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Permit `� � '� BUILDING PERMIT CITY F TIGARD PERMIT #: BUP2003 -00612 DEVELOPMENT SERVICES DATE ISSUED: 11/5/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S10100-00500 SITE ADDRESS: 12670 SW HALL BLVD BLD 1 SUBDIVISION: TIGARD CENTRAL INDUST. PARK ZONING: I -L BLOCK: LOT: JURISDICTION: TIG REISSUE: • FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: 19,600 sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N : sf N: S: E: W: OCCUPANCY GRP: F2 TOTAL AREA: 19,600 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 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: $ 5,000.00 Remarks: Change in occupancy, add walk in cooler and processing equipment. No change in TIF or Parks fees. Owner: Contractor: H WILLIAM GAZELEY TENANT PO BOX 230414 TIGARD, OR 97281 Phone: Phone: Reg #: FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUPPLN] Pln Rv 10/10/03 $59.35 Electrical Permit Required Final Inspection [FLS] FLS Pin RI/ 10/10/03 $36.52 [BUILD] Permit Fee 11/5/03 $91.30 [TAX] 8% State Surchar 11/5/03 $7.30 Total $194.47 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 •i •-•- '9 or 1- 800 - 332 -2344. Issue B , �f / t Permittee • Signature: ), - Call 639 -4175 by 7 p.m. for an inspection the next business day 12 47' S w f/A14 �oR ICI ORE GO-' 0 et,"40 ' . - Building Permit Application FOR OFFICE USE ONLY y4 :`r Received j 1 Building Date /By:M /0/03 Permit No.: ,907y3 ewe /;3, 1. Planning Approval Other City of Tigard Date /By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date /By: /Q — Z94'}/73,5)0 Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 V . 114' Post - Review Land Use I Date /By: Case No. Internet: www.ci.tigard.or.us __.. 24 -hour Inspection Request: 503- 639 -4175 Contact Juris.: Su See Page for P 9 Name /Method: Supplemental Information _'' . .. TYPE ".E∎MORK.'' :; :4 / . t; ry r: r max. 4: _ a r .. Al New construction Demolition _ RE QU ATA ° WELL � 1 ' N.'J > ❑ Addition/alteration/replacement El Other: � � � ^ " � � � �� � " " -. :. • ' •T. ` CAT .EGORYxOF „" - ° ° ,, Note: Permit fees* are based on the total value of the work performed. indicate ❑ 1 & 2- Family dwelling Z Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. El Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation 8 , SITE INFORMATION anil LOCATION- No of bedrooms: No of baths: Job site address: /06 765's i/( /34.0, 13L i Total number of floors New dwelling area (sq. ft.) Suite #: et Garage /carport area (sq. ft.) Project Name: O 12e, G Aev -e "-Aye v/olt.k r Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) \. /-/ 4 /( 4 C o A•,.rH e.r. e ( Other structure area (sq. ft.) ' ''- f?'' : 3!i ? r'''' ''I 1'` 5 "' , .' `•11 r f z - .. ''. ,.:.4.,,,,f, Subdivision: Lot #: . ` _ ", -. , „ COMMERCIAL'` ` .SE CHEC 11 w Y ti %,. Tax map /parcel #: AS/ CJ / 0 0 - 0 o 506 Note: Permit fees* are based on the total value of the work performed. Indicate , ;:?, , .t ". '(' DESCRIPTION OF'W,ORKi . NI.li�.� e.. t°�'°t ', .'; the value (rounded to the nearest dollar) of all equipment, materials, labor, /� overhead and profit for the work indicated on this application. A 61,91 N WA N /k t coo /e_ ti 9' 'H4NGe- Ca /1) 0j ccQP,& c Y Valuation S Soon Existing building area (sq. ft.) New building area (sq. ft.) Number of stories 5 ® :, PROPERTY OWNER'' ' .. '1,a.Q` TENANT I, ci °.` °'•,''' ; ;'1k x4 .:3, Type of construction VA- Name: ORee 0 /./ 6e 1).ex -A5 •e u/ at-As s S N0' . Occupancy group(s): Existing: Address: / a 6 7a s w /a (f tit v,9 1 City /State /Zip: T,y qte I o /z Q 7.2 3 Phone: I0 3 - -4� 3 Fax: NOTICE: All contractors and subcontractors are required to be APP ° " - ' -. ; , licensed with the Oregon Construction Contractors Board under LICANT . fit. -' ' a: -; i ® �:CONTACT4PERS.ON`: provisions of ORS 701 and may be required to be licensed in the Business Name: ©/1.9 il e. Q t,U r..4 jurisdiction where work is being performed. If the applicant is exempt Contact Name: Cur - i - ; s T. O,.vV e rcw'C 4/14 from licensing, the following reason applies: Address: /01-6 70 - w /M- /( RLv 9 #" / City /State /Zip: T, AJA .,J p r z q � y Phone: ,(03 -5,..-4347 Fax: ,,,p , , • �� :,: J, w, , ,. E -mail: y � :1 f; ' ^ ^ B UIL D t ING *�O , PER MITFEES� x v/� -�"'} S I f -OtJ'C ,C vN si '� ` � t A, a°` =`K .;ai, -`< ; $ } at '? x ;,� C G $ % I � 3 , • � �''t +s � > ,�Pleaselr e fer to; ^ 'r � x ,� ; s � � � 4n '`i ^s a;,. rv',z,...z " .CONTRACTOR~ ':m.:: , tma =. r„ . . .. ,,. 4'. "t .... h.,�' . w' , P.. �.« 1 ., Business Name: Fees due upon application $ Address: ,0,41,7_ City /State /Zip: Amount received $ Phone: Fax: Date received: CCB Lic. #: Authorized \/ '�"" Notice: This permit application expires if a permit is not obtained within Signature: f is — fvcor ice Date: /04 /9 ? 180 days after it has been accepted as complete. 7_,&01? ve/ G *Fee methodolou set by Tri- County Building Industry Service Board. (Please print name) is \Dsts \Permit Forms \BldgPermitApp.doc 01/03 , �'� Plan Submittal Requirement Matrix '� Commercial & Multi- Family City of Tigard New, Additions or Alterations E�S.; _ i �w,.i,.� ib'- ;.ya p. ;,�,•`'..�.• . *,,t� :x,.+,:- ., _:,��- ° ":Y %� �� % -n y 'zit: �'r,:r��.. - "�.n;';44 „: �” ,`-�. � } � "'r " s s - �" �'f'�'„x„�`�: �rc ��-. @ ass .x-� �. •+. � � a - - ,�. ,. TYPE OF' SUBMITTALS { -J Y �'# of Plans. (Includes New,,Addons or Alterations) Required at.� f -.y dt".+f�ktit� • ,4er�ar, ` tom Sub rmttaI Site Work 4 , (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. is \Building \Forms \PlanSubMatrix.doc 04/03 NOV. 3. 2003 3:23PM N0, 0964 P. 2 ! . - " 42 621 SW Morrison. orris Portland, OR 97205 Suite 800 _1I 503/223 3171 TEL Stevens — hN_ 503/228.2136 FAX Ina. _ y. www.norri�- stevens - -com Commercial Real Estate Sales, Leasing, and Property Management , ' MEMORANDUM Date: 11/03/03 To: Tigard Plans Examiner From: Scott Perry Subj: Oreg Beverage Works Free Standing Cooler Oregon Beverage Works has the landlord's approval to install a 20' x 20' Imperial, free standing cooler in their leased space at 12670 SW Hall Blvd, Bldg #1 in Tigard, Oregon If you have questions, please feel free to call me at (503) 225 - 8445. fITIO AE.,:vo TC N �" A`ANAa �n�ry{ O�OA NIZr�f10 Na W 0 k t i) W I U i • DATati C ZED5 PLANS CHECK NO. FI PROJECT TITLE: ofeepn t elsoeleXecArLi4* -- COUNTYWIDE TRAFFIC IMPACT FEE WORKSHEET APP ICANT: 00(1 (FOR NON FAMILY USES) M ILI f CITY/ZIP/PHONE7 0 q -7 2-2--3 TAX MAP NO.: ° C ) IS ID( CO (OSO f2St at) i ZA je ll • LAND USE CATEGORY RATE PER TRIP SITES NO.7 l RESIDENTIAL $ 253.00 BUSINESS AND COMMERCIAL $ 64.00 OFFICE $ 233.00 INDUSTRIAL $ 244.00 INSTITUTIONAL $ 105.00 PAYMENT METHOD: CASH/CHECK CREDIT BANCROFT (PROMISSORY NOTE) INSTITUTIONAL ONLY: DEFER TO OCCUPANCY LAND USE CATEGORY DESCRIPTION OF USE WEEKDAY AVG. WEEKEND AVG. TRIP RATE TRIP RATE BASIS: pan( ci - ezo J fq 4 co p f e,hcut - . CALCULATIONS: -- ppea/W 4U...in/A *&4L F 61' oi-arAnty P 6 occuparti uitit c.,4444. - 4 ( e-itikaA± am- t F 0v /co - x,t) l avits2cv - caddLeYvt-- l o , a4 PROJECT TRIP GENERATION: FEE: FOR ACCOUNTING PURPOSES ONLY ADDITIONAL NOTES: 6r-711ex. Arruct Lau etkodcaxters ptafdadwks vatj k as 0) et eny kIZS' 1/4tta (S) ROAD AMT.: TRANSIT AMT.: - same tict iat PREeR Be1242/721) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 INSPECTION DIVISION Business Line:' (503) 639 -4171 MST BUPcW 1 ( / Z Received 3 i NO Date Requested q. AM PM BUP Location '' . • 7 n ,D,P /l Suite d~ / MEC Contact Person Z 62 76 da-- Ph ( U ` ,352 3996 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner 1' AA % i i1 _ t _di' ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear comp L Framing Q.J�J��� G (J Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Ot er: Fin - Li PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service • Rough -In UG /Slab Low Voltage Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: i Unable to i r pect – no access Fire Supply Line — ADA Approach/Sidewalk Date // Inspector • _.�� -� Ext Other: de Final DO NOT REMOVE this inspection recor rorn the Job site. PASS PART FAIL