Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00161
4 : DEVELOPMENT SERVICES DATE ISSUED: 5/29/01
I �� 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 12058 SW WILDWOOD ST PARCEL: 2S110BA -06700
SUBDIVISION: SHADOW HILLS NO.2 ZONING: R -2
BLOCK: LOT: 050 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FIRST: 288 sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 288.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 10 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: $ 18,500.00
Remarks: Inground Pool 12X24
Owner: Contractor:
WILLIAM MAJORS POOL WORLD INC
12058 WILDWOOD STREET 4000 SW 114TH AVE
TIGARD, OR 97224 BEAVERTON, OR 97005
Phone: 503 - 968 -8285 Phone: 503 - 643 -7621
Reg #: LIC 141519
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Foundation Insp
PLCK CTR 5/8/01 $146.71 27200100000 Final Inspection
PRMT CTR 5/29/01 $225.70 27200100000
5PCT CTR 5/29/01 $18.06 27200100000
Total $390.47
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.
Pemiittee •/
Signature* . • s ! . , ,
Issued . , ,I . � A
Call 639 -4175 by 7 p.m. for an inspection the next business day
SlI‘/o(
'Building Permit Application
:a
Date received: — r—?) Permit no.: ! ,_ 00/ - DO 4,
7 , City of Tigard Pro'ect/appl.no.: Expire date:
Cityoj7igard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By:. Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type: l '\
Land use approval: l&2 family: Simple Complex: ‘,
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family liniew construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm 0 Other.
JOB SITE INFORMATION
Job address: j O 5 ,a c ./ 1 LQ„Joon 7'/6 4 gf) JtP i f12 Bldg. no.: Suite no.:
50 Lo 4J3lock: ' 5//i& w / c s '1/0 g_ I Tax map/tax lot/account no.: a S //Q fir9 - d670 0
Project name: , f ffr/W ci ffo $.J Peryt trio r0,),
Description and location of work on premises/special conditions:
OWNER . FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (,J I LL SAM /V► TO ( Floodplain ,septiccapacity,solar,etc.)
Mailing address: 17. 9 5g Se./ ,., I L D r../o O 1& 2 family dwelling:
City: 7/ / /1.n I State: JQ I ZIP: 9192 y Valuation of work $ I K, So D
Phone: 50 3 .- 6391l5 fFax: I E-mail: No. of bedrooms/baths
Owner's representative: Total number of floors
• Phone: Fax: E -mail: New dwelling area (sq. ft.)
- APPLICANT Garage/carport area (sq. ft.)
Name: 6-10460S 11' 1A 1 /rb 11.01 Covered porch area (sq. ft.)
Mailing address: cid s-,,,) / N ■ /- Deck area (sq. ft.)
City: 62,,gy 2 7J iV 'State: c g, I ZIP: Q 1ooj Other structure area (sq. ft.)
Phone: - 6y 16 i Fax: 6E41 16 E-mail: CommercialPndustrial/multi- family:
CONTRACTOR Valuation of work $ 12� Set J ...,,)
Existing bldg. area (sq. ft.)
Business name: r ooL,,,o/ZVy7 I'y C New bldg. area (sq. ft.)
Address: -4 -1 000 Sc.-) H '1 "h Number of stories
City: ; J/✓ State: oQ ZIP: 0 v Type of construction G in P w-
Phone: 50 j 4,43711i Fax: 6N 31/(2/ E-mail: Occupancy group(s): Existing:
CCB no.: (q / ." 1 9 New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCI I ITECTIDESI GNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
exempt from licensing, the following reason applies:
City: I State: I ZIP:
Contact person: Plan no.:
Phone: Fax: E-mail:
ENGINEER
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 a erodit cads. please call juisdiction for more information
attached checklist. All provisions of laws and ordinances governing this °visa Cl MasterCard
work will be complied wi whether specified herein or not. Ciodit card number: / /
Authorized signature: ( n�rv) Date: S"` Name / ' d/ Na of cardholder as �owo on credit a
$
Print name: 6-10X / • O S 6, MI,'y &W WI Cardholder signature t
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4444613 (6■0/LOM)
4 6'1 •
Date Rec'd:
CITY OF TIGARD Recd By< ..
COMMERCIAL TENANT IMPROVEMENT
APPLICATION /PLANS SUBMITTAL REQUIREMENTS
Applicants: Please complete APPLICANT
1. APPLICANT NAME: 6- IORo -o S fJfAln46/241 PHONE #: 5v3 - i3 76 V
2. SITE ADDRESS: /1-d a 5) .mil 1,/I�v.7/) FAX # ,Sv3 - 6N3 -6 ) - 2
9 SITE PLAN (Fully dimensional, drawn to scale, showing existing parking, accessible route
to building) labeled with:
❑ map & tax lot #, ❑ project name, ❑ site address, ❑ site number,
❑ zoning, ❑ applicant name, ❑. phone number.
A. North Arrow
B. Scale (any standard, architectural or engineering only)
C. Street Names
2. See the "Commerical Plan Submittal Requirement Matrix" for number of plans required
based on submittal type (no redlines or tapeons accepted).
SIZE REQUIREMENTS: 24" X 36" (ROLLED)
ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS
A. Floor plan(s)
B. Wall details
C. Reflective ceiling plan
D. Seismic bracing detail for suspended ceiling
E. Specifications & calculations
F. ADA barrier removal worksheet
G. Deposit - based on valuation of project
I:WstsVorms kcomtiaPP.doc 10/4/00
06/26/01 13:46 FAX 6038463641 UNIFIED SEWERAGE AGENCY a 001 /001
Re Number
Iti.)
cep Sensitive Area Pre - Screening Site Assessment
Unified Sewerage Agency
of Washington County -
Jurisdiction — 11 /li Date - 'd
Map & Tax Lot ZS 1 j l�l Owner s
Site Address lZp5 a 5t~ 1,c1i I _
� Contact Pit, I�ja td
Proposed Activity _ Address • VVV11 1. 1 - u a6
Phone _ 3 loLC3- 7,(
Y N NA Y N NA
• ❑ ❑ USA Composite r i- Stomnwa In ructure maps
Map # 51 QS ft
ri Locally adopted studies or maps r Other
Specify u Specify
Based on a review of the above information and the requirements of USA Design and
Construction Standards Resolution and Order 00-7: .
0 Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT
MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE
PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas
exist on the site or within 200 feet on adjacent properties, a Natural Resources
Assessment Report may also be required.
t\I Sensitive areas do not appear to exist on site or within 200' of the site. This pre-
screening site assessment does NOT eliminate the need to evaluate and protect
water quality sensitive areas if they are subsequently discovered on your _
property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS
REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A
STORMWATER CONNECTION PERMIT.
l__I • The proposed activity does not meet the definition of development. NO SITE
ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.
Comments:
11111Wil
Reviewed By: sarjog■■' Date: PITH
•
Returned to licmtt
Mail Fax Counter
Date -T .171 By ,■
X16'5
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• AQUA
MATI(
tO +u r.uu•I1
4, Exclusive Manic fict Manufacturer of the HYDRAMAT1C Hydraulic Swimming Pool Safety Cover
RE: ASTM F- 1346 -91 CERTIFICATION
To Whom It May Concern,
The pool cover fabric used by Aquamatic Cover Systems for all the safety
• ••. •
•
••..cover systems consists of a 16 oz. sq. yd. solid vinyl, including a polyester
...lubstrea =Jim reinforcing layer to enhance tear strength and prevent tear
• ...ptopagitlbh;
• •
•. : ••The maEgie4 used substantially exceeds ASTM requirements set forth for
• • • • •" safety ctyv�fs of the type manufactured and distributed by this company.
. • : "ASTM•f 3446 -91 requirements are as follows;
• •
:. The cover and fabric installed on the swimming pool filled to its normal water
'..level sliall•be capable of supporting the weight of 485 lbs. This total weight
. . • • • shall be composed of one 210 lb., one 225 lb., and one 50 lb. weight, each
distributed over a one square foot area and all three contained within a three
foot radius. The test weights shall be placed at the center of the cover system
(or at least 4 ft., but not to exceed 6 ft.) from the edge of the swimming pool.
The above test shall not cause damage to allow any of the test objects or the
persons to pass through the cover.
The Aquamatic Cover Systems have, in fact, been independently tested by
two testing agencies including Underwriters Laboratories to exceed the above
listed standard.
Sincerely,
Harry J. Last, BSME, MBA
President
dm:hjl
Corporate Offiiell• 200 Mayock Road, Gilroy, CA 95020 • 800- 2624044 • Fax 800 - 600-708
Branch Offices: Alhambra, CA • Sterling. VA • Houston ,TX
.
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May I1
408/247.4937 FAX 408/247 -7540 Cl)
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AUTOMATIC SWIMMING POOL COVER CERTIFICATION
ECS® File: #059T3030 -2 c
Date Tested: May 20, 1993
Date Reported: May 21, 1993 C7
Z
Specification: ASTM Designation: F 1346 -91 ...
CA
•••• F ,
• • Test'ed Unit: ]3 jUt -In, Under - Deck - Track, Automatic Swimming Pool Cover mb
••
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Source: 'M�iiiufacturer: AquaMalic Cover Systems Z
• •• •:.• 'Ad�Jress: 441 Aldo Avenue, Santa Clara, CA Q
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. . • • • •
• • •••• * LABORATORY ANALYSIS *
• •
• •• G, 4,
••• R1 t.14ENCe: Standard Performance Specification and Labeling Z
••• Requirements for Safety Covers for Swimming Pools, --
•••• Spas and Ilut Tubs (ASTM Designation: F 1346 -91). a e
• d
1. SCOPE w H
Requirements for safety per ASTM F 1346 -91. Z 0
2. As stated in referenced standard.
3. As stated in referenced standard.
4. CLASSIFICATIONS & MINIMUM CRITERIA
4,1 Power Safety Cover (PSC):
Provides a high level of safety for children under the age of five
by inhibiting their access to the water.
4.1.1 As stated in referenced standard.
•
S. MATERIALS AND MANUFACTURE
Test unit complies with the 5.1, 5.2 and 5.3 requirements.
•
, . ' i s TIC A ti G _ • OV r
(Page 2 of 4)
ECS® File: #05973030 -1
6. GENERAL REQUIREMENTS FOR SAFETY COVERS
6.1 Installation/Use of safety covers. Unit complies with requirement.
6.2 Label attached to the cover meets, and/or exceeds the general
requirements as required by the 8.5.1, 8.8, 8.8.1 and 8.8.2 guidelines.
...•
• b.3 .4grkings for safety covers. •
•� ,•d.�.4 Unit lists manufacturers name. Unit complies with guideline.
• • •:4K2 Unit lists date manufactured. Unit complies with,guideline.
• • ..6.k5 Manufacturer provides instructions to consumers to inspect the
• • . cover for premature wear in consumer packaging. Unit
• • • • • • • therefore complies.
• • . •••• 6.3.4 Label attached to unit meets the general requirements
described in 8.4.1, 8.7, 8.7.1, 8.7.2., 8.7.3, 8.8; 8.8.1 and 8.9.
Unit complies with guideline.
6.4. Fastening Mechanisms or Devices. Fastening devices remained in their
intended, secured positions when the test unit was subjected to the load
and perimeter deflection tests performed as called for under the 9.1
and 9.2 guidelines. Unit complies with all requirements.
6.5. Openings. No openings were allowed, when tested by the test method
described in 9.4. Test object did not gain access to the water, nor was
it subject to entrapment. Therefore, unit complies with this guideline.
6.6. Seams, ties or welds in the cover showed no signs of damage when •
tested by the methods described in 9.1, 9.2, 9.3 and 9.4. Unit met all
requirements under this guideline.
7. PERFORMANCE ethods described FOR
in ttliet9.1 SAFETY 2, 9.3 COVERS
Refer to Test 9.4 guidelines.
T• : W uu . •O CO F _R l
(Pg. 3 of 4)
ECS® File: #05973030.1
• S. MINIMUM LABEL REQUIREMENTS FOR ALL COVERS
Unit complies with requirements.
9. TEST METHODS FOR SAFETY COVERS
9.1 Static Load Test. Test Unit was subjected to 490 -lbs (composed
of one 150 -1b, one 160-lb and one 180 -lb weight) slightly
• • • exceeding load required per Standard. Test objects were
• • • • •applied at two different points (the center point of the cover,
; ;;; • ••'Mrid, between attachment points at a distance 'of 4.5 feet), and
• •" 'remained in each test position for a period of 5, minutes or
•
• • • ...water. Although, normal deflection was observed, no passage
. • •"
• • •.trough the cover was possible. Test Unit complies with
• •
• requirement.
•
• . • • 9.2; • • •Pgrimeter Deflection Test. Applied 50-lb weight at a distance
• • • • • • • . of four -and- one -half feet from side of pool. Applied 36.6 -lb.
"" ellipsoidal shaped test object. Test Unit did not allow the test
• ••••••
• object to pass through, gain access to, or- be subject to
entrapment between the cover and the side of the pool. Test
Unit complies with requirements.
9.3 Surface Drainage Test. Applied a 36.6-lb. distance so sh aped test
objec in a supine position, faceup, at
one -half feet parallel with edge of pool. An even water spray
was applied at a rate of 10 gallons per minute. After 3 minutes,
minimal water collection was observed around test object.
Continued applying water with no unsafe water pooling. After
30 minutes drain time, re- applied 36.6 -lb test object with no
unsafe amount of water pooling. Test Unit complies with
requirements.
9.4 Openings Test. Applied solid faced spherical test object with a
surface breadth of
o f the in. l t No allowable of Nsteadily, bservable. Test ,
surface pool.
Unit complies with requirements.
10. OPERATING CONTROLS, SAFE'T'Y COVERS
10.1 Unit complies with requirements.
AUTOMATIC _SWIMMING POOL COVER CERTIFICATION
(Pg. 4 of 4)
ECS. File: #059T3030 -1
10.2 Unit complies with requirements.
• 10.3 Unit complies with requirements.
10.4 Pool cover operating controls.
10.4.1 Controls comply with requirements. Unit complies with requirements.
.... •
• • • ...40.4.2 Unit complies with requirements. •
• .•.• •
• •
••••
•. ••
• • •
• •• •
• roll CLIJSI f4: •
• ▪ • • •. •
•
• Tcsted unliVikmel all requirements of this Standard. •
• • • • 'UNIT COMPLIES WITII ASTM F 1346 -91 REQUIREMENTS. •
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST _
24 -Hour Inspection Line: 639 - 4175 ; Business Line: 639 -4171 ,_,
/ p 4 � BUP 1 - 421 3 2 /- -- 00/6!
Date Requested �7 i AM PM BLD
Location /.? G W,l',F Suite MEC
Contact Person Ph 47 1 . 4-- - */ -63w PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Fou • a io l FPS 4) g II rain
Crawl Drain Inspection Notes: Q SGN
Slab I Y � / 1 VA ' . SIT
Post & Beam
Ext Sheath /Shear (
Int Sheath /Shear
Framing
04.,
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F.
PASS PART FAIL
BI NG
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 t
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
Approach/Sidewalk P
Other D Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY TIGARD BUILDING INSPECTION DIVISION
• MST
24 -Hour, Inspection Line: 639 -4175 Business Line: 639 -4171
BUP Su/ -- ao /c
Date Requested Z AM PM BLD
Location J 241 5 4,/ t dt,dut/d Suite MEC
Contact Person Ph CC( 3 7 C 2 / PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT •
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing .. C- . . G— — A' ;ter "
Insulation /
Drywall Nailing ,�, b e -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
isc P a
Final
SS PART
PLUMBING
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
Approach/Sidewalk
Other Date 7 26- Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION Ms s ,
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3P- AM PM BLD
Location • 1 -D'R il4) Phiti/ Suite MEC
Contact Person Ph <4O -'D /- c5g/ PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing % /L� ' /<'l ' ?4PIP/ -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling //�
Roof
Mis ' Ao l diy r
PART FAIL
PLUMBING
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
Approach /Sidewalk Date ! ICJ / Inspector �! Ex __
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.