Permit • L CITY OF TIGARD BUILDING PERMIT
` COMMUNITY DEVELOPMENT Permit*: BUP2013 -0013
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/05/2013
TIGARD RD 9 Parcel: 2S102AB04200
Jurisdiction: Tigard
Site address: 12386 SW MAIN ST
Project: Cafe Allegro Subdivision: KINGSTON Lot: 2
Project Description: Remove (1) atrium window and replace with (2) windows and small roof.
Contractor: BLACK DIAMOND HOMES INC Owner. CAPISTRANO, NICOLAS III REV LIV
15685 SW 116TH AVE SUITE 290 BY CAPISTRANO, NICOLAS III TR
TIGARD, OR 97224 6646 SW 35TH
PORTLAND, OR 97221
PHONE: 503 - 201 -6304 PHONE:
FAX: 503 - 579 -3990
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee - Additions, Alterations, 06/05/2013 $134.54
Demolition
Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Building 06/05/2013 $16.14
Dwelling Units: 0 Plan Review 06/05/2013 $87.45
Stories: 2 Height: 0 ft Info Process/Archiving - Sm $0.50 (up to 06/05/2013 $3.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $3,250
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck. 0
Garage: 0
Mezzanine: 0
Total $241.13
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 5e .232.1987 or 1.800.332. 344
1 1 r. .
Issued By: Permittee Signature: ArY .r / 1
a eril . 10 0.
Call 603.639.4176 by 7:00 a.m. for the next available Inspectio d: :. , .
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.
ill o Building Division
° Development Code Provision Review
T I c A 1 . D Commercial Projects - No Associated Land Use Case
Building Permit No: ,haxpedite Rev
Project Name: C1"76 ", r)
Site Address: 023 J , S&7 A.09 - i•1 S T, , Suite /Bldg #:
Plans Routed:
Original Plan Submittal Date: 4/.57.3 Routed By:
1" Revision Submittal Date: Routed By:
2" 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 lll I £ai '\ at (503) 718- a?'1 Clierti I C- @tigard - or.gov)
Proposal: .Su_ l7 oo
Zoning flu C g D
Permitted Use Yes l No ❑
Land Use Required: Yes ❑ No T
Notes: Replac c. ex;s4:1n5 ■ &x,. - h ., 4; /x5 f add: -Ii tM as" ci el e}i t.).-t
a U ,I+ trF I,s■AdowS. `RQ Vu- d
cla,e 1s'(1duc,3 - replace
e isi'ri�-
Uin8. -33- ,c aMP Si 2e. r acid r- r --Vt. ,r,na4c.■ P1,LJ-1-,i17 ri eS_ Na
1k,,^ e1- u re .-e_tu : .e ra .
ji Approved ❑ Not Approved ❑ DCPR Not Required - No DCPR Fees Due
Date Routed to Building:
I. \CURPLMMasters\Development Code Provision Review\DCPR_COM NoLandUse.doc Rev. 01/16/13
Building Permit Application .
Commercial FOR OFFICE USE ONLY
City of Tigard Date/B: go.. Permit N / 2021/3 -evils-
A
n 13125 SW Hall Blvd., Tigard, OR .MI11i2b 0 5 2013 Plan Review lip /�
. ' Phone: 503 718.2439 Fax: 503.598.1960 Date/B : ,, - tJ Other Permit
TI G A R D Inspection Line: 503.639.41 on /G � Date Ready : y turfs ® See Page 2 for
Internet. www.tigard -or.go niNG DIVISION Notified/Method �� Supplemental Information
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: e DBIa eg F equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUC ( work indicated on this application.
❑ I- and 2- family dwelling 14 Commercial /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: (7_3 go set mA:/4 S7 New dwelling area: square feet
City /State/ZIP: T[ 61 "1" 9) Z2-3 Garage/carport area: square feet
Suite/bldg. /apt. no.: '" ,r Project name: r C / &Lati Covered porch area: square feet
Cross street/directions to job site: DO � ^r-uA n Deck area: square feet
�T s—+� Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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.
Valuation: $ 3 zsb —
tire. S tw� t � Existing building area: square feet
l r New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: bt f> j IC . , l
� (c. 1 E' Type of construction:
Address: L '33(4 a 604 DNA-- RD �'�' Occupancy groups:
City /State /ZIP: e1i , osoje e at-- 9 � 3
W Existing:
Phone: (163) . Fax: ( ) New:
g APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: (A '0e cni Rot , L
( A
1 ` i • ` Structural plan review fee (or deposit):
Contact name: e e lr " &TM/4 1
/�� `'r tr / / � 11 v FLS plan review fee (if applicable):
Address: /J 8S /l t� SW -- A , SIt7 240 City /State /ZIP: Ti 6 o 6,e_ (` 7 -2-7.11 Total fees due upon application:
513 ) C QI 3p'O Amount received:
�
Phone: (503) 'i —�o3t��{ Fax:: ( 7 T v
E -mail: 131ci c1:0t41!'Nd /L mv)5 cow nisr,4e'r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
- Ll�"'� "l Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: 6 / - �j(�,IM . i � Submit two (2) sets of roof plan with connection details
1. L 11J and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City /State /ZIP: / ' J ' • y Permit fee (includes plan review $I80.00
and administrative fees):
Phone: ( ) Fax: ( )
State surcharge (12% of permit fee): $21.60
CCB lic.: f 09 "2, Total fee due upon application: $201.60
Authorized signature: 4 Afia I , " 44 etrIriVELLI This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Vr // / / Date: & Fee methodology set by Tri -County Building Industry
i
Service Board
I: \Building \Pe its \BUP - OM PermitApp.doc 02/24/2011 440 -46I3T(I I/02 /COM/WEB)
11,1 ° Building Division
Over - The - Counter (OTC) Building Permit
T I G A R D Check List
Project Description: 1 l
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: " Occupancy Group: 17‘,..z.., Type of Construction: — (3
*Type of Use: Occupancy Load: Oregon Specialty Code: - 2<f)V
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 $ EOM, Permit Fee – Add, Alt, Demo
Project Valuation Planning LRP $ h 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 4aie 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 $ 3 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: ( (3 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. \ Budding \Forms \OTC- BUP.docx 07/01/2012
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12386 SW MAIN ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
2013-11-22 00:00:00
BUP2013-00135
PASS - No C of O
Violation Summary:
Inspector Contractor