Permit CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00233
' ' COMMUNITY DEVELOPMENT DATE ISSUED: 12/30/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136CC-02100
SITE ADDRESS: 11744 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: DUTCH BROTHERS COFFEE LOT: JURISDICTION: TIG
PROJECT: DUTCH BROS. COFFEE
Project Description: Demo 1100 sq. ft. building. Verify sewer cap.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM 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:
Owner: Contractor:
RYAN HAWKINS DALKE CONSTRUCTION CO INC
18216 SW MCCONNELL CT 2180 16TH ST NE
SHERWOOD, OR 97140 -8796 SALEM, OR 97301
Phone: 503 - 349 -6245 Contact #: PRI 503- 585 -7403
FAX 503 - 585 -1978
Reg #: LIC 63080
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 12% State Surch 9/12/2008 $7.50 Ersn Cntrl 681 -4444
[EROSN] Erosn Pin Rv ( 9/12/2008 $8.45
[ERPLN] Erosn Pln Rv C 9/12/2008 $8.45
[ERPRMT] Erosion Con 9/12/2008 $26.00
(additional fees not listed here)
Total $112.40
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 U ' ' . • • ' ion Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of the - rules or direct q • estions to OUNC by calling 503.246.6699 or 1.800.332.2344.
k
Issu d By: �V �� Permittee Sign. j _ r i �� /1 i _�
� —
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.
// 7 Pat; 7;2
R.��if.'i Permit pp ication � � 7- d /
• 13oni4nerciat , ,,0 ev E D FOR OFFICE USE ONLY
City of Tigard ec Received ?
DateB �,` rmtt No.: 60/ b .
13125 SW Hall Blvd., Tigard, OR 97223 '10
Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 \V \L ® DateBy: Other Permit: S D -J
T I G A R D Inspection Line: 503.639.4175 � AR p Date ReadyBy: 1uris: ® See � age 2 for
Internet: www.tigard - or.gov �kItY ‘° 10 , Notified/Method: 74'/( !� Supplemental Information
TYPE OF Wt REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction emolition 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 pr, fit for the
CATEGORY OF CONSTR ION work indic• ed on this application.
❑ 1- and 2- family dwelling Commercial /industrial c
Valuation: $
El Accessory building ❑ Multi - family Number of be • OMs:
❑ Master builder ❑ Other: Number of bathrooms.
JOB SITE INFORMATION AND LOCATION Total number of fl a . :
Job site address: f I 794 � Pk et t F ( L. 14 L y New dwellin::% - a: uare feet
City /State/ZIP: -ri A 64- q--722.- Garage/c .. .ort area: s• : - feet
Suite/bldg. /apt. no.: I Project name: -' i 4 L O al. Lt 3.4:rttiJ Cove : • :. area: square feet
Cross street/directions to job site: 3w 79 n , oI F Deck area: square feet
J OF H W' !c'i Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: N I Lo no.: hoc Z i oo Permit fees' are based on the value of the work performed.
t Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: I t ) 3 ‘c...C. /---- eq ipment, materials, labor, overhead, and the profit for the
DESCRIPT OF WORK / wo k indicated on this application.
- - - Dc Ho / /DO Ile /iv/ V, nation: $
I Existing building area: square feet
„j�/' New building area: square feet
eot �ROPERTY OWNER ❑ TEN !J "' Number of stories:
Name: / ^ N. w 1,e.;.,,, Type of construction:
-- Address: 1621 6 5w 11 c-C,,„ 1 I (,..,+ Occupancy groups:
0 City/State /ZIP: 5kotv 1 0 2 / 4<) - 819 6 Existing:
Phonc: ( b3) sir( ._b Z 4 S Fax: ( ) New:
\t ❑ APPLICANT E CONTACT PERSON NOTICE
N. ►�
Business name: �v i♦e �c 11 &v�� "i�+' All contractors and subcontractors are required to be
Contact name: Jt II ) -11„,,,,„ NJ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
I Address: 1 SS j 54r•:....f _ jurisdiction in which work is being performed. If the
City /State /ZIP: l G-+ /L o Z applicant is exempt from licensing, the following reasons
S apply:
IN Phone: (5.+3) 36 3-q Zz 7 I Fax:: (6.3) 34,4 -1 ZGo
}� E -mail: . 1 \ t1., t` Mi.i Hi .Lv$
N, CONTRACTOR
‘1.1` Business name: 1 tee- ,' rs .,,�'u,,, Co . BUILDING PERMIT FEES*
(Please refer to fee schedule)
2 Address: Q 13,04. W") v
J City /State /ZIP: 5 De 9 7 3x Structural plan review fee (or deposit):
Phone: ( 5 a3 ) 56S" ._ 74 3 Fax: (5 5 ss n FLS plan review fee (if applicable):
t CCB lic.: C 3o8Q Total fees due upon application: ijAa •CP j Amount received:
Authorized signature: This permit application expires if a permit is not obtained
thin 180 days after it has been accepted as complete.
L Pr int name: L Date: �j /7/566 ' Fee methodology set by Tri -County Building Industry
Service Board.
l:\Building\Permits\BUP -COM PermitApp.doc 2/23/07 440 -4613T(I1 /02 /COM/WEB)
S w F - a A/ ° 5 AT /e__ 1)64Albo -Atkig -7
)1,
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to 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 under this section, priority shall be 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): $
I: \Building \Permits \BUP -COM PermitApp.doc 10/30/07