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Permit CITY OF TIGARD BUILDING PERMIT 1 COMMUNITY DEVELOPMENT Permit #: BUP2010 00240 T 1 G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/04/2010 Parcel: 2S101DA00104 Jurisdiction: Tigard Site address: 13333 SW 68TH PKWY, STE# 100 Subdivision: FARMERS INSURANCE Lot: 0 Project: ACS Project Description: Exterior diesel fuel tank for generator. Owner: FEES TRIANGLE POINTE LLC Description Date Amount 901 NE GLISAN ST #100 Permit Fee - Additions, Alterations, 11/04/2010 $210.59 PORTLAND, OR 97232 Demolition PHONE: 503- 297 -8791 12% State Surcharge - Building 11/04/2010 $25.27 Plan Review 11/04/2010 $136.88 Contractor: COCHRAN INC 7550 SW TECH CENTER DR. #220 TIGARD, OR 97223 PHONE: 503 - 234 -6564 FAX: 503 - 238 -2098 Specifics: Type of Use: COM Class of Work: ALT Dwelling Units: 0 Stories: 0 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $8,310 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $372.74 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a •,a 0 i e • or direct questions to OUNC by calling 503.246.6699 r 1.80 .332.2344. Issued By: Permittee Signature: 9.4175 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 �y i FOR OFFICE' USE ONLY City of Tigard ( "V Received I t /1 � . �� Permit No.: �' / lig �/ Date : ai �I — q 13125 SW Hall Blvd., Tigard, OR 97223 P lan Revi o . G Phone: 503.639.4171 Fax: 503.598.1960 4 2010 Date /B : 1 ' °SID© ( Other Permit: j v / I 0 —U ? T I G A R ll Inspection Line: 503.639.4175 \ Date Ready /By: ® See Page 2 for Internet: www.tigard or.gov F�iG P+� Notified/Method: / D / Supplemental Information TYPE OF WORIfl D1Nv 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 ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATIO N Total number of floors: Job site address: (? 33 3 5 ctrk-1^R G r-1 a-4 New dwelling area: square feet City/State/ZIP: — r,. 3 4 ,....4 Q . '"l 22-3 Garage /carport area: square feet Suite/bldg. /apt. no.: I Project name: K 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. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 1)<c.Se_ 4e ..c ,f- 4,-....,..1Li Valuation: $ ', . 00 Existing building area: square feet gL,.,..e., .r New building area: square feet ❑ PROPERTY OWNER I ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: (.o c .,\Nfe.,,,1\ \ , All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: �G under ORS 701 and may be required to be licensed in the Address: 1 s(-.. -- r e Ce_ f �r 4 224 jurisdiction in which work is being performed. If the City/ State/ZIP: ^T 0 °�7� -2, applicant is exempt from licensing, the following reasons ∎. c.& .r apply: Phone: ( S o 3 ) 2 3 4 - - - ( „ 5 - 4 . 4 F a x : : ( ) 2 ”- 2O E -mail: CONTRACTOR Business name: C c G 1/4),,,i - 4V k.N. G BUILDING PERMIT FEES* Address: S 4 - c—S c.,--‘7 s) V (Please refer [o fee schedule) Structural plan review fee (or deposit): City/State /ZIP: FLS plan review fee (if applicable): Phone: ( ) Fax: ( ) CCB lic.: � . 1 Li 2 Total fees due upon application: Amount received: Authorized signature: This permit application expires if a permit is not obtained ' ` ` within 180 days after it has been accepted as complete. Print name: �t ..A.. L�ll� V. c Date: W (3 (ld * Fee methodology set by Tri-County Building Industry Service Board. 1: \Building\Permits \BUP -COM PermitApp.doc 10 /01/09 440- 4613T(11/02 /COM/WEB) 71 e ° Building Division Over- The - Counter (OTC) Building Permit rlcniz° Check List Description of Project: T V E--C__ � GENERAL INFORMATION Class of Work:* WT Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* Cat 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: _ 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: Handicap access: Smoke detector: Protected corridors: Fire alarm: Parking spaces ( #): Notes: Total Valuation: $ 6 ' n INSPECTIONS 1 FEES DUE Footing/ foundation Firewall $ Z le). Permit Fee Post /beam structural Smoke detector $ '21 State Surcharge Shear wall Misc. inspection $ ("Y . Plan Review Fee Masonry Approach /sidewalk $ 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 $ A Other: $ j 7z...7 T 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. 1: \ Building \ Forms \OTC - BUP.doc 08/19/08