Permit ,,ti
✓ CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00376
41 4 DEVELOPMENT SERVICES DATE ISSUED: 8/1/03
.,� 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13500 SW PACIFIC HWY 17 OLD CNTRY BUF PARCEL: 2S102CC -00500
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 9,600 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: A2.1 TOTAL AREA: 9,600 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 220,000.00
Remarks: TI, interior renovation & name change.
Owner: Contractor:
OCB RESTAURANT CO. ENBREE CONSTRUCTION
1460 BUFFET WAY 8050 AIRPORT RD.
' EAGAN, MN 55121 GEORGETOWN, TX 78628
Phone: 651 - 365 -2142
Phone: 512- 869 -2626
Reg #: LIC 70470
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pln Rv 6/19/03 $1,114.30 Electrical Permit Required
[FLS] FLS Pln Rv 6/19/03 $685.72 Sprinkler Permit Required
Fire Alarm Permit Requires
[TAX] 8% State Tax 8/1/03 $137.14 Plumbing Permit Required
[BUILD] Permit Fee 8/1/03 $1,714.30 Framing lnsp
Total $3,651.46 Gyp Board Insp
Susp Ceilng Insp
Final Inspection
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 By: • / t / , ' „ 1r
Permittee ��
Signature: �i�
•
/ 639-4175 by 7 p.m. for an inspection the next business day
/3S,0 5 w P,,cIFic NO
• No/ C7a wry •
- - - - eRor, -/0 - 03 135
Buildin g Permit Application - . OFFICE USE ONLY
Date received• , - • .03 Permit no.: l , . -op y / �.
p�-� City of Tigard 97223 '' \
' 1 r• •7 J • j Project/appl. no.: Expire date: J
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR, 7,223 e _ •.
Phone: (503) 639 -4171 .. Date issued: �_� Receipt no
Fax: (503) 598 -1960 C° h Y ( " 1 iI '' w
Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ New construction ❑ Demolition
' Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
o. a.. ress: /3 011 3 r Aa / /6f/ftJ 4 ' 0 1 Bldg. no.: Suite no.:
Lot: Block: Subdivision: =7LG -dw ' MEM Tax map /tax lot/account no.:
P 'I" t • ' . -47 GX3ihi`4 OI- • I .11'x. . — i WWI ET0 0 -r emr
Description and location of work on premises /s ecial conditions: '�3Ej'1X7.7)EL_._ O F �'/V!/IIC�
uF F67" ,ASEA
OWNER FOR SPECIAL INFORMATION, USE CIIECKLIS7•
I a / . 4 1 1 (Floodplain, septic capacity, solar, etc.)
Mailing address: si • _ - i 1 & 2 family dwelling:
City: 6c1 ' EIMEMZIP: 5_572. Valuation of work $
Phone& _VIM -a , _�;,,,, -mai „�, " No. of bedrooms/baths
Owner's representative: �, Total number of floors
Phone- _4 Fax: 415' e.. New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
IIMMIM1 Covered porch area (sq. ft.)
Mailing address: .0 i�� Deck area (sq. ft.)
M EMU IP: J" /2_ Other structure area (sq. ft.)
Phone;. -mai ', cr �° ' � ' Comme rcial/industriallmulti- family • - ON I L- adoi�
� � • . ,rx .. ,. `^
CONTRACTOR Valuation of work . - 11./ }L $ -- b(-) • °
Business name: DWI �j '�// p�� CO h 5� �' �, + (8 Existing bldg. area (sq. ft.)
Address: rid S O fi'�t 2 , , - 4 g.Q New bldg. area (sq. ft.)
City: 4 e, - Bu, n State:'tk ZIP: 7 g' (,z Number of stories al
Phones /Z 8(�j -Z{ z • E -mail: Type of construction S / Hoc(
Occupancy group(s): Existing: 4 -
CCB no.: `7 0 Co - -a3 -0 - New: , la-
City/metro lie. no.: Notice: All contractors and subcontractors are required to be
• ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name / ' ' / x-75 provisions of ORS 701 and may be required to be licensed in the
Address: // V1/ jurisdiction where work is being performed. If the applicant is
�� exempt from licensing, the following reason applies:
MI=�. IEMEM ZIP: 55
Contact person _ at, Plan no.:
Phone:' • y �6600r'1.f� E- mail;j& 0w/ - -
ENGINEER OFFICE USE ONLY
IZEI tG►.. �' 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. ∎ rovisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be co xiiii ith, whether sp cifi -d herein ■ r not. / card number: / /
Authorized si i _ p
gn / - A — ` ...—.. 10 • - • /� /O� Name o cardhol as shown on credit card Expires
Print name: , eie. . A. i...maV7� $
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 (6/00 /COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
� Bu .2003- 0o3/76
Received Date R uested 9//5/ . AM PM t 3— (50 5 0
Location /35700 G'/A/ Suite MEC
Contact Person Ph ( ) PLM
Contractor /4‘ 4 '' Ph ( ) SWR
43:117 Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
S PART FAIL
PPOMBING
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 111 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line G�
ADA
Approach/Sidewalk Date / / Inspector 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 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP — 60376
Received Date Requested 1.40.4, AM PM BUP
Location /3.S
Suite MEC
Contact Person Ph ( ) 7a -St 7 PLM 3 'D v a 7 7
Contractor / Ph (_ • ) SWR
BUILDING Tenant/Owner /54 —t4. YJ aeh .— ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
•
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
eam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
ANICAL
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 El Please call for reinsp- tion RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL