Permit (19) �3 ,- rI CITY OF TIGARD
BUILDING PERMIT
' 4
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00231
al G AR D. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 12/29/2009
;w•;! Parcel: 1S136DD05300
Jurisdiction: TIGARD
Site address: 11850 SW 67TH AVE, STE# 100
Subdivision: TIGARD TRIANGLE COMMONS Lot: 13
Project: Spec Space
Project Description: Interior TI.
Owner: FEES
PNWP LLC #2 & Description Date Amount
PNWP LLC, 6600 SW 105TH AVE #175 Permit Fee - Additions, Alterations, 12/29/2009 $1,250.91
BEAVERTON, OR 97008 Demolition
PHONE: 12% State Surcharge - Building 12/29/2009 $150.11
Metro Const. Excise Tax - Commercial 12/29/2009 $148.80
Use
Contractor: Plan Review 12/29/2009 $813.09
TRIANGLE CONSTRUCTION LLC Plan Review - Fire Life Safety 12/29/2009 $500.36
35155 NE ROCKY HILL RD
NEWBERG, OR 97132
PHONE: 503 - 625 -9194
FAX:
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $124,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,863.27
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. At work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: �
/ 1 Q Permittee Signature: (A_
5 Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial Vo:NAV `. A � .�� s i . � , va tii:
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�-`' ,t ' , C i t y of Tigard RECEIVE Ej Ej � Received 1
Irt't' a a.e.I�$�� j ''- DateBv: Permit No r 1 ' . � 0 .0 ..
, u :1-= V 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Vii, �
.� Other Permit:
?. ) Phone: 503.639.4171 Fax: 503.598.1960 2009 DateB LIT! !/�
T I G , % R D Inspection Line: 503.639.4175 DEC 2 9 Date Ready / JulI s : ® See Page 2 for
fill4iND■ta,sr. Internet: www.tigard or.gov Notified/Method: 1 l Supplemental Information
CITY OF TIGARD � (
TYPE OF WOffldILDING DIVISION 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 E4 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: \\S : 51,/J (,.)1 4'4'1 AVt✓V1\X ` New dwelling area: square feet
City /State /ZIP: '>r Aq py(c) t O dh q 7 'a ) 3 Garage /carport area: square feet
. bldg. /apt. no.: 100 Project name: S )( [ OD , e A.._ ?dvv , Q)`A Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
(e l I Pa + 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.
I °I ^ 61 Valuation: $ 12- t U u �
3 , w 5 r i U ,_ A , tr Existing building area: 3 s J quare feet
fv" !`^"° New building area: square feet
❑ PROPERTY OWNER • ❑ TENANT Number of stories: 2.
Name: Q ac -,..c.. ; L iAw ,,(0Qe-'��&.., S Type of construction: 3 D
Address: (( pp S V, 1 O S �l^ .A ve vt Occupancy groups: D
City /State /ZIP: i3 3./e_A.A -pcx t O j0 r\ On OOS Existing: 13
Phone: ( ) Fax: ( ) New: 13,
. ® APPLICANT • ® CONTACT' PERSON ` .
NOTICE: .
Business name: NA;. I, d t( \ q ,n �y 09 e. G , All contractors and subcontractors are required to be
Contact name: ( �i { y ��T n ex
licensed with the Oregon Construction Contractors Board
f under ORS 701 and may be required to be licensed in the
Address: I CoS 0 S • W et'.tle land. , S utke. (.,:a t, jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP:
Tv c( el r d 0 (e_,: � i i 2 o3 apply:
Phone: (so 3 - i L. ` 4 - Q S S a Fax:: ( )
E -mail:
CONTRACTOR. .... • .
Business name: Y h fi�-SL, BUILDING PERMIT FEES* •
Address:
Y (Please refer to fee schedule)
City /State /ZIP: Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: ( ) Fax:( )
CCB Iic.: 14 LV 2 Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
�� fi I within 180 days after it has been accepted as complete.
Print name: r Date: 7, eO e l * Fee methodology set by Tri-County Building Industry
Service Board.
1: \Building \Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(11 /02 /COM/WEB) 1 , /) V
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Building Division
i Accessibility: Barrier Removal Improvement Plan
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REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty -five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) \X'hen possible, additional accessible elements such as storage and .
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
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I:ABuilding \ Permits \BUP -CO\9 PermitApp.doc 02/23/07