hf""6-!?� Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land use Date/B _ Calc No.: Internet: www.ci.tigar-1.or.us Contact Juris.: 0 see Page z for 24-hour Inspection Request: 503-639-4175 Nam./Method: Su Itmental Information. TYPE OF WORK _ - PLAN REVIEW Please check all that apply) _New construction I _Demolition Service over 225 amps- Health-care facility commercial ElHazardous location /\dllttiOri/alteration/rcpl8cement Q Other: _ ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, ^ CATEGORY OF CONSTRUCTION I &2 family dwellings four or more residential units in &2-Farnildwellin _ommercial/Industrial ❑system over 600 volts nominal one structure ❑Building over three stories ❑Feeders,400 amps or more Accessory Buildin Multi-Family _-_ ❑Occupant load over 99 persons ❑Manufactured structures or RV park LJ Master Builder Other: ❑ligress/lighting plan ❑Other: .__— JOB SITE.INFORMATION and LOCATION Submit—sets of plans with auy of the above. The above are not applicable to temporary construction service. Job site address N� r _ _ FEE*SCHEDULE Suite#: $4k� i Bld JApt.#: i Number of Ins ectlonsTF terperml(allowed Project Name: Description ---- Qa Far(ea.) Total - Ntw residential-single or multi-randly per Cross street/Directions to Job site: dwelling unit.Includes attached garage. Service Included: 1000 .1l ur Its 145.15 4 Each additional 5t81 sq.it.or portion thereof 33.40 1 Limited energy.,residential _ 75.00 __ 2 Subdivision: -- Lot#: __ Limited energy,non residential 75.00 _ 2 Tax map/parcel M --- Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 ---- Services or feeders-Installation, - alteration or relocation: 200 am s or less 8030 2 _ ------.----__..----_- ------._-_---- 201 amtis to 400 mnps 106.85 i 2 401 amps to 600 am — 160.60 2 OPERTY OWNER IFNANT 601 w 1000 r v s — 240.60 2 � -•- Overr I00(1 amps or volts— 454.65 2 NameReconnect onl _ -- 66.85 2 Address: Temporary services or feeders-Installation, — alteration,or relocation: City/State/Zip: 200 amps or less _ 66.85 I — -- 100.30 Phone: Fax: 201 amps to 40(1 amps 2 -_- 401 to 600 amps � 133.75 _ APPLICANT CONTACT PERSON Branch circuits-new,alteration,or Name: extension per panel: A.Fee for branch circuits with purchase of Address:_ _ _ ____. _ service or feeder fee,each branch circuit 6.65 7 City/State/Zip: _ B.Fee for branch circuits without purchase of service or feeder fee,first branch circuit 46.85 2 Phone: Fax: Each additional branch circuit 6.65 2 Misc.(Service or feeder not included): E-mail: - Each pump or irrigation circle _ _ 53.40 _ _ CONTRACTOR Each sign or outline lighting _ 53.40 _ 2- Job No: Signal circuit(s)or a limited energy panel, alteration or extension Pee 2 Business Name: jL 7F A=52r Description: — Address: gAS ` ���`� Each additional Inepectlon over the allowable In4anf the above: City/State/Zip: f(Jjr,C,�(A/rJ Per inspection oar hour(min. I hour) — 62.50 _ Fax: ' �7 Inveati�ation fee: Phone_ �.Y�/ _ other: CCB Lic, #: SS�S�.S Lic. #: ,3 G Electrical Permit Fees* Supervising electrician subtotal S �Ptrintnature ree uired: Plan Review(25%ofPermit Fee)Name: State SurchargeSB°/a of Permit Fee) $_ _ TOTAL PERMIT FEE S _ Authorized Notice: This permit application expires If a permll Is not obtained wltIAn Signature: Date:G 180 days after It has been accepted as complete. (/ •:ee methodology set by 1'ri•(ountp lioildinr Industry Service board. least print name) t`Nts`.Permit Fomu\FlcPermitApp.doc 01103 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems............................................................ $75.00 Check't'ype of Work Involved: F] Audio and Stereo Systems* ❑ Burglar Alarm u Garage Door Opener* DHeating,Ventilation and Air Conditioning System* Vacuum Systems* Other_____— COMMERCIAL,WORK ONLY: Fee for each system.......................................................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: Audio and Sletco Systems Honer Conlro6 Clock Systems I)ata Telecommunication Installation Fire Alarm Installation IIVAC l Instrumentation Intercom and Paging Systems I andscape Irrigation Control* Medical Nurse(-ails Outdoor landscape Lighting* Protective Signaling L I Oth:r __—Number or Systems * No licenses are required. Licenses are required for all other Installations i\Dw\Pcrmit Forms\HcPrrmitAppPg2.doc 61/03 01TY OF TIGARD 24-Hour BUILDING Inspection Line, (503)639-4175 INSPECTION DIVISION Business Lire: (503)639-4171 MST — BUP Received — Date Requested �� 6P �� AM PM _— BUP Location �-��/D 7 2,�i�-cf Suite MEC __3 ��q 3 Contact Person r' � - Ph (—) 6-/�! PLM _ Contractor U __ Ph( ) — SWR BUILDING Tenant/Owner _�f/� .l.L,�7�� ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain --- Slab Inspection Notes: SIT Post& Beam Shear Anchors -- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing --- - - -- -- -- - --- ---- Firewall �f- Fire Sprinkler --- - -- -- ---_ .. --- - --- --- Fire Alarm Susp'd Ceiling ---- Roof / Other. Final PASS PART FAIL - --- _ ____ Post&Beam Under Slab -- - - - -- - - -- -- -- - ___ -- - -- Rough-In Water Service - -- - --- -- -- - - -- - - - -- -- Sanitary Sewer \ Rain Drains - -- ----- - Catch Basin/Manhole Storm Drain -- -- - - --- - -- - - Shower pan Other: ---- ----- __- ------ -- --- --.-- -- — Final ___--- _ RT FAIL --- -- - ----- - CRANI Rough-In _ Gas Line Smoke Dampers -- ---...__..- ------ -- - - — - - - ---- -- Mnal AS PART FAIL - EL . RICAL Service --- ------- --- -.- -— Hough-In UG/Slab Low Voltage ------- -_---- —� Fire Alarm - -- Final Reinspection fee of$__-- - required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL S_IT_E I Please call far reinspe,it,it, nF Unable to inspect-no access Fire Supply Line ! �_ ADA / v� �� Approach/Siaswall< Dart• = 7 Inspector J �' Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL