Permit BUILDING PERMIT . c
CITY OF T PERMIT #
DATE ISSUED: 11 /2yUP95 -0463
1 COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 191 36 AD -06 100
SITE ADDRESS...: 11419 SW PACIFIC HWY
SUBDIVISION • i ZONING:C –G •
BLOCK • LOT
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION- -
CLASS OF WORK.:ALT FIRST • 750 sf N: S: E: W:
TYPE OF USE...:COM SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF CONST.:5N ...: 0 sf N: S: E: W:
OCCUPANCY GRP. :A3 TOTAL 750 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 51 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:1HR
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD ° 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL :N SMOK DET..:N
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:N HNDICP ACC:Y
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR :N PARKING: 0
VALUE. $ : 30000
Remarks: Tenant improvement
Owner: FEES
GEORGE SCHOLIBO, JR. type amount by date recpt
12241 SW TERWILLIGER BLVD PLCK $ 125.45 JD 11/02/95 95- 272433
FIRE $ 77.20 JD 11/02/95 95- 272433
PORTLAND OR 97219 PRMT $ 193.00 JSD 11/29/95 95- 273345
Phone #: 799 -2147 SPCT $ 9.65 JSD 11/29/95 95- 273345
Contractor:
JUSTIN THOMPSON
1849 NE 142ND AVE
PORTLAND OR 97230
Phone #: 255 -8614 $ 405.30 TOTAL
Reg #..: 87436
REQUIRED INSPECTIONS
This peruit is issued subject to the regulations contained in the Framing Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other F i r e w a l l Insp
applicable laws. All work will be done in accordance with Gyp Board Insp
approved plans. This permit will expire if work is not started Susp Ceilng Insp ,
within 180 days of issuance, or if work is suspended for more Misc. Inspection
than 180 days. Final Inspection
, 41e/ ________
_
Permittee Si. - re: _ / - _ _ —
ti � _ — — - �/ - - -- _
I s s u e d B y -- —
Call for inspection – 639 -4175
l
L
` ./ 0 -..,4.' Corn • uilding Permit Application
City of Tigard ,(.1 13125 SW Hall Blvd �o�q q l2�
y • ) 11
Tigard, OR 97223 t I'" ete 0, . , 1
(503) 639 -4171 I ,/- ' -
Jobsite Address: //'W, - / de ,. c, % /�
y
Tenant: Suite # Office: Use Only
Planck/Rec. # /7- 0 177C
Valuation: .34 lr �`
Permit # W e q5- ot-ice?
Owner: (ro. o � P .S� yD /f�O `� - Map & n* :.` 1 3(-./14> - O(o/ o-r)
Address: ,2 .- /o r o v i �/ PI a /o/
�� � Approvals Required
A v fZ 0 / O ' 77 2/9 Planning: i A
Phone: 79,— 2/ 447 Engineering / /`'
7-107256. Other A
Contractor: LL „a h , ,
Address: 6'r-/ ir, /# �" ,
^�
11 I /02 J / .0 ,/ / p7z3 Type of const: / '1 ( "co
0 Occupancy class: .cr'- ,a~..,
Phone: V--6 - 86/ / 07e , Z73
Sprinklered? Yes L".
Contractor's License # C C6' 97
(attach copy of current Oregon license) Sq. ft. of project: / f J�
Contact name & phone: %Li / 7 /// y '73 -7e0P Story (1st, 2nd, etc.) /.e%
// Proposed use: /7.4 Z ��✓
Architect/Engineer: �d/ h rP,`
� � / Previous use: /o>"7 S T
23
Address: / r`' /I
/ � O� 97209 Note: Plumbing & mechanical plans
ov c'�� must be submitted at time of
building permit application.
Phone: .f7— /7 c/
JOB DESCRIPTION: i4 y A;..- , �sP ee. 7/ �Py 7,' -4
11.4.- l'iy Ile ,. / / I 9 7
'`/ ,? 5:5 / Are g.73 - 7Z
A• _. scant Signature ' • - e number 9
/ /' V
Received by: Date Received: /� ��
Permit # Account Description Amount Amt. Pd. Bal. Oue .
Bldg. Permit (BUILD) (9 /17
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax ' (TAX) 9 y ---- rj--
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) + /
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (T1F -MT)
Commercial TIP (TIF -C)
Industrial T1F (TIF -1)
Institutional TIF (TIF -IS)
Office TIF (TIF -0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS) " a k
�
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
/
TOTALS: YO e) F ( & a
4
02/10/2000 Activities for Case #: BUP95 -00463
10:13:47 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes •
BUPC007 APPlication received 11/02/1995 JD PEND B 11/09/1995
BUPC008 Permit created 11/09/1995 B PEND B 11/09/1995 .
BUPC010 Check for prcl. restrict. B 11/09/1995
BUPC015 Plans routed to Plans Examiner 11/09/1995 B PEND B 11/09/1995
BUPCO24 Plans Approved /Routed to DSTs 11/28/19$5 JHF APPR JHF 11/28/1995
BUPC460 Devel review cond. met B 11/09/1995
BUPC740 Framing Insp 11/30/1995 GS APP GES 11/30/1995 SUBJ TO ELEC COVER
BUPC760 Gyp Board Insp 12/01/1995 GS APP GES 12/01/1995
BUPC762 Susp Ceiing Insp • B 11/09/1995 .
BUPC799 Final Inspection 02/04/2000 RB FAIL AKJ 02/06/2000 The last remaining issue to
finalize permit is door signage
"door to remain unlocked during
• bus. hours" placed over each
• exit door
Complete and recall for insp by
2/21/00
BUPC798 Misc. Inspection 11/28/1995 JHF 11/28/1995
BUPC090 (F) Ready to issue 11/29/1995 JSD PASS JD 11/29/1995
BUPC100 (F) Issue permit 11/29/1995 JSD PASS JD 11/29/1995
BUPC802 Final Inspection 02/10/2000 RB PASS No Hold RB 02/10/2000 Case Final- All final req'mts
met.
BUPA990 (F) Issue Cert. of Occupancy 02/09/2000 RB DONE No Hold JMT 02/10/2000
Page 1 of 1
2'g • CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
al 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
� / / IA w n BUP — �� "
V LDate-F2egaeste<t' AM PM 3 BID
Location \ \ 41"x 4W L. c \J Suite MEC
Contact Person 4c7.- PLM
Contractor Ph ` - SWR
UILDIN Tenant/Owner 3\As 9 ,� S ��/" -vim^ \ L ELC
Retaining Wall ELR
Footing Access:
Foundation 6 is.- ` 004(.3 FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear I e � — CS Y'
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PART FAIL
• t MBING
Post & Beam /-(A.--/r151
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final ry0
PASS PART FAIL V\
ELECTRICAL \ ,/ U
Service
Rough
R In l
UG /Slab \ v 0�'
Low Voltage V �
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 - UV Inspector E x 9
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.