Permit 1h ..-
A
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CITY OF T I GA R D BUILDING PERMIT
PERMIT #: BUP1999 -00269
4 DEVELOPMENT SERVICES DATE ISSUED: 6/29/99
A, Ail
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171
SITE ADDRESS: 10220 SW GREENBURG RD 610 PARCEL: 1S135AB -01004
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR : 1,412 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
. OCCUPANCY LOAD: 12 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 11,000.00
Remarks: Demo existing walls and replace per plan. Electrical, Mechanical and Fire Sprinkler permits are required.
Owner: Contractor:
KNICKERBOCKER PROP, INC XXIV MALIBU PACIFIC
BY NORRIS, BEGGS + SIMPSON 735 NE JACKSON SCHOOL ROAD
10300 SW GREENBURG RD STE 200. HILLSBORO, OR 97124
P Phone ND, OR 97223 Phone: 693-9797
Reg #: LIC 059045
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT GEO 6/29/99 $86.50 99- 316489 Gyp Board Insp
Susp Ceilng Insp
PLCK GEO 6/29/99 $56.23 99- 316489 Final Inspection .
FIRE GEO 6/29/99 $34.60 99- 316489
5PCT GEO 6/29/99 $4.33 99- 316489 ORIGINAL
Total $181.66
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 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
,
Permitee
Signature: �.i
G,
Issued By: % / � % /„,,,`
6 C. 9393 -4175 by 7 p.m. for an inspection the next business day
— a,..0
CITY OF TIGARD Commercial Building Permit Application Rec'd BL
Y3125 SIN-HALL BLVD. Tenant Improvement
Date Rec'd el 7,2977
Date to P.E.
TIGARD, OR 97223 .* Date to DST et) 9 iyy v kC
(503) 639 -4171 Permit # teff i - (9 O
Print or Type Related SWR#
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Building J( New Building ❑
Job L i ncol n Ceviter
Address Street Address Suite Building 11
220 SW G►rbvr Data L I Cd h �W�'
(0
g Rd. GAO
Bldg # City /State Zip Existing Use of Building or Property:
L tt CoLN) Pore Kol O(- . 970.1 O CC i ce.
Name
Property Qrofevk ` es Inc, Proposed Use of Building or Property:
ty �
Owner Mailing Address Suite Y
O ('Ci ce
IO300 SW Greeniovrq P WO No. Of Stories:
City /State Zip Phone CG) SIX
flare O'-. 97223 452 -S9oo Sq. Ft
Occupant Name 1
Corm ; r,ed InsOran • Occupancy Class(es)
Name I P,
Contractor MSI i o y f ac;-f c Ty De(s) i � of Construction
Prior to permit Mailing Address Suite a- 1 P-
issuance, a copy ..„,,, this project have a Fire Suppression System?
of all licenses 735 Ne.jWi Oh Sck I M. Yes ' No ❑
are required if City /State Zip Phone
expired in C.O.T. I Americans with Disabilities Act (ADA)
database N I1SLoYo OP-, 9 7( 2 9 -- Ga93- 9797 Valuation X 25% = $ 2750 Participation
Oregon Cond. Cont. Board Lic.# Exp. Date Complete Accessibility Form
059045 2/ i g /oo Project $ o p
Name Valuation 11
Architect GIB Arckiic.cicr In c , Plans Required: See Matrix for number of sets to submit
Mailing Address r Suite on back
920 SW 3`4 A„ei 41-0oo
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
F ort{ A O� 972e� 221. o given is correct, that I am the owner or authorized agent of the owner, and
Engineer
Name I `� l that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent Date
Mailing Address • Suite 2 4 g,,11 0/29/99
Cor%tct Person Name Phone
City /State Zip Phone 1 II G`v r 22 I. -3 s
F014 OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition O Map/T,L# T Land Use.
n
Accessory Structure 0 Foundation Only 0 Alteratio ,� j `
Repair 0 Other 0
Notes as t
Description_ of work: - _ r t 3 � "
- re roveviev� a a m , :I. 3 M
f
i 4
._. :::,:', : . 3 , v. � - . Ste. . ' �'� 3t3 .z.y,Y, i , i.' @. b - � �. -.
Note: Site Work Permit Application must precede or accompany Building .
Permit Application
I: \COMNEWTI.DOC (DST) 5/98
\
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COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
9:04 :40.0 Ofmo:§010 0
signature dt
After plan revtew approval, PIan Examtner wdl contact the appitcant to equest
additional plan sets fcr thstnbithon purposes (Copy ftr Cantractr, City.,
Wathngtn County, Tualatin VaIey Fire & Rescue)
t Total # of
TYPE OF SUBMTTAL Plans •
KEY:
Subnitted
S (Private) 1 S = Site Work
B (New or Add) 1 B = Building
. .
F (New or Add or Alt) 3 F = Fire Protection System
M (New or Add or Alt) 1 M = Mechanical
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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
1111171§1§MAIP
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.....
NOTES:
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1: \dsts \ maxtrixl .doc 07/06/98
t _ 2L_
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Comb■ned In ran ce
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the
restroom, telephones and drinking fountains are readily accessible to individuals with
disabilities, unless such alterations are disproportionate to the overall alterations in
terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed
disproportionate to the overall alteration when the cost exceeds twenty-five percent
(25 %).
VALUATION of all renovation, alteration or modification being done
excluding painting, wallpapering. [1] $ 1 1 000.00
multiply: 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2] $ 2-
In choosing which accessible elements to provide under this section, priority shall be given to
those elements that will provide the greatest access. Elements shall be provided in the following
order:
(a) Parking (o-E re. i r ,hew curb co s, $ 2.,750. ov
sl&tewalk- s• v�a G ?hd accessible s*.,al►s,
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for
each sex or a single unisex restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and $
(g) When possible, additional accessible
elements such as storage and alarms: $
TOTAL: Shall equal line 2 of value computation $ 2 -, 750.
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OVER- THE - COUNTER (OTC) PERMIT
• COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: 2.94 (7 )J S Wet it/ e 1^.f&r 4(
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A _ P /..i . p )y)-e , ,./.„.„), 4- 1-J N A1-1 v P ! e r lc - ) 2
CLASS OF WORK: - FLOOR AREAS: / c-/ I L i EXTERIOR WALL CONSTRUCTION
TYPE OF USE: / /s- i FIRST SQ. FT. i N: S: E: W:
TYPE OF
CONSTR: I SECOND SQ. FT. � PROTECT OPENINGS ?:
OCCUPANCY GRP: 13 SQ. FT. N: S: E: W:
OCCUPANCY LOAD: ( i TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
STOR:_ HT: FT: BSMNT: SQ. FT. AREA SEP. RATED:
BSMNT?: MEZZ ?: GARAGE: SQ. FT. OCCU.SEP.RATED:
FIRE / FIRE SMOKE HANDICAP
SPRINKLER: ALARM: DETECTOR: ACCESS: '-
COMMERCIAL`INSPEGTION ACTIONS .: FEE.MENU
Foot/Found Post/Beam $ d Permit Fee
Masonry framing $ 5 b y3 Plan Review
Insulation Shear Wall $ ` � 5% State Surcharge
�O
Firewall //Gyp Board $ 3 4 FLS Plan Review
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�.7
- Suspended Ceiling Sprinkler Rough -in $ Add'l Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS Pln
Smoke Detector Approach /Sidewalk $ Inspection
Miscellaneous -Final $ MIS Fee
` (7
? F.OR_OFFICE:USEONLY
j TYPE OS USE OPTIONS (COM commercial,> GMS commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMIT (NEW new Add- additi A_ LT= alteration, ACS - accessory ;FND foundation, _ .:
OTR other; DEM =demolition; REP FPS fire protection system, NOTE US OTR FOR'FENCE RETAINING
WALLS., DETACHED DECKS, SIGNS, AWNINGS, CA
I: \ovrcntr2.doc (DST) 4/97
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CITY OF TIGARD BUILDING INSPECTION DIVISION -
MST
24 -four Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 6 /� - 7 // �� 9' 210
Date Requested i °ZCA - 1AM PM B 1619q- 002,72 Location 10.22-0 //�� l J r Suite Cp / �� MEC
Contact Person ��� �°t Ph ( ''L/ 2_,q q PLM
Contractor Ph SWR
4 UILDIft. >.? T‘/Owner CO Yy J, }/% ELC
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Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Intj -P}g SGN
Slab / SI T
Post & Beam ,
v
Ext Sheath /Shear Aid M n^ S I / �.f l 1 f /( I^ ►^�
Int Sheath /Shear t
Framing �. (no en vy,I , �'I . ���`� ��)
Insulation r _ -
Drywall Nailing
Firewall
Fire�. few
Susp'd Ceiling
Roof
Misc.
ilirl
PAS FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �
Approach /Sidewalk Date 7 r 7 — Inspector iY lJ Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.