Permit ' A BUILDING PERMIT
CITY TIGARD PERMIT #: BUP1999 -00494
00 DEVELOPMENT SERVICES DATE ISSUED: 11/22/1999
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S113AD -01900
SITE ADDRESS: 16640 SW 72ND AVE B -10
SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING: I -L
BLOCK: LOT: 009 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: 5N : 390 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 4 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 10,000.00
Remarks: Commercial TI
Owner: Contractor:
PACIFIC REALTY H L GREEN
15350 SW SEQUOIA PKWY #300 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300 BB 22
Phone: Tlone: ( aZ4 7Tgg ORIGINAL
Reg #: LIC 41328
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT KJP 11/22/199£ $124.00 99- 319951 Gyp Board Insp
Susp Ceilng Insp
PLCK KJP 11/22/199£ $80.60 99- 319951 Final Inspection
5PCT KJP 11/22/1990 $9.92 99- 319951
FIRE KJP 11/22/199£ $49.60 99- 319951
Total $264.12
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not 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 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 -1987.
Pe nn itee
Signature: it / .� / 7 , ARV .`
Issued By: /
Call 639 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Reed By
•
13125 SW HALL BLVD. Tenant Improvement Date Recd 41t ttl lit'
TIGARD, OR 97223 err- fdiA) Date to P.E.
p
Date to osT //h/A/4942
(503) 639 -4171 1' nIP.' Permit* &U.A 1 sq q -
Print or Type Related SWR # A* 40
Incomplete or illegible applications will not be accepted Called l ihtti99 tP 3: it
(Le c-oro-
Name of Development/Project � Existing Building, New Building 0
Job ,,,/ 4 V 25( .57/1/ -5- '
Address Street Address Suite Building
aeA' (514/ 7 AVO Data
B dg # City /State Zip Existing Use of Building or Property:
5 i 10 T G /siw o/? f7 o - � i .r/Ufif�G
Name ��
Property PACIFIC REALTY ASSOCIATES, L.P. Proposed Use
�/J�11l� of Building or Property:
Owner Mailing Address Suite ce,
15350 SW SEQUOIA PKWY 300 No. Of Stones: /
City /State Zip Phone
PORTLAND, OR 97224 624 -6300 Sq. Ft. Of Proje ct �� � �
Occupant Name
p/2.c NG Z,A/ /ter`7/t Occupancy Class(es)
Name / 23
Contractor H. L. GREEN COMPANY Type(s) of Cogs�tru pn
Prior to permit Mailing Address Suite fL /�/
issuance, a copy Will this project have a Fire Suppression System?
of all licenses 15350 SW SEQUOIA PKWY 300
Yes M No p
are required if City/State Zip Phone Americans with Disabilities Act '
expired in C.O.T.
database PORTLAND, OR 97224 624 -7717 Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
41328 / i / Z000 Project $ ,p�-�
Name Valuation /) (/vv.,
Architect JOHN H. ROMISH Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
2216 SE 24TH AVE. .
City /State Zip Phone I hereby acknowledge that I have read this application, that the information
PORTLAND, OR 97224 236 -6306 given is correct, that I am the owner or authorized agent of the owner, and
Engineer Name
that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent Date
Mailing Address Suite / /� / i/7/P
f i
Con act Perso am Phone
City /State Zip Phone / /� ��7 /Q�'�
FOR OFFICE USE ONLY �J !` ¢�!/
Indicate type of work: New 0 Addition 0 Demolition 0 Map/TL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration
Repair 0 Other O Notes:
Description of work: '/ / L'
dm zw_O /y/ 9l, ./ �G -✓ TIF:
/A/ X/ /,r/ s
Parks: Estimated # f Employees
Note: Site Work Permit Application must precede or accompany Building
Permit Application
I: \COMNEW.DOC (DST) 8/97
Activities for C #: BUP1999-00494 P,11„e/CeVi-'(--61Y1
2/23/2001 Case 004 -- , ,
8:38:45 AM
/6 go 72 d
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes 5j ---J o
BUPC005 Application received 11/18/1999 DRA RECD No Hold KJP 11/19/1999
BUPC008 Permit created 11/19/1999 KJP DONE No Hold KJP 11/19/1999
BUPC740 Framing Insp 11/19/1999 11/19/1999 11/24/1999 TLP DONE No Hold TLP 11/24/1999
BUPC760 Gyp Board Insp 11/19/1999 11/19/1999 11/24/1999 TLP DONE No Hold TLP 11/24/1999
BUPC799 Final Inspection 12/10/1999 TLP PASS No Hold TLP 12/13/1999
BUPC090 (F) Ready to issue 11/19/1999 KJP DONE No Hold KJP 11/19/1999
-
BUPCO29 DST Post Review Completed 11/22/1999 KJP DONE No Hold KJP 11/22/1999
BUPC100 (F) Issue permit 11/22/1999 KJP DONE No Hold KJP 11/2 999
BUPC070 HOLD for (note in activity) 12/17/1999 JMT DONE No Hold JMT 1 1 17/1999 hold CIO until TLP confirms ok
to process. Is this T.I. related to
Bup1999- 00455.
Also Mec1999- 00454,
e1c1999- 00626,
Bup1999- 00467(fps)
iti/ _.rie / 4/1. : #6/ e v....._ r i4..41)
0 e ---7 . P ----- rrn 7
i — V uil° 49 19 6141 q •
,',_ (-(V 1110.-• ,•••
frill /.. 4 ? i. 199
=. . V7 Tri>13/1""eAl
/ 17 I 1 ger
.,76 ,
i
, 44
Ir
Page 1 of 1
i
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE 1 1 -- -- 3 (j,o,u) -- --
B (New or Add) 1 1 -- -- 3 (j,o,w) -- --
F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f)
M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- --
B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- --
P (New, Add. or Alt) 2 -- 2 -- -- 20,0) --
B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) —
E New, Add, or Alt) 2 -- -- 2 -- -- 20,0)
B & M & P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o)
. ...................:......
.. ......................
::::::::. .
......... .
::::::::: .
..:........
.... ..:.:.......................:.. ....
r�' �<: kY, Y'':. ��.: �: �': :::' � i;::. ��: ����:>:: �: � i` i2Si c' i<`' i;' s' �» j> o�; �c''' ':.•. �y?' '_� >is�i > <'i�'2��) > ? ` >>t �
� » i <a ?�asir >< i�' 2<' �<> ; >i > s ` t: ` ' . : " <: >' ' � ? ' : <
::::.: :::.:.:::::::: . £ ,Alt .;;:: .:.::.:..�.:::::.::::::.::.:.:. 3 I ::.::.;:.;::.;::.;:. I 2 :;:::. >. :::.::.:l; . o ::<.::.. a ..:.
NOTES: - KEY:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M = MEC
updates and adds actions. f = Fire P = PLM
u =USA E =ELC
..:.........................................;;::.:;:::;;:.:.:_:.;;;;;;:;:.;:::;::.;:::;.mogQ.:;:: y.::.;::;.;;;;;;:.;:.;;;:.;::.;;::.;;:.; :.;:.;:.;;:.::.;:.:;.;::.:::.;: w = Wash. County F = FPS
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
h:Vmatric.Doc
A
OVER- THE - COUNTER (OTC) PERMIT PLAN REVIE
COMMERCIAL (STRUCTURAL) BUILDING PERMI
DESCRIPTION OF PROJECT: T 1
CLASS OF WORK: Adz FLOOR AREAS: 310 EXTERIOR WALL CONSTRUCTION
TYPE OK USE: FIRST SQ. FT. N: S: E: W:
TYPE OF
CONSTR SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: e THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: ® TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
STOR: HT: FT: BSMNT: SQ. FT. AREA SEP. RATED:
BSMNT ?: MEZZ ?: GARAGE: SQ. FT. OCCU.SEP.RATED:
FIRE FIRE SMOKE HANDICAP
SPRINKLER: ALARM: DETECTOR: ACCESS:
I COMMERCIAL INSPECTION ACTIONS I � FE � E MENU I
Foot/Found Post/Beam $ 1241' Permit Fee
Masonry r- ing $ c g e Plan Review
Insulation Shear Wall $ 1g State Surcharge
Firewall - ' p :oard $ 4 FLS Plan Review
Su .ended Ceili _ Sprinkler Rough -in $ Add'I Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS Pin
Smoke Detector Approach /Sidewalk $ Inspection
Miscellaneous 4.11123P $ MIS Fee
FOR OFFICE USE ONLY:
TYPE OS USE OPTIONS (COM= commercial; CMS= commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW=new; Add= addition; ALT = alteration; ACS= accessory;FND- foundation;
OTR= other, DEM= demolition; REP—repair; FPS=fire protection system, NOTE: USE OTR FOR FENCES, RETAINING
WALLS, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
hovrcntr2.doc (DST) 9/99 -
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 171q
Date Requested 1 /e7 AM PM BLD
Location (`P('E 0 SW 7D -2'` Suite 13- ME i�/
Contact Person GC-9 L 143 L- CO CK-� Ph 357 c-S3f' PLM vir
Contractor l , Ph SWR
BUILDING Tenant/Owner ere S(Cl� l YL CP ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Insmetion Notes:
Slab r (D7'yv call SO kt-ec,v. tam SIT
Post & Beam t)criA LJ eF ! t5 40
Ext Sheath /Shear
10* %/ r
all Nailing `�
Fire Sprinkler 1
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PART FAIL
PL ' = ING
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
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
Fire Supply Line [ ] Please call f reinspection RE: [ ] Unable to inspect - no access
ADA '�J
Approach /Sidewalk Date v Inspector YO Ext
Other
Final
PASS PART FAIL D NOT REMOVE t is inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP /q/ /57) '7 5°
Date Requested /4 AM / PM BLD
Location l (P 6o //f `t) S 7a Suite MEC
Contact Person lkfL �1 L &' ✓ - — Ph 35' 0 Cat PLM
Contrz star [ Ph SWR
iL1111 4)I•r4 Tenant/Owner Pre 6 15/ L �4. e(e.dyl ( ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Ins s�ee ction Noes:
Slab U A SC. Notes:, p4o 50 L. e sic y SIT
Post & Beam �, , - 1
Ext Sheath/Shear //w e 5C: r (/61 "f '
Int Sheath/Shear
Framing
Insulation •
Drywall Nailing •
Firewall
Fire Sprinkler
Fire Alarm .
Susp'd Ceiling
Roof
S ART FAIL
Pt B NG
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
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
BackfilllGrading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA E Y
Approach/Sidewalk
Other � D 1 21/0/ Inspector V Ext
Other
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.