Permit CITY OF TIGARD BUILDING PERMIT
s COMMUNITY DEVELOPMENT Pe r mit #: BUP2012 00163
TI GA 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2012
Parcel: 1 S134BC00200
Jurisdiction: Tigard
Site address: 12160 SW SCHOLLS FERRY RD 100
Project: Berry Farm Yogurt Subdivision: WINDSOR PLACE Lot: 32
Project Description: TI
Contractor: EAST WEST PLUMBING INC Owner: GREENWAY CENTER LLC
10610 SE 145TH AVE ANA KALAKAUA CENTER
HAPPY VALLEY, OR 97086 2155 KALAKAUA AVE #602
HONOLULU, HI 96815
PHONE: 503 - 777 -1594 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: DC Provision Review, COM TI - Ping 08/16/2012 $67.00
Occupancy Grp: Occupancy Load: DC Provision Review, COM TI - LRP 08/16/2012 $10.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 08/16/2012 $149.75
Demolition
Stories: 0 Height: '0 ft 12% State Surcharge - Building 08/16/2012 $17.97
Bedrooms: 0 Bathrooms: 0 Plan Review 08/16/2012 $97.34
Value: $5,000 Plan Review - Fire Life Safety 08/16/2012 $59.90
Info Process /Archiving - Sm $0.50 (up to 08/16/2012 $2.50
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $404.46
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 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. or 1.800.332.2 4.
Issued By: Permittee Signature:
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 sits until completion of the project.
Approved plans are required on the job site at the time of each inspection.
—
Building Permit Application d ��'
Commercial Permit No. r()R (lrricI; tjsi.: ()NIA
City of Tigard Date/Be s 00! -
v 13125 SW Hall Blvd., Tigard,OR 9 CEIVED
Plan Review , '"7:11 ir
Phone: 503.718.2439 Fax: 503.598.19Av G 1 6 2012 Date/By ( 1 t/ (O (7i Other Permit:
r I C. lL u Inspection Line: 503.639.4175 Date Re.. : y: Juris: El See Page 2 for
Internet: www.tigard - or.gov CITYOFTIGARD Notified/Method: - fly / Supplemental Information
O'P� 6
TYPE V1viSION REQUIRED DATA: i- 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
*ddition/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
omerciaUndustrial Valuation: $
m
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB // SITE INFORMATION AND LOCATION ,Q � Total number of floors:
Job site address: 121 bQ SW SoludISS f TI Fr Rd / New dwelli area: square feet
City/State /ZIP: '� : , 0K 1` 9 f) 2 2 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: g c rry Parma X U r - Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
S W S ll s F Rd /SW /2 1 1- Avg Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: G I ee rt1A. CG es+c I L ot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 1 513 (,/ B coo 2 QQ 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
1
Valuation: $ !,
"(''
ahaA+ 2 rv► Provemen 1' Existing building area �- square feet
New building area: square feet
❑ PROPERTY OWNER I TENANT Number of stories:
Name: G rc. q St; a n fIC I Type of construction:
Address: 1 2 I C) Sw S h Fern 1� Occupancy groups:
City/State /ZIP: �_'� Q 1`d O n fir �(K, 9'722 3 Existing:
Phone: 603) S 1 7 s( vg q Fax: ( ) New:
❑ APPLICANT X CONTACT PERSON BUILDING PERMIT FEES*
V (Please refer to fee schedule)
Business name: 8 Grry Farris F V q 4r Structural plan review fee (or deposit):
Contact name: (7- rt SC n Gl ( FLS plan review fee (if applicable):
Address: 12 160 30 & F c r lq #
City/State /ZIP: �� 9 Q _ _I F O R q)?oo Total fees due upon application:
Phone: 603) 6I+9 SNC Fax: : ( ) Amount received: •
E -mail: S cta n He ( 1 4- &__-F-0-o11 ,e r .corks. PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: +6 s,' , , rstt 4. (I .� L Submit two (2) sets of roof plan with connection details
tN and fire department access, along with the 2010 Oregon
Address: 1 06 I V 5 1116 Me Solar Installation Specialty Code checklist.
City /State /ZIP: p i )v- / Q a Permit fee (includes plan review $180.00
_ and administrative fees):
Phone: (47 )) . c. ... 'II e Fax: ( 5 7 7 7 / - f 5 1 (1 State surcharge (12% of permit fee): $21.60
CCB lie.: (t3 c).„ \ Total fee due upon application: $201.60
Authorized signature: ,1,..,/` This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
' Print name: p/j, C I Date: _ i c . `'L * Fee methodology set by Tri- County Building Industry
Service Board
I:\Building\Permits\BUP -COM Pe itApp.doc 02/24/2011 440 -4613T(11 /02 /COM/WEB)
. ` 43
ai
: 0 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): $
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
e,at/ 1,14,1 �/ 6u
IN e ° Building Division
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: ee g°/ C f & LtrExpedited Review
Plan Submittal Date: //,
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 (contact 1� at 503-718-2,/4'O
�,orr @ tigard- or.gov)
an -- &- �f Zoning G �' Permitted Use Yes [ No ❑
❑ Land Use Required: Yes ❑ No ❑ (explain below)
r
Notes: _ i _ �. V . .4.. / �I 0 I ' ,/ j
G� /tiiy ' / :,-.'; GI 5iit.& -Sr •-
Pg dtd
ti Approved ❑ Not Approved Date: r/A
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
/)°1-1-(- 1
Routed back to Building Division Date:
I: \CURPLN
o ° Building Division
Over - The - Counter (OTC) Building Permit
T I G A R D Check List
Project Description:
( � ,c - -a � r (t'\3
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: / Occupancy Group: jZ. Type of Construction:�j
*Type of Use: 6,7� Occupancy Load: Oregon Specialty Code: '20(C„)
SPECIFICS
Number of Stories: 1 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: $ 1. )C 1 C0 FEES DUE
$ •• DC Prov Rvw, COM TI — Ping
$ U , DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ k'5 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 7 . - 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ °1112M Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ • - 6 Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ 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 4 (, 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.docx 07/01/2012