Permit CITY OF TIGARD BU ILD PERM
11111
COMMUNITY DEVELOPMENT Permit #: BUP201 0 00241 IT
TI GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/15/2010
Parcel: 1S135CA90125
Jurisdiction: Tigard
Site address: 11046 SW GREENBURG RD 125
Project: Ash Creek Condominiums Subdivision: ASH CREEK CONDOMINIUMS Lot: 0
Project Description: Fire restoration of all units in building addressed as 11046 & 11048 SW Greenburg.
Contractor: HORIZON RESTORATION Owner: PHIL - ALEXANDER, LORRAINE
7235 SW BONITA ROAD 11046 SW GREENBURG RD #125
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 620 -2215 PHONE:
FAX: 503 - 624 -0523
FEES
Specifics: Description Date Amount
Type of Use: MF Permit Fee - Additions, Alterations, 11/04/2010 $9,456.95
Class of Work: ALT Demolition
Dwelling Units: 0 Plan Review 11/04/2010 $6,147.02
Stories: 2 Height: 0 ft Plan Review - Fire Life Safety 11/04/2010 • $3,782.78
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 11/04/2010 $1,134.83
Value: $2,000,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $20,521.58
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Yes Manual Pull Stations: Yes •
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 i nce 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. TTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notific -tion Center. Those rules are set forth in OAR
95 001 -0010 through OAR 952 - 001 - •0. o •• obtain a copy of the rules or direct questions to OU• - • .,: 03.22.1987 or 1.800.332.2344.
ssued By: j ,_ � Permittee •ignature: 4 ) 4,1
Call 503.639.4175 by 7:00 a.m. for the next available inspecti • • date.
This permit card shall be kept in a conspicuous place on the job site u completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial F OR OFFICE USE ONLY
RECEIVED
City of Tigard
' / Received
lig Pl an Re he Date /B : ,, y /U O _ M Permit No.: ,u/A / O!o__, 0,2 1
v 1 3125 S W Hall Blvd., Tigard, OR 9722 (( q � Other Permit:
Phone: 503.639.4171 Fax: 503.598.1060' L 0 10 Date/B : AIjli��. ��
TIGARD Inspection Line: 503.639.4175 Date Ready :y: Juris: E See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK ` REQUIRED DATA: 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 R] Other: 1g A equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCT
-` _ work indicated on this application.
1=1 1- and 2- family dwelling El Commercial /industrial Valuation: $
El Accessory building tgl Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
' JOB SITE INFORMATION; AND LOCATION Total number of floors:
'ill ° � t �
Job site address: / / o q 6 s y v a I U tau /ZD New dwelling area: square feet
City/State /ZIP: T/4 Aia,t i 0/2 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: AS/i°' Cp.s d o iziP4A Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
4/1-S7 OF /544/Y 2„/1' 0&t) 6AE-)4.)44 Other structure area: square feet
- REQUIRED DATA COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 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.
/ PAti To OY /STS t y demA wbulemi Valuation: $ 2, ,Y >, C.Ye)
C•?C ).A1-644,4f.)) Y c/Ax Existing building area: /g I 36 6 square feet
/3 [-I- t UJJi (WD EL ,4bb RE 65 ft, Il oq 4 w 11011 g ` db New building area: _— square feet
P ROPERTY OWNER_; ` ❑ TENANT Number of stories: w /BA.SrifE�T
Name: A C,UE OD-0.60 IgIciAts Type of construction: v—* a
Address: Occupancy groups: R,. 2_
City/State /ZIP: Existing: a. 2...
Phone: ( ) Fax: ( ) New:
,r ['APPLICANT `1i't ONTACT PERSON
NOTICE
Business name: W.4p. 4 hN /2.S IIVC.. All contractors and subcontractors are required to be
Contact name: „44A4Rium_,) Coo, ?in�4. licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: /0 Y5 / 3 -.- Gr . Ste. jurisdiction in which work is being performed. If the
City/State /ZIP: �E/.4 ,, 0 9 7. so , apply:
applicant is exempt from licensing, the following reasons
Phone: (Sos) 3e n... / 39? Fax:: (.52 3 - $259
E -mail: C,14A4X 12O.v C. U 4 � 4 /NZEi2.S • Coe/
CONTRACTOR
Business name: h/ vni abA—I 1j$7 iju4 T/Oti , ° BUILDING PERMI.T FEES*
Address: I z 3 5 n Ai/TA. jZ (P[ease,r'efer`fo "fee�schedu[e)
ty t »2r/� W b Structural plan review fee (or deposit):
Ci /State /ZIP: , OA. 97LZ Y
FLS plan review fee (if applicable):
Phone: (n3) 624 ' az 5 Fax: (SOj) 6 zit -OS?,3
CCB lic.: 6 R /6 o6 Total fees due upon application:
Amount received: 4)54. 61
Authorized signature: This permit application expires if a permit is n t obtained
within 180 days after it has been accepted as complete.
Print name: E Ctip-aemiG. Date: //-- y-2 * Fee methodology set by Tri -County Building Industry
Service Board.
L \ Building \ Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(11/02/COM /WEB)