Permit 11111 CITY OF TIGARD BUILDING PERMIT
�: COMMUNITY DEVELOPMENT Permit#: BUP2013 00201
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2013
Parcel: 1 S 134BD00100
Jurisdiction: Tigard
Site address: 10650 SW 121ST AVE 7
Project: Westwood Green Apartments Subdivision: ENGLEWOOD NO.2 Lot: 158
Project Description: Convert existing bedroom into 1/2 bath and storage room
Contractor: OWNER Owner: GARDNER FAMILY PROPERTIES LLC
KAREN GARDNER 15315 SW ALDERBROOK DR
15315 SW ALDERBROOK DR TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-590-1542 PHONE: 503-590-1542
FAX:
Specifics: FEES
Description Date Amount
Type of Use: MF
Class of Work: ALT Type of Const: Vg Permit Fee-Additions,Alterations, 08/08/2013 $195.38
Demolition
Occupancy Grp: R-2 Occupancy Load: 12%State Surcharge-Building 08/08/2013 $23.45
Dwelling Units: 0 Plan Review 08/08/2013 $127.00
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 08/08/2013 $1.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $7,500 '
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $346.83
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
952-00 :110 through •.: 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.
I -
1
ued By: I/� _ Permittee Signature: L /
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 Date/Bed G
8 a 43 Permit No.: _Qd
14
® U 13125 SW Hall Blvd.,Tigard,OR 97223 rf� p Plan Re ee i1, (��j i,
Phone: 503-718-2439 Fax: 503-598-1960 8 2013 Date/By: ► ( Other Permit:
1.I CJ 12 H Inspection Line: 503-639-4175 Date Ready:y: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITYOFTIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED,DATA:1-AND 2-FAMILY DWELLING
❑New construction , ID Permit fees*are based on the value of the work performed.
-- - Indicate the value(rotnded to the nearest dollar)of all
pt Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
—
El 1-and 2-family dwelling ❑Commercial/industrial Valuation: $
❑Accessory building Multi-family _ Number of bedrooms:
ID Master builder ID Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ( I:J3 5D ' 2.1 Si- New dwelling area: square feet
City/State/ZIP: -r t c 9 O e- Garage/carport area: square feet
Suite/bldg./apt.no.: l Project name: Covered porch area square feet
Cross street/directions to job site: '2k S+ (Li-4 S ctA6(1.6 cr 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(romded to the nearest dollar)of all
equipment,materials labor ovrhead,ate flte pref►t fe�tlle
•
. . ''// DES�SCRIPTION OF,WORK n w to waled on this application.
�p IN Cr r2 6 GLT-GL 4 c-Rtu �k (` �+�`7'4� , Valuation: $ 1 5-1)—Z.). 11"
_ C�C.� Existing bull'in: .t
v New building area: square feet
. .PROPERTY OWNER ❑ TENANT Number of stories:
Name: 4( ''` G'A.4-0) � Type of construction:
Address: \ S31 c.(A) ,ii)EY B?fir,K be Occupancy groups:
City/State/ZIP: G1' I-T1ep 0 7 2Z Existing:
Phone:(513) (0S N4—((( 'Z-- Fax:( ) • New:
❑ APPLICANT Q_GONTACT.PERSON. BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: \./ . 00)? 6 R.�' N f ZS Structural plan review fee(or deposit):
Contact name: (V\.( e._( _ n J/ f
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:(613) b- 1 S Lt. Z Fax: :( ) Amount received:
E-mail: -Q� '0(s ct 4,. i4 ci_ , r\� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONT CTOR roof-top mounted Photo Voltaic Solar Panel System.
•Business name: _ 0(k) c. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP: ( and administrative fees): $180.00
Phone:
( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB tic.: Total fee due upon application: $201.60
Authorized signature:X/Ut�GL . 4 i ia..CtJ This permit application expires if a permit is not obtained
,f� /y within 180 days after it has been accepted as complete.
Print name: x 9 �.of 74.4 t).N C� Date: 8/6/-0,3 - * Fee methodology set by Tri-County Building Industry
/ ` / Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev. 12/11/2012 440-4613T(I 1/02/COM/WEB)
° 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 Rev.12/11/2012
Building Division
C
Plan Submittal Requirements
T I G A R D Commercial & Multi-Family- New,Additions or Alterations
1. SITE PLAN (fully dimensional, drawn to scale) labeled with:
A. ❑ map& tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations, plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit- based on valuation of project.
4. EXTRA SET OF THE FOLLOWING:
A. Two (2) copies of site plan to include vicinity map.
B. One (1) copy of erosion control plan with details.
C. Fire Department Building Survey, and full set of architecture drawings.
I:\Buil ding\Pemtits\BUP_COM_PermitApp.doc Rev.12/11/2012
h
P Building ii, Division
0
Plan Submittal Requirement Matrix
T I G A R D Commercial&Multi-Family-New,Additions or Alterations
Type of Submittal # of Plans
(Includes new,additions and alterations.) Required at
Submittal
Demolition Permit 3
(site plan required showing location and square
footage of all buildings to be demolished)
•
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington
County, and Tualatin Valley Fire&Rescue),if applicable.
I:\Building\Permits\BUP_COM_PemvtApp.doc Rev.12/11/2012
1 ° Building Division
Over-The-Counter (OTC) Building Permit
T I G A R D Check List
Project Description: iii- co PATT-i-
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APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: R.Z. Type of Construction: '55
Type of Use**: CM( Occupancy Load: Oregon Specialty Code: Q(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: (+OO Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area: _
K Factor:
Total Project Valuation: $ 7 .-CO FEES DUE
$ DC Prov Rvw,COM TI—Ping
$ _ DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI (effective 7/1/2013) $ i7, i Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ 275,A 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ (2_ ,I' Plan Review,Structural
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$5,000-$74,999 $70.00 $10.00 $ Plan Review,Fire Life Safety
$75,000-$149,999 $174.00 $26.00 $ Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $278.00 $41.00 $ .i.„ Info Proc/Arch,Sm(up to 11x17$0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other:
Building Staff: $ Other: _ _
Date/Time: $ S*5 TOTAL FEES DUE •
*TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
"CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC-BUP.docx 07/01/2013