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7272 SW DURHAM ROAD STE I-750 rJ IJ t r� r n 0 7272 SW DURHAM RD BLDG 11750 CITY OF T I G A R D -----BUILDING PERMIT PERMIT#: BLIP2003.00189 DEVELOPMENT SERVICES DATE ISSUED: 4/24/03 13125 SW Hall Blvd., Tiqard, OR 97223 (593) 639-4171 SITE ADDRESS: 0727? SW DURHAM RD BLDG 1-750 PARCEL: 2S113AC 00102 SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING: I-P BLOCK: _LOT: 025 _ JURISDICTION: TIG _ REIS SUE: gyp, t FLOOR AREAS EY;TERIOR_WALL CONSTRUCTION_ ` CLASS OF WORK: AI� I 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: 16 BASEMENT: sf AREA SEP. RATED: STOR: I 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: f: FIR ALRM : HNDICP ACC: E;EDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 25,000.00 Remarks: Reconfigure existing finished space, add toilet. L-- Owner: Contractor: PACIFIC REALTY ASSOCIATES H L GREEN 15350 SW SEQUOIA PKVVY #300-WMI 15350 SW SEQUOIA BLVD PORTLAND, OR 97224 STE 300 Phone: TIGARD, OR 97224 Phone: 624-7717 Reg #: LIG 41328 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require BUILD] Permit Fee 4/24/03 —� $2f13.30 I Electrical Permit Required Sprinkler Permit Required TAX] 8,�„� State Tax 4/24/03 $22.66 Plumbing Permit Required [BUPPLN] Pin Rv 4/24/03 $164.15 Framing Insp [FLS]FLS Pin Rv 4/24/03 $113.32 Insulation Insp Total $603.43 Gyp Board Insp Susp Ceiing Insp Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not starteu within 180 days of issuance, or if work is sucpPnded for more than 180 days. ATTENTION: Oregun law requires you to follow the rules adopted by the Oregon U► -ty Notification Center. Those riles 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: _— Pe nn ittee Signature: Call 639-4175 by 7 p.m.for an Inspection the next business day AP"4'0'_9 �S D ouildiiig PeCnllt Appiic,�tion City of Tigard i Datereeceived: Pctmitno. AU�,?�_Vd�' i Address: 13125 SW Hall Blvd,Tigard,OR 97223 Prolcotiappl'no•: Expire date: City nJ 77gan_ Phone: (503) 639-4171 Date issued: By: Receip, Fax: (503) 598-1960 Case file no.: Payment type: ---- -- Land use approval: _�-- I&2 family:simple (or;tplex: - 1 51111 ' U 1 &2 family dwelling or accessory ❑C ommerr.ial/in-iustrial C]Multi-family Q New construction t.7 Demolition U Additiolt/alteration/replacement �*nant improvement ❑Fine sprinkler/alarm 0 Other. JOB SITE INVORNIATION' �- Job address: L F'ldg.no.: Suite no_: c./ Lot: I Block: Subdivision: Tax map/tax lot/account no.: Project name: - 1 Description and location of work on premises/speci conditions: FJ Name: PaCl`rUSt Mailing address: 15350 S W Se u O l dPkwy. ,__#_F00 1&2 family dweWog; City: Portland State: OR ZIP: 97224 Valuation of work........................................503 4 Phone:� _6 3 00 Fax16 4--7 73 E-mail: No.of bedroornVball s................................. coneys tepresentative:D e n n i s P a n i Total number of floors Phone: Fax: S d E-mail: ........................... ----- 1 iew dwelling area(sq.fL) .......................... Garuge/carriort a.m a(sq.ft)......................... Name: P a c T r u s t Covered porch area(sq.ft.) ......................... - - Mailing address:l 5 3 5 0 SW S eTStaKARL o i a P k 1g.. , #300 Deck.area(sq.ft.)........................................ City: Portland P: '07224 Ocher structure area(sq.fL)......................... - ----503 Phone:6 2 4- E300 1Fax624-77r5 E-mail: Comm,!rcisUlndusttial/multl-family: 1 Valuation of work........................................ Business name: H.L. G re e n Existing bldg.area(sq.ft.) ........:................. Address: 15350 S u D �' New bldg.arca(sq.ft.)................................ I Se uoia kw . , #300 — - - Number of stories City: Portland_ -- state: ZIP: 97224 ........................................ -- 503 Phone624- %717 Fax: E.mai: Type �oltstnrction.................................... CCB no.: 2 a - —- Occupancy gmup(s): Existing: City/metro lic.no -- - - - - New: Notice:All contractors and subcontractors are required to be t licensed with the Oregon Construction Contractors Board under Narne: J o h n R o fit 1 s h provisions of ORS 701 and may be required to be licensed in the Address:]5350 S W Sequoia P k wv. #300 jurisdiction where work i.being performed.If the applicant is City: Portland State' O R ZIP:9 7 2 2 4 exempt from licensing,the following reason applies: Contact person: Plan no.: --- -- - 503 Phone:� - UJQQ Fax{6 4-775 E-mail: 'ohnr@ act us -T.c- —y---- — I r� Name: _ Contact person: Fees due u ........ $ _ 1 Pe -` upon application ................... Address: Gate received: _ City: - State: ZIP: Amount received ............. Fax:Phone: Fa - E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Nat W iudsdic-dons accept cre fi!cards,please call jurisdiction fa rose udormahon- attached checklist. All ptovisir of law rtfinarrces'governing this ❑Visa 0 Mastercard work will he complied wi nether ciG heroin or not. Orad card number. / Espim PrintAuthorized SI agll �A/S �11 Date: �ve Name d evdholder ra shown oo credit cud Print rattle:fii7Y - $ Cord"da dena,we Aateam Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440.613(WWOM) CITYOF TIGARD -- BUILDING PERMIT DEVELOPMENT SERVICES DATES UIED: 5/'23/0 03 00292 13125 SW Hall Blvd.. Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S113AC-00102 SITE ADDRESS: 07272 3W DURHAM RD BLDG 1-750 SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING: I-P BLOCK: LOT: 025 JURISDICTION: TIG REISSUE: ----FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: FPS FIRST: sf ! N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUP4NCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT- ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: READ SETBACKS REQUIRED_ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPK[._. Y SMOK DET: DWELLING UNITS: FRNT: ft REAR. ft FIR ^LRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: # Lla5, 00 Remarks: Adding (2)heads and relocating (1). Owner: Contractor: PACIFIC REALTY ASSOCIATES FIRESTOP CO 15350 SW SEQUOIA PKWY#300-WMI 9384 SW TIGARD ST PORTLAND,OR 97224 TIGARD, OR 97223 Phone: Phone: 620-6140 Reg #: LIC 63846 FEES i REQUIRED INSPECTIONS Description Date Amount Sprinkler Rough-In [BUILD) Permit Fee 5/23/03 062.50 Sprinkler Final [TAX] 8"'..State'Tax 5/23/03 10 Total $67.50 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all othar 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 suspenr;ed 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 direct questions to OUNC by calling (503)246-6699 or 1-800-332.-2344. Issued By: Permittee ki Signature: U1i, all 83 -4 75 by 7 p,m. for an inspection the next business day Fire Protection System Building Permit Application ' ' ' ONLY — --- Received _ Building , Permit No.: P ) Citof Ti and Planning Approval Other y g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Ti6,.:d,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 "11 Post-Review Land Use Date/By: Cast No. Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for 24-hoar Inspection Request: 503-639-4175 Name/Method: ! Supplemental Information TYPE OF WORK , REQUIRED DATA: New construction _ Demolition_ 1 &2 FAMILY DWE> LING Addition/alteration/replacement Other: — CATEGORY O_F CONSTRUCTION Note: Permit fees*are based on the total value of the work performed. Indicate [E_1 &2-Familydwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. Accessory Building Multi-Fami� Master Builder Other: Valuation...................................................... . 5 JOB SITE INFORMATION and LOCATION No.of bedrooms: No.of baths:'_ Job site address:_' Z J rrATotal number of floors..................................... _ New dwelling area(sq. R.).............................. Suite#: 'jj B1d ./A t.#: garage/carport area(sq. fl.)............................ Project Name: p1„I f,'X— SAID 4'M Covered porch area(sq. fl.)............................. Cross street/Directions to job site: Deck area(sq.ft.)............................................ Other structure area(sq. fl.)............................ REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: _ Lot#: Tax ma ap reel #: Note: Permit fees*are based on the total value of the work perfornud. indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. pp�� F-�' ,Cx LL`� - - k o_ Valuation......................................................... 5 2 Existing tuilding area(sq,ft.)......................... -- -- - ---_— ----- New building area(sq.ft.)............. .......... ... Number of stories............................................ PROPERTY OWNER — TENANT Type of construction.................................. .... --__ Name: F1C r"�eT Occupancy group(s): Existing: New: Address: IS's`.�V �,�` t Uli4 pkjJq — — - Cit /State/Zip: PU F . q?2 PhonC: Pr� Fax:6- -'-7_7SS NOTICE: All contractors and subcontractors are required to be APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Name: 1 WZ71 a, C.[j _ _ _ jurisdiction where work is being performed. if the applicant is exempt Contact Name: from licensing,the following reason applies: �3r2uc� ��_�__ Address: 935%-L St.i. Tecr k.L tT___ ------ — City/State/Zip: 72 --- ----- _._._ Phone: `,13� (,:,j-j�_ (qdt� Fa� E-mail BUILDING PERMIT rEES* :.ONTRACTOR Please refer to fee schedule. - -----� --- Bisiness Name: _ --,;T-t:)P CL) . Fees due upon application......_ ..... .. ..__ . s—_ d-�,50 Address: r�& t�"T lE- '� vT Cit /State/Zip: g7ZZ3 Amount received................ ....._......._......... 5 Phone: lal Fax C '2 (e,ILI/ Date receivers:_ CCB Lie. #: (p1 _ — – –- Authorized !' — �jfz `� Notice: "This permit application expires it a permtt Is not obtained ssithin Signature: Date:?(( l- 180 dais after it has been accepted as complete. *Fee mrthodolop•set by Tri-County Building Industry Service hoard. (Please print name) i\I)sts\Permit Forms\DldgPermitApp.doc 01,103 Fire Protection Permit Check List A.) ❑ New 5d Addition ❑ Alteration ❑ Repair B.) Modification 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:AA�� Additional description of work: -Type of System (Complete A, B or C as a_ licable A. Sprinkler wet ❑ D ❑ Standpipes___ Additional Hazard Group Information Density Design Area K. Factor S r,nkler Pro ect Valuation: B. Type I - Hood Flre Suppression System Hood Project Valuation $ C. Fire Alarm Submittal shall Batte Calculations Yes ❑ Include: Individual Component Yes ❑ Cut Sheets Fire Alarm Project Valuation: $ _ Project Valuation Subtotal A, B & C : $ qZ&V' Permit fee based on valuation see chaff: $ tot 5R _ 8% State Surcharge. $ o5 c?- FLS Plan Review 40% of Permit: $ ---- — ----- - TOTAL: $ � - Plan review requires a completed application and 3 sets of plans at submittal. Plar, review fees are required at submittal. "New" fire protection systerns require that plans hear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. 0dsts\forms\FPScheck1ist doc 11/21101 CITY OF TIGARD ELECTRICAL PERMIT PERMIT : ELC2003-00296 DEVELOPMENT SERVICES DATE ISSUED: ,_/23/03 '13125 SW Hall Blvd., Tiaard, OR 97223 (5 03) 639-4171 PARCCL: 2S113AC-00102 SITE ADDRESS: 07272 SW DURHAM RD BLDG 1-750 SUBDIVISION: COUNCIL VIEW ACRES N0.2 ZONING: I-P BLOCK: LOT . 025 JURISDICTION: TIG Project Description: Job#8209 Install(4)branch circuits. _ RESIDENTIAL UNIT TEMP SRVC/FEEDER_S MISCELLANEOUS _ 1000 SF OR LESS: 0 - 200 gimp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/ FUR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 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: 3 IN PLANT: 601 - 1001 amp: _ _ _ PLAN REVIEW SECTION 1000+ arrp/colt: >=4 RES UNITS: >6;0 VOLT NOMINAL: Reconnect only: ___ SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC 15350 SW SEQUOIA PKWY#300-WMI 10948 SE.VALLEY V1EVV TERR PORTLAND,OR 97224 CLACKAM.AS,OR 97015-000 Phone: Phone: 503-698-3417 Recd #: LIC 51539 -- SIJP 2053S FEES ELE 1-243C Description Date Amount 1:LPRMTJ ELC'Permit $66.80 Required Inspections IAXI 8°G,State Ia\ i Oil $5.34 Rough-in Elect'I Final Total $72.14 This Permit is issued subject!o 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 you to follow rules adopted by the Oregon Utility Notification Center. .'lose rules are set forth In OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules ordirect questions to OUNC at(503) 2466699 or 1.800- 32-23244. _ Issued By: _ -L — V-) r. L: _ Permit Signature: _ OWNER INSTALLA-(ION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S S! NATURE: _ __. _ DATE:_ _ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N. _ DATE:---- LICENSE NO: ___�'4 5 -3 _ Call 639-4175 by 7:00pm for an inspection the next business (lay hartynn J.Leifsen To:City of Tigard Date 5/22/2003 Time: 12:31:20 PM Page 2 of 3 Electrical Permit A 'cation . r Date TOG:IVe�j.�! fl — Permit Do.:rel JC -t :: •�• City of Tigard Project/appl.no.: Expire dales: ('trynJ'TiRnrrl Addres4: 13125 SW Ilall Bly¢,A7 g1 14US23 Date issued By;' Recei Phone: (503) 639-4171 MMM Lam"" Pt Fax: (503) 598-1960CITY OF TIGARD Case file no.., Payment type: Land use approval int LnING DIVISION U 1 8t 2 family dwelling or accessory ®Commacial/industrial O Multi-family J Ten:.at improvement U New construction IJ Addition/alkTation/rerlacement ]Other _ — U Partial Job address 7272 SW Du----T __ Hldg uo.: Suite no.: 150 Tax map/tax loi/account no.: Lot: _ tilock�_ Subdivision:P" name:Proline Sales Description and location of work on premises: T6nant Improverrl9nt Estimated date of com Ictioa/inspecdotn: 5130/03 - MIIIIIIIM�MWTM Ell JNa/i: 8209_ __ For Him Business name: an Johsen Electric Inc. 9t!" tb■ un taw ea.le.p Address: 10948 SE Valley Vlew T_err, dwra�srN.larllre r rtaaeYei prase. City: Clackamas State:OR ZIP:97015 fderrkttardrtaed: Phone:503.698-3417 Fax:503 698-2488 E•mdl:Juhansenolact000l wen Ip110 sq.fL or less 4 CCB no.: 51539 Elec.bus.lie.no: 3-243C Pack Idilltirmal 500 ay. It.111 tmrtion thereof —'- - rgy, Limited ane , mideorlal 2 4896 t.tmdad onerg�, noxi-mideatial _ 2 _ 5/22/03 Bach mawfactared home nr mrdular dwelling Siputsm of au Was electrician (enquired) _ now Service atavor feeder 2 sup.!tact.same l ' 0: Carl K. Johansen Utimse no: 2053S AerrltbKtthen-IarlrtlxtlN, tlltanlMr. er rMeeaMoa: 2a)amp.a leu_ 2 Flame(print): 201 amps b 400 amps _ 2 Mailing address: _ 40l am�a n—6002-M—--- — 2 -- ---- - 601 amps to 1000 amps _ 2 City' State: ZiP: over 1000 amp$or vulu 2 Phone: l Fitx: E-mail: Raaam-1 n� - Owner installation! The installation is b-ing made on property i owts ?rrpneT serrlce$K twell r- which is not intended for sale,lease,rent,or exchange according to 11r1ar'lea,.Nerteh&,nrndrrntle■: ORS 447,455,479,670. 701 200 amps`r In, 2 201 amps to 4M a 2` Own"'I 8t hIIC'_ Date: 4n 1 b MW am e 2 ortarb rlrru t$-over,alterallor. Name: or exteeaioe tier pearl: A Fee fir Iwan:h cin•uits wWh ptueh&w of Address: service err feeder fee,each broach:inwit 2 City: - -- State: TIP: R. Pae fin branch circuits without par Aur -- -- �' of cavi«or feeder fee first trmcb circuit: t 46.66 4tI 9'�Phone: Fex: P-mailtech rlditlooal braotA circvil fG5 1U Serv6e ova 725 wnps-.znmxnial U HealWtue tac:lity Facb Puny nr JM$Mlion circle U Servioe ov x 120 amps ratutte of IS.2 U tionadous Ioatiou _laeb.��^� oudirc liahtina family dwelfirip U Ruildiog ova 10,0110 oquare feet four or Si)pm I cireviri)or a limited energyP owl, Syrlem over 600 volfY nominal more residential rnih in tote atncture &Iota&!,.,, eaiensicw• 2 U Iludirlio8 over thrrr Osie% ll Feedns.400 amps a most --- U(kciepant Mrd over 99 pasoas U Monuratmad menses$or RV pork l oeb eaMrJvrN Ira}vdlar icer rb.Mille-21.4h airy ad11a entre: U F.gredlrgkin8 plan U 111her — Per ingrm*tn s boil eels of plow wily My of se drove. lavaOiyesiun fee lh above we soot appoeoble tisleopervey eo sollemNiM seeIke. other --- -- --- Nd an iwrakdm Recap)crodrt cora,pleue call lwkdb*a for"Heretaaarrraon. Notice: This permit applicatim Pernit fee...................:..S 66.80 U vin U MastoWsM expires i1 a perrttit is nM otxtrined Plan review(atT ai4) S tiad th card number: _ within 1 R0 day.after it has been State surcharge(8%).....S Name of cradt�sed C - -- -- XP accepted as rnrrple(e TOTAI.. .........5 7214 ea older u a an — S — �at�aider NaMeM - Anaawt _.. _.. 4404613 16KIM'lYlhl) V . i Y OF TIGARL� SE�.NEFtCONNECTION PERMIT :1EVc:l OPMENT SERVICES PERMIT #: SWR2003 00174 13125 S'.. call Blvd.,Tigard, OR 97223 (503) 639-4171 LATE ISSUED: G/5/03 SITE ADDRESS; 07272 SW DURHAM RD BLDG 1450 PARCEL: 2S1 3AG-00102 SUBDIVISION: COUNCIL. VIEW Ac RFS NO. 2 ZONING: 1-I1 BLOCK: LOT: 025 JURISDICTION: 1 I( TENANT NAME: PRO LINE SALES & MARKETING USA NO: FIXTURE UNITS: 6 CLASS OF WORK: ALT DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL 7'(PE: BUSWR IMPERV SURFACE: Remarks: .5 EDU increase. Previous EDU = 7.5 for a total of 120 fixture values. Addition of 8 fixture values for a new total of 128 fixture values =8.0 current EDUs. Owner: - --- _ _ FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY#300-WMI _ PORTLAND, OR 97224 1SWI SAj Swr Cunnect 6/5/03 $1,150.00 1SWI ISAJSwrConnect 6/5/03 $0.00 Phone: - Total $1,150.00 Contractor: Phone: Ren #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The per expires 180 days from the date issued. The total amount paid will be forfeited If the permit expires. The Agency doe' not 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 located, the installer shell purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-6699. Issued by: ----__.__ l< Permittee Signature: i� , s L. ., �•` Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Accumulative Sewer Tally Tenant Name: Pro tine Sales& Marketing _ _ This SWRfi 2003-00174 Address: 7272 SW Durham#750 J This PI-M# 2003-00218 FixtureValue Previous Previous Credits Capped Fixture Fixture New New # value capped off value adder: added total total count off#s count # value #s values _ Baptisery/Font _ 4 0 0 0_ _0 _ 0 Bath- Tub/Shower 4 _ 0 0 0 0_ 0 ••Jacuzzi/Whirlpool 4 _ 0 0 0 _ 0 _ 0 Car Wash- Each Stall _ _- 6 0 0 0 _ 0 _ 0 _ - Drive through 16 I _ 0 _0 0 0 Cuspidor/Water Aspirator 1 U 0 _ 0_ 0 0 _ Dishwasher-Commercial 4 0 0 0 0 0� - Domestic _ ? U 0 _ 0 0 _ 0 Drinking Fountain_ +1 0 0 U 0 0 Eye Wash ^� 1 0 _ 0 0 0 0 Floor Drain/Sink-2 inch 2 0 0 0 _ 0 0 _ 3 inch _ 5 0 0 _ 0 0 0 _ — 4 inch _ 6 0 0 0 0 0 Car Wash Drr 6 0 0 0 0 0 Garbage Disposal Domestic(to 3/4 HP) 16 0 0 0 0 0 Commercial (to 5 HP) 32 0 _ _ 0 0 0 0 _ Industrial (over 5 HP) 48 0 — ` _ 0 0 0 0_ Ice Mach ine/Refrige rah r_Drain 1 __ 0 0 _ 0 0_ 0 Oil Sep(Gas Station) _ _6 0 _ 0 0 0 �0_� Rec. Vehicle Dump station 16--� _ _ 0 0 0 0 0_ Shower-Gang (per head) _ 1 0 0 _ 0 0 0 - Stall 2 0 0 0 0 _ 0 Sink- Bar/Lavatory 2 0 0 1 2 1 2 Bradley 5 0 _ 0 0 0 0 Commercial 3 0 0 0 G_ 0 _ Service _ 3 _ 0 0 _ 0 Y0 _0_J Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 _ _ 0 _ 0 0 0 Water Extractor 6 0 _ 0 _ 0 _ 0 �0 Water Closet-Toilet 6 0 0 — 1 _ 6 _ 1 _ 6 Urinal _ _ 6 0 _ 0 0 0 0 Previous EDU Count 7.5 120 120 Capped EDIJ Credit 0 TOTALS 1 0 1 120 0 0 2 1 8 2 128 i Current Fixture Value _ 128 divided by 16 = 8.0 Current EDU 1 EUJ = $2,300.00 Previous Fixture Value 120 divided by 16 = 7.5 Previous EDU t r Change 8 _ divided by 16 = 0.5 over (under) $ 1,150.00 Enter EDU Change Here 0.5 HISTORY r _ PLM# EDU# SvVR# PLM# EC U# _ SWR# PLM# .� Ef.tU# SWR.+ � Mame: Date: 6--� -L) Signature o/person that calculated this tally sheet and date perhomed Is required ELECTRICAL PERMIT- ' CITY OF TIGARD RESTRICTED ENERGY DEVELOPMENT SFRVIC.c S PERMIT#: ELR2003-00188 13125 SW Hall Blvd.. Tiqard, OR 97223 (503) 639-4171 DATE ISSI IED: 6/30/03 SITE ADDRESS: 07272 `,IN DURHAM RD BI-.DG 1-750 PARCEL: 2S113AC-00102 SUBDIVISION: COUNCIL VIEW ACRES NO 2 ZONING: I-P v_BLOCK: —`--- LOT-025 JURISDICTION: TIG Prosect Description: Data whiny. A. RESIDENTIAL B.COMME=RCIAL _ AUDIO R STEREO: AUDIO & STEREO: L..-ER,-OM & PAGING 13 JRGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS. VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE. OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION. OTHER: TOTAL#OF SYSTEMS: 1 Owner: Contractor: _ PACIFIC REALTY ASSOCIATES HIGHLAND ELECTRIC COMPANY INC 15350 SW SE(.lUOI^, PKWY#300-WMI PO BOX 655 PORTLAND, OR 97224 TROUTDALE, OR 97060 Phone: Phone: Reg #: L2¢0-193$09850 S11P 2431S ELE 26-962(' FEES _ A Required Inspections Description Date Amount_ Low Voltage Inspection ELPRM'I I E:LR Permit 6/30/03 $75.00 Elect'l Final TAX] 8`io Stare Tax (35/50/03 $6.OU Total $81.00 — I This Permit is issued subject to the regulations contained in the Tigard Municipal Cade, 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 suspenders for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility ,'Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at (503) 2.46-6699. � Issued by j < _.. Permittee Signature 4-1 b OWNER INSTALLATION ONLY 4 The installation is being made on property I ov-n which is not intended for sale, lease, or rent. — OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N LICENSENO: -- —� Cali 639-4175 by 7:00 P.M. for an inspection needed the next business day E, ,ctrical Penalt Application Received 1 f?:xttVT s/ r le/BY: Permi[N Dao City o Tigard Planning Approval � - Styes _ [)atdAy, Permit No,. 13125 SW Hall Blvd. Plan Rcvicw Othcr Tigard,Oregon 97223 1115 Date/13': Permit No.: Phone- 503-639-4171 Fax: 503-598.1. `3 Post-Rcvicw i-.and Irsc �— Intcrnet. www.Ci.tigard.or.us Datelft Case No.: 24-hour Ins ectiun Rc uesc 503-639-41IN' C.onfaot 1uriR.: See Page Z for P y v11, Name/Method: (_ Su lemcntal Information. d1/ ter•+k �p,,di iii rG+i�., i'f�=..;A;i�u�'IYn r '�.J i*iM1 l;M - 1UNA r' :'r:{•. ! NCW Corls(MCtion _ 1'�emolition U Service over 225 amps- i Hcalth-care facility commercial hazardous location Addition/alteration/r lacetnent Other: ❑Service over 320 amps-rating of El Building over 10,000 square feet, _ ilr�` ,i,? ', 1 2 tLmily dwellings four or more reaidanNul units in 1 &2-Family dwePing Comlr;ercial/Cndustrial System over 600 volts nominal Me structure Building over three stories ❑Fccdcrt,40(1 amps or more A—IlAccessory Building I U Multi-Family ❑Occupant Ionil over 99 persons Manufactured structures or RV park Master Builder ❑Other: ❑Egress/lighting plan H Other:_ ,• 1 'Xplrij;� I �f�&�rl I: y;�i-:,;'•r, Submit _sets of plans with any of the above.LIMP The above are nota ilicahic to teora .onstruttion service. Job site address: m r, , � ••.^'w�;, Suite#: Sd Bid ./A to _ Number of Ins tcctiot�er petrmit allowed ProiectNarne: RIO L//�/{_ 5 �-- Description Ory Fag(011.) rout New retlelentlal-slugle or multi-family i-or Crosr strect/l)irections to job site: dwelling unit.includes attached gar2ge. Sen•ice Included: _1000 sq.ft or less _ 145.15 d Each addidunal 500!9.ft or portion thereof 33.40 l Subdivision: _ — Lot#: Limited encrgy,residential '73.00 — Z ---- Limited ene�n residential Tax rrra / arcel#: Foch manufactured home or modular dwell g t i5 ,,6607,'7 service and/or feeder 90.90 2 ;Ii iServices or feeders-lettalbation, alteration or relocation: 2W amps or less 110.30 2 - --- ---- ---- 201 sinpq to 400 amps 106.85 2 401 _to 600 AMLX 160.60 2 s,� 1, �i'' ( 1 tfAtA7rNACiµli. ••,. I 601 amps to 1W0 amps 240.60 2 Name over IWO am or volts 454.65 2 ��N C �(�( /�,e}cl �c oiiCFoe Rccont".t only85 2 Address: ` $ S L(J_ Sy-ct 041 Temporary services or ferdet-s-installation, City/State/Zip: �L -0- e) Z. Alteration.or rdocagonr _ : 200 am or leas 66.85 1 Phone: 300 Fax: '2 C,/ 201—29 in 400 amts 100-30' 2 401 m 600 mn,+s 133.75 2 '' 1 " 1 (• ?l Branch circuits-new,alteration,or Name: _ extension per panel: Address: A.Fee for branch cimuils with putcltusr.of —_—�_ service or feeder fee,tach branch circuit 6.65 _ 2 Ci!X/State/Zip: _ N Fee fir branch circuits without purchase of servioe or(ceder fee,rust branch circuit 46.95 2 Phone. Fax: _ Each a itional branch circuit 6.65 2 E-mail: Mbsc.(Serviee or finder not included): -— f` &ch pump or irrigation circle -- - 7.40 Fla-ck sign or outline lighting 53.40 2 Job No: _ JlttMI cirr 'r(s)or a limiwd eM?,V Panel, Business N C: / �4 � also gado , extension __ _ Pae 2 2 Address: 0go)( 6 _ p _. city/state/zip: Each additional inspection over the allowable Its an of the abovx: :_ �� Per inspection per hour(min. I lour) 1 _ 62.50 Phone: 10 3` T Fax: — 6 2L inveati cation -- CCB Lie. #: Lic.#: b +. , thcr: w ,ta ,.i '� � ° 1 •' r',] I . r, �,. Supervising electrician r " `k -- Subtotal S — st tune requtrS!j, _ _ ` ' -- Plot Review 25%of Prrmit Feel Print Name_-_ _ Lie. #:^ l +' T� State Stucha%C 8%of Ptn alit Fix S b TOTAL PERMIT FEES $r Authorized Notice: This permit appiicallon expirei If it permit is not airs n with{o SignatureHater 18I days after it hu been accepted as complete. 'Fee methodology set by Tri-County Building industry Srtvice hoard, (Please print name) rc, i\0itin Perndt Fortnit0uPemntApp dtx 01/03 Td WULZ:80 j:00Z 02 'unr 92bZ+S99 'ON 9NOHd WM�J CITYOF T I G A R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-01.137' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 7/2/03 PARCEL: 2S113AC-00102 SITE ADDRESS: 07272 SW DURHAM RD BLDG 1-750 SUBDIVISION: COUNCIL VIEW ARES NO. 2 ZONING: I-P BLOCK: LOT: 025 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: ( OM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: _ 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: OD GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS C OTHER UNITS: FURN —100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: Remarks: Replace exi�l unit "illi 395 Ib. unit. I'.xlenll(lucts WILI grille. Owner: FEES _ PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300-WMI —' PORTLAND, OR 97224 JIM l c l l I Permit Fee 7/2/03 $72.50 TA.\ statcTax 712/03 $5.80 Phone: Total $78.30 — Contractor: BKM MECHANICAL INC 19840 S REDHOUSE RD MOLALIIA, OR 97038 REQUIRED INSPECTIONS Phone.: 503-829-2032 Heating Unt Insp Duct Inspection Reg #: LIC 154865 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 st.tspe:ided for more than 180 days. ATTENTION: Oregon law requires you to fo;low rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 I" Iss d By: ► Permittee Signature: Call (50 639-4175 by 7:00 P.M. for inspections needed the nex4 business day aaaaao•aaa� w�a�ai �s Mecl,anieal Permit Applica.tioll Received Mechanical �1 , bate/By: Permit No.: It (pity of Tigard Planning App val Building Date !3,-. Permit No,: 13125 SW Hal' 31vd. Plan Review Other - Tigard,Oregon 97223 Datdfi�,: Permit No.: Phone: 503-6394171 Fax: 503-598-1960 Post-Review Land Use Dater Cue No.: Internet: www.ci.tigard.or.us contact See Page 2 for 24-hour Inspection Request: 50.'-G39-4175 Nwne/Method _ / Sur lemental Information. TYPE OF WORK F CO MMERCIAL FEE*SCHEDULE-USE CHECICLIST ❑ New construction_ Demo lltion Mechamcal permit fires*are based on the total value of the work C_ Addition/aiteration/replacement fH Other' performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. 1 &2-Fanaily dwelling Commercial/Industrial value: S _ See Page 2 for Fee Schedule Accessety Building -Multi-Family RESIDENTIAL Es1JIPMENT/SYSTEMS EEE*SCHEDULE- Deseriplion 7 t Fee ea. Total Master Builder ❑ Other: Ifeatin coolie JOB SITE INFORMATION and LOCATION Furnace-add-on air condition" 14.00 Job site address: ?2 72- S LIP-it 4Av_ ` Jz) Gas heat pump I4A Suite#: � Bldg./Apt.#: Duct work 14.00 _ Pro ect Name: ��(rNL SM�LS i _Uy —dronic hot water system 14.00 -- Cross street/Directions to job site: Residential boilerJPor rodialor or hydropic system) 14.00 Unit heaters(fuel,not electric) in wall,in-duct, uspended,etc. 14.00 Flue/vent for an/of above) _10.00 _ :subdivision: I.,ot#: Repair units _ 12.15 _--�-- _ Other Fuel ApI Maness _ Tax map/parcel #: _ Water heater10.00 DESCRIPTION OF WORK Gas fireplace _ 10.00 qL£ AV4C- 1,41,17 Flue vent(wuter heater/gas fir lace) 10.00 VCS 0C/L ,..7-D Z' T7 Lo lighter gas' 10.00 -1 -�� - Wood/Pellet stove 10.00 ------ --- _ Wood fireplace/insert 10.00 _ _ Chimney/liner/flue/vent 10.00 PROPERTY OWNER TENANT Other: Y 10,U0 Name: Environmental Exhaust&Ventilation _—_��-- - - -- -- - Address: Range hood/other kitchen equipment 10.00 ------ Clothes dryer exhaust 10.00 Cil /_State/Zip: Single duct exhaust Phone: _ Fi1X: (bathrooms,toilet compartments, APPLI(.'ANT I LJ CONTACT PERSON utility rooms) 6.80 Nance:_ Attic/crawl s ace fans 10.00 Address: - - ----� Other: 10.00 --- -- Fuel Piping City/State/Zip:_ ""(S5-40 for first 4 SL00 each rddlNoaal t Furnace,etc. -T- Phone: "I X: � _ - -- -- - - - Gas heat pump— .• Email: Wall/suspended/unit heater ** CONTRACTOR Water heater +• Business Name: A�k.,vt yf f_c�14M�,�L n,e. Fire lee^ — Address: i9py0 .r Range __ •• _ City/State/Zi :.,,';ff0 J,X La 049 � � 13BQ — - •• — - --�-�_� Clothes dryer(gas) ** Phone: P 2 �-zy j`- Fax: Other: _ •:- CCB Lic. # / $C(��!S` t ot_al Authorized Mechanical Permit Fees* Signature: Dater 03 Subtotal: $ -- Minimum Permit Fee$72.50 Plan Review Fee 25%of Permit Fee S (Please print name) State Surcharge(8%of Permit Fee S Q7 - TOTAL PERMIT FEE S Notice: This perrnll applicetion expires if a permit Is not obtained within 'Fee methodology set by Tri-County Building Industry Senlce Board. 180 days after It has been accepted as complete. "Site plan required for exterior A/C units. i:\Dsts\Pcrmit ForimNeclremutApp.dnc 01/03 Mechanical Permit Aanlicatior>I - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Vaivation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 $5,001.00 to$10,000.00 $72.50 for the fist$5,000.00 and$1.52 for each additional$100.00 or traction _ thereof,to and including$10,000.00. S10,OOI.UO to$25,000.00 $148.50 for the first$10,000.00 and $1.54 for each additional$100.00 or fraction thereof,to and including _ $25,000.00. $25,001 (X)to$50,000.() $379.50 for the first$25,000.(10 and $1.45 foot each additional$100,00 or fraction thereof,to and including $50,000,OU. $50,001.00 and up $742.00 for the first$50,((X).00 and S 1.20 for each additional$100.00 or fraction thereof Assumed Valuations Per Appliance: Value 'Total Description: t- ([:a) Amount Furnace to 100,000 BTU,including 955 ducts&vents _ Furnace>100,000 D'rlJ including ducts 1,170 &vents_ Floor furnace including vent _ 955 Suspended heater,wall heaver 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 init. 2,310 BTU 30.50 hp;absorb.unit, 3,400 1-1.75 mil.BTU _ >50 hp;absorb.unit, 5,725 >1.75 mil.BTIJ Air handling unit to 10,000 cfm 6.56 _ Air handling unit>10,000 clm 1 170 Non-portable evaporate cooler 656 Vent fan connected to a single duct 446 _ Vent system not included in arpliance 656 rmil _ Hood served by rm hanical exhaust 656 Domestic incinerator _ 1,170 Commercial or industrial incinerator 4,590 Other unit,including wood stoves, 656 inserts,etc. _ Gas piping 1-4 outlets--�--- _360 [Each additional outlet` ,� 63 TOTAL COMMERCIAL. $ VALUATION: I i:\Dsts\PermitFonns\MccPcmilAppPg2.doc 01103 .l. CITY GFTIGARD 24-Hour BUILD' - Inspection Line: (503)639-4175 MSTINSPECTION DIVISION Busimss Line: (503)639-4171 -- BIJP Received ._ Date Reted �� Z AM __— PM BUP ues Location ____ 7 _ � — L.� Suite ��_ MEC Contact Person - �� - Ph(--_) _- G�-� PLM ^_ _ Contractor ._ - --�—) Ph(_ ) — SWR ------ BUILDING Tenant/Owner ELC Footing ELC Foundation access: --� - — Ftg Drain ELR _ Crawl Drain Slab Inspection Notes. SIT Post& Baam Shear Anchors - -- - -- - Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing _— --- - - - ---- -— ---- -- - - Firewall Fire Sprinkler -- - - - — Fire Alarm Susp'd Ceiling - ---- -- - - --A—- — Roof Other: /1 Final PASS PART FAIL -- Post& Beam Under Slab Haugh-In -- -- — ---- Water Service - - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain -- - --- -- - Shower Pan Other: Final PASS PART FAIL - -— MECHANICAL Post& Hearn Rough-In Gas Line - - --- - -- -- Smcke Dampers --- ------- - Final PASS PART FAIL ---- ---- - ------- -. - ELECTRICAL Service ---- - - --- --- - - Rough-In l I(;/Slab I ow Voltage Fire Alarm ruwi1 Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 4ip- PART FAIL Please call for reinspection RE:-_ _ -- L Unable to inspect-no access Fire Supply Line AGA Date - �i-C� Ins eCt ''1— c7-_'�' Ext------- Approach/Sidewalk ---v.� P - Other: Final DO NOT REMOVE this inspoctlon record from the ob site. PASS PART F. ITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST _ BUP Received --_-_ _.-Date Requested _- __ T� AM -- PM -_. BUP Location _ �-� VA.' -Suite-: -_2554- MEC -3.-7 Contact Person _ �r Ph(---) 03 z-__ PLM -_- -- Contractor_ _ w Ph ( -) - ----— SWR — � U_ILp1Mg Tenant/Owner — _— ELC Footing ELC Foundation Accezis: — ----_._- Ftg Drain ELR Crawl Drain ---_----- Slab Inspection Notes: SIT Post& Beam - --- - - - -.----- --- Shear Anchors ---- - ---- ----- Ext Sheath/Shear Int Sheath/Shear - -- - - Framing Insulation ---- -- -_ Drywall Nailing -----.- - FirewgL - �- ----- Fire Alarm -a`------ - -- -- -- --- - Susp'd Ceiling --- --- - -- _ --- Roof tASS 1[ PART FAILINE Post&Beam Under Slab - - ----- -- - ---- -- Rough-In Water Service ---- --- -- --- - --t - - -- ---- Sanitary Sewer Rain Drains - --- --. -- - - - ----- -'/ Catch P isin/Manhole Storm Drain - --- --- - -- Shower Pan - 1)ther:_ --- ------------- - ------- --- -- Final PASS PART FAIL -- --- - - ---- - ___--- - --- AMONAM < AL Post& Beam ---- CuTg- --- - ---.,.-- -- - --- _-. - ---- Smoke Dampers ---- -- - - -- -------- ---- -- - --- ------- J n AS PART FAIL ---- -- - -- -- - ---_ _- __�_ --- - T-RI CAL Service Rough-In UG/Slab -� ---- -- l_ow Voltage Fire Alarm � , _� ____----- --------------------- -- Final Reinspection fee of$-_ required before next inspection. Pay at City Hall, 13125 SW Hall Olvd. PASS PART FAIL SITE_E--- Please call for reinspection RE:__- _.. N _ ____ ❑ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Dates - /� Inspector _Ext __- Other: Final DO NOT REMOVE thls inspeeMon record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP —.—.-- -- Received —�— ,Dale Requeste{d� 77 _ AM —_r1PM BUP Location Suite —9l 0--- MEC SIS � Contact Person _. —_.—.___� _-- Ph(�� __) � _ V_ PLM __— Contractor_ _____ __ Ph(____— ) — _ SWR _BUILDING Tenant/Owner __-______— —.. _ -- ELC Footing ELC Foundation AWISS:Ftg �- CrawlrDain �� 1 OC �� ELR 0 � Slab Inspection Notes: SIT Post&Beam - -- -- - _ -- -- Shear Anchors ^ ----- - Ext Sheath/Shear Int Sheath/Shear Framing - --- - ------ --- -------- - -- Insulation Drywall Nailing Firewall Fire Sprinkler - -- -- -- Fire Alarm i Susp'd Ceiling - - -- -- -- -- - Roof � ---- --- ----.. Other:_--- - — - - - Final PASS PART FAIL - PLUMBING Post&Beam — — Under Slab -_-- -_-__-- _ Rough-In Water Service --------------- Sanitary Sewer Rain Drains --- - --- Catch Basin/Manhole Storm Drain --- -- -- Shower Pan j Other: - ------ -- - i Final - _PASS _P_ART _FAIL ME --- ----- __ C_H_ANICAL__ _ Post&Beam — Rough-In - - -- -- -- ---- - Gas Line Smoke Dampers -- - - -- ---------- -- Final PART_ FAIL ---- --- - ------ - -,ELECT IC Service ---'-' - --- --- --- ------ Rough-in UG/Slab - -..-- ---- -- — F�� ❑ Reinspection fee of 3,___- -__--_ required before neC inspection. Pay at City Hall, 13125 SW Hall Blvd. � _ 7PART FAIL SITE - -_ Please call for reinspection HE: _ -__ _ L] unable to inspect-no access Fire Supply Line ADA ^ It o+ Approach/Sidewalk Date _- ' -_ ' inspector Other.-- - Final DO NOT REMOVE this Inspection record from ih ob site, PASS PARI FAIL ' C11"Y OF TIGARD 14-How BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received __._— __Uaie Requested_-- y1- _I AM PM BUP Location —Suite -"17 -7,!n-.V MEC —� Contact Person ___—_____--- — Ph(—)7 62 E — PLM _- 0 Contractor----_____--- _. —__ _ Ph (-- ) -- - SWR --------_—�-- BUILDING Tenant/Owner i j\e �v _ ELC Footing ------ iELC Foundation Access' - --v-- - Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors - ---- - Ext Sheath/Shear Int Sheath/Shear Framing -- -- - -- - ------- -- Insule•ion Dryvw:�l Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Coiling ----- -- goof Other:--- Final ---- -- � PASS_ PART FAIL --- — � Prst&Beam Under Slab -- _-- _- Plough-In Water Eervice ---- -- Sanitary Sewer Rain Drains — ---------- - -- Catch Basin/Manhole Storm Drain - - - — Shower Pan Other: PA PART FAIL --- —`-- — ECHANICAL Post& Beam ------ _ -------- ---- Rough-In Gas Line Smoke Dampers - Final PASS PART FAIL — — - -- - -- — ELEC:TRICAL Service - Rough-In UG/Slab ----- --- ----- --------------__- Low Voltage Fire Alarm Final Reinspection fee or$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ Please all for reinspection RE---—----_.__.._._. _ �� Unahle to inspect-no access Fire Supply Line ADA Approach/Sidewalk Dato_� Inspeetor -_---_._--- -- - -- -_ _ Ex# Other: Final DO NOT REMOVE 's Inspection record from the Job site. PASS PART FAIL \ CITY OF TIGARD __ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00218 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/5/03 SITE ADDRESS: 07272 SW DUrIHAM RD BLDG 1-750 PARCEL: 2S113AC-00102 SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING: I-P BLOCK: LOT: 025 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPA14CY GRP: R FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS. RAIN DRAIN: ft Remarks: Plumbing tlXIUreS 1 new lav and 1 new toilet, rnove 1 breakroorn siri' . _ FEES Owner: '-- ---_= _�— Description Date Amount PACIFIC REALTY ASSOCIATES - — --- 15350 SW SEQUOIA PKWY #300 WMI IIvi.UMBI Pernur I cc 5/2710:1, $72.50 PORTLAND, OR 97224 I'IAX] 8`0 Slaw I,i\ 5/2.7/03 $5.80 Total $78.30 Phone : Contractor: ADDISON PI UMBING 17506 SE RIVER RLQ MILWAUKIE, OR 97267 REQUIRED INSPECTIONS Phone : 501-785-1840 Rough-in Insp Underfloir/Underslab Re a #: LIC 151754 Top-out Insp PLM 3-1481113 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oreton law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: Permittee Signature: Call (503) 639-4175 b�, 7:00 P.M. for an inspection needed the next business day F fixtures _ ,g, Permit Application Received Plumbing.,, .L ,1 Date/B - ' / {'J Permit No.7L. 1nW -t�Ct�/Fi Cit of Tigard Plunning Approval Sewer � -/ City b Date/B1. _ Permit No.<-U/1t -OC' Y 13125 SW Hall Blvd. Plan Review - Othet Tigard,Oregon 97223 Da-l3 : Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Iznd Use Internet: www.ci.ti ard.or.us Date% - ('ase No. g Contact luris -See Page 2 for 24-hour Inspection Request: 503-639-4175 Namc/Methcd -. Supplemental Information. TYPE.OF WORK FEE"SCHEDULE(for special Information use checklist _ New construction Demolition Description 1 Qth. I Fcc(ca.) Total x. Addition/alteration/'c lacemenl� Other: New 1-&2-family dwellings CATEGORY OF CONSTRUCTION _ - (.includes 100 ft.for each unlit connection) �- SF'K )bath 249.20 �fl & 2-Familydwelliq A] Cornmercial/lndustrialSFR 2 bath !- 350.00 Accesso Butldin�' Multi-Family LSFR 3 bath 399.00 Master Builder ❑Otho- Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION Firesprinkler-sq. ft.: Pa'c 2 Job site address-7 7- z •w Site Utilities Suite#: 7;m Bldg./Apt.#: Catch basin/area drain 16.60 Project Name: 3, r`r ,. Yl },�h Dr ell/Irich lincArench drain 16.60 Fo_otin6 drain(no, linear ft.) _ Pae 2 Cross street/Directions to Job site: Manufactured home utilities _ 110.00 Manholes _ 16.60 Rain drain connector 16.60 Sanitary sewer no.linear ft.) Pae 2 Storm sew (no. linear . Pae 2 Subdivision: Lo sewer R1 t#: W - - ---- 'Fax ma / aret'1#: -� Water service no. linear fl Page 2 DESCRIP'I�ON OF WORK Fixture or Item -- --- Absorption valve _ _ 16.60 Backflow,preventer _ Pae 2 Backwater valve _ 16.60 - Clothes washer _ 16.60 --- - --�--- Dishwasher 16.60 � --- Drinking fountain IG.6U �PROPERTYOWNER --�TEhAN� Ejectors/sump _ 16.60 V� Name: �'�w'C•.�� C,,,p�,r .rs Expansion tank _ 16.60 1 Address: Fixture/sewer ca _^ I 16.60 City/State/Zip: - - _ Fbor drain/floor sink/hub _�- 16.60 Garba c disposal 16.60 Phone: _ Fax: Hose bib 16.60 APPLICANT 0 CONTACT_PERSON Ice maker 16.60 Name: - Interceptor/grease trap 16.60 Address: Medical gas-value: S _Page 2 ' - _ -__ .--- _ ----- Primer _ 16.60 cit /State/Zi `- y p• -__- Roof drain(commercial)_ 16.60 Phone: _ FBX: - - - Sink/basin/lavato _ 16.60 3 3-2-7, E-mail: -` �T- - Tub/shower/shower pan _ 16.60 l CONTRACTOR Urinal Y 16.60 Business Name: f;+ t,, c Water closet 16.60 r� - ---- 1-=� 1-L`' Water heater 16.60 Address: t ;iG Q �r,r �,��! Other: Cit /State/Zi : L CAL r Jt-�,t Other: Phone: -)%S-lR4t� Fax: 7b 1,o t14 7 Plumbing Permit Fees* r , Plumb. Lic.#: subtotal CCB L1C. #: 1 > `t FQ f'1' Minimum Permit Fee$72.5(. S Authorized -G Signature: �.� r.. .v�syY,.�_----- Date: 5 L - - Residential Backflow Minimum Fee it _ 7 _Plan Review(25%of Permit Fee) • �� , _ State Surcharge 8%of Permit Fee S (Please print name) r TOTAL PERMIT FEE_ $ Notice: This permit application expires If a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or IAO days after It has been accepted a%complete. riser diagram for pian rc%lew. 'Fee methodology set by Tri-1"ounh Building Industry Service hoard. i\Dsts\Pemtit Fontts\PlmPermitApp doc 01/03 PI_umbini! Permit Aplication - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire-suppcession Systems: Site Utilities - Qty_ Fte(ea) Total ware Footage. _ Permit Fee: Fuming drain- 1" 100' ',5W —$1!to�(N)0 $1 15.00 Footing drain-each additional 100' 46.40 2,001 to X6003,601 to 7,200 5220.00_ 5160.00 Sewer-I st 100' 55.00 7,201 and greater _ _ 5309.00 Sewer-each additional 100' 46.40 Water Service- Ist 100' 55.00 — Medical Gas S stCms' Water Service-each additional IMY 46.40 _ Valuation: _ Permit Fee: Storm& Rain Drain- I tit 100' 55.00 $1 (9)to$5,000.00 Mimmun fee$72.50 Sturm&Rain Drain-each additional IAV 1 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 51.52 for each additional 5100.00 or fraction thereof,to and Fixture or Item Qty, Fee(es)_ Total —$10.00 including 510,000.00. Commercial Hack flow Prevention lkvice - 46 411 $10.001.00 to 525,000.00 $148.50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee$36.25 27.55 and including$25,000.00. Rain Drain,single family dwelling 65 25 $25,001.00 to 550,000.00 $379.50 for the first$25AM 00 and$1.45 for Inspection of existing plumbing or -- each additional$100.00 or fraction thereof',to specially and including$50,000.00, requested inspections•per hour 72 Sit $50,001.00 and up $742 00 for the first 550,000.00 and 51.20 For Subtotal: each additional 5100.00 or fraction thereof. Fixture Work: Are you dapping, mofing or replacing existing fixtures? If "yes",please indicate work performed by fixture. Failure to accurately re)ort fixtures could result in increased sewer fee%*. uautlty 1)(Hint re Work Performed Comments r-i-ar'ding fixture work: Fixture Type: Replace New MovedVNIS(hill Copped — -- — -------- --._.,..__�----- fla list /Font — -- Bath -l'ub/Shower -Jacuzzi/Whirlpool -- -- _ _-- - - ---- — ----- ----------- Car Wash -Each Stall - •Drive Thru ---- - ------- ---�..---- Cus idor/WaterAspirator ---------- - Dishwasher -Commercial -Domestic -- --- - --�.��---- --- ------ Drinking Fountain --- ------ - -_E yr Wash - Platt Drain/sink -2" _ --_ --_ `- -------- --- -- N--- -- 3" -- ---- -------- 4„ - - — Car Wash Drain *Note: If the fixture work under n this permit results in a Garbage -Domestic i Disposal -commercial _ increase of sewer EDPs,n sewer permit will be issued and -industrial – fees assessed for the sewer increase must be paid before the Ice Mach/Rcfri .Drains plumbing permit can he issued. Gil Separator(Gas Slat ion) _ Rec.Vehicle Dump Station _ Shower -Gang _ -Stall Sink -Bat"!Avatory -Bradley -Commercial -Service Swimming fool Filter _ Washer-Clothes Water Extractor _ Water Closet-Toilet Urinal Other Fixtures t:\Ilsts\Pemiit Fomtt\PlmPermitAppPg2.doc 01103