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10075 SW CASCADE BLVD
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
Date Requested: ►I7I�^` (y q
_L_ — A.M – -- ('.M.. ---- MS'f:
Location: BUP:
Tenant:— Suite Bld
-- g A MEC:
Contractor: 't / Phone: -----. W.
Owner: Phone: ELC:
ELR:
_ SIT:
L
BUILDING BLDG(con't) PLUMBING-._- MNICA
BOT-77—iii FLRC—AL SITE
Site PosJBeam Post Scam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndlI/Slah Rough'n Ceiling rWaCer-Mme"`-.
Slab Framing Top Out Gas Line Rough-In UG pn ei:
Foundation Insulation Sewer ilood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Ih Ilest Pump IoW Volt
Approved Approved Approved Approved Approved
Appt/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL, FINAL FINAL FINAL
0 Call for reeins}pcction 0 Reinspection foe of S_ req 'red before next inspection U Unable to inspect
Inspector. ' /� —._ Nte: Page of _.
CITY CF TIGARD
DEVELOPMENT SERVICES
13125 5W Hall Blvd., Tigard,OR 97223 (503)639.4171
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CITY OF T IGARU Plumbing Application Rec'd By c
13125 SW HALL BLVD. Commercial and Residential Date Rec'd 777-2
TIGARD, OR 97223 Date to P.E.
Date to DST
(503)'639-4 71 Permit 7 Z--OU��%
Print or Type Related SWR 0
Incomplete or illegible applications will not be accepted Called _
Name of Development/Prp ect On back Indicate Work Performed by fixture.
Jc b 1 E,ur> •cl ��P,4 0 C� FIXTURES (individual) QTY PRICE AMT
Address Street Address Seal Suite Sink 9,00
(`C l�'— -A`C.A D �-tY t_avatory -- 9.00
Id9* GI /State Zi Tub or Tub/Shower Comb. 9.00
—---- 71 " 7Z?3
Name Shower Only 9.00
S�l W +• f Water Closet - 9,00
Owner Mailin Address" " oe Suite Dishwasher - 9.00
Garbage Disposal 9.00
City/State ZI PI one
c .2S ) n� b� Washing Machine 9.00
Namew,, b /' Floor Drain 2' 9,00
5 �^.-- 3" - 9.00
Occupant Mailing Address Suite 4" 9.00
City/Stale Zip Phone
Water Heater O conversion O like kind 9.0u
Laundry Room Tray 9.00
Name — Urinal 9,00
1 vC'r' StIL ►1/b Other Fixtures(Specify) 900
Contractor ilind ss Suite -- —
Prior to peiTnil /State Zip Phon 9.00
issuance,a copy ` � r C 1 l 9.00
of all licenses are Oregon Cunst.Cont.Bong;L,^..* Exp Date 9.00
required if Sewer- 1 st 100' — 30.00
expired in COT Plumbing Lic.0 Exp.Date - 25.00
database - -?-6 -Sp`�I p�j Sewer-each additional 10C' _-
Name Water Service-15t 100' 30.00 C,
Architect Water Service-each additional 200' 25.00
or Mailing Address Swte — Storm&Rain Drain-1st 100' 30.00
_ Storm&Rain Drain-each additional 100' 25.00
Engineer -ity/State Zip Phone Mobile Home Space 25 00
Commercial Back Flow Prevention Device or Anti- 25.00 -
Des-tibe work New O Addition O Alteration O Repair 4D Pollution Device____
to ae done Residential O Non-residential O _ Residential Backflow Prevention Device' �— 1500
♦dditiunal descnption of work:
(1 e P L-wc t 5c-x-+o L) Any p Tra or Waste Not Connected to a Fixture 9.00
f,`( �.F41�j 1-10,0! ( , - f-) Crot,v► WtQ%(-Q6- Catch Basin 970
Insp.of Existing Plumbing 40.00 —�
per/hr
Fxistiny use ofSpecially Requested Inspections 40.01)
building ar property ce 'In It.4 � �
-�� _- perlhr
Rain Drain,single family dwelling 30.00 —�
Proposed use of Q Grease Traps --� 9.00 —�
building or property J
I hereby acknowledge that I have read this application,that the QUANTITY TOTAL
nformation Isometnc or rise diagram is requim,it Quanoy Total is >9
given is corre,.l,that I am the owner or authorized agent of the iwner,and --- 'SUBTOTAL
that tans sub t are in compliance with Oregon State Laws - -
C lure of nor gent Date --" - �5% SURCHARGE
Con et Porao a @7— Pho e
PLAN REVIEW 25% OF SUBTOTAL
R_egwred on A fixture qty total rs>_9
_ f 1#4,J �►1 S o�c 3 b�152 / TOTAL I1
*Minimum permit fee is$25-5%surcharge,except Residential Back9
Prevention Device,which is S15•5%surcharge
I wsr!',pimnpp doer
PLEASE COMPLETEi
Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink_
Lava' ry
Tub or Tub/Shower Combination _
Shower Only
Water Closet _
Dishwasher
Garbage Disposal
Washing MachinF
Floor Drain 2" --
41)
Water Heater _
Laundry_Room Tray
Urinal —
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
i,rsis` mavo 0'x Sr9;
CITYO F T I O A R D � � BUILDING PERMIT
IGIIV4 PERMIT#: BUP1999-00207
DEVELOPMENT SERVICES DATE ISSUED: 5/2.0/99
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10075 SW CASCADE BLVD
� PARCEL: 1S1351313-00100
SUBDIVISION: ZONING: I-P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREASEXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 4.200 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N 0 sf N: S: E: W:
OCCUPANCY GRP: B 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:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,000.00
Remarks: Remove walls. No new construction other than repair of removal damage. Accessiblity not an issue. Electrical
and mechanical permits are required. - -
Owner: Contractor: �J
SUBURBAN PROPANE EVERGREEN PACIFIC INC
ATTN. CARL J REMMES 5664 CARMAN DR
240 RT 10 W LAKE OSWEGO, OR 97035-3358
WAIIPPANY, NJ 07981
one: Phone: 636-5165
Reg #: uc 41521
FEES _ REQUIRED INSPECTIONS
Type By Date — AmountReceipt
PRMT DRA 5/20/99 $38.50 99-3,,,543
PLCK DRA 5/20/99 $25.03 99-315543
FIRE DRA 5/20/99 $15.40 99-315543
5PCT DRA 5/20/99 $1.93 99-315543
Total $80.86
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 worts 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!hese riles or direct questions to OUNC by
calling (503)246-1987.
r
pe ryn itee
Signature:
11'
Is�ued By:
Call 639-4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Recd By
13125 SW HALL BLVD. Tenant Improvement De Rec'd�i ,
TIGARD, OR 97223 Date to P.E.4
(503) 639-4171 `� =- Date to DST s
Print
PermitsC1''2c ,
rent or Type Related SWR s
Incomplete or illegible applications will not be accepted Called
i `c�-- r'.r l it-
Job
iJob No of velopm t/Proiect
,� ✓ pru n�� (Ze V�pG, � Existing Building k New Building C3Address Street Address Suits
(�75 ��� G��� Building
Bldg 0 city/State Zip g
Rrc,,Z1> 0 j Y72 2 Data
Property Name
btt'" Fk-bpa Exist' ig Use of Building or Property:
Owner Mailing Addrosa Suite s 'QQ '�'(AC w V-Qd M
(int�� "� ►F'.�'>��• ��Jo �r /
city/state a ZI Phone Proposed Use of Building or Property:
if 'I%!'f'; +��T X39 Pb I cw'0a,,.,
Nam i , n �
Occupant Mailing Address Suite No. Of Stories: I
city/state Zip Phn Sq. Ft. Of Project: i �}
Z: &91 �'Z 60
Name Occupancy Class(es)
EUeg&aCEN �fK l Ft c 1L vC
Contractor Mallin Address suite
� _ 71� L Qevv►,gn, D Type(s)of Construction
City/Stats fr'e Phone
cfg np 970 �" Li(, t lbs
(Prior to issuance Oregon Const.Cont.Board Li .0 Exp.Date Will this project have a Fire Suppression System?
a copy of all 41S-72,12 25- vv Yes❑ No
licenses are Oregon Const,Cont.Board Lica Exp.Date
required if
expired in COT Business Tax or Metro s Exp.Date Project Valuation $
C.O.T.dsta base) �r
Name Americans with Disabilities Act(ADA)
Architect C:vPK.(',r2t-UAJ RteIFILQ INC Valuation X 25% = $ Participation
innddress suite Complete Accessibility Form
w l_gr?wAr4 Ck
City/stato Zip Phone Plans Required: See Matrix for number of sets to submit
OK H7t' &rl on back of submittal requirement sheet
Engineer Name
C:VErL fc4zt t ni f't1G FI C. ZN(. I hereby acknowledge that I have read this application,that the information
Mailing Addros� Suite given is correct,that I sm the owner or authorized agent of the owner,and
(,Z y vv L,},¢yyf A�i that plans submitted are iri compliance with Oregon State Laws.
City/State Zlp Phone
L 0 tJ2 705 "- (0 540S Sigyre� rp pWrter/ entf Date 7,0
Indicate type of work: New O Addition O Demolition 1 �Wn(^ IY�
Accessory Structure O Foundation Only O Alteration Or Contact Person Name Phone !�
Repair O Other O
Description of work:
►�^:.vo�( �� �oev� �eav( 0 FOR OFFICE USE ONLY
( Map/TLs Land Use:
Notes:
TIF:
Parks: Estimated•of Employees
Vote: sl:e Work Permit Application must precede or accompany Building
Permit Applictlon
11COMMAPP COC (DST) t0lge
PERMIT# ACCOUN'r DESCRIPTION COT WACO AMOUNT AMT.PD.
`^ Building Permit (BUILD) (UBUILD)
Plumbing Permit (PLUMB) (UPLUMB)
Mechanical Permit (MECH) (UMECH)
State. Tax (TAX) (UTAX)
Bldg.
Plumb.
Mech.
Plan Check (BUPPLN) (UBIIPPLN)
Bldg.
Plumb.
Mech.
i� Sewer Connection (SWUSA) (USWUSA)
Sewer Inspection (SWINSP) (USWINSP)
Parks Dev Charge (PKSDC) (UPKSDC)
CDC - Planning (CDCPLN) (UCDCPLN)
CDC - Building (CDCBLD) (UCDCBLD
__ _ Mass Transit TIF (TIF-MT) (UTIF -MT)
Commercial TIF (TIF-C) (UTIF -C)
Industrial TIF (TIF-1) (UTIF -1)
_ Institutional TIF (TIF-IS) (UTIF -IS)
Office TIF (TIF-0) (TIF -O)
Fire Life Safety (FL.S) (UFLS)
Erosion Control Permit (ERPRMT) (UERPRMT)
Erosion Planck!USA (ERPLN) (UERPLN)
Erosion Planck/COT (EROSN) (UEROSN)
TOTAL:
I�COMMAPP DOC (DST; 10196
SUBJECT: ACCESSIBILITY
'4ARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMEN OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected bul;dings 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 ill 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
excluding painting, wallpaperiny. [1] $ u
mutt pA1 : 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2) $
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 $;G' ----- _
V
(b) An accessible entrance: ' $
(c) An accessible route to the altered area $
I�
(d) At least one accessible restroom for $
each sex or a single unisex restroom: /
(e) Acces:.ble te!ephones $ _
(f) Accessible drinking fountains and $
(g) When possible, adJitional accessible
elements such as storage and alarms: $
TOTAL: Shall equal line 2 of Value Computation $
i Adsts\forms\acccss.doc