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Permit CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit #: BUP2009 -00163 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2009 Parcel: 2S102AA02302 Jurisdiction: Tigard Site address: 12200 SW MAIN ST Subdivision: Lot: 0 Project: Bead Bullies Project Description: Replace window with new entry door. Owner: FEES • B -B -B- PROPERTIES Description Date Amount C/O FLETCHCO PROPERTIES LLC, BY Permit Fee - COM 09/08/2009 $62.50 JEFFREY B FLETCHER, 2065 FAIR OAKS CT 12% State Surcharge - Building 09/08/2009 $7.50 PHONE: Plan Review 09/08/2009 $40.63 Contractor: TENANT PHONE: FAX: Specifics: Type of Use: COM Class of Work: ALT Dwelling Units: 0 Stories: 1 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $1,500 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $110.63 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 r ance ith- 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. ENTION: Oregon law require u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 1 -0010 through OAR 952 -001 100. You obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issu d By: Permittee Signature: k ll G 3�/)if I _ • ��• 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. uildin Permit A licatio - � I i va~ t vv., N_. --IT . tr Commercial ED t, (woo roll ()HA( 1 U\I.1 City of Tigard c c P 0 009 -r(,« ply. 9 9 09 Permit No.:. ottPn:JU7 00 /6.5 • 13125 SW Hall Blvd. Ti , O 23 Plan Revi ( � ([ �` q Phone: 503.639.4171 Fax:�� a, �� ` l U V 1 Other Permit: it I Inspection Line: 503 .6 1$10 Date R y: kris: ® See Page 2 for Internet www.tigar EDI DN Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: l- 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 equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling ® m Comercial/industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other; Number of bathrooms: 1 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 12200 SW MAIN STREET New dwelling area: square feet City/State/ZIP: TIGARD,OR 97223 Garage/carport area: square feet • 3 Suite/bldgJapt no.: Project name: BEAD BULLIES ENTRY DOOR Covered porch area: square feet i Cross street/directions to job site: MAIN STREET AND SCOFFINGS BY US BANK Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2S102AA02303 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. REMOVAL OF WINDOW AND REPLACEMENT WITH ENTRY DOOR ON EAST Valuation: $ nl SIDE OF THE BUILDING. f �V Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER I ® TENANT Number of stones: 1 Name: KARI DONALDSON Type of construction: Address: 8550 SW COLONY CK CT Occupancy groups: City/ State/ZIP: TIGARD, OR 97224 Existing: Phone: (503)828 -8520 Fax: ( ) New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: BEAD BULLIES LLC All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: KARI DONALDSON under ORS 701 and may be required to be licensed in the Address: MAILING ADDRESS: 8550 SW COLONY CK CT jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/ State/ZIP: TIGARD, OR 97223 apply: Phone: (503) 828-8520 I Fax:: ( ) E -mail: BAD.BULLIES @VERIZON.NET CONTRACTOR Business name: •ri (1 (.J i--- BUILDING PERMIT FEES* Address: (Please refer to fee sr-heal-0 Structural plan review fee (or deposit): 1 SO City/State/ZIP: 1 FLS plan review fee (if applicable): -- Phone: ( ) Fax: ( ) Total fees due upon application: y0• !O 3 CCB lic.: 6,-1.1( Amount received: 7 . 'J5 Authorized signature: )C This permit application expires if a perm f ed within 180 days after it has been accepted as complete. ` Print name: Date: • Fee methodology set by Tri - County Building Industry fY7D1 to • Il Building Division TIGARD Over - The - Counter (OTC) Building Permit ll Check List Description of Project: l I GENERAL INFORMATION Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* First floor: N: S: Type of Construction: Second floor: E: W: Occupancy Group: Third floor: Openings Protected Y /N ?: Occupancy Load: Total sq ft.: N: S: Stones: I 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: OD Handicap access: Smoke detector: Protected corridors: /�3d Fire alarin: Parking spaces ( #): Notes: Total Valuation: $ j INSPECTIONS FEES DUE Footing /foundation Firewall $ , 0 Permit Fee Post /beam structural Smoke detector $ ' 7,.-.3© State Surcharge Shear wall Misc. inspection $ 4 Q . �� Plan Review Fee Masonry Approach /sidewalk $ 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: $ I 1 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