Permit CITY OF T I G A R D BUILDING PERMIT
PERMIT #: BUP2001 -00382
4I'6 DEVELOPMENT SERVICES DATE ISSUED: 2/25/02
R°- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11705 SW PACIFIC HWY M PARCEL: 1S136CD -00100
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 1,980 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: 1,980.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 70 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: N SMOK DET:N
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 70,000.00
Remarks: Commercial tenant improvement, converting retail space to restaurant.
•
Owner: Contractor:
PACIFIC CROSSROADS PROPERTIES, PRECISION INSTALLATIONS
BY WYSE INVESTMENT SERVICES CO 12413 NERUSSELL
200 SW MARKET ST STE 345 PORTLAND, OR 97230
P 'nRone ND; OR 97201 Phone: 503 - 257 -1330
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PLCK CTR 10/15/01 $377.13 27200100000 Electrical Permit Required
Plumbing Permit Required
FIRE CTR 10/15/01 $232.08 27200100000 Framing Insp
PRMT CTR 2/25/02 $580.20 27200200000 Gyp Board Insp
5PCT CTR 2/25/02 $46.42 27200200000 Susp Ceilng Insp
Final Inspection
Total $1,235.83
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 - • o.ted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 95 :-001 1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-6699,o P:1 ! ", " ' 4.
Permittee = ^' 1k
Signature: J C_
Issued By:
Call 639 -4175 by 7 p.m. for an inspection the next business day
v & (0 .2_10-6( 1 0 3g . T 1' - r ,
Building Permit Application
Date received: /G -/" O/ Permit no. :5uAaoo /'45 5g
` ��_lrliji City of Tigard
"= Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 5,
Phone: (503) 639 - 4171 Date issued: By: Receipt no.:
S
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex: z
C, •
TYPE OF PERMIT
0
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
e
JOB SITE INFORMATION N
lob address: p NJ '4clPIG W` . Bldg. no.: Suite no.: it
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: Q v R/J a 'S SIBS . 4
Description and location of work on premises/special conditions: T. ( . Ft3(2 SAfJD J k+4 QU (EROKE
Q r — s�7ct V R 6 1.17 .
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
• `� a • _ (Floodplain, septic capacity, solar, etc.)
Mailing address: /41 S - • 9 L ta j , cr. l & 2 family dwelling:
City: i • p Statep iL ZIP: q ZZ3 Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: _ 2 J• ARC4.{ /77Er-1 RE Total number of floors
Phone:503 - 82`7 Fax: $27•7981 E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: .><1 IL.Izg o • l c rulee b , • Covered porch area (sq. ft.)
Mailing address: 2-125 S, --• UR - g • S -rE t/(D Deck area (sq. ft.)
City: 0-9- - rLptiJ. State: a_ _ ZIP: • 2. ( Other structure area (sq. ft.)
Phone:S03 -921• • • Fax: ; 27 1 E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $141 noo
Business name: _ Existing bldg. area (sq. ft.)
(, — D / O/O /�5! i :i v area (sq. ft.) 0 Q
Address: I _ '1S) - % IZ.US
�Ll State :Y2.._ ZIP: 9 7 . Number of storie Ov
Type of construction
Phone: • 3 as Fax: E-mail: Occupancy group(s): Existing:
CCB no.: €,,,D,•" _ S New: cam' A - 3
City /metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: gyp,/ -1 • • 'Liam 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: Plan no.:
Phone: Fax: 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 prov' log,' f law and ordinances governing this Cl Visa ❑ MasterCard
work will be complied w l w iith �s sifted herein or not Credit card number: Expires
/
y.._ Authorized signature: 41 ' Print name: Date: I pt I7! o I Name of cardholder as shown on credit card
� (�.1 ( - M(LLt — III $
Cardholder 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 (6r00ICOM)
. /
j 77 (PO9. coo 20 (46.k{?___ a3a. og
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1
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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).
TYPE OF SUBMITTAL Total # of
(Includes New, Additions or Plans
Alterations) Submitted
Site Work (must include location of 4
all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
*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.
is \dsts \forms \COM- matrix.doc 9/4/01
•
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
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 unless
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 of all renovation, alteration or modification being done
excluding painting, wallpapering. [1]$ 00
multiply: 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL [2] $ 13, 60 0
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 $ WA
(b) An accessible entrance: $ i(�-k
(c) An accessible route to the altered area: $ N/A-
(d) At least one accessible restroom for $ 20 ,o •
each sex or a single unisex restroom: ,t S /
(e) Accessible telephones: $ AA'
(f) Accessible drinking fountains: and $
c
(g) When possible, additional accessible
elements such as storage and alarms: $ 61000
TOTAL: Shall equal line 2 of Value Computation $ 26/ 00
is \dsts \forms \access.doc
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION - Business Line: (503) 639 -4171 MST
t .260( ad 3g`2._
� K
Received Date Requested 3 -� AM PM BUP
Location Suite (Y\ MEC
Contact Person Tl� Ph ( ) %R'S {0 PLM
Contrac • Ph ( ) SWR
- ILDINIP Tenant/Owner ELC
Fo• •
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Ins - - on
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
j 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 71
nsp•etor Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour .. , ( '
BUILDING , _ - Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
,i• BUP ,-,/e) / b 03$
Received — Date Requested 3 - AM PM�1� BUR. -
Location // 7 OS 2 Suite ill ___
Contact Person `- �� Ph ( ) .40 40 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner (2 u ELC
Footing
Foundation ELC
Ftg Drain
Access: �� ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
mi
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
( . T '
onBIN
.ost & 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 reinspec • n RE: ❑ Unable to inspect — no access
Fire Supply Line L
ADA `�
Approach/Sidewalk Date / tJ ` r Spector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
-
BUP o4'J6/ 6'0 3 gd,
Received Date Requested > ' AM PM BUP
Location _/ 7 D 5 Suite 6/ MEC 2.DOZ - d0 //V
Contact Person Ph ( ) v- 6 5 7 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
Ina Sheath/Shear �� c 4 2 c /' �•��
Framing
Insulation (�
'Drywall Nailing
Firewall
Fire Sprinkler 401111•0°'
Fire Alar 5
d Ceiling ;
oof
Other:
4
PART FAIL _
MBING
Post & Beam
Under Slab
Rough -In
Water Service = i
Sanitary Sewer A 6
Rain Drains — _ `�
Catch Basin / Manhole //
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PART FAIL
TRICAL
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: LI Unable to inspect – no access
Fire Supply Line
ADA V --c- • Approach/Sidewalk Date _ Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL