Loading...
11539 SW PACIFIC HIGHWAY ADDRESS. i:\records\microflm\targets\buikfing.doc CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service (JNA Foundation Water Line Ceiling -Plumb. Post/Beam Mech. Shear/Sheath Framing Mech. PIbg.Und/Flr/Slab Pibg. Top Out Insulation -Elect. Post/Beam Struct. Mech, Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: Date: /l 7_STJ ( A.M. P.M.__ Entry: _ Address: / 1 C, /" �`('c. —� 4 Tenant: —�. Ste: MST: Con/Own; 0 2,V MEC: PLNI: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _ Inspector: _ Date: APPROVED __-.DISAPPROVED/CALL FOR REINSP. CF CO CITY CSF TIC-YARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503!839-4171 SUBDIVISION— .. I T';'F'E 0-r VOLUME: ENG S".iLL^. . . . . lJ OWrie1". TIGI)RD OR 1) C tit AC ro r1 + r"CJRT AND 0 P 9'"1" "��'• This approved plans. I.is Pei-fit i'i"! e.�p1.a :r wor, is �t st v e.1 +li}hit. 192 days of i5svan:e, :i' 1f riv i. i5 MA than IN days. C_. y f l .oto Commercial Building Permit A cation /.� VI �/City of Tigard — , �, . 4 )l v 7 13125 SW Wall Blvd. Tigard, OR 97223 (503) f 19-4171 l yl -bft— qDO( Jobsite Add7ress: Tenant: _ gvrz G C4-t C4-tV ,r-J ro Suite S NIA _ Office Use Only Planck/Rec Valuation: Permit # -Dii -- Owrwr: uric- P/L�frt1' 1CS. ING • Map & TI. #_� >� ?IOtI�`LWI Address: _ I ( � I S S t-� pRr c F i L 11. U a•_ _ ApprovalsReg,--', i� c1 4 c7`(Z "1 Z Z 3 Planning �_-- Phone: 0 7, Z `l Engineering Other Contractor: T LLt lL INC. Address: h'D Type of const: _ c-,,r Occupancy class: Pnone Contractor's License # 3 s / T,> Tcx) C° L `� Z 17- (attach copy of current Oregon license) Sq. ft. of project: (oJa - �?c5-b Contact name & phone: _E-j-JstJk ST-VkL (VZS'YM"J Story (1st, 2nd, etc.) villi --_ Proposed use- Arch se Arch itect/Engineer: �,::r_�rv�r U�GSr G►�6.n1T t/1�r+6 CQYLP Previous usc,: _ Address: X.zS- N £ F1 U I+c.Jo rph . 5'b —� Note: Plumbing & mechanical plans ��,,•L c �,.-�(� �') Z 3 must be submitted at time of building permit application. Phone: S �� - IL 1 - (o O��" � J08DESCRIPTION: SNV)&,Tv-,nr-+tir6>� rti-fntTN,3� ixc�✓�-II or 367 C� __44�. ,r— 4L J s _i. I-F\ c_, ta*N i N p c. S ,ktQ fZ E�i�Y'�h i ori e Applicant Signature & Phone number Received by��1��1-4' N��c^ � Date Received: Pelmii;$ Account Description Amount Amt. Pd. Bal. Jue Bldg. Permit (BUILD) s, Plumb. Permit (PLUMB) Mech. Permit (MECH) State Tax (TAX) Z Bldg: -- Plumb: Mech: Plan Check (PLANCK) L� � 166, Bldg: Plumb: Mech: _^ Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (TIF-R) Mass Transit TIF (TIF-:N-i� Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF.-IS) Office TIF (TIF-0) Weter Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Planck/LISA (ERPLAN) Erosion Fianck/COT (ER.OSN) 1 I �rl 'rD �� V TOTALS: � i��� P� CANOPY _ Y QO cr r z �a BU!?�ER J L�J KINC a: af a LJ CtrY()F.i I(3AI is u Approved 0 i-or only the work is rIngribcd in: z PERMIT r',v �9 1 CAl CH HASIN PLAYGROUND —APPROXIMATE EXTENT OF SELECTED CONTAMINATED SOILS FOR REMOVAL 4W-3 (300 CUBIC YARDS) EXCAVATION DEPTH TO BE 3 FEET I CATCH BELOW SIDEWALK GRADE, BASIN® --- STORM RESTAURANT SEWER / DRIVE—THROUG14 , VAUI-T ------ WALL \ / —RETAINING \4� IBURGER KING LANDSCAPE AREA CATCH\� "AGN BASINS Op MANHOLE BIO—FILTER BAGS SW PACIFIC HWY (ROUTE 99W) 0 20 40 mm SCALE: 1 "=20' DFSIGNED BY:BA CHECKED BY: SITE MAP DATE: - tar0:?/14/96 DRAWN BY:KFP SCALE: 1"m20' ME PROPERTIES, INC. Centurywest FIGURE: 11505 SW PACIFIC HIGHWAY ENGINEERING CORPORATH'I FILE:40760001.01 4014-02 TIGARD, OREGON 2 1-T j(v Post•It"routinp request pad 7664 l�OUTING — REQUEST Piease, ... .-3���9 , HEAD To��tolky ir.- wl HANDLE1/l a APPROVE r _�� 3-z? and. , LJ FORWARD RETURN b111V` 11M ❑ KEEP OR DISCARD C� REVIEW WITH ME ` j r NIC Date.- , From centur ywest ENGINEERING CORPORAIIC)N REMEDIAL WORK PLAN IME Properties, Inc. Burger King Property 11505 S.W. Pacific Highway, Tigard, Oregon INTRODUCTION Century West Engineering Corporation has been retained by JME Properties, Inc. to assist in meeting environmental requirements established in the escrow agreement associated with the sale of the subject property. As part of our work, we were instructed to develop a Remedial Work Plan. This pian describes the following casks: • Removal of an estimated 300 cubic yards of petroleum contaminated soils; • Backfill, compaction, and restoration; • Soil and groundwater sample collection and analysis; and, • Data evaluation and reporting. Century West Engineering Corporation reviewed a Phase 1 Environmental Site Assessment dated October 26, 1995 by Transpacific. Ltd., as well as the draft and subsequent final Subsurface Investigation prepared by Pemco for Transpacific dated January 9, 1996. The site appears to have soil and groundwater contaminated with gasoline and diesel-range products which likely resulted from the removed underground storage tank. The Pemco report suggested the presence of free product towards the downgradient (southern) portion of the property, There are three on-site monitoring wells, and only one of the wells (MW-3 in the sidewalk, southern portion of the property) contained low levels of gasoline constituents (55 ppb benzene). Soil sample collection and analysis performed by others in the southern portion of the property detected hydrocarbon concentrations ranging from 200-740 parts per million (ppm) Total Petroleum Hydrocarbons as gasoline (TPH-G) and 380-14,000 ppm TPH-418.1 as shown on Figure 1. REMEDIAL WORK PLAN This Remedial Work Plan reflects the procedures and protocol that we believe are appropriate to adequately address the environmental issues asse-iated with the subject property. We have developed this work plan based on our quantity estimates and have described the recommended extent of contaminated soils removal. L E A D I N G T H R O U G H E F F E C T I \, F S O L U T i O N 5 825 N E Multnomah,Suite 425 Portland,Oregon 97232 Phone: 15031 231-8078 FAX:(503)231-8482 Printed on Recycled Paper 'I'his work plan details all actions necessary for the completion of this work, outlined as follows: • Permitting • Removal and Off-Site Disposal • Backfill, Compaction, and Restoration • Sample Collection and Analysis • Data Evaluation and Reporting PERMITTING: Century West will satisfy all project permitting requirements, including the City of Tigard's site specific (SIT) permit for excavations greater than two feet in depth and for fills greater than 50 cubic yards in accordance with the Unified Building Codes, Appendix Chapter 70. The SIT permit application will include a site plan detailing the quantities and locations of excavation, fill and restoration. We will have performed soil compaction testing to 90 percent of maximumm dry density by modified proctor and submit the results to the City as required. Additionally, erosion control devices to the Unified Sewerage Agency's standards will be installed and then insr"ted by the City. Appropriate traffic control devices, including flag pe,sons, will be employed as necessary. Because the subject property adjoins S.W. Pacific Highway (Route 99) to the south, the Oregon Department of Transportation may require special consideration in terms of rights-of- way, traffic control, and general project logistics. REMOVAL AND OFF-SITE DISPOSAL Century West will use a subcontractor, Terra Hydr, Inc., under our direction for portions of the work including excavation, loading, transportation, and restoration. An estimated 300 cubic yards (up to 4.50 tons) of petroleum contaminated soils will be excavated and directly loaded into dump trunks for transportation to a landfill (e.g., Hillsboro, Oregon). We will minimize impact to ongoing site operations such as access to the existing restaurant's drive through and parking through project completion. We will use utility locators and any outside vendors necessary to identify and mark all existing services through and near the selected removal area shown on Figure 2. Existing site services associated with the removal area will be protected for the duration of the project. Using a subcontractor, Century West will clear and grub all landscaped vegetation over the selected removal area. Vegetation without soils attached to the root stntctures will be segregated to the extent practical. Existing trees, two each, will be removed, if practical, for replanting during restoration. The lateral lines and sprinkler heads will be disconnected throughout the removal area and the remaining sprinkler system will be protected (to be re-assemhled or replaced during restoration). RernedinI Work Plrtn-Burger King Property -2- 11505 S.W. Pacific Highway, Tigard,Oregon Century West will preserve and protect the retaining wall, forming the easterly tending boundary of the selected removal area. Also, we will preserve and protect the storm sewer vault and ancillary system in the southern portion of the removal area. Excavation will begin in the northern porta-n the area selected for removal, approximately 12 feet in the northwesterly direction of the monitoring well installed in the sidewalk (MW-3) as shown on Figure 2. The removal will progress between the retaining wall and the sidewalk to a depth of three feet below sidewalk grade while proceeding in a southerly direction toward the storm sewer vault. Using a subcontractor, we will directly load up to 450 tons of petroleum contaminated soils into dump trucks for transportation to the Hillsboro Landfill (Sanifill). We will collect, retain, and provide all transportation documents (manifests or bills cf lading, weight slips) and receipts of disposal to be included in a wntien report at the completion of our field work. f BACKFILL, COMPACTION, AND RF,STORATIONd l" n Century West will oversee the supply and placement of up to 400 tons of selected backfill and an additional 50 tons of appropriate topsoil. Backfill material will be placed such that the material shall conform with original and adjoining grades and pass compaction testing (90% of maximum dry density by modified proctor). Documentation of density testing will be supplied. The topsoil material will be compacted as required to sustain the vegetation to be restored. In addition to revegetation and replanting of four to five bushes and two trees, any sidewalk or curbing damage will be restored to code. SAMPLE COLLECTION FOR CIIEMICAL ANA1,YSxS Soil. Century West has selected the. number and loca'don of confirmation soil sample collection points based on an excavation area. • a perimeter oi' 180 feet and a bottom area of 6C0 square feet. The Century West onsite representative will collect discrete confirmation soil samples at approximately 15 loot intervals along the walls at the excavation limits. Sample collection may occur in shorter intervals at the southern boundary and longer intervals in the northern portion of the excavation for a total of 12 samples. Up to 6 soil samples will be collected from the bottom area excavation limits. Therefore, a total of 18 confirmation soil samples will be collected for laboratory analyses. All 18 soil samples will be analyzed for petroleum hydrocarbons using TPH-G and 'TPH-418.1 for comparison of detecteu concentrations to established cleanup levels. Additionally, two samples will be selected for leachable metals analysis (lead, cadmium, chromium, arsenic), polychlorinated biphenyls (PCBs), polynuclear aromatic hydrocarbons (PAHs), and benzene, toluene, ethylbenzene, and xylenes (BTEX). Remedial Work Plan-Burger King Property 3 11505 S.W. Pacific Highway, Tigard,Oregon In addition, we will collect samples of any soils that have field evidence of contamination (e.g., staining, odor, organic vapor readings on field instruments). Headspace readings will be obtained by filling a clean jar half full and capping it with aluminum foil and lid. The sample will be placed in a non-agitated state for approximately one-half hour to allow any volatiles in the soil to collect near the top of the container. Using the probe on an organic vapor meter with a 10.2 eV lamp, we will obtain a field instrument reading. Groundwater. The purpose of conducting groundwater sampling is to further characterize the site hydrogeology and groundwater chemistry. Measurement of the water table elevations and collection and analysis of groundwater from the three on-site monitoring wells would provide data after the r-moval of selected contaminated soilq. All samr'^s will be analyzed for BTEX. Monitoring well MW-3 will be additionally monitored for TPH-418.IM to screen for polynuclear aromatic hydrocarbons (PAHs) and metals analysis (lead) for comm • on of detected concentrations to established cleanup levels. All chemical analyses will be completed by Century Testing Laboratories of I;end, Oregon under contract with Century West. Equipment Decontamination. Equipment used to collect samples for chemical analysis will be cleaned before field use and between each sample collection by a detergent and water wash followed by a distilled water rinse. Health and Safety. Prior to conducting field activities at the site, Century West will produce a site Health and Safety (H&S) plan. The H&S plan will be prepared in accordance with OSHA and Oregon Administrative Rues for the use of Century West employees and as guidance for subcontractors. Century West personnel will have the H&S plan present at the site during the field activities. DATA EVALUATION AND REPORTING We will document all of our activities and findings, including removal and restoration work, laboratory analyses, and data evaluation in a letter report. Data evaluation resulting from confirmation sample analysis will dictate whether sufficient information exists to recommend no additional work at the subject property. Our recommendations will be based on: • removal of petroleum-impacted soils from under the subject property to the extent practicable; and • comparison of detected constituent concentrations in the soils and groundwater to established DEQ cleanup levels for leaking UST systems. Remedial Work Plan-Burger King Property -4- 11505 S.W. Pacific Highway, Tiga.-d, Oregon i Centt:ry West will summarize previous environment<-1 work performed at the site and describe our implementation of the Remedial Work Plan. The purpose of the report will be to combine all of the data collected in the above tasks and formally present our conclusions and recommendations regarding the environmental issues relating to the subject property. PROJECT SCHEDULE Century West will be prepared to proceed with implementation of the Remedial Work Plan upon approval by the City of Tigard. Time is of the essence to satisfy the project escrow rcquiremer.,. CLOSING Thank you for the opportur.Aty to submit this Remedial Work Plan to you and the City of Tigard. Please call me at (503) 231-6078 if you have any questions or require additional information. Sincerely, William E. Annen, P.E. Program Manager Attachments: Figure 1 Figure 2 C. Mr. Michael Elorriaga, IME Properties, Inc. Remedial Work Pid -Barger King Property -5- 11505 S.W. Pac fic Highway,Tigard, Oregon Appendix B GRADING / EROSION CONTROL INFORMATION GENERAL CONTRACTOR BUILDING PERMIT APPLICATION# NAME: Terra Hydr, Inc _ ADDRESS: P .O . Box 3616 PARCEL I.D. # 1S136AD Lot : 4Q01 Portland , Oregon 97206 SUBDIVISION NAME: PHONE: �nj ,,r,;?g_annn H,,my J . Stukey EXCAVATION CONTRACTOR SITE ADDRESS: 115 n 5 S W P a� c_ .i f i c Hwy. NAME: same US of oye ADDRESS' _ LOCATION FROM NEAREST INTERSECTION:@ /1st & 9 9 u FT. PHONE: _ .SOB SITE: (circle. one) PRIVATE PUBLIC UWNF PP�LI _:� � . 2AC,j AMOUNT OF WORK AREA TO BE NAME: Century West Engineering Coy FXCAVt',TED: ADDRESS:825 NL MultnpiTiali . St , 425 _ 600-80 - SQ. FT. Portland , OR 97232 EXISTING & PROPOSED SITE RUNOFF DRAINS: PHONE: 503/231-6078 Bi I ' Annen (circleorre DITCH PIPE CREEK for JMf•: Properties , Inc . 10C_ATC_R_BA_`S`TR:) OTHER: 24-HOUR EMERGENCY CONTACT: SOIL DISPOSAL: S a n i f i i 1 landfill NAME: Hill A n n o n ADDRESS:C e n t u r West _Engineering DISPOSAL LOCATION ADDRESS: 825 NE Multnomah , St . 477 Hillsboro landfill V07Tand , OR ESTIMATED AMOUNT: PHONE: 503/231-6078 COQ CU FT. 503/690-8047 I agree to comply with the "Erosion Prevention and Sedimentation Control Plan Technical Guidance Handbook" and will construct and maintain ESC measures to contain sediment on the construction site. March 6 , 1996 _ Owner/Applicant Signature Date ��+ centurywest ENGINEERING CORPORATION Erosion Control Plan Attachment to Appendix I3: Erosion Control Information form and Remedial Work Plan for ME Properties, Inc. Burger King Property 11505 SW Pacific Highway, Tigard, Oregon Bio-filter bags will be installed around the storm sewer vault for the duration of the prdect as shown on Figure 2. Bio-filter bags are acceptable erosion control devices according to the Unified Sewerage Agency's standards (recommended as designated in Tables 3-3 in Chapter 3 of agency strndards). Century West Engineering Corporation is prepared to proceed with removal activities Murch Is, 1996 and complete restoration activities by April 1, 1996. Erosion control measures will be in place for the duration of the project and will be removed after landscaping is established. L E A D I N G I II R (-) U r; F F E C T I V E S O l U T 1 0 N S 925 N.E.Multnomah,Sults 425 Portland,Otepot..,/232 Phone:15031 231-8078 FAX:15031 231.8482 Printed on Recycled Paper I CANOPY B-7 W • #F!,p} 3 ' °, +, i- } e r }}i > B-6 ap #y S#r>} fI r tit a I �.} F ipaft ii 1 #F i S 9� }Pgrt 'iii 6 f}3x�I�f t7rsgl , }}�#} y i j —i z F 6 r— y{{{{ QDf 3 0 Q I } BURGEP } f ` 1n Lij Q > `! KING kI rp ( MW-2 P��'�` I � iJf � { �i' HO3i :rp Ii Ity.fx js} � H ,I z 2ppm TPH g ND TPH—G • � I #Eplz �« 48)pm TP 1Ie, � f:i�' ## p (} ' ,o ,; CATC H ;�} �' � O HA-2 1 C Oppm TPH—G(6-7' APPROXIMATE EXTENT OF M — SOIL AND/OR GROUNDWATER p CONTAMINATION IDENTIFIED WA E —BENZENE 55ppb BY OTHERS SO 5-6') PLAYGROUND 20 p m TPH—G CATCH B-4 38 p m TPH-418.1 BASIN • HA-3 — MW-1 OHA 1 •N — ID(10-11' ND—BTEXA 7 p m TPH—G 0390 I?1 pm STOP, TPH— 8— ') _ pIANTEI3 TPH1 1 SEWER B-3 RESTAURANT (5-5.—� VAULT ND—HCID(10-14') DRIVE—THRUUGII RETAINING WALL_ (BURGER ING CATCH SIGN IANDSCAPE AREA BASINS 0 MANHOLE SW PACIFIC HWY (ROUTE 99W) 0 20 40 • BORINGS (DRILL. RIG) MONITORING WELLS SCALE: 1 "=20' O BORINGS (HAND AUGER) DESIGNED BY:BA CHECKED BY: SITE MAP DATE: EXISTING ANALYTICAL WORK �. 02/14/96 DRAWN BY:KFP SCALE: 1"=20' JME PROPERTIES, INC. 11505 SW PACIFIC HIGHWAY centurywest FIGURE: FILE:40760001,01 4F7_01 TIGARD, OREGON ENGINEERING CORPORATION 1 . 1 1.] I Y IIP 1 I11iIIItI H1.(J. 1l'I LIt I%It'rlilt HI I:I" l.I II' I 1'11.1. r96 i-' rill LA it I J'S �Wll11.11•d I : ;:t o1 . oo NOME ! IaE N f I.IN Y4.11.::3 1 1.14!it I I IMI 11 JI'J I e 0 1110 Hou!R .Sbi I FOPS NP. MIDI. 1 NI.IMP•;III (%I I ��'; I'FtYh11 f i I 1111 I I �r+i I!!1. "tt� I-'(7tt7l.HNU I.1PI :•illl:tlJ 1,I) 1'::)I ON q rr.',�r...... PLINPOSt: LJt PHYMI N! P1116'0:•:4 11t P'i 0 MF I•t I IIpl1 11 trt I PH 1 1, ItIJII.LI7.IVl:i 4't..l+hl ti] f 46 01006 t,. li10 I , ttlll{ 1! 1'P 1' J?'. HO 1 I`�:')'i tib! I�P•11.. l l- l L' 111�t'r 196-0008 I I1 1•11 1.1111 It IN 1 1 '14.1 I 1 .I II:,1 "{'•, V"Hrll 11 I1�I I I;'1., !;�YwY U (11'JiNt. I•I, ld l i I �11'1 1 1.i 11;l l 1-11'11 N II'I I I �„I�., LVY I ! IT 141111.v 111 I I '1IYhN ldl I!illk !:'1.:r'Vu: .li IVII II I I,I 11'1!11 1 4 1 I-'LIi�TI 1.ILII! I !t. , V'MI I'I • I'I 1(1� 1 I It 1 I ! 1 1 �I 1 I CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection LjLii�nee��(Rec-O-Phone): 639-4175 Business Phone: 639-4171 Footing SAp. Ceiling Sprink. Hough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. IJnderflr. Insul. Shear W II Gyp. Bd. ` lett. c Date Requestpd:_ J r/ c� _Time: AM PM v Address: Builder: Permit #: THE FOL 0WIING COL H JIONS ARE-REQUIRED �M-'�--f-(.moi✓ C� Inspector: /��C� rt'��Id L�L/L Datwrj YAPPROVED DISAPPROVED _APPROVED SU3JECT TO ABOVE !Call For Reinsp. DEPARTMENT OF LAND USE&TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 155 NORTH FIRST,HILLSBORO,OR 97124 COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415 OREGON XXXXXXXXX--> 1 Date 01/2b/9b 'Time 14 : 43 Permit 'Type Commercial Electrical Permit Permit # 050632bU Permit Status APPROVED Applied : 01/2b/95 bitals Address 11b39 bW PACIk'IC HW '1'1 issued U1/2b/9b Permit 'Title BURGER KING #2351 - SIGN Completed : Permit Uescr .. JUb NUMBER 46-1208 / '1'o Expire 0'//L41'95 Project 'Title BURGER KING - SIGN Project # PUU4'/Ubb Project Uescr . 02351 * EROSION I-,arc:el Number 261'1'1 - Land Use District : valuation Legal Uescr . Owner iW-AJECTION - 7'J_GAI(L) Construction 01'IH Applicant Name HEATH SIGNS Classification 900 Applicant Addr . : 4644 b):: 1'/'I'H AV Occupancy ?UK-I'LAND, OR 97202 Validated by JS Applicant. Phone : '1.3'2-2bZtt Inspector Area Fee description Units Nee/Unit Ext fee Data Sign or Outline Lighting 1 40 . OU 40 . 00 Subtotal b'lectrical Pees : 40 . 00 state Surcharge of b% 2 . 00 Total Electrical Pees : 42 . OU *** Nees Required *** *** Pees Collected & Credits *** Method Check # Receipt No . Date P.=.yment CK 3446 01/25/95 42 . 00 TUTAL 'I'HI:i DATE ********* 42 . OJ Fees : 42 . 00 Adjustments : . 00 Total Credits : . 00 Total Fees . 42 . 00 Total Payments : 42 . 00 Balance Due : . UU NOTICE: This permit becomes null said void if the work or constriction tar which It Is Issued Is not commenced within 180 days. Once constnictlon has started, the permit becomes null and void If construction Is Interrupted for a period of 18P buys. I certify that the information presented by the applicant and his agent or aq mts In suppnut of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance upon false and misleading Information may Invalidate this permit. All provisions of applicable laws an ordinances governing the construction and use of this building or structure will be compiled with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of the structure or building permitted depends upon my calling for inspections at various times during the process of construction and the building Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to proval by the Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection require are.0101L and approval Is given by the Building Official I further acknowledge that a lien may he pla on the tti—e- a property upo the permit is Issued specifying that the use or occupancy of the building or structure A provisional and revocable until the s tl ctlon of s e nn requirements. APP NT'S URE WASHINGTON COUNTY ELECTRICAL PERMIT Department oof Land Use & Transportation .•• Electrical Inspection Section APPLICATION ' 0 155 North First Avenue, 11350-12 Hillsboro, Oregon 97124 Information: 503 640-3470 Fax: 503 -4 693412 • A PRINT R F.ojecUPermit � � � Number _C -� Date 1 • • • sections, through 1. Location of Installation 4. Complete Fee Schedule below Address 11539 SW Pac ii is Highway Number of Inspections per permlt allowed Building Service included: Items Cost(ea.) Sum CityTigard _ Suite No. Tenant Name A. Residential-per unit (it cummerci,.Q _Burger King 2351 _ 1000 sq.ft or less $110.00 4 Each additional 500 sq.ft Tax Lot- ----- Map No. or portion thereof _- $25.00 --_�- Limited Energy _� $^5. 00 __ 1 Thomas Map Book: Page: Section:Section: G2 _ Each Manuf'd Home or Modular DirectioflsRep l acEh-m,-nu board Dwelling Service or Feeder _ _ $68.00 2 NE rORNER Dr--nw at SW 71-0-. B. Services or Feeders Ccmmercial �_� Residential n Installation,alterations or relocation 200 amps or less _ $60.00 -- 2 2a. Contractor Installation only: 201 amps to 400 arnps $80.00 ___-�- 2 Y 401 amps to 600 amps $120.00 _ 2 Electrical Contractor He_ath Slgn.5 601 amps to 1000 amps $180.00 2 Address 4644 SE 17th Ave. Portland _02 Over 1000 amps or volts -- $340.00 - 2 Date Zf2"i/95 Job Number 46-12nB7 ReconnLct only -- $50.00 _ - 2 Property Owner P Gta trant Moat- NW C. Temporary Services or Feeders Contractor's License No. _33 Contractor's Board Reg. NO. Installation,alteration or relocation 200 amps or less $50.00 2 201 amps to 400 amps _.__ $75.00 �_ 2 Signature of Supr. Elec'n 401 amps to 600 amps $100.00 _ _ 2 License No. 433.,3-_ ' Phone ?-262_Q _ Over 600 amps to 1000 volts see•B•above 2b. For owner installations: D. Branch Circuits Nr w,alteration or extension per panel rint(5�Wnwt'a R-me Phone No. - n) The fee for branch circuits with purchase of service or feeder fee. ABdFSs�------ -- --- Each branch circuit __ $5.00 _-___ 2 b) The fee for branch circuits without �bty State -- purchase of service or feeder fee. First branch circuit $35.00 _- 2 The installation is being made on property, I own Each add'nl branch circuit $5.00 - _ 2 which is not intended for sale, lease or rent. E. Miscellaneous (Service or Feeder not included) Each pump or irrigation circle $40.00 - 2 Owner's SignatureEach sign or outline lighting (L!_ $40.00 40-00 2 Signal circuit(s)or a limited 3. Plan Review section (if required) energy panel,alteration Please check approp riate hem and enter fee In section 5B. or extension $40.00 -- 2 1 & 2 family dwellings over 320 amps s/c meter F. Each additional inspection over the allowable 4 or more residential units ir, one structure in any of the above - Per inspection $35.00 - _ Service over 225 amps; feeder 400 amps or more Per hour $55.00 _ System over 600 volts nominal In Plant $55.00 -.- __ Building over 3 stories in height _ Building over 10,000 sq. ft. 5. Fees _ Occupant load over 99 persons A. Enter total of above fees g 40.00 _-_ Manufactured Structures Park or Recreational 5% Surcharge (05 X total fees) $ 2.00 Vehicle Park; new, addition or alteration Subtotal $ --- Classified ,area or structure containing special B. Enter 25% of line A for occupancy as described in N.E.C. Chapter 5 Plan Review if required (Section 3) $ ----- Subtor-il $ Submit 2 sets of plans with application where any of the L c-ss Bulk Label Fee $ above apply. Not required for temporary construction - --- services. Balance Due $ 42.00 For Inspections call This permit bacon ae null and void H the work @uthorired by the permit I•not commenced within 190 days ho m 'eeuance of su<:h perm„or II the work euthorb rod Is 640-3561 or 693-4415 suspended or:bar Joned at any time @her work Is commenced for a period of 160 Gaya. 24-hour recorder,one working day In advance of need ElectNcal Permits ars non refundable and non-transferable. 5/93 "125&W.Fba Www CITY OF T16;A7' RD Bo,2.W7 P�/� # rpt aro-Ivm3 PERMIT ff COMMUNTY DEVELOPME'VT DEPARTMENT- (5031&19-4v' ATF tiSSLJFD ----- JOB AWRESS: /15.3/ �, U_ /�F�;fiC _mow y _ •rte: ru+P/urr --- SUB: Tar: _ IAIII) [ E: --- OWNER SPBCIAL NVI'F tME: va c -� K RIME OF: Aaxt=: _ 5 —S w• c! 1�Y -------- LASTj - —_ F JJOD P - 1SQNE_ / ..• 00 -- S'FFSI,>N:>i'r1VE I.AIvLI: —. APPJDVALs RT (IR D C Q0KII2ACI�DR PIADN IM: NAME: 41zvUroij /1.-C^ So-1,l — ENGI t .: = � �._._ FIRE DEPT `% amt: — PHONE: -2 33--9,7 / rim; R>~x NJIMERS BOARD f_ , ) 3 EXP DAZE: _ 2- - -9�_ r,=% Zs: BUS TAX: ARCH/EWINEER CALCOU2ZC1N3: NAME: _ _ TRUSS MIMS: ADMESS: _ oma. — PHONE: — — (xIVENYS: _ 'T-Y1i S Vid, r-1101-IM, Qr- 71/E 4QC`I�LACC•/'fCTI T—ftnx! st.Ir xxapumcats: palm: - — MEal: ; f' . TU PERMIT if A= f DES CR=-CN AMJi311' AM-'X= PD. BAL. DUE _- 10-432 00 Dailding permit Fees IA.' ),/ " . 5 i -__-_- 30-431 00 Plumbing ppuait Fees - -_- 10-43101- vANchan1ca1 Permit Fees ` - -- 10-230 Oil „tate Building Tax (5t) - Btdlding V — Plumbing tiU Piech 10-433 00 1P13ty; Check Fee lkuldirg UO ----- P lwnbing Psi, - -- 30-202 00 Sewer Ocxviection 30-444 00 Sewe,- Thsper,.1,x► 51^448 00 :; Systen I)ev Charge pXD 1 52-444 00 Parks :rst-em rev Charge (PDC) 31--450 00 f,'tMm Drainar3e Syst Dev Chug (SSDC,') - 10--230 06 Fire -' - - APPLICANT sT Reoei� By: � � e.�r � vale F�oeived: of/3587p_ilpr-• G — QQ b n tl ' ~ , m E 151 Cr C, 4 Lc b 1S^ eW5, to 6 t k,e Y Cn ••�N w oil r O �loib o 10 • r OUjI � � �' •O�Cj� I Q 4 x 9r _ 4 n a iii rQ� C � 8 d 145IS HUDD� 311U Ec:;t E8, OCE AQW — �a Rv C h .� d �b (rj f1 WPI" L 1C ll u t e . .11Ilk t- E g yb � � r9 C L k�� Z 5, Sig tan 1 ~ Gli 1�•�.�1 e aI I CIDG i p O fIdQ Co r CL ccs k , A4a z'd N5IS PJdOItf3Wt1 E2:ST E9, 02 AON .111TY OF TIGARD RECEIPT OF PAYMUN F RECETPT N0. a 90-2104887 CHECK' AMOUNT : 55.26 NAME !MEATH mer-,THWEST. INC. CASH AMOUNT o 0.87 ADDRESS DBAc 3RFC30N S10t,l PAYMEN"r DATE (7)9/18/90 P.O. IBOX 176(43 SOLID T Y T S I 01\1 YAV'.TMA, WA 96907-7,-, 11.5-39 SW PACIFIC PUF"POSE OF` PAYMENT (AM(JUN7 FA T D PURF'OEST. OF' PAYMENT AMOUNT PA 11) r;cj—l[-DING PERM -'."2. 5#0 Pl....ON CHECl , VP. 9-47C 13.C. GT. AW. 9. oo BU I L.D PER J- 67 MTSIGELLANErOUS TIG. DATA B RUF,:GLRf--' JNG SIGN FVITAL AMOUNT P0.10 541.