Permit 4 . CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00092
4N0'1A DEVELOPMENT SERVICES DATE ISSUED: 2/26/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11875 SW PACIFIC HWY PARCEL: 1S135DD -00900
SUBDIVISION: HOFFARBER TRACTS NO.2 ZONING: C -G
BLOCK: LOT: 021 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: M 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: $ 114,000.00
Remarks: Tenant improvement
Owner: Contractor:
LEFEVER, GEORGE & TAMMY TROYCO
11875 SW PACIFIC HWY TROY DEAN TAYLOR
TIGARD, OR 97223 PO BOX 1786
TUALATIN, OR 97062
Phone:
Phone: 503 - 740 -7714
Reg #: LIC 145337
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 2/25/03 $798.90 Electrical Permit Required
rm
TAX 8% Tax 2/25/03 $63.91 Plumbing Permit Required
[TAX] Foot/Found Insp
[BUPPLN] Pln Rv 2/25/03 $519.29 Framing Insp
[FLS] FLS Pln Rv 2/25/03 $319.56 Shear Wall Insp
Total $1,701.66 Gyp Board Insp
Final Inspection
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 OUNC by
calling .699 or 1- 800 - 332 -2344.
Iss d By:
Pe rm ittee •
Signature: Oc " ,s �P. u 1 -t-L
Call 639 -4175 by 7 p.m. for an inspection the next business day
• Building Permit Application
City of Tigard r Date received: A A5-03 Permit no.:gm 3-t ? , /
Address: 13125 SW Hall Blvd, Ti C
� v Project/appl.no.: ' ed ate:
CCity of Tigard Phone: (503) 639 -4171 Date issued: (1 b jI Receipt no.:
Fax: (503) 598 -1960 FEB 2 5 2003 Case file no.: Payment type:
Land use approval:
WY OF TIG 1 &2 family: Simple Complex:
a k I �71STON
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory Ei ommercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: 1 ( 1S SV..I IfIC - i- 1 \1.1`� i ' z 0E- q 77 3 Bldg. no.: Suite no.:
Lot: Block: (Subdivision: I Tax map /tax lot/account no.:
Project name: / Ort 4, o2 HOT/ i/E S
Description and location of work on premises/special conditions: ti lH /� /� vr Pi fAir
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name:( Qr l — `'f -.AM -? [r/4 _ (Flood plain, septic capacity, solar, etc.)
Mailing address: 1 i ? E .i T K 1Le 1 & 2 family dwelling:
City: f (, - 24) IState:(. _IZ1P: el - 12Z2 Valuation of work $
Phone: IFax: IE -mail: No. of bedrooms/baths
Owner's representative:■ j c LO (L f rvaa..O COI ■ISTC . Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: - Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ 1 14 1 000'
Existing bldg. area (sq. ft.) 9>
Business name: '_(J -? C0 New bldg. area (sq. ft.)
Address: 1?-j0.K 1 l;C D i
City: �-f 04 I Stat 12_1 ZIP: C�jQj Number of stories
�40 7-714- I 0Z Type of construction
•Fax: Email: Occupancy group(s): Existing: 1 (2 . c
CCB no.: (4 - 33 — f New: eigt.i. "5
City/metro lic. no.: Notice: All contractors and subcontractors are required to be '
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: 1 Plan no.:
Phone: Fax: E -mail: •
Name:"EO. J LC ` Contact person:( {ib)- Q.11..t L Fees due upon application . $
Address: 4 S SE 102- ,&e Date received:
City: D ZTLP\P 1 ] IState:c 1Z IZIP: GT1Zllfi Amount received $
Phone: 254 [E -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 0 Visa 0 MasterCard
work will be complied a speci herein or not. Credit card number: / /
Expires
Authorized signature: Date: Name of cardholder as shown on credit card
Print name: 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 (6/00/COM)
Commercial Plan Submittal
#,Alk
.i111 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.
iAdsts\forms \COM- matrix.doc 9/24/01
' } J
•
Accessibility:
Barrier Removal Improvement Plan
City of 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: of all renovation, alteration or modification being done
excluding painting, wallpapering. [1] $ 1 [ 4 �
multiply: 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2] $ M
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 $ 1 i 1 50
(b) An accessible entrance: $ COO
(c) An accessible route to the altered area: $ COD°
O l
(d) At least one accessible restroom for $ q 1 - 3C0 C
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 Value Computation $ N 5 °°
• i:\dsts \forms\Accessibility.doc 06/07/02