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Permit
CITY OF TIGARD - • BUILDING PERMIT II I COMMUNITY DEVELOPMENT Permit #: BUP2009 -00081 T IGA•RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/19/2009 Parcel: 2S110DC00700 Jurisdiction: Tigard Site address: 11205 SW SUMMERFIELD DR Subdivision: Lot: 0 Project: Summerfield Golf Cart Storage Project Description: Construct pole barn for golf cart storage. Owner: FEES TIGARD RETIREMENT RESIDENCE LLC Description Date Amount 600 UNIVERSITY ST STE 2215 Permit Fee - COM 05/15/2009 $169.75 SEATTLE, WA 98101 Tax - 12% State Surcharge 05/15/2009 $20.37 PHONE: Plan Review 05/15/2009 $110.34 Plan Review - Fire Life Safety 05/15/2009 $67.90 Contractor: OMT CONSTRUCTION INC PO BOX 455 COLTON, OR 97017 PHONE: 503 - 630 -7030 FAX: 503 - 630 -6090 Specifics: Type of Use: COM Class of Work: ACS • Dwelling Units: 0 Stories: 0 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $17,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $368.36 Required: Required Items and Reports (Conditions) 1 Pln Gen FINAL INSPECTION BY PLANNING DIVISION Fire Sprinkler: Parapet: 2 Pln Gen OBTAIN BUILDING PERMIT 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. ATTENTIO • Ore•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0 through OA -. !1-0101 You may obtain a copy of the rules or direct questions to OUNC by�7lling 503.246.6699 or 1.800.332.2344. Issued y: ' /�f = / Permittee Sign ure: �� Call 503.639.4175 by 7:00 a.m. for an inspection that business 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. uiRl�ing Permit Application D 026T F- OGO // Commercial j)j��' LL I' FOR OFFICE USE U ONLY City of Tigard ��jj�Jl./ Date/B d / % Permit No.: I o q.� g/ : 114 13125 SW Hall Blvd., Tigard, OR 972� 4 2009 Plan Re� I. • C Phone: 503.639.4171 Fax: 503.598.1996V� 1 Date/B : i1� , �A ni Other Permit: T i C. A R D .� Inspection Line: 503.639.4175 Date Rea. y :: � ® see Page 2 for Internet: www.tigard - or.gov CI OF Notifie j ethod: Jt- 07 D Vtl� ' Supplemental Information gt)ILD1N0 DIVISION OW 0/4 � TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING lid 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. Valuation: $ 0© 1:1 1- and 2- family dwelling ❑ CommerciaUindustrial / 7.0046 Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ID Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: tfili 2. S Jyh me r f IG Or New dwelling area: square feet - City /State /ZIP: 7 j foi i u R 7 7Z i'- Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Ctel c ISc to /e 8, h 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. Valuation: gaud /c .5 4Cd'ib n pole ba fa pt4rk; nei G rp $ /7 hoG 00 Char'/ n9 I<Gtir"4.5 Existing building area: square feet 0_ New building area: 71.0 square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: ,S U rr, I a, k4 SS O Type of construction: Address: 2. S o &e w-po r i Celli e r Dr .SiJJ/- E )L3 , Occupancy groups: City/State /ZIP: /tie' tz.` o r 1 Qeec� C19 92660 • Existing: Phone: (9y9) 72/ 1 1k 2Z Fax: (gI/q) 7Z9 lmai New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: cm T CIIn5 t+ Inc. BUILDING PERMIT FEES* Address: it a 4? (Please refer to fee schedule) Structural plan review fee (or deposit): fi , 31/ City /State/ZIP: C 6 i 976 FLS plan review fee (if applicable): , 7 . fo Phone: (543 ) 630. ,74 3 0 Fax: (56 )6"•3L` - Z 0 90 Total fees due upon application: / 7 g' .%i Ce CCBIic.: /a9i�O � ► 1�1 Amount received: �i � „� O Authorized signature /J yt /� � � LC ` � 1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Rc h + n 11,5 Date: /L1 -QC/ * Fee methodology set by Tri -County Building Industry 11 Service Board. I:\Building\Permits\BUP -COM PermitApp.doc 2 /23/07 440- 4613T(11/02 /COM/WEB) a 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 06/25/08 :„e 05/06/2009 08:11 5036243681 TIGARD BUILDING DEPT PAGE 01/04 Letter of Transmittal Ciry of Tigard _ DATE RECEIVED 41 5/( I o9 C S - b3) ► Ve 4- Dear) ( ?B - (e o5 O pole Bar l"►gc - h eeJ ric c4g5 TO:d DEPT: FROM: PHONE NUMBER: (S 0 P \ — RE: `"^' (Case number, si c address, parcel number, etc.) COMMENTS: Ee_ I: data\ formaetDetT»esmiinl. 07/31/01