Permit _. CITY OF TIGARD BUILDING PERMIT
j Permit#: BUP2016-00103
' COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/12/2016
T f c.A I.I.T7 9 Parcel: 2S102DA00800
Jurisdiction: Tigard
Site address: 13335 SW HALL BLVD
Project: Fanno Creek House Subdivision: 1992-069 PARTITION PLAT Lot: 2
Project Description: Change of occupancy from R-3 to B.
Contractor: Owner: TIGARD, CITY OF
13125 SW HALL BLVD
TIGARD, OR 97223
PHONE: PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: VB Permit Fee-Additions,Alterations, 05/12/2016 $53.27
Demolition
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Building 05/12/2016 $6.39
Dwelling Units: 0 Plan Review 05/12/2016 $34.63
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 05/12/2016 $1.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $95.29
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. 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: f Permittee Signature:
1503.639.4175 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 I 012(H I l( I I til.0\1.1
City of Tigard ``�1'•ateived
Date/B :;� il
q 13125 SW Hall Blvd.,Tigard,OR 97223 ON t.PlanRev�c a31111,41611011■ �a Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 to/B :a �
I:I Inspection Line: 503.639.4175ceiV1 ti(�' �,I �� 61 See Page 2 for
Internet: www.tigard-or.gav �% R���;jk`{� /' Supplemental Information
TYPE OF WORK �P O��O,,\ 0�� lewil�
\ 0�� REQUIRED DATA:1-AND 2-EAMILY DWELLING
0 New construction 0 Demolition c! Permit fees*are based on the value of the work performed.
�� Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ®Other:Occupancy equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® I-and 2-family dwelling 0 Commercial/industrial Valuation: $681,410
0 Accessory building 0 Multi-family Number of bedrooms: 0
❑Master builder 0 Other: Number of bathrooms: 4
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address:13335 SW Hall Blvd New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Fanno Creek House Covered porch area: square feet
Cross street/directions to job site: Hall Blvd.North of Omara St. Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: 1-2 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S102DA00800 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Change of occupancy from R-3 to B Valuation: 4446"44444*--' ill;/V
Existing building area: 2505 square feet
New building area: 0 square feet
® PROPERTY OWNER 0 TENANT Number of stories: 2
Name:City of Tigard Type of construction: Wood Frame
Address: 13125 SW Hall Blvd. Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing: R-3
Phone:(503)718-2588 Fax:(503)684-4191 New: B
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to lee schedule)
Business name:Fleet and Facilities Supervisor .
Structural plan review fee(or deposit):
Contact name:Kevin Cole
FLS plan review fee(if applicable):
Address: 13125 SW Hall Blvd
City/State/ZIP:Tigard OR 97223 Total fees due upon application:
Amount received:
Phone:(503)718-2588 Fax::(503)684-4191
E-mail:kevinc@Ngard-or.gov PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:NA Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review
and administrative fees): $180.00
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:
Total fee due upon application: $201.60
Authorized signature: /1Z ,/ This permit application expires if a permit is not obtained
� f�__ within 180 days after it has been accepted as complete.
Print name:Kevin M.Cole Date:3.23.2016 * Fcc methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46l 3T(I I/02/COM/WEB)