Permit .4: CITY OF TIGARD ORIGINAL BUILDING
99 00209
101 DEVELOPMENT SERVICES DATE ISSUED: 5/20/99
-' " '- I� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11680 SW PACIFIC HY PARCEL: 1S136CD -01700
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: 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: 44 I1&O
Remarks: DEMO AND EXISTING 675 SQUARE FOOT BUILDING.
Owner: Contractor:
MAGNOLIA HI Fl T M CONSTUCTION
11680 SW PACIFIC HWY PO BOX 20820
TIGARD, OR 97223 SEATTLE, WA 98102
Phone: Phone:
Reg #: LIC 61240
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Final Inspection
5PCT GEO 5/20/99 $1.25 99- 315554
PRMT GEO 5/20/99 $25.00 99- 315554
EROS GEO 5/20/99 $26.00 99- 315554
ERPU GEO 5/20/99 $8.45 99- 315554
(additional fees not listed here)
Total $69.15
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: /‹.--- / �__...
Issued By: /
C 439 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Application Rec'd By
13125 SIN HALL BLVD. New Construction and Additions Date Rec'd
TIGARD, OR 97223 Date to P.E. DST
(503) 639 -4171 Date Permit #2t
Permit #*it 12/gQ- 00 o?O 9
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
•
Name of Development/Project
Job Existing Building Et Building ❑
Address Street Address Suite
I 11,W 5e) 6- Aim Building
Bldg # City/State Zip Data
rim¢ p al 973 Existing Use of Building or Property:
Name
Property p `d' G i a G7. 5 "-oft r/
Owner Mailing Address Suite Proposed Use of Building or Property:
$ 34 w sf'ez.vr v,4e,4-,tT
// City/State Zip Phone S v3 No. Of Stories:
Occupant Name Sq. Ft. Of Project:
Phi vC s71¢77ahJ 6 ,--- 4)
Name Occupancy Class(es)
Contractor y 70 fr,euL°/ - 7d S
Prior to permit Mailing Address Suite Type(s) of Construction
Issuance, a copy a we �
of all licenses g V /j� ,„..313-01J
are required if City/State Zip Phone Will this project have a Fire Suppression System?
expired in C.O.T. � c ic� Yes ❑ No
database 4�`
Oregon Const. Cont. Board Lic.# Exp. Date Americans with Disabilities Act (ADA)
Valuation X 25% = $ Participation
Complete Accessibility Form
• Name Project $
Architect 0t Pide°IF4--sue Valuation
Mailing Address . / Suite
10-e /- 32 090 'l/ Plans Required: See Matrix for number of sets to submit
City/State Zip Phone x_OG on back
* ity
Ie5 AP- IS /ct, s- Lod d • .
Engineer Name 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
Mailing Address Suite that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent Date
City/State Zip Phone .5"_ Rd f /
Contact Person Name Phone
Indicate type of work: New 0 Addition 0 Demolition �"---
Accessory Structure 0 Foundation Only 0 Alteration 0
- - Repair 0 Other 0 FOR OFFICE USE ONLY
Description of work: Dr... 7 O ��� �f P7 t4 Map/TL# Land Use: 4 �D V� 6 q Notes:
Parks: Estimated # of Employees TIF:
If the above figure is not supplied at the time of application, the city will
calculate the fee based upon the number of parking spaces.
Note: Site Work Permit Application must precede or accompany Building
Permit Application
I: \COMNEW.DOC (DST) 5/98
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
apphcaton For an eiectncal submittal, the application must coritatn the
faxi
#09149 priAgtfpvtianjitfig.igk::::00011ItaiilldiliiiiiiaggifIA:11001111P
Washington County, Tualatin Valley Fre & Rescue)
1111111.1111011012.1111:1111.111:1tookor
Submtfted
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
ilt0:114:114.
.13CR.MECRIEANAitignigni
NOTES:
its$114041#0
hdsts\formstmatrxcom.doc 10/30/98
02/29/2000 Activities for Case #: BUP1999 -00209
9:48:21 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPC007 Application received 05/20/1999 GEO No Hold GEO 05/20/1999
BUPC008 Permit created 05/20/1999 GEO No Hold GEO 05/20/1999
BUPC802 Final Inspection 05/20/1999 05/20/1999 09/22/1999 GS PASS No Hold AKJ 09/22/1999 debris is gone, receipt for septic
in file
BUPC100 (F) Issue permit 05/20/1999 GEO DONE No Hold GEO 05/20/1999
BUPC105 (F) Reprint Permit 09/16/1999 GEO DONE No Hold GEO 09/16/1999
BUPC960 Case Finaled 09/22/1999 AKJ DONE No Hold AKJ 09/22/1999
Page 1 of 1
1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP f 9'q —Od Z02
/ D Requested JJ ' 9 — /l9 -97 AM PM B1i 19C/q (xzo�
Location / / ogV Poi P-�T.(J Suite MEC
Contact Person 194AJP Ph t — 2_% -- x/97 PLM
Contractor i (/)J'L • Ph SWR
BUILDING Tenant/Owner ELC
rnng W all ELR
Footing Acces t
Foundation , D % „0 131 s tm len r ei h se FPS
Ftg Drain V'� SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation � �
Drywall Nailing «(.Q v`r'w4 A.0 7 ,-
Firewall
Fire Sprinkler
Fire Alarm J l ET n e e2 G l 3 1 ✓/, -
Susp'd Ceiling (/ �rif 7 re,vvit Roof V OI 0(19
r ASS PART FAIL
PLUMBING
Post & Beam
Under Slab /f.P —!�.� ' / Y ��- �2 %�r4�i e� /L-�• 74
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 Hail, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk 9 ” Z
Other Date - 2 Inspector �� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.