Permit V CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00166
T.I GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/17/2009
Parcel: 2S 101 AC00700
Jurisdiction: Tigard
Site address: 12700 SW 72ND AVE
Subdivision: BEVELAND NO. 2 Lot 13
Project: Pauley & Rogers
Project Description: TI - add lunchroom area
Owner: FEES
ROGERS, ROY R Description Date Amount
13690 SW TWELVE OAKS CT Permit Fee - COM 09/17/2009 $254.90
TIGARD, OR 97224 12% State Surcharge - Building 09/17/2009 $30.59
PHONE: Plan Review 09/17/2009 $165.69
Plan Review - Fire Life Safety 09/09/2009 $101.96
Contractor: Tig -Tual School CET - Non Residential 09/17/2009 $172.00
CENTREX CONSTRUCTION INC
8250 SW HUNZIKER RD
TIGARD, OR 97223
PHONE: 503 -684 -0443
FAX: 503- 620 -6692
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $30,000
Floor Areas:
Total Area: 344
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $725.14
Required: Required Items and Reports (Conditions)
Fire Sprinkler: 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. ATT • • `: • re, • • law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 4010 through OAR • 52-01 -1 1 6 1. You may obtai a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu = • By: / , Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an Inspection that bu= ness 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.
Bu Permit Application
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ommercial
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City of Tigard
ECEI VED R / y d/ 1 Permit No.: , I -� /4
13125 SW Hall Blvd. Ti 97223
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Phone: 503.639.4171 ard Fax: 503.598.191 E P 0 9 2009 Pl Daant Rev , ew
lip v other Permit:
i �, `It I - Inspection Line: 503.639.4175 Date Ready/By: / l ed/Method: ® See Page 2 for
• Internet: www.tigard- or.gov CITY OF TIGARD Noti fieed/Method: 77/4 " / Supplemental Information •
TYPE OF wltcl![ING DIVISION / / / ���
ilEQU ED 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
gik 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 El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: °
Job site address: I 1 700 S td 12 r ..d A vG New dwelling area: square feet a'
City /State /ZIP: T i y a' s- v ( (7g. C.1 -7 Z Z ) Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: pt R u yc 2- Covered porch area: square feet
Cross street/directions to job site: 7 2 H „( /.1c2/4 fie. 5 k Deck area: square feet
Gl (col, F ' w.. (c:> w o9 Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: r3 v . 1 u K a kJ 0. Z I Lot no.: L" Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Z 5 O f}� Op 00 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.
/� / I F / /� Valuation: $ 30 (00. C°°
, , Existing building area: 12...)b b s feet
��_i� _ .— � . • • 1 .. � .may 4 ' I ��__'
■ New building area: 1 3, 0 0 0 square feet
IX PROPERTY OWNER I ❑ TENANT Number of stories: Z ,
Name: IQe R d9 rr r g Type of construction: v 0
Address: 1 z 1 (9 O 51) i Z r c j jAh Occupancy groups:
City /State /ZIP: -r. 9 , O Z cr7 Z Z 3" Existing: OFF r•cG - 3
Phone: ( ) 503— b ZO— 2b32.- Fax: ( ) New:
(90F. c,e — l
14 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: e,,„ +, e e'vt S +_,_,,+,.,,,,, = ✓ti _ All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:
e 2 - t t..i c— 1. G u 1 t-r- tre under ORS 701 and may be required to be licensed in the
Address: $ 2-5 Q ¶ 1-.1 14 is E. ; &c r. 5'- jurisdiction in which work is being performed. If the
City /State /ZIP: r t' 9 e , ei Q Cf -q.. Z `z
applicant is exempt from licensing, the following reasons
apply:
Phone:( ) 573 /9g ei-UL(°l3 Fax::( ) SS0.- b20 - 6b2...
E -mail: 5TC 0 6e IA tr COv LeC if -1'oH, vl
CONTRACTOR
Business name: - .4we 4 , u 19 c 9 uG BUILDING PERMIT FEES*
Address: (Please refer to fee schedule —
Structural plan review fee (or deposit): 4 Z b T 1°,
City /State /ZIP: ll
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB tic.: b 3 5 Total fees due upon application:
5 Amount received: *A6 0 0
Authorized signature: �T This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 5.}r,,, c 1. s 4 , a Date: C - c(- Q 9' * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 2/23 /07 440- 4613T(I1 /02 /COM/WEB) ` '
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Building Division
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- 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.
4 (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): $
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I: \Building \Permits \BUP -COM PermitApp.doc 06/25/08