Permit (19) ;
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00422
� i � , DEVELOPMENT SERVICES DATE ISSUED: 8/11/03
'�' '=--' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16200 SW PACIFIC HWY A PARCEL: 2S115AB -01900
SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 6,746 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: A3 TOTAL AREA: 6,746 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 207 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: $ 25,000.00
Remarks: Convert existing day care facility into buffet restaurant.
Owner: Contractor:
BIT HOLDINGS LTD PARTNERSHIP OWNER
BY FORUM PROPERTIES INC
FIVE CENTERPOINTE STE 290
LAKE OSWEGO, OR 97035
Phone:
Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pln Rv 7/18/03 $184.15 Electrical Permit Required
[FLS] FLS Pln Rv 7/18/03 $113.32 Sprinkler Permit Required
Plumbing Permit Required
[BUILD] Permit Fee 8/11/03 $283.30 Framing Insp
[TAX] 8% State Tax 8/11/03 $22.66 Gyp Board Insp
Total $603.43 Susp Ceilng Insp
Final Inspection
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: ,f/ 46,0711Z
Perm ittee �,
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
/(Lao SA) PACIFIC Hwr
+ �� o�oa3 -OOO i > ,a f1Ro b .2-et 15-5-P .n Iliv • �.I I Ic I . ! �1 ,I,rl
Building Permit App coon
-a ,� _ , \ Date received: 9 *1rG Permit no.:: �7 - --...S. • )il'� L `, \l
.41- ; ,; City of Tigard si = dam:
s ec t/ no.:
City of Tigard 13125 SW Hall Blvd Tigard, OR 97223 Pro I�
Phone: (503) 639 -4171 ,, `,1 ',1 ' i,,,,3 D ate �Oed: no.:
Fax: (503) 598 - 1960 ° `\ Case file no.: Payment type:
ti V OF Ttl GA� �(� 1&2 racy: Simple Complex: �!
Land use approval: _ ,� �Ivfi�l0
I \ I'I. (►I 1'1 10111 ` p.
O 1 & 2 family dwelling or accessory O ommercial/industrial O Multi - family Cl New construction O Demolition
O Addition / alteration /replacement Tenant improvement O Fire sprinkler /alarm O Other.
jo lt SI II . 1 \I ORAI \ I I() \
lob address: i r .1-0 0 5 •M r^)/
- 17, Q• Bldg. no.: Suite no.: '
Lot: Block: 'Subdivision: // Tax map/tax lot/account no.: .,
Project name: - r( ltJ T7N guFPET a
v tfi�vi • r _� o ✓ — Co Yl 4 �ccs r
Description and location of work on pretni special con tions: - ;1
`'u+Ll� c
O\1 \1.0 I (),, SI'F( I \I. (NI OIn 1 \ I I(1 \. I'l: ( III (hl I . I 1
1-0-41‘1,0 n , II Iundlilain ..cpiiccaparil■..ul:u'.ctc.) '`
Name: V � \ FFF
Mailing address: , - • S f • . _ ' 1 & 2 family dwelling:
State: OIZ $ Valuation of work t.
Phone: 5 413).54 a Fax: E -mail: No. of bedrooms/baths
Owner's representative: t , 0 akar -MILL° Total number of floors ik
Phone: aIc ∎ ih • • . _ 3 a :3.7 . -mail: _ 5/6� l New dwelling area (sq. ft.) ,\ k.
,19,11(.‘. I Garage /carport area (sq. ft.)
i Covered porch area (sq. ft.)
Name: /3 ii'M
g e *` d _ Deck area (sq. ft.)
Mailing add Other structure area (sq. ft.)
City: /U`( I State: loyl ZIP: I 0001-
I
. • E -mail: CommerclaIIlndnstriaUmulti- family:
l)\
Phone:,>i1 a , FaON U li.lc r01 I Ol i Valuation of work $ c2.5-
C 6q-46 (= Y )
EEIMMNMIIIIIIIIIIIIIIIIIIIIIII Existing bldg. area (sq. ft.) 6� r
TAM New bldg. area (sq. ft.)
Address: Number of stories
City: I State: I ZIP= Type of construction t/- Al
Phone: I Fax: I E -mail: Occupancy group(s): Existing:'
CCB no.: New: SE1'4 L-r . ' 3.
City/metro lic. no.: — _ Notice: All contractors and subcontractors are required to be
■ RCM I f f I: ( - ',-/ I) I :SIG \ I: R licensed with the Oregon Construction Contractors Board under
� ` w� provisions of ORS 701 and may be required to be licensed in the
Address: �j
A K (>(- ( M ,,,,e c Q ' • jurisdiction where work is being performed. If the applicant is
R_ exempt from licensing, the following reason applies:
City: / State : IZIP: /001) L
Contact person: / / d & et Plan no.: •
Phone: a 1 . B$, 3 Faxa11, _, E -mail:
f.\GINI:I:R ()FFI( I: I_ I•• (► \I_\
n-_ Con person: Name: "� G� r , � pc ,^�' y.s � /u' Fees due upon application $
p Date received:
Address: . ,1 le 0 A ,, / _ y $
City: - State: ZIP: /o00 -- Amount received
Phone: al l 3 I Fax: 24)2j/E-mail: Please refer to fee schedule.
I hereby certify I have read and amined this application and the Not all j,cisdicuams accept credit cards, please call jurisdiction for nano information
attached checklist. All provisio of laws a ordinances governing this O Vsa Cl MasterCard
Credit card number. / I
te:
work will be complied with, ( r died herein or not. � ,
Authorized signature- Name of cardholder as shown on credit cad S
Print name: Z( I /.i. . - cardholder signature Amami
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.
4464613 (b'OWCOM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection LTie: (503) 639-4T 5
INSPECTION DIVISION Business Line: (503) 63 71 MST
Received Date Reque ted D -� AM PM BUP
� �Z � � .
Location � _ _ . ite MEC
Contact Person . .414 ■ Ph ( ✓ ) £ 1 0 (Ob/ PLM
WIP
Contractor 4 Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ,
ic ,Q CA--6 (, _ ,� SIT
Post & Beam `� -�-�-
Shear Anchors LAyes / �„ ' -
Ext Sheath/Shear Y ` •
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm U( _V /,j QGG
Susp'd Ceiling
Roof
Final
440 • PART FAIL
- ING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer i 441:ino
Rain Drains
Catch Basin / Manhole
Ifil
Storm Drain g'!
Shower Pan , v —, r Ili
Other:
Final ILO
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line \ t ;
ADAroach/Sidewalk Date 2 7' c( Inspector ✓ Ext
PP
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL