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Permit CITY OF TIGARD BUILDING PERMIT 741 COMMUNITY DEVELOPMENT Permit#: BUP2013-00120 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013 v21 �:� Parcel: 1S135BC00202 Jurisdiction: Tigard Site address: 10763 SW GREENBURG RD 120 Project: Subway Subdivision: HILLSBORO Lot: PTS 1-2 Project Description: Interior remodel to a Subway: walls,ceiling,flooring,wallcoverings,bathrooms. 8/20/2013: REPRINT permit to correct suite from 100 to 120. Contractor: JUSTIN L BALDWIN CONSTRUCTION Owner: BELANICH, ROGER M PO BOX 1688 22020 17TH AVE SE#200 TUALATIN, OR 97062 BOTHELL,WA 98021 PHONE: 503-805-0150 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 07/08/2013 $167.00 Occupancy Grp: A-2 Occupancy Load: 51 DC Provision Review,COM TI-LRP 07/08/2013 $25.00 Dwelling Units: 0 Permit Fee-Additions,Alterations, 07/08/2013 $917.70 Demolition Stories: 1 Height: 0 ft 12%State Surcharge-Building 07/08/2013 $110.12 Bedrooms: 0 Bathrooms: 0 Plan Review 07/08/2013 $596.51 Value: $75,000 Info Process/Archiving-Lg$2.00(over 07/08/2013 $18.00 11x17) Info Process/Archiving-Sm$0.50(up to 07/08/2013 $3.50 Floor Areas: 11x17) Plan Review-Fire Life Safety 07/08/2013 $367.08 Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $2,204.91 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 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: Permittee Signature: DA/ �L,e �����W// Call 603.639.4176 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. CITY OF TIGARD BUILDING PERMIT "1 s _ . COMMUNITY DEVELOPMENT Permit #: BUP2013 00120 T l CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013 Parcel: 1 S135BC00202 Jurisdiction: Tigard Site address: 10763 SW GREENBURG RD 100 Project: Subway Subdivision: HILLSBORO Lot: PTS 1 -2 Project Description: Interior remodel to a Subway: walls, ceiling, flooring, wallcoverings, bathrooms - Contractor: JUSTIN L BALDWIN CONSTRUCTION Owner: BELANICH, ROGER M PO BOX 1688 22020 17TH AVE SE #200 TUALATIN, OR 97062 BOTHELL, WA 98021 PHONE: 503 - 805 -0150 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB DC Provision Review, COM TI - Ping 07/08/2013 $167.00 Occupancy Grp: A -2 Occupancy Load: 51 DC Provision Review, COM TI - LRP 07/08/2013 $25.00 Dwelling Units: 0 Permit Fee - Additions, Alterations, 07/08/2013 $917.70 Demolition Stories: 1 Height: 0 ft 12% State Surcharge - Building 07/08/2013 $110.12 Bedrooms: 0 Bathrooms: 0 Plan Review 07/08/2013 $596.51 Value: $75,000 Info Process /Archiving - Lg $2.00 (over 07/08/2013 $18.00 11x17) Info Process /Archiving - Sm $0.50 (up to 07/08/2013 $3.50 Floor Areas: 11x17) Plan Review - Fire Life Safety 07/08/2013 $367.08 Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $2,204.91 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 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 503.2 1.800.332.2344. Issued By: Permittee Signature: ( \/� `"' (1/4j\i Cali 503.839.4175 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. �iuilding Permit Application Commercial .... RECEIVEt ,! FOR c>rhacr USE OM.) 114 City of Tigard Recei Day: eived / 3 ffi Permit No.: &( 03 - CV/ j.0 ` q 13125 SW Hall Blvd., Tigard, OR 97223 MAY O 9 2013 O � 3 Plan Review 1 61 Phone: 503 - 718 - 2439 Fax: 503 - 598 - 1960 Date/By: 41074 t5t I. . Other Permit: Notified/Metho� T I Ci It n rc , Internet: www.tigard or.gov Inspection Line: 503 - 639 - 4175 CITY OF TIGARD Date Ready/By. RI See Page 2 for BUILDING DIVIDIVISION • '' 3 / ' ' ' T' CO Supplemental Information TYPE kOF _ WORK I REQUIREDDATA: l- AND 2- FAMILY DWELLING IN New 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 CONSTRUCTION work indicated on this application. dwelling Valuation: $ ( ❑ 1- and 2-family g ❑ Commercial/industrial ❑ Accessory building 1:1 Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: • ' JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /07 (7 3 S1,0 `,recil Ere- OsA New dwelling area: square feet City /State /ZIP: '"r 4 r c_\ Or ) Garage /carport area: square feet Suite/bldg. /apt. no.: . ( ro Project name: ju V W car Covered porch area square feet Cross street/diredions 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. 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. 3 1 ` l Valuation: $ ' CVO 0;1G O,J 5 1 W : a, dice / Wt'll, ceiLI, Pore. 4 vd4Iti-tkit iel f / K2` f Existing building area square feet New building area: square feet , .:❑ PR OPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ,0 APPLICANT. ' . ' ❑ CONTACT PE RSON 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: Total fees due upon application: City /State /ZIP: Phone: ( ) Fax: : ( ) Amount received: E -mail: PHOTOVOLTAIC:SOLAR PANEL SYSTEM'FEES* : . Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. 11 Submit two (2) sets of roof plan with connection details Business name: ; L ` \I a v ` and fire department access, along with the 2010 Oregon Address: a.0 3 i , 88 Solar Installation Specialty Code checklist. _ City /State /ZIP: 97 Permit fee (includes plan review $180.00 �v�1 �'� +� G 14 �� and administrative fees): Phone: (5b ) 80 c V 1 5"0 Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lie.: r 7 3 Total fee due upon application: .60 Authorized signature: /�` W - This permit application expires if a permit is not obtained I! within 180 days after it has been accepted as complete Print name: a• -07r'iH �IcW V. Date: �/ / ZG+t ^ y * Fee methodology set by Tri - County Building Industry Y Service Board I: \ Building \Permits\BUP_COM_PermitApp.doc Rev. 12/11/2012 440- 613T(l 1/02 /COM/WEB) P, IR III a 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_PermitApp.doc Rev. 12/11/2012 ° Building Division • Over- The - Counter (OTC) Building Permit T 1 G A li ° Check List Project Description: T( &LP jot 3 -Ol) f?() APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION_ *Class of Work: Occupancy Group: 1�2 Type of Construction: 5j Ej *Type of User girt Occupancy Load: Oregon Specialty Code: 2,©(0 SPECIFICS Number of Stories: 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 �44 Fire Sprinklers: IV 0 Fire Alarms: Smoke Detectors: Parapet: Manual Pull Stations: Protected Corridors: Total Project Valuation: $ r-- FEES DUE $ `7, CO DC Prov Rvw, COM TI — Ping /� $ I • DC Prov Rvw, COM TI — LRP r2 S , DC Provision Review Fee for COM TI $ - 7 t 7() Permit Fee — Add, Alt, Demo Project Valuation Planning LRP $ g o., 2, 12% State Surcharge Up to $4,999 $0.00 $0.00 $ r iC",50 Plan Review, Structural $5,000 - $74,999 $67.00 $10.00 $ �j(p eiR Plan Review, Fire Life Safety $75,000 - $149,999 $167.00 $25.00 $ (7 ,CC, Info Proc /Arch, Lg (over 11x17 $2.00) $150,000 and over $268.00 $39.00 $ '3 enc, 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: $ I'DTAL FEES DUE *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; END = 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 - BUP.docx 07/01/2012 Ill Building Division ° Development Code Provision Review TI c A R D Commercial Projects - No Associated Land Use Case Building Permit No: &LP d0 / — DDt 12<pedited Review Project Name: . /% Site Address: /an,' i .P4/ all "-- , Suite /Bldg #: 420 Plans Routed: / Original Plan Submittal Date: 5 /3 Routed By: S '"1 - 1St Revision Submittal Date: Routed By: 2nd Revision Submittal Date: Routed By: 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 at (503) 718 -�7YU or 44 @tigard- or.gov) Proposal: / kr Wt4e7 er',/X iry/Ote/e/ //14 Zoning frl u e% Permitted Use Yes No ❑ l / Land Use Required: Yes ❑ No 'L9" Notes: ti Approved ❑ Not ppr ed E DCPR Not Required — No DCPR Fees Due Date Routed to Building: �// <7 1: \CURPLN\Masters\Development Code Provision Reviev/d3CPR_COM_NoLandUse.doc Rev. 01/16/13