Permit , CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00217
' 1 ' COMMUNITY DEVELOPMENT DATE ISSUED: 9/4/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134BC-00500
SITE ADDRESS: 12388 SW SCHOLLS FERRY RD ZONING: C -G
SUBDIVISION: PP1993 -057 LOT: 001 JURISDICTION: TIG
PROJECT: MCDONALDS
Project Description: TI. Adding beverage center.
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: A2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 65,000.00
Owner: Contractor:
MCDONALD'S CORPORATION GA BENTLEY CONSTRUCTION INC
036/0002 PO BOX 363
PO BOX 66207 GRESHAM, OR 97030
CHICAGO, IL 60666
Phone:
Contact #: PRI 503 - 661 - 2103
Reg #: LIC 30870
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/25/2008 $285.16
[TAX] 12% State Surch 6/25/2008 $175.48
[BUILD] Permit Fee 9/4/2008 $438.70
[TAX] 12% State Surch 9/4/2008 $52.64
(additional fees not listed here)
Total $951.98
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 throu• 0 952- 001 -0100. You may obtain a copy
of these rules or direct • estions to OUNC • calling 503.246.6699 or 1.800.332.2344
Issued ' . /` // � Permittee Signatur � ��_ _�� s i -
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.
IAA c 00 At-IDS l`2 e,E3.
Building Application
Commercial � , =o,z n, rlci_ USE ONLY City of Tigard G E it No.:
III
° 13125 SW Hall Blvd ,Tigard, t" . Plan Revie Il ", ' _ / - - i
9 Phone: 503.639.4171 Fax: 503.598.19�Qm ti 5 200 Date/B : 1S �/� _ '!�� Other Permit:
1. i G A P. D Inspection Line: 503.639.4175 ,U �D Notified/M Date R y: r uns: ® See Page 2 for
Internet www.tigard- or.gov 1 01 Not .a: 7 / , V A j cp Supplemental Information
O �
V `. 1O W i2
TYPE a -\ 1t L` t • REQUIRED 1; A A: 1- AND 2-FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are • ased on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ICI Other: {/Af„h f/1110Vemeiv t equipment, materials, labor, overhead, and the profit for the
CATEGORY. OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling 14 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: ,Q39 A / s i tJ S ch ode Fax V New dwelling area: square feet
City/State/ZIP: T /mod / p k3 Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: /yf d/J q / Covered porch area: square feet
Cross street/directions to job site: pi at / 'Ve " sGh /k Fee" 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. �y
A //�d,� irn ,74� retii fjl� fi , /y m 1, Valuation: $ 6, t ll0
pew i'everA� k, -- Existing building area: square feet
�/ New building area: square feet
[ PROPERTY OWNER y II ❑ TENANT Number of stories:
Name: h �t'�(! 1T // „/J // 6 - Type of construction: yy
Address: /5 _ � XO /f t� y' J0,' c . Occupancy anc groups: c 9 % t
City/State/ZIP: lE 'G/ v&- i27 , 04 q7-0069 Existing: n 4, e,
Phone: (so3) 9 /d -i$ /a/ Fax: ( ) New: �J
❑ APPLICANT ' • ❑ CONTACT PERSON
NOTICE
Business name: `� /7 All contractors and subcontractors are required to be
Contact name: / 'f /1.-le 1.-C Z licensed with the Oregon Construction Contractors Board
/� under ORS 701 and may be required to be licensed in the
Address: ¥O 2O L 4j j i #8 �L)s jurisdiction in which work is being performed. If the
City/ State /ZIP: j ejelk _ifiV� W 4 - j 8 49g03-3 a pplrcant exempt from licensing, the following reasons
apply:
Phone: 05 ) R c W 7 _5q3 Fax:: ( •-J p ) t'J�� rA p -
E -mail: 474/ 474/ r /'a/ e i y 7g G, G4/r7
CONTRACTOR
Business name: • m =y�e A - ___ _ ,_ :.. BUILDING PERMIT FEES”
Address: (Please refer to fee schedule
ee` 4,y. �P3 - Structural plan review fee (or deposit): '0 5 l(,
City /State/ZIP: (nc,s/.ti.— � c170 Pr,,- Ica14.4 7s, el
Phone : ( ) Fax : ( )
9� FLS plan review fee (if applicable): it
CcB tic.:. 30 7 . q Total fees due upon application: 4k)
Amount received:
//i,„4--D. 4. �T
Authorized signature: A NTES This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: l� 4 ZT I ICI /—A 1 L I Date: 6 1 7701? I • Fee methodology set by Tri -County Building industry
Service Board.
'•` :.,,vopr.niro :c lP-COM PermitApp.doc 2 440- 4613T(l1 /02/COM/WEB)
Form 3a Project Name: McDonald's # 11502 Page: 1of3
BUILDING ENVELOPE - GENERAL
•
Check all boxes 1. Exceptions (Section 1312) RECtJVtL.i
that apply. l No Envelope Components. The building plans do not call for new or altered building envelope
components, e.g., walls, floors or roof /ceilings. JUN 2 5 2008
❑ A Non - conditioned Building. The proposed structure has no spaces_ h_gat or T�QAR
an HVAC system.
Exceptions ❑ Exception. All new or altered building envelope components do natINUMNei DivJSION
Discussion of qualifying requirements, Section 1312, but qualify for Exception: 0-1 0 -2 ❑ -3 0 -4 ❑ -s
exceptions In Portions of the building that qualify:
instructions section.
Plans/ Specs
Show compliance by The plans /specs show compliance in the following locations:
including a drawing
sheet, detail number,
specification section 2. Air Leakage (Section 1312.1.1)
and/or subparagraph. ❑ Complies. Plans require penetrations in building envelope are sealed and windows and
doors are caulked, gasketed or weatherstripped.
The plans /specs show compliance in the following locations:
3. Suspended Ceiling (Section 1312.1.2.1)
❑ Complies. Building plans do not show suspended ceilings used to separate conditioned
space from unconditioned space. No exceptions permitted.
4. Recessed Light Fixtures (Section 1312.1.2.2)
❑ Complies. The building plans do not show recessed light fixtures installed in ceilings
separating conditioned spaces from unconditioned spaces.
❑ Exception. The building plans require that fixtures installed in direct contact with insulation
be insulation coverage (IC) rated. The plans /specs show compliance in the following locations:
5. Moisture Control (Section 1312.1.4)
❑ Complies. A one -perm vapor retarder is installed on the warm side (in winter) of all exterior
floors, walls and ceilings, and a ground cover installed in the crawl space of both new and
existing buildings where insulation is installed.
The plans /specs show compliance in the following locations:
❑ Exception. All new or altered building envelope components do not comply with the vapor
retarder requirements of the code, but qualify for an exception. Note applicable exception.
Section 1312.1.4, Exception: 0-1 0-2
Portions of the building that comply:
Climate 6. Climate Zones
Zones ❑ Zone 1 - A building site is in Climate Zone 1 if its elevation is less than 3000 feet above
sea level and it is in one of the following counties: Benton, Columbia, Clackamas, Clatsop,
Coos, Curry, Douglas, Jackson, Josephine, Lane, Lincoln, Linn, Marion, Multnomah, Polk,
Tillamook, Yamhill, or Washington.
,�. ❑ Zone 2 - Building sites not in Zone 1, or where construction site elevation is 3000 feet or
4r ) higher in Zone 1, are in Zone 2.
3 -1
Compliance with OSSC, effective 04/01/07
Form'4a' Project Name: McDonald's # 11502 P age: 2 of 3
SYSTEMS - GENERAL
Applicability Plans /Specs
Discussion of qualifying Show compliance by including a drawing sheet, detail
exceptions on page 4 -25 number, specification section and subparagraph.
1. Applicablity (Section 1317)
Is this form required?
❑ Form Required. Complete form if a new HVAC system is being installed, or components of an
existing HVAC system are being replaced (I.e., equipment, controls, ductwork, and insulation.)
❑ Exception. The building or part of the building qualifies for an exception from HVAC
code requirements. Applicable code exception is Section 1317.1. Portions of the building
that qualify:
Area: Exception 0-1 0-2 0-3
Area: Exception 0 -1 0-2 0-3
Area: Exception 0-1 0 -2 0-3
❑ Form Not Required. This project does not contain work required to comply with code.
2. Simple or Complex Systems (Section 1317.9 or 1317.10)
❑ Simple System. Building contains only Simple HVAC System(s). Complete this form (4a) and
equipment efficiency worksheets as required. Form 4b is not required.
❑ Complex System. Project includes a Complex System. Complete this form (4a), form 4b and
equipment efficiency worksheets as required.
3. Equipment Performance (Section 1317.5)
❑ No New HVAC Equipment. The building plans do not call for new electrical HVAC equipment,
combustion heating equipment, or heat - operated cooling equipment.
❑ Complies. All new HVAC equipment have efficiencies not less than those required by code.
The following equipment efficiency worksheets are attached:
0-4a 0-4b 0-4c 0-4d 0-4e 0-4f 0-4g 0-4h 0-41 ❑-4i
•
4. Duct Insulation and Sealing (Sections 1317.7 & 1317.8)
❑ No Ducts. The building plans and specifications do not call for new HVAC ducts or plenums.
❑ Complies. The plans and specifications call for all air - handling ducts and plenums to be
insulated and sealed as required by Sections 1317.7 &1317.8.
5. Distribution Transformers (Section 1316.1)
❑ No Distribution Transformers. The plans /specs do not call for new distribution transformers.
❑ Complies. All new distribution transformers comply with efficiency, testing, and labeling
requirements of Section 1316.1.1.
❑ Exception. The project qualifies for an exception per Section 1316.1.1, Exceptiion:
❑ -1 ❑ -2 ❑ -3 ❑ -4 ❑ -5 ❑ -s ❑ -7 ❑ -8 ❑ -9 ❑ -10 ❑ -1' ❑ -12 ❑ -13 ❑ -14
Attach relevant documentation for appropriate exception. The plans /specs show compliance in
c'`'_''•. the following locations:
4 -1
Compliance with OSSC, effective 04/01/07
rip
Form 5a Project Name: McDonald's # 11502 P age: 3 of 3
LIGHTING - GENERAL
1. Interior Exceptions (Section 1313.1)
❑ No Interior Lighting. The building plans and specifications do not call for new or altered interior lighting.
Skip to item 5, Exterior building Lighting - General, below. •
Exceptions p Exceptions. 1. The building or part of the building qualifies for an exception from code lighting
Discussion of qualifying requirements. Applicable code exception is number: 1313.6
exceptions in instructions
section. 2. Lighting equipment that qualifies for an exception - in addition to general lighting and is separately
controlled. Applicable code exception is number:
Areas of the building and equipment that qualify for any exceptions:
Plans /Specs
Show compliance by including
a drawing sheet, detail
number, and/or specification
section and subparagraph. 2. Local Shut -off controls (Section 1313.3.1.1)
❑ Complies. At least one local shut -off lighting control for every 2,000 square feet of
lighted floor area and for all spaces enclosed by walls or ceiling height partitions.
This control is detailed in the building plans on drawing number:
❑ Exception. The building or part of the building qualifies for an exception.
Applicable code exception is Section 1313.3.1.1, Exception:
Portions of the building that qualify:
3. Automatic Shutoff Controls (Section 1313.3.1.2)
❑ Not Applicable. Office floor area is not over 2,000 square feet of contiguous office floor area or
permitted space is not over 5,000 square feet. No offices less than 300 square feet, meeting
or conference rooms, or school classrooms.
❑ Complies. All interior lighting systems are equipped with a separate automatic control to shut off lighting
during unoccupied periods. Offices less than 300 square feet, meeting and conference rooms, and school
classrooms are equipped with occupancy sensors that comply with Section 1313.3.1.2.1.
Compliance details in plans /specs:
❑ Exception. The building or part of the building qualifies for an exception.
Applicable code exception is Section 1313.3.1,2, Exception:
Portions of the building that qualify:
4. Daylighting Controls (1313.3.1.3)
❑ No classrooms or atriums with skylights or window to wall ratio greater than 50 %.
❑ Complies. All classrooms and atriums with window to wall ratio greater than 50% and /or skylights are
equipped with automatic daylight sensing controls, as required by Section 1313.3.1.3.1 and Section
1313.3.1.3.2. The daylight sensors specified comply with Section 1313.3.1.3.3.
Compliance details in plans /specs:
Exterior Build 5. Exterior Lighting (Section 1313.5)
ing Lighting ❑ Complies. The plans do not call for use of incandescent or mercury vapor lamps for use on building exterior.
is lighting directed to ❑ Exception. The building plans indicate luminaires with incandescent or mercury vapor lamps, but are
illuminate the exterior of the specified for use in or around swimming pools, water features, or other locations subject to requirements
building and adjacent of Article 680 of the 2002 National Electrical Code.
walkways and loading areas
with or without canopies.
Clock Switches 6. Exterior and Canopy Lighting Controls (Section 1313.3.2)
shall be astronomic (seasonal ❑ Complies. The building plans and specifications include photoelectric and /or dock switches on all exterior
correcting) type with separate lighting systems which are designed and programmed to extinguish lights when daylight is present, as
programs for each day of the required by Section 1313.3.2.
week and shall store energy
to maintain timekeeping
during power outages. 7. Connected Lighting Power (Section 1313.4)
I NO (Complies. The lighting power does not exceed the power allowance established
in either the Tenant Space Method (Form 5b) or the Space-by -Space Method (Form 10 1'111111t6? ..
E Tenant Space Method (Form 5b) CSpace -by -Space Method (Form 5c)
O-1
V2.4.3 - Compliance with 2007 OSSC
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: BuPZOOe 00217
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9P1/2008
Phone: (503) 639 -4171 A I �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/22/2008 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 12388 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: PP1993 09 LOT #: 001 TYPE OF USE:
PROJECT NAME: MCDONALDS
DESCRIPTION: TI. Adding beverage center.
OWNER: MCDONALD'S CORPORATION, PHONE #:
CONTRACTOR: GA BENTLEY CONSTRUCTION INC PHONE #: 503^661 -2103
Inspection Request Scheduled For: Date: 9/22/7008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
0 EltietvJ
299 Final inspection 075699.01 503 -519 -8569
Corrections /Comments /Instructions:
is_..m.
( 0 PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
• lin CALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED
Inspector: Date:
a Phone #: (503) 718- �