Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2013 00008
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/09/2013
Parcel: 2S110DCO2300
Jurisdiction: Tigard
Site address: 11535 SW DURHAM RD C -3
Project: Beltone Hearing Subdivision: 1998 -128 PARTITION PLAT Lot: 1
Project Description: TI remodel of walls and installation of new walls
Contractor: BRIDGE CITY CONSTRUCTION LLC Owner: HIP WILLOWBROOK LLC
2250 NW FLANDERS G02 BY HARSCH INVESTMENT CORP
PORTLAND, OR 97210 PO BOX 2708
PORTLAND, OR 97208
PHONE: 503 - 756 -9752 PHONE:
FAX: 503 - 719 -4932
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg DC Provision Review, COM TI - Ping 01/09/2013 $67.00
Occupancy Grp: B Occupancy Load: DC Provision Review, COM TI - LRP 01/09/2013 $10.00
Permit Fee - Additions, Alterations, 01/09/2013 $256.22
Dwelling Units: 0 Demolition
Stories: 0 Height: 0 ft 12% State Surcharge - Building 01/09/2013 $30.75
Bedrooms: 0 Bathrooms: 0 Plan Review 01/09/2013 $166.54
Value: $12,000 Plan Review - Fire Life Safety 01/09/2013 $102.49
Info Process /Archiving - Sm $0.50 (up to 01/09/2013 $1.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
•
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $634.00
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, 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 n iPs 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 callin 03.232.1987 or 1.80r.332.234..
Issued By: 4d.Litt `' , i J Permittee Signature: ■ `
Call 503.839.4175 by 7:00 a.m. for the next available inspe Ion ate.
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 Ume of each Inspection.
Building Permit Application
RECEIVED ED
Commercial FOR OFFICE USE ONLY
City of Tigard JAN 09 2013 Received / / / 3 Permit No.:> api - CO A
® 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
®. ` • Phone: 503- 718 -2439 Fax: 503 - 598- 1960CM( Date/By: h 15 Other Permit: .
T I C. A R D Inspection Line: 503 - 639 -4175 Date Ready/By: Jurls. ® See Page 2 for
Internet: www.tigard- or.gov BUILD DNISIO Notified/Method: � Supplemental Information
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 (rotnded to the nearest dollar) of all
X Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the .
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling Commercial /industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /Jj'36 63 t� D a . e.,. ct v. . New dwelling area: square feet
City /State /ZIP: _/�� c�2 51 7, 2 3 !J Garage /carport area: square feet
r
Suite/bldg. /apt. no.:"'G• , Project name: /,y I Covered porch area square feet
Cross street/directions to job site: 9/Ai ✓ " 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 (rouyded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
/ i 2-P �►J C o. ` ,(,LS 7.v.s�'". �r �, Valuation: $ 12- �i is
0-(--- i � �� A` Existing building area square feet
, �J New building area: square feet
❑ PROPERTY OWNER g TENANT Number of stories:
Name: Type of construction: .
Address: 1 -1 t t4 Occupancy groups:
City/State /ZIP: ) Existing: ' '
Phone: Si3) 2& ' 9707 Fax: ( ) New:
121 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: r (Please refer to fee schedule)
2 l "°�- Structural plan review fee (or deposit):
Contact name:--r,11 � t
FLS plan review fee (if applicable):
Address: 226-a 4,.....K13 4,.....K13 � -.f- Z
City/State /ZIP: ' Total fees due upon application: / ,� 1�
�� /� �2 �� Amount received: (p3 ` f; U lJ
Phone: (52 j) 774 —9762_ , Fax: : ( ) 7/9- t '"
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E -mail: """I"'") C • �_ Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two (2) sets of roof plan with connection details •
r and fire department access, along with the 2010 Oregon
Address: V Solar Installation Specialty Code checklist.
City /State /ZIP: Permit fee (includes plan review $180.00
and administrative fees):
. Phone: ( ) ( I Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic:: /9 7J�. �e -- 11 °"'' '
Total fee due upon application: $201.60
Authorized signature: Ir This permit application expires if a permit is not obtained
`� within 180 days after it has been accepted as complete.
Print name: jyn w Date: /�j * Fee methodology set by Tri -County Building Industry
J / / , Service Board.
I:\Building\Permits\BUP _COM_PermitApp.doc Rev. 12/ 11/2012 440- 4613T(I 1 /02 /COM/WEB)
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 Rev. 12 /11/2012
r
III a Building Division
Plan Submittal Requirements
T t G A R D Commercial & Multi- Family - New, Additions or Alterations
1. SITE PLAN (fully dimensional, drawn to scale) labeled with:
A. ❑ map & tax lot # ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking, including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape -ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations, plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit - based on valuation of project.
4. EXTRA SET OF THE FOLLOWING:
A. Two (2) copies of site plan to include vicinity map.
B. One (1) copy of erosion control plan with details.
C. Fire Department Building Survey, and full set of architecture drawings.
I:\ Building \Permits \BUP_COM_PerrnitApp.doc Rev. 12/11/2012
Building Division
.'r Plan Submittal Requirement Matrix •
• T; G . MD Commercial & Multi- Family - New, Additions or Alterations
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 3
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington
County, and Tualatin Valley Fire & Rescue), if applicable.
I: \Buil ding \Permits \BUP_COM_PermitApp.doc Rev. 12/11/2012
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description: t I 60-, JO 1 - e
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: \ �� Occupancy Group: ,:5 Type of Construction: 59
*Type of Use: Occupancy Load: Oregon Specialty Code: *V
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: 01/4)0 Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ (2 ( ) FEES DUE
$ (p 7,10 DC Prov Rvw, COM TI — Ping
$ f G , by DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ W:75 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ EM ' 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 $ ( , Q7 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: $ - - j,Qc) 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.
1: \ Building \ Forms \OTC - BUP.docx 07/01/2012
wr
Building Division
Development Code Provision Review
T I GA RD Commercial Projects - No Associated Land Use Case
Building Permit No: P C D ( 3 'x000 f Ilr pedited Review
Plan Submittal Date: / a p3
(( c 3c
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 at 5037l82/V or @tigard- or.gov)
Proposal: /
If 1
//
Zoning (. G I D
Permitted Use Yes E No ❑ —
Land Use Required: Yes ❑ No LE
Notes:
E Approved ❑ Not Approved Date: / /e/ 1 5
f
REVISED 10/4/12