Permit CITY OF TI BUILDING PERMIT
PERMIT #: BUP2004 -00082
I DEVELOPMENT SERVICES DATE ISSUED: 3/3/04
� - J 13125 SW Hall Blvd., Tigard, OR 97223 (5031 639 -4171
SITE ADDRESS: 09370 SW GREENBURG RD 201 PARCEL: 1S126DB-02800
SUBDIVISION: PP1991 - 018 ZONING: C -
BLOCK: LOT: 001 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 9 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 19,800.00
Remarks: TI New walls for medical office.
Owner: Contractor:
•
FRANKLIN COMMONS ASSOCIATES ROBERT TODD CONSTRUCTION INC
BY NORRIS + STEVENS 4080 SE INTERNATIONAL WAY #D -1
520 SW 6TH STE 400 MILWAUKIE, OR 97222
PORTLAND, OR 97204
Phone:
Phone: 653 - 5704
Reg #: LIC 98517
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 3/3/04 $235.30 Electrical Permit Required
[TAX] 8% State Surcharl 3/3/04 $18.82 Plumbing Permit Required
Framing Insp
[BUPPLN] Pln Rv 3/3/04 $152.95 Gyp Board Insp
[FLS] FLS Pln Rv 3/3/04 $94.12 Final Inspection
Total $501.19
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 than 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By:
Pe rm ittee
Signature: / j/ � 4
/ • II 639 -4175 by 7 p.m. for an inspection the next business day
•
5
Building Pei , 1T . FOR OFFICE USE ONLY • '
City of Tigard ` Receive.
Dates : ' � Permit No.: A 900 t (.7i9e a_
13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev' -w -
Phone: 503.639.4171 Fax: 503.598.1960 4 f /(Mi 'lIti' Dates : 1 ' — 0 y 135.1 Other Permit:
Inspection Line: 503.639.4175 �.1� � �p , ci 1 Date Ready/By: Ei See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
-` , . h i .e m E.,QF1,,W0R +K�,,,t k Tut 3 . - ty ' . `.t< REQU D.:'.TA -1 AND 2 FAIVIII
3
a er �. . - .. .,ter.. _ten. ��, i- �'r..�w, 5���. e'�'�a.. _�- - t`�s1�� ���- .:. .�;rh = : �y "_- ,�,.:.��, �-- .. >�r +�N.:;;;.+„; «t ,„ -
❑ 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
s�RO K I x t .Ri ki Ok 'CQ IS itedTIOIVa ; p '' n work indicated on this application.
��� Valuation: $ •
❑ 1- and 2- family dwelling Commercial /industrial
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
V: 4tiS4 . , »: i es ` n - 5 T ; ` a > Total number of floors:
4si`4 . :' � J ®B SX JBO 13iU i AND LOC I CO � N' E ,;
Job site address: `37 5 I /- . / F9 j �
� � New dwelling area: square feet
�'): , / . 7 7 . - Garage /carport area: square feet
/bldg. /apt. no.: - V Project name: pI ylt Covered porch area: square feet_
Cross street/directions to job site: j Deck area: square feet
14 /' r ' . Other structure area: square feet ,.
c REQUIRED DATA: 9, - V ERCIAI: CIIECKLIST ;:
Subdivision: 1 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
a x map/parcel r , , , , „ y Mn t µ „ 4 , y1 y equipment, materials, labor, overhead, and the profit for the
1 „ a ¢ , . .) ; ¢ �C ' 4tD SMT'4IflI�I IAV6 ' r work indicated on this application.
- .. / ^. ,.� .t ,,r e1 tea ,; ; " �_ 6° P �� n ty L p _ Valuation: $ /��
1 en 4r9 4.0 �ti i rC Existing building area: / square feet
New building area: square feet
;bad '��''i'z�;�.�� t � „;�"c�:v'�. ;'.:.ai6C.:,'�"n`�� ��1�;,;' �_,�� `�#r; 4 '`$'.;'�:' °E:' : i�;�' u .� ,, .��;r;'.� %i=: - '.::?:. "s -': - .::cy`,� % "r,�..;
BROP,E'RTY, OWNER � 1 I k �, f t ®0 -4. ilYT ' ; F Number of stories:
Name: c%s , ^1s �I4$ ..... rd Type of construction:
Address: , / / €.53 4/ 14 /' Occupancy groups:
y
City/State /ZIP: �� o � J ¢ Existing:
Phone: (_ 4) ,- ; 7 I Fax: (5 ) 7 New:
. '. , x:.;0.41- :. �.; >. M ph
°�� t ,� - �. -I a : x ' : <'; .. '° �' : ^ . �, r yes ,: "�a �,,.-- •xr�. �: :� :� �. - :. �; . , L. �r;� ";• � k
V 4, --- CA 11 n pr; .CONY TAPE .: , , °' `
<., . . ,�,Q���.�� � �.,. ���°�� '� � �:.i:" � AC RSON ,�' ".�,�t n<�,rs �; . ��;°`:
Business name: a ilte m py - r .� All contractors and subcontractors are required to be
Contact name: p 0. licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: / `rte I ' . c i!. /411.1 � �y ! . jurisdiction in which work is being performed. If the
City/State/ZIP: f. 7 ` 42 1 0 e 77 e7 applicant is exempt from licensing, the following reasons
apply: s
Phone:,( 3) �,� ' n . eral Fax:: ) Z,743 .. (-� -2 /'
E- mail: /
-
°. u k ' : �5', ';a tit��'iI=T+V :z:. E't "S.a`;•r "' ;"R:i�;-r r,v �? - , a; �•r - .;i ': kgra*
N` Pat d ea < ,W RApCTO R - `" 4 4
Business name: t Y
CA'a/ ). ��yL��T/ C�I�J /� r -' R '; ,BUILDING_PERMIT"-FEES *`
Address: ♦ �� �� 1 ���. Please refer to fee schedule.
City/State /ZIP: I' WrI /_J i <i az_ 7z ;.z.
/ / Fees due upon application
Phone:
9 C_ � 1' /o41--- Fax: 6j5) .3"5171
/ ■ Amount received
CCB lie.:
Date 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: :- ;� ` f w ,� �/ Date: '� , * Fee methodology set by Tn County Building Industry
Service Board.
r\ Building \ Permits \BUP- PermitApp.doc 12/03 440- 4613T( I1 /02 /COM/WEB)
Building Division
°d 1711 I Plan Submittal Requirement Matrix
` ---• Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
t yp ofSutmrtta� #ooIans
�Oncludes uew add tons an o alterations �� 12 e q uxred at -
3 t s �: 0
�`�' .101-131 ,kai.�' ep , a ` : s11 m11�ta1 g
.�pUY ttke`. .. .x.9s s s.g1;. ... , &x„ ., ;k- .w .�_,_a
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) ) 2
Building 1*
Fire Protection System 3**
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03