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Permit x BUILDING PERMIT CITY TIGARD PERMIT #: BUP2000 -00093 -_� ilili DEVELOPMENT SERVICES DATE ISSUED: 04/11/2000 4II • 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 07400 SW LANDMARK LN PARCEL: 2S112AB -00400 SUBDIVISION: ZONING: I -H BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2N : sf N: S: E: W: OCCUPANCY GRP: S2 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: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 30,000.00 Remarks: Tenant improvement - Adding accessible bathroom and sprinkler riser room. Owner: Contractor: GLENN HAYTER ELLIOTT SHEETS CONST INC 5455 SE ALEXANDER ST PO BOX 12906 HILLSBORO, OR 97123 SALEM, OR 97309 Phone: Phone: 503 - 362 -1164 Reg #: LIC 1205 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Mechanical Permit Require PLCK BON 03/22/200C $192.73 0000841 Electrical Permit Required Plumbing Permit Required FIRE BON 03/22/200C $118.60 0000841 Framing Insp PRMT GEO •04/11/200C $296.50 0001321 Gyp Board Insp 5PCT GEO 04/11/200C $23.72 0001321 Final Inspection Total ORION!. $631.55 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: / l Issued By: 7',,�' - �� Call 639 -4175 by 7 p.m. for an inspection the next business day CITY OF TIGARD Commercial Building Permit Application Plan Check # =,?� 13125 SW.HALL BLVD. . Tena.nt Improvement Rec'd }/ TIGARD, OR 97223 Date Recd ' - 22 7D Date to P.E. - 3 - 2- 2A O (503) 639 -4171 P4- Date to DST 3-al "' isle Print or Type G U 3 e., Permit# J z 3 Related SWR # Incomplete or illegible applications will not be accepted Called 1 4 - - 7 - 249tO Name of Development/Project � Existing Building [X New Building 1=1 Job rl S 1"Iha ClS Address S 53 tAddress Suite Building 7 S 4 )Qn_vilark Data Bldg # City /State Zip Existing Use of Building or Property: Y LOh 97 AZ Name Property 1-ktyZr (Cl / i �� Proposed Use of Building or Property: Owner hilailind Address Suite PR-r t No . O Stories: S4C.TINC/c ` LSVI ,� 1 ntir. Phone `Y794 (7741-3 Sq. Ft. Of Project: Occupant Na e 1' 1 Er) Occupancy Class(es) P)Cmi 2311: Phoci C> /a_Si Name Sr-1 ,I I ,/ Contractor ) jO 1. k—c)te t 0.14, Type e r)) of Constrution Prior to permit J ailing Address Suite L' ' °' S [ 'e R L issuance, a copy p (�j ►� , �J / Wi ll this p roject have a Fire Suppression System? of all licenses tOi 130/1 1 l0 6 C / Yes RX NO ❑ are required if City /State Zip Phone expired in c.o.T. / ��//v1 ` � f � t ?� Americans with Disabilities Act (ADA) database ! Ok ?Z d 30 , Valuation X 25% = $ Participation Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form 1 S Valuation $ C Name aluati on �3 J 1 0Oa Architect r`h i V Plans Required: See Matrix for number of sets to submit Mai in Addre S de on back ti o Ai�a ity /Stt f ate Zip Phone I hereby acknowledge that I have read this application, that the information Le ©h C n30/ 6S00 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 Signatur• of Ow / /Age Date / Mailing Address Suite ■ , f ' � ^- gv, c `0i '�i�_ Contact Perso ame Phone City /State Zip Phone - D S )Sc h ` ' .11.6-,_"" r� FOR OFFICE USE ONLY Indicate type of work: NewX Addition 0 Demolition O Map/TL# Land Use: Accessory Structure 0 Foundation Only 0 Alteration 0 Repair 0 Other 0 Notes: Description of work: 1 �g L --'� 1210G�/ 47 f TIP: — I r a. ! mod. )-11" i Note: Site Work Permit Application must precede or accompany Building . , 60 Permit Application o �� ` y �j I: \COMNEWTI.DOC (DST) 5/98 Itini • • COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan ftevlew is depend s dpor submittal of BATH plans AND i COMPt ETEI application, For an electrical submittal, fhe appllcatian must co Lain the signature of the supervising electrician before flan review will k e con ducted. After plan review approval Flans Examiner will contact the applicant o request additional plan sets for distribution purposes. {Copy for Contractor, City, It#lashir ton''Coun Tualatin Valle' Fire &Rescue Total # of TYPI OF SUBMITTAL Plaits. <':: KEY: 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 B & .: P`(Alt) j 3 *B& !{ &P &E &F(Alt) 3 NOTES: *Shaded areas designate ALT submittals only I: \dsts \forms \matrxcom.doc 10/30/98 MAY -15 -00 07:58 AM PLSI 15036829576 P. 02 • r . ��v2U71D ..v 93 • i' ' . 304808 • • . . ,: A E.: r . 5 . . ..i. . ; - - - W PN WS•AW,WA ❑ EXISTING BACKFLOW ASSEMBLY TEST REPORT ❑ REMOVED PROPERTY ❑ REPLACEMENT OWNER: r • aka . ,(I NE: MAILING . 7 ,.0 T I ADDRESS: : _�a_i ______ + .= I Q i CITY i STATE ZIP ASSEMBLY —. ` l ADDRESS: " 6' �� L yk 1414— I v. — 1 - 1 q 11 223 � � STREET I V f ❑R.P.R.A.' L. � V.A. ❑ R,P,D,A ❑D.C, ,A. .A. ❑P, V. B. ❑S.V.B ❑ R-V.B. ❑AIR OAP SIZE: l ► l /7 l•D,C, MAKE: , (...) �4r t? . MODEL: 5S0 � WATER - SERIAL . . PURVEYOR: 1 �L1r� NUMBER: �� ASSEMBLY l LOCATION: pi RlI. 44/ t ip R y REDUCED PRESSURE ASSEMBLY P.v,B.A / S.V.B.A INITIAL TEST 1 M I DO,.1JBL1r,:ONECK - :< AI CHECK PASSED Et ' 1 _ PRESS DROP (A )1 CHECK p INLET FAILED ❑ INITIAL RELIE D (B CJ TIGHT "Z„,1 OPENED A2 SEE DROP TEST MIN 2 11 PSI DATE: RESULTS BUFFER ( LEAKED ❑ 5 J ri4 c> A - B o I CHECK ill PSID — 3>S1S MIN D PSI RELIEF VALVE ITiGHT DID NOT FAILED SYS PASS ❑ FAIL ❑ LEAKED P� OPEN ❑ ❑ , PSI 77 COMMENTS REPAtR1 AND /OR PARTS RfiouceOPRESSUREASS P.V.B. A. /S,V.B.A. AFTER REPAIRS PI CHECK PRESS oRop (A) " " — DATE: TEST CHECK k1 OPENED AT MESS DROP . AFTER OPENED (B) I TIGHT ❑ PsID I / REPAIRS roam. I TIP CHECK >a2 TIP ITIGHT ❑ PSID PSID PSID PASSED ❑ IN COMPLETING AND SUBMITTING THIS TEST REPORT. THE TESTER CERTIFIES THAT THE ASSEMBLY HAS BEEN TESTED AND MAINTAINED M ACCORDANCE WFTH ALL APPLICABLE RULES AND REGULATIONS OF INS WATER SYSTEM.. AND STATE REGU(.ATTONs GAUGE CALIBRATION DATE / //5 Of METER READING 73`/ 7G, TESTER SIGNATURE LZ 5 " TESTERS NAME PRINTED C .C"' .r , . + .�` ..— 443t ) 7� TEsrERSADDRESS • �'.` PNONCE� r COMPANY NAME REPORT RECEIVED BY ❑ SERVICE RESTORED (REPRESENTATIVE OF OWNER) WHITE • VAL.( Syskm Copy PINK • CUIMTOCT Copy YELLOW . TrrIor Copt CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 � BUP �/� -U ©G � 3 Date Requested �O AM PM u -c u/ 7 J Location 7 V '0 3� / 4 ) h?Gis' /< <- ✓I Suite EC .2.vvv — "i7 y Contact Person el/A / Ph 932, -27x5 .IMF /3 Z. Contractor / Ph SWR BUILDIN Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing 6/9 e Drywall on 77/0 S / 55V "/ (, & L t T'Pi r{ Drywall Nailing � �� Firewall /-- Fire Sprinkler Z6v' /�J a// t/�/j' 1 �� I Fire Alarm U — ---� Susp'd Ceiling / Roof ,,�� 2 Misc: ! AIL- �% SS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PAS T FAIL CHANICAL Rough In Gas Line 11. e Dampers � PART FAIL - ICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE 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 Date ,, (OL) Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.