Permit �� 11 CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2012 -00244
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/05/2012
Parcel: 1S135DD00600
Jurisdiction: Tigard
Site address: 11831 SW PACIFIC HWY
Project: Young's Funeral Home SubdivisionARBER TRACTS NO.16 TO NO.40 INCL Lot: 40
Project Description: TI
Contractor: PORTLAND MECHANICAL CONTRACTORS Owner: YOUNG'S FUNERAL HOME
2000 SE HANNA HARVESTER DR 11831 SW PACIFIC HWY
MILWAUKIE, OR 97222 TIGARD, OR 97223
PHONE: 503 - 656 -7400 PHONE:
FAX: 503 - 655 -0620
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg DC Provision Review, COM TI - Ping 12/05/2012 $67.00
Occupancy Grp: A -3 Occupancy Load: 293 DC Provision Review, COM TI - LRP 12/05/2012 $10.00
Permit Fee - Additions, Alterations, 12/05/2012 $195.38
Dwelling Units: 0 Demolition
Stories: 1 Height: 0 ft 12% State Surcharge - Building 12/05/2012 $23.45
Bedrooms: 0 Bathrooms: 0 Plan Review 12/05/2012 $127.00
Value: $8,000 Plan Review - Fire Life Safety 12/05/2012 $78.15
Info Process /Archiving - Sm $0.50 (up to 12/05/2012 $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 $503.48
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit - • subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be d• - in accordance tlapproved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da . ATTENTION: Oregon law •ui = you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
• •2 -001 -0010 through OAR 952-1%1-0090. You • - obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/
ssued By: � / , , Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available ins ' n date.
This permit card shall be kept in a conspicuous place on the job site tit completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
Rece ived
Ci of Tigard / Permit No.: 1111 tY g Date /B : �� : �, —o
• 13125 SW Hall Blvd., Tigard, OR 0 5 20 12 Plan Review •
13 Phone: 503.718.2439 Fax: 503.50711960 p� Date /B : Other Permit:
1' I C A R D Inspection Line: 503.639 CITY 1 O F TIGARD Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK 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
® Addition/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 ® Commercial /industrial
Valuation: $ (}.1�`
❑ 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: 11831 SW Pacific Highway New dwelling area: square feet
City/State /ZIP: Tigard, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Young's funeral home 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.
�GJ
Remove 18' wide x 7' 71/2" tall garage door. Install new 14' wide x 7' 6" tall Valuation: $ 75000
garage door and a 3' wide x 7' tall emergency exit door, repair siding and paint Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name: Youngs Funeral Home Type of construction:
Address: 11831 SW Pacific Hwy Occupancy groups:
City/State /ZIP: Tigard, Oregon, 97223 Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: Portland Mechanical Contractors (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: Doug Place
FLS plan review fee (if applicable):
Address: 2000 SE Hanna Harvester Dr
Total fees due upon application:
City/State /ZIP: Milwaukie, Oregon 97222
Phone: (503) 969 -9525 Fax: : (503) 656 -6374 Amount received:
E - mail: dplace @pmc -g.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Portland Mechanical Contractors Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 2000 SE Hanna Harvester Drive Solar Installation Specially Code checklist.
City/State /ZIP: Milwaukie, Oregon 97222 Permit fee (includes p lan review $180.00
and administrative fees):
Phone: (503) 656 - 7400 Fax: (503) 656 - 6374 State surcharge (12% of permit fee): $21.60
CCB lie.: 151807
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: Doug Place Date: 12/03/2012 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -COM PennitApp.doc 02/24/2011 440- 4613T(I 1 /02 /COM /WEB)
Building Division
Development Code Provision Review
T[GARD Commercial Projects - No Associated Land Use Case
Building Permit No: ❑ Expedited 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 DAryun. 1.-- at 503 -718- yY or +'^e-- @tigard - or.gov)
Proposal: /1 "—' 4014 f 4uG <53 4 . , t€ Aw,. � a1.41.. .0
Zoning M U— C 6D
Permitted Use Yes No ❑
Land Use Required: Yes ❑ No
Notes:
4 Approved ❑ Not Approved Date: 12 / //Z
REVISED 10/4/12
Building Division
Over- The - Counter (OTC) Building Permit
T1GnR° Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: l_ j Occupancy Group: /-3 Type of Construction:
*Type of Use: fC1,11 Occupancy Load: a y 5 Oregon Specialty Code:
SPECIFICS
Number of Stories: 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: $ FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ 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: $ 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.
I: \Building \forms \OTC- BUP.docx 07/01/2012