Permit i CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 -00215
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2010
Parcel: 2S102CB01802
Jurisdiction: Tigard
Site address: 13407 SW PACIFIC HWY
Project: AutoZone Subdivision: Lot: 0
Project Description: Racking.
Contractor: CORESTONE CONTRACTORS LLC Owner: BAR -AM, LLC
PO BOX 2280 BY GODFATHER'S PIZZA
SNOHOMISH, WA 98291 1416 THIRD AVE
SEATTLE WA, 98
PHONE: 360 - 862 -8316 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 11/17/2010 $736.98
Class of Work: ALT Demolition
Dwelling Units: 0 Plan Review 09/24/2010 $479.04
Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 09/24/2010 $294.79
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 11/17/2010 $88.44
Value: $51,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,599.25
Required: Required Items and Reports (Conditions)
1 Bolts in Concrete
Fire Sprinkler: 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth iq OAR
952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued ; _^< <�' 'G, Permittee Signa -
CaII 503.639.4175 by 7:00 a.m. for the next available' :action date.
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 FOR OFFICE USE ONLY
iii ' ` Received
City of Tigard °c Date/B : t q_ m Permit No.: I l,} _ i • aA �1
13125 SW Hall Blvd., Tigard, OR 972 r1-1 Plan Review
l ; ' Phone: 503.639.4171 Fax: 503.598.1960 S�Q k'i
Date/B : Other Permit: I .. ( "
�
Inspection Line: 503.639.4175 .{ r R�o Date Re ady /By: See Page 2 for
TIGARD Internet: www.tigard- or.gov \ Ok 1 Notified/Method: ` 7 Supplemental Information
' TYPE O WORI16, 1 1 � \J 7 S REQUIRED DDA 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
❑ 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: $
❑ 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: 13407 SW Pacific Highway New dwelling area: square feet
City /State /ZIP: Tigard, Or 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Autozone #3756 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.
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.
Installation of interior racks in an existing Autozone building Valuation: $$51,000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT " 0 CONTACT PERSON NOTICE
Business name: Seizmic Inc All contractors and subcontractors are required to be
Contact name: Amy Edwards licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 161 Atlantic Street jurisdiction in which work is being performed. If the
City /State /ZIP: Pomona, Ca 91768 applicant is exempt from licensing, the following reasons
apply:
y:
Phone: (909) 869 -0989 Fax: : (909) 869-0981
E -mail: aedwards @seizmicinc.com
CONTRACTOR.'
Business nam e: (70,, 9 reNY. ( T/24ri'1 - ' r! L[„ BUILDING PERMIT FEES* -
4 ^� (Please refer to fee schedule)
t♦:' -
Address: O . � 4 O Structural plan review fee (or deposit):
City /State /ZIP: SPC9N, Hi 51-1 (V' 9s a9/
FLS plan review fee (if applicable):
Phone: c,470) g( --551p Fax: ( )
Total fees due upon application:
CCB lic.: 15 0 0I.
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: /1 I� E G cJ� ,eqf S Date: 9 �® * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB)