Permit CITY OF TIGARD BUILDING PERMIT
•. COMMUNITY DEVELOPMENT Permit#: BUP2014-00014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/30/2014
Parcel: 2S 112ACO2100
Jurisdiction: Tigard
Site address: 14875 SW 72ND AVE
Project: Ortho-Med Subdivision: FANNO CREEK ACRE TRACTS Lot: 48
Project Description: Racking for TI.
Contractor: NORLIFT OF OREGON INC Owner: RSD PROPERTY LLC
PO BOX 68348 3208 SE 13TH AVE
PORTLAND, OR 97268 PORTLAND, OR 97202
PHONE: 503-519-3043 PHONE:
FAX: 503-632-7178
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 01/30/2014 $53.27
Occupancy Grp: S-1 Occupancy Load: 1 Demolition Stte
12/o State Surcharge-Building 01/30/2014 $6.39
Dwelling Units: 0 Plan Review 01/22/2014 $34.63
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 01/22/2014 $21.31
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 01/30/2014 $2.00
Value: $500 11x17)
Info Process/Archiving-Sm$0.50(up to 01/30/2014 $7.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $124.60
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
_ � p
Issued By: Permittee Signature:
.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
(5'G,(1/)-./ �� IOR Ol.I I( I I til OBI 1
III City of Tigard ,r � Received I / Permit No.: �� - #1 —, .
• 13125 SW Hall Blvd.,Tigard,OR • �,J A� Plan R w
Phone: 503.718.2439 Fax: 503. •I rt%\�t
Date/B : �� ra Other Permit: / — 0.. 7
1 l u n R I1 Inspection Line: 503.639.4175 `\�� �� Date Ready: : ofe mop i funs: %'See Page 2 for
Internet: www.tigard-or.gov 0 ,c O Notified/Method: Supplemental Information(05% 4)(te- /An i Al)G1-.........
TYPE OF WO 414.0 REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Dep�1j Permit fees*are based on the value of the work performed.
Q�tl` Indicate the value(romded to the nearest dollar)of all
„m Addition/alteration/replacement ❑( er: equipment,materials,labor,overhead,and the profit for the
(� CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ommerciallindustrial
Valuation: $
ID 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 y 6 ,S s W 7, New dwelling area: square feet
City/State/ZIP: 7%. A I i Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Vv_/yV J 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: 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 rofit for the
DESCRIPTION OF WORK work indicated on this application. _tom
C ki„I Valuation: $ < 7 _ '" "
Existing building area square feet
New building area: square feet
&PROPERTY OWNER ❑ TENANT Number of stories:
Name: G r ,ti o m eJ Type of construction:
Address: /Y g 75- S w 2,2 r1 Occupancy groups:
City/State/ZIP: j f` `,1 Existing:
Phone:( ) J Fax:( ) New:
A APPLICANT An CONTACT PERSON NOTICE
Business name: do ell 71 All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: r 0n f e 11 L
/ , /- tinder ORS 701 and may be required to be Icensed in the
Address: 7 3 7 3 $ , '< A,/ p 1 a ' performed.jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:(4)3 If 9 3 D y3 Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES"
f (Please refer to fee scheduli)
Business name: o/14/or ,i f Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
F14-plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application.) 5-5"'• at h
CCB lic.: & 7 l y Total permit fees:
Authorized signature Amount received:
�A� This permit application expires if a permit not obtained
Print name: ic", ter-7 o---f ` Date: 77:?WI C( within 180 days after it has been accepted as complete.
1 * Fee methodology set by Tri-County Building Industry
Service Board
1:\Building\PermitsWFPS-PermitApp.doc Rev 01/05/2012 440-4613T(I I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A,B&C above): $
Permit fee based on project valuation(see fee schedule): $
Permit fee based on square footage(see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review(40% of permit fee): _ $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 2