Permit ,..• - .
At. CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00276
d� DEVELOPMENT SERVICES D ATE ISSUED: 7/5/2006
-'�� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103DD -00800
SITE ADDRESS: 13815 SW PACIFIC HWY 100 ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: TI - walls (1,200 sq ft)
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: 2N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 27 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 32,450.00
Owner: Contractor:
D.W. SIVERS COMPANY SIVERS CONSTRUCTION
4730 SW MACADAM AVE 4730 SW MACADAM AVE #101
#101 PORTLAND, OR 97239
PORTLAND„ OR 97201
Phone: Contact #: FAX 503- 223 -2750
PRI 503 - 223 -2680
FEES ' Reg #: LIC 102469
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/5/2006 $343.30
[TAX] 8% State Surcharl 7/5/2006 $27.46
[BUPPLN] Pin Rv 7/5/2006 $223.15
[FLS] FLS Pin Rv 7/5/2006 $137.32
Total $731.23
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 to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 1- 0010th ough OAR 95 - 001 -0100. You may obtain a copy of these ules •r direct questions to OUNC by
ca ing 503 - 246- 6699\o -806332 -2344. 1‘ 11 /
Iss ed By:.� /'' 1 4 , ' Permittee Signature: , K C I ; A
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business d:
This permit card shall be kept in a conspicuous place on the job site until completion oft e project.
Approved plans are required on the job site at the time of each inspection.
� 6 C O N c c 7 1 Building Permit Applig er l' D IRO O v
� -, Washington Phone: 503- 846 -3470, Fax: 503-31 503-8A6L343 ? l ect on Request: 503 - 846 -3699
15 V, Suite 350 -12, Hillsboro, OR 97124 a 61A on.or.us
O REOO ' Land Use Approval: Project # BUILDING DIVI it #
AUPSE-6&-IPe6
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation n
❑ 1- and 2- family dwelling J�Comntercial/industrial
❑ Accessory building ✓ ✓✓ ��, Number. of bedrooms:
ry g ❑ Multi - family
❑ Master builder Number of bathrooms:
❑ Other:
JOB SITE INFORMATION AND LOCATION Total number of floors:
New dwelling area: square feet
Job site address: f e H t( "' 5U �'M 1 b
City/ State/ZIP: �r� ' „I' ! �` Garage/carport ea: square feet
( Covered p ch area: square feet
Suite/bldg. /apt. no.: \ 1-1 F, �0p Project name: rr� ) 1 1 e
Cross street/directions to job site: 1 t� "� �'f Deck ea: square feet
J � ' t ' `l� " / Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Permit fees* are based on the value of the work performed.
Plan No. Reissue: Yes [ ] No [ ] Indicate the value (rounded to the nearest dollar) of all
Subdivision: I Lot no.: equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
Tax map /parcel no.: Valuation 6k 1+51) ? =
DESCRIPTION OF WORK Existing building area: square feet
AD° VVAt I, 5 1b (2M ( 4 T'c , l919 New building area: square feet
D 1l - - Fop i-E4- / D k12/_>. ' Number of stories:
TeD 1 C j2 \ Type of construction: °0 6
Occupancy groups:
�
❑ PROPERTY OWNER I ❑ TENANT Existing: 6 6ec e
Name: 1 rW SJt/ €tom Cm/ f C New:
Address: 41 0 5w M pr- .C%p,& m_ IA _U a,,a ( / ' * L p I NOTICE
City/ State/ZIP: PTr `�I�l� 3 All contractors and subcontractors are required to be
�- 1 i] ( C) (�- �Z23 I 1 licensed with the Oregon Construction Contractors Board
Phone: ) ^
(�3 ?-�� . +�. -�� Fax: ( ✓" 193 'L23 • Z1cJO under ORS 701 and may be required to be licensed in the
❑ APPLICANT ❑ CONTACT PERSON jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
Business name: r7 f e 1)S I Are-c,t4 apply:
Contact name: i yak) kv.
Address: 4 ,..),,,/ Lj A -
City/State/ZIP: 1- ng- ci ^12W9 BUILDING PERMIT FEES*
Phone: (503) I 3-2f1974 7 I Fax: : ( 5b3 ) Z • 912-1 Please refer to fee schedule
E -mail: Fees due upon application $
CONTRACTOR Amount received $
Business name: 5 C6 S-rp,J - 1.1 d ki Date received:
Address: C FI?) p 5W hAa€M7t4.. Ad *to I
This permit application expires
City/State/ZIP: T A I corz_ 112.S1 if a permit is not obtained within 180 days
Phone: (93..V z t 3. z.4,$ Fax: ( ) 2 2 , ZZSO
503 3 after it has been accepted as complete
CCB lic.: I C9 2.1. (
* Fee methodology set by Tri- County Building
Authorized 1
signature: A i Industry Service Board
Print name: fl\ C. I Date:1 . C_ bc 440-461 3T (7 /03 /COM/WEB)
i
-CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200&00216
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2006
Phone: (503) 639 -4171 A '
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I �
INSPECTION WORKSHEET FOR DATE: 10/1Q12006 TIME: 7 : 06AM PAGE: 83
SITE ADDRESS: 131315 SW PACIFIC HWY 100 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PETRONE DELI/LOTTERY
DESCRIPTION: TI - walls (1,200 sq ft)
OWNER: SIVERS COMPANY, D.W. PHONE #:
CONTRACTOR: SIVERS CONSTRUCTION PHONE #: 5032232630
Inspection Request Scheduled For: Date: 10/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 037893-01 503. 785.6177 N
Corrections/Comments/Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR I ■ SPECTION ❑ ADDITIONAL F ES ASSESSED
Inspector: A ���.. Date: ( 5/ � V Phone #: (503) 718 �/J
CIT 'OF TIGARD
1
BUILDING DIVISION PERMIT #: BUP2000.00276
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/5/2006
Phone: (503) 639 -4171 7 A
Inspection Requests (24 Hrs.): (503) 639 -4175 �- �'' L
INSPECTION WORKSHEET FOR DATE: 8/11/2006 TIME: 7:06AM PAGE: 86
SITE ADDRESS: 13816 SW PACIFIC HWY 100 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PETRONE DELI /LOTTERY
DESCRIPTION: TI - walls (1,200 sq ft)
OWNER: SIVERS COMPANY, D.W. PHONE #:
CONTRACTOR: SIVERS CONSTRUCTION PHONE*: 503 - 222680
Inspection Request Scheduled For: Date: 8/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message A
276 Framing 034753.01 603-789-6177 Y
Corrections /Comments/ Instructions:
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❑ A ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED - 1 7 A - A.) Inspector: Da te: i k. Phone #: (503) 718 - 24Z3