Permit iih v CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00013
°' COMMUNITY DEVELOPMENT DATE ISSUED: 1/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AB - 00200
SITE ADDRESS: 14295 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: CANTERBURY SQUARE LOT: 1 - JURISDICTION: TIG
Project Description: PENNYS DELI. Change of use from M to B.
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: 5N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 46 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: o-'
Owner: Contractor:
KAHLM SARBJIT
9334 SE PENNINGTON CT
PORTLAND, OR 97266
Phone: 206 - 850 - 1568 Contact #:
FEES Reg #:
Description Date Amount REQUIRED ITEMS AND REPORTS
[HRBLD] Hourly Buil 1/10/2007 $57.87
[HRTAX] Hourly 8% St 1/10/2007 $4.63
Total $62.50
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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 - 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: Le Permittee Signature: 1/ ill ti tn
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.
4 . • Csnmercial Tenant Improvement
Building Permit Anplicati0IRECE %VED colt orrlcl t sl ONL\
City of Tigard
II
JAN II 1 0 2007 / ? No.: _ X00 4 /3
° 13125 SW Hall Blvd., Tigard, OR 97223 J Hen Review
. Phone: 503.639.4171 Fax 503.598.19 Date/B . Other Permit:
Inspection Line: 503.639.4175 COY � uI F � T R D Date Ready/By. ® Sa
T I G A It I Internet: www.tigard-or.gov
BUILDING DIVISION Notified/method E 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
❑ Addition /alteration/replacement ( ether: Cl11 &41Q��. 4 v a equipment, materials, labor, overhead, and the profit for the
work OF CONSTRUCTION JJ ork indicated on this application.
❑ 1- and 2 -family dwelling ❑ Commercial /industrial Valuation: S
❑ 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: 1L- l6 'O�� New dwelling area: square feet
City/State2LP. Garage/carport area: square feet
Suite/bldg /apt. no.: 0 I Project name: ,t'Un U' S b-(17 / 1 Covered porch area: square feet
Cross street/directions to job site: f Deck area: square feet
(`l a II VV . RiA . 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.
OAanp - ( c Q /) U C Valuation: S
( ( Existing building area: /ea0 square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: ' l � v - 1- 1 1 Type of construction: S W
4 a i r !n ' 1 � ►
Address: cJ� 1 `ni � . Occupancy groups:
B
City /StateLlP: fl p� ( Fax: � (/ Existing: . • rn
Phone: ( l 603- 4P (. A f f( �/� _ IL/ New: I 1
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name:v ( All contractors and subcontractors are required to be
Contact name: Ar771Q licensed with the Oregon Construction Contractors Board
_Q `-� (� under ORS 701 and may be required to be licensed in the
Address: I G 1'ht jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/StatelLlP: Tel t`� l� ot -viz apply:
Phone: ( 0 — l 0 I Fax:: ( )
E-mail: is L �
v
E-mail: nd . CU) vvt
a�
CONTRACTOR
Business name: BUILDING PERMIT FEES*
Address: (Playsr refer to fee sehedak)
Structural plan review fee (or deposit):
City/State/ZIP:
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB lac.: Total fees due upon application:
_ Al Amount received:
Authorized signature: •
A This permit application expires if a permit is not obtained
f Print name: � 'r 11,,.,, within 180 days after it has been accepted as complete.
L h-1' 9 Lei i� / CLI4 (MA I Date: 1 0 C:14- • Fee methodology set by Tr-County Building Industry
Service Board.
I:\ Building \PermitslBUP- TI- PermitApp.doc 03/23/06 440-4613T(I1102/COM/WEB)
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, 1
,
111 Building Division
Plan Submittal Requirement Matrix
T ► 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 -TI- PermitApp.doc 03/23/06
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007- 00013
13125 SW Hall Blvd., Tigard, OR 97223 0 D ATE ISSUED: 1/10/2.007
Phone: (503) 639 -4171 //41t d
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' ° 'I I.. 1
INSPECTION WORKSHEET FOR DATE: 11/19/2007 TIME: 7 :01AM PAGE: 36
t5
SITE ADDRESS: 14295 SW PACIFIC HWY /' ® CLASS OF WORK:
SUBDIVISION: CAN1 ERBURY SQUARE LOT #: 1 -3 TYPE OF USE:
PROJECT NAME: �`r'" -`" "`^ CL
DESCRIPTION: PENNYS DELI. Change of use l from M to 13.. ` ' OW NER: SM CJF�14LM 6� & ( ~ v • PHONE #: 206
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 11/19/2007 Pour Time:
C e # inspection Description Confirm # Contact # Message
299 Final inspection 059876 -01 503 - 939 -6928 N
Corrections /Comments /In e
41/r3 J D 6 6 <--e 6---%- k
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: L I A Phone #: (503) 718- 2424
CITY OF TIGARD ._
BUILDING DIVISION S PERMIT #: BUP2007 -00013
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1110/2007
Phone: (503) 639 -4171 ...V it
Inspection Requests (24 Hrs.): (503) 639 -4175 -__ !.L.
INSPECTION WORKSHEET FOR DATE: 10/17/2007 TIME: 7:02AM PAGE: 45
SITE ADDRESS: 14296 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: CANTERBURY SQUARE LOT #: 1 - TYPE OF USE:
PROJECT NAME: PENNYS DELI
DESCRIPTION: PENNYS DELI. Change of use from M to B.
OWNER: SARBJIT, KAHLM PHONE #: 206-850 -1668
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 1 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 057738-01 503- 620 -8087 N
jo( Corrections /Comments /Instructions:
P al U [ - - r-b4'l :
A � O 7 , s r 4"-___ _ D v �A'�.a��� /fir•' -
rie o v / i. C! /qD(L - f c� � i 6,'l 14"C - x C- e 4.b-4,
i 4 - Pr v f -' A.k ■ .. .. c .. , r
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• - - I °ARTIAL APPROVAL El CANCEL ❑ NO ACCESS
` L FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
7 Phone #: (503) 718-
p i D 1 G fib Y
Inspector: 1 Date: