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Permit (19) CITY OF TIGARD BUILDING PERMIT a.. COMMUNITY DEVELOPMENT Permit#: BUP2013-00272 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/12/2013 l Parcel: 251018800401 Jurisdiction: Tigard Site address: 11880 SW PACIFIC HWY Project: Fidelity Fleet Subdivision: TIGARD ROAD GARDENS Lot: 5 Project Description: TI-remodel restrooms for ADA Contractor: CLEAN COAT-CHUCK ZWEBER Owner: GULSONS PACIFIC LLC 13365 SW KINGSTON PLACE 307 LEWERS ST, STE 600 TIGARD,OR 97223 HONOLULU, HI 96815 PHONE: 503-858-4144 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 11/12/2013 $70.00 Occupancy Grp: B Occupancy Load: DC Provision Review,COM TI-LRP 11/12/2013 $10.00 Dwelling Units: 0 Permit Fee-Additions,Alterations, 11/12/2013 $241.01 Demolition Stories: 1 Height: 0 ft 12%State Surcharge-Building 11/12/2013 $28.92 Bedrooms: 0 Bathrooms: 0 Plan Review 11/12/2013 $156.66 Value: $10,166 Plan Review-Fire Life Safety 11/12/2013 $96.40 Info Process/Archiving-Lg$2.00(over 11/12/2013 $2.00 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $604.99 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 •r me rui- - •'ect questions to OUNC by calling or 1.800.332.2344. Issued By. Ate— ermittee Signature: ��,'_ /L`/ - Ca 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. hlding Permit Application Commercial FOR OFFICE USE ONLY • City of Tigard RECEI V Received �/A g 1 pm Permit No.: : Q o?p 3-60,,,,,q 7 ■ 13125 SW Hall v Tigard,OR 97 all BI d, gar ,O 97223 Plan Review 7-1/11k 2 Phone: 503.639.4171 Fax: 503.598.I�V 5 2013 Date/By: 1 , Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 171 See Page 2 for , Noti ethod: M �A Supplemental Information Internet: www.tigard-or.gov CITYOFTIGARD TYPE 'Ow t et t N 1 i 1 . I 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 CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: // 0 $ ® 5 W Pd e/I New w dwelling area: square feet City/State/ZIP: 2 3 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: ,. Covered porch area: square feet Cross street/directions to job site: Deck area: square feet 4a II Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I 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 �,/_ D/E'SCRIPTION OF WORK ,�® work indicated on this application. re,rn 0 CLG-C.- -� 1...5 h - z 'Cl� �,7✓ Valuation: $ /0 �O Existing building area: 5-130z square feet New building area: /to `A qu et ❑ PROPERTY OWNER i TENANT Number of stories: Name: Fi cie,/„ 72 Type of construction: p. Address: % % 1 / L 'i .d III 1 Occupancy groups: City/State/ZIP: ` J l,(/l 4 Existing: Phone:(5O3) 7 0`s— Li I g Fax:( ) New: /] APPLICANT ❑ CONTACT PERSON NOTICE Business name: 77 ...4..s.c La " / /7 6 fp Gr All contractors and subcontractors are required to be �I h �Iir sue., licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the Address: PO SIB OA Go /' g 7 jurisdiction in which work is being performed.If the City/State/ZIP: �� U�' i / 075 applicant is exempt from licensing,the following reasons apply: ( ) 7 z5! j,7 1 / I Fax:: PP Y Phone: ( ) E-mail: lr Sh,,721, e -7`-tc/t ftl..) g r'z',//A. GDrn CONTRACTOR __ Business name: ` -,7 - _ -- BUILDING PERMIT FEES* Address: (Please refer to fee schedule) Structural plan review fee(or deposit): City/State/ZIP: Phone:( ) lJSP �/ ! (-,� Fax:( ) - FLS plan review fee(if applicable): CCB lic.: /� D ` JJ Total fees due upon application: Amount received: Authorized signature: % This permit application expires if a permit is not obtained !� within 180 days after it has been accepted as complete. Print name: `i,,, (L ow!/, Date: //. /3 * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 2/23/07 • 440-4613T(I l/02/COM/WEB) Building Division • Over-The-Counter (OTC) Building Permit T I G A R D Check List Project Description: T APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION Class of Work*: ikur Occupancy Group: iM Type of Construction: Type of Use**: COIAA Occupancy Load: _ Oregon Specialty Code: 20(� SPECIFICS Number of Stories: I 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 � p,.� Fire Sprinklers: k ) Fire Alarms: Smoke Detectors: Parapet: Manual Pull Stations: Protected Corridors: Total Project Valuation: $ 10)1 (:%6 .CO FEES DUE $ 70,c0 DC Prov Rvw,COM TI—Ping $ (Q,cO DC Prov Rvw,COM TI—LRP DC Provision Review Fee for COM TI (effective 7/1/2013) $ Permit Fee—Add,Alt,Demo Project Valuation Planning LRP $ 7P.3,`l� 12%State Surcharge Up to$4,999 $0.00 $0.00 $ 6'o.(pCo Plan Review,Structural $5,000-$74,999 $70.00 $10.00 $ 1%40 Plan Review,Fire Life Safety $75,000-$149,999 $174.00 $26.00 $ Z,QO Info Proc/Arch,Lg(over 11x17$2.00) $150,000 and over $278.00 $41.00 $ Info Proc/Arch,Sm(up to 11x17$0.50) $ Metro Construction Excise Tax $ School Construction Excise Tax $ i Hourly Rate Fee Planning Staff: $ Hourly Rate State Surcharge $ Misc.Admin Fee Permit Coordinator: $ Other: $ Other: Building Staff: $ Other: Date/Time: $ TOTAL FEES DUE *TYPE OF USE: COM=commercial;CMS=commercial manufactured structure. **CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new; OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies). I:\Building\Forms\OTC-BUP.docx 07/01/2013 Building Division °- Development Code Provision Review TIGARD Commercial Projects - No Associated Land Use Case Building Permit No: Pa u P s-oC?7 9- Expedited Review Project Name: / D tc.-i —y Site Address: ii gee) iD k A C F t e_ , Suitc/Bldg #: Plans Routed: Original Plan Submittal Date: II /4 Routed : 1" 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 _)O1,,/1 at (503) 718-02142, or @tigard-or.gov) Proposal: C,4.4 e G4tJ VICE /rte 5°,k' Ai /mooICI' LSt c Zoning //1v-Ck50 Permitted Use Yes 0No ❑ Land Use Required: Yes ❑ No l!�' Notes: Approved ❑ Not Approved ❑ DCPR Not Required-No DCPR Fees Due Date Routed to Building: __1:\CURPLN\Masters\Development Code.Provision Reviev ADCPR_COM=NoLandUse.doc_Rev..01/16/13_