Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2012 -00085
T I: G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/26/2012
Parcel: 1S136DCO2504
Jurisdiction: TIGARD
Site address: 7275 SW DARTMOUTH ST 160
Project: Benitoite Nail Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: TI
Contractor: VT CONSTRUCTION LLC Owner: AMERICAN INDUSTRIES INC
1200 NE 160TH AVE 1750 NW FRONT AVE STE #106
PORTLAND, OR 97230 PORTLAND, OR 97209
PHONE: 503 - 706 -8345 PHONE:
FAX:
FEES
Specifics:
Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 04/26/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 04/26/2012 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 04 /26/2012 $225.80
Stories: 1 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 04/26 /2012 $27.10
Value: $10,000 Plan Review 04 /26/2012 $146.77
Plan Review - Fire Life Safety 04 /26/2012 $90.32
Info Process /Archiving - Lg $2.00 (over 04/26/2012 $10.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $572.99
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes 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 all other appli :tale law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of is - •, or if work is sus•Anded for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi • • Ce =r. Those rul are set forth in OAR
952 - 001 -00 • • • • • • R 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling •03 0 32.198 or 1.800 .3 44.
Issue. By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available Inspection 7te.
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.
nog
Building Permit Application
Commercial REC ED Received FOK OFFICE e r m i t ONLN
City of Tigard DateB ��� i°61' g� S
° 13125 SW Hall Blvd., Tigard,OR 97223 P lan Review �, �
Date/I3 �r �7 � Permit
ll Phone: 503.718.2439 Fax: 503.598.1960 APR 26 2012 Other PeNo.: rmit:
i- I c Ic t) Inspection Line: 503.639.4175 Date Ready : ruris: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIG 7RD Notified/Method: Supplemental Information
B'Jes nilkr ni,v!gtn "a /
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
D Indicate the value ( rotnded to the nearest dollar) of all
El Addit ion /alteration/replacement ,'Other: 94) fla.i d equipment, materials, labor, overhead, and the profit fos the
CATEGORY OF CONSTRUCTION work indicated on this application.
El i- and 2- family dwelling ❑ Commercial/industrial Valuation: $
El Accessory building ❑ Multi- family
Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION / 40 Total number of floors:
Job site address: c27 5 c!,i. DA iTM (0 a �,-/
7 . . New dwelling area: square feet
City/State /ZIP: P or4 hd , 0 k G] 7 22_ . 3 Garage /carport area: square. feet
Suite/bldg. /apt. no.: Project name: i /Vet fi a lea Covered porch area square feet
• Cross street/directions to job site: 7 ha. ��- f J ( T - d tTE, fJAi L 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.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, ove . - . ••••- ••• - -- for the
DESCRIPTION OF WORK work indicated on ' I rrrion.
�`
-- O i l' h q k
9- Sr (4/,L corm / Litoe /, Valuation: $ -
S' GA Dl r j"s ) I Existing buil , ' : area /square feet
New building area: - square tee
❑ PROPERTY OWNER - TENANT Number of stories:
Name: (s(( Tot,/ Type of construction:
Address: 7 37 5.-p c nrrIn I A fd Ok .. Occupancy groups:
City/State /ZIP: p r f L rt (� p �
' 2O 6, Existing:
Phone: ( '9 56 7 _ -7 U� 1 Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Afr Structural plan review fee (or deposit):
Contact name: 06 r fA-1---
Address: ��S— �E �/ A AV � FLS plan review fee (if applicable):
ty 5 h cows/ , l q G 6 3 Total fees due upon application:
City/State/ZIP:
Phone: ()/� gr ,06 I 2___ I Fax: : ( ) Amount received:
E -mail: �`'`'' _ •' + PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
V
Business name: . r eti y "� ' ' , A 1-.1.4....-- Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: t200 1 JC 4 Co ha" - Solar Installation Specialty Code checklist.
City/State /ZIP: 1 Land l q-12- ` Permit fee (includes plan review $180.00
q / � and administrative fees):
Phone: ( -1)0 — z3 itc I Fax: ) o
State surcharge (12% of permit fee): $21.60
CCB lic.: / zC
/,,, �� [ J �I 2` Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: .-) (.4.p BJ-(r Date: Li./2, c ft y * Fee methodology set by Tri -County Building Industry
T/ Service Board
I: \Building\Permits\BUP -COM PermitApp.doc 02/ 24/2011 440- 4613T(11/02 /COM/WEB)
I
° 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 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(0 Accessible drinking fountains: and, . $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
7x 7 5 afb m il /6a
III ° Building Division
Development Code Provision Review
T[GARD Commercial Projects - No Associated Land Use Case
•
Building Permit No: 6aA0 /A ❑ Expedited Review
Plan Submittal Date: 4/dtGbv-
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 (contactp!t•a FI,yr( at 503 -718- 210t't or Jokn @ tigard or.gov)
❑ Zoning Permitted Use Yes No ❑
❑ Land Use Required: Yes ❑ No LE (explain below)
Notes: Q l/1e4 a. gel owte.,' A1ill4
E Approved ❑ Not Approved Date: ¥C) k /.Z
Permit Coordinator Review (contact Albert Shields at 503 718 - 2426 or albert@tigard - or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPIN
• ° Building Division
Over- The - Counter (OTC) Building Permit
T I G A R D Check List
Project Description: TC
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: LT" Occupancy Group: j Type of Construction: 515
*Type of Use: CCU Occupancy Load: Oregon Specialty Code: 2LD (()
SPECIFICS
Number of Stories: ( Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: � �G j Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ (0 CCED I FEES DUE
$ CO DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ 22.5 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ Z . (O 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ , Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ IP Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ 0, CC./ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ �J 1Z 91 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; ant = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC - BUP.docx 01/13/2011