Permit a C ITY OF TIGARD ' BUILDING PERMIT
11 PERMIT #: BUP2007 -00116
° - COMMUNITY DEVELOPMENT DATE ISSUED: 3/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102AA -00200
SITE ADDRESS: 11920 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: TIGARD HIGHWAY TRACTS LOT: 013 JURISDICTION: TIG
PROJECT: MIXERS BAR & GRILL
Project Description: Remove dry chemical system, install Amperex KP600 UL300 fire suppression system.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS 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: $ 2,900.00
Owner: Contractor:
BARNES, SANDRA L UNITED FIRE HEALTH & SAFETY EQUIP
do TUMAY CORPORATION 4611 NE MARTIN LUTHER KING JR
11920 SW PACIFIC HWY PORTLAND, OR 97211 -0771
TIGARD, OR 97223
Contact #: PRI 503 249 - 0771
Phone:
Reg #: LIC 65290
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/1/2007 $72.10
[TAX] 8% State Surcha 3/1/2007 $5.77
[FLS] FLS Pin Rv 3/1/2007 $28.84
Total $106.71
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.
/ / r
Issued By: Permittee Signature: . 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.
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Awi Mx,'&5 sag. 4. 4 Itsfrl.
Building Permit Application
°" �'�'�l� City of Tig Date receivcc�l / d 17 Permi m` tA\D v8 7 -o' ) 6
"= P roje ctiapp �/� xp
Address: 13125 S I
City of Tigard ( J, T ,i ( ,� y : 1
Phone: (503) 639 7 I E \,d — Dale issued: By: Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
('.6- .`? 0 1 2001
Land use approval: I &2 family: Simple Complex:
k s.ss*N.'
TYPE OF PERMIT
0 I & 2 family dwelling or accessory )0 Commercial /industrial ❑ Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION •
Job address: S • Q (, Y Bldg. no.: Suite no.:
Lot: Block: (Subdivision: 'Tax map /tax lot account no.:
Project name: rf (d uts fo p, } i l
Descript'on and location of we k on premises /special conditions: L' t1_" J . .4 �. = �,, S ■ �.
.7
OWNER • FOR SPECIAL INFORMATION, USE CHECKLIST
Name: "3'efrei (Floodplain, septic capacity, solar, etc.) (--7 Mailing address: l & 2 family dwelling:
sois
City: I State: I ZIP: Valuation of work $ 00 tlZ fo
Phone: Fax: (E -mail: No. of bedrooms/baths l
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Tye_ - cL Covered porch area (sq. ft.)
Mailing ddress: (oil 1Z f \.L1k... ak d Deck area (sq. ft.)
City: P 44 I Stat ZIP: 0/12_- yi Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
IMITER.PMERMIPMWEMMIll Existing bldg. area (sq. ft.)
Addre . , M L„ : New bldg. area (sq. ft.)
City: L , Sta 9 J ZIP :4 /24 Number of stories
Phone:y '-O T7 ' - 06 S [. _ / . • f construction
CCB no.: 6 /S
•c ' u . . c group(s): Existing:
New:
City /metro lic. no.: 6 3 eta Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER 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
City: State: (ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $ /0 t
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 provisions of laws and ordinances governing this pvisa 0 M - -- - -
work will be complied wit , h ther pecified herein or not C . • d num. _ _-
4� -. U.2. �.c Expires
Authorized Sig r Date: ,.Z �l0 )h i' i' der as hown on credit card $
Print name: .r- tO �, ar.hol. r signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6100/COM)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: RUP2007 -00116
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/19/2007
Phone: (503) 639 -4171'
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' W 4 'I
INSPECTION WORKSHEET FOR DATE: 4/312007 TIME: 7:00AM PAGE: 79
SITE ADDRESS: 11920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: TIC: ! GHWAY TRACTS LOT #: 013 TYPE OF USE:
PROJECT NAME: i -.R = R & GRILL
DESCRIPTION: ' = ve dry chemical system, install Amperex KP600 UL300 fire suppression system.
OWNER: BARNES, SANDRA L, PHONE #:
CONTRACTOR: UNITED FIRE HEALTH & SAFETY EQUIP PHONE #: 503 - 249`0771.
Inspection Request Scheduled For: Date: 4/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
920 Suppression trip test 045830 -01 971- 563-1592 N
( 2 : e, C)
Corrections /Comments /Instructi :
er- 117
G.
K PASS TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL %/ ' ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: • Phone #: (503) 718-