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Permit r_ CITY OF TIGARD BUILDING PERMIT ' COMMUNITY DEVELOPMENT Permit #: BUP2011 -00032 13125 S H all Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/15/2011 7 i G ARD Parcel: 1S 136 DA00700 Jurisdiction: Tigard Site address: 11530 SW PACIFIC HWY Project: Hi Hat Subdivision: Lot: 0 Project Description: TI - remove demising wall in dining room. Contractor: WANG K PARK CONSTRUCTION Owner: HI HAT INC 3200 SE CLINTON ST 11530 SW PACIFIC HWY PORTLAND, OR 97202 PORTLAND, OR 97223 PHONE: 503 - 761 -9032 PHONE: FAX: 503 - 761 -9032 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee - Additions, Alterations, 02/15/2011 $377.90 Class of Work: ALT Demolition Dwelling Units: 0 Plan Review 02/15/2011 $245.64 Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 02/15/2011 $151.16 Bedrooms: 0 Bathrooms: 0 DC Provision Review, COM TI - Ping 02/15/2011 $64.00 Value: $20,000 DC Provision Review, COM TI - LRP 02/15/2011 $9.00 12% State Surcharge - Building 02/15/2011 $45.35 Info Process /Archiving - Lg Sheet (over 02/15/2011 $6.00 Floor Areas: 11x17) Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $899.05 Required: Required Items and Reports (Conditions) Fire Sprinkler: No Parapet: Fire Alarm: No 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 rul: are set forth in OAR 952- 001 -0010 through OAR 9 - 001 -0090. You may obtain a copy of the r -s or direct questions to OUNC by calling 50 .'32.1987 or 1.: '0.332 344 Issued By mittee Signature: Call 503 • • •, • :00 a.m. for the next available inspec '• n,ate. This permit card shall be kept in a conspicuous place on the job site unti completion of the pect. Approved plans are required on the job site at the time of each inspection. • • Building Permit Application Commercial tl �j'' / , FOR OFFICE USE ONLY City of Tigard �"'°� CE�ED Date /B : 4, /V / �/ Permit No.: 0 L�L'k��5g II ° 13125 SW Hall Blvd., Tigard, OR 97223 t_B Plan Review � III ' Phone: 503.718.2439 Fax: 503.598.1950 1 0 2.011 Date/B : ' / 1 Other Permit: 1't G A R D MY Inspection Line: 503.639.4175 Date Ready /By: ® See Page 2 for Internet: www.tigard - or.gov Y OF TIGARD Notified/Method: ' J5 r ' / ja Supplemental Information TYPE O`NR KN�'3 DIVIciIO 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/p placer ent ❑ Other: equipment, materials, labor, overhead, and the profit for the C ATEGORY OF CONSTRUCTION work indicated on this application. ID 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder CI Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ! Ir.) 2 f 0 47 -1 I 1 l e. 11 New dwelling area: square feet City /State /ZIP: 1161-4-1247 . V Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet i 1 I G Hwy 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. i l /I _ / �( D ' It �' 1 /L/ Valuation: $ 2,0 004- ��d' 1/ '7[��� i I Ls- V Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER X TENANT Number of stories: Name: ><( }i7c) u� ` / Type of construction: Address: // (/ 4L19." ' 6�T i17 ' / ] / .r /( N Z B Occupancy groups: City /State /ZIP: ref I J D /)A 9/222-5 Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT CONTACT PERSON NOTICE Business name: . -L4 lib / /1 C - j All contractors and subcontractors are required to be Contact name: '" �' i ' tl licensed with the Oregon Construction Contractors Board �. �� under ORS 701 and may be required to be licensed in the Address: &4.1. /` jurisdiction in which work is being performed. If the City/State/ZIP: n �j' applicant is exempt from licensing, the following reasons Cit y !° % l / � _ apply: Phone: ( �) 7 `_ � 9 0 / J c ° I Fax: : � ( J /� /C �� 1 � � � d RI r� � E -mail: '7 /,L q //4 i ■ L'a A - ,/ CONTRACTOR Business name: \ J K jet k1 / 2 �,l) k l ec r e11 0 x BUILDING PERMIT FEES* Address: 3 a� d 0 c ._:6_ ._:6_ , 1 L% , ! , X) 4 l � _ . (Please refer to fee schedule) City/State /ZIP: ` d_ 0, dr _ q 1 Za Structural plan review fee (or deposit): Phone: (�� �� 0 Fax �O? )� ! (1)7 FLS plan review fee (if applicable): e l Total fees due upon application: CCB lic.: 1 19/ I 0 Amount received: 4siCi SC Authorized signatur - • . zei This permit application expires if a permit is not obtained / within 180 days after it has been accepted as complete. Print name: Date: 'Z. / 0 � I * Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Petmits\BUP- COM PermitApp.doc 09/09/10 440- 4613T(11/02/COM/WEB) y 1y, (J.) Building Division Accessibility: Barrier Removal Improvement Plan TIGARD REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five per -cent (25 %). VALUATION: Total of all renovation, alteration or modification being done, excluding painting and wallpapering: [1] $ MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ / 2i) 0 ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains: and, $ / (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL (shall equal line [2] of Valuation Computation): $ I: \Building \Permits \BUP -COM PernutApp.doc 06/25/08 IN Building Division Development Code Provision Review TIGARD Commercial Projects - No Associated Land Use Case Building Permit No: &,‘ I l 6O0 3 a_ ❑ Expedited Review Plan Submittal Date: a - 10 -- I f To the Applicant: ➢ If the proposed use is not permitted within the zone, please contact the Building Division to cancel the permit application. Building Permit Technicians (503) 718 -2439. ➢ If a land use is required and for all other questions, please contact the staff person listed above the Planning Review section. Staff: please check items along left only if approi d. Planning Review (contact 1EZLr L' / .I at 503 - 718 - 2'13V or @ tigard- or.gov) Zoning C - G Permitted Use Yes No ❑ ❑ Land Use Required: Yes ❑ Nof (explain below) Notes: )� 6 C, — 3d OSe. //1 © E7j30S /�- 7 gi Approved ❑ Not Approved Date: - J C I Permit Coordinator Review (contact Albert Shields at 503 -718 -2426 or albert @tigard - or.gov) Notes: te r'^ Routed back to Building Division Date: // I: \CURPLN II II Building Division Over- The - Counter (OTC) Building Permit TIGARD Check List Project Description:`: ' / Tit — A- )1 5 APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: A 1 --/- Occupancy Group: A 3 Type of Construction: 5—/V *Type of Use: CC,-/v1 Occupancy Load: YIP Oregon Specialty Code: Q 0 1 0 SPECIFICS Number of Stories: I Building Height: Mixed Use: Number of Dw Units: Number of Bathrooms: Number of Bedrooms: BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES Story Square Footage: Accessory Structure: Covered Porch: Basement: Garage: Deck: Total Square Footage: Carport: Mezzanine: SETBACKS Sideyard Setback — Left Sideyard Setback — Front Sideyard Setback — Right Sideyard Setback — Back CONSTRUCTION Exterior Walls: Openings Protected: Firewall Separation: N: S: N: S: Occupancy Separation: E: W: E: W: Access. Parking Spaces: REQUIRED ITEMS Fire Sprinklers: Fire Alarms: Smoke Detectors: Parapet: Manual Pull Stations: Protected Corridors: Total Project Valuation: $ .(9 K FEES DUE $ G t' DC Prov Rvw, COM TI — Ping $ I DC Prov Rvw, COM TI — LRP DC Provision Review Fee for COM TI $ 1c/7 C iq Permit Fee — Add, Alt, Demo Project Valuation Planning LRP $ 14 S. 12% State Surcharge Up to $4,999 _10 $0.00 $ c-1 -. ( Plan Review, Structural $5,000 - $74,999 $64.00 $9.00 $ 1 '3I. it, Plan Review, Fire Life Safety $75,000 - $149,999 $160.00 $24.0 $ 6/ax:, Info Proc /Arch, Lg (over 11x17 $2.00) $150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50) $ Metro Construction Excise Tax $ School Construction Excise Tax $ Hourly Rate Fee Planning Staff: a. p. $ Hourly Rate State Surcharge $ Misc. Admin Fee Permit Coordinator: A .S. $ Other: $ Other: Building Staff: M A ✓ $ Other: Date /Time: —IS-- // $ Vi 05 TOTAL FEES DUE *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; END = foundation; DEM = demo; END = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. I: \Building \Forms \OTC - BUP.docx 01/13/2011