Permit ti' ,,
CI TY OF TIGARD BUILDING PERMIT
PERMIT #:
IN ' COMMUNITY DEVELOPMENT DATE SSUED: 11/102007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110DC -02200
SITE ADDRESS: 15660 SW PACIFIC HWY A -3 ZONING: C -G
SUBDIVISION: TIGARD PROMENADE LOT: 011 JURISDICTION: TIG
Project Description: AFFORADABLE GRANITE. T.I. (2100 sq. ft. area).
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: 70 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: 0337)0, 0 0
Owner: Contractor:
TIGARD CENTER DEAN SHELLEY CONSTRUCTION
9777 WILSHIRE BLVD. 3100 SE 116TH ST
#609 PORTLAND, OR 97266
BEVERLY HILLS, CA 90212
Phone: Contact #: PRI 503 - 761 - 9695
FAX same
FEES Reg #: LIC 100943
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/10/2007 $81.70
[TAX] 8% State Surcha 1/10/2007 $6.54
[BUPPLN] Pln Rv 1/10/2007 $53.11
[FLS] FLS Pin Rv 1/10/2007 $32.68
Total $174.03
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.
Issued By: 4 , A� - I Permittee Signature: 0 , _ LA '_
f 7 ,
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 Improvement
Buildin; Permit Application roiz oi.FicE (SE ONLY
City of Tigard Received / Q 11 / y
:Ili ' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 8
Phone: 503.639.4171 Fax: 503.598.1960 DatcIB . Other Permit:
T G n x:17 Inspection Line: 503.639.4175 Date Ready/By ' j ji ® Sn See Page 2 for
Internet: www.tigard- or.gov Notified/Method
pplem ®talInformation
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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work 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: 15 1,1 (.1) , ( to y /:)--.-
r New dwelling area: square feet
City/State/ZIP: — 1 -- i d O Q Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: P �� // 0 r �i � c ( 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
. P�-tr.h c-y l �ij /&, Valuation: $ 3 5
Existing building area: g ° square feet
New building area: square feet
❑ PROPERTY OWNER I yiENANT Number of stories: I
Name: V e i — V 0 Type of construction Ti T a s W
Address: 1 9 2 /j4 m vt; Occupancy groups:
City/State/ZIP: 0 /At //_j j .J. DR._ 17-1.0,/ 40 S Existing:
Phone: ( S 1) g), 6 � Fax: ( 5'62, )
'- 7-15, g g New:
❑ APPLICANT `�' ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: urisdiction in which work is being g performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: apply:
Phone: ( ) I Fax:: ( )
E -mail:
CONTRACTOR
Business name: - 1* . ')g4 1 " C L1auj epekSSTRociimc BUILDING PERMIT FEES*
` (Please refer m fee schedule)
Address:
�p qsD 5 E u1Qot92FP Q pQ, Structural plan review fee (or deposit):
City/State/ZIP: Pat TtA ' Ct.-
Phone: (,5 3 ) 1(0 f — 9 95- I Fax: ( ) g,�„r, FLS plan review fee (if applicable):
CCB lic.:
( D b 9 y Total fees due upon application:
Amount received:
uth store: This rmit application expires if a
pe pp p' permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ` _ r� Date: / A • Fee methodology set by Tri-County Building Industry
Service Board.
1:1 Buil ding \ Permits \BUP- TI- PermitApp.doc 03f23/06 440-4613T(1I/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*
Xjh 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.
l:\ Building \Permits \BUP -TI- PermitApp.doc 03/73/06
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: BUP2007- 00014
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11W12007
Phone: (503) 639-4171 1 � 6i I�
• Inspection Requests (24 Hrs.): (503) 639 -4175 `__
INSPECTION WORKSHEET FOR DATE: 2/1 /2007 TIME: 7 :01AM PAGE: 5
SITE ADDRESS: 15€60 SW PACIFIC HWY A - CLASS OF WORK:
SUBDIVISION: TIGARD PROMENADE LOT #: 011 TYPE OF USE:
PROJECT NAME: AFFORDABLE GRANITE
DESCRIPTION: AFFORADABLE GRANITE. T.I. (2100 sq. ft. area).
OWNER: TIGARD CENTER, PHONE #:
CONTRACTOR: DEAN SHELLEY CONSTRUCTION PHONE #: 503-761 -9695
Inspection Request Scheduled For: Date: 2/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 042853 -01 503-998-9695 Y?
Corrections /Comments /Instructions: k IAOU.— I '
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED
Inspector: ,� `�& Date: 7 Phone #: (503) 718-
% OFTIGARD
1 BUILDING DIVISION PERMIT #: BUP2007 -00014 '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: //100007
Phone: (503) Ake
Inspection Requests (24 Hrs.): (503) 639 -4175 „_ IL -. 1
INSPECTION WORKSHEET FOR DATE: 1/19/2007 TIME: 7 :01AM PAGE: 17
SITE ADDRESS: 15660 SW PACIFIC HWY A -3 CLASS OF WORK:
SUBDIVISION: TIGARD PROMENADE LOT #: Q11 TYPE OF USE:
PROJECT NAME: AFFORDABLE GRANITE
DESCRIPTION: AFFORADABLE GRANITE. T.I. (2100 sq. ft. area).
OWNER: TIGARD CENTER, PHONE #:
CONTRACTOR: DEAN SHELLEY CONSTRUCTION PHONE #: 503 - 761 -9695
Inspection Request Scheduled For: Date: 1/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 042308-01 503-990 -9695 N
Corrections /Comments /Instructions:
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PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
WI - ❑ CALL FOR INSPECTION ❑ ADD IONAL EES ASSESSED 4 ,
Inspector: Date: 1. V� Phone #: (503) 718 -
� -or