Permit . `n -\ CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00452
COMMUNITY DEVELOPMENT DATE ISSUED: 8/27/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136CD - 00102
SITE ADDRESS: 11685 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: BAJA FRESH MEXICAN GRILL
Project Description: Demo of interior walls.
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: B 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: y( a`, 00
Owner: `�' Contractor:
WILLIAM & SALLY FLOWBERG TJ NISBET CONSTRUCTION INC
834 SW ST CLAIR PO BOX 40
PORTLAND, OR 97205 CLACKAMAS, OR 97015 -0040
Phone: 503 - 225 -0700 Contact #: PRI 503 - 257 -0308
FAX 503 - 257 -0309
Reg #: LIC 92315
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/27/2007 $62.50
[TAX] 8% State Surcha 8/27/2007 $5.00
Total $67.50
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 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 OU C by calling 503.246.6699 or 1.800.332.2344.
Issued = i/i/ i// /_
Permittee Signatur-
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.
I Buildi - gg ermit Application
Application
Commercial FOR OFFICE USE ONLY
1 14 City of Tigar ee d ar 7 O % Permit No.: / 13125 SW Hall Blvd., Tigard O Plan Review • II . Phone: 503.639.4171 Fax: 503.598. y Date/By: Other Permit:
T I G A K D Inspection Line: 503.639.4175 A 2 "( 2007 Date Ready/By: Jai El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 6 Supplemental Information
CITY OF TIGARD
TYPE MdtltG DIVISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑,1- and 2- family dwelling g Commercial/industrial Valuation: $
❑ 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: • / ) (o g S -$1.! MAGI Ft � 14 t 611 b4 M l New dwelling area: square feet
City/State /ZIP: II 6 4 tjip 012. Garage/carport area:. square feet
Suite/bldg. /apt. no.: Project name:ON— t'a vteto(A G Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Co 0.4 (L' PA (..t F∎ L tkv+`A S X} Other structure area:. square feet
_ REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fee:,• are based on the value of L 1 . ; : foi_..ac , '
Tax map /parcel no.: Indicate the value (rounded to the nearest doi,ar) of all
equipment, materials, labor, overhead, and'the profit for the
DESCRIPTION OF WORKK work indicated on this application.
p-i T, o i7°-, c�4 / / ( Valuation: $ d O O ��
fj
J
' Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 81 V TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
IKI PLICANT EKONTACT PERSON NOTICE
•
Business name: d .,41,,,,. - -- FI2cu '111^– U.G / 'L. iaJ c,k {�\ All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: C >_.S
under ORS 701 and'may be required to be licensed in the Kb Address: $ �(�p S p �,,� M�1 OA jurisdiction in which work is being performed. If the
City/State /ZIP: SN ��,t a o c D b (l. ` l� r; 0 applicant is exempt from licensing, the following reasons
apply:
Phone: (So3 ) (, 4 a S6(I /So3 Qs 3S}� Fax:: ( sal ) 6 a-• 3 R S-R-
E -mail: e C s- . c� p_b \• C A
U CONTRACTOR
Business name: ! a ( 7 0 S 8? /4. BUILDING PERMIT FEES•
Address: �� $� �/ �� (Please refer to fee schedule) City/State /ZIP: G''c � 1445 0 2 q / S� Structural plan review fee (or deposit):
X 03) 3g-57 0308 Fax: / (�3) ZS'7 -O,�p FLS plan review fee (if applicable):
Phone: e�
CCB lie.: D0 Z3/5 / Total fees due upon application:
q �Z� O$
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
• Q within 180 days after it has been accepted as complete.
Print name: / k i l /5 p r Date: Z7 -Z7 •.04, I • Fee methodology set by Tri -County Building Industry
Service Board.
1:IBuilding\Permits\BUP -COM PermitApp.doc 2 /23/07 440 -4613T(11 /02 /COM/WEB)
• ,
Building Division
•
Accessibility: Barrier Removal Improvement Plan
TIGARD
•
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification t� affected buildings and related
facilities shall be made to insure that 'the path of travel to the altered area and the restroom,
telephones and drinking fountains are - readily accessible .to .individuals with disabilities unless
such alterations are disproportionate to. the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to..
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25..
• TOTAL BUDGET FOR BARRIER REMOVAL: [2], $
•
ELEMENTS: In choosing which accessible,elements•to provide ,underthis,section,.priority shall given
to those elements that will provide the, greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered-area:. $
(d) At least one accessible restroom for each sex or .a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and,• $
(g) When possible, additional accessible elements such' as storage and -
alarms: $
• TOTAL (shall equal line [2] of Valuation Computation): $..
•
•
r i
I: \Building \Pemvts \BUP -COM PermitApp.doc 02/23/07
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: BUP7007_00462
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/27/2007
Phone: (503) 639- 4171gyp�
Inspection Requests (24 Hrs.): (503) 639 -4175 "I �..
INSPECTION WORKSHEET FOR DATE: 10/5/2007 TIME: 7:01AM PAGE: 48
SITE ADDRESS: 11686 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: BAJA FRESH MEXICAN GRILL
DESCRIPTIOe —D o f interior w'zirrs
OWNER: FLOWBERG, WILLIAM & SALLY PHONE #: 503-225-0100
CONTRACTOR: NISBET CONSTRUCTION INC, TJ PHONE #: 503- 257 -0308
Inspection Request Scheduled For: Date: 10/5!2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 057026.01 971 - 678-3094 N
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - Ve_ Date: G� / Phone #: (503) 718 - 1