Permit ' 1 '
^•� `' BUILDING PERMIT
CITY TIGARD PERMIT #: BUP2002 -00260
� a^JI�� DEVELOPMENT Tigard. ) 639 -4171 DATE ISSUED: 8/30/02
SITE ADDRESS: 11636 SW PACIFIC HWY PARCEL: 1S136DB -02500
SUBDIVISION: ZONING: C -G
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 37 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: $ 120,000.00
Remarks: Tenant improvement to convert fast food restaurant to a Starbuck's.
Owner: Contractor:
NACHTIGAL, FRED C SUC PERS REP WESTERN CONSTRUCTION SERVICES
KESSLER, JULES E 4612 NE MINNEHAHA ST
101 SW WASHINGTON ST P�ONBOX 5 v 7 F 6 R 8 26 �p/
A g
HPlio BOR 593 %'2 9 • V iPtlon O e 365
Reg #: LIC 63717
•
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Foot/Found Insp
PLCK CTR 7/5/02 $534.50 27200200000 Masonry Insp
Masonry Insp
FIRE CTR 7/5/02 $328.92 27200200000 Framing Insp
PRMT CTR 7/5/02 $106.44 27200200000 Gyp Board Insp
PRM2 CTR 8/30/02 $715.86 27200200000 Final Inspection
(additional fees not listed here)
Total $1,751.50
•
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 • - rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throw • - 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -\6^ :. -: 10- 332 -2344.
Pe mt ittee : . \ k.—
■
Signatui :,� -�
e ril„...„4_,,
Issued By: v 1 ,I .
,..
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application OFFICE USE ONLY
t l f I Ci of Tigard Date received: ep A7 6,2, Permit no.: �u P �.- 604 • _
.. Project/appl. no.: M , i n agii k date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - Date issued: 1 By K,i) Receipt no.:
Fax: (503) 5984960 Case file no.: Payment type:
Land use approval: HHOPooZ -c0 / 7 1 &2 family: Simple Complex:
TYPE OF PERNlIT
O.
U 1 & 2 family dwelling or accessory U Commercial /industrial U Multi- family U New construction _I Demolition
U Addition/alteration /replacement ,Tenant improvement U Fire sprinkler /alarm U Other:
.IOl3 SITE INFORMATION 1
Job address: 1 ' L 3C .5 ) P S.,'� W �� T l a q �. - � el q �a�.3 Bl dg. no.: — Suite no.: —
Lot: o5 Block: 'Subdivision: J I Tax map/tax lot/account no.: LS/ 3‘ .013
Project name: c 5-1--c t e ., h tAc, kS
` Description and location of work on premises/special conditions: Teevanf t .w
✓ -Tv0ve'F +o e rS4.11 -1 bcr i d ,�-t
J .1
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: Nicole: Kelso (Floodplain, septic capacity, solar, etc.)
Mailing address: C 3 i f'S ( y S r e i 1d St 1 & 2 family dwelling:
City: (,(Jest' L i yr v-+ 'State: a I ZIP: q L 0 , Z Valuation of work $
Phone: 5a3- )3 =7 75 'ax: 1E-mail: No. of bedrooms/baths
Owner's representative: hf icoIe Ke.(5 a Total number of floors
Phone:$' 3- 3 - 51 Fax: E -mail: New dwelling area (sq. ft.)
Garage /carport area (sq. ft.)
Name: nd q Ober /51 S e-e Covered porch area (sq. ft.) `J
Mailing address: a� 1 h Ave So Deck area (sq. ft.)
City: 1 - f ( I State: al I ZIP: qS 13 it Other structure area (sq. ft.)
Phone:a06 3I5-157S Fax: E -mail: Commercial /industrial /multi- family:
CONTRACTOR Valuation of work $ D D
Business name: (�(�ps4e,, S l c.4 -1'� Existing bldg. area (sq. ft.) � , 3 i,
Address: 4-6,1 ) / 141,..-. In a 54 -V New bldg. area (sq. ft.) I, 3o3s� -PI:
e. a Number of stories 1
City: \ Jc tco.t v`e'V' I State: ({/} I ZIP: ci566, / IV
Phone: 3(0 Cq'q -531A Fax: I E -mail: Type of construction 1/—
CCB no.: rI ?1 Occupancy group(s): Existing: ,
7 New: J C fl3
City/metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: I provisions of ORS 701 and may be re
anda O�` �✓1Cr�1,etie' e�M.+t i �e' i3 P Y required to be licensed in the
q
Address: 1 0940 IV G 5 J ....a pL rle, aQ a jurisdiction where work is being performed. If the applicant is
W� I q ��O`f' exempt from licensing, the following reason applies:
City: 13011 e✓tA.e, State: ZIP:
Contact person: hywo Ja Obe Plan no.:
Phone:ij -$. -DIDU Fax: 3 &La -mail:
Name: VI.MK (, f,,,,,. Contact person:. _ Fees due upon application $
Address: 3133 51.) Ct,t g Date received:
City: {o r' f l o n a J (State: pi< (ZIP: c( no 1-41,30 Amount received $
Phone:503, aa . Fax: 572 v1 k ®.,I .►rk, coy 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 O Visa ❑ MasterCard
work will be complied wit' , . t ether specified herein or not. edit card number. / /
Expires
Authorized sips • lure: II %L.Lf� Date: / ' / I '40 Name of cardholder as shown on credit card
' $
Print name: Lu ice:( _ i ' LL" a. _/ / U . Cardholder signature Amount
Notice: This permit application expires if . ermit is not obtained within 180 days after it has been accepted as complete. 440.4613 (6 %00/COM)
CITY OF TIGARD .-- .A• .
� �� 24-Hour , -
. . BUILDING _• Inspection Line: (503) 639 -4175 r
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP o " Como
Received Date Requested l I (/3 AM PM BUP
Location 1/ 3 4 �- Suite s• MEC 2-15102-- 0 0 Ze
Contact Person Ph ( j —7 7a J O (6 /
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation - - - ' - -
Acces
Ftg Drain � . — d • _ __ _ A, • ELR
Crawl Drain % = • IT
Slab l No = ; .
Post & Beam / �
Mfg ; lkihi
Shear Anchors /
Warr; �� � , 7 . fati , Ext Sheath/Shear / ice'
Int Sheath/Shear ! ���
Framing ' �-
Insulation �—
Drywall Nailing -
Fi reveal I �---
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ..
O Othe
�thet'.f � ',..;;:. ____-__...._ Iii , - *---
• V BING araarm
Post & Beam 41M t',.W
Under Slab v iI . -. -
Rough -In
Water Service
Sanitary Sewer
Rain Drains '
Catch Basin / Manhole
Storm Drain '
Shower Pan
Other: Oth rr �• /'�
Ot h ` _ i► ,se, z-- or) z.-( 0
• PART FAIL
' "'" ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final .1
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab `.
Low Voltage • i
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE l 0 Please call for reinspection RE: n Unable to inspect - no access
Fire Supply Line ,
ADA Date . /// 3 /° Inspector 9 Ext
Approach/Sidewalk
Other: ,
Final s ' DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL