Permit j . � CITY OF TIGARD BUILDING PERMIT
z, � " a n
Ft I COMMUNITY DEVELOPMENT Permit #: BUP2010 -00140
T(GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/23/2010
Parcel: 1S135BC01100
Jurisdiction: Tigard
Site address: 11131 SW GREENBURG RD
Subdivision: Lot: 0
Project: Spec Space
Project Description: Demo interior walls for future TI
Owner: FEES
ROBINSON FAMILY TRUST Description Date Amount
BY E LEE & EVELYN L ROBINSON TRS, PO Permit Fee - Additions, Alterations, 06/23/2010 $362.69
BOX 91305 Demolition
PHONE: 12% State Surcharge - Building 06/23/2010 $43.52
Plan Review 06/22/2010 $235.75
Plan Review - Fire Life Safety 06/22/2010 $145.08
Contractor:
ROBINSON CONSTRUCTION
21360 NW AMBERWOOD DR
HILLSBORO, OR 97124 -9321
PHONE: 503- 645 -8531
FAX: 503 - 645 -5397
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $19,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $787.04
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit's iccued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d in accordance approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for mor> he 180
da . ATTENTION: Oregon -w re. ' -s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in O
9 2- 001 -0010 through OAR 9. '01 -0100 You may obtain a copy of the rules or direct questions to OUNC by calli 3.246.6699 or 1.809 32.2344.
I sued By:
� `� / Permittee Signature:
�a raaSL
Call 503.639.4175 by 7:00 a.m. for an inspection that b sin � da
This permit card shall be kept in a conspicuous place on the job site until co `.letion of the project.
Approved plans are required on the job site at the time of each in . ection.
Building Permit APPIICatio EC IVES P r a_r
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Cit of Tigard 9, 2 (0 .;) e Received Co / /
NI 11114 y g Date /B : � ✓ 01-9- IO Permit No r �j /D .Oa / ( 69 r
a 13125 SW Hall Blvd., Tigard, OR 972
Plan Revie - �,
9 t . Phone: 503.639.4171 Fax: 503.598. MY OF TIGARD Date /B : r Other Permit:
�
l iI n1 ii I 'M' Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready /By: .1,4j,...._ El See Page 2 for
Y i ri•t xI Internet: www.tigard - or.gov Notified /Method: t » ' 16 Or ' l tie Supplemental Information
0 S Ullt t ✓; , fro."(` - / re
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: 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: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
1/13/ JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:Th:01SW Greenburg Rd New dwelling area: square feet
City / State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Sky High TI Phase I Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
NW corner of intersection at SW Greenburg Rd, SW Tiedeman Ave and Other structure area: square feet
SW North Dakota St REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: 1100 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 1S135BC 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.
Work is limited to-exterior Valuation: $$19,000.00
ipwpeauenientr.and interior demising wall. Tenant build out will be Phase II. Existing building area: 69017 square feet
New building area: 0 square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: 1
Name: Robinson Family Trust Type of construction: III -B
Address: 21360 NW Amberwood Dr Occupancy groups:
City /State/ZIP: Hillsboro, OR 97124 I. Existing: M & S-1
Phone: (503)645 -8531 Fax: (503)645 -5357 New: A -3
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: CIDA, Inc All contractors and subcontractors are required to be
Contact name: Kourtney Strong / Kim Walmer licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15895 SW 72 Ave Suite 200 jurisdiction in which work is being performed. If the
City / State/ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 226 -1285 I Fax: : (503) 226-1670
E -mail: kourtneys @cidainc.com / kimw @cidainc.com
CONTRACTOR
Business name: Robinson Construction BUILDING PERMIT FEES*
•
Address: 21360 NW Amberwood Dr (Plecserejerrojeesehedule)
City /State /ZIP: Hillsboro, OR 97125 Structural plan review fee (or deposit):
Phone: (503) 645 -8531 Fax: (503) 645 -5357 FLS plan review fee (if applicable):
CCB lic.: 63147 �� Total fees due upon application:
Amount 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: Kourtney Strong Date: 06.2(2010 * Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 2 /23/07 440-4613T(1 I /02/COM/WEB)
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