Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00053
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/31 /2009
Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10170 SW NIMBUS AVE H1
Subdivision: Lot: 0 •
Project: Kumo Math & Reading
Project Description: TI
Owner: FEES
ROBINSON, CONSTANCE A & Description Date Amount
ROBINSON, LYNN ET AL, BY KG INVESTMENT Permit Fee - COM 03/31/2009 $205.50
MGMT, 10240 SW NIMBUS AVE #L3 Tax - 12% State Surcharge 03/31/2009 $24.66
PHONE: Plan Review 03/31/2009 $133.58
Plan Review - Fire Life Safety 03/31/2009 $82.20
Contractor:
GUILD CONSTRUCTION INC
PO BOX 674
BEAVERTON, OR 97075
PHONE: 503 - 957 -1173 •
FAX: 503 - 291 -1532
Specifics:
Type of Use: COM
Class of Work: ALT
. Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $22,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $445.94
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 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 da' - - • - • • Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -01 -0010 through OAR • • - . • 1 .0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu d By:
� II : Permittee Sign
• 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.
-- Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY 1
•
City of Tigard DateB Received
I Permit No.: u legp09 • 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review )
' C . Phone: 503.639.4171 Fax: 503.598.1 W 312009 Date/By: t N ' 01 •" 1 1 Ulf Other Permit:
T i G n rc D Inspection Line: 503.639 Date ReadyBy: luris ®See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: � � Supplemental Information
BUILDING 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
K Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CON UCTION 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:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 0170 ,5t,t) / v 3 us- i‘ii,e New dwelling area: square feet
City/State /ZIP: Aperzi9A J J, OK . 9 -74.2.3 � ,, .� Garage /carport area: square feet
Suite/bldg. /apt. no.: y — / I Project name VA.A / 11/ ?ga D 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
DESCRH'TION OF WORK ,� work indicated on this application.
7 / . J r,ENfDO,L`L O E,r,fSTi s/�AGE .6/Re-Aril Valuation: $ 20 ) QOO . CO
1749.4 rr 45 P » /'i � ��� A. , r ,i.<- / Existing building area: square feet
/¢ODi u) u.S"roe • mil. 4 4 X
a) Ato #2 New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: / X //1/4,57;v1„‘"( Type of construction:
Address: /jot' S/,c7 Akkie US 4(f,E " S L3 Occupancy groups:
City/State/ZIP: /� 7Z .v) O R . 972z 3 Existing:
Phone: (. 3 ,5 — 99 ,'e Fax: ( 5o5 ) 6 / d' / %.292. New:
& APPLICANT i( CONTACT PERSON NOTICE
Business name: ,2, //' . /'4 %itu.s7s11/ / o C , L!-.// Z , All contractors and subcontractors are required to be
Contact name:uj ‹....53/1Y/(-1 under with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: AO &7Z) .37A) ft4Ac01 ,0.5+4 4 E S :i7E / jurisdiction in which work is being performed. If the
City/State /ZIP: I c Tz ar 9 72/ 9 applicant is exempt from licensing, the following reasons
�/
�7 -7 apply:
Phone) 245 -7/06 Fax: j,3 ) 2 S -' / /) 0
E -mail:
CONTRACTOR
Business name: 0/1-40 CXIs7AeVC..7000 BUILDING PERMIT FEES*
Address: (Please refer w fee schedule)
City / State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: /0 9 /140 /2-'X 9}//0 Total fees due upon application:
Amount received:
Authorized gnature. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: r/ / Cc 46//1) I Date: 3 3/ - Q c) • Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits1:. • -COM PerrnitApp.doc 2 /23/07 440- 4613T(11/02 /COM/WEB)
NI Building Division
e .
Accessibility: Barrier Removal Improvement Plan
TIGARD
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): $
•
I: \Building \Permits \BUP -COM PermitApp.doc 10/30/07
Building Division
T 1 C; n It D Over - The - Counter (OTC) Building Permit
i Check List
Description of Project:
GENERAL INFORMATION
Class of Work:* 1\--1 Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* C First floor: N: S:
Type of Construction: Cep 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: 1.)c) Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ 12
INSPECTIONS FEES DUE
Footing /foundation Firewall $ ), Permit Fee
Post /beam structural Smoke detector $ ,(, State Surcharge
Shear wall Misc. inspection $ �� , Plan Review Fee
Masonry Approach/sidewalk $ � 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:
$ 4-y5, Total Fees Due
*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