Permit CITY OF TIGARD BUILDING PERMIT
1 >C. COMMUNITY DEVELOPMENT Permit #: CMS2011 -00001
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/21/2011
TIGARD Parcel: 2S114DB00100
Jurisdiction:
Site address: 17005 SW 92ND AVE
Project: Cook Park Shelter & Bathroom Subdivision: Lot:
Project Description: New manufactured structure for restroom facility.
Contractor: CENTREX CONSTRUCTION INC Owner: TIGARD, CITY OF
8250 SW HUNZIKER RD 13125 SW HALL BLVD
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 684 -0443 PHONE:
FAX: 503 - 620 -6692
FEES
Specifics: Description Date Amount
Type of Use: CMS DC Provision Review, COM New - Bldg 04/21/2011 $128.00
Class of Work: NEW DC Provision Review, COM New - Ping 04/21/2011 $128.00
Dwelling Units: DC Provision Review, COM New - LRP 04/21/2011 $38.00
Stories: 1 Height: 0 ft Permit Fee - COM - New Construction 04/21/2011 $285.12
Bedrooms: Bathrooms: 12% State Surcharge - Building 04/21/2011 $34.21
Value: $19,277 Plan Review 04/21/2011 $185.33
Plan Review - Fire Life Safety 04/21/2011 $114.05
Info Process /Archiving - Lg Sheet (over 04/21/2011 $22.00
Floor Areas: 11x17)
Info Process /Archiving - Sm Sheet (up to 04/21/2011 $18.50
Total Area: 11x17)
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $953.21
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is - -. •'ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don- accordance with - • •roved 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 la re••ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95. 001 -0010 through OAR 952 -001 '090. You m- obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/ n
I sued By: , Permittee Signature: l ` . •
Call 503.639.4175 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.
• CxP£
Building Permit Application /loc o y /9 # ti
Commercial ") F012 01,1,1(1.: 1 Sl: 0\1.1
City of Tigard � R eceived /� �i�ii
{� , DateB : I i Permit No. t
13125 SW Halt Blvd., Tigard,OR 97 v_ -�� ems � �� �
w))� ����
Phone: 503.718.2439 Fax: 503.598. 0 10 � Date B Revie y : //Vtr�V a, 0 Other Permit:M J� � Q/ V
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TI G A R U Inspection Line: 503.639 �� �G `� '` Date Ready7BBy: Juris. H See Page 2 for UU
Internet: www.tigard- or.gov c- S " .rS Notified/Method: - 1 -.. .C, Supplemental Information
TYPE OF WORK -.` REQUIRED DATA: 1- AND 2- FAMILY DWELLING
ew construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rotnded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRU ION
work indicated on this application.
1:1 1- and 2- family dwelling ommercial /industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
12 Master builder ❑ Other: Number of bathrooms:
1 _ 5 JOB SITE INFORMATION AND LOCATION Total number of floors:
� G�
Job site address: 51 / a AUe. j 1 0 O New dwelling area: square feet b
City /State /ZIP: 7 ! (rag m (Z.. 9 72. 2-3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Lop K pe, It k i(.e t,,,J ge > /2p"„ Covered porch area square feet
Cross street/directions to job site: .1putt 0.1 / 5 clr N Ih dvt ya. Deck area: square feet
`/ u n ") k , J 't" h'i ® 4 /2- �l g J 1 a Other structure area: square feet
Vat* & 'a Fi s (ifs / REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivisi (pp y pu L k, G' Lot no.: 9. ? 7 Permit fees* are based on the value of the work performed.
Indicate the value (rotnded to the nearest dollar of all
Tax map /parcel no.: 2.5 / 00/6 U equipment, materials, l a b s . - - - . ; , • - - • • 1 the
DESCRIPTION OF WORK work indicated on s application.
&-S-772() Valuation: $ i d27 7, -
0"7 S7 K
Existing building .. • . square feet
New building area: ,
r,kfitopEirry OWNER ❑ TENANT Number of stories:
Name: CL rdy -t- yg`le Type of construction:
Address: 13 / LS S j-�u / / J3 f t>� Occupancy groups:
City/State /ZIP: 1 / e ex- 712.3 Existing:
Phone: j�� 7 / g L o'd S Fax: (.. t73) tog evy e9 New:
❑ APPLICANT g2-"CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: ii)j4.1 /1044'L — Y vZS4?-- Structural plan review fee (or deposit):
Contact name: A/ / c Jr /le) / .s3c r�E(/E" /c 1 f ,A
//`` p FLS plan review fee (if applicable):
Address: / 3 / Z5 S co ! ;.-7er s� f/A/ I efild
City/State /ZIP: 7 / G 4 .e.._ y 7 i z3 Total fees due upon application:
/ Amount received:
Phone: ( ) 7r g- 'Z 4,5 Fax: : 6 :9�' `f 87 ( +C'
E -mail: Ai el 4) da 'T/ Y '►e , y,p PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
/ Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
Business name: C12-t r e....,>,..),-;-: /Ale-, Submit two (2) sets of roof plan with connection details
� and fire department access, along with the 2010 Oregon
Address: g 2 7 _5 /Q u Jz 1 kf/ Zip , Solar Installation Specialty Code checklist.
City/State /ZI it 2 ?7 o o:V-3 Permit fee (includes plan review
PS $180.00
r and administrative fees):
Phone: (5t) ) g l/ • Q !r 3 Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: 54 ?,! Total fee due upon appication: $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: Date: * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11/02 /COM/WEB)
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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: $
(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 PernitApp.doc 02/24/2011
4 ) �'�� � �k /DL / Tom -
Building Division
. .
Development Code Provision Review
TIGARD Commercial Projects with Approved Land Use
Building Permit No.: Cis l7 // ° c2e 0O /
Land Use Casefile No.: /y/y1, .Qa D — Qn D/O
Routed Plans:
Submittal Date: f/0/ DA /6 we V./9A/
Submittal Date:
Submittal Date:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies
to the Building Division. Only checked (/) items are approved. Items not approved and those listed in the
notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed
above each section.
STAFF: please only mark those items on the left side that are approved.
Planning Review (contact \) 0 yl v, flat /�f at 503 or i 0 �7 @tigard- or.gov)
L7 -and Use Approval
C`1 Building Plans Match Approved Plan: Yes Ci No ❑
❑ Maximum Building Height
❑ Conditions Met
Notes:
Original Plan: Approved [J Not Approved ❑ Date: e l --20
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
,Ja' Actual Slope: I ' Z
❑ PFI Permit #
❑ Conditions Met
Notes:
Original Plan: Approved „Er Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
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It
City Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard- or.gov)
S treet Trees
❑ Protected Trees
Notes: r0 I.. / 4;q etc Init' �/i "V 5,,v,r/inr
Original Plan: Approved [( Not Approved ❑ Date: 41 *1
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov)
❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit
❑ Engineering Okay to Issue Permit
Notes:
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes/XD No ❑
Date Routed to Building:
Page 2 of 2
RECEIVED
0 A ' 7 211
SCALE: 1" = 20'
Eir: t sewe CIT OF TI GA — ��
yet pipe
BUILDING DIVI ION 20. 0' - 20•
k j0®C `
`
p a
TENNIS COURT VOLLEY BALL COURT /
J
a
X
4 l'eAr.
s' wide path ASPHALT PATH
Exist water y {.. access path
PL /Eh CA P �,
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1
r f 1 PL P L , PL PL
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stump
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t 4, ..;, ....,i, A . .
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11 EXIST 0 \\ GAZEBO /
al
PAD v %
.�. 1 ��� �i.` wide path
around Bid /
11 \ j • tg 2 stroom conc
1
az
Sidewalk around
side and back (non
pedestrian travel
CQ
- j area) should be 6 PRELIM /NARY doh
s, a3 feet wide. rs
UC WORKS DEPAR
y TMENT COOK PARK
11 FIGURE
13123 , s. `u" 12% New Restroom Building Rc —'
• PI. VOICE: J
FAX 30w. 0J-639 -1171 171
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FAX 303- 624-0752
FILE NO
T IGARD N1 Layout Plan
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•
SCALE: 1" = 20'
Ex - t sewer APR — r�
w t pipe n / I[ a' �-- N
7 I 20' 10' 0 20'
CITY OF TIG .
BUILDING DIVIS ON pot k / Ij i
TENNIS COURT
J VOLLEY BALL COURT f
a ( { 4D
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, s' wide path ASPHALT PATH
\ Exist waterMH SIG access path
PL No � PL P �' „ /PL o
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\ \ 'f �) \ lump / / / / / / / / / / / / / / / /��Ai'11 'lump /t7 �� , _� 1 r \ 1
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El ii \ Q
,r 20'x20' concrete
t Q restroom bld pad
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/ ,
S t Sidewalk around
P side and back (non
R p travel
area) should be 6 PRELIMINARY
s a feet wide. °° "° a ° ” �" MO
i s ISOINSER"° DIVISION COOK P ARK FIGURE
rueuc WORKS OSPAR FI E
F GUR 1
I 1 S.W'w" IS.w. New Restroom Building
- n cun . oae corl 9722)
!"t' VOICE 6aJ -6J9 -4171
P'1"_. FAX JOJ FILE NO
1 ~ a; RD wwwncwa-0a.cov Layout Plan 0683