Permit CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit#: BUP2014-00034
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/18/2014
Parcel: 2S102AA00905
Jurisdiction: Tigard
Site address: 12000 SW MAIN ST
Project: Sierk Orthodontics Subdivision: PAYLESS SHOPPING CENTER Lot: 5
Project Description: Enclosure of drive-thru. Previously reviewed and approved under BUP2013-00246. Administrative fee collected to
change contractor.
Contractor: OREGON BATH&KITCHEN INC Owner: HAAGEN, GARY L&CANDACE C TRS
PO BOX 9277 2514 SE 112TH AVE
BROOKS, OR 97305 VANCOUVER,WA 98664
PHONE: 503-393-6407 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Misc Administration Fee 02/18/2014 $90.00
Occupancy Grp: Occupancy Load:
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $0
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $90.00
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 suspend-d for more the 180
day N • •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules . set forth in OAR
9 -001-0010 through O'' 952-00 -•090. You may obtain a copy of the rules or direct questions to OUNC by callin• • •32.1987 or 1.:•• 4
sued By: Permittee Signature:
can 503.639.4175 by 7:00 a.m.for the next available inspela
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.
tsunami rermit Application
Commercial I Oft UI1 Hi L l sE ON L1
City of Tigard RE VED D �mQ1r� Permit No r P ,/ .. j-
• 13125 SW Hall Blvd., fi OR 97223 Plan' a . Phone: 503.718.2439 Fax: 503.598.49 18 2014 Date/By:1EW Other Permit. 4��/3_mod' V�
I ,t.,.\-
.,,\-F,t, Inspection Line: 503.639.4175 2014 Date Ready/By: runs Bt See Page 2 for
Internet: www.tigard-or.gov t��CITYYOF rI ARD Nntified/Method Supplemental Information
TYPE O6'1 D61f t IIG/I,sIf Pt' REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Ig Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
— indicated application.
Valuation: S
❑ 1-and 2-family dwelling N Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
S New dwelling area: square feet Job site address: 12.O G C w ,nn.t►t 1 S T
.
City/State/ZIP: Garage/carport area: square feet it,
Suite/bldg./apt.no.: 1 P r o j e c t name: S 111.441.1.4 ,,,,,,....r 6)4 3,bOwS•Ye 45 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet 1
1
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: J 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: S
Ito C,Lt.— C V > 5..r1,Je_ 7)fl.tat'v "r►-]cr_o.Jc.t..L.
Existing building area: square feet
New building area: square feet
•
ix PROPERTY OWNER r-^-- ❑ TENANT Number of stories:
Name: [ t K i,fy Pat t�.T t a S LA, L Type of construction: v R
Address: / /
1 $Z wk. R.v j W 00 I C t�.i a.7 Occupancy groups:
City/State/LIP: LtsiE s_i L Ie.I tJ c'2— _a j o_G-$,. _ Existing: Q
Phone:( ) Fax:( ) New: ',) r c,
Q APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: 7-0,....._. (Please refer lo fee schedu e)
hJ W pa �•t 5,0,3 S t J Structural plan review fee(or deposit):
Contact name: -) A ti t tJ O t9 S tL-A,
HS plan review fee(if applicable):
Address: 2-Z.-t;,e, S ii L-'.10 E ,Liks_r c7
City/State/ZIP: Total fees due upon application:
s HE ILu.!Ov t� erS(L 1 4(j Amount rec:aived:
Phone:(4n3) Gsso — c 4.4�4 11 Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
•
'Q n.L..� P.- t.) V..1 P it,>s Cr1 f P 0 s✓C ws. Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: R fie, Submit two(2)sets of roof plan with connection details
J 3ATit b t� T(,J6 J l 1 trJl,r and fire department access,along with the 2010 Oregon Address:
pp i-2,t7 X 9'j,"1'? Solar Installation Specialty Code checklist.
City/State/ZIP: j�2 00 105 O n_ `7 105
Permit fee(includes plan review $180.00 I
and administrative fees):
Phone:(503) 393 - 4..40 Fax:( ) o-
State surcharge(12%of permit fee): $21.60
CCB lie.: ' ( Vic' -
�, 7(� Total fee due upon application: $201.60
•
Authorized signal This permit application expires if a permit is not obtained
(."."--1---- within 180 days after it has been accepted as complete.
[Print name: ;t J A!L t J l?o V S Ke Date: Z 4 4 • Fee methodology set by Tri-County Building Industry
Service Board.
1:1BuildinglPermits\BUP-COM PcrmitApp.doe 02/24/2011 4404613T(I I/02/COMIWEB)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12000 SW MAIN ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
2014-03-11 00:00:00
BUP2014-00034
PASS - C of O
Violation Summary:
Inspector Contractor