Permit ,, CITY OF TIGARD BUILDING PERMIT
111 COMMUNITY DEVELOPMENT Permit #: BUP2011 -00182
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/19/2011
Parcel: 2S103DD00600
Jurisdiction: Tigard
Site address: 13770 SW PACIFIC HWY
Project: Tigard Grange Subdivision: Lot:
Project Description: Replace front entry stairs and install new guardrail.
Contractor: C & S QUALITY HOMECARE & REPAIR INC Owner: TIGARD GRANGE NO. 148
PO BOX 82512 PO BOX 230252
PORTLAND, OR 97282 TIGARD, OR 97281
PHONE: 503 - 558 -6395 PHONE: 503 - 590 -7773
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 08/19/2011 $134.54
Class of Work: OTR Demolition
Dwelling Units: 0 12% State Surcharge - Building 08/19/2011 $16.14
Stories: 1 Height: 0 ft Plan Review 08/19/2011 $87.45
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm Sheet (up to 08/19/2011 $1.00
Value: $3,410 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $239.13
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. ATTENTIO • : • .. law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 rough OAR 95.- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503232 or 1.800.332.2344.
Issued B ' 7 Permittee Signature: y / /
' � /rr.
Call 503.639.4175 by 7:00 a.m. for the next available inspection n 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.
3.
' Building Permit Application
Comm ercial RECEIVED FOR OF
au FICE USE ONLY
da / . y
'� 13125 SW Hall Blvd., Tigard, OR 972
City of Tigard Date/B : I. lit Permit No.: P
- 2! U G '8 2011 Date /B view =- 1 EN
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : / g�i Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready : Juris: FA 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
❑ New 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 ❑ Commercial /industrial Valuation: $
El 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: / 770 SW /ode / b c i $ J{rd/ New dwelling area: square feet
City /State /ZIP: //fir : a - / Garage /carport area: square feet
Suite/bldg. /apt. no.: // Project name: gefigeC' �gf �ll ho Covered porch area square feet
i
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (romded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
494(e /51v0 'i`r/;' ,7*' / ( eir k c h r/v1) Valuation: $ . 4f`a
I re Cd e,e / ,,e 1 0f )Y fA /4vj / Existing building area square feet
en ? 47d4® /' 1L „479 Y�.0 • / New building area: square feet
❑ 'PROPERTY' OWNER ❑ TENANT Number of stories:
Name: -72, 9 / 6"r N /f / Type of construction:
Address: Pa "ate 2. Occupancy groups:
City /State /ZIP: 7;1„ VA , 7 / G72. 2_ Existing:
Phone: ( j�l ) J` 9 / t 1/ Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address:
City /State /ZIP: Total fees due upon application:
Phone: ( ) Fax:: ( ) Amount received:
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial a. d residential prescriptive installation of
• CONTRACTOR, roof -top mount:, ' otoVoltaic Solar Panel System. II
Business name: (.- ,&5 & ',6 fo„+et ie- �aj/► Submit two (2) sets o oof plan with connection 4 -tails
� 70.2.5? 7 and fire department ace= along with r , t 1 Oregon
Address:
P 04'4' Z Solar Installation Specialty . o. - ecklist.
City /State /ZIP: Pvi-7/740// aid 77,28z- Permit fee (inclu�.: • a e view $180.00
and . mstratve d ii :
Phone: (WI .53 a , 7 - Fax: 5) . 2 ' — 4 4 X5 -. State 1, _ • _° , e . • u it fee): $21.60
CCB lie.: /5252/ C/5 Total fee due upon application: $201.60
Authorized signature: j����
P��/ / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ., ft . >r ,`' Date: 8///72a// / * Fee methodology set by Tri -County Building Industry
/ Service Board.
I: \Building \Permits\BUP -C OM PermitApp.doc 02/24/2011 440- 4613T(1 I /02 /COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
TIG'ARD
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
I If Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: kCLT Occupancy Group: �j T e of Construction: 7 ,�.
*Type of Use: n"j &A Occupancy Load: Oregon S.ecial Code: ����'
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: Fire Alarms: Smoke Detectors:
. Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ /- 6-4-tO FEES DUE
$ DC Prov Rvw, COM TI – Ping
$ DC Prov Rvw, COM TI – LRP
DC Provision Review Fee for COM TI $ •Wik ermit Fee – Add, Alt, Demo
Project Valuation Planning LRP $ MR, 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 $ ( , Cr, 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: $ 'Z ,,1 ?7TOT FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured strucm ---"`
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.
•
t: \Building \ Forms \O"CC- BUP.docx 01/13/2011