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Permit <t ri- ,, CITY OF TIGARD BUILDING PERMIT ° '�l COMMUNITY DEVELOPMENT Permit #: BUP2009-00127 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/09/2009 Parcel: 2S101AC01300 Jurisdiction: Tigard Site address: 7105 SW HAMPTON ST Subdivision: Lot: 0 Project: Kaiser Dental Project Description: Relocate telecom to operatory, modify existing telecom room to storage. Owner: FEES KAISER FOUNDATION HEALTH Description Date Amount PLAN OF THE NORTHWEST #838, ATTN: Permit Fee - COM 07/09/2009 $713.62 GENERAL ACCCOUNTING 11TH F, 500 NE 12% State Surcharge - Building 07/09/2009 $85.63 PHONE: Metro Const. Excise Tax - Commercial 07/09/2009 $159.60 Use Plan Review 07/09/2009 $463.85 Contractor: Plan Review - Fire Life Safety 07/09/2009 $285.45 SCHOMMER & SONS INC 6421 NE COLWOOD WAY PORTLAND, OR 97218 PHONE: 503 - 287 -4646 FAX: 503 - 287 -4499 Specifics: Type of Use: COM Class of Work: ALT Dwelling Units: 0 Stories: 1 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $133,000 Floor Areas: Total Area: 0 • Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,708.15 Required: Required Items and Reports (Conditions) Fire Sprinkler: No Parapet: Fire Alarm: No 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 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 5x3.246.66.9 0 1 800.332.2344. Issued By: k � 9 Z°\91/49(N% Permittee Signature: ' I'. I V Call 503.639.4175 by 7:00 a.m. for an inspection that business 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. Building Permit Application Commercial RECEIVE_ ys =' OFFICE USE ONLY Cl of Tigard Received III City g JUL 0 9 2009 DateB : Permit No.: 6 0 W , OA r " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ►�� Phone: 503.639.4171 Fax: 503.598.1960 Date/B : `1A E ©t Other Permit: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Re... El See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISIO', 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 ❑ Addition/alteration/replacement ® Other: Tenant Impro equipment, materials, labor, overhead, and the profit for the . ' CATEGORY OF CONSTRUCTION ` work indicated on this application. CI 1- and 2- family dwelling ® Commercial /industrial Valuation: $ 12 Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: , AND LOCATION ' • ; Total number of floors: Job site address: 7105 Sw Hampton New dwelling area: square feet City /State /ZIP: Tigard, OR, 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: KPNS Tigard Dental Covered porch area: square feet Cross street/directions to job site: Hampton ST and 69th Deck area: square feet Other structure area: square feet ` REQUIRED DATA: COMMERCIAL=USECHECKLIST. Subdivision: Lot no.: 1200 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 , ,. . ,�" ,,,, DESCRIPTIONS` OF : WORK ' ' , work indicated on this application. ' Relocate Telecom to abandoned operatory Valuation: 53,CO3 i' modify ex. Telecom room to Storage Existing building area: 6870 square feet New building area: 158 square feet ;, `PROPERTY' "OWNER ®c .TENANT i :I- Number of stories: 1 Name: Kaiser Permannte NFS- Tom Emerson Type of construction: V -N Address: 500 NE Multnomah Occupancy groups: City /State /ZIP: Portland, OR, 97223 Existing: B -2 Phone: (503)913 -3900 Fax: ( ) New: B -2 ' 1111 APPLICANT • ' ' , _ • ®: CONTACT PERSON ' .. . - NOTICE : , • Business name: PKA Architects All contractors and subcontractors are required to be Contact name: Paul Hosey licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 6969 Sw Hampton ST jurisdiction in which work is being performed. If the City /State /ZIP: Portland, OR, 97223 applicant is exempt from licensing, the following reasons apply: Phone: (503) 968 -6800 Fax: : (503) 968 -6860 E -mail: paul @pkaarchitects.com CONTRACTOR Business name: Schommer & Sons • • " ' BUILDING PERMIT FEES* " . • Address: 6421 NE Colwood Way • . (Please r eferto l eeiehediele) . . Structural plan review fee (or deposit): City/State /ZIP: Portland, OR, 97218 FLS plan review fee (if applicable): Phone: (503) 287 -4646 Fax: (503) 287 -4499 CCB lie.: 4937 Total fees due upon application: Amount received: Authorized signature: �` , This permit application expires if a permit is not obtained Print name: /'(J � I Date: '717/07 * Fee methodology set by Tri- County Building Industry Service Board. 1: \Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(11 /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 0 /0). VALUATION: Total of all renovation, alteration or modification being done, excluding painting and wallpapering: [1] $ 5 MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $� �d ELEMENTS: In choosing which accessible elements to provide under this section, prionty shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: ® (a) Parking $ 2 -11 C � 9 /46 � (b) An accessible entrance: $ 10 t& (c) An accessible route to the altered area: $ !COW (d) At least one accessible restroom for each sex or a single unisex $ / l Q restroom: y �Ay�l (e) Accessible telephones: $ /V (f) Accessible drinking fountains: and, $ QA / � Urrat4 (,vim (g) When _possible, additional accessible elements such as storage and P I�T d alarriTO #j(pc fAMO $ TOTAL (shall equal line [2] of Valuation Computation): $ 11 a � ' r � � �U 1 V 4 A S(p I . 1t '' x/417 I:ABuilding \Pemuws \BUP -COM Perrmt \pp.doc 10/30/07 J