Permit •
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00040
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/16/2009
Parcel: 1 S134BC00101
Jurisdiction: Tigard
Site address: 12140 SW SCHOLLS FERRY RD
Subdivision: Lot: 0
Project: Carl's Jr •
Project Description: Interior alteration effecting accessibilty.
Owner: FEES
GREENWAY CENTER LLC & Description Date Amount
ANA KALAKAUA CENTER, 2155 KALAKAUA Permit Fee - COM 04/16/2009 $609.94
AVE #602 Tax - 12% State Surcharge 03/11/2009 $73.19
PHONE: Plan Review 03/11/2009 $396.46
Plan Review - Fire Life Safety 03/11/2009 $243.98
Contractor:
MENEMSHA DEVELOPMENT GROUP INC
4950 W 145TH ST
•
HAWTHORNE, CA 90250
PHONE: 310- 343 -3430
FAX: 310 - 343 -3431
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $100,036
Floor Areas: •
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0 •
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,323.57
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet: No
Fire Alarm: No Protected Corridors: No
Smoke Detectors: No Manual Pull Stations: No
Accessible Parking: 0
This p it•is bject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
e done in accordan ith a? • r ved plans. This permit will expire if work is not started within 180 days of isuance, or if work is suspended for more
the 180 days. ATTENTION: a gon law r- • uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OA •42-00 •. You may obtain a •py of the rules or direct questions to OUNC by calling 503.246.6699 or 1.801 2.2344.
Issued By: / - /`�-�� Permittee Signature: r_ 3.1.4=
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.
CP RL.S 12 N ko -:= (`E
?uil4,in2 Permit Application
Commercial
p,C
E Dr c�lt cli ri( t: tiI : (),I.)
City of Tigard D I B 3 9 6 I Permit No.. 64 j 9taoy- Yo
• 13125 SW Hall Blvd., Tigard, OR Plan Review, Ile
■ Phone: 503.639.4171 Fax: 503.598.IQ¢Q� O �� DatelB : `jrL�t r Other Permit:
i - it D Inspection Line: 503.639.4175 ��V1INN Date Ready/By: RI See Page 2 for
Internet: www.tigard -or.gov Notified/Method: (j Supplemental information
C.... i 1� GUN
TYPE O1g 1 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: Finish Upgra equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2 -family dwelling ® Cormnercial/mdustrial Valuation: S.
❑ 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: 12140 S. W. Scholls Ferry Road New dwelling area: - square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: - square feet
Suite/bldgJapt. no.: I Project name: Carts Jr. #316 Covered porch area: - square feet
Cross street/directions to job site: S. W. 121 i Ave Deck area: - square feet
1 mile west of Hwy 217 (Beaverton- Tigard Fwy) Other structure area: - square feet
- REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: - I Lot no.: - Permit fees* are based on the value of the work performed.
Tax map /parcel no.: - Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New decor. new laminate tabletops and vinyl boot seat backs, new laminate and ss Valuation: $$100,036.00
trim on cabinet facings, replace 9 light futures, new wall tile in restrooms & Existing building area: 3050 square feet
replace plumbing futures in restrooms. No structural work or Mech work. New building area: 0 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 1
Name: Carl Karcher Enterprises - Type of construction: V
Address: 401 W. Carl Karcher Way Occupancy groups:
City/State/ZIP: Anaheim, CA 92801 Existing: A2
Phone: (714)254.4813 Fax: ( -)- New: same
❑ APPLICANT ® CONTACT PERSON NOTICE
Business name: 4G Development and Consulting All contractors and subcontractors are required to be
Contact name: Ed Hale licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 2153 Oak Hill Drive jurisdiction in which work is being performed. If the
City/State/ZIP: Escondido, Ca 92027 applicant is exempt from licensing, the following reasons
apply:
Phone: (760) 884.7011 I Fax: : (760) 946.7821 _
E -mail: ehale@4Gdev.com
-
CONTRACTOR -
Business name: Menemsha Construction BUILDING PERMIT FEES*
Address: 4950 W. 145 Street (Please refer to fee schedule)
City/State/ZIP: Hawthorne, CA 90250 Structural plan review fee (or deposit):
Phone: (310) 3433430 I Fax: (310) 3433431 FLS plan review fee (if applicable):
CCB lic.: 179922 ��Il Total fees due upon application: $1,323.50
Amount received:
Authorized signature: C
This permit application expires if a permit is not obtained
t.,,,,,
within 180 days after it has been accepted as complete.
Print name: Ed Hale I Date: 3/5109 • Fee methodology set by Tri-County Building Industry
Service Board.
L:\BuildinggPermits\BUP -COM PennitApp.doc 2/23/07 440- 4613T(l l /02/COM/WEB)