Permit CITY R ,. r ; DEVELO R f G1
L,so ' �SSUED: 20/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 63 PARCEL: 2S110CD -07600
SITE ADDRESS: 15655 SW 116TH AVE
SUBDIVISION: KING CITY NO. 2 /4090 ZONING:
BLOCK: LOT: JURISDICTION: KIN
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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 : HNDICP ACC:
BEDRMS: „, IMP SURFACE: PRO CORR: PARKING:
VALUE: ScC
Remarks: Repair structural damage done by automobile.
Owner: Contractor:
TOBIAS INVESTMENT CO SUMMIT CONSTRUCTION
300 SE SPOKANE ST PO BOX 10345
PORTLAND, OR 97202 PORTLAND, OR 97210
Phone: Phone: 223 -9703
Reg #: LIC 000632
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT DST 5/20/99 $38.50 99- 315548 Misc. Inspection
PLCK DST 5/20/99 $25.03 99- 315548
FIRE DST 5/20/99 $15.40 99- 315548
5PCT DST 5/20/99 $1.93 99- 315548
Total $80.86
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.
Permitee ,
Signature: _ L-,-- L-,-- �/ /
Issued By: - --
t
Call 639 -4175 by 7 p.m. for an inspection the next business day
ITY OF TIGARD Commercial Building Permit Application Recd By 2b P
3125 SW HALL BLVD. Tenant Improvement Date Recd 5 - ?f
TIGARD, OR 97223 „C 5 - j?
r( J
(503) 639 -4171 G r 0I Q Date to P Date to DS I T
Permit*
Print or Type Related SWR
Incomplete or illegible applications will not be accepted Called 51
Name of Development/Project Existing Building "New Building ❑
Job 1 ' (e 5
Address Street Address ! / 1 Suite Building
1 5 (5 5 Data
Bldg it City /State Zip Existing Use of Building or Property:
I NY CN , 11 Z -- -rS--.l.-.
Name �/? �ST/�l
4 /° - 7 1 F� 00 Proposed Use of Building or Property:
Property S
Owner Mailing Address Suite F
-//� 500 k4 -tl/Z- 5% No. Of Stories: 1
1 ty /State Zip Phone l
F rLiD o 9 7,02— Sq. Ft. Of Project:
Occupant Name
_-%LC Occupancy Class(es)
Name -
Contractor wt vii I i 671.t. 5 - Type(s) of Construction
Prior to permit Mailing Address Suite
issuance, a copy p c::) + 1D--9A-5 Will this project have a Fire Suppression System?
of all licenses Yes ❑ No u
are required if City /State Zip Phone Americans with Disabilities Act ADA
expired in C.O.T. ' �Cs - RTL 0 ,1 Z� ' 3 -� t7 ( )
database l (p V aluation X 25% _ $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
( ' 3 4 9 G/2)000 Project $ 2 c
Name Valuation
Architect L 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
that plans submitted are in compliance with Oregon State Laws.
Engineer Name
t/ Signature of Owner /Agen Date I
Mailing Address Suite • %earn' .`' c t (
Con ct Person Na e Phone
City /State Zip Phone 9 7:23-976'5
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 Other 0 Notes:
Description of wo /�� , - r\
ft \ �J n V6AA6\3 l ' (1W " TIF:
/ r�
&uAIL
Note: Site Work Permit Application must precede or accompany Building
Permit Application
I: \COMNEWTI.DOC (DST) 5/98
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
.. : :.:.:. .
lbitReVI** t± :0 00fit Ot!Ok t i t:la 'p TH 1ar s:A D s >O
pp::: >:: >:: >::> .... � Por a� eleotncal aubmit the appticatt>an �'#'���t €rr
ignat r of tt a su .e rvisi .. electric n before ;let' rev ll: co ducted:: >::
After plan review approval;: flans Examiner will con applicant to reque
additiona plan sets far distribution urpose� (Copy fa Contractor, City
l Tashi gton County. Tualatin Malley Fire & Rescue}
Total #of
�l�itTTJ�►� ............., f'�ens KEY:
rn�tted
S (Private) 1 S = Site Work
B (New or Add) 1 B = Building
F (New or Add or Alt) 3 F = Fire Protection System
M (New or Add or Alt) 1 M = Mechanical
B & M (New or Add) 1 P = Plumbing
P (New, Add, or Alt) 2 E = Electrical
B & M & P (New or Add) 2 New = New Building
E (New, Add, or Alt) 2 Add = Addition
B & F & M & P & E 3 Alt = Alternation to Existing
(New , Add) Building
*BorB &M(Alt) 1
*B &M &P(Alt) 3
&JI & P &F(Alt) •
.......
B &M &P+ E&Fr$It 3
sf
NOTES:
.W T.
:.. ::
�`���. d....�� ....ate....... "�....bl.�#.S.
y �
I:\dsts \forms\rnatrxcom.doc 10/30/98
' OVER - THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: e . 77Z4,44t444(., t 1 -
CLASS OF WORK: T' FLOOR AREAS: ' � EXTERIOR WALL CONSTRUCTION
TYPE OF USE: C,6 rr) I FIRST SQ. FT. N: S: E: W:
TYPE OF
CONSTR: SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: Al THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: ---------- TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
STOR: HT: FT: : BSMNT: SQ. FT. i AREA SEP. RATED:
I I
BSMNT ?: MEZZ ?: i GARAGE: SQ. FT. i OCCU.SEP.RATED:
I I
FIRE FIRE SMOKE HANDICAP
SPRINKLER: ALARM: DETECTOR: ACCESS:
COMMERCIAL INSPECTION ACTIONS FEE MENU
Foot/Found Post/Beam $ ;xS t Permit Fee
Masonry Ing in $ 1.6 Plan Review
Insulation Shear Wall $ 1 5% State Surcharge
•
Firewall Gyp Board 9 $ FLS Plan Review
Suspended Ceiling Sprinkler Rough -in $ Add'I Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS Pln
Smoke Detector Approach /Sidewalk $ Inspection
Miscell s 6 $ MIS Fee
W II So(/ tt 2A 5O '41fid
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)
I: \ovrcntr2.doc (DST) 4/97
4
411 KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
r Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete. legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: /! JO_ / I Ls, ,i _ ii Id , ,I „ � e .. ,7
located at: 15655 - 45605 , SAJ / /(Q f't'
King City Representativ
I DSTSKCINST DOC
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Ca I u w CITY OF TiGAh�D
„ �� ............... ...............................
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Approved..
7 Conditionally App roved ..........................I
i.
Fw a d escribe s
PERMIT or only NO. the = 1::
•
See Letter t o: Follow .................... I ; .
3�� -� Job Adcsress:�o!✓ , � IN� �f
J �L r�ra R c)', -
•
6/8/00 Activities for Case #: BUP1999 -00205
2:46:34 PM trp /R�
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPC005 Application received 5/19/99 RDP RECD No Hold DRA 5/19/99
BUPC008 Permit created 5/19/99 DRA DONE No Hold DRA 5/19/99
BUPC010 Check for prcl. restrict. No Hold DRA 5/19/99 Planning approval letter from
Kimg City is attached to
application.
BUPCO24 Plans Approved by CPE 5/19/99 RDP DONE No Hold DRA 5/19/99
BUPCO29 DST Post Review Completed 5/19/99 DRA DONE No Hold DRA 5/19/99
BUPC090 (F) Ready to issue 5/19/99 DRA DONE No Hold DRA 5/19/99
BUPC740 Framing lnsp 5/19/99 5/19/99 No Hold DRA 5/19/99
BUPC792 Misc. Inspection 5/19/99 5/19/99 No Hold DRA 5/19/99 Under soffitt inspection.
BUPC100 (F) Issue permit 5/20/99 GEO PASS No Hold DST 5/20/99
BUPA865 Request inspection research 3/23/00 JMT DONE No Hold JMT 3/23/00
BUPC160 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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