Permit s Isullalllg Y41'mit Application :: FQR, OFFICE USE ONLY
Received Building
Date/By: y— — / 6 1 I S Permit No.:,,ta J 9 , -O. I
City of Tigard Planning Approval Other
13125 SW Hall Blvd. ; Date/By: Permit No.:
Tigard, Oregon 97223 Date/By: Permit No.: Plan Review Other
Phone: 503- 639 -4171 Fax: 5 9 6 i RECEIVER* '� Date/By: Case No. lt Post- Review Land Use
Internet: www.ci.tigard "or "us A "' �` (
2LO / I
24 -hour Inspection Request: (4' �6 9> -4? ARD Contact Juris.: u Sec Page l for
BUILDING DIVISION Name /Method: Supplemental Info Nat /
` `TYPE OF' WORK .. New construction .
REQUIRED DATA:
❑ D emo l ition 1 &.2 'FAMILY DWELLING
❑ Addition /alteration /replaceme ❑ Other:
"CATEGORY•OF CONSTRUCTION' > Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling X CommerclaUlndustrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for e ork'�;,�r ix : ted o his a^
❑ Accessory Building ❑ Multi - Family
ip
n Master Builder El Other: Valuation . ,�`.
JOB: SITE INFORMA.: $
TIQN `: _ No o f b e d rooms: No of baths:
Job site address: Total number of floors
Suite #: I Bldg: /Apt - #: New dwelling area (sq. ft.)
Project Name: Garage/carport area (sq. ft.)
rn /'9�,� '/ Covered porch area (sq. ft.)
. Cross street/Directions to job site: Deck area (sq. ft.)
W k / .R /'7 E/L ' Other structure area (sq. ft.)
ef 4 560 9 S S.4 -.. :.
; . ': AREQUIRED DAT:4: - -
Subdivision: I Lot #: d`,%% 7 " - e-it'` - QIVIMERCIAL'= IUSE'CHECKe1si: . ' .
Tax map /parcel #: / S 1.3.5 — �}C° 0 � ...,:.,, :.. .- .., . ; •:
W eb Note: Permit fees* are based on the total value of the work performed. lndicat:
', ` :' ' ' ' 'DESCRIPTION:OF'WO ''` "- ;i the value (rounded to the nearest dollar) of all equipment, materials, labor,
e/-1 P/ZW4( overhead and profit for the work indicated on this application.
i� ii .S ll iJ
Fre. Lo<• ') f T evl v\ di Valuation $ `ic -0la
0 im, ( I - , , S Existing building area (sq. ft.) 1
New building area (sq. ft.)
Number of stories
TY;QWhT ER; g:_:: `. 5 :., << ..:
PROPER q ,T;- TENANT: ; :: , �; i;: :gati "3: Type of construction
Name: d� eriG/J f!4 /JS Occupancy group(s): Existing:
Address: 76e 7 s <-4,) a 9 74 ,vir-- New: \
City /State /Zip: 77E; - ' - 9 7.6707,3 Phone: f ax NOTICE: All contractors and subcontractors are required to be
_''- 'CONTACT�P'ER.SO ,, licensed with the Oregon Construction Contractors Board under
Business Name: of ORS 701 and may be required to be licensed in the
� ��,� / /"f s SA/G jurisdiction where work is being performed. If the applicant is exempt
Contact Name: / ,.p rrtz ,tr' —[c. from licensing, the following reason applies:
Address: /,,,?_7 lyt, a47 sr
City /State /Zip: 1i.-,4M C paw pis 9d'66,,;
Phone:-?(20- i06 75 7 Fax: 3 > — I 1� 6 •e. ,i,/.2_
•- ° 'i:s;,;: - �±w.'�,t -y �:t r .v:?';'4'[".yYV -:` �1wyi, _' .`. .^£ii;"_ " }" - :.r.':
E-mail: 5' f �G�� c ems = s : �i�:� atu,ILDINGI?ERMITaFE tNvia :'r
w7 E .
_ &._ Q CS ' , te a,. x s ��� c�. <1 3. f a""''s � ^ 4,_`;• ^� - e.r'.;>-r:. 1 .r �,� x �.n�` ^ 7.y;s..,:a, ": ::.�';.
���,rkr �i?;r�'. - -:aria °...��;,.. -err �`,�' $ �:�2:.:'�`a.. ���.. "�t r:�'. -air, �z,cs?i.�S:,:��ait atrs .c.£�`, ,�,yx�irt`��i ^' r: <.a.-
.,.. ,,.r. :- i.�.�..",.�.� `•i. r r =:�r:: . J.a `�'AY'.s4,'�: • - ,$ "fx�. r'� „�,,/...w3'_. PI x -
""_ - .: it .GONT 5 -, w,- , ::r.V :' ti;: , . . ,,.. - ,. ease:refer to'gfee:sch'ed $:: ,,< :
.. RA. CT; OR �LL� .��:.:�}���w'����*��'��.:.t.,- �.�E ��;�wn:.= � � - : iz :. st ..ule.,, ,f
Business Name: anima 0 —��
- Address: / 3'7 Cc/ 1 3 Fees due upon application
City /State /Zip: Lc” . / i 6v-e__ c17 e-te",„/— Amount received $
Phone;5 - 9 / -3. y- o l<74 Fax: _gr 4v5---4 Vt(4- Date received:
CCB Lic. #: e) 5 ‘,-
Authorized
Signature: �i'��_ Dater Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete"
.�-- ar7 /' G .J1 j ?/C --
(Please print name) *Fee methodology set by Tri- County Building Industry Service Board.
i:\Dsts\Permit Forms \BldgPermitApp•doc 01/03 Exhibit 0
Page /f of
a - ..)-.. Pages
(`, FILE COPY
A Commercial Application Checklist
C WED
.. - .I�'_��! City of Tigard
UE
City of Tigard 13125 SW Hall Blvd., Tigard, OR 97223 APR 0 4 2003
Phone: (503) 639 -4171, Fax: (503) 598 -1960 IG
T�RU
CITY OF
Internet address: www.ci.tigard.or.us BUILDING OF T I ARD
PROJECT INFORMATION
Project name: fvt S Date: y 10 3
Address: City: State: diZ ZIP:
Scope of work: oirti jfWti4sj FR=P_v,0,1/4.,/ 69 r „ feel o •
Reference no.: Map and tax - no.: 1?-:) 1 ‘3S -c _ 9 00
Contact person name: �� v� Company: t 64 a
Phone: (360 C406 _093 ei Fax: (3o) q06 ty`it v
Cellular phone: Sc' 5 51 3 j 9 E -mail: 7; S F 2dv�C2 A-0 . 6k4
f• NOTES AND INSTRUCTIONS
• The purpose of this checklist is to help define a complete submittal package for the scope of work. Plan
review will not take place until a complete package is submitted.
• This checklist can be used for all commercial construction projects, including new construction, additions,
alterations and tenant improvements.
• For complex projects, applicants should use the "location" space to note the item's location and page
number from the plans or the specification book.
• It is not necessary to duplicate submittal information, even if it is asked for in multiple sections.
• In the checklist, "Required" means that the applicant must provide this information for plan review.
• In the checklist, "P" means —
• if checked by the applicant — the information is provided for the plan review.
• if checked by the plans reviewer — this information is required for the plan review.
• In the checklist, "NA" means that the information does not apply.
• . Choose only those sections of the checklist that apply to your scope of work. Section 1.0, "General Project
Data," must be included with each •ro'ect submitted.
PRE- SUBMITTAL PROCESS •
An applicant may request a pre - submittal meeting with representatives of the jurisdiction in which the project
will be built. The meeting may take place during the conceptual, schematic, or in- progress phase, or when the
applicant has completed plans.
INDEX OF CHECKLIST SECTIONS
1.0 General project data Page 2 7.0 Mechanical data (Types I and II
2.0 Civil data Page 2 kitchen -hood permits) Page 6
3.0 Architectural data Page 3 8.0 Plumbing data Page 7
4.0 Structural data Page 4 9.0 Electrical data Page 8
5.0 Mechanical data (new construction, tenant 10.0 Fire - suppression data Page 9
improvement, gas - piping permits) Page 5 11.0 Fire - detection and fire -alarm data Page 9
6.0 Mechanical data (additional or replacement 12.0 Re -roof installation data Page 10
rooftop- equipment installation permits) Page 6 13.0 Jurisdictional requirements Page 10
This checklist is for building department jurisdictions in Clackamas, Multnomah, and Washington counties.
440 -2734 (8 /01/WEB /COM) -
i:\ Dsts\Forms \COM- AppChecklist.doc 01/17/02 Exhibit 3'
Page /Z of
/6 Pages
SECTION 1.0 — GENERAL PROJECT DATA
Construction documents Location (sheet number or spec section)
•
1.1 Required No. of sets of plans: New: 1 TI: 2
1.2 ® Required Cover sheet title block
1.3 ® Required Cover sheet vicinity map
1.4 ® Required Cover sheet plan index •
1.5 ❑ P ❑ NA Code summary
•
1.6 ❑ P ❑ NA Deferred submittal summary
1.7 ❑ P ❑ NA Professional stamp and signature
1.8 ❑ P ❑ NA Fire and life - safety plan
1.9 ❑ P ❑ NA Landscape plan
1.10 ❑ P ❑ NA Landscape specifications
Supporting documents Notes
1.20 ❑ P ❑ NA Land -use or planning actions
1.21 ❑ P ❑ NA Required fire -flow calculations
1.22 ❑ P ❑ NA Fire - hydrant flow -test report
1.23 ❑ P ❑ NA Fire department or fire district building survey report
1.24 ❑ P ❑ NA Material safety data sheets (MSDS)
SECTION 2.0 — CIVIL DATA •
Construction documents Location (sheet number or spec section)
2.1 ® Required Site plan
2.2 ® Required Site utility plan
2.3 ® Required Grading plan
2.4 ® Required Erosion - control plan
2.5 ❑ P ❑ NA Utility -vault location and details
Supporting documents Notes
2.20 ❑ P ❑ NA Geotechnical/soil engineer report
2.21 ❑ P ❑ NA Storm -water calculations
2.22 ❑ P ❑ NA Site retaining -wall structural calculations
2.23 ❑ P ❑ NA "Assurance of Compliance" with environmental rules ....
•
•
440 -2734 (8 /01/WEB /COM) Tri -County Commercial Application Checklist 2
For use in building department jurisdictions in'Clackamas, Multnomah, and Washington Counties
i:\ Dsts\Forms \COM- AppChecklist.doc Exhibit
Page / of
/, ?- Pages
•
h SECTION 3.0 - ARCHITECTURAL DATA
Construction documents Location (sheet number or spec section)
3.1 • ® Required Floor plan(s)
3.2 ® Required Transverse and longitudinal cross sections
3.3 ® Required OSSC Chapter 11 accessibility requirements
3.4 ❑ P ❑ NA Interior elevations
3.5 ❑ P LI NA Exterior elevations
3.6 ❑ P ❑ NA Roof plans
•
3.7 ❑ P ❑ NA Exterior wall sections and details
3.8 ❑ P ❑ NA Reflected ceiling plan(s)
3.9 ❑ P ❑ NA Fire -rated construction details
3.10 ❑ P ❑ NA Energy code compliant construction details and
specifications
3.11 ❑ P ❑ NA Door schedule
•
•
3.12 ❑ P ❑ NA Glazing schedule
3.13 ❑ P ❑ NA Furniture plan
Supporting documents Notes
3.20 ❑ P ❑ NA Energy code compliance forms /calculations
3.21 ❑ P ❑ NA Material safety data sheets (MSDS)
3.22 ❑ P ❑ NA Hazardous materials inventory statement (HMIS)
3.23 ❑ P ❑ NA Hazardous materials management plan (HMMP)
3.24 ❑ P ❑ NA Written fire and life - safety evacuation plan for area
of rescue assistance
3.25 ❑ P ❑ NA Active and passive smoke - control information
•
440 -2734 (8 /01/WEB /COM) Tri-County Commercial Application Checklist 3
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i: \ Dsts\Forms \COM- AppChecklist.doc r
Exhibit S'
Page /17/ of
\ /��- Pages
SECTION 4.0 STRUCTURAL DATA
Construction documents • Location (sheet number or spec section)
4.1 ® Required Structural cover sheet
4.2 ❑ P ❑ NA Foundation plan
4.3 ❑ P ❑ NA Under -slab mechanical plan
4.4 ❑ P ❑ NA Under -slab electrical plan
4.5 ❑ P ❑ NA Under -slab plumbing plan •
4.6 ❑ P ❑ NA Floor framing plan
• 4.7 ❑ P ❑ NA Roof framing plan
4.8 ❑ P ❑ NA Structural elevations
4.9 ❑ P ❑ NA Structural details and cross sections
- 4.10 ❑ P ❑ NA Standpipe information
- 4.11 ❑ P ❑ NA Special inspector /structural observation matrix
Supporting documents Notes
4.20 ❑ P ❑ NA Geotechnicallsoil engineer report
4.21 ❑ P ❑ NA Site - specific seismic hazard report
4.22 ❑ P ❑ NA Design narrative
4.23 ❑ P ❑ NA Structural calculations
•
•
•
440 -2734 (8 /01/WEB /COM) Tri -County Commercial Application Checklist 4
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties _
i:\ Dsts\Forms \COM- AppChecklist.doc Exhibit
Page ),° of
/&.Pages
SECTION 5.0 — MECHANICAL DATA (New construction, tenant improvement, gas piping permits)
Construction documents Location (sheet number or spec section)
5.1 Z Required Floor plan
5.2 ® Required Equipment schedule
5.3 ❑ P ❑ NA Site plan
5.4 ❑ P ❑ NA Under -slab mechanical plan
5.5 ❑ P ❑ NA Roof plan
5.6 ❑ P ❑ NA Fuel gas piping plan
5.7 ❑ P ❑ NA HVAC equipment and duct plan(s)
5.8 ❑ P ❑ NA Roof access details
5.9 ❑ P ❑ NA Duct smoke detector plans
5.10 ❑ P ❑ NA Fire /smoke damper locations
5.11 ❑ P ❑ NA Smoke control plan
5.12 ❑ P ❑ NA Outside air (OSA) table
5.13 ❑ P ❑ NA Refrigeration equipment and piping plan
5.14 ❑ P ❑ NA Kitchen equipment plan
5.15 ❑ P ❑ NA Type I and/or Type II kitchen hood plan
(see Section 7.0 — Mechanical Data)
5.16 ❑ P ❑ NA Fume /vapor hood plan
5.17 ❑ P ❑ NA Process piping /product and/or exhaust - conveying
duct plan
5.18 ❑ P ❑ NA Fire -rated construction details
5.19 ❑ P ❑ NA Equipment hanger /fastener details
Supporting documents Notes
5.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
5.21 ❑ P ❑ NA Equipment manufacturers' catalog "cut sheets"
or specifications
5.22 ❑ P ❑ NA Outside air (OSA) calculations
5.23 ❑ P ❑ NA Smoke - control calculations
5.24 ❑ P ❑ NA Combustion air calculations
5.25 ❑ P ❑ NA Fuel gas piping sizing calculations
5.26 ❑ P ❑ NA Make -up air calculations
5.27 ❑ P ❑ NA Energy code compliance forms
5.28 ❑ P ❑ NA Boiler information
•
440 -2734 (8 /O1/WEB /COM) Tri- County Commercial Application Checklist 5
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\ Dsts\Forms \COM- AppChecklist.doc
Exhibit 9
Page a to of
/6-r Pages
SECTION .6.0 — MECHANICAL DATA (Additional or replacement rooftop installation permits)
Construction documents Location (sheet number or spec section)
6.1 ® Required Roof plan
6.2 ❑ P ❑ NA Roof framing plan
6.3 ❑ P ❑ NA Fuel gas piping plan
6.4 ❑ P ❑ NA Roof access details
Supporting documents Notes
6.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
6.21 ❑ P ❑ NA Equipment manufacturers' catalog "cut sheets"
or specifications
6.22 ❑ P El NA Fuel gas piping sizing calculations
6.23 ❑ P ❑ NA Energy code compliance forms
SECTION 7.0 _— MECHANICAL. DATA (Type I and Type II kitchen hood_ permits). •
Construction documents Location (sheet number or spec section)
7.1 ® Required Site plan
7.2 ® Required Floor plan(s)
7.3 ® Required Kitchen equipment plan
7.4 ® Required Kitchen equipment and hood elevations
7.5 ❑ P ❑ NA Roof plan
7.6 ❑ P El NA Cross sections through hoods, ducts and shafts
7.7 ❑ P ❑ NA Fire -rated construction details
7.8 ❑ P ❑ NA Fire suppression details
Supporting documents Notes
7.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
7.21 ® Required Make -up air calculations
7.22 ❑ P ❑ NA Equipment manufacturers' catalog "cut sheets"
or specifications
7.23 ❑ P ❑ NA Hood/grease extractor listing documentation
7.24 ❑ P ❑ NA Hood/grease duct sizing calculations
7.25 ❑ P ❑ NA Fire suppression information
•
440 -2734 (8 /01/WEB /COM) Tri- County Commercial Application Checklist 6
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\ Dsts\Forms \COM- AppChecklist.doc Exhibit g'
Page / 7 of
/$2 Pages
SECTION 8.0 — PLUMBING DATA •
Construction documents Location (sheet number or spec section)
8.1 ® Required Floor plan(s)
8.2 ® Required Piping and material schedule
8.3 ® Required Equipment layout plan
8.4 ® Required Fixture schedule
8.5 ❑ P ❑ NA Site utility plan
8.6 ❑ P ❑ NA Building cross section
8.7 ❑ P ❑ NA Rise diagram
•
8.8 ❑ P ❑ NA Roof plan
8.9 ❑ P ❑ NA Back flow prevention location
8.10 ❑ P LI NA Irrigation plan .
8.11 ❑ P ❑ NA Fire -rated construction details
8.12 ❑ P ❑ NA Under -slab plumbing plan
Supporting documents Notes
8.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
8.21 ❑ P ❑ NA Equipment manufacturers' catalog "cut sheets"
or specifications
8.22 ❑ P ❑ NA Utility maintenance agreements
8.23 ❑ P ❑ NA Water supply calculations
8.24 ❑ P ❑ NA Sanitary system calculations
.. 8.25 ❑ P ❑ NA Irrigation demand calculations
8.26 ❑ P ❑ NA Roof drain and storm water calculations
440 -2734 (8 /01/WEB /COM) Tri -County Commercial Application Checklist 7
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\ Dsts\Forms \COM- AppChecklist.doc
Exhibit $-
Page /7 of
/S..)—Pages
SECTION 9.0 — ELECTRICAL DATA
Construction documents Location (sheet number or spec section)
9.1 ® Required No. of sets of plans:
9.2 ® Required Floor plan(s)
9.3 ® Required Electrical load calculations
9.4 ® Required One line diagram
9.5 ® Required Feeder riser diagram
9.6 ® Required Available fault current information
9.7 ® Required Panel schedule(s)
9.8 ❑ P ❑ NA Site electrical plan
9.9 ❑ P ❑ NA Fire -rated construction details
9.10 ❑ P ❑ NA Lighting plan
9.11 ❑ P ❑ NA Emergency power system and emergency lighting plan
9.12 ❑ P ❑ NA Under -slab electrical plan
Supporting documents Notes
• 9.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
9.21 ❑ P ❑ NA Energy code compliance forms and calculations
•
for lighting
9.22 ❑ P ❑ NA Emergency power system specifications
9.23 ❑ P ❑ NA Feeder riser information
9.24 ❑ P ❑ NA Lighting equipment manufacturers' catalog
"cut sheets" or specifications
•
•
440 -2734 (8/01 /WEB /COM) Tri-County Commercial Application Checklist 8
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\ Dsts\Forms \COM- AppChecklist.doc
Exhibit
• Page /g of
)�. Pages
SECTION 12.0 — RE -ROOF INSTALLATION DATA •
Construction documents Location (sheet number or spec section)
•
12.1 ® Required Site plan or building location map
12.2 ® Required Occupancy classification
12.3 ® Required Type of construction
12.4 ® Required Minimum roof class required
12.5 ® Required Class of roofing to be installed
12.6 ® Required Roof plan
12.7 ❑ P El NA Parapet and scupper cross section(s)
Supporting documents Notes
12.20 ® Required Pre -re -roof inspection report
12.21 ® Required Roofing system listing information
12.22 ® Required Roofing manufacturer's catalog "cut sheets"
12.23 ❑ P ❑ NA Structural calculations
•
12.25 ❑ P El NA Structural engineer's report
' SECTION 13.0 JURISDICTIONAL – SPECIFIC REQUIREMENTS • , -
Construction documents Item Location (sheet number or spec section)
13.1 ❑ P El NA ❑ Required
13.2 El P El NA ❑ Required
13.3 ❑ P ❑ NA El Required
•
13.4 El P El NA El Required
13.5 El P ❑ NA El Required
13.6 ❑ P El NA El Required
13.7 El P ❑ NA El Required
13.8 El P ❑ NA ❑ Required
13.9 ❑ P ❑ NA El Required
13.10 El P El NA ❑ Required
•
•
•
440 -2734 (8 /O1/WEB /COM) Tri- County Commercial Application Checklist 10
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\ Dsts\Forms \COM- AppChecklist.doc Exhibit 0
Page of
Pages
' SECTION 10.0 - FIRE SUPPRESSION DATA
Construction documents Location (sheet number or spec section)
10.1 ® Required Floor plan(s)
10.2 ® Required Sprinkler piping plan(s)
10.3 ❑ P ❑ NA Site plan
10.4 ❑ P ❑ NA Standpipe information
10.5 ❑ P ❑ NA Back flow prevention information
10.6 ❑ P ❑ NA Reflected ceiling plan(s)
10.7 ❑ P ❑ NA Transverse and longitudinal cross sections
10.8 ❑ P ❑ NA Fire -rated construction details
10.9 ❑ P ❑ NA Specialty fire suppression system plans
and list of systems
Supporting documents Notes
10.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
10.21 ® Required Equipment manufacturers' catalog "cut sheets"
10.22 ❑ P ❑ NA Hydraulic calculations
10.23 ❑ P ❑ NA Specialty fire suppression system information
SECTION 11.0 - FIRE DETECTION AND ALARM DATA
Construction documents Location (sheet number or spec section)
11.1 Required . Floor plan(s)
11.2 ❑ P ❑ NA Site plan
11.3 ❑ P ❑ NA Reflected ceiling plan(s)
11.4 ❑ P ❑ NA Transverse and longitudinal cross sections
11.5 ❑ P ❑ NA Wiring schematic
11.6 ❑ P ❑ NA Elevator recall information
11.7 ❑ P ❑ NA Operational matrix
11.8 ❑ P ❑ NA Fire -rated construction details
11.9 ❑ P ❑ NA Standard electrical notes
Supporting documents Notes
11.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
11.21 ® Required Equipment manufacturers' catalog "cut sheets"
11.22 ® Required Installer certification information
11.23 ❑ P ❑ NA Battery calculations
11.24 ❑ P ❑ NA Sample fire alarm log book
11.25 ❑ P ❑ NA Emergency power system specifications
11.26 ❑ P ❑ NA Monitoring station information
11.27 ❑ P ❑ NA Voltage drop calculations
440 -2734 (8 /01/WEB /COM) Tri-County Commercial Application Checklist 9
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i: \ Dsts\Forms \COM- AppChecklist.doc -
Exhibit 7
Page c of
/�a� Pages
FILE COPY
Site Address:
Letter of Transmittal
�' '"'''li'j Building Division
City of Tigard
DATE RECEIVED:
TO: r\ � 1 `J� Ut.i�\ t��d v 1�
DEPT: BUILDING DIVISION APR 22 2003
CITY OF TIGARD
i I�G DIVISION
FROM: �b in ZV Wn V - 1 't AC`r�,l C'..
COMPANY: \ _LANC , i
PHONE NO.: 3 — ?'0 gtl1L ®
��
�9 By 1��
RE: iltdk Q 003 -- 00 t (0d I a2 " -- 1 `i S te,
(Case number, site address, etc.) L
�O k , i/\ — ' -1 p , v`T
(Project name obdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies:. Descrip.fi °on ,. t ffi , , , ',:7,'' , , , :i--., - -,.; ,Cop>.es ;D "escr ptron ::. -- . F .
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. t Engineer's calculations.
Other (explain):
REMARKS:
For Office Use Only
Routed o`Perftild eeh uc an , tDate ' ; • a In tiais: _ - .
`- Fe Due :� " b • . ` '''$;. 1 D l
_ - = Iritiais.:
-: , , ' Permit (per E:lari_s`Ex ner);- Ye , No
Notified,Apphc , , L, : ; „ __ Date ,, ' . , I
i:dsts \forms \LetterTransmittal.doc 02/15/02 Exhibit q
Pae of
, . Pages
Media Art, Inc. Proposal Site Plan
State of Oregon off - premise permitted / Scale- 1"=-56' OFFICE COPY
Freeway - oriented sign ÷ w
Property Owner: Foreign Mission Foundation A
Legal Description: 1 S -1 W -35AC -4900
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Tax Lot 4900
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- — Page A.3 of
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