Permit (78) '� BUILDING PERMIT
C ITY OF TIGARD PERMIT #: BUP2005 -00463
� 4, DEVELOPMENT SERVICES DATE ISSUED: 9/13/2005
- A=-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S115AB-01900
SITE ADDRESS: 16200 SW PACIFIC HWY D ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT: JURISDICTION: TIG
Project Description: TI
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: 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: $ 10,000.00 ,��
Owner: Contrac kk a�� grid
r tV
BIT HOLDINGS LTD PARTNERSHIP V
BY FORUM PROPERTIES INC 13i NW Muuvy 0.2=f
FIVE CENTERPOINTE DR STE 290 p��j�( .5``360
yhon OSWEGO, OR 97035
Phone:
5)3— 4 ,zl q— 3.360
Reg #:
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/13/2005 $139.30
[TAX] 8% State Surcharl 9/13/2005 $11.14
[BUPPLN] Pin Rv 9/13/2005 $90.55
[FLS] FLS Pin Rv 9/13/2005 $55.72
Total $296.71
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 -6 9 0 1-800-332-2344.
Issued By: > „GZC/ Permittee Signature: i
, ' •
Call 503 -639 -4175 by 7:00 a.m. for an inspection that burin - s 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.
. -- Building Permit A R JE4VED FOR OFFICE USE ONLY
ceiv
City of Tigard /414741110 Re e iv e d � j / �
P 1 7 Permit No.: 01 , a3'4'
13125 SW Hall Blvd., Tigard, OR 97 2005 Pl an Review
; / Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date
Inspection Line: 503.639.4175 Date Ready/By: Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supple mental Information
BUILDING DIVISION
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
f 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:
ID Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of ' oors:
Job site address: I G ZOO 5W pp Cl Ft G Alt' 14 Hr/17 SvtTa ' New dwelli i • area: square feet
City /State /ZIP: - 1 Ago d g dori 2- 24- Garage!'. sort area: square feet
Suite/bldg. /apt. no.: 5L 7) Project name: (21Tc ,4 l 0 TRtc...dale. ( - ov ed porch area: square feet
Cross street/directions to job site: ieck 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.
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.
ADD Thiel. da' G /.•'ti /Uu t5e- p✓/- Gt►Ttoi e 2 Valuation: $ fa, p o 0
O FFt ce S orGvt re' 54,(,zs ¢.. w CAI, i t. • M et T 'Co
Existing building area: - t square feet
TLe phive PtA-G New building area: .-.,1--- square feet
❑ PROPERTY OWNER a TENANT Number of stories: j.
'7
Name: g, re A t D c.-e'-P. Type of construction: 3 .
Address: /5 S 5, w Seep vo I A p k.wA 7 ob 3 go Occupancy groups: M
City /State /ZIP: Do fl-T (*.N p es)2.- 9 7 Z 24, Existing: W1
Phone: (5b5) ti 24 — s1 go Fax: ( °3) q 4 $ • O 7 7 3 New: WI.
ja APPLICANT ❑ CONTACT PERSON NOTICE
Business name: rj•r'ap. / C _
ic�l A ► c/j/TLrc'rs All contractors and subcontractors are required to be
Contact name: ! licensed with the Oregon Construction Contractors Board
e l I 1 • g ° under ORS 701 and may be required to be licensed in the
Address: 677 S 5 v 61 / r # A - va Svl to Zo jurisdiction in which work is being performed. If the
City /State /ZIP: 1 3 �A.I ._- C-p>'� o e- , 7 �oo � applicant is exempt from licensing, the following reasons
apply:
Phone: (So3 6 44- 42ZZ Fax:: (5b3) G 44. G SG 7
E - mail: g I c . A , 1 2 . . . c 1 4 . GP Ve I zAz ?4 . Al G - r,.
N CONTRACTOR
/
Business name: s 1_, A _ r _AL , , %► • e! _� . ' 1 �9 BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City /State/ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
Amount received
CCB lic.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: /(!<< / 4- G -c_.— Date: 9l/3104 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\Building\Permits\BUP- PermitApp.doc 17/03 440- 4613T(II /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200�00463
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171 4 +� /01l
Inspection Requests (24 Hrs.): (503) 639 -4175 , . � j _..
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 4:11P PAGE: 62
SITE ADDRESS: 16200 SW PACIFIC HWY D CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: RITE AID
DESCRIPTION: TI
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: CHRISTENSON VELAGIO INC PHONE #: 503 - 419-3300
Inspection Request Scheduled For: Date: 10/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 019596 -01 516 -637 -9535 Y
Corrections /Comments /Instructions:
,---- . P Ill
"(.'-.- ( t l\Y
I ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
`' J
Inspector: i / It Dater `411 4.4 411 Phone #: (503) 718-
CITY QF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00463
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171 ,
Inspection Requests (24 Hrs.): (503) 639 -4175 `_ _ I
INSPECTION WORKSHEET FOR DATE: 10/25/2005 TIME: 7:10AM PAGE: 73
SITE ADDRESS: 16200 SW PACIFIC HWY D CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: RITE AID
DESCRIPTION: TI
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: CI VELAGIO INC PHONE #: 503 - 419.3300
Inspection Request Scheduled For: Date: 10/25/2005 Pour Time:S
Code # Inspection Description Confirm # Contact # Mess- se 05
0 299 Final inspection 019210 -01 516 - 637 -9535 JIC
G s" 'L_ _
Corrections /Comments/ Instructions:
>czTc -0o'
0 , -e---k- E-C-E-C CON ( PcTi'i
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: (Q Z5 OS Phone #: (503) 718-