Permit CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit #: BUP2010 -00153
T / G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2010
Parcel: 2S112DB00200
Jurisdiction: TIGARD
Site address: 15255 SW 72ND AVE
Subdivision: FANNO CREEK ACRE TRACTS Lot: 45
Project: Pittman & Brooks
Project Description: Second floor addition and new elevator at main entrance.
Owner: FEES
BROOKS & PITTMAN RENTALS Description Date Amount
15255 SW 72ND AVE Permit Fee - COM - New Construction 10/07/2010 $1,482.92
PORTLAND, OR 97224 12% State Surcharge - Building 10/07/2010 $177.95
PHONE: Plan Review 10/07/2010 $963.90
Plan Review - Fire Life Safety 10/07/2010 $593.17
Contractor: Park - Commercial and Industrial 10/07/2010 $1,069.00
OBRIEN CONSTRUCTORS LLC CDC Building Review, COM 10/07/2010 $128.00
8037 SW 17TH AVE CDC Planning Review, COM 10/07/2010 $128.00
PORTLAND, OR 97219 CDC Planning Review, COM - LRP 10/07/2010 $38.00
Erosion Control 10/07/2010 $88.00
PHONE: 503 - 241 -2875 Erosion Plan Review CWS 10/07/2010 $28.60
FAX: 503 - 274 -9691 Erosion Plan Review COT 10/07/2010 $28.60
Specifics: Metro Const. Excise Tax - Commercial 10/07/2010 $300.00
Use
Type of Use: COM Tig -Tual School CET - Non Residential 10/07/2010 $664.50
Class of Work: ADD TDT - Transportation Development Tax 10/07/2010 $4,282.00
Dwelling Units: 0
Stories: 2 Height: 22 ft
Bedrooms: 0 Bathrooms: 0
Value: $250,000
Floor Areas:
Total Area: 1329
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $9,972.64
Required: Required Items and Reports (Conditions)
1 MST Bolts in Concrete
Fire Sprinkler: Yes Parapet: 2 BUP Ersn Cntrl 681 - 4444
Fire Alarm: No Protected Corridors: No 3 BUP Reinforced Concrete
Smoke Detectors: No Manual Pull Stations: No
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 do ' accordance • 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
d. • s. ATTENTION: Oregon .w re. ' - s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -00 0 through OAR 9 101 -0 0' ou may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344
Issued By: �� Permittee Signature: /
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 `5t. . DO
Commercial fi
DatDate/I3 F OR OFFICE USE ONLY
City of Tigard RECFJVED Received / Ot n�`�
r Permit No.: �m, vO. UQ4 S
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ► it
III G . Phone: 503.639.4171 Fax: 503.5 02 5 2010 Date/I3 : /�i�� !` WI
III
Other Permit:
T I G A R D Inspection Line: 503.639 Date ReadyBy: n fur s: S See Page 2 for
Internet: www.tigard or.gov CIS OF TIGARD Notifies , ethod: l �� Supplemental Information
++fi�tt!! 2MDION . / /
/
TYPp>`31 P
I '� ∎'ermt fees* are based on the value of the work performed.
ndicate the value (rounded to the nearest dollar) of all
❑ New construction ❑ Demolition ' equipment, materials, labor, overhead, and the profit for the
O
® Addition/alteration/replacement ❑ Other: work indicated on this application.
CATEGORY OF CONSTRUCTION Valuation: $
❑ 1- and 2- family dwelling
Commercial/industrial Number of bedrooms: O
❑ Multi -famil
❑ Accessory building Multi-family Number of bathrooms:
❑ Master builder ❑ Other: Total number of floors: O
JOB SITE INFORMATION AND LOCATION New dwelling area: square feet
Job site address: 1 . 56 644. 1 2 Wi•,b,„w Garage /carport area: square feet ■
City /State /ZIP: Tt bi A, p..T , 'ma (al 2,24 Covered porch area: square feet
Suite/bldg. /apt. no.: Project name: Fir MAN .. blunts) Au riot] Deck area: square feet
Cross street/directions to job site: Other structure area: square feet
NGtZti r7 OF TIZACk6 014 flr W S I 0e OP 7i REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Permit fees* are based on the value of the work performed.
Subdivision: I Lot no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
Tax map /parcel no.: 2! t 2.0 igb 2-00 work indicated on this application.
DESCRIPTION OF WORK • . Valuation: $ 260, Op Q •
1(.09 4.V 'SF.t!OliD L.01)12- MA111014 i K Existing building area: 9, 44# square feet
i uoiptrop & MINH ENITI2Aile. • New building area I 1529 square feet C-
Number of stories: Z
® PROPERTY OWNER I Q TENANT Type of construction: y.. p>
Name: PItTN1AN 1- 13 1e,,(p Occupancy groups: L
P YF� s: P
Address: 5104E AS rim otTE Existing: e, ! t ,. \\
City /State /ZIP:
New: e,
Phone: (505) (p bet • 012.33 Fax: ( ) NOTICE
• ❑ APPLICANT 6 CONTACT PERSON All contractors and subcontractors are required to be
Business name: N 0L4 0,Kedge a 1 14(0• licensed with the Oregon Construction Contractors Board
/ under ORS 701 and may be required to be licensed in the
Contact name: ,)` M Akins L•10 jurisdiction in which work is being performed. If the
Address: frO • /30$ f S1 VI applicant is exempt from licensing, the following reasons
City /State /ZIP: 1, t►t?•17 d2. q1 logy I apply:
Phone: (502, (02O• 2,0g5 t I Fax: : ( 503 1054. »!4.
E-mail: %)al'17 i1r1 b 1`41LOU 13KAlMEF. 4pi at . G014
__CONTRACTOR
�J BUILDING PERMIT FEES*
Business name: nig (f /v CO /J 5MACTD e. 41. (Please refer to fee schedule)
Address: g0 3 7 a / 7 1 `,40 f Structural plan review fee (or deposit):
City /State /ZIP: /1/Z714 AJIIIi ,Jr 02 9 7, / S FLS plan review fee (if applicable):
Phone: (�/ 3 ) ;.// -A 75 Fax: (5p3) ,2 71 -y4 f'/ Total fees due upon application:
CCB lic.: f6 d6 Amount received: „...6,1"-----' „...6,1"-----' Authorized signal _ / — This permit application expires if a permit is not obtained
Print name: 1 M brjwW I Date: • Zy • 20 ID within 180 days after it has been accepted as complete.
I * Fee methodology set by Tri- County Building Industry
REQUIRED DATA: 1- AND 2- FAMILY DWELLING Service Board.
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