Permit CITY OF TIGARD BUILDING PERMIT
V COMMUNITY DEVELOPMENT Permit #: BUP2010 -00232
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 1S136AD06100
Jurisdiction: Tigard
Site address: 11419 SW PACIFIC HVVY
Subdivision: Lot: 0
Project: Buster's BBQ
Project Description: TI - move wall near bar area.
Owner: FEES
SCHOLIBO, GEORGE E JR & STEPHEN A Description Date Amount
12241 SW TERWILLIGER BLVD Permit Fee - Additions, Alterations, 10/21/2010 $149.75
PORTLAND, OR 97219 Demolition
PHONE: 12% State Surcharge - Building 10/21/2010 $17.97
Plan Review 10/21/2010 $97.34
Plan Review - Fire Life Safety 10/21/2010 $59.90
Contractor:
DERALD SCHOCKLEY
PO BOX 2471
OREGON CITY, OR 97045
PHONE: 503 - 539 -7872
FAX:
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $4,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $324.96
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
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. ATTEN • .: Oregon law re• uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 • $10 through • R 95 •01 1 1 1 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue. By: t 1/ / - PermitteeSignature: j
Call 603.639.4175 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.
Building Permit Application
Commercial r () R cl l I l c l . : 1 s i.: ( ) N I . ,
111 11111 City of Tigard $ Q , DateeB ' P/ /0 M Permit No. I / �j /0- -40,2 3.2„ 0 13125 SW Hall Blvd., Tigard, OR 97 :,Z Plan Review'
0 : Other Permit:
Phone: 503.639.4171 Fax: 503.598.1' ?i + �0 .� . Datem : ai, 0
I . i C \ -- R 1 , Inspection Line: 503.639.4175 0 t8.9 Date ReadyBy: turi9 ® See Page 2 for
Internet: www.tigard or.gov � Av..) U Notified/Method: Supplemental Information
TYPE OF WORKr'
" ' REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Degb Tition Permit fees* are based on the value of the work performed.
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.
❑ 1- and 2- family dwelling 'Commercial/industrial Valuation: S
❑ 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: + 9 Sk(J c_^ j f!!V' New dwelling area: square feet
City /State /ZIP:
' 7 7 9 "` ,t:( I Q c! / 2 2-3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 13 US A R A, ,L/ , Covered porch area: square feet
Cross street/directions to job site: 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.
Al ovE iv ^aE..4 -Z3....4 q lit/.gW fa
Valuation: S �sQ� r
Existing building area: square feet
New building area: square feet
❑r PROPERTY OWNER I ,- TENANT Number of stories:
Name: 81/35 5 Type of construction:
Address: / Z 2., ) 5 1,4_, TeiZvi //�� e '-. ��r�sy. Occupancy groups:
City /State /ZIP: p y r'z.�� / Q� a 99 al? Existing:
Phone: (SU) /74? , 2 / y 7 Fax: ( ) New:
lir APPLICANT ❑ CONTACT PERSON NOTICE
Business name: /Q A p",c� ,y t d lOA All contractors and subcontractors are required to be
Contact name: �C� d licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: Po ,,,, 74 ? / jurisdiction in which work is being performed. If the
City /State/ZIP: O/P�, / 7'70
applicant is exempt from licensing, the following reasons
apply:
Phone: (5 )ur� ., 27 2 Fax:: ( )
E-mail: CI aid 4ze. 2 ® , ea -
CONTRACTOR
Business name: 1R /94, E ercat t%tS1 . BUILDING PERMIT FEES*
Address: / ' 0 , sit/' 2 //7!
(Please refer to fee schedule)
City/State /ZIP: °iC /� Structural plan review fee (or deposit):
r! ��� FLS plan review fee (if applicable):
Phone: (643) cSes3 9 • ? Z Fax: ( )
CCB lic.: 0 C," •.. ., i.rt _ ^ , . _.-� 5-5 8.? Total fees due upon application: Q
�r // 4 y Amount received: (3 7 rP
Authorized signature: / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: f 02e'Lc( pG11 " Date: f 0 , Z 6 , (0 * Fee methodology set by Tri-County Building Industry
Service Board.
I:,Building,Permits,BUP -COM Per nitApp.doc 10/01/09 440- 4613T(11 /02/COM/WEB)
i
v
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
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): $
I: \Building \Permits \BUP -COM PcrmitApp.doc 06/25/08
1 • ° Building Division
Over- The - Counter (OTC) Building Permit
riCInizI) Check Li t
Description of Project: 7 6AVICX/E.-1.
GENERAL INFORMATION
Class of Work: * 1 Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* t First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: ?� Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: I Note: Combine total floor area for E: E:
Height: _ all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: KID Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ 4 }��(��r a
INSPECTIONS 1 FEES DUE
Footing /foundation Firewall $ ' c , i c, Permit Fee
Post /beam structural Smoke detector $ 7. " State Surcharge
Shear wall Misc. inspection $ I. Plan Review Fee
Masonry Approach /sidewalk $ ' , 41 FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
•
$ 324 ,'q(j Total Fees Due
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
.I: \Building \Forms \OTC - BUP.doc 08/19/08