Permit • ` CIT VI
Y OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00249
�I�� DEVELOPMENT HO BMEN SERVICES 639 -4171 DATE ISSUED: 8/28/02
SITE ADDRESS: 12394 SW SCHOLLS FERRY RD PARCEL: 1 S1346C -00900
SUBDIVISION: PP1993 -058 ZONING: C -G
BLOCK: LOT: 003 JURISDICTION: TIG •
•
REISSUE: �y FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: . % / ' f 4 l - FIRST: sf N: S: E: W:
TYPE OF USE: COM '-/ SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N : sf N: S: E: W:
OCCUPANCY GRP: H4 TOTAL AREA: 0.00 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: $ 45,000.00
Remarks: TI attaching wireless communication antennas to comm. bldg.
Owner: Contractor:
THOMPSON, DENNIS C AND SITE TECH
DAVIDSON, WILLIAM G 15875 SE 114 AVE. STE C •
12475 SW MAIN ST CLACKAMAS, OR 97015
TI onD % 22392 Phone: 503 - 650 -7377
Reg #: LIC 102415
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required Final Inspection
PLCK CTR 6/21/02 $281.65 27200200000 Foot/Found Insp
Foot/Found Insp
FIRE CTR 6/21/02 $173.32 27200200000 Struc Steel Insp
PRMT CTR 8/28/02 $433.30 27200200000 Masonry Insp
5PCT CTR 8/28/02 $34.66 27200200000 Masonry Insp
Masonry Insp
Total $922.93 Structural welding final reps
High strength bolts final rer
Lic.fabricated steel final rpt
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 -6699 or 1- 800 - 332 -2344.
Pe rm ittee _
Signature: % /.------
Issued By: : _ (L;
Call 639 -4175 by 7 p.m. for an inspection the next business day
�F TTAC OIL ,t C ONT/ - T r N poQ iod
', eye as h b�
/�c� ` B u i lding Permit Application
. ii.. Date received: G -a i - U �- Permit no • 0 _ .., _ Ociatfil %
,1,:Illi City of Tigard
_.. Project/appl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, d20,#t '��' 3
Phone: (503) 639 -4171 .1U1 Date issued: By:. (' Receipt no.:
Fax: (503) 598 -1960 i. l 1 Y ij2 ilia i) Case file no.: Payment type:
o ()f , Land use approval: Yt� 1 &2 family: Simple Complex:
❑ 1 & 2 family dwelling or accessory .;ommercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
ArAdditio `1 teration/rep)acement f'Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION 4-
- Job address: /,2 3 9 ( St..) Sc (^ v / j f"C r r 01. Bldg. no.: Suite no.:
Lot: I Block: 'Subdivision: 7 /4 I Tax map /tax lot/account no.: /'S 3 f[ ,gC goo
Project name: 6-/1FENWoi /✓d I GF577F r✓1 �r,,er .- LiSS
Description and location of work on premises/special conditions: -
O1%NElt I ()It SPECIAL INFOR11A I ION, I SE CIIE(7■LIST
Name: n,8-../ Ste+ - 1)6 vi ds - L L c_
(Floodplain, septic capacity, solar, etc.)
Mailing address: ■9 Q S er - < e G ; / 1 & 2 family dweng:
City: 7-,.h f� ,,a S lli
State: c t. I ZIP:Q 7 d 3 Valuation of work $
Phone: I Fax: I E -mail: No. of bedrooms/baths ,4
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
Garage /carport area (sq. ft.)
Name: `f D / ee lye a,m w; P t es S Covered porch area (sq. ft.
Mailing address: /SD NE -7 vi /1'6 Al S30 Deck area (sq. ft.)
City: /Ja y I State . I ZIP:q 7.2 3 2 Other structure area (sq. ft.)
Phone: , 7 •61D . ) al p. ax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ '5, COO
Existing bldg. area (sq. ft.)
Business name:5are" T/ New bldg. area (sq. ft.) r
Address: ( S 5 - t, l LI r�l- AV6
y�LA-Lc.44,1.,05. I � �� 3 Number of stories
Cit State ZIP: `l (9 {
Phone:(p5z, ^�f r77 Fax:(,$?. - 737$E- mailer .(7(24v' L� ,L Type of construction
CCB no.: I b G/ j - /U - �/ -OY 1.- T'i'3t • ; cupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: ♦ G vv fr a ✓c� NS D L �e , L provisions of ORS 701 and may be required to be licensed in the
Address: j q q I 0 $ c (�) c.:1 r jurisdiction where work is being performed. If the applicant is
City: - h� State• I ZIP: ! �' p S S exempt from licensing, the following reason applies: \
Contact person: D i rt t,,.) V e r S Plan no.:
Phone4D3_ " -24 58 - Fax :5D3 - 22 - - ail:
Name: Contact person: Fees due upon application -- $
Address: Date received:
City: 'State: IZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied ith, whe a specified herein or not Credit card number: / /
n Expires
' Authorized signatur x'!'10, --- Date: 4A-11,2 Name of cardholder as shown on credit card
$
Print name: q • >a ,, ! -r, A yir Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6V00/COM)
P l-,21 X - EV . DZ/•to5 y
FL's 1 73, 31_ .J
Commercial Plan Submittal
. X11 Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Lin (503) 639 -4171 MST Odd
BUP (4-
Received Date Req ested 2 d AM PM BUP
Location RA/ Suite MEC
Contact Person Ph ( p ) 3 4 0- / r'o 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner �""� -e ELC
Footing 11 ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection e �: -- s , / SIT
Post & Beam V
Shear Anchors /�
Ext Sheath/Shear L��/
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
l - PART FAIL
PLUMBING
Post & Beam
Under Stab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA /42 AA / Ext
Approach/Sidewalk Date V� Inspector �t�
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING' Inspection Line: (503) 639 - 4175
INSPECTION DIVISION - - • ' Business Line: (503) 639 -4171 MST
BUP - 00.2 Z 9
Received Date Requested ////e AM PM BUP
Location ) ? � � MEC
Contact Person ( Ph ( ) -3 4 // - /(o V PLM
Contractor _ Ph ( ) SWR
AQiL
BUILDING Tenant/Owner , L 1 S j i ELC
ooti
oundatio Access: ELC
Ftg Drain ELR
Crawl Drain .
Slab Inspection Notes: itc.rilf _ SIT
Post & Beam Anchrs
Ext Sr Sh ea t h / ear /02, ` 3o .,
Ext eah/h
Int Sheath/Shear
Framing
Insulation .2 - / � 1 i,//� e- Td4s'
Drywall Nailing
Firewall
Fire Sprinkler / i 1
Fire Alarm � 6 Ts - /j/076:, Roof Ceiling all' /� Roof ,'f. e./ 4 S ,�' -- ' I
Other:
Final
� S PART FAIL
e"
PLUMBING i� , /
�� - i�'�'� S 4i `/ A 06
Post & Beam �� " - ' � e �7311:1 / l� s�-Z
Under Slab // r
Rough -In J
Water Service A,/ e' ..„ �f
Sanitary Sewer /
Rain Drains
Catch Basin / Manhole
Storm Drain �`�� - – % L' �� v Ud iGr
Shower Pan 4' /_ A7bc.11(....,. 4
Other: �'�°
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 0 Reinspection fee of $ required befor= spection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call fo reinspection RE: - 0 Unable to inspect — no access
Fire Supply Line / "Ir ,.
ADA
Date/ v
Approach/Sidewalk _ Inspect i Ext
Other:
Final . D • NOT REMOVE this in - i e . on record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
ns Inspection Line: (503
BUILDING P ) 639 -4175 ''ffST
INSPECTION DIVISION Business Line: (503) 639 -4171 e"?
Received / q
-BUP v� 7
Received Date Request-d /6A AM PM ,y BUP
/
Location 3 • "• :uite MEC
Contact Person Ph ( , ) (' / 6 q7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing V �� ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
4.407 111!
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain 2? // , . ` � 0 /7
Shower Pan CN
Other:
Final �v r� � Z Al C) / O -� /�l'N ti/
PASS PART FAIL
MECHANICAL / S /25,e///2 ( 5.)
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA / /1
Approach/Sidewalk / lk Date d Z/ o -1 - --- Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIOAFtD 24 -Hour .
BUILDING c Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST � ./
• 'BUP � — , ( 7
Received Date Reques ed 30 AM PM i BUP
Location / Z 3? FaAA8, Suite MEC
to Person 43 - 1�
Contact erson Ph ( ) PLM �/ Y7
Contractor Ph ( ) SWR
t: UILDIN , Tenant/Owner ¢ PLC
....._ ELC
F oundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: , SIT
Post & Beam 00
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: ,
`® PART FAIL / !
BING r
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA > �
Approach/Sidewalk Date d ` — lespec Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL