Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 00069
0,11_ DEVELOPMENT SERVICES DATE ISSUED: 3/3/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13855 SW PACIFIC HWY PARCEL: 2S103DD -00900
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR 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: $ 3,600.00
Remarks: Monument Sign
Owner: Contractor:
EMPIRE ENTERPRISES INC ARTICO LITE
ATTN: YANG -JUN SHIN 8621 SE POWELL
422 RAILWAY STREET PORTLAND, OR 97266
Phone:
Phone:
Reg #: LIC 141398
FEES REQUIRED INSPECTIONS
Description Date Amount Foot/Found lnsp
[BUPPLN] Phi Rv 2/12/03 $53.10 Final Inspection
[BUILD] Permit Fee 3/3/03 $81.70
[TAX] 8% State Tax 3/3/03 $6.54
Total $141.34
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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 -00 ; : • r gh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli • (503) 246 -66•' or 1- 800 - 332 -2344.
Issu > • By: / • it
Pe rm ittee
Signature: (a:t n ,, • Call 639 -4175 by 7 p.m. f
Y p n inspection the next business day
• 1 tPti FOR OFFICE USE ONLY
Building Permit Application Received Building
Mr -- Date/By: Cel f 2I O,3 9nte Permit No •?m3 —6 40 6 ?
Planning Approval Other
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 -639 -4171 Fax: 503 -598 -1960 � C ,.� U ' -ifi ' '` , Post - Review Land Use
e l I Date/By: Case No.
Internet: www.ci.tigard.or.us Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:
(� ® New construction ❑ Demolition I & 2 FAMILY DWELLING
\O Ii] Addition /alteration/replacement [] Other:S f9 r%
1 CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
0 ❑ Accessory Building ❑ Multi- Family
S) 4 Valuation $ ,0��
❑ Master Builder [ Other: S 1 I.%
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: % 3 55 ,w 1�J CAF IC tr1 Total number of floors
I 1 New dwelling area (sq. ft.)
Suite #: I Bldg. /Apt. #: Garage/carport area (sq. ft.)
P roject Name:'' - 0 4 t? ocv\tK A j -t. � y 0,6,0 I`C,� Covered porch area (sq. ft.)
Cross street/Directions to job site: ` Dec area (sq. ft.)
M La TOSS c+; Gactr Other structure area (sq. ft.)
1 REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
n ° Lk.A..l VIA O S iC h .00
Valuation $?czC30
Existing building area (sq. ft.)
New building area (sq. ft.)
C
Number of stories
❑ PROPERTY OWNER ❑TENANT Type of construction
Name: Occupancy group(s): Existing: ��
New: A.
Address:
City /State /Zip:
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
❑ APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
k) Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip: •
Phone: ( Fax:
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule.
CONTRACTOR
'.- Business Name: (i t ico LA Fees due upon application $
Address: o Z - ( op 1 k & k/cl. ,
t City /State /Zip: -P cue Amount received $
Phone: as -3 --ci co c, ax: p,5 '-el clo 7 Date received:
si� CCB Lic. #: J-l(l 35 R
Authorized / / Notice: This permit application expires if a permit is not obtained within
1 \ Signature: ,_.1 _ ,i ■ . fir �n nn Date: of — (Z. — 180 days after it has been accepted as complete.
t
� �t . *Fee methodology set by Tri- County Building Industry Service Board.
(Please prig name) 3P '51 r �] O
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Commercial Plan Submittal
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 **
" .W Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
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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.
•
is \dsts \forms \COM- matrix.doc 9/24/01
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This permit does not authorize the violation dan • • • • •� • • • •
rights of holders of private easements. The a Y • • •
plicznt is urged to-contact any such parties and • • • • �' •
secure their approval before commencing work. • •
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CITY OF TIGARD
Approved < •
Conditionally Approved _..w...._.....( k 0 i r•
For only the wArk seals tied in. 9 >�
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PERMIT NO, � 3 _ —
See Letter to: Follow .,,._.( ): (Di (,..7.) - •
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B �I ! ' date: 2,,,..-7_3_, 3
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