Permit •
CITY OF TIGARD BUILDING PERMIT
„„
' • COMMUNITY DEVELOPMENT Permit #: BUP2009 -00104
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06!10/2009
Parcel: 2S110DCO2300
Jurisdiction: Tigard
Site address: 11555 SW DURHAM RD A -4
Subdivision: Lot: 0
Project: Oregon Music Academy
Project Description: TI
Owner: FEES
HIP WILLOWBROOK LLC Description Date Amount
BY TAX DEPARTMENT, PO BOX 2708 Permit Fee - COM 06/10/2009 $361.11
PORTLAND, OR 97208 12% State Surcharge - Building 06/10/2009 $43.33
PHONE: Plan Review 06/05/2009 $234.72
Plan Review - Fire Life Safety 06/05/2009 $144.44
Contractor:
PACIFIC CREST STRUCTURES INC
17750 SW UPPER BOONES FERRY RD SUITE
190
PHONE: 503 - 968 -8949
FAX: 503- 598 -6658
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $48,600
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $783.60
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Protected Corridors: No
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 i rdance wit oved 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. ENTION: Oregon law require •u t• follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 01 -0010 through OAR 952 -001 :100. You • - obtain a copy of the rules or direct questions to OUNC by calling 503.246.66 9 or 1.800.332.2
Iss d By: ( ' ALk drAdi.....dAat Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that b siness day.
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.
ii ;�5 v I
Building Permit Application ]��C,EIV
COMmercial ``� ED foR OFFICE ESE ()NIA
City of Tigard JU N 0 5 ?009 Dat ira MOM Permit No.: , (200 — //t Lei;
13125 SW Hall Blvd., Tigard, OR 97223 C+ Plan • e
Phone: 503.639.4171 Fax: 503.598.11 1T O FTjG A Date/B : �l ���t � Other Permit.
I ' I c; n R D N Inspection Line: 503.639 ILDI RD Date Rea y/By: �� See Page 2 for
Internet: www.tigard- or.gov DIV IS I ON N otifed/Method: i 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
❑ Addition/alteration/replacement Other: - rEN Pt. , 'i iAtr raw eW1t =NT equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /lttdt+sfiel
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: 1 15 S 5- S .W . VtRkr WvAn "R.OPtt,. New dwelling area: _ square feet
City/State /ZIP: —7 1 C.,PrP-0 , O(Z. 9 7Z2.1- Garage /carport area: — square feet
Suite/bldg. /apt. no.: A _ T Project name: W tLLpttJF52_0 7. I Covered porch area: - square feet
Cross street/directions to job site: 1 Vx] 4 �DtR.1+►st ,AA Deck area: - square feet
- V\\ I1,t_otr.1 512.00V- ' BUSINESS �tt}1?-- - 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.: 2 S I I O D G O o Z3 00 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.
t NTEtz, 10 la_ ' W1PRAUM.NZ of .1c I S'Tt h1C� Valuation: $ Ot ( p 00 • Od
Existing building area: 6,, 4. square feet
-EN AN'T 1.— F�.ASE SP Nc-e
New building area: — square feet
PROPERTY OWNER ❑ TENANT Number of stories: ONE
Name: I AR -SGk4 1NIV£r .FRrirER Type of construction: - ty 1,
Address: 11 I - • V\S • S rt LvA ON S TR - .€, - "i Occupancy groups:
City/State /ZIP: ` i.. LA D I 0F,.... 17 2 o s Existing: VA
Phone: t 5 6 ' 3 1 q7 3. O 2 S 9 Fax: (S 0.31 . 31 SZ. New: "b
g APPLICANT ❑ CQNTACT PERSON NOTICE
Business name: i___ A RC_A - I.T --, All contractors and subcontractors are required to be
�`� licensed with the Oregon Construction Contractors Board
Contact name:
p�Zr� -�- under ORS 701 and may be required to be licensed in the
Address: CQto .> \)•• l I l 1n AV>✓NutG t SIA�"tE ZO jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
y Rt_mF_#Z -OiV I OCZ 1 ° o ff apply:
Phone: (503) t 41_4.. I-22.2_ Z Fax:: (5 c +4. . • (pc 40 7
E -mail: I`R1v_. . p Q.. Le6KI4 l NC . co t
CONTRACTOR
Business name: tFig. ___C � t =S BUILDING PERMIT FEES*
Address: -- 72_'• S•W. 1 -- A-E>L.rc LIf41w(6 J1_1t - r 9 0 (Please refer to fee schedule)
Q 1 Structural plan review fee (or deposit): a 3,/, 72
City /State /ZIP:
�r. e.....7 Lt , ( � . ! 7 4'
Phone: (.v3) 1 (P$ . � 14`j Fax: (Sp3) S� o . (oC� $ FLS plan review fee (if applicable): /'1f . 4P
CCB lic.: d� (D c1 I
Total fees due upon application: 3 79 „ lo
/ Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: iL1K P>rp_s 61 ,1 Date: 2 -2 co * Fee methodology set by Tri -County Building Industry
l Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02 /COM/WEB)
6 .
1111 " Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Description of Project: R '
GENERAL INFORMATION
Class of Work:* ��� a Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* r First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: 1 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: OLD Handicap access:
Smoke detector: Protected corridors: a'a
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $) �J
(-.'
INSPECTIONS FEES DUE
Footing /foundation Firewall $ 4 • I Permit Fee
Post /beam structural Smoke detector $ ti State Surcharge
• Shear wall Misc. inspection Pl Review Fee
Masonry Approach /sidewalk $ ( "T , Al A 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 e 3 .(,0 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.
1: \ Building \ Forms \OTC- BUP.doc 08/19/08