Permit CITY OF TIGARD BUILDING PERMIT
IN '
m.. COMMUNITY DEVELOPMENT Permit #: BUP2012 -00055
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/22/2012
Parcel: 2S101AB01606
Jurisdiction: Tigard
Site address: 7357 SW BEVELAND RD 200
Project: Beveland Wellness Center Subdivision: HERMOSO PARK Lot: 17
Project Description: TI
Contractor: THOMAS C. CLARKE CONSTRUCTION Owner: CLARKE, THOMAS C & SUSAN L
7357 SW BEVELAND ST. 12439 SW 22ND AVE
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
PHONE: 503 - 597 -7017 PHONE:
FAX: 503 - 597 -7018
FEES
Specifics: , Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 03/22/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 03/22/2012 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 03/22/2012 $509.05
Stories: 2 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 03/22/2012 $61.09
Value: $30,000 Plan Review 03/22/2012 $330.88
Plan Review - Fire Life Safety 03/22/2012 $203.62
Info Process /Archiving - Lg $2.00 (over 03/22/2012 $2.00
Floor Areas: 11x17)
Info Process /Archiving - Sm $0.50 (up to 03/22/2012 $0.50
• Total Area: 0 11x17)
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0 -
Mezzanine: 0
Total $1,180.14 • Required: Required items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: 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 , o her - pplicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days -. or ' work i- suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N• en -r. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calli • 2.1987 'r 1.800.3 1 2.2344.
��
Issued By _ - ermittee Signature: _
Cally 7:00 a.m. for the next available Inspection date.
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 0 )‘ FOR OFFICE USE ONLY
Received ^
C ity of
Tigard • ^O�� Dat : j Perm ` . , V 0 __. 000 • 131 25 SW 7 Hall Blvd. T igard , OR �j l• Plan Review I� ����
/�
C Phone: 503.718.2439 Fax: 503.598.l9� . pateIB : y `'.�' M • Permit:
T I G /� R D Inspection Line: 503.639 �" GrcIGP rS‘e114 Da te Ready :. ®Page 2 for Internet: www.tigard - or.gov c N G Notified/Method: Supplemental Information
TYPE OF VI'�l�E' 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: equipment, materials, labor, overhead, and the profit for the
/ CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Wommercial/industrial Valuation: $
❑ 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;S7 r 5) , q . RO aO 5„4,..._ 7,- New dwelling area: square feet
City/State/ZIP: F , j) OA, qe7 223 Garage/carport area: square feet
Suite/bldg. /apt. no.: 7 Project name: ints5ion Tpium Fr x.4.17*- Covered porch area: square feet
Cross street/directions to job site: "" Zia 4 'gr,i iA rt() S'C— Deck area: square feet
vir `1- 1-c> 5 othersrmare 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.: 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.
Valuation: $ ' �0
o� �,'t>'s l_ Oho RfActel i 14- 1 t f )
.r iw�2E_AS -� S Sfvc o icVS Existing building area: square feet
Bk 0- 1 `) uA4-L # e e 0 . 7 - f gery tc New building area: square feet
d PROPERTY OWNER ❑ TENANT +//(J Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule) name:
e)
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone: ( ) I Fax :: ( ) Amount received: / /, , / t
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* /
CONTRACTOR Commercial and residential prescriptive installation of
1l roof -top mounted PhotoVoltaic Solar Panel System.
Business name: vtn� CA/Lk`T_ culio ac.41Q/L ['n Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
7
Address: ' 7 <-, -72-v1Q AS.-, 51411Q_ HD Solar Installation Specialty Code checklist.
City/State/ZIP: 1_,Alfz. ds� G p o, _ Permit fee (includes plan review $180.00
L��- ( and administrative fees):
Phone: a3 -- zi F • ) .,/-••) ---70 18 State surcharge (12% of permit fee): $21.60
CCB lic.: 19)('') Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
1./m - within 180 days after it has been accepted as complete.
Print name. C ` I Date: 3122,1 1 Z I Fee methodology set by Tn County Building Industry •
Crrvirr Rnard
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: ()ti Pa 0 l) — Ow 55 ❑ Expedited Review
Plan Submittal Date: 3b-,,11/ /4::
To the Applicant:
> If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
➢ If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review ( `---17 /4(J at 503 - 718 -0 or idol/ n 1�/ @tigard- or.gov)
(vi
❑ Zoning RUE- Permitted Use Yes Er No ❑
❑ Land Use Required: Yes ❑ No E (explain below)
Notes: /Vv 044 1 '7 Ore - ( erkc/
® tlpproved ❑ Not Approved Date: 3
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
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