Permit CITY OF TIGARD
Vii, DEVELOPMENT SERVICES SEWER
F'CONIECONNECT ION
°' 1I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PE PERMIT T # SW R97 -0353
DATE ISSUED: 11/30/98
PARCEL: 15134DC -03000
SITE ADDRESS...:11130 SW TIGARD ST
SUBDIVISION - CHERRY HILL ACRE TRACTS ZONING: R -4.5
BLOCK LOT •001 JURISDICTION: TIG
TENANT NAME •TIGARD— TUALATIN SCHOOL
USA NO • FIXTURE UNITS...: 20
CLASS OF WORK...:ALT DWELLING UNITS..: 1
TYPE OF USE -CMS NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: To place a modular 2 classroom structure on a foundation.
Owner: FEES
TIGARD — TUALATIN SCHOOL DIST type amount by date recpt
13137 SW PACIFIC HWY PRMT $ 2300.00 JSD 11/30/98 98- 311132
TIGARD OR 97223 INSP $ 35.00 JSD 11/30/98 98- 311132
Phone #:
Contractor:
OWNER
Phone #: $ 2335.00 TOTAL
Reg #..
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from Sewer Inspect ion
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a °Tap and Side Sewer° Permit and the Agency will install a lateral.
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR
952- ' through OAR 952 - 0001-0880 You may obtain copies of
these rules or direct questions to Id!! by calling (503)246-1987. Arir
Issued by: �/ Permittee Signature: dr.
i.
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY b TIGARD Commercial Building Permit Recd By
Date
13125 Stfil HALL BLVD. Tenant Improvement Date o E.
TIGARD, OR 97223 Date to DST
(503) 6394171 Permit*
Print or Type Related SWR # Q7 03h3
Incomplete or illegible applications will not be accepted Called
Job Name of DemieOment/Proje /) �5 r r
l ( Vt (/ ✓ ti Existing Building ❑ New Building ❑
Address Street/�c�dre � Swte
Bldg # I II City/State Zip Building
Data
Property Name Existing Use of Building or Property:
Owner Mailing Address Suite
City/State Zip Phone Proposed Use of Building or Property:
Name
Occupant Mailing Address Suite No. Of Stories:
City/State Zip Phone Sq. Ft. Of Project:
Name Occupancy Class(es)
Contractor Mailing Address Suite
Type(s) of Construction
City/State Phone
Zip
(Prior to issuance Oregon Const. Cont. Board Lic.# Exp. Date Will this project have a Fire Suppression System?
a copy of all Yes No
licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if Project Valuation $
expired in COT Business Tax or Metro # Exp. Date
C.O.T data base)
Name Americans with Disabilities Act (ADA)
Architect Valuation X 25% = $ Participation
Mailing Address Suite Complete Accessibility Form
City/State Zip Phone Plans Required: See Matrix for number of sets to submit
on back of submittal requirement sheet
Engineer Name
I hereby acknowledge that I have read this application, that the information
Mailing Address Suite 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.
City /State Zip Phone
Signature of Owner /Agent Date
Indicate type of work: New 0 Addition 0 Demolition 0
Accessory Structure 0 Fou ndation Only 0 Alteration O Contact Person Name Phone
Repair 0 Other 0
Description of work:
FOR OFFICE USE ONLY
Map/TL# Land Use:
Notes:
TIF:
Parks: Estimated # of Employees
Note: Site Work Permit Application must precede or accompany Building ��JJ
Permit Appliction
I: \COMMAPP DOC (DST) 10/96 �� (fr3 / "`
PERMIT # ACCOUNT DESCRIPTION COT WACO AMOUNT AMT.PD.
d
Building Permit (BUILD) (UBUILD)
Plumbing Permit (PLUMB) (UPLUMB)
Mechanical Permit (MECH) (UMECH)
State Tax (TAX) (UTAX)
Bldg.
Plumb.
Mech.
Plan Check (BUPPLN) (UBUPPLN)
Bldg.
Plumb.
Mech.
Sewer Connection (SWUSA) (USWUSA) +p� 0 0 A00
Sewer Inspection (SWINSP) (USWINSP)
Parks Dev Charge (PKSDC) (UPKSDC)
CDC - Planning (CDCPLN) (UCDCPLN)
CDC - Building (CDCBLD) (UCDCBLD
Mass Transit TIF (TIF -MT) (UTIF - MT)
Commercial TIF (TIF -C) (UTIF - C)
Industrial TIF (TIF -I) (UTIF - I)
Institutional TIF (TIF -IS) (UTIF - IS)
Office TIF (TIF -O) (TIF - O)
Fire Life Safety (FLS) (UFLS)
Erosion Control Permit (ERPRMT) (UERPRMT)
Erosion Planck/USA (ERPLN) (UERPLN)
Erosion Planck/COT (EROSN) (UEROSN)
TOTAL:
2 a 23 19
I. \COMMAPP DOC (DST) 10/96
,k1A CIT -Or!TIGARD BUILDING INSPECTION DIVISION _ 06 � 7
24 -Ho r Inspection Line: 639 -4175 Business Line: 639 -4171 /,
kece-- uested "t /; P' 97 - OO (7
Date Requested �� � AM PM BLD
Location 1, l t 30 ` j t \ \ c,r'ok Suite MEC /�
Contact Person Ph % 2 - U0.)- 35
Contractor Ph SW 97 03C
Tenant/Owner ELC
Retaining Wall . 7► R 7 - C2 S
Footing Access:
Foundation I 1 � /L 6 0, C-( �l CADS rA S �- FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab 1 , 7 - Q 06 6
Post & Beam ��/
Ext Sheath /Shear
Int Sheath /Shear
Framing f `r ' L, dkd , '2i7i - 2-7 j '_
Drywall on \ C{ " A,6,.., Drywall Nailing � lit � � `� Q � g L�� Q,�J X •
Firewall J6
Fire Sprinkler
Fire Alarm > U4.,cZ c Susp'd Ceiling ¢zx
Roof
Mis
inal
PASS ' ..RT FAIL
Post & Beam N
Under Slab Od
Top Out �
✓ Water Service
� Sanitary Sewer 56, Rain Drains
oral
S 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
PAS PART FAIL
:ackfill/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
och ‘
� Ap � � ra
� Yo�,1 /Sidewalk f ; �, D ate /4/q '\ Inspector Ext
in - ln.J o-44,
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
Date: (4h9 b,�N.,A
N
anlje ( crG* 1 RD
\ ■ OREGON
Address Permit #
To Whom It May Concern: RESEARCH V A l r/3 - YV/l `
The permit listed above is currently inactive in our file and apparently went un- noticed,
either by never being inspected or it failed and was never re- checked by one of our
inspectors. Whether or not this be another attempt to make the required inspection, or the
first attempt, {or} creating a new permit, it is the responsibility of the owner to make the
necessary arrangements to obtain compliance and complete the inspection process.
Therefore, you are hereby advised to make these arrangements as early as possible, but no
later than 10- working days. I would be most please to assist you in any way that I can,
but you must contact me to do so. You may reach me at 639 -4171 ext. 319 between the
hours of 08:00 through 09:00 and at 3:00 through 4:00. If an emergency should arise you
may page me at 955 -5665 during the remaining hours.
Issue Date: ,/A /'i 7 Original Notice Date: - 7/1-1/ (See Inspection Card)
The following procedure shall apply: This is your -
VFirst Notice- Make the necessary arrangements as mentioned above; Call 639-4175 or
for work without a permit(s) call 639 -4171 Ext. 310 (Jeanne).
Second Notice- Without consideration to the contents of the first notice, a
re- nspection fee shall be assessed in the amount of $ , AND an investigation
616
fee shall be assessed in the amount of $ . The investigation fee shall be
100% of the permit fee. All fees shall be thereafter doubled.
TOTAL DUE: $
_ Third Notice- All fees mentioned above are payable before any inspection can be
made. If arrangements are not made within 10- working days from the day of this notice,
the City of Tigard Code Enforcement Agency will be notified and a Civil Infraction
notification will be delivered to the principles in ownership of the above noted address.
All prior fees shall be carried over and doubled and not withstanding any fees assessed by
the Civil Infraction Notice.
2 NOTICE: DUE $ (2) = TOTAL DUE $
It is with my deepest appreciation, that you help in any way that you can to bring closure
to this permit {or} lack of. If you wish to speak with me, please do not hesitate to call.
Thank you for your patience and pro attention regarding this matter.
Rick Bolen
City of Tigard Inspector II
• • Cud. OR 97223 (03) -4171 TDD (503) • : _
t. i.t J' �. ML A_ ______ - __ S ___ -• " _. ' .fM t ; R 3. �'q+F