Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2011 -00108
TIGARD 13125 SW Hatt Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/01/2011
Parcel: 2S113AB00500
Jurisdiction: TIGARD
Site address: 16083 SW UPPER BOONES FERRY RD 200
Project: State Farm Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37, F
Project Description: TI
Contractor: BARTEL CONTRACTING INC Owner: G &S FC LLC
PO BOX 160 16083 SW UPPER BOONES FERRY RD,
GLADSTONE, OR 97027 STE
TIGARD, OR 97224
PHONE: 503 - 650 -4084 PHONE:
FAX: 503 - 650 -4104
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 06/01/2011 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 06/01/2011 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 06/01/2011 $164.96
Stories: 3 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 06/01/2011 $19.80
Value: $5,089 Plan Review 06/01/2011 $107.22
Plan Review - Fire Life Safety 06/01/2011 $65.98
Info Process /Archiving - Lg Sheet (over 06/01/2011 $2.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0 •
Garage: 0
Mezzanine: 0
Total $432.96
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/
Issued By: // -. Permittee Signature: ' r / , j j
503.639.4175 by 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
:i., ECE:N,E7:,;.,_, FOR OFFICE USE ONLY
III City of Tigard Received ( / / permit No.' 1
- „ 13125 SW Hall Blvd Ti OR 972 0 Plan Review °� ' l, r ~� �,
Phone: 503.718.2439 Fax: 503.598.0 Date R : �- �� Other Permit.
T I G A R D Inspection Line: 503.639.4175 T Y O F A Date Ready i RI See Page 2 for
Internet: www.tigard or.gov BLDING IN Notified/Method: my Supplemental Information
' ' , TYPE OF "RK REQUIRED DATA 1 AND FAMI LY DWELLING.
❑ New construction De Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
O Addition/alteration /replacement Ot equipment, materials, labor, overhead, and the profit for the
' ''` CATEGOR OF. CTRUC „ ; , work indicated on this application
.� r. . � b,aa xx /� '• _. z -. ,.. .Po ,,. _,mot, ,f.. « ✓ >a.;�.. .F o- k. <..
❑ 1- and 2- family dwelling ® Commercial /industrial
Valuation:
❑ Accessory building 12 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE. INFORMATION AND LOCATION
Total number of floors:
Job site address: 16083 SW Upper Boones Ferry Road New dwelling area: square feet
City /State /ZIP: Tigard, Oregon 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 200 Project name: State Farm Office Expansion Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
- xr
;REQUIRED DATA:h"COMMERCIAL =USE :CHECKLIST
Subdivision: Prop ID: W248295 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.
Construction of (1) new office in an existing tenant's suite. Valuation: $5,089
Existing building area: 49,963 square feet
New building area: No change square feet
, ' " ❑ PROPER OWNER . - '''- 64^TENANT " Number of stories: 3
Name: State Farm Type of construction: II -
Address: 16083 Upper Boones Ferry Road, Suite 130 Occupancy groups:
City /State /ZIP: Tigard, Oregon 97224 Existing: B & S -1
Phone: (253) 912 -7373 Fax: (253) 912 -7575 New B
i® APPLICANT .• ' _11 CONTACT PERSON ” "
NOTICE
Business name: LRS Architects All contractors and subcontractors are required to be
Contact name: Darcie McConnaha licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 720 NW Davis, Suite 300 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, Oregon 97209 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 221 -1121 Fax: : (503) 221-2077
E - mail: dmcconnaha @Irsarchitects.com
,./. CONTRACTOR
_ _ _ s. ., . 4 <• . ... x. _ .,M -raa ry . ._._, _.- „
Business name: Bartel Contracting, Inc. : a" • ,BUILDING,�PERMITFEESt�'.�
Address: PO Box 160 u. _ . .. .(Plense re'/er`io fees "chedule) n . '''
City /State /ZIP: Gladstone, Oregon 97027 Structural plan review fee (or deposit):
Phone: (503) 650 -4084 Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: 79970 Total fees due upon application:
Amount received: Li 3 ) - . 4�
hWjilk.(/t.9AXI..jlk___, Authorized signature: This permit application expires if a per ' t is not obtained
within 180 days after it has been accepted as complete.
Print name: Darcie McConnaha Date: 06.01.11 * 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)
I
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description: Te
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction: 2
*Type of Use: C O"vA Occupancy Load: .L Oregon Specialty Code: •Z 0
SPECIFICS
Number of Stories: 1, Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS •
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: if Fire Alarms: tee: j Smoke Detectors:,
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ '7 0 67 FEES DUE
$ ,(' DC Prov Rvw, COM TI — Ping
$ ,( DCProvRvw,COMTI — LRP
DC Provision Review Fee for COM TI $ 1. ,' (, Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ I ,FP 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ \ 7I.?1. Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ Y: . Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ "2„00 Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ 4 \52.5 ) t TOTAL FEES DUE
•
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; END = foundation; DEM = demo;
END = 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.docx 01/13/2011
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: 6" Expedited Review
Plan Submittal Date:
/ h' 3 ' , 't."-/,L
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 ( at 503-718-20/0 or G " ! _@ tigard- or.gov)
Zoning — P Permitted Use Yes No ❑
Ir Land Use Required: Yes ❑ No Cr ' (explain below
Notes: r 441fec;..)2 / ,L� '' n() r .!z y LLd-e___.
�/ /�
Approved ❑Not Approved Date: 6 /
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard- or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN