Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00062
1 -1411 DEVE
DEVELOPMENT Tigard, -639 -4171 DATE ISSUED: 1/26/2006
PARCEL: 1S136CD-02200
SITE ADDRESS: 07850 SW DARTMOUTH ST ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Produce cooler expansion. Walk -in cooler assembly.
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: : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 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: $ 20,000.00
Owner: Contractor:
COSTCO WHOLESALE CORPORATION KEY MECHANICAL CO OF WASHINGTN
ATTN: EXCISE TAX DEPT 111 19430 68TH AVE S
999 LAKE DR KENT, WA 98032
ISSAQUAH, WA 98027
Phone: Contact #: FAX 503 - 236 -5848
PRI 503 231 - 8731
FEES Reg #: LIC 00093479
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharl 1/26/2006 $18.82
[BUILD] Permit Fee 1/26/2006 $235.30
Total $254.12
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 ru s or direct questions to OUNC by
calling 503 - 246 - 99 or - 800 - 332 -2344.
Issued By: 40 - � Permittee Signature: /A
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.
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Building Permit x Diiii&C o l V E ®
FOR OFFICE USE ONLY
R eceived / Permit
City of Tigard JAN p N 2 00 6 / - al - O i , 0 „_ . — : .. 1942 O
13125 SW Hall Blvd., Tigard, OR 97223 JA 2 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ! j `�IJI Date/By Other Permit.
Inspection Line: 503.639.4175 CITY OF TIGAR/Dp.. Date Ready/By El See Attached Checklist for
Internet: www.ci.tigard.or us BUILDING DIVISION Notified/Method: Supplemental Information
i
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: $ (TO (csoC.
ID Accessory building El Multi-family Number of bedrooms:
El Master builder — El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors.
Job site address: 78543-` _o) 15d).�P741Dur-. New dwelling area: square feet
City /State /ZIP: 7- - /6A � 9 la _7 Garage /carport area square feet
Suite/bldg. /apt. no.: Project name: (-7 (t'S Covered porch area: square feet
Cross street /directions to job site: /KAY( "/ Deck area: square feet
l 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 /gyp �(`)N ro) Valuation: $ ;7OO
/} I ` all Ili 000 ( U € r 0 py� n °Pi � cca L i ly Existing building area: square feet
New building area: square feet
OPERTY OWNER I 0 TENANT Number of stories:
Name: C c 6 Type of construction:
Address: ,ter 6mE Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ,,®CONTACT PERSON NOTICE
Business name: 7 ' y 4ac/y /7tV (cog L C 6 o All contractors and subcontractors are required to be
Contact name: / /L G fiv licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: /2 ti ) .'. 7 .,?- L ALIt /4 ( 1. jurisdiction in which work is being performed. If the
City /State /ZIP: I c.u � (F" j ®� l ` applicant is exempt from licensing, the following reasons
/ [ / apply:
-
Phone.,3) ,c,3f, .6,7_1' / Fax: : ( 67.3‘ `5 '1 g
E-mail: c ,,m0R iyA--" /iqKth f)(4(t < Q
CONTRACTOR .
Business name: ' 64(,cN4CI IIIS(4,6 -C BUILDING PERMIT FEES*
Address:
City /State /ZIP:
Please refer to fee schedule.
rl
,,,o--- � Fees due upon application t 9, 5 ` 3
Phone: ( ) r ` I Fax: ( ) jj
Amount received 1 t‘• '
CCB lie.: V F
� I Date received: li G is i
Authorized signature: ` `7 This permit application expires if a permit is not obtained 411 7 within 180 days after it has been accepted as complete.
Print name: pg Gm h ik ' ' Date: / RC - 6.( • Fee methodology set by Tri -County Building Industry
Service Board.
i.\ Budding \Permits\BUP -T1- PermitApp doe 12/03 440- 4613T(I 1 /02/COM/WEB)
Building Division
•
l' Plan Submittal Requirement Matrix
Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
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 3 **
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.
\ Building \Permits\BUP- TI- PermitApp doc 12/03 440-4613T(11/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: l3t1P20 6-000 2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/26/2006
Phone: (503) 639- 4171 ll
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 5/2312005 TIME: 7:03AM PAGE: 94
SITE ADDRESS: 07050 SW DARTMOUTH ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GOSTCO
DESCRIPTION: Produce cooler expansioil. Walk-in cooler assembly.
OWNER: co sTCO WHOLESALE CORPORATION, PHONE #:
CONTRACTOR: KEY MECHANICAL CO OF WASHINGTN PHONE #: 503. 231 - 88131
Inspection Request Scheduled For: Date: 5/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
2.99 Final inspection 03037()•01 503-519-1222 N
Corrections /Comments/ Instructions:
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.. ASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FA, • CALL F. - INSPECTION ❑ ADDITIs NAL FE'S ASSESSED
Inspector: =, M, Date: coy �410" hone #: (503) 71 8 - ` .,2
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