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Permit • A � BUILDING PERMIT CITY OF TIGARD PERMIT #: BUP2006 -10013 � ' DEVELOPMENT SERVICES DATE ISSUED: 3 /8/2006 s-��� 5 =-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S136DA - 00700 SITE ADDRESS: 11530 SW PACIFIC HWY • ZONING: C - SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Modify restroom to provide unisex ADA restroom. 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: 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: $ 3,100.00 • Owner: Contractor: HI HAT INC OWNER 11530 SW BARBUR BLVD ' PORTLAND, OR 97219 • Phone: Contact #: • Reg #: FEES Description • Date Amount REQUIRED ITEMS AND REPORTS [TAX] 8% State Surcha 4/1/2006 $6.54 [BUILD] Permit Fee 4/1/2006 $81.70 [BUPPLN] Pln Rv 4/1/2006 $53.11 Total $141.35 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 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: :27/ R L Permittee Signature: of i N I V 1 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. Building Permit Application OFFICE USE ()NIA' of Tigard k p eed ...._• � `� Permit /� r00 13125 SW Hall Blvd., D , Tigard, OR 97223 Plan az Review 3 AMj7� C mher Pe Phone: 503.639.4171 Fax: 503.598.1960 /4, ^ y - jl eJB Inspection Line: 503.639.4175 k g- Date Ready/By. JuN: El See Attached Checklist for Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. � y Indicate the -value (rounded to the nearest dollar) of all Er AdditiO alteratiso/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 $ 1 l ,9 • ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /1.53‘.2 5 w PA-C../ 7:1 L ii-f• `r New dwelling area: square feet City /State/ZIP: Garage /carport area: square feet Suite/bldg. /apt. no.: I Project name: 14.1 - "of (Vs 1; f Covered porch area: square feet Cross street/directions to job site: Deck area: square feet H r - Pt' T / (LA S ."...„l.f., % 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. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. n r Valuation: S PAA•✓l 4 1 1 - Vim/ S f-q/4- A-A-s r/�. -oe /� Existing building area: square feet New building area: square feet 5' PROPERTY OWNER I ❑ TENANT Number of stories: Name: H ., 9 i '7 co , A. 0 Type of construction: Address: / / ,, ..5 ;, S CA, f NGgr H .e• Occupancy groups: City /State/ZIP: Prl G A A.4 0A, I Z 2.23 Existing: Phone: (9') 1,144, ". $5 Fax: ( ) . New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be • . Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City / State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) I Fax:: ( ) E-mail: • CONTRACTOR Business name: _ ( .. r , ` (..f cis... Sly v/1 � ►�'ow T � S BUILDING PERMIT FEES * Address: L�/1.� %1t Gw....ei �J f} S Please refer to fee schedule. City /State/ZIP: . k . Fees due upon application Phone: ( ) , r• I Fax: ( ) < Amount received CCB lic.: Date received: Authorized signature ' �.J / �, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: //°"."..w^N 00 ....T y I Date: 3/{yp 6 • Fee methodology set by Tri -County Building Industry • 7.7.....,%. f}' / -* r rrP ?" • i Service Board. I:\ Building \Pamits\BUP- TI- PamitApp.doc 12/30/05 440 -4613T(I I /O2/COM/■EB) °1 •��' - ` , AV ' Building Division Y, i1 •' g'' V t f Plan Submittal Requirement Matrix Commercial & Multi- Family - New, Additions or Alterations City of Tigard Type of Submittal # of Plans r • , (Includes new, additions and alterations.) Required at -c Submittal Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) - 1 • Site Work 2 (must include•'liication`of all accessible•parking). . Plumbing (site utilities) 2 Building 1* Fire Protection System '~ ° • 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) . • 9 1 * For over - the - counter commercial tenant improvements; submit sets of plans: ** "New" fire protection systems require thatplans bear the original seal of an • Oregon licensed fire suppression engineer, or NICET level "3" technicians. I: Building \ Pamits\BUP- TI- PamitApp.doc 12/30/05 440-4613T(11/02/COM/WEB) 1•