Permit N q CITY OF TIGARD BUILDING PERMIT
. o COMMUNITY DEVELOPMENT Permit #: BUP2010 00230
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/19/2010
Parcel: 2S101 BB01400
Jurisdiction: TIGARD
Site address: 12060 SW GARDEN PL, BLDG# 5
Subdivision: PARK 217 Lot: 0
Project: Expressions Printing
Project Description: TI
Owner: FEES
GVA KIDDER MATHEWS Description Date Amount
ONE COLUMBIA STREET SUITE 950 Permit Fee - Additions, Alterations, 10/19/2010 $210.59
PORTLAND, OR 97258 Demolition
PHONE: 503- 221 -9900 12% State Surcharge - Building 10/19/2010 $25.27
Plan Review 10/19/2010 $136.88
Plan Review - Fire Life Safety 10/19/2010 $84.24
Contractor:
COMMERCIAL CONTRACTORS INC
1265 SOUTH 35TH PLACE
RIDGEFIELD, WA 98642
PHONE: 503 - 227 -4440
FAX: 503 - 227 -6644
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $8,441
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $456.98
Reauired: 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 ' a eceoRtanee iv ith 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. ATTENTION: Oregon w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
2- 001 -0010 through OAR 9527 � 01 011 000. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.23
I ssued By: �" " o ,,,,4.1t, Permittee Signature: 4/
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 ApplicatioRECEIV ®
Commercial F012 OFFICE USE ONLY
City of Tigard OCT 19 2010 010 Date /B :. , /G / 9 /0 ' 4 /o9o/o-d o�
/ I Permit No.:
1 11 ° 13125 SW HaII Blvd., Tigard, OR 97223 Plan Revie p t f i in in Other Permit:
Internet: P . e
Phone: 503.639.4171 Fax: 503.59ZIQ�l OF TIGARD DateB : J,
Inspection Line: 503.639.4175 ard or Date Ready Juris: H See Page 2 for
TIGARD. BUILDING DIVISION Notified/Method: Supplemental Information
www. ig
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
Eg ❑ 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:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATIOON AND LOCATION Total number of floors:
Job site address: IZ()&O SV\I C of de✓I i ace- • New dwelling area: square feet
City/State /ZIP: '-Afi rd 1 Q g l) Z23 ._ . Garage /carport area: square feet
Suite/bldg. /apt. no.: l _S Project name: & ire` `p)nS 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 (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
r DESCRIPTION OF WORK work indicated on this application.
(�(`(1�! \A1 01 0 in OYl SirUCt,t rcO 1�1�i pvis Valuation: $ j s LL ( I
r ' (-Iv-F..1 c - h 0 ,., Of VA Oh Skru 11 ckui a. U i -1 Al O K S Existing building area: 2� �D square feet
New building area: (f Li Kosquare feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: '
Name: C V A ,, CtC3.PrMo( - eWS Type of construction: V—
Address: °VIC SYV C O ` � umlo (Str t Ru ire C ) Occupancy groups:
City/State /ZIP: por1tt//��/', t ay, Q i Existing: g
3 (�
Phone: ( )70 - lni� Fax: (raj) 1 ) 22 2ZT — / 7 New: g
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Commar i a 1 Co/tract i%1 . All contractors and subcontractors are required to be
Contact name: i (1�� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1' b5 C n ( tom- Ftq� jurisdiction in which work is being performed. If the
City/State /ZIP: 1 i ,\ �cy4\ (\ (!I 1 A 9S,(0/4-7_ applicant is exempt from licensing, the following reasons
Phone: ( ) 27/) -ISO Fax:: ( ) 227 VOW
E -mail: e r j t. 0 cci lc , Cow)
/'� CONTRACTOR
Business name: l O 1 Y �/� t YI' ,^/� 1(T c i 0 ( Co v-YQ ( I C. • . BUILDING PERMIT FEES*
Address: i7 b6 &601/ 39 Race (Please refer to fee schedule) .
/� p� Structural plan review fee (or deposit):
City/State/ZIP: j♦ ( ( d r W / I f�L-� Z
Phone: (55(3) 221 ,, • v Fax: ( ) Z2-7 (b(�L4 FLS plan review fee (if applicable):
CCB lic.: 123 Total fees due upon application:
Amount received:
Authorized signature :(jl .��� This permit a pplication expires if a permit is not obtained
"L within 180 days after it has been accepted as complete.
Print name: . I (, rm D Y l�C 9 Date: - 1 0 1 l� J't) * Fee methodology set by Tri-County Building Industry
v / Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 10 /01/09 440- 4613T(11 /02 /COM/WEB)
0 ° Building Division
Over- The - Counter (OTC) Building Permit
TIG AR° Check List
Description of Project: 1 (
GENERAL INFORMATION
Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction:7 Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stones: Note: Combine total floor area for E: E:
H _ 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: Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ Fyk-4-1
INSPECTIONS 1 FEES DUE
Footing /foundation Firewall $ Z 0 • 'S'? Permit Fee
Post /beam structural Smoke detector $ 2.5 Z State Surcharge
Shear wall Misc. inspection $ - v Plan Review Fee
Masonry Approach /sidewalk $ :�.T 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:
$ C cn 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