Permit •
CITY OF T I GA R D BUILDING PERMIT
PERMIT #: BUP2004 -00462
DEVELOPMENT SERVICES DATE ISSUED: 11/24/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115AA -OTOOA
SITE ADDRESS: 16105 SW 108TH AVE BLDG B
SUBDIVISION: OAK TREE APARTMENTS ZONING: R -25
BLOCK: LOT: OOA JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: NEW FIRST: 9,312 sf N: 1HR S: 1HR E: 1HR W: 1HR
TYPE OF USE: MF SECOND: 8,900 sf PROJECT OPENINGS?
TYPE OF CONST: 5-1HR : 8,533 sf N: N S: N E: N W: N
OCCUPANCY GRP: R1 TOTAL AREA: 26,745 sf ROOF CONST: C FIRE RET?
OCCUPANCY LOAD: 114 BASEMENT: sf AREA SEP. RATED:
STOR: 3 HT: 31 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: 50 psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:Y
DWELLING UNITS: 24 FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y
BEDRMS: BATHS: 30 IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 2,193,008.0C
Remarks: Building B - 24 units
Owner: Contractor:
OT2 LLC KEYWAY CORP
5437 ROSALIA WAY SUITE 100 7275 SW HERMOSO WAY
LAKE OSWEGO, OR 97035 PORTLAND, OR 97223
Phone: 503 - 620 -4373
Phone: 503 - 684 -5100
Reg #: LIC 127522
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit RequirE Insulation Insp
[FLS] FLS Pln Rv 9/29/2004 $2,996.63 Electrical Permit Required Shear Wall Insp
Parks SDC 11/24/2004 $23 Sprinkler Permit Required Exterior Sheathing Insp
[PKSDC] Plumbing Permit Required Firewall Insp
[TAX] 8% State Surcharl 11/24/2004 $599.33 Ersn Cntrl 681 -4444 Drywall nail /screw
[CDCBLD] CDC Bld Re 11/24/2004 $132.00 Footing lnsp Gyp Board Insp
(additional fees not listed here) Foundation Insp Smoke Detector
Slab Insp Bolts in concrete final repo
Total $36,201.60 Underfloor insulation Structural welding final rep
Framing lnsp Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
•
Issued By: f L.Z.A4AL
Permittee
Signature: C
Ary
Call 639 -4175 by 7 p.m. for an inspection the next business day
RECEIVED
/i Building Permit Application FOR OFFICE USE ONLY •
City of Tigard SEP 2 9 2004 Received . '
13125 SW Hall Blvd., Tigard, OR 97223
Date/By: Permit No.: .1
OIT OF TIGAR Y U' Plan Review
r-al� I p I � �'
Phone: 503.639.4171 Fax: 503.598.1960 `" 2 - r - °Y fi�� Other Permit:
� f DateB
Inspection Line: 503.639.4175 BUILDING DIVI s0— A �I Date Ready/By: J
g W / f / See Attached Checklist for
Supplemental
Internet: www.ci.ti ard.or.u Notified/Method;�/ lnformation
D
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CAD
te. t,.,... ,.F ,; k; : o ili
TYP WORK � �. .;:; ..,-- 4 �: -. ��,:�:
�;. ._':• a � .�..�.t ��•,, .> _..�.�,...:: a. ... .,,, . .FA MILY ;DWE�LLI
,,,.,,� . _w. , „a .. _..._ ; .. ata ,...,,„ _” - ... ,,;��3_�.z -,._ - .. - -.:: IRD ��, _. .�
® New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and theprofit for the
,z., . �_.. - . '., ` ` " ' i ' work indicated on this application.
:. �.k�-GA CONSTRUCTION€ ' : ;r
❑ l - and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ® Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
" .. Total number
"' T of floors
V; <', �,,': JOB .SITEtINFORMATION:' ° A N D L OCAI O N` ' ii • • •
Job site address: 14(65' ' A.0 (U •i-J� New dwelling area: square feet
City /State /ZIP: 97224 l ttt��� --���' Garage /carport area: square feet
Suite/bldg. /apt. no.: BLDG B Project name: OAK TREE II APARTMENTS Covered porch area: square feet
Cross street/directions to job site: SW 108 Ave. & SW Durham Road Deck area: square feet
Other structure area: square feet
REQUIRED BATA COMMERG1iAL-USE GHECKLISe,
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S115AA 00700, 01000, 01100, 01200 Indicate the value (rounded to the nearest dollar) of all
�', ; :. - � ,:':- �;�`:_:: �_:.:) ,_ ,., .. • . ;".�.:•�., - ,.':.:" ; ;,.;::::a „ -, � and the profit for the
equipment, materials, labor, overhead, a e r
' ' '�' ;' "`' '` -'', ., '`" e' :DESCRIP,TION Or 'oRKc:.. ••. , ;' :''.. ?; : work indicated on this application.
,.N
; New construction . .w,.. Valuation: $1, l l 3 I v C 0
Existing 'building area: square feet
New building area: 26744 square feet
' ° Number of stories: 3
�PROPERTY,;OWNR'? N
Name: OT2 LLC • Type of construction: V -1 hour
Address: 5437 Rosalia Way, Suite 100 Occupancy groups:
City/State /ZIP: Lake Oswego, Oregon 97035 Existing:
Phone: (503)620 -4373 Fax: (503)620 -1243
New: RI
T CONTAGI=:- PERSON; F r u'i,_ e , , ,,,
..:`,' a ,. - ..,; ,, < >:? �. :. ,.' G;f -,' ,A::�::,i "•�' "ta �,r' - ',.
: .,, Vie :..�� �.,.. a.. ..,�,- ',c.,•,• . ,. - �.. ..,.. .,.. .,, ,. .,- �
R.
s,..4.. _ . ,,•�,., . .�, :.� t� F . _.a � x - s� � . a � " »'� ;»;'r.;� �,
Business name: Ossey Development Corporation All contractors and subcontractors are required to be
Contact name: Dick Ossey licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5437 Rosalia Way, Suite 100 jurisdiction in which work is being performed. If the
City/State /ZIP: Lake Oswego, Oregon 97035 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 620 -4373 Fax: : (503) 620 -1243
E -mail: richard.ossey @verizon.net
,��- �.x��=. -gyp "„
P:' <; :GONTRA'GTORr; =f'•;0' :' :y`
',
Business name: Keyway Corp '' ?'' •; 4 U DING,.PERMIT FEE * S4g ''
Address: 7275 SW Hermoso Way
Please refer to fee schedule.
City /State /ZIP: 97223
Fees due upon application
Phone: (503) 684 -5100 Fax: (503) 684 -5500
Amount received
CCB lic.: 127522
/ Date received:
Authorized signature '/ This permit application expires if a permit is not obtained
\ \\ �� within 180 days after it has been accepted as complete.
Print name: Richard B. Os y lJata 9/24/04 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits \BUP- PermitApp doc 12/03 440- 4613T(I I /02 /COM /WEB)
t
RECEIVED
lgoV 2/.1 2004
• CITY OF TIGARD
COUNTYWIDE BUiLoINlG D+v+S1r)N
TRAFFIC IMPACT FEE
PAYMENT OPTION FORM
d scar (aeil
Scl�fie,
Date Site Address
•
_ f7 Ooe/CZ
Project Name Plan Check #
I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this
time. Therefore, I request the following (choose whichever option or options are
applicable):
n Cash or Check
•
O Credit Voucher
•
•
Bancroft or Installment Payments
• or •
a The Ordinance allows for deferral of payment of the TIF until issuance of the
occupancy permit if the TIF is greater than $5,000. If the TIF meets this
requirement, I also request this option. I understand the TIF must be paid prior to
issuance of an occupancy permit. I also understand that the TIF will be
•recalculated based on the prevailing rates at the time of payment. Please be
advised that TIF rates may increase up to six percent each July 1st. This rate
increase is not subject to appeal. •
/lam C
O ER/APPLICANT OWNER/APPLICANT
cc: Building Permit File
Payment Option Notebook
is \dsts\tif\TIF- PayOption.doc 03/28/02
/ /oiva�� I\
November 18, 2004 �..
CITY OF TIGARD
OREGON
Dick Ossey
Ossey Development Corporation
5437 Rosalia Way, Suite 100
Lake Oswego, OR 97035
RE: NEW APARTMENT, BUILDING B
Project Information
Building Permit: BUP2004 -00462 Occupancy Type: R1
Tenant Name: Oak Tree II Construction Type: V /1HR
Address: 16105 SW 108 Avenue Occupant Load: 114
Area: 26,744 Sq Ft Stories: 3
The plan review was performed under the State of Oregon Structural Specialty Code (OSSC)
1998 edition; and the Tualatin Valley Fire & Rescue Ordinance 99 -01 (TVFR99 -01) 1999
edition. The submitted plans are approved subject to the following conditions.
• The deferred submittals listed on sheet A1.0 may be charged a deferred submittal fee
based on the valuation of the portion of the work being deferred. The minimum fee
shall be $200.00.
Special Inspection: Special inspection is required for items listed on sheet S101.1. The
special inspection agency of record, shall furnish inspection reports to the Engineer of
Record, Conlee Engineers, Inc. the General Contractor, Keyway Corp and the City of
Tigard, Building Division, attention Hap Watkins. All discrepancies shall be brought to the
immediate attention of the general contractor for correction. The special inspector shall
submit a final signed report stating whether the work requiring special inspection was, to the
best of the inspector's knowledge, in conformance with the approved plans and specifications
and the applicable workmanship provisions of the code. 1701.3 OSSC
American with Disabilities Act (ADA): It shall be the responsibility of the Architect,
Engineer, Designer, Contractor, Owner and Lessee to research the applicability of the ADA
requirements for the structure. The City of Tigard reviews the plans and inspects the structure
only for compliance with Chapter 11 of the OSSC which may not include all of the
requirements of the ADA.
Approved Plans: 1 set of approved plans, bearing the City of Tigard approval stamp, shall
be maintained on the jobsite. The plans shall be available to the Building Division inspectors
throughout all phases of construction. 106.4.2 OSSC
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
Jun 01 05 09: OGa Hydro Tar�h OS , 360 256 2817 p.2
CI „.. .0 VP ZO cO .62_
WASHINGTON STATE FIRE MARSHAL'S OFFICE ABOVEGROUND SPRINKLER ADVISORY
PROTECT BOAR ION D
C ONTRACTORS MATERIAL & TEST REPORT FOR ABOVEGROUND PIPING HYDRO TECH FIRE flyC
P.O. BOX 40
BRUSH PRAIRIE, WA _ .. 98606
PROCEDURE _........ --._.
..._._.... _...
.. _ _ .. .........................._
Upon completion of work, Inspection and teats shall be made by the contractor's representative and witnessed by an owner'a representative. All defects
shall be corrected and System left In service before contractor's personnel finally leave the Job.
A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities. owners, and contractor. It Is under-
stood the owner's reprasentative'a signature In no way prejuticea any claim against contractor for faulty material, poor workmanship, or failure to comply
with approving authority's requirements or local ordinances.
PROPERTY NAME A / �l °� DATE
v A'tt I 1
t2 aV-1 'ti' n l C�0ir...Tj./ -*1 2 4 1 - 6 O`..
PROPERTY ADDRESS
16 cc3� Loa. • AVE t�o, tt i c G,Gtjt
ACCEPTED BY APPROVING AUTHORITIES (NAME)
- 3( enF -- CT 6 ..n
ADDRESS
•
INSTALLATION CONFORMS TO ACCEPTED PLANS YE NO
PLANS EQUIPMENT USED IS APPROVED BYES ❑ NO
IF NO, EXPLAIN DEVIATIONS
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION YES NO
OF CONTROL VALVE AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT?
IF NO, EXPLAIN
HAVE COPIES OF THE FOLLOWING SEEN LEFT ON THE PREMISES: YES NO
INSTRUCTIONS I. SYSTEM COMPONENTS INSTRUCTIONS F1 YES ❑ NO
2. CARE AND MAINTENANCE INSTRUCTIONS. =1 ES 0 N
3. NFPA 13A I.?: YES ❑ NO
LOCATION
OF SYSTEM SUPPLIES BUILDINGS 1(4: r J k) tJ L
G_ , U k L.j)f /06k
t YEAR OF ORIFICE - TEMPERATURE
MAKE MODEL MANUFACTURE I SIZE QUANTITY RATING
kilt Ltw1a" F F i S .i/ j Loc.:4 4 /2 7' j . 5'
SPRINKLERS
PIPE AND TYPE OF PIPE '; /QC
—
FITTINGS TYPE OF FITTINGS C Piss_ •
ALARM ALARM, DEVICE MAXIMUM TIME TO OPERATE –.
VALVE THROUGH TEST CONNECTION
OR FLOW TYPE MAKE I MODEL MIN SEC.
INDICATOR tC ;: f•„a> t : C.I-d i r�(Z„ \ ( =j;4_ ` .
DRY VALVE 0.0D.
MAKE 1 MODEL 1 SERIAL NO. MAKE MODEL SERIAL NO.
• TIME TO TRIP – • TIME WATER ALARM
DRY PIPE THRU TEST WATER MR TRIP POINT REACHED OPERATED
OPERATING CONNECTION PRESSURE PRESSURE AIR PRESSURE TEST OUTLET PROPERLY _
TEST MIN. SEC. PSI PSI PSI MIN. SEC. YES ' NO
WITHOUT _
O.O.D. .
WITH
1�)l 0.0.0. _
Y/ IF NO, EXPLAIN
• MEASURED FROM TIME INSPECTORS TEST CONNECTION IS OPENED
85A (OVER)
Jtn 01 05 08:06a H Tech 360 256 2817 p.3
•
•
• PERATION
❑PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC
DELUGE & PIPING SUPERVISED ■YES • NO DETECTING MEDIA SUPERVISED ■YES • ■
PRF.ACTION
IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING IF NO, EXPLAIN
DOES VALVE FROM THE MANUAL TRIP AND /OR REMOTE CONTROL STATIONS NO
YALVES
OYES (CF/E7
—
❑ YES ❑ NO
DOES EACH CIRCUIT OPERATE DOES EACH CIRC( MAXI MUM TIME TO
/1/44/X MAKE MODEL SUPERVISION LOSS ALARM OPERATE VALVE RELEASE
OPERATE RELEASE
TEST • Ott or s s nrr11 . med. at rot I. then 200 pd (1311 ban] 13( r hour/ or 60 W (3A bars} stow awls proawra In /spew of ISO
DESCRIPTION • - -a "' r"'p P• Iappora shat be 4,et upon a 1n last b Prawnl dame. An ato ogrpund pIpinII AmAnpo stall be
slapped pot
{102
• - ruin"; EioIMtoh 40 poi (2.7 boral air pronoun Ind msaauro drop .,Inch /h4( rot ereo.d I -112 pal 10.1 tan) In 24 lynx*. Test prasaurs tarn al rormal wont
....I and ak pronoun. end mae•ur. Mr proesure drop welch shall not sac..d 1 t(2 pal (0.1 bent In 24 hours.
" PI HYDROSTATICALLY TESTED AT 3 PSI FOR ,HRS. I IF NO, STATE REA ON
DRY PIPING PNEUMATICALLY TESTED/1/ YES ONO
EQUIPMENT OPERATES PROPERLY GIVES 0 N
• • YOU CERTIFY AS THE SPRINKLER SYSTEM CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM
SILICATE OR DERIVATIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TEST-
ING SYSTEMS OR STOPPING LEAKS? SZYES ❑ NO
TESTS DRAIN I READING OF GAGE LOCATED NEAR WATER ( RESIDUAL PRESSURE WITH VALV l ST
ST j SUPPLY TEST CONNECTION: PSI ( CONNECTION OPEN WIDE
UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO PSl
SPRINKLER PIPING.
RJRED BY COPY OF THE U FORM NO.855 OYES 0 NO OTHER
FLUSHED BY INSTALLER OF UNDER - EXP[ EXPLAIN
c ROUND SPRINKLER PIPING OYES ONO
BLANK TESTING NUMBER -USED LOCATIONS
GASKETS l"' NUMBER REMOVED
•EOPIPING L IYES - ONO
00 YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT PROCEDURES COMPLY
H THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3 0 YES 0 NO
a • YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN
WELDING COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3
AYES ONO
Al A ]/ A • • YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPUIWCE WITH A
/A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE
- RJEVED, THAT OPENINGS IN PIPING ARE SMOOTH. THAT SLAG AND OTHER
2 • ING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF
PIPING ARE NOT PENETRATED
OYES ❑ NO
CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL
Ni Ii (DISCS) . OUTS (DISCS) ARE RETRIEVED? DYES
❑ NO
FUNCTIONAL DOES AHJ REQUIRE A FUNCTIONAL FLOW TEST OF RESIDENTIAL SPRINKLERS?
FLOWTEST RE FUNCTIONAL FLOW TEST RESULTS SATISFACTORY? OYES 0 NO _
❑ YE5 []
HYUHAUUC NAME PLATE PROVIDED 1 NO
DATA NAMEPLATE IF NO, EXPLAIN
YES ONO
REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:
NAME OF SPRINKLER CONTRACTOR CONTRACTOR UCENSE #
-Ma� •r I tea: zZ 1 1-.z
TESTS WITNESSED BY
FOR PROP • NER (SIGNED) DATE
SIGNATURES ( TITLE
FO'.,e ! CONTRACTOR (SIG E • TITLE . .
- AP - 0V1 AUTHO 1114/1 '�5� TITLE f 0 E
I CERTIFY T THE INFO - , TION HEREIN IS TRUE AND THAT THIS SPRINKLER SYSTEM WAS INSTALLED IN ACCORD -
WITH RCW 15.160 AND THE RULES ADOPTED BY THE WASHINGTON ADMINISTRATIVE CODE AS ADMINISTERED BY
CERTIFICATION HE STATE FIRE MARSHAL
NAME OF CERTIFICATE OF C:WE IICtDER (PRINT CA TYPE)
ERTIFICATE REGISTRATION SJONATU CF CATIFI ATE OF COMPETENCY HOLDER
DATE
ACOITIQt.AL EXPI/WA(X3P1 ma NOTES
•SA BACJC
CITY OF`
BUILDING DIVISION PERMIT #: BUP2004 -00462
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2'1/2004
Phone: (503) 639- 4171 ��mulpi ti � l
Inspection Requests (24 Hrs.): (503) 639 -4175 ,' __
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 33
SITE ADDRESS: 16105 SW 108TH AVE BLDG B CLASS OF WORK:
SUBDIVISION: OAK TREE NO. 2 APARTMENTS LOT #: OOA TYPE OF USE:
PROJECT NAME: OAK TREE II APARTMENTS
DESCRIPTION: Building B - 24 units TIF Deferred
OWNER: OT2 LLC, PHONE #: 503- 620.4373
CONTRACTOR: KEYWAY CORP PHONE #: 503- 684-5100
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 018395 -01 503- 888 -2082 Y
/
Corrections /Comments /Instructions:
AIN
• 'I'
...- rovir-
, ,
, -.
L_ ASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL C FL CALL FOR IN . PECTION n ADDITIO, AL FE S ASSESSED
►`\ rr' ( ' Ins ector: , Date: Phone #: (503) 718 -