Permit .r
CI TY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00054
COMMUNITY DEVELOPMENT DATE ISSUED: 1/30/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102CB -03101
SITE ADDRESS: 12950 SW PACIFIC HWY 275 ZONING: C -G
SUBDIVISION: HUDSON PLAZA LOT: 021 JURISDICTION: TIG
Project Description: DOBLER SALON. Repair to damage on exterior of bldg.
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: 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: �a r 000 bb
Owner: Contractor:
HENDERSON, MARILYN DOROTHEA HORIZON RESTORATION SYSTEMS
JENSEN HUDSON TRUSTEE 7301 SW KABLE LANE
11795 SW KATHERINE ST SUITE 100
TIGARD, OR 97224 PORTLAND, OR 97224
Phone: Contact #: PRI 503 - 620 - 2215
FAX 503 - 624 -0523
FEES Reg #: LIC 160672
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/30/2007 $235.30
[TAX] 8% State Surcha 1/30/2007 $18.82
Total $254.12
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.
I
Issued By: — 4 Permittee Signature: iilmiiiii, .
I
Call 503.639.4175 by 7:00 a.m. for an inspection that busi ess 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.
Building Permit Application
Commercial Tenant Improvemiztt. �j FOR OFFICE USE ONLY
City of Tigard ' Received _
�► P ermit N .
DateBy:/ 3Q �l /� I` � Vd 7 IWO.5
a 13125 SW Hall Blvd., Tigard, OR 97223 JAN 3 2007 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 °� Date/By: Other Permit:
T I G n li D Inspection Line: 503.639 CITY OF � Date Ready/By: Juris: RI See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK 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
V Addition/alteratio if replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling j 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: f & 5 O / 'p
$ G B 'F ' I C N ' } wa � / New dwelling area: square feet
City/State /ZIP: L-1 a or 41 �..L� / Garage /carport area: square feet
Suite/bldg. /apt. no.: i Project name: N Ilt,ravN pi.. 4Q Covered porch area: square feet
Cross street/directions to job site: � l Deck area: square feet
W AZ 1 . f () li t t 1 Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: 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.
gt 14 C2 Di v44 e d Stare Fr. Valuation: $ a ee 4
VII v\ c OWE , - ^ OAS) il WA II St( %a Existing building area: poo square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: '
Name: Type of construction: I4lop rrk
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
g APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Aff Z.Gh X e sT / AT; a „ \ All contractors and subcontractors are required to be
Contact name: ZA y miller licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7361 S W kQ 'B L L h jurisdiction in which work is being performed. If the
City/State /ZIP: 1 ( u,. o 9 - /JA y applicant is exempt from licensing, the following reasons
apply:
Phone: (503) b Ad a). k S Fax:: (SO3) 0 4 - d Sa 3
E -mail: TAY ' "l frGf) 'i.or lies 1 Grp . C o rn
CONTRACTOR
Business name: S q,y,,, R a S a C V Q BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State /ZIP: Structural plan review fee (or deposit): Z 9 d
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: /60(,72 Total fees due upon application: / d ,. y;2...,
Amount received: j 5 y
Authorized signature: •- • • This permit application expires if a permit is not obtained - •
A within 180 days after it has been accepted as complete.
Print name: A f m I 1r Date: ( — 30 -o '7 * Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits\BUP- TI- PermitApp.doc 12/27 /06 440- 4613T(11/02 /COM/WEB)
11 114 ° 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 \Permits \BUP- 11- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION F • ' PERMIT #: BUP2007 -00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/30/2007
Phone: (503) 639 -4171 p.eoI Tit,
Inspection Requests (24 Hrs.): (503) 639 -4175 °T I L.
INSPECTION WORKSHEET FOR DATE: 3/9/2007 TIME: 7:01AM PAGE: 62
SITE ADDRESS: 12950 SW PACIFIC HWY 275 CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: 021 TYPE OF USE:
PROJECT NAME: HUDSON PLAZA
DESCRIPTION: DOBLER SALON. Repair to damage on exterior of bldg.
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #:
CONTRACTOR: HORIZON RESTORATION SYSTEMS PHONE #: 503.620 - 2215
Inspection Request Scheduled For: Date: 3/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 044549 -01 501793-5739 N
Corrections /Comments /Instructions: ������
. :� i.ft.1.1. _: _ .'% -4 4 . ► .. ' J2►.1 A j.zr� =_J, i ,Ir, A A ti1P4
. - - -- :. l /1 D 6 o 2- L l
1 = IA ! d`
El PASS 1f , •ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL %I I FOR INSPECTION ❑ ADDITION L FEES ASSESSED
Inspector: _ ■ Date: 5 I 0 Phone #: (503) 718 -
■
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007- 00054
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/30/2007
Phone: (503) 639 -4171 A •
Inspection Requests (24 Hrs.): (503) 639 -4175 „alit :_..
INSPECTION WORKSHEET FOR DATE: 5/16/2007 TIME: 7:00AM PAGE: 54
SITE ADDRESS: 17950 SW PACIFIC HWY 275 CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: 021 TYPE OF USE:
PROJECT NAME: HUDSON PLAZA ■.----”
DESCRIPTION: DOBLER SALO Repair to damage on exterior of bldg.
OWNER: HENDERSON, MARILYN DOROTHEA, PHONE #:
CONTRACTOR: HORIZON RESTORATION SYSTEMS PHONE #: 503- 620 -2215 C
p(.6
Inspection Request Scheduled For: Date: 5/16/2007 Pour Time: f ^ ..,e_
Code # Inspection Description Confirm # Contact # M - - .age 1°
299 Final inspection 04836E -01 503 - 793.6121 Y '`
Corrections /Comments/ Instructions:
0.--
i
1)
OsAss
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1�� L
Inspector: "U Date: J 1 6 7 Phone #: (503) 718 -2 z7