Permit t p
CITY OF TIGARD BUILDING PERMIT
14 'Y COMMUNITY DEVELOPMENT Permit #: BUP2011-00131
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/25/2011
Parcel: 1 S 136AD06000
Jurisdiction: Tigard
Site address: 11433 SW PACIFIC HWY
Project: Kentucky Fried Chicken Subdivision: Lot: 0
Project Description: Demolition of existing Kentucky Fried Chicken drive -thru restaurant., 2,340 sq. ft. Upon building final, demo credits
for future SDC fee will apply.
Contractor: TJ NISBET CONSTRUCTION INC Owner: EJM PROPERTIES INC &
15896 SE 82ND DR MAVERICK DECATUR GEORGIA LLC
CLACKAMAS, OR 97015 -0040 BY MAVERICK INVESTMENTS
3633 E BROADWAY
LONG BEACH, CA 90803
PHONE: 503 - 257 -0308 PHONE:
FAX: 503 - 257 -0309
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 08/25/2011 $64.00
Class of Work: DEM DC Provision Review, COM TI - LRP 08/25/2011 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 08/25/2011 $408.32
Stories: 0 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 08/25/2011 $49.00
Value: $22,000 Info Process /Archiving - Sm Sheet (up to 08/25/2011 $1.00
11x17)
Erosion Control 08/25/2011 $26.00
Floor Areas:
Erosion Plan Review CWS 08/25/2011 $8.45
Erosion Plan Review COT 08/25/2011 $8.45
Total Area: 0
Accessory Struct: 0
Basement: . 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $574.22
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet: 1 Ersn Cntrl 681 -4444
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in acco dance with approved plans. This permit will expire if work is not started within 180 days o _ante, or if work/ i$'suspended for more the 180
days. ATT ION: Oreg• law requires you to follow the rules adopted by the Oregon Utilit /% catio ► -nter. Those rules are set forth in OAR
952 -001- 010 through OAR 9' -Or -00'0. You may obtain a copy of the rules or direct questions to OUN • `fling . 03.2`2.1'17 or 1.800.332.2344.
Issu d By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available ins. date.
This permit card shall be kept in a conspicuous place on the job site until completion of he project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application � �j
C CE ED FOR ^ Oil ICE USE ONLY
- `
City of Tigard � ,; Permit No.: 4up X 40/5
14 . w 13125 SW Hall Blvd., Tigard, OR 97223 JUN 21' 2011 Date /B : Received plan Review
' Phone: 503.718.2439 Fax: 503.598.1960 Date /B -: Other Permit: /Q+ B��~
Ti GA'RD ' Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris:. Et See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
it .�_ zi a: a� � z u r ��r
` 1 ..TYPE OF WORK g f REQUIRED DATA 1' ANDz2 FAMII YDWELLING 1
❑ 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
C
k ATEGORY OF CON5TRUCION 0 5; • work indicated on this application.
ob
❑ 1- and 2 -family dwelling ® Commercial /industrial Valuation: $ Z2., t
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
' ` Rr J NFOTION AND Total number of floors:
JOB SITE ' IRMA LOCATION �, r g
Job site address: 11433 SW Pacific Hwy New dwelling area: . square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Carts Jr Covered porch area: square feet
Cross street/directions to job site: Project is on the north side of Highway Deck area: square feet
99 on the west side of Busters BBQ Other structure area: square feet
i REQE1RED D ETA COMMERCIAL-USE CHECKLIST Ill
Subdivision: Lot no.: 6000 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 1S1 36AD Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
Na ',::::';::::1:gligilibSeitii*tiOStgdilliVtifirOMINIMINIIVIRMIN work indicated on this application.
Demolition of Existing Kentucky Fried Chicken Bldg. Valuation: $
Existing building area: 2,340 square feet
New building area: square feet
PROPERTI OWNER ' EA TENANT; Number of stories:
Name: KWKG, INC Type of construction:
Address: P 0 Box 1012 Occupancy groups:
City/State /ZIP: Wilsonville, OR 97070 Existing:
Phone: (503)682 -8474 Fax: (503)682 -7035 New
111 ,Alg - ►1 APPLICANT. liCONTACT PERSON a f UILDI PERMIT'FEES* i' r. 3
Business name: KWKG, INC .n „ (Pleaseref fee's chedule), . ! ; lg
Structural plan review fee (or deposit):
Contact name: Dan Gjurgevich
FLS plan review fee (if applicable):
Address: P 0 Box 1012
Total fees due upon application:
City/State /ZIP: Wilsonville, OR 97070
Phone: (503) 682 -8474 Fax:: (503) 682 -7035 Amount received
E -mail: dodgers088@aol.com ti 1HOTOVO T A1CSOL�A R P�A�NE�LSYSTEMFEES* 1 1
r x . F
Commercial d residential prescriptive installation of
x CON1IRk1CTO WO roof -top mounte. 'hotoVoltaic Solar Panel System.
Business name: TJ Nisbet Construction Submit two (2) set of roof pl. • ith connection details .
and fire department a ess, •. ong with the 2010 Oregon
Address: 15896 SE 82 Ave Solar Installation Speci ••°v Code checklist.
City/State /ZIP: Clackamas, OR 97015 Permit fee (ii tides review $180.00
.p. administrate - fees):
Phone: (503) 257 -0308 Fax: (503) 257 -0309 State sur . arge (12% of permit $21.60
CCB lic.: '-ice 92.-s 1 5—
T. al fee due upon application: $201.60
Authorized signature: This permit application expires if a permi is not obtained
within 180 days after it has been accepted as complete.
•
Print name: T'p/./I iJ i 5 6 1i-r- Date: 6 —I • - I1 * Fee methodology set by Tri -County Building Industry
Service Board.
a,.
I: \Building \Permits \BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11/02 /COM/WEB)
i
CONSTRUCTION, INC.
PO BOX 40 CLACKAMAS, OR 97015 PHONE 503- 257 -0308 FA
juN 2 1 2011
Transmittal CTY° � � �G
To: From:
City of Tigard Building Division T.J. Nisbet Construction, Inc.
13125 SW Ha11 Blvd PO Box 40
Tigard, Oregon 97223 Clackamas, Oregon 97015
Debbie Adamski Shelley Striplin
shelley.s@tjnisbet.com
Ph: 503- 718 -2439 Ph: 503- 257 -0308
Fax: 503- 257 -0309
June 21, 2011
Dear Debbie,
Enclosed is the Building Permit Application for the demolition of the existing Kentucky Fried
Chicken Building on Highway 99, along with three sets of the drawings from the Engineer.
Please let me know if need anything else regarding this permit application.
Best Regards,
`a a ._N.i
Shelley Striplin
OR CCB #0092315 • WA REG #TJNISC1044DN
AZ LIC #ROC 174616 • CA LIC #802630
//'/33 51.-J /atc -
— Dew) P
Building Division
Development Code Provision Review
TIGARD Commercial Projects with Approved Land Use
Building Permit No.: I QuPc9a/ /- OD/ 3/
Land Use Casefile No.: . D (Z. ab / -b0003
Routed Plans:
Submittal Date: to lA A4
Submittal Date:
Submittal Date:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies
to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the
notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed
above each section.
STAFF: please only mark those items on the left side that are approved.
Planning Review (contact \Toh Kayo( at 503 - 718- 61 or ,104 ' @ tigard- or.gov)
❑ Land Use Approval Sip/, 010/0 -0 0003
❑ Building Plans Match Approved Plan: Yes CT No ❑
❑ Maximum Building Height
❑ Conditions Met
Notes: - + ' ►.wf'
L f - ¢+ i,ys of 4 vP 111,. 617vp aunt S/€01.0r
+w✓
Original Plan: Approved 'Z Not Approved .0 Date: Svn+. o1 9,.2o!!
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
Actual Slope:
❑ PFI Permit #
❑ Conditions Met
Notes:
Original Plan: Approved Er Not Approved ❑ Date: "C '
Revision 1: Approved ❑ Not Approved ❑ Date: ( I
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
Cit Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov)
CJ treet Trees
U Protected Trees ,,y
Notes: i " r_ , ^s I'/ 'c po-4- } ro�.lc �• � w F;ro. s,1 c01' sk ) b'� rcn , ,
l
Original Plan: Approved ❑ Not Approved II( Date: C- 30 - )01)
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov)
❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit
❑ Engineering Okay to Issue Permit
Notes:
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
M
Okay to Issue Permit: Yes ❑ No L
Date Routed to Building:
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