Permit CITY OF TIGARD
SITE WORK PERMIT
r DEVELOPMENT SERVICES PERMIT #: SIT2000 -00045
='�'L '�' I ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 9/21/00
SITE ADDRESS: 06825 SW SANDBURG ST PARCEL : 2S101DD -00400
SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING : C -P
BLOCK: LOT: 001 JURISDICTION : TIG
CLASS OF WORK: ADD PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: Y VALUE: $170,000.00
EXCV VOLUME: 2,500 cy LANDSCAPING ?: Y
FILL VOLUME: 4,800 cy SITE PREP ?: Y
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: Y IMPERV SURFACE: 8.355 sf
Remarks: Site work permit for adding 15,054 square feet to an existing office building.
Owner:
FEES
TOC MANAGEMENT SERVICES
6825 SW SANDBURG STREET Type By Date Amount Receipt
TIGARD, OR 97223 PLCK CTR 8/30/00 $602.23 27200000000
FIRE . CTR 8/30/00 $370.60 27200000000
PRMT CTR 9/21/00 $926.50 27200000000
Phone: 620 -171.0 5PCT CTR 9/21/00 $74.12 27200000000
Contractor: EROS CTR 9/21/00 $80.00 27200000000
MCCORMACK PACIFIC CO ERPU CTR 9/21/00 $26.00 27200000000
7190 SW SANDBURG ST ERPC CTR 9/21/00 $26.00 27200000000
TIGARD, OR 97223 Total $2,105.45
Phone: 624 -2090
Reg #: LIC 00063111
Required Inspections
Erosion Control Insp 846 -8444 Final Inspection
Excavation
Fill
Grading
Paving Insp
Strm Drain Insp
Culvert/Catch Basin
San Sewer Insp
Domestic water line inspect.
Landscaping Insp
Misc. Inspection
Final Report Enq'd Grading
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. Yo y obtain copies of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Permittee Signature:
(,) ‘
Issued By: ___22
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
•
4. CITY OF TIGARD Site Permit Application Plan ck#
- Complete ENTIRE form Recd By ->-
13125 SW HALL BLVD. Commercial and Multi Family. p Date Recd 1 '� '' ..-°
TIGARD, OR 97223 Residence: Complete SHADED areas Date to P.E. d=.! - C:r'�
(503) 6394171 x304 Date to DST f�to0-
. Permit# 4)/T P -CCO
Print or Type Related SWR#
Incomplete or illegible applications will not be accepted p Called f-•Qo
#cPr.
Project Name -. • .::. Utilities (Complete all that apply)
Jo b T 'M M 5 —Al22
., -.
Addre Address Sewer
ewer L Ft
_ - _ • _ VA A 1.1
5 i/5V 5-7. 7 inear .
artie , ,: n� �"' ��`` /. Sanitary Sewer GT
: :MA NI AbSM W 0 ' Linear Ft.
Mailing Addre Fresh Water I� � Owner / ' 1 Q I� ,•
�p "ej: `�•� .s1/Y SA 4P rJ f ' 5 Linear Ft.
`: - ;City/State . ∎ Phon Catch Basins
•, _ 4&1b ice' Z5 4 o . - II # 3
` G.:0_00. 7];, a#0:::: r � � v 1i . Clean Outs
Con _ ! �f� IJZ�� r F' & #
N J
Prior to permit' .:Mailing Address Describe work to be done:
.issu a _ . NewO Addition AlterationD Repair
c o p yofa il .11 W 6A1113/1,to S r• El
licenses are Ci /Sta a � i • Ph n . ion Additional Descript of W ork: .., l:, i:. >r 4f.1," ^'.
req A 1 \�� G� �IA -v`" i . kY:"r? 5 >r :7.` 7 ;" �
,,, !',!;(.
expi in COT::' t .Cons .`C nt. Board Li Da • ''
database :: ',.'
N me Project : ,:•::; = _ .. •Y .. ' _
AL al ' £4 11 - A &I " . A 1 „ Valuation . $ (7 0 ODD`
Architect Mailing Address : Plans Required: -See'Matrix on back::. - `
G 7 � M , A Gk� 44 (e The following, must accompany this application:
Ci /Stat Zi
�' � �� ?i —�� Phone Site plan'with Vi co p Map : ; parking (inclining
rP r Showin ADA compliance ADA)'8� Lighting Plan
Na a • Grading Plan and _details Landscaping Plan
t Vo w` I •
Engineer Mailing Address Erosion:. Control Plan nand Retaining _ Structures -:
0/J P M� det including calculations ..
City/State Zip Phone Site Utility Plan and details Soils Report
6n l� g -1 G (showing :connection to:: : (if
_ approved `system) :: ,
Excavation Volume I hereby acknowledge that , I have read this application that the :
information giv- •;incorrect; :that I am the owner or authorised
✓ 2000 cu. yds. agent of • . er and that plans submitted are in compliance -
with 0 tate I - ::
Grading Volume � aY
Si•.•- ,ureof0' '''r' nt Date _
(Soils report required for >5,000 cu. Yds,) - A Q / $ ,,qq,,��
UP yds. Rt• � vv
Fill Volume Cod', -ct Person a on'
(Fill exceeding 12" in depth shall be compacted
To 90% of Maximum Density) 1 °. ��
. 3�cu. yds. - _ G'''[ ✓� i
Retaining structure? (check one) ['Rock FOR OFFICE USE ONLY
MU Notes:
"Otoncrete
❑Other
•
Total new impervious area including all Lan .Usse ase # Map/TL#
buildings, sidewalks, and paving � � q- Ft. - '—��
o -.
i :\fists \forms\site - app.doc 12/2/99 AAI
cb ,, ,`
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•
, • •
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
, .......
Plan Review is dependent upon submitta of BOTH plans AND a COMPLETED
goggatmoligotipoiliglogookigoolittokiporoppliootion:
signature :igt mgii4gpgtglpg jotiogEedilog:1
After plan feview approval, Plans EigiAii4f will contact the applicant to request
ddifionalpItooets::::fot:ixiistributiortpdriacisespOppr fiar:.atifittodititv:etsimmE:g::em:
WathifigtomeoutityATualgtimVallOf Fire & Rescue)
litill111111
KEY:
Subimtted
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
NOTES:
. .............
I: \dsts Worms \matrxcom.doc 10/30/98 •
•
• •• 4. .0" -
•
CITY.OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 2 - / AM PM BLD
Location r z5 5t.) 5 6frt Suite MEC
Contact Person Ph 79, — PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT D b 'oUo yJ
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing PA-odro / ' in4>i? A) 1 4 '/LOS /A 6
Insulation n _ f /
Drywall Nailing /91:7" , � Z4 � �N ,'� 41
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS 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
� 1
ckf 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 /Sideylalk Date , (0,0 Inspector Ext
Other P400/14, p
Final
PASS PART 67 DO NOT REMOVE this inspection record from the job site.
_CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested A - 6 G/ AM PM BLD
Location 4 2i.c 5 Suite - MEC
Contact Person Ph 7T) -/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab S IT b" —G U D N,)'
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall Fire Spnkler lY1 £ 7 76 8 ;,) /o4 6-
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PI I IMci •,^ =
Post & Beam
Under Slab
To Out
at ice
am a wer
Rain Drains
(WE PART FAIL
HANICAL
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
Appr Date 07/ /0 0 / / (' I Inspector 77 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TI3ARD BUILDING INSPECTION DIVISION MST
24- Hour In`spection Line: 639 -4175 Business Line: 639 -4171'
BUP
Date Requested ` / — AM PM BLD
Location 8 3 Sw S Suite MEC
Contact Person Ph S7-)3 3 f 2 -z-3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT ..20- a'I
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall 'I
Fire Sprinkler O 0ETe/[ /7/9A-J y Sir /h ✓'T /���
Fire Alarm , 5 - -- Q / 7 3 A� 4 7 Ai �' -- d 3o ii
Susp'd Ceiling C /
Roof /)�L ,UA / N e
Misc: -
Final
PASS 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
Backfill /Grading
Sanitary Sewer
[ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Fire upply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date / 1 — / 00' Inspe ctor T - 5 //k Ext
Other
r,, PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ' ' MST �
BUP
Date Requested / — r AM PM BLD
Location 6 8 &) 561" - 56-161 Suite MEC
Contact Person _ / Ph 793 C7/4 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
& SIT 2#..'L' -
*
S / }
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall /
Fire Sprinkler –.�7' Cam_
A i
Susp 'd Ceiling larm
I
Roof
Misc:
Final
PASS PART FAIL � - � � ��� � _—
PLUMBING Y
Post & Beam r1
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
�SIT�F'
Backfill /Grading
Sanitary Sewer
. ijjag .. [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
�.� n
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date 0 1 l Inspector frn Ext
P S PART FAIL DO NOT REMOVE this inspection record from the job site.
' c, CITY OF TIGARD BUILDING INSPECTION DIVISION . MST
24 -I4our Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / — r AM PM BLD
Location 06 Suite MEC
Contact Person Ph 7f3 — (-/-& PLM
Contractor Ph . SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT let/t/ —000 C/ 3
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall `
yy m _a
Fire Sprinkler (E: / :/ 5 7 . _, /(2
Fire Alarm , -
Susp'd Ceiling ` ' � . (__ ),_ � /-r
Roof ._..
�� �• " << > �_`: /5 7 7 , . ; ,�r�2 '4
Misc: ! :- � ; : c _..._
•
Final
FAIL ('� , .�.. �✓ 2
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
T
'Bntkfill /Grading
Sanitary Sewer
[ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
a ch Basin •
Fire Supply Line [ ] Please call for reinspe tion RE: [ ] Unable to inspect - no access
Approach /Sidewalk
Other
Date / `�I spector c Ext
-
(, ' PART FAIL DO NOT EMO'E this inspection record from the job site.
City OF TIGARD BUILDING INSPECTION DIVISION . =
•
24 -Hour Inspection Line: 639 -4175 'Business Line: 639 -4171 MST
BUP
Date Requested (o —1 1 AM PM BLD
Location OG 8L) Sw See-- Suite MEC
Contact Person .)/r Ph 7 f3 67/C9 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT "2&,0 c/3
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing _
Firewall // / �r
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
P ASS PART FAIL
PLUMBING
Post Beam
Undnder r 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
SIT)
fill /Grading
Sanitary Sewer
uraj [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA 1?1'2 Approach /Sidewalk Date 'f) I L Inspector '42 Ext
Other
Final
PART FAIL DO NOT REMOVE this inspection record from the job site.
L
.CITY QF TIGARD BUILDING INSPECTION DIVISION MST,
2 Inspection Line: 639 -4175 .Business Line: 639 -417
BUP
Date Requested /4 - AM PM BLD
Location 6 f is 5 w .5A-^I G u" " Suite MEC
Contact Person Ph 7o/ 0/7, PLM
Contractor Ph SWR
BUILDING Tenant/Owner 7j.' &5-e CG; ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT . Z - tJ GUG C/ J
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS 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
P ASS PART FAIL
a6 ckfiil /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 bi00 Otoach // idewalk r
he DRte 0 Inspector Ext
Fi -It a< / n
azilw PART FAIL ✓ DO NOT REMOVE this inspection record from the job site.