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12085 SW HALL BLVD STE 130-1 i11 C: r+ H 4 H W m Ln � ra wr c� r r m 0 i I 1,1085 S,v HALL BLVD, SUITE 130 btl W a: d btl G1 d C O 4 N N O O O oo to a r) rib �v ro a o LA 4 i r tr �A In CDs ro un o z z z z z z z z z z z r rJ ro ro ro � ro ro ro ro ro ro � � �r, r b It o w � CA � CA Lon LA n J -fin a Cl M ea o � > CITY OF TIGARD DEVELOPI"ViENT cvr;*1/1CFS W's-11 a BUILDING PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : BUP97-0237 DATE ISSUED: 05/12/97 PARCEL: 2SI02AA-00490 SITE ADDRESS. . . : 12085 SW HAL-I., Bl..,VD #130 SUBDIVISION. . . . : ZON ING:CBD BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . JLJRISDICTION:TIG RE ISSUE: FLOOR PREAS---­­­- EXTERIOR WALL CONSTRUCTTOfl– CLASS OF WORK. :ALT FIRST. . . . : 1225 s N: S: E: W: TYPE OF USE. . . :COM SECOND. . . : 0 S f PROTECT OPEN INGS?­­­­­ TYPE OF CONST. :5N . . . : 0 -,f N.. S: E; W.- OCCUPANCY GRP. .-B TOTAL--------: I(.'J"i s ROOF CONST: FIRE RET?: OCCUPANCY -OAD: 43 BASEMENT. : 0 s AREA SEP. RATED: STnR. : 0 HT: 0 ft GARAGE. . . 0 s OCCU SEP. RATED: BS'MT? .- MEZZ?1 REOD SETRkCKS.---­--- REQUIRED-- FLOOR LOAD— . - 0 psf L.EFT* 0 ft; RGHT: 0 f=t FIR SPKL: SMOK DET. . : DWELLING UNvrs- o FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:Y BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING- 0 VALUE. $: 22000 Remarks: White Rhino Coffee tenant improvement. Owner: FEE'S RICHARD ROSENBrIUM type Anoi.int by date reept HALL STREET CROSiS)ING WYSE INVESTMEN PRMT $ 1.5:x:. 50 DRA 05/12/97 97-294415 806 SW BROADWAY STE 700 P I_CK $ 99. 13 DRA 05/12/97 97-294415 PORTLAND OR 97205 FIRE $ 61. 00 DRA 05/12/97 97-294415 1-11ione #-. P94-0400 5PCT $ 7. 63 DRA 05/1.2/97 97-294415 Cont?-ar_tor,: ML. ML. OLSON ENTERPIRTSES Pn BOX 937 414 PIONEER PVF RIDGEFTEI 1) WA 9A642 ------------------------------------------ Phonp #: 60--887-31 91 $ '31.7,0. 26 TOTAL. Req 17100890 REQUIRED INSPECTIONS ------- This permit is issued subject to the regulations contained in the Ft-amiviq Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Insi-ilatiori Insp applicable laws. All vorP will be done in accoriance with Gyp Board Insp approved plans. This permit will expire if work is not started Si.isp Ceil;ig insp within 180 days of issuance, or if work is suspended for more than 18@ days. e t'M i,t t 0 Sfqnatl_�v-p : Trisi..ted Sy : Call for inspection 639--41175 05%07%97 10:58 :9'507 684 72:7 CITY of TIGARD 0081,012, -r� 2C �I SAI Dili inn City of Tigard 13125 SW Hall Blvd, Tigard,OR 97223 (503)830-4171 ►obsite k ddress:_�ZQeS Ack11 �(i�il inN4 K>•> aP+t *�a4,,i�;au, N�A'nlQtft7�61 <w Tenant:.�.�V,rye, �j1/ 15uite# 13C� ' ° �� g"� IK' ' ;.w.�► rii ` 4. Valuation: 22-,DOD ° ��' �',' 1 J a V-rS6iN $^A ��r t,k�r.>r 1 � i"✓'r v817 �i QWMz:r: VV S ai i , ," P Rosenb ';;�'� b M nus I awl k Address: �yW " � o SritjL j � �� jC�� n j+ T�)r'j r-t 1 cLrt L2- Iklt�l�eq!`itti� , Telephone: _ �E b O p .4 c ,1, ,.i,�t c• � 4 r Contractor: P)L En 1 gar Dr I S Address: 42- Type of constr:_ fy Telephone: _ L: ) X87- -,�tig I Occupancy Class: "L i Contractor's License Sprinkler? ( No (attach copy of current Oregon license) ' Sq. Ft. Of Projec� (2,Zej Sir Contact name & telephone: _y—i fu QQ Mbr- Story (1st, 2nd, etc.): 1225 SF= Architect & Engineer; b4 ,, Proposed Use: ,I� �E Address: IJ Zoo �, YY�cicT ��2t) Previous use: (A ynk-nowY'� Note: Plumbing & mechanical plans must Telephone: _�, ;'d�i ZZ(o� 2� _ be submitted at time of building permit application. JOB DESCRIPTION: e_ !(Applicant Signature & Telephone Number) Received b hate Received: I\C:OMTI DOC (DST) 10/98 CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT PERMIT #: EL.C97-0318 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE 13)SUED: 05/29/97 PARCEL: 25102AA-0,0490 S1TF_ ADDRESS. . . : 11_:!085 13W HALL BLVD #130 SUBDIVISION. ZONING:CBD FLOCK. . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: 'FIG Pr^oject Descilipt ion : White Rhino Coffee - tenant improvement. ---------------------------- L)NIT----- ----TEMP SRVC/FEEDERS---- -------MISCELLANEOUS-- ---- 10071 SF OR LESS. . . . : 0 0 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 EACH ADDIL 500SF. . . : 0 201 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401. 600 amp. . . . . . . : 0 SIGNAL,"';' NEL. . . . . . : 0 MANE. HM/ SVC/FDR. . : 0 601+aMpS­ 100L71, volts. : 0 MINOR LABEL ( 10) . . . : 0 ..-----.---BRAI\ICH CIRCUITS----- ---ADDIL INS-,EC'TT.OlqS---. 0 200 amp. . . . . . : 0 14/SERVICE OR FEEDER: 0 PIER INSPErTION. . . . . . 0 201 400 3mp. . . . . . : 0 1st W/O SRVC OR FDR. : I PIER HOUR. . . . . . . . . . . : 0 401 6.00 amp. . . . . . : 0 EA ADDIL BRNCH CIRC: 6 IN PLANT. . . . . . . . . . . : o 601 1000 amp— . . . : 0 REVIEW 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL.. . : Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPIEC OCC. : Owner-: FFES NORPAC DEVELOPMENT CORP type amol..Int by date t,ecpt 6560 SW FALLBROOK LANE FIRMT $ 65. 00 DRA 05/29/97 97-29522271 BEAVERTON OR 97005 5FICT $ 3. 0-5 DRA 05/29/97 9 7-121 9 5'.21 2 0 Phone #: Contv-actor: --------------------------------------------------------------------- --- PROIRIE ELECTRIC INC 68. 25 TOTAL 600k NE 88TH STREET REQUIRED INSPECTIONS VANCOUVER WA 98665 Ceiling Cr et- Elect' 1 Phone #: 360-573-27-0 Wal 1 Cover- Elect' l Final Reg #. 60178 41 This permit is issued subject to tf.it regulation_ contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signati-tr-e applicable laws All work will be done in accordance with approved plars. This permit will expire J work is not started within 180 days of issuance, or if work ii suspended for tore j_, than lB@ days. Issl.ted By -------_- ---_---_—___—._--._._.._OWNER INSTALLATION The installation is being made on property I own which is not intended for- sale, or- saIe, leaso, or-, rent. OWNS"RIS SIONA,rURE: DATE: _--.—_—_—_—_----_.____.....—__CONTRACTOR INSTALLATION SIGNATURE OF SUPR. ELECIN: DATE: LICENSE NO: Call for inspection 639-4175 CITY OF TIGARD Electrical Permit AppiicaVoin Plan Chec 13125 SW HALL BLVD. Recd Ry TIGARD OR 97223 Date Recd ' Date to P.E.hone (503)639-4171, x304 Date to DST p ----'- Ins action (503) 639 4175 Print or Type incomplete or ililegible will not be accepted Permit#-AL-4 2 Fax (503)684-7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development___ Number of Inspections per permit allowed Name(or name of business) W{, r I`h!1L COC Service included: Items Cost Sum Address 2 0$'S 5 cu• P-0 1 (3) 1' ) 4a. Residential-per unit City/State/Zip 61!�'Rr-c1 GrBa�>n 1000 sq.N.or less $110.00 _. Each additional 500 sq.ft.or Cornmercinl r , Residential ❑ portion thereof $25.00 r Limited Energy `. $25.00 _ Each Manuf'd Home or Modular Dwelling Service or Feeder $88.00 2a. Contractor installation only: --- (Attach copy of all current licenses) 4b.Services or Feeders Electrical Contractor PRAIRIE ELECTRIC, INC. Installation,alteration,orrelocntion Address 6000 NE 88TH STREET - 200 amps or less $60.00 2 -- 201 amps to 400 amps __ $80.00 2 City VANCOITVER State WA ZipT-98665 401 amps to 600 amps $120.00 2 Phone No. X360) 573-2750 _ _ 601 amps to 1000 amps $160.00 _ _ 2 Job No. ` Over 1000 amps or volts $340.00 Elec. Cont. Lice. No.PRAIREI150RZ Exp.Date 5/31 S8 __ Reconnect only - $50.00 OR State CCB Reg. No. 60178 Exp.Date 5/15 98 4c.Temporary Services or Feeders COT Business Tax or Metro N 3014 Exp.Date12 97 Installation,alteration,or relocation 200 amps or less $50.00 Signature of Supt. Elec'n _ l 97 201 amps to 400 amps $75.00 401 amps to 600 amps $100.00 Over 600 amps to 1000 volts, License Nr 3562 S Exp.Date 0 t see"b"above. Phone Nr (360) 573-2750 4d.Branch Circuits New,alteration or extension per panel 2b. Fol owner installations: a)The fee for branch circuits with purchase service or Print Owner's Name leader lee.. Addre99 Each branch circuit 15.00 b)The foo for branch clrcults City State Zip without purchase of Phone No service or Leede,-lea. First branch circuit $35 13n35 2 The installation is beinc made on property I own which is not Each additional branch circuit $5.00 2 intended for sale,lease or rent. 4e.Miscellaneous ce or feer not Owner's Signature _ __ Ei ach pump ordIrrrrigation included)f f cle $40.00 ____ Each Agn or outline lighting $40 00 2 3, an Review section (if required):' Signal ciwu;l(c)nr a limited energy panel,alteration o-extension __ $40.00 _ _ 2 Please check appropriate Minor Labels(10) $100.00�!em end enter fee in section 5H. -- - __� 4 or more residenhar ur,ts in one structure 41.Each additional Inspection over Service and feeder 24 amps or more the allowable In any of the above System over 600 volts nominal Pet inspection 435.00 _ Classified area or structure containing special occupancy Per hour $55.00 qs described In N.F C.Chapter 5 In Plant - $55.00 Subml!2 sets of plans with application where any of th-above apply. 5. Fees: �r Ov Not required for temporary construction services. 5a.Enter total of above fees $ ? 5%Surcharge(.05 X total fees) $ - NO I 'F_ Subtotal $ ----- 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRI IJTION AUTHORIZED IS Plan Review If reguired(Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER t"/ORK IS COMMENCED. ❑ T,ust Ac,�(,unt Total balance Due C --.- I tDSTS\ELC96 AI111 new 91 -__ - -- Page No. 1 CASE HISTORY FOR CASE NO.: MC97-0318 NORPAC DEVELOPMENT CORP 12085 SW HALL BLVD Unit: 130 02/17/98 Action Description Req/ Schd/ End/ Action Notes Disp By Update pi Code Ser.t Done Done Date i, EL,CC001 Application received / / / / 05/29/97 RECD DRA 05/29/97 DST EI,CC003 Permit created / / / / 05/29/97 PASS DF.A 05/29/97 DST ELCC500 M Issue permit / / / / 05/29/97 PASS DRA 05/29/97 DST ELCC700 Ceiling Cover 05/29/97 / / (36/04/97 Walls and ceiling electrical ok on PASS ARP 06/04/97 J•H raughin. Floor PVC ok to cover. ELCC720 Wall Cover 05/29/97 / / 06/04/97 electrical roughin ok PASS BRP 06/04/97 J*H IL.CC730 Elect'1 Service 05/29/97 / 06/26/97 PASS MJR 09/02/97 J•H BL/'C799 Elect'1 Final 05/29/97 j / 06/26/97 1. close telephone outlet box. PASS MJR 09/02/97 J-H 2. Change plug in bath to GFCI. AFTER CORRECTIONS, ELECTRICAL FINAI, APPROVED. EL.CC'800 Case Finaled / / / i 09/02/97 PASS MJR 09/02/97 J*H CITY QF TIf5;`iARD ISE`✓ELOPMENT SERVICESPERMIT PLUMPING PERMIT FSE RM I T #. . . . . . . : F'LM97--0188 13125 Si'v Hall Blvd., Tigar.i,OR 97223 (503,1639-4171 DATE ISSUED: 06i03/97 PARCEL: 2S 1 Of-'AA--00490 SITE ADDRESS. . . : 1=085 SW HALL BLVD #130 SUBDIVISION. . . . : ZONING: C13D BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG ---------------------------------------------- CLASS OF WORK. . :AL-T GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . : P WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0 FIXTURES------------------ LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 3 URINALS. . . . . . . . . . . . 0 GREASE TF0PS. . . . . . . . 0 1_AVATLIRIES. . . . : 0 OTHER FIXTURES. . . . : TUB/SHOWERS. . . : 0 SEWER L..INE (ft ) . . . : 0 WATER CLOSETS. : 1 WATER LINE_ (ft ) . . . : 0 DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . : 0 Remarks : White Rhino Coffee -- tenant improvement. Owner,: ______.______..____.___.__.__________.___..___.__.______.__----- -•—__-.-- FEES WYSE INVESTMENT type amoi.rnt by date -ecpt 806 SW BROADWAY STE 700 PRMT $ 72. 00 DRA 06/03/97 9-7--x'95389 PORTLAND OR 97205 SPCT f 3. 60 DRA 06/O3/97 97-295339 Phone #: RAY' S PLUMBING 1O7O6 NE 109TH AVE BRUSH PRAIRIE WA 986O6 --------------_.__.---------•-.----___._______ Phone #: 360-892-8700 f 75. 60 TOTAL. [Reg #. . ----- REQUIRED INSPECTIONS - This pewit is 1ssu?d subject to the regulations contained in the PLM/Underfloot- Tigard Municipal Code, State of Ore. Specialty Codes and all other Top- dist Insp applicahle laws. All work will he done in accorda+ce with Misc. Inspection approved plans. This permit will expire if work is not started Final T n s p e c t i o n within 188 days of issuance, or if work is suspended for more than 188 dal-s. f Prmitt?e Giunature : A Call for inspection - 639--4175 Y OF TIGARD Plumbing Application /�/ Rec'd By C11- 3 125 3125 SW HALL BLVD. CorT;rrlercia! and ResidentialDate to P E. Dale Recd _ iGARD, OR 97223oti�1 Date to DST [h/ "'3) 639-4171 �rt1' Permit L. �2`/9'�' Print or Type mit Related SWR*`ML79- ) 01�< Incomplete or illegible applications Will not be accepted called _ Nimeof DMT evelopmenUPrrolect FIXTURES (Individual) QTY PRICE A Job /'Ir tC A'rl I no CAJ�(feSink 9.00 /` -/ ,2 Lavatory 9.00 Address Street Add a Swte �.� /7/)X :1" q/� a Tub or TublShower Comb 9.00 -� Bldg J Slats / ip Shower Only 9.00 / r ��rtf Q Na water Closet -__ i 9.00 Cr� S4f lit Jdjm,n Dishwasher_ 9.00 -- Mei dread Suite Garbage Disposal 9.00 Owner 7Q _ 1 �`Sl� ,OQ 1766 Washing Machine 9.00 � C � 1 �,� Phone �� y� Floor Drain 2" 9.00 i N ( 3" 9.00 4" 9.00 Water Heater Occupant M i ng rasa, �t' Sutle _ 9.00 ,� 1 S W' / c-erl I !.aundry Room Tray 9.00 City/State Pho a Urinal g 00 - J!✓ ) Zi f7i; D -_'� Other Fi�wres(Specify) 9.00 /174 s I /e, T iqj� r/�`c '2 9.00 .,0 Contractor Mailing/Addre s S Suite "'P a - 9.00 04I L 9.00 (Prior to issuance Cityistate Zip Phone -- - applicant mustFf?Q (n.', yf•'(�o �`t �i �rJC� _ 9.OU provide all Oregpn�nst.�ont�n,rd LIC.* Exp,Date 9.00 contractors (507-57•117 9.00 license Plumbingyf 'T Lic a ExQ�Data Sewer-1st 100" 30.00 information 3�/ 30 ` Sewer-each additional 100' 25.00 for COT COT Business Tax or Metro a Ex Data Water Service-1st 100' 30.00 database). 000,13� - -/- gig Name Water Service-each additional 200' 25.00 _ Architect C tL t Storm&Rain Drain- Ist 100' 30.00 or Mailing Address / Suite Storm&Rain Drain-each additional 100' 25.00 UJB /'144.0`q r Mobile Home Space 25.00 En ineer C' ISt'tgr Phone. Commercial Back Flow Prevention Device or Anti- 25.00 9 '} :ri �1 h,1('1 - J Pollution Device Describe work New O Addition O Alteration Repair O Residential Backflow Prevention Device' 15.on to be done. Resid••ntial O Non-residential Any Trap or Waste Not Connected to a Fixture 9.0D Additional description of work Catch Barin 900 Insp.o1 Existing Plumbing 40.00 per/hr Existing use of --- Soe-iaily Requested Inspections 40.00 buiWry or property per/hr -- Rain Crain single family dwelling 30.00 Proposed use of Grease Traps 9.00 building or property_ QUANTITY TOTAL Are you capping. moving or replacing any fixtures? Yes C3 140 Isometric or,ser diagram is reax,ed t rluurdy,To el is >9 ` (If as see back of form) *SUBTOTAL 2 1 hereby acknowledge that I have read this application.that the informatinn given is correct.that I am the owner or authorized agent of the jwner and 5%.SURCHARGE .t that plans submitted are in compliance with Oregon State Laws na'u/o bf Own ►e(Agent Date �i / ( J PLAN REVIEW 25%.OF SUBTOTAL !Vf �equir"or r t P.xlure Cir 'Dials>9 _ TOTAL ont'ci P N • rPhone *Minimum permit he,s 525 • 5%surcharge.ex cept Residential Baw Prevention Device,wldch is S15-5%surcharge I: plmapp.doc 12 96 (dst) _ ACQM.PI. TE APPROPRIATE TCS PR¢,LC : Fixtures to be capped, moved or replaced Qty Sink Lavatory Tub or T ub/Shower Combination Shower Only Water Closet _ Dishwasher Garbage Disposal Washing Machine Floor Drain — 2" Water Heater Laundry Room Tr,jy Urinal Other Fixtures (Specify)_�q___ _ COMMENTS R-GARDING ABOVE: I: plmapp.doc 12.96 (dst) Tenant Name:LZ4�irc �" ' C Accumulative Sewer Tally This SWR#: Address: /sc This PLM#: P-- Fixture Value Previous N Previous (aedit5 Capped Fixtures Fixtures New New Value Capped off value addad# added total #s *ptal Count off#a catrrtt value values RaptistrvlFortt 4 Bath .Tub/Shower 4 -Jacur/Whol 4 Car Wash- Each Stall 6 -Drive Throuqh �16 Cusuidor/Water Aspirator 1 Dishwasher -Commer r. L__j j -Damest 2 Drinkinq Fountain 1 Eve Wash 1 Roar Orain1ink 2 inch 2 3 inch 5 4 inch 6 -Car Wash Oram H v `� Garbage Disposal 16 Dom Ito 314 HF! Comm Ito 5 HP) 32 Ind (over�5 HPI '8 i Ice Machine/Refrigeretor Drains -1 ' Oil Sep(Gas StationV 6 Recreational Vehicle Dump Station 16 -Siiawar- Gana(Per Head) 1 Stall 2 /i Sink - Bar/Lava.o'v 2 ,..-- 8radley _ 5 Commercial //,v&i /-me,V 3 Service 3 Swim+nr.y Fool Filter 1 Washer, Clothes 6 L", Water Extractor 8 Water Closet, Toilet 8 Urinal_- 6 TOTALSmmmffmrgwm L_ Total fixture values: ' divided by 16 EDU - 0I l li PIMA • ,�.-EDU# SWR# "- - PLfN# EDU# SWR# 1 4 - h PLM# EDU# c.' SWR# PLM# EDUAr SWR# PLM# - EDU# SWR# `' FILM# EDU# SWR# II II PLM# EDU# SWRa - ill MIT F.DU# SWRrr Paye No. 1 CASE HISTORY FOR CASE NO.: DL1497-0188 NYSE INVE£TMENT 12005 SN HALL, BLVD Unit: 130 02/17/98 Action Description Req/ Schd/ End/ AcLiun Notes Disp By Update Code Sent Done Dome Date By PLMC003 Application received / / / / 05/16/97 RECD JSD 05/26/97 DRA PLMC005 Permit Created % / / / 05/26/97 Need copies of contractor info for Ray's PASS DRA OF/28/97 DRA Plumbing as they were not in our c�,mputer, verified Metro from list, but need CCB & plumbing. PLMC050 (F) Ready to issue / i' / / 05/28/97 Need to incue sewer processing card for FASB DRA 05/28/97 DRA sewer. Need current contractor info for Ray's Plumbing. Need to pay for SNR97-0168 before ineueing. PLMC050 (F) Issue permit / / / / 06/03/97 PASS DRA 06/03/97 CTR PLMC120 Plumbing Undersl. 05/28/97 / / 06/04/97 PASS MS 06/08/91 J•H P114C725 Top-out Insp 05/28/97 / / 06/04/97 PASS MS 06/08/97 J'H PLMC799 Final Inspection / / / / 06/26/97 NOT:: Nater over 140 degrees, needs to PASS MS 06/27/97 J+H be at lower temperature. FL4r800 Case Finaled / i / / 0'1/09/97 07/09/97 JT I 1 CITY C F T I G A R D SEWER CONNECTION DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : SWR97-0168 DATE' ISSUED: 06/03/97 PARCEL: 2St02AA-00490 SITE ADDRESS. . . : 12 085 SW HAI..-l_ BLVD #130 SUBDIVISION. . . . : ZONING: CBD BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG TENANT NAME. . . . . :WHITE RHINO COFFEE COMPANY USA NO. . . . . . . . . . : FIXTURE UNITS. . . . iR ff .LASS CF WORE:. . . :ALT DWELLING UNITS. . : 2 r)'QF OF USE. . . . . :COM NO. OF BUILDINGS: 0 INSTALL TYPE. . . . :BUSWR IMPERV SURFACE: 0 sf Remar-ks - White Rhino Critfee tenant improvement. Owner-: FEES ---------------- WHITE RHINO COFFEE type amol.trit by date reept 12085 1W HALL #130 PRMT $ 4400. 00 DRA 06/03/97 97--295379 TIGARD OR 97223 Phone #: Contr,ar-toi-: OWNER ------------------------------------------ 11hone #: $ 4400. 00 TOTAL Req REQUIRED INSPECTIONS rhis Applicant agrees to 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 forfeited if the ppreit expires. The Agency does 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 free the distance given. If not so located, the installer shalur le — a "Tap and Side Sewer" Permit and the Agency wol 091all a I - ra 1. — a Ir Per m i t t e e rat ijt,e CITY OF TIGAPD DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard,OR 97523 (503)639.1171 GE:R7'I F I CATs or OCCUPONCY Ft'RMI T #. . . . . . . s DUP97 -.02'37 DATE ISSUED- 06/2.6/97 PARCEL- 20102AA-00490 I rE ADDRESS. . . s 1:'085 SW HALL_ BLVD iii l i0 5IJBI)IVISION. . . . s IJNTNG%CBFi iSI.,.00K. . . . . . . . . . s L.OT. . . . . . . . . . . . . . JL moi,_"+I CTIL]Nt TIG L;LASS OF WORK. s IaLT ISE OF USE. . . s COM t AE OF' CONST R s SN OLCUPANGY CYR;`. -P OCCUPANCY LOAD: +:? 1 L.h IAN't NciME:. . . -WHITE RHTNO COFFE:C omai ks : White Rhino f—,flee tenant smpr-overncTit. RICHARD ROSE.NBAUM HALL STREE:_I. UPOSSING WYSE INVESTMEN 30ts SW BROADWAY STE 700 PORTLAND OR 97205. Phone #: ('ontractors - -- ._—_..__._.____...._.-._._._..._.___...._._.._....._ 11L. MI_ OL SON ENTE V.PP I ES PO PDX 9:37 414 PIONEER AVE V I DGEF IELD WA 9864c' Phoney its 360 -887- 3191 N r5 N #. . 1 000890 This, Certificate grAnts oc:cuparrry of tht, Above reference(I building or portion thereof and confirms that the building has been inspact rd for compliance with the State of Orgen Specialty Codes for the group, Cclupan , and use under which the referenced permit was i.ssmed. IJ C'•�111 CSI f3 XTnR NLIIL13ING OFFICIAL POST TN C ON5P I CUI]US PLACE