Permit CITY OF TIGARD BUILDING PERMIT
'�''` COMMUNITY DEVELOPMENT Permit #: BUP2011 -00181
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/19/2011
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 210
Project: NuScale Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: TI
Contractor: DURUS CONTRUCTION LLC Owner: PACIFIC REALTY ASSOCIATES
15806 UPPER BOONES FERRY RD ATTN: N RIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 320 -8601 PHONE: 503 - 624 -6300
FAX: 503 -244 -4318
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 08/19/2011 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 08/19/2011 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 08/19/2011 $195.38
Stories: 3 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 08/19/2011 $23.45
Value: $7,500 Plan Review 08/19/2011 $127.00
Plan Review - Fire Life Safety 08/19/2011 $78.15
Info Process /Archiving - Lg Sheet (over 08/19/2011 $4.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $500.98
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 -00 roug c t R 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 or 1.800.33 4.
Issued :y: L Permittee Signature: 4,
` Call 503.639.4175 by 7:00 a.m. for the next available inspection d.' v /
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 RE CEIVED ' izoi, OFFICE USE ONLY.`:' .: .:; ,
City of Tigard AUG 19 2011 R Date/B D / yn eceived (� /�� , ' PermitNo.: %il.....,, /g
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review r!7
Dat : � �' �� Other Permit:
' I Phone: 503.718.2439 Fax: 503
T yr TIGARD
T I G A R I) Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information
,.,.0 - { `'c T;Y UII WORD 3 ' x z,� - = REQUIItED DATA - I *ii FA :∎iit li4i1.IN4'
w
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
► :. Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
x t 0 r - , - 1p....r work indicated on this application.
El and 2- family dwelling 0 ommercial/industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder 0 Other: Number of bathrooms: ,--------
MR S f iron t list th fT0 4 ATIOi _ Total number of floors:
Job site address: � � _f ). d ti v New dwelling area: square feet
City/State /ZIP: ?d /7 f /t d e,,,, 9 7 7 ) ei Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project names , i 4, Covered•porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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
4 t y.. t trt, i .t . CtX -'0:1-4-:- work indicated on this application.
Valuation: $ 'd,0
Existing building area: square feet
New building area: square feet
431 F RI " *Teit ? .. n '.M MpN'P Number of stories:
Name: PacTrust Type of construction: "'f = r
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: jr
City/State /ZIP: Portland, OR 97224 Existing: --576
Phone: ( 503 624 Fax: ( 503 ) 624 New: 4;2''' - L , A p w ' - �� . ' _ +.mss P .'' �mia ,, ,r, :._ -; 1,0 - . ,° � C " ' , i l ._.
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
DPnni n Pagni under ORS 701 and may be required to be licensed in the
Address: 15350 S.W. Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
City/State /ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 624 - 6300 I Fax:: ( 503 ) 624 - 7755
E -mail:
_ �i fill -, � f ' k-�
Business name: o p t' ( e C/-J 7 ' `' ' - t to 4 t 'f � s;
Address: G . 4 `X t L341: 1 21i- , s ,?;;.- -R. a a tk 3=.
o
Structural plan review fee (or deposit):
City/State /ZIP:
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: l S' J 8�/ 1 Total fees due upon application:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name: D / I , within 180 days after it has been accepted as complete.
*
N /'Y tse % a �// �f �/ Fee methodology set by Tri Building Industry
/ Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 09 /09/10 440- 4613T(11 /02/COM/WEB)
.
III Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD.
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modificat 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 aliered'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] $
1 a -
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): $
;0
. Ap 2 6 p Ji n-"A &"
•
%
\ ,1
I: \Building \ Permits \BUP -COM PennitApp.doc 06/25/08
1111 . Building Division
TIGARD • Over- The - Counter (OTC) Building Permit
•
Check List
Project Description: " 11
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: Occupancy Load: 4 Oregon Specialty Code: C)
SPECIFICS
Number of Stories: � 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: l67 Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 4J FEES DUE
$ A £0 DC Prov Rvw, COM TI — Ping
$ ,• DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ �j Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 1?, , — 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ f77, On Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ ' `7 ; 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 $ 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: $ .e) TONAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured stru tore.
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
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: l o LA. P / I iS1 C Review
Plan Submittal Date: 0 9//
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 4.14 only if approved. l J�
Plan -ing Review (contact at 503 718 �/`r Dor @tigard or.gov)
Zoning £ Permitted Use Yes L No ❑
Ud Land Use Re wired: Yes ❑ No lk (explain below)
r
Notes: —4.2/4"/ 1 Is .. '/i
/ -
/Approved ❑ Not Approved Date: '/�9/ll
l
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard- or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN
.5o s4(1g//'1 ?/o
Building Division
.14
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: 119tA r / ' - o° /-?/ Review
Plan Submittal Date: g// Sf //
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. ' J�
Planying Review (contact at 503-718,03 �/Y(}or y,. @ti:ard or.•ov)
Or Zoning . 1 Permitted Use Yes L No ❑
be land Use Re uired: Yes ❑ No L'i' (explain below)
Notes:
■ / 13� / sy • •
c
Ii Approved ❑ Not Approved Date: OA
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
r: \cuRPLN
CITY OF TIGARD RECEIPT
I
1111115 . . ' I ... 13125 SW Hall Blvd Tigard OR 97223
503.639.4171
'TIGARD
Receipt Number: 183706 - 08/19/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
BUP2011 -00181 DC Provision Review, COM TI - Ping 100 - 0000 -43112 $64.00
BUP2011 -00181 DC Provision Review, COM TI - LRP 100-0000-43117 $9.00
BUP2011 -00181 Permit Fee - Additions, Alterations, 230 - 0000 -43104 $195.38
Demolition
BUP2011 -00181 12% State Surcharge - Building 100- 0000 -24001 $23.45
BUP2011 -00181 Plan Review 230 - 0000 -43106 $127.00
BUP2011 -00181 Plan Review - Fire Life Safety 230 - 0000 -43108 $78.15
BUP2011 -00181 Info Process /Archiving - Lg Sheet (over 230 - 0000 -43135 $4.00
11x17)
Total: $500.98
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 01577C DADAMSKI 08/19/2011 $500.98
Payor: Dennis Pagni - PacTrust
Total Payments: $500.98
Balance Due: $0.00
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