12442 SW SCHOLLS FERRY ROAD STE 205 V
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12442 SW Sc polls Ferry Rd '
/ pSuite 205
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IF THIS NOTICE APPEARS CLEARER THAN THE t1 T 1 �99
DOCUMENT, THE 130CUMENT IS OF MARGINAL QUALITY. L� ED
TA � tt l ! { 11 ► ! IMADE rrr Gtr rr6A
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N�W SUITE �X�'�4NSION � �
►. —_.- _ _- EX15TING SMITE REt-IODEL �T RIvA s:
D tail2,A3 tzed unit cost for overhead cabinets at each exam as shown on plan and
-
V-7 1/2 �f' \ C� 2. Provide and i.stall recessed ceilin ON R.JU GENS ''
f g mount;d music/speakers. Place (2 in Waiting ]
Room and (3,)within corridor system. Locations to be confirmed with Tenant prior
p - ---- w - to installation. Speaker cables to be routed back to Storage Room 103 to connect
' receiver sound system. g nett to
A4 M 1 C 9 9A ____9 _ 31&'-4 _ �� A.F.F. to serve sound system provide duplex electrical outlet within Room 103 at 72" � PORT ND,URfG
A4TERNATE 9
AAII�� '' OY
P
irl
�>� _�`_ � •. \ 3• Revise existing rete tion countertop to accommodate new intersectio r..ounte►-to .-� Relocate existng file drawers tod of new unit and add relocated overheadpncabinets from Waiting Room 106 to west wall of Rece tion 101 l/iIElevation 10:end 11 on A3. P ,as shown on Cabinet-_.BT B. O e LAYEROF - E I 1' Gt3. t0b' MIN. ABOVE I l _" ' `ENISHED CEILING TYP. AT C IISExTEh210R WINDOW WALL CI RELOCATEDE 5 N , 1 Upgrade exis in du lez t 4_12 I'mFROf"1 ROOM I I g P o plex outlet;half to be dedicated, half to be standard. 4I= NEW EkaANSION AREA 15 ! + FROM
I -- 5 L..l_ .lam I { [�] x
E 2 Provide one 4-plex back box and 2"diameter
j I 0 Iva F ter conduit from back box to 6 above
--- _ _
OFF:ICE CE OI F I c t ceiling grid fo-computer cable raceway access for all lines. a
I UTIL f T`'t' + EX14 --� i 1 i ., . ._
(I ��f• I I X11 s _ �� EXA1 I r-- - -�� 11 OFFICE 3 Lower existing outlet from current height to 15"A.F.F.
B 13 ! , !II A3I lm8 * 101 '— , 4 Toilet room grab bars ono accessories to meet t---I
A D.A mounting heights.
+
IT 5 Provide 6"wise by 2'-0"Ione b`'3/16"t J
5 I I - I hick ac lit chair rat
li P ry •1s at two locations in each
1 r 5 i=-3,-0, E E I \ / Qi ' 1 exam room to rutect wall. Mount at 31' A.F F to centerline. T
\ r^ U g
i �5 I C I ^' LCL�tIOPENING I 1 , J: I , 6 Revise existin t tenant sign to reflect new tenant names. O _ 1
1 -- I � I I i I signage with �enant. wner to confirm text o
3,_0, L t - ._ — — �1 L _ 1 � 9� f
I
r �r
V 24 j j 21 E "- -� E 7 Remove existing sheet vinyl and replace with direct glue loo ca ■
U I 1 I1/�1 EX 1"> I1 1/2' I CORRIDOR
IT't01 2 - » + L___ �}, the Interior Finish Schedule. g p !pet as specrfi..d rn
�t RELOCATE DOG7R i9 �._ ^,j $ Remove construction door and frarr
l 'V r _� I�� 6'-h' Ian' 131-4 --1
WALL I r-&-mo \� % TO RuOM 114 4 " " ''tore for r Umer re-use, Infill opening to
U - s•I --*- --------- �_ E. OUTLETS 26 I E meet wall Typ A Standards, paint .
�► -` - I -- - -- ' -R E d n new color scheme on tenant side and
_ 7_ t SV5 ��I I N� I corndot color scheme on corri or sine. Patch in rubber base on corridor side.
110 S
�nn ALT. �t - - O . _ +_ _.� i _ F-77-` ��� F _ I 9 Existing wind(.w blinds to remain. Clean and/or refurbish as needed.
V / 19 CLR IN I* I I IOro t•- o°
1 c,LT, I 9A Modi •windoty blinds into two separate blinds and controls to accommodate new c�
Z �' - ill Q I _ C i ..- ' I E E ��I `- -- I intersectio wall. P
g rrTT,,
c) �� \E �4LTERNATE M I I E I - 11 -I®3 18 11 - 10 M�
TO I C 15 C -a-- A256 1 sT 0� 2 Ncw v►mdow horizontal t
1 s I -�-� ,qLT ,► I UPPER IE r-- J 1 with Owner, Dotal mini-blinds to match existing burcli standard. V `
1 Z A3 Xr�l I A3 I��� CA9EI1019K i N"` S� IO3 I f Ct'ffycokw
lU � I �
' --� � 8 C -°+°,Fcrr•�,� EX f.�I"i I ��E E '102 I E ; -""�' ~� 1 �� c-� I 11 Ganeral throughout suite. Patch and aint touch u ezistin wallsdamagedx
lU 1- r 3'-0' 1 1 -48rOaee-T,,,q, I ; I i 4� T�_ ` 1 a removal of shelving standards,artwork molly screws, Plumbing,electrical a ►-� s
n I 113 • 0-E X�1� ! 19 ? ! ' P g by
_ tG
_ l
I � ...-. . _.J � 1, 2 " ., �
I n� 4'-5' 2 �. �? A3 _Q j EI I ! �__. �~ J 11 E Add new Type C wa11, break ceiling grid and extend wall to Underside
5 C 1 26 I ___ _ - NEW RELOCATE TO I above. Repair ceiling of structure
1 C•+At- A3 0 - -- 91-2 ; I I 11 E g g grid and tile, and tic back into new wall Maintain existing
2 C�Ofa'RIDOR 119 1 O I G / st=eel vinyl f a tin Intact and tie ttt new rubber base to coasting. „ .11
,
e I 11
4 �-' L. -� 1 _ 1" ' E / 13 > xistine exposed, col
t
I [ p end insulated demising wall extending the entire depth of suite.
I,UORf� AREA Add 5/$" thick Tvr,c 'X' psum board to structure above.
As �C .Z2 I -- b D lU L �______..._-• - �-_._J...._- --- 1.. SURFACE MOUNT:vHER
rn, I I :�_ ._.._______ - _ FIRE EXTiNGU! 105
C E I 3 11 14 Existing huildiag corridor wall Type "A". Currently wall is gypsum board covered and -+
'
122 0 I { \� nI; 1 _ _ RELOG,AfI?-Tp r- taped. Modify as required to accept t architectural, electrical or lumbin it
p p g ems to 0
? I i '�� ! / 1�,�., � E �' accommodate new floor plan. Wall hoard to extend to underside of structure above I ='
_ _./
`�, �;' E E -�'-" unless othetwiie confirmed with Building Official.
'� L-- --- -- SJRFACE MOUNT I I I
a D A - FIRE EXTINGUISHER - t IQ )= 1 - - -----
11 _ _ I
15 Existing expusect sound insulated demising wall►o be cotnpletcd to wall Type
y' +4b --' �9 standards. t
-_ -- — Irl i r-- -- -- —
_ 16 Remove existing demising wall in its entirety. Remove,repair and refinish existing /
I ( !
finishes for flooring,walls and ceiling as required
23 --- i I j 1 _ OFFICE/
I E j g to accommodate new floor;�lar.
WAIT T ING I � RECERT I ON CE/ �
R >> 1�3 ;.� ( I t I I � - 17 Remove ceilin3 grid in former roller room and re-confi�{ure layout to accommodate
�'I I I it?J0 I I I A3 lal j �� AREA Corridor 115 1:, out. Reinstall 2 x 4 lay-in flt.orescent light figure from fa►mer Totiet
11 I/2' ,_6, j jE - REMvvE ExrsTlr� _..> 1 , F 10 Room into Cci ridor 115 as shown. J
( INSTALL _r� EXISTING j 4
DEMISING WALL I SLIpiNG ELECT. - I E E I 18 Remove existi overhead cabinetry and relocate to Reception
S 1 A = r1ELoe 4TE0 FROM �.1 �� ; , shown a Det;i s 10 and 1 101 w
123 NEAR F,-OOM IC755 I I 1s 24 I WINDOW I + I o�, E� Gl'� PANEL 1 on A3. est wall as
ro EXISTING; I I Aj , I'I / To REM<,IN I T Y....
1 D T o` I I OPENING I i ! r_._"""' "_ " - - " - ` j 19 Owner to verif%•with tenant relocation of existing chart racks
_ I I I I I g cks(C.R.) to appropriate
f p F-� N
. I a' _1 � i I I . '• �; I I ' ` locations and reinstall. Patch and paint holes left by removal of chart racks. Provide
A I^ s rn r I �,, F j `�`�. I two 2 additional chart racks 14 I \ I I O fo.new Exam Rooms 120 and 121. Match existin .
A3 �C > I I A \ 1 I E , k1 E �" I 1 _' . ► _..__ g
ONE ")UR RATE` CORR!►�Ui2 8 I ALT. 3 /�pnrpy@d • /J �il - E.M13BiNG: V 1 0 i
47)
WALL .YSTr=r; I �i� ....,, 11 i
('pr, I I n O M--■� N
0 i -) ;;l Ar •,rSt.Ad . .......... [ 1' 21 Remov
e, reloc rte or cap orf existing plumbing fixtures and/or associated lines to
100 For nIT th ork de99crihed in ................ � [ accommod,:to tew flour plan.
f' NO. :
- '- ------ 1.? Relocate toil't and sink plumbing fixtures and toilet accessories to new ,'r,ilet Room
NEW SUITE .Sea letter to: +--�
EXF"""NS I ON EXISTING CjU 1-j }tet ..................................... 122 and rein!tall as shown on plan. ^ ' .
- ----_._ � RI�I IODEL Attarh.......... •j- I' !~-■'�
f�/ic+dress ............................. .( L RI F--
W .
- _ *. 4
_..
a e: W t�
"t Provide supple mental electrical panel as required for suite expansion, in the event • y
A P PF O V E D: existing panel at capacity. See electrical sheet for confirmation.
-------- FLOOR ' �..
24 Remove, reloc.,te or cap off existing electrical o1.ttlets and/or ! '
accommodate new floor plan Conduit to
:
APPROVED: 1/4 a I I-��,� �
DATE: _ 25 Provide safety,ops for all e used electrical rr-ceptacles throughout suite
26 Providi and ins tall 2 bank surface mounted viewing boxes..S& S Trim Line Model
r....i
WALL T*"rf=E5
� ----------.�_--- 222. Mount at,,4"A.1~,F. to xnterlir:e of view boxes. -
� � T�TfSTIL"�END
SCROLLS MEDICAL FLAVA
_ 12442 SW SCHOLLS FERR-f RD-, I-uITE 0205 'r 1JlLDfNG OC UPANCY----B2
PROVIDE FIRE SEALANT _ TIG,4RD, OR 9-1223 CONS TRUCATION TYPE----TYPE VN
AT G.B. WALL TERMINATION PROVIDE FIRE SEALANT SUITE -7PQUARE FOOTAGE--29160 SQ FT
POINTS AND AF:'XA�Ip ALL AT GB, WALL TERMIt4,4T!Ot,! PROVIDE DIAGONAL
POINTS AND AROUND ALL F'ROVIDE ACOUSTICAL BRACING SL1F�F"CRTS t
OUTLETS, BWItr�;E;} ETC, TE MI N7 AT PO AT 48' OC- FROM Tor-
OUTLETS,
SWITCt,ES, ErC. � �
TERMINATION POINTS OF WALL A'�lD SECURE �' NEIu DUPLEX
TO UNDERSIDE Of= -'-- —- ITEMS TO BE REMOVED � � � .
STRUCTURE ABOVE _—_ — ;) (� r
t� tdcU.l GF.I. DUPLEX _ . •--�0�0' ._._ �_�'� � '�_� �p•p• �,0.
Revisions:
I �
INFILL OPENING AND
5T ON ONE SIDE 7C7 { I NEW •4-PLEX MATCH CON5TRUC:TION
1 STRUGTtJRE, OTHER G$. ON B07a•a SIDES I j I
SIDE b' MIN ABOVE TO b' MIN AM:,-ve I �1 NEW CUh1F�UTER LINE "xx 4l_TERNATE Pi I
GE IL!NG CEILING �[ _
- -- - -- _ UPPER A
-----
-------- ---
_ ____._.._ _-. -- � �- -•� NEW TELEPI•aONE LINE. WORtC �.-`� I --• `. y
E EXISTING DUPLEX
E EXISTING GF.I. DUPI-EX
�- E EXISTING 4-PLEX L• - _ _ .__ __.-_ - _ -
rt -
TYPE 'X' G B. y _.... ..—
�' E EXIST(*Iry COt"IT'I.,TER LINE bI �� IOBeY
BOTH SIDES ON 3��' � ��� TYPE '�`' GB.
BOTH SIDES ON 31i2' se' GYP••X1M gOAor� /
MTL. STUDS AT[6] MTL- STUDS AT 24' BOTH 51DFS ON 3�2' E EXISTING Tt_LEF'f-KJN!" LIN(=
�.
OC. WITH SOUND MTL STUD& AT 24' BOTH SiJE� ON -,v O
INSULATION. INS WITH sOt�4D OC. ,LITH 5oUND MTL. STUDS AT 24' EXISTING THERE-tOgTAT
INSULATION. INSULATION OC• i F.E. ■ FIRE EXTINGUISHER LOCATICt4S - - -
_ Project Number:
_ NOTE: ALL NFW AND MODIFIED
ELECTRICAL, TE=LEPHONE / FAX, AND '
�! ( Fi13 Number:
Ct7R+e?(DC7R / 1 NR. WALL - - coMPUTER L!r,tEs ARE 15' ABOVE FIN. !
DEMISINCx WALL SOUND WALL FLOOR UNLESS NOTED OTHERWISE ON
A TYPICAL WALL --___ .-___ - -- - - — _. _ Da VSA4cl"G
Date:
\Q R■REFURB!!")HED l;.NEW E:■EXISTING
orb-�
D FO.I.V. FURNIeHED BY OWNER INaTALLE D BY VENDOR
FD-lo- R.IRNI£441rD BY OWINER, INSTALLED BY OWNER FLOOR PLAN - L15VEL YWO
FLIRNIS'-IED BY OWINE
-.----- FL.IG. FURNISE;ED t3Y ��dTR4CTOR�NOR
SDALLEDD BY GON7 TRAC=TOR - +
442 SW Scholls Ferry Rd
Al
S•lite 205 -"� .
2of3 ' ' '• M
.--.
IF THIS NOTICE APPEARS CLEARER THAN THE
DOCUMENT,THF DO('I1MFNT IS OF MARGINAL QUALITY. DDFZT(
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DUCT L.DO2G� X 14 SUPPLY" AIR IZ X IZ EXHAUS-!-
DUCT I BOOR
............................................... ........... *
Mee 9
PLAN ............
-�T- RF Zolv,5 Exl'r" rlrj -
/►� 730.9NEW ADDITIONJ _
E F. E X HAU5T FAQ REV. L DATE DESCRIPTION - _ DY�
5 R O a N C670 IF—OV- 10 PROJECT _—
(9
FAQ 5 W I"1'C H
T-. V I N J C. E- fel i
TIS E R Ilc: 5 T,d T
NEW STREIMER SHEET METAL WORKS, EINI"
740 N. Knott Street / P.O. Boy 12125 / Portland, Oregon X7212
Telephone (503) 288-9393
Joh 0 - DATE - U - 2 7- 9`:)
_
12447SW Scholls Ferry Rd TITLE
Suite 205 !
DWG.#
3of3 "� :- L XD� �� ��D R` , U
�-
c
7U ITE 205 HVAC PLAQ !
SCALE -- 1/4"
IF THIS N01'1('F APPEARS CLE AR ER 1'IIAN THF.
I) )t'IIMENT,THE UOCl1MF NT IS OF MAR61NAL QUALM-V.
I L I I all I ► , A 11i ,n�i:»
( III ! I I I � I I !�I► ! �!�It�l��,t11 I �!►III��� I!I�I! 'llllli;►IIII ! 'lif�!t l ,l!I � � � � �t I t!I I. , I ,
INCH ' MADE IN C4104Aio,;
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TUALATIN VALLEY FIRE & RESCUE
C�1 `
AND
j BEAVERTON FIRE DEPARTMENT
FIRE MARSHALS OFFICE
41, J
a pE� (503) 526-2469 POSTED:
F
OCCUPANT
s -
CONTRACTOR BLDG. PERMIT 0
PROJECT NAME PLAN REVIEW rk
LOCATION 4 I( �'- Gff
P�1-
JURISDICTION: 1= Be. 2= Du, 3= K. 5=5= Tu. 6= Sh. 7= Wi. D= CC 9= WC 0= K
r
COVER FINAL SPECIAL FOLLOW-UPIREINSPECTION ATTEMPTED FINAL
j.
i R
❑ Framing ❑ Separation .Jal.ls Sprinkler System j
❑ Shaft ❑ Fire Dampers (Ove head) riderground)
I Alarm System El Hood Extug Systems El Conference
1 ❑ Spray Booth ❑ Ceiling Cover Other
_ 1
17
-.K,/O ALA)
ljim- tJ ( 4) r l r �� ,�.� /(JJ
i
Date:_I. - 1 Inspector: V' L'�
y t� � o � 36
hF :}
fts
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MC
,
TUALATIN VALLEY FIRE & RESCUE
AND
BEAVERTON FIRE DEPARTMENT
• 4755 S.W. Griffith Drive• P.O. Boz 4755 • Beaverton, OR 97076• (503) 526-2469• FAX 526-2538
October 29, 1993
J.R. Juigens & Associates I
15455 N.W. Greenbrier Pkt+iy. , Suite 260
Beaverton, Oregon 97006
Re: Primary Care Expansion
Scholls Medical Plaza
12442 S.W. Srholls Ferry Rd. j
5988A-132-005 I
I
+ Gentlemen:
+�
This is a Fire am Life Safety Plan Review and is based
l on the 1991 edit-:ons of the Uniform Fire Code (UFC.) and
those sections of the Uniform Building Code (UBC) and f
Uniform Mechanical Code (UMC) specifically referencing
the fire department, and other local ordinances and �
regulations.
i
F;
Plans are conditionally approved subject to Tigard
Building Department requirements and the following
items:
1 . The tenant space number mint be prominently
displayed on the street front where it is readily
visible to drivers and officers of responding fire
apparatus and other emergency vehicles. UFC Sec.
10 ,208
2 . Not less than one (1) approved fire '
r
extinguisher(s) with a rating of not less than (*)
shall be provided for each (**) square foot of
I floor area or fraction thereof. The travel
distanoe to an extinguisher from any portion of
the buildinq, shall not exceed 75 .feet. UFC Sec. .
10.303
*) 2A10B:C - Light and Ordinary Hazard
4A10B:C - Extra Hazard
(**) 3, 000 - Light Hazard
1, 500 - Ordinary Hazard
1, 000 - -xtra Hazard
"Working"Smoke Detectors Save Lives
{
a
J.R. Jurgens & Associates
October 29, 199.3
Page 2 I.
Note:: Where flammable or combustible liquids are
used, "B" ratings of extinguishers may need to be
higher and travel distances shorter. See M
requirements in National Fire Protection
Association Standard 10-1 .
3 . If this building is protected by an automatic fire
protection or requi:.�-e-d fire or smoke det-rtion
system, not addressed un these plans, contact this
office before proceeding. Demolition, new `
construction, or changes in HVAC could alter or
eliminate protection from these life safety
systems.
4 . If a fire/evacuation alarm is required for this ,
occupancy (ADA) , not less than 3 sets of plans for
the installation shall be submitted to this office s
fore approval prior to installation. Cut sheets
of equipment and battery power calculations shall
be included with submitted plans. An .inspection,
test, and approval of the system will be required
by this office prior to occupancy.
Approval of submitted plans is not an approval of
omissions or oversights by this office or of non-
compliance with any applicable regulations of local
government.
i
' If I can be of any further assistance to you, please
.feel frea to contact me ,at 522469.
1
Sincerely,
Bradley N. Wanamaker
Deputy Fire Marshal
BNW:kw
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..wx*K+�YMINti°M1tP°C� *w.wa+.�M,..+�^ ,_.......,rr:,•�Maxaw!err.M+rw,,,.-rrv.+rt�,•<nr.n�.:.. ,,,:...�,
IRS PECTION-P-0-710-
r city of Tigard Building Departimant /
13125 611 Rall Blvd. Tigard, Oregon 97 3
Inspection Line (Roc-MPhone)s 639-4175 Bur' .eso e. 6
39-•4171
Inspections �•�__ _
Tooting Plbg. Undorslab Ne:ch. Rough-in Appy/Sftlk
Pound. Plbg. Top Out Gas Line FINAL:
root/Ream Struct. San. Bower Framing
Post/Herm K4w-h. Rain Drain Insulation -Plumb.
Plbq. Und.rflror Mater Line Gyp. Bd. -"ch.
Date Reep:ested:_ l ' / ( ' T11set AM FH
Addreae:' �'(_�' � rj �f rY 4 _AA LOT LO J Per111t f1
Builder:
THE FOLLOWING CORRECT7.ONS AAE REQUIRED:
.�IZ.ZlIl r ,ad
QL
Inspector: Z '�
Date:G
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF
TI
G7ARD
t..E�E1TIFICATE C•
OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT M. . . . . . . : NUN9,3. 018
13125,",W Hall Blvd.'ri9ard,Oregon 87;•23.81911 (")639.4171 DATE: ISSUED 1 10/28/9.3
PARCEL.- 1 S 134DC•--00401
SITE ADDRE'GS. . . r i c?44P- SW SLHUI..L S FERRY RD W.3. 203
SUDDIVIS)ION. . . . t ZONING1C•--G
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . 1 1
CLASS OF WORE, a ALT
7 YPE UE LIME:'. . . 1 CUM
OCCUPANCY lf.,RP. :0 �
OCCUPANCY LOAD:29
TENON) NAME. , . IDRS. BUEFFEl.. 8; E7E KLCJTi
Rernarkrtr Tunartt expansion inter•iur partitions, toilet r•oome
Owners -.. .._ ...._...__.._._ .._..._.._ __...
ST. VINCENT HOSP. h MED. CN : F7. M
9205 S.W. BARNES ROAD I
ErUR 1 t_AND OR 97225
I
291
i.•urttractorl __ ___..__.._...._. .__._._......_..__. ..._.___... __ _.
OWNER
"nantr Nt
QVg M. . 1 0000,It
ilc•cupancy of the above referenced building ig hereby given, and certifies
Che compliance with the. State of FJrryr,.n Swactelty Codes for- the group,
OU rapanty, and rtsp under, which the, refera:iced per-nit wa-, sr,,.ted.
F'I RE DF'PAF?TME"NT f h "FSE=CTUR
BUILDINU ` 'ICIAL
POST IN CONSPICUOUS PLACE
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TUALATIN VALLEY FIRE & RESCUE
AND I
BEAVERTON FIRE DEPARTMENT
FIRE MARSHALS OFFICE;
bm � ' (503) 526-2469 POSTED:
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AR
dCCU_tiPN1S b1
' _ —
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� CONTRACTOR BLDG. PERMIT 11 ,
PROJECT NAME r�,//� �'/ Q�C.�/i �l PLAN REVIEW ft
LOCATION
JURISDICTION: 1= Be. 2= Du. 3= K.C. 4 5= Tu. 6= Sh. 7= Wi. 8= CC 9= WC 0= MC
COVER SPECIAL FOLLOW-UP/REINSPEC'iION ATTEMPTED FINAL
i
Framing El Separation Walls Sprinkler System
QShaft Fire Dampers (Overhet.4/Underground)
yL7 Alarm System F1 Hood' Extag Systems F1 Conference f
y
Spray Booth EJ Ceiling Ccver Other` f
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Dater— � Inspector:
wraan ...nYr FY.nM*rnb-rThMt=�.wr
� Y. '..b.+*,n....w...u.,r+ur,w..►r...., _, ._. ...r,...-:..L�rv�alfMiYnaN.'
��. IN I�q� TUALATIN VALLEY FIRE dt RESCUE
ry AND
BEAVERTON FIRE, DEPARTMENT _
FIRE MARSHALS OFFICE
Fd4 PiEG (5 ) 52b- i9 POSTED:
''
OCCUPANT _�
a CONTRACTOR BLDG, PERMIT ' � I w j
PROJECT NAME PLAN REVIEW 11
LOCATION
` JURISDICTION: 1= Be. 2a Du, 3= K. v= Ti, 5= Tu. 6= Slt. 7= Wi. 8= CC 9= WC O= MC
COVER FINAL SPECIAL FOLLOW-UP/REINSPECTION ATTEMPTED FINAL
I
i
Framing L7 Separation Walls Sprinkler System
�4Shaft Fire Dampers (Over nderground)
1 �
Alarm System ❑ Hood Extng Systems Conference
-� -��-
Spray Rooth C� Ceiling Co Other
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Dates �J "� - r � Inspector:
1
j�ePacTIO' JTICE
City of Tigard Buiauing Dmpaatmsnt
13125 M Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-0--,Phone)o 639-4175 Business Phone: 639-4171
Inspections____ y_ I Q <z t'1 • ----
i
Footing Plbg. Undvrelab Mach. Rough-in Appr/Slwlk
round. Plbg. Top Out vias Line FIX"s
Poet/Beam Struct. San. Hewer _-raining -Bldg.
I
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Line Gyp. Bd. -Mech.
Date Requestods_ Timms AM PM
Addr.us 7 W 12 k,,.A`'> Y VY--( x« Q. ZU� NrMLt
Builders
THE VOLLOMIMG CDRRECTIOMS ARE REQUIRED:
Inspector: _JL'n`�J ___ Date: 1 .•` y-�
Gam•'
_APPROVED DiSAPPROVRD _ APPROVED GMTRCT TO N80VE
781.1 For Roi.nsp.
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PERM I
CITY OF Tl %zrp%RD r1Er2MiT u. . . . . . . c MF.C93-0a,
' COMMUNITY DEVELOPMENT DEPARTMENT DATE JSSI ED; 09/16/93
13125 SW Hall Blvd.Tigard,Orvpon 97223+6199 (503)639.4171
F'ARrz L: 1 I:a:f1G 0Q1�+�11
n Eit,11a1).'tV1:i;[iJiV. . . Z(.JNING: t.--La
r I:_F-13c. Ur WORK. . :ALT F i-OOR F'1JRN
TYr'F C1F UaI~, . . . ICOM Ur'I T HEAL ER!�- - : VENT F•ANS. . . :L
0C(.UPr;i :":Y n . . :fie VENTS W/O APDL t VENT 'YSTE:MS t C'
SJ OP7 El-. . . . r ItL ILEI�:si C(1Mr°Fdir:i�;t.)F2a l�CIgD . . . . . . .
: _ 15 HP, „ , , COMML. INLIN:
MAX FiVr'u`: tl'TL 1 30 (,G'. „ . -. c REPAIR UNITf;: :f.
FI RL DAMC _:.F? i^. ., 30-5Vt Nor', . , . : WOODS I OVL'S. . :
GAS f'flii 66URE, „ 50 lip. . . .
NO. OF UNITS----- ” --~~ - P IR HANDL I NO UNIT'S OTHER UNITS. :
JRN ( iV"k�l; BTU: <m 10000 cfm: GAS OU i E`5.
RN >-1001!, 11TIJ. > 10000 c:fm:
(!My%J-k -. 1p3'1 ) LI 1'' fi #?i'iC;Y plclr't ;.t17'",`:. t;r1]. Iet, a 0 m
41)Cr. , _._..._. _.._._. . _ . ,__-_..._.._. . . .._ _.._..._...- _ .__ ... _.. _ .
r I •il is ti, Or-Y.;P. 5. hti'.! '.:f'� i'i,_ atn > .Int h'y date r�erph
taRNC:r; FOOD i�ki'yl � __.. 01i JW09 lF!
r, 6. 25 JF I
)R T*L.ANP OR 97 :':`: ; f'".: 1. 1. 2:J JH 09/ 16 M6
X91-c2+93
' rsr:' r�f:.rt �i i1: lC T •'L :t. .; ;,zc',. �
r,�,()lJl:FdF.11 LN'J'E_.0:T•ION 3 - ._._ ._ ...
-is peralt is issued Subject to the regulations Centalned i, the Ingichcit1.1.caI lnsp
grd 4uricipal Code, State Cf O-e. Specialty Cades and all other D_ic::t 1 r• 1nect i.nn _�_,_._.._• _ _. _ __ ___
plicaCle laws. All walk 'mill to dere 1„ acc:rda*ce w,.th
proved plans. Thit pt-eit Mill expire 1f ,iCrk is !',et Started --
:;hir. 191 days of i0mance, or if worl, is suspe^ pd f- sere
`pan 189 days.
-.•M-I t t E e
c 21 C%T'• 1r' C'E'C. 1 :7 T! /31 9 4175
.y�.,.w.o ,�- r Y n..,`... ns. A...•.�..�,.wr�}..,'.„` ,th•t. J""'�F., w. ,..,R: A- ..-:.�
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PjIN vq TUALATIN VALLEY FIRE & RESCUE
AND j
BEAVERTON FIRE I)CPARTMENT
FIRE MARSHALS OFFICE
ki GJw (503) 516-2469 POSTED:
F di RE,
{;{ OCCUPANT
CONTPACTOR -- BLDG. PEP.MIT 11 / 0
1 ;+Jr• y
PROJECT NAME CJ PLAN REVIEW 11
LOCATION
a JURISDICTION: 1= Be. 2= Du, 3 d,' 1
.i= Tu. 6= Sh. 7= Wi. 8= CC 9= WC 0= PIC
j COVER FINAL t SPE FOLLOW-UP/REINSPECTION ATTEMPTED FINAL
Framing El Separation Walls El Sprinkler System
\•Shaf.t Fire Dampers (Overhead/Underground) f
El Alarm System Hood' Ext:ng Systems 0 Conference
IJ Spray Booth Ceiling Cover 0 Other
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Dates J �� Inspector:
o tit ILAIN I�
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CITY OF T I GA R D
COMMUNITY DEVELOPMENT DEPARTMENT
13i26 SW Nell Blvd,Tigard,Oregon 97223.0199 (503)539-4171
•
SC. )t�{h'"g':bKkWStarAx .,...w..w.w.rr.,.wrM..r..+m,...........x..w.l,,.+.....,.,,.......:................. _ ......».-.. ANS
1—
\...11' 1- I� DIZS SW fl,u Duni PLNCK/RECT # O
CITY GARD PERMIT # __ �`���--
COMMUNITY DEVELOPMENT DEPARTMENT Ti[�Ore"97M
(503)639-41" DATE ISSUED
JUB ADDRLSS: _1a`�`{-� S' w' Sc�tfi eC TAX MAP LOT
SUB: LOT: LAND U ** APS VE J (
— 8Y:
VALUATION: y�,'36G, • �' 7
OWNER SPECIAL NOTES
NAME: ,5rt 411,yc-*4-1' /�Q -s i� �� � �-/ ��_ REISSUE OF:
ADDRESS: 17Zes- 'S LAST REISSUE: _
-2 S- FLOOD PLAIN/
PHONE: d 5i 7 W' SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: S 7 Ve •<Jc-e- ;4AL-c �✓�`�-f C-/;" PLANNING: Qkl- —tG��
ADDRESS: o--o ENGINEERING:
FIRE DEPT:
PHONE: 2-0 r & OTHER: ;V"D i/F
CONTR. BOARD II: /ol37 EXP DATE:i"
ITEMS RF.UQ IRED
SUBCONTRACTORS: PLUMB: /,v ��� _ LIST/SUBCONTRACTORS:
MECH: /N /3�N _ BUS TAX:
ARCH ENGINEER A� CALCULATIONS:
NAME: _ J, ,�C, TU-n±, o ,4jj,,w,c-- TRUSS DETAILS: _
ADDRESS: /�5ys_r ti, w•
ya•,F.�` Jf JTHER:
PHONE:
PROPOSED BLDG. USE:
fV
COMMENTS: f
u 7ZIqls}
PPLICANT . IGNATURE �T
Rece i ved By: P r
i
Oate Received: /
TJR!'�l,MF.HA2n .;N+1 •.q•,;y,:q:..« «x_...,...n... .., ...
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PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD.. BAL. DUE
gUfq� -U1K10-432 00 Building Permit fees
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit fees
10-2.30 01 State Building Tax (5Y)
Building
Pl umbi rig
Mechanical
10-433 00 Plans Check fee
Building
Plumbing
Mechanical
10-230 06 fire
3G-202. 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Instituti(mual TIF " es
25-448-03 Office TIF Fees
2.5-448-01 Residential Traffic Fees
25-4413-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
21-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
nrM'3587P.WPf
) A
:
Pag< No. ] CASE HISTORY FOR CABG NO.: BUP93-0185
3T. VINCENT 1103P MSD. CRI'R.
12442 BW SCHOLT.+: FERRY PD Milt: 205
05/26/98 ^
Action 7escriptim IIaI/ Schd/ End/ Action Nortem Disp By Update Upd i
Code stat Done Done Date 8y ,tr
6`.
-- ------------- ---- --- -. ------ --- f:
F;
eUPC007 Application received / / / / 07/30/93 08/06/93 MAB
BURC]10 Plan check deposit paid / / / / 07/30/93 08/06/93 MAB ti
BUPCO20 Plan check by / / / / 09/06/93 A7PR MB 08/06/93 MAP
SUPC040 Check for prcl. restrict. / / / / 07/30/93 NTIF VRG 08/06/93 MAB
BUPC100 (F) Issue permit / / / / 09/11/93 PASS JLH 09/I1/03 .TH
Hf)RC-110 Framing Inep / / / / 09/01/93 APP GS 09/01/93 GBS
HUPC760 ryp Board Inep / / / / 09/16/93 1xv locked NIR GS 09/24/93 GBS
BUPC760 Gyp Board Insp / / / / 09/17/93 APR 09 09/24/93 GSS
SUPC762 Hump Ceiing Inep / / / / 10/06/93 APR GS 10/07/93 GBS
BUPC799 Final Inspection / / / / 10/20/93 handycap bathrms not right DIB GS 11/05/93 TLP
BTJPC950 (F) Issue Cert. of Occupancy / / / / 10/29/93 PASS JLH 12/09!93 JH
SUPC960 Case Finaled / / / / 10/26/93 VWIOUB COMMONB COMPLSTB PASS TLP 11/05/93 TLP
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CITY OF TIGARD � .-
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Heil Blvd.Tigard,Orogon 97223.8+99 (503)839-4171 PLUMBING PERK. r
PERMIT M. . . . . . : PLM93-0171
639-4171 DATE ISSUED: 09/01/93
PARCEL: 1 S 134BC—:?10401
SITE ADDRE:SS. . . : 12442 SW SCHUL_LS FERRY RD #S. 205
SUBDIVISION. . . . : ZONING: C—G
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :
-----------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. . : MOBILE HOME SPACES. :
TYPE OF USE. . . . :COM WASHING MACH. . . . . . . a BACKFLOW PREVNTRS. . :
OCCUPANCY GRP. . :B2 FLOOR DRAINS. . . . . , . : TRAPS. . . . . . . . . . . . . . :
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : CATCH BASINS. . . . . . . :
FIXTURES------------- LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . :
SINKS. . . . . . . . . . :7 URINALS.. . . . . . . . . . . . : GREASE TRAPS. . . . . . . a
LAVATORIES. . . . . ..3 OTHER FIXTURES. . . . . a
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :
WATER CLOSETS, . :3 WATER LINE (ft ) . . . .
3 DISHWASHERS. . . . : RAIN DRAIN (ft) . . . . :
Remarks : Tenant expansion— interiorpartiticl,is, toilet rooms
Owner: ----------------•---------------------- FEES -------- --------
ST, VINCENT HOSP. & MED. CNTR. type amount by date recpt
9205 S. W. BARNES ROAD GRMT t 97. 50 JH 08/26/93 —
`" PLCK f 24. 38 JH 08/26/93 —
PORTLAND OR 97225 SPCT f 4. 88 JH 08/26/93 --
Phone Ms 291-2098
Contractor-
PULLMAN COMPANY
5711 SW HOOP
PORTLAND OR 97201 --------------------------------------.
Phone M: 224-5221 f 126. 76 TOTAL
Reg #. . t 00445
------- REQUIRED INSPECTIONS -------
Wadd This permit is isssed subject to the regulations contained in the Rough—in I n s p _—
Tigard Municipal Code, State of Ore. Sp!zialty Codes and all other Trp--nut Insp
applicable laws, All work wi. be done in accordance with Final Inspection
approved plans. Itis poreit will expire if work is not started
within IN days of issuance, or if work is suspended for sore
than IN days.
Permittee Signature: 1 �wkley� — ---
I55llefi
By :
Call l for inspection - 639-4175
4 .l
: ✓k Mnww.,:.i-.;.: .. ... .,.... ,. .. .. .. . ....vl�.Atr78f+F'�4N.--I`"ar',f�'a..
CITY OF TIG7, ARD r
COMMUNITY DEVELOPMENT DEPARTMENT
13125 5W Hall Blvd.Tigard,(Dragon 97223.0199 (503)639-4171 y
.UCK. . . . . . . . .
T'PCIJC
i
3i Applicant agrers to Cosp,y Mtt! all the "'a:tS S•ic lg1 latjon! '.: t'Wf'T• !f� (tE'. °: .,_._........._..�__...._,__.�...�__.,....._..
the Lmified Siwge Avrr° y. '�!-e rre:'. espi"et i@M days `rot
data issopel. 'he ttta'i ate,:nt pail m,is ,e `3rteite: it t're
:'alt ex-piets. l'c Al"ey rites rot yb3rantet °LLr ares:z ar y ;if
-it Sewer #aterAlS. if the sewer 1; +`7t harm e: c`, tl''?
itst, the tnttatier shali prespect 3 feet i^ a.: d: er't��� °-�• _ �._y__ ___.._________._ ....
' 4 distance giver:. if Ant so Ircated, the ireta:'er sI
'14P and SlOt 6!lvtr: Ptrut and `,r: A
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Jon R. Jurgens & Associates
ArchitectureRlu nning
13133 N.W.Greeubrkr Parkway-Suite 260
Beaverton,o"gon 97006 • (M)690-1779
FIELD
ARCHITECTS
S
NUMBER: 1
ORDER •
PROJECT: SCROLLS FERRY DATE: August 18, 1992
MEDICAL OFFICE BLDG
Dr.BueReVDr.DeMots Suite
OWNER: St Vincent Hospital ARCHITECT'S PROJECT NO.: 87133-09
and Medical Center
TO: Mr.Warren Simpson
St. Viarent Hospital
9205 S.W. Barnes Road
Portland, Oregon 97225
You are hereby directed to crecute promptlyy this Field Orcier which interprets the changes in the Work
without change In Contract Sum or Contract'I9me.
If you consider that a change in Contract Sum or Contract 11me is required,please submit your itemized
proposal to the Architect immediately and before proceeding with thL,; Vork. If your proposal is found to
sa
e tisfactory and in proper order,this Field Order will in that event be superseded by a Change Order.
DESCRIPTION:
See Attached.
r:
ATTACHMENTS: )revision Drawings R-1,R-2, R-3
ARCHITECT: Jon R.Jurgens &Associates
BY: Paul M. Smith
i:c: Ms. tacy Peterson - St. Vincent
Dr. Bueffel and Dr. DeMotz
I
Dr. Bueft'el/DeMotz Suite- (Continued)
Field Order No. l
August 18, 1992
F.O. 1.O1 Clarification - General Notes Sheet A-1:
i
General notes,plumbing and electrical notes are referenced on the Floor
Plan and Reflected Ceiling Plan with ; numerical hexagons.
F.U. 1.02 Clarification- General Note No. 13 on Sheet A-1:
Add "Replace any missing sound insulation".
F.O. 1.03 &LO -Toilet Room,No. 114:
Plastic laminate wainscot 48"hi¢h on all four walls. Provide metal cap and
cove trim along top and bottom of plastic laminate. Color to be Wilsonart
No. D381-6-Fashion Grey.
F.O. 1.04 Ad¢-Toilet Room 12'2:
Plastic laminate wainscot 48"high on north-east and west walls only. Provide
metal cap and cove trim along top and bottom of plastic laminate. Color to
be Wilsonart No. D381-6- Fashion Grey.
F.O. 1.05 r�'a i0cation -Specification-Page 14:
i_
Scup, towel,toiletaper and toilet seat cover dispensers as well as mirrors ure
to be provided andinstalleduy the Hospital.
i
F.O. 1.06 Cjarif tion- Cabinet Elevation No. 10 on Sheet A-3: i
Reception cabinetry and window paper slots are existing with exception of left
hand addition using relocated file drawers from existing reception cabinetry.
F.O. 1.07 Clari catipn Fran Detail No. 3 on Sheet A-4:
Add "No Exception"to end of existing note.
F.O. 1,08 Revise Nurse Station cabinetry elevation No. 5 on Sheet A-3 by deleting
bottom two drawers adjacent to the knee space and replacing with a second
file drawer. I
See Revision Drawing R-1.
F.O. 1.09 Clarification:
Corridor walls of Rooms 113 and L16 within Corridor 115 of the new suite
expansion area, are to align with existing suite walls at the same locations as
are Rooms 111 and 112.
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„yp,,,'..�,-.,r .q:, �,v,.�. �r.�.w r..y.....w�t+^v•+q'+."�r°” .rrllMr •re. ...•a � x ..Mv ,tY.yr •�vny.,,�,+..,.w•��?+• sar.iMrM-v'-..a.. r�.My�+,.
.g
F.D. 1.10 garif' tiQ1'oilet Rooms 114 and 122:
r
Coved rubber base to be 6"height by code in lieu of standard 4"heightSeeheight
Room Finish Schedule for calor.
F.D. 1.11 a 'ficafio-Waiting Room 100:
See Revision Drawing R-2 for east wall layout.
F.O. 1.12 &d d:
Waiting Room 1.00-book shelf storage counter. See Revision Drawing,R-3
for details.
N1�: Provide cost to Tenant prior to fabrication for Tenant's approval.
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JON R. JURGENS & ASS O C I A T E S
ARC HI 'TECTURB & PLANNING
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SPECIMEN ABS-THM
CABINET (500RICK 505)
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LOCKABLE FI
DRAWER '
KNEESPAC � I I
10 �� 9 8 I '•
A4 A4 ,A4 �
5 NUR5F. &TATION
SCALEr 3/8'• 1'-0' r7
��'VIS�- EyAcwlK. orr
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PROJECT .___ 1`_���fi S�i kl,a�r DATE 8 '`� _ PAGE ~
Cornell Oaks Corporate Cenurlihe Commons Buildink 15455 N W Greenbrier Parkway,Suite 260 Beaverton.Oregon 91006 (50])690-1779 PnR(303)690 091
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ARCHITECTURE & P L A N N I N G
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114 EXAM I EX
PAW-D-M 113 EEXAME 19
(43)
Olio WC-2
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SURFACE I-X0 NT
FIRE EXTINGUISHER I �� E
II
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WAITING L..
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IIF-- . EXISTMG WALL r
CsM'!ISING UTAU 3LI*0IMCi
cau
WAR 9 0 I I 1 f 24 O RMSITHat
OPENWI
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of 'rt�t
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PROJECT �._ _— �_. DATE _ _.__ PAGE MIND
Cornell Oako Ctvpotate Center/the Common$Building 15455 N.W.rireenbriet Parkway,Suite 260 Beaverton,Oregon 97006 (501)690.1775 fax(50711690-091)
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ARCHITECTURE do PLANNING
C44 I Wt-049i
AILG�I�
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PROJECT __-- - ---_--_-__ DATE _ -- PAGE
Cornell Oaks Corporate Commons Building 15455 N.W.Greenbrier Parkway,Suit,20 Beaverton,Oregon 9701:' (503)690.1779 fax 1503)690.09
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..,.....,�...,�.....:..,wvasss+i.•o..._.:..._.,.,...«u��rw�+'gwt�w,MHM ��-
INSP8CTLON NOTICE
City of Tigard Building Uepartwent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businees Phone: 639-4171
Inspections
Tooting Pl.bg. Undernlab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line PINAL: '
Post/Beam str,,ct. San. Suver Praminy
Post/Beam Neer. Rain Drain Insulation ~ .
Plbg. Underfl.xjr Water l..ine Gyp. Rd. -Mach.
Date Requeatod)t �S �l Time: AN _�__PH
Addree-i:-�_ ___ Pe�t'f t�911-f-41
Builder: '- —-/�1s 1 L �/ - � � L-L'�2� sP
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THE FOLLOWING CORRECTIONS ARE RRQUIRM
Inspector:` --- - Date:
G APPROVED �_ DISAPPROVED APPROVE'D SUBJECT TO ABOV! f"
C311 Per Reinsp.
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CITYOFTIFARD
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GTY RD OCCUPANCY
COMMUNrfY DEVELOPMENT DE�Aj N'T 0410000 PERMI T N. . . . . . . o SUP90--•t.! _'84
13126 SW H.p BW P.O.Bo.23397,TomM,Orgpn 97 6�Qlro�1d6
SITE ADDRESS. . . t 12442 SW SCHOLLS FERRY RD NS. 205 PARCEL t 151340C--00401
SUBDIVISION. . . . t Z ON:I NU t C 0
BLOCK. . . . . . . . . . t LUTo . . . . ooa . . . . . t
CLASS OF WORK. oALT
TYPE OF USE. . . t COM
OCCUPANCY :iRP. j8,2
OCCUPANCY LUADo17
I TENANT NAME.:. . . t T I ME SHARE SUITE
a„ `;: Remar k,rt Tenant Mods First tenant build out, interior partitions, toilet rm.
Owners
ST. VINCENT HOSP. R MED. CNTR.
92205 S. W. BARNES ROAD
PORTLAND OR 97223
Phone Apt 291-2099
Cont ract or t ----- --------------------------
OWNER/CONTRACTOR
---- _-_------.___-__-_OWNER/C:ONTRACTOR
Phone Mt
Reg #. . t -
Occupancy of the above referenced building is hereby given, and certifies
the compliance with the State Of Oregon Specialty Codes for the group,
occc5►, and use under which the referenced permit was issued.
FIRE DEPARTMENT BUILbING IN C70F --
BU lof IN OPIF ICIAL r
POST IN CONSPICUOUS PLACE
r45 -
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INS EY (TION NOTICE
�\
City of Tigard Building DeFartamt
/1 13125 BW Ball Blvd. Tigard, Oregon 97213
J Inspection Line (nee O--Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing P'bg. Underslab Mach. Rough-in Appr/Sdwlk •
Found. Plbg. Top Out Gns Line FINALS
/ 0
Poet/Ream Strutt. San. Sewer Framing -81dq.
Port/Berm Mach. Rain Drain insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. Yash.
Date Requested: , Time: Am PN
Address: �
Permit 1.r
fG 9
Builders / ° ' T� L�j �• �A
---
,bP°
THE FOLLONINo OORRECTIONS ARE REQUIRED:
401 S i
Inspectors,/ � nates--z- e- Z
_APPROVED
APPROVED __ DISAPPROVED APPROVED SUBJECT TO ABOVE II
Call For Reinap. ( t
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Septemt,,?r 24, 1990
J. R. Jurgens and Associates
13765 NW Cornell Road
Portland OR 97229
Re:
12442 7SW y Road
Plan Check/Receipt #9-37C/204774
i FMZ #
i
Dear Gentlemen:
This is a Fire and Life Safety Plan Review and is based on the 1960 editions
of the Fire and Life Safety Code (UEC), Mechanical Fire and Life Safety Code 1
(U'!C), Uniform Fire Code OFC), and other local ordinances and rcqulations.
Pians are conditionally approved subject to the following items:
1. Automatic Sprinkler Plans: Plans referred to and examined by this office
contain no provisions for the alteration or installation of automatic
sprinkler system. Not less than three sets of plans for the installation
shall be submitted to this office for approval prior to Installation
1 [ UBC 302(b) ].
i f
i 2. Exit Door Hardware: All doors shown on the drawings must be openable f
from the inside for immediate exit at all times without the use c a key,
special knowledge, or effort [ UEC Sec. 3304 ].
3. Mechanical Equipment Approval: All heat producing and electrical
equipment and appliances installed in conjunction with the construction
or occupancy of this project must be approved by Underwriters
Laboratories, Inc. or other nationally recognized testing agency and
Installed in accordance with the testing agency's specifications [ UMC
Sec. 502 ].
4. Fire Extinguisher Requirements: Not less than one (1) app-rved fire
ext. nguisher s with a rating of not less than 2A108:C shall be provided rk
for each 1,500 square feet o° floor area or fraction thereof. The travel
distance to an extinguisher from an portion of the building shall not
exceed 75 feet [ UFC Standard 10-1
1
1.
`�, �*+ M'ar .„. .,... .r�.,,,,,�,.� .•..t«. .�,.�p., .. .. .,. ., + ,. , .,�. .. „r,y,�..�,. .,,,v.,,,rw «n..•+yn�V.+vl�• ,,'�,., i,
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Page 2, 9/24/90, to J.R. Jurgens
Re: St. Vincent M.O.B. , Time Share Suite
_
5. Building Corridor stem: Considering location and area of this
particular office, as well as the remainder of the leased space for this
floor, it is the opinion thi'; office that 1-hour corridor construction
will be required. Please prov'de details of corridor construction; i.e.
the proposed confir4uration of the corridor and fire resistive assemblies �► "'
to be used [ UBC Section 3305(g) and (h) and 302
i4 �II p
6. APPro-veddlans on Job Site: One set. of approved plans bearing the stamps ` «.
OTthe •build ng department issuing the construction permit and this
office must be maintained on the project site throughout all phases of p
construction and must be made available to building and fire inspectors
for reference during required construction inspections [ UBC Sec. 303 ].
7. Required Occupancy Certificate: Prior to the use and occupancy of the j
project space), a certificate of occupancy or other written instrument
of approval must be obtained from the building department issuing the
construction permit [ UBC Sec. 307 ].
I'
if I can be of
any further assistance to
You please feel free to contact me II
at 526-2502.
�I I II
Sincerely,
Gene Birchill, 1111;
Deputy Fire Marshal/Plans Examiner
finer I
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GB:b,j 1:4618e II,IIPI
cc: Wash.Cty.Bldg.Dept.
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MECHANICAL
� ��� C:'EFiMIT .
C17YOF711FARD I,ERM'rT N90-•
. . . . . . . : MECC�a00
G'IYOF 11A11tIJ
COMMUNITY DEVELOPMENT DEPARTMENT + / DATE ISSUED: 01/04/91
13126 8W HWI Blvd. P.O.Bat 2390; llpmd.0mg n+01'121(S0)'65%M 76
S ITT ADDRLSS. ., . r 1244r_' SW SCHOL.LS F C.RRY RD #S. 205 F,ARCELs IS134BC- 00401.
SUBDIVISSION. . . . ;; 'I_CINING: C-G
BL0C,K. . . . . . . . . . 9 LOT'. . . . . . . . . . . . . :
....r_««..__.u.uu.__._.._......._....K..__._..r_.........u..u.u_..r.__rr.r.r.u.rr...u._.....r.._w..w._.r....rr.._r.._...r.r._..�._u..«._.._r_.r..r._.__w r....0 u.r u...r._.,.
CLASS OF WORK.. . a ALT FLOOR FLIRN. . . . : EVAP COOLERS s '
TYPE. OF USE. . . . .COM UNIT HEATERS. . ". VENT FANS. . . a1
OCCUPANCY GRF'. . a B2 VENTS W/O AK'L a VENT SYSTEMS s
STf.1F'IE.S. . . . . . . . .*2 I?OTLERS/CO1'IF'RE:SSORS HOO.DS. .. . . . . . .
F•'UEL_ 0-3 PIP. . . . a DOMES. I MC I N e
./GAS/ / / 3-1.5 HP,. . . , a C:OMML_. IN(.:IN:
I'IAX INPLIT: EIIU 15-•30 HF,. . . . . RE:F,AIR UNITS:
FIRE DAMF',ERS?. . aY 30--._;0 HE'. .. .. . : WOODSTOVE:S. . a
GAS PRESSURE. . . aM 50+ HF'. . . . ., CLO DRYEi'RS. . s
" NO. OF UNITS---- «_.______ AIR u01IDLING UNTTS OTHER UNITS. a
F'URN < 1O0K BTU: 10000 q.:fni.4 CTAS OUTLETS. s
FURN )=100K ATU: ? 1.0000 r_ fm.
;"f-ronrks;a Tenant Mod., FiTst terlai-it build-•Out, inte•r:i.a•r Tlartitiorls, tr.ilet IM
_
FEF:S _..__..._..___..__._.__ .. ..
J. VINCENTHOSE'. R MED. CNTR. type amount by date recpt;
9205 S.W. BARNES ROAD F',RI'IT $ 31..00
F,LCK $ 7.75
H'ORTLAND OR 97225 `T.,G!CT $ 1.. 55
Phone "i ?91-2098 F'AYM $ 40. 30 JI_H 01/04/91
CONTRACTOR NOT (34 F'll_E i
4�
(
F",Itnnp N� 9• 40. 30 TOTAL..
Re Ft N. . _
RE.QUIRE:D :INSF,ECT'ION5
This permit is issued subject to the regulations contained in the Gas Line :Irlsp
'ioard Municipal Code. State of Ore. Specialty Codes and all other Mechallical Ir1sp
Applicable laws. All woo will be done in. accordance with Heating Unt Insp
approved plans. This permit will eipire if wore is not started Cool i ns7 Unt I ns p ._ _ _ .__.........._._.._...._......
.
within 181 days of issuance, or if %urk is susoended for mere Duct I1ispec�t-i.Gn
than 181day1,• Final. [n7pection
.... __.._...._........
Issued Bye _ f
CAII for insc)er_tion 63.3-••4:1.7; !�
I
l
1.
'ITY OF TXGMW MECHANICAL PERMIT Receipt
Al2 c SW HALL BLVD. Permit N
'. 0. BOY. 23397 Daa+.ription
IGARD, OR 97223 Tanta aA Mechanical Cad� QTY PRICE AMT
'503)639-4175 1) Permit Fee -0- -0- 10.00
Nr q1 Da'�Op"'a"t� Supplemental Permit 3.00
Job A I 1 Furnace to I00X')0 BTU 6.00
Addres4 incl.ducts 1R vents
Tax W Map No ) Furnace 100,000 BTU +
Lot Block Subdivision2 incl.duds A vents _„_ 7.50
NO (or norm of was) / 3) Floor Furnace 6.00
incl.vent ----- -- ------ g
Ma1111 $a rasa p M --- -4 Suspended heater-wall heater 600 -
Owner ) or floor mounted heater ii
cTlyiBuM ZIP 5) Vent not incl.in --- --- 3.00
appliance permit
twns(or nrnad ► 6) Repair of heating,refrig., 6.00
i n 1 � S�/ cooling,absorption unit
MaikV Address ) Boiler or comp to 3 HP 6.00Occupant 2QS absorp unit to 100,000 BTU--
ciry�Stala ---”
BID 8) or comp to 3 HP-15 HP
8) absorp.unit to 500,000 BTU 11.00
9) Boiler or comp 15-30 HP u-- -- 15.00
( absorp,unit 1/4-1 million
FMating 10) Boiler or comp to 30-50 HP - 22.50
absorp.unit 1 -1.75 million _
C,ontrador aty stale --- tip 11) Boiler or comp to 50 HP 31.50 R,
absorp.unit 1,750,000 BTU
State 17egistration I to — `--- city Flus Tax No. 12) Air handling unit too ') 4.50 J
10000n CFM --— - /0 �0
I hereby adugnledge that I have read this apph ation that the information given Is 13) Air handling unit 7.50
rr
10,000 CFM +
cAerl.Meat 1 am rte owrwnr a autnnari:ed agent of the owner,that plans submined are in — -- - —
cortpNrnoe with Stall law%,that I am registered with the State Builders Board,that the Non portable
nuer mbgiven is cad re (H exempt hum state registration ptease give reason bebwi 1 a) evaporate cooler 450 `
Vent fan connected
15 to a single dud / 3.00 3,00
_-__— ----- -_ - ----_ -- 16 Ventilation system not 4 50
included in appliance permit
17) Hood served by 4.50
mechanical exhaust
Deh+ 7.50
18) Domestic typ,4 -
Describe work F addition P alteratt' I incinerator ore air r ^-_
to be done _ residential U non-residential Commercial or industricl
Existing use of y 19) type incinerator 30.00
building or properly _ Other i.e.,woodstove,water
�) heap 3r,solar,clothes dryers,etc. 4.50
Prov rr-ed use of _
t'iita, g or property -� - r 21) Cas piping one to four outlets 2.00
Type of fuel- oil i_I natural gas LPG U electric ❑ I --� — —
J 22) More than 4-per outlet
Q --------- — SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON -- -
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 1P0 _ 5%SURCHARGE
DAYS, OR IF CONSTRUC I`ION OR WORK IS SUSPENDED OR pWL 7EVIEW 25'X.OF SUB-TOTAL7S
ABANDONED FOR A Pt^IOD OF 180 DAYS AT ANY TIME AFTER --- ' - {
WORK IS COMMENCED. - TOTAL 40,30
Special Conditions
------ -- -- --- - - g ---- ---- Date i^sued----- by
'"fie{.N
� "�.'n r r '+- ,,.,}p.w t .� �� ... . ,, r„r a`K ri 5 rye, ylr"" •n..ere.:+ e.
CITYOFTIGrARD CITY!
COMMUNITY DEVELOPMENT DEPARTMENT PLUMBING PERMi T
4 13125 BW NWl Blvd. P.o,Bm 23;!97,TOW,Oregon 97223(603)KWAI 7i,
PERMIT ti. . . . . . . a PL..M'3f- r" r
GRIM. PERMIT M. a 1rUP9O-•O284
Li,1'1 a 1'71 gA T F' I SSl1E'D s 10/09/90
1:31TE: ADDRESS. . . a 12442 SW SCHOLLS FERRY RU NS. 2O5 PARCELS 1S134BC-004O.1
RD
SUBDIVISION. . . . : ZONIHGa C"-G
s BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . ..
CLASS OF' WORK. . SALT GARBAGE: DISPOSALS.. . : MOBILE HOME SPACES. e
TYPE OF USE. . . . :COM WASHING MACH. . . . . . . e BACKFLOW PREVNTRS. . c
UCCUPANCY GRP. . :B2 FLOOR DRAINS. . .. . . . . t. TRAPS. . . . . . . . . . . . . . a
STORIES. . . . . . . . ..2 WATER HEATERS. . .. . ., ,, .. CATCH BASINS. . . . . . . .
LAUNDRY TRAYS. . . .. . ., , SF' RAIN DRAINS. . . . . :
SINKS. . . . . . . . . . ..6 URINALS. . ., . . . . . . . .. . . GREASE TRAPS. . . . . . . :
LAVATOKIES. . . . . a1 OTHER FIXTURES. . . . . :
TUP/SHOWERS. . . . : SIEWER LINE (ft) . . . . ;
WATER CL OiaFTS. . : I WATER LINE: (ft) . . . . :
DISHWASHERS. . . . : RAIN DRAIN 0t) . . . . -,
ff
Remarks: Tenant Mad: First tenant guild-•out, interior pa'rtitiorls, toilet •rnt. k
s
a
FEES
ST. VINCENT HOSP.,X MED. CNTR. type amaunt by date -recpt
9205 S.W. HARNE:S ROrli) PRMT $ 60. O0
PLCK $ 1.5. 00
I`ORTLAND OR 9721 `i1--.1 l j' t, 3.00 1 !
1=1hane+ p: 291 -2098 PAYM $ '78. Flo .TL_H 1O/08/90
Contractor:
F'ULL_MAN COMPANY
,g 571.1. SW HOOD {
9 PORTLAND OR 97201
311-ione Na 503224522.1. $ '713.00 TOTAL
Reg M. . : 445
REGUIRE:D TNSPECTIONS -- - -
This permit is issued subject to the regulations contained in the Rough-iii Insp
liJard Municipal Code, State of Ore. Specialty Codes and all ether PL.M/UndPrfloo•r _
applicable laws. All wore will be done in accordance with Tc1p-•nctt Tnsp
approved plans. This permit will expire if lark is not started Final lnspeetiur1
0 thin 16@ days of issuance, or if work is suspended for more f
than 189 days.
/ ...-........
_
Permittee Si.gnatctr.
].<;!sued h y. ------------_.._
Call fo-r ir'spectior) - 639 4175
i
--riot
• fit -
...............
13125 SW HALL BLVD.
PLUMBING PERMIT P. o. Box 23397
Applicants nest hold Oregon Registration to crIni a plumbing TIGARD, OR 97223
MrsinessormumbepropertyawneflOperat«-" iring0utsidehelp_ (503)639-4175 P4MCV-0175
of ent � -- YSumbing Permit No-
Description
O. -
OUAN. PRICE AMT
�5 914-21.610
.lob Tax Lot Map.No.
Address __— —_.. FIXTURES _--_-
- tSbockfivlslon Sink 7.50 �.
-- Lavatory 7.50 ' sv
ams of ill 3S , —--
C—may 11 Tub a TutWSh~Comb. 7.50
�a iq rtes Sh cmw Only 1.50
Walwcl�set -- -� 1.50 Q
Owner tido/Sate 7.50
Dishwasher
ptgne Garbage Disposal i T -_ 7.50 -
Washiy MacJwe,_— — 750
N r Floor Drain 7.50 �-
7.50
e11 Phone Water Healerill,ww —.- - -- -
_ --- Laundry Roan Tray --- 1.50
Occupant CilyiState Zip (Jrinal -- 7.50
Other Fwtures(Spetih)
Te — 7.50
nese — Phor — 7.50
__ ---- 7.50
Contractor Csy/State �- . '
MIaCEI.tJINEOUS
—— Rue T nx No 5*~1 s1 100 30.00 --
r N , 15.000
Sewer�a-Addil. '
rs t.,t �irs-t,c. 100 20.00
r;t;. (Wes�.lerNiatl Water Service 1st 100'
Water Service aa_Addil — 15.00
1 hereby aclawwlsdps that f haus read"s IgVk o^that iM�pnnation 30.00
given is correct.Cho I am registered with Ifs Stats guldens Board.and also Storm&Rain Drain 1 st 100'
taw a 5tete Plurvft fl Roane that the numbers given are O rsci,that ate 15.00
pkxor
ribing wk will be done in accordance with appacmi pr� oro-al e- Stam i Pin Orem Addit.100'
pon Revwed Statutes Chapters 447 and 693 and spp�Codes and that Mobile Hman
os Spans
25.00,no two help wdl be employed unbss licensed under ORS 693-(1141190"pt fl Back Flow Prevention -
State rslratfa+ platy give red—be". Dever or NdiPOIIulian- Device 7,50
pk {
HOMEOillil IEFZ,S--I hereby cm*111011 ern 11e Owner of the property ds-
eaMed above,at whic+t is r 110 I pr)ptnse lorresko•pkeTd*n0 krrtaMadm tar Any Trap M Waste Not
rrry own use end Ota property Ilia e not bill cort ucied td nate,tease a rent Cennsotsd to a Fbcb" - 7.50 _
Catch Basin 7.50 —
G rnap.d tadst.Ptun+binq 10.00 Per Hr. I
— -Specia� onS 10.00 Pa Fk. I
Rahn Drain, 1500
single ran. Dwlq. _---�- •.
AUTHORtTED SIfINATL1FrE --- Oats --
LOssm*w work new❑ additirxt❑ repalf❑ — ~_--- _-- -__
!2 be dobe_v_^resldermal[l non-ro
HINI14UH PERMIT PEE 25.00
Exits lrtq use of SUB-TOTAL 4 00
btAk*V of Olt-_----- ----- -- - - I
d 5% SURCHARGE
25% PLAN REVIEW co
` HmncE a TOTAL
Thla parry*baoorrrss null and void f work or oonstruc ten autlarzed w not axn
rrtermed wrM11Yt 190 dayeatr M c ermtrucilon or worltis stlrte w%d Or rabsndoned for
a period d 160 days M arty tkne after erak Is 011innrninoad.
"'•,, BrICyAL OON[XT10ff6_.—.__.—__.___.—�____—.—_----- ----
Flate Issued --- by ---__ -
•r
i
............ .......... ........ .......
BUJI-VING PERMI T
CITYOFTIFARD CnYO-F F& PERMIT' N. . . . . . . : ElUP90-ElP8,,
F RIM. PE EMIT N. : BUP9O-O284
COMIMUhiRY DEVELOPMENT DEPARTMENT ones
131268WHWIBW. P.O.Box23307,7iprd,O"Vw+07223(SW 6;s0AVA!1 VAT'E ISSUED: 10/08/90
BITE FIDDRE.C'S. . . : 12442 SW SCHOLLS FERRY RD 0S. 205 PARCELs 16134E1C;-0O4Oi.
GUBDIV19ICN. . . . : TUNING: C-G
BLOCK. . . .. .. . . . . . . LUT.. . . . . . . . . . . . . s
REISSUFs F'L_OOR AREAS-_._.__._.__.___ EXTERIOR WALL C014STRUCTI(:1N_.
CLASS OF WORK. -.AI-T F'IRS'T. . . . : st Ns S: E: Ws
IYPE OF USE. . . :LOM SECOND. . . : 1660 .f PROTECT OPENINGS"'-__..__.______._
T :PE OF CONST. :l-_'FR T'HIRD. . . . : sf Ns pis E3 W: I
j I OCCUPANCY GRP. -BP TUTAI_-- _ - : 1660 sf RVJF CONSTs FIRE RET": i
OCCUPANCY LOAD: 17 F+A5F::PIENT. : sf nRE.A SEF'. FATED:
ED:
HT. :24 ft GARAGE. . . s gf OCCU SEP. RATEDs
B3MT":N ME77''-.N RECD 5E TAACKI;._._._.._.___.-• RE0UIRED--•_.___._.._...._.._.._._...__........ ......._
1"'LOOK L UAD. . . . ..50 ps f LEFT: ft RGHT n t't FIR SPKL.:Y SMOK DET. . :Y
DWELLING UNITS: f"RN'T. ft REAR- +'t FIR ALRM:Y HNDICP ACL0
BEDRM5: NA'THS: IMF' SURFACE::: PRO CORK:Y PARKINGs
VOLUE. $: 56000
� marF;s: Tenant Mod: first t;erlant: tMild•-•out interi.o•r
partitions, toilet rm.
Owner: -____....____..___.._.._.._....__....__.___...._...__.._.._._ . FHF_a
(;T. VINCENT' HOSF'. R I'ILD. CNTR. t I
ype amount by date recpt f
'-12O5 S. W. BARNES ROAD PAYM $ 31.6. 05P JI-14 09/J.4/90 204774
PRI'IT 4 301. 00
f?ORTLAND OR '�3722PLCK `1 195. 65
['hone M: P.91.....2O98 FIRE $ 120. 40
Contraetor: -..___.__.._...._...__________.__.___.._._.__.___._. [:'AYM s 316.05 JL.H 1.O/O6/90
CONTRACTOR NU'T ON FILE::
PhC1ne N $ 632. 10 10TAI.-
Reg t>`. . .
REOUIRE:I) INSPE:C'TICINS --_.._..._.........
This permit is issued subject to the re,ulatio,s rontained in the Framing Insp
Ti0ard Municipal Code, 5tite of Ore. Speci,.lty Foees and all other Insulation Insp
applicable iaws. All work will be done in acrorJa•cr with Gyp hoard Insp
approved plans. This permit will expire if work is not started SUsp Ceiing :Insp
within ISN days of issuance, or if work is suspended for more Final Inspection
than 180 days.
1 �
Permittee Si Si gn<a .0
I:sUed DY:
Call for insper..tion - 639-4175
E�
_ TP7.'1�}yt? MtltMralllMdw�i?1Urf�4i4MYM,kYm+,.w,,.•«,.. ... r
CITY OF T16;A7KDWI% u,fsW-��.�v:c.e«� PINC7C/�x--r #�•% "o
3 7 �J'y7
rbaa aepon v7n3 PEFd�r ,¢ •�
COMMUNITY DEVELOPMENT DEPARTMENT (W)&W-4171 ����— o
DATE ISSTJFD
J08 ADDRE*Si: / y'/ 3i,- Sr,vcxc ftrt�e7 /lvr4� _ _ TAX MAP/lDr LS/ 39 BC- 0b4Uf
lor: LM) USE:
VAI.0 MON:
': SPFJaAL NOBS
NAME: .5T UiivG'c�r,6/i -� ��e�v,r a� crr4-
�__ RELSSTJE OF:
• ADORES: 9 2 v r S c,L e +ecf'�,rc . _ IA ST RE SSIE: ------+-■-� 1
/"e•rya-./. 6 r7.�S' _ FIM) PIAIN/ —
SEN.:ITVE TAM:
�
PHONE: F/-�� !_ �*"s�' �y 7� Z o a'.S- — -- ------ .
:D
CIOMNACA'OF2 1-'ANN
NAME: S-r «�r iE.4�I
FIIZ DFgr
PFS: d• --� ITE�15 I
BUH DERS BOAWJ 1: EXP OATS: X TAX:
ARO
NIWE:� I.�6vtv+, � r.rc c TRUSS DEIA7IS: ------- I
37e s' /v e9! CIZHFR: —_
OMKWIS-
PERMIT I ACCT DE9cKnMCN ANIM 1 MXW PD. BML. E 4
1.0-432 00 Building Permit Fes; ,Ov
i —
At --"175 ].0-4371 00 Pluvbing Perrit Fb
�1Li'Qni 19-431 0 Med�atLi.casl Permit ins
10-230 Ol State Bu ildirg Ta3C
P. ging L
M01�1 _
].0--433 00 Ply ctv rdC Fee
&dldirg D
I P.lumbi-g s,
' Mem i
30---202 OO Sewer Cbrmection
30-44.4 00 Sewer Inspection
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I 52-4149 00 PaX s System Dav Qmxy-- (PDQ r
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31-450 00 Storm Dralrtiage cyst Dev C" (SSDq
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Rx ei.v ed By: Date Reoe i-ved:
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SEWER CONNECTION
PERMIT
CITYOFTIFARD PIE.RM IT N. . . . . . . s SWR90 0.3 7;3
CIRY JF 11670FtD y
” COMMUNITY DEVELOPMENT DEPARTMENT tanem PERMIT' Ii. : HUP90--0284 I
13125 SW I W16M1 P.O.Boos 23097,rlgaM,Onvon9=003MI 7111 DATE ISSUED: 10/08/90
SITE ADDRESS. . . : I.P442 SW :.;(.'J )LLS FERRY RD NS.205 PARCEL: 1S1:34BC•-00401
SUBDIVISION. . . . : ZONING: C-G
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . .
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TENANT NAME. . . . . -'T'I'ME' SHORE SUITE
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+ LISA NO. . . . . . . . . . : FIXTURE' UNITS. . . t20
CLASS OF WORK. . . -.01-l' DWELLING UNITS. . e2
TYPE Or USE. . . . . sCOM NO. OF BUILDINGStl
INSTALL TYT-'F:. . . . -DUSWIR IMPERV SURFACE. . : f
Rpmar,ir,sls Tenant Mods First tenant. build-out, interior partitions, toilet rm.
Owners ______..___..__._.__.___._._.-__._____._._..._-___ _.__..__._.__.__.___._..._ FEES _... .__._._._._.._.,
{ ST. VINCENT HOSP. K I*IED. CNTR. type etmourlt by date reept
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9205 S.W. BARNLS ROAD PRMT $ 3000. 00
PAYM $ ;3000. 00 JLH 10/08/90
PORTLAND OR 9722
Phone Pe 291-2098
Contractor:
CONTRACTOR NOT ON FILE
Phone . 00 TOTAL
Req �� . :
- REOUIRE:D INSPECTIONS - - _-This Applicant agrees to comply with ail the rules and regulations Sewer Inspection
of the Unified Sewate Agency. The permit expires 120 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement t
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, V instalinr sha rchase
a "Tap and Side Sewer" Permit and &t.hee;cy ail 0,11 l�ra
.......
_._ _...
1=P•r m i.t t e e :�i r1<�t u r � ._,�___._._...__...
Issued By:
Call fo-r, inspection - 639-4175
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a 09'21 90 15x23 E 503 604 4672 EXCALISUR P.002
USE&`TFIAW8P0FOA10HDEP
La4NDA C 1f..8ERyq= DIVISION.
P AEN
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QREGON '� : PHONE:"' .1¢7Q
05007174 R pi
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01/09%9Q AP , .Kf' �• NOTE SEH: FILE !
' 03/07/90. AP Kp
04/02/,9'0.;, AR +HA '1,` "; USE APPRnIJED FASTENERS
04/04/90 AP r :)N9 MECHSHAFT WALL
r, 04/�q?,04 . .- OP.._ AN Ci1UF:il OY,
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