Permit • -
CITY OF TIGARD BUILDING PERMIT
•
a . COMMUNITY DEVELOPMENT Permit #: BUP2009 -00071
T (G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/15/2009
Parcel: 2S 112 DA01300
Jurisdiction: Tigard
Site address: 6640 SW REDWOOD LN 301
Subdivision: Lot: 0
Project: Orthopedic and Fracture
Project Description: TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee - COM 06/15/2009 $438.70
#300 Tax - 12% State Surcharge 06/15/2009 $52.64
PHONE: Plan Review 05/13/2009 $285.16
Plan Review - Fire Life Safety 05/13/2009 $175.48
Contractor:
REIMERS & JOLIVETTE INC
2344 NW 24TH AVE
PORTLAND, OR 97210 •
PHONE: 503 - 228 -7691
FAX: 503 - 228 -2721
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Specifics: -
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 45 ft
Bedrooms: 0 Bathrooms: 0
Value: $65,000
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Floor Areas: •
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $951.98
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet: No
Fire Alarm: Yes Protected Corridors: Yes
Smoke Detectors: Yes Manual Pull Stations: Yes
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 = 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 •ork is spended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those les ar= set forth i .: R
952 001 - 0010 ug AR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 43.246.6 .9 or4 .:!li . . • 44.
. Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an Inspection that buss s y.
This permit card shall be kept In a conspicuous place on the Job site until ' o • lotion of the . roJect.
Approved plans are required on the job site at the time of each Ins . ion.
OR�HDI I�tCCLItUIG (d bUs ?cr_f
Buifding Permit Application D
Commercial RECEIVE L, FOR OFFICE USE ONLY
City of Tigard MAY 0 4 2009 Date/Bea API 111 Permit No.: 41.1 Ali.? _ 7/
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
114 " 0 : Phone: 503.639.4171 Fax: 503.598.1960
Date/B : ATM
. �mj Other Permit:
TI G A R D Inspection Line: 503.639 CITY OF TIG I Date Ready/ :y: ®See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISI I ► 'otified/Method: 5" a.8"
TYPE Information
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.
El 1- and 2- family dwelling ® Commercial/industrial Valuation: $
CI 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: 6640 SW ReedwL od Lane New dwelling area: square feet
RatX4clip
City/State/ZIP: Tigard, Oregon Garage/carport area: square feet
CIie.T idt b re. 1- i 11A117,Ga_
Suite/bldg. /apt. no.: Project name: e_ L.4 C Covered porch area: square feet
Cross street/directions to job site: South on % Carmen Exit, Right on Carmen, Deck area: square feet
Left onto Sequoia 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.
Remodel of approx, 535 sf of existing radiology area into medical office space Valuation: $65,000
Existing building area: 535 square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name: The Portland Clinic LLC Type of construction: I
Address: 800 SW 13th Occupancy groups:
City/State/ZIP: Portland, Oregon 97205 Existing: BI
Phone: (503)221 -0161 Fax: ( ) New: B1
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Mahlum All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Mathieu Jacobs under ORS 701 and may be required to be licensed in the
Address: 1231 NW Hoyt jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: Portland, Oregon 97209 apply:
Phone: (503) 224 -4032 Fax: : (503) 224-0918
E -mail: mjacobs @mahlum.com
CONTRACTOR
Business name: Reimers and Jolivette BUILDING PERMIT FEES*
(Please refer to fee schedut
Address: 2344 NW 24th schedule) 1 r
Structural plan review fee (or deposit): ‘ pj 5. `t' ^
City/State/ZIP: Portland, Oregon 97210
FLS plan review fee (if applicable): l '7 5 �g
Phone: (503) 228 -7619 1)7( I Fax: (503) 228 -2721 h
Total fees due upon application: 4// (p1-I
CCB lic.: 11614
Amount received:
Authorized signature: / �� �� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Mathieu cobs I Date: May 4, 2009 * Fee methodology set by Tri-County Building Industry
Service Board.
I: \Building \Permits\BUP -COM ' • itApp.doe 2/23/07 440- 4613T(11/02/COM/WEB)
1. .
° 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: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
1: \Building \Permits \BUP -COM PermitApp.doc 10/30/07