Permit n CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2012 -00096
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/10/2012
Parcel: 1S136DCO2504
Jurisdiction: TIGARD
Site address: 7275 SW DARTMOUTH ST 120
Project: Great Clips Subdivision: HUNTER POLLOCK NO.2. Lot: G
Project Description: TI
Contractor: CREEKSIDE CONSTRUCTION Owner: AMERICAN INDUSTRIES INC
13525 SW 21ST 1750 NW FRONT AVE STE #106
BEAVERTON, OR 97008 PORTLAND, OR 97209
PHONE: 503 - 789 -7781 PHONE:
FAX: 503 - 591 -7522
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 05/10/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 05/10/2012 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 05/10/2012 $164.96
Stories: 1 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 05/10/2012 $19.80
Value: $5,500 Plan Review 05/10/2012 $107.22
Plan Review - Fire Life Safety 05/10/2012 $65.98
Info Process /Archiving - Lg $2.00 (over 05/10/2012 $8.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $438.96
Required: Required Items and Reports (Conditions)
Fire Sprinkler: 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 -00 rough • • ' 952 -00 .090. 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: k — , 4" /u .rte Permittee Signature: 1. 1/1L-2
/
Call 503.639.4175 by 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 l Olz clr•hlct: List: (NI.,
City of Tigard DECEIVED Received R 6 to Permit No.: i ., , a019 Q
;� ° 13125 SW Hall Blvd., Tigard,Olt 97/21., , 1 0 2012 Plan Revie • ili � Other Permit:
Phone: 503.718.2439 Fax: 503.598. Date/B : l ftRA I ll!
TI RD Inspection Line: 503.639.4175 Date Rea kris: El See Page 2 for
GA
Internet: wirw.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
RI IIl.DING DIVISION
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
❑ 1- and 2- family dwelling $Commercialindustrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7o, 7S S Dq,+Mae 4-1 New dwelling area: square feet
City /State /ZIP: ;t N.-01 OA Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 6 re1ej 61 y 5 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.
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.
do
` L s Valuation: $ 5: �Q '
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT 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)
Business name: C /'G C k S 1 tJ c dot g } /WI' w� Structural plan review fee (or deposit):
Contact name: D cit0.11
L FLS plan review fee (if applicable):
{
Address: 1 3 6'dS 503 Z V S 7
Total fees due upon application:
City/State /ZIP: Qea✓1rc,r VR 7700
Amount received:
Phone: ("U3) 7 g5— '7 7 g/ Fax: : ( )
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Greg Ics.NikA. ( cr)vx 4 44 Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 1 -3 5 c )-5 S..d Z I - Solar Installation Specialty Code checklist.
City/State /ZIP: �'je4�,t,, 0& i`7 Permit fee (includes plan review $180.00
( ,� �_ ?' � , I ( ) and administrative fees):
Phone: Fax: State surcharge (12% of permit fee): $21.60
CCB lic.: y7s Total fee due upon application: $201.60
Authorized signature: J It 1wt, This permit application expires if a permit is not obtained
) within 180 days after it has been accepted as complete.
Print name: U e,..., 1 I/ I Date: 5 /9/ / a * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc. 02 /24/2011 440 -4613T(11 /02/COM/WEB)
■
° Building Division
N.
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: $I
•
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line 121 of Valuation Computation): $
•
I: \Building \Permits \BUP -COM PermitApp.doc 02/24/2011
..A fa-,9-4- Q L.k--.
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1 e ° Building Division 44 /2-0
Development Code Provision Review
T I G /\ R D Commercial Projects - No Associated Land Use Case
Building Permit No: P 19‘019- Expedited Review
Plan Submittal Date: 57/0A 9—
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 on if approved. ''11
Planning Review (contact (®% r at 503 - 718 ;4 ��% JJ V or I @ti or.
I]d' Zoning 0-6 F Permitted Use Yes IEK No ❑
[Land Use Required: Yes ❑ No B (explain below)
Notes: v � _ ^ /
Approved 0 Not Approved Date: /0
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albcrt @tigard - or.gov)
Notes:
- t )1 k .-----
Routed back to Building Division Date:
I: \CURPLN
III e ° Building Division
Over- The - Counter (OTC) Building Permit
TIG,\RD
Check List
Project Description: T7
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: i\L'J Occupancy Group: 4 Type of Construction: JY
*Type of Use: e , Occupancy Load: Oregon Specialty Code: 7. e )1)
SPECIFICS
Number of Stories: I 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: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $___ FEES DUE
$ Llri DC Prov Rvw, COM TI — Ping
$ ' CO DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ raw Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ al_ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ �, — Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ /� -ii :: Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ i 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: $ 4, %6, 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.
I: \Building \Fortes \OTC - BUP.docx 01/13/2011