Permit •
CITY OF TIGARD BUILDING. PERMIT
111 q
B • COMMUNITY DEVELOPMENT Permit #: BUP2012 -00105
T t G A.R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2012
Parcel: 2S 113AA01000
Jurisdiction: Tigard
Site address: 16578 SW 72ND AVE B9
Project: Gingerbread Traditions Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS C,C
Project Description: TI
Contractor: DURUS CONTRUCTION LLC Owner: PACIFIC REALTY ASSOCIATES
15806 UPPER BOONES FERRY RD ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
•
PHONE: 503 - 320 -8601 PHONE: 503 - 624 -6300
FAX: 503 - 244 -4318
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 05/24/2012 $925.23
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 05/24/2012 $111.03
Stories: 1 Height: 0 ft Plan Review 05/24/2012 $601.40
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 05/24/2012 $370.09
Value: $75,260 Info Process /Archiving - Lg $2.00 (over 05/24/2012 $6.00
11x17)
DC Provision Review, COM TI - Ping 05/24/2012 $160.00
Floor Areas: DC Provision Review, COM TI - LRP 05/24/2012 $24.00
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
•
Garage: 0
Mezzanine: 0
Total $2,197.75
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 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 c R 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: i / / 1 Permittee Signature. ' /�
, �% / try
Call 503.839.4175 by 7:00 a.m. for the next available Inspection ate.
This permit card shall be kept Ina 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 RECEIVED
(FI'ICE USE ONLY
Received I P- 4 , , Q - , /J n 7D5
City of Tigard DateB : Permit No.: aO /,Z�p
° , ard, 97 e��
Phone: 13125 SW 503Hall . 718Blvd. . 2439 Tig Fax: 503.598.1960 OR 223 MAY 2 2 2012 Date/By: Revi (w J Tv V 050. ' I Other Permit:
- t c; n t , n Inspection Line: 503.639.4175 Date ReadyBy: / / /.Ions ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: S I'3 f Supplemental Information
BUILDING DI\IISION
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: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling %Commercial /industrial Valuation: $--1-S I O t 41`)
❑ 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 is '}-42) 'c - -- fZ. " A,,,, New dwelling area: square feet
City /State /ZIP: Tit ,X. Y k ,o-e. Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 6 i vit,fr 19 &AA T; 7606 his Covered porch area: square feet
Cross street/directions to job site: 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK , �" work indicated on this application.
TetAaAA - ,1M • �a Ni , 1 (� "U'( „(, k` I Valuation: $
` . / ' 4, ■ . , / h 0 ; . ' / b ,, `d J = Ex building area square feet
•
New building area: square feet
[ iPROPERTY OWNER I 0 TENANT Number of stories:
Name: 1a fl� �+ ` �CA,k S L-� Type of construction:
Address: k 3, s V O� u o l a t3 at) Occupancy groups: —
City /State /ZIP: , I I -ck 04 9 7- Existing:
Phone: (S L 2 – 6220D Fax: (6-63 , n a3 -77S New:
yl APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: A. 6 W N2,4,,- (Please refer rofee schedufel
(I� C Structural plan review fee (or deposit):
Contact name: —
AAA_ 191 V ■ � FLS plan review fee (if applicable):
Address:
City /State /ZIP: Total fees due upon application:
Phone: (Spy) 701 1 1 I Fax: : ( ) Amount received:
E -mail: y yuA 1 • , 1 & * b' V t d- f t.. v r r ` PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: G V �v (1.& S S V uko." Submit two (2) sets of roof plan with connection details
f ■ A � ^ s n ' and fire department access, along with the 2010 Oregon
Address: g a., i l Y/ * w� A` Solar Installation Specialty Code checklist.
City /State /ZI 70 3 Permit fee (includes plan review $180.00 and administrative fees): _ Phone: (56) 3 �0 -� .B I Fax. ( 2 � 9 11 - g v 4 q State surcharge (12% of permit fee): $21.60 CCB tic.: J • Total fee due upon application: $201.60
Authorized signal r a� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: �/` M Date: 4721 f 2 *Fee methodology set by Tri- County Building Industry
1 " Service Board.
I:\Building\Permits�BUP -COM PermitApp.doc 02!24!2011 440-461 3T( I 1 /02/COM/WEB)
1111 e a Building Division
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
- 71 Building Permit No: (.t l c90/ g- 00/05 ( Expedited Review
Plan Submittal Date: A-
z 1/L
To the Applicant:
(Ds' 7g � a � /fit/
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. ,,/
Pl Review (contact !
at 503 -718 -2 t' r i — orr k @tigard- or.gov)
M Zoning 3 -L Permitted Use Yes �l No ❑
1:4 Land Use Required: Yes • - - No L7 (explain below)
Notes: / / / frt051 ?"4140dvniriA ''-1 - •
N diA4/1 '
/Approved ❑ Not Approved Date: 4 2-2
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard- or.gov)
Notes: /
N Iff
Routed back to Building Division Date:
I: \CURPLN
1
11 ° Building Division
Over - The - Counter (OTC) Building Permit
T I G A lZ D Check List
Project Description: Ti
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: . 1 ..1 Type of Construction: �-f
*Type of Use: LCait Occupancy Load: ZZ Oregon Specialty Code: '"Z
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: Ve-' Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ '? ) 2GO I FEES DUE
/60. $ DC Prov Rvw, COM TI — Ping
( �j , DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ �tZ5 ' Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ ,I .0 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Ire (, • r Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ Q, Al Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ or , A Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sin (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: $ (471 7( Oth r:
4'
Date /Time: 5 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.
l: \ Building \Forms \OTC - BUP.docx 01/13/2011