Permit IN, CITY OF TIGARD BUILDING PERMIT
DEVELOPMENT SERVICES R BUP98 -0316
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 PEM ISSUED: 08/13/98
PARCEL: 15136AD -04000
SITE ADDRESS...: 11509 SW PACIFIC HWY
SUBDIVISION • VILLA RIDGE ZONING:C —G
BLOCK • LOT -007 JURISDICTION:TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION —
CLASS OF WORK.:ALT FIRST • 1500 sf N: S: E: W:
TYPE OF USE...:COM SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF CONST.:SN ••.. 0 sf N: S: E: W:
OCCUPANCY GRP. :B TOTAL : 1500 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 20 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 1 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: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. $ : 27686
Remarks: Greenspan Clinic - TI install non - bearing walls for Dr office
Owner: FEES
SMITH, WOODROW & EDITH type amount by date recpt
520 SW SIXTH PRMT $ 184.00 DLH 08/13/98 98- 308229
PORTLAND OR 97204 SPCT $ 9.20 DLH 08/13/98 98- 308229
PLCK $ 119.60 DLH 08/13/98 98- 308229
Phone #: 223 -3171 FIRE $ 73.60 DLH 08/13/98 98- 308229
Contract or:
GREAT WESTERN RESTORATION
13705 S LAZY CREEK
OREGON CITY OR 97045
Phone #: 655 -4739 $ 386.40 TOTAL
Reg #..: 009914
-- 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
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 952-881-8810 through OAR 952-00101987.
You many obtain a copy of these rules or direct questions to OUNC
by calling (503)246 -1987.
Permittee Signature: .���/ Issued By- t ldr "
++++++++++++++++++++++++ -++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
- - - - - . • •
r 8. CITq ~OF TIGARD Commercial Building Permit Application Recd By
13125 SW HALL BLVD. Tenant Improvement Date Recd 0--1/ "If(
OR 97223 Date to P.E.
TIGARD, 1 Date to DST Ci$ e (503) 639 -4171 fr , �,'. 1 Permit # : c,( fl 5 �
Print or Type
C V Related SWR #
Incomplete or illegible applications will not be accepted Called6'?7
Y.„--) 0 f'F
Name of Development/Project Existing Building L ' New uilding ❑
r
Job ,W: .,4- - MP-Y1
Address Street Address Suite Building
_ •S" - llii�L' . , ;L , Data
/
Bldg # City/ tate Zip Existing Use of Building or Property:
. . � :�'D 4 �' -1 c ` P + ` (n
m
Name 7 /(/pei2; - r ,71, : - .. r . " Z:t c,, A L
r C
Proposed Ue of Building or Property:
Property / !i/a/1� 6„2 */, N :771 rn
M ailing Address Suite f T�
)C1
Owner DT7)ezei c� , CI
S. D 3 4 i J/.(fl, g No. Of Stories:
City/State Zip Phone
�triz 6 k 97 = � a 7 3 � 9 Sq. Ft. Of Project:
Occupant Name 1C
450/ Q J Occupancy Class(es)
Name r /
Contractor 6 2tAr �; r ST e -mez-it,rl Type�s)ofConstruction
Prior to permit Mailing Address Suite 6.D U.
issuance, a copy Will this project have a Fire Suppression System?
of all licenses tips S L - C .2_t_fL Yes ❑ No a
are required if City/State Zip Phone
expired in C.O.T. /� /- 1 1 Americans with Disabilities Act (ADA)
database bPLI -t), o P ;-1/ ((E'. �rur(�J.. -47 9 Valuation X 25% = $ 445't o ? Participation
Oregon Const. Cott. Board Lic.# Exp. Date Complete Accessibility Form
609q ly9 6-P9 Project $
Name Valuation -'' f .
Architect Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
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
Si re of Ow er • ge Date
Mailing Address Suite / • // /! J
Conta 'e .
� sue ••n Name Phone �"�
City/State Zip Phone �4 /v C , / c /73
tiff" 77
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition 0 MapfTL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration
Repair 0 Other 0 Notes: ��a�
Description of work: g ! /.. .yi it o �,,� : i 7•1 ✓4Gt;r lt
TIF: A i /.J_ .P : A -rte... - '`�^. _ /', Yr
eV nOl� F __ .c...? _. ' 1.. 1--- . / ° -t. • -
■
Note: Site Work Permit Application must precede or accompany Building ......,
Permit Application eJ . (.0 A7) ZO
1: \COMNEWTI.DOC (DST) 5/98 V tJ
-
ti
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
rattta
4p pItcetatifi>> Frxr < Aft
?�t�i�t�lil < <tl�'a . ! aattart.�rt�€s...t .. h ......, ..............
:: :4 .::::af:: e_ >st .. m 't : ele :r etor..a > tat t ievi4ott > nrt tr
After: •.lar:�:::revte r<: rr vaa :<:P:l s::: cami er rilt:::contact: >the a � . > licant>to request <
addt€iartet:: <.taa:oti a::#'I90 ;y01.1000 #
_` al ..:'
to .. �..
taimpiggissii KEY:
aa :.t
:::pia � tt •
S ( Private)::.., :............................................ ........:::..1::.::::d
.::( :.: S = Site Work
B (New or Add) 1 B = Building
F (New or Add or Alt) 3 F = Fire Protection System
r � u
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
NOTES:
�:: >�had�d:<�t`���:�si � .:: �T>: subrat��s.. t�.... 1 ....................................:.:,.............................. ...................:.:.:.::::..
I:\dstslmaxtrix1.doc 07/06/98
CITY OF°TIGARD Date Rec'd:
COMMERCIAL TENANT IMPROVEMENT Rec'd By:
APPLICATION /PLANS SUBMITTAL REQUIREMENTS
Applicants: Please complete
1 APPLICANT
APPLICANT NAME: (2 J T T .IJ Q€.s PHONE #: 6S7
SITE ADDRESS: 1t5n9 CAM- y FAX # (o BPS
1. A. SITE PLAN (Fully dimensional, drawn to scale) labeled with:
0 map & tax lot #,.. ❑ project name, ❑ site address, ❑ suite number
❑ zoning, ❑ applicant name, ❑ phone number.
A. North Arrow.
C. Scale (Any standard, architectural or engineering only).
ID. Street Names.
2. See Matrix on back of Application for number of plans required based on submittal type.
ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS
4. FLOOR PLAN(S).
WALL DETAIL.
C. REFLECTIVE CEILING PLAN.
�D. SEISMIC BRACING DETAIL FOR SUSPENDED CEILING.
✓6. SPECIFICATIONS & CALCULATIONS.
\I. ADA BARRIER REMOVAL WORKSHEET.
4. DEPOSIT - BASED ON VALUATION OF PROJECT.
CITY OF TIGARD
I:SFAPP.DOC (DST) 8/97
. .
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities, unless
such alterations are disproportionate to the overall alterations in terms of cost and scope
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five percent (25 %).
VALUATION of all renovation, alteration or modification being done
excluding painting, wallpapering. [1] $ /g02/1/. 3?
multiply: 25% Barrier removal requirement. _ .25_
BUDGET FOR BARRIER REMOVAL [2] $ - e7 / 57/. 09
The dollar amount of the BUDGET established on line (2) in the computation above shall be spent
providing the accessible elements in the following order:
1. An accessible hgio.accessib)e pedestrian
e]Vay $
(incl amings,
marked crossings, ramps handrails and landings)
2. Not less than one accessible parking space. Thu P,eope e7zy "/NA / //. °9
(including but not limited to adjacent access aisle, signs and curb ramp is 02-f."
connecting with the accessible route). Gd12.66 'f C2114T^14
t'i13 i fie ' -
3. Accessible entry or entries. $
(including but not limited to ramps, handrails, landings,
door sill height, door width and door hardware).
4. An accessible interior route to the altered area. ADDi^.) 4 A"8448sL'T ' $ 666- °°
(including but not limited to door -ways, maneuvering TO lePS
clearances, door hardware and stairways). •
5. At least one accessible restroom for each sex. PrDO' Jb, raoA in $ 5
6. At least one accessible telephone where public phones
are provided. $
7. When drinking fountains are required, fifty per -cent but
not less than one shall be accessible. $
8. Additional accessible elements such as storage, reach ranges,
alarms, etc. $
,/
TOTAL: Shall equal line 2 of Value Comput $ TJ //. 09
V�
� 1
° 1 ( 1 is /otc4.doc(DST) p
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OVER - THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: 77 4A)
CLASS OF WORK: 4,T FLOOR AREAS: EXTERIOR WALL CONSTRUCTION
TYPE OF USE: C° FIRST ia6 SQ. FT. N: S: E: W:
TYPE OF
CONSTR: SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: 6 THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
STOR: HT: FT: i BSMNT: SQ. FT. i AREA SEP. RATED:
BSMNT ?: MEZZ ?: i GARAGE: SQ. FT. i OCCU.SEP.RATED:
I �
FIRE FIRE SMOKE r HANDICAP e
SPRINKLER: o ALARM: N d DETECTOR: N a ACCESS:
COMMERCIAL INSPECTION ACTIONS FEE MENU •1
Foot/Found Post/Beam $ igq — Permit Fee
Masonry Framin $ / / 0
9 Plan Review
Insulation Shear Wall $ 5% State Surcharge
Firewall Gyp Bo $ ! J 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 $ 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: \ovrcntr2.doc (DST) 4/97
OVER-THE-COUNTER (OTC) PERMIT PLAN REVIEW
• COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project:
Class of Work: -z-i Floor Furnace: Evap Coolers:
Type of Use: Ce)41 Unit Heaters: Vent Fans:
Occupancy Grp: 6 Vents w/o Appl: Vent Systems:
Stories: 1 Boilers/Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3-15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: <= 10000 cfm: 0th Units: r
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn >=100k Btu:
NOTES:
$ - Permit Fee
_______".
Gas Line Inspection $ t A `› Plan Review
Mechanical Inspection $ / . 2( 5% State Surcharge
Cooling Unit Inspection $ Additional Permit Fee
Shaft Inspection $ Additional Plan Review Fee
Hood Inspection $ Inspection Fee
Fire Suppr Inspection $ Miscellaneous Fee
DucCLispegton--
Fire Alarm Inspection
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
Fire Alapinsizection
Final tien"
::FOR OFFICE' USE. ONIN'.:::::::, : • . :: • . :: :: : ..: :. *: • :" • , : • • . •::::::•::::‘, ": ..: :: :: : ::i.:::
TYPE OF USE OPTIOOS(COM:=;cOrnmerciet:CMS= ccimnierclat manufactured structure ' . :. •::::: ' ::' ::,.::. ::::::::::".,:::..:::: !:::::.::::::::.:.:., ..
CLASS OF WORK oPTioNsifogALL PERMITS (NEW = new ADD = addition; ALT = alteration: ACS= ar,cessOry;
.:.:FND = oth -dernolitioniREP= repair;..FPS= tire protection system; NOTE=USECITH:FORFENCES::::::::,::!:::.::::..;::'
: ' AWNINGS, CANOPIES) • • ", ::': • % .. ' • ::::..,. . ! - - .",:: :•:. ,* : ; .
i:\ovrcntr.doc (dst) 8/97
1
Page No. 1 CASE HISTORY FOR CASE NO.. BUP98 -0316
DAVID GREENSPAN
11509 SW PACIFIC HWY
12/09/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
---- --- -- - - - - -- - --
BUPC005 Application received / / / / 08/11/98 RECD DEB 08 /11/98 DRA
BUPC008 Permit created / / / / 08/11/98 Bob P reviewed and determined it . DONE DEB 08/11/98 DRA
qualified for over- the - counter review.
BUPC012 Plans routed to Plans Examiner / / / / 08/11/98 DONE DEB 08/11/98 DRA
BUPCO24 Plans Approved by CPE / / / / 08/12/98 APPR RDP 08/12/98 RDP
BUPCO26 Approved Plans routed to DSTS / / / / 08/12/98 APPR RDP 08/12/98 RDP
' BUPCO29 DST Post Review Completed / / / / 08/12/98 PASS JSD 08/12/98 JSD
BUPC090 (F) Ready to issue / / / / 08/12/98 PASS JSD 08/12/98 JSD
BUPC100 (F) Issue permit / / / / 08/13/98 reprinted due to system crash on 8/12/98 NOTE JT 08/19/98 JT
BUPC740 Framing Insp / / / / 10/08/98 BRACE WALLS AS PER DETAIL FAIL RC 10/12/98 DGW
PROVIDE ELEC. - PLUMB. APP. BEFORE FRAMING
DO NOT COVER
/ / /PLM insp appr 10/7/98 TLP, ELC insp
appr 9/24/98 CD...hap / ///
BUPC740 Framing Insp / / / / 10/15/98 PASS RC 10/15/98 J *H
BUPC760 Gyp Board Insp / / / / 10/15/98 PASS RB 10/19/98 J *H
BUPC762 Susp Ceilng Insp 11/18/98 / / 11/18/98 PASS RB 11/18/98 J *H
BUPC802 Final Inspection / / / / 11/17/98 1. Ceiling grid was not inspected for FAIL RC 11/17/98 J *H
seismic.
2. Need handicap sign on wall latch side
60 -inch to center.
3. Need plumbing final.
DO NOT OCCUPY.
BUPC802 Final Inspection 11/18/98 / / 11/18/98 1. Threshold needs to be no greater than FAIL RB 11/18/98 J *H
1/2 -inch high. •
2. Need to install signage on door,
"Doors shall remain open during business
hours."
3. Install mirror in ADA bathroom no
greater than 40 -inch from bottom of
mirror.
4. Provide smooth surface for ADA
bathroom at 48- inches in height.
BUPC802 Final Inspection / / / / 11/20/98 As per RC report dtd. 11- 17 -98. PASS RB 11/20/98 RB
BUPC950 (F) Issue Cert. of Occupancy / / / / 11/20/98 12/09/98 JT
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ajar: d
f.
/ 42-7 Date Requested ' _ 0 � i PM BLD •
Location I I5�� (SU) Suite MEC v
Contact Person - 11(//it Ph PLM
Contractor .4. 1. 4t i I��ti - ! iIf /A _ ./J Ph 6,55 / / `i'73 SWR
LIMING Tenant/Owner i JA / , ` � . J J ELC
Retaining Wall ELR
Footing Access: �(x I
Foundation .i. A 1 V FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
Post & Beam TYPE I � �/ ']'� _SIT ^-�� /\
Ext Sheath /Shear WO OP 6 1 `- l o PU& 1 L
Int Sheath /Shear ---
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
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 1 !/
Other Date ) t nspector Ext
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.