Permit CITY OF T I G A R D BUILDING PERMIT
PERMIT #: BUP2000 -00004
�1 DEVELOPMENT SERVICES DATE ISSUED: 1/6/00
All 13125 SW Hall Blvd., Tigard, OR 97223 (503) OW,
SITE ADDRESS: 12442 SW SCHOLLS FERRY R 206 � PARCEL: 1S134BC-00401
SUBDIVISION: a ZONING: C -N
BLOCK: : LOT:. • 1 URISDICTION: 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: 5N : 1.500 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 15 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:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
• VALUE: $ 40,000.00
Remarks: Commercial TI. Separate electrical, plumbing and mechanical permits are required.
Owner: Contractor:
SISTERS OF PROVIDENCE IN OR IN LINE COMMERCIAL CONSTRUCTIO
BY STEVE FOSTER PO BOX 5837
POOR BOX 13993 ALOHA, OR 97006
P Phone ND, OR 97213 Phone: 642 -5117
Reg #: LIC 51880
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT DEB 1/6/00 $364.00 00- 320954 Gyp Board Insp
5PCT DEB 1/6/00 $29.12 00- 320954 Susp Final Inspection
PLCK DEB 1/6/00 $236.60 00- 320954
FIRE DEB 1/6/00 $145.60 00- 320954
Total $775.32
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 . uestions to OUNC by calling (503) 246 -1987.
•
Permitee
Sign. I re: l ,: / ./:_ t%././
Is ued BY: ` / j �!:d i ' /
Call 639 -4175 .y 7 p.m. for an inspection the next business day
�, � � a n Che ��C
CITY OF TIGARD Commercial Building Perm A pp li ca ti on Pl
13125 SW HALL BLVD. Tenant Improvement Rec'd By
OR 97223 Date Rec'd
'P 3ARb, Date to P.E.
(503) 639 -4171 Date to DST / .1l f1
Print or Type Permit # kkaar2 -tVt00
Related SWR #
Incomplete or illegible applications will not be accepted Called ---
Name of Development/Project Existing Building New Building ❑
Job
r S tree t Address Suite , Building
Address •
12442S115' = Data
Bldg # City/State Zip Existing Use of Building or Property:
l(G�
J f/ �� �� Proposed Use.of Building or Property:
Property v� d 0 , 1Tv , SN
Owner Mailing Address Suite
i - -- 'D // �� • • 39.? 5 No. Of Stories: L
C'ty/State Zip Phone •
r 7-O O/Z9 Sq. Ft. Of Project: { A so (, 4
Occupant
Nam
V w Utiockitrt5 Ch I s T E0 4 ( 00 Occupancy Class(es)
Name �+
Contractor __LA CM_ Q, ayme,Kici ( Type(s) of Construction
Prior to permit Mailing dress Suite
issuance, a copy Will this project ' ay. a Fire Suppression System?
of all licenses �� �� Yes E NO ❑
are required if City/State Zip Phone
expired in C.O.T. IA Z ��� Ameri with +isa:llities Act (AD
1 k� � ? Valuation X 25% _ $/7� �y Participation 14
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
6 / e -0 ? Project $ '/0 QO O
Name Valuation
Architect sha .As v i ,�
. ' 3aC Plans Required: See Matrix for number of sets to submit
Mailing Address Suite g--- on back
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
2 37— 7377 given is correct, that I am the owner or authorized agent of the owner, and
that plans submitted . re in compliance with Oregon State Laws.
Engineer Name
n , re of = /Agent Date , I /� //
Mailing Atl' dress Suite Q �,A O P i ( O �`` 0 6
' C •ct Person Name Phone -7
City/State Zip Phone i- ` in �,1 CO 4 L — 1 z
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:
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 dependent upon submittal of 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 Valle Fire & Rescue
Total # of
TYPE OF SUBMITTAL Plans KEY:
Submitted
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
*BorB &M(Alt) 1
*B &M &P(Alt) 3
*B &M &P &E(Alt) 3
*B &M &P &E &F(AIt) 3
NOTES:
*Shaded areas designate ALT.submittalsonly. _
I:\dsts \formsMatrxcom.doc 12/1/99
OVER - THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL (STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT:
CLASS OF WORK: 1-+C,7 FLOOR AREAS: I �a EXTERIOR WALL CONSTRUCTION
TYPE OF 1.15 FIRST SQ. FT. N: S: E: W:
TYPE OF
CONSTR: SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: 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 INSPECTION ACTIONS FEE MENU
Foot/Found Post/Beam $ Permit Fee
Masonry ramin $ 2o6° Plan Review
Insulation Shear Wall $ IZ 8% State Surcharge
Firewall yp Boar l r $ 14 " � FLS Plan Rev
esp-nded Ceilint Sprinkler Rough -in 11 $ Add'I Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS Pln
Smoke Detector Approach /Sidewalk $ Inspection
Miscellaneous Final $ MIS Fee
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 -
2/16/00 Activities for Case #: BUP2000 -00004
3:08:30 PM •
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPC005 Application received No Hold DEB 1/6/00
BUPC005 Application received 1/6/00 DEB DONE No Hold DEB 1/6/00
BUPC008 Permit created 1/6/00 DEB DONE No Hold DEB 1/6/00
BUPCO24 Plans checked /approved by PE 1/6/00 RDP APPR No Hold DEB 1/6/00
BUPC762 Susp Ceilng Insp 1/6/00 1/6/00 2/2/00 RB FAIL No Hold AKJ 2/2/00 a) elec cover app req before tile
placement
• b) supp lighting fixtures at both
• ends
c) rivots missed req at 4' ctrs
do not place tile in system
before app and remove all tile
to view lateral braces and supp
• of t grid
BUPC760 Gyp Board Insp 1/6/00 1/6/00 1/20/00 RB PASS No Hold AKJ 1/20/00 all rooms
BUPC740 Framing Insp 1/6/00 1/6/00 1/13/00 RB PART No Hold AKJ 1/13/00 1) brace walls at 8' intervals
2) protect column within 1 hr
corridor
3) firestop corridor at ceiling
level rock wool ok tightly fitted
BUPC799 Final Inspection 2/9/00 RB PASS No Hold AKJ 2/9/00
BUPC100 (F) Issue permit 1/6/00 DEB DONE No Hold DEB 1/6/00
BUPC758 Firewall Insp 1/20/00 1/20/00 1/20/00 RB PASS No Hold AKJ 1/20/00 corridor
BUPC762 Susp Ceilng Insp 2/6/00 2/6/00 2/4/00 RB PASS No Hold AKJ 2/6/00
BUPA990 (F) Issue Cert. of Occupancy 2/9/00 RB DONE No Hold ST 2/16/00 2/16/00- mailed to
onwer/tenant/TVFD/file
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Date Requested I AM P_M__ x ZCW - COO 130
Location i 2ip-o, ,s( S ( titq- Suit j 4 0917050-03:,/0 0
Contact Person 61V-at Ph g iq / Z2( PLM
Contractor Ph SWR
ILDI '1 Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: fry
Slab Q - ' �IJC � ,�{� SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire all
ire rinkler
Fire Alarm ,
Susp'd Ceiling
Roof
Misc:
Sap PART FAIL I
BING A
Post & Beam
r ' ►
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
IldECHANICb
Post & Beam
Rough In •
Gas Line
S ke Dampers
in
A PART FAIL
CTRICAL
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 �/q 66 Inspector ' Cam+ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.