Permit BUILDING PERMIT
CITY OF TIGARD
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COMMUNITY DEVELOPMENT Permit #: BUP2010 -00109
Date Issued: 05/27/2010
T IGARL7. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101 BB00400
Jurisdiction: Tigard
Site address: 11959 SW GARDEN PL
Subdivision: Lot: 0
Project: Spec space
Project Description: TI.
Owner: FEES
WALTON CWOR PARK BC 8 LLC Description Date Amount
BY TTA/EPROPERTYTAX DEPT 325, PO BOX Permit Fee - Additions, Alterations, 05/27/2010 $66.83
4900 Demolition
PHONE: 12% State Surcharge - Building 05/27/2010 $8.02
Plan Review 05/27/2010 $43.44
Plan Review - Fire Life Safety 05/27/2010 $26.73
Contractor:
BORLAUG CONTRACTING INC
2061 NW ALOCLEK DR
HILLSBORO, OR 97124
PHONE: 503 - 533 -4464
FAX: 503 - 533 -9770
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $900
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $145.02
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No 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 -0100. You may obtain a cot or direct questions to OUNC by calling 503.246 or 1.800.332.2344
Issued By: ; •ermittee Signature: �� // ,/
Call •' 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 � A � � �, r� ' IOktl I I( r � l , ti l t) \ � ,-
1 Ci of 'T 20 DateB �� Permit No. / a t() — W f 1
,,,, i `' a 13125 SW Hall Blvd., Tigard, OR 97223 2 _
M Plan Review Ill M a
C Phone: 503.639.4171 Fax: 503.598.1960 P R1 Date/ : S l�� Other permit.
a J Inspection Line: 503.639.4175 .�y Q c `GI 1 Date Ready : y: ®Sec upplemental Pa 2 for lofo ation
,-.11,1'4';') l i D C o v15 Notified/Method. Srm
i � + , � Internet: www.tigard-or.gov 1 ► " � 1
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
FiAddition/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 51 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: // q51 w aarv� G/ / 7 /�LGG New dwelling area: square feet
City/State/ZIP: / R r oic 17 22-3 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 6a . m P/ Covered porch area: square feet
Cross street/directions to job site: 961 Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.:25/00,600.— 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.: gez, equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
/ . �� Valuation: $ RQ(, ae
mu Existing building area: 7/257 square feet
1:1/ 570, // 8 6r P G/,?-f
New building area: s a,, square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: /
Name: Type of construction: V— A/
Address: Occupancy groups: 8/5
City/State /ZIP: Existing: 310` h2 (
Phone: ( ) Fax: ( ) New:
a APPLICANT ❑ CONTACT PERSON NOTICE
Business name: /Qu G+ /717'4 6.171 �� All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: ,C /, /s/a cif
', / under ORS 701 and may be required to be licensed in the
Address: k G / A/14/ c -Je -I D,' /
s tc'- 902 jurisdiction in which work is being performed. If the
City/State /ZIP: /�� �rsio Ore? °/e. 9 7/ 2 it apply:
is exempt from licensing, the following reasons
PP Y:
Phone: (5-03) X31 /7 /4- 7 /6 . t, Fax: : ($?J ) .5-33 J 7 70
E -mail: olooriz & � /,Ci- % 7y► • n�%
J CONTRACTOR
Business name: 5 u.ne BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/State /ZIP:
FLS plan review fee (if applicable):
Phone: ( ) Fax: ( )
CCB lic.: / 1 7 3 yo 4/7 /// Total fees due upon application: / l-( 5< 0 ?-
Amount received: ( 1.-(5 — _,(J)—
Authorized signature:,� � This permit application expires if a permit is not obtained
� within 180 days after it has been accepted as complete.
n
Print name: 4 1 ao y, / Date: 5 --= 27 --/6 * Fee methodology set by Tri -County Building Industry
Service Board.
1:\Building\Petmits\BIJP -COM PermitApp.doc 10 /01/09 440- 4613T(11 /02/COM/WEB)
' PI
s ° Building Division
Over- The - Counter (OTC) Building Permit
T i c n ii D Check List
Description of Project: 1 I-
r GENERAL INFORMATION
Class of Work:* 1 Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* ii', ' First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: "" Total sq ft.: N: S:
Stories: ' Note: Combine total floor area for E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinlder: f`-Y Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ Cit , an
INSPECTIONS FEES DUE
r
Footing /foundation Firewall $ , a ■ Permit Fee
Post /beam structural Smoke detector $ # , State Surcharge
Shear wall Misc. inspection •431m.w.f. �'�.. Plan Review Fee
Masonry Approach /sidewalk d $ ,,7 FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ (4tZ- Total Fees Due
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I: \Building \Forms \OTC - BUP.doc 08/19/08