Permit CITY OF TIGARD BUILDING PERMIT
14 2 - COMMUNITY DEVELOPMENT Permit #: BUP2009 -00108
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/12/2009
TIGARD Parcel: 2S102DB00100
Jurisdiction: Tigard
Site address: 8840 SW BURNHAM ST
Subdivision: .- Cot: 0
Project: Verizon
Project Description: TI - Power room expansion
Owner: FEES
VERIZON NORTHWEST INC Description Date Amount
PO BOX 152206 Permit Fee - COM 06/12/2009 $310.80
IRVING, TX 75015 12% State Surcharge - Building 06/12/2009 $37.30
PHONE: Plan Review 06/12/2009 $202.02
Plan Review - Fire Life Safety 06/12/2009 $124.32
Contractor:
PRECISION CONSTRUCTION CO
8025 NE KILLINGSWORTH ST
PORTLAND, OR 97218
PHONE: 503 - 253 -4827
FAX: 503 - 253 -5177
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $40,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $674.44
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors: No
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This p-. it is issued subj- o the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be • • ne in accordance with ap• •ved pla his permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da s. ATTENTION: Oregon law re• i - you o folk the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 •- 001 -0010 through OAR 952 -0• 1100. ou• obtain a copy of the rules or direct questions to OUNC by calling 50 6.6699 or 1.800.332.2344.
1
Is ed By: u\ • / �I / / Permittee Signature:
r '
Call 503.639.4175 by 7:00 a.m. for an inspection that bu - mess day.
This permit card shall be kept in a conspicuous place on the job site until completion of th = • eject. I
Approved plans are required on the job site at the time of each inspection.
Building Perm A licatio
Commercial CE�E� FOR OFFICE USE ONLY
City of Tigard JUN 12 2009 Date/B d 6 ,a og Permit No.: Li /og
223
v 13125 SW Hall Blvd., Tigard, OR 9 w' 1�,,
C Phone: 503.639.4171 Fax: 503.51�(1Q TIGARD Date/B : Plan Revie _` � ��. Other Permit:
1 1 G A li D Inspection Line: 503.639.4175 B UILDIN Date Ready : y: 0 See Page 2 for
Internet: www.tigard- or.gov G DIVI SION 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
'A Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ii: 1- and 2- family dwelling KI Commercial /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 sa/ f�ua,c/ /171141 /24 New dwelling area: square feet
City /State /ZIP: 17 64 e -d / 0 t Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: !o N/ee. IQaD'vvl 6. j . * vs ,o / Covered porch area: square feet
Cross street/directions to job site: 11A/ 8-vi—L.L.- 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Demo wil-L-L- $ 2 El c 4 'h �cpp, eX /S4 i Valuation: $ Q l
Existing building area: square feet
r Q Lw — M t5 c ��L2 C 4- bVl CG t`hK/i L
P LUMB' Wet New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: V&—e(24,11 Cam► -, h l j v 1 Glik-47 -a1 S Type of construction:
Address: lO tj 15z 0 c 2 - .. , Occupancy groups:
City /State /ZIP: _K v (i7t5 y -- - IS Existing:
Phone: ( Z2t 6, is 54, 14 Fax: (9 (0 5 4074 New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: /6 C(Si C- tS J All contractors and subcontractors are required to be
Contact name: , 4i- yOVi(/(?• licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: () 2$3 46 27 Fax: : (5(4) 7-53 S ( r7
E -mail:
CONTRACTOR
Business name: P g & ct5t ®v1 Gerv l 5111,44c,--11-01/1 BUILDING PERMIT FEES*
Address: 80 25 NC '_ t it �t/( 1,`,,�,c--�„ (Please refer to fee schedule)
�o>G�Gc��/d C yL q--7 I � Structural plan review fee (or deposit):
City /State /ZIP:
I FLS plan review fee (if applicable):
Phone: 51 ) 3 4 65 2 ;7 Fax: (5503) 7,53 5 (-7 7
/_�
^ Total fees due upon application:
CCB lic.: & 4
Amount received:
Authorized signature: i9 This permit application expires if a permit is not obtained
/ within 180 days after it has been accepted as complete.
Print name: P4 agid OVW6 Date: 6,, f o (o 7 * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Perrnits'BUP -COM PermitApp.doc 2/23/07 440- 4613T(l I/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: $
(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 \Pemuts \BUP -COM PermitApp.doc 06/25/08
111111 _ IN Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Description of Project:
GENERAL INFORMATION
Class of Work:*
A r:14 � Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* k First floor: N: S:
Type of Construction: o f Second floor: E: W:
Occupancy Group: i Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: �� Note: Combine total floor area for E: , E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: Handicap access:
Smoke detector: Protected corridors:
0
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ 4 10 ) 000
INSPECTIONS FEES DUE
Footing /foundation Firewall $ Q . Permit Fee
Post /beam structural Smoke detector $ (, State Surcharge
Shear wall Misc. inspection $ Zra,,,CYZ_Plan Review Fee
Masonry Approach /sidewalk $ t 9A" , 32... FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ 7 - 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; on = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
is \ Building \ Forms \OTC- BUP.doc 08/19/08