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Permit a CITY OF TIGARD BUILDING PERMIT IL r 1. 13 COMMUNITY DEVELOPMENT Permit #: BUP2010 00199 :TI G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/25/2010 Parcel: 1S136AD04000 Jurisdiction: Tigard Site address: 11527 SW PACIFIC HWY Subdivision: Lot: 0 Project: Spec Space Project Description: Demo interior walls and restrooms. Owner: FEES PACIFIC TERRACE COMMERCIAL LLC Description Date Amount CIO NORRIS & STEVENS, 621 SW MORRISON Permit Fee - Additions, Alterations, 08/25/2010 $286.64 SUITE 800 Demolition PHONE: 503 - 223 -3171 12% State Surcharge - Building 08/25/2010 $34.40 Plan Review 08/25/2010 $186.32 Plan Review - Fire Life Safety 08/25/2010 $114.66 Contractor: ROBERT TODD CONSTRUCTION INC 4080 SE INTERNATIONAL WAY 8113 MILWAUKIE, OR 97222 PHONE: 503 - 653 -5704 FAX: 503 - 653 -5729 • Specifics: Type of Use: COM Class of Work: ALT Dwelling Units: 0 Stories: 1 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $14,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $622.02 Required: Required Items and Reports (Conditions) Fire Sprinkler: No Parapet: Fire Alarm: No Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 0 This permit' - - ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be d• • - in accordance with a • • oved plans. This permit will expire if work is not started within 180 days of issuance, • work is suspended for more the 180 d - s. ATTENTION: Oregon law re• ires • to follow the rules adopted by the Oregon Utility Notification Center. Th . - • les are set fort in OAR • 2- 001 -0010 through OAR 952 -00 : 00. • - may obtain a copy of the rules or direct questions to OUNC by callin• : lc %' •,•9• • 1):0• 332.23- - ssued By: 0 // 0 - / - Permittee Signature: - 1 l 1 i 11111 ,.1 Call 503.639.4175 by 7:00 a.m. for an inspection that busine 1 ' f f//' This permit card shall be kept in a conspicuous place on the job site until comp.. ' � � . n of th ' proj t. Approved plans are required on the job site at the time of each inspection. Li, Building Permit Application Commercial e �\ Received FOR Ohf ICE USC ONLI � ; City of Tigard + , .• Date/B : A /0 Permit No.: 6 _ - 13125 SW Hall Blvd., Tigard, OR 9�7 � ,,,' O Q , Plan Review �i7 / - Phone: 503.639.4171 Fax: 503,. 9 f'1, " � < 1, Date /B : �.'�IJ � ether Permit: st*`IGAy ?.r( RD V ,• Inspection Line: 503.639.4175 : • t�.`J s � Date Ready /By: Luis: El See Page 2 for Ula�.,r = T Notified/Method: Supplemental Information •*a Internet: www.tigard- or.gov \ c,.. „\ a,;�� - TYPE OF WO REQUIRED DATA: 1 AND 2 FAMILY DWELLING ❑ New construction ❑ Desetl ton Permit fees* are based on the value of the work performed. � Indicate the value (rounded to the nearest dollar) of all X Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the 'CATEGORY OF CONSTRUCTION work indicated on this application. ❑ I- and 2- family dwelling Commercial /industrial Valuation: S ❑ Accessory building ❑ Multi- family Number of bedrooms: E1 Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 l 5 �7 nit i fc. MAN New dwelling area: square feet City!State /ZIP: .i-1f. / p D ©2- Garage /carport area: square feet Suite/bldg. /apt. no.: � •-.—, Project name: S PU LTI 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 (routded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: S 1 (XJD nr• Existing building area square feet New building area: square feet PROPERTY OWNER - • ❑ TENANT Number of stories: Name: %O IWIZ424 S + Type of construction: Address: / _2 i U I M ` ^ o 1 . e/y) . Occupancy groups: City/State/ZIP: . / ayA F��. X1 7405 eri l Existing: Phone: (=�-' 2. 2 , . -5(1 f 1 Fax: 9 2g _ New: X APPLICANT ❑ . CONTACT PERSON • NOTICE Business name: e7Rq 'Rosj i 1_ All contractors and subcontractors are required to be Contact name: 1 go j Lt -', V licensed with the Oregon Construction Contractors Board go under ORS 701 and may be required to be Icensed in the Address: &? ON. .:( I jurisdiction in which work is being performed. If the City/State/ZIP: ,cY� applicant is exempt from licensing, the following reasons ��J.t6.‘1) f apply: Phone: ( 60 3 2 . 9-74.1-7 Fax:: (C= 2:Z.15,''67Z1 E -mail: . CONTRACTOR Business name: j219, z T --'ezic epj`s Jerk) J BUILDING PERMIT FEES* Address: `mow !.E_ 10 - io fjiIw/ 3_113 view erejerrde posit dale : `-''' �� q 'zi� Structural plan review fee (or d eposit): City/State/ZIP: L� r Phone:1� 0c3,��O Fax:52 FLS plan review fee (if applicable): 3)�0 i 2 . .572e, CCB lie.: 146,17- Total fees due upon application: Amount received: Authorized signature: This permit application expires if a permit is not obtained w ithin 180 days after it has been accepted as complete. Print name: ) v /�s��f _ Date: Z ti D * Fee methodology set by Tri- County Building Industry 1�`�4v Service Board. 1: \Building \Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(11/0 OM /WEB) I ° Building Division Over- The - Counter (OTC) Building Permit T i c n �i o- '; Check List Description of Project: T1 GENERAL INFORMATION Class of Work:* k Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* C k 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: l 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 Tl'EMS Fire sprinkler: 00 Handicap access: Smoke detector: Protected corridors: Fire alarm: Oe5 Parking spaces ( #): • Notes: Total Valuation: $ (4 1O INSPECTIONS FEES DUE Footing /foundation Firewall $ _y . Permit Fee Post /beam structural Smoke detector $ -' • 416 . State Surcharge Shear wall Misc. inspection $ 8 • to Plan Review Fee Masonry ' Approach /sidewalk $ . . 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: • $ (pu . 02, 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