Permit (175) CITY OF TIGARD BUILDING PERMIT
■ COMMUNITY DEVELOPMENT Permit#: BUP2018-00003
T I c;A 1=.f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/26/2018
Parcel: 2S110DCO2200
Jurisdiction: Tigard
Site address: 15570 SW PACIFIC HWY
Project: Safeway Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: Reconfigure floral sales area,construct new fresh cut fruit prep room,replace cases in produce,meat,bakery and
Deli.
Contractor: ENGINEERED STRUCTURES INC A CORP OF IDAHO Owner: ROIC OREGON LLC
3330 E LOUISE DR STE 300 ATTN: SCHOEBEL, RICHARD
MERIDIAN, ID 83642 8905 TOWN CENTRE DR, STE 108
SAN DIEGO, CA 92122
PHONE: 208-362-3040 PHONE:
FAX: 208-362-3113
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB Permit Fee-Additions,Alterations, 02/26/2018 $2,917.95
Occupancy Grp: M Occupancy Load: 400 Demolition
12/o State Surcharge-Building 02/26/2018 $350.15
Dwelling Units: 0 Plan Review
Stories: 1 Height: 0 ft 01/16/2018 $1,896.67
Info Process/Archiving-Lg$2.00(over 02/26/2018 $38.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $400,000 Metro Const.Excise Tax 02/26/2018 $480.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $5,682.77
Required: Required Items and Reports(Conditions)
Fire Sprinkler: 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 tain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ! permittee Signature:
Call 603.639.4175 by 7:00 a.m.for the next available inspectio date. .1071
This permit card shall be kept in a conspicuous place on the job site until c mpletion o,the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial � � J' FOR OFFICE USE ONLY
City of Tigard ! ie!
lQ � �13125 SWHall Blvd.,TigardOR 97223 6c PermitNo.:/�/i 't- 5
Phone: 5037182439 Fax: 503.598.1%0 j 4 - j it LG LC
Date/By: � 1 � � , 1 '�� Other Permit:
T 1 G A R p Inspection Line: 503.639.4175 � . Date Read/B
k�O�r P' Y Y Juris:
See Pa
Internet: www.tigard-or.gov I �� No red Met d: �� �� Page 2 for
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Supplemental Information
' jY,ii ry w
r -,, O N . . T ®ate ', „tv sr la g a
ew construction
0Demolition Permit fees*are based on the value of the work performed.
Ni Additio alteratior�lr�placement ❑Other: Indicate the value(rounded to the nearest dollar)of all
i` equipment,materials,labor,overhead,and the profit for the
�, O 6 i ? work indicated on this application.
❑ 1-and 2-family dwelling i' Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
0 Master builder
❑Other Number of bathrooms:
` 14:*; 6 Total number of floors:
Job site address: --5---70
�h
G0 !%i riC-• 44i/0 T. New dwelling area: square feet
City/State/ZIP: Ti&Ay /
2- .0 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:s
AfeWAy "t'. Z , Covered porch area: square feet
Cross street/directions to job site: SAU
'F.pliel U� rI--VIJ..r. Deck area: square feet
Other structure area: square feet
g..^ ., s mix
Subdivision: ..,. '. �.. �. , . , 1 x _
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
'i - J s .. equipment,materials,labor,overhead,and the profit for the
�1 l ' _ , ,® `' work indicated on this application.
`� C/t/ )t Fe P 1- ��a A/44 'CvNS i� Valuation: 140,9/
060 . -.
vlS , �I ■ or O / �, Existing building area:5� square feet
e1'Etr 1,4 PUL>C' e T, ,; [ ( New building area: / square feet
* g _ :fir -zlf
Y� *� :.� ` � E. � • . � Number of stories:
Name: 160,.4; iL-(�[�7oN�i �= }i ce /NiDtz p vlLDf•� Type of construction: S ����� -�
Address: 11,2N)C) 'Se- E '(T (� J �Yf`�C/ ✓/
t 1�t1 t Occupancy groups: iii/
City/State/ZIP: v fJ Gy-(v J
`�• t Existing:
Phone (5C'?� �Jl�r” ,7154? Fax ( ) '
New. F-1/7-,-G::, ii4i z2v,i4xl‘„r___
PPL
..,V1�171 eeKr 1�"�l-i f"�-5 ': i Ceus�eJe t fe ch ir1
w Business name: 1
Contact name: -j v Structural plan review fee(or deposit):
Address: 192 t 5e. c_t_r r ---t-p FLS plan review fee(if applicable):
City/State/ZIP: jbgT ,. 1p 1 bQ 112.1+1 Total fees due upon application:
Phone:( ) 1 ��I�+ i7 `Fax::( ) �� Amount received:
Email: ( .G+ J
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City/State/ZIP: ME,p (0 i f#N i t 1) C, tiPermit fee(includes plan review
C and administrative fees)_ $180.00
Phone:( ,Cl, ) SC, — 1150(0 I Fax:(:-d's) 5(..-, } , 113 State surcharge(12%of permit fee): $21.60
CCB lie.: 77 l(u (J" d 6)// ,4 ;
f �. l Total fee due upon application: $201.60
Authorized signature;
--�-��-3 �- --.. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: j a G, 60 I Date: b i /0/ tiF) I * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15570 SW PACIFIC HWY, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Building BUP2018-00003
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor