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Permit
CITY OF TIGARD BUILDING PERMIT 1 11 COMMUNITY DEVELOPMENT Permit #: BUP2013 -00128 Date Issued: 05/28/2013 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S1356C00202 Jurisdiction: Tigard Site address: 10763 SW GREENBURG RD 110 Project: Mattress Closeouts Subdivision: HILLSBORO Lot: PTS 1 -2 Project Description: TI for new tenant. Contractor: ROBERT TODD CONSTRUCTION INC Owner: BELANICH, ROGER M 4080 SE INTERNATIONAL WAY B113 22020 17TH AVE SE #200 MILWAUKIE, OR 97222 BOTHELL, WA 98021 PHONE: 503 - 653 -5704 PHONE: FAX: 503 - 653 -5729 FEES Specifics: Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: IIIB DC Provision Review, COM TI - Ping 05/28/2013 $67.00 Occupancy Grp: M Occupancy Load: 96 DC Provision Review, COM TI - LRP 05/28/2013 $10.00 Permit Fee - Additions, Alterations, 05/28/2013 $347.48 Dwelling Units: 0 Demolition Stories: 1 Height: 0 ft 12% State Surcharge - Building 05/28/2013 $41.70 Bedrooms: 0 Bathrooms: 0 Plan Review 05/28/2013 $225.86 Value: $17,500 Plan Review - Fire Life Safety 05/28/2013 $138.99 Info Process /Archiving - Lg $2.00 (over 05/28/2013 $4.00 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total 5835.03 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 calling 503.232.1 or 1.800.332.2344. Issued B� � r Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection 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. Building Permit Application Commercial RECEIVED FOR OFFICE USE ONLY City of Tigard ^ 0 ryry u i� Received S �I�1 Date/I3 Permit N• • 13125 SW Hall Blvd., Tigard, OR 97223 MAY 8 L Plan Review .. —// '/ O/ • I Phone: 503.718.2439 Fax: 503.598.1960 RD DateDate/I3 : �G � � Other Permit: T I G A R D Inspection Line: 503.639.4175 CITY OF TIGA Date Read • . VI See page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method I A Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND2- FA111L1 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 [Addit /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 •ommercial /industrial Valuation: $ ❑ 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: l 0760 ,,, & {��► t „ New dwelling area: square feet I ij � !� �'�'� City /State /ZIP: ' 1 Garage /carport area: square feet Suite/bldg. /apt. no.: I ` Project name: v 4 ) '! J 5 �j C( 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 DEsou ION OF WORK work indicated on this application. �l1-D /2 ) p �l V4{1-5 O bk Valuation: S 17 . C lb ( Lei 'r5 _ Existing building area: square feet _,/ New building area: square feet Lr PROPERTY OWNER ❑ TENANT Number of stories: Name: StJ Fo 1 p DBwG t- FOR.. prolate. ( I Type of construction: — `, Address: -ZZO c (1 h+ i t f, Cj �/T , 2 c o B , Occupancy groups: City /State /ZIP: ? Existing: Phone: ( , � &�ZS .�Z? f, Fax: (SOO 47... — L `—Tw" 1,S -. 5 71E New: N At'PLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name:11.0,4 Structural plan review fee (or deposit): Contact name: '`ibth.Y.0 FLS plan review fee (if applicable): Address: P, © . i rR ( 40150 I — City /State /ZIP: f'o )) Z. C T 2540 _ Total fees due upon application: Phone: (!��% 2��z$� T 7 Fax:: �3) � . ( 2� — Amount received: E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: �(. _-�--• 'rod Submit two (2) sets of roof plan with connection details �� I t�A Co — and fire department access, along with the 2010 Oregon Address: LIC:KgOt 450 IA A.. W64 Solar Installation S. •cial Code checklist. City /State /ZIP: 1 L i t cr.. es1 7Z Permit fee (includes plan review $180.00 1 and administrative fees : Phone: (ej,3) 4,53.'3 di Fax: (52-36)5 3 '' 72.311 �State surcharge (12% of permit fee): $21.60 CCB lie.: �� / ,,//'' Total fee due upon application: $201.60 Authorized signature: " T� This permit application expires if a permit is not obtained TT within 180 days after it has been accepted as complete. Print name: W 1 , yat'~ Date: -Z S i 4.4.y Zot * Fee methodology set by Tri -County Building Industry Service Board. 1: \Building \Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T(l I /02 /COMIWEB) 114 • Building Division a Development Code Provision Review Ti ( A R D Commercial Projects - No Associated Land Use Case Building Permit No: 4 a - a i ° 0 /3 . - - - , , ' ❑ Expedited Review Project Name: i9 /977-2ESS C LOSE - 0u TS Site Address: 10 ?6. 3 S) 6---,2-e-6-Azar..- 2L , Suite /Bldg #: /7o Plans Routed: Original Plan Submittal Date: Routed By: 1st 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 only if approved. Planning Review (contact i/ a A: OW 4 (4 at (503) 718- or jJl! S V- @tigard- or.gov) Proposal: 1 II re f e 1 L 1 I Zoning V1 LA C. Permitted Use Yes -Q No ❑ Land Use Required: Yes 0 No Er Notes: 1\1 O any O Ugei Approved ❑ Not Approved ❑ DCPR Not Required — No DCPR Fees Due Date Routed to Building: I: \CURPLN\Masters\Development Code Provision RevieWADCPR_COM_NoLandUse.doc Rev. 01/16/13 1 ' Building Division Over - The - Counter (OTC) Building Permit I `' ' r) Check List Project Description: f ( ie-f,G/?:.24 -pD /o2 APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: al Occupancy Group: Type of Construction: W *Type of Use: CCM. Occupancy Load: Ct' Oregon Specialty Code: D (('] 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: !•-b Fire Alarms: Smoke Detectors: Parapet: Manual Pull Stations: Protected Corridors: Total Project Valuation: $ 7 / ' b m' I FEES DUE $ 7, c DC Prov Rvw, COM TI — Ping $ 0 ,CT) DC Prov Rvw, COM TI — LRP DC Provision Review Fee for COM TI $ '7 .$6 Permit Fee — Add, Alt, Demo Project Valuation Planning LRP $ k(, 70 12% State Surcharge Up to $4,999 $0.00 $0.00 $ 2 , Plan Review, Structural $5,000 - $74,999 $67.00 $10.00 $ ( 395,11 Plan Review, Fire Life Safety $75,000 - $149,999 $167.00 $25.00 $ Ce 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 I Permit Coordinator: $ Other: $ Other: Building Staff: $ Other: $ Date /Time: 6-4. 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; END = foundation; FPS = fue protection system; NEW = new; MR = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. I: \Building \Forms \OTC - BUP.docx 07/01/2012