Permit •
CITY OF TIGARD BUILDING PERMIT
I'1 ;. COMMUNITY DEVELOPMENT Permit#: BUP2014-00128
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/16/2014
Parcel: 2S 102CC00500
Jurisdiction: Tigard
Site address: 13600 SW PACIFIC HWY
Project: Dotty's Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: TI for new tenant. Converting from personal service use to an eating and drinking establishment(fast food).
Contractor: WILLIAM CADY CONSTRUCTION Owner: ROIC OREGON LLC
6500 CHESSINGTON LANE 8905 TOWNE CENTRE DR, STE 108
GLADSTONE, OR 97027 SAN DIEGO,CA 92122
PHONE: 971-533-5132 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 06/16/2014 $917.70
Demolition
Occupancy Grp: A-2 Occupancy Load: 62 12%State Surcharge-Building 06/16/2014 $110.12
Dwelling Units: 0 Plan Review 06/02/2014 $596.51
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 06/16/2014 $367.08
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 06/16/2014 $174.00
Value: $75,000 DC Provision Review,COM TI-LRP 06/16/2014 $26.00
Info Process/Archiving-Lg$2.00(over 06/16/2014 $18.00
11x17)
Floor Areas: Info Process/Archiving-Sm$0.50(up to 06/16/2014 $5.00
11x17)
Total Area: 0 Park-Commercial and Industrial 06/16/2014 $1,878.64
Accessory Struct: 0 TDT-Transportation Development Tax 06/16/2014 $5,704.00
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $9,797.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Protected Corridors.
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 the 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 332.2344
Issued By: - Permittee Signature: JI
3.939.4175 by 7:00 a.m.for the next available inspection date.
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.
ButidinePermit Application
� y
. �.o.POrtcA at l kA 1We' �� FOR OFFICE USE ONLY
`�� Received
City of Tigard Date/B : if •;, Permit No.: .4 , I r - .
1111
• . •• 13125 SW Hall Blvd.,Tigard,OR 9 %)\b Plan Revie
Phone: 503,718.2439 Fax: 503.598.1960 Al DateBy: i ".-�, 6:16;i//9 Other Permit: n'1/►-l�rk`�_ coo L(_tx
TI G A R D Inspection Line: 503.639.4175 \�* A Date ReadyBy: kris: H See Page 2 for
Internet: www.tigard-or.gov J (�,�T" `,, • otified/Meih•d: 9,/:Y/q �..) Supplemental Information
TYPE OF WORK ik),1r 0\-31 #11 'P/(vR �-'I
* 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.
Valuation: $
❑ 1-and 2-family dwelling ACommerciaUindustrial
❑Accessory building ff❑`��Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1S(47 oo S by lr-i C -(1-wy New dwelling area: square feet
City/State/ZIP: T&42a
a Q • Garage/carport area: square feet
Suite/bldg./apt.no.: 7 Project name: G-r 7 fs Covered porch area square feet
Cross street/directions to job site: J Deck area: square feet
L2• Other structure area: square feet
,b
, P REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: (�(..,,_t.., ^, Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 0° 6� Indicate the value(rounded to the nearest dollar)of all
7) equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
),&]-TE;�elorz_ •'T-3�Idt.!-I IJ-'/ au e R- Valuation: �� S ,�j 6�'jQ
1
Existing 1� its ng area ( C p 0 square feet
New befit ig~ : 1 Goo square feet
t
❑ PROPERTY OWNER A.TENANT Number of stories: Q t,j .
Name: g(,C.ç E-7-t)C7/4 /1D:37-n/5 Type of construction: > 1(.B
Address: f'•Q• '> 472,(0 Occupancy groups:
City/State/ZIP: re,k- Npl c , 9720 1= 1"1t ,
Phone.O3) Cgiect „ ' Of.3 Fax:( ) New: r�
"
cit APPLICANT ❑ CONTACT PERSON NOTICE
Business name: A. H i/L•(j12 44 c.+1. -ice(J . All contractors and subcontractors are required to be
Contact name:6( 1.1 f(1 licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 543-s H G A/6 rx/ v�y 546_ (ocjZ jurisdiction in which work is being performed.If the
City/State/ZIP: L / -22S1t_ 1�b c7 9-7o3 S q q applicant is exempt from licensing,the following reasons
�) �?�" ! I ( l Fax: 3 t g !O apply:
Phone: ) �.
E-mail: ler\ , . h i 1I j•Pv 1,4e�fi1r'e, ca.,4
CONTRACTOR BUILDING PERRMIT FEES*
tiJ 11 I 'A t1 Ab , (Please refer fee schedule)
Business name: W fl,.� C�� I Permit fee:
Address: CQ GtT��s0\--17no ,v&
State surcharge(12%of permit fee):
City/State/ZIP: (i�7LA. 704E I op. 177o27
FLS plan review(40%of permit fee):
Phone:q7() 3 -•53 Z I Fax:( ) (Due upon application.)
CCB lic.: 11 2?10 ,eb.y iy Total permit fees:
Authorized signature: '� Amount received:
This permit application expires if a permit is not obtained
Print name: �-� 1 d I MIta_ 2 Date: 4-/' 1/ — within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\BuildingTermits\FPS-PermitApp.doc 02/01/2011 440-4613T(11/02/COM/WEB)
.. w
•
City of Tigard
111 COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Commercial - With Land Use
Building Permit #: 84,,piIl'I -oc i
Site Address: 400 SW Pac;i-4iL µwy, Suite/Bldg#: L 2
Project Name: '6
(Name of Commercial business occupying the space. I f vacant,enter Spec Space.)
Planning Review
Proposal: irrj'p,(to( + n \- improveAftros Tor ne.W e4In9 arvj d rinkin3
es abl i 5 r 1)i.
LJ Verify site address/suite#exists and active in permit system.
I/LandUseCase#: MMD2oI4-0001 i
kli Plan Match Approved Land U e:
1Site Plan nl0' Plan ❑ Other:
Ala. n1kL5 Urban Forestry Plan ru l A Lb Elevation Plan
OM irrit,r n(d :uilding Height: Maximum Height y S Actual Height
f11 A- lY Conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
Notes:
Approved by Planning: YL f rn LpJn(bade) Date: 6121111
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: y1-4jw
Site Plans:
Building Plans: # , _
Building Permit#: n uilding permit#above.
Workflow Routing: ®4la g ❑ Engineering ❑ Permit Coordinator m--11 g
Workflow Sign-off: [ 'S ff for Planning(include notes from planning review)
Route Application Documents: ding. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 6)7- Date: 6./d/y
1:1 Building\Forms\BldgPermitRvw_COM_W ith LandUse_0429 I4.docx
Engineering Review
❑ Actual Slope:
❑ PFI Permit#:
❑ Conditions Met
Notes: /-1 o -,\J ,a a a�s.r,t 6 t s 5v1/415.
r
Approved by Engineering: Date: 6 • 3 ,i
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
K to Issue Permit
Approved by Permit Coordinator: V Date: (o 3 /I
l:\Building\Forms\BldgPermit Rvw_COM_W ithtandUse_042914.docx
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13600 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00128
Chip Barnett
rsheldon@orsistores.com
Violation Summary:
Inspector Contractor