Permit CITY OF TIGARD BUILDING PERMIT
I COMMUNITY DEVELOPMENT Permit #: BUP2012 -00246
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/05/2012
Parcel: 2S113AB00500
Jurisdiction: TIGARD
Site address: 16083 SW UPPER BOONES FERRY RD
Project: Fanno Creek Plaza Bldg. B Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Add batteries to power supply, change push to exit buttons with pneumatic button
Contractor: ACTION TECHNOLOGY SYSTEMS LLC Owner: G &S FC LLC
835 SE 17TH AVE 16083 SW UPPER BOONES FERRY RD,
PORTLAND, OR 97214 STE
TIGARD, OR 97224
PHONE: 503 - 231 -1992 PHONE:
FAX: 503 - 231 -1402
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee - Additions, Alterations, 12/05/2012 $53.27
Demolition
Occupancy Grp: Occupancy Load: 12% State Surcharge - Building 12/05/2012 $6.39
Dwelling Units: 0 Plan Review 12/05/2012 $34.63
Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 12/05/2012 $21.31
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Lg $2.00 (over 12/05/2012 $2.00
Value: $500 11x17)
Info Process /Archiving - Sm $0.50 (up to 12/05/2012 $1.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $118.60
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 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 1.800.332 2344.
Issued By: 2111/4/dIq j1124t Permittee Signature:
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 / FOR OFFICE USE ONLY
City of Tigard REC Date /Bea I }. s" Permit No..d 'tJ-
I in 13125 SW Hall Blvd., Tigard, OR 97223 201 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DEC 0.5 Date /B : Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready /By: Juri ® See Page 2 for
Internet: www.tigard or.gov pp, GITY OETIGARD Notified /Method: t Supplemental Information
TYPE OF WC/ftVID/NG BMW 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.
dwelling Valuation: $
❑ I- and 2-family g ®C ommercial /industrial
III Accessory building ❑ Multi- family Number of bedrooms:
1:1 Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16083 SW Upper Boones Ferry Road New dwelling area: square feet
City/State/ZIP: Tiard, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Fanno Creek Plaza Bldg B Covered porch area: square feet
Cross street/directions to job site: 72nd 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
fax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Add Batteries to power supply, change push to exit buttons with pneumatic button Valuation 55500.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( )
New:
Z APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address:
City /State /ZIP: Total fees due upon application:
Phone: ( ) Fax::( )
Amount received: I ( g , & p
E PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Action Technology Systems Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 835 SE 17 Ave Solar Installation Specialty Code checklist.
City /State /ZIP: Portland, Oregon 97214 Permit fee (includes plan revie $180.00
and administrative fees):
Phone: (503) 231 - 1992 Fax: (503 - ) 231 - 1402
State surcharge (12% of permit fee): $21.60
CCB lie.: 157630
_ Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
‘2.-5 2... within 180 days after it has been accepted as complete.
Print name: Steve Barry Date: - " ".�,.3.' 2_ * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -COM PermitApp.doc 02/24/2011 440- 4613T(I I /02 /COM /WEB)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16083 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Building
299 Final inspection
03/29/2013 00:00
BUP2012-00246
PASS - C of O
Violation Summary:
Inspector Contractor