Permit . ,
allti CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00312
- , � 1 � � DEVELOPMENT SERVICES P1 1 G I N A LATE ISSUED: 7/19/99
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 9-4 PARCEL: 2S102BA -01000
SITE ADDRESS: 09538 SW TIGARD ST
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. ZONING: I -P
BLOCK: LOT: 057 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: S2 TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 2 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: $ 4,000.00
Remarks: Adding mezzanine to existing commercial tenant space.
Owner: Contractor:
GREEN VALLEY DEV OWNER
10585 SW WALNUT
TIGARD, OR 97223
Phone: 503 - 816 -4737 Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PLCK GEO 7/19/99 $28.93 99- 316982 Final Inspection
FIRE GEO 7/19/99 $17.80 99- 316982
5PCT GEO 7/19/99 $3.12 99- 316982
MISC GEO 7/19/99 $44.50 99- 316982
(additional fees not listed here)
Total $138.85
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 r les or direct questions to OUNC by calling (503) 246 -1987.
Pe rm itee I /
Signature: ��r
1
Issued By: l,- � 1. a ,
Cal : 9-4175 by 7 p.m. for an inspection the next business day
A
CITY OF TIGARD Commercial Building Permit Application Plan Check#
13125 SW HALL BLVD. Tenant Improvement Recd By
TIGARD, OR 97223 Date Recd
(503) 6394171 Date to P.E.
61-1C Date to DST 7 it y Ili
Print or Type Permit #tuP /19
Related Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Develop nt/Project Existing Building] f New Building ❑
Job C ID-It? 4r) £ 9 " � l
Address Street Address S u i te Building
i StIO %4-47' Data
Idg # Ci State Zip Existing Use Building or Property:
pp /a( OA. f 7az3 rz,
Name
t1 ,e,o
• I ➢�� Proposed Use of wilding or Property:
Property Gieem/ V p
Owner Mailing Address ) Suite
Os� S4J 14//964 No. Of Stories:
-, City /State Zip Phone
1 am 0 i2 1hZ, 916-V732 Sq. Ft. Of Project:
ZZ
Occupant .. ?-21.9 Sf,
C /O , d / � & c Occupancy Class(es)
'Name 't' 2 ,
Contractor al V_ .4 G o Type(s) of Construction
Prior to permit Mailing Address Suite
issuance, a copy Will this project have a Fire Suppression System?
of all licenses / rj�/
are required if City /State Zip Phone YeS NO ID
expired in C.O.T. Americans with Disabilities Act (ADA)
database 7 4 , i J or C / 7 ,j 9-� Valuation X 25% = $ Participation
,O re n Const/Cont. Board Lic.# p. ate Complete Accessibility Form
Project
Name Valuation - ., () ~ , 010 , da
Architect Plans Required: See atrix for numbe 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
Engineer Name
that plans submitted are in compliance with Oregon State Laws.
S na , of er /Agent Date
Mailing Address Suite • l , / I S ' 1q
9
e -.` P ame Phone
T ,
City /State Zip Phone r t tawsJ
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 O Notes:
Description of work:
TIF:
Note: Site Work Permit Application must precede or accompany Building
Permit Application
1: \COMNEWTI.DOC (DST) 5/98
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Res:tiew)e.0ependent t4on submittal �f BOTH plans AND a:COMPLETEb .
application For aRioloatical syl*ittel, the appli4tiOn: must contain the
signature of 066t00.146 before plan will *00rittl
After Olen review appt*.af,Plansf:ierninet will conta the applicant to'requeet?:
additional plan sets fikOstribution•pun*es...:,(000. for Contractor, City. :.
Washington VeileyFitq
. . . .
: ..;
.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
3 •
• • • •
3 .-•
. • ••!;•.-:::. • : .
NOTES:
'*.iiaOirep •
I:\dstsforms\matrxcom.doc 10/30/98
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 per -cent (25 %).
VALUATION of all renovation, alteration or modification being done ,
excluding painting, wallpapering. [1 ] $ LI,
multiply: 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2] $ I ,OQ 0
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 $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for $ 2,000, CIO
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 $
i• \dsts \fortes \access doc
OVER - THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: 4DD/ilf , frk.-= =7-7.-,4n//NJ
CLASS OF WORK: 7 44..r' FLOOR AREAS: - EXTERIOR WALL CONSTRUCTION
TYPE OF USE: : FIRST SQ. FT. N: S: E: W:
TYPE OF
CONSTR: `'_ - SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: 5 ^ Z' 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 I
Foot/Found Post/Beam $ -i- Permit Fee
Masonry $ Zt 3 Plan Review
Insulation Shear Wall $ 3 z 7% State Surcharge
Firewall Gyp Board $ i I FLS Plan Review
Suspended Ceiling Sprinkler Rough -in $ 4G Add'l Permit Fee +o P �� _,
Sprinkler Final Fire Alarm $ Add'I FLS Pln
Smoke Detector Approach /Sidewalk $ Inspection
Miscellaneous Fi nal $ MIS Fee
)3S. el.
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)
hovrcntr2.doc (DST) 4/97
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 // Business Line: 639 -4171 BUP f 9Q! �oo 3
Date Requested to t/S/ AM PM BLD
Location - n5ciAd Suite Q MEC
Contact Person q5 3 fi-Q Ph (o ! ^ So g7 PLM
Contractor Ph SWR
UILDR Tenant/Owner -rb 6n ELC
Retaining all ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: c p
SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
(Framing)
Insulation
Drywall Nailing D (// v � C
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fi
PASS ART FAIL
cLU 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
Otheoach /Sidewalk Date (0 Inspector i■ ((G/// Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site