Permit _n
CITY OF TIGARD BUILDING PERMIT
IN j=. COMMUNITY DEVELOPMENT Permit #: BUP2013 -00116
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/14/2013
Parcel: 1 S 136AD04000
Jurisdiction: Tigard
Site address: 11527 SW PACIFIC HWY
Project: Labor Works Subdivision: VILLA RIDGE Lot: 7
Project Description: Build two barrier free toilet rooms and one wall at center of space
Contractor: ROBERT TODD CONSTRUCTION INC Owner: PACIFIC TERRACE COMMERCIAL LLC
4080 SE INTERNATIONAL WAY B113 BY SMITH, EDITA M
MILWAUKIE, OR 97222 833 NW 170TH DR
BEAVERTON, OR 97006
PHONE: 503 - 653 -5704 PHONE:
FAX: 503 - 653 -5729
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review, COM TI - Ping 05/14/2013 $67.00
Occupancy Grp: B Occupancy Load: 15 DC Provision Review, COM TI - LRP 05/14/2013 $10.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 05/14/2013 $362.69
Demolition
Stories: 2 Height: 0 ft 12% State Surcharge - Building 05/14/2013 $43.52
Bedrooms: 0 Bathrooms: 0 Plan Review 05/14/2013 $235.75
Value: $18,500 Plan Review - Fire Life Safety 05/14/2013 $145.08
Info Process /Archiving - Lg $2.00 (over 05/14/2013 $2.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $866.04
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 rules 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 5. -'"i• • :7 or 1.800.332.2344.
/ I
Issued By: Permittee Signature: J I �ij� ////
I�
Call 503.639.4175 by 7:00 a.m. for the next available inspecti n date. • r'
This permit card shall be kept in a conspicuous place on the job site until completion of the p
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
/ �"
City of Tigard ma 14 2013 Date/By Received _ f 4[ ( ct Permit No.: o f 3 - t r / r 6
NI 13125 SW 1 -tall Blvd., Tigard, OR 97223 Plan Review
t7 . ' Phone: 503.718.2439 Fax: 503.598.1960 Date /By: f/k Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready y : Ju�ns El See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified /Method 1� Supplemental Information
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILYDWELLING
❑ 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: S
❑ I- and 2- family dwelling ommercial /industrial
❑ 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: 11527 4.61 , � New dwelling area: square feet
City /State /ZIP: 4 _D, cpa Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: j12— \dgIG'. 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.
Indicate the value (rounded 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.
L . -� i n 1 ., PL To t.-f- Valuation: S 1 G°61 G°61 n •i
p 1 � I A K IO 66 - W -� 2
� � m .. 3 : 7try Existing building area: square feet
New building area: square feet
*PROPERTY OWNER ❑ TENANT Number of stories:
Name: r-1G 9 0 etM I-I-
c.. Type of construction:
Address: % Mozpic& gemikeithit 21 ( .q Occupancy groups:
City /State /ZIP:.12 y 6 `17205 '5(U S Existing:
Phone: Q 3 7 2 2 , - 5 1 7 7 ( Fax: (63 )22. v New:
XAPPI,ICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: - G�+s�I llc ISM Sozf view erejertnje posit dnle)
11^ Structural plan review fee (or deposit):
Contact name: 4,1t , N in 0 '
Q D ` r 1 plan review fee (if applicable):
Address: w C) l
City /State /ZIP: r�D Z_ c1'f2� total fees due upon application:
� Z214-5 Amount received:
Phone: �.J'<. l L� u� • q ��, Fax;
E -mail: •400,4 op_si �` r 2 , tc'(Nl
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: .,`rdc4 Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: l Solar Installation Specialty Code checklist.
City /State /ZIP: fitaVL d le•W �r � .91 � Permit fee (includes plan review $180.00
( _ and administrative fees):
Phone: (50", (053 - 97 Fax: (s 6,5 -5'7241 State surcharge (12% of permit fee): $21.60
CCB lie.: 1
° 7th Total fee due upon application: $201.60
Authorized signature: l This permit application expires if a permit is not obtained
A A A ,iJ C_ within 180 days after it has been accepted as complete.
Print name: ' .F.--1,, �(0 Ts Date: IL j/) * Fee methodology set by'fri- County Building Industry
����I/ 1 r Service Board.
I: \Building \Permits \BUP -COM PermitApp.doc 02/24/2011 440- 4613T(I 1 /02 /COM /WEB)
"hi .
Building Division
• Over- The - Counter (OTC) Building Permit
TlcnliD Check List
Project Description: ( &A )613
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: IL Occupancy Group: j T .e of Construction: ,1P•
*Time of Use: WirOMI Occusane Load: Oreton S.ecial 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: $ P9 FEES DUE
$ , cO DC Prov Rvw, COM TI — Ping
$ I (). n o DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ 322, (�cl Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ '3.''SZ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 2:35; 7 j Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ -[ 4 B Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ Z,CC 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: $ e ,o4— TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; END = foundation; DEM = demo;
END = 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
1 :14 Building Division
Development Code Provision Review
T I GA R D Commercial Projects - No Associated Land Use Case
Building Permit No: AU P ( 3 - 00 ( L9' Expedited Review
Project Name: L -460(-- 4k jcs
Site Address: /7 5 2 7 4? /17 - / . Suite /Bldg #:
Plans Routed: _
Original Plan Submittal Date: /y// Routed By: I
1" Revision Submittal Date: Routed By:
2n Revision Submittal Date: Routed By: •
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 onl if approved.
Planning Review (contact .kd at (503) 718-R1 or _ @tigard- or.gov)
Proposal: ^ �%� i� ' / i„ i■rh / / . i u GLr�Gr
1
Zoning (� —
Permitted Use Yes No ❑
Land Use Required:. Yes ❑ No LY
Notes:
V ipproved ❑ Not A roved L7 :CI uired – No DCPR Fees Due R Not Re PP q
Date Routed to Building: 5' / 1 /F. /3
L \CURPLN\Masters\Development Code Provision ReviekDCPR_COM_NoLandUse.doc Rev. 01/16/13
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11527 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
06/25/2013 00:00
BUP2013-00116
PART
Store Front framing
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11527 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
06/25/2013 00:00
BUP2013-00116
PASS - C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11527 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
06/25/2013 00:00
BUP2013-00116
PASS - C of O
Violation Summary:
Inspector Contractor