Permit .. CITY OF TIGARD BUILDING PERMIT
;�''� :t COMMUNITY DEVELOPMENT Permit #: BUP2011-00163
T1.GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/26/2011
Parcel: 2S 102AB05300
Jurisdiction: Tigard
Site address: 9169 SW BURNHAM ST
Project: Tigard Vision Center Subdivision: Lot:
Project Description: Installation of (1) monument sign, 6' 7" in height.
Contractor: MEYER SIGN CO OF OREGON Owner: JB OAK HILL LIMITED PARTNERSHIP
15205 SW 74TH AVE 9169 SW BURNHAM
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 620 -8200 PHONE:
FAX: 503 - 620 -7074
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 07/26/2011 $134.54
Class of Work: OTR Demolition
Dwelling Units: 0 12% State Surcharge - Building 07/26/2011 $16.14
Stories: 0 Height: 6.5 ft Plan Review 07/26/2011 $87.45
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm Sheet (up to 07/26/2011 $2.00
Value: $4,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $240.13
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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
332.2344.
_ _ `2�
Issued 'i • � Perm ittee Signature:
,�1l • 175 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.
. Buildin Permit A lication
�
Commercial FOR OFFICE USE 'ONLY
Y r
o City of Tigard J U L 2 2 2011 DateB 7 �d1mm PermitNo r��jtQ
'� 13125 SW Hall Blvd., Tigard, OR 97223 . Plan Review
.. Phone: 503.718.2439 Fax: 503.598 OF TIGARD Date/By: 4 . 1/ / Other Permit:
T l G A It D Inspection Line: 503.639.4175 Date Ready/By: Juris. ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rotnded 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.
❑ 1- and 2- family dwelling ommercial /industrial
Valuation: $
,
❑ 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: q ( , DI = , 7 s ��q / ' r l �/t em New dwelling area: square feet
City /State /ZIP: 1t (� , r - J �^ � jP) 2 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: VI (4.\ �� b `J , 16a) �� . overed porch area: square feet
Cross street/directions to job site: t�i v 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 (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
T r n i kt,- wi ii- i `4i Valuation: $ 9 cs6 Q , O
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER 1(TENANT Number of stories:
Name: T ` / is 1 O C T Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
l Structural plan review fee (or deposit): ' S t . -^ Contact name: C _ rC,�
Address: 11-4- FLS plan review fee (if applicable):
" Total fees due upon application:
City /State /ZIP: �0 O q7 2
Phone: C Z -y) "'v I Fax: ( ✓ C , s 7y Amount received: _ --
E -mail: k� i t,,Lte( ., tir a „ ✓ (' o �1 �J 1 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
`° ) 4 Commercial and residential prescriptive installation of
dONTRAC R roof -top mounted PhotoVoltaic Solar Panel System.
Business name: .. � '`_ 4 ' Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City /State /ZIP: Permit fee (includes plan review $180.00
and administrative fees):
Phone: ( ) I Fax: ( ) State surcharge (12% of penult fee): $21.60
CCB lic.: s 0 jL _ Total fee due upon application: $201.60
Authorized signature: • / - / . This permit application expires if a permit is not obtained
aidisi • within 180 days after it has been accepted as complete.
Print name: D Ca V `42 Date: 'r 221 l * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440 4613T(1 I /02 /COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
TI GARD
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): $
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: LZ� Occupancy Group: () Type of Construction: —
*Type of Use: Ci Occupancy Load: Oregon Specialty Code: – 745)(C)
SPECIFICS
Number of Stories: Building Height: >'S • 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: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ FEES DUE
$ DC Prov Rvw, COM TI – Ping
$ DC Prov Rvw, COM TI – LRP
DC Provision Review Fee for COM TI $ Permit Fee – Add, Alt, Demo
Project Valuation Planning LRP $ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $160:00 $24.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ '��i 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: $ 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.
I: \Building \Forms \OTC - BUP.docx 01/13/2011