Permit � A
*t zw :41 tIt: BUILDING PERMIT
i$ v CITY OF TIGARD
` a COMMUNITY DEVELOPMENT Permit #: BUP2009 -00194
Date Issued: 10/28/2009
7EGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102BD03200
Jurisdiction: Tigard
Site address: 13075 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Denture Design
Project Description: Interior TI.
Owner: FEES
SANCHEZ, J GUADALUPE & Description Date Amount
ZAVALA, BLANCA E, 13075 SW PACIFIC HWY Plan Review 10/23/2009 $54.46
TIGARD, OR 97223 Permit Fee - Additions, Alterations, 10/28/2009 $70.22
PHONE: Demolition
12% State Surcharge - Building 10/28/2009 $8.43
Plan Review - Fire Life Safety 10/28/2009 $28.09
Contractor:
OWNER
PHONE:
FAX:
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $1,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $161.20
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 wit
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 thr ugh ?AR 952- 001 -0100. You m- obtai a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ( \ ' t Permittee Signature:
CaII 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
7
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.i City of Tigard Dat /B : Pe rmit No.:
° 13125 SW Hall Blvd., Tigard, OR 97223 OCT 2 3 2009 'i G � 14U
g Plan Review �> ,
' 0 ����� Ot Pe
i; Phone: 503.639.4171 Fax: 503.598.1960 _ DateB : 1, //ii
y Ins ection Line: 503.639.4175 CITY OF TIGARD Date Ready/By j ® See Page 2 for
1 i t ,y�it l� p
.. Internet: www.tigard- or.gov BUILDING DIVISIO ' NotifiedlMethod 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: 03 p7 J — XIV ? c / N
c New dwelling area: square feet
City /State /ZIP: T 4 / D,� 72 23 Garage /carport area: square feet
Suite/bldg. /apt. no.: 00 Project name: Covered porch area: square feet
Cross street/directions to job site: 7.0EAfragE' 1Z. ES /G/V 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.
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.
3/ 11/ 4 ezae4 . k Grt, Valuation: / 9b O $
Existing building area: i� feet
New building area: square feet
. ❑ PROPERTY OWNER ® TENANT Number of stories:
Name: G /fA 3 O/2 44 4, Ai D Type of construction: Into - M. F ` a
Address: / r L 2 96 Ik/ Tea" xvd Occupancy groups:
City /State /ZIP: s wri 7.7 0x 970 0? Existing:
Phone: ( 54. ( ) -76/ - ,S-`f Fax: ( )
New:
❑ APPLICANT CONTACT PERSON ' NOTICE. ,
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) Fax::( )
E -mail:
CONTRACTOR
Business name: BUILDING PERMIT FEES*
Address: (Please refer to fee schedule
Structural plan review fee (or deposit):
City /State /ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received: 5L4 , l l[J
Authorized signature: i lo ,C.--/- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: C. 8 0,2 404/7, Date:
_ Fee methodology set by Tri- County Building Industry
Service Board. 9 9 �7
I:\Building\Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02 /COM/WEB) 9 -7 9 • 2-
• •
IN
Building Division
Accessibility: Barrier Removal Improvement Plan
TslGAR
-
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) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building \Permits \BUP -COM PermitApp.doc 06 /25/08