Permit n CITY OF TIGARD BUILDING PERMIT
111 s, COMMUNITY DEVELOPMENT Permit #: BUP2012 -00210
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/31 /2012
Parcel: 1S135DC00200
Jurisdiction: Tigard
Site address: 11825 SW GREENBURG RD 113
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: TI
Contractor: GENERAL CONSTRUCTION SERVICES Owner: TWO G'S REAL ESTATE LLC
18395 WOOD THRUSH ST 18395 WOOD THRUSH ST
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503 - 684 -0550 PHONE: 503 - 684 -0550
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee - Additions, Alterations, 10/31/2012 $149.75
Demolition
Occupancy Grp: B Occupancy Load: 2 12% State Surcharge - Building 10/31/2012 $17.97
Dwelling Units: 0 Plan Review 10/25/2012 $97.34
Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 10/25/2012 $59.90
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Lg $2.00 (over 10/31/2012 $2.00
Value: $5,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $326.96
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No 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, •r if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification • nt- . — T = e les 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 5 9 .. 32.1 or :00.33 .2344.
Issued By: killL � Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available I - •e . • 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.
uilding Permit Application
Commercial RECEIVE I FOR OFFICE USE ONLY
City of Tigard Ileceived D���
Date/B Permit _ (,( Rap /e2`euo �e,
1, a 13125 SW Hall Blvd., Tigard, OR 97223 OCT '2 5 2012 Dat Revie
, Plan Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Wcao u IZ Other Permit:
TI G A R D
Inspection Line: g 03.639.4175 CITY OF T�pRp Date Ready/By: r s 0 Su Pee Page 2 for
Internet: www.ti ard -or. ov BUILDING DIVISION vtr"I Noti 4ed , 36 1 `� �Q S Information
� V I J Rise u r
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
til Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1:1 I- and 2- family dwelling gCommercial/industrial
Valuation: $
ID Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder CI Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 1 Ts ZS S ti j SVLEZ a 0 olt.c. (. b New dwelling area: square feet
City /State /ZIP: M ` Ati t ) Ot Garage /carport area: square feet
i.Idg. /apt. no.: (l 3 1 Project name: S 0 , 7 e. ( 1 3 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: 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.
Et TEL/ Old— lAia L C A A."1 % T t D .J$ , 7 c �/ S 04-d��GD Valuation: $ 5, Q
Existing building area square feet
CE tlrt.._J S /3 T0"---
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 2
Name: Type of construction: v3
Address: Occupancy groups:
City/State /ZIP: Existing: Q
g�
Phone: ( ) Fax: ( )
New: sjp C1.}Aa+Lttl
- APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES`
Business name: — D A ti 10 1 30 V S K A (Please refer or deposit):
i t):
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address: 'L Z (o0 5 S pt a to) 0r, 7 C 7
Total fees due upon application:
City /State /ZIP:
S oJ e O 0 91 14o Amount received: i j 7 w 5/
Phone: 6)3 ) 6 To . 6444' Fax:: ( )
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: (L S Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address:
1 SC '3 c 5 W v..) -5-4 ,4c 0, 3± Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee (includes plan review
ity/State /ZIP:
Ld(Ce flS1A/B( O O A-- �Z0 3 and administrative fees): $180.00
Phone: ( ) (v 4 - 0 S s C Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: Iv 00x I Total fee due upon application: $201.60
Authorized signature. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name ' ' ' Date: p — Z - ) 2 * Fee methodology set by Tn - County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 02/2 e 440- 4613T(11 /02 /COM/WEB)
Building Division
. 1 11 11 q Development Code Provision Review
TI c A R ° Commercial Projects - No Associated Land Use Case
Building Permit No: r P / a oo 0 ❑ Expedited Review
Plan Submittal Date: /o %S / /7-
•
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 pproved.
Planning Review (contact at 503 - 718- i:2.`/Y or @tigard - or.gov)
Proposal:
Zoning V` /
Permitted Use Yes B No ❑
Land Use Required: Yes ❑ No L7
Notes:
- r ezi' a' /0/
/Approved ❑ Not Approved Date: d „p '/D—
REVISED 10/4/12