Permit CITY OF TIGARD
BUILDING PERMIT•
1114 0 n
2 : COMMUNITY DEVELOPMENT Permit#: BUP2013-00136
T I G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/17/2013
Parcel: 2S102AC00202
Jurisdiction: Tigard
Site address: 9110 SW BURNHAM ST
Project: Ferguson Enterprises Subdivision: BURNHAM TRACT Lot: 3
Project Description: Interior remodel.
10/08/13:Reprinted permit for additional plan review.
Contractor: JOHN DONALDSON CONSTRUCTION INC. Owner. MILLER, PRUDENCE M TRUST
2472 EASTMAN AVE., SUITE 32 BY PRUDENCE M MILLER TR
VENTURA,CA 93003 4220 SW GREENLEAF DR
PORTLAND,OR 97221
PHONE: 805-654-1359 PHONE:
FAX: 805-643-4043
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 07/09/2013 $1,226.75
Demolition
Occupancy Grp: M Occupancy Load: 159 12%State Surcharge-Building 07/09/2013 $147.21
Dwelling Units: 0 Plan Review 06/05/2013 $797.39
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 06/05/2013 $490.70
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 07/09/2013 $167.00
Value: $120,000 DC Provision Review,COM TI-LRP 07/09/2013 $25.00
Info Process/Archiving-Lg$2.00(over 07/09/2013 $14.00
11x17)
Floor Areas: Metro Const.Excise Tax-Commercial 07/09/2013 $144.00
Use
Total Area: 0 Additional Plan 10/08/2013 $180.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,192.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
' x'.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.
•
FOR OFFICE USE ONLY—SITE ADDRESS: 9//0 54J ,6GLfZ,,A! / ,
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
. This form and the information it provides helps the review process and response to your project. •
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
III a Transmittal Letter.
T I G A R In • 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • w .ti. .rd-or.gov
TO: &IV DA 1 EI _ 1 •
DEPT: BUILDING DIVISION CLi `! ' D"
� I T 3 2013
FROM: w �--J TIGARD
IP�' ?eu's CITY OF
BUILDING DIVISION
COMPANY: .3-0 t ft) - ,S Gvvas-- .
PHONE: ,g3O.S. —3 2 0 —s- 4 - By: 137)---
RE: //D l� BG,_-ter) !. / ' 'OF t) -00t
�te Address) (Permit Number)
5---- ) $
'17...,/L_ `�LLt-
'roject itre or sum ion name '! 1 er
•
ATTACHED ARE THE FO OW ,G '.
Copies: Description: Copies: Description:
Additional set(s) of pl. ,s. evisions: R yd ._
Cross section(s) and det.ls Wall bracing and/or lateral analysis.
Floor/roof framing. / Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Perm Tec r ician: Date: ((j f`](I-- Initials c
Fees Due: Q'Yes ❑No Fee Descri stion: Amount Due:
(=cam-( ) V( $ (ejO I e
$
$
$
• Special ___ • _
ns ruction .
Reprint Permit(per P es I ❑No [' Done
• Applicant Notified: Vog,(_ 'Date: /6/0 3 Initials: 4rf
1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
y n CITY OF TIGARD BUILDING PERMIT
11111 a - . COMMUNITY DEVELOPMENT Permit #: BUP2013 -00136
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/17/2013
Parcel: 2S102AC00202
Jurisdiction: Tigard
Site address: 9110 SW BURNHAM ST
Project: Ferguson Enterprises Subdivision: BURNHAM TRACT Lot: 3
Project Description: Interior remodel.
Contractor: JOHN DONALDSON CONSTRUCTION INC. Owner: MILLER, PRUDENCE M TRUST
2472 EASTMAN AVE., SUITE 32 BY PRUDENCE M MILLER TR
VENTURA, CA 93003 4220 SW GREENLEAF DR
PORTLAND, OR 97221
PHONE: 805 - 654 -1359 PHONE:
FAX: 805 - 643 -4043
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee - Additions, Alterations, 07/09/2013 $1,226.75
Occupancy Grp: M Occupancy Load: 159 1 St
12 /o State Surcharge - Building 07/09/2013 $147.21
Dwelling Units: 0 Plan Review 06/05/2013 $797.39
Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 06/05/2013 $490.70
Bedrooms: 0 Bathrooms: 0 DC Provision Review, COM TI - Ping 07/09/2013 $167.00
Value: $120,000 DC Provision Review, COM TI - LRP 07/09/2013 $25.00
Info Process /Archiving - Lg $2.00 (over 07/09/2013 $14.00
11x17)
Floor Areas: Metro Const. Excise Tax - Commercial 07/09/2013 $144.00
Use
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,012.05
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes 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 don ' • = - - • • - nce with approved plans. This permit will expire if work is not started within 180 days of iss - -, or if work i suspended for more the 180
d- . ATTENTION: Or-, • law r •u -s you to follow the rules adopted by the Oregon Utility Notifi : '•n C:nter. Thos.- -s are set forth in OAR
52- 001 -0010 through OAR 9 0'. -0090. • may obtain a copy of the rules or direct questions to OUNC by callin• 03.232 987 or 1.800.• • 4.
ssued By: ' i Permittee Signature: i 4 % 1 �, /4/ i
pp, wt. Call 503.639.4175 by 7:00 a.m. for the next available I = • , • date.
This permit card shall be kept in a conspicuous place on the Job site ompletion of the project.
Approved plans are required on the Job site at the time o each Inspection.
Building Permit Application , ,,,n._._ I 4 i; ;
Commercial JUN -= 3 2013 FOR OFFICE USE ONLY
Date/B (� �. ig ig � . 641)•.0/3 --col
City of Tigard 1 Permi No.:
13125 SW Hall Blvd., Tigard, OR 9722 �� ��''���� plan Review
Phone: 503.718.2439 Fax: 503.598.19 i NG DIVISION Date/By: SI•. s y Z ' � Other Permit:
I' I G A R D Inspection Line: 503.639 Date Ready/By: n // kris ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: / / .C L � I /
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 (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.
❑ 1- and 2- family dwelling 2 Commercial/industrial
Valuation: $
❑ Accessory building ❑ Multi - family
Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11 5 knl `•U r 'Roa a e /4 y, y New dwelling area: square feet
City /State /ZIP: ' y, 1 U 1 i OR 1 Cl , Z, - 3 "�
°� Garage /carport area: square feet
Suite/bldg. /apt. no.: J Project name: Covered porch area: square feet
Cross street/directions to job site: rt/eatt A3 t t J7 / i5 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
DESCRIPTION OF WORK work indicated on this application.
j n -krioy pivmVsi ecpres5 re-k t I 40114-�uln+ —
Valuation: $ Zg Qpp
4- 14-F l tri or l of 4 I ,gyp Existing building area: /46, 9�3 square feet
l New building area: J 9) 3 square feet
('.�a vo�e S a sN.r -1 ►,mot f I s. 19
❑ PROPERTY OVINER ❑ TENANT Number of stories: i
Name: F s S 7.43scr N v i S ,� in G Type of construction: .7- p� V- (j Address: I a F Occupancy groups:
City/State/ZIP: T � S 14 ve z loo I'►'le r an fi I e /a .e___ Ci
ty N # /'I.e..(it/j LL (/f!' r 3 Exis ting:
Phone: (77) 8 7 4 — 7 7 `l` S tax: ( ) New:
"® APPLICANT -®" CONTACT PERSON BUILDING PERMIT FEES*
_ (Please refer to fee schedule)
Business name: .d�n anc,d' Y' (C 15 t y - ion 1 -r-►? G Structural plan review fee (or deposit):
Contact name: La( 1 rev, ( ,r t a1/4)
FLS plan review fee (if applicable):
Address: a4 - 1 07 E4s+-?von Ave,. S✓! �j 2
/ Total fees due upon application:
City /State /ZIP: Ve -vi-fwa 64 fa' 3
Phone: (ooi') 4, ^ 1 �!1 Fax:: (s05" ) ( 5 - ( 3 S - q Amount received:
3 �A ! PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E -mail: ia.Vreel e & oh l'IdoitaI(dSOrl US
J � Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: -T411� ' P i ldSty COLS i � Z n L and two (2) sets of c roof plan with connection details
✓✓ and fire department access, along with the 2010 Oreg
Address: aqua F a r , Ave 1‘ 5,,-.46 2V 3Z Solar Installation Specialty Code checklist.
"f Permit fee (includes plan review
City/State /ZIP: ei G} q3� 3 $180.00
V � " and administrative fees):
Phone: (8 (or 4, 15 q t�24yl Fax: ($X ) (64 — 4o4 3 State surcharge (12% of permit fee): $21.60
CCB lie.: / d L` a / / / //y _ Total fee due upon application: $201.60
Authorized signatu I This perm aplipies if
n a permit is not obtained
within m 8i days p after it ex has be
accepted as c omplete.
Print name: f . x Date: 5 3 r 3 / • Fee methodology set by Tri- County Building Industry
Service Board.
l: \Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11/02 /COM/WEB)
Building Division
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit o: P / 3 6 ❑ Expedited Review
Project Name: l (D `d ,va tJ H-v 4 -t om •
Site Address: - r - E. E.N E5 Suite /Bldg #:
Plans Routed:
Original Plan Submittal Date: e f / l 3 Routed By:
1St 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 %/4 nly if approved.
Planning Review (contact at (503) 718°') � or @tigard-or.gov)
Proposal:
Zoning 44
Permitted Use Yes I No ❑ I v'
Land Use Required: Yes ❑ No
Notes:
dti/ t
L►� Approved ❑ Not • proved ❑ DCPR Not Required - No DCPR Fees Due
Date Routed to Building:
I: \CURPLN\Masters\Development Code Provision Review\DCPR_COM_NoLandUse.doc Rev. 01/16/13
CITY OF TIGARD
BUILDING DIVISION PERMIT #: pzoj 3
13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 2 /
Phone: (503) 639-4171 d J b
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 'T f/ 0 ED U'( Jt (-1 AtA CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
Corrections/Comments/Instructions:
%� '• /V PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 45- Phone #: (503) 718-