Permit N
CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00530
�� DEVELOPMENT SERVICES DATE ISSUED: 11/1/2006
j l l l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102AC -01701
SITE ADDRESS: 12700 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: TI, change of use from retail to office.
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 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 23 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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:$ I a � 7 100 DD
Owner: w Contractor:
CHC ENTERPRISES LLC PACIFIC CREST STRUCTURES INC
18100 SW KRAMIEN RD 7233 SW KABLE LN STE 900
NEWBERG, OR 97132 PORTLAND, OR 97224
Phone: 503 516 - 9509 Contact #: 'FAX 503- 598 -6658
PRI 503- 968 -8949
FEES Reg #: LIC 66915
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/1/2006 $168.10
[TAX] 8% State Surcha 11/1/2006 $13.45
[BUPPLN] Pln Rv 11/1/2006 $109.27
[FLS] FLS Pin Rv 11/1/2006 $67.24
Total $358.06
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 503 - 246 -6699 or 1- 800 - 332 -2344.
Issu d By: J��e Permittee Signature: ;;M-e---,
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.
"CoMmercial Tenant Im rovem
P ��II
Building Permit Application cC/ i Foil Owner [Isl.. o\l.\
City of Tigard N OV . o` . / 1// / ' is � .. i 00S •
:74 • ° 13125 SW Hall Blvd., Tigard, OR 972U Q 2
1 Plan Review
Phone: 503.639.4171 Fax: 503.598.04,W Op QQ / Date/B . „ Other Permit:
TI G A R D Inspection Line: 503.639.4175 '`� //VG T /(�'q Date Ready f . El See Page 2 for
Internet: www.tigard- or.gov rtil IN D 2 � 1 � � 60 -- Notified/Method /� Supplemental Information
TYPE OF WORK U (/v I 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 m
Comercial /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: /Z 7d p J ,) if.C..z /04/.4ed, New dwelling area: square feet
City / State/ZIP: T g lt'ad' , /t
C. 722 3 Garage /carport area: square feet
6
Suite/bldg. /apt. no.`. I Project name: Fj92Mi / 1J , . Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
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.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ a �' 00
.2741/4 /arc. /1 er✓!aa/cL l
Existing building area: 6 f/ square feet
New building area: square feet
,,la PROPERTY OWNER I ❑ TENANT Number of stories: /
Name: L1 h // feep-i-7/1/deb .‘,G Type of construction:
skg
Address: / 9 // cSc v /-( 4' D Occupancy groups: 3 car
City /State/ZIP: /Ve� f pt' f7/3 Z Existing: i�i.�-
Phone: (,,513 ,S /G /`'. - o !` Fax: (,3) C I" 5� 7375--- New:
J . APPLICANT ❑ CONTACT PERSON NOTICE
Business name: C //c ezzii ti ,,,ziJ G All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: t 9 ' /7 t < .I under ORS 701 and may be required to be licensed in the
Address: ,/,/dd f� /fie/9 /e ms G ,/ jurisdiction in which work is being performed. If the
City /State/ZIP: �l�d 4 ! Z 72' /JZ applicant is exempt from licensing, the following reasons
apply:
Phone: (5a?) ,s /G-/rsr % Fax: : (.w3) !oil f 7TfS'
E-mail:
CONTRACTOR
Business name: , G..0 /ZG C/e.ev.c1 6 /ii,z , .Z- BUILDING PERMIT FEES*
Address: 7_ 3 3 ,,�/ d� ' ' E P fey review (Please fee (or d e)
� 7 / GJ Structural plan review fee (or deposit):
City / State/ZIP: Ave / /L /�, ,E.., 7 c/
FLS plan review fee (if applicable):
Phone: (....03) idg_ , P5 - i, 7 I Fax: (.5 .57,f- 4 GSA
CCB Iic.: o dr ,/,.."-- Total fees due upon application:
Amount received:
Authorized signature: 6 .a66! /1
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
I Print name: ei,j/// 6:1SO-ror � I Date: /7-/-' a 6 I • Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits\BUP -TI- PermitApp.doc 03/23/06 440 -4613T(11 /02 /COM/WEB)
Building Division
Plan Submittal Requirement Matrix
T I G A R D Commercial & Multi- Family - New, Additions or Alterations
•
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
• (must include location of all accessible parking)
Plumbing (site utilities) 2
Building ' 1*
Fire Protection System 2 **
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.
I:\ Building \Pemtits \BUP -TI- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2000 -005.0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _- i +�- I
INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: 7 :04AM PAGE: 28
SITE ADDRESS: 12700 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE AGENCY
DESCRIPTION: TI, change of use from retail to office.
OWNER: CHC ENTERPRISES LLC, PHONE #: 503-516-9509
CONTRACTOR: PACIFIC CREST STRUCTURES INC PHONE #: 503-968-8949
Inspection Request Scheduled For: Date: 12/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message -
299 Final inspection 041161 -01 503.805.4408 Y
Corrections /Comments /Instructions: re
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E. PASS PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
❑ FAIL _ CALL FOR INSPECTION ❑ ADDITIO' AL FE S ASSESSED
Inspector: 1 Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2006-0Of;30
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2006
Phone: (503) 639- 4171 , I
In Requests (24 Hrs.): (503) 639 -4175 F ._..
INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7 :01AM PAGE: 29
SITE ADDRESS: 12700 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE AGENCY
DESCRIPTION: TI, change of use from retail to office.
OWNER: CMG ENTERPRISES LLC, PHONE #: 503- 516 -9509
CONTRACTOR: PACIFIC CREST STRUCTURES INC PHONE #: 503.960 -8949
Inspection Request Scheduled For: Date: 11/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
CS
2/6 Framing 039961 -01 503-806.4408 � j ¥ l
Corrections /Comments /Instructions: �� `Y
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Waal II 0.1._CMILT411
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL i II AL F v R INSPECTION El ADDITION ' L F ES ASSESSED
di 1 " 1
Inspector: / Date: 1 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION = PERMIT #: BUP2006•00530
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2006
Phone: (503) 639 -4171 tit
Inspection Requests (24 Hrs.): (503) 639 -4175 �' F 'I � ..
INSPECTION WORKSHEET FOR DATE: 11/15/2006 TIME: 7:07AM PAGE: 27
SITE ADDRESS: 12700 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE AGENCY .
DESCRIPTION: TI, change of use from retail to office.
OWNER: C! -r r r: r)'7 , 1rr..!%; E.4 t; PHONE #: 4 03.r 1F,9919
CONTRACTOR: .r. 7 fl r•!r PHONE #:
Inspection Request Scheduled For: Date: 1i/1r,/2!05 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 FrPrnina 039795 -?1. E0 ?, 8 Y
Corrections /Comments/ Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 �C 1 \ (1
Date: , 1il "c/o 6 Phone #: (503) 718- 721 2 l