Permit •
� r $',„�� + '. 1' �'�Y OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00124 IIII
� �''° : ci; COMMUNITY DEVELOPMENT DATE ISSUED: 3/12/2007
,TIGA 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102AC - 01100
SITE ADDRESS: 12564 SW MAIN ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: MAIN STREET LLC
Project Description: TI - change of use, move wall.
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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 25 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: $ 2,500.00
Owner: Contractor:
MAIN STREET LLC DENNIS WANLESS CONST
18380 RIVER EDGE LN PO BOX 23453
LAKE OSWEGO, OR 97223 TIGARD, OR 97281
Phone: 503-781-4764 Contact #: PRI 503 - 780 -7658
Reg #: LIC 93348
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/12/2007 $72.10
[TAX] 8% State Surcha 3/12/2007 $5.77
[BUPPLN] Pln Rv 3/12/2007 $46.86
[FLS] FLS Pln Rv 3/12/2007 $28.84
Total $153.57
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 • • - •.2- 001 -0100. You • ..I obtain a copy
of the - u es o •' -ct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
/ Is ued By: , ` �� _ � ✓;� Al Permittee Signature: r 0 ,
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.
' Buildin Pe A pplication 0 ,„,., N E l�Sa t'�
Commercial Tenant Improvement , ' ' "' r ' ``
` FOR OF FICE USE ONLY f ;�
Received U „�) �l
City of Tigard DateBy: 1 , a 7 Permit No i p?
iyi
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
_ Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: Alvin D -,pot -f 7
4.1 G A RD' Inspection Line: 503.639.4175 Date Ready /By: � ® See Page 2 for /
, AK' Internet: www.tigard- or.gov Notified/Method: / r C.P Supplemental Information
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 R Commercial /industrial Valuation: $
El 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: I 'L v s t,,,, / - iyJ ST • New dwelling area: square feet
City /State /ZIP: 7 t a.At ) Tj Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: k td,lrt,ra--E b 030 Covered porch area: square feet
Cross street/directions to job site: 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.
M O u C &j o. .J — �Ep n. t C _ iL. 1 t S CZ-> Valuation: $ :� t SUD. U
-) �f E o.- OGLU r esit 1 O Existing building area: () square feet
K AsIL.- '[r b 6S co Ex G C , New building area: 1 Z •1 . \ square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 2—
Name: G^ (rO,' -(,.Q 1,o AA0tti.lt Type of construction: S 13
Address: Occupancy groups:
City /State /ZIP: Existing: .tr\
Phone: ( ) Fax: ( ) New:
0 APPLICANT 0. CONTACT PERSON • NOTICE
Business name: ok- ,, )gyp. G, ...7 sl t) (-4t43.7 c 3 D 0 F old-. _ , All contractors and subcontractors are required to be
Contact name: 'gyp,, ( - C C t y licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: ISZAS StA) As W I�l D R . jurisdiction in which work is being performed. If the
/State /ZIP: 0 �` * ZZ � l apply:
is exempt from licensing, the following reasons
City/State/ZIP: pOI l IQ•�
� pp l Y:
Phone: (, 031 set o - 3 1 q 4 Fax:: ( )
E-mail: 1 Flt r pr ; a_ V e .t -.O ►v . &.) rT
CONTRACTOR 7.-.• /O
usines name: G v of s LiG�1 tni BUILDING PERMIT FEES"'.
Address: " O. �a Zq5 ' (Please refer to fee schedule)
Structural plan review fee (or deposit): 44 . '1,
City /State /ZIP: (1 ti> - 7 z9 f 2 �� °
FLS plan review fee (if applicable):
Phone: ( j) 2c5 .2 ? - P r Fax: 69 ) / 4 - qS7 Total fees due upon application: 7/
CCB lic.: e Lg'1
r , , Amount received: ! 6 6 61
Authorized signature: ' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: "Z --,ej gf E Ell I Date: S t Fee methodology set by Tri- County Building Industry
Service Board.
1:\ Building \Permits \BUP -T1- PermitApp.doc l2/27/06 4404613T(11/02ICOM/WEB)
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7
Building Division
Jam �. Plan Submittal Requirement Matrix
o GSAR-D Commercial & Multi- Family - New, Additions or Alterations
Type of Submittal # of Plans
(Includes new, additions and alterations.) ' Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 2 ** •
Mechanical ,2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
•
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington
County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an ,
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
I:\ Building \Pemuts \BUP- TI- PermitApp.doc 03 /23/06
CITY OF TIGARD -`
BUILDING DIVISION PERMIT #: BUP2007-00124
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/12/2007
Phone: (503) 639 -4171 :NNi �i
Inspection Requests (24 Hrs.): (503) 639 -4175 ∎�' "' mamma
INSPECTION WORKSHEET FOR DATE: 3/26/2007 TIME: 7:OOAM PAGE: 39
SITE ADDRESS: 12564 SW MAIN ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAIN STREET LLC
DESCRIPTION: TI - change of use, move wall.
OWNER: MAIN STREET LLC, PHONE #: 503- 781 -4764
CONTRACTOR: DENNIS WANLESS CONST PHONE #: 503.7E30.7658
Inspection Request Scheduled For: Date: 3/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 045379 -01 503 -880 -3388 N
Corrections /Comments/ Instructions:
��, PASS i1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I 1 F L
i
N •ALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: — Date: --°‘ Phone #: (503) 718- ...Jr