Permit CITY OF TIGARD BUILDING PERMIT
il
III 8 COMMUNITY DEVELOPMENT Permit#: BUP2015-00214
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2015
Parcel: 2S102AC00100
Jurisdiction: Tigard
Site address: 9040 SW BURNHAM ST
Project: B&B Print Source Subdivision: BURNHAM TRACT Lot: 4
Project Description: Construction of concrete base for placement of artwork.
Contractor: SUN RIVER BUILDINGS Owner: STEVENSON, MICHAEL J& KAY L
12220 SW JAMES ST 16815 MAPLE CIR
TIGARD, OR 97223 LAKE OSWEGO, OR 97034
PHONE: 503-608-2739 PHONE:
FAX: 503-213-6538
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: Permit Fee-Additions,Alterations, 08/20/2015 $63.44
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 08/20/2015 $7.61
Dwelling Units: 0 Plan Review 07/20/2015 $41.24
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 08/20/2015 $8.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $750
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $120.29
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 if work is suspended for more the 180
days. ATT • •.: a -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-•.10 through OAR ' •• -•,P90. You may obtain a copy of the rules or direct questions to OUNC by calling 503. .1987 or 1.800.332.2344.
il'.6414-r<11-1 Issue By: Permittee Signature: �6- ia" �-
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.
-=` -uldin2 Permit Application
Commercial ECEIVED OFFICE USE ONLY
Cl of Ti and RECEIV�� Received
Iiiii • g Date/B : i t Y/ 41' // C 1
13125 SW Hall Blvd.,Tigard,OR 97223 1 Plan Review
I. Phone: 503-718-2439 Fax: 503-598-1964UL Date/B : �6ti��� RelatedPernut:
T I G A R D Inspection Line: 503-6394175 2 0 2015 15 Date Read''" / Juris ® See Page 2 for
Internet: www.tigard-or.gov City OF 7-!� Notified/Method: 7 Z�//S ''/''''' --a Supplemental Information
BOLD/ AFB /(J N ///.,, .,` �--W
TYPE WO I REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees* are based on the value of the work performed.
Indicate the value(rotnded to the nearest dollar)of all
1 ❑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 ❑Comercial/industrial Valuation: $
m
III Accessory building ❑Multi-family Number of bedrooms:
.i' 1 aster builder El Other:
Number of bathrooms:
\. JOB SITE INFORMATION AND!LOCATION Total number of floors:
Job site address: G�'1 - / Sit/ /0K,[h/LG ( - New dwelling area: square feet
jCity/State/ZIP: 7� yAiii l4 0/ 97 2�3 Garage/carport area: square feet
Suite/bldg./apt.#: I Project name: Pi0re-A 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
L Subdivision: Lot 4: Permit fees*are b lied on the value of the work perfbrmed.
Indicate the value(rotnded to the nearest dollar)of all
Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the
/
DESCRIPTION OF WORK work indicated on this application.
.. Q G4,id e ce e/c_ e#-.e4 /7)...G Valuation: $ 7 570 beau f` Existing building area �' Bad square feet
a/fit.'or D� -- 7'� {fy rl#
i
POGrJhfo&rL GL C. New building area: square feet
i :. PROPERTY OWNER I E t ENANT Number of stories: ---
Ai I Name: A GA/c-C/ S'r",,,ei/-"it.1°es., Type of construction:
Address: 9Q Lg Q S'4)g i 4 4 a,,, Occupancy groups:
IA
City/State/ZIP: // et r., /, e),Q q 7 2-23 Existing:
Phone:(5 3/1( i feel/ Fax:( ) New:
V ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: t ,� /� (Please refer to fee schedule)
1,-7w ,e >\J n. �p a rc_�'
_ Structural plan review fee(or deposit):
ontact name:
`� FLS plan review fee(if applicable):
- Address: .
City/State/ZIP: Total fees due upon application: r li '
Phone:( ) I Fax::( •) Amount received: Y
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
x Commercial and residential prescriptive installation of
^ roof-top mounted Photo Voltaic Solar Panel System.
Business name: LL • J�1+L '4''''`I.- Submit two(2)sets of roof plan with connection details
�,� ( � — and fire department access,along with the 2010 Oregon
\.Address: r� t' -
3� : w J Solar Installation Specialty Code checklist.
Permit fee includes an review
City/State/ZIPekazo c,-,Q_ 7Y2-3 Permit
administrative fees):
$180.00
Phone: �''� 09�'yL'1�j� Fax:( State surcharge(12%of permit fee): $21.60
CCB Lic.: 7 re•v 0,5
\/ / / cc Total fee due upon appication: $201.60
Authorized signaturJ V/// . , c / This permit application expires if a permit is not obtained
�/f ��'YYY ` r �J within 180 days after it has been accepted as complete.
Print nfl/ j! /‘/ Z-y'-t. ,•,- Date: Zil 20 j/5"- * Fee methodology set by Tri-County Building Industry
Service Board
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
IN City of Tigard
a
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: 13u.P 0015 00 a `{-
Site Address: 90 40 .S w &tern h ) Suite/Bldg#:
Project Name: 504 a ?v;cd- cSvcc.res_.
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 6uyncxe..-4-e base .Fr. et..4-w0,-4c4
Existing Business Activity: — kj/f{
Proposed Business Activity: — Nl I}
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ Yes X51 No
l Zoning: M Lt - CZ(D
A Permitted Use: I:21 Yes ❑ No ❑ Spec Space
Confirm no land use required.
l J7 Business License:
`�j Exists: ❑ Yes .❑ No,applicant notified to obtain business license
Notes:
Approved by Planning:' r et_ • C-.'^-"1"— Date: 7— a 0 -1 5
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 7/6/r j
Site Plans: # 3
Building Plans: # ?
Building Permit#: n�ter building permit#above.
Workflow Routing: [l1 tinning B 1'emut Coordinator El—BO-ding
Workflow Sign-off: fig--Siln-off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 72d//3--
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions(after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
)7,
Parks SDC: ❑ Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: 41���� Date: 7-t- l 6'
ac 7Z:76 :7 1 --7-0/ (6--
I:\Building\Forms\B1 dgPermitRvw_COM_NoLandUse_070915.docx
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9040 SW BURNHAM ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2015-00214
Chip Barnett
Violation Summary:
Inspector Contractor