Permit 4' .41,,, CITY OF TIGARD
21061, DEVELOPMENT SERVICES SEWER CONNECTION
'-1-- � 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 PERMIT #PERMIT . SWR97 -0335
DATE ISSUED: 10/07/97
PARCEL: 2S11EDC -01500
SITE ADDRESS...: 15655 SW 74TH AVE #BLD
SUBDIVISION :FANNO CREEK ACRE TRACTS ZONING: I —P
BLOCK LOT °004 JURISDICTION: TIG
TENANT NAME -74TH AVE INDUSTRIAL PARK
USA NO FIXTURE UNITS...: 33
CLASS OF WORK...:NEW DWELLING UNITS..:
TYPE OF USE •COM NO. OF BUILDINGS: 1
INSTALL TYPE °LTPSWR IMPERV SURFACE: 0 sf
Remarks: Add sewer connection to new proposed 5,760 sq. ft. warehouse.
Owner: FEES
JIM CASTILE type amount by date recpt
8100 SW DURHAM ROAD PRMT $ 4400.00 JDA 10/07/97 97-299844
TIGARD OR 97223 INSP $ 75.00 JDA 10/07/97 97- 299843
Phone #:
Contractor:
OWNER
Phone #: $ 4475.00 TOTAL
Reg #.. .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit 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 from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer° Permit and the Agency will install a lateral.
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 952- 0001 -0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
Issued by: Permittee Signature: / ,
r
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ ++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
c rr QF`TIGARD Commercial Building Permit Recd By
13125 SW HALL BLVD. Tenant Improvement Date Recd iO . `!
TIGARD, OR 97223 Date to P.E.
Date to DST
(503) 6394171 Permit # i7f 97- 6 335
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Building ❑ New Building ❑
Job
Address Street Address Suite Building
4 Data
Bldg # City/State Zip Existing Use of Building or Property:
Name
Property
Proposed Use of Building or Property:
Owner Mailing Address Suite
• No. Of Stories:
City/State Zip Phone
Sq. Ft. Of Project:
Occupant Name
Occupancy Class(es)
Name
Contractor Type(s) of Construction
Prior to permit Mailing Address Suite
issuance, a copy Will this project have a Fire Suppression System?
of all licenses Yes ❑ No ❑
are required if City/State Zip Phone Americans with Disabilities Act (ADA) in C.O.T. ( )
database Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
Project $
Name Valuation
Architect Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
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
Contact Person Name Phone
City/State Zip Phone
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition O Map/TL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 Notes:
Description of work:
((( rks: Estimated # of Employees _6-362\
J J
Parks:
a
Note: Site Work Permit Application must precede or accompany Building
Permit Application
•
I:\COMNEW.DOC (DST) 8/97
OIVIMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Applicant DSTs to Plans Examin ;. Plans Examiner to DSTs
I r.'tial No. Plans required to complete
1 ns Routi i__ (processing (see note a.)
Submi ed
TYPE OF SUBMITTAL '1 ` CPE '' PE EPE CPE PPE EPE
SITE<>> ''? >'> 1 -- -- -- --
3 (j,o,u)
B ew or Add) >` > >«<>> -- -- -- --
(N ) 3 (j,o,w)
F ew or Add or Alt. >< >' >` > ><<>'> 3 -- --
(I`l ) 3 (j,o,f)
M (New or Add. or Alt) '` 1 -- -- 2 (j ,o) -- --
B & M (New or Add) `'' >:? >< 1 -- 3 (j,o,w) -- --
P ew Add. or Alt) -- 2 -- -- --
, 2'0
,
B & M & P (New or Add.) > » <::> ><: >< `< > < < 1 1 -- 3 (j,o,w) 2(j,o) --
E (New, Add, or Alt) <` <<<'> -- -- 2
B &M &P &E ew Add) Cl`l ) 3 (j,o,w) 2 (j,o) 2 (j,o)
B or B & M (Alt) -- -- -- --
( ) 2 G,o)
B & M & P (Alt) -- --
B &M &P &EAlt 2
NOTES: KEY
a. The applicant 11 be requested to submit the correct number of j = Job B = BUP
revised plan• when all plan review issues have been resolved. o = Office M = MEC
f =Fire P =PLm
,.. <. ...1 , c Ed arias destgrtates lm0al sttbrn1ttal requt0ments ,: > ,:,: ;: ,,: ;. u = USA E = ELC
w
-7 `l n Ad s`' w n _u l ative Sewer Tally
This S
Tenant Name: f }lJ'e .Lt/YJl Tr may,, �� WR# ' -6 3 � 1
Address:ISt/SS- SW - 7 � + 4 - � } �p , This PLM#: - � �
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New •
# , Value Capped off value added # added #s total
1 , Count off #s count value values
Baptistry/Font 4 1\1\ I. v
•
Bath - Tub/Shower 4
- JacuzzilWhirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink - 2 inch 2
-3inch 5
- 4 inch 6
_ - Car Wash Dm 6
Garbage Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) • 32 .
_- Industrial (over 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Rec. Vehicle Dump Station 16 .
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar /Lavatory 2 3 C„ j ( --
- Bradley 5
r ,
- Commercial 3
3 _,, ._
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6 _3 , 5 j(,.
Urinal 6
TOTALS i ) -
Total fixture values: - , - ) divided by 16 = - ' ? EDU ! G L- - / . 1:,- ( - S C C^ J� - -
HISTORY
PLM# A � -f?�NEDU# SWR# PLM# EDU# SWR#
PLM# l ' EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
i:\dsts\swrtaly.doc
� CITY OF TIGARD BUILDING INSPECTION DIVISION
k ‘ 24 -Hour Inspection L 639 -4175 Business Phone: 639 -4171
Date Requested: AO -/3 -q7,. A.M. P.M. MST:
Co Location: 15 t 5- -g(A) a`-A-€._- BUP:
Tenant: imdadlid Pao, n 7 � Y' T Suite: Bldg: MEC:
Contractor: / yn r..,nt( �, Phone: t!7 3 ?S GM. PLM:
Owner: Phone: 3/ C ta— ELC:
_// ' i .�/71.0, /_ _ 1 Cis ' _ /,,,,,,. .,rr , 1 s I ELR:
#eZ `C 'cif ' _ V skt 7 -0335
BUILDING BLDG (con't) PLUMBIN MECHANICAL ELECTRICAL SITE
_Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing •. Gas Line Rough -In UG Sprinkler
Foundation Insulation f.�� Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Craw ound Dr Heat Pump Low Volt
Approved Approved Approved p proved
Appr /Sdwlk Not Approved of Approved Not Approved Not Approved Not Approved
FINAL .7 FINAL FINAL FINAL FINAL
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_____________
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O Call f. R O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: f Date: Page of