Permit • A , CIT OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00300
,y4. DEVELOPMENT SERVICES DATE ISSUED: 8/27/01
A 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S136AD -05901
SITE ADDRESS: 11455 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP 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: TOTAL AREA: 0.00 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: $ 15,000.00
Remarks: Replace canopy damaged by truck
• Owner: Contractor:
DAYS INN COOPER CONSTRUCTION CO
ART HOWARD 2305 SE 9TH
11455 SW PACCIF22I22C33HWY PORTLAND, OR 97412
T R A M: : 3 91 963 Phone: 232 -3121
Reg #: LIC 00008587
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PLCK CTR 8/21/01 $121.75 27200100000 Final Inspection
FIRE CTR 8/21/01 $74.92 27200100000
PRMT CTR 8/27/01 $110.50 27200100000
PRMT CTR 8/27/01 $187.30 27200100000
(additional fees not listed here)
Total $509.45
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344
Pe mi ittee
Signature: � - / ""
v-
/ / 6 :4, 9�
Issued By: A ,;,,a,,,
Call 639 -4175 by 7 p.m. for an inspection the next business day
0
Building Permit Application V
Date receive g / / / a, Permit no.: , City of Tigard d
1 1,L - _ Project/appl. no.: Expire date:
Ciry ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: By, I Receipt no.:
' t
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex: .
TYPE 01: PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
In Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: ,/41 41 56 S - • kv /pOc/ /?. /...//y w ✓ Bldg. no.: Suite no.:
Lot: I Block: (Subdivision: ITTax map /tax lot/account no.:
Project name: a, 'S / / n ?./) L?'
Description and I /C ation of work on premises/special conditions: � C P C /7 op / V02o9c3y/
,<, rrue k
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: /p /j p• / a [)Oo /9 t /hl ( Floodplain , septic capacity,solar,etc.)
Mailing address: // • 5 5 J " I4/ / 2 c / hi y. 1 & 2 family dwelling:
City: 7' q . ` ,q1 IState: CJ, IZIP: Valuation of work $
Phone: I Fax: I E - mail: No. of bedrooms/baths
Owner's representative: Total number of floors sn
Phone: Fax: E -mail: New dwelling area (sq. ft.) s
Garage/carport area (sq. ft.)
Name: t : 0 a p a ,is , Co Covered porch area (sq. ft.)
Mailing address: a 3O 3 .r -' 9 Deck area (sq. ft.)
City: 7 r 7 I State:Q/Q I ZIP: 9 7 e J4 Other structure area (sq. ft.)
Phone:„5"o3 23Z - iFax: E -mail: Commercial /industrial/multi - family: o;
CONTRACTOR
Valuation of work $A5 -0470
Existing bldg. area (sq. ft.) .0 t ?pt SYESI 52 //
Business name: ,5 E Q S 4ioli New bldg. area (sq. ft.)
Address:
Number of stories
City: I State: I ZIP:
Type of construction y
Phone: I Fax: I E -mail: Occupancy group(s): Existing:
CCB no.: B 6 e 7 New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
AROIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address:
``"�� jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: Fax: E -mail: •
Name: Z 7 — & ..... c f- Contact person: Fees due upon application $
Address: 3 717 s' a? v , Date received:
City: /70 / / State :Og IZ 9 ZO Z Amount received $
6"03 Phone: e 3 - 8.79.5' I Fax:233 75.g' E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the
attached checklist. All provisions of laws d ordinances governing this
N« all jurisdictions accept credit cards, please call jurisdiction for more information. ❑ visa ❑MasterCard
work will be compli - hethf : /ifred herein or not. Credit card number: Expires
r
Authorized Slgnatu = �� � � � �J i �' % a ' : ! / Name of cardholder as shown on credit card
$
Print name: f_�'.q i , G - /9,D� ' /s 4 Cardholder signature Amount
Notice: This permit application expires if a perrnit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6,oacoM)
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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 plan sets for distribution purposes (for Contractor, City of
Tigard, Washington County, and Tualatin Valley Fire & Rescue).
Total # of
TYPE OF SUBMITTAL Plans KEY:
Submitted
S = Site Work (must include
S (New, Add or Alt) 4 location of all accessible parking)
•
B (New, Add or Alt) 1* B = Building
F (New, Add or Alt) 3 ** F = Fire Protection System
M (New, Add or Alt) 2 M = Mechanical
P (New, Add or Alt) 2 P = Plumbing
E (New, Add, or Alt) 2 E = Electrical
New = New Building
Add = Addition
.Alt = Alteration to existing
building
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
* *"New" requires that plans bear the original seal of an Oregon licensed fire
suppression engineer, or NICET level "3" technicians.
I:\dsts \forms\matrxcom.doc 10/27/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP c) 300
Date Requested ! d f [ AM PM BLD
Location 1 I `4S-LS t /t Suite MEC
Contact Person 1(3 Ph sc ?„3 f D 7/0 PLM
Contractor Ph SWR
BUILDING Tenant/Owner Dc1-(10 ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Mis
4°1
•J PART FAIL
BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS . PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA / Otheoach /Sidewalk Date / `, ' Inspector / Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.