Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00514
14, DEVELOPMENT SERVICES DATE ISSUED: 12/08/1999
. `--' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16290 SW UPPER BOONES FERRYRD PARCEL: 2S113AB -01201
SUBDIVISION: MEMO CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf . PROJECT OPENINGS?
TYPE OF CONST: 3N : 4.500 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 45 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 80,000.00
Remarks: Commercial TI
Owner: Contractor:
PACIFIC REALTY MATTHEW.OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 5393 OAKRIDGE RD
PORTLAND, OR 97224 LAKE OSWEGO, OR 97035
Phone: Phone: 697 -9446
Reg #: LIC 00066070 -
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing lnsp
PRMT DST 12/08/199E $571.00 99- 320259 Gyp Board Insp
PLCK DST . 12/08/199E $371.15 99- 320259 Susp Cs Final Inspection
5PCT DST 12/08/199E $45.68 99- 320259
FIRE DST 12/08/199E $228.40 99- 320259 ORIGINAL
Total $1,216.23
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.
Pe mt
Sig naatur r e:
Issued By: s
Call 639 -4175 by 7 p.m. for an inspection the next business day
P , : ' d
CITY OF TIGARD Commercial Building Permit Application Recd By
131 25 SWiIALL BLVD. New Construction and Additions Date Recd r
Date to P.E.
TIGARD, OR 97223
/ ti " „ Date to DST ///'241/q1
(503) 639 -4171 VV Permit # W v.� I y94 511
Print or Type @,..
Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project
Job , WQ A11.5J'US //I/, -SS �' C , TG`/
Jr Existing Building New Building ❑
Address Street Address Suite
/o79DS,W 1/ •//B.s/ Y ' 1 ° Building
Bldg City/State y1 �, Z Zi i ip p Data
/6 /�v / y f7;-;- Existing Use of Building or Property:
Name
Property �f /� /e44‘,13- ■
d� r / JS�
Owner Mailing Address Suite Proposed Use of Building or Property:
City /State Zip Phone
7/Gi9R 4e 17",# Z0/7 b � ';' No. Of Stories: /
Occupant Name Sq. Ft. Of Project
Name Occupancy Class(es)
Contractor 4407'7' ",s -,./v GDS s7 ,ce) Pi.
Prior to permit Mailing Address �/� �/��/7 Suite /� Type(s) of • +- ; ruc '9,9
issuance, a copy 5:29S S k// !//`1 ', 0O� / � /i • ,�/1 . "' 4 tr
of all licenses . i / a/
are required if City/State Zip 9104r Phone Will this project have a Fire Suppression ystem?
expi u /C/_e DA. A97 ,y Yes i e No ❑ •
database
lC �`VVl�G7 J � !' �=
Oregon Const. Cont. Board Lic.# Ex Date Americans with Disabilities Act (ADA)
.� Valuation X 25% _ $ Participation
7 2001 Complete Accessibility Form G ��G /Af
Name Project $
Architect JP/b(/ 6f f1/ Valuation ieDG�
Mailing Address Suite
;,�/4, 3 &. I/ J 'j/ Plans Required: See Matrix for number of sets to submit
City/State Zip 9�/9'Phone on back
, 'V /1 D� I -6.346 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
Mailing Address Suite that plans submitted are in compliance with Oregon State Laws.
Si nature of Owner /Agent ate
City/State Zip Phone )/ . r�Vf7/7/// ,. 9'r
Contact Perso h Name / Phone
Indicate type of work: New 0 Addition 0 Demolition 0
Accessory Structure 0 Foundation Only 0 Alteration 9(
Repair 0 Other 0 / FOR OFFICE USE ONLY
Description of work:
C 1 " No-14/7-4.07/v/— �p � x /s7/ Map/TL# Land Use:
sA4ol/ f/,�Q Notes:
H arks: 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.
Note: Site Work Permit Application must precede or accompany Building
Permit Application f ,
I: \COMNEW.DOC (DST) 5 /98
1
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
air t
A��r �anirevtewa :' �' cvel >is�lan;3arrrrne��i�[cont�c# #fee : > icir�nt.��.. .
o' eat >:«'l�i >setef�rd` >:� ::;:;:;:: >: >::;,,,<, >: > >:: <;:,;<:::;::; >:<: >�:::: >` ;;;..::::: >::< � r >i✓r�trctcr...
Total < > >__
KEY:
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 \forms\matrxcom.doc 10/30/98
OVER-THE-COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL (STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT:
CLASS OF WORK: i-f-74-- FLOOR AREAS: .4��b EXTERIOR WALL CONSTRUCTION
TYPE OF Le FIRST SQ. FT. N: S: E: W:
TYPE OF
CONSTR: t SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: J THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
STOR: HT: FT: BSMNT: SQ. FT. AREA SEP. RATED:
BSMNT?: MEZZ ?: GARAGE: SQ. FT. OCCU.SEP.RATED:
FIRE FIRE SMOKE HANDICAP
SPRINKLER: ALARM: DETECTOR: ACCESS:
COMMERCIAL INSPECTION ACTIONS FEE MENU
Foot/Found Post/Beam $ 571 Permit Fee
Masonry ;_ $ 37/ (S Plan Review
Insulation Shear Wall $ A "3 8% State Surcharge
Firewall yp :oar. $ 2240 FLS Plan Review
Suspencfed Ceilin Sprinkler Rough -in $ Add'I Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS Pln
Smoke Detector Approach /Sidewalk $ Inspection
Miscellaneous $ MIS Fee
FOR OFFICE USE ONLY:
TYPE OS USE OPTIONS (COM= commercial; CMS = commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW =new; Add = addition; ALT = alteration; ACS = accessory;FND- foundation;
OTR= other; DEM= demolition; REP= repair; FPS =fire protection system, NOTE: USE OTR FOR FENCES, RETAINING
WALLS, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
I: \ovrcntr2.doc (DST) 9/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business 639 -4171
Date Requested Qn AM PM /9f9-06255- l
Location 1 Co 29 O l k pp. 1 &1tD uite 19i-b()'-/'f 7
Contact Person V i e Ph c/S PLM
Contractor 0 1 6 0 1 - - Ph ')7 OS SWR
Tenant/Owner L - (J ELC
Retaining Wall E
Footin
Foundation A ccess: FPS •
Ftg Drain SGN
Crawl Drain Inspection Notes: p1 i ,1
Slab I I SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
M' •
P
PART FAIL
1 BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
Post & Beam .
•
Rough In
Gas Line
Smoke Dampers '
• ina
PART FAIL
EL - TRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL •
SITE
Backfill /Grading
Sanitary Sewer •
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk )
' Other Date /77.,// w �/ Inspector Tel Ext
Final .
PASS PART FAIL • • DO NOT REMOVE this inspection reco!d from the job site
i >