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Permit • A ' CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00166 �11; DEVELOPMENT SERVICES DATE ISSUED: 4/15/2004 �-��''` ���" 13125 SW Hall Blvd., Tigard, OR 97223 (5031 639-4171 SITE ADDRESS: 11626 SW PACIFIC HWY PARCEL: 1S136DC -00500 SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR 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: $ 159,960.00 Remarks: Reroof, overlay. Per Planning Department, screening must be installed prior to building final. Owner: Contractor: TOM MOYER THEATRES NORTH AMERICAN ROOFING BY ACT III 3 WINNERS CIRCLE 7132 COMMERCIAL PARK DR ARDEN, NC 28704 KI[OXVILLE, TN 37918 one: Phone: 503 - 551 -5602 Reg #: LIC 130112 FEES REQUIRED INSPECTIONS Description Date Amount Final Inspection [BUILD] Permit Fee 4/15/2004 $978.30 [TAX] 8% State Surchari 4/15/2004 $78.26 Total $1,056.56 • 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: Permittee Signature: e ) i Call 639 -4175 by 7 p.m. for an inspection the next business day p Building Permit Application FOR OFFICE USE ONLY City of Tigard Dat ed f�� :1 Permit No.: j . 13125 SW Hall Blvd., Tigard, OR 97223 �d0 Phone: 503.639.4171 Fax: 503.598.1960 p l,y, P Revie � "S�» DateB A. Phi Other Permit: Inspection Line: 503.639.4175t� ,1' 'I .. Date Ready/By: . , ® See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: y�' 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. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement %Other: R l rear equipment, materials, labor, overhead, and the profit for the . CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling 5f Commercia1industrial Valuation: $ ❑ 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: I i t02. t0 S .c, ,,; s: ti .-. / New dwelling area: square feet City/State/ZIP: T, a J 4 ,d 0 F , _ q 7 Z24, l Garage/carport area: square feet Suite/bldg. /apt. no.: Project name.�j /2_b 2,,Jt,J`atg Covered porch area: square feet Cross street/directions to job site: S w. Ca 4.1'61 4- - 2 2 f .,4 Deck area: square feet 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. N18��,a, , c.t , c f+S.L VL't ►n Sw 1t'�' [.,,1a1 • ,a‘,5- N7; Valuation: $ � S� J I 6 0 f- p 0 M Existing building area: S1, y 39 square feet New building area: — square feet • ❑PROPERTY OWNER TENANT • Number of stories: Z Name: R p i c j c -& vi j r 1-c :�,?...'t G y� [� , , I) Type of construction: W o - � w( T c Address: 71 Z R e c, I l C, H? // Occupancy groups: City/ State/ZIP: .(„v x „ I ( T' 3 G ! ` b Existing: Phone: (g 9 . Z— j / Z - s Fax: (fs6S) 5v1 9 7 6 `3 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 followir'g reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: 1\2 01,.-1- I. A. r,,,,ta N ecr. R O oil ►: :., BUILDING- PERMIT FEES* Address: 3 \1I 1 h vt p i (.6 w CI P ^A G Please refer to fee schedule. City/State/ZIP: A. r. d, h N G g • 2 ) v L/ Fees due upon application Phone: (too) S5/ - 5 -6,c7 424)(28.7_ ax: / 2 3 D CCB lic.: ] - 1 1 3, °7(//40 Amount received 7 Date received: Authorized signature: () 0\72,- This permit application expires if a permit is not obtained J within 180 days after it has been accepted as complete. Print name: G V I (A 1`� u in c t c 4 Sc, V• Date: H J 1 9 I ( i • Fee methodology set by Tri County Building Industry Service Board. i:\ Building \Permiu\BUP- PermitApp.doc 12J03 440.4613T(I1 /02/COM/WEB) Building Division 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. i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03 IN . . - City of Tigard Building Department 13125 SW Hall Blvd., Tigard, OR 97223 Phone: (503) 639 -4171 �,�, ,�� Re -Roof Pre - Inspection Report Form ' Requested by Telephone ( g 1 Z 5 1 9 7- 22 -1 1 / 4 Job Address I I t`o 2 (c S W Pc t-::-Viz- �1 ' '7'`'-/ Permit #: Roof Access Location • Date Requested Time Requested Type of Existing Roof 1 4 .SN. o I.ft% s _ v f 4, - P (3 i,. rti- 4 r nbf 1. Slope of roof deck 1 /9 — t [l - I/2- i9 /P-r- 2. Roof /Penetrations /General Conditions gFair ❑ Poor 3. Are there blisters? ❑ Yes gNo 4. Are there cracks? _ ❑ Yesalo 5. Is there evidence of water ponding? ❑ Yes VNo 6: Is moisture present under roofing (leak)? ❑ Yes gNo 7. Is roof insulation existing? ❑ Yes gNo 8. Is roof insulation wet? . ❑ Yes g'No • 9. Property line setbacks on all sides > 10 feet 4Yes ❑ No 10. Building size . ❑ < 3000 sq. ft. ❑ < 6000 sq. ft > 6000 sq. ft. 11. Building height 2 Stories ❑ > 2 Stories 12. Class of roof required ❑ Non -rated Apk. 0. ❑ C. 13. Type roof deck Combustible ❑ Non - Combustible . 14. Roof drains ❑ Provided ❑ Required. . J °l Adequate 15. Overflow drains ❑ Provided ❑ Required ArAdequate ` n 16. Attic ventilation ❑ Provided ❑ Required ❑ Adequate X Nb R �4 UA at-3 17. Roof listing • Ili Provided ❑ Required 18. Installation Instructions n Provided ❑ Required To re of this st cture following con itions must be met: j� V l v'^ 0 !!CN Q �'�1 �"-f ll/laTi��l"e �GI/ l *:e4 P�....I l s i T I �dv � Vi I � . dbh14Ra.4 1 - /after /d -- y el itid A Ae hy i pi The re -roof proposal is ❑ Approved for permit issuance if the conditions listed above are met. After obtaining your permit you must contact the Building Division for an inspection when the roof deck is ready for the first inspection. The first inspection for a complete tear off is the deck inspection. For a built -up roofing system (overlay), the first inspection is at the start of the job. After the re -roof is complete, a final inspection is required. / . //--, / V/O 1 P Ins ector I Ext. d Date 11BugdingtReroot Prelnspection Report Form CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Busi ess 'ne: (503) 639 -4171 MST IGG BUP Received Date sted AM PM BUP Location ((b z� Suite MEC Contact Person OI e- Ph ( 6( ) 5 ? 7 z- (e C. C•' : • -C- 3(7) 4 r 3( - 3 1©SSWR • - Tenant/Owner ELC ootrng Foundation ELC Access: Ftg Crawl r D Drain ( � C�% 9S q• ELR Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear r l wlU Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler � Fire Alarm Susp'd Ceiling Roof Other is 'ASS PART FAIL .• ING Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole 01111==VAtfi Storm Drain Shower Pan V_A.MrI Other: 1■ , — 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call • r reins. - ction RE: Unable to inspect — no access Fire Supply Line ADA 16- Approach/Sidewalk Date Inspector • Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL li CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST /,, l BUP Cog -r�((gp Received / / `�' a /gate Requested 11 ' A _� BUP Location !a Suite MEC Contact Person ,Q. .2 Ph (3/ 7 ) 93/ -3/ 01/4_5 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner /1 ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab )h peCtion.1� . r / -� SIT fiF Post & Beam / I � lJ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing �� � " f �/ c � Firewall d+ ��/� J Fire Sprinkler "'� Fire Alarm ,'/44x.1 Susp'd Ceiling __ Roof__ J — /_1 � r 'f��l� -Pil /-v\ � et (-- PART FAIL BING 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please II for rein ectio R Unable to inspect — no access Fire Supply Line ADA (, Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL