Permit CITY OF TIGARD BUILDING PERMIT
0 COMMUNITY DEVELOPMENT Permit #: BUP2011 -00039
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/17/2011
Parcel: 1 S135BC01100
Jurisdiction: Tigard
Site address: 11131 SW GREENBURG RD
Project: Jump Sky High Subdivision: Lot: 0
Project Description: TI - addition of ADA ramp to trampoline platforms.
Contractor: ROBINSON CONSTRUCTION Owner: ROBINSON FAMILY TRUST
21360 NW AMBERWOOD DR BY E LEE & EVELYN L ROBINSON TRS
HILLSBORO, OR 97124 -9321 PO BOX 91305
PORTLAND, OR 97291
PHONE: 503 - 645 -8531 PHONE:
FAX: 503 - 645 -5397
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 02/17/2011 $97.34
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 02/17/2011 $11.68
Stories: 1 Height: 0 ft Plan Review 02/17/2011 $63.27
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 02/17/2011 $38.94
Value: $1,800 Info Process /Archiving - Lg Sheet (over 02/17/2011 $2.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
•
Total $213.23
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
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 •• •': cregon la requires you to follow the rules adopted by the Oregon Utility Notification - - -r. Those rules are set forth in OAR
952 -00 #010 through OAR 95 001 00 • • You may obtain a copy of the rules or direct questions to OUNC by calling 503. .800.332.2344.
Is- ed By: /� �� L Permittee Signature: ,
Call 503.639.4175 by 7:00 a.m. for the next available ins section date.
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 V
Commercial , FOR OFFICE USE ONLY
` � Received / •
City of Tigard � �`�
IIIII � A DateB : /7 it _
C Permit No.: , �(/ D
° 13125 SW Hall Blvd., Tigard, OR 9.72,3 G,Q` Plan Review
Phone: 503.639.4171 Fax: 503.5Q :1960 eSl �C Date/B : M . / Other Permit:
TI G A R' D Inspection Line: 503.639.4175 Q � Date Ready /By: Juris: RI See Page 2 for
Internet: www.tigard - or.gov CS $\6 Notified/Method: Supplemental Information
V
TYPE'o 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
X Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
work indicated - F on this ,cation
' . � °� � � � CATEGORY .OF CONSTRUCTION - ` � ` � : ' PP
El 1 - and 2- family dwelling %Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
' ; ;JOB SITE INFORMATION;` AND= LOCATION, f / � ` Total number of floors:
Job site address: I 1 i 1 g , y New dwelling area: square feet
� f`C�
City /State /ZIP: V () ; '7 2.n � Y/�1 Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: ''',-C_di -I-h €L (2 Covered porch area: square feet
Cross street/directions to job site: V Deck area: square feet
k) " V o V 4 G1:4 6 ' 4K Other structure area: square feet
S W I , R DA COMMERCIAL-USE C ,
Subdivision: Lot no.: ) f ees* are based on the value of the work
II(� performed.
p
Tax map /parcel no.: ! 1 .3t �� Indicate the value (rounded to the nearest dollar) of all
1 equipment, materials, labor, overhead and profit for the
thg
DESCRIPTION,' OF WORK- w ork • indicated on th • appl '
I . I . . , A 4� 0 Valuation: $
„ ' 1 ; , �` Existing building area: 0 f � oil square feet
New building area: //) square feet
®' PROPERTY OWNER ' _ ' ~I TENANT
Name: 5) - Number of stories: ��
, �A� J d J J ( Type of construction: 1 i 16
Address: 1' s11 l 7 ) "\ Occupancy groups:
City/State/ZIP:—ti 4 7s rci 1 6 Z2 ° Existing: i�//1� n
Phone: ( ) Fax: ( ) New:
❑`C PERSON NOTICE
Business name: C f 1U ik ) r All contractors and subcontractors are required to be
Contact name: t� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: I ' ' - i -2 \ jurisdiction in which work is being performed. If the
t- ' 1 7 2 2-Li applicant is exempt from licensing, the following reasons
City /State /ZIP: D r •44, l
t� � aPP
Phone: ( ..,3 2 3 1 1 Z � Fax: :156. Z2 (P I1 1
E- mail: l e_OL. rf j s (U an i n. C . Lbr-‘
• ,''..,._ CONTRACTOR
7t i l c 7b y l L '
Business name: BUT FEES * _ - _,
Address: 2 ( t D ep n J A- v� L - BUILDING PERMIT:
,f (Please refer to fee schedule)
? 1 "v ' �-'N l �/
City /State /ZIP: 4 // S bArJ De el i r i � S Structural plan review fee (or deposit):
Phone: (563 ) li �5 _ 5� I , Fax: ( 5t 3 ) lL/ LtS— �35-1 FLS plan review fee (if applicable):
CCB lic.: 3 i 1--14 Total fees due upon application:
Authorized signature:
' / Amount received:
►/ � 6 ,`
//)4_ `�`� This permit application expires if a permit is not obtained
.�� D Ran. Ran. within days after it has been accepted as complete.
Print name: rd ► irli W' /. Date: * Fee methodology ology set by Tri- County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(I l /02/COM/WEB)
: .
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: Pc_.9
o ( (- o0o 5 / Expedited Review
Plan Submittal Date: cR /7 1/
To the Applicant:
If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only i ; approved. q�q�
Planning Review (contact W %,� at 503 -718- 1 l r Az t( @ tigard- or.gov)
K Z _ oning 14 or _ ' ermitted Use Yes X No ❑
P Land Use Required: Yes ❑ No' (explain below)
Notes:
A pproved ❑ Not Approved Date:
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date: -
if'
I:ACURPLN