Permit F
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00402
0hki DEVELOPMENT SERVICES DATE ISSUED: 09/10/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114D0 -00101
SITE ADDRESS: 17005 SW 92ND AVE
SUBDIVISION: COOK PARK ° ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: 1,600 sf N: S: E: W:
TYPE OF USE: COM SECOND: 1,440 sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: A3 TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 106 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: BATHS: • IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 156,561.00
Remarks: Gazebo and Picnic Shelter - Gazebo having a square footage of 1600, the Picnic Shelter having a square footage
of 1440. All Inspections complted by Special Inspection.
Owner: Contractor:
CITY OF TIGARD ROBERT GRAY PARTNERS INC
13125 SW HALL BLVD PO BOX 1016
TIGARD, OR 97223 SHERWOOD, OR 97140
Phone: 244 -5322 Phone: 692 -4675
Reg #: LIC 000654
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Foot/Found lnsp
PRMT BON 09/10/199c. $575.50 99- 318242 Reinf Steel lnsp
Framing lnsp
5PCT BON 09/10/199 $28.78 99- 318242 Final Inspection
PLCK BON 09/10/1995 $374.08 99- 318242
FIRE BON 09/10/199c, $230.20 99- 318242 ORIGINAL
(additional fees not listed here)
Total $1,458.56
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 rm itee
Signature:
Issued By: 6. /14.01, g u 1 ---
Call 639 -4175 by 7 p.m. for an inspection the next business day
CI r Plan Check #
TY " . r GARD m
Comercla�l BuildingPerm�,it Application
13125:8 HALL BLVD. •' • N;ew Construction and Additi Recd By
- Date Reed
TICARD; O'R'- _97223'
/t Date to.P.E. 4 /1101401.
`(5 639 -4171, 0/ Date to DST q hta t
Print or Type Permit # �uPDOdo
Incomplete or illegible applications will not be accepted Related sWR# ?i
Called_ • Narne'of DeJeloprrment/Projec
Job , Tl4Aeb Co Yk , -
.. Existing z B u i l'd i n g p N ew B
Address ., .Street:Address, _ - Suite
yyy �
, 1 L r N2 .
. :: 7o ' � S(,J f a ` ) Building • , • _ .,, '
Bld # � C ity /State. Zip „�� ��a't1 ', i, •
( � 3 Existing Use: of Building or Property'. h
a
. Name I ,
-` �-� 6 r 'w
Property Li or 1 n ), _. 4 '
M ailing A • ress S uite ' Proposed Use of Building or Prone �y . .
Owner 9 .. rh!
i3la: �- 111 �J f � � h , �A
Gty /State Zip Ph o ne 1 1 U (ti �U �O- ®�? {' ,�
97 3 No Of Ston ` - " •
' r 4 .� �:: p Ok bag V r „; _
Occupant Nam
' . . .Sq , f Of Project y
Name' ; OCcupan Clss(
Co,ntra "r � ,2A ('- T rok'S ,iJG ,
Prior -to e . 'Mailin Address 1,
04. . Sui " �s i^ _
P_ Mailing
_ ��� - � T_ +• e �s of Construe ion �r
issuance.�a co ( � 9 Yp (�
of all keenses ' I � . � _ 0 , ', , 1 °Dl� ���p °i �%f f�
are required if City /State Zip .Phone • • . WII' this project 'have aTFire SUp�presslon +tSystem?
expired-in C.O.T. , . 77/ Yes b ' No -
database h6 I . - i 4, '631- p a 171 Americans - Disablhties Act (
Oregon Cont. Cont., 'Board L+c: #� Exp: Date .
Valuation X. 25 % _ $ �PartUcipatiom
CG6 -° 4.57. � O Co m p le te Acces si b illt yA F orm
Name I 1 " Projec ; - $
Architect f i ' , valuation
Mail+ng.,Address � , ' ,
*foe e Plans. Required . • See Matrix for number of sets to submit ,,
City /State. `- Zip Phone 1 on ;back t. ,,
Na me
ineer "
En
g., ( I here6y,acknowledge,that hav application that the information ;
!ti O4 � h1 . ? L/ given is_ correct that 1 am the owner or authorized agentof"the owner and : -
5” that.plans submitted are ip c ompliance with Oregon State :.Laws:
Mailing Addres u
s .rL: •Suite
1O - ,Sin u
�' 1' �_ S 9 , of OwneP /Ag Date
Ci /State. Zip Phone ` • +I `'
gY b • �' '' ?2� Cori ct Perso Name ?+ Phone -
Indicate type•of work: New Addition 'O' Demolition O , - � ' e f`-" 60 P:04;,,,..';' ' rP T �7 (4 X _ J , +`.
ti;, Accessory Structure 0 Fou el ation Only O. Alteration 0 i? i
Repair o other 0 FOR OFFICE USE ONLY
Descript'on of ork: / � 1 , i
6 iJ �' 2r " / a�+zc Map -' �v Yn +� ,Land, Use P, � 7,. [
P ic,4i'4- tie : t - -/Z No•te: M .: �' Q ,.i, , _, 7 „-' ,;,
Parks: 'Estimated:-# of Employees
'1.- r 1_' , " yu - , r a;,
If the above figure is not supplied at the time of application, the city will
calculate the fee based upon the numberof parking spaces. ����
s
Note: Site Work Permit Application must precede or accompany Building P ✓!`- T c / 1
Permit Application p � t � "„,:
i,,
i:Adsts \forms \comnew.doc 5/10/99
j aw
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
fg otaii§:::Ais.40::*00.1.4PLETEDIE
tigtottlir0::::OUthe*VetvIsteig.:0000d100
Aftor:::Olort review apiorpoloRa tit Etarnif.ler:.
TYPE OF SUBMITTAL Plans KEY:
Submitted
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 =
B & M (New or Add) 1 P = Plunlbing
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 & 'E 3 Alt = Alte Existing
(Nev,v ., Acid) .
• Building
.... ........ . ................
......... • ... ..
•
NOTES:
" • ..... "•-..""":::":....::.::::::::.""
••
I:\dsts\forms\matrxcom.doc 10/30/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP /Y57
Date Requested 7'/16/ g AM PM BLD
Location / 7e-' S `� Z- / G Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING r Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
•
Ftg Drain
Crawl Drain Inspection Note :
SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing /./ ,,��► _iv t mac, t
Insulation J �
Drywall Nailing , /);/& , /);/& �t � .�..�.np�ati��=-
Firewall J 7
Fire Sprinkler 06/2.4/1"coo7,„tz.../..2_
Fire Alarm
Susp'd Ceiling
Roof f / y
Misc: 1 _! - - •
Final
PASS PART FAIL ...� _ � -.� � ./
PLUMBING`
Post & Beam .► �-r _ �_
Under Slab
Top Out ,�/
Water Service �,,�� �,� c ,� rod. `/
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 7
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 for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other ? Date / /C) ~ / p
? Inspector ,/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
10/7/99 Activities for Case #: BUP1999 -00402 •
2:27:29 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPC008 Permit created • 9/10/99 BON DONE No Hold BON 9/10/99 Directed by written notice
(e -mail) from Sherman Casper
to create permit this date.
BUPCO24 Plans Approved by CPE 9/10/99 RDP DONE No Hold RDP 9/10/99
BUPCO22 Plans Approved /Routed to DSTs 9/10/99 RDP DONE No Hold RDP 9/10/99
BUPC705 Foot/Found Insp 9/10/99 9/10/99 9/10/99 RDP DONE No Hold RDP 9/10/99
BUPC716 Reinf Steel Insp 9/10/99 9/10/99 9/10/99 RDP DONE No Hold RDP 9/10/99
BUPC740 Framing Insp 9/10/99 9/10/99 9/10/99 RDP DONE No Hold RDP 9/10/99
BUPC802 Final Inspection 9/10/99 9/10/99 9/10/99 RDP DONE No Hold RDP 9/10/99 Letter from Special Inspector
dated 9/10/99 states all work
competed with scope of the
project design, drawings and
specification. A temporary
Occupancy is authorized for a
period of 60 days, pending final
approval of Site drainage
permit.
BUPCO29 DST Post Review Completed 9/10/99 BON DONE No Hold BON 9/10/99
BUPC090 (F) Ready to issue 9/10/99 BON DONE No Hold BON 9/10/99
BUPC100 (F) Issue permit 9/10/99 BON DONE No Hold BON 9/10/99
BUPC792 Misc. Inspection 9/12/99 9/12/99 9/10/99 GS PASS No Hold . AKJ 9/12/99 This structure was built without
permits or inspections from this
department.
At the request of Jim Hendryx, I
performed a fire /life safety
inspection on the structure after
completion.
The structure appears to be
structurally sound, access
appears to be good.
BUPA950 Case Finaled 9/15/99 JMT DONE No Hold JMT 9/15/99
•
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