Permit r .
CITY TIGARD B UILDING PERMIT
PERMIT #: BUP2000 -00135
r DEVELOPMENT SERVICES DATE ISSUED: 4/26/00
-_ -'.- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134DC -03000
SITE ADDRESS: 10960 SW TIGARD ST
SUBDIVISION: CHERRY HILL ACRE TRACTS ZONING: R-4.5
BLOCK: LOT: 001 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 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 RGH r: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 500.00
Remarks: Demolition of one single family residence and three outbuildings. All demolition debris is to be removed and the
sewer capped and inspected. Approximately 600 square feet to be demo'd.
Owner: Contractor:
SCHOOL DISTRICT NO. 23J OWNER
WASHINGTON COUNTY
13137 SW PACIFIC HWY
TIGARD, OR 97223
Phone: 684 -9233 Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Misc. Inspection
5PCT DEB 4/20 /00 $4.00 1583 Cap Sewer Line Insp
ERP2 DEB 4/20/00 $8.45 1583 Finallnspection
EXPIRED
ERPC DEB 4/20/00 $8.45 1583
PRMT DEB 4/20/00 $50.00 1583 5/ I /
(additional fees not listed here)
Total $96.90
1 °0
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 PO
calling (503) 246 -1987.
1 §
Permitee
Signature:
Issued By:
Call 639 -4175 by 7 p.m. for an inspection the next business day
th
. .►
BUP - Building Permit EL C - Electrical Permit
J Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical fmal
Masonry/Reinforceme t ED
Framing t
MFG - Structure set -up E * 6� MEC - Mechanical Permit
Insulation �
Drywall nailing �jU� Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in •
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
- 4 Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm fmal Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer yz,V00 ✓N�
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final /2.1 /Q 1J BLS
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR ELC, ELR, MEC, SIT PERMITS
w
CITY OF TIGARD P V PERMIT #:
DEVELOPMENT SERVICES � DATE ISSUED: 4/26/00
AL
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 ` PARCEL: 1S134DC 03000
SITE ADDRESS: 10960 SW TIGARD ST
SUBDIVISION: CHERRY HILL ACRE TRACTS ZONING: R-4.5
BLOCK: LOT: 001 O JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 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: $ 500.00
Remarks: Demolition of one single family residence and three outbuildings. All demolition debris is to be removed and the
sewer capped and inspected. Approximately 600 square feet to be demo'd.
Owner: Contractor:
SCHOOL DISTRICT NO. 23J OWNER
WASHINGTON COUNTY
13137 SW PACIFIC HWY
TIGAR OR 97223
on e.. Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Misc. Inspection
5PCT DEB 4/20/00 $4.00 1583 Cap Sewer Line Insp
Final Inspection
ERP2 DEB 4/20/00 $8.45 1583
ERPC DEB 4/20/00 $8.45 1583
PRMT DEB 4/20/00 $50.00 1583
(additional fees not listed here)
Total $96.90
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.
Sign atit
S ur N \[,...)U.s,_ 1
ignure: ``� �,,�, `�,'C'rC�"U �
` � ,_ c .,,,�.
Issued BC ,, _ C p c,.. „ nAilli
Call 639 -4175 by 7 p.m. for an inspection the next business day
01/28/00 0 FRI 10:08 FAX 503 598 1960 CITY OF TIGARD E 002
CITY OF TIGARD Commercial Building Permit Application Plan eok
13125 SW HALL BLVD. New Construction and Additions Rec' y
Date Recd -CO
TIGARD, OR 97223 pate to P.E. —
(503) 639 -4171 Date to os-
Print or Type Permit* OW retw)- - COI 3,5
Incomplete or illegible applications will not be accepted Related SWRir r
Caged /Q•
Name of DDevelopment/Project 9 -x°
Job �.lpL)3 ST�L+� � [ T Existing Building Li �" " " New Building ❑
Address • � i-1 • r •Tess Suite
l•
QD.."12,r \ 0 0ail/ A- Building ,
t 9( Bldg P Ity194a a Zip Data
( v∎ c.,r ..., gi 2 �5 Existing Use of Building or Property:
Nme
Property 1 1� �l(1 (.t.'�'1 1 ��
Owner Meilin Address Su Proposed Use of Building or Property
\ 1 1 1 1 S1g A —
C /State Zip Phone
7777 No. Of Stories:
Occupant N Sq. Ft. Of Project:
Name Occupancy Class(es) '-q ' -
Contractor \ ` Q r
Prior to permit Mailing Address , Suite Type(s) of Construction
issuance, a copy 7 NA / IL:. ,;
of all licenses
are required if City /State Zip Phone Will this project have a Fire Suppression System?
expired in C -O -T. f i at) 1 ,/f d ip Yes (71 No a
database a � t
Orog Comet. Cora_ Board Llc.# Exp. Data Americans with Disabilities Act (ADA)
Valuation X 25% = $ Participation
Complete Accessibility Form
Name Project $
Architect Valuation 86
Mailing Address Sutte
Plans Required: See Matrix for number of sets to submit
- City/State Zip - Phone on back
Engineer Name I hereby acknowledge that I have read this applicatibn, that the information
given Is correct, that I am the owner or authorized agent of the owner, and
Mailing Address Suite that plans sub .1• - - in compliance with Oregon State Laws.
'Signcur of il n !'Age t Date
City /State Zip Phone 4y1e 2 114 2
1
CZ taut Person' Name Phon
Indicate type of work: New 0 Addition 0 Demolition 1 l } A tio l 51 c 7
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 FOR OFFICE USE ONLY
Description of work: --
/no i ST 124)c - Lre. 3Y Co 1 oLL 7. Lana user •�1
U`tpL a
1, i �G as, 03 0,-i- 6U( c,')/ i...4 '
Parks; Estimated 1F of Cmployeee — r
If the above figure is not supplied at the time of application, the city will r:=*^qprr-fe _ _'•- j';' w i' - -
parking P aces_
calculate the fee based upon the number of r s f -• - .,
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Note: Site Work Permit Application must precede or accompany BuIlding CP
Permit Application 4 W , f 1 L /�, J o -
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. CITY OF TIGARD BUILDING INSPECTION DIVISION
. - 24YHour Inspection Line: 639 -4175 Business Line: 639 -4171 MST G
' .,. BUP -24-0,1 G "/5)
Date Requested .° 1 ) AM PM BLD
Location /0 q7G u .5,..✓ T( > ' v ci 5 t i Suite MEC
Contact Person , Ph 647- ', 04 2 - PLM
Contractor Ph SWR
` _ (BU LI DI 1 - Tenant/Owner ELC
Retaining Wall ELR
------ F-ootin .^2 � 7.! '`: • -' Y %. r,;i i!, } � ":4 r a v , , i !.. ., .". . ..
Foundation , '27
r ; , � ,� : , ; • ` � 1 - • l. :. , �� .i- FPS
'" f, S� ,c yr! s > :t 7 � f�� -1> ..
.' 5r.;�
Ftg Drain ,� � � 1. .F• •+ ;! '+�"' �,: ""5.4,k11:::-.-T71.`„- ls ,; , 14 •: /: : t}•; SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear .
Int Sheath /Shear a -
Framing 4.:- S 7":� Nom: r T All "5 ,,r i , ri - s Miv�: , ',is?, c 4
Insulation �-
Drywal&Nailing _ / �-- i.F /r2-, /,, c.. ,_. 57;4 • A/c .. y- „-, .-ir'.€3-r1U,t/
Firewall
Fire Sprinkler - / - A•r-- '77 .... -- 5:: .Ti C- - r - i , -4 K. > 1 14 1�., 1 ri,`,� i� c• [ .%i.
Fire Alarm - -
Susp'd Ceiling 5 - -'7 --) - -e ird. 7., S� /�. /,�rd. i •
Roof //
Misc: 12 61/TI 6--
Final `
AjiT FAIL iii
P - NG
Post &Beam Under Slab 4 r 1' f'
*/*
Top Out ,,, dl I /27/ .
Water Service ; -,�
Sanitary Sewer :r� t . 11-1 Rain Drains 11' P !� ; •a t t
Final / r
PASS PART FAIL a ' I_
MECHANICAL
Post & Beam �� f 1 "° I/ a f if
Rough In . /f = — r
Gas Line I r �
Smoke Dampers � �.! °,f 1 L ; Pd �
Final -; ,
PASS PART FAIL / /AC . /
ELECTRICAL
Service
/(7:..}.0 -
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
Approach /Sidewalk Date 2/S� .
- Inspector ” Itor Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
9999999 421 P02 AUG 17 '00 09:01
, Riyer City Environmental Invoice Number 101091
• P.O. Box 30087 Invoice Date: 5/30/2000
Portland, OR 97294 Account: DANORBRIST
Phone: 503 - 253 -5656 Terms:
FAX 503 - 288 -7220 .00 % 0 NET 10
Invoice
To: Dan Obrist Excavation Ship To:
6431 SE Jenne Rd 6912 NE 63RD
Portland OR 97236 PORTLAND OR
Quantity Billing Code: Description: Price Amount:
1.00 SEP 11583 SEPTIC SERVICE, 0.00 360.00
1800 gal. from 2 tanks.
Location: 10960 & 11040 SW
Tigard St. 5/25/00
•.
,a : seittx 2 ; 0 = juig.-6--L20-
RECEIVED JUN 0 1 2000
Non - Taxable: Taxable: Tax Rate: Sales Tax: Invoiced:
$360.00 $0.00 0.00 % $0.00 $360.00
T 421 P03 AUG 17 '00 09:02
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Ordered B }` litocinef .1 --) . _i'S „Date, , _ ,r _
Job Location_ � t, J \ 1 - I'7 ' 3t I,,
s F .►
Service Call
•
Labor `` $
Pumping ipT \ ( gallons 0 $ ,
' MisC Tx_ $ •
f
Conditions of tank /Distribution Box
lfOTAl- C ►RGES ct�
�
L River City Enyi mantel Inc. is In no- ay 0esponsjble for damage to •the,sept1c tantc o rlids on'tl}e system.
!!! TERMS; Net 10 .d s- 1 1 /4% per h will be ha
f: a ' �! • rt r.,t • - i G rged, ; - POa4 due aoco4nts.` � • •, annum)
'ti • 1..".'y''", ` 1 ;.1 • . \?(.. •. ::!t4,..„.:,.."
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Customer's Signature: r •
Drivers Si — � '' 0 � . . ' it
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TERMS AN C ONbtTI • s( .RE .....BLF &iII i' C
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9999999 421 P02 RUG 17 '00 U9:01
River City Environmental Invoice Number: 101091
P.CABox 30087 Invoice Date: 5/30/2000
Portland, OR 97294 Account: DANORBRIST
Phone: 503 253 - 5656 Terms:
FAX 503 -288 -7220 .00 % 0 NET 10
Invoice
• To: Dan Obrist Excavation Ship To:
6431 SE Jenne Rd 6912 NE 63RD
Portland OR 97236 PORTLAND OR
Quantity Billing Code: Description: Price Amount:
1.00 SEP 11583 SEPTIC SERVICE, 0.00 360.00
1800 gal. from 2 tanks.
Location: 10960 & 11040 SW
Tigard St. 5/25/00' "1 6- � j p c -5 E
RECEIVED JUN 0 1 2000
Non - Taxable: Taxable: Tax Rate: Sales Tax: Invoiced:
$360.00 $0.00 0.00 % $0.00 $360.00
9999999 421 P03 AUG 17 '00 09:02
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Ordered By � '.► k•• ' ' •'• 1:-•21g.' t s ,
.. ■ . • : .. ..•• ,� „; , •.:-:• ' r e f . j , ) ''S, .gat %� •
Job Location di "i e ✓ �� .mo ' r
•
Service Call
Labor - $ .
``
Pumping k, ( . g allons /Roc $ , , . .
•
• Misc T f $ • •
•
•
Conditions of tank /Distribution Box • . •
•
• •• . • TAB C�1Alf pES c�
I Ir. Riser City Enyjpogmentai Inc. is In no :4* desponejble for damage to •# septlG tamer c�oriiiiss on the system.
TE Ne t0' de/$.1'i % wilt w '
�: i ., , be �Cha , m, • p�ffi due eoco4rltq.` 48°l annum)
i J`,` v''1„ai
Customer's l�
mer's Signature:, �`
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g �� % 7 1 7 ' . /')d i 1 r- M me , a+ Cate ZS-Gc
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8/17/00 Activities for Case #: BUP2000 -00135
2:22:45 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPA005 Application received 4/19/00 DEB FAXD No Hold DEB 4/20/00 ,
BUPA010 Permit created 4/20/00 DEB DONE No Hold DEB 4/20/00 Per, Laura Anderson, USA, . r
they have given the school
district the okay to go ahead
with the burn, but they i
CANNOT remove any of the
demolition debris until they
have obtained their Service ,
Provider letter from USA. This
will take a while, but it should
not take 6 months, so they
should be able to get their
inspections done before the
permit would expire.
BUPA800 Misc. Inspection No Hold DEB 4/20/00 All demolition debris is to be
removed.
BUPA840 Cap Sewer Line Insp
No Hold DEB 4/20/00
BUPA870 Final Inspection
No Hold DEB 4/20/00
BUPA075 Ready to issue 4/20/00 DEB DONE No Hold DEB 4/24/00
BUPA085 (F) Issue building permit 4/26/00 DEB DONE No Hold DEB 4/26/00 Issue and mail per Sheri
Renhard, Tigard - Tualatin
School District.
BUPA090 (F) Reprint Permit 8/11/00 ZZZ DONE No Hold ZZZ 8/11/00
Page 1 of 1