Permit y q CITY OF TIGARD BUILDING PERMIT
►'! I, COMMUNITY DEVELOPMENT Permit#: BUP2014-00154
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/28/2014
Parcel: 2S102AC00500
Jurisdiction: Tigard
Site address: 12492 SW MAIN ST
Project: Spec Space Subdivision: BURNHAM TRACT Lot: 1
Project Description: Frame and sheetrock restroom per ADA standards
Contractor: OWNER Owner: WOODARD LIVING TRUST
WOODARD LIVING TRUST PO BOX 23303
PO BOX 23303 TIGARD,OR 97281
TIGARD, OR 97223
PHONE: PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee-Additions,Alterations, 07/28/2014 $119.33
Demolition
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Building 07/28/2014 $14.32
Dwelling Units: 0 Plan Review 07/28/2014 $77.56
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 07/28/2014 $1.00
Bedrooms: 0 Bathrooms: 1 11x17)
Value: $2,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $212.21
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 thr• • • 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.
Issue. By: � Permittee Signature: 4
Call 503.639.4175 by 7:00 a.m.for the next available inspection d e.
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.
'fluikfin2 Permit Application
Commercial _ I OR (11 1 1( 1 1 'l (1\L1
1 • t :
Ili City of Tigard IV I l i 3� R� ed ? (o I a _ , Permit No.: l per/ -o) l 5
. ■ 13125 SW Hall Blvd.,Tigard,OR Plan Review a P
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : ,��� er ermit: 64-44101 2-. Oaat
Inspection Line: 503.639.4175 Date Ready/By: �WM Juris. ® See Page 2 for
IIC,ARD i/,
Internet: www.tigard-or.gov ,{ Notified/Method: 3 23 / •- Supplemental Information
l/t i I 0 t ItJF'i't0 4Z-r--
TYPE l 1E HR! /I(' 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
ddition/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 ❑Commercial/industrial Valuation:Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE 1 INFORMATION` AND LOCATION Total number of floors:
Job site address: / 'Z L-( 2 5(A-1 A n 14 1)Q New dwelling area: square feet
City/State/ZIP: `►-; _�v.).,_ 0fg.. E 72 7 Garage/carport area: square feet
Suite/bldg./apt.no.: J Project name: S pE c �ei4c E Covered porch area: square feet
Cross street/directions to job site:) Deck area: square feet
ATT y a ' 1' o'',G� L. it.0 f '1 <fL 11 Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 3 IA N H 4 M T AA C r I Lot no.: ( Permit fees'are based on the value of the work performed.
Tax map/parcel no.: 'Z s 0 2 A- c06 r 00 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESSCrRIIPTION OF WORK r u f� work indicated on this application.
FR A ME S b CET 5 r Kw, le (-1.,4 7 4T'1'I ail Valuation: $ 2 SCD 0 . a CO
?p(/ 4 b i j¢4AJ D401)", - Existing building area: square feet
!! r7
New building area: square feet
ElRO PIX Y OWNER I 0 TENANT Number of stories:
Name: ( j-tAcx / , 0 6 h A il, 0 Type of construction:
Address: 1 O 13,0 2 3 3 0? L l l/l Id& ilwri Occupancy groups:
City/State/ZIP: 'r`t. 0_,‘fk 0 Existing:
Phone:(5 V�) 3 — J
3 Fax:( ) New:
APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:
Meese reefMie whale*
Contact name:
4_/q G /)c &NI) Structural plan review fee(or deposit):
Address: I 3 /A i&O{tC>� Lk) FLS plan review fee(if applicable):
City/State/ZIP: Ti t r 7 2 Total fees due upon application:
Phone:(cD3) 47 4 _7110 I Fax::( )
Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYS EM FEES*
CONTRACTOR Co cial and residential prescriptive ins , :tion of
roof-top . ted Photo Voltaic Solar P: - System.
Business name:
Ca)/0 Ei.2.- Submit two(2 - of roof plan w' connection details
and fire department a • ,al.._with the 2010 Oregon
Address: /6 0 cy 3 S LA j CL ,���� ) /� \ Solar Installation Special checklist.
City/State/ZIP: �Jd ' �J Permit fee(Inc ..•es plan re - $180.00
P CJ-( an' .r • 'strative fees):
Phone:( `ub) 3�C� q I c9 Fax:( ) States arge(12%of permit fee): $21.60
CCB lic.: C t f,_ I Total fee due upon application: $20 .60
Authorized signature: x ,/%�J�/ / This permit application expires if a permit is not obtained
( ' ! h "LL// J� within 180 days after it has been accepted as complete.
Print name:M/40c r C�6 ._) ���������v Date:C n 4.. l yf • Fee methodology set by Tri-County Building Industry
Service Board.
City of Tigard
71 •
■
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: 7)0 p9O ,4 -0°,5q
Site Address: i a 4 q MA i ,..) 'Dr- Suite/Bldg#:
Project Name: `gyp 1✓c 6 41-e_t.,
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
, L Q�
Proposal: & 4,f m rn -TU(' &fe.c Ti .
kr Verify site address/suite #exists and active in permit system.
Zi Zoning: MU GILD
' Permitted Use: ❑ Yes ❑ No ...-Er Spec Space
lI Land Use Required: ❑ Yes ,,Q. No Type Required
Notes:
Approved by Planning: Illg a Date: 1111-t114
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: Cl Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 7//0/4
Site Plans: # A-/rq
Building Plans: # 5
Building Permit#: 'Enter building permit# above. /
Workflow Routing: Planning ❑ Engineering ❑ P C,..�� i t cancer rotor 1d Building
Workflow Sign-off: CYSign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: C Lp Date: 7/171/ 1
I:\Building\Forms\B IdgPermitRvw_COM_NoLandUse_042914.docx
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Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12492 SW MAIN ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2014-00154
Jeff Grove
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12492 SW MAIN ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2014-00154
Jeff Grove
Violation Summary:
Inspector Contractor