Permit , ` CITY OF TIGARD BUILDING PERMIT
m . :r. COMMUNITY DEVELOPMENT Permit #: BUP2009-00190
T (GA1RQ. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171.
Date Issued: 12/08/2009
Parcel: 1S 136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Subdivision: Lot: 0
Project: Winco
Project Description: Deli /Seafood remodel.
Owner: FEES
WINCO FOOD, LLC Description Date Amount
ATTN: SUSAN BUSCHE, PO BOX 5756 Permit Fee - Additions, Alterations, 12/08/2009 $1,407.95
BOISE, ID 83705 Demolition
PHONE: 12% State Surcharge - Building 12/08/2009 $168.95
Plan Review 10/14/2009 $915.17
Plan Review - Fire Life Safety 10/14/2009 $563.18
Contractor: Metro Const. Excise Tax - Commercial 12/08/2009 $180.00
D AMYX CONSTRUCTION INC Use
316 E MAIN ST
EMMETT, ID 83617
PHONE: 971 - 221 -9991
FAX:
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $150,000
Floor Areas:
Total Area: 0
Accessory Struct. 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,235.25
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
Smoke Detectors: No Manual Pull Stations: Yes
Accessible Parking: 0
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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules a e set forth in OAR
952 - 001 -0010 thr•ugh • ' R 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by callin 03.24 6699 or .800. 32.2344.
Issued By: / l / i P ermittee Signature: ' NI.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Bui ding' Permit Application
Commercial
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enn•.r / ��
City Of Tigard Date /B C Permit No.. U O► 407.,e155 MO
O
� "Ia a 13125 SW Hall Blvd., Tigard, O " C ` i 2 y 0
g Plan Review f ., i
. L $ � 2' t y f r , l � ("!R Other Permit:
3� Phone: 503.639.4171 Fax: 50 5 ' 540 Date /B c
isMI G Inspection Line: 503.639 OCT 4 2009 Date Ready /6y: , O � J" ® See Page 2 for
t, s ,.* Internet: www.tigard- or.gov iikl
I N otified/Method: . S ! /(-. Supplementat Information
TYP DRAW a m liti Permit fees* are based on the value of the work performed.
O� REQUIRED DATA: 1- AND 2- FAMILY DWELLING
ID New construction Demolition
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7500 SW Dartmouth Rd. New dwelling area: square feet
City /State /'LIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: WinCo Foods Store #23 Covered porch area: square feet
Cross street/directions to job site: 72 Avenue Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead. and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Remodel of Deli /Seafood service dept. including new floor and wall finishes, Valuation: $$150,000.00
sinks, service cases and 1 -hr. rated hood at fryers. Existing building area: 95299 square feet
New building area: N/A square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: WinCo Foods LLC Type of construction: 11 B
Address: 650 Armstrong PI. Occupancy groups:
City /State /ZIP: Boise, ID 83704 Existing: Group M
Phone: (208)377.0110 Fax: (208)377.0470 New: N/A
0 APPLICANT ® CONTACT PERSON NOTICE
Business name: Petersen Staggs Architects LLP All contractors and subcontractors are required to be
Contact name: Byron Dills licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5200 W. State St. jurisdiction in which work is being performed. If the
City /State /ZIP: Boise, ID 83703 applicant is exempt from licensing, the following reasons
apply:
Phone: (208) 345.1462 Fax: : (208) 345.1532
E -mail: byron_h @psarch.com
CONTRACTOR
Business name: liffEP. ID ( 9.11/40 )( 0 0 N g E 1 3 1 BUILDING PERMIT FEES*
Address: t L • NA. I ,..-r- (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /"ZIP: ?, H 1.4 F --/-r /Tj s 3C, / 7
FLS plan review fee (if applicable):
Phone: 97/ /5///0. A j - 991/ Fax: ( )
CCB lic.: ♦ /g / //Q /a /v Total fees due upon application:
Amount received:
Authorised signature: J a This permit application expires if a permit is not obtained
/�
� within 180 days after it has been accepted as complete.
Print name: Byron hills Date: 10/13/2009 * Fee methodology set by Tri- County Building Industry
Service Board.
1: \Building \Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(11/02/COM /WEB)