Permit Get; ef'Y perm rr. '* covyfecc -
71 . CITY OF TIGARD BUILDING PERMIT
#: BUP2008 -00246
PE
COMMUNITY DEVELOPMENT DATE ISSUED: 7/16/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 B D -00701
SITE ADDRESS: 12785 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 008 JURISDICTION: TIG
PROJECT: BURGERVILLE
Project Description: Interior demolition to prepare for TI.
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: : 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:
Owner: Contractor:
CATHERINE BENNETH LEASE CRUTCHER LEWIS
0/0 LAWRENCE K. PETERSON 921 SW WASHINGTON #150
8 NORTH STATE ST 301 PORTLAND, OR 97205
LAKE OSWEGO, OR 97034
Phone: 503 Contact #: PRI 503 - 223 -0500
FAX 503 - 223 -2874
Reg #: LIC 92919
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/16/2008 $62.50
[TAX] 12% State Surch 7/16/2008 $7.50
Total $70
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 B .._ 1 Permittee 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.
� P
Community Development
TIGARD Request for Permit Action
TO: CITY OF TIGARD
Building Division Services Coordinator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard- or.gov
FROM: ❑ Owner ® Applicant ❑ Contractor ❑ City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
City /State /Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
❑ CANCEL PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach receipt, if available). •
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below).
® REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: BUP- 2008 -00246
Site Address or Parcel #: 12785 SW Pacific Hwy
Project Name: Burgerville
Subdivision Name: No. Tigardville Addition_ Amend Lot #: 008
• EXPLANATION: Change in contractor from Westview Builders to Lease Crutcher Lewis
921 SW Washington Street, Suite 150 Portland, OR 97205 Ph. 503.223.0500
Fax 503.223.2874 CCB: 92919
•
• Signature: Date: 8/11/08
Alan Ainustrong .
Print Name:
Refund Policy
1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
FOR OFFICE USE ONLY
•
Rte to Sys Admin: Date By Rte to Bldg Admin: Date By
Refund Processed: Date By Invoice Processed: Date By
Permit Canceled: Date By Parcel Tag Added: Date By
Receipt # Date Method Amount $
I:\ Building \ Forms \Regl'ermitAction.doc Rev 07/26/07
CITY OF TIGARD BUILDING PERMIT
NI :
PERMIT #: BUP2008 -00246
A
COMMUNITY DEVELOPMENT
DATE ISSUED: 7/16/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102BD - 00701
SITE ADDRESS: 12785 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 008 JURISDICTION: TIG
PROJECT: BURGERVILLE
Project Description: Interior demolition to prepare for TI.
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: : 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:
Owner: Contractor:
CATHERINE BENNETH WESTVIEW BUILDERS
0/0 LAWRENCE K. PETERSON 23235 SW LASALLE LN
8 NORTH STATE ST 301 SHERWOOD, OR 97140 -8855
LAKE OSWEGO, OR 97034
Phone: 503-635-3546 Contact #: PRI 503 - 625 -8789
Reg #: LIC 140490
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/16/2008 $62.50
[TAX] 12% State Surch _ 7/16/2008 $7.50
Total $70.00
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 Utilit N g 'cation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of these es or dire es ns to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue By: itm Permittee 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 RECEI 9/� FOR OFFICE USE ONLY
V ,, coved •�
City of Tigard Date /B I to 6, Permit No.: au g_D0 a /�
r a 13125 SW Hall Blvd., Tigard, OR 97223 JUL 1 p Plan R ' r
Phone: 503.639.4171 Fax: 503.598.1960 6 2000 Date /: � nsm Eram Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Rea: B': See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified /Method:
pp r
Supplemental Information
rs A
. . ,, ,;,,, , „ ,,, , , -; .<.. � � : = � _ . , .. .. , .- ;,,. ` � QN<.V9>� � _,� � TA:�1” = 2- FAMILY"" LL'•IN
, TYPE OF. WO RK ; , I �e " REQiTIRED DA D WE G " " ":
❑ New construction ® Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
P� i * ;, work indicated on this application-
*- GATEGORY's' a ""'
''r ` .,,,,,a,,,,,,-- CON . N' ,, :1,
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
El Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
:�,�: CATION;; ; " a., Total number of floors r.
el, .. ;:.x;, , :: JOB ` SITE- " =INFORNI'ATIONy�AN, p; "`I;O, ; ; �".
Job site address: 12785 SW Pacific Highway New dwelling area: square feet
City /State /ZIP: Tigard /OR/97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: N/A Project name: Burgerville Remodel Covered porch area: square feet
Cross street /directions to job site: SW McKenzie Street & SW Pacific Hwy Deck area: square feet
Other structure area: square feet
REQUIRED'DA,TA: COIGIMERCIAL- USE"iCHECKIIST
Subdivision: N/A Lot no.: N/A Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S102BD00701 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
^
h
° ° ' _ " work indicated on t is
<,.,,, -. - �;�>,;• >„�,': '?�: 'DESCRIPTION; >OF. WORK application.
Burgerville Restaurants is proposing to remodel the existing Wendy's restaurant. Valuation: $$0.00
The remodeled building would not extend beyond the existing footprint except for Existing building area: 2860 square feet
a minor change to the existing drive -thru service windows. New building area: 2860 square feet
®:PROPEROWNER..,, :❑ � TEN ANT ; , - Number of stories: 1
a;?
"
Name: Catherine Benneth, do Lawrence K. Peterson Type of construction: Demolition
Address: 8 North State Street, #301 Occupancy groups:
City /State /ZIP: Lake Oswego /OR/97034 -3956 Existing: A -2 Restaurant
Phone: (503)635.3546 Fax: ( )N /A New: A -2 Restaurant
: APPLICANT �r., 'GONTACT:'PERSON,. ;r . °_' "'"` �i';
.- .a „:. .�,_.... ,- •^,..,. .- ..��._,- ..,...,...... -. ,.,� ,- �.��:. .�'� .. _,� „NOTICE'.?;;'?.”
Business name: Litmus Design & Architecture LLC All contractors and subcontractors are required to be
Contact name: Alan Armstrong licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 206 NE 28 Avenue jurisdiction in which work is being performed. If the
City /State /ZIP: Portland /OR/97232 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 731.5909 Fax: : (503) 731.5911 N/A
E -mail: apa @litmus3d.com
>' �x., 4I C ONTRACTOR ;'•'
Business name: Westview Builders • ," ':"s BUILDING PERMIT. - E . ES* ': ; ` ' ,, "-`"-; {``� ;"
Address: 23235 SW Lasalle Lane
AVM; =�4, '.(PIerrsesef r:t fe"escbedu•Ie),;F:: :.' '',; . ""
City /State /ZIP: Sherwood /OR/97140 -8855 Structural plan review fee (or deposit): '( DoZ, S�
Phone: (503) 625.8789 Fax: ( ) N/A � FLS plan review fee (if applicable):
CCB lie.: 140490 I 1 110 , T �•
Amount received: - 7Q L. v
Authorized signature: This permit application expires if a permit is not obtained
f within 180 days after it has been accepted as complete.
Print name: Brian Carrico for Alan Arms rong Date: 7//6/0-R * Fee methodology set by Tri County Building Industry
Service Board.
1: \Building \Permits \BUP -COM PermitApp.doc 2/23/07 440-461 3T(1 1 /02/COM/WEB)