Permit CITY OF TIGARD BU ILBUP2 DING PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: 01 1 00
Date Issued: 09/20/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel: 1S136AD06000
Jurisdiction: Tigard
Site address: 11437 SW PACIFIC HVVY
Project: Carl's Jr Restaurant Subdivision: VILLA RIDGE Lot: PTS 1 -2
Project Description: New drive -thru restaurant
Contractor: TJ NISBET CONSTRUCTION INC Owner: EJM PROPERTIES INC &
15896 SE 82ND DR MAVERICK DECATUR GEORGIA LLC
CLACKAMAS, OR 97015 -0040 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 New - Bldg 09/20/2011 $128 00
Class of Work: NEW DC Provision Review, COM New - Ping 09/20/2011 $128.00
Dwelling Units: 0 DC Provision Review, COM New - LRP 09/20/2011 $38.00
Stories: 1 Height: 22 5 ft Erosion Control 09/20/2011 $136.00
Bedrooms: 0 Bathrooms: 0 Erosion Plan Review CWS 09/20/2011 $44.20
Value: $490,000 Erosion Plan Review COT 09/20/2011 $44 20
Metro Const Excise Tax - Commercial 09/20/2011 $588.00
Use
Floor Areas: Tig - Tual School CET - Non Residential 09/20/2011 $1,476 58
Park - Commercial and Industrial 09/20/2011 $640 92
Total Area: 2786 TDT - Transportation Development Tax 09/20/2011 $7,313 00
Accessory Struct: 0 Permit Fee - COM - New Construction 05/19/2011 $2,560 52
Basement 0 12% State Surcharge - Building 09/20/2011 $307.26
Carport: 0 Plan Review 05/19/2011 $1,664.34
Covered Porch 0 Plan Review - Fire Life Safety 05/19/2011 $1,024.21
Deck: 0 Info Process /Archiving - Lg Sheet (over 09/20/2011 $142.00
11x17)
Garage: 0 Info Process /Archiving - Sm Sheet (up to 09/20/2011 $74 00
Mezzanine 0 11x17)
Total $16,309.23
Required: Required Items and Reports (Conditions)
Fire Sprinkler No Parapet Yes 1 Reinforced Concrete
2 Ersn Cntrl 681 -4444
Fire Alarm' No Protected Corridors: No 3 Bolts in Concrete
Smoke Detectors No Manual Pull Stations: No
Accessible Parking: 2
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 • - ..tio Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952-001-0090 You may obtain a copy of the rules or direct questions to OUNC .y calling r 87 or 1 800 332 2344
Issued By:( ") CaeCit__,AL Permittee Signature: •41.1111111,
Call 503.639.4175 by 7:00 a.m. for the next available inspectiTte.
This permit card shall be kept in a conspicuous place on the job site until corn. etion of the project.
Approved plans are required on the job site at the time of each inspection.
' Building Permit Application # � 6 -- 6 I
-
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700W l ! ! Received
� ut "w ' C , Permit No . 7
,� ' w'�;a `J O� Tigard
Date/By. �,. �li�' Jr,
) 0
13125 SW Hail Blvd , Tigard, OR 97223 r 0� Plan Revie is
bry . Other Permit
Phone 503 718.2439 Fax 503 5981 60 �� f ® ., Date /B : rr,fi ���
ti ,, .4 Inspection Line. 503 639 4175 t ;,_ \'� h'• Date Ready : .. 0 See Page 2 for
;TIIGARD` Internet' www tigard-or gov . 4.z.... . `�,, \� Notified /Method 9 '' .*. Supplemental Information
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INt New construction Demolitio' 'v Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of . 1
K Addit ton /alteratioi replacement) ❑ Other: equipment, matenals, labor, overhead, and the pro for the
iy ts;' } k
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❑ 1- and 2- family dwelling c ommercial /industrial Valuation: $ ° �- or
111 Accessory building 111 Multi-family Number of bedrooms:
['Master builder ['Other:
Number of bathrooms:
" ''' '�JOBv SITE "l1VF„ ; - QcND ' � - � ' .r t Total number of floors:
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Job site address: �(.t) PAC-4F/ C UW Y c New dwelling area: square feet
—t.
City/State /ZIP: i 1 r : p,e•� Q 2 • • r' Garage /carport a -'.: square feet
Suite/bldg. /apt. no.: Project name: c a z ` 15 J2 • ,\ Covered po area: square feet
Cross street/directions to job site: t. dN a `� e ,{.t}�,G, t ' • k area: square feet
k r
S r 'F ' •iJ r Other structure area: square feet
V ` `(`� tiA r7 n1 :''REQU7R $D'A EI) lt. ;' - - C HECI&fiST i:'
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Subdivision: ��fA1 a n Lot no. �,t Permit fees* are based on the value of the work performed.
v--I) ....s....,.. • AV" Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: ��' •
T�J
equipment, materials, labor, overhead, and the profit for the
k.; " a '
-- i & a., 'era- ex,w1 -O ems: ' ,,,,,-.".:,-t" w 4.Z =9,% t "r 1 �.', lia , ; ,. ,,11 , .�
n '�� °��' ' �D WO 12 K ` ���� �t�' ° � T �' " T ` work indicated on this application.
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g e , p lc FC., 8 t-,d4' L✓ G p.67- V aluation: $ e,t,0 * o
Existing building area: square feet
i\- E i.Zi — 6 LLI 1..1-, New building area: '7 1 a, square feet
i ^ �r ��,,, 4 „;,f. w 1 r PROPERL C OW_ NERS v•,x,t, r S,
' i t Ir r r�. TENANT.. . Number of stones: /�
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Name: pik 1`i j uyi e .v 1 c I-I Type of construction:
Address: 7 Z Co 3 Ly Iti K w O°.4 6T, Occupancy groups A. 2,
City/State /ZIP: (J( (G , vi [L D 12—. 1 7U 7 d // Existing: AZ
Phone: (Sji3) 642 4.74 Fax: (1-2,3) fwSZ• 70 3S New: its 2+
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Business name:
Le. A /� 2 G{. �T 6.7 02 E Structural plan review fee (or deposit):
Contact name: N &I L_ L FLS plan review fee (if applicable): '
Address: ) ¢O Z S t= _ c&' — ' T•
Q Total fees due upon application:
City/State /ZIP: pcATLA W D 012 ! 7 Co Z
( �3l 2 , - 2 Z / Amount received:
(
Phone: 4,4+. 2� Fax. Y '�
¢ � u,�''.� L n�rlwil: a"..,s� ", �. �r .M:�x, e� � • o , "" ' :�t.', "' !r� z •. p. y; f j::,, e. Le 1 rte_, 'r er,PH ; OT O VO L T A I,GSOI.AR P ANEL ; v ,,;
E -mail: SoGGe �� e�
�, ,, fi r._ ' , , ,.a rs ,, ; ,, r = 4 4 - , ;, :• . i , t .. ,, • »., Commercial and residential prescnptive installation of
4
4'tiq .AVP', e° 'X COIVTRACTORh•' , ,; , �r i,,..
`., . , ` � `` , , t'aa 1 , :' .>i, ,,,a .,,.,.aN- ,,1•: , t. ' .,� . e v 1-4- �', .. roof-top mounted :ALL �'=x�,„ at~��1?:.:s: ''K. oK•��:, :� „�.a+ '.vp': -.., •'� p d Photovoltaic Solar Panel System.
Business name: /� Submit two (2) sets of roof plan with connection details
T j . pit 'r • °t” sr and fire department access, along with the 2010 Oregon
Address: 5-get � S k� D Solar Installation Specialty Code checklist.
City/State /ZiP: c (A k O Q 70 /. Permit fee (includes plan review $180.00
and administrative fees):
Phone: ( 50,3) 2 57 • 0 3O F ax: ( 503) 2 S 7 • e 301 State surcharge (12% of permit fee). $21.60
CCB lie.: GG t 2.. 3 5
, L Total fee due upon application: $201.60
Authonzed signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Pnnt name. !v e f .e.-c..- Date: S/ 1,0 / 1( * Fee methodology set by Tri- County Building industry
Service Board.
I \Building \Penmts \BUP -COM PennitApp doc 02/24/2011 440- 4613T(1 1 /02. /COM /WEB) •
T _
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Coi3A
Building Division
Development Code Provision Review
TIGARD Commercial Projects with Approved Land Use
Building Permit No.: 6 1, tl 11— U0 \Oo
Land Use Casefile No.: 5 lei I ►'vu - ./. ( ? • f 8Th
Routed Plans:
Submittal Date: 9//,
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 `iO44 at 503- 718 - 4,2- or \ 1044 p @tigard- or.gov)
❑ Land Use Approval .ARdo10 ONO —
❑ Building Plans Match Approved Plan: Yes No ❑
❑ Maximum Building Height 'S"
❑ Conditions Met //II_ ,r
Notes: //e e. i t�o (41, e- 5/6j ?ge. ((G, 1p- 41-) a) 4Qed del p<;"
� �IaN'( ' ovt �� 1. - 444 mono vra ' - 4)sbe cwt. riot Si fr,(zwr
Original Plan: Approved ❑ Not Approved Date: 7 r '/7
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)
la Actual Slope: S
DEP PFI Permit # 2 0 I ( 0000
❑ Conditions Met
Notes:
Original Plan: Approved Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
i= I
City trborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov)
Q Trees
E ( Protected Trees //�� T
Notes: Per ,7-/ °II1 t(-� 44-' afnfoa e r`e t),-(t),-(,,t,,. tc: nr�j .f. k
;\ 144U h ,hipz� pm;,- 1 f alV,w��.
Original Plan: 1 Approved ❑ Not Approved Date: r�oji
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
Okay to Issue Permit: Yes ❑ No ❑ '
Date Routed to Building:
•
Page 2 of 2
Auaog -O a)
//- 7 -5 ,J
TUALATIN VALLEY WATER DISTRICT Test #: 928
ARE HYDRANT FLOW TEST REPORT Hydrant ID #: 1 S1W36A41 HSO
Location: HWY 99 AT TANG'S GARDEN Date: 6/14/2011
Test made by: JAMES & HERB
Witness: Time: 2:00
Project name: CARL'S JR �1�0� 0%0 - /t)e C C ,/;?,e- ge`r
Discharge coefficient: .54816
Inside dia. of outlet = 4.5 inches
Pitot reading = 18 psi Pitot 2 = 0 psi
Observed flow rate = 1404.4 gpm
Flow method: HOSE MONSTER
Static pressure: 57 psi Residual pressure: 41 psi
Flow at 20psi residual pressure (calculated): Y 2208 gpm d� 3
Location map: To be attached to test report and to show which hydrants were
used to monitor residual pressure and flow.
Gage information:
Static and-residual pressure gape: 120997 -2C Pitot gage: 9864E1
Hydrant information:
Hydrant ID Year Make Notes
Flow hydrant: 1 S1 W36A41 HSO 1985 MUELLER see map for location
Read hydrant: 1S1W36A33HSO 1985 MUELLER see map for location
Remarks:
The mapping, flow or pressure information contained herein reflects conditions on the date
and time of the test. Tualatin Valley Water District makes no representation as to the system's
ability to meet specific fire flow requirements. Future system capability may differ from the
flows reported herein because of subsequent modifications to the district's system and/or
because flow and pressure may vary by time of day and season. Test gage callibration
information available upon request.
•
iris is,
•
SPECIAL INSPECTION 7409 SW Center Dr., Suite 145
FINAL REPORT
Tigard, OR 97223
503.4433799 Phone: 503 -443 -3799 Fax: 503-620-2748 -
Date: Feb 29, 2012
Job # 11- 3364 -D00
Permit # BU'P2011 -00100
Mail To: Project :
TJ. NISBET CONSTRUCTION INC. CARLS JR.
PO BOX 40 14433 SW PACIFIC HWY
15896 SE 82ND DRIVE TIGARD, OR 97224
CLACKAMAS, OR 97015
To Whom It May Concern:
ACS Testing, Inc. attests that their inspectors performed special inspection(s) on a continuous and/
or periodic basis as required by the specific jurisdiction and /or IBC. Special inspection(s) were
performed for the following:
El Structural Steel ❑ Proprietary Anchors ❑ High Strength Bolts
❑ Structural Masonry ❑ Shotcrete ❑ Wood Nailing
41 Reinforced Concrete •
Other:
Based on personal observation, inspection and reports reviewed by me for the above project,
I attest on behalf of ACS that work was performed to the best of my knowledge, in
accordance with approved plans, specifications, and the applicable codes and standards for
this jurisdiction.
Approved by: %'�
BOB Brown/President •
BB:sa
Field Report
Project: //? Hid/ Date: /'9y //
Location: rtyt-9 , vtA Weather: _ST r J/ V
Developer: T . J NJ e Mia Mahedy- Sexton, P
Permit No. nJ f to /1 — d t1 /Uv
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. OREGON
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Rp (EXPIRES j A - jr— z.c) /C
SOIISOIWIIOflSLLC
3915 SW Plum Street
Portland, OR 97219
P: 503- 816 -3689
F: 503- 285 -1636
mia @rapidsoilsolutions.com