Permit Y, I ' a CITY OF �� BUILDING PERMIT
T PERMIT #: BUP2008 -00369
COMMUNITY DEVELOPMENT DATE ISSUED: 11/17/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136DC-04500
SITE ADDRESS: 07501 SW DARTMOUTH ST ZONING: C -G
SUBDIVISION: PP1995 -013 LOT: JURISDICTION: TIG
PROJECT: WINCO
Project Description: TI - add (2) security offices in Customer Service area.
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: 2N sf N: S: E: W:
OCCUPANCY GRP: M 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 : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 45,000.00
Owner: Contractor:
WINCO FOODS LLC D AMYX CONSTRUCTION INC
650 N ARMSTRONG PL 316 E MAIN ST
BOISE, ID 83704 EMMETT, ID 83617
Phone: 208-377-0110 Contact #: PRI 971- 221 -9991
Reg #: LIC 181110
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/14/200E $338.75 Bolts in concrete
[TAX] 12% State Surch 11/14/200E $40.65 Structural welding
[BUPPLN] Pln Rv 11/14/200E $220.19
[FLS] FLS Pln Rv 11/14/200E $135.50
Total $735.09
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 thes ules or .. ect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue y _ a. Permittee Signature 1Z7,7-140
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.
1
. Building Permit Application
Commercial ""� FOR,Of FICE USE -0NLl' • . A �
City of Tigard , i R ��.!? Received Date /By:, // �? d .'/' Permit No.:46(,(&�8 365'
\\
° 13125 SW Hall Blvd., Tigard, OR 97223 I ` t Plan Re
�
Phone: 503.639.4171 Fax: 503.598.1961N �P�� Date /B +'1� \ J/ I( 1'7 O� 6 Other Permit:
T f G At? , Inspection Line: 503.639.4175 �, Date Ready /By: ris ® See Page 2 for
Internet: www.tigard- or.gov G� 1A ® \p \ � \ Notified/Method: /' / or
''7 07,7 l( Supplemental Information
TYPE O R • , REQUIRE 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 El Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El I- and 2- family dwelling ® Commercial /industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
750J JOB SITE INFORMATION AND LOCATION • Total number of floors:
Job site addresk Dartmouth Rd. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: WinCo Foods Store #23 Covered porch area: square feet
Cross street/directions to job site: 72 Avenue Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL- USE'CHECKLIST
Subdivision: 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.
Add (2) new security offices to store @ existing Customer Service Valuation: $45,000.00 `
Existing building area: 95299 square feet \_ ..
New building area: N/A square feet
® PROPERTY OWNER ❑ TENANT . Number of stories: I
Name: WinCo Foods LLC Type of construction: II B
Address: 650 N. Armstrong Pl. Occupancy groups:
City /State /ZIP: Boise, ID 83704 Existing: Group M
Phone: (208)377.0110 Fax: (208)377.0474 New: N/A
® APPLICANT , ® CONTACT PERSON NOTICE
Business name: Petersen Staggs Architects LLP All contractors and subcontractors are required to be
Contact name: Byron Hills licensed with,the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5200 W. State St. jurisdiction in which work is being performed. If the
City /State /ZIP: Boise, ID 83703 applicant is exempt from licensing, the following reasons
apply:
Phone: (208) 345.1462 Fax: : (208) 345.1532
E -mail: byron_h @psarch.com
CONTRACTOR
Business name: " P,B:I : 7 4 HX X e....01..... _ / j•.) BUILDING PERMIT FEES *'
Address: 3 lip Z 11 A' I ��t-
(Please refer to jee;sehedu(e)
!� Structural plan review fee (or deposit):
City /State /ZIP: 2 i4 )4 d ro D 36 ( 7 V 8D f8 FLS plan review fee (if applicable):
Phone: 9Jt� t Vgi Fax: ( )
CCB lie.: Total fees due upon application:
Amount received:
Authorized signature: t 0/3 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Byron Hills Date: 11/11/08 * Fee methodology set by Tri- County Building Industry
Service Board.
L \Building \Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(I1 /02 /COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SUP2008- 003(i9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 1/17/2008
Phone: (503) 639 -4171 l
Inspection Requests (24 Hrs.): (503) 639 -4175 ._'!+�- 87 � � .
INSPECTION WORKSHEET FOR DATE: •I '1/19/2008 TIME: 7:02AM PAGE: 41
SITE ADDRESS: 07501 SW DARTMOUTH ST CLASS OF WORK:
SUBDIVISION: PP1995`013 LOT #: TYPE OF USE:
PROJECT NAME: Wilco
DESCRIPTION: TI - add (2) security offices in Customer Service area
OWNER: WINCO FOODS LLC, PHONE #: 208.377 -0110
CONTRACTOR: D AMYX CONSTRUCTION INC PHONE #: 971 - 221 -1991
Inspection Request Scheduled For: Date: 11/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
276 Framing 070205 -01 2003. 961 -1384 6
Corrections /Comments/ Instructions:
FLAW S
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' ' t It_ �� - � ,0 / C U@ e�
:6 6 'ASS d • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL VA CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . _ IP ,
Date: I1, O Phone #: (503) 718- 1 '
i r
PETERSEN•STAGGS
� ° LETTER OF TRANSMITTAL
ARCHITECTS L L P (�yw �� ,,�
: N C A R B C E R T I F I E D 4l
D A : JOB NO:
5200 W. STATE S TREET, BOISE, IDAH 3 v10 , i 1 , h / I 0,6 0 1S — Z
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PHONE: (208) 345 -1462 FAx: (208) 345- 532 J b
EnnEMAIL: psa(c�psa�h.corn � alp , . , \1111 - NTION:
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ITEMS SENT ARE: Attached For Pick Up Sent via
COPIES DATE DESCRIPTION
1 11 J tc8 , t NE:, 1° H. IT Art',
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ITEMS SENT ARE: - /,
_For your use _ As requested XJ For review and comment Other '
COMMENTS:
COPIES: L 1a (u 1 a 1 �� SIGNED: (..
c LA/ I ( rl p ,
ILL- e - 4 ( ) )
o -'( /V 4 '"JOLEfGS Ntf'fJY PSA IF ENCLOSURES ARE NOT AS NOTED.
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