Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00084
Date Issued: 06/19/2009
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S136DB02501
Jurisdiction: Tigard
Site address: 11632 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Tigard Cinema
Project Description: Demo concrete under existing interior trampoline, lower trampoline.
Owner: FEES
WESTSIDE HOLDING CO LLC Description Date Amount
BY MELLANIE HENIFF, 11632 SW PACIFIC Permit Fee - COM 06/19/2009 $534.70
HWY Plan Review 05/15/2009 $347.56
PHONE: Plan Review - Fire Life Safety 05/15/2009 $213.88
12% State Surcharge - Building 06/19/2009 $64.16
Contractor:
EXCEED BUILDERS
7523 SW GARDEN HOME RD.
PORTLAND, OR 97223
PHONE: 503 - 307 -5348
FAX: 503- 841 -6561
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $85,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,160.30
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet: •
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This per ' ' ssued subje tJ regu - _ contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be a in accordance with approv: • plans. Th . pe • it will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
s. ATTENTION: Oregon law - quires you e rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52- 001 -0010 I rough OAR 9; - 001 -0100 • • btain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: G Permittee Signature: . A __
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 '
Approved plans are required on the Job site at the time of each Inspection ��'
' • b T t G t6I tpr 1-16sz `F a a c t
ilding Permit Application A � � a^ (� F C
Commercial 5 role orrice: use: ()Nix
City of Tigard MAY 1 5 2009 Dat eStt v`j Cq 4.6.
Permit No.:Mp2ocq crc, ` -
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Supplemental Information
► .�
0 Other Permit:
_ Ph one: 503.639.4171 Fax: 503.598.1960 CITY � Date/B : � �� ,� ( •
Inspection Line: 503.639.4175 �'F I (�� Date Ready y: t � ® See Page 2 for
rlcnlil� -,1 M.L G O N DIVISION y L ' 4 ^^ . 1 `da /�
Internet: www.tigard-or.gov '� . �:,.� � Notified/M O'
)) � .�1
L VA •
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
"Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation:
El 1- t[ S , 0 OD
l -and 2- family dwelling CommerciaUindustrial pp
ID Accessory building ❑ Multi - family Number of bedrooms:
CI Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: i t b 3Z 4 1.J PACAC; C l�v t New dwelling area: square feet
City/state /ZIP: �l ,5 A Yd 0 ft- 11 113 l Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
4 itk n q I l ( 9 1C y C t IV a Other structure area: square feet
ll Y A r iC i /f 5 f n 4 REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 9 Lot no.: Permit fees' are based on the value of the work performed.
Tax map /parcel no.: 1St 3(0 a�Zr } Indicate the value (rounded to the nearest dollar) of all
J� equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF OF WORK work indicated on this application.
NAND €. k S "VZN (
S �N C- - 1' i Valuation: $ 00 ( D oll Existing building area: square feet
New building area: square feet
tr PROPERTY OWNER I 0 TENANT Number of stories:
Name: A p, 1 1 i( Type of construction:
Address: / , w Vn { ` Occupancy groups:
City /State /ZIP: Existing: 3
Phone: ) q'i (D _, y I qS Fax: ( ) New:
❑ ` APPLICANT yr CONTACT PERSON NOTICE
Business name: ex C P e 1 '.t p r ' p All contractors and subcontractors are required to be
Contact name: ' � (p p / licensed with the Oregon Construction Contractors Board
s under ORS 701 and may be required to be licensed in the
Address: '1s 2'7 "�� J 1A./ v r6t (L ` jurisdiction in which work is being performed. If the
City/State/ZIP: �( - applicant is exempt from licensing, the following reasons
b r- 02 t Q — 1^ VZ.
apply:
Phone: 601) 1_53 c Fax:: (SO'3) I) (S6 r
E-mail: (l It € ICCeCtf blitz [ R S • Coiut
CONTRACTOR
Business name: Qc1QC(JS 1 4 k i lk ^ ti 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.: l O6 61c, "t • t'l . `C) 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: V ` t t e t Q r o `(s Date: S r (S O q * Fee methodology set by Tri -County Building Industry
1 1 +� Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 2 /23/07 440- 46I3T(11 /02 /COM/WEB)
Building Division
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: $
(0 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 06/25/08