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TWIT
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DATE. PLANS CHECK NO.:
-3- '35 r.
PROJECT TITLE:
COUN:t'YWIDEO r oS ,�d�.•;:��
TRAFFIC IMPACT FEE ANT;
WORKSHEET
MAILING ADDRESS ,
(FOR NON-SING12 FAMULY USES) �o 01 �P_, ,, �?e z 3 0-z,
CITY/23P/PHONE:
RA FE PER F t-JA 9 s
ND USE QATEGORY TRIP TAX MAP NO.:
RESIDENTIAL $159.00 �' o Den 1
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BUSINEFS ANDUMMERCIAL 40.00 SITUS NO ADDRESS::
QFFICE 146.00
INDUSTRIAL 1153.00
INSTITUTIONAL $66.00
Y PAYMETJT METHOD:
.ASH/ :H GK
CREDIT N+smuna+AL rja.r.
BANCROFT PROMISSORY NO USE CATeGG SCMMION OF USE PlEOLAY AWL TRIP RAT4 WEnOM AVE TRIP RA
DEFER TO OCCUPANCY ��•:>l ��,,.,� 1 ��f;a � c�%r,�$ T,/, a„� �
Bads: 4�u s B3s.S 7b
7-b r.aTc
l S S e 4 rtes
Wcr �J��S �- y��c Tia p7-23f�t S'
CALCULATIONS:,� _
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r 1 IC« IST•-,-- MOJECT TRIP OENlM"W
k ;RrP La 5_ i 5 7
fes. +fLo
ADDITIONAL NOTES: WR ACCOUNTING PUnPOSES ONLY:
ROAD AMT.:
J y4't f!i 3 r,
TRANS T AMT.:
PREPARED BY:
Cc WASHOMM N COUNTY
TIF NOTEBGJK
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CITY OF TIGARD
July 17, 1995
OREGON `
a
Louise H. Piacentini i
2001 6th Ave Ste 2300
Seattle WA 98121-2522 a
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RE: Plaid Pantry Addition 5
15995 SW Hall Blvd
Plans Check #3-35C
BUP95-0105
The rates for Traffic Impact Fees (TIF)s were increased on July 1, 1995. Since your
original TIF assessment letter was prepared on March 23rd, 1995, the fee will remain
$6,140.00 unless you defer payment to occupancy. If you defer paymer� of the TIF until
occupancy, the fee will be $6,297.00.
Please find enclosed a TIF workslieet prepared this date using the new rates. Again,
the new rate will apply only if you defer payment to occ,ipancy.
Also, please find enclosed a TIF payment option r c4�ice. TIF guidelines require
applicants to declare the proposed method of payrr ent t the time of plans submittal, we
have no indication of which payment method you are intending to use. Please return this
notice at your earliest convenience.
If you have any questions, please telephone me at 503-635'-1171.
James S. C,uckett
Development Services Tecl,>sician
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772
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COUNTYWIDE CITY OF TIGARD►
TRAFFIC IMPACT FEE OREGON
PAYMENT OPTION FORM 8
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Date Site Address
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Project Name Plan Check #
I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore✓,
I requeat the following (choose whichever option or options are applicable): '
❑ Cash or Check ;
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J Credit Voucher '
❑ Bancroft or Installment Payments
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and/or
❑ The Ordinance allows for deferral of payment of the TIF until issuance of the occupancy permit }
if the TIF is greater than $5,000. If the TIF meets this requirement I also request this option.
I understand the TIF must be paid prior to issuance of an occupancy )ermit. I also understand
that the TIF will be recalculated based on the prevailing rates at the time of payment. Please
be advised that TIF rates; n iy increase iip to six percent each July 1 st. This rate increase is not
subject to appeal.
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OWNER/APPLICANT OWNER/APPLICANT
c: BulUng Permit File
Payment Option Notebook
to vogoldinew"U D
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2Ti'2 — - -- — — ---�
JV*
�«WwilYlwr+ 'as _
CERTIFICATE OF
CITY OF TIGARD OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. • . • . . . a DUP94--0 056,
13125 5W Ha;l Blvd.Tigard,Orsgon 97223.9199 (�03)9'39-4171 DATE l SSUF.D a 04/12/94
FIORCEL.a c 13111DD- 00200
ITL ADDRESS. . . a 1599b) SW HALL BLVD 1
:BLOCK— ow
'UPD�I/V[137GN. . . . a IONIN0sC-M
BLCll.r1'i:. . • . . . . . . . R L_U 1 n • • • . . w • . . • • . a
GLASS ASS OF' WURK. 901-1'
Y PEr CIF U;:L. . . I COM
OCCUPANCY GRrl. a BP
OCCUPANCY L.LAD a 42
1 ENANT NAME— W1.011) PANTRY
F"tfemurF;t>!a Plaid Pant:•ry-. •rarmodely ADA improk.-eme,st>w
Ow n e r a _M._.._..__.._._ ..._._.__. .........-...._..._....,...- . ._....._-........_.....
PLAID PANTRY INC;
J.0025 £3W ALLEN BLVD
BEAVE:RTON OR 97005
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Phone #u '303-646-4246
C:ont•ractara ............_._.__..__..._..._..,-..........._...............
w..... ...................
COMPL.E::TEE CONSTRUCTION
1000 NW UUATAMA ST 086
9LAVER7*014 OR 970M.,
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Phone 141 780-3815
Rag #. . t 613:"114
ftcupancy of t:hr* above referenced bUildinl1 is hereby givens and r.ev•tifies
t:he compliance with the 1:3-tater Of Specialty Codes for the group,
occupancy, and USP Udder which the refereimed permit; w•il :I.>asu..ceri»
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FFtF DEt'WR1'ME:NT >C♦ l..ri:C7- 1i -83 F'Et"1'pF�
FUST TN CONSPICUOUS PLAC K,
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tZ�Sp)rCTION NafICE
City of Tigard Hn1.1ding Depart-mmit j -
13125 SW Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 .
Inspection:___--�--- - -
Footing Pl-bd. Underelab Hoch. Rough-in Appr/Sdw1k
round. Plbg. Top Out Gas Line A
Poet/Beam Struct. San. Sewer Framing .
Poet/Beam Mech. Rain Drain Insulation -PIS,
Plbg. Underfloor Water Line Q Gyp. Bd. -Mech.
Date Requeated: [fi_- % / 7 _ Time: _AM PN
Addrese:l� q� — Permit#t-2q
Builder:
THE FOLLOWING (ARRECTION3 ARE REQUIRED:
�
Inspector: � -------- - ---------------------yj/�—��-_
APPROVED -_-- niSAPPROVRD APPROVED SUB.Tgr1'O E
Call For Reinap.
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F�I C A'T'E
Or-- OCCUPANcy
CITY OF TIGARB PERMIT #. . . . . . . . BLIP9 40056
COMMUNITY DEVELOPMENT DEPARTMENT DATE 1r,3SUED- !' 1-7 q41
13125 SW Hall Blvd.'rigard,Origon 97223*8199 (503)6394171
. 11E AUDRES,(G. . . 1,51395 CoW HALL IALVU PARGELA 2G111DD--00c?01
USV 11J I S I GN. .
1.nNIN(33v C.••-N
LLASS OF WORK. .-ALT
TYPE OF 113GE. . . &COM
OLIEW.'AANCY GRP. :82
OCCUPANCY LOPD142'
TENANT NAME. PLA i D PAN 1'P Y
VemArksc 7EMPORARY OCCUPANCY rup Dwy,s FROM DWE, OF' IES! U WE.
R C'
f-"10j-d PAntry - retwodel., ADA impruvementj 1EMPORARY CEPTIr- TCATE OF OCCUPAN('�'v pI
PROVED
1.04111- 4/21 /94 Tn COMPLETE'" ADA REQUIREMENTS.
PLAID PANTRY INC'
100215 SW ALLLN BLVD
BEAVERTON OR 97005
Phone #3 .503 -646-4246
Cont ravt ort
COMPLLTE CONSTRUCTION
��i '( 00 NW GlUnTAMA ST #86
8E'4"VERTON UR 97006
r,t-tonp its
Reg #. 60514
Oc�c.,upancy (:)f thr above referenced building is herc?tjV jjj I %?Pn, and cortifivi.t
thv cOmPliance with the State Of Or-egov, E3pp
.CiAlty
ode
Or-c-upwincy, And 1,se i.inder wjjjcjr ththeyPefee
rnc.ed permit -,watosuefor the grouP9
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FIRE DFPARTMENT
. .. .......
U TAL
fN C01\15PICUOU,13 PLACE'
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INSPECTION NOTICE
city of Tigard Buiidic apartment
13125 AW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639--4175 Business Phone: 639-4171
41
Inepectiou: r 1
Footing Plbg. Underslab Mech. Rough-in Appr/gdwlk
Found. Plbg. Top Out Gas Line Flllt
- d
Poet/F1eam 5t.r�,ct. San. Sewer Framing Bl4•
Poet%Beam Mach. Rain Drain Insulation -P1umbJ
�__
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
f
Date Requeated: , I r � PN
lufdreae r C I ` Permit is v( 1�
Builder:_
T[DS F.)LLnWING CORRECTIONS ARE REQUIRED:
dL
cfl - —
Inspectors. Dates
OPROVE'1 DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SR 811 Blvd. Tigard, Oregon 97223
Inspection Line (Rec-C-Phone): 639-4175 Business Phone: 639-4171
1
Inspection:_ - - — --- -�— -- _- ^—
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plby. Top Out Gas Line ( pIN11l.t
Post/Beam Struct, San. Sewer Framing -Bldg.
Poet/Beam Meeh. Rain Drain Insulation -pl
Plbg. Underfloor Wator Lina l L� Gyp. Bd. -Mesh.
qa
Date RFuentd:-.__ Lf--_ ( l (� Time: AM PH
Address: VC Permit f t
Builder:-__
THE FOLLOWING CORRECTIONS ARE RF.QUIRFD:
(
I nopectoro � -
Dates
APPROVED DISAPPROVED —` APPROVED SU&TELT TO ABOVE
__^Call Por Reinsp.
SIGN PERMIT o
PERMIT #: SNG94-0042 DATE ISSUED. . . . : 03/24/94
EXPIRATION DATE:,--;L
PARCEL. . .. . . . .. . 2S111DD-00201 e
ZONE. ....... .. . . : C-N
BUSINESS NAME. .: PLAID PANTRY/TACO BELL EXPRESS 1 r
SIGN LOCATION. . : 15995 SW HALL BLVD
APPLICANT/AGENT: MEYER SIGN COMPANY
BUSINESS TAX NO:
sR>tmaas r+ssmsma=arsvm=coma-._ma aasys=cc.vca.aaav:ac=oasxa=c-c_oca--oca..-s==:--__
SIGN:
PERMANENT (X) FREESTANDING (X) FREEWAY ( )
TEMPORARY ( ) WALL ( ) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIOPIS. .. . ..: 216" X 611"
TOTAL SIGN AREA.. . . ... 15 sq.ft.
WALL AREA. ....... . . ... sq.ft.
V WALL FACE. (DIRECTION): N
SIGN HEIGHT. . ... . . . ..: 10 ft.
PROJF^'"InN FROM WALL.: in.
ILLUMiNATION.. .. . . . .. : INT
s
DESCRIPTION OF SIGN:
Tn addition ':o an existing Pylun Sign with the copy "Taco Bell Express".
MATERIALS. . . . ... . METAL/PLASTI
EXISTING SIGNS. . . ....• 01
ELECTRICAL PERMIT .^.BQUIRSDS YES r
i BUILDING PERMIT REQUIRED..: NO i
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f ADI ?JZSTItATIVE EXCEPTIONS.: N/A
PERMIT FIM: $ 10.00
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APPROVED BY:
DATE: 03/24/94
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Permit No.
CITY OF TIGARfl — L
SIGN Pa:d= APPLICATION
The applicwit hereby applies for a pe=it fcr the warn indicated or as shown in the
Y�
a p specifications.
bans and
t' C/q ,� /
SIGN LOCATION NDDRF'�S: 15 /sS 1 ZONING: C-Al
` NAME OF BUSINESS:
x APPLICANr/AGENT: L-417
ANY: , PHONE: L�, O- X00
' Me City of Tigard imposes an annual Tax which must be kept current on all •
persons doitx.I business in the City. Do you presently have a current business tax?
YES ( NO ( ) U.L. Iatael
_, PROPOSED SI(W: (Check as many as apply) — --
s PE R ANEUr (p{) FREESTANDE% (e C) FREEWAY ( )
TEMPORARY. ( ) WAII, ( ) E LEC.'IRONIC ( )
' OTHER ( ) BI LTDOARD ( ) BALTOW ( )
SIGN DIMENSIOUS: �� { —� — - />C / EXPIRA IQN
7011 SIGN AREA (Sq. Ft.) : _ /S i 7 Z�> ^`�_
WALL AREA (Sq. Ft.) :
® WALL FACE: —
HEIG-U (I.t) _
PROJrk=— ON FRix4 WAIL.
III �R/t�
( ) NO LLL'( 1
II��TION: YES OL
MATERTALS: �b r,N.�'� �f�1 r 7jn���p• �: �
EXCFPIZON: N/A ( (-I APPROVED ( ) HOW MUM g
AREA�•( ) HEI(
03MMFNI°S: ___6.1.E a �'i �n /D C a✓�• - 3 ��� a
--�`� n � _s Qt. - ! Lr✓��Q 0.. uvc4 � -...i�1�r��-('a�G
L/' eI.LfC. / �' //�1 / L� G /�l�_ c„ i'i
PIANNIW.; DEP �V
All sign permits mist be acooapanied by a scale
unit Fee: drawing and plot plan. If work authorized t*oder
Bocrivt No: a sign permit has not been ocupleted within ninety
APP days after the issuance of the pent, the permit
Date: ���-[---- _:hall becume Mill. and void.EIID
ZICAL PERMITI CERTIFY UM I AM M RE)OLMDED OWNER R OF THE
�II2ED: YES (��1 ( ) PROWW OR AN AGENT AUIti10RIZFD BY = CWN R.
BUIIDING PERMIT
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RBQMED: YES ( ) NO (.� Applicant's Signature �-
73 y0 Sw el.
�/E3EQI1'EI1T2r Address Tr-leph)ne
N:\1-)ORD\tXX.IDFV\
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SIGN PERMIT
PERMIT #: SGN94-0048 DATE ISSUED. . . . : 03/24/94
EXPIRATION DATE: /r�/ ; N
PARCEL. . . . . . . . . : 2S111DD-00201
ZONE. . . . . . . . . . . : C-N
BUSINESS NAME. . : PLAID PANTRY
SIGN LOCATION. . : 15995 SW HALL BLVD
APPLICANT/AGENT: MEYER SIGN COMPANY
BUSINESS TAX NO:
aaaasaaasar+m xrxxaaaasssxxxxaxnoassxxxra==aaQsxxxaxaasaxxnxx=s=xasaasas=xaaasa.aaa
SIGN: A'
PERMANENT (X) FREESTANDING ( ) FREEWAY ( )
TEMPORARY ( ) WALL (X) ELECTRONIC
OTHER ( ) BILLBOARD ( ) BALLOON
SIGN DIMENSIONS. . . . . . : 151BI 117"
TOTAL SIGN AREA. . . . . . : 23 sq.ft.
WALL AREA. . . . . . . . . . . . . 960 Bq.ft.
WALL FACE (DIRECTION) : E
i SIGN HEIGHT. . . . . . . . . . : 12 ft. v.
i PROJECTION FROM WALL. : 10 in-
ILLUMINATION. . . . . . . . . :
n_ILLUMINATION. . . . . . . . . : INT
DESCRIPTION OF SIGN:
A wall sign of 23 square feet with the copy "Plaid Pantry".
MATERIALS. . . . . . . . . . . . : PLEXIGLASS
EXISTING SIGNS. . . . . . . : 01
ELECTRICAL PERMIT REQUIRED: YES
BUILDING PERMIT REQUIRED. . : NO
ADMINISTRATIVE EXCEPTIONS. : N/A
PERMIT FEE: $ 10.00
APPROVED BY:
DATE: 03/24/94
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Permit No.
' CITY OF ZIGARD
Y
SIGN PERMIT APPLICATION
The applicnrit hereby applies for a permit for the wor3: indicated or as shown in the
aeoonpanying plans and specifications.
SIGN LU=Otl ADDRESS: I� �l ,dot%� ZONING: z V_
NAME OF BUSI]NES.S: - •
APPL7.CAUr/AGENT: -X/I n ANY: "C La. PHONE:
The City of Tigard inposes an annual Business Tax which must be kept current on all
persons doing business in the City. Ngo you presently have a current business tax?
YES NO ( ) U.L. E-ibel of — —
PROPOSED SIG4: (Check as many as apply)
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PERQNENr FREESTANDING ( ) FRUHMY ( )
i TFI-T xzAMI ( ) WAIL. (�) EZDCIRocNIC ( )
(M-MR ( ) BIIZEKXkM ( ) BALLON ( )
y SICSN DIMIM)IONS: /5 1 7 _ ENPIRATIgN -
z nTT. SRN AREA (Sq. Ft.. �3�-- V -eS�
WALL AREA (Sq. Ft-) :
WALL JFA(M
I FIGO (FY_) t r 6,
PRaJ TION FROM WALL: CC
nILMMMO N: YES NO ( ) TYPE: GYI
COPY:
: _ A
MATERIALS:
EXISTLNG SIGNIS:
,a
EXCEPTION: N/A ( /_,r-�APPNgD ( ) HOW MUCH
AREA ( ) IiELGHr ( )
M-24 MS:
PLAMTING DETARruair All sign permits mist be accompanied by a scale
Permit Fee , r'l dT drawing and plot plan. If work authorized wider .
Receipt No: 111 a sign permit has not bei oompleted within ninety
App _B _� '' days affix the i_ss�tanoe of the permit, the permit
Date' shall beacme null arra void.
ELEL-micAL PERmrr I C=FY MAT I AM THE RDODRDED OWNER OF IIS
REWIRED: YES �I'No ( ) PROPFRN OR AN AGENT AUIVORIZED BY THE OWNER.
BUII,DI2dG PF-T. •u r
RKUIRED: YES ( ) ' No Applirint's Signature '
c{�/13 7PI?d1I' Jerre', ThInoionc
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Permit No.
QTY OF TIGARD r
SIGN PERMIT APPLICATION
Zhe applicant hereby applies for a permit for the work indicated or as shown in the
acocupanying plans and specifications.
SIGN IACATION ADDRESS: ZONING:
MIME OF BUSINESS:
APPLICANT/AGENT: �7—CWANY: MME: 10 0 ZOo
The City of Tigard imposes an annual Business Tax whidi must be kept current on all �r
Persons doing busicv-.ss in the City. Do you presently have a vent business tax?
YES (,) NO ( ) U.L. Iabel if t
PROPOS'ID SIGN: (Check as many as apply)
PER q NENT FREEMMING FREEWAY
T TiPORARY ( ) FILL (wc) ELWIRDNIC ( )
( ) BM 30ARD ( ) BALLOON ( )
SIGN DIMENSIONS: �� �' ,/S _ FXPIPATION
M SIGN ARE7X (Sq. Ft.) : _ 2GZ- J�
Tt7
WAII, AREA (Sr. Ft.) :
WALL FACE: _ I t 4 ?( p —
HEIGHT (Ft) : _�
"FUTECTION FIM WALL: �D'•
ILIIfiMsMTION: YES (yc ) NO ( ) TYPE: /lW?7
COPY:
��: 21�� Ste'
EX MING SIGNS:
ADMINISTRATIVE EXCEPTION: N/A APParvM ( ) HOW MUCH
AREA ( ) ( )
• CO�Nl'S
.MANNING DEP A11 sign permits must be aOompanied by a scale
—_ --
Permit ee S
F
drawing aid plot plan. If work authorized under
Receipt No: 9v--5M76 a sign per.mi_t has not been ampleted within ninety
Arvmred days of Ler the issuance of the permit, the permit
Date' Y' shall beoame null and void.
ELSE MICAL PERMTT� I CERTIFY TMT I AM TE{E RDGOI2i'ID OFIIJFIt OF T4 f
SIRED: YES (' ) NO ( ) PMPERTY OR 1.NT AUINORIZID BY THE OWNER.
BUILDING PEI-4IT
RBXDZFD: YES ( ) NO (� licant's Signature
cp/BIQMPL7d°II' Addre<;s — -- •IhleEitione
N:\W0RD\(XY-1T)1'
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SIGN PERMIT 6
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1 PERMIT #: SGN94-0043 DATE ISSUED. . . . : Z1,�94
EXPIRATION DATE: GG/j6
PARCEL....... . .: 2511JDD-00201
ZONE. ... . .. .. . .. C-N
BUSINESS NAME. . : PLAID PANTRY/TACO BELL EXPRESS
SIGN LOCATION. . : 15995 SW HALL BLVD
APPLICANT/AGENT: MYER SIGN COMPANY
BUSINESS TAX NO:
----------
SIGN-
PERMANENT (X) FREESTANDING ( ) FREEWAY ( )
TEMPORARY ( ) WALL (X) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
•
SIGN DIMENSIONS. . . . . . : 18' BY 17"
TOTAL SIGN AREA. . . . . . : 26 sq.ft.
WALL AREA. . . . . . . . . . . . . 800 sq.ft.
WALL FACE (DIRECTION) : F.
SIGN HEIGHT. . . . . , . .. . . 11 ft.
( PROJECTION FROM WALL. : 8 in.
ILLUMINATION.. . . . .. . . : INT
DESCRIPTION OF SIGN:
A wall sign of 26 square feet with the copy "Taco Bell Express".
T MATERIALS. . . . . . . . . .. . : PLEXIGLA::4
r
EXISTING SIGNS. . .. . . . :
e ELECTRICAL PERMIT REQUIRED: YE;,
BUILDING PERMIT REQUIRED. .: NO
ADMINISTRATIVE EXCEPTIONS. : N/A
PERMIT FEE: $ 25.00
APPROVED BY:
Gj��i�71�,1� G'b`'✓'e
DATE: 03/1.4/94
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JNSPECPION NOTICE
City of Tigard Building Department .
13125 SN Ball Blvd. Tigard, oregon 97223
Inspection Line (Relc-o-Phone): 639-41775q Busineas Phone: 639- 1
Inspection:— _. 4\l j \k oc '
Footing plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Guo Line FINAL:
l Post/Beam struct. San. Sewer Framing -'Bldg.
Post/Beam Mech. Rain Drain Ineulati.on -Plumb.
Plbg. Underfloor. Water Line Gyp. Bd. 'Mech.
Date Requested: ----TLmei AN PM
---f— E
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� 'e-1 Permit #sc�u ('�i�(—c t�(�
Address: ---- --
Builder:THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector — Date'
AP 016 D DISAPPROVED - APPROVED SU&JE(--T Tt) ABOVE
Call For Reinap.
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INSPECTION NOTICE t /
City of Tigard Building Department
13125 SW Ball Blvd. Tigaxd, Oregon 97223
Inspection Line (Roc-O-Phone): 639 175 Bussineas Phone ff 39
Inspections ,\�
Footing Plbg. Undersl Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Oar Line` FINAL:
Poet/Beam Struct. San. Sewer /rsming / -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
PI-bg. Underfloor Water Line Gyp. Bd. -Mech.
JJ G 1
Date Requte�eteds .� IC U� Times (�,� (�.AM pM �
Address: J� I A 1
f I� l Permit f'.'Y.L.__
Builders 1L. Q `ew-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inepectorr Date:
_._ PPROVED A_ DISAPPROVED _-_ APPROVED SUBJECT TO ABOVE
_Call For Reinap.
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INSPECTION NOTICE
City of. Tigard Building DePa--tint
131!5 aw E&11 Blvd. Tigard, Oregon 47223
Inspection Line (Rec-O-Fhons)s 639-4175 Business Phone: 639-4171
Inopections —,_
1' l V_VV V), // y( l—r, -
+ l 1
-
T, Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. / Y1 Top Out Gas Line FINAL:
Yost/Beam Struct. Ban. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
? Plbg. Underfloor Nater Line Gyp. Ed. -Mech.
Date Requested%C� 1 (7 TSI
Address: P-?! Permit s
�+ S�
Builder:-----,
TBE FOLLOWING CORRECTIONS AAE REQUIRED:
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— ---- � � � Dates
Inepecto
--- -
CPPROVRD DISAPPROVED v APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE i Z_-
City of Tigard Building Department
13125 .'W Ball Blvd. Tigard, Oregon 97223 k
Inspection Line (Rec-U-Phone): 639-4175 Business Phone: 639-4171
I
Inspection: l I �Lt_1/1. { �1( L V\�L1.k)m
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post-/Beam Hach. Rain Drain Insulation -Plumb.
Plbg. Underfloor W,+ter Laine (� Gyp. Bd. -Hach.
Date Reque+steds _ V R� / _-_—Times AN1/ /�n PH
Address: 1 � I � � 1-'IUC� Permit #:((7 c M �i I On 3J
Builder:
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector Date•
____APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
4-SA— 1 For Rninap.
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CITY OF TIGARD BUILDING P1_F.,1IT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : BUP94--0056
13125 SW Hall Blvd.Tlgard,Oregon 97223.9199 (50 1., 9 4 71.. DATE ISSUED: 03/08/94
PARCEL.: 2S 1 1 1 DD•-00201
SITE ADDRESS. . . : 15995 SW HALL BLVD
SUBDIVISION. . . . : ZONING: C-N
BLOCK. . . . . . . . . .. . LOT. . . . . . . . . . . . . :
4
REISSUE: FLOOR AREAS-------------- EXTERIOR WALT- CONSTRUCTION-
CLASS OF WORK. :ALT FIRST. . . . :,='400 sf N: S: E: W.
TYPE OF USE. . . :COM SECOND. . . : s P:ROTECT
TYPE OF CONST. :5N THIRD. . . . : s f N: S: E: W:
OCCUPANCY GRP. :B2 TOTAL--------,- - : 400 s f ROOF CONST: FIRE RET? -
OCCUPANCY
E'T? :OCCUPANCY LOAD:42 BASEMENT. : sf AREA SEP. RATED:
STOR. : 1 1-11'. : 15 f t GARAGE:. . . . s ff OCCU SEP,. RATED:
BSMT? : MEZ Z ): REUD SETBACKS-------
FLOOR
ETBACKS----- -----FLOOR LOAD. . . . : p a F LEFT: ft RGHT : ft FIR SPKL.: SMOK DET. . : ar
DWELLING UNITS: FRNT : ft REAR: ft FIR ALRM: HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE. $ : 18000
Remarl<s : Plaid Pantry- remodel, ADA improvements
Owner-: --______-.__._.__________._..______.______._.__.__....___.._._____._-•-- FEES
PLAID PANTRY INC type amount by date recpt
1002S SW ALIEN BLVD PRMT $ 128. 50 - 03/03/94 94-249618
F='LCK $ 83. 53 - 03/133/93 94-249618
BEAVERTON OR 97005 5PCT $ 6. 4" - 03/03/94 94-249618
Phone #: 503--646-4246
Contractor:
COMPLETE CONSTRUCTION
1000 NW GIUATAMA ST #86
BEAVERTON OR 97006 _---___._-.__._____---------------•---.____
F'h on e #: 780-3815 $ 218. 46 TOTAL
Reg #. . : 68b14
REQUIRED INSPECTIONS
This pereit is issued subject to the regulations contained in the Framing I n s p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gyp Board Insp
applicable laws. All work will be done in accordance with S l_i s p C e.i 1 n g I n s p
approved plans. This pereit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for sore Final Inspection
than 180 days.
Permittee S iren a t i_I r e :
Call for inspection - 639-4175
11111 Ii't !11111 111�1111111�1 11111 11111 Ilya III:,!
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TUALATIN VALLEY FIRE & RESCUE
AND •
BEAVERTON FIRE DEPARTMENT
4755 S.W. Griffith Dive• P.O. Box 475_ • Beaverton, OR 97076 • (503) 526-2469• FAX 526-2538
March 7, 1994
I
Terry W. Pyle
Plaid Pantries, Inc.
10025 S.W. Allen Blvd.
Beaverton, Oregon 97005
>r!
Re: Plaid Pantry #19
15995 S.W. Hall Blvd.
6189D-094-000 '(
Gentlemen:
This is a Fire and Life Safety Pl, ,i Review and is based on
the 1991 editions of the Uniform Fire Code (UFC) and those
sections of the Uniform Building Code (UBC) and Uniform
Mechanical Code (►IMC) specifically referencing the fire e
department, and o,.-her local ordinances and regulations.
Plans received for the above noted project have been
reviewed and are conditionally approved subject to the
following:
1 . Address Required: The tenant space number must be
prominently displayed on the street front where it is I
j readily visible to drivers and ufficers of responding
fire apparatus and other emergency vehicles. UFC Sec. I
10 .7.08
2 . Fire Extinguisher Requirements: Not less than one (1)
approved fire extinguisher(s) with a rating of not
less than (*) shall be provided for each (**) square
foot of floor area or fraction thereof. The travel
distance t- an extinguisher from, any portion of the
buildingshall
,not exceed 75 feet . UFC Sec. 10 .505
(*) 2A10B:C - Light and Ordinary Hazard
4A10B:C - Extra Hazard
(**) 3 000 - Light Hazard
1, .500 - Ordinary Hazard
1, 000 - Extra Hazard
i
"Worklnir"Smoke Detectors Save Lives
I
0,rMviPr!9'.iLTI 'S 'Y4bi.mm..w.
Terry W. Pyle
March 7, 1999
Page 2
t
Note: Where flammable or combustible liquids are
used, "B" ratings of extinguishers may need to be
higher and travel distances shorter. See
requirements in National Fire Protection
Association Standard 10-1 .
t
Approval of submitted plans is not an approval of omissions
or oversights by this office or of non-compliance ;pith any
applicable regulations of local government.
If I can be of any further assistance to you, please feel
free to contact me at 526-2502 .
Sincerely,
Gene irchilJ_, DFM
i
Plans Examiner
GB:kw
cc: Complete Construction
City of Tigard Building Department
t`'
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13128 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
PLUMBING PERMIT
PERMIT #. . . . . . . : PLM94--0035
639-4171 DATE ISSUED: 03/07/94
PARCEL: 0S000X X-•0000+21
SITE ADDRESS. . . : 1.5995 SW HAi_L BLVD
SUBDIVISION. . . . : ZONING:
BLOCF(. . . . . . . . . . . LOT. . . . . . . . . . . . . .
---------------------------------------- ----------------------------------------------------
CLASS OF WORK. . :AI.-T GARBOGE DISC'OSALS. . : MOBILE HOME SPACES. :
TYPE OF USE. . . . :CUM WASHING MACK. . . . . . . : BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :B2 Fl 0014 DRAINf . . . . . . . :3 'TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . . i WATER HEATEFS. . . . . . : 1 CATCH BASINS. . . . . . . .
FIXTURES _.___._._._______ LAUNDRY TRAYS. . . . . . : SFRAIN DRAINS. . . . . :
SINKA. . . . . . . . . . ..3 URINALS. . . . . . . . . . . . . GRFASE TRAPS. . . . . . . . m1
LAVATORIES. . . . . : 1 OTHER FIXTURES. . . . . :2
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :
*; WATER CLOSETS. . : WATER LINE (ft ) . . . . :
DISHWASHERS. . . . RAIN DRAIN (ft) . . . . :
Remarks : Plaid Pantry- remodel, ADA improvements
__---__--._--_-__--_---.__--_-___--------_..__...___ FEES
PLAID PANTRY INC type amol_rnt by date r~er_Ipt '
1.0025 SW ALLEN BLVD PRMT $ 82. 50 JH 03/07/94
PLCK $ 20. 63 JI-1 03/07/94 - I.
BEAVERTON OR 97005 ' PCT $ 4. 13 JH 02,/07/94
Phone #: 503-646-42'46
Contractor-: -.-.___.__..---•-____.-.---..___.____._._____
MP MILWAUKIF_ PLUMBING
PO BOX 393
CLACKAMAS OR 9701 -- ----.-----___-_----.-___-_______________
Phon e #: 44--•6600 $ 1117. 26 TOTAL-
Reg #. . : 05002
- --__-- REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Top-nut Insp
Tigard Municival Code, State of Ore. Specialty Udes and all other Misc. Inspection
applicable laws. All work will be done in accorcance with RF'/Backf I ow Prev
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspendeO for more
than 180 days.
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Pei ittee Si.gnatiire: ,�
Issued By : _
Call for inspection - 6:33-4.175
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Citv of Tigard. PLUMBING PERMIT Planck/Rec. #
13125 sw Hall Bird. APPLICATION Permit # _
PO Box 23397
Tigard, OR 97223
(503) 539-4171 _—
_ srnption
i A N` ^J- ORS 814-21.610 TW PRICE _AMT
Job S'1115 S,-) Z\J& FIXTURES S
Address Sink00.1 50
,any 5o p
�... Tub or u lower Comb. _
Shower Only 7.50
uw.p ..,. ater Closet 7.50
a
ishwasher 7.50
Owner
3w-- - ge Disposal -
WasNng Machine 7.50 1r
loor Drain 7.50
ata eater - .50 17
-` �- ur0(_yRoom I ray
Occupant Urinal 7.50
Other Fixtures( .ea ) 50
7.50
22 2 7.50 �?
MMry PA*— is
O 1�23 OMISCELLANEOUS -
Contractor
E—�� Sewer 1st 100' — 30.00
� t:_�►-tr��i "llll_-5
r'1Gai. � M ••W Sewer-ea.Addit. 100' 15.00
10 D'L, 13,�_T Water ice Sery1st 100' 20.00
hereby ac oa In that have reis ep nation,th—..' i}t a Water Service ea-Addit-200' 15.00
Information given Is conect,that I am the owner or outha zed agent of
Ute ownor,that plans submitted are in congAanoe with State laws,dint I Storm 6 Rain Drain 1st 1l0' 30.00
am registorod with the Construction GontracWs Board,that din number Storm 6 train Drain Adclit 100' 15.00
given is carted. (If exempt from State registration,p(oase give reason - --
— Mobile Nome Space _25.00
below.) -
w Prevention
_312- Device or Anti-Pollution Device _ _` 7.50 '15C
•-�-« -Tr �iy Trap or Waste Not
Connected to a Fixture 7.50
Describe work now C aridition alteration repair l atclr sin —�50
re be done residential Q non-residential 40.00
Insp.of Exist.Plumbing per hr
40.00
Specially Requested Inspections per tir
Existing use of R11 rain,sang 1—
buiKiing or ixoporty^ _ dwelling 15.00
Residential backflow prove- .ion
devices 15.00 p
Proposed use of —'
Ww"g or property
'( cept rerr n(a/ aclow —
prevention devices)
NOTICE *Minimum Fee$25.00 SUBTOTAL CJS
PERMITS BECOME VOID IF WORK OR CONIMUCTION 5%SURCHARGE t 1,13
AUTI-IORIZED IS NOT COMMENCED WITHIN 130 DAYS,OR IF —
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED p REVIEW 25X OF SUBTOTAL 1.�.
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS _
COMMENCED. —
,
Special Conditions TOTAL—J-�-- — — --101
Date issued
wrtuovn
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cIlY Ot I.IGARI) Fir.f t I4:' r �.,� FFaYMFiVr Ftkf.E'Ir'T NO.
L:F1ECK AMOUNT t 107. 2
hIF, a MA PLUMBING CO.
AMOUNT
PAYMENT D
DtJRES'E a
A I F..: a 0a/N 1/war
`-i(.tBUIVIlrI1.7N
4,
OF �AYME:N T' AMOUNT �'A I[) K•IL1RP-1t)(IF CSF PAYME:N r P)Ivli:JUNT' PA EDIURPOSE ,
ILAIMBING T''ERM a '.. 50 ''iT,. klIATLD PER
UM UHECK VE
All) PANTRY 159915 SW HAt_L. IAL-901 T :t�'iNFli)
OTnt_ AMOUNT 1-401)
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Commercial Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite AddrAss' 15995 SW Hall Blvd. ,Tigare
Tenant: o®®— a Suite# Offl a Ug�itlVa;�
Valuation: Permitable valuation is appA uximat-ely s� , r y - r t'J•
@ � ` k
:5;,o��a- Balance is removable t-ade fixtures l
Uwner: Plaid Pantries, Inc. '* sf r s �` ,° ,
a >
10025 SW .Allen Blvd. � ��� ���� " >'�` •
,Address: _ rtyVafs
h* Y� !
Beaverton OR 97005 � w�' 7
>Y 2 �'��/ �'b�ip+fk+ R• >`fl 3>}'�y��S+�t���l Ke,•ae
Phone: (503) 646-4246hee'ritii� xskc;< 3e° �
Contact: Terry W. Pyles s <
I Vice President/Corp.Development
�Y Y. �.���XYZ`�"SO ,p�`'�+iA 1stA9fj,j�`4•K�w 77��;ya£�,{q
Contractor: Complete Construction �f.
1 QMtWt
Address: 21000 NW Quatama St. #86
Type of const: J��
Beaverton OR 97006 _
_
Phone: (503) 780 3815 Occupancy class:
_
Sprinklered? Yes Jo
Contractor's License # 68.514
(attach copy of current Oregon license) Sq. ft. of project:_ `,GO y?'
Story (1 st, 2nd, etc.) / S'T"
Arch ltect/EngIneer: BR Consulting Proposed used L, Z_ -� .SJNtr-4
Address: 122 SE 27th Previous use: t' • ��rc J
Portland OR 97214 — Note: Plumbing & mechanical plans
Phone: (503) 234 7845 - Fax: (503) 232 2357 must be submitted at time ofbuilding permit application.
COMMENTS. Project consists of replacing existing food service inside existing
convenience store with nar•_ brand service, replacing cabinetry,• fixtures, signage and oper-
ational _r--ed a NQ to rtuctnr^I or Use—Changes are plann d_ Health apt_ apylroval wi U
be part of process.
-�7
Applicant Signatu & Phone nuff&r Terry W. Pyle
Vice President/Corporate Development (503) 646 4246
Received by: Date Received:_ i
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Permit # Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) .
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tar (TAX) G�
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg: /
Plumb:
Mech:
I j
_ S7wer Connection (SWUSA) _
Sewer Inspection (SWINSP;
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC) _
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-!)
InstiM.;onal TIF (TIF-IS)
Office 11F (TIF-0)
Water Quality (WQUAL)
Water Quantity .(WQUANn...._ {:...
P
E
Fire District (FIRE) _
i
j TOTALS:
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1
03-03-1994 11:32RM FROM PLAID PANTRIES INC TO 684729? P.02
plal"d
P n ries, inc,
neighborhood convenience stores
I March 3, 1994
City of Tigard
Building Department
Re: A.D.A. Compliance/Building Permit - 15995 SW Ball Blvd., Tigard, OR
This correspondence is to confirm that we expect to spend an amount equal to or
exceeding 25% of the pe.rmitable valuation of our tenant improvements.
i
The items that we intend to improve to bring this into compliance with A.D.A. S
are shown on the plans and are listed in the A.D.A. accessibility report for
this property attached.
Y
The contractors estimate of cost foT these improvements are as follows:
1) Install A.D.A. approved handicap access ramp, install
Signage, paint parking space... . .. ........... ...............s. $ 2,500.00
2) Redo threshhold at entry door, adjust or replace closure
hinges, adjust or replace doors........... ... ........4........ 1,500.00
3) Retrofit one pay phone per A.D.A. requirements... ........ ... .. 500.00
Total estimated cost......... . ... . ... ...... ..... .... ........ ... ... 14,500.00
The A.D.A. improvements will be part of the construction process and will. be
completed prior to building final.
Please contacL me- at 646-4246 with any questions.
Sincerely,
5i
e y W. Pyle
Vice President,
Corporate Development
'AHP/sv
10025 S.W. Allen Blvd. Beaverton, OR 97005 (503) 646-42.46 FAX # (5031 won7l
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to -.. �.-,.�...-,--._.._.._...._..__.� -...._........�---•-- —____-... .—...._..-....�---''---. _.�.,.. __.....�-'----.- _ _._.-.._,/ti-_,w__..n`.�__.w_�._�..__..�_....�._..�_..-__•_ _. _.__.._
CITY OF TIGARD — FBFGF:IPT OF PAYMENT RECEIPT NO. a94-~c:4961.E3
CHECK AMOUNT i R18. 46
JAMF a
PLAID PANTRIES .L IVC CASH AMOUNT a IA. i11rD
lDDRESti a PAYML*..N?' DAlk a FD.3/I�,i/94
1.3UBD I V 181 UN e
•'1..1F1P09F-: OF PAYMF.N C AMOUN f PA 117 4'I.IF�NI':1:iH: OF P$4 Y MF N F �0 11 11 II I 1
_............_.._._._�
0-11LDING PERM i2A. 'no S.i'F. Hl_IH 1.) F-+R 6. 4.3
. -AN CHECK FE 83. 51.3
1!i�+
S, W HALL. BLVD
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x' 1 1:1 F AL AMOUNT F)ta T I) — > P 1 S. hili
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