Permit CITY OF TIGARD
A DEVELOPMENT SERVICES BUILDING PERMIT
hp�j�E I j BUF'9
� �.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # DATE ISSUED: 09/ 03 / 97 7 -0422
PARCEL: 251O2BD—OO1OO
SITE ADDRESS...: 12645 SW PACIFIC HWY
SUBDIVISION • NO.TIGARDVILLE ADDITION AMEND. ZONING:R -12
BLOCK • LOT •52 JURISDICTION:TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION—
, CLASS OF WORK.:ALT FIRST • 281 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.:E2 TOTAL 281 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 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: SMOK DET..:
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 9986
Remarks : Handicap ramp
Owner: FEES
ROMAN CATHOLIC ARCHDIOCESE OF type amount by date recpt
PORTLAND OREGON PRMT $ 80.50 B 09/03/97 97- 298898
2338 E BURNSIDE SPCT $ 4.03 B 09/03/97 97- 298898
PORTLAND OR 97214 FIRE $ 32.20 B 09/03/97 97- 298898
Phone #: PLCK $ 52.33 B 09/03/97 97- 298898
Contractor:
PBM SPECIALTIES INC
41870 SE KLEINSMITH RD
SANDY OR 97005
Phone #: 668 -8385 $ 169.06 TOTAL
Reg #..: 000083
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Foot /Found Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Framing 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 wore
than 188 days. ATTENTION: Oregon law requires you to follow the
rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952-801-0010 through OAR 952- 0181987.
You many obtain a copy of these rules or direct questions to OM
by calling (503)246 -1987.
Permittee Signature: �t/ ." • Issued B : / / 9 Y
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
/ -
CITY OF TIGARD Commercial Building Permit Rec'd Byd
13125 SW HALL BLVD. Tenant Improvement Date Re °1 '� •
Date to P.E.
TIGARD, OR 97223 Date to D T ‘31.1.-a r iliP (503) 639 -4171 0 Permit # t P 4Y
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Job Name of Development/Project
- Existing Building ZNew Building 0
Address Street Address/AO ral. ger{ Suite
Mo . Building
' Bldg # City /State (7 Zip
/1-4rd Data
Property Name e t / B .jE -t4A), 612 Existing Use of Building or Property:
Owner Mailing Address Suite ,
2832 t, fir'A ski e_
City/State Zip Phone Proposed Use of Building or Property: •
13A—el ////�J q �n I _ _.,
51, e /1h7 �y f `4r�'�� + fele-e/ CALM(
Occupant Mailing AddresT441 9' sGr/ Suite No. Of Stories:
City/State Zip Phone Sq. Ft. Of Project: 55--7F4 A d? ?7 4.04--(07, ��
N Occupancy Class(es)
e ,n. fFQ-c,a / /;er
Contractor Mailing Address Suite
y /I7o SE 4,as,.,• Rd, Type(s) of Construction
City/State Phone -
PAzip 97o 2w-op 7/
(Prior to issuance Or on Const. Cont. Board Lic.# Exp. Date Will this project have a Fire Suppression System?
a copy of all 93 ‘ c-,16- / Yes ❑ No%
licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if Project Valuation $ 7 98d -
expired in COT Business Tax or Metro # Exp. Date /
C.O.T.data base)
Name enca wi abilities Act (ADA)
Architect Valuation lr X 25 °/ - $ Participation
Mailing Address Suite ( Complete essibility Form
City/State Zip Phone Plans Required: See Matrix for number of sets to submit
on back of submittal requirement sheet
Engineer Name
I hereby acknowledge that I have read this application, that the information
Mailing Address Suite 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.
City /State Zip Phone
Signature �of • •er /r gen Date
Indicate type of work: New 0 Addition 0 Demolition 0 ? g7. Pe / � f—.?-- � . .
Accessory Structure t r Fou ndation Only 0 Alteration O Contact a r Name Phone
Repair 0 Other 0 \ ► c- r (n M. h K� `I 7J- oat? • Description of work: �( w Q \'
,a. �J /�� Q FOR OFFICE USE ONLY
di. c 4,,r.. I 08 1 Lec/ e6,.. iJ /7 ,f • Map/TL# Land Use:
Ner7 sia a oq
fcA ore-/ Notes:
TIF:
Parks: Estimated # of Employees
Note: Site Work Permit Application must precede or accompany Building
Permit Appiiction .
I: \COMMAPP.DOC (DST) 10/96
PERMIT # ACCOUNT DESCRIPTION COT WACO AMOUNT AMT.PD. -
Building Permit (BUILD) (UBUILD)
Plumbing Permit • (PLUMB) (UPLUMB)
Mechanical Permit (MECH) (UMECH)
af State Tax (TAX) (UTAX)
Bldg.
Plumb.
�� Mech.
'523 Plan Check
(BUPPLN) (UBUPPLN)
Bldg.
Plumb.
Mech.
Sewer Connection (SWUSA) (USWUSA)
Sewer Inspection (SWINSP) (USWINSP)
Parks Dev Charge (PKSDC) (UPKSDC)
CDC - Planning (CDCPLN) (UCDCPLN)
CDC - Building (CDCBLD) (UCDCBLD
Mass Transit TIF (TIF -MT) (UTIF - MT)
Commercial TIF (TIF -C) (UTIF - C)
Industrial TIF (TIF -I) (UTIF - I)
Institutional TIF (TIF -IS) (UTIF - IS)
Office TIF (TIF -O) (TIF - 0)
31. Fire Life Safety (FLS) (UFLS)
Erosion Control Permit (ERPRMT) (UERPRMT)
Erosion Planck/USA (ERPLN) (UERPLN)
Erosion Planck/COT (EROSN) (UEROSN)
(A) TOTAL: _
I t s`
I: \COMMAPP.DOC (DST) 10/96
•
OVER - THE - COUNTER (OTC) PERMIT
COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: b %rrp 42".v-. r •
CLASS OF WORK: hur ' FLOOR AREAS: 2-11( EXTERIOR WALL CONSTRUCTION
TYPE OF USE: Co 001% - i FIRST SQ. FT. N: S: E: W:
TYPE OF
CONSTR: 1fl I SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: it E2 I THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: ------ i TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
STOR: HT: FT: BSMNT: SQ. FT. AREA SEP. RATED:
BSMNT ?: MEZZ ?: i GARAGE: SQ. FT. OCCU.SEP.RATED:
FIRE FIRE SMOKE HANDICAP
SPRINKLER: ALARM: DETECTOR: ACCESS:
COMMERCIAL INSPECTION ACTIONS FEE MENU I
Foot/Found Post/Beam $ g0 Permit Fee
Masonry Framing $ SS" Plan Review
Insulation Shear Wall $ 3 5% State Surcharge
Firewall Gyp Board $ 32■ 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 x Final $ 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:lovrcntr2.doc (DST) 4/97
05/15/2000 Activities for Case #: BUP97 -00422
2:53:29 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
•
BUPC005 Application received 09/03/1997 B RECD BON 09/03/1997
BUPC008 Permit created 09/03/1997 B PASS BON 09/03/1997
BUPC010 Check for prcl. restrict. 09/03/1997 B PASS BON 09/03/1997
BUPCO24 Plans Approved by CPE 09/03/1997 RDP APPR BON 09/03/1997
BUPC740 Framing lnsp 08/31/1998 GS PASS GES 08/31/1998
BUPC802 Final Inspection 08/31/1998 GS PASS GES 08/31/1998
BUPC100 (F) Issue permit 09/03/1997 B PASS BON 09/03/1997
BUPC960 Case Finaled 08/31/1998 GS PASS GES 08/31/1998 .
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP 9 >- c>
Date RequesteedJ ���� AM PM BLD
Location /7.2 �/S ��z� 4 it Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
• Retaining Wall _ ELR
Footing Acces (12133,1
Foundation / FPS
Ftg Drain /�� "rico A.,--,46t SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Miser 1 4
• AS PART FAIL
PL I :ING
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
Other oach /Sidewalk Date CS - J l 9E Inspector ✓ ,- Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.