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Permit
BUILDING PERMIT • !p - �� -CITY OF TI GARD PERMIT #: BUP2009 -00019 COMMUNITY DEVELOPMENT DATE ISSUED: 2/26/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136DC-04500 SITE ADDRESS: 07501 SW DARTMOUTH ST ZONING: C - SUBDIVISION: PP1995 - 013 LOT: JURISDICTION: TIG PROJECT: WINCO Project Description: Bakery Department - 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: 2N sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 117 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: N MEZZ ?: N 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: BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING: VALUE: $ 275,000.00 Owner: Contractor: WAREMART INC BY BURKE + NICKEL 3336 E 32ND ST #217 TULSA, OK 74135 Phone: Contact #: Reg #: FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUPPLN] Pln Rv 1/29/2009 $755.27 [FLS] FLS Pln Rv 1/29/2009 $464.78 [BUILD] Permit Fee 2/26/2009 $1,161.95 [TAX] 12% State Surch 2/26/2009 $139.43 (additional fees not listed here) Total $2,851.43 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 c it cu ( J �gA . b Permittee Signatur :: : i 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. V) t ao C0 7' ( tr eirt Building Perm Application Commercial FOR OFFICE USE•ONLI' RECEIVED Received f City of Tigard DateB : / ' ,2; 09 A Perm No. i G� �_ l? a 13125 SW Hall Blvd., Tigard OR 97223 Plan ReviM7/ , Other Permit: ' Phone: 503.639.4171 Fax: 5 03.598.1';.•i N 2 8 2009 Date/B : • di 1 © �� TIGARD GARD Inspection Line: 503.639.4175 � Date Ready /Oy H See Pa g e 2 for Internet: www.tigard- or.gov CITY OF TIGARD Notified/method: A Ju . /1 1 , / " / t lJ( Supplemental Information _ a ∎ _ ■ ll_ 1.11 ' kr A - TYPE O " i RK R E Q U I R P 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. Valuation: $ ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: " 7 5-0/ JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:,7,f,0 'SW Dartmouth Rd. New dwelling area: square feet City /State /ZIP: Tigard, OR 97223 g rP q Gara e /ca ort 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: 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. Remodel of Bakery Department including new walk -in Freezer box and walk -in Valuation: $$275,000.00 Cooler box. 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 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: T.B.D. BUILDING PERMIT FEES* Address: (Please refer to fee schedule) Structural plan review fee (or deposit): 7 55; A City /State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): z uD `i 7 CCB lie.: Total fees due upon application: // 9-9-0 o5 Amount received: / -.e.) , O Authorized signature: 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: 01.23.09 * Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(l I /02 /COM /WEB) 1 g 4 cPETERSEN•STAGGS LETTER OF TRANSMITTAL I ARCHITECTS LLP I N C A R B C E R T I F I E D , : 5200 W. STATE STREET, BOISE, IDAHO 83703 DAT..: _ JOB NO: PHONE: (208) 345 -1462 FAx: (208) 345 -1532 �`�J 07w ' � EMAIL: psa@psarch, corn ATT NTION: TO: ( t 1 OF /41� RE: (1 ¶\I\,1 HALL. ) L-v Y2. NGo .c..1 7 films , al '7 Alf ..._ .i:. d Y� ITEMS SENT ARE: /Attached _ For Pick Up _ Sent via COPIES DATE DESCRIPTION I, Z5 7 6, t °Ei / 1 N- °rt-14 1rc-)M 1 ii=. ems/ M a566 )o. rLA-v 0 11.11. 57Ly4i . e--4 -4.c, It.21.al G aki . >fK J iv(>6' tS ITE S SENT ARE: F or your use As requested For review and comment _ Other COMMENTS: r 'L-!4S- _c- - fJ/- 4- FLOE 14)/ Jl/`7- c p vES17 c / T7t� A Jk- . U, )4 I -d iSo C__ COPIES: SIGNED: , MIL - - t - Clq L!- rrrr(wn,� 1 LL c.--/ ( k . N4S. 14 (k PLEASE NOTIFY PSA IF ENCLOSURES ARE NOT AS NOTED.