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Permit A CITY OFTIGARD SITE WORK DEVELOPMENT SERVICES PERMIT M � . 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 D PERMIT # S I T 98 -0008 DATE ISSUED: 07/28/98 PARCEL: 2S11OCD -00114 SITE ADDRESS...: 11755 SW QUEEN ELIZABETH ST SUBDIVISION • KING CITY NO. 2 ZONING: 6 0 - ) /O7 BLOCK • LOT • JURISDICTION: KIN CLASS OF WORK..: NEW PAVING? • Y RESO. NO.: TYPE OF USE •COM : GRADING? • Y VALUE...$: 20000 EXCV VOLUME: 200 cy LANDSCAPING? • FILL VOLUME: 0 cy SITE PREP? • Y ENG FILL? • N STORM DRAINS ?...: Y SOILS RPT READ ?: Y IMPERV SURFACE: 6034 sf Remarks : Parking lot and grading for new dental clinic. Owner: FEES KIM MOOKI type amount by date recpt 11870 SW KING JAMES PLACE PLCK $ 91.33 GEO 03/02/98 98- 303748 KING CITY OR 97224 FIRE $ 56.20 GEO 03/02/98 98- 303748 PRMT $ 140.50 DLH 07/28/98 98- 307753 Phone #: Contractor: LANDMARK CONSTRUCTION 15075 SW KOLL PARKWAY BEAVERTON OR 97006 Phone #: 646 -3016 $ 288.03 TOTAL Reg #..: 001215 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Strm Drain Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Culvert /Catch Ba applicable laws. All work will be done in accordance with San Sewer Insp approved plans. This permit will expire if work is not started Domestic water 1 within 180 days of issuance, or if work is suspended for more Misc. Inspection than 180 days. ATTENTION: Oregon law requires you to follow rules Final Inspection adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0910 through OAR 952 -001 -0080. Your may obtain copies of these rules or direct questions to OUNC by calling (503)246 -9187. Issued by• Permittee Signature: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ - CITY -OF TIGARD Site Permit Application • 13125 SW HALL BLVD. Commercial: Complete ENTIRE form ._ r TIGARD, OR 97223 Residence: Complete SHADED areas ,�„ (503) 639 -4171 x304 -,` n S I - , cco r Print or Type pQ e aJ d - c 4 , ,.,,r,. Incomplete or illegible applications will not be accepte • - Utilities . . :: . : erect Name :: :.:: : ::: :.:::::::: • ::::.::::::::. ::: ::::.;.:.;;:.;: :.;:.;;:.;:.: (Complete all that apply) ( P ' :: ddress' : » :<: > # >' :» :' > : > : : :: ? >;': < < > : > > :> : > ' : ' > :: <: - >;:�4d0: test ;:.: ::::::. >:;:. >;:.:.;::.::; .:.::.::.:::.::.:.::.::.;;:.>:<.:;.;:.;:.;:.;:.;:.;:.;:.:;.;;:.;:.;.....;::.:.:.;:.:.;;: ;,.;:.;:.;; Storm Sewer F . . ..... ... .... . ....... . ...... ........: r� Linear Ft. : .:..... ::.:::.:.:::.�::.�::::.::::.:: :.:::..:.:......:.......... .:...................:......... Sanitary Sewer C'� . :: > .............. ........:...................... (v Linear Ft. it :::»»:>:»>::>: >: >:: :>:.>< :: >:'..:...;:.; :........:::: tip 2 0 ...................... .................:...... Linear Ft. .: ..:..:..::... S t at e............. ............... Pho�a C atc h Basins 1 C .:.................... . . . ....... ...:....:. ..�....... .. ::.::.;:.... ::. Clean Outs €::Cir11 '` < :.;:.:.::.;;:.;Det:;; :»l �aili�g; �tifd: >: ;:.:<...: :;:.;::.:.:. ��: >:: >:<: >::: » >..::.:;::: � ; »:: > :::::::.. Describe work to be done: : .:.�: < >:::�:.: » >:<:.::. ,.;:- ; .... ;; > :: ::::�� New Addition Alteration Re air :.;:: s :..rat ka .:::.:........:......................... . .... ...... .....::::::::. : Add�,gaal:.......:. trop: of: tttfor# c........ ::::::::::::,.....:.::::: ..:::::::::.. .: < .;::.::.; . . .. ...:.:..... .v ............ . Nam ::E�q :::. i' Architect Ma lin Address >::#rarbs;:lr� , crired,;:;;See:l�i3zar� i3 :;: ;::;;::;: � Si 4�� � h�te�Ita�,rinJ, n>:t : accta�i?enY the a ppl€to� ;.::;:.: >;.:.; Ci State Zi 97 Phone t' Vi" ni y : :i . :i :: € f : : ::: . P '< »'it�la wi th .::c acti . :i!�a� :.::::..:::. �t indt �€ ©�' 'V2 - 85 : ? > Showi t I A?i omp : ri es:<:: =: <::::AOA : & g Plat :: Name :.: Plan trt . ; . B ait;#;:; :.;:. : r ;::: • %.: 4 :: #ts¢ : In fi i; :<;;. dlp Mailing Addr Engineer eer es s 9 9 i� Control Pilo e nd Ir�etemin� Structures �ietaita.:::. • • • • • ....:, ::::::: :.: : ::: . � ,,- - ,.:::: n cl n calculations >: : City/State Zip .... ° °' i Phone . . >: Sidi' t#a? :a€tets » > >:::::::: i ::. ,. 9�a :. . :::::.:. � . requl r�ac[;; . ;:.;:.;: . ;: .:<.; >;:�;:- ;:.;;: ...: e • oved Excavation V'-'• -,me > taae a " ackn: ` thatI hav < i s ;:::::;�:::: ;:::;; :..:.:::.:.. :: , 4 i4 49 ::.::.::::::::: ti.:teal :.. g aRp : 9 t at[3�?e it :: (Soils report r: wired for >5 000 cu. Yards Cu. yds. >: ±fpj tipi'i : : tS #ect tt i >t: It tier> r :age t of tt a ai r ':: • r <: :art d t at Alai s <s ubr <are c o liani : < : : Fill Volume 5 :. e • ; -• .1.w.i'...,:-.......:.:!`::::::::::::::::::::::::::•1::::::::*::::::::::•::::::::,44.;: •:::.:w::•:.::::-,:.:::::: required ". (Soils report o rt e uir for 5 000 cu. Yd s.) c s Will h the fill support asru PP ort structure (Engineer required if answer i s e ed a yes) Y N q Y ES O 0 � O O Retaining structure? (check one) ❑Rock , FOR OFFICE USE ONLY ❑ CMU Notes q x._ ❑ oncrete p ' / # �_{ ['Other ��l �lj G 1 ; .. ;ill i ) C ' — . Total new impervious area including all La C Map/TL# buildings, sidewalks, and paving G�3C14. Sq. Ft. -- �;7$f /B�➢ - • adi/ siteapp.doc9 /97 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST EXAMINERS (Note a.) TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 -- -- 3 (j,o,u) -- -- B (New or Add) 1 1 -- -- 3 (j,o,w) -- -- F (New or Add or Alt.) 3 3 -- -- • 3 (j,o,f) M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- -- B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- -- P (New, Add. or Alt) 2 -- 2 -- -- 2(j,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) - 2(j,o) -- E (New, Add, or Alt) 2 -- -- 2 -- -- . 2(j,o) B & M & P & E (New, Add) 3 1 1 . 1 3 (j,o,w) 2(j,o) 2 (j,o) .`` :<. ......::...... ............ .:::.:::::::.:.::..:.:::. ;:.;:.;:.; :.::.;::.:.::.;:.:.;:. NOTES; KEY: a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP number of revised plans from applicant, stamps and completes, o = Office M = MEC updates and adds actions. f = Fire P = PLM u = USA E = ELC ?..:: 4 #4.4d 4 d . ,A 0000445 % «: >< ::`: :11<> :::: w = Wash. CountY F = FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. h:\matric.Doc / • Page No. 1 CASE HISTORY FOR CASE'NO.i SIT98 -0008 MOOKI DENTAL LAB 11755 SW QUEEN ELIZABETH ST 03/02/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent 'Done Done Date By - - -- - -- - - - - - - -- --- SITC005 Application received / / / / 03/02/98 RECD GEO 03/06/98 GEO • SITC008 Permit Created / / / / 03/06/98 DONE GEO 03/06/98 GEO • SITC010 Check for prcl. restrict. / / / / 03/06/98 King City land use approval, check with MEMO GEO 03/06/98 GEO King City for any landuse restrictions prior to issuance. SITC013 Plans Routed to Plans Examiner / / / / 03/06/98 PASS GEO 03/06/98 GEO SITCO30 Reviewed plans routed to DSTS 07/27/98 / / 07/27/98 APPR RDP 07/27/98 RDP SITCO32 DST Post - Review Completed / / / / 07/28/98 DONE DLH 07/28/98 DLH SITCO50 Hold for / / / / 08/05/98 NO INSPECTIONS UNTIL HOLD RELEASE. 08/05/98 JT ACCOUNT CLOSED /CHECK RETURNED TO ACCOUNTING DEPARTMENT. QUESTIONS? CALL PHYLLIS EXT.353 • SITCO55 Hold Release / / / / 08/31/98 fees paid at the finance dept. JMT 10/05/98 JT SITCO80 (F) Ready to issue / / / / 07/28/98 Need copy of general contractor's PASS DLH 07/28/98 DLH •• current CCB. u. SITC092 (F) Issue permit / / / / 07/28/98 DONE DLH 07/28/98 DLH SITC740 Strm Drain Insp 05/26/98 / / 09/04/98 rain drain perimeter.. PASS TLP 10/09/98 J *H • -- SITC740 Strm Drain Insp / / / / 11/03/98 EXTERIOR RAIN DRAIN TO CATCH BASIN PASS TLP 11/03/98 J *H • SITC744 Culvert /Catch Basin 05/26/98 / / 11/03/98 EXTERIOR RAIN DRAINS & CATCH BASIN PASS TLP 11/03/98 J *H SITC750 San Sewer Insp 05/26/98 / / 11/02/98 Not City of Tigard's jurisdiction. PASS TLP 11/04/98 J *H 20 -ft. of 3 -inch ABS SITC757 Domestic water line 'inspect. 05/26/98 / / / / 05/26/98 RDP SITC770 Misc. Inspection 05/26/98 / / / / 05/26/98 RDP SITC799 Final Inspection 05/26/98 / / 02/26/99 I'm assuming wtr service was inspected PASS GS .02/26/99 GES by plm inspector SITC800 Case Finaled / / / / 03/02/99 03/02/99 JT • • 06114/1998 13:24 5036266183 LANDMARK DEVELOPMENT PAGE 03 5036443190 CASUELL'HERTELBEAGLE 246 P82 AUG 1.4 '98 11.37 S IT`f c ovvo 5 • STE SURVEY I. FOR LANDMARK DEVELOPMENT CONSTRUCTION IN NE SE 1/4 OF Th E SW 1/4 OF SECTION • . . , -. 1 W. , W.M. KING CRY WASHINGTON COUNTY - OREGON SCALE 1' 20' C AUCU 13, 1988 *ieziekt7xy . 4 V� fv l QV .0 0' 1.3.00' • • i • i 1 FOUND 5 /8 10/4 ROD • WITH YELLOW CAP P 5.00' INSCRIBED ' 133? • IN ASPHALT P KING CASWELL/ , _ e HERTEL SURVEYORS INC. 6120 S.W• LOMBARD AVE BEAVERTON, OREGON 97008 (503) 644 -3179 P . 5.00' . • • • — • . • LAIC - . . . • • .• MIT 11111. ' .:. • ALBE'Itf N J i EXPIRES 6/3b/1999 OUND 5/8" IRON ROD 'ITN RED PLASTIC CAP ; IcMONAGIE . a JOB NO. 5911 i t ' X8714/1998 13:24 5036266183 LANDMARK DEVELOPMENT PAGE 04 5036443198 CASWELL /MERTELE 246 Pte; AUG 14 '98 11:38 IN • M J A wai y � 7 S . §: ,, ,10 , • i 9a orr�w o � dvo 3USV1d 03b HUM • • o y 00e1 NOW .6/S oNno4 '.r y I I .L6'/ B NI - 1 t ; 370�owPw cIVO 311SYld 0321 HJJM :Sr OW NOM s/s oNno4 ! aur, sv„ rimb ... N • •• ...- . a f [ o v • a —1 4 0 .GOT c 4 ro • 1332113 11*H4SY NI ' gin 011.5Yid 140113.1 AVM \ - ` b il • • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 9, — "/0 bb.. 'GIO" Date Requested .,2h � , AM C PM BLD Location // 7-575 5$ �L--6 Suite MEC X��0 -1. Contact Person Ph c==. /6/ PLM Contractor Ph CMTILDINA? Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: � Slab ��,�1 i/ i /o, 1 SIT 9� �6Q� Post & Beam Ext Sheath /Shear ' Int Sheath /Shear � " /� Framing C� l �-, �` -e.it� l,�t,�t_dr ��yub _ Insulation ,...--- Q Drywall Nailing •-e::; - - �1�,4„ sue' . _. L.,' L - ., s Firewall f ,, Fire Sprinkler � _ !�' A-- c�.G_. V Fire Alarm /J Susp'd Ceiling J� `� _ . 4- ,- .�r-r/'iai - L�-e_. �` . Roof i Misc: — -��- -- ' _ i : '/ _ p rnal i- PART FAIL PLUMBING Post & Beam • . Under Slab _ _ _,ojc_ r--, Top Out Water Service 7' �,., ,.fir r .A.-• �p�?�Q /�1 � y ✓1�.-.�J i[��..N Sanitary Sewer Rain Drains �?�.�• Final PASS PART FAIL C HANICb■ ) r ,f' Zl(.a - r te _ ..:( e ptQ ,„e Post & Beam Rough In _ 9 ® Gas Line Smoke Dampers Ed 9 ! I P ...e.-0 /� A - A SS >ART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final ya6k PART FAIL SIT 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 �f� Approach /Sidewalk Date Z - ?' ‘. 7 I nspector . .< Ext < PART . FAIL DO NOT REMOVE this inspection record from the job site. `� P 1