Permit I,
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A �'N CI TY OF TIGARD BUILDING PERMIT
PERMIT #: BU P2006-00410
��� DEVELOPMENT SERVICES DATE ISSUED: 8/28/2006
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- 13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 PARCEL: 1S134AD -06202
SITE ADDRESS: 10500 SW NIMBUS AVE T ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Interior Demo Only. Solid Rock Fellowship.
REISSUE: //��,,�� F LOOR AREAS EXTERIOR WALL CONSTRUCTION
E'1Gi j L.
CLASS OF WORK: D FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 18,000.00
Owner: Contractor:
ROBINSON, CONSTANCE A + COMMERCIAL CONTRACTORS INC
ROBINSON, LYNN + BELL, KAY ET 1265 SOUTH 35TH PLACE
BY INSIGNIA COMMERCIAL GROUP RIDGEFIELD, WA 98642
BEAVERTON, OR 97008
Phone: Contact #: FAX 503 - 227 - 6644
PRI 503 - 227 -4440
Reg #: LIC 123729
FEES
Description Date Amount • REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/28/2006 $216.10
[TAX] 8% State Surcha 8/28/2006 $17.29
Total $233.39
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 than 180 days. ATTENTION: Oregon law requires )(du to follow-the rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By:
42friA Permittee Signature: V.L4 V. Li. •
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.
Commercial Tenant Improvement
Buildin Permit Application 4 FOR OFFICE IiSE ONI
City of Tigard G c,, 6 Rees / 'w Permit o.j ■ _I i I d
° 13125 SW Hall Blvd., Tigard, OR 97 ^��
II I
l- Plan Review
Phone: 503.639.4171 Fax: 503.598.1 6 ``\\� P� N p� . Other Permit:
T 1 G A u D Inspection Line: 503.639.4175 W �( \G s \O Date Ready/By: ® See Page 2 for
Internet: www.tigard- or.gov ON- Q \J\ Notified/Method: Supplem ®talInformation
TYPE OF WORnsr 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.
❑ 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: I 0 con. S c KI I l rS New dwelling area: square feet
City /State/ZIP: Ti Cy .,t O-_ 1'7'123 Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: So b poC,iC 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.
1■ - 6 — ki Jl_ h � M in Valuation: $ t g o6C�
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: at' t 4 _ J t s % . n1 T Type of construction:
Address: Occupancy groups:
City /State/ZIP: Existing:
g
Phone: ( ) Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: la, 1 '.- All contractors and subcontractors are required to be
Contact name: Vt../ Lx LAS licensed with the Oregon Construction Contractors Board
• x 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: ( 613) C-kt i — 2,i, I I I Fax: : ( )
E -mail:
CONTRACTOR
Business name: C c_ ' BUILDING PERMIT FEES*
•
Address: 6 J 0-' 5 , r 3�- \ (Please refer to fee schedule) O� 1 Structural plan review fee (or deposit):
. City / State/ZIP: �Zx o r .e \ W a n'
Phone: ( ) I g am: ( ) FLS plan review fee (if applicable):
T fees due upon application: _ i X3.,39
CCB lic.: � � q c.�--�
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
r L within 180 days after it has been accepted as complete.
Print name:
( � Le -�� � I Date: ` ' � � � • Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits\BUP- TI- PermitApp.doc 03/23/06 440 -4613T(11 /02 /COM/WEB)
° Building Division •
Plan Submittal Requirement Matrix
T I G A R D Commercial & Multi- Family - New, Additions or Alterations
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking) -
• Plumbing (site utilities) 2
Building 1*
Fire Protection System 2 **
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. •
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington
• County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
• Oregon licensed fire suppression engineer, or NICET level "3" technicians.
t •
I:\ Building \Permits \BUP -TI- PermitApp.doc 03/23/06
CITY OF TI RD N.Psootp- ON( o
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Atodtb
Inspection Requests (24 Hrs.): (503) 639 -4175 `' 1 ..
INSPECTION WORKSHEET FOR DATE: II/ %'k 06 TIME: PAGE:
SITE ADDRESS: I 60 + 0 VI S CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Ins ection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
4
NCV
. 7
►: 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 �
Inspector: 1� Date: I � � Phone #: (503) 718 -L