Permit BUILDING PERMIT
CITY T I G A R D PERMIT #: BUP2002 -00312
A DEVELOPMENT SERVICES DATE ISSUED: 8/9/02
-=` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11465 SW PACIFIC HY PARCEL: 1S136AD -05800
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SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N : sf N: . S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 84,000.00 •
Remarks: Reimage existing Texaco to Shell image, square canopy, replacement of signs & fascia.
Owner: Contractor:
EQUILON ENTERPRISES LLC PACIFIC NORTHERN ENVIRONMENTAL
PO BOX 4453 1081 COLUMBIA BLVD.
HOUSTON, TX 77221 LONGVIEW, WA 98632
Phone: Phone: 360- 423 -2245
Reg #: LIC 00078140
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT CTR 8/9/02 $656.78 27200200000 Final Inspection
5PCT CTR 8/9/02 $52.54 27200200000
PLCK CTR 8/9/02 $426.91 27200200000 •
FIRE CTR 8/9/02 $262.71 27200200000 •
Total $1,398.94
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 than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or -800- 2 -234 /
Pe rm ittee / .
Signature: .,
Issued By: ` le :a
Call 639 -4175 by 7 p.m. for an inspection the next business day
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Building Permit Application
4,, Datereceived: 7 OP- Permit no.: -OD 3/�
City of Tigard 1/ ,� ProjecUappl.no.: Expire date:
Address: 13125 SW Hall Blvd, Tigard, OR 9
City of Tigard Phone: (503) 639 -4171 Date issued: I �,Cosu Receipt no.:
Fax: (503) 598 -1960 JUL 9 2002 Case file no.: - Payment type:
CAI Y Oe 0-i m
Land use approval: l&2 family: Simple Complex:
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TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory IS Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
$1 Addition/alteration /replacement 0 Tenant improvement ❑ Fire sprinkler /alarm - I8 Other: ".._. - -
JOB SITE INFORMATION
Job address: lig (CS St& ?ACtF-t. }may Bldg. no.: Suite no.: '
Lot: 'Block: (Subdivision: 'Tax map /tax lot/account no.:
Project name: si p Q Q . , a
Description and location of work on premises/special conditions: 2.eiry'Ot q P. Q]c%S?ln 9 Te, AC0 - -o She,A 1 6slet92
/Ntdidoes - PiliA1T, sojagIN, et,930nel coRneRS R - of 5 - 17.S - b Ff15U:R
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplaiu, septic capacity, solar, etc.)
��LLILO N • EIJTeI�IZ.►Ct25 4LL �]r�sA
Mailing address: lolan2 NE 2 i$ pt. 1 & 2 family dwelling:
City: 14,19.1F 1 State: Lo ZIP: 9$033 Valuation of work $
Phone: 213/-09 (Fax: — 1E-mail: — No. of bedrooms/baths
Owner's representative: - rit'yt LoroS& Total number of floors
Phone: 29/ 6-11)-202_0 Fax: — E- mail:' New dwelling area (sq. ft.) .
//��
Garage/carport area (sq. ft.)
Name: Vt7 nz550- r'(1.� 5 g gill- «estq n t; fLot. P .Trr. Covered porch area (sq. ft.)
Mailing address: llc g'. o'b A,tQ St,s,t - e, IOC) Deck area (sq. ft.)
City: VVl e, St ate: WA ZIP: q9-_, 99040s--eds-no Other structure area (sq. ft.)
Phone: 4/25 g)9 - 1x 301 Fax :tar tllo E-mail: v l) Co ercial/industrial/multi- family:
aluation of work $ § QOb
�� Existing bldg. area (sq. ft.) I 5 . F:
Business name: "ENE P 1 ,, G b�l .Z. l tp./{rt►t • New bldg. area (sq. ft.) i38y S.
Address: Number of stories I
City4tfiliAggsvmw. State: p Type of onstruction �N
Phone: ax: 1E-mail: pancy group(s): Existing: S - /n
CCB no.: e G :, ii , -= ' I / ' New: ,S //j3
City /metro lie. no.: / 6g , .. I . ., P " A a 4 Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: } me As fl-ppliCant. provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
Cit : State: ZIP: exempt from licensing, the following reason applies:
Y
Contact person: Plan no.:
Phone: Fax: E -mail:
Name: . Contact person: Fees due upon application $
Address: • Date received:
City: State: ZIP: Amount received $
Phone: 1 Fax: 1E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this ❑ Visa 0 MasterCard
work will be complied with, whether specified herein or not. f� Credit CBfd nu Expi
res
Authorized sign re: VQi1 tea Date: 7 ✓ �2 Name of cardholder as shown on credit card
btu $
Print name: Vanessa m. az5 Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6t0acoM)
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C ommercial Plan Submittal
` 1 1 41 I � Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans •
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1
Fire Protection System 3 **
• Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \forms \COM- matrix.doc 9/24/01