11535 SW DURHAM ROAD STE C-3 1
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11535 SW DURHAM RD STE C:-3
CITYOF TIG,A►RD CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: BUP2001-00138
13125 SW Hall Blvd.,Tigard, OR 97223 (50316,19-4171 DATE ISSUED: 05/16/2001
PARCEL: 2S110DC-02300
ZONING: C-G
JURISDICTION: TIG
SITE ADDRESS: 11535 SW DURHAM RD C-4
SUBDIVISION: PARTI'TION PLAT 1998-128
P'-OC K: LOT:
CLASS )F WORK: ALT --�-� —i
TYPE OF USE: CUM
TYPE OF CONSTR: 3 1 HR
OCCUPANCY GRP: B
OCCUPANCY LOAD: 56
TENANT NAME:
RENIAF.KS: Tenant Improvement
Owner:
DURHAM/99 ASSOCIATES LTD PTNSH
BY CRIIMI MAE SERVICES LP
ATTN LOgN SERVICING
ROCKVILLE, MD 2.0852
Phone:
Contractor:
COUNCIL CONSTRUCTION INC
819 SIERRA VISTA
NEWBERG, OR 97132
Pl.one: 503-538-7595
Reg 0: LIC 46613
This Certificate issued 06/14/2t'411 grants occupancy of the above referenced building or
portion thereof and confirms that the building has been inspected for compliance with the
State of Oregon Specialty Codes for the group, occupancy, and use under which the
referenced permit was issu
1
N
POST IN CONSPICUOUS PLACE
CITY CJ F T i G A R D BUILDING PERMIT
PERMIT#: BUP2001-00138
DEVELOPMENT SERVICES DATE ISSUED: .5/16/01
13125 SW Hall Blvd.. Tiraard, OR 97223 (503) 639-4171 PARCEL: 2S110DC-02300
SITE ADDRESS: 11535 SW DURHAM RD C-4
SUBDIVISION: PARTITION PLAT 1998-128 ZONING: C-G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERi_OP WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: v sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3-1 HR sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0,00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 56 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSPAT?: MEZZ?: REQD SETBACKS __REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEORMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VX.UF: $ 10,000.00
Remarks: Tenant Improvement
Owner: Contractor:
DURHAM/99 ASSOCIATES LTD PTNSH COUNCIL CONSTRUCTION INC
BY CRIIMI MAE SERVICES LP 819 SIERRA VISTA
ATTN LOAN SERVICING NEWBERG, OR 97132
RQKdILLE, MD 20852
no Phone: 503-538-7595
Reg #: LIC 46513
FEES-- REQUIRED INSPECTIONS__
Type By Date Amount Receipt Mechanica, Permit Require
PLCK CTR 4/24/01 _ $96.79 27200100000 Electrical Permit Required
PlUmbinq Permit Required
FIRE CTR 4124101 $59.55 27200100000 Framing Insp
PRMT CTR 5116/01 $235.30 172005100000 I Gyp Board Insp
5PCT CTR 5116/01 $18.82 27200100000 Susp Ceiing Insp
Final Inspection
Total � $410.47
This permit is issued subject;o 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 -:,tans. This permit will expire if work is
not started within 180 days of issuance, or if work is susoended for more th-,,i 180 days. ATTENTION: Oregon law
regiIires you to follow the rules adupted by f8 O+eyon Utility Notification Center. Those rules are rot forth in OAR
952-001-0010 through, OAR 952-fiU1.1987. You may ubtam a copy of these rules or direct questions to OUNC by
calling 1503) 246-6699 or 1-800-332-2344.
Pe rm It tee
Siynatura:
Issued By:
CPII 639-4175 by 7 p.m. for an inspection the next business day
1
Building Permit Application
1
City of Tigard Date received: q-0 LPe it n .:-2"l _oo
City of Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no,: Expire date:
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) J98-1960 Case file no.: Payment type:
Land use approval: 1&2 family:Simple Complex:
U &21'a m' lling or accessory ommercd /industrial U Multi-family U New construction v6cmolition
Additio alteratto eplacement ❑ anent indpmvement U Fire sprinkler/alarm U Other:
�.
i
Job address: '" •) a V Bldg.no.: Suite no.:_
Lot: Block: Subdivision: rTax map/tax lot/account no.:
Project name: L -- ----
----
•scription and locatic n of work on p mises/spccial cunditiolr1s: t�
Name: 6V, o L)_C '
Mailing addrek 5zc, C LtdU !dt 2 family dwelling:
City: State: v ZIP: Valuation of work........................................ $
Phone: fax: E-mail: No.of hhlaaomlbaths................................ -
Owner's representative: total number of ............. .............
Phone: Fax: - E-mail: New dwelling area(s ........ ............
NELGarage/carpo (sq. ft.)......... ...... .
Name: v —C' Covered po h area(sq.ft.) .............•......... -
Mailing address: 2 r. �-- Deck area(sq.ft.) ........................................
City: State: Y "LIP: Other struA re area(s .ft.).........................
Phone: Fax: E-mailommercla ndustrial/multi-family:
a uation of work........................................ $Akov6
Existinghid areas ft. SLG
Business name _P CbLA re ( q. . ..•....................... _
Address: �' � New bldg.area(sq.ft.). ..........................:...`--+._�._...-•--
Number of stories _
City: „ Statc:O✓ ZIP: .. .... . .... ..... ...... ... -
--A 25! d — Type of construction.................................... its
Phone: - 7 ax: TE-mail.
CCB no.: y* c,,,�91 koro rz�- Occupancy group(s): Existing:
New:
City/metro lic.no.: Notice:All contractors and subcontractors are rNuired to be
licensed with the Oregon Construction Contractars Board under
Name: ���� ��'Q11111 , provisions of URS 701 and may be required to be licensed in the
Address:�f+ Zt �, -- jurisdiction where work is being performed.If the applicant is
City: Stat r P; exempt from licensing,the following reason applies:
S--
Contact person, _ Plan no.: _ ---- — --- — ----
Phone: —�— I,= E-mail: -- -
Name: Contact person: Fees 0e upon application ....... ................... $
Addtres: _ Date received:
City: _ State: ZIP: Amount received ... ..................................... $
Phone: _ Fax: E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Not all jurisdiction arcerA credit cards,pkax caa juri%diction for more intormatlon
attached checklist.Ail provisions of laws and ordinances governing this Uvisa UMasterCard
work will be complied with,whether specified h 111 or not. Credit cud number:
F.xpitcc
AlllnOfi7.ed signature: Date: —a _a Nuns of cider as shown on credit card
Print name:
Codwder siaruhue Amounl
This permit application expires if a permit is not obtained within 180&ys after it has been accepted as comple 440.4611 ttWa2'0M)
-- , 3S
1
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan review is dependent upon submittal of a completed application and plans.
After plan review approva', the Plans Examiner will contact the applicant to
,equest additional plan se s for distribution purposes (for Contractor, City of
Tigard, Washington Count/, and Tualatin Valley Fire & Rescue).
--- \ Total # of
TYPE OF SUBMb Plans KEY:
_ Submitted
S = ite Work (must include
S (New, Add or Alt) 4 location of all accessible parking)
B (New, Add or Alt) B = Building
F (New, Add or Alt) 3** = Fire Protection System
M (New, Add or Alt) 2 M = MechanicalP (New, Add or Alt) 2 �� P = Plumbing
E (New, Add, or Alt) 2 `�,= Elertri ,I
l New =New Building
Add = Additi6q
Alt = Alteration�m\Pxisting
building \
*Fur over-the-counter rommercia! tenant improvements, submit 2 sets of plans.
**"New" requires that plans bear the original seal of an Oregon licensed fire
suppression ehgineer, or NICET level "3" technicians.
I\dsts\torms\malrxcom.doc 10/27/00
May 7, 2001
Narayan Gurung
17828 SW Gatewood Drive
Sherwood, OR. 97140
RE: TAE Kwondo World BUP2001-00138
11535 SW Durham
Dear Applicant:
Your plans for the proposed tenant improvement have been reviewed, the following
items require your attention.
1. Your proposal requires two (2) exits. OSSC, Table 10A. The exits must swing in the
direction of travel.
2 Based on the occupant load, OSSC, Appendix chapter 29, of the proposal, two (2)
Water Closet rooms, one male and one female will be required. Under the provisions
of OSSC, Chapter 11, both shah be made handicap accessible.
3. Exit illumination and egress identification will be required complying with OSSC,
Section 1003.2.8.and 1003. 2.9.
Provide Tv;ro Sets of revised drawings.
If you have questions, please call me at 503-639-4171 X 392
Sincerely,
Robert Poskin, CET, CBO
Senior Plans Examiner
Sunday, April 29,2001
City of Tigard
Planning and Building C-)mmission
Site in Willow Brook Business Park Suite C-4, 11535 Durham Road,Tigard, Oregon
After review of your requirements for handicap accessibility, we offer the following
responses. 'There are no lease improvements to be made to make the facility more
accessible to handicap people. In response to each item asked we respond with the
following:
Valuation - $12,000 in modifications resulting in a budget of$3,000.00 for handicap
modifications.
Items to be modified:
a) Parking, the lease is directly in front of a single handicap space with a left(car
nose to the building)easement of two parking spaces for people to move
wheelchairs or other items into and out of the vehicle. The stripped area over the
two parking paces is graded to support a ramp up to the curbed sidewalk.
b) The parking from the graded ramp leads to a double door entry with no center
pole in the doorway providing a full eight feet of access into the suite.
c) The walls are from the doorway into the training area and the viewing areas are
more than seven feet from any other wall.
d) The single bathroom has already been modified for handicap since th prior
tenants served elderly, disabled people exclusively.
e) The two tc-lephones are reachable from the desk by anyone.
f) Tivc= is no drinking fountain but there are two sinks,one in the bathroom and one
just outside the bathroom at a counter. All facets are handicap conforming
handles.
g) There are storage areas and shelves without doors above and below counter height
for all visitors.
We hope that you will find the accommodations in order.
Please note we are moving May 15`x',because the old school is closing on May 151'. If
there are anv other concerns with the plans, please let us know so we may accommodate
you further and that we may complete our modifications in order to open May 151h
Sincerely,
Master Na �an
Y g
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration c modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readiiy 4xessible to individuals with disabilities unless
such alterations are disproportionate to the overa,; alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION of all renovation, alteration or modification being done
exJuding painting, wallpapering. [1)$
multiply: 2.5% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2)$
In choosing which accessible elements to provide under this section, priority shall be given to those
elements that will provide the greatest access. Elements shall be provided in the following order
(a) Parking $ ex r> rS
(b) An accessible entrance $
(c) An accessible route to the altered area $_1 Xe
(d) At least one accessible restroom for $ "s+t
each sex or a single unisex restroom
(e) ,accessible telephones
(i) Accessible drinking fountains and $ x"s fs
(g) When possible, additional accessible
elements such as storage and alarms: $
TOTAL_ Shall eaual 11ne.2 of Value Computation
iAdsts\forms\access doc
C!TY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4176 Business Lite: 639-4171 �� —��---- --
P
Date Requested_ 6,
AM PM BLD
Locallon /1 � .�, .tfv 1 _ Suite _C ----
MEC
Contact Person / ' " Ph rr� l _ PLM
Contractor. Ph _ SWR -- - -
-_�_�
UILDELCING' Tenant/Owner k Uv I`+ ►SCJ ------- -----
Retaining Wall ELR
Footing Access
Foundation FPS
Ftg Drain -- SGN
Crawl Drain Inspection Notes: -- --- ---
Slab _-- --- - SIT
Fast&Beam
Ext Sheath/Shear _
Int Sheath/S1;agr
Framing Cov.,
Insulation Q1 -.211-0
Drywall Nailing l�_
] j G 00
Firewall -a�., ,/�/�--�
Fire Sprinkler _-
Fire Alarm
Susp'd Ceiling
Roof !!ll ,r r
3 PART FAIL A' Q V
PLUMBING tl'L t-R CI (0 'a,�^.)--
Post& Beam _ ( \`
Under Slab 4 I �L
Top Out
Water service �,�`� ` e Zo k__ L (3
Sanitary Sewer /
Rain Drains _
Final
PASS PART FAIL ---""�� �'C�_-- -�-✓` --+,.��-�
MECHANICAL 1
Post& Beam I - ✓-�-' Vl•` , `'-' ==T� .- ----
Rough In
Gas Line ' —--
Smoke Dampers
Final -
PASS PART` FAIL Alk 2 >b
ELECTRICAL -- -
ei rice A
Rough In
11GlSlab
Law Voltage _- --- -----
Fire Alatm
Final -- -
PASS PART FAIL
SITE
Backfill/Grading
Saniiary Sewer
Storm Drain ( j Reinspection fee of$ _�_-required before next inspection. Pay at City Hail, 13125 EW Hall Blvd
Catch Basin
ire Supply line ( ]Please call for reinspection i�E. __- , ( ]Unaule to inspect-no access
ADA i
A roach/Sidewalk
Ott er Date �� Inspector !_ w <�- Ext -
Final
1_PASS PART FAIL 00 NOT (REMOVE tti'ss inspection record from the job site.
CITY CF TICARD BUILDING INSPECTION DIVISION NIST
24-Hour Inspection Line: 639-4175 Business tine: 63 4171 -- ---
BUP __-
--._—_Date Requested _ _ AM� PM — BLD
Location S�.S� Du r �""'` ----_-- -- Suite --- MEC ----
Contact Person _ Ph — PLI'/l t5 0 2 4 V
Contractor — _ _ Ph i_ SWR
BUILDING Tenant/Owner ELC
Retaining Wall _- ELR
Footing Access.
Foundation FPS
Ftg Drain --'- `"-
Crawl Drain Inspection Notes: "- SGN
Slab - --- - ----- SIT
Post&Beam -- -----
Ext Sheath/Shear
Int Sheath/Shear -Framing
Insulation
Insulation -------_--.._____A__ ---------__--- -
Drywall Nailing - _-
Firewall ;�7
Fire Sprinkler C '�6 S� 4•�• __ ,!�^ 2_ .�_-_�� `
Fire Alarm
Susp'd Ceiling
Roof /_ G; / -
Final ------ _--
PASS PART FAIL ------------ --_____. _ _ _
PLU ING
r P kst&Beagy -- `
n ei Slab
er Service
Saniiary Sewer
Rain Drains
dr.71nq-T
5 ) PART FAIL
MECHANICAL
IPost& Beam ----- t--
Rough In
Gas Line
Smoke Dampen,
Final - -
PASS PART FAIL
ELECTWCAI. -----
Service _
Rough In
UG/Slab
Low Voltane -�
Fire Alarm
Final _.---- ---
PASS PART FAIL I SITE 1
Backfill/Grading _-- -
Sanitary Sewer
Storm Drain ( j Reinspection fee of$ regrdred before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RF:-__ _ [ ]Unable to inspect-no access
ADA
Approach/Sidewalk
Other pate / Ings ctor _ Ext
---__ Pe -.� �•
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYOF TIGARD _ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-0010:1
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE_ ISSUED: 6/4/01
SITE �,DURESS; 11535 SW DURHAM RD C-4
PARCEL: 2S110DC-02300
SUBDIVISION: PARTITION PLAT 1998-128 ZONING: C-G
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME: TAE KWONDO WORLD
USA NO: FIXTURE UNITS: 6
CLASS OF WORK: ALT DWELLING UNITS: .�
TYPE OF USE: COM NO. OF BUILD114GS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: .4 EDU increase: Previous EDU count was 3.0 for a fixture count of 48, plus added new fixture
count of 6 equals 54, for a current total of 3.4 EDUs.
Owner: -
- FEES__
DURHAM/99 ASSOCIATES LTD PTNSH Type By _ Date Amount Receipt
BY CRIIMI MAE SERVICES LP
ATTN: LOAN SERVICING PRMT CTR 6/4/0'1 $920.00 2.7200100000
ROCKVILLE, MD 208b2 Total $920.00
Phone: --- --- --
Contractor:
Phone:
Reg #:
Requited Inspections
This Applicant agrees comply with all the rules and regulations of the Unified .sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be fo feited if the pF:rmit expires. The Agency does riot
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given. If not so loc;,!A, the installer shall purchase a"I ap and
Side Sewer" Permit and the Agency will instail a lateral ATTENTION: 9regon law requires you to follow rules adopted
by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rues or direct questions to OUNC by calling (503) 246-1 S87.
Issued by:4— _— Permittee Signature:—_
Ca1�639-4175 by 7:00 P.M. for an inspection needed the n . t bttsi ess day
Accumulative Sewer Tally
Tenant Name: 7t76 This SWR#'? 0/
Address: /
This PLM#: ;Zool
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added# added #s total
Count off#s count value values
Ba tist /Funt 4
Bath-Tub/Shower 4 _
-JacuzzlMhirlpool 4
Car Wash-Each Stall 6
-Drive Through 16
Cus Idor/Water Aspirator— 1
Dishwasher-Commercial 4
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink-2 Inch 2
3 Inch 5
4 inch 6
-Car Wash Drn 6
Garbage Disposal 16
-Domestic(to 3/4 HP) —
Y-Commercial to 5 HP 32 __-
-Industrial(over 5 HP) 48 _
Ice Machine/Refrigerator Drains 1 _
Oil Sep(Gas Station_)___ 6 _ __—
Rec.Vehicle Dump Station 16
Shower-Gan Per Head 1 _ -
-Stall 2
Sink-Bar/Lavatory 2 _—_--
Bradley 5 --- --
-Commercial 3
Service 3
Swimming Pool Filter 1 _
Washer-Clothes 6 _
Water Extractor 6 -
Water Closet-Toilet 6
Urinal 6 _ — --• -
TOTALS 7(5
Total t;xture values:__... divided by 16 =- .3, 3 Q EDU =J / /n/cizEAsc 5� ESU_
---- /°FR a - Y,;Zo.0
HISTORY _ g-t�us on/ S 16,101
PLM# EDU# SWR# PL.M# EDU# SWR#_ _
PLM# _ EDU# SW_R# PLM# _ EDU# _ SWR# _
PLM# EDU# SWR# _ PLM# ECU# SW_R#
PI-M# EDU# SWR# PLM# EDU# SWR#
1Ad9tslswrtaly.doc
�t r-10 /
CELECTRICAL PERMIT
CITY O F T I G A R D
PERMIT#: ELC2001-00286
DEVELOPMENT SERVICES DATE ISSUED: 6/4/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110DC-02300
SITE ADDRESS: 11535 SW DURHAM RD C-4
SUBDIVISION: PART(TION PLAT 1998-128 ZONING: C-G
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Installation of 6 branch circuits for commercial TI.
_
RESIDENTIAL UNIT TEMP SRVC/FEEr)ERS i MISCELLANEOUS —
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMIT r-D ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANE HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
--------- - �_ —. _ ADD'L INSPECTIONS__
0 - 200 amu: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 5 IN PLANT:
601 - 1006 amp: _ PLAN REVIEW SECTION
1000+amp/vr;t: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >=225 AMPS:, _ CLASS AREA/SPEC OCC:
Owner: Contractor:
DURHAM/99 ASSOCIATES LTD PTNSH ANDERSEN ELECTRIC; LLC
BY CRIIMI MAE SERVICES I_P 9390 SE HIDE A WAY COURT
ATTN LOAN SERVICING GRESHAM, OR 97080
ROCKVILLE, MD 20852
Pho,ie: Phone: 503-665-4327
Reg #: ELE 3-516C
SUP 48265
LIC 147561
FEES _ Required Inspections
Type By By Gate Amount Receipt Wall Cover
PRMT CTR. 6/4/01 $80.10 2720010000( Elect'I Final
5PCT CTR 614/01 $6.41 2720010000(
Total $86.51
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or if work is
susrended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted b�/the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503)
246.6899 or 1.800-332-2344.
Permit Signature: r� � � _ Issued By: ---
\
_ f _ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ � _._. DAIS: _
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELFC'N: — DATE:—
LICENSE
ATE:LICENSE NO: __—
Call 639-4 175 by 7:n0pm for an inspection the next business day
Electrical Permit Application
Date received: 0/ Permit no.: [tC 1100/'100 d.
A Z�k L City Of Tigard Project/appl.no.: Expire date:
C'iryu/%'igarrl Address: 13125 SW Hall Illvd,'fipaidl (W '!"1"t Date issued: B ecei tno.:
Phon»: (503) 639-4171 p
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
U 1 &2 family dwelling or accessory Commerci /i.(d pstl•ial U Multi-family U Tenant improvement
U New construction teration/ lacement J Other: U Partial
Job address: It S 15 S W Dit 4�01 hi I Bldg.no.: JSuite no.:VIj ITax map/tax lot/account no,:
Lit Block: Subdivision:
Project name: rWh,16 Description and location of work on premises:
tsstimated date of completion/ins ction:
"Jobt c. _ Fee Max
Business name: A-nd,&Y$e, i 4 le r, r-) Description (NY. (ea.) 'total no.Ins
Address: y'S!10 GNew residential-single ar moil!-family per
11'_d�CLI,J `�� dwellirrRunit.IneludesattachrrlRaraRe.
City: A4� State:'OK- 'LIP: cl U Service included:
Phone: "Sr— L Fax: E-mail: IOW sq.ft.or less _ .I
Etch additional 500 sq.ft.or portion thereof
CCB no.: / 7 S Elec.bus.lic.no '� S 6 �,. Limited energy,residential -- 2
Cityhnelro tic.no.:-4 2�S —�_ Lhnjledenergy,non-residential — —?
Fach manufactured home or modular dwelling
Signature of supervising electrician(required) Date Service and/or feeder 2
Sup.elect.name(print): I License no: Services or freders-installation, —
alteration or relocation:
200 amps or leas
Name(print): 201 amps to 400 amps �—�� — 2
Mailing address: 2-n _�w S lX 64 4 e,p 401 amps to 600 amps — 2
601 amps to 1000 amps 2
City: QUI►. /A State: S� ZIP: Le' Overlo00ampxorvolls -
Phone: ZLS 'r4l I Fax: Ltd!• 9tis I E-mail: Reconnect only - 1
Owner installation:The installation is being made on property I own Temporary services orfeedem-
which is not intended for sale,lease,rent,or exchange according to Intfallatlon,■ueration,orrelocatlon:
ORS 447,455,479,670,701. tiro amps or less 2 "
201 amps to 400 amps 2
Owner's si rnalure: Date: 401 to 600 amp.
011111 IN Branch circuits-new,alteration,
Nance: ►,yam /'ktA Wld A extension per panel:
— — A Fee for branch circuits with purchase of
Addrl s: ]- bt✓ _�$S— L� service or feeder fee,each branch circuit 2
City: 7 i fAr• State:O_ ZiP; q ;X J 13 Fee for branch circuits without purchase I
Phone: �7 ;l Fax: F-mail: of service or feeder fee,first branch circuit: _ —2
Foch additional branch circuit:
Mtge.(.Service or feedernot Included):
U Service over 225 amps-rnmmerrial U Health-carefacilityI ac',pump or iniganon circle _ 2
U Service over 320 amps-rating of I&2 U Har,vdouslocation Each sign or outline lighting _ _ 2
(artily dwellings U nuilding over 10,000 square feet four or Signal circuil(s)or a limited energy panrl,
U System ove 4(10 volts nominal nxsre residential units in one structure alteration,or extension* 2
U Building over three stories U Feeders,4W amps or more Description.
U Occupant load over 99 persons U Manufactured stmclures nr RV park FAch additional Inspection o•;r IF allowable In any or the above:
U I* ss/lightingplan U Other. 11crinspection
Submit sets of plans vrith any of the above. Investigation fee
The above are not applicable to temporary consirvactlon service. umrr
--- --
Permit fee ....................$ /O
Nd ell jurialic,i,x,s accept credit canis,please call iurisdicdon for mare Infortnatiai Notice:This permit application
0 —
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
Cmda wed number: within 180 days aRcr it has been State surcharge(8%)....$
splrcs eccepted as complete, TOTAL .......................$ e6__�
Namr d ca older v ah•�wn on credit card–��
_ _ S
—_�Cardhrrlder sipature��` Amount UO 4615(rA XWOM)
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule iBelow: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
p Restricted Energy Fee..................................................... $75.00
Number of Inspections per rmit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work Involved:
Residential-per unit
1000 sq,ft or less $145 15 4 ❑ Audio and Stereo Systems
Each additional 500 sq It or
portion thereof $3340 1 ❑ aurglar Alarm
Limited Energy $7500
Each Manurd Home or Modular ❑
Dwelling Service or Feeder $90.90 2 Garage Door Opener'
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less __ $80.30 l
Vacuum Systems'
201 amps to 400 amps $10685 2 ❑
401 amps to 600 amps $160.60 2
601 amps to 1000 amps �_ $24060 2 Other
Over 1000 amps or volts _ $454.65 2
Reconnect only $66,85 _ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system.......................................................... $75.00
200 amps or less $66.85 _i 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps —� $133.75 �_ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits ❑
New,alteration or extension per panel Boiler Controls
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder lee.
Each branch circuit $6 65 _ 2 Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit �L_ $46.85
Each additional branch circuit J $665
❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $5340 ❑
Each sign or outline lighting `� $5340
intercom and Paging Systems
Signal circuit(s)or a limited energy
panel,alteration or extension _ _ $75.00 _ ❑ Landscape Irrigation Control'
Minix Labels(10) $125.00
Medical
Each additional Inspection over i __ ❑
the allowable In any of the Above ❑
Per inspection $62.50 Nurse Calls
1'er hour ---- $62.50 _--
In Plant $73 75�~ _ ❑ Outdoor Landscape Lighting'
Fees: I [] Protective Signaling
Enter total of above fees $ F]
8%State Surcharge $ 4 _Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses are required Licenses are required for all other Installations
front of application - --
Fees:
Total Balance Due = s /� Enter total of above fees
❑ T-ust Account A' 8%State Surharge $
Total Balance Due $__
i\dsts\forms4lc-fees.doc 10/09/00
05/04/2001 14:11 5032555270 ALMAP. TOOL'- PAGE 01
Electri rmit Application
DMe n oeive0: i O� plw•rtit tp.',('�'ZOQ�� �7
City of Pra�a,�epyLon: �>Dlr�dte
Ciryalr4pard Addrus! 13125 1 Blvd.Tigard,OR 97223 Datellaued: _ 6 _eelptno,;
Phone: (303)63 ----
Flax; (303)599.1 Cate f le no, Payment type:
Land use appy
Q 1 &2 fano y dwelling or atc I Ormtmerci t al .1 Multi-family J Tensult improvement
New constrlcoon IrmtlQ V Incemcnt A Other: — J Partial
Job addooat: ( &td l Bldg.nu.. 9tuue rto.:r'f T'ax map/t ac
lotlaount no..
Lal: Block: inion;- —
project mune: tt*p _ [)sten tion sad Iaation of work on mt
ENmnated date of nom lation/ina
Job M: G 1+er hSa
Husiaesa nanlc � 1� t� @ __ a) T�/al aw V
Addltss: Nnr or milli-umilyper
`� - Hr. (J dwatiy11t11+IfteLbtaaadrdttsaye.
G _Czi_ aw Stat/: ZIP: 9 o A �
11mnc j Fax: 8-mail' t)ml.q e I
CCR[1,-.: / Q us. no. BscheddltioulSOON,A.luportion tha'of
City/ k lic 4 l.imirdeneamd�ql�lcisMal
t ,atete
_ al4mti d 2
IL �1 t� 4i.ch tnernf� and hnme of modutardwel4nt
SCAR eupery el tctan Mq Dari Senice anNlt feakr
911Lieenearw- tleR►7pltldaR–Ia4Qerits
aNerrAMa trloeYlaat
:On W US ]
MCPhleryoiln:ieng,�a•dtId3ret3b r] ON t W l�i�s1�i j.&2 — wt aM to 10oetupNamc nnt): b � k M�pa
W o _ al� OOO
Qtto0yat o-L- 4F ZP: p
I - - -_._--
27z
Fax: Email: Rte. I
Owner inswiedon:T11e initrllah ing mode on Mpeny I own 1tgaran•I lr.ioul or
which is not tnmaded fur sale,le 1,or exchallgc ymbadrr, ieorarlral,ornlaoanaan
ORS 447,455. 479,670,701.
:111 artQ 1��i 10(1 ami --�� a
0 unit's 3 utt:
lnaaen cl ,1a•lesw,alhMloa.
hams'. r IRA I( I crertsilmloa prr prank
1 A Fee Irrt .mal oircato vial.pamhue�i
Addrrsa L d1al tT' _ cervirecykedort'1c,each Omy-hcJraeh 2
State:0 ap 1 y Lj R Pee fna N uw.a clmdts%mlfota purtMu
Cly : -7 1 _nfatrvtc nr4edvfor,MtbrvSarwit: f
Phone: ye --7 Pas: � � B�tnatL ---- 1 1
gaM sal u �1 hr�>nclt c4mult
sm
Mhe(9etd xr or RrrTir ti Ins )1 I
J!Js•11uv n.er 22S amps mrrorsumal al!h tare fauliry Fmoa prmp o 1 a+i dreAs 2
rt �._ �__�___
7Revimovv"i�Durpa.rednaofls: anrdpelkrcaden flacaal&e,�-l•ratine:� - --- 2
Yndrdarel4o� —_ -- _
aUdlnaetyerloom aquareleNtnurar 9itsnalr'..adllaleralUuleedeta'f)'Carol,
.l S►aaoavei fSln wlb fk rtdttal traldatlal Ynih 111 am.t7umm almrit"Cl of "WMIure 2
Ci RulldlnRnvarl(itev akytea AM ante is ann ---
U Comipan+(vad ova 99 mv'm aavful—A rrxlwm ur RV part
U ft"saAigbaty plan aadMiaad(retwetm Nar Me allowaHe in rap or MR ettevt
' Pe;w Moll
NattaaM _wtrt*/ any of do Aeve, Inv ado"Ilam
'T1s Alto aro tact Spramm petxr7 ceeatlretlq twrsiee. Diller --
, Nottlhle ptttpct{ u '
..... .......v—r ..H _ -
U +
U MrraCrQ "puss if a pr:mit is not )bullied flan review(at � %) , _
(r f within I R0 tlayo after it hu been State Rurchatyc IP961....S l y/
c mr.. k�,t„dasamplctc TOTAL .......... .. ..
ate.. e■ - .......9
— m—
uarsu rtxrvcrn4
i00(�I � � UlIV91.L 30 .*a.LIJ tlgRl VRC Cn4 YV.a p4:Ci unit TOifO�On
CITYITY O F T I GA R D __ PLUMBING PERMIT
DEVELOPMENT SERV`DES PERMIT 4: PLM2001-00220
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/4/01
SITE ADDRESS: 11535 SW DURHAM RD C-4 PARCEL: 2S11ODC-02300
SUBDIVISION: PARTITION PLAT 1998-128 ZONING: C-G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of one additional water closet.
Owner: FEES
-- —
Type By Date Amou.-,t Receipt
DURHAM/99 ASSOCIATES LTD PTNSH PRMT CTR 6/4/01 $72.50 27200100000
BY CRIIMI MAE SERVICES I-P 5PCT CTR 6/4/01 $5.80 27200100000
ATTN LOAN SERVICING
ROCKVILLE. MD 20852 Total $78.30
Phone 1.
Contractor:
ADVANCED PLUMBING
CHUCK MCALI_iSTFR
PO BOX 593
PORTLAND. OR 97207 REQUIRED INSPvr110NS
Phone 1: 503-478-9735 Rough-in Insp
Reg #: LIC 140302 Final Inspection
PLM 37-477PB
This permit is issued subject to the regulations contained ir. the Tigard Municipal Code, State of OR.
Specialty Co des 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 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987
Issued By: �. _ Permittee Signature:
Call (5 3) 639-4175 by 7:00 P.M. for an inspection needed the next bll54116SS -lay
4� fir
ci
Plumbing Permit Application
Date received: Pennitno.:`''/y;GO/,QB220
City of Tigard Sewer permit no.: Building permit no.:
Al� 6 Address: 13125 SW Hall Blvd,Tigard,OR 97223
Ciryof''Figard Phone: (503) 639-4171 Project/appl.no.: -- Expire date:
Fax: (503) 598-1960 Date issued: By-./fReceipt no.:
Land use approval: - - _ Case file no.: Payment type:
U 1 &2 family dwelling or accessory CoawZrciaihndustrial U Multi-family U Tenant improvement
U New construction �Additio_-r4teration/replacement U Food service U Other:
.1011 SI 111:INFORNLA IJON FEE S(*IIEI)1'1.,I-'(I'or,speciiiiliiforiti.iiiiptitiseclieclilisf�-.
Job address: it 3', ❑kwcrl tion Fee(ea.) Ty s� .��t�ti�►Lr, tv. of&,a.�J . _ s
New I-and 2-family dwellings only:
Bldg. no,; _Suite no.:
G• (Includes 100 R.for each utility connection)
Tax map/tax lot/account no•: _ SFR(1)bath
l.cri: Block: T3utxlivision: SFR(2)bath ----- -_ _-_
Project name: 'T 4q w o Mi 0 w o SFR(3)bath - - —
City/county: -ri qq r aL I ZIP: q 7 I-y3 Each additional bath/kitchen
Description and loco ion of work on premises: _ Slleutilities:
_ Catch basin/area drain _
Cat.date of,completion/inspection: _ Drywells/icach line/trench d-am
Footing drain(no. lin.ft.) _
Manufactured home utilities
Business name: v n vrCPc -Vwr, r _ Manholes
Address: c, 3 Rain drain connector
City: �. �, - State: ✓ ZIP: �0-�- Sanitary sewer(no.lin.ft.)
Phone: Fax: .S U' et,y E-mail: Storm sewer(no.lin.ft.)
CCB no.: Plumb,bus.reg.no: %Z i tj Fater service(no.lin.ft.)
-�— - Fixture or item:
City/metro lic.no.: p
- Absorption valve _
Contractor's- rTprcsentatrve signature Bark flow preventer
Print name: ' l r Date: A r -Backwater valve
Basins/lavatory _
Name: Clothes washer ---_
-- Dishwasher
Address: Drinking fountain(s) -
City: State: ZIP: Ejectors/sump
Phone: Fax: E-mail: Expansion trek
Fixture/sewer cap
Name(print): (.A +e�LV►�G GS (,(.G• Floor drains/floor sinks/huh _
---- f o -- Garbage disposal
Mailing address: S L0—s w 1.4-% S , Hose bibb
__ State: eL ZIP: 4120 -"—
City: P.rt 17 hd _ -- _-- -- Ice maker — --
Phone: M -'�1-1 Fax L2�- 1t;6 Email: Interceptor/grease trap ^- --
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee )n the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Sum —
Tubs/shower/shower pan _
11011111 Urinal
Name: b /►'land- - _ _ Water closet
Address: Water heater -
State:p� ZIP:
City: aid ?Z3 Otner:�-
-- - ------ — -
Phone: Fax: I E-mail: Total
Na all jurisdictions accept credit canis,pteate call jtui"ction for nxwe infortnation. Notice•This permit application
Minimum fee................$
.
U vita U MasterCard expires if a permit is not obtained Plan review(at -. `oF) $ ,
t relit:ard number:_ L within 1 R0 days after it has been State surcharge(8%) ....$
------ p• TOTAL $
Expires ....................... 1_
- ----- ---- accepted as complete.
Nartx or cardhnl:Mr u aMwn on credit—cad
---- -f'ardholder signature —� T^-- — Atnuum "0J616(601000M)
PLUMBING PERMIT FEES:
PRICE TOTAL New Tand 2-family dwellings only:
FIXTURES (Indlyldual) --_ QTY e3AMOUNT (includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the fintt100 ft. QTY (ea) AMOUNT
Lavatory
for each utility connection)_
16,60
-One 1 bath $249.20
Tub or Tub/Shower Comb. 16.60_ T_wo_U2 bath $350.00_
Shower Only 16.60 Three 3( )bath $399.00 —
Water Closet 16.60 -- --
_ __ SUBTOTAL
Urinal 16.60 8%S TATE SURCHARGE
Dist"washer — 16.60 PLAN REVIEW_25%OF SUBTOTAL _
Garbage Disposal 16.60 - w. ___ TOTAL
Laundry Tray 16.60
Washing Machine 16.60
r-loor Drain/Floor Sink 2" — 16.60
3" - 16.60 PLEASE COMPLETE:
4" 16.60
Water Heater O conversion O like kind 1660 uantlty b Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. _ _ _ Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory --
Tub or Tub/Shower
Hose Bibs -16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain — 16.60 Water Closet
Other Fixtures(Specify) 16 60 Urinal
' Dishwasher
Garbage Disposal
"- Laundry Room
-- - ---
Washing Machine _
-- - - - Floor Drain/Sink: 2'' --
Sewer-1st 100' 5500 "'—"" —3"
Sewer•each additional 100' 46.40 4"
Water Service-1st 100' 55.00 Water Heater
Water Service-each additional 200' 46.40 Other Fixtures
_ (Specify) _ _—
Storm 8 Rain Drain-1st 100' 55.00
Storm 8 Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 4640
Residential RackHow Prevention Device' 27.55 — - - —'
Catch Basin 16.60 -�
Inspection of Existing Plumbing or Specially 7250 -
Re1c nestedIns ep clions _— or/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65,25 —
Grease Traps — 16.60 —
QUANTITY TOTAL
Isometric or riser diagram Is required If --` —
___ Quantity Total is >9 __ -- — — -- --—
'SUBTOTAL — ---- —-- -- —
8%STATE SURCHARGE
"PLAN REVIEW 25%o OF SUBTOTAL
Requiredonlyll fixture qty total Is>9
- TOTAL $ —
"Minimum permit fee is$72 50•8%state surcharge,except Residentlat Backflow
Prevention Device,which is$39 25+8%state surcharse
"All New Commercial Buildings require plans with isometric or riser diagram and
plan review
I:\dsts\fonns\pltn-fees.doc 10/10/00