Permit A ... . CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00137
*r DEVELOPMENT SERVICES DATE ISSUED: 4/22/02
- - �.� I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11640 SW PACIFIC HWY PARCEL: 1 S136DB -02400
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: A3 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 54 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: $ 32,000.00
Remarks: Tenant improvement to convert retail space to restaurant.
Owner: Contractor: .
CHAMPION, RONALD V AND TENANT PER APPROVAL FROM OWNER
ROBERTA E
11642 SW PACIFIC HIGHWAY
TIGARD, .. OR 97223 Phone:
Reg #: LIC 00013125
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PLCK CTR 4/17/02 $218.27 27200200000 Electrical Permit Required
Plumbing Permit Required
FIRE CTR 4/17/02 $134.32 27200200000 Framing Insp
PRMT CTR 4/22/02 $335.80 27200200000 Gyp Board Insp
5PCT CTR 4/22/02 $26.86 27200200000 Susp Ceilng Insp
Final Inspection
Total $715.25
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 mt ittee r
Sign re: _ -a..
Issu d By: 4,1 , V I % �,e
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
Building Permit Application
i I' City of Tigard
a Date received: // / 2 D P. Permit no.:gy/P - e'Ci/_ 7
1�. r ' - Project/appl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall BIK,d, 'igard, OR 97223 -
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: . . _ l&2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory ❑ cofnmerciallindustrial 0 Multi- family 0 New construction ❑ Demolition
❑ Addition /alteration/replacement veTenant improvement 0 Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION '
Job address: . I 0 5\ PACA IIMIIIIIIIIMIIIMIMIIIM Bldg. no.: Suite no.: •
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: U . i (U (Al 141+1 • gU?...(a - ' G j
Description and location of work on pr mises/special conditions: l vJJA IN' ?I M 2A90 A-04
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
• 1 IIt ' a./ i •6 - A . ' 010-4Q (Floodplain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling:
City: State: ZIP: Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) _ •
APPLICANT Garage/carport area (sq. ft.)
Name: P r rstA LA U ¢ 0/11146, AN Covered porch area (sq. ft.) II
g 5 J t7 w. �V S �U� � ,,,, Deck area (sq. ft.)
Mailing address: _.x,
IIIMEM State:& ZIP: R. yL Other structure area (sq. ft.)
Phone: , _ $43 1.1, Fax: E- mail: Commerciallindustrial/multi- family: J o C ere
RACTOR Valuation of work $ t
Business name: Existing bldg. area (sq. ft.) i (44
Address: New bldg. area (sq. ft.) sal 0/ le
City: State: ZIP: Number of stories
Type of construction r OnrSt • .
Phone: Fax: E -mail: M
CCB no.: / Occupancy group(s): Existing:
New:
City /metro lic, no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
/ provisions of ORS 701 and may be required to be licensed in the
Addres : DO ' iVltli., OM ' amimmill jurisdiction where work is being performed. If the applicant is
® State:GY-t. ZIP: ' z3 Z exempt from licensing, the following reason applies:
Contact person: ' 11,1, 1 1 Pnr Plan no.:
Phone: . 2...1- D 9--O Fax: 231 -0by s E-mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All . 'sions • f laws and ordinances governing this 0 Visa 0 MasterCard
work will be compli:�i r , cified herein or not. Credit card number: Expires
11 l- - OL
Authorized signature: D ate: Name of cardholder as shown on credit card • Print name: \VILVI AM 1 1 PPF F Li0 $
C ardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. +40-0613 (rv)WcoM)
Commercial Plan Submittal
.1�,� ��II! Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
• Building 1*
r
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:\dsts \forms \COM- matrix.doc 9/24/01
5/16/02 Activities for 'ase #: BUP2002 -00137
8:12:18 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPC005 APPlication received 4/17/02 DEB DONE No Hold BLD 4/17/02 .-
BUPC008 Permit created 4/17/02 DEB DONE No Hold BLD 4/17/02 .
BUPC012 Plans routed to Plans Examiner 4/17/02 DEB DONE No Hold BLD 4/17/02
BUPCO24 Plans checked /approved by PE 4/18/02 DWJ DONE No Hold DWJ 4/18/02
BUPCO26 Approved plans routed to PT DWJ No Hold DWJ 4/18/02 -
BUPC530 Electrical Permit Required
\ CD' No Hold DWJ 4/18/02
BUPC565 Plumbing Permit Required No Hold DWJ 4/18/02
BUPC520 Mechanical Permit Required No Hold DWJ 4/18/02
,
BUPC740 Framing Insp No Hold DWJ 4/18/02
BUPC760 Gyp Board lnsp No Hold DWJ 4/18/02
• BUPC762 Susp Ceilng lnsp No Hold DWJ 4/18/02
BUPC799 Final Inspection No Hold DWJ 4/18/02
BUPC016 Requested information received 4/19/02 BB DONE No Hold BB 4/19/02 Letter from owner authorizing
tenant to perform necessary
repairs /improvements
to tenant space.
BUPCO29 Post - review completed 4/22/02 DEB DONE No Hold BLD 4/22/02
BUPC090 Ready to issue 4/22/02 DEB DONE No Hold BLD 4/22/02
BUPC100 (F) Issue permit 4/22/02 DEB DONE No Hold DLH 4/23/02
f
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I I 640 :;0.1 PACIFIC fiNY BUP1999-00544 BUP I CARTRCVICS CAF:T ROI'
11640 SW PACIFIC HWY )43UP20024113137 ---- - EIUP 1 Uture3t I-I, CHAMPIOIliii
11640 SW PACIFIC HWY BUP98-00077 BUP V CARTRONICS RON CHAI I!
11640 SW PACIFIC HWY BUP99430098 BUP V CARTRONICS RON CHAU
11640 SW PACIFIC HWY CE02001-00583 CEO C CARTRONICS "CHAMPROI. I :
11640 SW PACIFIC HWY ELR99-00039 ELR I CARTRONICS ...—
11640 SW PACIFIC HWY SON1399-0131 48 SGN C CARTRONICS CAR
11640 SW PACIFIC ENVY SON1 999-013149 SGN C CARTRONICS CARTROI-
11640 SW PACIFIC HWY SGIV2001-00211 SGN C NORTFAEST CARTINORTHWE.
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CITY OF TIGARD _ 24 -Hour f
'BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 452 Z-ao
Received Date Requested - / L AM PM �I BUP
Location / 1 t/ U 5 C I in Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
Tenant/Owner ' _AA& ' � _ , ` C
•
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear �i I R V l .
-ion Li 2,662 \ tp
Drywall Nailing
Firewall 7-) P1 r s\
Fire Sprinkler
Fire Alarm N 0 G1, L S
Susp'd Ceiling
Roof
Other:
Final
PASS 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA c -4 ( (O ?� VZ
Approach/Sidewalk Date Inspector Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OETIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
p BUP . 2 -ep/
Received � Date Requested AM PM BUP
Location //t 5 S Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
- = . th/Shear
Framirig
In•.on
Drywall Nailing /r!=
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fi
PAS 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date v?/ Inspector ✓ ` Ext
Other:
Final DO NOT REMOVE this In ctlon record from the job site.
PASS PART FAIL
CITY QF TIIGARD 24 -Hour
•
- BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST -7
�o BUP — 1YD 13 7
Received Date Requested < AM BUP
Location L 14 46 Suite MEC
Contact Person "vt.Gc Ph ( ) q � ZZ Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner � _� _.` �i ` %' / -I ELC
Footing V
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insul
irewalf
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
11112) 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 befo °= spection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Date S 2 L Inspector Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this In = elon record from the job site.
PASS PART FAIL
CITY OF.T CARD 24 -Hour
BUILDING Inspection Line: (503) 639-4175
• INSPECTION DIVISION Business Line: (503) 639 -4171 MST
'3i;)<; —o / .3 7
Received Date Re uested � AM PM BUP
Location 1/ r � LID Suite MEC
Contact Person � Ph ( ) G3 9-- To D-1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: . SIT
Post & Beam
Shear Anchors - `—�
Ext Sheath/Shear - (�....„
Int Sheath/Shear j � ,� m is �•�- 1/ s &
Framing ' ,i 1 °Z
Insulation E/ /' • • 0 g' 0 iG _ � /_ (�
Drywall Nailing / �t � G Cn
F
)
ire Sprinkler �°` �U - o 0o9 (`'` cbc� s:r -
Fire Alarm POI � _ o - ad /s - T'= ad ( LI
Susp'd Ceiling
Roof e--e 61 r /----e-e9lise p-
*ASS PART A / / /L
PLUMBING SC..� i cLc....i. ÷t-7 ' - :&--0 4 4 4 ' p
Post & Beam
Under Slab /��
Rough -In ADA"' /O# - / t 4 L•f/ S- L� _ • Water Service t.
Sanitary Sewer C 1 c A C . � A...t (ill/ Lv -- S vC_st - �
Rain Drains (
Catch Basin / Manhole o� - �,(
*�- k6_ — x-7,1 arr.' T
Storm Drain
Shower Pan -, ., % 1)i/ ., �•' - . (J
Other: a )
Final - /■€ rh e-r 4---c-a-__
PASS PART FAIL `�
MECHANICAL "'� - �--s� 1 g 1.. s - (`e— _
Post & Beam � ,� G 9 - i
Rough-In Gr..--c..-- [.o
Gas Line '' l • LA Smoke Dampers ( " �
Final
PASS PART FAIL 1
ELECTRICAL (-1 l C-ikk- 0?____- 4- 1/- 0.---" y...-s"--Q-4--/ '
Service ✓ Rough -In ( !J (14-----■ 1_ .: �[ _ l.S� Z�.Q_. S' � '
UG/Slab r
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 for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line `
ADA W0119/6 `� ( � Approach/Sidewalk Date Inspector v C� C/ `� Elct
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CINIIrfGARD 24 -Hour ikAr i 37
BUILDING Inspection Line: (503) 639 -4175 J �`
INSPECTION DIVISION Business Line: (503) 639 -4171
/ / ST
ll..D: BMUP
Received Date Requested Co 7�' AM PM BUP
Location / /6 Ill() P . r� i �� Suite MEC
Contact Person 1 Ph ( ) 3q- g" a 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
(.1 Fire wall /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
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 call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA �/
Approach/Sidewalk Date (i (V Insp ector Ext ��`
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL