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10260 SW GREENBURG ROAD STE 950 a^e Cq C z c� i i i I Y� 10260 sw GREENBURG RD 950 CITY OF �TIGAR® CERTIFICATE OF OCCUPANCY � i DEVELOPMENT '�►ERVICES � PERMIT#: B002-00186 13125 SW Flail Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: BUP2UP25/14/2002 PARCEL: 1 S'135AB-03400 ZONING: C-P JURISDICTION: TIG SITE ADDRESS: 10260 SW GREENBURG RD 950 SUBDIVISION: LINCOLN TOWER-TOWN OF METZGER BLOCK: LOT:014 CLASS OF WORK: ALT "TYPE OF USE: COM TAPE OF CONSTR: 2FR OCCUPANCY SRP: B OCCUPANCY LOAD: 'TENANT NAME: S LC SPACE REMARKS: Tenant improvement, remove some interior walls a econstruct corridor wall Owner: EOP LINCOLN, LLC 10260 SW GREENBURG RD SUITE # 100 Z� P%;6 NDBRY29W3 503-234-6617 Contractor: C SCHIEWE & ASSOCIATES INC 1024 NE DAMS ST PORTLAND, OR 97232 Phone: 503-234-6617 Reg#: LIC 54105 This Certificate issued 11/13i20112 grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under which a referenreci permit &, Ljs7*yed. BUFL_DI G INSPECTOR - BU D q-OFFICIAL POST IN CONSPICUOUS PLACE CITY OF 24-Hour BUILDlIv�� Inspection Line: (503) 639-4175 MST INSPECTION DIVISIC. Business Line: (503)639-4171 p BUP Received Date Request d—_ - AM_ _ PM BUP Location .. —_ 2 Suite 5 MEC 2 Contact Person — __—T _ _ Ph( ) �1 ��3 PLM - Contractor -- - -- ------------_ _ _ __ Ph(-- ) -- SWR BUILDING Tenant/Owner - -- _ _ ELC Footing Foundation _ ELC Access: Ftg Drain ELR Crawl Drain - Slab Inspection Notes: SIT Post&Beam Shear Anchors -- - Ext Sheath/Shear Int Sheath/Shear Framing ------T - Insulation Drywall Nailing - ---- Firewall Fire Sprinkler - — - -- -- Fire Alarm Susp'd Ceiling ----- - ---- Roof XSS ) PART FAIL — ` -�- ING Post&Beam Under Slab --- Rough-In Water Service Sanitary Sewer I � Clain Drains \ Catch Basin i Manhole Storm Drain - ---- i Shower pan Other: - -- - Final PASS PART FAIL -_ MECHANICAL_ _ _-- _------ --- - - _--- ---- Post&Beam Rough-In -- --- ---- ----- - ---- Gas Line Smoke Dampers ------------ - -- --- -- - Final PASS PART_ FAIL ELECTRICAL _ Service - Rough-In - -- ----- -- - - _- UG/Slab Low Voltage — --- ---- ------ -------- Fire Alarm Final Reinspection We of?___- required before next inspection. Pay at City Hall, 13125 SN'Hall Blvd. PASS PART FAIL 81TE — Please call for reinspection RE: _ El Unable to inspect-no access Fire Supply Line ADA //// 7 Approach/Sidewalk p�--�� `-�1�d- = Inspector _ t---- Other: Final DO 14107 REMOVE this Inspection recerd from the Job site. PASS PART FML --- BUILDING PERMIT CITY OF TIGARD _ PERMIT#: BLJP2002-00186 DEVELOPMENT SERVICES DATE ISSUED: 5/14/02 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 950 SUBDIVISION: LINCOLN 'TOW ER-TOWN OF METZGER ZONING: C-P BLOCK: LOT: 014 JURISDICTION: TIG _ REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION_ CLASS OF WORK: ALT FIRST: Sf� N: S: E: W: TYPE OF USE: COM SECOND: Sf PROJECT OPENINGS? _ TYPE OF CONST: 2FR Sf N: S: Y E: W: OCCUPANCY GRP: B TOTAL AREA: 000 Sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: Sf AREA SEP. RATED: STUR: HT: ft GARAGE: Sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS _ _ REQUIRED F1 COR LOAD: psf LEFT. ft RGHT: ft FIR SPKL: Y SMOK DET:Y DWELLING UNITS: FRNT: ft REAR: ft FIR ,AI_RM : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 5,500.00 Remarks: Tenant improvement, remove sorne interior walls and reconstruct corridor wall Owner: Contractor: EOP LINCOLN, LLC C SCHIEWE &ASSOCIATES INC 10260 SW GREENBURG RD 1024 NE DAVIS ST SUITE # 10n0 n 7 PORTLAND,OR 97232 P rTnle N5t73 J49Z Phone: 503-234-6617 Reg #: LIC 54105 FEES REQUIRED INSPECTIONS _ �M Type By Date Amount Receipt Framing Insp PRMT CTR 5/14/02 $100.90 27200200000 Insulation Insp Gyp Bc•ard Insp 5PCT CTR 5/14/02 $8.07 27200200000 Susp C:eling Insp PLCK CTR 5/14/02 M.59 27200200000 Final I ispection FIRE CTR 5/14/02 $40.36 27200200000 Total i $244.92 his permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire it work is not started within 180 days of issuance, or if worts is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-6699 or 1-800-332-2344. Permit tee Signature: Issued By: j Call 639-4175 by 7 p.m. for ar. inspection the next business day Building Permit Application "Dateived:511 d Permit no.: City of Tigard Address: 13125 SW Hall Blvd,'I Igaid, t)It 117221 ProJecUappl.no.: edate: CirynfTlgarJ phone: (503) 639-4171 Date issued: B eceiptno.: Fax: (503) 598-1960 Case file no.: 7ayment type: Land use approval: 1&2 family:Simple Complex: U I & 2 lamily dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Additioi/alteration/replacement U Tenant improvement O Fire sprinkler/alann U Other: — JONSITE INFORMATION Job address: 10UC) SW Grc+eh6L) o e Bldg.no.:Tow6 Suite no.: 9503 Lot: Block. Subdivision: Tax map/tax lot/account no.: Project name: en -t: ate ( Description and location of work on premises/special conditions: Tenant ­> NO !2 ANCoN �Nt'S P !E MIT 4� Name: ENUITY GFFI eE NRoDER-TIES ' Mailing address: l0240 J GIXE&J114O P-0 SUITC- loo l &2 family' dwelling: City: po(LTLPYJ0 State:o(t ZIP: 97223 Valuation of work........................................ $ Phone5os $92-150o Fax: I E-mail: No.of bedrooms/baths................................. Owner's representative: PAY rt.. GLuP Gay Arent tech' Inc Total number of floors................................. Phone5b*5 224.1%5Cp Fax: IF-mail: New dwelling area(sq.ft.) .......................... _ Garage/carport area(sq. ft.)......................... Name: GBD P-rch�teA-r,Jne Covered porch area(sq.R.) ......................... Deck area(sq.ft.) Mailing address: 920 SW 3-rd avenue Seri fir �00 """"' - City: port I a State:p ZIP: oj720Other structure area(s .ft.)......................... Gommerclal/indu.,4trlrl/multi-family:. Phone5o3 224-9� FaK l' mail: y .. $ S t70 00 Valuation of work...................................... _-- Existing bldg.area sq. ft. .......................... S die e (. ) Business name: G. w ("7777 f New bldg.area(sq. ft.) ................................ Address: 102,1- Nlel Urav i r ; 't. City: �Ckt- ay.d --- - State: ZIP: 97'Z32Number of stories............................ ...........-to(o17 Fux: E-mail: Tyle of construction.................................... ZP� - Occupancy group(s): Existing: b CCB no.: 5+105 _ New: d City/metro lic.no.: Notice:All contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to he licensed in Ute -- - �- i-trisdiction where work is being performed. If the applicant is Address: - — -- - - ---- -- exempt from licensing,the following reason applies: City: Cntact person: _ Stag: oZIP: Flan no.: Phone: I ,t. F-mail: -- Name: unlet person: Fees due upon application ........................... $ Address: Date received: City: State: ZIP: Amount received ........................................ $ Phone: Fax: Email: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cauda,please call jurisdiction for more infMaut"on. attached checklist.All provisions of laws and ordinances governing this U Visa U MestrrCard work will be complied with,whether specified herein or not. Credit card rrUmte, Authorized signature: YZDate: 5.4-07.-d2 Name of c►.&-aider u aho m on credit card — Print name: P-av (t`. G _ _ cwdrd.rer aijnaiure S Amount t — Notice:This permit application expires if a permit is not obtained within 180 days after it has').-en accepted as complete. 410.4613(b+ WOM) Commercial Plan Submittal Requirement Matrix City of Tigard TYPE OF SUBMITTAL. I # of Plans (Includes New, Additions or Alterations) —� Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 9 Building Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 E'.ectrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements. Submit 2 sets of plans. **"New" fire protection systems require that plans bear the original sea! of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i'\dsts\forms\coM-matrix.doc 9/24/01 NOW ON \\ N \ Kit; � 11 ,/ tool A\�\\_ \ 1 ilii= �� �r1�� �ii • FA11 OCR Ma ` I ...► '•,;111 w '\ \ It ._- CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line- (503) 639-4171 LAM--- PM -- . BUPReceived -Date Requested - BUP Location Z 2- —Suite _L _ _ MEC Conta-.t Person — Ph ) C PLM Contractor Ph(--) _ _ SWR BUILDING Tenant/Owner -_--_ _ -__ ELC ---- ----- -------- - Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Beam - ---- -- ------ -- - Shear Anchors Ext Sheath/Shear - Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler -- - Fire Alarm ' Susp'd Ceiling — - Roof Other: Final PASS PART FAIL PLUMBING ----------- Post&Beam _ Under Slab -- Rough-In Water Service Canitary Sewer Rain Drains - Catch Basin/Manhole Storm Drain -- — - Showor Pan Other: FWAVIPART FAILCAL _ Post& Beam Rough-In Gas Line Smoke Dampen Final PASS PART FAIL -- --—-'--- — - _ELECTRICAL Service Rough-In UG/Slab Low Voltage ^--^-,—_-- Fire Alarm Final Reinspection fee of$_.._ —.__._.required before next Inspection, Pay at City Hall 13125 SW Hall Blvd. _PASS_ PART FAIL_ SITE_ —_ Please call for reinspection RE: _ F Unable to inspect-no access Fire Supply Line ADA Approech/8ldewalk Dotes_ i1_ _ Inspector _ __._ Ext Other: Final D NOT REMOVE this Inspection record from the job site. PASS PART FAIL / CITY OF T I G A R DEL.ECTRICAL�PERMII PERMIT#: ELC2 002-00262 DEVELOPMENT SER%. . ,-"ES DATE ISSUED: 6/12/02 13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 950 SUBDIVISION: LINCOLN TOWERJOWN OF METZGER ZONING: C-P BLOCK: LOT : 014 JURISDICTION: "FIG Proiect Description: Install branch circuits. (2) __RESIDENTIAL UNIT TEMP SR_VC/FEEDERS _ MISCELLANEOUS 100x1 SF OR LES'i: 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+amps - 1000 volts: MINOR LABEL (10): _ SERVICE/FEEDER _ BRANCH CIRCUITS — ADD'L INSPECTIONS___ 0 200 amp: W/SERVICE OR FEEDER: PER INSFECTICN: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 600 amp: EA iAOD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: _ _ _ PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: �> 600 VOLT NOMINAL.__ Reconnect only:_.__ - SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: EOP LINCOLN, LLC CAPITOL ELECTRIC CO INC 10260 SW GRE ENBURG RD 12810 NE AIRPORT WAY SUITE # 100 UNIT 1 POR(LAND, OR 97223 PORTLAND, OR 97230 Phone: 892-2500 Phone: 255-9488 Reg #: LIC 048748 SUP 31325 ELE 26-496C FEES _ Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 6/12/02 $53.50 2720020000( Rough-in Elect'I Final F,PCT GTR 6/12/02 $4.28 2720020000( Total $57.78 This Pe-lit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specially Codes and all other applicable laws. All work will be done in accordance with approved pians. This permit will expire if work is not started within 180 days of issuance,or it 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 952-001-0010 through OAR 95"-001-0080. You may obtain copies of these rules or direct questions to OUNC at(503 2468699 or 1800-332-2344 Permit Signature: Issued By: L _/�'Z.[dd�" _ _ OWNER INSTALLATION ONLY +_ The instillation is being made on properly I own which is riot intended for sale, lease or rent. OWNER'S SIGNATURE: DATE:_ �r CONTRACTOR INSTALLATION ONLY S! SIGNATURE OF SUPR. ELEC'N: )Iq c-Lq X?z _ -_------- DA i E:- _---- -------------- LICENSE NO: Call 1539 4175 by i:UUpm for an inspection the next business day i-O Electrical Permit Application ' nl nate received: I'crnut nu.: / Project/appl.no.: Expire dale: City of Tigard Date issued: R Recellw nrr. CITY Of TICAPD liddress: 131125S%% IIAI.I.IILVI II]GA12D,Olt 97223 Cast file ro: Payment type: Mimic: 03)639-4171 Fax(503)598-1960 ].and use approval: ❑ I &2 family dewlling or accessory C'ontmercial/industrial C] Multi-family ❑ 'Fenton improvement New constructionD L-,k Vru ❑ Addition/alteration/rcpfacentcnl ❑ Other: ❑ partial Juh adtfres,,: SW GREENBURG RD _ ( ON: TIGARD Bldg.No.: Suite n 960 'Fax neap/tax lot/account no 'ol: lr lilrrl Nr;1 tiuhditisiun: Project rat SUITE 950(DEMO) Description and location of work on premises: ELECTRICAL DEMO IN SUIT.:950 I"I' utied dm:of ctanple(ion/ins lection 7/1/02 — —�--� �— Joh nu: 22-744 tee +t.r.. Business NameCapitol Electric Co.,Inc. Dexcri ntiun Oly. len.) t,t.d no.insp Address: 12810 NE Airport Way New residential-single or nndti fnrnih per City: Portland Stale: OR ZIP: 97230-1029 dwelling unit. Includes attnched garage. Phone: 503.255-0488 lFax 257-7121 E-mail: darrea¢Zcepds con; Service Included: ('('B no.: 48748 lilec,bus.lic.no: 26-496C 1000 sq,11,or less $ 145.15 City/metro lic.no.: NIA Each additional 500 sq it or portion theicol ti 1.1,41) 8/8/02 Linoiled energy residential y 75.00 Sign supervising electrician(required) Date (,halted energy,non-iesidentinl 4S oo Sup vial name(pr int) Derrell McNee/ License no.. 3132-8 Each tnunullicitlred home or modular dwelling Service andho iceder ........ 7(pr Services or rceders-)nshdfathm, alteration or relocnliou: State: /.il': 200amps or less 5 80.30 2 1'3x: E-Illail: 201 amps to 400 apps , 11161-1 2 Owner invlalh.rh to: 7 he installntien is being made on property I own '101 maps to r100 nmps + u,o r,n 2 which is not inten led For sale,lease,rent.or exchange according to fill mops to 1000 nmps v w 2 ORS 447,445,479,670. 701. Over 1000 amps or volts t W, 1 2 (inner'. alnre; Dale: Reconnect only s x< I Temporary services or feeders- Name: Installrtion,alterations,or relocation: Address: _ 200 nmps or less 4q,xs City: Stale - 7.1 P: 201 loops to 400 amps v pltotte: P:tx I -nuu1: 4111 maps to 600 maps Branch circuits-new,niteralion, ❑Service aver 225 nnrps•conmtercial C]I Iellhll-cale lei h" or extensloo per pnnel: O Service over 120 props-rating of I&_ E3 tiarardous luvmino A Ere for branch circuits wish purchnse of fatally d%clliiig% ❑Building over 100 t square Itfour or service or feeder Ice,each bt,.ach circuit (]System over wto volts nononni more residential or its lit rine stnicture B Fee for branch circuits without purchase ❑lholding over Jtree stories u Feeders,41xl mnps or more m wrvice or Iceder fee,first branch circuit. I;Ich additional haunch circuit -- I�--_- _---� E3Occopattt mall over t9 persaar O Mmu,factures sinrcuucs or RV 11n,k ❑fprewliphting plan d rater: xlisc.(Ser%ice or feeder not Included): tiuhndt is or plans%%Ilh any of the nbove. Each pump or irrigation circle a 53.4o 2 he above are not nppficabfe In temporary construction service._ Bach sign or outline lighting 33411 _ 2 Signal circ-tit(s)urn limited energy panel. nitcraliun ui cVrnti�n" 1, 75,Un 'Dewoploltl I ach additional inspectiu.nover th allowable in any otthc above Per inspection + ' Investigation f'cc 101her _ Q Visn ❑ MasterCard Permit fee........... .... 1 53.50 uiedu cad number _ Notice.this permit application Plat review ( I 1 _ expires If a permit is not obtained Slate Surcharge 806 ► 'f. 4.28 Nome.d nnlholile,as rhmvn on credit card within 180 days after P has been S 9 Y 1'r1I'A1................... S 57.78_ Cardholder signature Anamnr accepted as complete. CITY OF TIGAR D 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 - -� SUP _— Received _ —Date Requested1 -���U Z` AM oPMMr� BLIP Location _��G $w ��«h e,'% y� -Suite—z� MEC _ Contact Person Ph(--) r — X73 PLM — Contractor__ �lf Ph(— ) SWR —.—� BUILDING Tenant/Owner ___— ELC _el ell Z(L ELC Foundetion Access: — Fig Drain ELR Crawl Drain Slab Inspection Notes. SIT Post&Beam Shear Anchors -- --- Ext She Oh/Shear Int Sheath/Shear Framing — -- — insulation Drywall Nailing - -- - - - - Firewall Fire Sprinkler --- — — Fire Alarm Susp'd Ceiling ------ �--, Roof Other: Final ----------------- - = PASS PART_ FAIL PLUMBING — Post&Beam Under Slab Rough-In Water Water Service -- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain -- -- —- — Shower Pan Other. - -- --- Fins) --- -------- PASS PART_ FAIL MECHANICAL. — Post& Beam Rough-In Gas Line Smoke Dampers Final PASS T FAIL -- ---....__._---_.. -------------- C---T -n UG/Slab Low Voltage Alarm [ Reinspection fee of$--_ _required before next Inspection. Pay at City Hall, 13125 SW Nall Blvd. S PART FAIL SITE [1 Please call for reinspection RE: — —__ Ej Unable to Inspect-no access Fire Supply Line ADAExt ,r f�,_i-1 _ Approach/Sidewalk Other: DOW —� Inspector ��/�� Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITYOF T!GARD PLUMBING PERMIT _ DEVELOPMENT SERVICES PERMIT#: PLM2002-00339 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/29/02 PARCEL: 1 S 135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 950 SUBDIVISION: LINCOLN TOWEr:-TOWN OF METZGER ZONING: C-P LOT: 014 -__ JURISDICTION: TIG _ CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES- TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURE;;: TUBISHOWERS: SE1 rER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Fixture replacement. 1 primer. 1 sink, 1 water heater. _— _ FEES Owner: -- -- — Type By Date Amount Receipt EOP LINCOLN, LLC PRM1 CTR 8/29/02 $72.50 2.7200200000 10260 SW GREENBURG f 5PCT CTR 8/29/02 $5.80 27200200000 SUITE # 100 -- -- -- PORTLAND, OR 97223 Total $78.30 Phone 1: 892-2.500 Contractor: POWER PLUMBING CC PO BOX 23144 TIGARD, OR 97281 REQUIRED INSPECTIONS Phone 1: 244-1900 Final Inspection Reg #: LIU b23fd PLM 34-150PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is Suspended for more than 180 days. ATTENTION: Oregon law requires you to `rollow rules adopted by the Oregon Utility Notification Center. -Chose 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 GUNC by calling (503) 246-1987. Issued By: yl�), �1i7 '�.`� �. -----_ Permittee Signature: '%1 f". / ' Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business bay MIG :_''1 2110' H: 461`1M HP I FASIlkJLT 32[1[1 P. 1 Plumnbmg-Permit Application ' Palno Ci of Tigif'r`l 3`Y Sewer permit no: Building permit ao.: Address:13125 SW Hall Blvd,Tigard,OR 977.23 -- CityofTigard phone: (503) 6394171 I'n,;ctiappl.no.: Expire date:_! AUG '2 7 2002 - ; �• Fax: (503) 598-1960 Dale issued: By: Rcrciptrw.i CIL I UY 1 iUAXD Case file no. -- - Payment type: -- Land use approval: r U 1 iRt 2 family dwelling or accessory C]1;7ommercialhndustrial ❑Multi family Tenant imp.nvernent a U Nca construction �2<Vdition/alu-ration/replacement LI FcxA setvic e l l 0—flier:_ 1 � ]oh address: � �J _Desac�on -� - Qty l�ee(ea.) Total Alb no.: Suite,uu.: New 1-and 2-family deellings only: 8 _I'y�- -- (includes 100 ft.for each udWyconnection) TAX map/tax lot/ancount no.: � SFR(1)bath Lot: Block: Subniivision: SPR(Z)bath _project name: � SFR(3)bath -_ - --- City/countyr ZIP: �'1 l.1 Isachaddition�6at1�/kitchen�� L?tscn'ption and kxaliqfi of work on premises: Citetati --- - -- - Catch basin asin/i area drain j Drywclls/leach linc/trtnch drain F-A,date of c.nnpletionhnspection: I'll., Footing drain(no. lin ft) - Manufactured home utilities HuSinebB name: fl Manholes -- Address: 1 q / Rain&iin connector - -- Uty; State: ,Z Sanitary sewer(nm lin M) Pllone.,;_[1 - Fax: lFrmall: Startu sewer(no.lin.ft-) - CCB no.: Plunnh.hus rrg.no. - Water service(no. n.ft) - � - - Flxtcre or Rem: City/nietro lic.no.: L am_ rA'nso tion valve _ Contractor's tuprosentativo signatt"u; B (low reventer - -- --- Ptintbate "U Iiackwatar valve — -- asins/lay.atory Name: Clothes wcsher = Q 1�.�1 — Dishwasher - - -- Address: lhitticrng fountaln(a) - -- - - -- City: _ State r- Zh': �'7.].�3 H'lxton/sum Phone - Fax: &-mail: parson tank - _^ Fix3txetsewer cap Name(print)- Ijarhrooi -- -Mailingaddrewil: [� �� Hosebi b 66I � 4_ State: ZIP: 9 Ice maker ---- _ -- Phone: - flob Iax &mail: Interce toorease trap pwner iltstallntion/rrsidanial maintenance only: The actual imallation Primer(s) will be made by me or the maintenance and mpa;r made by my rerilar _oof drain commeminl) _ employee on the property I own as per ORS Chapter 447, Sink(s), esin(tt), ays(s) owne-, signature: •--_-- Suntn bsho Urinalteshower pan - _ - Nalur: Water closet Addteas: J _ - Y Water ter City: - State. _ 7dI': - er. Phone: Fax: �_&mai.: otal - - Minimum(cc................S _! L 7' 5 f�- Na al jwIsdirar.aw=M teed'rods,please cAi 1 fm amee inrwn=anNotice:This permit application Visa UMasrerCud Man review(at _96) $ U _—_ expires lie permit t�not obtained no C.+•dlr acrd aumbcr ---�-.L - within 180 days after it has brr- Stale surcharge(8%) S �- plm accepted as r-omplete. TOTA I. .......................S - -- —team d�det u �,�wo ro N cu s – e olderitpwuee �— — �iawmr 100.4010 MAG/Com 9 �4 h sink 16.60 lavatory ---- -T6.60 On© 1 barb .r $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath _,'_ $350.0 - $399.00 x6.60 — Three 3j bath - _ Water Closal 16.60 - SUBTOTAL -lJnnal y 16.60,- eX STATE SURCHARGE pl,�rvaslu�r - --16.60 PLAN R[V1EW 25X_OF SUBTOTAL ?` TOTAL s "� Galtxagn Disposal 16.60 �:•., q_ --_.. I Laundry tray`::fit+✓ 41 , IG.Bur, Washir g Machine 16.60 Floor UraitbTloor Sink r 16'80 PLEASE COMPLETE`` 3 16 --- .80 16.60 -- 1 Water Heater O Conversion O like kind 16.80 �i y Gas 01pin0 roqukos a separate mechanical Sink MFG Home New Water SorAce 'b� - �� Lavato MFG Homo New SaryStorm Sevrror Tub or Tub/Shower . t lose Bibs ---- -16—60 - Roor Uralns - 6. Show ` Shower -- - 16 80 Water Closet t)riNting Fountain. Urinal_ _ Other f Muree(Specify) - �J 16.60 Otsltwashor — .,� Garbage Disposal- < -y11r -. Laundry Room ira L_ _-_ _--- - Washing y -- Floor DraiNSlnk: 2' _ Al Sower-1sl 100' �J- —- 55.00 �• -- - Sower-each 46.40 additional 100' - - - 55.00 - Water Heater °'' " ervice Water S -16t 100' - tither Fixtures ,A WaMa+ ter Se -esch eddttlorW 200'-- 46.40 SttxS GG Rain Drain•.1x1100' 55.00 _ T" ;-'uL- 1 r Storm&Rain Drain-sadi addtdonal 100' - 46.40 -i Cexnmwrcial Bade Flow Preventlon Devito- 46.40 - Residential Backflow Prevendat l7ovke' 27.55 _ - tatdi Hasin 16.60 -— -72.50 japer tion of Existing Plumbing or Spodally Iv rueInspedbns COMMENTS REGARDING mindJl00VE: w.l — 6525 L�- -- - -- I.jAfn t)raln•tskigle family dwelllg -_-_----_ '- ----. .--- — Grsaao Traps ---- - QUANTITY TOTAL ---- Isometric:or reser diagram Is required M k; ---- -- ---ousouty Talal Is >9 *S!IBTOTAL .' 8%STATE SURCHARGE. ----__ -_-------- -- ---- 5,a lJ -------------— -- - - ;'-1;7FXN REVIEW 25%OF SUBTOTAL ' liequlrod only if redurs cs..WWI If>9 �t ryry — TOTAL 'Nlntrrtmr permit lee b X72 SC r DX dale surclurrQe,sxnept Roslrinrlual tleddbw nrovorNtrn nevlce,which M$3`5 25•8%$tete 81rd'9" All New CommerClsl aulldinps require ptnns w!h isornel'Ic a riser dlagrom anA plan revkxw i:rdsts\forT71nWm•fee9,doc 10/10/00