Permit t iTY OF T I GA D BUILDING PERMIT
PERMIT #: BUP2002 -00190
11& DEVELOPMENT SERVICES DATE ISSUED: 6/24/02
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09714 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: 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: NONE : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: $ 15,500.00
Remarks: Rack Storage.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC CHALLENGE CONSTRUCTION CORP.
P.O.BOX 21545 PO BOX 3500 -226
SEATTLE, WA 98111 SISTERS, OR 97759
Phone: Phone: 541 - 549 -8810
Reg #: LIC 149490
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT CTR 6/24/02 $196.90 27200200000 Final Inspection
PLCK CTR 6/24/02 $127.99 27200200000
5PCT CTR 6/24/02 $15.75 27200200000
FIRE CTR 6/24/02 $78.76 27200200000
Total $419.40
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spec�atty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 -01 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6. • • 1-814- :2- • 4.
Pe rm ittee
Signature:) /
Issued By: 44.
Call 639 -4175 by 7 p.m. for an inspection the next business day
r ilv +,��s 5123 a r ,, A- i u ldin g kikpolakvior\
ernut A PP Application
, Datereceived:S 7(/ py Permit no. ?ate /Q'
�.
� r iiii City of Citf Tigard Project/appl. no.: Expire date:
City oJTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By ) I Receipt no.: p
Fax: (503) 598 -1960 Case file no.: Payment type: y
;�
Land use approval: IJ U pa7;- '00 / ir'- 1 &2 family: Simple Complex:
TI PE OF PER1917•
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration/replacement Itqenant improvement 0 Fire sprinkler /alarm 0 Other: ° °h
Job address: 7 i' SO 5O I ro 4 4.1a
9 - 52_ Bldg. no.: Suite no.: * l'
Lot: 7 Block: Subdivision: - I Tax map /tax lot/account no.:
Project name: A L D D S,Jp&$
Description and location of work on premises/special conditions F-...iYC.(st '"1-0-2rk2 -, �i
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST ' -- -
Name: A-4 D0 C/ Eepges' PC-ttan+i'97 ( Floodplain ,septic capacity, solar, etc.)
Mailing address: ( 3 2'1 Pos T 40E-4 4 I & 2 family dwelling:
City: - T.-* ' c.E I State: [1\ I ZIP: Q DS Valuation of work $
Phone: 1 /b 3 C )I Fax:5 / O 3ZSD33 -mail: •.---. No. of bedrooms/baths (l
Owner's representative: -Rzis NA Total number of floors -
Phone: /x328 43oa Fax :3028o33G E-mail: New dwelling area (sq. ft.) t
Garage/carport area (sq. ft.)
Name: A L. DC) Covered porch area (sq. ft.) pQ
Mailing address: 131 Qa i r Ave 41- 4 Deck area (sq. ft.) t
City: —T z. N«c State: CA I ZIP: 9OSO / Other structure area (sq. ft.)
Phone: 3 ID 37g6 3 Fax E-mail: Commercial/industrial/multi- family: ‘ C)
Valuation of work $ 1
Business name: ,A ,'TO 8 1 D, i Existing bldg. area (sq. ft.)
Address: din 1 ' a _ //mil New bldg. area (sq. ft.) Q
Number of stories
City: ' State: I ZIP: Type of construction XI
Phone: I Fax: I E -mail:
CCB no.: Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: IAlah) \l/... 0 N AO) A tJ o _66)00 P 4 u r n provisions of ORS 701 and may be required to be licensed in the
Address: 327 POST AV 4 - H jurisdiction where work is being performed. If the applicant is
ty: — rza_e.k N L E Ste: � I ZIP: 9aS / exempt from licensing, the following reason applies:
Ci
Contact person: -fit /S //fi ! Plan no.:
Phone: 3/x32 -SC3o Fax:3 3 LgO3 E-mail:
Name: a ,,, - p. Contact person: Fees due upon application $
Address: Date received:
City: IState: 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 accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this Ci Visa la MasterCard
work will be complied with, speciei: � Ha[e q
I tin c 0 not C1edit card 0number ExP /
Authorized s re: �}l-Da �6 F .g if Z' Name of cardholder as
signature s shown on credit card
AEA b � • �
Print name: f hilt' Q ?_ Oa r.Aa $
Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6AOtCOM)
ar
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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 plan sets for distribution purposes (for Contractor, City of
Tigard, Washington County, and Tualatin Valley Fire & Rescue).
Total# of
TYPE OF SUBM_ ITTAL Pla s, KEY:
Subnnitt d
S = Site Work (must include
S (New, Add or Alt) 4 location of all accessible parking)
•
B (New, Add or Alt) 1* B = Building
F (New, Add or Alt) 3 ** F = Fire Protection System
M (New, Add or Alt) 2 M = Mechanical
P (New, Add or Alt) 2 P = Plumbing
E (New, Add, or Alt) 2 E = Electrical
New = New Building
Add = Addition
.Alt = Alteration to existing
building
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" requires that plans bear the original seal of an Oregon licensed fire
suppression engineer, or NICET level "3" technicians.
I: \dsts \forms\matrxcom.doc 10/27/00
7
CITY OF: TIGARD 24 -Hour
Inspection Line: (503) 639 -4175 a •
�oUIL�u'ING MST
INSPECTION DIVISION Business Line: (503) 639 -4171 _ D (g�
/ X33 1 s B" - Received Date Requested F` k, AM PM / 9 6
Location - 0 e 4 Suite ri frt 5 4 0 a '$
Contact Person `- 'L.r:,, Ph ( ,S ) 46 — 719O PLM
Contractor 0 Ph ( ) SWR
BUILDING Tenant/Owner 2 ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain - •
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear Y 1 V 2 G e _ Od / �, S r` _ tj —
Framing `
Insulation
Drywall Nailing
Firewall 6 2- —od /go C&-eJC Sprinkler
Fire Alarm I //� /y S --e-eQ.
Susp'd Ceiling % J)
Roof 1( b- ) / 'jam ,y S 6i� P „, ' U Al o
'Uh
5 A < /le , -(mil ms's r1L12.1 4. ck
ASS PART diai t vC -&TS r\Q, i c1 .
/
PLUMBING • .,, - - _ � /4 �t�1 /
' ' Post & Beam n) .� YQ (�- h-
� .S ‹ , e_ S
' Under Slab / / J CY •
Rough -In
Water Service .
Sanitary Sewer /3/.-f � _ e / S ? ( T L )
Rain Drains `�`" /- �/�
Catch Basin / Manhole t 23-0—. J S /i 5 tic, f s C D s � ce--�s
Storm Drain 1 /'�
Shower Pan `j ) Z.4 - c Li C 1 --/" "e
Other: :
Final ,,,e
� 1 c Z�ls
PASS PART FAIL -
MECHANICAL
Post Beam � ��� oV •
Rough-In
Gas Line 1 p►U✓
Smoke Dampers
le PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS . PART FAIL
SITE . 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line ( ( 6 V � D- Y?
Approach/Sidewalk • Date ` In spector
Other: •
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
" BUILDING Inspection Line: (503) 639 -4175
MST r
INSPECTION DIVISION Business Line: (503) 639 -4171 •1 _
Received Date Requested AM PM 40 0 – 6 /
77/4 LOA 5 Q i IR.DSuite MEC
Contact Person Ph ( .Sq() t f g — 7l 4 b PLM
Contractor Ph ( )) ^ / SWR
•
BUILDING Tenant/Owner � 4 ?�v�, _t ELC
Footing ELC
Foundation 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 O ' ,40
F
(77
ire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
P BING
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
Approach/Sidewalk Date ���C� Z Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site. •
PASS PART FAIL