Permit a CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00392
COMMUNITY DEVELOPMENT DATE ISSUED: 12/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 B D -01900
SITE ADDRESS: 12910 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: HUDSON PLAZA LOT: OOD JURISDICTION: TIG
PROJECT: SALON DOBLER SWAILS
Project Description: Replacing store front. like for like. Minor sheet rock repair.
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 0 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: $ 10,500.00
Owner: Contractor:
MARILYN HENDERSON HORIZON RESTORATION
JENSEN HUDSON TRUSTEE 7235 SW BONITA ROAD
11795 SW KATHERINE ST TIGARD, OR 97224
TIGARD, OR 97224
Phone: Contact #: PRI 503 -620 -2215
FAX 503 -624 -0523
Reg #: LIC 160672
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/11/200€ $126.85
[TAX] 12% State Such 12/11/200€ $15.22
Total $142.07
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: „ - • • ee Signature:
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
' Commercial FOR OFFICE USE ONLY
City of Tigard Received /f � Q ,- Permit No: / ,1 . yob
. /,
g DateB i : ..n.. _
13125 SW Hall Blvd., Tigard, OR 97223 n�j Plan Review
' C . Phone: 503.639.4171 Fax: 503.598.196 DateBy: Other Permit:
TI G n I: D Inspection Line: 503.639 �f 008 Date ReadyBy 's: El See Page 2 for
Internet: www.tigard - or.gov DV- VI. L Notified/Met r . _ Supplemental Information
TYPE OF WORD. O* DG 1 I0� REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ DOV CI " Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
E/I Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling 0 Commercial/industrial 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: 2 q 1 o St PA -c / is u WY New dwelling area: square feet
City/State /ZIP: 1 ' 6i1 p 7 22 / Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: N�.0 -SO r l 5 41 , 0r ,/ p„ g�Q Swm Covered porch area: square feet
Cross street/directions to job site: w4 6/0-r ( Hwy 99 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.
STo1- EF>2O/Jl vM Now) � i)G-45s Li K c - )CIND Valuation: $ 10
1 19"(E 'iv`t J A 0'y W*-u._ 4 -s , eil I�7 Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: I
Name: 12 jiap ticivOeSoi4 Type of construction:
Address: l `1 '' 5 C,' ty 1/ .,,E sr Occupancy groups:
City/State /ZIP: T roan t> OK 9 72-23 Existing:
Phone: ( ty )321_ 0 1 .5- 1 Fax: ( 5b ) 6 3' _ 36, 6 3 New:
❑ APPLICANT p CONTACT PERSON NOTICE
Business name: k o _' Up/ R € - a , All contractors and subcontractors are required to be
Contact name: ��s� a f�(ts 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: ( 5 - 83) 7q 3 -C I S° Fax:: ( )
E -mail: 1Ftt ate/ B @Jk -' 77P/ t , Co M
_Tr��7l I CONTRACTOR
Business name: ,( p(L\ 2,o1J z L� ( a OAI BUILDING PERMIT FEES*
Address: 723s 514 ,30 1.1( TA 2D (Please refer to fee schedule)
Structural plan review fee (or deposit): l4. IS
City/State /ZIP: -Ti Cify 0 7 2-1-
/ ee (if applicable): tc.
Phone: (', 13) 6 20. 22 i S' I Fax: er03) 624 -o5 Z'
CCB lic.: lb 0 6 72- Total fees due upon application:
Amount received: f yd U 7
Authorized signature: This perm app expires if a permit is not obtained
/ within 180 days after it has been accepted as complete.
Print name: Jt^ER y gki �G s Date: 1 2_ / 1 (2_0 • Fee methodology set by Tri -County Building Industry
j ( Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 2/23 /07 440- 4613T(11/02 /COM/WEB)
MI
IN a Building Division
e
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities un less
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building \Permits \BUP -COM PermitApp.doc 06/25/08
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BLJP2008 -003f 2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/11 /2008
Phone: (503) 639 -4171. i
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I �..
INSPECTION WORKSHEET FOR DATE: 1/ 3/2009 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 12910 SW PACIFIC HWY. CLASS OF WORK:
SUBDIVISION: HUDSON PLAZA LOT #: OOD TYPE OF USE:
PROJECT NAME: SALON DOBLER SWAILS
DESCRIPTION: Replacing store front. like for like. Minor sheet rock repair.
OWNER: HENDERSON, MARILYN PHONE #:
CONTRACTOR: HORIZON RESTORATION PHONE #: 503.620-22.5
Inspection Request Scheduled For: Date: 1113/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 079623 -01 503- B19.0866 414 idr - 0e'
Corrections /Comments/ Instructions:
6 ,7,4 PA - % PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
II FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/F
. x
Inspector: Date: �//''
Phone #: (503) 718 - L=—(�