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12755 SW 69TH AVENUE STE 202 i ADDRESS : I69 AVA I:\records\mlcroflm\targetstuliding.doc ^� m -LEGIBILITY STRIP 0 2 3 4 5 6 7 a 9 IO I I 12 13 14 16 17 18 I � 20 21 22 � '"� `' �'" 23 24 25 26 27 2e 29 3o b e ►�.���.�„��.���ot, .� �.,, I I I I i I I I I I I i 1 I I I I � a ! � ! � I I I I I I � !� I � ��� i I � I � I I � I � � ; HOW SU100 oz I I ILII ( � illll � ll�, llillilll � ll ili ! � I I � I � I I , ! I � � i i � l ► I ili � � , � i � l � l � l � i � ll � � � � � � , � I � I � lil � l , l � liil�� l � I � I � i � l � l � l !� � IIIIiIi ► II iilillll I Rugglows By 1 dw� it t #A - �j'' ' • • - -=to10 Gd►' .el•�moi► :�-'�''�?- ' �. O • i ITMn � r I • V „� • �r GC's me- scr Vp�. ID tLl V. 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C ,� _ t �'• - - _ Am No 4�YhD �u { ,� ��� S�'1_CI£T •MIS GRA XS TO PC AX;FD XOWS U-ESS OT1lF,7tVIS£ WT['a. 1 • !�, � 7 v I tTRiNGutS d ,'> �>t''�L•;• ^a.�• .: t•jl� r �";• 6' '"�.• OOLK�IAS �f•�a�yt 1� _ "•• h .% t'' mit 1 /�l.l. � LD tri ffff •d T110S ,, p y . ; AS �-R + j rmn[L� DIAM►T� T ' SILLSPLATT IMO .T ICDGE DU X'L'44 r #2 l*VW TRFi U • J �.l /ISD tAh'1L1RDS� 't _ 1'YtXIA hj-rVt740 TO Rt" t;R� E LITH EXTER10R GL LIC MR-ESS ! '� '- ����/`l`� 1"+� � O ,v �.J n G I �' 6� 1e ,1 *'CDOE 1m •t�t'"YtD'F' :;A ' a"VDCMSC Wnt�TC& JW T BE AS T • . � �' "�''El� 'Y 1� .'�" .� hS�J t•� � � tja�{� �+ �N�„�� �t M ST�tt 1r Ga, yKJt, ��� t . 0 w Eo t7►+ PLA1t� ? �r, ' yy, . 1U"T S ALL 1►rG 1'0 !E 'At ICAT� lipl rt MtS, • ti e.. r '•K ���. ak�LUIG`'ALL W $MAU cowLT %n TM UVC TABLE r3ate `� " �-- ��Y few � •.,�. `to[DyLG i1lL,2NG • • � 'Wim! v t&fT � T r �� ,1` J► , .ialSTL �r �t17S $"I tC WA rAC"r lY �.' • ` .� �� �� � � Scale � � M � ,,,. ,� ,�. _ '�' , • ,,. .; � sA ST Cdr. •. �!- ` a � 4t rRl�t 11PF'RUVfD TkVS3 h�wIXACT .h 1 �c •:.r. �ij f w .,. , AfxRS ECT. TTWCNCCT TO TME 1F PER NAIL �A� 11 S STARWD O.TAILi ;, f�, , ,�,r„ � -� �, ..o:' t�► ► . ,,! :; ": •� ItAVt1cI_= lY A REGAUTERED ErKlW.ER IN >�' TE ''� : ��' N '�'i Drawn • , � ,,' �• _•^ , +/ A`X, I-A T"•uN• �• • �{`"�' -'' � cum �� . . ,t r +! .y- 7 i t11101111 � \pI ' I �I /� [• r� Til t�Y G}i�A su. E,1�1TM � s � P1►i�. � 1 -1.1�J 9 �K . . f .. •,�• •M..�i �,•. fy,y,;: .�'S y •��� (�``. t �Ir•�LY -.S � Job ��o vas * TE- 2T UW r=L nWt TO K iS+ - . '� {ti �' rl fYPStpt VALL ~: I '�I�� *1 %Klvi c hr y vat, usE u= see TlOSEj) s s u.x�Lc s ,� # Cr,� 1T �� ���/✓f1�.� Va + �� W 1 #1 i Cr � � KETAI. TR � Sheet ~ ?I CLY 1/1TH I1YS SPCCS! r .JO1KtSD ALL F1N .►1R'DEIIRE�ASt1$[�yA�• TAP _. 0 ' •' �, i "� �i" 1 - ` `� Air�ARr MlJ►T[ VASIiRS ALL"MLT TYPE 'X rAND C1QE� v a .. �• RO(lHS. `. AND MffR 111 C.T KTACT trM `'Q'Ia. /1M A-= jKLT= K4 77 7p7'LY D. P4 �� ► i lK mAXoit. *%vmKjKL ' M OT1E7t vED ` '4 wo two �AAMMn 0 Of Sheets 4 - S E ) • `•,• �,� � ) . ,` - - _• •_ _ _ X109.11 rOr�vat+ala.�y k � . '. A � rM.'+!`�''; '+ r . REVISIONS 8Y 004 �,;, L ,• 1 __ _ _ _ _ __ _ -._. __ 1rU �� ' prOrlded•v thlD titobonat of*Odeplt >� - ', a eltaaiata at k4a 60ea (l Su ma►i, Doors in say •�. '" 1 y tuw,6is grce by ri a A m tea 12 , (34d•i '. .. • 0 - � 41 -'�V •!mAo►). dw (kw spaces of Umms.the waeua& 1 Aretrr�e�r �109.1 Cloln�cft-r•natt�acaf and , �1t t coupc�r vus and is ke - , ed in =I too. ik 1 • ;::11119.(1.1.1 ArctssiWe titcs Its t�DOtzu, rLtti- . commmiry tchena arxi :icnih►r wem awl cam- ' with thin subs& �i rA ` '` L109-11.3.3 Hd&hL As shx?:l be with the V f!1V'11�7 a;4t nrn no l Ahrr than 34 bat (964 in above the fulRscounta h Hoot�� r{earance'Ow is M kap 77 ., K �' . YL 4nches (686 atm) h1th. 3a (42 nam) Bide and t inoses 'k 1X3 mm) " %W be provt ti+L See ADA AG �� pC� pip 31 and 32 ,+ r k . ' =2109.1 L3..4 'Depth, Elad ` ' be a m"impAm 94 61/ 3 _ Y`'' 1''L 1�'( a (165mm deep.1. �0� �, th e 09.11.0 �r floor A of , !- Ii- floor apom at hast 30 _ _ 40cbei b r 48 hrbes(7d b 1219 With t- _ ��= - _ - ~� - ��'� 1 I X19.2 j tda11 r broai a aY� Soy- - _ be in tic aibw ford. I I , 7.app�n°rdi-'tie 49e,+►r space shall be sa wemak tpdex _ .._.I ' ¢sad StAn tate a nwsp of 19 L. fi Ae s�. Sec AD G Figure 32.' ' � ,,,..c_ ------+- - - }� � 0 71.`.. •.�. . ••ice `� ..�' ' � 1 �j i' _J � + ��••-,�Q�s.��!P� �¢ �M ��� - pira� A,a• .t a dcu hoar vwd Mf'r's .► - .- - { • j � ��i^t'�+ t�lldat H+ot &M dna�ltt .__..._.__ ` �'//�`1 W t�� •-�'�� �1�('1 � � sha11 be�tulatcd ar u►o69-� - JP. ,�$ 'sink- "hwt. shill be 4c4 . A .. . .3.7 xmcd& Faoats sha#1 Curve casurols and I s with one Fraud and shall nae mquim •ng• pinching or twisting of the wrist. The tome t` `� - �t� sha11 be ' ( t / � I � _ �/ III _ _ � 8�;u '� 5 .poondx-toscc , 4� �­/ A/0. 77� lip- A. '111 1 11". ILI )c%I j. IL-11 IF ILI- 1 Q 114 t NO EXTEMO``R I.IOHTM TO]BE t4CANDESCENT I.IGHTM. vym ' 1 -- • ' ` j� ....�., ._ w ._ _ ,L • :. .-', `+' •.&eU w1 OtfIT1MF UO ,. M 0O -.,,OL MW..LYom. • .\•/MVV• • M V". ,- , ' �' i ; '� ' ' 2:;• . 2.000.bQ.'FT.OF L!T FLOQR A,-RFA : IVB SPJ1 S �BY WALLS OR CELOP ,a� . ���•►? HEIGHT PAR1'il ON. FOR OFF" S OVER z000. 90. FT. OF S FUROR AREA.ALL Jv 3. � SYSTEMS SMALL BE EOU PPED 1 M1H/ASEPARA E AUTOMAT>G • �. , .� t CONTROL TO SHUT OFF LK; 'f M.AUTOWATIC CONTROLS MAY iNCL.UDE --- ,-- _ tOCCUPANCY BE?MRS,AUTOMATIC TW $1NRCHE6 Of t OTHER OEVI " OAP�E OF AUTOMATICALLY S�*rrn t` OFF THE UGHTING OUTING 1iORfrtM.iY D •, I ' 1 � ' PERIODS. AUTOMATIC CONTROLS SHALL WCORPORATE LOCAL OVERME DEVICES THAT: I { A. ARE READILY ACCE<SSM E; B. ARE LOCATED 60 A PERSON USM THE DEVK.E CAN SEL-THE EFFECTS OF THE CONTROLS; C. ARE IrANU/1LLY OPERATED; b. AI..LOW THE :. LIGtffM TO REII+" ON FOR NO MORE THAN rnn HOURS AFTER THE OV£RR 9)E IS ' r _, tNtT1ATED; AND F_ CONTROLS AN AREA NOT EXCE EDM 2000 SCI. FT. LOCIAL OVERRDE f, T S1MTCHING VEYiCFS ARE NOT REQl1MD W�WUM CCCUPANCY SENSOR ARE USED. 4. EXTERIOR LO-(TM CONTROLS. EXTERIOR KNI) d(3 UGHTING NOT V TENDED FOR 24- : '-��,' ". HOUR CoNTPPJOS USE SMALL BE AUTOMAT1C&LY CONTROLLED BY A TWEE OR p' ` l PHOTOCELL OR BOTH. TIMERS SHA I BE CAPABLE OF AUTOMATIC ADJL16'TiOr-WT FOR ;�' � •-- SE-VEN OKAYS AND FOR SEASONAL DAYLIGHT VARIATIONS AND HAVE BACK - UP �� � 1 CApAB>OLITIES TO PREVENT THE LOSS OF THE C►E:1/!CF'S PROGRAMA AND Stc`T71N0 FOR AT • " '�~�� LEAST 10 HOURS IF POWER�, NrERRuPTEo. � .r///0 lev ,p �. tJ s77 A u 1-ow tl"* t.� -Ir f�e + t/� W -.f- q'1 �w1(7 0.0 C, L/V" 6�'1 t, r � 'S N i •P.. 4110 t04 T l-fl Q hl WN v -A D Ws;�- N OCA k)OI-f j *vet4jr� G1 Vihs,jj7 r � I Date * � �,�� � . � C� t� l t1p�, ��.. W�L- d,0�>8�,r�.�.��� � w �.w o�� �. . Scares . _ `r= ��. ir7 0 1�" Cteafl000lVel Uravrl►n �t � Job .r.r•O \1& Sheet Of �- Shect� � � • t• rw.w.�n o•► as 1ooc.+ c Lt,ui rw 1.n . - �.EGIBILITY STRIP - .. µ �� � :r` •�', s - �• � i; •� f ,�" ., •f, ••,! J� aJ 'rl •s-./_Ts •s .4���� *���,f�„�`�. REVISIONS BY 00 it 1 j4 r- `• , , Pe— E�t',F4 FAN vSF,O FOR MEC�iMDCAIREADILY W V9MLATION SM LL BE PROVIDE WITH READILY'�.� FUJOK ' - - _ . _ _. . .` . �,,y� � � w • •�,,,}_� w +� 11 � - ' . '� sa♦u'r4FF swrTc.H LOCATED No MORE THAN 4�ABOVE ` GM FRED hOOF UNr S$HALL HAVE A NAlPI ` A7 wVc.C GTY ANp oo URCIE VKY RATNV�CI OF ?S% . ' .7211 AY wt CAPAC ITYI� C40UNG DUCTS IN WALLS Mb AVW SPAS 6Wg11 f3E IIN""'"TED WITH Rab ` *4ULAT)ON W1 .5 PEtt#A VAPOR&APJUM rr 4. HEATING NXT1S IN WALLS AND ATT= SH&L BE*4SULATED WITH R� INSULATIONWITH r ,. A PM 1lAFaO�RA RIER , ,• ` t' S. HEATED tSPW. �� L . •. DEGREES- "a-Ll BE�STASM TOSPR01A0 TEMPERA'T1W_ RANGE OF TAT WTH A RANGE OF 65 DEGREES O TO P 14 aEG :ES f BETWEEN FUI HEATING AND FULL COOLING d• M & MTU SHALL-SE EQUIPPEDWTH SETBACK MO SHUT-OFF CONTROLS. EACH ---- -- TN�06'TA? SHALL,t'!AVE A DEAD PNO.TO ALLOW FOR ZFAO NEA-NG QR COOLING. s'' T. LAVATORIES &1ALL BE TIO PREVENT AFLOW OFNO2E TFUW .E GA. /Mgt 'r AND BE EQU6 F�D TO PREVENT AN tiXJT1.ET TEMPERATURE GREMER T" 110 DESS FAHRENHEIT , ' o e. WATER WATER sal HAW A AtJTOWTIC TEMPEfEATURE CONTROLS CAPABLE OF ADJUSTMENTS FROM LOWEST TO I xx CST ACCEFTABtLE TEMPERATURE SETTINGS FOR EACH INTENt7Ep USE. 9. WATER HEA ` j • . TER SMALL HAVE A WATCH TO TURN OFF THE ELECTRICITY TO THE WATER HEATER- ►10. INFIL1RAT01 RATE FOR WWQOW:S TO BE .37 CFM PIER FOOT OF SA&I CRACK(AM 283) Z � LTRA ION RATE FUR DOORS To BE 11 CFU PER FOOT OF GASH CRACK(ASTM E M + N I 12. SEAL EXTERIOR JppVTS AROUND Hl":)OW ANO DOOR FRAMES BETWEEN WALL AND ROOF, AT PEN'ETRAT10Ns OR UTILITY S:RVICE THROUGH WALLS, FLOORS, OR ROOF AND ALL OTHER OPENMS IN THE EXTERIOR ENVELOPE. 14 ' ,1 13. PRO`VmE 1 PERM VAPOR BARRER ON THE WARM 610E OF ALL ROOF AND WALL � INSULATION AND FLOOR INSULATION. 14. GLAZING To BE OOLWE WATH 1R' AR spAcE WITH LOW - E COATING OR ANY A,SSEWXy I WITH A ktkt U .54 OR LESS. Y C0tV MAT. FE Dt4rj"T 0 10 C Oa " RiN•4ER - MAN 15EAM >I LIGM FDCTURZ w. l ��1 ---.---••�-- MAXI 1Pi LOAD 334 »b. c-AFnTAL. TEar� The suspended ac6usttcal cuing system "shaft be anchomd to resist lateral i seismic forces [Section 1630.2 and Table 160). Provide suspension wires not smaller than No. 12 gauge spaced at 4' on center, perimeter wires on terminal ends of cross and main, runners at a maximum of $' from each wall, four No_ 12 �. - - --- - -- +-- gauge wires splayed 90 degrees from oach other at an angle not exceeding 45 " degrees from the plane of the ceiling with a strut centered and extending to the • structural members supporting the •floor or roof above and spaced 12' on cantor - ' in both directions starting 6' from ipach waft. All fighting fixtures weighing less than 55 lbs. shall be positively attached to the suspended ceiling system (ASTM C635-94). When using an intermediate grade system, No. 12 gauge wires shall be attached to the grid members VAthin 3" of each corker of the fixtures, end fighting fixtures weighing less than 56 115s. shall have two No. 12 slack wires � connected from the fixture to the structure above. Ceiling mounted air terminals 1 or"services weigNng less than 20 -lbs. -Shall, be positivety attached to coiling runners. l N Th tj -`C _- \ W f<LA F i 0/1114 � -scale t Atv _ ._ �.� ...��,r..'{�-�. �- ,• �'� �'�� J Ufa Sheet DSM �V)# �•� �l I 1 t 'I►' of Sheets Li � L. ; Tl � T �� I A i ADDRESS : SU I TZ c;tw*,r-:);L 4 J c] Li l J i \records\microflm\targets\building.doc 0 z 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 h h h h h h h m h O ❑. N_ N N N N N N O N O O O 0 0 O O O O O d O v Z Z Z Z Z Z Z Z F -U MO O O 0 0 0 0 Y O z CL m m m m w m m a m CL T7 N 0 O O O 0 O O O O O U > T T T T T T T T T T Lf') J Z z Z Z Z Z Z Z Z Z N O Oa w w w w w w 0 0 0 0 0 C O O O o o o 0 o a ❑ ❑ O � m N c Z z_ Z a w Z a o m m m a r ' m i m � r rn0 0 ^, to r Y/ (1) Q � 0000 00g O O O O O G V N N N r r r 3 a3 L `I N N N ONO OO O C+ O O O O O O O O N O O O h h � •�_ O O O N O O O V) E p u C N X � Cl. w :3 V U J y co o U a _ G] U O C c N O O c Q) c c v d a U O n O v o o w a Q) Q) �pp c U O U U Q N (]C14 00 W m 11 �'° N -c C ° E a fA O C] Q L a Q LL V) c7 ii cc LP In 0p N O O N O tT O O 00 ai N "�' G O O N ti EDD (D rn O tT 5 � a s as m a a a m i tl `f m m m m m m m m m m CITYOF TIGARD CERTIFICATE OP OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP2000-00025 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 01/27/2000 PARCEL: S101AD-02900 TONING: MUE JURISDICTION: TIG SITE ADDRESS: 12755 SW 69TH AVE 202 SUBDIVISION: WEST PORTLAND HEIGHTS BLOCK: LOT:031 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 5N OCCUPANCY GRP: B OCCUPANCY LOAD: 6 TENANT NAME: KELLI MURDOCK EICKELBERG, MA-CCC REMARKS: Tenant improvement Final Building Inspection and Certificate of Occupancy Approved 2/8/00 by Tom Plescher, Building Inspector Owner: ROTH, J T JR + THERESA A + ZOUCHA, MICHAEL S 12600 SW 72ND AVE #200 TIGARD, OR 97223 Phone: Contractor: J T. ROTH CONSTRUCTION INC 12600 SW 72ND AVE #200 TIGARD, OR 97223 Phone: 639-2639 Reg #: LIC 31700 a f2 H N 1- J cc This ::ertificate grants occupancy of the above referenced building or portion thereof and w confirms that the building has been inspected for compliance with the State of Oregon J Specialty Cqdes for the groi4p, occupancy, and use under which the referenced permit was issued. BUILDINIf INSPECTOR BUILDINd OFFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BLIP ZOO-CQQZS Date Requested .� AM PM BLP Location Z 7S S CD L,_( �'� Suite LSO 2- NIEC Contact Person '17 Ph S f �b �S PLM Contractor Ph _-- SWR —_ UILD Tenant/Owner ELC Retaining Wall ELR Footing Access: coundation FPS 'Ftg Drain SGN Crawl Drain Inspection Notes: - -- Slab - --- — ---- - SIT Post&Beam Ext Sheath/Shear I --- Int Sheath/Shear Framing -------- - -- — -- -- — — Insulation Drywall Nailing Firewall Fire Sprinkler --- Fire Alarm Susp'd Ceiling ------------- —_ Roof Misc: _-- --- - -- -- 10' S PART FAIL — — -- --- - -----.��--- ----�._ --- BING Post& Beam --__-__- Under Slab Top Out Water Service _ Sanitary Sewer Rain Drains ----- Final __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 N Fire Alarm - -- -- —._ ——�— -- Final h PASS PART FAIL — - --- SITE m -- Backfill/Grading — �: Sanitary Sewer Storm Drain [ ] Reinspection fee of$ _required hefore next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ) Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date 2 _. Inspector Ext Other _ Final PASS PART FAIL [?JNOTIRIE OVE ttits inspection record from the job site. CITYOF TIGARD — BUILDING PERMIT PERMIT#: BUP2000-00025 DEVELOPMENT SERVICES DATE ISSUED: 01/27/2000 13125 SW Hall Blvd.,Ti-'ird, OR 97223 (503) 639-4171 PARCEL: 2S101AD-02900 SITE ADDRESS: 12755 SW 69TH . - 202 SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 031 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: 292 sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 6 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: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 3,630.00 Remarks: Tenant improvement Owner: Contractor: ROTH, J T JR + THERESA A + J T. ROTH CONSTRUCTION INC ZOUCHA, MICHAEL S 12600 SW 72ND AVE #200 126;;,,00 SW 72ND AVE #200 TIGARD, OR 97223 T IFJtione. OR 97223 Phone: 639-2639 Reg #: LIC 31700 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing Insp PRMT BON 01/27/2000 $6850 00 321435 Gyp Board Insp Susp Ceiing Insp 5PCT BON 01/27/200C $5.48 00-321435 Final Inspection PLCK BON 01/27/2000 $44.53 00-321435 FIRE BON 01/27/200C $27.40 00-321435 ORIGINAL Total $145.91 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 v 952-00 1-0010 through OAR 952-001-1987. You inay obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987. J LLI GJ Pennitee Signature: Issued B Call 639•4175 by 7 p.m. for an inspection the next business day C?iY OF T!GARD Commercial Building Permit Application Plan Check 13125 SAN HALL BLVD. Tenant Improvement Recd By ('ice--- Date Recd ' Z.-7- U90t TIGAR[',.OR 97223 Date to P.E. I 2 2-7. (503) 659-4171 DatetoDST 1-7,?-2LXOL)U`� Print or Type Permit# (�!C LCC.a 1W045 Related SWR# Incomplete or illegible applications will not be accepted Called I - _Job Name of Development/Project f Existing Building L] New Building Job Address Street Address Suite Building �y rip Data Bldg# City/State Zip Existing Use of Building or Property: ! G 27 23 Name Proposed Use of Building or Property: Property C, Owner Mailing Address Suite Uf ��•F �A�E .SJ�1� AVE --��'� No Of Stories: City/State Zip Phone - _ _ C S — $ Sq. Ft. Of Project: Occupant Name Occupancy Class(es) �! Name Contractor t Type(s) of Construction Prior to permit Mailing Address Suite -[ _- Issuance,a copy Will this project have a Fire Suppression System? of all licenses Yes L No are required If City/State Zip Phone expired In C.O.T. Americans with Disabilities Act(ADA) 11 r 1GN database Valuation X 25% _ $ Participation Oreg n Const.Cont.Board Liz.# Exp.Date Complete Accessibility Form Project $ Name Valuation J C Architect Pians Required: See M trix for number of sets to submit Ply) Ld Mailing Address Suite V on back I City/State Zip Phone I hereby acknowledge that I .ave read this application,that the information t:%?- given is correct,that I am thi owner or authorized agent of the owner,and that plans submitted are in compliance with Oregon State Laws. Engineer Name _ ?CLL _ lea Signature of Owner/AgeNi Date �r Mailing Address Suite N©Avr_ Contact Person Nqpfe Phone City/State ZIP Phone C Y C c- FO_R OFFICE USE ONLY Indicate type of work New Addition O Demolition O Mapli L# Land Use: Accessory Structure O Foundation Only O Alteration O Repair O Other O Notes: - Description of work: _ TIF: Nolo: Site Work Permit Appl!catlan must precede or accompany Building Permit Application (V\' 11COMNEWTI DOC (DST) 5198 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review will be conducted. After plan review approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes. (Copy for Contractor, City, Washington County, Tualatin Valley Fire & Rescue) Total # of TYPE OF SUBMITTAL Plans KEY: Submitted S (Private) 1 S = Site Work B (New or Add) 1 M 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 *B or B & M (Alt) 1 *B & M & P (Alt) 3 *B & M & P & E(Alt) _ 3 *B & M & P & E & F(Alt) 3 J H C, Il' NOTES: *Shaded areas designate ALT,submittals only. t\d srsVormsWatmeom.doe 1211199 OVER-THE-COUNTER (OTC) PERMIT PLAN REVIEW COMMERCIAL (STRUCTURAL) BUILDING PERMIT CHECKLIST DESCRIPTION OF PROJECT: CLASS OF WORK: t FLOOR AREAS: EXTERIOR WALL CONSTRUCTION TYPE OFA E: FIRST SQ. FT. N: S: E: W:__ M TYPE OF CONSTR: `7 '`� SECOND SQ. FT. PROTECT OPENINGS?: OCCUPANCY GRP: ' TI'!RD SQ. FT. N: S: E: W: OCCUPANCY LOAD: tD TOTAL SQ. FT. ROOF CONSTR: FIRE RET: STOR: HT: FT: BSMNT: SQ. FT. AREA SEP. RA"rED: BSMNT?: MEZZ?: GARAGE: SQ. FT. OCCU.SEP.RATED: FIRE FIDE SMOKE HANDICAP SPRINKLER: ALARM: DETECTOR: ACCESS: COMMERCIAL INSPECTION ACTIONS FEE ME14U Foot/Found Post/Beam $ 6915;v Permit Fee Masonry Framing 7 $�3 Plan Review Insulation Shear Wall $ �J�a 8% State Surcharge _ cb Firewall Gyp Board $ FLS PILn Review Suspended Ceiling _ Sprinkler Rough-in $ Add'I Permit Fee a Sprinkler Final Fire Alarm $ Add'I FLS Pin _ Smoke Detector Approach/Sidewalk $ Inspection Miscellaneous Final $ _MIS Fee tjt FOR OFFICE USE ONLY: TYPE OS USE OPTIONS(COM=commercial; CMS=cnmmercial 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 syst_m, NOTE: USE OTR FOR FENCES, RETAINING WALLS, DETACHED DECKS, SIGNS, AWNINGS, CANc)f'IES) Ilovrcntr2.doc (PST) 9199