Permit (34) CITY OF TIGARD BUILDING PERMIT
s . COMMUNITY DEVELOPMENT Permit#: BUP2016 00153
T[G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2016
Parcel: 2S 101 DA00105
Jurisdiction: Tigard
Site address: 13009 SW 68TH PKWY B
Project: Extended Stay America Subdivision: VARNS ACRES Lot: 9
Project Description: Building B-Dry rot repair for(4)staircases.
Contractor: FIKE INDUSTRIAL CONSTRUCTION LLC Owner: BRE/HV PROPERTIES LLC
P.O. BOX 873607 TAX DEPTARTMENT
WASILLA,AK 99687 EXTENDED STAY HOTELS
OP BOX 49550
CHARLOTTE, NC 28277
PHONE: 503-357-6003 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VA Permit Fee-Additions,Alterations, 05/10/2016 $1,709.95
Demolition
Occupancy Grp: R-2 Occupancy Load: 12%State Surcharge-Building 05/10/2016 $205.19
Dwelling Units: 0 Plan Review 05/10/2016 $1,111.47
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 05/10/2016 $683.98
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 05/10/2016 $4.00
Value: $200,000 11x17)
Info Process/Archiving-Sm$0.50(up to 05/10/2016 $5.00
11x17)
Floor Areas: Metro Const.Excise Tax 05/10/2016 $240.00
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,959.59
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 OU NC by calling 503.232.1987 or 1.800.332.2344.
or
Issued By: ,Ar 4. Permittee Signature: y_e_e_ __
i .639.4176 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 RECEIVED FOR O1FI( I. I sl.O\I.I
g Received �
Cityof Tigard Date/B ` �. Permit No�uP / ...-00,
Ili ill 13125 SW Hall Blvd.,Tigard,OR 97223 1,7,Y 0 9 2016 Plan Revie 1•�
Phone: 503-718-2439 Fax: 503-598-1960 DateB : +��,_���11119
Related Permit:
II
i,1 t,A R l) Inspection Line: 503-6394175 CITY OF FIGARD Date Ready/By: loris: S See Page 2 for
Internet: www.tigard-or.gov I Notified/Method:Method: , f� y'1'�� SupplemeotalInformation
BUILDING DIVISION 0S` �! QUIREDDATA:1-AND 2-FAMILY DWELLING
TYPE OF WORK
❑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
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling 0 Commercial/industrial Valuation: $
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 30,9!p ') ( Jake New dwelling area: square feet
City/State/ZIP: 74b DR__ Garage/carport area: square feet
Suit ]dg./ pt.#: Project name: Sfl xJ/ Ci1'- 1 A /t4 Covered porch area: square feet
Cross street/directions to job site: �J / Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 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.
2/Ly zo7 . -&/ f}/2 by S7 / c ifs e=S' ('v) Valuation: $0200/ OM, . OZ)
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) ..-
New:
fia APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
Business name: k& fruusr,,, (Please refer to fee schedule)� ST�PuCT/a1t� LL� Structural plan review fee(or deposit):
Contact name: i6me t�,1Ef! (37-740. S
/ /3 640 FLS plan review fee(if applicable):
Address: /r)'�6 ,aIC�!
City/State/ZIP: Total fees due upon application:
Phone:(5j7j) a7 10 0 63 . Fax: :( ) Amount received:
E-mail: be I/ly_-*metasT-04-/@6U-r toe ,�l^`7_ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: F,6 /d rfil ars-rocrmh i(�, Submit two(2)sets of roof plan with connection details
p L ter"' c��^� and fire department access,along with the 2010 Oregon
Address: / .6, box Gr1!%?y1,l,i:.,.: 873&07 Solar Installation Specialty Code checklist.
City/State/ZIP: (,01S OA 11--/as 91057 - '56o 7 • Permit fee(includes plan review $180.00
Phone:(jb7 ) 3s7 (,,00 5 Fax:( ) and administrative fees):
State surcharge(12%of permit fee): $21.60
CCB Lic.: {/D 3 l t
Total fee due upon application: $201.60
t&U)4
Authorized si This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:--111y1 1LS. Date: (*-Q * Fee methodology set by Tri-County Building Industry
� Service Board.
I:ABuilding\Permits\BUP_COMPennitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)