Permit t CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit #: BUP2010 -00269
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2010
TIGARD Parcel: 2S102AC00800
Jurisdiction: Tigard
Site address: 12555 SW MAIN ST
Project: MyConnect LLC Subdivision: Lot: 0
Project Description: TI - adding wall.
Contractor: MASTERPIECE CONSTRUCTION INC Owner: HEUVELHORST, MICHAEL J
13849 SW MISTLETOE DR C/O KADEY, GEORGE S JR
TIGARD, OR 97224 12551 SW MAIN ST
TIGARD, OR 97223
PHONE: 503 - 750 -5549 PHONE:
FAX: 503 - 524 -4371
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/14/2010 $53.27
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/14/2010 $6.39
Stories: 1 Height: 0 ft Plan Review 12/14/2010 $34.63
Bedrooms: 0 Bathrooms: 0
Value: $500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $94.29
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. AP TION: Ore" • law requi -s •u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0* -0010 through OAR 95 '01 -• *90. • ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: !� Permittee Signature:
CaII 503.639.4175 by 7:00 a.m. for the next available inspection • : te.
This permit card shall be kept in a conspicuous place on the job site until co letion of t ' • roject.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial \ FOR OFFICE USE ONLY
City of Tigard , �j �� eiv �
1,
Re e a � � % Permit No.: M 00/00 -0 „A
a 13125 SW Hall Blvd., Tigard, OR 97.:3 1 cEIl tl Plan Review
C Phone: 503.639.4171 Fax: 503.598. ' .1 Date/B : Other Permit:
I I C. A R D Inspection Line: 503.639.4175 4 �} {� Date Ready/By: Juris: 0 See Page 2 for
. Internet: www.tigard-orgov DEC 14 �.0 1 S(� V Notified/Method: Supplemental Information
TYPE OF : 0 ' , IDIVISIO� fees* REQUIRED'DATA: 1- AND 2- FAMILY DWELLING
tbDI► G P ermit ees are based on the value of performed.
e vaue o the work
El New construction emo tdon p
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
CI 1- and 2- family dwelling ®•ommercial /industrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
111 Master builder 111 Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11,C c G J ) 4 „,,„ 4{- New dwelling area: square feet
City /State /ZIP: ` k L --1w2- a C p 1111 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ` •-^ Covered porch area: square feet
Cross street/directions to job site: k. ,.\ -- Q ' Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this application.
C LAO S., ft CO ns..LIv. c .1 V n Valuation: S 5 Q Q
Existing building area: square feet
New building area: square feet
❑ p PROPERTY OWNER I L - 1ENANT Number of stories:
Name: ('j 0 r`t S Type of construction: ^ c k aSj
Address: 1/555 S,., K h: n S c Occupancy groups:
City /State /ZIP: - .6. 02, cti1V -1 Existing:
Phone: ( 503) L%Ij1_ 0(565 Fax: ( ) New:
'APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: ( ft a , . All contractors and subcontractors are required to be
Contact name: �� licensed with the Oregon Construction Contractors Board
t — JAS under ORS 701 and may be required to be licensed in the
Address: 1215 5.J (A • >, S .1 jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
f � b R p l,ZZ y apply:
Phone: (105) LA Z,t 4,5-65 Fax:: ( )
E -mail:
CONTRACTOR
Business name: V\l.(5 ‘ tr P, Q tE C Un 5k .V : 0 ,A 1 w- k- BUILDING PERMIT FEES*
Address: ( e C "g t i \ S Y i 5- t' a Ave W ■ r ■ (Please refer to fee schedule)
City /State /ZIP: �y Structural plan review fee (or deposit):
Pc_� 0 4 I
Phone: (4, "] S5' l.{ e Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: G C\ Q 10 1 l , t Total fees due upon application.
r Amount received: q ' (, P. Y
Authorized signature: T his permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 1l `c k/ 0 A t� �: v Date: (A.--( 3-.i 0 * 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) /
•
I
'' Building Division
Accessibility: Barrier Removal Improvement Plan
TIGAR 11
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): $
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