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Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTM 711 Re uest for Permit Action ,;.II q 9,s11 T I G A R D 13125 SW Hall Blvd. •Tigard,Oregon 97223 • 503-718-2439 •www.tigard-or.gov '1'0: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @�tigard-or.gov FROM: El Owner El Applicant ID Contractor ❑�(:i y Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) Mailing Address: City/State/Zip: Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: ,86, / (}d V‘f 7 Site Address or Parcel#: I/$3 S(,i jfet.& ?/a/ Project Name: g,l 6-eed( / yc n&t Subdivision Name: Lot#: EXPLANATION: Lr-e f e d ,,,,....0-` r 1f e,-rj, _, ,s-/,,,,t,( 1a-le p_,,,,f. Ae..--) a9""' i `, 0 Ec1e ii-- 43CXa Signature: ,-._ Date: /./r ci' Print Name: /3,--24)-(4"../ c t Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ONLY Route to S s Admin: Date AIM= B iiV Route to Records: Date -©© B fall= Refund Processed: Date j7G� ri ja Invoice Processed: Date B Permit Canceled: Date 4, y / B r- ,arcel Tag Added: Date B I:\Building\Forms\RegPermitAction_0 231'.doc p CITY OF TIGARD BUILDING PERMIT ' • COMMUNITY DEVELOPMENT Permit#: BUP2015-00147 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/21/2015 Parcel: 1 S135DD01600 Jurisdiction: Tigard Site address: 11580 SW HALL BLVD 1 Project: Silver Creek Apartments Subdivision: METZGER ACRE TRACTS Lot: 32 Project Description: Reroof-remove and replace for entire building:Units 1-10. Contractor: ARM CONSTRUCTION Owner: ROTH, CURTIS 10537 NE PRESCOTT#F 6937 SW 10TH PORTLAND, OR 97220 PORTLAND, OR 97219 PHONE: 503-317-6117 PHONE! FAX: 503-246-9931 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT T Permit Fee-Additions,Alterations, 05/21/2015 $271.43 ype of Const: Demolition Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 05/21/2015 $32.57 Dwelling Units: 0 Stories: 0 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $12,345 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $304.00 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 co y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: i� all 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 FOR OFFICE USE ONLI Received .� Er City of Tigard Date/ : ?ii j a r Permit No.. 1js,��I S 'C X I 17 13125 SW Hall Blvd.,Tigard,503 972 2�,^0\15) Plan Review �/� W Phone: 503-718-2439 Fax: 503- ,V-�i6oJ DateB : Related Permit: TI GA RD Inspection Line: 503-639-4175 e1o15 Date Ready/By: turfs: ® See Page 2 for Internet: www.tigard-or.gov V\N\( 2 y L Notified/Method: �7 c.. Supplemental Information TYPE OF • '. O ON REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction .R1 0 !►� Cn Permit fees* are based on the value of the work performed. • Indicate the value(rotnded to the nearest dollar)of all ID Addition/alteratio 0 equipment,materials,labor,overhead,and the profit for the EGORY OF CONSTRUCTION work indicated on this application. •I=1 I-and 2-family dwelling El Commercial/industrial Valuation: $ ❑Accessory building Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND fOCAA ION Total number of floors: Job site address: I, t _6fj0 c h.� l R V'V„ New dwelling area: square feet City/State/ZIP: ' (r-,ea l `"'� I/ Garage/carport area: square feet Suite/bldg./apt.#: 4 project nname: 5-/ l U a '` CI tzo 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#: Permit fees*are based on the value of the work performed. Tax map/parcel 4: 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. 4 - � Vi Q Valuation: $ /�1 J(Z 5 r 4' ✓f/} C ,1 3 e`c.1h 0 0 v Existing building area square feet v,(S/!fl l New building area: square feet ❑ PROPERTY OWNER I ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: ir- i.,(7.., I Ots>+ v u / vi ease refer to fee deposit): rte) r.+ ! ` V� Structural plan review fee(or deposit): Contact name: Q—.-in U IZ�M r> f7� Address: ` ( � \ "�� V� FLS plan review fee upon applicable): ` City/State/ZIP: ` L.;` 9 1, 6 Total fees due upon application: 6U� Phone:( �1 I7r-11 Fax::( ) Amount received: E-mail: /] M 61_,..0,04-6‘.._ /v p I (� '4geed t& /l PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* �V`" Ell / Commercial and residential prescriptive installation of CONTRACTOR ,v roof-top mounted PhotoVoltaic Solar Panel System. Business name: el 2Z( (3 L}, Wt 0,„1... --(---. ��! Submit two(2)sets of roof plan with connection details V` '�+t, V l r 1 and fire department access,along with the 2010 Oregon Address: ene_ 4:Li 4e...) Solar Installation Specialty Code checklist. City/State/ZIP: Permit fee(includes plan review $180.00 9 6'�� O2":5, and administrative fees): Phone:( ) Fax: � State surcharge(12%of permit fee): $21.60 CCB Lic.: `D f ti / Total fee due upon appication: $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: ? A jn 0�� I Date: * Fee methodology set by Tri-County Building Industry y'L Service Board L\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 4404613T(11/02/COM/WEB) s � City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT II • Accessibility: Barrier Removal Improvement Plan • Commercial & Multi-Family - Additions or Alterations T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov 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 percent(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 PernitApp.doc Rev.12/18/2014