Permit N r,
CITY OF TIGARD BUILDING PERMIT
` , 2 COMMUNITY DEVELOPMENT Permit #: BUP2010 -00204
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Date Issued: 11/30/2010
.,,. Parcel: 2S102CB01802
...... _ ...... .
Jurisdiction: Tigard
Site address: 13405 SW PACIFIC HWY
Project: AutoZone Subdivision: Lot: 0
Project Description: Demolition of existing one story structure(3,737 sq ft), parking lot, utilities and landscaping.
Contractor: PACIFIC UNDERGROUND Owner: BAR -AM, LLC
PO BOX 2258 BY GODFATHER'S PIZZA
OREGON CITY, OR 97045 1416 THIRD AVE
SEATTLE, WA 98101
PHONE: 503 - 632 -3534 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 11/17/2010 $408.32
Class of Work: DEM Demolition
Dwelling Units: 0 12% State Surcharge - Building 11/17/2010 $49.00
Stories: 0 Height: 0 ft Erosion Control 11/17/2010 $26.00
Bedrooms: 0 Bathrooms: 0 Erosion Plan Review CWS 11/17/2010 08.45
Value: $22,000 Erosion Plan Review COT 11/17/2010 $8.45
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $500.22
Required: Required Items and Reports (Conditions)
1 Ersn Cntrl 681 -4444
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. ATT . ••' Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 0010 through O: 52- 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. C '\ Jl A Iss ed By: //J Permittee Signature:` _ / / r f ���
Call 503.639.4175 by 7:00 a.m. for the next available inspection .. te.
This permit card shall be kept in a conspicuous place on the job site until co pietion of the project.
Approved plans are required on the job site at the time of each inspection.
11/17/2010 08:40 5035981960 CITY DF TIGARD PAGE 02193
,41tdi[�g Permit A.ptaiicatilon0
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. pity of Tigard � cit \l ? , . etve�l ''''
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13125 SW Hall Blvd., Tigard, OR 97222 ' i s -.00„,,v,0
' • ' � :. Phone: 503.639,4371 Fax: 503.598.1960 Zt\ "Uri It ev Tarnillal
Inspection Line: 503.639.4175 p Q D rIN ` ' 1` cunt Paemrc
r;,' r ;, Internet `'� `yG Rordy /gy, 7w;r: Sue Pepe or
td: /hrtensod � .� /}r So k ®cwt Inform nips
TYPE OF WORK ,
t " v 4Q0*tii P# W. 14$0 FAMILY If ING , . .
Cl New crntstruai on ID Demolition' Permit fees"' are based on the value of the work performed.
• indicate the value (rounded to the neatest dollar) of all
❑ Addition/ahem tion /repl aeement 0 Other: equipment. materials. labor, overhead, and the profit for the
'CATECORY. CONSTRUCTIO141 vwrtt indicated on Ch application.
❑ 1• and 2-family dwelling i:+ Commercial /industrial valuation: 1
❑ Accessory building ❑ Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB sn 1$PORMA71ON:•'Al+iD LOCATION. • • .. .. Total number of floors:
Job-eite address; 13405 SW Pacific Hwy New dwelling area: square feet
Ciity/State/Z1P: Tigard, Olt. 97223 — Garage/carport area: square feet
Suite/bldgdapt. no.; 1 Project name: A utoZon a, 43756 _ Covered porch area: square feet
Cron street/direetions to Job Rite; north of SW Medoneld Reek Brea: squats met
Other structure area: square !bet
P. QTJ1VE; DKTA ' 401/7148 C4 E&T1 cruse
Subdivision: l Lot no.: Perish fees' are based on the value of the work performed.
Tax map/parcel no,: 25102C11-01802 Indicate the value (rounded to the Wettest dollar) of all
equipment, materials, labor, overhead, end the profit for the
DESCIRJFTION OF''WO# ` `.''' work indicated on this
Demotion of a one story bteUdleg, pandas lot, utlllefei and valuation: t c)
Iondaenpin8 Existing building arca: 3,737 square feet
_ New building area: 6446 square feet
V.
PRO *;PATY''O1iol : 1' 0, T .
Number of storied: 1
Name Bar -Ant, LLC; Isaac Barnett Type of construction: VD
Address :14i6 3rd. Avenue
Occupancy groups:
G5 /Stty etc/Z P: Seattle, WA 98101 Existing; R
Phone ( ) 206 624 -6315 6)464.0187
L s Hama A . . ACT > Ori , . ' ,•..,:• .
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L. ®NPLIC+tiNl'r, t
New: M
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Business utoZoac, Inc — : rz 'r.1,3 .. •. `i .:' ' :'
All contractors and eube°ntraetora are required to be
Contact name: Mitch Bramliitt licensed with the Oregon Conttnicclon Contractors Board
Address: 123 South Front Street under ORS 701 and may be required to be licensed In the
jurisdiction in which work is being peutbrmed. 1f the
City/StatdZiP: Mersphta, TN. 38103 applicant is exempt from licensing, the following reasons
apply:
Phone: (901)495-8714 1 Fax :: (901) 0541991
E -mail: nsitch
Business norm: ' C. - I L. L.t a -%�icc tQ F_ }
:, r BUILPENO PI6R145R ES
Address: 2M,.., . ' 2'265$ :,..;:'• . . 1� 41 . Ile .. . te. - iteget es ..
City/5tatd7.iP: �jlLO ` C1 t T a � Structural plan review fee (or deposit):
Phone 4,S) Fax: ( ) FLS plan review fee (if applicable);
L CC13 tic: gft< g1 7 .l► Total fees due upon application: 4 7,500.4 A2
Authorized signature: 1 Amount received: .
'fi`>✓~ ' i'4' This permit application expke■ If a permit Is not ehtalned
Print name: �� - • b too.— Data: 07 -13 10 * within 190 days after It has boars aceeppted at template.
Fee methodology set by Teti- County Building Industry
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