Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2012 -00141
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2012
Parcel: 25101 DA00101
Jurisdiction: TIGARD
Site address: 13190 SW 68TH PKWY 110
Project: Stearns Lending Subdivision: VARNS ACRES Lot: 9
Project Description: TI - new walls, doors, relites and cabinetry
Contractor: NORWEST CONTRACTORS INC Owner: PACIFIC NW PROPERTIES LIMITED PA
PO BOX 25305 STERN FAMILY LIMITED PARTNERSHIP
PORTLAND, OR 97298 -0305 STERN, HELEN R REVOCABLE TRUST
6600 SW 105TH AVE #175
BEAVERTON, OR 97008
PHONE: 503 -291 -6986 PHONE:
FAX: 503 - 291 -7036
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review, COM TI - Ping 07/18/2012 $67.00
Occupancy Grp: B Occupancy Load: 43 DC Provision Review, COM TI - LRP 07/18/2012 $10.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 07/18/2012 $718.43
Demolition
Stories: 2 Height: 0 ft 12% State Surcharge - Building 07/18/2012 $86.21
Bedrooms: 0 Bathrooms: 0 Plan Review 07/18/2012 $466.98
Value: $48,180 Plan Review - Fire Life Safety 07/18/2012 $287.37
Info Process /Archiving - Lg $2.00 (over 07/18/2012 $4.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,639.99
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 Notification Center. Those rules are 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 503.232.1987 or 1. 00.332.2344.
Issued By: Permittee Signature: L % "z
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.
Building Permit Application
Commercial
RECEIVEt FOR OFFICE USE ONLY
Received
City , $4 Permit No q ••� Z.(� Q
`J Of Tigard
13125 SW Hall Blvd., Tigard, OR 97223
g Date /B it ii Z JO/ Yr
JUL 1 2012 Plan Revie'
Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Plan R : �...
T I G A R D CITY OF Inspection Line: 503.639.4175 Date Ready Juris: RI See Page 2 for
Internet: www.tigard- or.gov C a g� Lf!�4l i /1 I p ARD Notified/Method: Supplemental Information
BUIL Pr / i(»
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.
❑ 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: 13190 SW 68th New dwelling area: square feet
City/ State/ZIP: Tigard, Oregon 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: 110 I Project name: Stearns Lending TI 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Tenant Improvement including new walls, doors, relites and cabinetry. Valuation: $$48,180.00
Existing building area: 5116 square feet
New building area: 0 square feet
0 PROPERTY OWNER I ❑ TENANT Number of stories: 2
Name: Pacific NW Properties Type of construction: II -B
Address: 6600 SW 105 Ave Occupancy groups:
City/State/ZIP: Beaverton Oregon 97005 Existing: B
Phone: ( ) Fax: ( ) New: B
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* schedule)
Business name: Mildren Design Group ( refer to fee
Structural plan review fee (or deposit):
Contact name: Curt Trolan
FLS plan review fee (if applicable):
Address: 7650 SW Beveland St, Ste 120
Total fees due upon application:
City/State/ZIP: Tigard, Oregon 97223
Phone: (503) 244 -0552 I Fax: : (503) 244 -0417 Amount received:
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Norwest Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: PO Box 25305 Solar Installation Specialty Code checklist.
City/ State/ZIP: Portland, Oregon 97305 Permit fee (includes plan review $180.00
and administrative fees):
Phone: (503) 291 -6986 I Fax: (503) 291 -7036 State surcharge (12% of permit fee): $21.60
CCB lic.: 89425 ., 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: Curt Trolan I Date: 7/18/2012 * 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)
o Building Division
Development Code Provision Review
T i c n ° Commercial Projects - No Associated Land Use Case
Building Permit No: ❑ Expedited Review
Plan Submittal Date: `"? - - l
To the Applicant:
If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact C .11 Cc.; 4es at 503 - 718 - .P or Ckentl G @ tigard- or.gov)
Zoning KU-E Permitted Use Yes FI No ❑
td Land Use Required: Yes ❑ No (explain below)
Notes: E•ipa r+S; an f y-i S A-+n 1 O � - + et_ u...) C. .1 n-}v ar. Qdj ac.er A -
v a c . a h f a _ . seta. •
Approved ❑ Not Approved Date: 7 - I? - I.
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard- or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN
1 111111 a Building Division
Over- The - Counter (OTC) Building Permit
l' I G A R D Check List
Project Description: r ( gapxr a.-Oo ( I/
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: Occupancy Load: _. j Oregon Specialty Code: ---g O
SPECIFICS
Number of Stories: Z. Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: l'` Fire Alarms: 1, Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 48 ' J •eo FEES DUE
$ ff, I DC Prov Rvw, COM TI — Ping
$ I r • DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ I •. ' 7 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ i 0, Z. 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ .�>;!111r Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ ,3 Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ 1, 91 TOTAL FEES DUE
*OPTIONS: J
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.
l: \Building \Forms \OTC- BUP.doce 07/01/2012