Permit +� CITY OF TIGARD BUILDING PERMIT
iP �
`� b COMMUNITY DEVELOPMENT Permit #: BUP2010 -00132
ARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/16/2010
Parcel: 2S112ACO2100
Jurisdiction: Tigard
Site address: 14865 SW 72ND AVE
Subdivision: FANNO CREEK ACRE TRACTS Lot: 47
Project: InBark
Project Description: Construct room dividers.
Owner: FEES
PARRISH- CHURCH, LLC Description Date Amount
PO BOX 2687 Permit Fee - Additions, Alterations, 06/16/2010 $53.27
TUALATIN, OR 97062 Demolition
PHONE: 503- 692 -4742 12% State Surcharge - Building 06/16/2010 $6.39
Plan Review 06/16/2010 $34.63
Plan Review - Fire Life Safety 06/16/2010 $21.31
Contractor:
PHONE:
FAX:
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $115.60
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes 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 at other applicable law. All work will
be done ' • - • • = 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
day . , TTENTION: Orego aw requi : you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fo in OAR
9 - 001 -0010 through OAR 9 -9.1 -0100. •u may obtain a copy of the rules or direct questions to OUNC by calling 503 46.6699 or/ .800.332.23
sued By: ' / I Permittee Signature: 0
Call 503.639.4175 by 7:00 a.m. for an inspection that bu iness d..�
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.
Buildint; Permit Application
Commercial i« e ms `, .* t;4, a K ,:% r ,
RECEIVED ° , ' to d� w OI I ICI :USI t)I . o r „ ;: a a , , .�'
"'°f w .�il:n ,S � r4 i N�wd;. a Yr ;�i I�h .i •>L urx :i.,�- ..l ^L. ,, i. .:€ w.i� ".r eaax� , s ; L P,
/ _
� Recei
711 City of Tigard DateB ved : e.P / tD 1 0 Permit No.: `u 49 , (3
q 13125 SW Hall Blvd., Tigard, OR 97223 JUN I pp Plan Revie 7tlrem I �p
(�
C Phone: 503.639.4171 Fax: 503.598.1960 J N l 6 2010 O Date/ : �'( Other Permit:
Inspection Line: 503.639.4175 Date Ready - 7)T- y: Juris: ® See Page 2 for
11 `' "' RI
L 1' ' www.tigard-or.gov CI OF TIGARD Supplemental �! Internet: www.ti ard -or. ov Notified/Method: Su lemental lnformafion
BIJILDING DIVISION
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.
dwelling Valuation: $
❑ 1 -and 2-family g ❑Commercial /industrial
El Accessory building ❑ Multi- family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 148 5 5 (Jv 1 a 1 441 e plte New dwelling area: square feet
City /State /ZIP: 1 aa rc 0 q'7 3-- Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: x 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.
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.
�l room caV 1c S _ set \oo r Van Valuation: $ 500!
floor
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: 'Br vo (1 par (t S Type of construction:
� Address: D Sot a o Q 7 Occupancy groups:
n
City /State /ZIP: ' (u 0. . .� Y) � a. r! 1Dt9).' D gbg i Existing:
Phone: ( (gq a �' 74-9- Fax: ( ) New:
❑ APPLICANT . ❑ CONTACT PERSON NOTICE
Business name: 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 /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) Fax::( )
E -mail:
CONTRACTOR
Business name: NIA BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
� /� � ' Amount received: 11115
Authorized signature:� �~ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: vvv Date: * Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 2/23/07 ' 440- 4613T(11 /02 /COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
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 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
•
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
L•\ Building \ Permits \BUP -COM PermitApp.doc 06 /25/08
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_ :, . . Building Division
Over- The - Counter (OTC) Building Permit
Trcnlz° Check List
Description of Project: - Ft
GENERAL INFORMATION
Class of W ( Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: 1 o 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: T F� 7 Handicap access:
Smoke detector: Protected corridors: OD
Fire alarm: _ Parking spaces ( #):
Notes:
Total Valuation: $ �✓C X� , CC)
INSPECTIONS FEES DUE
Footing /foundation Firewall $ 6 2.7 Permit Fee
Post /beam structural Smoke detector $ ID '.-is State Surcharge
Shear wall Misc. inspection $ 3 ( Plan Review Fee
Masonry Approach /sidewalk $ 'Z( j 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:
•
$ I. )5
I (,,n Total Fees Due
*O PTIONS:
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
FROM :GUY ALTMAN ARCHITECT FAX NO. :5036595285 Apr. 27 2009 10:34AM P1
i}p 2a/ 0
Do / 3
CITY OF TIGARD
COM.MUNTTY DEVELOPMENT DEPARTMENT
PLANNING DIVISION
13125 SW HALL BOULEVARD
TIG -ARD, OREGON 97223
PHONE: 503 - 639 -4171 FAX: 503- 624 -3681 (Attn: Patty /Planning EMAIL: patty@tigard-or.gov
v�R •O �q- 2 ' i 4 A,� M 1 z ,�,rN�e t l�irrc�nar!
request for 500 -foot property owner mailing list
Property owner information is valid for 3 months from the date of your request
INDICATE ALL PROJECT MQZI 'I:AX_LOT NUMBERS (,e. 1S134AB, Tax Lot 00100) OR THE AIDDRFSSRS FOR ALL
PROJECT PARCELS BELOW:
(If more than 1 tax lot or if the parcel has no address, you must separately identify each tax lot associated with the project.)
a- 1 E30 - og 13-1
B _. :. - . .. ,...4. • t. ! • : _? . ; .' 1.1 ! .' z
NEIGHBORHOOD') MEETING, After submitting your land use application to the City, and the project plannct.has reviewed your
application for completeness, you will be notified by means of an incompleteness letter to obtain your 2 filial sets of labels. !EMU
HAVE BEEN AXIMED BY PLANNI ‘ . • • kl , It. • ; ;
2 SPTS4UABEy1„
Completeness Letter Received Indicating 2 Sete of Envelopes w /Affixed Address Labels Required
The 2 final sets of labels need to be placed on envelopes (no self - adhesive envelopes please) with ftrat class letter-rate postage on the
envelopes in the foram of postage stamps (no metered envelopes and no return address) and resubmitted to the City for the purpose
of providing notice to property owtt of the. proposed land use application and the decision. The 2 sets of envelopes mug be kept
separate. The person listed below will be called to pick up and pay for the labels when they are ready.
NAME OF CONTACT PRRSO.N: ('L l kl-- brut PHONE: ',; b' e 1
NAME OP COMPANY: CjV A- kL�F./ J, A GH 1 e.4 FAX b1- 970
EMAIL: Gn'4lITMGIY1 I'ilr'_%I.► -
This request may be emailcd, mailed, faxed, or hand delivered to the City of Tigard. Please allow a 2 -day minimum
for processing requests. Upon completion of your request, the contact person listed will be called to pick up th.eir
request that will be placed in 'Will Call" by the company name or by the contact person's last name if no company)
at the Planning /Engineering Counter at the Permit Center.
The cost of processing your request must be paid at the time of pick up, as exact cost can not be pre-determined.
PLEASE NQTE; FOR. REASONS OF ACCURACY, ONLY ORIGINAL MAILING LABELS
PROVIDED BY THE CITY VS. RE- TYPED MAILING LABELS WILL BE ACCEP7,ED.
Cost Description:
$11 to generate the mailing list, plus $2 per, sheet for printing the list onto labels (20 addresses per sheet). Then, multiply
the cost to print one set of Iabels by the nurnber of sets requested.
- EXAMPLE ^ - COST FOR THIS REQUEST -
1 sheets of labels x $2 /sheet = $8.012 a 2 sets $16.00 sheet ®) of labels x $2 /sheet = ter sets =
1 sheets of Labels x $2 /sheet for interested parties x 2 sets= $ 4.00 sheet(s) of labels x $2 /sheet for interested parries = $ x setw n
G[;Nt;li� = ILLQQ CI ;NE1ly
ILQQ
r0'rAl. = $31-00 TOTAL. =$