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Permit
CITY OF TIGARD BUILDING PERMIT 1111 °.: COMMUNITY DEVELOPMENT Permit#: BUP2009 -00103 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/04/2009 Parcel: 2S 101 AD02400 Jurisdiction: Tigard Site address: 12753 SW 68TH AVE Subdivision: WEST PORTLAND HEIGHTS Lot: 32 Project: George Fox University Project Description: TI Owner: FEES GEORGE FOX UNIVERSITY Description Date Amount ATTN: FINANCIAL AFFAIRS, 414 N MERIDIAN Permit Fee - COM 06/04/2009 $191.20 NEWBERG, OR 97132 12% State Surcharge - Building 06 /04/2009 $22.94 PHONE: Plan Review 06/04/2009 $124.28 Plan Review - Fire Life Safety 06/04/2009 $76.48 Contractor: BNK CONSTRUCTION INC 45 82ND DRIVE SUITE 53B GLADSTONE, OR 97027 PHONE: 503 - 557 -0866 FAX: 503 - 557 -1085 Specifics: Type of Use: COM 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: No Parapet: Fire Alarm: Protected Corridors: Yes Smoke Detectors: Manual Pull Stations: Accessible Parking: 0 This permit is i ur•rt rect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done ' 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. ENTION: Oregon law : • ire yo • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 01 -0010 through OAR • 2 - 001 - • . You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2 . lss ed By: ire‘i , / / Permittee Signature: / / //�L Call 503.639.4175 by 7:00 a.m. for an inspection that bus ess 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 FO12 OFFICE IISE ONI.Y City of Tigard ee a 67 �/ Permit No.: , 7..00/0 IN f7 q 13125 SW Hall Blvd., Tigard, OR 97223�� fi�"'v tt,,'' 0 4 2009 Date/B Plan Revie - $'?!,, ' © `� Phone: 503.639.4171 Fax: 503.5 Date/B : , /� Other Permit: r 1 i; ,- is 1l Inspection Line: 503.639.4175 TIGARD Date Rea ® See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: lail 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 j1 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 lia 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: 1 Z 75 5 w 6 8 f A fif New dwelling area: square feet City /State /ZIP: r- 5 t;f 0 /L Garage /carport area: square feet Suite/bldg. /apt. no.: I Project name: PC c A ' 4. nom I Covered porch area: square feet Cross street/directions to job site: //4 i „., �„., 1 7 2. d Deck area: square feet Other structure area: square feet REQUHtED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I 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.: ZS - / • / 4 p - L (foV equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. /J • Al / w t/- r Valuation: $ Z O c2 1e. .. 0 d!/I /to [ A /00 -. Ge H ^ ill ; - ? OO l -11 v J c a 4 _ ' ��, / � _ / /, , , 4 46-,) Existing building area: square feet 1 � .147 g ,-; II s e C ` A K o S New building area: square feet lia PROPERTY OWNER I J ❑ TENANT Number of stories: . Name: (7 .e o r y, PDX U y rS % �C'/ Type of construction: Address: ( Lf /V. AL.Qr ielf a C Occupancy groups: City /State /ZIP: /V e,.✓b.e O/c ci 7472. Existing: Phone:,;) ,r8C/ 2.o /5/ Fax: L.51i )55-r/ 2.470q New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: ('-e o r .,2 ( i V. k L} o All contractors and subcontractors are required to be Contact name: o SG h 0 -� licensed with the Oregon Construction Contractors Board �'1 under ORS 701 and may be required to be licensed in the Address: C f /Y /V 141-P.; 10.4 (771- jurisdiction in which work is being performed. If the City/State /ZIP: Al 6,. 04 q 7i3Z applicant is exempt from licensing, the following reasons J apply: Phone: (S"03 f 5 / o )/I / Fax: Ale. .S - 9 Zoo 9 E -mail: as 6 2 .. Itto 1".... ajeo y•e A .X ��H CONTRACTOR Business name: 6 . k C opt .0 ' ,,,/,1,, 4 c • 1 BUILDING PERMIT FEES* Address: z . _ •••• r `4 82.I Or J d ' 1 Q (Please refer to ter schedule) City /State /ZIP: _ G/j el ieR c> e "7o i� - Z 7 s � J Structural plan review fee (or deposit): Phone: (5 sf 7 0 8 ,j6 C ( S)3 / S,S7 /00S' FLS plan review fee (if applicable): Fax: CCB lic.: 01 0 7.5 Total fees due upon application: r Amount received: Authorized signature: This permit application expires if a permit is not obtained ,Z,,r3C__040 within 180 days after it has been accepted as complete. Print name: 06 ..t 5c4 m ii e r' I Date: 6- L 0 1 * Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\BUP -COM PermitApp.doc 2 /23/07 440-4613T( 1 1 /02/COM/WEB) 4 III e Building Division Accessibility: Barrier Removal Improvement Plan TIGA \RD 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] $ MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 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 $ (b) An accessible entrance: $ • (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains: and, $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL (shall equal line [2] of Valuation Computation): $ I: \Building \Permits \BUP -COM PermitApp.doc 06/25/08 • • III m a Building Division Over- The - Counter (OTC) Building Permit T l c n lz ° Check List Description of Project: Ti • ' GENERAL INFORMATION Class of Work:* ft-1-- Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* . First floor: N: _ S: Type of Construction: j(j Second floor: E: W: Occupancy Group: 9 Third floor: Openings Protected Y /N ?: Occupancy Load: Total sq ft.: N: S: Stories: 7-- 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: �`'CJ Handicap access: Smoke detector: Protected corridors: • S Fire alarm: Parking spaces ( #): Notes: Total Valuation: $ c INSPECTIONS FEES DUE Footing /foundation Firewall $ 9 1,� Permit Fee Post /beam structural Smoke detector $ c l t State Surcharge Shear wall Misc. inspection $ ( 2 , y Plan Review Fee Masonry Approach /sidewalk $ 7 , ' i , 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: $ itA 4-4 .ei'OTotal 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 7 - new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. . I: \Building \Forms \OTC - BUP.doc 08/19/08