Permit Tifi CITY OF TIGARD BUILDING PERMIT
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COMMUNITY DEVELOPMENT Permit #: BUP2009 -00124
-5 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/08/2009
T i G AR D; Parcel: 1S134BC00300
Jurisdiction: Tigard
Site address: 12264 SW SCHOLLS FERRY RD
Subdivision: Lot: 0
Project: Spec space
Project Description: Demo interior walls.
Owner: FEES
FW OR- GREENWAY TOWN CENTER LLC Description Date Amount
PO BOX 790830 Permit Fee - COM 07/08/2009 $105.40
SAN ANTONIO, TX 78279 12% State Surcharge - Building 07/08/2009 $12.65
PHONE: Plan Review 07/08/2009 $68.51
Plan Review - Fire Life Safety 07/08/2009 $42.16
Contractor:
PACIFIC CREST STRUCTURES INC
17750 SW UPPER BOONES FERRY RD SUITE
190
PHONE: 503 - 968 -8949
FAX: 503 - 598 -6658
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $7,765
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $228.72
Required: Required Items and Reports (Conditions)
Fire Sprinkler Yes Parapet:
Fire Alarm: Protected Corridors: No
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 thr• • • h OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503 46.6699 or 1.800.332.2344.
Issued By* 'l • , , I 1 I , , Perm ittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application 4 , ; I } ` { { -`s/ w✓ "'?.YI OI. ( }:1a5 )i\ , r •! ,$'-
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City of 'Tigard Received
Date/B : UZIEL)00 ` - 1 `te Z-
13125 SW Hall Blvd., Tigard, OR 97223 • �5 Pl Review ��
Phone: 503.639.4171 Fax: 503.598.1960 ' '11 ° z � G' D ate/g : /e. Juris
��7�j�� Other Permit:
Line: 503.639.4175 !! � `li1l *�"
Inspection ., ��, �, � Date Re: � : 0 See Attached Checldist for
Internet: www.ci.tigard.or.us C1 . '^ i - • - • Notified/Method: Supplemental Information
BUILDING DIVISIO
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ArDemolition 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.
El 1- and 2 -family dwelling �mmercial/industrial
Valuation: $
ID 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: 17,:z..4,4 G am) 5c,}i�� 1" ' p New dwelling area: square feet
City/State/ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: S G ,q,,� r ' 0G,...., Covered porch area: square feet
Cross street/directions to job site: 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.
�e l �l."- -roL•c> 2 1�4. -LZ.S Ulm GRZ Valuation: 7 .7 $
5y/57 l NU t `t A../C, 6 4 - % Existing building area: square feet
New building area: — square feet
pg7PROPERTY OWNER ❑ TENANT Number of stories: '
r Name: Z.>L) 6„e,,,, Type of construction: ig _4
Address: 5 I'S a .a,..J ✓i' ' ere 043-g Occupancy groups:
City/State/ZIP: L,,A.,,LE PJ �cJ'e-6-,0 czm., 9 7c 3 S' Existing:
Phone: (s'4 ) (pa's — 14 0 Fax: ( )
New:
A APPLICANT ❑ CONTACT PERSON NOTICE
Business name: f�,4,,, pa ` � - r �1�U a 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 0�c..... iz r - u �� S •
BUILDING PERMIT FEES
Address: J - `7'5CO 4) (�i PPER ,rwIi5 _l - r ft 2 '*19 0
Please refer to fee schedule
City/State/ZIP: R 4.,,a,,, e 4 3 - 7 7.--7.
9 Fax: ( j ) 5 ��� �� r � Fees due upon application
Phone: (5'1 )
(� ` �� � 9 3 �/ — � C� s Amount received "1-x(3 . 'la
CCB lic.: (9� 5 e S-- lol�j
Date received:
Authorized signature: /�L ` - of T s permit application expires if a permit is not obtained
•
'/ / within 180 days after it has been accepted as complete.
Print name: C—:, f 14 1 s e- I -- Date: 7/e C79 • Fee methodology set by Tri- County Building Industry
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CITY OF TIGARD 0 -,� -C:
Scamp's Pet Store Demolition .. Approved..,.. o 1 .
12264 SW Scholls Ferry Road ; See d as": Foitow 1
Tigard, OR 97223 . ,.:;y, ` ..a.
Rated Caddo: L��R; %' Code .writ
' Br � "'., �rw'rm
Accessibility .d..
OFFICE COPY