Permit l if i ----- CITY OF TIGARD BUILDING PERMIT
11 COM MUNITY DEVELOPMENT Pe r mit #: BUP2013-00110
Date Issued: 05/09/2013
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 1S136AD04000
Jurisdiction: Tigard
Site address: 11507 SW PACIFIC HWY A
Project: Engineering for Kids Subdivision: VILLA RIDGE Lot: 7
Project Description: TI with change of use from personal services to daycare.
Contractor: ROBERT TODD CONSTRUCTION INC Owner: PACIFIC TERRACE COMMERCIAL LLC
4080 SE INTERNATIONAL WAY 8113 BY SMITH, EDITA M
MILWAUKIE, OR 97222 833 NW 170TH DR
BEAVERTON, OR 97006
PHONE: 503 - 653 -5704 PHONE.
FAX: 503 -653 -5729
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee - Additions, Alterations, 05/09/2013 $149 75
Demolition
Occupancy Grp: E Occupancy Load: 34 12% State Surcharge - Building 05/09/2013 $17 97
Dwelling Units: 0 Plan Review 05/09/2013 $97.34
Stories: 1 Height: 0 ft Plan Review - Fire Life Safety 05/09/2013 $59.90
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Lg $2.00 (over 05/09/2013 $2.00
Value: $4,200 11x17)
Floor Areas:
Total Area 0
Accessory Struct 0
Basement: 0
Carport: 0
Covered Porch 0
Deck' 0
Garage' 0
Mezzanine: 0
Total $326 96
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No 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 wit
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 Notificati• • Center Those rules are set forth in OAR
952 - 001 -00 rough • • - 952- 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 50 • 1987 or 1 800 33, 2344
Issued / ti / Permittee Signature:
eli /
•.
Call 503.639.4175 by 7:00 a.m. for the next available inspection d. te.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial Received RECEIVED FOR OFFICE USE ONLY
Iii - City of Tigard Date /B $ • A Permit No Aj?pi3— Q0f/7?
n 13125 SW Hall Blvd , Tigard, OR 972 - ll Plan Review inn 4 V
Phone 503 718 2439 Fax 503 598 I '‘t U 9 2013 Date/B Other Permit j _000
TIGARD Inspection Line 503 639 4175 Date Ready /By lens Ei See Page 2 for
Internet www tigard -or gov CITY OF TIGARD Notified /Method Supplemental Information
A11ILDING DIVISION
TYPE OF WORK REQUIRED DATA: I- 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
work indicated on this application.
CATEGORY OF CONSTRUCTION _
❑ I- and 2- family dwelling mmercial /mdustnal Valuation: S
❑ Accessory building ❑ Multi- family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SFFE INFORMATION AND LOCATION Total number of floors:
Job site address: 11t _ / c`4 1 4., k , v + 4 6,v New dwelling area: square feet
1
City /State /ZIP. _ ��oN 1 Garage /carport arca: square feet
l ,1
Suite/bldg. /apt. no.: Project name: i4,( N�.a Foia Covered porch arca: square feet
Cross street/directions to job site: 1•t Deck area: square feet
Other structure arca' 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
/"/ ZOO ..
Valuation: S�r�YV'
4 sr _„_� 0 ' A a '4.l,c"7:-. Cs•, _ —
Existing building arca. square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: G!0 Iio9 .1 5 4 ---1 -- v" S Type of construction:
Address: f 02 - j G9 Mop ..124 31\ ' rP (Or Occupancy groups:
�'"'11
City /State /ZIP: " D �-. 11 5 Existing:
Phone: (605 0 , Fax: ( ) New:
> . 3
IR APPLICANT + ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: / f�. Y r k J (Please refer to fee schedule)
de)
o.`F°�� �Lt� -�' Structural plan review fee (or deposit):
Contact name: 1 * ■ 631.) 7
�
1 FLS plan review fee (if applicable):
Address: PA 7
. K e=3) 1
City /State /ZIP' F6�-I , 10 / OR. - l�� Total fees due upon application:
�% • Amount received:
Phone: (..-- (..-- 22.....-.1-7 � Fax: ( ZZB'• c7 - 72 I
E PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: rei ?.}-• = ��er47k5 .th �� Submit two (2) sets of roof plan with connection details
^ and fire department access, along with the 2010 Oregon
A
Address: `fC D c_ 1.14 WAY Solar Installation Specialty Code checklist
City /State /ZIP: IaALIWi6(GK, CZ GJI•E,e_IIz Permit fee (includes plan review $180.00
and administrative fees)'
Phone: Cam?') eS3-• 5 Fax (6,3 65s ..5 /2i State surcharge (12% of permit fee): $21.60
CCB lie. 111..7 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: /T' [s]� . ( Yeki 4- Date Z.5 Aryl/ 215/3 * Fee methodology set by Tn- County Building Industry
Service Board
I \Building \Permits \BUP -COM PermitApp doe 02/24/2011 440- 4613T(I I /02 /COM /WEB)
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description:
APPLICATION SPECIFIC INFORMAT N
GENERAL INFORMATION .
*Class of Work: Occupancy Group: v Type of Construction:
*Type of Use: CL Occupancy Load: Oregon Specialty Code: 2On
SPECIFICS
Number of Stones: 1 Building Height: Mixed Use:
Number of Div 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: 'Op Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors: ,
Total Project Valuation: $ 4 CC . FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ ( j t 7'S Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ \L7 ( 7 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 7. 3 Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ 593.4Q Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ or, 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: $ 3Z6 TOTAL FEES DUE
*OPTIONS:
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.
I \Building \ Forms \OTC -B docx 07/01/2012
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
11507 SW PACIFIC HWY A, TIGARD, OR, 97223
Commercial - Building
275 Framing
05/22/2013 00:00
BUP2013-00110
PASS
Violation Summary:
Inspector Contractor