Permit •
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT
Permit ft: BUP2009 -00067
T [ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/14/2009
Parcel: 1 S134AA01800
Jurisdiction: Tigard
Site address: 10260 SW NIMBUS AVE M4A
Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project: Pro Video
Project Description: TI
Owner: FEES
ROBINSON, CONSTANCE A & Description Date Amount
ROBINSON, LYNN ET AL, BY KG INVESTMENT Permit Fee - COM 04/14/2009 $148.30
MGMT, 10240 SW NIMBUS AVE #L3 Tax - 12% State Surcharge 04 /14/2009 $17.80
PHONE: Plan Review 04/14 /2009 $96.40
Plan Review - Fire Life Safety 04 /14/2009 $59.32
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: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $14,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $321.82
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 • • - _ _ - • rdance 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 :0 days. ATTEN • N: 0 - , • aw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through 0 ' 52 -0' . . 1 30. You may obtain a copy of the rules or direct questions to OUNC by calling 50 . 6.6699 or 1.8 0.332.2344.
I - sued By: , , . ��� / �� ' Permittee Signature: k •
Call 503.639.4175 by 7:00 a.m. for an Inspection that uslness d .
This permit card shall be kept In a conspicuous place on the job site I complition of the project
Approved plans are required on the job site at the time of e h Ins action.
r : Building Permit Application
CommercialCEIVED FOR OFFICE USE ONLY
N�
City of Tigard Date/By. Received /y e a
7 10 Permit No 90� - 7
13125 SW Hall Blvd., Tigard, OR 97223 14 200 Date/By: � 1 Plan Revi Y f
Phone: 503.639.4171 Fax: 503.598.1960 A Q„1'4. Other Permit:
�
T I G A R D Inspection Line: 503.639.4175 �� ►oil Date Ready/By: See Page 2 for
Internet: www.tigard - or.gov CITY OF t►iW Notified/Method: �l .a Supplemental Information
DIVISION
TYPE OF W 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
X ) Addition/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 ComerciaUindustrial
Valuation: $
m
❑ 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:/p26D sou iamodusiVi /e it - 4- New dwelling area: square feet
City/State /ZIP: 7 7 ) O • 7 ZZ g Garage /carport area: square feet
Suite/bldg. /apt. no.: A i.. Al Project name: J „71...ArAi wso & 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: 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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
P �1v c.s C _ Valuation: $ i¢000 . d 0
T I. I�,EI�lGKL�L . A o 4 �� ��
o
Mk) /1/441�ST.c' aP
)?d 7 Tsf,t/AALL� ;
C0‘44-= . , „ ;ri Existing building area: square feet
���
rEai xr� ,�
, .Age 444 � /FS New building area: square feet
i Wf PROPERTY OWNER ❑ TENANT Number of stories:
Name: A/ 6 m/ve Type of construction:
Address: /Q e 4 5„ Sic) N/y ar.Zs- 4 G 3 O ccupancy groups:
City /State /ZIP:) R �ON� 0R• 9> 2,0 Existing:
Phone: . 0 )�9'S - 9 487 Fax: (50.3 g9 5 -998z. New:
tg” APPLICANT r CONTACT PERSON NOTICE
Business name:A/ 7 /hssrjc /9740 /9864//T.K, All contractors and subcontractors are required to be
Contact name: /7:7 "/ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6 720 SA) / .C4o . 1 4, j SV/�� Ato jurisdiction in which work is being performed. If the
City /State /ZIP: /'RT Q J ce, 517zi9 applicant is exempt from licensing, the following reasons
apply:
Phone: 6a3 ) 4 -7,4 I Fax:: Z1 - 77/O
E -mail ji /lrj(.ricv/'r'1aGa
CONTRACTOR
Business name: 9,/i/Lo C SZecC-�/o ti) 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 recei • ed: if j 91 • Is y 1
Authori a . t ; .
_ This permit application expires • • a permit is n i t obtains •
within 180 days after it has been : ccepted : com
Print n • C-5.44/3/A) I Date: �•/j • /1 -09 • Fee methodology set by Tri -County Bui • . 4 • -:
r Service Board.
I:\Building\Permits 1 UP-COM PermitApp.doc 2 /23/07 440- 4613T(11 /02 /COM/WEB)
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 Per itApp.doc 10/30/07
el : I
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Description of Project: +
GENERAL INFORMATION
Class of Work:* A Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* t 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: ice- 0 Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ /4�
INSPECTIONS FEES DUE
Footing /foundation Firewall $ /4- 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:
$ a ,7,1 ez.- 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