Permit A
TIGARD BUILDING PERMIT
CITY OF P ERMIT #: BUP2005 -00411
,LA DEVELOPMENT SERVICES DATE ISSUED: 8/18/2005
■ 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103DD -00800
SITE ADDRESS: 13815 SW PACIFIC HWY w•ft- iio ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: TI, walls and bathrooms.
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 12 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: $ 50,000.00
Owner: Contractor:
D.W. SIVERS COMPANY PACIFIC CREST STRUCTURES INC
4730 SW MACADAM AVE 7233 SW KABLE LN STE 900
#101 PORTLAND, OR 97224
P A I eLND„ OR 97201
Phone: 503 - 968 -8949
FEES Reg #: LIC 66915
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/18/2005 $470.80
[TAX] 8% State Surchaq 8/18/2005 $37.66
[BUPPLN] Pln Rv 8/18/2005 $306.02
•
[FLS] FLS Pln Rv 8/18/2005 $188.32
Total $1,002.80
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 day : TION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those r -s : set forth in OAR
952-001-1! : • ough OAR 952 - 001 -0100. You may obtain a copy . - - ules or dir -, quit ions to OUNC by
calling . 03 -246 -6. 9 1 -X0- 332 -2344.
Issu :d By: (�C. Permittee Signature 41; A , 2 _
Call 503 - 639 -4175 by 7:00 a.m. for an insp ctio hat business day.
This permit card shall be kept in a conspicuous place on t" - ..b site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
A
Building Permit AnpI�n D r oli oil ici: us„. ONLY
ll rn - ��
City of Tigard Received - ,,% i_ C If . • 'i :� 4s • 1/
13125 SW Hall Blvd., Tigard, OR 97223, .; . QQ ' Plan Review /Anal _a"
Phone: 503.639.4171 Fax: 503.598.1�601 t. U L oa � I it it�r- �;'Ii Date/B : f f V 0 ref Permit:
Inspection Line: 503.639.4175 Date Ready 1e/ ® See Attached Checklist for
Internet: www.ci.tigard.or.us
CITY OF TIGARD Notified/Method: MI Supplemental Information
Bull RING DIVISION
TYPE OF WORK REQUIRED DATA: l- 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. T ,,,,-r I pIprAwEMbJT equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® 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: i Vi31 S g G.l PAGHc__ . . 1- (14Hr,JJ4`( k 110 New dwelling area: square feet
City/State/ZIP: "" r(4gRp o z . . q 1 zZ % Garage/carport area: square feet
Suite/bidgJapt..ao.: 1( O I , Project name: ( i a g _ Jc__ J 11 G ov j = - Fria ` Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
/744-? 9 6 1?// S //IL ' /3957 &c) Br A t/ mil? Teti Other structure area: square feet
(/ r , k7 <'/) 416 REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: Zglo 311D 00,000 equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ W kV
*[ .tAist 1►-11420/614t.a Foe_ A Pizza Peu aEti R
STOfz Existing building area: (,200 square feet
New building area: 6,200 square feet
❑ PROPERTY OWNER I TENANT Number of stories: i
Name: s{ p , ', J � y j q G `G Type of construction: 1— A
Address: &230 9 Z ' ' , Occupancy groups: g
City/ State/ZIP: / x9(0)Cgto i toga? . 9 70.3 Existing: g
Phone: (3 )(6.5'-- 7712 Fax: (‘0,1 )65 - 75P) New:
❑ APPLICANT Eit CONTACT PERSON
NOTICE
Business name: V1t -1 Age IT -TU(L� All contractors and subcontractors are required to be
Contact name: 440 A� �� licensed with the Oregon Construction Contractors Board
W under ORS 701 and may be required to be licensed in the
Address: 1$1000 RZ= 1 : 4 10f0 n (AAAT 4(01 jurisdiction in which work is being performed. If the
City/ State/ZIP: 447,14033-) i.. Qe,osZ appl an t is exempt from licensing, the following reasons
Phone: ( 4-2,5) e,eS. 14,3 Fax: : (lfZy) Ices - 9-303
E -mail: 440WAgt) 1.'1AA U.A.1 A .C.44/ T ECTS _ Cow
CONTRACTOR
Business name: Lw ` 1' C 4r � T „ � ( BUILDING PERMIT FEES*
7 d
Address:
33 .k. kA 4.1.. ii ?pp P lease refer to fee schedule.
I /
City/State/ZIP: N.). q-n b • ' 919
4 Q t _ Fees due upon application
Phone: 60,) 9 `f / . : , • : ( )
CCB lic.: " , Amount received
Date received:
Authorized signature: / t This permit application expires if a permit is not obtained
/ A l within 180 days after it has been accepted as complete.
Print name: A _ i„, F5 .....c4' ca._ N'/ V I Date: e l � O S •Fee methodology set by Tri-County Building Industry
Service Board.
i:\ Building \Permits\BUP- PemtitApp.doc 12/03 440- 4613T(11 /07/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200Er00411
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (503) 639 -4171 A , Inspection Requests (24 Hrs.): (503) 639 -4175 ... W 1.L
INSPECTION WORKSHEET FOR DATE: 11/23/2005 TIME: 7:00AM PAGE: 53
SITE ADDRESS: 13815 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GARLIC JIMS PIZZA )
DESCRIPTION: TI, walls and bathrooms.
OWNER: SIVERS COMPANY, D.W. PHONE #:
CONTRACTOR: PACIFIC CREST STRUCTURES INC PHONE #: 503 - 968 -8949
Inspection Request Scheduled For: Date: 11/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 02233 8-01 503- 804 -2447 N
Corrections/Comments/Instructions:
11I
11747MIIIVI7
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t....„,
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL F S ASSESSED
1 1,
Inspector: Date: 6 a Co: hone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00411
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/18/2005
Phone: (503) 639-4171 y r°�u
Inspection Requests (24 Hrs.): (503) 639 -4175 'I L.
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7:02AM PAGE: 88
SITE ADDRESS: 13815 SW PACIFIC HWY 110 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GARLIC JIMS PIZZA
DESCRIPTION: TI, walls and bathrooms.
OWNER: SIVERS COMPANY, D.W. PHONE #:
CONTRACTOR: PACIFIC CREST STRUCTURES INC PHONE #: 503- 968-8949
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 021256-01 503804 -2447 Y pvi Corrections /Comments /Instructions:
) lit I .
mo ripliwiL_Iftmi' or w
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
i / I r r Inspector: Date: v1! ` . Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005.00411
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �' ° "I � ..
INSPECTION WORKSHEET FOR DATE: 10/25/2005 TIME: 7:10AM PAGE: 63
SITE ADDRESS: 13815 SW PACIFIC HWY 110 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GARLIC JIMS PIZZA
DESCRIPTION: TI, walls and bathrooms.
OWNER: SIVERS COMPANY, D.W. PHONE #:
CONTRACTOR: PACIFIC CREST STRUCTURES INC PHONE #: 503 - 968 -8949
Inspection Request Scheduled For: Date: 10/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 019240 -01 503- 804 -2447 N
Corrections /Comments/ Instructions:
-' 4
0 2 }' ' L
)
z
F P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI• AL F: S ASSESSED
:VW -----.
Inspector: Date: hone #: (503) 718-
1 —
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200 &.00411
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/113/2005
Phone: (503) 639 -4171 �qp �''�
. Inspection Requests (24 Hrs.): (503) 639 -4175 `�' I
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 77
SITE ADDRESS: 13815 SW PACIFIC HWY 110 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GARLIC JIMS PIZZA
DESCRIPTION: TI, walls and bathrooms.
OWNER: SIVERS COMPANY, D.W. PHONE #:
CONTRACTOR: PACIFIC CREST STRUCTURES INC PHONE #: 503.968 -6949
Inspection Request Scheduled For: Date: 10/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 018989-01 503-804 -2447 Y &4,2 P ""^AP
Corrections /Comments /Instructions:
l
7 ■ / 1
� 6 ` .4 , �_ �., �� ! ! ter. _ A/_ 1.I _ .. ,./ 4 i i ii :# fi d - iiiiv ,I-0
„e1,44,v-p_ilefte.—
aot ar
II: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/b/ (J l ) /
Inspector: . Date: J� / Phone #: (503) 718-