Permit A' CITY OF TIGARD
.� DEVELOPMENT SERVICES SEWER CONNECTION —
�i
°' PERMIT
13125 SW Ha1181vd., Tigard, OR 97223 503 639 -4171 PERMIT # • SWR98 0307
DATE ISSUED: 11/10/98
PARCEL: 2S113AB- 00300
SITE ADDRESS...:16O45 SW UPPER BOONES FERRY RD
SUBDIVISION •FANNO CREEK ACRE TRACTS ZONING: I —L
BLOCK LOT -036 JURISDICTION: TIG
TENANT NAME -NW LANDSCAPE INDUSTRIES
USA NO FIXTURE UNITS...: 8
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE •COM NO. OF BUILDINGS: 0
INSTALL TYPE •LTPSWR IMPERV SURFACE: 0 sf
Remarks: Connecting existing building to existing sewer lateral.
Owner: FEES
NORTHWEST LANDSCAPE INDUSTRIES type amount by date recpt
16075 SW UPPER BOONES FERRY ROAD PRMT $ 2200.00 JSD 09/18/97 97- 299324
TIGARD OR 97224 -7733 PRMT $ 100.00 DLH 11/10/98 98- 310717
INSP $ 45.00 DLH 11/10/98 98- 310717
Phone #:
Contractor:
OWNER
Phone #: $ 2345.00 TOTAL
Reg #.. .
REQUI RED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a °Tap and Side Sewer° Permit and the Agency will install a lateral.
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 952-0001 -0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
Is , , . -,i
Issued by Permittee Signa . /.� /, ✓i��� .�.��
I
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
/ 1 .
O
I, CITY OF TIGAR Commercial Building Permit Application Recd By r
13125 SW HALL BLVD. New Construction and Additions Date Recd / / —�Q -5�
Date to P.E.
TIGARD, OR 97223
Date to DS
(503) 639 -4171 Permit # P LR 8 - OW 6
Print or Type Related SWR # 6w(2-9V
Incomplete or illegible applications will not be accepted Called
•
Name of Development/Project
Job Existing Building ❑ New Building ❑
Address Street Address Suite
1(4045 ‘,., ILA PPE2 o /As/ 2 'D Building
Bldg # City /State Zip Data
66t,fria-b , o2 7 .24 Existing Use of Building or Property:
Name
Property ---i,c.tIA2-.0 "so. Ak��r.4A 0
Owner Mailing Address Suite Proposed Use of Building or Property:
140/5 '`a-e LA ?rZ2 v,ae),res g ' '
City /State Zip Phone
No. Of Stories:
Occupant Name Sq. Ft. Of Project:
Name Occupancy Class(es)
Contractor Cor +4 A �x A )411 o 13
Prior to permit Mailing Address Suite Type(s) of Construction
issuance, a copy
of all licenses
are required if City/State • Zip Phone Will this project have a Fire Suppression System?
expired in C.O.T. Yes ❑ No ❑
database
Oregon Const. Cont. Board Lic.# Exp. Date Americans with Disabilities Act (ADA)
Valuation X 25% = $ Participation
Complete Accessibility Form
Name - Project $
Architect Valuation
Mailing Address Suite
. — 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 application, that the information
��, - given is correct, that I am the owner or authorized agent of the owner, and
Mail Address Suite
�il that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent Date
City/State Zip Phone
Contact Person Name Phone
Indicate type of work: N ew 0 Addition 0 Demolition 0
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 FOR OFFICE USE ONLY
Description of work: Map/TL# Land Use:
Notes:
Parks: Estimated # of Employees TIF: -• ��
'
If the above figure is not supplied at the time of application, the city will _
calculate the fee based•upon the number of parking spaces. /j -
7 `` o U
Note: Site Work Permit Application must precede or accompany Building' w (-1. 4 0 /00 • o c�
Permit Application n [� ,�
I: \COMNEW.DOC (DST) 5/98 cJ �N 51 7 5
�--,._
L .
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
. .
flpp.kovii6Wii4epeniietit 1106nsybottp.[App a COMPLET
.
application . the•Opti.iiaticOlnust.
.SOnatt4rafithe supervising el potgrp..p!op review wifi be conducted
After plan review approval, Plans Examiner will contact the applicant to request
additional plan sets faeo§topytokpot06ies::::(popyikr egntractOr;: •
Washington CoOnty,:Tuai6tifiVOloi:Firp & Aesc . .-;•••••• -
" • '' ' • - Total # Of
,.„.
: tYPE0#:: : d040litf4L• Plans : KEY:
• . • .• Submitted
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
''' ' •
E(Ait)
• • • . -• •
.E Af(P.40
NOTES:
. ,
:t§f 0*k
1:kists \maxtrixl.doc 07/06/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
-
q 0� 1 Date Requested i . - AM PM
BLD
Location 1 60. 5 55 � ' Still ( .�� 112. U Suite MEC
Stt
Contact Person t�'C _. Ph q - I 42zo 98-0(// h
Contractor .,r,tdL aidk _ . _ _ _ / Ph 4ZO W
BUILDING Tenant/Owner N w t DSGA P I kl CT ELC
Retaining Wall ELR
Footing Access:
Foundation L G�'�/�v / A/J' FPS
Ftg Drain (AA �►� \
Crawl Drain Inspection Notes: ( -7 {� �` SGN
Slab [1 i' - �� �^-C- SIT
Post & Beam /
Ext Sheath /Shear W , IS I AM ItJ
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof OS4'
Misc: - r
Final
_PASS RAT FAIL
" PLUMBING ,
Post & Beam
Under Slab
Top Out
Water
Rain Drains
77 - 7 771 7 j27- 1 '
ty EPM
ART FAIL
1 ANICAL
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 r ' nspection RE: [ ] Unable to inspect - no access
ADA
Other oach /Sidewalk Date Inspector A " Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.