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Permit
CITY OF TIGARD BUILDING PERMIT 14 ' I . COMMUNITY DEVELOPMENT Permit#: BUP2013-00204 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2013 Parcel: 1 S135BC00202 Jurisdiction: TIGARD Site address: 10763 SW GREENBURG RD 100 Project: Spec Space Subdivision: HILLSBORO Lot: PTS 1-2 Project Description: TI for new suspended ceiling and barrier removal for restroom. 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 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 08/20/2013 $70.00 Occupancy Grp: B Occupancy Load: 26 DC Provision Review,COM TI-LRP 08/20/2013 $10.00 Dwelling Units: 0 Permit Fee-Additions,Alterations, 08/20/2013 $256.22 Demolition Stories: 1 Height: 0 ft 12%State Surcharge-Building 08/20/2013 $30.75 Bedrooms: 0 Bathrooms: 0 Plan Review 08/20/2013 $166.54 Value: $12,000 Plan Review-Fire Life Safety 08/20/2013 $102.49 Info Process/Archiving-Lg$2.00(over 08/20/2013 $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 $638.00 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 0 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: i.1//�/� / /I f , A, Call 503.639.4175 by 7:00 a.m.for the next available inspection tflir This permit card shall be kept in a conspicuous place on the job site until completion of the prof: Approved plans are required on the job site at the time of each Inspection. Building Permit Application Commercial RECEIVED FOR OFFICE USE ONLY City of Tigard L Received p- Permit N G IN ° 13125 SW Hall Blvd.,Tigard,OR 97223 AUG at Date/E3 : Q=s �j� a .26v..3-a0_ i g A`, 0 I Plan Review;, �$ y �� Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 Date/B : 1, TI GARD Inspection Line: 503.639.4175 Date Rea. : ® See Page 2 for Internet: www.tigard-or.gov CITYOFTIGARD Notified/Method: �� Supplemental lnformation BUILDING DIVISION 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 A Idition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ I-and 2-family dwelling Commercial/industrial Valuation: S ❑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: i Q 76,-3 ' ,(112-, f 4r© (Ts.fob New dwelling area: square feet / City/State/ZIP: -nowt), � Garage/carport area: square feet / uit bldg./apt.no.: I� Project name: ?.�N, -r Iotile{Mr5 Covered porch area: square feet YY Cross street/directions to job site: -F00- ■ e(t Wei/LOylS1N Deck area: square feet Si)EC. s//1-C J 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. per, y�� / 'tl 1 � �'© C�UIJ&, I�111� Valuation: S z n€.„�.�� - biLa - Nk, Existing building area: square feet 1��w New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: al iSr= =s .T.( - itAS J1 - Type of construction: Address: 22020 11+14 tA4,) 5 • G (-tom 1b0 Occupancy groups: City/State/ZIP: ell_./ ^ �{'�� 14P ( Existing: Phone: 4z5) 4e/76-4660 Fax:A.z 4$5 "X19(p New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: ''i0,1 (4e� e.v}f- yr-i1(J Structural plan review fee(or deposit): Contact name: D.644 Nkx.1 D , �X � FLS plan review fee(if applicable): Address: F City/State/ZIP: � ( 0i2— �7Z r� Total fees due upon application: Amount received: Phone: A) 22 • TV 7 Fax::(9)31 -zzc^•S7z1 E-mail: OA,P,40�IZ44( 1 ,.(�y�� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: -'"r Submit two(2)sets of roof plan with connection details �"'""-� and fire department access,along with the 2010 Oregon Address: 46,69 143 T1 ..wA. Solar Installation Specialty Code checklist. y A a'„ o I,�I o� Q-10z� Permit fee(includes plan review City/State/ZIP: 1v1 '-'y`�trU I 1 and administrative fees): $180.00 Phone:(50-9 6S3. .,7o11 Fax:(9.5)bs3.5721 State surcharge(12%of permit fee): $21.60 CCB Tic.: q 1�f ` Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: F glatat, oU Date: 2-0 Aid& i3 * Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB) • 111111 . Building Division Development Code Provision Review TIGARD Commercial Projects - No Associated Land Use Case • Building Permit No: .45a/°c O/3 `/ /EP Expedited Review D7 C--- Project Name: Si°E-G s■49-CE Site Address: /D 7(O 3 5e.t.) GlZEE-N/,u26 , Suite/Bldg #:/4 Plans Routed: Original Plan Submittal Date: c/Z03 Routed By: 4Z7*--- 1St Revision Submittal Date: Routed By: 2nd 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 at (503) 718-1'I 17 or @tigard-or.gov) Proposal: Zoning 1YI U L Permitted Use Yes ❑ No ❑ kv-0 `01 Land Use Required: Yes ❑ No ,1 Notes: 11 f' e-R i J l'e JN.4_ I I Approved ❑ Not Approved ❑ DCPR Not Required—No DCPR Fees Due Datc Routcd to Building: 8 x12 L\CURPLN\Masters\Development Code Provision Reviev kDCPR_COM_NoLandUse.doc Rev.01/16/13 .114 ii Building Division Over-The-Counter (OTC) Building Permit T I G A R D Check List Project Description: l APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION Class of Work*: 11— Occupancy Group: Type of Construction: °"313, Type of Use**: (A?/(x Occupancy Load: 74, Oregon Specialty Code: -26(0 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: . 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: $ 12-1�� I FEES DUE $ —JO.CO DC Prov Rvw,COM TI-Ping $ IO,C' DC ProvRvw,COMTI-LRP DC Provision Review Fee for COM TI(effective 7/1/2013) $ t ,2 • Permit Fee-Add,Alt,Demo Project Valuation Planning LRP $ . -re,775 12%State Surcharge Up to$4,999 $0.00 $0.00 $ MV,di Plan Review,Structural $5,000-$74,999 $70.00 $10.00 $ 02,, '� Plan Review,Fire Life Safety $75,000-$149,999 $174.00 $26.00 $ - _401 Info Proc/Arch,Lg(over 11x17$2.00) $150,000 and over $278.00 $41.00 $ 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: Building Staff: $ Other: Date/Time: . $ � CO FEES DUE *TYPE OF USE: COM=commercial;CMS=commercial manufactured structure. **CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration; — emo;NEW=new; OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies). I:\Building\Forms\OTC-BUP.docx 07/01/2013