Permit — FUR c
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00186
A-4 DEVELOPMENT SERVICES DATE ISSUED: 6/13/03
I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10865 SW WALNUT ST PARCEL: 2S103AA -00101
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: 3,100 sf N: NR S: NR E: NR W: NR
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: N S: N E: N W: N
OCCUPANCY GRP: El TOTAL AREA: 3,100 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 200 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 25 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: $ 306,590.00
Remarks: Addition of 3,100 sq foot play structure and interior tenant improvements.
Owner: Contractor:
SCHOOL DISTRICT NO 23 J OBRIEN CONSTRUCTION LLC
13137 SW PACIFIC HWY 1631 SW JEFFERSON STREET
TIGARD, OR 97223 PORTLAND, OR 97201
Phone:
Phone: 226 -6950
Reg #: 503- 241 - 2$5105
FEES REQUIRED INSPECTIONS
Description Date Amount Erosion Control Insp 846 -8 Structural welding final rept
[BUPPLN] Pln Rv 4/22/03 $1,006.69 Sprinkler Permit Required High strength bolts final ref
[FLS] FLS Pln Rv 4/22/03 $619.50 Foot/Found Insp Appr /sdwlk Insp
Struc Steel Insp Final Inspection
[BUILD] Permit Fee 6/13/03 $1,548.75 Reinf Steel Insp
[TAX] 8% State Tax 6/13/03 $123.90 Slab lnsp
(additional fees not listed here) Framing lnsp
Roof nailng Insp
Total $3,683.64 Reinforced concrete final re
Bolts in concrete final repot
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: / /W /O / ���. i .._ _
Permittee ,f/
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
( v 4 ''` ' BUILDING PERMIT
CITY TIGARD PERMIT #: BUP2003 -00186
j y DEVELOPMENT SERVICES DATE ISSUED: 6/13/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103AA -00101
SITE ADDRESS: 10865 SW WALNUT ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: 3,100 sf N: NR S: NR E: NR W: NR
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: N S: N E: N W: N
OCCUPANCY GRP: El TOTAL AREA: 3,100 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 200 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 25 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: $ 306,590.00
Remarks: Addition of 3,100 sq foot play structure and interior tenant improvements.
Owner: Contractor:
SCHOOL DISTRICT NO 23 J OBRIEN CONSTRUCTION LLC
13137 SW PACIFIC HWY 1631 SW JEFFERSON STREET
TIGARD, OR 97223 PORTLAND, OR 97201
Phone:
Phone: 226 -6950
Reg #: 5113- 241 - 2855105
FEES REQUIRED INSPECTIONS
Description Date • Amount Erosion Control Insp 846 -8 Structural welding final reps
[BUPPLN] Pin Rv 4/22/03 $1,006.69 Sprinkler Permit Required High strength bolts final rer
Foot/Found Insp Appr /sdwlk Insp
[FLS] FLS Pln Rv 4/22/03 $619.50
Struc Steel Insp Final Inspection
[BUILD] Permit Fee 6/13/03 $1,548.75 Reinf Steel Insp
[TAX] 8% State Tax 6/13/03 $123.90 Slab Insp
(additional fees not listed here) Framing Insp
Roof naiing Insp
Total $3,483.64 Reinforced concrete final re
Bolts in concrete final repot
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (50 9 or 1- 800 - 332 -2344.
Issued y: ?bJ ..Q- E.LOt,vzk_&&.,,
Pe mi ittee
Signature:
/ Call 639 -4175 by 7 p.m. for an ins; • ction the next business day
JW" $ " WALA. '
OFFICE USE ONLY
Buirtling Permit Application Received ,/ FOR Building
. L v J , y: , , . Date/By: 7 , D� Permit No.:ekibi ;0— (g
City of Tigard Planning Approval Other
Date/By Permit No..
13125 SW Hall Blvd. i , s r "'' Plan Review Other
Tigard, Oregon 97223 „. • f Date /By: Permit No :
� ■ y.i ' • : ,, /p { P - Review Land Use
Phone: 503-639-4171 Fa :. 4 8- �9CO,, i � 6T 22-• A' 41 �'li� 0 '
Internet: www.ci.ti ard.or:tis''` °' ”` •r _ Date/By Case No.
g Contact �J�s.: See age 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method " Supplemental Information
TYPE OF WORK REQUIRED DATA: eC'-
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING o
Addition/a1teration/rep1acement III Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed Indicate 0.
❑ 1 & 2- Family dwelling EgCornmercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, LP
overhead and profit for the work indicated on this application
❑ Accessory Building ❑ Multi - Family
El Master Builder El Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: to 64,5 94 woa... t t WOW Total number of floors..
t ...... ...... ... l
New dwelling area (sq. ft )
Suite #: t`►h Bldg. /Apt. #: 13A. Garage /carport area (sq. ft.)..
Project Name: Fb$JI.(y2 riS •'0 Md12CL. Covered porch area (sq. ft.)
Cross street/Directions to job site: C;Ct W ii, Deck area (sq. ft.) C
WP /4 f C,16155 StiRf.1T lS Other structure area (sq. ft.)
'T'tt vi.m 4Np REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: I Lot #: lot
Tax map /parcel #: 2.S 10 3 AA Note Permit fees* are based on the total value of the work performed. Indicate A
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, matenals, labor, ti
KLJ STOLL• + C. � t� ST, vIr1. overhead and profit for the work indicated on this application., 59d r ,
t Ij# #4. epigge Lets i E- � Valuation $ °
ECi �N � tet Avant' 0.;f‘c Existing building area (sq. ft.1 N AAVMA,,_g_i_b_MIt C
New building area (sq. ft) .t 't.S1Y ITJ VCIO F L)
I Mt}}. IWO JA' L Kt(t.S ctis Number of stories
'® PROPERTY � WNER 1 ❑ TENANT Type of construction v }J IWO)
Name: 116 4n •'WM•44 - CM Su4obL 1015C Occupancy group(s): Existing: el
New: El
Address: 611,0 S4) 5ANn 6*%4 Cr.
i
City /State /Zip: - 'tvAie. 7 D.. 4"7223
Phone: Soy - 45 t Loa 4 I Fax: (Alt.. 404'7 NOTICE: All contractors and subcontractors are required to be
❑ APPLICANT la CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: Vut.L othoN 1)fict$ AtabvitcAS jurisdiction where work is being performed. If the applicant is exempt
Contact Name: 1 J7S44 AAA, from licensing, the following reason applies:
Address: Sl 5W Wp64k9.4.1b0 46 Zoo
City /State /Zip: eigt'f'L.PMa DK. g 7Zo14
Phone: SO- 22b -69 SD I Fax: SD3 •Z`17- et 11Z.
BUILDING PERMIT FEES*
E -mail:
i )1 J 0 _ dD . CAttt Please refer to fee schedule.
CONTRACTOR
Business Name: d2 //jy 0 e_el't.& 1 1 - 1 - C-- Fees due upon application $
Address:
City /State /Zip: Amount received $
Phone: Fax Date received:
4 ..._ CCB Lic. #: /5 / /O S � 2 -P y —
Authorized , . i( d Notice: This permit application expires if a permit is not obtained within
Signature: •it, v•1 Date: "l1 ZZ /0 3 180 days after it has been accepted as complete.
V M1h✓ A t
i tec1 j *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name) /0O(0. ee 9
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 4 / e 50
.
Commercial Plan Submittal
ma y, I I� Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site ork 4•.
(mustnclude location of all accessible parking) •
•
Plumbing - Site Utilities 2
•
•
N Building • 1*
1.• " "' Fire Prot ion 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
a ?LA AID E PO 1..�'
Site Address: eVV 5 , te/
Letter of Transmittal
Building Division
City of Tigard
DATE RECEIVED:
TO: F)C.A e [A 1,-(4._
DEPT: BUILDING DIVISION RECEIVED
MAY 2 9 1003
FROM: �Cl.) CITY OF TIGARD
COMPANY: DO [(_ e)( c _M ., ) .P
,eii`re S BUILDING DIVISION
e�
PHONE NO.: '7 ®�j tit° 4C 5-0 By:
RE: lu e 1 O 3 ` °oCb&
(Case number, site address, etc.)
1 10 Ai 4J
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: I Description: Copies: Description:
Additional set(s) of plans. /4.) Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. 1 Engineer's calculations.
Other (explain): Or ,� 5
REMARKS: 33.4/ I
For Office Use Only:
Routed to Permit Technician: Date: Initials:
Fees Due: $ Date: Initials:
Reprint Permit (per Plans Examiner): Yes: No:
Notified Applicant: I Date: I Initials:
i:dsts\forms\LetterTransmittal.doc 02/15/02
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business tine: (503) 639 -4171 MST
3 BUP - aa 1?�
Received Date Request d AM PM BUP
Location 2 Suite MEC
Contact Person Ph ( /71 ) 5-q 3 ( PLM
Contractor Ph ( ) SWR
UILDI a, Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
.f
SS 'ART FAIL
: ING
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 fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE n Please call for reinspection RE: Unable to inspect - no, access
Fire Supply Line yyyyy�R,��
ADA Date 14/9/e /e Inspector YY� Ext
Approach/Sidewalk 11
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL