Permit •
A � BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2006 -10013
� ' DEVELOPMENT SERVICES DATE ISSUED: 3 /8/2006
s-��� 5 =-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S136DA - 00700
SITE ADDRESS: 11530 SW PACIFIC HWY • ZONING: C -
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Modify restroom to provide unisex ADA restroom.
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: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 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: $ 3,100.00
•
Owner: Contractor:
HI HAT INC OWNER
11530 SW BARBUR BLVD '
PORTLAND, OR 97219 •
Phone: Contact #:
•
Reg #:
FEES
Description • Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcha 4/1/2006 $6.54
[BUILD] Permit Fee 4/1/2006 $81.70
[BUPPLN] Pln Rv 4/1/2006 $53.11
Total $141.35
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 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 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: :27/ R L Permittee Signature: of i N I
V 1
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
. 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 OFFICE USE ()NIA'
of Tigard
k p eed ...._• � `� Permit /� r00
13125 SW Hall Blvd., D
, Tigard, OR 97223 Plan az Review 3 AMj7� C mher Pe
Phone: 503.639.4171 Fax: 503.598.1960 /4, ^ y - jl eJB
Inspection Line: 503.639.4175 k g- Date Ready/By. JuN: El See Attached Checklist for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
�
y Indicate the -value (rounded to the nearest dollar) of all
Er AdditiO alteratiso/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 $ 1 l ,9 •
❑ 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: /1.53‘.2 5 w PA-C../ 7:1 L ii-f• `r New dwelling area: square feet
City /State/ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: 14.1 - "of (Vs 1; f Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
H r - Pt' T / (LA S ."...„l.f., % Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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.
n r Valuation: S
PAA•✓l 4 1 1 - Vim/ S f-q/4- A-A-s r/�. -oe /� Existing building area: square feet
New building area: square feet
5' PROPERTY OWNER I ❑ TENANT Number of stories:
Name: H ., 9 i '7 co , A. 0 Type of construction:
Address: / / ,,
..5 ;, S CA, f NGgr H .e• Occupancy groups:
City /State/ZIP: Prl G A A.4 0A, I Z 2.23 Existing:
Phone: (9') 1,144, ". $5 Fax: ( ) . New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be • .
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City / State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E-mail: •
CONTRACTOR
Business name: _ ( .. r , ` (..f cis... Sly v/1 � ►�'ow
T � S BUILDING PERMIT FEES *
Address: L�/1.� %1t Gw....ei
�J f} S Please refer to fee schedule.
City /State/ZIP: . k .
Fees due upon application
Phone: ( ) , r• I Fax: ( ) <
Amount received
CCB lic.:
Date received:
Authorized signature ' �.J / �, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: //°"."..w^N 00 ....T y I Date: 3/{yp 6 • Fee methodology set by Tri -County Building Industry •
7.7.....,%. f}' / -* r rrP ?" •
i Service Board.
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°1 •��' - ` , AV ' Building Division
Y, i1 •' g'' V t
f Plan Submittal Requirement Matrix
Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans r • ,
(Includes new, additions and alterations.) Required at
-c Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
- 1 •
Site Work 2
(must include•'liication`of all accessible•parking). .
Plumbing (site utilities) 2
Building 1*
Fire Protection System '~ °
•
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) . •
9 1
* For over - the - counter commercial tenant improvements; submit sets of plans:
** "New" fire protection systems require thatplans bear the original seal of an •
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
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