Permit CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00183
______
_4
i Ail. DEVELOPMENT SERVICES DATE ISSUED: 5/3/2006
I-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S1 12 D C -00701
SITE ADDRESS: 15989 SW 72ND AVE BLDG - ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK III LOT: 038 JURISDICTION: TIG
Project Description: TI
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: 5N sf N: S: E: W:
OCCUPANCY GRP: F1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 10 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 12,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES BNK CONSTRUCTION INC
15350 SW SEQUOIA PKWY #300 -WMI 10730 SE HWY 212
PORTLAND, OR 97224 PO BOX 66
CLACKAMAS, OR 97015
Phone: Contact #: FAX 503 - 557 -1085
PRI 503 - 557 - 0866
Reg #: LIC 107555
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/3/2006 $158.50
[TAX] 8% State Surcha 5/3/2006 $12.68
[FLS] FLS Pin Rv 5/3/2006 $63.40
[BUPPLN] Pln Rv 5/3/2006 $103.03
Total $337.61
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: 2,,„/„,,,,,, „zi Permiftee Signatur . r
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.
a' I I:( /R ()hl[l(.1 :l!tiI1 ()\1.1
Bu' � Permit Appl'C!'�.� 1\i
Cl of Tigard Received / Permit No G
131 Hall Blvd., Tigard, OR 97223 � r t DateB ' Q ,� h _ do. _ 0 / a
g V !•y , Plan Revi
Phone: 503.639.4171 Fax: 503.598.1960 P 1 AY 2 n, �F DateB 5' ^ -O ' 13.57 Other Permit
Inspection Line: ine: 50303 .639.4175 I ' ' Date Ready/By: ruris: ® See Attached Checklist for
Internet: www.ci.tigard.or.us CITY Vr ° 1u� t Notified/Method: Supplemental Information
T TIT TITATC 11— Vi TN TON
TYPE OF WORK 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.
❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 15989 SW 72 Avenue New dwelling area: square feet
City/ State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Domino's Pizza Covered porch area: square feet
Cross street/directions to job site: SW 72 Ave. & SW Carman Dr. Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Relocate existing Oven/Hood, new non structural partition wall, new soffit menu board, Valuation: 512,000
new ADA Cashiers Desk
Existing building area: 24,000 square feet
New building area: N/C square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories: 1
Name: Pacific Realty Associates Type of construction: VB
Address: 15350 SW Sequoia Pkwy, Suite 300 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing: M/F1
Phone: (503)624-6300 Fax: (503)624 -7755 New: N/C
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: NW Precision Design All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Darin Bouska under ORS 701 and may be required to be licensed in the
Address: 1844 NW Couch St jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: Camas, WA 98607 apply:
Phone: (503) 680-6444 I Fax: : (360) 838 -0657
E -mail: darin@nw-precision.com
CONTRACTOR
Business name: BnK Construction, Inc. BUILDING PERMIT FEES*
Address: 45 82 Drive, Suite 53B Please refer to fee schedule.
City/ State/ZIP: Gladstone, OR 97027 Fees due upon application
Phone: (503) 557 -0866 I Fax. .1 ) 557 -1085 Amount received
CCB lic.: 0107555 / ) 3 7 � ,
Date received: 5Z3/6 b
Authorized signal - This permit appltatr n expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Darin Bouska Date: 5/2/06 * Fee methodology set by Tri -County Building Industry
Service Board.
CITY F TIGARD
BUILDING DIVISION PERMIT #: BUP2006-001€33
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 513/2006
Phone: (503) 639 -4171 iv/ - h 7hl #.
Inspection Requests (24 Hrs.): (503) 639 -4175 AA '11.
INSPECTION WORKSHEET FOR DATE: 6/7/2006 TIME: 7 :06AM PAGE: 11
SITE ADDRESS: 15989 SW 72ND AVE Bl.DG -A CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK 1I1 LOT #: 036 TYPE OF USE:
PROJECT NAME: DOMINO'S PIZZA
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: BNK CONSTRUCTION INC PHONE #: 503 - 567.0866
Inspection Request Scheduled For: Date: 6/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 031279 -01 503.8813 -0226 Y A
Corrections /Comments /Instructions: Kao
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'Mk if Pr t
-
A � i � ��.pr ` : r I
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAI ❑ CALL OR INSPECTION ❑ ADDITI NAL F ES ASSESSED
AO Inspect 41117 7 A I k Date: ( L Phone #: (503) 718-
/
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 13UP2006- 001133
13125 SW Hall Blvd., Tigard, OR 97223 - DATA ISSUED: 5/3/2006
Phone: (503) 639-4171 194, 0 0 41i �T�
Inspection Requests (24 Hrs.): (503) 639 -4175 ' I�
INSPECTION WORKSHEET FOR DATE: 6/25/2008 TIME: 7:00AM PAGE: 2
SITE ADDRESS: 15989 SW 72ND AVE BLDG - CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 0313 TYPE OF USE:
PROJECT NAME: DOMINO'S PIZZA
DESCRIPTION: Ti
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: BNK CONSTRUCTION INC PHONE #: 503.557 - 0866
Inspection Request Scheduled For: Date: 6/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message K�
299 Final inspection 071844 -01 503 - 8813.0226 ��— � �
CO.3o
Corrections/Comments/Instructions:
OP PARTIAL APPROVAL El CANCEL 111 NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 6 l �‹ Phone #: (503) – �Y
p � ) 718 -