Permit CITY OF TIGARD BUILDING PERMIT
11
2 COMMUNITY DEVELOPMENT Permit #: BUP2012 -00035
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/23/2012
Parcel: 1S135BC00202
Jurisdiction: Tigard
Site address: 10763 SW GREENBURG RD 100
Project: Spec Space Subdivision: HILLSBORO Lot: PTS 1 -2
Project Description: Interior demo.
Contractor: ROBERT TODD CONSTRUCTION INC Owner: BELANICH, ROGER M
4080 SE INTERNATIONAL WAY B113 22020 17TH AVE SE #200
MILWAUKIE, OR 97222 BOTHELL, WA 98021
PHONE: 503 - 653 -5704 PHONE:
FAX: 503 - 653 -5729
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 02/23/2012 $347.48
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 02/23/2012 $41.70
Stories: 0 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 02/23/2012 $0.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $17,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $389.68
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
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
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Not'fii - Center. Those rules : re set forth in OAR
952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling ' • 32.1987 0 1.800. 2.234
Issued By: Permittee Signature: W /
639.4175 by 7:00 a.m. for the next available Inspection date.
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 FOR OFr ICI: Us[: ONI.V
City of Tigard �� Received , a Permit No.: /f
14 ° 13125 SW Hall Blvd., Tigar, c!, Plan Review r i t
■ •
' Phone: 503.718.2439 Fax: f 98.1960 ��Z Date/fly: Other Permit:
Ins ection Line: 503.639.4175 C L �y Date Ready/By: Saris: El See Page 2 for
T I G\ R 1.1 p Gv Notified/Method: Supplemental Internet: www.tigard or.gov F �Q� pp emeotal Information
TYPE a ' ,e r. REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction B y '_� 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 CCONSTRUCTION work indicated on this application.
❑ 1 -.and 2- family dwelling ° 5 ommercial/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: ID 7 1 t l0 1 Q / New dwelling area: square feet
City /State /ZIP: � r � () / 2 Garage /carport area: square feet
Suite/bldg. /apt. no.: / Project name: N/A 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
Dev �, DESCRIPTION OF WORK work indicated on this application.
" `-' 1` /� ✓f (a/ Q ( f X41 I Is Valuation: $ ] �] l7
Existing building area ` square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: 3L�Siti.ers p ^el k- Type of construction:
Address: V . Occupancy groups:
City /State /ZIP: Existing:,
Phone: ( ) Fax: ( ) New:
PLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
n r D Structural plan review fee (or deposit):
K �� C Q -
Contact name: `�
FLS plan review fee (if applicable):
Address: .-
City/State/ZIP: Total fees due upon application:
Phone: ( ) . I Fax: : ( ) Amount received:
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONT OR Commercial and residential prescriptive installation of
roof -top mounted Photo Voltaic Solar Panel System.
Business name: si,t��� Submit two (2) sets of roof plan with connection details
(� and fire department access, along with the 2010 Oregon
Address: ! L4 d - Solo Installation Specialty Code checklist.
City /State /ZIP: /in c 9 712-2_ ff Permit fee (includes plan review 5180.00
I I l and administrative fees):
Phone: 3) 6,5 " 570 7 o LI ( Fax: (563) 653-5721 State surcharge (12% of permit fee): $21.60
CCB Sic.: Total fee due upon application: $201.60
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 ,e / J C Date: 2 - � / � j ' Fee methodology set by Tri -County Building Industry
J 23 Service Board.
1:\Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T(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 overahalterations 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 03/03/2011
IIIII B uilding Division
Plan Submittal Requirements
T I G A R D Commercial & Multi- Family - New, Additions or Alterations
1. SITE PLAN (fully dimensional, drawn to scale) labeled with:
A. ❑ map & tax lot # ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking, including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape -ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations, plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit - based on valuation of project.
4. EXTRA SET OF THE FOLLOWING:
A. Two (2) copies of site plan to include vicinity map.
B. One (1) copy of erosion control plan with details.
C. Fire Department Building Survey, and full set of architecture drawings.
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
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 3
(site plan required showing location and square -
footage of all buildings to be demolished)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
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), if applicable.
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011