Permit At CITY OF TIGARD SITE WORT.
tl , DEVELOPMENT SERVICES PERMIT
°j �'
PERM IT # : SIT98 -0022
°1J— I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/19/98
Vto 0 PARCEL: 2S1O1DD -00702
SITE ADDRESS...: SW SANDBURG ST
SUBDIVISION • SALEM FREEWAY SUBDIVISION ZONING: I —P
BLOCK • LOT •004 JURISDICTION: TIG
CLASS OF WORK..:OTR : PAVING? • N RESO. NO.:
TYPE OF USE •COM . GRADING? • N VALUE...$: 17000
EXCV VOLUME: 0 cy LANDSCAPING? N
FILL VOLUME: 0 cy SITE PREP? Y
ENG FILL? • N STORM DRAINS ?...: N
SOILS RPT READ ?: N IMPERV SURFACE: 220 sf
Remarks : Site work for an unmanned equipment modular of 220 sq ft.
Owner: FEES
J & K PROPERTIES type amount by date recpt
I 6900 SW SANDBURG PLCK $ 79.63 DEB 06 /23/98 98- 306724
TIGARD OR 97223 FIRE $ 49.00 DEB 06/23/98 98- 306724
PRMT $ 122.50 DLH 08/17/98 98- 308338
Phone #: 5PCT $ 6.13 DLH 08/17/98 98- 308338
EROS $ 80.00 DLH 08/17/98 98- 308338
Contractor: ERPU $ 26.00 DLH 08/17/98 98- 308338
SCHOMMER & SONS INC ERPC $ 26.00 DLH 08/17/98 98- 308338
6421 NE COLWOOD WAY QUL% $ 23.07 DLH 08/17/98 98- 308338
PORTLAND OR 97218 WQUN $ 16.70 DLH 08/17/98 98- 308338
Phone it: 287 -4646 $ 429.03 TOTAL
Reg #..: 004937
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspect ion
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 -8080. Your may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issued by:i Permittee Signature: /i/" /L-�` /
ON /7P/et / &-77707
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Site Permit Application Rec'd By 6 -7 7 .C
• Date Recd i %--6949 ° Q+i
13125 -SIW HALL BLVD. Commercial: Complete ENTIRE form Date to P.E. Ce — 13 Q4'
TIGARD, OR 97223 Residence: Complete SHADED areas Date to DST J'/ y /' 4 , , a` /,'t
(563) 639 -4171 x304 f5.9ln'• �1'r'r Permit #�j''Q- • ob�Z-
Related SWR #
gi 0 � � Called CI _5 — 1'6 PhSwPr i ,+
Print or Type
Incomplete or illegible applications will not be accepted
Project Name a I �}- �- � Utilities (Complete all that apply)
Job 1 V� `
Address Storm Sewer
6'7 090 C - Sa � ,- \ Linear Ft.
N -
am , Sanitary Sewer
4 rr _ Linear Ft. •..„.. A\
Owner Mailing Address Fresh Water
LA) WOO 4 S Ccvi S`'�`,, Linear Ft.
City /State Zip Pone Catch Basins r
`1 - � ar - • 0r 722.7 - , - , a \ #
General .( - Clean Outs
nci, Contractor l�oi -'•r MP � c - ` tf\S #
Prior to permit Mailing Ad drew - Describe work to be done:
Issuance. a C�44Z _ ..� p �.l?0 C7t5 et 1,1.7 �-y-
copy of all New❑ Addition❑ Alteration❑ Repair❑
licenses are ((•�t a - Zip � Phh ( /� Additional Description of Work: ,, C f
required it \ � � _" t (..C3 /-41 va.m4ist .� et Lkl'iQ n .e'i i S 7_20 , k,
expired in COT State CCo / n j� Co rd Lic. # Ex D to p ,
database On() `t-`7 '9 .27 / p ✓ i NQ..W dC✓t Y1MQS O rd d2 t t_ movivo L o
Name / Project .
Valuation , _ . 1 .. :4;445‘4 1 , 1.7
Architect Mailing Address Plans Required: See Matrix on back V _ ' :
The following, must accompany this .application:
City/State Zip Phone Site plan with Vicinity Map : Parking (including
Showing ADA compliance' ADA) & Lighting Plan
Name Grading Plan and details Landscaping Plan
Engineer Mailing Address Erosion Control Plan and Retaining Structures
details • - , including calculations
City /State Zip ' Phone _ Site Utility Plan and details. Soils Report
(showing connection to (if required)
- approved system) - . • -. .
Excavation Volume I hereby acknowledge that I have read this application, that the
(Soils report required for >5,000 cu. Yards .\\''‘‘ information given is correct, that I am the owner or authorized
cu. yds. agent of the owner, and that plans submitted are in compliance
with Oregon State laws. - -
Fill Volume Signatu of er /A nt _ Da -
(Soils report required for >5,000 cu. Yds.) I j �j
1 cu. yds. k ., t /i D 1
Will the fill support a structure Contact erson Name - - Phone -
Engineer required if answer is yes) YES❑ NOD
To A - . erahes q7 T730
Retaining structure? (check one) ❑Rock FOR OFFICE USE ONLY
❑ CMU Notes:
i ❑Concrete �
! ( ' y e ❑Other
i
Total new impervious area including all Land Use Case # Map/TL#
buildings, sidewalks, and paving _G GD Sq. Ft.
siteapp.doc3 /98 C :V' 1 'e v - 79. 6 .3
.___ _ - - -- fi ag-4/3
k
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) --
B (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)
. .
..............:.................
.....:.:::::::.::::::::::...::: ::::::.:.::::...............:.. .
: >::
. ..::::..:::.:: >::: .........
..
::.::.::
>..
t..
.:. ... .... ...
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
b ad ar
: : Shd : as:;des� e.::AL 1: !mit ;:o ::::.::::: >:::: :::::::::::: ;:::::v:::::::: >: >::>::::::::: ;:::: < = —
... ............ gua fi::. ::::::::::::::: ::.::::..: :: ....,. ..,..,.;:. ;.::.::.::: :.::.:::...:.:,. >:..:.:;:.::::: 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:Vnatric.Doc
1
CITY OF TIGARD BUILDING INSPECTION DIVISION Op/
MST
24-Hour Inspection Line: 639 -4175 Business 63 -417 � 0 - (172 .
1 `(15 1 Date Requested /// - -, AM /J PM BLD �' ' _
Location 4 rcd.0 SamAliwIr YT � Suite MEC
Contact Person 6 Ph 20q'Q UU PLM
Contractor S S t7�� j Ph J SWR
UB I TeletiltiGkeilW 3/7, /999 ELC
Retaining Wall 1 ELR
Footing Ac a � s: � `,�� �/ /��
Foundation �� �G� �. lam' v aa� n N - 1d �✓'-4� FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ,�
(fide, ��— QQ
Slab �p
Post h Beam
Ext Sh ' � '� j`./ 1.
eath /Shear /,
Int Sheath/Shear
Framing
Insulation 'Ai r %i / _ / /
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Fi ART FAIL
• °'" = ING
Post & Beam --1
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 PART FAIL
ac fill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
[ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
A
DA
.ppeoach /Sidewalk Date /� — nspector rot s Ext
Wit►
e PART FAIL 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 -10d-'6)
(0 /oi& p D ate Requested � � 0 PM BLD
Location i / / OM" / Suite ' `/ MEC
Contact Person //0 Ph 067- - '7 W5 PLM
Contractor d /7,571tL/U t c57L-3 Ph " ¥O ¥ & SWR
` BUILDING Tenant/Owner Ao W.irAK- < ELC
Retaining Wall ELR
Access:
W FPS
Ftg Drain
Slab
Crawl Drain Inspection Notes:
®�ZN�Q STN
Post & Beam �' �, I / 7g -QQa-�
Ext Sheath /Shear P9(�tIC../ /v& /2 /V
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
ASS PART FAIL
PL BING
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: All II [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date g Inspector 4 _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.