Permit CITY OF TIGARD BUILDING PERMIT
I
1 . . COMMUNITY DEVELOPMENT Permit#: BUP2016-00188
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
T r t_;:\R D9 Parcel: 1 S135BC00700
Jurisdiction: Tigard
Site address: 10831 SW CASCADE AVE
Project: Rose City Futsal Subdivision: None Lot: None
Project Description: Interior demolition of partition walls,door,and toilet fixtures.
Contractor: JH KELLY LLC Owner: ICON IPC PROPERTY OWNER POOL 2 L
2311 E 1ST STREET BY INDCOR PROPERTIES
VANCOUVER,WA 98661 2 NORTH RIVERSIDE PLAZA, STE 235
CHICAGO, IL 60606
PHONE: 360-423-5510 PHONE:
FAX: 503-285-0812
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 06/02/2016 $729.45
Demolition
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Building 06/02/2016 $87.53
Dwelling Units: 0 Info Process/Archiving-Lg$2.00(over 06/02/2016 $4.00
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $50,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $820.98
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: Permittee Signature:
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.
Building Permit Application
Commercial RECEIVED ' 0,, ()1 1 '( ' I \' O\' '
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City of Tigard RDate/Beived: lP o� •�• Permit NeuA�/b-po/c
111 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 2 2.016 Plan Review
• Phone: 503-718-2439 Fax: 503-598-1960 Date/B : Related Pertq f/y2S,7?(9/6-etv/7
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Inspection Line: 503-639-4175 CITY OF TIGARD Date Ready/By: Juns: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
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❑New construction jgDemolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
r41-03,,, ,$0
ti $1, ;my 34 g work indicated on this application.
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Valuation: $
❑ 1-and 2-family dwelling Commercial/industrial -
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
�r. ".. 1 ,�# , ,%;7 ', ' i1ra1 4 ��' ., , Total number of floors:
Job site address: /083/ ,$Cts CstsCgp(.t A VG. New dwelling area: square feet
City/State/ZIP: -77q40.-4 OR- 97Z •/z' Garage/carport area: square feet
Suite/bldg./apt.#: ✓ I Project name: Rase Cr AK -4 / Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: I Lot#: 74,0 Permit fees*are based on the value of the work performed.
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Tax map/parcel#: �`rn .15.2.3s$c. Indicate the value materials,(rolabord,
to the nearest and the profit)of of
equipment, labor,overhead,and the for the
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4 "- � , ,, 5 work indicated on this application.
in 7IGelor f i,wo/i i7'Oh ore /440,-717%,44,A Valuation: $ .56-Ci;,.2)C74.
Iv4//f _j �Coor- ap.of 74O/A"74 /7dIC
' 5, Existing building area: 34 0O4quare feet
New building area: •--'--" square feet
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' `!'°xt sf :
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Number of stories: 2-
Name:
Name:
Type of construction: 1E-15
Address: Occupancy groups: A 1
City/State/ZIP: Existing: $/spcsivS-Z
Phone:( ) Fax:( ) New: • -4
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'''..-t5'.-,1,. x,er.*. , ) 4,x4,,.. . ,, -*,t., .l'-'''' „e $ ; ` , .t a4:t 7 '/A'44%'14:4; v' ( t • S r
Business name: t.L , re4 iotec S'
/ Structuralplan review fee(ordeposit):
Contact name: A.„,..„,aG A e,e siWe/-
,3z00 S e m yt� Avc., 57"E 3 OZ FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
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Amount received:
Phone:(lO8) zap Fax::( )
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E-mail: a11-;0; -}seG 1a 0cum,COM Commercial and residential prescriptive installation of
'° '; ' , ' 5 1' ” ',N roof-top mounted Photo Voltaic Solar Panel System.
Business name:�� C� t'�/ Submit two(2)sets of roof plan with connection details
7 and fire department access,along with the 2010 Oregon
Address: 23// C., /Sr- 57.0 'ECT- Solar Installation Specialty Code checklist.
WQ /0�6 Permit fee(includes plan review
City/State/ZIP:VQ n,C pave r / and administrative fees): $180.00
Phone:(%o) (114 1.7 .— 5+S/4) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB Lic.: ii 75- yy 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: AA, LC (/t Date: 4A//e. * 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)