Permit 411k CITY OF TIGARD
,, DEVELOPMENT SERVICES BUILDING PERMIT
" I t; I PERMIT #
1 BUP98 -0162
"� 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 04 / 6 / 98
PARCEL: 1S136DA -00100
SITE ADDRESS...: 11308 SW 68TH PKWY
SUBDIVISION • ZONING:MUE
BLOCK • LOT JURISDICTION:TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION —
CLASS OF WORK.:ALT FIRST • 7925 sf N: S: E: W:
TYPE OF USE...:COM SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF C0NST.:3N .... 0 sf N: S: E: W:
OCCUPANCY GRP.:B TOTAL 7925 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 96 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD • 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL:Y SMOK DET..:Y
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:Y HNDICP ACC:Y
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 90000
Remarks : Providence Health Systems - Tenant improvement to construct office
walls, repair ceilings. An electrical, mechanical, fire alarm and sprinkler permit
are required.
Owner: FEES
BENENSON CAPITAL CO type amount by date recpt
708 3RD AVE PRMT $ 403.00 DLH 04/16/98 98- 304987
NEW YORK NY 10017 5PCT $ 20.15 DLH 04/16/98 98- 304987
PLCK $ 261.95 DLH 04/16/98 98- 304987
Phone #: 212- 867 -0990 FIRE $ 161.20 DLH 04/16/98 98- 304987
Contractor:
IN LINE COMMERCIAL CONSTRUCTIO
PO BOX 5837
ALOHA OR 97006
Phone #: 642 -5117 $ 846.30 TOTAL
Reg #..: 51880
-- REQUIRED ACTIONS or INSPECTIONS--- -
This permit is issued subject to the regulations contained in the Framing Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gyp Board Insp
applicable laws. All work will be done in accordance with S u s p C e i i n g Insp
approved plans. This permit will expire if work is not started `/NA-_ /,v.,"
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 952-081 -0010 through OAR 952 -N101987.
You many obtain a copy of these rules or direct questions to OUNC
by calling (503)246 -1987.
/9 r /ON e0M/`1 eN7S //V L' L 44-6 6
/V 'QE'1/472KS S ri an! /9f397/E
Permittee Signature:.SEr fh /C Issued By:
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + ++
, CITYOFTIGARD
�w� „,,. ,� DEVELOPMENT SERVICES BUILDING PERMIT
M,I I PERMIT #.... ..: BUP98 -0162
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED. 04 / 16 / 98
PARCEL: 136DA -00100
SITE ADDRESS...: 11308 SW 68TH PKWY
SUBDIVISION • ZONING• UE
BLOCK . LOT JURIS► CTION :TIG
REISSUE: FLOOR AREAS EXTE••OR WALL CONSTRUCTION —
CLASS OF WORK.:ALT FIRST • 7925 sf N: S: E: W:
TYPE OF USE...:COM SECOND...: 0 sf P'ITECT OPENINGS?
TYPE OF CONST.:3N ...: 0 sf S: E: W:
OCCUPANCY GRP.:B TOTAL 7925 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 96 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD • 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL:Y SMOK DET.. :Y
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:Y HNDICP ACC :Y
BEDRMS: 0 BATHS: 0 IMP SURFACE: r: PRO CORR: PARKING: 0
VALUE. $ : 90000
Remarks: Providence Health Systems - Tenant improvement to constr• t office
walls, repair ceilings.
Owner: FEES
BENENSON CAPITAL CO type amount by date recpt
708 3RD AVE PRMT $ 403.00 DLH 04/16/98 98- 304987
NEW YORK NY 10017 5PCT $ 20.15 DLH 04/16/98 98- 304987
PLCK $ 261.95 DLH 04/16/98 98- 304987
Phone #: 212 - 867 -0990 FIRE $ 161.20 DLH 04/16/98 98- 304987
Contractor:
IN LINE COMMERCIAL CONSTRUCTIO
PO BOX 5837
ALOHA OR 97006
Phone #: 642 -5117 $ 846.30 TOTAL
Reg #..: 51880
-- REQUIRED ACTIONS or INSPECTIONS--- -
This permit is issued subject to the re, lations contained in the Framing Insp
Tigard Nunicipal Code, State of Ore. .ecialty Codes and all other Gyp Board Insp
applicable laws. All work will be „ ne in accordance with Su s p Ce i l n g Insp
approved plans. This permit will xpire if work is not started
within 1 :% days of issuance, or ' work is suspended for more
than 180 days. ATTENTION: Ore..n law requires you to follow the
rules adopted by the Oregon ) ility Notification Center. Those
rules are set forth in OAR ' 401-0010 through OAR 952- 00101987.
You many obtain a copy of hese rules or direct questions to OIJNC
by calling 15031246 -198
Permittee Signature: L,U` ‘∎ Issued By: _
+ + + + + + + + + + + + + + + + + + + + + + + ++ ++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + ++
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: ( 574— 7 @ X P.M. MST:
Location: 1130? Sit) 6 8 lit c !I BUP: W-0/6 cg,
Tenant: Suite: Bldg: MEC:
Contractor ,63/\ /Lei - jiA. )' 0 1L. Phone: 51 q - 397 7 / PLM:
Owner: Phone: it 870- 0 7 6 ELC:
G ELR:
-
SIT:
BUILDIN con't) PLUMBING 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 Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer 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 Crawl/Found Dr Heat Pump Low Volt
A. • . ved Approved Approved Approved Approved
Appr /Sdwlk `". ved Not Approved Not Approved Not Approved Not Approved
1 .__Ar FINAL FINAL FINAL FINAL
rt.g.Te 514
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ZL9- 0/3f 51W
Sit tca 100153 new 6ctittrentile8 tA
61 T` —alp 7 5 7/V ,./
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`i . , � -G106 pi/ 519 -3q 7D
15tleg-L:NO Spwidde(i/O.ke t &wk Fri i. a AA) 285- (855' .
ca 4 uC ' 'Q 6
? $ + 1 dU o- - livA- SY,w- nv oUJ'., ./,
'als r / F " , .e ° -' Cam - ... :.
Ourci8 -Dog pi, , eiti 0/- 3 TIO 9 Dg,&!.n-Povoie.. c 34 -9TO
0 Call for rein :: 0 Reinspection fee of $ requir before ext ' lion O Unable to inspect
/ .!
Inspector:/ Date: L Page of
OVER - THE - COUNTER (OTC). PERMIT PLAN REVIEW
J Z n COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: 7..
- T . rd n J f' rK f_ 7 0 J4 c l 1.... 1/J re
( / it/ r .
W /+ f lee frtla 4 7,1 ee,?� ,' «, I yerr'.e a in H n•• A n f r,t'A- pe .-.,, a ).- if
CLASS OF WORK: 4 L t FLOOR AREAS: 743 1..r
„ r EXTERIOR WALL CONSTRUCTION
TYPE OF USE: e!, Pry FIRST • SQ. FT. N: S: E: W:
TYPE OF
CONSTR: 3 —A/ SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: /3 THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: 99 TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
1
STOR: HT: FT: BSMNT: SQ. FT. i AREA SEP. RATED:
BSMNT ?: MEZZ ?: GARAGE: SQ. FT. t OCCU.SEP.RATED:
FIRE FIRE / SMOKE At HANDICAP
SPRINKLER: ALARM: ✓ DETECTOR: ACCESS: k" ----
COMMERCIAL INSPECTION ACTIONS FEE MENU . .I
Foot/Found Post/Beam !3 / L '' $ 1 403 Permit Fee
95
Masonry L Framing QuPPz-n/ $ 2t I Plan Review
Insulation Shear Wall 77¢7 $ A0 5% State Surcharge
Firewall ✓ Gyp Board F L S $ /L / y � 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
Miscellaneous 1 / Final $ 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)
I:lovrcntr2.doc (DST) 4/97
dITY OF TIGARD Commercial Building Permit k I Rec'd By .)L
Recd Mr:
13125-IN �A% HALL BLVD. Tenant Improvement Q 0 S Date Date
' TIGARD, OR 97223 i,,. 4 1
Date to DST
(503) 639 -4171 mu 7 Permit # auPV D/6 .2-,
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Buiidin , New Building ❑ '
Job Prot/1401(z_ 71i 464 1'1 i
Address Street Address suite Building
11308 SW 68 ar �,,I Data �fi�.e �vr I /1 vks
Bldg # City /State Zip / . Existing Use of Building or Property:
Tr evil k OR 0 ,� ;
Name ANW 40 4...4 re pit Proposed Use of Building or Property:
Property >th OW". Cpii - 41 6 .
Owner Mailing Address Suite
FOR 3 o1 t1V>r No. Of Stories: ..-
City /State Zip Phone
hy. w Go 0 17 2/2 - 8a7. 4 q�f D Sq. Ft. Of Project:
Occupant Nate,: / 'J 1'5 - � .
Prbv RN /C4ry frw,, cie/um Occupancy Class(es)
Name J U
Contractor Li , 1.01 (p A /VW. he g"' • Type(s) of Construction
Prior to permit Mailing Address Suite 3 N
issuance, a copy p� o Will this project have a Fire Suppression System?
of all licenses f • 0 , 1 OX ra 3 7 Yes' No ❑
are required if City /State Zip Phon
expired in C.O.T. �^1 �JSO Americans with Disabilities Act (ADA)
database /��6 O R R 7 �2 _ S�f •� Valuation X 25% = $ 2 Z05 0 Participation
Oregon Cor(t. Cont. Board Lic.# Exp. Date Complete Accessibility Form / /Wit 15 CQw p &t
5' 1 8Ao /I•/3 • Project $
Name Valuation 1 0 00 0
Architect &oltrJo`, Abwwski 64rt {G LS Plans Required: See Matrix for number of sets to submit
Mailing Address Suite
T on back
11o5' Se 1 J' 84,4. SvifeLa
City /State Zip Phon1# co I hereby acknowledge that I have read this application, that the information
b� L,i4 11 t1 r � - 2;1`• ? 3 7 7 given is correct, that I am the owner or authorized agent of the owner, and
7 T '"J that plans submitted are in compliance with Oregon State Laws.
Engineer Name
.f Own- -A• -nt Date
Mailing Address Suite / A. 1 11-. r 14 • - p
Cont- VILA& Perrsoo ' F Phone
City /State Zip Phone / In-c PGl L wr so?) 2 - 7 ;71
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition 0 MapfTL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration /s/ 3661 -6./.6r
Repair 0 Other O Notes:
Description of work:
TIF:
�~
Parks: Estimated # of Employees �f )'i 4-- 6,../ I / 1 d i . i
Note: Site Work Permit Application must precede or accompany Building
Permit Application
I: \COMNEW.DOC (DST) 8/97
t
t
•
COMMERCIAL PLAN SUBMITTAL
.........:....
REQUIREMENT MATRIX •
Su 'di' P n eve is :<de :. ;ndent.0 ' : ' : su b • • ` o f: r
su trad>
ea , : pp c a t , o n ... F < an : electrca€I submnitta heta .lhcaUo u .......
::.:::..: :::.::::::?::::::::.. �::::::...........::...,.:... �:::..:......: ... ........... : : : : : :.. : :. : : : : : : : :. �.t: : : :. : :..PP..... u: �? t.c :::....:::.:,.::::::: .
Q • :tic :; ;• :G'i : +:
g � : ...: ,..c�rfstEt .. e trt cu�nv : far. :e <: n:< :reY�$v� : :: •.. :::.. . ..::::>:::> : : : :
.: . : :... : :. : : :. :. : : :.. :. :.;.. :... �. .. : : : , pi ..r�ud€�cte�c�,. : : : : ' . .
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 (N-s?.w 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 - - 2(j,o) -
B & M & P (New or Add.) 2 1 1 - 3 (j,o,w) 2(j,o) -
E (New, Add, or Alt) 2 - - 2 -- - 20
B & M& P& E (New, Add) 3 1 1 1 3(j,o,w) 20,0) 2 0,0)
R . . .. .: �tjr�, :........ :..:: •....................... .. . ;. ::.....:::... POW .........MM.:..........:::: fr::YM......... n....: : .rx. i; . : i +•'iii :: _:i:4: ?i iiiii': :. : iii > : :,'.lii;ir F.•::: :
-: � ;? �i �; iY!,... A1• F. : : : : : : : : :. :..y : : : :• : : : : : : : : :: :•.vv :: v::. � :viii ^,� .. n ................... ..... .. ........... : :. +.• : : : :: {•;,...n. .r.� v. .� : :: v v:.::: . - .... x:.... ..: r':: . �.
: : :r.v........ v:: •:: ........v...n ...............::. r..... w:: x:: .. �•::::: :. -..... {•. : :: ... ......... r......... E : : .. f.
....:::.:....:::..::::.:.:
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»:;:eyes ��':� :i : % : : : <• -.
f ,
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: • :nom : :: v. .: : :. ... : : : : �' -. .: w:::; : w.; � : : : :n +• :•.v.:. ..... ice : : : : :.� :: n......
... -. & . �. Art . ..r ........ ........ . : : :. : :.i : :? :...:.:. r::.::: : : : :.. : : :i : : : :i i : : : : r : : : :. : : .
NOTES: KEY:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and o = Office M = MEC
completes, updates and adds actions. f = Fire P = PLM
. : : : : :. : : :.;. :. : : :. : :; :.; :. ' ?.; ::•?.;::..:.:::.;.::::?:.:?:;:;::..;..:..:.:::>::;?::.»:<:>::>;>::::.>:.:;:.:.::.: : :<- '.�.; :.; >; :;.� » > : ? :.; :< > : :: :iii >; : ?� : : . : :.
u SA E ELC
t �<:Shad = -
:a as °des n t > ' : : : : ::
.. a .ALT�� :��xbttal`ss :;: � :� : < • -� : <;; > : >< > » : > : : : > > < : :>
.... . i. �..:.......::.:..:.:...:.:::;?;.:::::' �??::.. �::::.:: �::.,:?:.:;.:,:::::<:::::.:<?:??:.:::;:,::: �::?;>.?::::::«± ���# K.: i.: �::::> «; :• :.; :. :;., : : : :. : : > : : : : : 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
cal;,ulations.
I: matrix.Doc
(;.,,
...!.....
PagQ fo. 1 CASE HISTORY FOR CASE NO.: UP98 -0162
t ANDERSON DABROWSKI ARCH ECTS
11308 SW 68TH PKWY
07/30/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
BUPC005 Application received / / / / 04/16/98 RECD DLH 04/16/98 DLH
BUPC008 Permit created / / / / 04/16/98 DONE DLH 04/16/98 DLH
BUPC012 Plans routed to Plans Examiner / / / / 04/16/98 SENT DLH 04/16/98 DLH
BUPCO26 Approved Plans routed to DSTs / / / / 04/16/98 APPR JHF 04/16/98 DLH
BUPC100 (F) Issue permit / / / / 04/16/98 DONE DLH 04/16/98 DLH
BUPC520 Mechanical Permit Required 05/14/98 / / / / HAS 05/22/98 J *H
BUPC530 Electrical Permit Required 05/14/98 / / / / HAS 06/17/98 J *H
BUPC540 Sprinkler Permit Required 05/14/98 / / / / HAS 06/17/98 J *H
BUPC550 Fire Alarm Permit Required 05/14/98 / / / / NEED 06/17/98 J *H
I3UPC740 Framing Insp / / / / 04/21/98 PASS TLP 04/22/98 J *H
BUPC760 Gyp Board Insp / / / / 04/21/98 PASS TLP 04/22/98 J *H
BUPC762 Susp Ceilng Insp / / / / 05/20/98 PASS TLP 05/22/98 J *H
BUPC802 Final Inspection / / / / 05/20/98 PASS TLP 05/22/98 J *H
D3 L-fi 4
., ___1:6
Yte �/�
I IG
\ b .
Page No. 1 CASE HISTORY FOR CASE NO.: BUP98 -0162
ANDERSON DABROWSKI ARCHITECTS
11308 SW 68TH PKWY
08/11/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
BUPC005 Application received / / / / 04/16/98 RECD DLH 04/16/98 DLH
BUPO008 Permit created / / / / 04/16/98 DONE DLH 04/16/98 DLH
BUPC012 Plans routed to Plans Examiner / / / / 04/16/98 SENT DLH 04/16/98 DLH
BUPCO26 Approved Plans routed to DSTs / / / / 04/16/98 APPR JHF 04/16/98 DLH
BUPC100 (F) Issue permit / / / / 04/16/98 DONE DLH 04/16/98 DLH
BUPC520 Mechanical Permit Required 05/14/98 / / / / HAS 05/22/98 J *H
BUPC530 Electrical Permit Required 05/14/98 / / / / HAS 06/17/98 J *H
BUPC540 Sprinkler Permit Required 05/14/98 / / / / HAS 06/17/98 J *H
BUPC550 Fire Alarm Permit Required 05/14/98 / / / / NEED 06/17/98 J *H
3UPC740 Framing Insp / / / / 04/21/98 PASS TLP 04/22/98 J *H
BUPC760 Gyp Board Insp / / / / 04/21/98 PASS TLP 04/22/98 J *H
BUPC762 Susp Ceilng Insp / / / / 05/20/98 PASS TLP 05/22/98 J *H
BUPC802 Final Inspection / / / / 05/20/98 C/O APPROVAL TO JILL 7/30/98 PASS TLP 07/30/98 JT
BUPC950 (F) Issue Cert. of Occupancy / / / / 05/20/98 08/11/98 JT