The URL can be used to link to this page

12540 SW MAIN STREET STE 110 01'6 RS 1S NIVW AAS Oti5Z6 o N r r N 0 t sA9 ui V m N .. Q 2 Q cn ci � a o d r C4 41 m L � �7 L a cn cn pa NC4 C4 C N r r r r r O r' r W I-- cn Z_ !Q i V. C C` 12540 SW MAIN ST STE 110 A CITY OF T I C A R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PEPMIT#: BUP2000-00458 h4 a 13125 SW Hall Blvd.,Tigard,OR 97223 (603)639-4171 DATE ISSUED: 2000 PARCEL: 2S 2102102AC-0070Q ZONING: CBD JURISDICTION: TIG SITE ADDRESS: 12540 SW MAIN ST 110 SUBDIVISION: BURNHAM TRACT BLOCK: LOT:001 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCYLOAD: 9 TENANT NAME: REMARKS: Commercial TI Owner: DOLAN+ CO LLC BY FLORENCE T DOLAN 4025 SE BROOKLYN PORTLAND, OR 97202 Phone: Contractor: GRIGSBY CONSTRUCTION INC 5845 JEAN ROAD LAKE OSWEGO, OR 97035 Phone: 503-675-8000 Reg#: LIC 45073 a oc _J m JThis Certificate issued 01/26/2001 grants occupancy of the ab-)ve referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under which the reference ,rmit was is BUILDING INSPECTOR UILDI 1 1 POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24--lour Inspection Ling: 639-4175 Business Line: 639-4171 / BUP Tir d�l�fi$ Date Requested_ �AM PM LocationI SGV 61Wr. 4r—«0 _ Suite MEC ;ADD -Abd?Z Contact Person _ Ph �� 3 _ PLM Contractor Ph _ SWR BUILDING i Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SIGN Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear 7 +� 7 Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof � �a Mi _ — _ PART FAIL ---- — --� PLUMBING Post& Beam Under Slab Top Out I — -- Water Service Sanitary Sewer — Rain Drains Final PASS PART FAIL C ! Post& Beam -- Rough In Gas Line — S Dampers PAS PART FAIL ECRTRICAL - Service IL Rough In HUG/Slab ---�_ N low Voltage Fire Alarm Final PASS PART FAIL SITE to Backfill/Grading -- —"— J Sanitary Sewer Storm Drain [ ]Reinspection fee of S required before next inspection. Pay at City Hall. 13125 SW Hall Blvd Catch Basin [ Please call for reinspection RE:. ( J Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Inspector Date / / / Other P� / Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site. / \• CITY OF T I G A R D ELECTRICAL PERMIT PERMIT#: ELC2000-00649 iNA DEVELOPMENT SERVICES DATE ISSUED: 11/28/2000 13125 SW Hall Blvd..Tigard, OR 97223 (503)639-4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 110 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT : 001 .JURISDICTION: TIG Proiect Description: Installation of service and 15 branch circuits. S0(3 Ne . 9135 RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 601+8mps-1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W/SERVILE OR FEEDER: 15 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC CC: Owner: Contractor: DOLAN + CO LLC PHOENIX ELECTRIC CO BY FLORENCE T DOLAN 7379 SW TECH CENTER DR. 4025 SE BROOKLYN TIGARD, OR 97223 PORTLAND, OR 972U2 Phone: Phone: 684-3600 Reg#: LIC 00052288 SUP 4140S ELE 34-247C FEES Required Inspections_ Type By Date Amount Receipt Ceiling Cover PRMT CTR 11/28/2000 $180.05 2720000000( Wall Cover SPCT GTR 11/28/200( $14.40 2720000000( Elect'I Service Elect'I Final Total $194.45 This Fermit is issued subject to the regulations contained in the Tigard Municipal Code.State of OR. Specialty Codes and all other applicable laws. IL All v ork will be done in accordance with approved plans. This permit will expire if r A is not started within 180 days of issuance,or i(work is a suFpended for more than 180 days. ATTENTION. Oregon law requires you to follow i ides adopted by the Oregon Utility Notification Center, Those N rules are set forth in OAR?52-001-0010 through OAR 952-001-0080. You may obtain copies of these rules ordlrect questions to OUNC at(503) 246-1987. PERMITTEE'S SIGNATUREOA/ r9/'r°��r'74r/ ,fi x�� ISSUED BY: - 0 OWNER INSTALLATION ONLY W -- - --� The instal;ation is being rude on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: - DATE: LICENSE NO: Call 639-4175 by 7:00pm for an Inspection the next business day NOV-28-2000 TUE 08;46 AM PHOENIX ELECTRIC, CO FAX N0, 15036843611 P, 02/03 - � Electrical Permit Application — nate rocr!ivcd: ii �� Pernlll no.:'&W 2o1y 0 6Y9 City of Tigard RECEIVED Prnp,yappl.no.: — Hxpintdate; of T ignn! — /lddresx: 13125 SW Vial] Blvd,Tigard,OR 97223 Varclssued: T1 !heel Itnn.: Ci l y Y: 1 pl-me: (503) 639-4171 NOV 2 2000 Fax: (503) 599-1960 Caeefilono.: Payment type: Land me approval: _XMMUK IY DEYE;QP_MENI 1' U I & family dwelling or accessory lnnirrclaliindusltial U Mull-famlly Q<Cnant improvement U New conslruclion Addition/altci,uticnrr.:plaumenl 0 Other: ❑f atrial Is .fob address; V p (,.) , 131d .no.: I Suite no.: Trx tnalr/rax Jot/account no.: Lia: 1110t.k; Subtlivision: I'ruju I nanlr: h T ih cription and location of wodc on rr.miscs: , .a Fsliultled(late of com Ictionlimpcction: L 2 Job no: �l��s _ - Business Warne: Dar"riptigrt eat&) Tolwl ne.'na v�' r IVewntaidarrl siryk of Nwilld#aAly par Atldrtas; /,3 `3(J Tec_ �w_ Qn dweI111Konktnclydaatt.mirrdgarage, Cily. i, a State: 0 71P: S ZZ,� 3enitsincluird: ION a4.ft.or Irre Phone: � Y-_.3 ,ml :�1e: �r�Y_3� G mnii: ! dh a y�G Fnch adnnal�' ho0&I.rL or onion themor CCII nn.: .�. � Elec.bus,lic,no: �� — Limited enerpy,nmiden0al 3 Ci! ittleirnIie,no.: Urnitedenerry,non-reeldenlal 3 Lino,mnnuractur xi home or modulor dwelling dLr ---------- , --• - T ' bService eand/or fee - — 2i�nawre ofsurvsng ele0rieinu(required) pae - eederwd - suelrr,oan+c(print):rANJ, oak P,4,4—J License no:3 163 f, ahteratton or relerelien: 2nn amps or less 3 Name.(print): 10T; to s 100 amps - 3 _..-. .._--_- - 40111111113 to 600 amp3 2 601 amps to 1000 ampe 1 State:iZ1P: Over 1000 amps or vola 2 Pharr.: �— Fax: F.mall Rtetrneolonly —�. — -- 6kvner installation:Thr inls(allution is hcing made on property I own Tamperwryrerrlceaorfetders- which is not infendrd for s:dc,lease,rent,or exchange according to 200 t opsfiratterallop,errelogdbn: O S 447,455,479,670,701. 200 am s t—.4 2 201 amps to 4 ampe 2 Owner Is sl mature; Onte: 401 to RO(t ams 3 Branch eirculta-new,a leralion, or exle"Ieft per panel. Nome:_ T A. Pee ror branch circuits with purchase af Address: service or feeder fee,each branch circuli 3 Cl ly: Stute: ZIP: R. Fre for brtltich 0"Ite without purchase of service or reeler fee,first branch circtil: 2 L Phnno; tax: 13-mail: t ur.l aT Jili[lopal hfanchclrcu l: -- Abe.($e�ee or feeder net lhcladed)t U lZervic a over 225 amps-comuvetri&1 0 Heallh,tare racility, Each pump or Irrigation eintla 3 U Servicc over 370 amps•rating of I&I U Hazardous Iut.alit-41 Rach sign or oniline lightingZ family dwellings ❑Ouilding over 10,000 sgmm-:--at four or gignal eireuir(s)or a limited etletly pnncl, J USyslcrrtover 6011volts nonllnul mnn,rurldcnikdouihinmm.Ruucluru altara,inn,ercxtrtulon• U Building overthret stories U Riders,400 mops or mntc •Uoa:rl lion:r.� _ U occupant load over 99 persona G Manufacturd aructuras or RV park F2ch a dil e-nat impeerlon ever the allowable Its stay of Iha aboral u U Itgres+Jlirhring plan U Mier: Pc ms ecdon anbmll,—_stets of plane with any of(lie abrtve. I Invcsli,nlinn fee �- 11he ohove or-not applicable to temporary constrtscllon sartiee. other Nm all lari•:JknlaM acce{M rtMii caar cud,pfce call jorlsd'ctlnn Cor o-- n inrinna,1w. Notice:Tlile permit nppliication I'r,:rmil fl`.0.....................$ U vi^a O Mastercard expires if a permil is not obtained flan revlcw(at __,_ %) $ _ r e,c,lu owd ImrnWr• within 180 days after It has been Slate surcharge(R%) ....$ r o `� neccpted ixc enlnplcic. TOTAL ...$ • s6ewn on ct 1 card IS_ s --Cunl'61ld,:r s snatom moon, 41n nali(tM cum) NOV-28-2000 TUE 08:46 AM PHOENIX ELECTRIC CO FAX NO, 15036843611 P. 03/03 . Electrical Permit Fees: Limited Energy Fees: Com Isle Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY P Restricted Energy Fee................. . $70,00 Number of inspection*per pertnit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work InvolvQd, Residential-per unit 1000 sq.It.or less $145.15 4 ❑ Audio and Stereo 9y31ems Each additional 500 sq.R,or portico thereof $33.40 1 ❑ Burglar Alarm Llmlted Energy $75.00 Each Manul'd Horne or Modular ❑ Owulling Service or Foodur $90.90 — 2 Garage Door Opener Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alleralkm,a relocallon 200 amps or lets �T $80.70 J .3a 2_" ❑ 201 amps to 400 amps $106.85 2 Vacuum Systems' 401 amps to 600 amps S16o,60 _ 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000:imps or volts _ 5454,65 2 Reconnect only 566.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED.COMMERCIAL ONLY InFtallation,alteration,or relocation Fee for each systirn.......................................................... $75.00 200 amps or less :66.85 2 (SEP OAR 918-260-260) 201 amps to 400 ompa $100.30 2 401 amps to 600 amps , $133.75 2 Chock Typo of Work.Involved: Over 600 amps to 1000 volts, see"b"above. Audio Ond Stereo Systems Branch Circuits ❑ Now,alteration or extension per panel Boiler Controls a)The fee for branch circuits witrn purchase of service or ❑ Clock Systems fbodur fen. Q Each branch circuit �+� — $6,65 9 1 s ��_ 2 ❑ Dela Telecortxnunicallon Installation b)The foe for branch circufls without purchase of service ❑ Fire Alar Installation or fader fee. Fir-At boner circuit _ $46.85 -_J r� Each additional branch circult $6.65 l. HVAC Miscellaneous ❑ Instrumentation (Servica or feudur not included) Fach pump or Inirjatlon circle $53.40 Each sign or ovnlne lighting S53.40__ ❑ Intercom and Paging Systems Signal clrvuil(s)or a limited energy panel,alteration or oxtonsion _ $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) _ S125.00 _ Medical Each additional Inspection over v ❑ the allowable In any of the above ❑ Per inspection $02,50 Nurse Calls For hour _ $62.50_ 1n Plant $73.75 J Outdoor Landscape UShtln0' L Fees: ❑ Protecdve Signaling C Enter total of above frets $ Da'D s ❑ Other R%State Strrcnargn $ 1 Y. I d Number of Systeme J 2556 Plan fn vlaw Reelaw"aMaion on Foo he See"Pt7ov ' No 11conses are required. Limmas err required for ed ether Install s S asons — u front of application. -- u —cl Foos: a Tara!Balance Due 5 �g I.g s— ( � Enter total of above fees S YNTrust Account N u_�� _ 6%State Surcharge $ Total Balance Due $ i 41,vofnrrrutelc-fees.doe 10/09/00 CITY OF TIGARD PLUMBING PERMIT ,__ DEVELOPMENT SERVICES PERMIT#: PLM2000-00433 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 DATE ISSUED: 11/28/00 SITE ADDRESS: 12540 SW MAIN ST 110 PARCEL: 2S102AC-007'00 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of new plumbing fixtures for commercial TI. Owner: FEES Type By Date Amount Recelpt BY FL + N E T PRMT CTR 11/2.8/00 $72.50 27200000000 40 FLORENCE T YN 5PCT CTR 11/28/00 $5.80 27200000000 4025 SE BROOKLYN _ PORTLAND,OR 97202 Total $78.30 Phone 1: Contractor: EAGLE PLUMBING 13801 S FORSYTHE RD OREGON CITY, OR 97008 REQUIRED INSPECTIONS Phone 1: 503-650-8703 Rough-in Insp Reg#: LIC 47914 Underfloor/Underslab PLM 3-154PB Top-out Insp Finan Inspection C vThis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. i Issued By: �,��,o _ y Permittee Signature: Call(503) 639.4175 by 7:00 P.M.for an Inspection needed the next business day >t Plumbing Permit Application 7p,,nt r Z eF M) Pemhit no.*./e/j City of Tigard Building permit no,: - "Poo _ 40 Address: 13125 SW Hall Blvd,Tigard,OR 97223 Aq CirvofTigard phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: hy:.L/`;r* Receipt no.: Land use approval: Case file no.: Payment type: U i &2 family dwelling or accessory (XCommercial/industrial 0 Multi-family MiTenant improvement Mk New construction U Addition/alter,5tion/replacement U Food service U Other: Job address: 0 _ _ Description Fee ea. finial Bldg.no.: Suite no.: New 1-and 2-famlly weWngs only: 'Tax map/tax loUaccount no.: (ttecluder100It.for eaehuttlftyconnectbn) SFR(1)bath Lot: Block: Subdivision: SFR(2)bath _ Project name: SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description and location of work on premises: _ Siteutilitles: Catch basin/area drain _ Est.date of completion/inspection: -dC Lf" Drywells/leach line/trench drain _ Footing drain(no. lin.ft.) Manufactured home utilities Business nam, : t�PNa_c` �$c� Manholes Address: 13 8QA $,_ Rain drain connector City: ,( State: r-w- ZIP.17 ^ Sanitary sewer(no.lin.ft.) _ Phone: SZ3. -k_87O Fax: .gni Email: Stotm sewer(no.lin.ft,) CCB_no.: yTg I _ Plumb.bus.reg,no_3 t 5*1 Wp to service(no. lin.ft.) City/metro lie.no.: Fixture or Item: Contractor's representative signature: Absorption valve Print name: Dates Back flow recventer _ Backwater valve _ Basins/lavatory Name: Clothes washer Address: Dishwasher City: State: ZIP: Drinking fountain(s) Ejectors/sump Phone: Fax: E-mail: Expansion tank Fixture/sewer cap Name(print): I U3-'U lw7 S ka Floor drains/floor sinks/hub _ Mailing address: vy V,AA I N Garbage disposal —1Z- --� Hose bibb tl City: T-1 U State: pL ZIP: _ ice maker � Phone: Fax: E-mail.• lnlerce for/grease trap Owner installation/residential maintenance only: The actual installa!ion Primer(s) will be made.by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) -� Owner's signature: Date: Sump m T•ubs/shower/shower pan t9 Urinal W Name: C t �rA, — Water closet Address: � -` �_ Water heater City: r� A State:d ZIP: �� Other: Phone: 2 Fax: E-mail: Total Not all jurisdictions accept credit earls,please call jurisdiction for«xre information Minimum fee................$ �e� s O Notice:This permit application plan review U visa LiMasv!tCard expires if a permit is not obtained (at __ %) $ Credit card number: _:. - / I within 190 days after it has keen State surcharge(8%)....$ Expifef TOTAL Namenfcudhnlderushown oncredit card accepted as complete, .......................a --7k) 0 _ S Cardholder sisnatme Amount I,61tN616(60YCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 24amlly dwellings only: FIXTURES individual,-_ QTY ea AMOUNT (Includes all plumbing fixtures In PRICE TOTAL Sink 16.60 2p the dwelling and the first100 ft. CITY AMOUNT Lavatory 16.60 for each utility connection) _ - One(1)bath $249.2_0 _ Tub or Tub/Shower Comb 16.60 Two 2 bath $350.00 _- Shower Only 16.60 Three(3)bath $399.00 Water Closet 16.60 - SUBTOTAL Urinal 16.60 8%STATE SURCHARGE _ Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 - Washing Machine 16.60 Floor Draln/Floor Sink 2" 16.60 3" 16,60 PLEASE COMPLETE: 4" 16.60 Water Heater O conversion O like ki.mri 16.60 Quantity b I Work Performed Gas piping requires a separate mechanics; / /G, ,(art Fixture Type: New Moved Replaced Removed/ permit. _ - -- Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 4640 Lavatory _- Tub or Tub/Shower Hose Bibs 16.60 Combination _ Roof Drains - 16.60 Shower Only _ Drinking Fountain 16.60 Water Closet Other Fixtures(Specify) - 16.60 Urinal _ Dishwasher _ Garbage Disposal Laundry Room Tray Washing Machine Floor Drain/Sink: 2" Sewer-1 sl 100 55.00 3" -'- Sewer-each additional 100' 46.40 _ 4" - Water Service •IM 100' 55.00 Water Heater - Water Service-each additional 2.00' 4640 Other Fixtures (Spec fy) Storm d Rain Drain-1st 100' 55.00 Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specialty 72.50 Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram Is required if - Quantity Total Is >9 % 'SUBTOTAL - 8%STATE SURCHARGE - -- ------- "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture qty.total Is>9 TOTAL $ a "Minimum permit fee Is$72.50 4 8%state surcharge,except Residential Backflow Prevention Device,which is$36 25+8%state surcharge "All New C ommercial Buildings require plans with Isometric or riser diagram and plan review L%cistslformsom-fees.doc 10/10/00 CELECTRICAL PERMIT CITY O F T I G A R D PERMIT#: ELC2000-00652 DEVELOPMENT SERVICES DATE ISSUED: 11/29/00 13125 SW Hail Blvd.,Tigard,OR 97223 (503)6394171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 110 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG Prolect Description: Outline lighting for sign RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 9000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGNIOUT LINE LTG: 1 LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/FDR: 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: 4 3 W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+amplvolt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect o!i!y: SVCIFDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: DOLAN + CO LLC HIGHLIGHT SIGN CORP BY FLORENCE T DOLAN 8200 SW HUNZIKER 4025 SE BROOKLYN TIGARD, OR 97223 PORTLAND, OR 97202 Phone: Phone: 503-620-8205 Reg#: LIC 00104599 SUP sig517 ELE 26-888CLS FEES Required Inspections Type By Date Amount Receipt Elect'I Final ` PRMT CTR 11/29/00 $75.00 2720000000( 5PCT CTR 11/29/00 $6.00 2720000000( Total $81.00 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 U work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules , topted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0010010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503) 246-1987. PERMITTEE'S SIGNATURE ISSUED BY: _ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: __. DATE: LICENSE NO: Call 6394175 by 7:00pm for an Inspection the next business day Electrical Permit Application Date received: IPermit no.:Ek-,, o T .ecr✓S Z City of Tigard Project/appl.no.: Expire date: City ofTigarr/ Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date is-cued: By:� Rcceiptno. Phone: (503) 639-4171 — — — Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: U 1 &2 family dwelling or accessory tFo6merc:ial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Other: _ U Partial Joh address,: 1 s¢p C,CO, Bldg. no.: Suite no.: Tax map/tax Iot/account no.: Lot: Block: Subdivision: Project nnrne: Description and location of work on premises: hWt W jpA t,t.. 5; Estimated dale of completion/inspection: 17� D D ". Mwp gMjW f Business name: N 1 `/&*t r -�',/10, L1�►'l� ^--- De" ion Qty. (OL) Tout no.Ins or mai New Address: gr Sill jt(l�l lClrs - �- raldeNhtI-si ni ft l-faWAY per daellYrs tarty.Intclades attxitsd prase. City: r1 17 S(ate:O ZIP: TIA,'43 Serrkehtclr+kd Phone: /J o- ;o5 Fax:( -'jr) E-mail:NL//,N'f A, 0.1000 sq.ft.orless 4 Each additional 500 sq.ft.or portion thereof _ CCB no.: /pµf'f9 Flet.bus."C'no: S/(��F-� Limited energy,residential 2 City/metro lic.no.: 3 7(eg Limited energy,non-residential 2 F-Ach manufactured home or modular dwelling Signature of supervising etmilician(required) Dote Service andlor feeder 2 Sup.elect.name(print): License no: Services or feeders-Installation, alteration or relocation: 200 amps or less 2 Name(print): �F„p�eJ 4 (e�,, � � 201 amps to 400 amps - 2 Mailing address: 1 d1tAJ �� _401 amps tol'10amps - _ 2 601 amps to R'10 amps 2 City: I State:00. ZIP: _ Over l000 amr -volts _ 2 Phone: lool Fax: E-mail: Reconnect only t Owner installation:The installation is being made on property I own Temporary services orfeeders- which is not intended for ,lease,rent,or exchange according to Installation,aitenstion,orveloeatlon: ORS 447,455,4 70 200 amps or less _ 2 201 amps to 400 amps 2 Owner's signatu Date: 8 r'v 401 to 600 ams 2 Lin 1101110 1 Branch circuits-new,alterntlon. Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch cir-uit 1 2 City: r State: ZIP: R. Fee for branch circuits without punch�re - Ph mail: of service or feeder fee,first branch circuit: 2 Fax: E- Each additional branch circuit. Misc.(Service or feeder not Included): 'i Service o rx 225 amps-commercial Cl Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 C]Hamtrdous location Fach signor outline lighting / ( 2 family dwellings U Building over 10,(W square feet four or Signal circuit(s)or a limited energy panel, C]System over 6W volts nominal more residential units in one structure alteration,orextension* 2 LI Ruilding over three stories U Feeders,400 amps or more *Description: _ U Occupant load over 99 persons U Manufactured structures or RV park Fich additional htspectlon ever the allowable to any of the above: re U FgsI7 Other ther. _ Per inspection :submit sets of plata with soy of the above. Investigation fee t ast The above are nopplicable to temporary conruction service. Other Na all jurisdictiau accept credit cards,please call jurisdiction for mote Inforrrrarion. Notice:This permit applicalie,, Permit fee..................... U Visa U MasterCard expires if a permit is not obt-,Led Plan review(at _- %) $ _ Credit card number: L_L within 180 days after it has been State surcharge(8%)....$ _ . Expires accepted as complete. TOTAL $ ...................... Name of cardholder u shown on c t card S Cardholder signature Amount 44134615 iISKKWOM) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY p Ins Restricted Energy Fee...................................................... $75.00 Number of a Inspections per permit allowed (FOR ALL SYSTEMS) Service Included: Items Cost Total Check type of work Involved Residential-per unit 1000 sq fl or less $145 15 4 ❑ Audio and Stereo Systems Each additional 500 sq It or portion thereof $33.40 _ 1 ❑ Burglar Alarm Limited Energy _ — _ $75.00 Each Manurd Nome or Modular Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.05 _ 2 EJ Vacuum Systems 401 amps to 600 amps $160.60 _ 2 601 amps to 1000 amps _ $240.60 2 ❑ Other Over 1000 amps or volts _ $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders V� TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system................................................. ........ $75.00 200 amps or less _ $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Typo of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel ❑ Boller Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder tea. Each branch circuit $6.65 , 2 ❑ Data l-elecommunication Installation b)The fee for branch circuits without purchase of service ❑ or feeder fee Fire Alarm Installatlo,l First branch circuit _ $4685 _ ❑ Each additional branch circuit $6.65 HVAC Miscellaneous Instrumentation (Service or feeder not included) l._1 Each pump or irrigation circle _ $53.40 _ Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(%)or a limited energy panel,alteration or extension —__ $75.00 _ ❑ Landscape Irrigation Control' Minx Labels(10) _ $125.00 Each additional inspection over ❑ Medical the allowable in any of the above Per Inspection _ $62.50 ❑ Nurse Calls Per hour _ _ $62.50 In Plant y $73.75 ❑ Outdoor Landscape Lighting' a Fees: ❑ Protective Signaling Enter total of above fees $ _ ❑ Other N 8%State Surcharge $ -- -- Number of Systems J 25%Plan Review Fee See"Plan Review"section on $ No licenses are required Lkenses are required for all other Installations ro front of application a - Fees: J Total Balance Due $ 4 Enter total of above tees ❑ Trust Account#_ 8%Slate Surcharge $ _ Total Balance Due $ i:\dsts,fomrsklc-fees,doc 10/09/00 _ BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2000-00458 DEVELOPMENT SERVICES DATE ISSUED: 11/17/00 13125 SW Hall Blvd..Tlaard,OR 97223 (503)639-4171 PARCEL: 2S102AC-00700 SITE ADDRESS: 12540 SW MAIN ST 110 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG REISSUE: FL('!�rt AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT r-'IRST: 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: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 9 BASEMENT: of AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psi LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: f)o Remarks: C04ercial TI Owner: Contractor: DOLAN + CO LLC GRIGSBY CONSTRUCTION INC BY FLORENCE T DOLAN 8114 SW NMISUS AVE 4025 SE BROOKLYN BEAVERTON, OR 97008 Pgpone:TLAND, OR 97202 Phone: 641-7343 Reg#: LIC 45073 FEES _REQUIRED INSPECTIONS_ Type e B Date Amount Receipt Mechanical Perm!;Require Y _ PRMT CTR 11/13100 $358.30 27200000000 Electrical Permit Required Sprinkler Permit Required 5PCT CTR 11/13/00 $28.66 27200000000 Plumbing Permit Required PLCK CTR 11/13/00 $232.90 27200000000 Framing Insp FIRE CTR 11/13/00 $143.32 27200000000 Gyp Board Insp Susp Ceiing Insp Total $763.18 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 woi s will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules au,.,1ed by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-1987. Permitee Signature: e: � - - f Issued B ��j . Call 639-4175 by 7 p.m.for an inspection the next business day Building Permit Application Datereceived: 11-Ig-0c) n=dtno.: a —GdV Ci of Tigard City �.. Projocdappl.no.: Fix iredale: City nfTigard Address: 1317.5 SW hall Blvd,'1'igard,OR 97223 P — . Recei tno.: Phone: (503) 639A171 Dateiasual: Y Pax: (503) 598-1960 Case fit:no.: Payment type: Land use approval: _ I&2(at-lily:Simple Complex: I ccesro U Commercial/industrial U Multi-family O New construction ❑Demolition U l �t 2 family dwelling ora ry O Addition/alteration replacement U Tenant improvement Q Fire sprinkicc�alarm 0 Other: I Job address: Sk_O $%,0 r+'\MN 5'r� ��- Bldg.no.: Suite no.: Lot: }Uo Block; Subdivision_ _ Tax map/tax IC t/aceount no.: I-a- 'ectname: T. oR 1 LAG �— ProJ A-t�o� 11 1. F Description and location of work on preniiscs/special conditions: 1%,. LITMA (AAM, I ki N MCT�4�NU of vx1CTt1, gulLD14(e_ — loodploill,seliticc.IP1166.SOW.etc.) Name: Mailing address: J Cl U. %I I u E. 1 k 2 fcmlly dwelling: City: PQState:M P: 9 W 0 9 Valuation of work.. ..................................... $ Phone �Teu9 Faxf' �T't9� E mail: No.of bed wms/baths................................. Owners representative: p��q� _ ----- Total number of floors...................... ......... — Phone; 200.59an1 Fax:�l-t9 6a E-mail. New dwelling area(sq.ft.) ............ OaMeicarport area(sq.ft.)......................... Covered pinch area(sq.fQ ........................ Name. C Mo. — Deck area(sq.ft.)........................................ Mailing address: t t S' Svv o R i3 Wb —�`---�,�•r� Other structure area, (aq.ft.)................. State:oA ZIP• o� ----- City: 0.11..bgb - Comeserc!al/indestdol/multi-family: qOo. Phone: o� alb n1s Fax:DP*-i 6 a•v Umail: $ 3 Valuation Awork. ........... � Existing bldg.area(sq.ft.) .......................... I F Business name: 6R I IoSQ Y C 0 N S-t 00 t--f 12 N New bldg.area(sq.ft.)................................ AM- Address: tf`f -1 r, At Number of stories........................................ Q Strrc:p ZIP: V'N City: U�•ki% C SW (�C Type of cc nstruction...................................: — Phone 5�3 --- o e o Fax Yf$i61 F'rnail: Occupanc;�group(s): Existing: g(R�Au�oFPux) CCB no.: New: S•sa-►+��• City/metro lic.no.: Notice:A.I contractors and subcontractors aro required t�be licensed with the Oregon Construction Contractors Board under provisions of URS 701 and may be required to be licensed in the Name:_(i DA jurisdictioi where work is being performed.If the applicant is Addr_%s: 441-+5 i� ��W uR ��C' exempt from licensing,the following reason applies: 4 Ci �0.�tlAN� State:6k ZIP:91a o _ — FContact mmon:� &AuIWQSL1-S Plan no.: _ N Phone n d-ta9aS FaxbT$.'$6.16� E-mail: MEN- -� Name: Contact person: Dees due upon epplicadon ...........................$ m Address:-_-- DAIe received: — State: ZIP: Amount rxetved ......................................... - W City: _ - -- _. J Phone: I-ax: E mall: _ Pleas refer to fee schedule. Nd as iu 1$"Om WOW cl"'cam,r�call Juri�r0on tar mar lafem,etloo. 1 hereby certify i have read and examined this application and the is Vice t]MutrtCard attached checklist.All provisions of laws and ordinances governing this CMM Mi aameu work will be complied with;wheth r specified herein or not. _ Authorized signaturrt/�i _ Date: Print name: �01der O e Aanuci Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. Mx►�ecr�(6loat`otfi 7 d I g I Lt t . 'Y COO 4Nf'DLL d0 JI,1,1� 0961 965 C04 Idd LZ.:6t IM 00/LZ/OI i ELECTRICAL PERMIT- CITY OF TI GARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT 0: ELR2000-00293 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 12/7/00 SITE ADDRESS: 12540 SW MAIN ST 110 PARCEL: 2S102AC-00700 SUBDIVISION: BURNHAM TRACT ZONING: CBD BLOCK: LOT: 001 JURISDICTION: TIG Prolect Description: HVAC System A.RESIDENTIAL _ B.COMMERCIAL AUDIO 3 STEREO: AUDIO&STEREO: INTERCOM&PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEnICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: X PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: _ TOTAL#OF SYSTEMS: Owner: Contractor: DOLAN + CO LLC AMERICAN HEATING BY FLORENCE T DOLAN 1339 SW GIDEON ST 402E SE BROOKLYN PORTLAND,OR 972.02 PORTLAND,OR 97202 Phone: Phone: 239-4600 Reg#: LIC 00033135 ELE 26-583CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 12/7/00 $75.00 2720000000 Elect'I Final 5PCT CTR 12/7/00 $6.00 2720000000 Total $81.00 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 !L not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law pL requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR F' 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or di ct estions tom at (503) N 246-1987. J Issued by �� Permittee Signature OWNER INSTALLATION ONLY W The Installation Its being made or property 1 own which Is not Intended for sale. lease,or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N; _ DATE: _ LICENSE NO: Cali 639-4175 by 7:00 P.M. for an Inspection needed the next business day Electrical Permit Application Date received: Permit no.94 _oZ City of Tigard Project/ap'pl.no.- Expire date: CiryofTignrd Address: 13125 SW Hall Blvd,'Tigard,OR 97223 Date issued: By: Receipt no Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: U I &2 family dwelling or accessory Litomrnercial/industrial U Multi-family U Tenant improvement VNew construction U AdditiorJalteration/replacement U Other: U Partial Job address: Q (j &IAl_�r Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: Block Subdivision: Project name: fi2L_MLcMWDescription and location of work on premises: 4C Estimated date of completion/inspection: Job no: 80,8 41Fee Max Business name: Desert en. Total no.hu Address: :sewreriinNlal-sl orwdd-tswYyger T dwellilaguall.lntitsdusunchedjpaaa . City: slate:on- ZIP: 7 pL arer,loe, A ','- Phone: q— d/G pyo Fax: -V2 E-mail: 1000 sq.ft.or less 4 3313 Each additional 500 .ft.or portion thereof CCB no.: Elec.bus.lie.no:,16 x-653 GLG' Limited energy,residential 2 City/metro lic_no.: _ Limited energy,non-residential 2 Z -Z Farh manufactured home or modular dwelling Signature of supervising tlectri n(required) vete Service and/or feeder 2 Sup.elect.name(print): License no: Servicorfeeden-Installation, alteration or relocation: 200 amps or less 2 Name(print): � 201 amps to 400 amps 2 Mailing address: al / Tt+ - 401 amps to 600 amps 2 601 amps to 1000 amps 2 City: State: ZIP: 47opq. Over 1000 amps or volts 2 Phone: Fax: E-mail: Reconneclonl l Owner installation:The installation is being made on property I own Temporaryservkraurteeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,670,701. 200 amps or leas 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 sine! 2 11101H&3 1 t ■ranch elrnib-new,alteration, Name: or extension per panel: -- — A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: ZIP: B. F«for branch circuits without purchase 4. Phone: Fax: E-mail: of service or feeder fee,first branch circuit: 2 Each additional branch circuit: 14 as I AM- Mi lin Ifn Mbar.(Service or feeder not Included): U Service over 225 amps-commetcial U Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous location Foch signor outline lighting 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,orextensiono 2 m U Building over three stories U Feeders,400 amps or more *Description: WU Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In wry of the above: J U EgressAightingplan U Other __ Per ins don Submit_sets of plans with may of the above. Investigation fee The above are Dot applicable to temporary construction ser,ice. Other NM air jurisdictions-emit credit cards,please call jurisdiction for rate infrrmstton Notice:This permit application Permit fee..................... U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit cant number: Within 190 days after it has been State surcharge(8%) ....$ rapine accepted m complete. TOTAL $ Name d cardholder as drown on credit card ....................... _ S Cardholder signature Amount I40.4617(6000R)OM) Electrical Permit Fees: Limited Energy Fees: ` Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Restricted Energy Fee...................................................... $75.00 Number of Inspections per pennilt allowed (FOR ALL SYSTEMS) Service Included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less _ $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq.R.or portion thered $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular E]Dwelling Service or Feeder $90.90 2 Garage Door Opener' Services or Feeders ❑ Heaft Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.852 ❑ Vacuum Systerw 401 amps to 600 amps $160.60, 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED-COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less — $66.85 2 (SEE OAR 918-260.260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits F-1 New,alteration or extension per panel Baler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems Feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Firs Alarm Installation or Feeder he. First branch circuit _ $46.85 Each additional branch circuit _ $6.65 ❑ HVAC Miscellaneous ❑ instrumentation (Service or feeder not Included) Each pump or irrigation circle _ $53.40 Each sign or outline lighting $53.40_ ❑ Intercom and Paging Systems Signal ckcult(s)or a limited energy panel,alteration or extension $75.00 ❑ Landscape Irrigation Control' Minx Labels(10) $125.00 Each additional Inspection over ❑ Medical the allowable in any of the above Per Inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant _ $73.75 ❑ Outdoor Landscape Lighting' Q. Fees: ❑ Protective Signaling NEnter total of above fees $ _ ❑ Other 8%State Surcharge $ _Number of Systems -� 25%Plan Review Fee m See"Plan Review"section on $ Nc ilcenses are required. Licenses are required for all other installations front of application. W Fees: 'J Total Balance Due $ r—� Enter total of above fees $_ U Trust Account N 8%State Surcharge $ Total Balance Due $ i:\dstsVomnklc-fees.doc 10109/00 CITY OF T I GA R D MECHAWCAL PERMIT - DEVELOPMENT SERVICES PERMIT#: MEC2000-00472 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 12/7/00 PARCEL: 2S 102AC-00700 SITE ADDRESS: 12540 8W MAIN ST 110 SUBDIVISION: BURNHAM TRACT ZONING;: CBD BLOCK: LOT:001 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 -50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: CLO DRYERS: FURN <100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <=10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Mechanical tenant improvement Owner: FEES DOLAN + CO LLC Type By Date Amount Receipt BY FLORENCE T DOLAN PRMT CTR 12/7/00 $72.50 2720000000 4025 SE BROOKLYN 5PCT CTR 12/7/00 $5.80 2720000000 PORTLAND,OR 97202 PLCK CTR 12/7/00 $18.13 2720000000 Phone: Total $96.43 Contractor: AMERICAN HEATING INC 1339 SE GIDEON STE 1 REQUIRED INSPECTIONS PORTLAND,OR 97202 Gas Line Insp Phone:239-4600 Mechanical Insp Reg#:LIC 33135 Final Inspection a it U) J_ m_ WThis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted 'n the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010„through OA 52-001-0080. You may obtain copies of these rules or direct questions to OUNGAc ( 3)2, 9. Issue By: Permittee Signature:Call(503) 639-4175 by 7:00 P.M.for Inspections neededslness da % L Mechanical Permit Application Datereceived: tV-1e-eV Permit no.:r WeW—601/7' cit. of Tigard Project/abpl.no.: Expire date: Ciryull'i,gnrd Address: 13125"W Hall Blvd,Tigard,OR 97223 Date issued: H Recei tro.: Phone: (503) 639-4171 - y P Fax: (503) 598-1960 Case file no.: Payment type: Land ,ise approval: Building permitno.: ❑ 1 &2 family dwelling or accessory 13ir'fommercial/industrial ❑Multi-family ❑Tenant improvement W14ew construction ❑Addition/alteration/replacement ❑Other: Job address: /il;,NO 5'0 rrTsitite ST _ Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: no.: / value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: Subdivision: *See checklist for important application information and Project name: . jurisdiction's fee schedule for residential permit fee, City/county: Tr 3410. _ I ZIP: Description and lo5tion of work on premises: HE Fee(e&) ToW Est.date of completion/inspection: / S X00HVICDeaerl Resodonly Res Tenant improvement or change of use: ' Air handling unit CFM,�� / Is existing space heated or conditioned?❑Yes UeNo Ir conditioning(site plan required) Is existing space insulated'?UOYes ❑No Alteration of existing HVAC system Boiler/compressors Business name: mite boiler permit no.: % HP Tons BTU/II Address: _—mumT - 1-ire/smoke amper uctsmoke detectors I ZIP: q-7$L0 cal pump(5 l pan required) Phone: yG�p Fax:�3y �as8 E-mail: nsta repace umac urner_ 1:11UIH Including ductwork/vent liner arYes O No CCB no.: nsTtall/repaT�elrefocate heaters-suspen e , City/metro lic.no.: 101-2 wall,or Floor mounted Name(please print): dXA-r J. S�r't+-t Vent fora lance other than furnace e etst Absorption units BTU/H Chillers_ _ HP Name_ S Srt!T r „ / tf Compressors HP Address: e d N ST -,- --- v rorrse�tn exhand• vest t n: City: Slate:01Z_ZIP_ 0f7901— Appliancevent Phone: pd Fax: 34- pr E-mail -- Terex gust 9_R5i_xFs,7ype res. itc a azmat hood fire suppression system Name: Exhaust_ Exhaust fan with single duct(bath fans) Mailing address: A/t f / irof v gr Exhaust system a an from Itassn or AC CL City: State: ZIP: 7 Feelog s on up to outlets) Type: LPG Na Oil H Phone: Fax: E-mail: Fuel piping each additional over 4 outlets U) rotes plilift(schematic required) Fes- Number of outlets Name: � siphuace or eq pdsreet: Address: _ Decorative fireplace 0 City: _ State: ZIP: nsert-ty W Phone: Fax: -mail: Woes.tov pe et stove Applicant's signature: Date: - t Name (print): R0.2MIK S m- r► Na all jurixlictims accept credit cards,pleas call jurisdiction for more infcwmation. Permit fee.....................a Notice:This permit application U visa U MacleH:ard Minimum fee................$ -- expires if a permit is not obtained Plan review(al _ 96) a t and t card number_ -- — r-�- within 180 days after it has been ro State surcharge(896)....$ _ --Name cW cardholder as shown on credit card - accepted as complete. TOTAL Cardholder altnatwe Amount 140.1617( ) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE:, TOTAL VALUATION: FEE: Description: Pda Total $1.00 to$5,000.00 Minimum fee$.°.50 Table 1A Mechanical Code 01Y (Es) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 tum cash adjitional$100.00 or Including duds 6 vents _ 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ $10000.00. including duds&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the fast$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or Including vent 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $25.000.00. or floor mounted heater 14.00 _ $25,001.00 to 550,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included In appliance permit $1.45 for each additional$100.00 or 8.80 fraction thereof,to and including 6) Repair units $50,000.00. 12.15 550,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Beller Heat Alf $1.20 for each additional$100.00 or For Items 7.11,m or Pump COW fraction thereof. footnotes below. O"P* 7)<3HP;absorb unit BTU 14.00 A_SSU_MED VALUATIONS PER APPLIANCE: - -15 - Value Total 8 8)13 3-15 HP;absorb 25� unit 100k to 500k BTU Description: Ea Amount 9)15-30 HP;absorb Furnace to 100,000 BTU,n c!vding 955 un!t.5-1 mil BTU _ 3`•00 duds 6 vents 10)30-50 HP;absorb Furnace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU 52.20 ducts&vents 11)>F,UHP: Floor furnace Including vent 955 BTabsorb - -- unit>1.75 milllBTU 87.20 Suspended heater,wall hfeater or 955 12)Air handling unit to 10,000 CFM floor mounted heater 10,00 Vent not Included in appllcance 445 13)Air hpndling unit 10,000 CFM+ permit _ 17.20 Repair units 805 _ 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 10.00 to 100k BTU 15)Vent fan connected to a single duct 3-15 hp;absorb.unit, 1,700 6.80 101k to 500k BTU 16)Ventilation system not Included In 15-30 hp;absorb.unit,501k to 1 2,310 appliance permit 10.00 mil.BTU 17)Hood served by mechanic.I exhaust 30-50 hp;absorb.unit, 3,400 10,00 1-1.75 mll.BTU 18)Domestic Incinerators >50 hp;absorb.unit, 5,725 _ 17.40 >11.75 mil.BTU 19)Commercial or Industrial type Incinerator Air handling unit to 10,000 ctm 656 69.95 Air handling unit>10,000 cfm 1,170 20)Other units,including wood stoves Non-portable evaporate cooler 656 1000 Vent fan connected to a single duct 446 21)Gas piping one to four outlets Vent system not Included In 656 5.40 appliance permit 22)More than 4-per outlet(each) Hood served by mechanical exhaust 656 1.00 Domestic Incinerator 1,170 Minimum Permit Fes$72.50 SUBTOTAL: $ IL Commercial or Industrial Incinerator 4,590 Other unit,Including wood stoves, 656 e%State Surcharge $ Inserts,etc. -_ U) Gas piping 1-4 outlets 360 _._ 25%Plan Review Fee(of subtotal) Each additional outlet 63 Required for ALL commercial permits only 'J TOTAL COMMERCIAL : TATAL RESIDENTIAL PERMIT FEE: _ m VALUATION: _ W .J 0her Inspections and Fees: 1 Inspections outside of normal business hours(minimum charge-two hours) $72.50 per hour. 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour) $72.50 per hour 3 Additional plan review required by changes,additions or revietons to plans(minimum charge-one-half hnu)$72.50 per how *State Contractor Boller Certification required for units>200k BTU. "Resldenttal AIC requires site plan shoving placement of unit. I:\dsts\formsvnech-fees.doc 10/11/00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-1171 OUP Date Requested p 29 AM X PM BLD _ /t D Location��ih�� 1 Lt/ Suite MEC Contact Person '5�44&0— Ph G;; Oct ar PLM Contractor Ph SVVR — RLII4 Tenant/Owner ELCMmru Retaining wall ELR ?u�-Q 3 Footing Access: lot how FPS Foundation Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post&Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL a C Service N Rough In Ajd � UG/Slab - Low Voltage Fir larm m W ASS PART FAIL J Backfill/Grading Sanitary Sewer Storm Drain [ j Reinspection fee of$, required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Unable to ins no access Fire Supply Line [ ]Please call for reinspection RE: _ _ [ ] t ADA Other Approach/Sidewalk DateIVY Inspector Ext Other Final PASS PART__fAILJ DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 • BUP 1 Date Requested AAA PM BLD Location / 2,1 U SW h'Il�� Suite MEC Contact Person / Ph S�3 �� PLM Contractor Ph SWR BUILDING Tenant/Owner ELC .��✓ -wGf�y Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SIGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation , N Drywall Nailing _ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL _PLUMBING Post&Beam Under Slab Top Out Water Service _ Sanitary Sewer Rain Drains Final PASS PART FAIL _ MECHANICAL Post&Beam - Rough In Gas Line Smoke Dampers Final PASS PART FAIL Service Rough In UG/Slab Low Voltage 3 F' Alarm p F AS PART FAIL — — u J Backfill/G4,, g Sanitary Sewr-r Storm Drain ( )Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ]Please call for reinspection RE: _ �_ [A Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date 7 Inspector tt-- Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Line: 639-4175 Business Line: 639-4171 — 0 . IBUP Date Requested / 2'_ AM PM BLD Location Zy s w /r41rt Suite //0 MEC Contact Person CYi d Ph 577;- �S-V -6103 PLM 2,acz,-Gy y3 3 Contractor Ph s03 J-7Z_ G/.PL 8WR BUILDING Tenant/Owner ��-/ h ELC Retaining Wall IleELR Footing Access: Foundation FPS Ftg Drain SON Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Calling Roof Misc: Final PASS PAR i FAIL Post$Beam , r Sla �pU yl, r , Top Out Water Service _ Sanitary Sewer Rain Drains _ Fi PART FAIL ANICAL Post&Beam Rough In / Gas Line — Smoke Dampers Final PASS PART FAIL ELECTRICAL Service _ Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ please call for reinspection RE: [ J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date —+o-i Inspector_ _ Ext �- _ ��-- Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site, CrTY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 o SUP Date Requested / —/d –O AM x PM BLD Location Suite /1 MEC Contact Person Ph 0 T205PLM Contractor Ph SMR BUILDING Tenant/Owner ELC Retaining Wall ELR 2LG4)—0G,311t9 Footing Access: �, how o,Y FPS Foundation (�.� '�"" Fig Drain SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing — Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final \ PASS PART FAIL PLUMBING Post&Beam Under Slab _ l-op Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post&Beam -- — Rough In Gas Line Smoke Dampers Final PASS PART FAIL C Service Rough In NO UG/Slab — Low Voltage 4rmli� _— PART F.IL _ Backfill/Grading Sanitary Sewer Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Sripply Line [ J Please call for reinspection HE: to ins___ _ [ J peel no access ADA Approach/Sidewalk Date � � In-npector _ Ext Other ____ Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.