Permit G
„
III CITY OF TIGARD BUILDING PERMIT
a.: COMMUNITY DEVELOPMENT Permit #: BUP2009 -00058
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/07/2009
Parcel: 2S112BA05900
Jurisdiction: Tigard.
Site address: 14058 SW MILTON CT
Subdivision: Lot: 0
Project: Westcon
Project Description: TI
Owner: FEES
GOODHEAD, DAVID & JAN M Description Date Amount
9846 SW PEPPERTREE LN Permit Fee - COM 04/07/2009 $198.35
TIGARD, OR 97224 Tax - 12% State Surcharge 04/07/2009 $23.80
PHONE: Plan Review 04/07/2009 $128.93
Plan Review - Fire Life Safety 04 /07/2009 $79.34
Contractor:
TODD HESS BUILDING CO
4707 SW KELLY AVE #206
PORTLAND, OR 97201
PHONE: 503 - 220 -5953
FAX: 503 - 222 -2670
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Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $21,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0 .
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $430.42
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 ' .subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be a in accordance 'th app • ■ - • •lens. This permit will expire if work is not started within 180 days of issuance, or if work is spended for more
the 1 days. ATTENTION: Or =, •n law re• :s you to follow the rules adopted by the Oregon Utility Notification Center. Those rul are et forth in OAR
952 01 -0010 th ough OAR 9 - 101-0 f r • u may obtain a y py of the rules or direct questions to OUNC by calling 503.246,66 or 1 00.332 3
Iss ed By: /I , \?, , • Permittee Signature: /1x�
Call 503.639.4175 by 7:00 a.m. for an Inspection that bu9lness 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.
Building Permit Application '
Commercial C EO H oa off hl ce USE ol.N .
City of Tigard Received y 7 0 9 �/ Permit No.: L��pVG9_ cnos8'
° 13125 SW Hall Blvd., Tigard, OR 97223 .„,1 'Z OOS Plan Revie �1 (� �q
Phone: 503.639.4171 Fax: 503.598.1'.: "? R Da te/ e y : 4 ( C l Other Permit:
T I G n R D Inspection Line: 503.639 pj2() Date Ready/By: Jung' ® See Page 2 for
Internet: www.tigard or.gov CIDI �� pF ICAV Notified/Method: O j Supplemental Information
TYPE OI�V�tlPP IDN REQUIRED DATA: 1- AND 2- FAMILY DWELLING
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❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
111Addition/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:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ) tl0$'g A S L.,,/ /14,`-n Cr. New dwelling area: square feet
City/ State/ZIP: •r e f i l l . - 4 , Q R. el 7Z Zy Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 1„,Q5., 4 Covered porch area: square feet
Cross street/directions to job site: [[ Deck area: square feet
C �/ an r), 7 Poi( 4- / T117tn CT; Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees' are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
d i '-e. . (2) o -T. ceS I - 1.• - t'e�, / ((),7e ti/ Valuation: S Z / t�VO
b -V---c L rJ -tr 're-, ( I) o- -Fire- Existing building area: 1 Lrif square feet
New building area: square feet
❑ PROPERTY OWNER I er4 TENANT Number of stories:
Name: ratels a — / 1..../..e.s7T° 0 Type of construction: TIM —N
Address: S' Ltr 5.e_ ?CV — •77 -- or Occupancy groups:
City/State/ZIP: R ocl,,LST Al . i W z- y Existing: g 2
Phone: (i- )87$ -- )10 A 3 93 ,s' Fax: cam" 3S"2 7 gy-z. New: S'c 0-
4 APPLICANT [+ii CONTACT PERSON NOTICE
Business name: e B 41 - tf 0. All contractors and subcontractors are required to be
Contact name: -Sel 1, i Se'r licensed with the Oregon Construction Contractors Board
I under ORS 701 and may be required to be licensed in the
Address: 7 Y, y / St", fz� r/44— �1 f/O't , . I jurisdiction in which work is being performed. If the
City/State/ZIP: f P o cr i t 0 9 7 Z/ G`
applicant is exempt frm licensing, the following reasons
apply:
Phone: ( S'tn ZZo sI . 5--- Fax: : (3=i3 ) L ZZ 24' TO
E -mail:
CONTRACTOR
Business name: .Sc•, L a S 4- 11/;604— BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: 6‘ e Z f L ( R 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: .S eel, I/ f � q Date: 1 1 t/O ' Fee methodology set by Tri -County Building Industry
�" f Service Board.
I: \Building\Perrnits\BUP -COM PermitApp.doc 2 /23/07 440- 4613T(I1/02 /COM/WEB)
i
° Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Description of Project:
GENERAL INFORMATION
Class of Work:* p Flo or Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* [°� First 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: 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: Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ 24
INSPECTIONS FEES DUE
Footing /foundation Firewall $ 11 .- " Permit Fee
Post /beam structural Smoke detector $ 2. , 80 State Surcharge
Shear wall Misc. inspection $ (20, c ..3 Plan Review Fee
Masonry Approach /sidewalk $ `7' ' ,'A- 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
$ ' o • t . to State Surcharge
$ Other:
$ 4 3 ' 4 Z Total Fees 1 j •
*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.
1: \Building \ Forms \OTC -BUP doc 08/19/08