Permit �1 R' n CITY OF TIGARD BUILDING PERMIT
g COMMUNITY DEVELOPMENT Permit #: BUP2010 -00106
1 s,. al Date Issued: 06/15/2010
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
;:TIGARD CARD, Parcel: 2S102BD00701
Jurisdiction: Tigard
Site address: 12785 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Spec Space
Project Description: Remodel of existing restaurant space, addition to replace solarium area previously removed.
Owner: FEES
THE HOLLAND INC Description Date Amount
109 WEST 17TH STREET Permit Fee - Additions, Alterations, 06/15/2010 $2,011.95
VANCOUVER, WA 98660 Demolition
PHONE: Plan Review 05/25/2010 $1,307.77
Plan Review - Fire Life Safety 05/25/2010 $804.78
12% State Surcharge - Building 06/15/2010 $241.43
Contractor: Metro Const. Excise Tax - Commercial 06/15/2010 $300.00
RSV CONSTRUCTION SERVICES INC Use
1115 ESTHER ST CDC Bldg Review, COM 06/15/2010 $143.50
VANCOUVER, WA 98660 CDC Plan Review, COM 06/15/2010 $143.50
PHONE: 360- 693 -8830 CDC Plan Review, COM - LRP 06/15/2010 $42.00
FAX: 360 - 693 -8910
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 15 ft
Bedrooms: 0 Bathrooms: 0
Value: $250,000
Floor Areas:
Total Area: 2792
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $4,994.93
Required: Required Items and Reports (Conditions)
1 BUP Structural Welding
Fire Sprinkler: No Parapet: Yes
2 BUP Bolts in Concrete
Fire Alarm: No Protected Corridors: No 3 BUP Reinforced Concrete
Smoke Detectors: No Manual Pull Stations: No
Accessible Parking:
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 a. • • - • • the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throu AR 952 - 001 -0100. ou ay obt - -py of the rule or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B
n Signature: ,/1 d ��
Y • i �� ice: � - ittee Si 9 i r ► � 11 ��_-
.39.4175 by 7:00 a.m. for an inspection that busin ' a. V
This permit card shall be kept in a conspicuous place on the job site until c. r letion of Project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial . .
. : .. _, . , - . • 'FOR OFF CLUSE ONL1
City Of Tigard ® Received r 4 .1 5 D Permit No.: 0
II ' ' ° 13125 SW Hall Blvd., Tigard, OR 97223 ~� 4 �O,O Plan Revie /` + p 4 ea CO /0 /
i I: , P 503.639.4171 Fax: 503.598 DateBy: " 'A,f1i/ km / j Q
(T IGA ItD Other Pernut:
r
Inspection Line: 503.639.4175 p TI OF G Date ReadReady/By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov D qRD Notified/Method: ip / y 10 Arr •-- Supplemental Information
G DiVISIoPJ L. (AM- - Tuff
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 newest dollar) of all
54 Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
1 CATEGORY OF CONSTRUCTION
work indicated on this application.
❑ 1 -and 2- family dwelling g 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: 1 /2 7 ft, 6w - a,/ if, 1 al New dwelling area: square feet
4i t y /State /Z1P: /d r O re co- 1 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
, Cross street/directions to job site: he, Pil-"e_t_ Deck area: square feet
\ 7W feaff(/ athw r/W at14 rl Se L. `71
i , Other structure area: square feet
1 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 newest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
1 of t YIOV •Ve 4� lt yw Je /� V Valuation: $ '25 00 1 00
// �� ox. �"1 l y W� G� Y/t 1 e f Existing building area: 4 1 Li square feet
/?.
efeVW Z, G,gj I V ‘01111v 41, IA a4 lifra(,Q- , New building area: *5 square feet
❑ PROPERTY OWNER pi TENANT Number of stories: One,.
Name: T le '''P W n Type of construction: \ I l'
Address: X001 '1,■10.71 n1 -T Occupancy groups:
r
City /State /ZIP: V W 'v WV WA 1' t 0 Existing: 43, Phone: ( ) Fax: ( ) New:
ts
APPLICANT CONTACT PERSON NOTICE
A Business name: Aye.. tar i7 G 141-i v -e... All contractors and subcontractors are required to be
Contact name: e L -b licensed with the Oregon Construction Contractors Board
\ f ' 'l1V- under ORS 701 and may be required to be licensed in the
ddress: 5 n.e (12.2e1, (12.2e1, I L dfl,� Gve , ,4»(r4-16/- jurisdiction in which work is being performed. If the
City /State /ZIP: LMM tl yV J WiV 9 866 13 applicant is exempt from licensing, the following reasons
i 2 --to apply:
Phone: (SO 51 - 1 0 lT Fax: : (�0) v) 1 - g
4 E -ma J e no YliJO'T2(iTS 2 . G6YY1.
CONTRACTon
c vote, , r 7C Ut Let Tl✓(,
Business name: fk ,„-:� t _ »-- ._./.ru r�n416.... --- 4 -- BUILDING PERMIT FEES*
Q Address: 116 � j " t/f t r 41-1. .Vie (Please refer to fee schedule) • City /State /ZIP: V O�rQV W Structural plan review fee (or deposit):
Phone: (3b0 ) VII" Zj ^ 6830 1 Fax: ( ) 013 5910 FLS plan review fee (if applicable):
(..) CCB lic.: R C o ` * `g2, 1) 9 t7Wtilf I/q/ Q, Total fees due upon application:
�� 1 Amount received:
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: - , Date: .-2,14 1 1.� * Fee methodology set by Tri -Cou • = ilding`dustry
Service Board.
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