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Permit (3) • • . t CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2000 -00107 11i DEVELOPMENT SERVICES DATE ISSUED: 4/6/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DA -00800 SITE ADDRESS: 11540 SW PACIFIC HWY SUBDIVISION: FRUITLAND ACRES ZONING: C -G BLOCK: LOT: 001 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: NEW FIRST: 200 sf N: 1 HR S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 6 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:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 2,500.00 Remarks: Construct a 10' x 20' key shop. Separate electrical and mechanical permits required. Owner: Contractor: HI HAT INC OWNER OF BUSINESS 11530 SW PACIFIC HWY TIGARD, OR 97223 Phone: 620 -2475 Phone: Reg #: FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Foot/Found Insp PRMT KJP 4/6/00 $59.25 0001226 Post/Beam Insp Framing Insp 5PCT KJP 4/6/00 $4.74 0001226 Insulation Insp PLCK KJP 4/6/00 $38.51 0001226 Shear Wall Insp ORIGINAL FIRE KJP 4/6/00 $23.70 0001226 Gyp Board Insp - -' Final Inspection Total $126.20 • 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 -1987. Permitee .f1 r Signature: Issued By: AlkiLtkatUr Call 639 -4175 by 7 p.m. for an inspection the next business day • I ' . <- • a THIS REQUEST FOR MINOR MODIFICATION APPROVAL HAS BEEN APPROVED BASED ON THE FOLLOWIING CONDITION Submit to the Planning Department (Mathew Scheidegger, 639 -4171, ext 317) for review and approval: 1. Prior to occupancy, two parking stalls, including one handicap stall will be striped in accordance with Development and Building code requirements. If you need additional information or have any questions, please feel free to call me at (503) 639 -4171 ext. 317. Sincerely, , c . AP -- it - . Mathew Scheidegger Assistant Planner i : \curpI\Mathew\minmod\2000-00005 c: MMD2000 -00005 Land use file uAiklwe^ C7 • ' Tigard Lock and Key Minor Mod. /MMD2000 -00005 Page 3 of 3 Re: MMD approval to place a 200 sq. ft. building located at 11540 SW Pacific Highway. • . Permit #: B' -p a -coo - aC\ /0 7 • F 0 41 „04, Address: / 1 5 / 0 S1.,) Rc, -r c. PvIti ° = "" -° ' I.5 /\ Issued by: - R A ' W 14- 4 — b " Date: 1 /0% Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required ' for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: n 1. I own, reside in, or will reside in the completed structure. I 1 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale ' 1 before or upon completion. li 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 511 -- 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. OJe w 6- 1,5 to/ 5 %l� � e "/ o 000 (Signature of permit applicant) ca5 X3633 2 (Da e) (White copy to issuing agency permit file, pink copy to applicant) • Information Notice to Property Owners About Construction Responsibilities Note: This Ihrormation Notice to Property Owners about Construction Responsibilities was dePelrp' l by the Construction Contractors Board in accordance with ORS 701.055(5). if you! arc acting as ou owr eontraLtor to constnr� a new home or make a substantial improvement to an existing structure, you can pre N. cnt mar.} problem: by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not regitrred with the Construction Contractors Board to do labor in constructing or assisting in the construction or !mpro\ C'. a residential structure, y on will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax la's As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945 - 8091. Unemployment insurance tax: As an employer, you arc required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources at 378 -3524. Workers' compensation insurance: As an employer. you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensatic n insurance for your employees. If you fail to obtain workers' compensation insurance, you may he subject to penalties and ti ill he liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compen Division at the Department of Consumer and Business Services at 945 -7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1 -800 -829 -1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re -done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052, 503/378- 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own.prn4 1 /94 • CITY -OF TIGARD Commercial Building Permit Application Plan Check# 3 - `$`/ 10125 SW HALL BLVD. New Construction and Additions Recd By TIGAIfD, OR 97223 Date Rec'd 3 ; -,7 Or r- Date to P.E. (503) 639 -4171 VV Date to DST 312.6% oil Print or Type Permit # 60'70ot -00101 Incomplete or illegible applications will no be accepted Related SWR# Called 4 - 4/ - 24900 • Name of Development/Project Job Ti I 42D 1,0c. k I- KE. Li Existing Building ❑ New Building, Address Street Address Suite 1 1510 $ui QAc1 IM?y 'Tic( ,zp oe. Building - Bldg # City/State Zip Data _ Ti f /RD 6e, CI =3 Existing Use of Building or Property: Name Property j-) i tfyvt „77,\/C ....cosprierc-� Owner Mailing Addreks Suite Proposed Use of Building or Property: 1/530 cc.) Pic; f` to � z Zl y Phone No. Of Stories: C 0 /72 J Occupant Name #1 ( (cfa- gel Sq. Ft. Of Project: - T . l.v cl1 12. o2D0 Name Occupancy Class(es) Contractor Co! air-2.42_ jrn Prior to permit Mailing Address Suite Type(s) of Construction c issuance, a copy /V of all licenses are required if City/State Zip Phone Will this project have a Fire Suppression System? expired in C.O.T. • Yes ❑ No IN database Americans with Disabilities Act (ADA) sA. Oregon Const. Cont. Board Lic.# Exp. Date Valuation X 25% _ $ Participation s: Complete Accessibility Form ,P Name Project $ Architect Valuation 2S-173 r Mailing Address Suite Plans Required: See Matrix for number of sets to submit City /State Zip Phone on back Engineer Name 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 Mailing Address Suite that plans submitted are in compliance with Oregon State Laws. Sign- - • • ; r /Agent Date City/State Zip Phone / �t / / / 3 - cJ _ a C 00 , Contact Person Name / Phone indicate type of work: New Id Addition 0 Demolition 0 / 4 t J l ' 2 ( y & ! ( � 4 / / S S 3 " “ 4 9 - 1 9 7 7 4 Accessory Structure 0 Foundation Only 0 Alteration 0 Repair 0 Other o FOR OFFICE USE ONLY Description of work: P cie_e 4 /V X140 mftpo/Z 84.4.0• .-y Folt cts� AlS A Ke ( SEfp. rI IOW —0 Land Use: Notes: Parks: Estimated # of Employees / TIF: • If the above figure Is not supplied at the time of application, the city will calculate the fee based upon the number of parking spaces. I r Note: Site Work Permit Application must precede or accompany Building { l -vt , 0 `f- exthaf - p buSNroSS Permit Application -4 1-3 `tV ta 4U21 r own. _ !y_� �/_ ^ � j ga is \dsts \forms \comnew.doc 5/10/99 G7c.C'J�J�' `( • •• COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX signature of the supervtsiruj e1e±tcan before plan revew wifi be conducted After plan revtew approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes (Copy for Confractor City., Washington County, Tualatin Valley Rre & Rescue) Total # of TYPE OF SUBMLUAL 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 ••• NOTES: I:\dsts\forms\matrxcom.doc 10/29/98 r - OVER- THE - COUNTER (OTC) PERMIT PLAN REVIEW COMMERCIAL (STRUCTURAL) BUILDING PERMIT CHECKLIST DESCRIPTION OF PROJECT: Cesorgi4V6 W SC 10 gett p . `11.64.. t M is e. admits ea • CLASS OF WORK: 1slStAI FLOOR AREAS: EXTERIOR WALL CONSTRUCTION TYPE OF USE: FIRST ZoO SQ. FT. N: l OE S: E: W: TYPE OF CONSTR: 0 P SECOND ) SQ. FT. PROTECT OPENINGS ?: OCCUPANCY GRP: VVI THIRD VL SQ. FT. N: S: E: W: OCCUPANCY LOAD: (V TOTAL Vb 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: I COMMERCIAL INSPECTION ACTIONS FEE MENU I Foo Fou • • ' ost/Bea •. $ 6 Permit Fee 2 t Masonry raming $ 7 Plan Review Inst. l - $ ek 8% State Surcharge Firewall Gyp Board $ W FLS Plan Review Suspended Ceiling Sprinkler Rough -in $ Add'I Permit Fee Sprinkler Final Fire Alarm $ Add'I FLS PIn Smoke Detector Approach /Sidewalk $ Inspection Miscellaneous $ MIS Fee iciP 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) I: \ovrcntr2.doc (DST) 9/99 • - CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 240 - C0/07 Date Requested S S f 09 AM PM cc BLD Location S d P6i-e- ) 11: S uite MEC Contact Person v 4 Ph 69 �Z� ro PLM Contractor Ph SWR LDIN Tenant/Owner LOGY, rj_1 ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Q D Q Slab �""� p")ar SIT r .b'7 Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof c: r;> PART FAIL P u BING 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 OITE) 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 z ," Approach /Sidewalk Date Other 5 0 O Inspector Ext 'a PART FAIL DO NOT REMOVE this inspection record from the job site.