Permit II °, CITY OF TIGARD BUILDING PERMIT
in
' COMMUNITY DEVELOPMENT Permit #: BUP2010 00097
`'= Date Issued: 05/12/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102AB03600
Jurisdiction: Tigard
Site address: 12271 SW MAIN ST
Subdivision: Lot: 0
Project: Rojas Market and Gifts
Project Description: Change of use. No land use review required per Cheryl Caines.
Owner: FEES
JOHNSON FAMILY TRUST & Description Date Amount
JOHNSON, REES C TRUST &, JOHNSON, Permit Fee - Additions, Alterations, 05/12/2010 $53.27
MARYANNE G TRUST, 3112 SW SANTA Demolition
PHONE: 12% State Surcharge - Building 05/12/2010 $6.39
Contractor:
PHONE:
FAX:
Specifics:
Type of Use: COM
Class of Work: OTR
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $59.66
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: No Protected Corridors: No
Smoke Detectors: No Manual Pull Stations:
Accessible Parking: 0
This . = is issue. •'ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
b= :one in accordance with . p roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
.ays. ATTENTION: Oregon law e you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in • •
952 - 001 -0010 through OAR 95 01 -0 00. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.; %r 344
Issued By: Perm ittee Signature: fe '
/ is
Call 503.639.4175 by 7:00 a.m. for an inspection that b sines . ay.
This permit card shall be kept in a conspicuous place on the job site until completion of the pro :ct.
Approved plans are required on the job site at the time of each inspection.
■
- Building Permit Application
R ECEIVED 1 t r i�H{ F ''`In r v l r l a =^ e ! I m i ' ,
Commercial � „,,K;,l c) I cl u51 c)l
p
c l�;�r� .4�c_� e� „,F e �$'.�' 11�Jdb L h; �;, I 1 K I ° � .LSI. N l '
Received
City of Tigard DateIB : 0 / . ►d Perm No. , a/
�^^
° 13125 SW Hall Blvd., Tigard, OR 972Y[\Y 1 2 2010 Plan Review
': '' Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
f 1 ti A I . I)' Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: Ilir' ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: / t' Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY•DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
ddition /alteration/replacementther: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: $
❑ 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:/ d 5V(/ A 4 )9/N s / New dwelling area: square feet
City /State /ZIP: t goo Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
/ L 1 (,q4 fP/ e S� Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
' Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF -WORK work indicated on this application.
Valuation: $
dir
r � / � a �`��� Existing building area: square feet
,iii 4 New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT . Number of stories:
Name: �s (. Tv/Asa/ lfsa/ J/11 ,4f/ 5
��� �o Type of construction: cJ
Address: p d ., )( _L `./ ? Occupancy groups:
City /State /ZIP: Ce / pit_ 9'70/3 Existing:
Phone: (503 ) � G a Fax: (S ),24<r---//77 New:
❑ APPLICANT ❑ CONTAth PERSON , ' NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: / 20 f 1 � < - licensed with the Oregon Construction Contractors Board
6 `'�.° under ORS 701 and may be required to be licensed in the
Address: 4 y/ jurisdiction in which work is being performed. If the
City/State/ZIP: /State /ZIP: 3 applicant is exempt from licensing, the following reasons
Y /(, y, � G Y L app
Phone: (spa) G7q,zl9,i/ 9 Fax: : ( )
E- mail: / 90�A..� .te&_1 771- ,(/l9 /*/
• CONTRACTOR
Business name: BUILDING PERMIT FEES*
�/ A� s (Please refer to fee schedule)
Address:
f ""�
m i Structural plan review fee (or deposit):
City /State /ZIP: C6/j/ i . 50V1. �
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: / Total fees due upon application:
Amount received:
Authorized signal re: / � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Permits \BUP -COM PermitApp.doc 10/01/09 440-46 I 3T( I 1/02/COM/WEB)
F ee
•
Building Division
Accessibility: Barrier Removal Improvement Plan
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
• TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $ •
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
l:\ Building \Permits \BUY -COb1 PermitApp.doc 06 /25/08
CITY CERTIFICATE OF OCCUPANCY
lir n v OF TIGARD
@ Permit #: BUP2010 -00097
;, COMMUNITY DEVELOPMENT Permit Issued:
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102AB03600
Jurisdiction: Tigard
Site address: 12271 SW MAIN ST
Subdivision: Lot: 0
Project Description: Change of use. No land use review required per Cheryl Caines
Class of Work: OTR
Type of Use: COM
Type of Constr:
Occupancy Group:
Occupancy Load:
Project Name: Rojas Market and Gifts
Owner: JOHNSON FAMILY TRUST &
JOHNSON, REES C TRUST &, JOHNSON,
MARYANNE G TRUST, 3112 SW SANTA
Phone:
Contractor:
Phone:
Fax:
This Certificate issued 5/12/2010 grants occupancy of the above referenced building or portion thereof
and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for
the group, occupancy, and use under which the referenced permit was issued.
"Ph_ -,(40
ilLIPTALVO
Bu • mg Inspector '�i = uilding Offi•cia
POST IN CONSPICUOUS PLACE