Permit V CITY OF TIGARD BUILDING PERMIT
111 a COMMUNITY DEVELOPMENT Permit #: BUP2009 -00119
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/13/2009
Parcel: 1S133AD16000
Jurisdiction: Tigard
Site address: 12744 SW NORTH DAKOTA ST
Subdivision: Lot: 0
Project: Key Bank
Project Description: TI
Owner: FEES
HALL, DONALD W & GRACE L & Description Date Amount
HALL, JOHN G ET AL, BY FIRST AMERICAN Permit Fee - COM 06/26/2009 $911.26
REAL ESTATE TA, 8435 N STEMMONS Plan Review 06/26/2009 $592.32
PHONE: Plan Review - Fire Life Safety 06/26/2009 $364.50
12% State Surcharge - Building 08/13/2009 $109.35
Contractor: Metro Const. Excise Tax - Commercial 08/13/2009 $232.80
P & C CONSTRUCTION CO Use
PO BOX 410
GRESHAM, OR 97030
PHONE: 503 - 665 -0165
FAX: 503- 667 -2565
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $194,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,210.23
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: No Protected Corridors: No
Smoke Detectors: No Manual Pull Stations: No
Accessible Parking: 0
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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
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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 throu h 0 R 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 G'
46.6699 or 1.800.32344.
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Issued By: O� � .......t ...... ` - �n7^y�n Permittee Signature: K f
Call 03.639. f75 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 o project.
Approved plans are required on the Job site at the time of each inspection.
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.suildin Ferulut t Il lt4 au vaa 4���+
�p RECEIVE'
CoYfilt medal FOR OFFICE 1JSE ONLY
City of Tigard JUN 2 6 2009 Porutir No.: 00 l l 9 Plan R
.- v 13125 S W Hall Blvd., Tigard, OR 97223 v' • �' /� c� ��
s Plume: 503.639.4171 Fax: 5t13.598.1966 CITY OF TIGAR • Uata'B '' A `v- J OcbcrPcrmit: Mg-2- 00q •_CO312
inspection Line: 563.639.4175 B DIVISI • '`0C Rc • : jti ® See PPagcc - 2 ` ff rr
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interact: www.tigard- or.gov o1it d/ eihnd: • O NM
Suppleraeanl Information
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❑ New construction %Demolition Permit fee* are based on the value of the work performed.
indicate the value (rounded to the newest dollar) of all
❑ Additionialtcrationhcplaocmcnt 0 Other: equipment, materials, labor, overhead, and the profit for the
RX' fPW i 2� u + " i�. ^siliM- ti i5 .' 3: ' :1?: aT 2:, v work indicated on this application.
• • Valuation: $
❑ 1- and 2- family dwelling kit omnicrcial /industrial - ._ - _...__...
12 .Accessory building Q Multi- family Number of bedrooms!
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Ai ❑ Master builder ❑ Other: Number of bathrooms:
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' ,a � d 2`''• a� � ,� c � a7 Total number of floors:
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\ 4` Y 1 i y \ _ e / ' ) Job site address amm i'•!!�S►v� taa�: - • - �a'� akt Iti cw dwelling area: _ square feet
` t'r C�ity/Stata'7.iP: li O e, - -- 9' r„ Garagckarport area: square feet
v�vlllL.. Suite:b]dg.+apt. no.: Project name: +f ,_ 42 Covered porch area: square feet
Crust street/directions to job site: L., ` I A ' I. Deck area: squats feet
R ex a, pp I(C �,...cr1/2- , Other structure area: square feet
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Subdivision: Lot no.: Permit fe c i* are bared on the value of the work performed.
Tax map/parcel n a. 1 000 Indicate the value (rounded to the nearest dollar) of all
_ equipment, materials, labor, overhead, and the pro (l for lire
i'.. •;.'••'4.v�•.J,,.. f H�7 G 0 t =y9, :} +•+• +•"••••+'••• : = •: ^ ,a•• "*„ -"� 'work indicated on dais r101L •
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W MA> 7�i!`P4 f ! M �iT+�'fl� a Valuation $ tegli 150 0
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Existing building area :, square feet
New building area: Mir-. square feet
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Name: ee:L'' Type of construction: It
Address: 7 r t 1.--i- F Occupancy groups:
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CityiStatc!'L1P: el 'b' if ) 04 zght5 Fixi din 04„ r-
Plume: ( ) Fax: ( ) 11evH: r - "' it,—
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Business name: � ' iftce j All contractors and subcontractors am required to be
Contact name• licensed with the Oregon Construction Contractors Board
under ORS 701 and maybe required to be licensed in the
Address: ? 0 i.,f tI2- ti5O jurisdiction in which work is being performed. If We
CitylStatc!L1P: ea,40t01/ 644
applicant is exempt from licensing, the following reasons
Phone: „, ) 47 • � .�0 i , Fax:: ( ) ^.. 4,-12_4 rt rr •
E- snail: 5 e • �3 a ._.......
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Address: . 0 16
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City: Stato'ZIP: 6, / L. ,. . ■ Z 7.0 56 Structural plan review fee (or deposit):
Phone: ' j . , '+ ) (, Fax: ( • ) Iple7 � as plan review fee (if applicable):
CCR lie.: 3 $ Total fees due upon application: t n . 8 Z I I
Authorized signature: ��:•�'f�l9tJ1'av e e if received: Ivo This permit application on expires if a permit in not obtained
Print name: 6414 t � Date; � 'r ✓y'� T1� I within 180 days after it has Ices accepted as complete.
1 * F cc methodnloa set by Tri- County Building Industry
Service Buard.
I% PcrmitApp.doc 2:23/07 440.4613T(11 :l .VOM/WEB)
q Building Division
Accessibility: Barrier Removal Improvement Plan
C IGARD
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REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.24L
(1) Everyproj«:t 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 arc 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 iv an altered arca may be deemed disproportionate w
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] $ k°44 4 JO
MULTIPLIER (25% barrier removal requirement): x 25
TOTAL BUDGET FUR BARRIER REMOVAL:. [2] $ X 560
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ELEMENTS: In choosing which accessible elements to ptavide under this section, priority shall be given .
to those elements that. will provide the greatest aeons. Elements shall be provided in the
follawing order.
(a) Parking $ !7
(b) An accessible entrance: $ 69
(c) An accessible route to the altered area $ 1 d 0 0
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ 10 / 660
(e) Accessible telephones: $ CI
(f) Accessible drinking fountains: and, $ 600
(g) When possible, additional accessible elements such as storage and
alarms k 10 11.4.4 e, 4 •J $ / 65C)
TOTAL (shall equal line (2] of Valuation Computation): S 77 6
I:1Buifding \Pe rmit \ BLIP- COMPcrmitAppdnc t0 /3Wo7