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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2003 -00077 �-�l " "t�l�4c DEVE ICES DATE ISSUED: 3/13/03 639 -4171 SITE ADDRESS: 11571 SW PACIFIC HWY PARCEL: 1S136D6 -00201 SUBDIVISION: FRED MEYER • ZONING: C -G BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: 1,280 sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 1,280 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 20 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: N MEZZ ?: N REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 35,000.00 Remarks: Tenant improvement to convert retail space to restaurant space. Owner: Contractor: WILMINGTON TRUST CO, TRUSTEE STEWKO, INC. BY FRED MEYER, INC P.O. BOX 567 3800 SE 22ND AVE SPRINGFIELD, OR 97477 PORTLAND, OR 97242 Phone: Phone: 541 - 747 -3210 Reg #: LIC 92040 FEES REQUIRED INSPECTIONS Description Date Amount Electrical Permit Required [BUPPLN] Pln Rv 2/14/03 $40.63 Sprinkler Permit Required [FLS] FLS Pln Rv 2/14/03 $25.00 Plumbing Permit Required BUILD Permit Fee 3/13/03 $358.30 Framing Insp [BUILD] Gyp Board Insp [TAX] 8% State Tax 3/13/03 $28.66 Susp Ceilng Insp (additional fees not listed here) Final Inspection Total $763.18 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) , • -6699 or 1- 800 - 332 -2344. Issued B i„,1, /. , 4 ■�_ _, Pemtittee Signature: - f � / Call 639 -4175 by 7 p.m. for an inspection the next business day I ' r L3 -i d. c • Building Pe it Application - _ _ V ( ii: 1:!(1 L4f O \1 1= T _ Date received: Mrs Permit no.: ;1�1 ,I ' ,07 rl•j. City a Tigard �® pp. .: p - ..t City of Tigard Address: 13125 SW Hall Blvei >�2�3 __ D Project/al no e: �- Phone: (503) 639 - 4171 Date issued: B Receipt no.: Fax: (503) 598 -1960 FEB 14 2003 Case file no.: Peyment type: Land use approval: CITY or TIGARD &2 family: Simple Complex: O I & 2 family dwelling or accessory Commercial /industrial O Multi- family i] New construction ❑ Demolition 0 Addition/alteration /replacement )4 Tenant improvement D Firc sprinkler /alarm !] Other: - - "- TT_ -- T: JOB SITE INI:0101,N ION _, - -- Job address: P5 S k/ pg4,p l c _ ,./s—y 779,50401) °l �Z3 Bldg. no.: Suite no.: Lot: ' Block: 'Subdivision: 1Tax map/tax lot/account no.: Project name: Rr,‘ , frocv/i J 0/2 Description and location of work on premises/special conditions: - 7 - 1-n-19 7 2- 4 7 .- S "- $0/ldvn...40,.�i 0 =- - - - - -- 1)117 \talc — - - - - - - - =1 (3K SI'1 C1:11� 1 \1�(?ft1111'lU\ I SL (H7sChL151' - -= =_ - -- (Floodplaln septlt s tpac -il - solar eti.) —. - -- - -, Mailing address: S / .017 4/4„, /99 T /i YF 1 & 2 family dwelling: City: • Ae ,y�-TO� _______State: efte_J ZIP: ° 7 0 07 Valuation of work $ Phone:sp? 6 it y od g y' Fax: _ — 1E - -mail :1 ,,.p yd .' No. of bedrooms/baths Owner's representative: 57 y q A../E. "s,v• 401 Total number of floors Phone: ��Y VAC' b? Fax: E -mail: New dwelling area ft.) . e-= . _ __ .._________________A P P,I 1 CA NT___ -=_- Garage/carpo area Name: Covered porch area (sq. lt.) Mailing address: Deck area (sq. ft.) City: 'State: 'ZIP: Other structure area (sq. ft) Fax E-mail: Commercial/indusMalli nitl - farm Phone: 3 © w -„__.___-_______________c (}\ l R-t G R)N= = -__ - Valuation of work $ Existing bldg. area (sq. ft.) /28'0 Business name: C Rf` _37 ,241-#2.:7" New bldg. area (sq. ft.) Address: 5;6'/+1 ji,i A,t,f,) )E ».. City: • „„_.,..6 .._, State:R2 ZIP: - 7�v7 Number of stories - Phone:se3 7422 7 Fax: E -mail: Type of construction CCB no.: ,9z0,y9 Occupancy g P(s)- Existing: i New: City/metro lie no.: Notice: All contractors and subcontractors are required to be '- = --- _A R I'II 1 F :G /1)6SiG 1 =14-- -- -- 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 Ci exempt from licensing, the following reason applies: ry: State: ' ZIP: Contact person: Plan no.: Phone: Fax: E -mail: Name: Contact person: Fees due upon application $ Address: Date received: City: 'State: 'ZIP: Amount received $ ■ Phone: 1 Fax: LE-mail: Pleace 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 mom information. attached checklist. All provisions of laws and ordinances governing this G visa 0 Mastercard work will be complied w> vhether specif d herein or not. CrMit card nnmber - / / _ /I Expires Authorized signatur- /J% <,; ...�/' -' Date: 7''114? Name of cardholder as shown on credit card Print name: j7-' 1 175-. Pra sYN Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 441 -4613 (f aCOM! V CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION. Business Line: (503) 639 -4171 MST BUP `3 — dO0 '77 Received Date Requested I - °Z ( AM PM BUP Location / 1 S 71 P Suite re 24)v3 - 00r , g 7 Contact Person = Ph ( ) a `' 7 71 PLM Contractor Ph ( ) SWR ‹JaUILDIN� 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 C� C ` L i✓ ci��- Drywall Nailing �/ 1/z z / C uiiK�u S , / �� /69 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Oti 1r: i i- •,• SS 'ART FAIL • 1.' :ING - 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 El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA / /2 1 Inspector / � 3 Ins Ext Approach/Sidewalk Date p Other: Final DO NOT REMOVE this inspection record from the Job site PASS PART FAIL