Permit at
CITY OF TIGARD
BUILDING PERMIT
; COMMUNITY DEVELOPMENT Permit #: BUP2010 -00182
..
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/10/2010
,..j 1 E� n; 9 Parcel: 2S101 BB01400
Jurisdiction: TIGARD
Site address: 12178 SW GARDEN PL, BLDG# 3
Subdivision: PARK 217 Lot: 0
Project: Colossae Church
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, 08/10/2010 $663.33
4900 Demolition
PHONE: 12% State Surcharge - Building 08/10/2010 $79.60
Plan Review 08/10/2010 $431.16
Contractor:
Plan Review - Fire Life Safety 08/10/2010 $265.33
COMMERCIAL CONTRACTORS INC
1265 SOUTH 35TH PLACE
RIDGEFIELD, WA 98642
PHONE: 503 - 227 -4440
FAX: 503 - 227 -6644
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $43,197
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,439.42
Required: Required Items and Reports (Conditions)
•
Fire Sprinkler: Yes Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503 46.6699 or 1.800.332.2344.
Issued By: , Permittee Signature: M1
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit A p p l i c a t i o n / 4 H b 00(o- ( " o 6 C
Commercial \� FOR OFFICE USE ONLY --
�,
City of Tigard and - • Received
Permit No.: �'
`J g .1. Date/B : iiinsi1�J1ip1� /lliu7
II q 13125 SW Hall Blvd., Tigard, OR 97 71 V Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 \ : G � Date/B : Other Permit:
T I G A RD Inspection Line: 503.639 J ` ' � ` � `S Date Ready/By: Juris• El See Page 2 for
Internet: www.tigard - or.gov G\ �� `G� Notified/Method: Supplemental Information
TYPE OF WORKQ$ 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.
Valuation: $
❑ 1- and 2- family dwelling Commercial/industrial —
❑ 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: , a j 7 g $ W 6- ro( e Place. New dwelling area: square feet
City/State/ZIP: . ea rr4 , O el (179.3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: COI O Ss 4 e 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: 1 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.
Oer, vlit 0/1 Of Non - 6 LI ctUrra ear Valuation: $ 1 13, / R 7 '
on —
Cal c U r.1 n Q f 1 s fru c(- (a. 1 f ( On c Existing building area: -//, i j g square feet
New building area: y iP® square feet
.f PROPERTY OWNER ❑ TENANT ry Number of stories:
Name: 14/ 1 f v C v ` P o A 8 G R t cD 6-V A K MA
AS er II AS Type of construction: V- 1V
Address: One, W Ct /um b r a 5+ 514 • i c j 50 Occupancy groups:
City/State /ZIP: P m 012 97a5S Existing: Pr-3
Phone: ('S03) 22/ - I 7 Fax: (6 " 2277 New:
136/ ' 3
APPLICANT j, ❑ CONTACT PERSON NOTICE
Business name: C ni p, r`ciG. ( L OY , I ," C i121,5 -I r , All contractors and subcontractors are required to be
Contact name: ' licensed with the Oregon Construction Contractors Board
�rl �r) L under ORS 701 and may be required to be licensed in the
Address: 19 �: 1 n jurisdiction in which work is being performed. If the
City/State /ZIP: J ( N G 1��,3 C/ apply ant is exempt from licensing, the following reasons
Phone: ( a)3) i9z-A'e
y tiv Fax:: ( 503 d, 7. C1 Y
E -mail: P r' ) tG CcI /C,
C NTRACTOR
Business name: CO M fir(I iti a � �� ! / S � BUILDING PERMIT FEES*
Address: , d ( `+° f t ' 5 3 6 iii_ p ia ci (Please refer to fee schedule)
L
City/ State/ZIP: Structural plan review fee (or deposit):
�
( 6 03) ;3 -/ / ( e � �� a l�l ( 50 3) � �Y � —
FLS plan review fee (if applicable):
Phone: Fax: /,j`, ! /
CCB lic.: j 37 g _ Total fees due upon application:
Amount received:
Authorized signature:
iidigi This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: �r! �r) t° Date: - 7,19, 0 * Fee methodology set by Tri-County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(11 /02/COM/WEB)