Permit CITY OF TIGARD BUILDING PERMIT
° COMMUNITY DEVELOPMENT Permit #: BUP2009 -00080
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2009
T I " � O g Parcel: 1 S136DD05300
Jurisdiction: TIGARD
Site address: 11850 SW 67TH AVE, STE# 110
Subdivision: TIGARD TRIANGLE COMMONS Lot: 13
Project: Grange Capitol
Project Description: TI
Owner: FEES
PNWP LLC #2 & Description Date Amount
PNWP LLC, 6600 SW 105TH AVE #175 Permit Fee - COM 05/14/2009 $191.20
BEAVERTON, OR 97008 Tax - 12% State Surcharge 05/14/2009 $22.94
PHONE: Plan Review 05/14/2009 $124.28
Plan Review - Fire Life Safety 05/14/2009 $76.48
Contractor:
NORWEST CONTRACTORS INC
PO BOX 25305
PORTLAND, OR 97298 -0305
PHONE: 503 - 291 -6986
FAX: 503- 291 -7036
Specifics:
Type of Use: MF
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $20,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $414.90
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 in acco an nth approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 0 days. ATTENTION: O r . . law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 - 001 -0010 through OAR • • - 011 • + s. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss ed By: � � / Permittee Signature: v L n
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
Commercial RECEIVED I O►R OI I ICI: UST: ONI_,
City of Tigard �1 14 2009 ReceiDate /B ved. fiY of Permit No.: ,, 1 , 960?..-000g0
• 13125 SW Hall Blvd., Tigard, OR 9722 w .
Phone: 503.639.4171 Fax: 503.598.1960 pate /B Plan Rev : ie / :c f m Other Permit:
r I c. n I: I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Read '• ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Wal 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
'a 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: t 1 6G, s , (f744„_ p . 2c ,,. (i p New dwelling area: square feet
City /State/ZIP: • G �� Garage/carport area: square feet
Suite/bldg. /apt. no.: t I Project name: 61„-.0.11,.. (o " J, `� ` n 1 �Q Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Co 741-- ? b +(,fit 'rn.a ts-÷tn Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHLrCIUAST
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.
Valuation: $ Z (7, ic=c_.
Existing building area: square feet
New building area: 23 'Li square feet
IF PROPERTY OWNER 1 ❑ TENANT Number of stories: 2
Name: Fa e¢ (- MA) (,•71.e-c,-E., Type of construction: . 5 Q
Address: ( pc' c.54_. �■-1 ( f .(I �°. - (7 r Occupancy groups: E !�
City/State/ZIP: Re...at/c. Existing:
Phone: ( ) Fax: ( ) New:
''APPLICANT )CONTACT PERSON NOTICE
Business name: (ekl 3-i c - &t 'azg r All contractors and subcontractors are required to be
Contact name: � J �,,� o �" licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: • -IM jurisdiction in which work is being performed. If the
City/ State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E -mail:
CONTRACTOR
Business name: N(ft r-w . G.- &.1,,,e,„_a < i.'t e't \ t- BUILDING PERMIT FEES*
Address: fps refer to fee sekethdtil
Structural plan review fee (or deposit):
City/State/ZIP:
Phone: ( ) FLS plan review fee (if applicable):
�� (. 4 a thc, I Fax ( )
CCB lic.: 4_ Total fees due upon application:
Amount received:
Authorized signature: I This permit application expires if a permit is not obtained
_it�� I L 4 ,__'.� within 180 days after it has been accepted as complete.
Print name: {, fi S L p _ Date: .1. ( 4 ; * Fee methodology set by Tri-County Building Industry
' " ( ^ Service Board.
1: \Building \Permits \BUP -COM PermitApp.doc 2/23 /07 440- 4613T(11 /02 /COM/WEB)
° Building Division
:1111
Accessibility: Barrier Removal Improvement Plan
TIGARD
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 ] $ Z 0 , cxx7
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ �oa0
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 $ t/
(b) An accessible entrance: $ t/
(c) An accessible route to the altered area: $ v
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ v
(e) Accessible telephones: $ c/
(f) Accessible drinking fountains: and, $ -.
(g) When possible, additional accessible elements such as storage and
alarms: $ (/
TOTAL (shall equal line [2] of Valuation Computation): $
v0.
1: \Building\Pennits\BUP -COM PermitApp.doc 10/30/07
■
o Building Division
Over-The-Counter (OTC) Building Permit
T l c n It Check List
Description of Project: l 1
GENERAL INFORMATION
Class of Work:* L Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* 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: — lj _ 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 sprinkler: CO' Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Y Parking spaces ( #):
Notes:
Total Valuation: $ 20
INSPECTIONS FEES DUE
Footing /foundation Firewall $ Permit Fee
Post /beam structural Smoke detector $ . State Surcharge
Shear wall Misc. inspection $ I21, 28 Plan Review Fee
Masonry Approach /sidewalk $ °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:
$ 414,90 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.
l: \Bwlding \Forms \OTC - BUP.doc 08/ 19/08