Permit liz4 BUILDING PERMIT
7 8 M CITY OF TIGARD ! . Os: -: COMMUNITY DEVELOPMENT Permit #: BUP2010 -00136
Al, G/A
IRD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/17/2010
�,� , ; , ,; _ Parcel: 1 S126DCO3300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD 245
Subdivision: Lot: 0
Project: State Farm Insurance
Project Description: TI
Owner: FEES
ATHERTON REALTY PARTNERSHIP Description Date Amount
200 SW MARKET ST SUITE 200 Permit Fee - Additions, Alterations, 06/17/2010 $104.12
PORTLAND, OR 97201 Demolition
PHONE: 503- 279 -1722 12% State Surcharge - Building 06/17/2010 $12.49
Plan Review 06/17/2010 $67.68
Plan Review - Fire Life Safety 06/17/2010 $41.65
Contractor:
BNK CONSTRUCTION INC
45 82ND DR SUITE 53B
GLADSTONE, OR 97027
PHONE: 503- 557 -0866
FAX: 503 - 557 -1085
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $2,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $225.94
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Protected Corridors: No
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 - 0 • -r applic: • - .w * II work will
be done - ordanc- ' approved pl - .s. This permit will expire if work is not started within 180 days of issuance, or if ,•tyr is suspe. • - • •r more the 180
day * TTENTION: Oregon = w req ' es y • to •flow the rules adopted by the Oregon Utility Notification Center. Thos- ■ i : are s- orth ' OAR
9 i- 001 -0010 through OAR 9 • -'' 1 -010' ou may obtain a copy of the rules or direct questions to OUNC by calling • 11•. or 1 00.332.2344.
Is sued By: t) ( / Permittee Signature: A . A l tbrA 11111011..'
—
Call 503.639.4175 by 7:00 a.m. for an inspection that b siness da
This permit card shall be kept in a conspicuous place on the job site until completr • of the project.
Approved plans are required on the job site at the time of each inspec • n.
,
J Building Permit Application y �
City of Tigard FOR OFFICE USE ONLY
410 " " � \0 Received , � �
Perm No.: � � /D .� / Date/8 y: `� / 7 /O i PdI�j
13125 SW Hall 131vd., Tigard, OR 97223 Plan Revi
Phone: 503.639.4171 Fax: 503.598.1960 ` . "' "n ,,,iftu : v '.I I C 't teitBe ew , :y � ���' '4.
OM
Other Pernik: Y.
Inspection Line: 503.639.4175 � _„ a _ ° ! � a Date Re / ® See Attached Checklist for
Internet: www.ci.tigard.or.us +p \ Notified/Method: 1011 Supplemental Information
TYPE OF WORK. 9) 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
y t Addition /alteration /replacement - '.„( ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling [Commercial /industrial Valuation: $
❑ 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: Lpt y/'/' Tel /4 f CN 1;f1 _ ei% y ir' G/Lt - /',9/'`..- New dwelling area: square feet
City /State /ZIP: /' 7 t f /�fp �,� y 7 Z .2-3 , Garage /carport area: square feet
Suite/bldg. /apt. no.: `f. Project name: S j,,9 7t g /I/'/ x - / f/ 5 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: 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.
�'7/� • L O LY`'G G Valuation: S .Z t%C�G_ / 0
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑. TENANT Number of stories:
Name: .4 THOf y8r/ f t4 i 1 y p ofre/t ff/ ft 7 r Type of construction:
Address: 7 0 0 (,y /1 .'1 y if 7 7, c h .[?"L• 2 , ( 9.. Occupancy groups:
City /State /ZIP: 19 f 4-r L - ,VU a/t. - q 7 yG % Existing:
/
Phone:(
5 y) 2.7 — i .7).- 7.- Fax: (Se) . 2_77..../ 7i Z New:
A APPLICANT ❑ CONTACT PERSON NOTICE
Business name: %',4- /-1-
' C , j ,....5 -- All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /Z]P: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax::( )
E -mail: L i9/} I-j' r f!/_� I2"/1/1; co" 711e4- 7 ✓_ le0/'7
CONTRACTOR
Business name: 4 A ---
l [ 7--'Q c Y <`,,. BUILDING PERMIT FEES*
Address. S y �` /7�1 _ 5,.,,_,- �� S 7. -' Please refer to fee schedule.
City /State /ZIP: !l- i 47/7c TC / ✓Gr `" - L% - Fees due upon application
Phone: (�`7 y) . 9 7- e cc v Fax: (0:4 ) S S 7 /Cj fcs �
Amount received
CCBlic.: r 5 rj"
Date received:
Authorized signature: .-- This permit application expires if a permit is not obtained
` within 180 days after it has been accepted as complete.
Print name: � Date: 7/77 L .�l * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Penn its\BUP- TI- PernitApp.doc 12/03 440 - 4613T(1 I /02 /COM/W En)
Q ° Building Division
Over- The - Counter (OTC) Building Permit
T rc n lz ° Check List
Description of Project: T(
GENERAL INFORMATION
Class of Work:* C� Floor .Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: 13 Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
_ Stories: 2— 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: 10Th Handicap access: � p � ,.,
Smoke detector: Protected corridors: Vw
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ 2)6 00
•
INSPECTIONS FEES DUE
Footing /foundation Firewall $ I cyk- ( 2.. Permit Fee
Post /beam structural Smoke detector $ (7,' State Surcharge
Shear wall Misc. inspection $ 7 Plan Review Fee
Masonry Approach /sidewalk $ 44t ,(' 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 Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Z : ►g4 Total Fees Due
*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.
I: \Building \Forms \OTC- BUP.doc 08/19/08