Permit CITY OF TIGARD BUILDING PERMIT
I I COMMUNITY DEVELOPMENT Permit #: BUP2011 -00050
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/08/2011
Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 100
Project: Amedisys Subdivision: Lot: 0
Project Description: TI
Contractor: BARTEL CONTRACTING INC Owner: G &S FC LLC
PO BOX 160 516 SE MORRISON #100
GLADSTONE, OR 97027 PORTLAND, OR 97214
PHONE: 503 - 650 -4084 PHONE:
FAX: 503 - 650 -4104
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 03/08/2011 $160.00
Class of Work: ALT DC Provision Review, COM TI - LRP 03/08/2011 $24.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 03/08/2011 $1,023.12
Stories: 0 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 03/08/2011 $122.77
Value: $88,900 Plan Review 03/08/2011 $665.03
Plan Review - Fire Life Safety 03/08/2011 $409.25
Info Process /Archiving - Lg Sheet (over 03/08/2011 $12.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,416.17
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This - - rmit is issued sup'= to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
b- done in accordance with - _ •roved r . This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
• - ys. ATTENTION: Oregon law r- ires • to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
=52- 001 -0010 through OAR 952 -01 1090. Yo mar obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I sued By: Permittee Signature: /
di AL
Call 503.639.4175 by 7:00 a.m. for the next available inspection 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
Commercial RECEIVED FOR OFF'IUF. USE ONIX
w L
City of Tigard { 1 R ece r7Gft m Permit No.: ka p� // 6 ^ p
ived ( ter
- - l l Date /B :
I l 13125 SW Hall Blvd., Tigard, OR 97223 Plan Plan R Review' �f�
Phone: 503.718.2 Fax: 503.598.19 , Other Permit:
.�+� TIGARD !y
T 1 G A R D Inspection Line: 503.639.4175 CI l F Date Ready : • . Juris: I3 See Page 2 for
Internet: www.tigard- or.gov DIVISION Notified/Method: Supplemental Information
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
t zt Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
�r, Valuation: $
❑ 1- and 2- family dwelling ,Ii Commercial/industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I(p083 5w UPpEl2 -• e)ODNES 242.)4 oj O New dwelling area: square feet
City /State /ZIP: 11 b r 2_41) O. 91 2-2-4 Garage /carport area: square feet
Suite/bldg. /apt. no.: 100 Project name: tAW1EL) f S•1S T I , 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: W e l ) ID v \ 1 . 2 _ 4- 8 4 1 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.
Valuation: $ 9 CO
�levJ 14I'h -1T I m e- ma' T IN ►fi'l ECl5T7r. E6 t
orn.L..E S�tL.• NO @CTS -tole - V.) 012-16-- Existing buildin area: 1(. square feet
t
New building area: 5eu square feet
PROPERTY OWNER ❑ TENANT Number of stories: 3
Name: p l y 1..."0-41) t vELOp mENT Type of construction: 11 - B
Address: IL 3 51■.i U wee_ 2,comes F2ui V...0A *lib Occupancy groups: 13, z 3 • I
City /State /ZIP:"n(iyl.-Dt O an 2-2-4 Existing: IS 5, t
Phone: ( (p 39 • O l 06 Fax: ( 5z) 4031 - 67O°f New: F3 i. S •
V• APPLICANT ❑ CONTACT PERSON NOTICE
Business name: LRt5 rtg- C21 - 1 TAM All contractors and subcontractors are required to be
Contact name: 3)11 L-1 E iViajDNIN PY I f licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 'nib Nw Dy t 45 S &DO jurisdiction in which work is being performed. If the
City /State/ZIP: '{�f2- -TL i O a_ 97 � applicant is exempt from licensing, the following reasons
apply:
Phone: (5(5)2.-2-1 .1 [Z) Fax: : (503) ZZI • 'Urn
E -mail: dw1 c t Ovir'iJ,l'ifxZ IVs afz-4- ■ f>!(-f S. cur
CONTRACTOR
Business name: enza L cc - tTe,um X6 , 1 Ni BUILDING PERMIT FEES*
Address: p O 2,0X I l0 0 (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State/ZIP: et L-t ka rpm e, O Q-- c1-J0 2-7
FLS plan review fee (if applicable):
Phone: (So5) (0 50 • `t v'-i- Fax: (03) (5550 • 4 1-11)4
CCB lic.: �ncl'i O Total fees due upon application:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
YyILC Date: I within 180 days after it has been accepted as complete.
Print name: ( * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 09/09/10 440- 4613T(11 /02/COM/WEB)
• •
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
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: $
(1) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
•
I: \Building \Pemrits \BUP -COM PermitApp.doc 06/25/08
111 _ " Building Division
Development Code Provision Review
T 1 G A R D Commercial Projects - No Associated Land Use Case
Building Permit No! ) // - DOO 5
g erm Expedited Review
Plan Submittal Date: /
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 if approved.
Planning Review (contact JOT Rove( at 503- 718 - )-Yl`c or I' din 0 @tigard- or.gov)
Zoning 3 —P Permitted Use Yes X No ❑
❑ Land Use Required: Yes ❑ No 1$ (explain below)
Notes: Dti C..t. v S., a Ito wed use. ,Oti- I E'. El6.1
4 Approved ❑ Not Approved Date: AteX D! oO 1(
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN