Permit CITY OF TIGARD BUILDING PERMIT
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- COMMUNITY DEVELOPMENT Permit #: BUP2013 -00070
T [GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/15/2013
Parcel: 1 S135DC00200
Jurisdiction: TIGARD
Site address: 11845 SW GREENBURG RD 100
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: TI for ADA bathroom
Contractor: GENERAL CONSTRUCTION SERVICES Owner: TWO G'S REAL ESTATE LLC
18395 WOOD THRUSH ST 18395 WOOD THRUSH ST
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503 - 684 -0550 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee - Additions, Alterations, 04/15/2013 $104.12
Demolition
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Building 04/15/2013 $12.49
Dwelling Units: 0 Plan Review 04/03/2013 $67.68
Stories: 0 Height: 0 ft Info Process /Archiving - Lg $2.00 (over 04/15/2013 $2.00
Bedrooms: 0 Bathrooms: 1 11x17)
Value: $2,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $186.29
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 ' • k is suspended for more he 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce • - r. z hose rules are s- 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. . .1987 6r 1.800.332.2344.
•
Issued By: 34 !U/(l J / � PermitteeSignature:
Call 503.639.4175 by 7:00 a.m. for the next available' spec • • ate.
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 RECEIVE FOR OFFICE USE ONLY
City of Tigard DateB y , +� P e rmit N
y3, • 10�i3 -000 7d
I - " 13125 SW Hall Blvd., Tigard, OR 97223 A PR 0 3 2013 Plan Review -b{ 'i" ) T i _, lot
Phone: 503 -718 -2439 Fax: 503 -598 -1960 Date/By:
Qir Other Permit:
Ins Line: 503 - 639 -4175 Date Ready/By: Juris: ® See Page 2 for
I 1 G AR D
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: �'I �/� Supplemental Information
BI III DING DIVISION V wi & cs
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
ID New construction 0 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 CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling IN 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: \ \ , f ■& WO New dwelling area: square feet
City/State /ZII' k C , j `.. 9'c L� Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area square feet
Cross street/directions to job site: sc 4F? V.6Lw►s.,,e C, 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 (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
F \ Valuation: $
`� Existing building area square feet
New building area: square feet
a OWNER ❑ TENANT Number of stories:
Name: ) y ,,,. U �\ 4*■"\---.5 1 . - Type of construction:
Address: ?�C2 C J C b l'�r \k t; \-\\ \ Occupancy groups:
City /State /ZIP: L;1 (: ...< £.40 j 'tD P? s Existing:
Phone: ( , r v 0)-. L). 1. Fax: ( ) New:
12 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:GQ‹, Structural plan review fee (or deposit):
Contact name: c( it..V..7*. FLS plan review fee (if applicable):
Address: y.&,""Th 0a D — 7�`c 0VS\-\‘ C
Total fees due upon application:
City/State /ZIP: 'L ..p_ W.< V
Amount received:
Phone:ti3) 7, 3 to Fax: : ( ) .
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: en�9.) Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: \C' c 4 ■Avpc C) Y.f.,c ‘ ' Solar Installation Specialty Code checklist.
City /State /ZIP: Lq�� �e 6 Gt`x ±3 Permit fee (includes plan review $180.00
and administrative fees):
Phone: 6 )7 9 , v.. Z O Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: 1�\_ d al 1
Total fee due upon application: $201.60
Authorized si tur . This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print e: 1 .1./ - �-0 _ Wyk Date: / ] 1 * Fee methodology set by Tri -County Building Industry
Service Board
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I:\Building\Permits\BUP COM_PermitApp.doc Rev. 12/ 11/2012 440- 4613T(11/02 /COM/WEB)
1Ni :
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] $ 2ciz 7
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 Rev. 12/11 /2012