Permit ', - CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00545
IAr DEVELOPMENT SERVICES DATE ISSUED: 12/18/02
.,� II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD PARCEL: 1S1266C -01506
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SUBDIVISION: 520 ZONING: C -G
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: 2FR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 59 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 24,000.00
Remarks: Tenant improvement
Owner: Contractor:
PORTLAND OFFICE ASSOCIATES PACIFIC CREST STRUCTURES INC
BY TC PORTLAND, INC 7233 SW KABLE LN STE 900
8930 SW GEMINI DR PORTLAND, OR 97224
BEAVERTON, OR 97008
Phone:
Phone: 503 - 968 -8949
Reg #: LIC 66915
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 12/18/02 $273.70 Electrical Permit Required
[TAX] 8% State Tax 1 2/1 8/02 $21.90 ) F Frr aming aming Permit Required
Insp
[BUPPLN] Pin Rv 12/18/02 $177.91 Gyp Board Insp
[FLS] FLS PIn Rv 12/18/02 $109.48 Final Inspection
Total $582.99
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued - . k adaf2-114.41-44
Perm ittee •
Signature: L ��. . _ % i t / r of •
■
Call 639 -4175 by , p m. fo an inspection the next business day
,/ • •
�Buildin Permit Application
,� •
Date received: /4 P ,,/ " .415
ti < � '� City of Tigard
-�-
J I° g Project/appl. no.: A E 1 ;7
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: ■ B ' 'VP • eceipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement tit Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: • OW VA) 144 k1)1 ; At S.. 'Cad Bldg. no.: Suite no.: ?_o
Lot: Block: Subdivision: s Tax map /tax lot/account no.:
Project name: RegaI-04c4T o czS,si# (b- tll, U.
Description and location of work on premises/special conditions: A4E14) (id ALLS r DO oi e5 CAA PET , 1t.rt-
t a 'tC.14t_ Sy pTµErS
• OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
,122112 ..r: .M9
( Floodplain, septic capacity, solar, etc.)
0
Mailing address: II( S W I u i ((DD I & 2 family dwelling:
�'dr a n d State:02 ZIP: q 24o Valuation of work $
Phone: 503 2' , pt/p o Fax: 22.7. 2.507 E -mail: No. of bedrooms/baths
Owner's representative: L. r J&h'teS Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name: kf & Covered porch area (sq. ft.)
Mailing address: W. SW, Cp ,t • r Deck area (sq. ft.)
M tin. State: d2 ZIP: 4 1 -7-7_0 Other structure area (sq. ft.)
Phone: 227 r(; to e;+ ax: 2 p , ; E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ Zl OOO,
Existing bldg. area (sq. ft.)
Business name: 'Pee ` ,- Cr - f New bldg. area (sq. ft.)
Address: /Z 3 3 C. b , n e. Number of stories
L'0r L et State: ZIP: 1 7 2 2
Phone: • 6i . - ' �jj r E -mail: Type of construction 11 fig
CCB no.: , Occupancy group(s): Existing: 13
New: 13
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: W ('5 provisions of ORS 701 and may be required to be licensed in the
Address: it 55 (4) OKdor jurisdiction where work is being performed. If the applicant is
Cit �, State: exempt from licensing, the following reason applies:
Y 01t ZIP 11 7 �,
Contact person: 1E50I; Plan no.: .
Phone: 24f .7 -, Fax:2 1 0 4 E - mail:
ENGINEER
Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All p e �' ions of laws and ordinances governing this 0 Visa ❑ MasterCard
work will be complied ,II:r, whe , specified herein or not. Credit card number. I /
natu Expires
Authorized si
g �� � 4 - r � /' D ate: �2 �� /�� Nam of cardholder as shown on credit card
Print name: LES(.I - Coo P f g._ $ •
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (ttVOICOM)
Commercial Plan Submittal
L����! Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \forms \COM- matrix.doc 9/24/01
Accessibility:
Barrier Removal Improvement Plan
City of Tigard
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty -five per -cent (25 %).
VALUATION: of all renovation, alteration or modification being done Da)
painting, wallpapering. [1] $
multiply: 25% Barrier removal requirement. .2/5)
BUDGET FOR BARRIER REMOVAL [2] $ i�o c
In choosing which accessible elements to provide under this section, priority shall be given to those
elements that will provide the greatest access. Elements shall be provided in the following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for $
each sex or a single unisex restroom:
(e) Accessible telephones: $ �~
Accessible drinking fountains: and $
• When possible, additional accessible
elements such as storage and al- 11 • $
TOTAL: Shall equal line 2 of Value Computation $
i. \dsts \forms\Accessibility.doc 06/07/02
is
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION BusinLane: (503) 639 -4171 MST
BUP
Received Date Requested ( �" AM PM BUP 2 c Z - ��U G /
Location ° S RD, Suite 5 2-0 „ 2.60 Z - OO
Contact Person Ph ( 7 No }-, j I PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
• Firewall / A a ✓ I d0
Fire Sprinkler ,
Fire Alarm C/ 6 3 Li mZ C/ ; r
Susp'd Ceiling •
Roof
Other:
in- _
F ART FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: Unable to inspect — no access
-
Fire Supply Line
ADA l f 2i `O V Ext
Approach/Sidewalk Date Inspector
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL