Permit II CITY OF TIGARD BUILDING PERMIT
`R'! ' COMMUNITY DEVELOPMENT Permit#: BUP2021-00249
Date Issued: 10/20/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134AD06200
Jurisdiction: Tigard
Site address: 10565 SW NIMBUS AVE 110
Project: Big Leaf Networks Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: A
Project Description: Interior demolition only. Demolition of partition walls,doors,and finishes.
Contractor: KIRBY NAGELHOUT CONSTRUCTION CO Owner: DIETRICH, NANCY BISHOP
63049 LOWER MEADOW DR ROBINSON, JERRY CHRISTOPHER TRUST
BEND, OR 97701 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 541-389-7119 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 10/19/2021 $286.64
Occupancy Grp: Occupancy Load: Demolition
12%State Surcharge-Building 10/19/2021 $34.40
Dwelling Units: 0
Stories: 0 Height: 0 ft Info Process/Archiving-Lg$2.00(over 10/19/2021 $8.00
11x17)
Bedrooms: 0 Bathrooms: 0
Value: $14,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $329.04
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. 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
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Call 503.639.4175 by 7:00 a.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.
Building Permit Application e
Commercial E V E IV FOR OFFICE USE ONLY
Rived
City of Tigard Date/By !d/�br/ 1 �' Permit No 6/Ai
),/ [f gli'r
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' • C Phone: 503-718-2439 Fax: 503-598-1960 Date/By. Related Permit
TIGARI) Al
Inspection Line: 503-639-4175 DateReadyBy: d orris ® See Page 2for
Internet: www.ti and-or. ov Notified/Method: /b/r8/n /7t77r Supplemental Information
g g CITY OF TIGAR /�,,, �� ✓//
TYPE OF WORKiUILDINO DIVISION REQUIRED DATA:I-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.
Valuation: $
❑ 1-and 2-family dwelling IXI Commercial/industrial
ElAccessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10565 SW Nimbus Ave, Building S New dwelling area: square feet
City/State/ZIP: Portland, R 97223 Garage/carport area: square feet
Suite/bldg./apt.#: Bid !co Project name: Big Leaf Networks Covered porch area: square feet
Cross street/directions to job site: Scholls& Nimbus Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 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.
Interior demolition of building standard wall partitions, Valuation: s14,000.00
doors, and finishes. Existing building area: 1 1,216 square feet
New building area: 11,216 square feet
0 PROPERTY OWNER 0 TENANT Number of stories: 1
Name: Joshua Shearer Type of construction: V-B
Address: 10300 SW Nimbus Ave, Suite P-C Occupancy groups: B
City/State/ZIP:Portland, OR 97223 Existing: B
Phone:(425)766-7040 Fax:( ) New: B
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer(ofee schedule)
Business name: Ankrom Moisan Architects
Structural plan review fee(or deposit):
Contact name: Bethanne Mikkelsen
FLS plan review fee(if applicable):
Address: 38 NW Davis Street, Suite 300 Total fees due upon application 3?3Y U
City/State/ZIP: Portland, OR 97219 (([
Amount received:
Phone:( 503)952-1593 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: bethannem@ankrommoisan.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Kirby Nagelhout Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 10180 SW Nimbus Ave, suite J3 Solar Installation Specialty Code checklist.
City/State/ZIP: Portland, OR 97223 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503 )530-8420 Fax:( ) o
State surcharge(12/o of permit fee): $21.60
CCB Lic.:95590 Total fee due upon application: $201.60
Authorized signature This permit application expires if a permit is not obtained
�j �� � / within 180 days after it has been accepted as complete.
Print name: ( ]1.taantt�/ --' Date: 1 O/5/21 * Fee methodology set by Tri-County Building Industry
�� ll�� Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(I l/02/COM/WEB)