Permit r rit:n4 CITY OF TIGARD BUILDING PERMIT
i k r: COMMUNITY DEVELOPMENT Permit #: BUP201000129
VA Date Issued: 06/15/2010
T i G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
a Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 92
Subdivision: Lot: 0
Project: Fantastic Sam's
Project Description: TI
Owner: FEES
13500 PACIFIC CORP Description Date Amount
BY CAPOZZOLI ADVISORY FOR, PENSIONS Permit Fee - Additions, Alterations, 06/15/2010 $553.13
INC, 21500 HAGGERTY ROAD, SUITE 100 Demolition
PHONE: 12% State Surcharge - Building 06/15/2010 $66.38
Plan Review 06/15/2010 $359.53
Plan Review - Fire Life Safety 06/15/2010 $221.25
Contractor:
CREATIVE CONTRACTORS & DESIGN
15357 UNION SCHOOL RD
WOODBURN, OR 97071
PHONE: 503 - 984 -3220
FAX: 503- 981 -7784
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $34,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,200.29
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Protected Corridors: No
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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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 acco • • • e with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for a the 180
days. ATT I TION: Orego . aw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fort e�
952 -00 0010 through OAR 9.2 -101 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 • „f:re : v 4��'
Issue By: j#1a-'14-(141 rr Permittee Signature: .� / / ///
CaII 503.639.4175 by 7:00 a.m. for an inspection that b i si ess day.
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 RECEIVEi'la ,.: 10o13oF y� :e
nip City of Tigard , 1
Received /4/1 Sr /b �uP�tO'Ob
Pe rmit No.:
IN I u 13125 SW Hall Blvd. Tigard, OR 9722 JUN 2010 01.516.)
g" Plan Review �., }
Phone: 503.639.4171 Fax: 503.598. Date/By: 4110 It Other Pcnnrt:
T fGA RD Inspection Line: 503.639.4175 CI OF TIGARD Date Ready/ „17-7—c: Su ®See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified /Method: pplemental Information
TYPE OF WORK 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
❑ Addition /alteration /replacement ® Other: TI IMPROVEME equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
y dwelling Valuation: $
❑ 1- and 2-family g ®Commercial /industrial
I=1 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: SUITE 92, 13500 PACIFIC HWY New dwelling area: square feet
City /State /ZIP: TIGARD, OR Garage /carport area: square feet
Suite/bldg. /apt. no.: 92 Project name: FANTASTIC SAM'S IIAIR SALO Covered porch area: square feet
Cross street/directions to job site: 99E Deck area: square feet
IN TIGARD MARKET PLACE NEXT TO ISLANDS TANNING & STAR BUCKS Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
BUILD OUT TENANT SPACE FOR HAIR, SALON, FRAME A FEW WALLS Valuation: 5534,000.00
AND SET OWNERS FIXTURES Existing building area: 1500 square feet
New building area: 0 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 1
Name: FANTSTIC SAM'S Type of construction:
Address: i 5- 3 c 1 a I Rv O S Occupancy groups:
City /State /ZIP: ? P6 f..4. (
3 e R. 9 2. Z CZ' Existing:
Phone: (Sob) y I'" _sit t 7 Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: CREATIVE CONTRACTORS & DESIGN All contractors and subcontractors are required to be
Contact namc: .1OS11UA TITTLE licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15357 UNIONSCHOOL RD jurisdiction in which work is being performed. If the
City /State /ZIP: WOODBURN, OR 97071 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 984 -3220 Fax: : (503) 981-7784
E-mail: JOSH @CREATIVECON.COM
CONTRACTOR
Business name: CREATIVE CONTRACTORS & DESIGN BUILDING PERMIT FEES*
Address: 15357 UNIONSCIIOOL RD (Pleasereferrojeesehedufe)
Structural plan review fee (or deposit):
City /State /ZIP: WOODBURN, OR 97071
Phone: (503) 984 -3220 Fax: (503) 981 -7784 FLS plan review fee (if applicable):
CCB lie.: 171728 Total fees due upon application:
/ Amount received: 0/ /1,,
Authorized signature: / This permit application expires if a perm is not obtained
within 180 days after it has been accepted as complete.
Print name: JOSHU. TILE Date: 6 -15 -2010 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(11/02/COM /WEB)
.. ' ,,a. te r. • •
11,.,.. ` Building Division
il ,.
O
,2 Accessibility: Barrier Removal Improvement Plan
,T'IFGA•RD
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 per -cent (25 %).
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VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: 11] $ 34000
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: (2] $ 8500
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall he given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
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(c) An accessible route to the altered area: $ 4500
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ 4000
• (e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
• alarms: $
TOTAL (shall equal line 121 of Valuation Computation): . $ 8500
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I:ABuilding \Permits \BUP -COM PermitApp.doc 06 /25/08
i iii . .
Building Division
Over- The - Counter (OTC) Building Permit
`r I c n ti o Check List
Description of Project: ( I
GENERAL INFORMATION •
Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: Second floor: E: W: •
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: (.j Total sq ft.: N: S:
Stories: l Note: Combine total floor area for E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler MO Handicap access:
Smoke detector: Protected corridors: 100
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ :ZA 1
/
INSPECTIONS _ FEES DUE
Footing /foundation Firewall $ X3.(3 Permit Fee
Post /beam structural Smoke detector $ to (c, aS State Surcharge
Shear wall Misc. inspection $ ✓' , " Plan Review Fee
Masonry Approach /sidewalk $ 2 2 Z- FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinlder final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ VIC 2 Total Fees Due
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*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks; retaining walls, signs, awnings
or canopies); REP = repair. -
1: \ Building \ Forms \OTC- BUP.doc 08/19/08