Permit CITY OF TIGARD BUILDING PERMIT
111 11 a..- COMMUNITY DEVELOPMENT Permit #: BUP2009 -00160
•T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/27/2009
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12264 SW SCHOLLS FERRY RD
Subdivision: Lot: 0
Project: Snap Fitness
Project Description: TI
Owner: FEES
FW OR- GREENWAY TOWN CENTER LLC Description Date Amount
PO BOX 790830 Permit Fee - COM 08/27/2009 $366.70
SAN ANTONIO, TX 78279 12% State Surcharge - Building 08/27/2009 $44.00
PHONE: Plan Review 08/27/2009 $238.36
Plan Review - Fire Life Safety 08/27/2009 $146.68
Contractor:
GIBB CONSTRUCTION & REMODELING INC
15755 SW SERENA WAY
TIGARD, OR 97224
PHONE: 503 - 407 -9686
FAX: 503- 549 -8986
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0 ,
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $50,000
Floor Areas:
Total Area: 0 •
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $795.74
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Protected Corridors: No
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 i - • • - , ith 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 TENTION: Orego .w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95. 001 -0010 through OAR 9 • -1: -01 i I. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is ed By: / • !/ / • Permittee Signature:
•
Call 503.639.4175 by 7:00 a.m. for an inspection that business ay.
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.
`S
Building Permit Application
'Commercial FOR OFFICE USE ONLY
City of Tigard RE CEIVED Received ¢ a7 09 �' Permit No.: ��a� �Q/6a
• 131 25 SW Hall Blvd., Tigard, OR 97223 P lan R e C
' 0 Phone: 503.639.4171 Fax: 503.598.1 Date/B ,ai y f TAIVZ KM Other Permit:
�� 2 7 2009 lun, ® See
1 i C _ A ii D Inspection Line: 503.639.4175 Date Re. g
Internet: www.tigard - or.gov Notified/Method: � Supplemental e2 Information
CITY OF TIGARD
TYPE %G DIVISION 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 tif Other: 1-iavikorc ( IVJ equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling g Commercial/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: 12,24, 0 4 S W rCi413 LA Pfaiht 12-Q , New dwelling area: square feet
City/State /ZIP: D i , 9 7 Z2 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: S ,,'4P h T..1 ES S Covered porch area: square feet
Cross street/directions to job site: f 21 S.- — C �� f U sue" ` Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: — 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 n/1�r work indicated on this application.
/#NI /M Pgv air( - Ab Z r 14-S / Valuation: $ O t O c7 0
/ 544414 Of-ft 7r '. , , / A r / 7 _ , a Existing building area: 2_2.5v 2_2.5v square feet
/ �t� j'' v"'- `W New building area: square feet
❑ PROPERTY OWNER I tzi TENANT Number of stories: l ' /
Name: `r VE rn L..I.E'J Type of construction: 2r'f "v 6
Address: No( q 7,1 S 0 R IA, v - f - r P 2, Occupancy groups:
City/State /ZIP: 1147440 t oil. 'j 7 2- Existing:
Phone: (SO' )) sZ p 1 2Z. Fax: ( ) New:
❑ APPLICANT wif CONTACT PERSON NOTICE
Business name:
('(PJ Cm�t,f4,14 64 mu 4 7a.,.fG j /1'G, All contractors and subcontractors are required to be
Contact name: `f pyyl gl� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
kddress: / s--is-f S' (.e _firA GT T. jurisdiction in which work is being performed. If the
City/State /ZIP: 7) 9 f f 7 7
I applicant is exempt from licensing, the following reasons
X16 apply:
Phone: ( ra3) `101 161'4, Fax: : (S03) 5-i of - ggR9
E- mail:. !/kpfg( .J 4- r, „/er
CONTRACTOR
Business name: Gi ((p (�yy.rf„yf V' &Hob 4u tjQ„ hie" BUILDING PERMIT FEES*
Address: /T7 $r Sin, f oi CT. (Please refer to fee schedule)
1ir47� Structural plan review fee (or deposit):
City/State /ZIP:
, v Q •t7�/
Phone: (Sd )1.07- 1694, I F ax: (�3 ) �,{. -9./ $'6 FLS plan review fee (if applicable):
:CB lic.: / 'Li 01 (1 c� Total fees due upon application:
[ Amount received:
Authorized signature: / � -.N.-- .��
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 6,21 /5 D g' (�
vv�c * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 2 /23/07 440- 4613T(I 1 /02/COM/WEB)
. t I
Q
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGi \RD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every projcct 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: $ (D 1 Cy3(2)
(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
I: \Building \Permits \BUP -COM PermitApp.doc 06/25/08
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Description of Project: —TT
GENERAL INFORMATION
Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* kWI First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: ( Note: Combine total floor area for E: I~;:
Height: all floors above third floor and Roof Construction: _ _
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED Tl'EMS
Fire sprinkler: e ° _ _ Handicap access:
Smoke detector: Protected corridors: kln
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ 9 )
INSPECTIONS FEES DUE
Footing /foundation Firewall $ . , Permit Fee
Post /beam structural Smoke detector $ / k , Crn State Surcharge
Shear wall Misc. inspection $ ,, Plan Review Fee
_ Alit Masonry Approach /sidewalk $ ' Mb FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ `5,7' 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.
L \ Building \ Forms \OTC- BUP,doc 08/19/08