Permit CITY TIGARD SITE WORK PERMIT
4 A DEVELOPMENT SERVICES PERMIT # : SIT2003 00024
Wel 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 10/14/03
SITE ADDRESS: 11565 SW DURHAM RD PARCEL : 2S110DC 02400
SUBDIVISION: SDR1999 -00022 WILLOWBROOK II ZONING : C -G
BLOCK: LOT: JURISDICTION : TIG
CLASS OF WORK: NEW PAVING ?: N RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 30,000.00
EXCV VOLUME: 150 cy LANDSCAPING ?:
FILL VOLUME: 200 cy SITE PREP ?:
ENG FILL ?: STORM DRAINS ?:
SOILS RPT READ ?: N IMPERV SURFACE: 7,793 sf
Remarks: Site work for new 5700 square foot office building.
Owner:
FEES
DOUG FRY
2423 REMINGTON CT Description Date Amount
WEST LINN, OR 97068 [BUILD] PrmtFee - Valu 7/24/03 $208.52
[FLS] FLS Pln Rv 7/24/03 $128.32
Phone: 503-348-2237 [BUILD] Prmt Fee -Valu 10/14/03 $320.80
[TAX] 8% St Tax -Valu 10/14/03 $25.66
Contractor: [ERPRMT] Erosion Cntl 10/14/03 $80.00
CARPENTER HOMES INC [ERPLN] Ersn Plck - USA 10/14/03 ' $26.00
4719 SW LAKEVIEW BLVD [EROSN] ErsnPlck -COT 10/14/03 $26.00
LAKE OSWEGO, OR 97035 [WQUAL] Wtr Qual % 10/14/03 $675.00
Total $1,490.30
Phone: 636 - 0381
Reg #: LIC 72307
Required Inspections
Erosion Control Insp 846 -8444
Paving lnsp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling (503) 246 -6699.
Issued By: A j/
Permittee Signature: • �•
Call (503) 639 -4175 by 7:00 P.M. for an inspect on needed the next business day
4. us as .71f.i POR-14 t1 ► 'C r
Site-Work p' ` ' n
Building Permit Application FOR OFFICE USE ONLY ;
Received Building
Datc /By: 7 443 /0 3 O' Permit No.: Sir,go0,�- OCt7o`
Pl an ni ng Approval Other
City of Tigard ( E C Y Date /By: Permit No.: oos�5"
13125 SW Hall Blvd. Plan Review p O Other
Tigard, Date/By: q li � ' � 9 Permit No.:
g Oregon 97223 JUL 2 `� 200�� ��p
Phone: 503-639-4171 Fax: 503-598-1960 � . post- Revi_.. Land Use Date /By: Case No. �nM.�3°Oe'o3
ar
Internet: www.ci.tigard.or.us OF TIGAI�. o
g ti W Contact J stcis : ® See Page 2 for V
5bf3
24 -hour Inspection Request iD1- $175VISIONV Name /Method: • — / / (/1 Supplemental Information
°'- ''-M:.k l -itt:: i TYPE: W. WO11401 M -i; s REQUI DA »TA $ ` � 4
- ,*; 'd' it. ire° t ,,,,,,, Y'''3 - } ' at £ ' \1 1
New construction II] Demolition , _ 1 SI F MIIEAD + 411:',:::!,,5-,:::1,..-L=-,M ,
❑ Addition/alteration/replacement ❑ Other:
, ' "_ ,° it CATEGORYKOF =CONSTRUCTION:- .,,,._ v- Note: Permit are based on the total value of the work performed. Indic e
❑ i. & 2- Family dwelling ❑ Commercial/Industrial the value (rounde• c the nearest dollar) of all equipment, materials, lab•
overhead and profit for .: work indicated on this application.
❑ Accessory Building ❑ Multi- Family .
❑ Master Builder ❑ Other: Valuation
s iliit oosiTE3INFO tta aniritoo Tt®N , i , ,, _ No. of bedrooms: No. o' ..ths:
Job site address: I, ( 56r5 2.4_, t2 k et Total number of floors .. ....
New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: F Garage /carport area (sq. ft.)
Project Name:)J( ((, et,A31.1-t (,, 1:4-i lit- lna F Covered porch area (sq. ft.)....
Cross street/Directions to job site: Deck area (sq. ft.)
get t-/ , our -,, Other structure area (s t.)
WI ((,e(44 vac, (.t (IpM lro, -c-i bP CP.at. , , l R E`QU IRE DJDAE A m � ' '
�h - ''" COMERC; iJSE CHECKLi§ 4
Subdivision: Lot #: wd „.� 4 . ,, . 4 y n. 4= t . _:Ri - A t;' . ;_
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
lMWSMPITION;�OF�WORK �;'' <:� „' .�;:_::':;�.
.s< , _._,-- ..-�_..._. O -._ CO ?, ! the value (rounded to the nearest dollar) of all equipment, materials, labor,
Si-Pc ” overhead and profit for the work indicated on this application.
1p Li( cJ�
t -C L `-€ 4 4e.4_ Si-lc df1
/ Valuation $�i
,p Existing building area (sq. ft.) /')/1/T T f tit c ov(- ? 4 -ei'hti 1' 'c-�' New building area (sq. ft.) A/ //
. Number of stories . a11 r'3
N ROPERLY OWNER a; , 'TENA�NrT t ,,, ;z Type of construction AIh (
P
a me. Occupancy group(s): Existing: rJ //-T
l� New: lJ /ti!-
Address: -242;3 (Le.M.41,.01 cif
City /State /Zip: (Aral+ C.; w,. or en 06. b
.ZZJ;'1 Fax: 4.12- fo o? `f NOTICE: All contractors and subcontractors are required to be
Phone ' licensed with the Oregon Construction Contractors Board under
�' a tivo ANT„ . t,�,,, : . rC.®Nt cTitERSONt�;`, , -
provisions of ORS 701 and may be required to be licensed in the
Business Name: &Ail di. re-a, Dz., i `4 b. enirtre jurisdiction where work is being performed. If the applicant is exempt
Contact Name: (1. 51,t..._ c.a_,-4 from licensing, the following reason applies:
Address: ic Fw i?,,tb-e.I : 1 S-/-rt
City /State /Zip: ' of 0(2- et/ Z - 2 - 3
Phone: 2 44• 05 S i- Fax: ? - x41 � :
P BUTL�DING j ERMTTT ' EES *H ��
E -mail be a Mel p �
» 1 f fee s cht It % w w ijos
,, _:N.EE s: C®NT`RATOR ._
Business Name: o �, Fees due upon application $
Address: 47LjD * LA t0 ttiA b
City /State /Zip: J O. c. 910135- Amount received $
Phone:54-•6V,.+ 6381 Fax: Date received:
CCB Lic. #: 7a3O7 '
x�n'i.:. •;±-.
Authorized
Notice: This permit application expires if a permit is not obtained witfiiqA,
Signature: ate: - 7•1 - 15 5, cD 180 days after it has been accepted as complete. `
6 .44 - 11. - 1 � - - aryl *Fee methodology set by Tri- County Building Industry Service Board.
(Please pr t name) do e • 5g
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 /19•Z • 5 91
SITE WORK PERMIT CHECK LIST
Commercial, Multi - Family (R -1 occupancy) and Residential:
Please complete all items below, unless otherwise noted.
Excavation Volume: cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be compacted to 90% of
maximum density) cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other
*Total new impervious area including all buildings, "''' ' •• • •
sidewalks, and paving: sq ft.
-^ s,� e a Y. say'#.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
�'{ Plans Required: See "Site Work Permit Application Plan Submittal Requirements" ,
y
attached,. Th,e following "must accompany this�application
=•Site Plan with Vicinity Map s howing k * Parking "(including ADAM) ands °
ADAcomplance �„ LightingPlanE �:
Grading detailsf *` *L`an'dscaping Plan. '_
a ,, ; ,Erosion w Coi trvol Plan and detailsn, .; Soils Repoit'(if required) � ` #;
°f Retain Structures A .. ` .... a • .; .... F .
*Does not apply to 1 and 2- family dwellings.
1 : .� :� � # of Plans
TYPE O SU BMITTAL � Req at .
(Includes New Addditions r Alterations) Submit a yrol •
Commercial - 4 . •
Multi- Family R -1 Occupancy ° • • 4
.
One- & Two - Family Dwelling '4., • ` , . • • :
14'
NOTE: Plan review is dependent upon submittal of.? completed application and
After plan review approval, the Plans Examiner will conttact applicant to request
additional sets of plans for distribution purposes (for Contractor, City o►f,T�gard, o
Washington County, and Tualatin Valley Fire & Rescue). . .
•
is \dsts \forms \SIT - checklist.doc 01/29/03
!lug ?5 03 02:33p WRG Design Inc 916 - 677 -8620 p,2
FILE COPY
•
..D' Marshal's Division Offices
N orth - 14480 SW Jenkins Rd., Beaverton, OR 97005, (503) 356 -4700
Tualatin Valley South - 7401 SW Wash Ct., Tualatin, OR 97062, (503) 612 -7010
Fire & Rescue
Fire Flow and Hydrant Worksheet
This worksheet is required to be submitted to and approved by the Authority Having Jurisdiction (AHJ) before
any permits for new building construction, building expansion or fire hydrants will be issued by any building
department within the TVF &R District. See the instructions for assistance completing this form or call one of
the above numbers.
RECEIVED
Preparer Information 'AUC 2 8 2003
Preparer Name: 1Jason Reed - WRG Design ( CITY OF TIGARD
BUILDING DIVISION
Phone: (503- 419 -2500 1 Fax :1503- 419 -2600 1
Architect! Engineer of Record: (Jon Reimann
Phone: 1503 -419 -2500 1 Fax:1503 -419 -2600 1
se,l „q;qy -.
General Building Information
Project Name: (Willowbrook Building "F”
Project Address: (NW comer of SW Durham Rd & SW Summerfield Dr(
City :(Tigard 1 County:[ Washington 1 Zip :1 1
Construction Type(s): [Type V Non -rated 1
Total Bldg Area: 1 5,7871sgft
Total Fire Area: 1 7,6381sgft
Bldg Fire Flow: 1 23601Gallons Per Minute
Describe Fire Area: (if more than one fire area, include an 8 112 x 11 or 11 x 17 drawing indicating the various fire areas)
Fire area is single structure with roof overhang included.
Type of Occupancy or Use of Building: [Likely Office
! Rug 2.5 03 02:33p WRG Design Inc 916 - 677 -8620 p,3
j r ..1
FiLE COPY
.,
A. Single Occupancy Hazard (If using Item A, DO NOT use Item B)
Al Building Fire Flow I 2360IGPM
A2 Occupancy Factor I 1
A3 Required Fire Flow I Z360IGPM
se ..Either Item A Above or Item B But Not Both..;::: :.
B. Multiple Occupancy Hazard (If using Item B, DO NOT use Item A)
B1 Determine percent of each occupancy hazard in the fire area.
Occupancy Haiard Class • Fire Area...: • 1 Total Fire Area .:..: • • Percent of -Fire Area
Light Hazard 0 SF - 1 7,638 SF .x:100- - 0 %
Ordinary Hazard Grp 1 0 SF / . 7,638 SF .x 100 = 0 %
Ordinary Hazard Grp 2 • 0 SF / 7,638 SF x 100 = 0 %
Extra Hazard Grp 1 0 SF / - 7,638 SF x 100 . - 0 %
Extra Hazard Grp 2 0 SF_ .1 7,638 SF .x 100 • = • • 0 %
Total Must equal 100% I 0 % I
B2 Calculate Fire Flow
Occupancy Hazard Class Factor I Fire Area - Fir•Flow : : Bldg Fire Flow
Light Hazard 1.0 x 0 % •x 2360 GPM = , 0 GPM
Ordinary Hazard Grp 1 1.2 x 0 % x 2360 GPM = 0 GPM
Ordinary Hazard Grp 2 1.3 x 0 % x 2360 GPM = 0 GPM
Extra Hazard Grp 1 1.4 •x 0 % x 2360 GPM — 0 GPM
Extra Hazard Grp 2 _ 1.5 x 0 % x 2360 GPM 0 GPM
B3 Required Fire Flow [ 0 GPM
C. Calculate the Minimum Number of Fire Hydrants Required
Required Fire Flow 2360 GPM / 1500 = I 2 INo. of Hydrants Required (Min. of 2)
D. Reduction of Fire Flow - Reductions are based on the following:
D1 - Reduced by 25% for A Full Fire Alarm (multiply by .75)
D2 - Reduced by 50% for Automatic Sprinklers (multiply by .50)
D3 - Reduced by 75% for Central Station Supervised Automatic Sprinklers (multiply by .25)
E. Required Fire Flow in Non - sprinklered or Sprinklered Buildings
El. Fire Flow 2360 GPM x 1 1 1 = 1 2360 GPM (Max. 3000 - Min. 1500 gpm) I
Aug ? 03 02:34p WRG Design Inc 916 677 -8620 p, 4
s
uu3 12:17 FAX 503 639 1471 CITY 0 ® 002
r .pry 03 03 04:01p TVF&R SOUTH DIV. � C O ] 612 -7003 p _ 1
TUALATIN VALLEY FIRE AND RESCUE
REQUEST FOR WATER FLOW TEST DATA
•
DATE: 3 -1 -o3
PROJECT NAME: TI LC7iKt -b - 1 .1 5 1 .-- 7 1 , -- • SQ. _ CVCO' 17
PROJECT LOCATION: IC aev SLA PAx.tptr Y DISTRICT: 1
CROSS STREET :
TYPE OF PROJECT:
NEW CONSTRUCTION 0 EXISTING D ADDITION 0
CALLZR'S NAME COMPANY PHONE CALL RETURNED
ICc t tJ 1L Ft -N-0 3
ct.. SateCe.,. Ct{, oc -- 111 -l4
RA", FL s( v" o F - c - r,
•
PREVIOUS TESTS:
HYD. # LOCATION DATE STAT RES PITOT GPM GPM 20
Post -(N Fax Note 7671 ' DaJ n ei
_ To ] prig.a •
(Z (C,�•t S a 1 (U- From utt M . —
CoJDepL co.
choir. Phoro .
•
Foci
MINA
•
NEW/RETESTS; -
HYD. # LOCATION DATE STAT RES PITOT GPM GPM 20
(;, -4)41, k - S7 14,1-co eci‹ hu 3-(' -o3 , in ..o L ('f ") 6 11W_ 506 r
DISCLAIMER:
The flow or pressure information contained herein reflects conditions witnessed on the date and rime of the test.
TVFR makes pro representations as to the system's ability to meet specific fire flow requirements. Future system
capability may differ from the flows reported herein because of subsequent modificatiortt to the system, andlor
because flow and pressure may vary by time of day and by season.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Q BUP
Received _ ate Re nested C.J �,3 /ok AM PM BUP
Location 1 i s ;, Du Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph (• ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation -
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT 2 003-00 O 2-
Post & Beam
Shear Anchors Trel—
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 'f
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING \ L
Post & Beam ''
Under Slab
Rough -In
Water Service ►,I
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA S_ PART FAIL
ITE 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other
11-45 DO NOT REMOVE this Inspection record from the job site.
PART FAIL