Permit CITY OF TIGARD BUILDING PERMIT
1. COMMUNITY DEVELOPMENT Permit#: BUP2013-00219
T i GAR]D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2013
Parcel: 1 S 136 DA00700
Jurisdiction: Tigard
Site address: 11530 SW PACIFIC HWY
Project: Lu's Sports Bar Subdivision: PFAFFLE PLAZA CONDO Lot: 2
Project Description: Change of occupancy
Contractor: Owner: HI HAT INC
11530 SW PACIFIC HWY
PORTLAND, OR 97223
PHONE: PHONE: 503-460-7434
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee-Additions,Alterations, 08/28/2013 $53.27
Demolition
Occupancy Grp: A-2 Occupancy Load: 557 12%State Surcharge-Building 08/28/2013 $6.39
Dwelling Units: 0 Plan Review 08/28/2013 $34.63
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $500
Floor Areas:
Total Area: 9945
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $94.29
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 the 180
days. A • e -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
852-151-0010 through OAR°-2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ed By: � � � Perm ittee Signature: I ,{
Call 503.639.4175 by 7:00 e.m.for the next available inspection date.
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.
BUildink Permit Application
Commercial FOR OFFICE USE ONLY
City of Tigard DReceatemivec.1 e.IMIEr 1 I� Permit No.: I, 1,49/5-60),/9
:� = 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1%0 Date/Bv_ Other Permit:
T I G A li D Inspection Line: 503.639.4175 Date Ready/By: runs: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method. Supplemental Information
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.
❑ 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: //r j .. stn/ eG.c f.-f- c. Ji New dwelling area: square feet
✓
City/State/ZIP: 73 a ,-1Z_ 172 7 Z Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: /`k(> S I)o t fs Jay Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
(-1.�Ir��,L aCJ`JN Valuation: $ 0y t
l(Je�Y��OL B�, Existing building area:99gS square feet
U
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: .9--/
Name: u. N 4 f Z..C Type of construction: 5-V
Address: /I o &V 4/,
j l j- � � HI. Occupancy groups: A-G9• i
City/State/ZIP: ' it y�� c1 k._ 9 2 2 2 3 Existing:
Phone:( ) ✓ Fax:( )
New: l!✓ •L-D/1=r) 55
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit):
Contact name: -
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received: /T/pi 9 J ,;19 Phone:( ) Fax: :( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
NTRACTOR roof-top mo.• ed Photo Voltaic Solar Panel Syste
Business name: Submit two(2) ,of roof plan with corn= .1 •etails
and fire department. • s,along wit ..-2010 Oregon
Address: Solar Installation Specia od• ecklist.
City/State/ZIP: Permit fee(includ• . : view $180.00
and ad.•. istrative fe
Phone:( ) Fax:( )
State surch. _ (12%of permit fee): $21.60
CCB lic.:
To •I fee due upon application: '. 01.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: �/t/ 7 4._� Date: r/ f/j * Fee methodology set by Tri-County Building Industry
1�' / Servire Rnard