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T[ G A R D Request for Permit Action
TO: CITY OF TIGARD
Building Division Services Coordinator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: El Owner ❑ Applicant ❑ Contractor JR1 City Staff
(check one)
REFUND OR Name: /
INVOICE TO: (Business or Individual) N / lq
Mailing Address:
City /State /Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): V 0 1 0
CANCEL PERMIT APPLICATION. /� /�� ' 4 ; 41--- RE FUND PERMIT FEES (a receipt, if available). A(0 F.6V$ P'611P'611). A
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: `o Lt. Po o i / — CO l 7
Site Address or Parcel #: E 6 / / 57
Project Name: lr — d£ T
Subdivision Name: Lot #:
EXPLANATION: ,t Q r 15 / /3 1 6Lt C k...o t43 . ,4PPL/ CA-4 7
t LL 7Dt A PPLy,,Jca 602 q i2 Pe2N/ i
Signature: C _ -.....1.-: „ 4Vi L -.I Date: _/ / 7 //t
Print Name: ` 1 i /3fi /-}T (4-MSk-f
Refund Policy
1. The Director or Building Official may authorize the refund of
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
FOR OFFICE USE ONLY
Rte to S s Admin: Date fsMAIMIUMNI, Rte to Bid! Admin: Date / QJffa B 4 'a�� -
Refund Processed: Date By a177A • oice Processed: Date By
Permit Canceled: Date / B ,,,4� Parcel Ta: Added: Date B
Receipt # Date Me od Amount $
I: \Building \Forms \RegPermitAction.doc Rev 07 /26/07
Building Permit AnulicationV 0 D
Commercial j b.,
FOR OFFICE USE ONLY �7 !l
Received
I l i City of Tigard RECEIVED Date/By: e� /iQ //I 1! Permit No. u7✓�0 f�' DV / ,
125 ll d., ard,2 Plan Review
Phone: 13 SW 503.7182439 HaBlv Tig Fax: 503.598OR 97 23 . is 1 1 2011 Date/By: Other Permit:
i 1 , \ 1z i , Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE
B OF WOR DIVISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING
0 - New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (romded 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.
dwelling Valuation: S
❑ 1- and 2-family g ❑ CommerciaUindustrial
E1 Accessory building ❑ Multi - family Number of bedrooms:
ID Master builder Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: New dwelling area: square feet
01.4 2 L _ 1\16 -p 6 bE l nrrx c (2._,
City /St P• 4 Wf /2tf961 S() #uw 14E72_ Garage /carport area: square feet
OF
Suite/bldg. /apt. no.: Project name: 1 /J �--r �� Covered porch area square feet
Cross street/directions to job site: Cn/ / p er L -4 > Deck area: square feet
//.5 S &6 Ems/% _4 SET / /S/ Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (romded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
5 ' k i 4 t (0'. r, ,,,1 0 A D , . L 44- --[ Dl +.J co, Valuation: $ Q
D fa--C7 #4-T f ( k ( • mil *---1 L17 L?-.1.1.S Existing building area square feet
( New building area: square feet
c- ❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: V v t: (..e( 4-.A (.4.) Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
PPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: -- k —� (Pleaserefe,tojeeschednte)
Structural plan review fee (or deposit):
Contact name: 147. y-�� J it-et-4 S
/�
Address: -110 4 E 1.4.0 01_4> �T FLS plan review fee (if applicable):
City /State /ZIP: 17% R.,-.-,- ,.. „..-t t O (Z OO - Total fees due upon application:
Phone: (GD3) "1 t 7 . ),.. Fax:: ( ) Amount received:
E -mail: g 0 �QAI C. K, t� -re t Ill (�� - o e- PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: -r&t, Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specially Code checklist.
Permit fee (includes plan review
City/State/ZIP: x180.00
and administrative fees):
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: Total fee due upon appication: $201.60
Authorized signature: l j p This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: - c > T1ij 1,3 t j QJ2..I.4 S Date: Cet - ti • l ( * Fee methodology set by Tri -County Building Industry
Service Board.
L:\Building\Permits \BUP -COM PermitApp.doc 02/ 24/2011 440-4613T( I 1/02 /COM/WEB)
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i 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
71 ' Building Division
Development Code Provision Review
T 1 G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: 3 u Po N. —‘,0 / 7 7 Expedited Review
Plan Submittal Date: ,//1 //
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. ,,, 1 /�
Planning Review (contact s at 503 718 - cf 'fi
or Sb�t �"1 @tigard-or.gov)
C/ Zoning _F=<' Permitted Use Yes 0' No ❑
❑ Land Use Required: Yes ❑ No Q (explain below)
Notes:
d Approved ❑ Not Approved Date: gl .)-I J f
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN
Burrus, Kristin
Sent: Wednesday, August 10, 2011 2:13 PM
To: Burrus, Kristin
Cc: Boll, Heather //A �� W/ —
Subject: RE: Loc id 2816
New Housing Authority low income assisted living facility has opened. Lots of lobbying over the past year to have the
stop moved to their site but it is near a turn and was impossible (even had a training bus test it). Recently a Wheelchair
user had difficulty using the current stop prompting the Housing authority to ask for help. We want an inexpensive
fix. When we visited the large facility it only had admitted a small percentage of its residents.
So _- Political and potential ridership growth.
From: Burrus, Kristin
Sent: Wednesday, August 10, 2011 10:16 AM
To: Baldwin, Ben
Subject: Loc id 2816
Ben –
Why are we doing an ADA pad at Hunziker NS Knoll when ridership is only 1/2/1 ? ??
Thank you -
Kristin Burrus 1 Project Coordinator, Capital Projects 1 TriMet 1 503.962.2139 direct 1 burrusk @trimet.org
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IN
E, CAPITAL PROJECTS BUS STOP I MPROVEMENT
t T R 1 a MET FACILITIES DIVISION SW HUNZ I KER ST AT SW KNOLL DR
710 N.E. HOLLADAY STREET SITE MAP
PORTLAND, OREGON 97232
PROJECT COORDINATOR: CONTRACT NO: DESIGN: DRAWN: CHECKED: DATE:
BEN BALDWIN 503 - 962 -2140 KB JHM KB 8/5/11
y SCALE: I FILE NAME: LOC ID: QTRSEC /SEC NO: ( APPROVED: SHEET NO:
1 1" = 50' HUNZ —KNOLL 2816 YP 1 OF 3
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#12490 SW KNOLL DR
CONSTRUCT 4' -6" X 8' CONCRETE PAD
DO NOT POUR PAD AROUND POLE,
0 SEE ri"%.
5'x7' ADA 3 OF 3
O LANDING AREA I �
z PiOPERTY LINE
Y ' (E) BUS STOP I
POLE
WOOD UTILITY POLE (E) SIDEWALK t (E
/.'' '-�- Z /1, (E) DRIVEWAY i -
1 4'- 6 " 8' 4 -- f -
9' -6"
SW HUNZ I KER ST
0 NOTES:
E I . (E) = EXISTING
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CAPITAL P ECTS BUS STOP IMPROVEMENT
T R 1 go MET FACILITIES DIVISION SW HUNZ I KER ST AT SW KNOLL DR
710 N.E. HOLLADAY STREET p
PORTLAND, OREGON 97232 W°p , I B, NS
PROJECT COORDINATOR: CONTRACT NO: DESIGN: I DRAWN: CHECKED: DATE:
3 BEN BALDWIN 503- 962 -2140 BB JHM I BB 8/5/11
0
y SCALE: FILE NAME: LOC ID: QTRSEC /SEC NO: SHEET NO:
I 1" = 10' HUNZ -KNOLL 2816 - 1APPROVED:
YP 2 OF 3
3
6
f '
CONSTRUCT CONCRETE PAD 4" MIN. THICKNESS,
3000 PSI PCC WITH 2" COMPACTED AGGREGATE BASE.
SLOPE TO DRAIN TO CURB (NOT TO EXCEED 2 %)
•
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LCD
•
•
•
•
. 8'
ADA PAD (I�
SCALE: 1 /2 , = V-0"
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CAPITAL PROJECTS BUS STOP I MPROVEMENT
T R 1 ® MET FACILITIES DIVISION SW HUNZ I KER ST AT SW KNOLL DR
710 N.E. HOLLADAY STREET DETA 1 L
PORTLAND, OREGON 97232
PROJECT COORDINATOR: CONTRACT NO: DESIGN: I DRAWN: I CHECKED: DATE:
BEN BALDWIN 503 - 962 -2140 BB JHM BB 8/5/11
SCALE: FILE NAME: LOC ID: QTRSEC /SEC NO: APPROVED: SHEET NO:
co
AS NOTED I HUNZ —KNOLL 2816 — YP 2 OF 3
co