Permit . CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00457
X1 DEVELOPMENT SERVICES DATE ISSUED: 10/21/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102BA -01400
SITE ADDRESS: 09685 SW JOHNSON ST LAUNDRY
SUBDIVISION: ROON)3ARDVILLE ADDITION AMEND ZONING: R -12
BLOCK: LOT: 054 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP FIRST: sf N: S: E: W:
TYPE OF USE: MF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: U1 TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: $ 7,000.00
Remarks: Repair fire damage.
Owner: Contractor:
ROBIN BALL LAYS CONSTRUCTION CO
PO BOX 230251 7400 SE MILWAUKIE
TIGARD, OR 97281 PORTLAND, OR 97266
Phone: 503 - 620 -8450 Phone: 503 - 233 -4989 ORIGINAL
Reg #: LIC 4017
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT KJP 10/21/199. $96.25 99- 319235 Gyp Board Insp
Final Inspection
PLCK KJP 10/21/199 $62.56 99- 319235
5PCT KJP 10/21 /199. $7.70 99- 319235
FIRE KJP 10/21/199c, $38.50 99- 319235
Total $205.01
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.
Pemiitee 0
Signature: X r♦fit i V66
'
Issued By:
Call 639 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Application Plan Check#
13125 SW HALL BLVD. Tenant Improvement Recd By
I ' Date Recd
TIGARD, 41 71 97223 ,1 4_`�_ `,��,, , msµn" �0`'� Q e 551 �Y Date to P.E.
(503)' 639 -41 �� ! ,Gy /1„--r6,- Date to DST Gt Z- S
�� Print or Type \)i l 0 � 1 ' Permit # r) 0 ' 9 -bo y5 7
15 Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Building ❑ New Building ❑
Job 6=6 50 ,4QO J- 4+2k fl-P
Address Street Address Suite Building
9635` - .5,0J dWsa� S 7 I��,(.IN,Ow Data _
Bldg # City /State Zip Existing Use of Building or Property:
492 I 7 /tom o 97.2a3
Name
Property ,2o {3i BA L Proposed Use of Building or Property:
Owner Mailing Address Suite
PD 3,Ox ,230-23 No. Of Stories:
City /State Zip Phone
77,4¢0 q7 2e , la0 8 if5CU Sq. Ft. Of Project:
Occupant Name .
KM Occupancy Class(es)
Name
Contractor LA-y5 Gb/UST2 7 1O J co Type(s) of Construction
Prior to permit Mailing Address Suite
issuance, a copy /� Will this project have a Fire Suppression System?
of all licenses 1 `Y'c.X.J 54 Itata4Ivia£ Yes ❑ No ❑
are required if City /State Zip Phone
expired in C.O.T. Americans with Disabilities Act (ADA)
database PD/27L�►7'Jc.It�G `L7z44 .3.3-40/ Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
46/7 7/f Project $ ��,
Name 12 7 Valuation
Architect 47/1- Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
City /State Zip Phone I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and
that plans submitted are in compliance with Oregon State Laws.
Engineer Name
2,( -20 k3 v(, Signatur: o. Own o f Date 7
Mailing Address Suite �'� / (�r III F
I / 56 Os F L-eoii/ -, , o a Person Nam- Phone
City /State Zip Phone
ailkieeitaits q70 I S'
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition 0 Map/TL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 Notes:
Description of work:
f Cl /- • TIF:
Note: Site Work Permit Application must precede or accompany Building
Permit Application
I:\COMNEWTI.DOC (DST) 5/98 -
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is depen upon submittal us 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 &
Total
TYPE.OF SUBMITTAL 'Plans KEY:
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
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
*S or B & M (N0 111111 ... 1
8 & R1l & P ...... 3
B &M &P &E(AIt)
&M &I' &E &F(Alt) 3
NOTES:
*Shaded areas designate ALT s ubmittals iniy.
I: \dsts \forms\matrxcom.doc 10/30/98 - -