Permit A . CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2000 -00146
, r5�1��` DEVELOPMENT H B SERVICES 39 -4171 DATE ISSUED: 05/03/2000
SITE ADDRESS: 15899 SW QUEEN VICTORIA PL PUMP PARCEL: 2S110CC -14000
SUBDIVISION: IIK61IJTY NO. 5 ZONING:
BLOCK: LOT: 020 JURISDICTION: KIN
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: NEW FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : 256 sf N: S: E: W:
OCCUPANCY GRP: S2 TOTAL AREA: 256.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 1 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: $ 55,000.00
Remarks: Pump House. Electrical permit required.
Owner: Contractor:
KING CITY CIVIC ASSOC TUFF SHED STORAGE
15245 SW 116TH 6500 NE HALSEY ST
KING CITY, OR 97224 A pR p R 721
Phone: P Ph - o a N 50P288 9 883
Reg #: LAC 105914
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
PRMT GEO 05/03/200C $454.75 0001871 Foot/Found Insp
Framing Insp
PLCK KJP 05/03/200C $295.59 0001756 Final Inspection .
5PCT GEO 05/03/200C $36.38 0001871
FIRE KJP 05/03/200C $181.90 0001756 . ORL G N A L
Total $968.62
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. ,
Pe mi itee
Signature: L1A 7D
Issued By: � /
Call 639 -4175 by 7 p.m. for an inspection the next business day
,. . Plan Check*
-. 6i - Z
CITY OP TIGARD Commercial Building Permit Application
13125 SW HALL BLVD. New Construction and Additions Recd By • — "o+i
TIGARD, OR . 97223 O " VOL
Date Recd /> /�
_ , Date to P.E.
(503) 639 -4171 Date to DST 47 I I rn PP
Print or Type Permit# 13..v/ 24a �t
Incomplete or illegible applications will not be accepted Related SWR#
Called
Name of Development/Project ' f
Job P /1"."-- Existing Building ❑ New Building Er
Address Street Address ) a Suite
16'.' / /V 614 Building
Bldg # Ci State ^ Zip Data
1 C '1A - '3 7 Z Existing Use of Building or Property:
Name
Property V/ x36 G)7 el v 6C, A sSoG, 6'01...r Ca-iw3f:
Owner Mailing Address 4.1 Suite Proposed Use of Building or Property:
. i* pf - 6 - sk) fib" 1 AMA .
City /State gZ¢ Phone
KING C 2 (03.7,(0666- No. Of Stories: 1
Occupant Name Sq. Ft. Of Project:
•.fie Occupancy C I 7s(es)
`✓
Contractor I U � Sto j2.t� I
Prior to permit Meiling A ress Suite Type(s) of Construction
copy issuance, a co / /
of all licenses ie
are required if City /State Zip Phone Will this project have a Fire Suppression System?
expired in C.O.T. p Yes ❑ No ❑
database } -! 723 � Americans with Disabilities Act (ADA)
Oregon Const. Cont. Board Lic.# Exp. Date
oG
D� 9 " // / cI/ Valuation X 25% = $
/ Complete Accessibility Form Participation
�
Name Project $
I
Architect 0 ---5-) vcO
Mailing Address i Suite
){� Plans Required: See Matrix for number of sets to submit
City/State Zip Phone on back
Engineer Name I hereby acknowledge that I have read this application, that the information
° RICA /Me ✓ W C "412.P given is correct, that I am the owner or authorized agent of the owner, and
Mailing Address Suite '�2 that plans submitted are in compliance with Oregon State Laws.
17 26" 6 p � Ave l/re Signature ofOwne /A Date
City/State Zip Phone _ 1 � �" 04 24/ 00
IY1JVcr71co1 80 ' C tact Person Phone �Q
Indicate type of work: New Addition 0 Demolition 0 37
Accessory Structure 0 Fo ndation Only 0 Alteration 0
Repair 0 Other 0 FOR OFFICE USE O LY
Description of work: Map/TL# Land Use:
C apt p4M41 J/Q r * r 7 E :
�`� Notes:
Parks: Estimated # of Employees TIF:
If the above figure Is not supplied at the time of application, the city will
calculate the fee based upon the number of parking spaces.
Note: Site Work Permit Application must precede or accompany Building � r r U p i V { e . 91
Permit Application
FL I • ()10
i:\dsts \forms \comnew.doc 5/10/99
I 'll 7. 141
OVER- THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL (STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: i
•
CLASS OF WORK: FLOOR AREAS: 25 Z4 9 EXTERIOR WALL CONSTRUCTION
TYPE OF USE: FIRST SQ. FT. N: S: E: W:
C„ /VI
TYPE OF
CONSTR: SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: 4 5"2 THIRD 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:
c4, e � rt w,ua
COMMERCIAL INSPECTION ACTIONS FEE MENU
7S
co ound Post/Beam $ Permit Fee
Masonry Amin $ Vie Plan Review
v
Insulation Shear Wall $?'` 8% State Surcharge
Firewall Gyp Board $ ! 81 FLS Plan Review
Suspended Ceiling Sprinkler Rough -in $ Add'I Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS PIn
Smoke Detector Approach /Sidewalk $ Inspection
Miscellaneous $ MIS Fee
1114 FOR OFFICE USE ONLY:
TYPE OS USE OPTIONS (COM= commercial; CMS= commercial 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 system, NOTE: USE OTR FOR FENCES, RETAINING
WALLS, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
I: \ovrcntr2.doc (DST) 9/99 -
. .
KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
® Phone: (503) 639-4082 • FAX (503) 639-3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: PU.,,,,, j l .L -,
located at: Sg S9 S Q - -' \I « i c PL
AU/1th i iitl
"--10' -ZO `� Representative
King City Re resentativ
I:'DSTS\XC[NST.DOC
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
(� BUP ZeX /moo
Date Requested 5 / - I/ 00 AM PM BLD
Location 15 99 QI A D.P.lrl IJ (60 VI ct�Suite MEC
Contact Person •D Y\ 1 Ph (p � CoS(05 PLM
Contractor Ph SWR
B1ILDIO Tenant/Owner ELC
Retaining Wall ELR
oot l ! Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: 1 rLrX� , 7 Post & Beam 'vI , I SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation r +
Drywall Nailing X.l'� —� 1 �� o
Fire Sprinkler Fire Sprinkler •
Fire Alarm
Susp'd Ceiling
Roof
Mi •
PART FAIL
PL I ' = ING
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
Other Date ct Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.