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CITY OF I lGARM
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10165 SW GREENBURG ROAD
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SIGN ±'ERMIT
PERMIT 0: SGN90-0061 DATE ISSUED. . . . : 07/23/90
IXPIRATIO3 DATE: 07/28/90
PARCEL. . . . . . . . . : 1S135BC-00201
ZONE. . . . . . . . . . . . C-G
BUSINESS NAME. . : 7- ELEVEN
SIGN LOCATION. . : 10765 SW GREENBURG RD
APPLICANT/AGENT: PAUL MILLER
BUSINESS TAX NO: Y
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SIGN:
PERMANENT ( ) FREESTANDING ( ) FREEWAY ( )
TIiS'ORARY (X) WALL ( ) ELECTRONIC ( )
OTW,'R ( ) BILLBOARD ( ) BALLO017 (X)
SIGN DIMENSIONS. . . . . .: 10' X 12'
TOTAL SIGN AREA. . . .. . : 120 sq.ft.
WALL AREA. . . . . . . . . . . . . sq.ft.
WALL FACE (DIRECTION) : NA
SIUN HEIGHT. . . . . . . . . . . 25 ft.
PROJECTION FROM WALL. : in.
ILLUMINATION. . . . . . . . . : INT
DESCRIPTION OF SIGN:
A temporary balloon sign, 120 eq ft in size, 25 feet in hei.ght, made of nylon, incandescen
lighting, copy: 7 - Eleven.
M;ATERIALS. .. . . . . . . . . . . . NYLON
';'XISTING SIGNS. . . . . . . : l
PLECTRICAL PERMIT RFQUIRED: No
B'IILDING PERMIT R3QUIRED. . : NO
ADMINISTRATIVE EXCEPTIONS. z N/T
PERMIT :RE: 10.00
APPROVED BY:
UA'In: 07/23/90
Permit No. SGN 90-00k
CITY OF TIGARD
SIGN PERMIT APPLICATION
Die applicant hereby applies for a permit for the work indicated or as shown in the
ac coaiganying plans and specifications.
SIGN LOCATION ADDRESS: 10765 SW GREENBURG RD ,'
—�---_—. ZONING: C-G
NAME OF BUSINESS: SEVEN ELEVEN
APPLICANT/AGENT: PAUL MILLER COWAN r: SEVEN ELEVEN PHONE: 620-9614
The City of Tigard imposes art annual Business Tax which must be kept current on all
persons doing business in the City. Do you presently have a current business tax?
YES ( X ) NO ( ) U.L. Label
PROPOSED SIGN: (check as many as apply) - —
PERMANENT ( ) FRE E91ANDING ( ) FREEWAY
TEMPORARY ( X ) WALL ( ) ELyCrRC.)NIC ( )
alum ( ) BILT13QARi7 ( ) BALiI)ON (x)
SIGN DIMENSIONS: 10' x 12' EXPIRATION DATE:
TU7TAL SIGN AREA (Sq. Ft.) : _120 sq ft —
WALL AREA (Sq. Ft.) :
WALL FACE: N/A --- .�/
HEIGHT (Ft) :, __ 251 7-W / Z-0 Z_
PRATECIrION FRCM {BALL: N/A 7 IF7
IIdiMINATION: YES ( X ) NO ( ) TYPE: INCANDESANT
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COPY: SEVEN ELEVEN_
MATERIALS: RIP STOP NYLON —
EXISTING SIGNS: SEVEN ELEVEN FACIA SIGN —
ADMIMSRATIVE EXCEPI'IOV: N/A ( ) APPROVED { ) HOW
AREA ( ) HEIG IT ( ) �—
CCMMFNTS: FIRMLY ANCHORED
PLAT,Ll
DEPAR'INIIWr __ All. sign permits must be acam pari.i ed by a scale
Permit Fee: x10.00 drawing and plot, plan. If work authorized under
Eg eipt No: 90-202830-- a sign permit has not been ccrpleted within ninety
lax-gyed By. DR _ days after the issuance of thepermit, the
Date: 7/18/9u sha11 bec - mill and void. h permit
EI ?IItICAL, PERMIT I CERTT T I RDCX)i2DFI� OWNET2 OF THE
REQUIRED: YED ( ) NO (X) PROPkI'Y AN AG RIZED BY THE OWNER.
BUILDIN.7 PE rr _ _
RDQMRED: YES ( ) NO (X) 1lpplicant' Signator.
>t� Ge�Ngret, (o
cp/�,�, -- --- ---- — -- -- - -
N.\WORD\��EV\ �(ov> �
Telephone
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Permit No. SGN 90-0060
CITY OF TIGARD
SIGN P11D= APPLICATION
The applicant hereby applies for a permit for the work indicated or as shown in the
accompanying plams and specifications.
SIGN LOCATION ADDRrns: 10765 SW GRF:NBURG RD ZONING: C-G
NAME OF BUSINESS: SEVEN ELEVEN
APPLICANT/AGS; PAUL MILLER COWpNy; SEVEN ELEVEN PHONE• 620-9614
The City of Tigard imposes an annual Business Tax which mustbe kept current on all
persons doing business in the City. Do you presently have a current business tax?
YES ( X ) NO ( ) ILL. Label #
PROPOSED SIGN: (Check as many as apply)
PERMANENT ( ) FREE19TANDING ( ) FREEWAY ( )
TEMPORARY ( X ) WALL ( ) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON (k )
SIGN DIMENSIONS: 1C` x 12' EXPIRATION DATE:
TOTAL SIGN AREA (Sq. Ft.) : 120 sq ft
WALL AREA (Sq. Ft.) : N/A
WALL, FACE: N/A
HEIGiT (Ft) : 25'
PRW]ECITON FROM WALL: N/A --
lL[JJMINATION: YES ( X ) NO ( ) TYPE: INCANDESANT
COPY: _ SEVEN ELEVEN
MATERIALS: RIP STOP NYLON
EXISTING SIGNS: SEVEN ELEVEN FACIA SIGN �.
ADMINISTRATIVE EXC'E'PTION: N/A ( ) APPROVED ( ) HOW MUCH_- %
AREA ( ) HEIGHT ( )
CC 4U VTS: _ FIRMLY ANCHORED
PLANNING DEPAR'1M�Nr All sign permits must be accompanied by a scale
Permit Fee: $10.00 _ drawing and plot plan. If work authorized under.
Receipt No: 90-202830 a sign permit has not been a mpleted within ninety
Approved : DR _ - days after the issuance of the Tic,mit, the permit
Date: _____7Z_18/90 ___ shall becotpe null and void.
I
F.LWIRICAL PERMIT I CERTI SMT I ZHE RECJORDE D OWNER OF TINE
REIQUIRED: YES ( ) NO (X) PROPEF�I'Y�/ AN AG TIORIZED BY 7NE OMIER.
BUILDING PERMIT 7 4_
REWIRED: YES ( ) No (X) Applicant' Signature
Sud 6) _ �tiO -gU(q
BKMIFERMT Telephone
�/ Address .
N:\WORD\001MDW\ u kp 1 0 I���3
JRAIMUILMIKMLM� MRPIjLMLMqLMLAM
PAYMENT PECEIPT NO. -10"
CITY or T'IGAFD PFUTPI Of
CHE(71, (Ap1oul"47
NAME 'SEI,'rN CLEVEN CASH AMOUNT r 10.
ADOPESS 3W OPEENBL)PI-3 PU PAYMENT CRATE: : 07, 113
SUPI)I V I a-,I ON 9
FIAPPOSE OF PA'tt-PH' AMOUNT PrIV PURPOSE Or., PAVIr-IrENT AMCMANT PAM
0. Of
7,GN
T(.')IAL AMOUNT PAP I Q.
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D1 IN-LINE ?'-ELEVE11 LOGOTYPE • SINGLE CHANNELUME LETTERS
SPECIAL ORDER,MANUFACTURED TO SIZE, MINIMUM SIZE: LETTERHEIGHT 12 INCHES
D2 —DIGITIZED 7-ELEVEn LOGO SINGLE CHANN LUME LETTERS
SPECIAL RDEk MANUFACTURED TO SIZE,MINIMUM SIZE: LOGO HEIGHT 24 INCHES
Description: loth signs, D1 and D2 to bismanufriclured In channelume lettere, Inter-
n Ily Illuminated. Faces to bIn F,candard 7 Eleven Colored Plexiglas.
Note: T one color version Is to Implemented only If the use of standard
1,; cal ale restricted by any ord�iance.
In Acceptable Colors. For one color versions
N Plexiglas White NW7136 o Ivory N2146.
Z STANDARD COLORS:
l,N) L) REO Wysndolle Poo F.1.&337 8 Silk Screen Pe 1
GF•2.8177 8 Spay VIKol"Y Runl
Spli isi Paint .A43160.1 Silk Susan Point�\
AS4447 SPreY ViscnsilY Ppnll
pte.1gtu \M
PMS Pantone ink 1M
��J L1 ORANGE Wyandol4 Palnl �OFA�34/2/ Silk Screen Point
0; `+-- ,...,^"�,. OF• 3N2 a Spay Viscosity i'uni
\ 01. SprsyUi pa"'I AL t Silk Screen Point
Spray Viscosity Punt
y\ //Q P14.1014% 2110
`/
\ k -r^ PMS Ponlone Ink 160
N tJ� GREEN Wyendotls Punt OF-1-1196 a Silk Screen Punt
Of-7 1166/ Spray VlecOsily Point
\y� tipuyUt Point
AL44Silk Screen Point
Spirit,VleCoaly
Pum
�)1 O Plengloo 210/
PMS Panlons Ink .266
O Gween Wyandotte Point . FA-1 10/Coal While 5 k Screen
Pail"Fn.a 1a Coot Whits 9PVutouly Point
SPINYiu Peml 4101-1110 Silketeen Pomt
403-W SP,sY�Vlscouiy Point
W.112/ ``
®O 211.1011111ShomiIII Witiama Paint A].. silver Bills Paint 1.7/01
lot equivelonil
1 BLACK Sherwin WIII}1ltme Punt
r IVORY Plaal/IU 2146
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Permit No. SP 89-123
CI'T'Y OF TIGARD
SIGN PERMIT APPISCATION
The applicant hereby applies for a permit for the work indicated or as shown in the
accompanying plans and specifications.
SIGN VOCATION ADDRFISS• _10765 Greenburg _ _ ZONING: C-G _
NAME OF BUSINMS: _ 7-11 _ — —
AppLICANT/pDENT. Greg Hume COMPANY: GregHume Propert ies PHONE: 697-8558_—_
The City of 'ligand imposes an annual Business Tax which must be kept current on all
persons doing business in the City. Do you presently have a current business tax?
YES ( X ) NO ( ) U.L. Label
PROPOSED SIGN: (Check as many as apply)
PERMANENT (X ) FREE.` SANDING ( ) FREEKAONIC ( )
TEMPORARY ( ) WALL (X )
OrTIIER ( } BILTJ30ARD ( ) BAUMN ( )
SIGN DIMENSIONS: 3 x_ 4 EXPIRATION DATE:
TOTAL SIGN AREA (Sq. Ft.) :— 12 sq. ft. N/A _
WALL AREA (Sq. Ft,) : 918
WAIS, FACE: --- east -—__--
TIEIGHT (Ft) : — _ N/A _ — --
PROJECTION FROM WAI-J,: _ awning extends 2' —
ILTWJ.NATION: YES ( ) NO (X ) TYPE: _
COPY: _ 7-Eleven— -_—_-- --- —W-
MATERIALS: -- canvass -----
EXISITNG SIC;IS: none_ _ ----- - - --—
ADMINISTRATIVE EXCFPTION: N/A ( X ) APPR0VED ( ) HOW
AREA ( ) HEIGH ( )
CC>MIKfNI'S
pl, pE�ARr All sign permits must be accompanied by a scale
Permit Fee:_ 10.00 drawing and plot plan. If work authorized under
Reaeipt_No: 1056_51_ a sign permit has not been completed within ninety
AppmnI.—By:_ DR _ days after the issuance of the permit, the permit
patkt 10-10-89.—_-- shall. become- null and void.
F7,F)=ICAT, PERMIT I CERTIFY THAT I AM THE REOORDFI) OWNER OF '11iE
REQ[T`_RID; YES ( ) NO (X) I'IROPEKI'Y QR AN AGENT AUTHORIZED BY THE OWNFR.
BUILDING PERMIT __--
REQUIRED: YF_S ( ) NO (X) Applicant's Si.g re
15631 Village s Lsk� Q0Weyo, QR 97034 697-8558
cp/BKMPERMI' Address Telephone
N:\WORD\CCMFV\
CITY OF TIGAF"'E) RE-Cf.: PT OF PAviF-.tjr PEC, NIDI 00105-65*1.
CHEU-� AMOUNT 35j.Oo
Go�,H AMOUNT - 00
4ORY P. HUMF- P011,01ENT DATE I Ll—10-69
co P E S IS, 15631 VJLLAGE DRIVE O(L
LAVE OSWEGO. OP 9-70714 BL. J. NWADDRi
PIPPOSE OF F'Wi-MEN1 AMOONT "-A 1) PUPFOSE OF PAYMFNT AiiotjvA'r PAID
rM FlF.PM I T FEE 35. 00
(A I HE --EL.EVE.I'-1 ON OREP.-NbI.W.'ri ROAD—'r MARD, OR
tdl rOfj
TOTAL AMOUNT f-AX D OL)
-k
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _1! L >� _ -------
Date
- - _Date Requested X 'd'-4 Time _ A.M.--P.M.
Address — S s c � j'�. Permit # _—
Owner .. Lot #
Builder
L
The following Building Code deficiencies are required to be corrected:
Presented to 1"fi Approved
Inspector - I I Disapproved
Date 2
CALL FOR REINuPF,CTION
Cl YES fl NO
A
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FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL 34291
INSPECTION NOTICE
OWNER -- DATE ✓_f 3 --
OCCUPANT._ �� OCCUPANCY L __
LOCATION
pUP ATTENTION 11 CALLED TO THE FOLLOWING FIRE SAFETY DEFICIENCIES!
ic.
FAILURE TO CORRF_^.T TF4F ABOVE CONDITIONS W.Ticti OA•S WILL MAKE YOU LIABLE TO PROSECUTION IHOULC FIRE
RF9ULT FROM SUCH CONDITIONII YOU MAS BE 1 IABLE FOR DAMAGES TO PeRSON1 - gpoor F UNDER PROVIIIONI OF
0" no Ion 9Y
WASHINGTON COUNTY FIRE DISTRICT N1 MaNSHAL
20665 S.W. BLANTON STREET
PRESENTED TO
ALOHA,OREGON 97006 649.8577 �,�••�-
FORM 000 40
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INSPECTION NOTICE
City of Tigard Building Department
P O. oox 23397
Tigard, Oreg,)n 9/223
Phone:,639-4/75
Type of Inspection
DTte Requested '� _ TI A.M. P.M.
Address /(C
Permit ;✓'
Owner _ n�Jt �►9c� Lot # --
Builder --Wi---
Thhee following Building Code deficiencies are required to be corrected:
Presented to _ _ Approved
Inspector —�—_ } ni
-_ _ -- sapproved
Date C21
CALL FOR REINSPECTION
❑ YES 0 NO
w n ar,
i
' _--- G. A. BENTLEY CONSTRUCTION, INC.
P O Bos 363 - 2204-9 N.W. Birdsdale - Gresham, Oregon 07030-0052
(503) 661-2103
February 23, 1987
Mr Brad Roast, Building official
City of Tigard
PO Box 23397
Tigard, UR 97223
Re: 7-Eleven Bottle Storage Addition
located at 10765 SW Greenburg Fuad - Tigard, Oregon
Dear Brad:
Per our telephone conversation today regarding the above referenced
location and your letter dated February 20, 1987, we will make the following
required corrections as discussed:
(1) Handrail at step location.
(2) Heavy duty door closure leading to oottle roan.
(3) Adjust "stickirx3" rear exit door.
We will take c1re of these corrections within the next few days and call
for another inspection.
Brad , should further correspondence be necessary regarding corrections to
the bottle room additions, please contact our office.
S ,
i
Gregg Bentley
GA Be ley Construction Inc
GAB:vs
cc: Southland Corporation
CITY OF TIGA RD
OREGON
5 veors of SeMce
1461-1486
February 20, 1987 \�_�
Southland Corporation
1035 Andover Park West
Tukwila, WA 98188
RF: 7-11 Bottle Storage Addition - 10765 SW Greenbury, Road
Dear Sirs:
On December 30, 1986 a final. inspection was conducted on an addition to the
above referenced address. Several cDrrections were noted at that time,
requiring a re-inspection.
On February 6, 1987, a subsequent inspection was conducted (not requested) .
There was no indication that any attempt was mede to correct the problem.
If no action is taken within five (5) days of receipt of this letter, Legal
action wLll be taken against you.
Sincerely,
Brad Roast
Bui'_ding Official.
BR:cn/0718W
cc: Bentley Construction
PO Box 363
Gresham, OR 97030
13125 SW Hall Blvd.,P.O,Box 23391,Tigard,Oregon 97223 (503)639-4171-- --
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard. Oregon 97223
Phone: 639-4175
Type of Inspection �-+ ` --- ------ -
Date Requested Z L�= 4 Time_ �_ A.M._. P.M.
65 ��b���oA- . Permit # _—
Address �
Owner - Lot #
Builder _ -— ---�--- -
The following Btailding Code deficiencies are required to be corrected:
,�_,�RiQn r�oorr._ _—L'R1=Tv�tti.._��_ez ,__-rte -
Z'— ')
T Q F � E� l= - G� /V
oV 46
Presented to _ Approved
Inspector -------- — XI Disapproved
Date
CALL FOR REINSPECTION
,(?� YES 0 NO
FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL
INSPECTION NOTICE
OWNER ! r��.r'✓ cpa DATE
OCCUPANT_ ,F > J/ -'�~" ��5 _OCCUPANCY
_ f^
LOCATION �►�CoC �'' �.4 tr•�r' " t`i^I' r b ---
YOUR ATTENTION 16 CALLED TO THE FOLLOWING FIRE SArETY DFFICIENCIESI
AMri i f 'r� u;'`f rbr'r cls,
C�:�������� �I Tt��[""r ;'LY t' t' ,��•�,I"•CtL.,�`YJ/J j''X�• _�.iQ16JE�.
-.�.--+� �1.;L'.ara:.�..=�r,�;i� r�� G'1'�. "C.!/ i�'r ��u � 'Sri.h� r' • .�'� �;v/' f"r
FAILURE TO CORF ECT THF AROYF CONDI TIr)NS WI TIIirI !)1.'S WILL MAKE YOU LIAOL Tp rRO9ECUTION SHCUL^ rlgr
RE!ULT FROM SUCH CONDITI01J9 YOU MAI 5E I.IARLF rOR DAMAGES TO PERSONS OR OPENDfR PROVISIONS Or
ORS 479 Ion
my %
WASHII IOTON COUNTY FIRE DISTRICT M1 �X'' ARE M ',HAL
20665 S. V. BLANTON STREET
ALOHA, IREOON 97006 649.6577 PF7ESENTED TO i
FORM 000
" ....... .. ...�.Y'4i..s..�.r.........�ru.w.......w_.�.,..u..:lo....�qh+...u�.r.tws.r.-a.au......w._ .. ..�.
CITY OF TIGARD 439.4171 6 3 5
BUILDING PERMIT DATE
TAXMAPI5_L,}2Z__LOTNO. ZOO, SUBDIVISION __-
OWNER___Southland _Corp* _- -----..__--- — JOBADDRESS _ 10765 S4 Greeuburg
BUILDER L%• A• -rjO ltley Conatr.6g(ion _ - 3U87
STATE REG.N0. 00UEXP.DATE -i_`'/19 116
BUILDER'S PHONE
ARCHITECT_ tqb ALChItoCt1 - i PHONE __224'4i11U _ _OTHER
STRUCTURE F1 NEW O REMODEL_ 3U ADDITION F REPAIR MOVE J OTHER
El DEMOLITION
- — - a
I 1 RESIDENCE 1XI COMM L] EDUCl.1ION IND I RELIGIOUSI ACCESSORY GARAGE I OTHER I ' FENCE
OCCUPANCY isl LAND USE ZONE �' _BLDG.TYPE 5" FIRE ZONE PLAN CHECK BY �'� HEFT
A(16 buttls aturu�eeetwyctute to convenience store
Yet approved plaris
_ubject to Eire Uept: kebulatiuns & Review
SEWER PERMIT N
OCC.LOAD FLOOR LOAD ';011C. HEIGHT 11 NO STORIES I AREA 216 NO.BEDROOMS VALUE 4,:)oU
BUILDING DEPARTMENT SET BACKS FRONT REAR /(,.i LEFT SIDE 50 RIGHT SIDE
Permit SU•SU THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 37.83 _ WORK WILL BE DONE IN ACCORDANCE WITH 1 HE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
$) J WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
PI.Ck.Fire 20.20 _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 2.02
� -'
Total 105.55 SDC- -
PDC# APPLICANT ORA NT
Prepd. 32.83
lBal.Due__]_ Recelpt No. ADDRESS HON
991.Duev --- �Z.7z _-�
Issued By-_—_.—__Approved By_
I
I
i
s
i
i
I
J
DAT�EO INSP. TYPE INSPECTION REMARKS PLUMBING DATE
o�Hraou'
ermH No. ---
Fixture -- _---
/' Final
HEATING
Contractor
.1-5=8z ------ _.— Permit No
77 GasorOil
Rough-in
Final -
-� — SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb R Street Final`
Approach -!
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTFICATE OCCUPANCY — —
Landscaping
Zoning Final
i
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Or9gon 97223
Phone: 639-4175
Type of Inspection A-6 ---�
Date Requested Time— A.M.— P.M.
Address _ '/v �w C '� '.04 PermitOwner------ ✓ Lot #
Builder _ —_
The following Budding Code deficiencies are required to be corrected:
-71
c
Presented to .ter _----T-_---_— __-- - U-irproved
Inspector /(- --_ -_ - r �J Disapproved
nate - –- -- —
CALL FOR REI.JSPECTION
El YES 0 NO
r° ,TON L,
WASHINGTON COUNTY FIRE DISTRICT NO. 1
DIST NP 2(1885 S.W. Blanton St • Aloha, Qreflon 97007 • 50.71849-A577
October 22, 1986
Mr. Michael G. Parich, A.I .A.
Hansen Dunahugh Nicholson Architects
215 N.W. Park Avenue
Portland, OR 97209
Dear Mr. Parich,
Thank you for your letter of October 7 , 1986. I appreciate your co-
operation on this project and have only one comment to make to set the
record straight.
Section 3314(c) of the 1985 edition of the Uniform Building Code
specifies illuminated exit signs . I realize it used to be okay to
put a paper sign up above the door and be in compliance with this
Section , but this has changed as of the adoption of the 1982 edition.
Therefore , an illuminated sign as specified or a paper sign illumin-
ated by two electric lamps having an intensity of not less than 5.0
foot candles from either lamp is required.
1 trust this letter will clear this matter. Please do not hesitate to
contact me if you need further information or have questions .
Sincerely yours ,
WAS IN TON COUNTY FIRE DISTRICT NO. 1
/�.
J n K. Dalby
ire Prevention Officer
ssw
cc: City of Tigard Bldg. Dept.
STOP FIRES—SAVES LIVES
TON
. .• WASHINGTON COUNTY FIRE DISTRICT NO. 1
/ DIST. 20665 S.W. Blanton St. • Aloha, Oregon 97007 • 5031649-8577
September 30, 1986
Mr. Michael G. Parir.h
Hansen Dunahugh Nicholson Architects
215 N.W. Park Avenue
Portland, OR 912139
Dear Mr. Parich,
RE: 7-I1 Bottle Storage Enclosure
10765 S.W. Greenburg Road
The plans for the above noted addition were reviewed by this office
on September 30, 1986. As a result, we found the following items for
which there were no provisions made on the submitted drawings.
l. . The exterior door from the corridor must swing in the direction
of exit travel .
(Ref. 3304(b) UBC)
2. An illuminated exit sign must be installed in the area directly
adjacent to the door to the new bottle storage room indicating
the direction of egress .
(Ref. 3314(a) UBC)
3. Doors opening to the 1-hour rated corridor must be fitted with
smoke gaskets across the top and down both sides where the stop
meets the door.
(Ref. 3305(h) UBC)
4. All doors shown on the drawings must be openable from the
inside for immediate exit at all times without the use of a
key, special knowledge or effort.
(Ref. 3304 UBC)
5. Regarding the finish hardware prescribed for the exterior
doors , key-operated deadlocks are not permitted unless there
is a sign posted on or over the door reading, "THIS DOOR MUST
REMAIN UNLOCKED DURING BUSINESS HOURS" in letters not less
than one inch in height on a contrasting background.
(Ref. UBC 3304)
STOP FIRES -- SAVES LIVES
Mr. Michael G. Parich
September 30, 1986
Page 2
6. It is our understanding the framing in the new walls will be
metal studs.
7. Inspection and approval of construction by a representative
of this office is required: (a) prior to the cover of any
new framing elements following the installation of all util-
ity runs which will be concealed within wall and partition
cavities; (b) upon completion of construction and prior to
occupancy of the tenant space.
(Ref. 305 UBC)
8. There must be a floor or landino on each side of all doors.
The floor or landing must not be more than one inch lower
than the threshold of the doorway unless serving access for
the physically handicapped.
(Ref. 3304(h) UBC)
9. One set of approved plans bearing the stamps of the City of
Tigard Building Department and this office must be maintained
on the project site throughout all phases of construction and
must be made available to building and fire inspectors for
reference during required construction inspections.
(Ref. 303 UBC)
10. Prior to the use and occupancy of the project space, a
certificate of occupancy or other written instrument of
approval must be obtained from the City of Tigard Build-
ing Department.
(Ref. 307 UBC)
We trust this will clear the way for this project. If you have any
questions or comments regarding this review please do not hesitate to
contact me at your conveniE_nce.
Sincerely yours ,
WASH N TON
/lCou�l Y /FIRE DISTRICT NO. 1
J n K. Dalby U
Fire Prevention Officer
ssw
cc: City of Tigard
District Inspector
CITY C* TIC IRI) No. 16184
12755 S.W. ASH
P.O.BOX 23397 pate
TIGARD,OR 97223
Ljbt
Name — — -------- —
Address ---------�_----- --
Lot BlocklMap Subdivlsion,/Address
Permit N's Bldg. Rumb Cash T Che
Sewer Other Other Rec. By)
Acct. No. — Description Amount
10-432 _ Building Permit Fees —
10.431-600 Plumbing Permit Fees
p 10-431.801 Mechanical Permit Fees m
10.230.501 "tate Bldg. Tax --
10.433 _ Plans Check Fee
30.443— Sewer Connactlon —
30.444 Sewer Inspection --
51.448 Street Syst. Dev. Charge _
52.449-8l—0 Parks 1—Sy st. Dov. Charge —�
52.449.620 Parks II Syst. Dev. Charge
31.450 Storm Drainage Syst. Dev. Charge
10.430 — Business Tax-
--- — —
10.434 Alarm Permit
t 10.227 _ Bali —
K 100-455• Fines - Traffic1MIsd1Parking ---
10.230•_ CPTA TrafflclMisdlV_ic. Asst. —�
10-456 Indigent Defense --
30.122.401 Sewer ServlcelUSA _—
30.122.402 Sewer ServicelCity 30%
30-123 Sewer SevlcelCity Maint. --
30.12 Unmatched
31.124 Storm Drainage ---
40-475 -- Bancroft Prin. Pymt. — —
40.471 =_ ancroft Int_ ym� t,
DEPT.
SIGN PERMIT APPLICATION COF TI(;ARD Date 2111e ti , 19 t';_' No. .'.�_.7
The applicant hereby applies for a permit for the work indicated or as shown in the accompanying plans and
specifications.
GN LOCATION ADDRESS: 10763 SW GreenburR Rd.
APPLICANT: Owner Lessee Authorized Representative
NAME/COMPANY Maze Sign W. Tel. .�
- - — — — — — — — — — — — — — — — — — — — — — -- — -- —
PROPOSED SIGN: Freestanding Wall Projecting Other
SIGN DIMENSIONS 3 X 20 _ AREA 60 HEIGHT WALL AREA
PROPERTY FRONTAGE COST ZONING DISTRICT _ILLUMINATION
MATERIAL _ COLOR
COPY i.zrg. _ DRB Y_
EXISTING SIGNS: Freestanding Wall Projecting Other
COMMENTS:
All sign permits must be accompanied by a scale drawing and plot
plan. If work authorized under a sign permit her. not been complete
within ninety days after the issuance of the permit, the permit shall
PLANNING DEPARTMENT beeome Ml Atrd void.
Permit Fee 25.00
Approved _ BCR c' can gture
11
Renewal Date__�__ Address f�)2 V 'loci ci-7.z S_ Telephone
BUILDING PERMIT APPLICATION TIGARD DATE _ ► ts_ _._ �192
THE UNDERSIGNED HEREBY APPLIES FCR A PERMIT FOR i HE WORK. HEREIN INDICATED BUILDER PHONE 224-0110
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER ko belanicli JOB ADDRESS 10765 SW Greenburg kd LOT NO. -•..._
811 Skimwr Bldg ENGINEERT
HUI "R _Westwood_ConstructiOU ADDRESS .1jeattl9a W#Shg_.Q$101 DESIGNER -
STRL,rURE U NEW �12 REMODEL L1 ADDITION_ ❑ REPAIR _❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
C] RESIDENCE I1 COMM U EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT U GARAGE ❑ STORAGE D SLAB U FENCE
OCCUPANCY ---8-2 LAND USE ZONE _� BLDG.TY6F SN _FIRE ZONE " PLAN CHECK BY� BT4i _HEAT. Gea
Tennant wdification of axisting building all per approved plots i Code requirements
Partition height to existing cielingj& -
SEWER PERMIT# BONE Permit #4683 allk"ad 16 p Unit (2 'nestroom)
OCC.LOAD FLOOR LOAD HFIGHT NO.STORIES AREA NO.BEDROOMS v VALUE 5*UUU
BUILDING DEPARTMENT SET BALKS FRONT -- RFAR LEFT SIDE ^w RIGHT SIDE _
Permit • 0 7H% PERMIT IS ISSUED SUBJECT TO THE RE_A.LATIONS CONTAINED IN THE BUILDING CODE ZONING
32.83 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCE3. AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
!<3 33 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sulk al • _ RESTRICTIVE COVENANTS. CONTRACTOR ANU SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tex
4 ti 2•G2 1 LICENSE.SEPARATE PERMITS R77UIRED FOR SEWER,PLUMBING AND HEATING.
x5.35 SDC— <
Total _
LL' PDC# APPLICA T OF AGENT -
By - --
Receipt No.
Approved 1''TG;I)s ADDRE88 - —
_- - - - PHONE
•r
11
UATE INSP. TYPE INSPECTION REMARKS u - PLtIMBING DATE
L-ZZ 0-1 u i��r !Cnnrr•ictor
Pnrrnit No,
- — ---._- ---. _- —,_-- Fixture -
Final
HEATINO
Contractor l
rex or VII
Hnul
SEWER --
F I nai
DRIVEWAY
Final
-- - - ---_ —.— -
!R,1 gain)Fine
Sidet',alk
-_-_�- Cum d Street Final
_--tAppiC'Uh
SDG. DEPT.FINAL TEMPORARY iT-CERTIFICATE OC AWANCY I _
Ce' Final%TTIFICATE OCCUPANC" I _-
Landscaping
• :dnfny Final
C
i•
f
i
r�
MCMONIER S! WHITLOW
ATTORNEYS AT LAW
400 POWERS BUILDING
65 SO.TMWESr YAMHILL STREET
PORTLAND. OREGON 97204
TELEPHONE 15031 221•1IF413
November 15 , 1984
HAND-DELIVLRED
Mr. Wilburn Dodge
Fire Prevention Officer
Washington County Fire
District No. 1
20665 S .W. Blanton
Aloha , Oregon 97007
Re: City of Tigard MLP 5-84
Uniform Building Code I:Iterpretation
and Compliance
Dear Mr. Dodge :
Pursuant to your request of November 9, 1984 , I
have revised the form of Declaration in the above to add , at
paragraphs 2.6 and 3 . 2 thereof, restrictions on changes in
the uses or occupancies of the building and the termination
of the Declaration without first having complied with the
pertinent provisions of the Uniform Building Code . The
legal description fol the lots willbe filled in when they
become available.
It is my understanding that, ri.ron receipt of the
enclosed, you will write to Mr. William Monahan , Director of
Planning, City of Tigard, indicating; that the enclosed form
of Declaration is a satisfactory compliance with the
one-hour fire wall requirement of the Uniform Building Code
for the subject structures situated on the new property line
created by the above minor land partition .
Thank you again for your time and cooperation in
the matter. Please call if you have questions.
Yours very truly,
Mark D„ Whitlow
vp
enclosures
cc: Mr. William A. Monahan
Mr. Ed Walden
Mr. Orvar Litsjo
client
ONE
DECLARATION OF COVENANTS, CONDITIONS AND RESTRICTIONS
FOR COMMON PARTY WALL
THIS DECLARATION is made on the date hereinafter
set forth by Roger M. Belanich, referred to herein as
"Declarant.. "
Declarant is the owner of adjacent parcels of
improved real property in the City of Tigard, County of
Washington, State of Oregon more particularly described as :
Lot No. 1 :
Lo* No. 2 :
The said improvements -hich occupy portions of Lots l and 2
above-described are two adjacent and adjoining commercial
buildings which share a common party well. along the property
line between said Lots 1 and 2.
Declarant hereby declares that Lots 1 and 2
described above and any portion thereof shall be held , sold
and conveyed subject to the following easements,
restrictions, covenants and conditions, which are for the
purpose of providing for the ownership, maintenance and
repair of such common party wall , and which shall run with
said Lots 1 and 2 and be binding on all parties having any
right, title or interest in the described lots, or any parts
the�-ecf, their heirs, successors and assigns, and shall
inure to the benefit of each owner and succeeding owner
thereof .
ARTICLE I
DEFINITIONS
1 . 1 "Owner" shall mean the record owner, whether
one or more persons or entities, of a fee-simple title tc
either Lot 1 or Lot 2, including contract purchasers .
1 . ; "Declarant" shall mean and refer to Roger M.
Be.lanich anu his successors and assigns .
ARTICLE II'
COMMON_WALL COVENANTS, CONDITIONS AND RESTRICTIONS
2. 1 Description of Common Wall. The suit ect
common wall is a load-bearing wall constructed of 2" x 6"
Douglas Fir studs with 5/8" type X gypsum board or, the south
side and 5/8" type X gypsum board over 3/4" thick, 6" wide
cha,ineled rustic cedar siding over 1/2" gypsum sheeting on
the north side . The wall is filled with R-19 fiberglass
insulation and is approximately 8 inches thick . The wall
extends along and is divide] approximately in half by the
property line between the northern side of Lot 1 and the
southern side of Lot 2 .
2 . 2 Declaration of Party Wall . The
above-described wall—Vha7.1 constitute a common party wall
and the owner of Lit 1 shall have the right to use the same
jointly with the owner of Lot 2 .
2 . 3 Insurance. The Declarant. and all owners
shall purchase and maintain in full fo-_ce and effect
adequate policies of casiialty and fire insu -arce on the
buildings above-described to the extent necessary to cover
any casualty loss relating to said common party wall .
2. . 4 Re air and Rebuilding. Should the common
party wall be injured by any cause other than the act or
omission of the owner- of either lot , the wall shall be
repaired or rebuilt at their joint expense. Should the
common party wall be injured by act or omission of the owner
of either lot, the wall shall be repaired or re-built at
that owner' s expense. Ir either event , any sum received
from insurance against such injury or destruction shall he
first applied to such repair or. restoration . Any repairing
or rebuilding of the wall shall be on the same location and
of the same size as the original wall or portion thereof,
and of the same or similar material of the szrnie quality as
that used in the original wall or portion thexeof.
2 . 5 Restriction Against Alterations. Neither
owner shall. make any alteretions to t} e common party will
which would affect its structural integrity without, the
prior, written consent of the other owner.
2 . 6 Restrictions on Use and Occupancy. The
Declarant and owrerr shall not ch�inge the uses, or
occupancies of the buildings situated thereon from those
def, ned in Group B, Division 2 nf Chapter 7 of the 1982
edition of the Uniform Building Code, without having First.
satisfied the .requirements of said Uniform Building Code for
any such change of uses or occupancies. Uses and
occupancies allowed in Group B, Division 2 of said edition
of the Uniform Building Code are:
"Drinking and dining establishments having on
occupant load of less than 50, wholesale and
retain stores, office buildings, printing
plants, municipal police and fire stations,
Page 2 - Declaration
factories and workshops using :Materials riot
highly flammable or combustible, storage and
sales rooms for combustable goods, stores
without bulk handling (See. Section 402 for
definition of Assembly Building) .
Buildings or portions of buildings having
rooms used for educational purroses beyond
the 12th grade with less than 50 occupants in
any room. "
ARTICLE II
GENERAL PROVISIONS
3 . 1 Covenants Run With Land. The benefits and
obligations of the covenants herein shall run with Moth
parcels of land above described and shall bind the declarant
and owners thereof, their heirs , legal representatives,
successors and assigns, but the covenants shall not operate
to convey to the owner of either lot the fee to any part of
the other lot, the creation of common party wall rights
being the sole purpose of this Declaration.
3 . 2 Restriction on Termination. The Declarant
and owners shall not rescind or otherwise terminate this
Declaration without having first complied with the onP-hour
fire wall requirement of the Uniform Building Code for
structures situation on a prope7f.y line.
3 . 3 Enforcement. Enforcement of the covenants
and restrictions contai end herein may be sought by Declarant
or by any owner, shall be by proceedings at law or in equity
against any person or persons violating or attempting to
violate any of these covenants, and may seek either to
restrain violation or to recover damages. Nothing herein
contained shall prevent the prosecution of a suit for any
other violation of these restrictions .
3 . 4 Saving Provision. Invalid,ition of any one of
these covenants by judgment or court order shall in no way
affect any of the other provisions, each of which shall
remain in full force and effect .
IN WITNESS WHEREOF, the Declarant has executed
this Declaration of Covenants, Conditions and Restrictions
on the day and year appearing herein below.
I' DATED this _ day of 1984 .
Roger M. Be anic
Page 3 - Declaration
STATE OF )
ss.
County cf )
The foregoing instrument was acknowledged before
me this _ day of , 1984 by Roger M.
Belanich. —�
Notary Public for
My Commission Expires :
Page 4 - Declaration
\NGTON
'y WASHINGTON COUNTY FIRE DISTRICT NO. 1
atsT 20665 S.W. Blanton St. • Aloha, Oregon 97007 • 5031649.8577
November 15, 1984
Mr. Wiliiam A. Monahan
Director, Planning and Devflopment
City of Tigard
P. 0. Box 23397
Tigard, Oregon 97223
Dear Mr. Monahan:
Re: Greenburg Center
10765 S. W. Greenburg Road
Concerning the City of Tigard MLP 5-84, for whatever it may be wcrth,
we are in receipt of a document prepared by Mr. Mark Whitlow of McMonies
and Whitlow, Attorneys-at-Law, titled "Declaration of Covenants,
Conditions and Restrictions for Common _fart a� which, among other
ti ngs, prescribes that the use con it ons of the property under
discussion cannot change and further prescribes that the owners may not
rescind the restrictions without first fulfilling the requirements of
the Uniform Building Code (the currently applicable code) which
describes the conditions of construction for buildings located on a
property line.
From my frame of reference this is a practical alternate method of
fulfilling the spirit and intent of the regulations which prescribe
the required fire resistance of exterior walls and walls located on
property lines; specifically, Section 504 of the 1982 edition of the
Uniform Building Code as promulgated by the International Conference
of Building Officials, 5360 South Workman Mill Road, Whittier, Calif-
ornia, 90601 , an adopted regulation of this jurisdiction.
I trust this letter will provide written verification of our stance
with ,.Cct to this issue. If you have any questions or if this
,offfce Kn be of ser in any other way, please let me know.
Sindi/r ly yo rs ,
/ A HINGe,TO NTY F R DI TRICT NO. 1
'0,
WiIb rn Dodge
Fire Prevention Officer
j c c
cc: I/ Ed Walden
Mark Whitlow
STOP FIRFS --- SAVES LIVES
MCMOIC ES & WHITLOW
ATTORNEYS AT LACY'
400 POWERS oulwlNC..
66 SOIrI MST Y.AMMILL STREET
PORTLAND, OREGON 67204
TELEPHONE 13031221-11149
October 25, 1984
Mr. William A. Monahan
Director of Planning 6 Development
City of Tigard
P.O. Box 23397
Tigard, Oregon 97223
Re : City of Tigar-I MLP 5-84
Uniform Building Code interpretation and
compliance
Dear Mr. Monahan:
To confirm our telephone conversation of October 25, 1984 ,
it is my understanding that you have agreed to waive condition
number. 3 as containee in your. decision .in the above of
October 9, 1984 and to accept, in lieu thereof, a new condition
of the nature described both in my letter to you and Mr.
Walden and in Mr, Wilburn Dodge' s letter to me, both dated
October 22 , 1984 , with the precise language of that condition
to be subject to the review and final approval of Mr. Dodge,
who's opinion you will defer to in the matter.
This letter will also confirm the fact that you have agreed
to extend the appeal period in the above through 4 : 30 p.m.
on Friday, November. 9, 1984 , so that I may submit and obtain
final approval of the provisions of the above mentioned
condition to Mr. Dodge. Would you please confirm the extension
of the appeal. period by signing and returning the enclosed
copy of this letter to this office in the self-addressed,
postage paid envelope enclosed.
Page 2
Mr. William A. Monahan
October 25, 1984
I wish to thank you and Mr. Walden for your time and co-
operation in this matter. Please call if you have any
questions.
Very truly yours,
I
Mark D. Whitlow
MDW:lh
Enclosures
cc: Mr. Ed Walden
Mr. Wilburn Dodge
Mr. Orvar Litsjo
client
The appeal period in the above is hereby extended 4Co
4 :30 p.m. , Friday, November 9 , 1984.
William A. Monahan—
Director of Planning and Development
FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL
2 ll
INSPECTION NOTICE
IT �� l t
OWNER_ 1I -- DATE
r�• k.:I I -
OCCUPANT ' OCCUPANCY
LOCATION
YOUR ATTFNTION IE CALLED TO THE FOLLOWING FIRS SAFETY 0EFICIEN4re slr
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FAIL.URF TO CORRECT TIAF AAOVF CONDITIONS wituiN OAYS WILL b1A1t LIAb E TO F'ROSE UT ** 'RE
RESULT FROM SUCH CONnITIONS YOU MAY RE LIARLF FOR OAMAG�S 7O, ERSOI�,� 'P DERTv NCER CR OF
ORS 471 Loo
WASHINGTON COUNTY FIRE DISTRICT 01 FIRE MANSHAL
It
20665 S.W. BLANTON STREET A-
p. .ilR,ro
ALOHA,OREGON 07006 $49.5577
FORM DOO • 40
f
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
P P 639
o -4171
o 639
1Type of Inspection —-------- - ---—--
Date
-----
Date Requested........
4e A.M.
Address Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Z7
——-----------
Presented to Appreved
Inspector Disapp,oved
Date
A?—
CALL FOR REINSPECTION
YES El NO
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SIGN PERMIT APPLICATION COF TIGARD oats 8 19ai_ No. 074
The applicant hereby applies for a permit for the work indicated or as shown in the eccompanyEng plans and
specifications
"IGN LOCATION ADDRESS: 1_0765 Sw .r nnh tr& ltc
APPLICANT: Owner SalathI""'Lessee Authorized Representative 'ra
Pauli l. xson
NAME/COMPANY - Tt1e '`•>>��=I,int ill (:cr.ilorat roil Tej
PROPOSED SIGN: 4 Freestanding — ' _Wall It Projecting _ — — .Other_ � _ — ^ _ —_
SIGN DIMENSIONS m' )" 2AREA 72 au. IL HEIGHT .��. WALL AREA '2 a
PROPERTY FRONTAGE _ — COST 250.00 ZONING DISTRICT _ILLUMINATION
MATERIAL tion Lear val2er ,
COLOR t�'(iite,T;c,,""L,�� �.,
COPY ii,I I „t,nni.a cr,nr11IY , —_ DRB
EXISTING SIGNS: Freestanding Wall Y Projecting .— Other _
COMMENTS: All sign permits must be accompanied by a scale drawing and plot
plan. If work authorized under a sign permit has not been completed
'LANNING DEPART ENT within ninety days after the issuance of the permit, the permit shall
-- — —~ becorne null and void.
Permit Fee
Approvedpt� Applicant's Signature "—""'-------
Recei t�.
Renel Da
wate__V� Addrep ----------
Telephone
SIGN PERMIT APPLICATION COF
IT TIGARD Date _Tu1y 1i �, 198 ' No.
The applicant hereby applies for a permit for the work indicated or as shown in the accompanying plans and
specifications.
SIGN LOCATION ADDRESS: —, 10765 S .W. Greenburg Rd. , Tigard , Or .
APPLICANT: OwnerSouLhl n6essee NSA _ Authorized Representative Paul Paxsr.►n
NAWE/COMPANY The Southland Corporation Tel. X45-9764
- -
PROPOSED SIGN: Freestanding — Wall ,X_ Projecting Other
SIGN DIMENSIONS 36 ' --x-/'-- AREA 72 sg ft HEIGHT 2 ' WALL AREA _72 sq ft
PROPERTY FRONTAGE COST `:Q,0 ZONING DISTRICT ILLUMINATION too
MATERIAL Non tear paper COLOR White/Red Letters
COPY Will change monthly DRB
EXISTING SIGNS: Freestanding _X Wall ____X — Projecting _ Other
COMMENTS: 960Sic �f.3r on bldg front X 15'1 = 144 rg ft n11nwn��'ln ; e iGt-ing
facia sign is 20 sq ft _plus 72 sq_ft for banner = 92 sq ft . See attachments .
All sign permits must be accompanied by a scale drawing and plot
( p;an. If work authorized under a sign permit has not been completed
within ninety days after the issuance of the permit, the permit shall
PLANNING DEPARTMENT hecome null and void.
Permit Fee , A C�_ - V_C:
/ L-
Approved i% Applicant's Signature
Reseiit o. 1 10250 S .W. Greenburg Rd. 2�5-9764
Renewal Date Address Telephone
--- �� Su1_to 103E
Portland , Or. 9722.3
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FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL 14755
INSPECTION NOTICE
OWNER DATE
OCCUPANT_ ---OCCUPANCY e�-
LOCATION
—7
YOUR ATTENTION IS CALLED TO THE FOLLOWING FIRE $AFnTY DE�'ICtFNtIUS!
ce
I C/kEZ4"
a4�
FAILURE TO CORRFCT TIIF. ABOVE CONDITIONS t�ITHIN_DAYS WILL MA 11 1 F YOU LIA14L t 'to PR054CUTIO4 SHOULI: FIRE
RESULT FROM SUCH coNr,:itot4s YOU MAY BE LIABLE FOR DAMAGES Ty P PER UNDE
>-940I,js OR R R oyI I"S OF
ORS 479 90
y4L
WASHINGTON COUNTY FIRE DISTRICT#1 FIRE-MARSHAL
20665 S.W. BLANTON STREET P.O. BOXY
ALOHA,OREGON 97006 649.8577 PREGENTED TO
FORM 900- 40
FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL Na 14497
INSPECTION NOTICE
OWNER _ -- f�ATE
OCCUPANT +n' �C —._._. OCCUPANQY�) f'
LOCATION
YOUR ATTENT'CN Id CALLED TO THE FOLLOWING FIRE SAFETY DEFICIENC�IlrSf"
(:4t
I
'~
I FAIL-URI[ TO CORR'�CT THE AOOVF CONDI (IONS WITHIN DAYSWI MIKL YOU M `.E TO nq0/ ECUTIO
YOU MAY �1 dNO�tU I/p FIRE
F'ESULT FROM SUCF. CONDITIONS 0E LIAELfl DAM4GE TQ' PEA p R'9RkR VY UNDER %!10
0'1 1ON� 7F
oqe 4,0 100 E#Y
I FIR': MARSHAL.�
WASHINGTON COUNTY FIRE DISTRICT 111
20665 S.W. BLANT014 STREET PI O. BOX Y
PRESENTED 'f0___-..-.__.__
ALOHA,OREGON 9-x006 649.6577 --`�"T- --J
FORM 900 40
Washington County Fire District No. 1
20665 S.W. Blanton Street
Aloha, Oregon 97007
Hureau of Fire Prevention
669.8577
Plans Examination Report No. 1516 _
County Plan N'). _ City of Tigard
Building-- Greenbur Center _
--.�--- Occupancy_.. B-2�_Mercantile
Address_. 10765 S. W. Greenburg Road _ __—Construction Type V-N
Architect/Designer Orvar N. J. LitsJo ---Address 0110_ S. W. Curry_ Street —
oWner_Roer Belanich Bus. Property DevelopmentAddress 811 Skinner Building_ Seattle 98101
Stories_.l First Story Area *1110 Basement Area notte Attic Height_ 30 inches
Draft Si.. -_ 2 Fire Walls__ none Exits 4—. _and Total Width 14 feet—
Stairs- n•a•_JEnclosed. __Other Vertical Shafts_ none /Enclosed -- Sprinklers- none
Area Covered _-- Manual Alarm__. none _Standpipes none _
Combustion Detection__non�Type _ /Area Covered--
Floor—,concrete
overed _Floor_ concrete _ Ceiling suspended acoustical _Roof class B BH-�____,
Str.Members--- wood _ _ _Wall Cover(Ext.)plywood-cedar s i d.-/(int.) GWB _
Heating System not Shown Fuel_ Cooling System_ not shown
The plans for the above described project were referred to this office 12-9-83
and reviewed 12-13_$3 — for conformity with State and District fire safety laws and regulations.
Listed as follows are applicable requirements for which we have found no provisions in our examination of the drawings,
general notes and/or specifications.
1 . The HVAC plans were not submitted to this office and therefore not revier d.
Please submit plans before approval of this building can be granted.
(ref: Sec. 302 U.M.C. )
2. The plans for tenant improvements of these spaces are to be submitted to this
office for approval prior to any construction taking place.
(ref: Sec. 303 U.B.C. )
Richard D. Butts
Fire Marshal CONTINUED
By /� — ----— ---
Fire Prevention Officer
cc: Roger Belanich
Oak. Hili Construction Co.
Form 900/3 .lard Building Department
Revised 10/83
Plans Examination Report No, 1516
Greenburg Ccnter
Page 2
3. All doors shown on the drawings must he openable from the inside for immediate
exit without the use of a key, spe:ial knowledge or effort; provided, however,
that the main entrance/exit door assembly which is composed of a pair of doors
may be fitted with a keyed deadlock if it is of the indicating type (that is,
being readily distinguishable as being locked when in the locked position) and
in conjunction therewith there is posted above the door assembly a sign reading
"THESE DOORS MUST REMAIN UNLOCKED DURING BUSINESS HOURS: in letters not less
than 1 inch in height on a contrasting background. Also, both doors must be
"active. " When one leaf is unlocked, both leaves must be free to swing. The
use of edge bolts, surface bolts or similar restraining devices are prohibited.
(ref: Sec. 3303 U.B.C.)
4. Firestopping consisting of 2-inch (nominal) lumber or equivalent must be pro-
vided in all concealed spaces of stud walls at the ceiling and floor levels
and at 10-foot intervals along the length of the wall as well as all inter-
connections between concealed vertical and horizontal spaces such as occur at
soffits, dropped ceilings and coved ceilings.
Penetrations in the firestopping to accommodate wiring, plumbing, duct work
and similar utility runs must be packed, following the installation of said
utility runs, in a manner which will effectively maintain the integrity of the
firestopping and cut off all concealed draft openings which could afford a
passage for flame.
(ref: Sec. 2516 U.B.C. )
5. Draft stops must be installed in attics, mansards, overhangs, false fronts set
out from walls and similar concealed spaces so that the area between draft stops
does oot exceed 3,000 square feet and the greatest dimension dons not exceed
60 feet.
Draft-stopping materials must be not less than 1/2-inch gypsumboard, 3/8-inch
plywood or other approved materials adequately supported. Openings in the
partition must be protected by self-closing doors with automatic latches con-
structed in the same manner.
(ref: Sec. 2515 U.B.C. )
6. The insulation proposed for installation in the attic space, including breather
papers and vapor barriers, must have a flame-spread rating of not to exceed 25
and a smoke development classification of not greater than 450 as measured on
the Steiner Tunnel Test Scale referred to as U.B.C. Standard No. 42-1 .
(ref: Sec. 1718 U.B.C. )
7. As hydrant locations were not indicated on the submitted drawings, fire hydrants
must be located so that no part of the building is more than 250 feet from a
fire hydrant. Fire hydrants must be placed at street intersections unless
otherwise authorized by this office.
(ref: Washington County Fire District No. 1 Ordinance 83-1 )
Plans Exaiiination Report No. 1516
Greenberg Center
Page 3
8. One set of approved plans bearing the stamps of the Tigard Building Department
and this office must be maintained on the project site throughout all phases
of construction and must be made available to building and fire inspectors for
reference during required construction inspections.
(ref: Sec. 303 U.B.C. )
9. Inspection and approval of construction )y this office is required:
a) prior to the cover of any interior f •aming following the installation
of the utility runs and firestopping.
b) upon completion of construction and prior to the opening of this
occupancy to the public.
(ref: Sec. 305 U.B.C. )
10. Prior to the opening of t!,is occupancy to the public, a Certificate of Occupancy
or other written instrume,it of acceptance must be obtained from the Tigard Build-
ing Department.
(ref: Sec. 307 U.B.C. )
SPECIAL NOTICE:
DEVIATIONS FROM THE -,UBMIITED AND HEREBY CONDITIONALLY APPROVED PLANS DURING
THE COURSE OF CONSTRUCTION, EXCLUSIVE OF THOSE NECESSARY TO COMPLY WITH FIRE SAFETY
REQUIREMENTS AS LISTED HEREIN, ARE PROHIBITED WITHOUT THE WRITTEN AUTHORIZATION OF
THE WASHINGTON COUNTY BUILDING, DEPARTMENT AND THIS OFFICE.
PLEASE NOTE THAT WE HAVE PROVIDED A REFERENCE FOLLOWING EACH RUQUiREMENT.
THIS NOTE INDICATES THE APPLICABLE CODE AND SECTION THEREOF IN WHICH THE REQUIRE:MLNT
IS CONTAINED. U.B.C. , U.M.C. AND U.F.C. REFER TO THE UNIFORM BUILDING, UNIFORM
MECHANICAL_ AND UNIFORM FIRE CODES RESPECTIVELY AS ADOPTED AND AMENDED BY WASHINGTON
COUNTY FIRE DISTRICT NO. 1 . PLEASE CGNTACT THIS OFFICE IF THERE IS ANY REQUIREMENT
WHICH YOU QUESTION OR DO NOT UNDERSTAND.
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0686
IT
SIGN PERMIT APPLICATION COF TI G A R Q Date "''.-!, 19 3 No.
The applicant hereby applies for a permit for the work indicated or as shown in the accompanying plans and
specifiratt'ons.
-'GN LOCATION ADDRESS: 10705 SW Greenburx Rd. _ Tigard. 01
APPLICANT: Owner Lessee Authorized Representative
NAME/COMPANY South Land Care. 7-11 SLoi: _ Tel.
PROPOSED SIGN: Freestanding x Wall _..4 Projecti.lg _Other
SIGN DIMENSIONS F.S. 5' 7"X17 AREA 70 _. HEIGHT ''' '" WALL AREA _ 11
PROPERTY FRONTAGE COST _ ZONING DISTRICT ---ILLUMINATION .
MATERIAL SLeel & plastic COLOR —
COPY __ 7-11 stirp DRB
EXISTING SIGNS: Freestanding uon(Vall 11011e Projecting r1otiC' Other11U�T" —
C -)MMENTS: I Free stawc iug Sign 70 Sic . Ft. or 140 :iq. FL. 2 skies
Wall Sign 411 Sq. Ft.
1 Wall Sign 25.00 ` All sign permits must he accompanied by a scale drawing and plot
I Free Standing 25.00 plan. If work authorized under a sign permit has not been completed
within ninety days after the issuance of the permit, the pertnit .hall
!CANNING DEPARTMENT become mill and void.
Permit Fee �i..;L �� I L a..,
Approved F,`t W Applicant's Signature
R`eceiptNo. Z21f
Renewal Date Address ��! Telephone
AL—_AL—_.MLj
BLIILDI'l::I PEHMIT APPLICATION TIGARD DATE ucllobe;i7 ,te_± — 4625
THE UNDEHSI6NED HERE GY APPi IE:,FOR A PERMIT FOR 1 hiE WORK HEREIN INDICATED BUILDER PHONE - 771•-u t,l
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER— llie 50t1ti1 Land C.4ur40.8ADDRESS_ 10765 SW Greenblirg Ild. 'lax 1,ot $UV Tax May 1 I 3"ll
ARCHITECT —
ENGINEER
BUILDER
llrk Hilj_jnyAsn -_uj ADDRCSS— ------ -- DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL __4ADDITION ❑ REPAIR ❑ RENEWAL C7 FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE f. COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE G STORAGE ❑ SLAB❑ FENCE
OCCUPANCY R9• LAND USEZONE C-3- BLDG.TYPE 5N FIRE ZONE____—PLAN CHECK BY E'TW HEAT— Gae
—_ Construct 3U X IS addition to existiny bldg. _ all per plans & Code requiremetrto
SEWER PERMIT 0 - of,. _ — Plumbing Perrit xeguired.
OCC.LOAD FLOOR LOAD HEIGHT bi NO.STORIES - I AREA 45U NO.BEDROOMS VALUE y.IJt1c_.
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGFIT SIDE
Permit — _14,50 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERE BY AGREED THP -HE
Plan Check 4 I.6' _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI CE
1 WITH ALL APPLICABLE. CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NUT WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRE IT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING ANP HEATING.
State Tax �+•`'3 l
— SDC—
Total 117.+36
-- -- PDC# APPLIC•A T OR AGENT
By l:H '
Receipt No. /�(J a?!� �-601w j ..Z
Approved ---�- -- J I1IDORFS `A) Y) r✓�p - --PHONE ---
DATE INSP, TYPE INSPECTION REMARKS PI i!IBJIVG DATE
C intractoi
Permit No.
_j 80.gh-in
Fixture
F,nal
HEAT,NG
Cuntractor
Pwmit No.
Ga.or•
oil
Rough-in
Final
SEWER/
Final
DRIVkAY
Final
Storm Orain
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DfP_T, FIUAL j TEMPORARY CURTIFICATr. OCCUPANCY
,Ct.ITIFICATE OCCU.-4NCY Pinel
Landscaping
Zoning Final
BUILDING PERMIT APPLICATION TIGARD DATE— : _ ,tg4511
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILUER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
„
L OT N 0. 'i;#` ":thy_' i31';
OWNER "tic !-louthland i.:yrp. JOB ADDRESS 10765 .iia Crc�enbrarr Rd,, _ i� ;,at
ARCHITECT I• `"S'v. TJtr,r
.dill Iran. ENGINEER
ADDRESS ` DESIGNER
STRUCTURE ❑ NEW _Cl REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL F-1 FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ E:'UCATIONAL. ❑ GOV'T C RELIGIOUS [1 PATIO El CARPORT_❑ GARAGE El STORAGE EISLAB❑ FENCE
_—--�`_�'�----� —,T� ----
OCCUPANCY —_=LAND USE ZONE BLDG.TYPE � FIRE ZONE.— PLAN CHECK BY HEAT
--- _ Construct A mm atiryfr�il��L .5,► 50 all 1mr -1-ins n*tt cOdo req. �--
/-! I ,torr."
SEWER PERMIT k 25, ,-1 - X115�Qi.
OCC,LOAD FLOOR LOAD Crc,r. HEIGHT 14 '-.1"NO.STORIES AREA "if.h+ NO.BEDROCMS _ VALUE
BUILDING DEPARTMENT_, SETBACKS FRONT ! +;'+ _ REAR a 3 LEFT SIDE RIGHT SIDE--; !0t
Perm
it3!+ 1 THIS PERMIT IS ISSUED SUBJECT TO THF. REGULATIONS CONTAINED IN THE bUILDING CODE,ZONING
I
2 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plapd. 5• WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
Su� i)ct. t32.�fU WITH ALL APPLICABLE CODES AND ORDINANCES. THE 'SSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUR'IENT CITY BUSINESS
Sta
I3.24 LICENSE.SEPARATE PERMITS REOUIRFD FOR SEWER,PLUMBING AND HEATING.
SDC—
Total ') 9
By PDC# -KP—PLIC A T OR AEN
AT �-
,_.
7.
A Rece�:No. //� <�cU• G`U+'p,c�
Approved PP ---— - 'ADDRESS c--/a... PHONE
DATE INSr TYPE INSPECT(I�ON REMARKS PLUMBING DATE
Contractor
�'ks•( 1&0 � /�g r Q7 C Cw r.�l_ Permit No ' �-
"� '�`�_ .`3
IAC Rough-in
Fixture _—
Final
'/p�/�� HEATING r
r/�`+ ✓✓11 :1��� _, — ContractXII-A _ , N`
/6- VAJ-=__Q. Gas or Oil
Final
SEWER .
+_ — e Final -� � • y/�1•p
DRIVEWAY
— — -
Final _
Storm Drainage g5_24-
Main Drain)FinaalTl 6
—_— Sidewalk
Curb&Street Pinel
Approach-
BLDG. DEPT. 6i.-AC 6i.—ACTEMPORARY CERTI?iCATE OCCUPANCY Final
(CERTIFICATE OCCUPANCY
Landscaping -
Toning Final -
t
Washington COLinty Fire District No. 1
♦r' ,I
:W 20665 S.W. Blanton Street Mailing Address: P.O. Box Y
Aloha, Oregon 97007 Aloha, Oregon 97006
Bureau of Firr Prc%ention
649-x577
Plans Ex urination Report No. 1495
Tigar� 4511
zz4aq Plan No. __
Building--7-El even Food Store _Occupancy __ B-2, Mercantile
Address_ 10765 S. W. Greenburg Road _ _ _ ConstructionType V•N
Arch itect/Designer _ OrVdr N.J.LitsO .___-___Address__. 519 S. W. �' Avenue
Owner Southland Corporation Address. 1035 Andover Park West _Tukwila, WA
Stories 1 First Story Area—?A400 Sqjt Basement AreanOn@ Attic Height 3 ft.
__�_
Draft Stops none 1'eC�. _Fire Walls none _ Exits_ _ 1 and Total Width _ f t t
Stairs— none /Enclosed Other Vertical Shafts none /Enclosed Sprinklers_ none
Area Covered____..__-___..—___--Manual Alarm none Standpipes none
Combustion Detection none /Type__ —" /Area Covered__ _
built-up, Class A
Str. Members wood Wall Covet(Ext.) __ wood i(Int.) G.W.B.
Heating System__fonce_d air ----Fuel------el ectri c---.. _ CoolingSystem__.int_ egral
The plans fnr the above described project were referred to this officeand reviewed__.___ 7�.-83-- ----for conformity with State and District fire sgfery laws and regulations.
Listed as follows are applicable requirements for which we have found no provisions in our examination of the drawings,
general notes and/or specifications.
1 . Due to the proximity of the south wall of the building to the south property line
it is required to be one-hour fire-resistive construction, not as shown on the
de drawings. further, the first 37 feet of that wall measured from east
o est nust extend above the roof line to form a parapet ri�jt less than 30 inches
in he That is, all rtions of the wall within 10 feet of the property line,
mea r• d at right angle r m the property line, is required to be provided with
a n hour F're-rated p apt.
e S X04 and 17 U B.C.
e CONTINUED
by
Plans Examiner onstruct n In for
cc: Southland Corpora n, 'Washington
Southland Corpor ion, Oregon
Tigard Building Department (2)
VIRE PREVENTION DOES NOT COST IT PAYS
Form !DO/3
Revised 6/11
Plans Examination Report No. 1495
7-Eleven Food Store
Page 2
2. All doors shown on the drawings must be openable from the "inside" for imp„ediate
,it without the use of a key, special knowledge or effort; provided, however,
that the main entrance/exit door assembly which is composed of a pair of doors
may be fitted with a keyed deadlock if it is of the "indicating type" (that is,
being readily distinguishable as being locked when in the locked position) and
in ,;'inction therewith there is posted above the door assembly a sign reading
"T,iESE DOORS MUST REMAIN UNLOCKED DURING BUSINESS HOURS" in letters riot less
tan 1 inch in height on a contrasting background.
.n any case, both doors must be "active. " "en une leaf is unlocked, both leaves
riust be ree to swing. The use of edge bolts, surface bolts or similar restrain-
ng devices are prohibited.
(ref: Sec. 3303 U.B.C. )
3. Referring to cross-section C/C and the reference to typical firestopping at ceil -
ira lines, penetrations made in this firestopping to accommodate wiring, plumbing,
dict work and similar, utility runs must be packed, following the installation of
said utility runs, in a manner which will effectively maintain the integrity of
the firestopping and cut off all concealed draft openings which could afford a
passage for flame.
(ref: Sec. 2517 U.B.C. )
4. The insulation proposed for installation in the attic space, including breather
papers and vapor barriers, must have a flame-spread rating of not to exceed 25
and a smoke development classification of n)t greater than 450 as measured on
the Steiner Tunnel Test Scale referred to as U.G.C. St.3ndard No. 42-1 .
(ref: Sec. 1718 U.B.C. )
5. One set of gj)roved plans bearing the stamps of the Tigard Building Department
and this office must be maintained on the project site throughout all phases of
construction and must, be made available to building and fire inspectors for
reference during required construction inspections.
(ref: Sec. 303 U.B.C.)
6. Tnspection and approval of construction by +.his office is re(;;,ired:
a) prior to the cover of any interior framing following the installation
of the utility runs and firestopping shown in cross-section C/C and
mentioned in requirement no. 3.
b) upon completion of construction and prior to the opening of i.his
occupancy to the public.
(ref: Sec. 305 U.B.C. )
7. Prior to the opening of this occupancy to the public, a Certificate of Occupancy
or othe- written instrument of acceptance must be obtained from the Tigard
Building Department.
ef: Sec. 307 U.B.C. )
Flans Exa,nination Report No. 1495
7Aleven Food Stere
Page 3
n
1
',IILCIAL NOTICE:
DUE TO THE ISSUE ADDRESSED IN ITEM NO. 1 OF THIS REPORT, WE ARE LEGALLY AND
MORF,LI_Y BOUND TO WITHHOLD APPROVAL OF THE PLANS AND ENDORSEMENT OF THE BUILDING
PERMIT UNTIL IT IS SATISFACTORILY RESOLVED EITHER IN THE CONTRACT DOCUMENTS OR OTHER
WRITTLN INSTRUMEN".
FOLLOW.[NG EACH REQUIREMENT LISTED IN THIS REPORT A REFERENCE NOTE HAS BEEN PRO-
VIDED. THIS REFERENCE NOTE INDICATES THAT SECTION OF THE 1979 EDITION OF THE UNIFORM
BUiI_DING CODE (AS ADOPTED AND AMENDED BY THE STATE OF OREGON) IN WHICH THE REQUIRE-
MENT IS CONTAINED.
IF ANY QUESTIONS ARISE REGARDING THE CONTENTS OF THIS RLPORT OR IF THIS OFFICE
CAN BE OF SERVICE IN ANY OTHER WAY, PI-EASE DO NOT HESITATE TO CONTACT ME.
CITY OF TIGARD-12430 S.W.MAIN-TIGARD,OREGON 97233
-G RECEIPT
DATE: AMOUNT:
--� =DOLLARS
NAME: _ - �A �i1_.n+� CASH:
ADDRESS: 4:2-///� .�LTJ �i_��f., �t 4:2 -_
-------�-- -�JaG� r/ — M.O.:
r OF
FOR: —__ - ACCT. E PERMITS SURCHARGE AMOUNT
SEWER BILLINGS 40-364 _— $
BUSINESS LICENSE 05-331 _ -
PLUMBING PERMIT 05-332
i
MECHANICAL PERMIT 05-332
BUILDING PERMIT 05-333
SEWER CONNECTION 40-36.3
SEWER INSP[CTION 40-365
SYSTEM DEV,CHARGE 25-366
PARK DEV.CHARGE #1 30-367
PARK DEV.CHARGE #2 30-368
ZONING ADJUSTMENTS 05-362
/C~
TOTALS $
RECEIVED BY:
PERM11 NUMBERS ASSIONED: _
Number Amount Numbor Amount Numbw Amount
Wall
---- s _ $ RECEIPT •1 4075
and Building Department
PLAN CHECK REPORT
i
Buildino r Permit#
Address- 70
Occupancy �� Building Type �� _ Land Zone �.L—
F ioor area B. � r,0-0--. 2. Other
-otal Area __ S-C) a
Allowable Area ka&I a Allowable increases
Occupant Load fid. _?____—sq. ft. CMZPQ sq. ft./ occupant=
__.sq. ft. 0 . _sq. ft./ occupant=
ft. ® sq. ft./ occupant=
Other — —
Total load—��,�^ � p�
Value ``dV 0 G' sq. ft. a / sq. ft._
Permit _ + _ x
Plan Check �A' ' 13 L `E� F D
4% Y -
Total 6_fL__z49__.
�4��� a 7�-
Sewer AV P�-acr s= � 0.U.s x &W.00
Surcharge _ `Athki `
r
Total _ A 7 f
{parking _---Spaces 0 50.00/space
1 0
Comments : ._ ,_---�—►�-- — ^.__- - _. ...
tt
SEWER PERMIT N': 25773
Ufnified Sewerage Agency
of Washington County CITY OF — /,q ,+ b _ DATF
OWNER : TAS K r Jul 4 /4 -A 0 C d (? (� V _ PHONE - 77 1-(rG�
OWNER 'S ADDRESStj :2 U-0 '^" It —
TYPE OF INSTALLATION:
❑ SIDE SEWER ❑ LINE TAP AND SIDE SEWER LINE TAP
TYPE OF OCCUPANCY%
❑ NEW ❑ EXISTING ❑ SINGLE FAMILY COMMERCIAL
❑ EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. [] INDUSTRIAL
FIXTURE UNITS -2V --- DWELLING UNITS ADDRESS OF STRUCTURE : _ ZA
Permit Conditions: The applicant agrees to comply with all rules and regulations of th Unilied Sewerage Agency,
When calling for Inspection, please refer to the Permit Number. The Application expires in one hundred twenty (120)
days The amount paid will be forfeited should expiration occur.
The Agency does not guarantee the accuracy of the location of side saver laterals. If the sewer is not located at
the measurement given, the installer shall prospect three feet in all directions from the distance and depth given.
If not so located, the Installer shall purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency
will install a lateral at the location specified by the installer.
FEES:
PERMIT FEE
CONNECTION CHARGE
LINE TAP INSTALLATION — _—
ISSUED BY
O'f HER --
&V 60
-
s60
TOTAL $-j 7
APPLICANT DATE
SEWER PERMIT 1 25773
ADDRESS OF STRUCTURE
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Commercial Heal Estate Services 3
GREG HUME !
(503) 697-8558
15631 Village Drive • Lake Oswego, OR 97134
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