Permit CITY OF TIGARD BUILDING PERMIT
2 ,3 COMMUNITY DEVELOPMENT Permit #: BUP2009 -00038
Date Issued: 03/25/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101CB00500
Jurisdiction:
Site address: 12670 SW HALL BLVD BLDG 1
Subdivision: Lot: 0
Project: APEX INDUSTRIES
Project Description: TI
Owner: FEES
GAZELEY, H WILLIAM Description Date Amount
PO BOX 230414 Permit Fee - COM 03/25/2009 $827.02
TIGARD, OR 97281 Tax - 12% State Surcharge 03/25/2009 $99.24
PHONE: Plan Review 03/25/2009 $537.56
Plan Review - Fire Life Safety 03/25/2009 $330.81
Contractor: Metro Const. Excise Tax - Commercial 03/25/2009 $201.60
CEDARLAKE CO INC Use
9120 NE VANCOUVER MALL LP
VANCOUVER, WA 98662
PHONE: 360- 694 -8000
FAX: 360- 694 -0174
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $168,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,996.23
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet: No
Fire Alarm: No Protected Corridors: No
Smoke Detectors: No Manual Pull Stations: No
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 in accordance 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 t .ug OAR 952- 001 -0100. Yo may obtain a copy of the rules or direct questions to OUNC by callii a s ••.6699 or 1.801. _ .
Issued By: \ 6 9, if f .. /1 , Permittee Signature: -
Call 503.639.4175 by 7:00 a.m. for an inspection that business 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.
ayleb3 /i (o
'' ' Permit A lication
C OII1IYlei'Clal FOR OFFICE USE ONLY
City of Tigard Received 2 � i
�
M AR 10 _d Permit No.: 9 � 47 �y�
2009 Date /B : u , OCJ / (.GC/
IM
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.19 Date/13 • /1 � !� Other Permit:
TIGARD
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready :y: See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified /Method: Supplemental Information
Ain... I * 1 /U • I -/.r..
x _- : ..- ,.. <. ,. -. _., � : . �.- .:r .'.:� .- -�aa.. .,�x. ,.. =� .:"� ^:, e ms - : .�,. >..-
^��:.�s- 'T €Yp�' . DIt-. �.�IRI<�'��'r ; -- :,- '- ,;�`:.
= \. ,: � . z � ', ,.. >� �` ^ ; . � ' E UIRED Dr1TA: �1,,AND 2 . F ANIILY DWEL,LTNG: ° =." "
.. ..�.....,_ ;.:...�.��:4;9�� �� '. <: ...v . ; < " � �� _� �� ����� >, � .... . � . s a mss' � . -;*
❑ 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
?a r `_ E .", .;...,..s,, • < 4;,. work indicated on this application.
lief , ` ,'.
�; "� ����, '.'CAT °GOR
1; -O GONSTR[1CTzION "' ��; ", -�:, >�: ",�<.: "
❑ 1- and 2- family dwelling Commercial /industrial
Valuation. $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
" ;;`� �C' " Total number of floors:
=s��: J073 SITErINP'OR�1A'I` ION ":r1ND L �GA'TION':�' >�:
.\ ...- _,..:�i'��; .- . as -. ^,. - - -. �... -..��� � ;,�;,�:��Q.', � � „�a,.���- ��:: `.. ;�:::,,.:.
Job site address: /2 (070 ` r ) GJ , 4 // .9tt New dwelling area: square feet
City /State /ZIP: j; g,Q,Qi. > �„42._ g7Z 2 3 Garage /carport area: square feet
Suite /bldg. /apt. no.: 21p + Project name: ��v h,/i t 1. ahe - Covered porch area: square feet
Cross street/directions tops, site: J Deck area: square feet
Other structure area: square feet
REQUIRED COMIaRCIAL:UE- GIIECKt;IST
Subdivision: I 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
IN
work indicated on this a
equipment, materials, labor, overhead, and the profit fort the
, "',..
,. >, DH,SGRIP7'ION..QF.: >VUORIi' ;f ^`
^. � �� ''W =^ application.
F
/ / J /f � r Q O � p�
lL�i6�rt/7� �MtQ� /Gl3 C� Ci�iJTi/lui G77�c` Valuation: 1 � iCJ) UV(
Existing building area: a2Y5.,-A square feet
New building area: g3 es square feet
PROP - le : l-2.9,, P :i - TE N ANT ,,, Number of stories:
Name: 1 770.2- �L c_ Type of construction:
/ 7'y/9c. l��
Address: / Zp,s /i 4.5 ,73--.. 4 Occupancy groups: 4 ep', • !'- / , zAd s y
./ / i
City /State /ZIP: l71/44i!� 97,2/e) Existing:
Phone: (5-a3) 0?.7 €/ 985 Fax: (567) 2 27 -'rl/7a_ New:
AN T.-,,.• ONT T R N> �: _<�
z .
�_ ;. >�: ;,,; . NOTICE ' .
Business name: (1CC4-1) co/hpA....c,. -- h c_ All contractors and subcontractors are required to be
Contact name: �� �� �%�Q >J7�th /n licensed with the Oregon Construction Contractors Board
� under ORS 701 and may be required to be licensed in the
.Address: 9/20 No � L , ma/ 606.2 mix , 22 jurisdiction in which work is being performed. If the
City /State /ZIP: /140,14 applicant is exempt from licensing, the following reasons
. 4 j a 9 'b'r! oI 2_ apply:
Phone: (34i') 6opeytt. 80Qta I Fax: : (3l?0 6 -4./79'
E-mail: fc,1A CGd 'G!A ke.. dam •
y, . tai: : ` .: ,
_., - � ": , <•:�. � •• ' �a, COiV TRA CTOB a�,.� : , ,� ..� : � ": � = , ,
Business *-, .:.:.. ",t;
ess name: G' G � �� G� �� ."�`� ; -;"" a:BI7II�DING'PER IT�FEE �' �..,� ^e.
/� i t1 -s = (Rieas "sc e > ?-:. . ` ` /
Address: 9/20, Ad: 4J4, ,, ,c doy o esa fJ 4049 . /�a 246
`� f Structural plan review fee (or deposit):
City /State /ZIP: 6/4/?e(nse/ec, , 4),4- 9,in-e,z
Phone: (36+0 )4,1y- g' t - Fax: (V„„0) 6N ✓ „ ®,f J,r FLS plan review fee (if applicable):
CCB lie.: It 77 7..5.-- Total fees due upon application:
Authorized signatur : J
-- Amount received:
This permit application expires if a permit is not obtained
�'� �� f within 180 days after it has been accepted as complete.
Print name: /444 earJ' t./ / Date: ..,,5 0? * 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)
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
n BUILDING DIVISION
TIGARD TRANSMITTAL LETTER
a
•
TO: y1 1 V p 1Wtn DATE RECEIVED:
DEPT: BUILDING DIVISION
RECEIVED
FROM: MAR 18 2009
COMPANY: CITY OF TIGARD
BUILDING DIVISION
PHONE:
By: VJ
•
RE: t 2 Le 7 o VU 2coq Dd� 6 (Site Address) (Permit/Case Number) �
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Co'`'es� D`escri 'tion:.°
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and /or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain): k icnn 5 .I Iry JOa CV � k kz �� es/ -4
REMARKS: C c ,• .Q - aka, : ( -_
,z...,. ; _.a
Routed to Permit Technici .. Date: (z l b`T Initials :d - ' &
Fees Due: ❑ Yes E"No Fee Description: Amount Due:
• it2 `� — - °`�t�a _r_ S,t Jy � p ,�k ..•p�F_
•
Special
Instructions:
Reprint Permit (per PE): H Yes n No ❑ Done
Applicant Notified: Date: Initials:
•
l: \Building\ Forms \TransmittalLetter- Revisions.doc 4/4/07