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Permit (277) . B? � � riGc '1 ii Ind e Permit A licatio • .EXPI R - ' 3 9� :i r Commercial � ) FOR OFFILF I'SE ON1.1 City of Tigard �(� Received !(['� DateB : it 3 , Permit No.:�Ai -�; - ul 13125 SW Hall Blvd.,Tigard,OR 97223 1�� O q O% Plan Review t I ,,y . Phone: 503.639.4171 Fax: 503.598.1960 v L� /1 I ® " Other Permit: *� DateBy: ; _ T I G A R D Inspection Line: 503.639.4175 �v� n Date ReadyBy: Juris: ® See Page 2 for Internet: www.tigard-or.gov Or,rOGINsw ,Notified/Method: � 5 r r` Supplemental Information N\sl !Vi TYPE OF WOR4SU REQUIRED DATA:1-AND 2-FAMILY DWELLING 1 ❑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 0 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: 16200 SW Pacific Hwy New dwelling area: square feet City/State/ZIP:Tigard/Or gon/97224 Garage/carport area: square feet Suite/bldg./apt.no.:JX4 OA Project name:Starbucks Remodel Covered porch area: square feet Cross street/directions to job site:SWC Pacific Highway&SW Durham Road Deck area: square feet 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.:25115BA02500 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. Minor remodel to a 1,400 s.f.bldg.w/a 30 occupant load that will not change Valuation: $32,051.00 Remodel entails refacing cabinets and counter tops. Removing open seating and Existing building area: 1400 square feet replacing with a tall and short eating bar. Mostly paint&refinishing decor. New building area: 1400 square feet ❑ PROPERTY OWNER ® TENANT Number of stories: 1 Name:Starbucks Coffee Company Type of construction: V-N Address:2401 Utah Avenue South Occupancy groups: City/State/ZIP:Seattle/Washington/98134 Existing: Ni Phone:(206)342-6641 Fax:(206)318-1745 New: M 0 APPLICANT 0 CONTACT PERSON NOTICE Business name:Stantec All contractors and subcontractors are required to be Contact name:Karen Wallace licensed with the Oregon Construction Contractors Board -- -'---- under ORS 701 and may be required to be licensed in the Address:4020 Lake Washington Boulevard,Suite 305 jurisdiction in which work is being performed.If the City/State/ZIP:Kirkland/Washigton/98033 ��� �� applicant is exempt from licensing,the following reasons apply: — Phone:(425)896-5959 Fax::(425)896-5960 E-mail:karen.wallace @stantec.com CONTRACTOR Business name:TBD BUILDING 1�ERMIT FEES* (i-0 Address: (Please refer to fee schedule)„47 67 City/State/ZIP: Structural plan review fee(or deposit): a. FLS plan review fee(if applicable): C U$. W Phone:( ) Fax:( ) CCB lic.: Total fees due upon application: 5'*5-3 Amount received: 5 CJ Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Karen Wallace Date: 10/29/2008 * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 2/23/07 440-4613T(11/02/COM/WEB)