Permit -q CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2012 -00217
•TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/01/2012
Parcel: 2S 101 AB90000
Jurisdiction: TIGARD
Site address: 12011 SW 70TH AVE
Project: CH Physical Therapy Subdivision: 2012 -009 PARTITION PLAT Lot: 1
• Project Description: TI
Contractor: D & J CONSTRUCTION Owner: RED ROCK CREEK CONDOMINIUM
20672 NW QUAIL HOLLOW DR OWNERS OF ALL UNITS
PORTLAND, OR 97229 00000
PHONE: 503 - 519 -5258 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 11/01/2012 $67.00
Occtipancy.Grp: B Occupancy Load: 38 DC Provision Review, COM TI - LRP 11/01/2012 $10.00
Permit Fee - Additions, Alterations, 11/01/2012 $377.90
Dwelling Units: 0 Demolition
Stories: 1 Height: 0 ft 12% State Surcharge - Building 11/01/2012 $45.35
Bedrooms: 0 Bathrooms: 0 Plan Review 11/01/2012 $245.64
Value: $20,000 Plan Review - Fire Life Safety 11/01/2012 $151.16
• Info Process /Archiving - Sm $0.50 (up to 11/01/2012 $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 $899.05
Required: Required Items and Reports (Conditions)
• Fire Sprinkler: Yes 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 uspended for more the 180
days. ATTE • • - :•n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thos= les are set forth in OAR
952- 001 -0', 0 through OAR 9 •- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by callin• 503.232.1987 or 1.8• 4 • .2344.
Issued By: / � Perm ittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available insp= • on date.
This permit card shall be kept In a conspicuous place on the job site u I completion o the project.
Approved plans are required on the job site at the time of = ach inspection.
Building Permit Application
Commercial E VED I cllt 01.1.1( 1: 1 si.. ()NIA RED
City of Tigard nn'' Received / Per No.: n
5111 0 13125 SW Hall Blvd., Ti ard, OR 97223 - 1 2012 Dare : �/�/ . 1 "G��� � 7
g Plan eviebv . S
Phone: 503.718.2439 Fax: 503.598.�19 T�GARD Date/B : JS Other Permit:
T i c n It u Inspection Line: 503.639.4175 ANN Ur 1'GA D Date Ready :Sr: Jw i : El See Page 2 for
Internet: www.tigard -ocgov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1 -AND 2- FAMILY DWELLING
❑ Demolition Permit fees' are based on the value of the work performed.
❑ New construction 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 Ki Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family
Number of bedrooms:
❑ Master builder
❑ Other r Number of bathrooms:
l2 on JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:+ s E J ^7,,TM-A-Ve New dwelling area: square feet
City/State/ZIP: ?MGR - 7aQ / d R. q - 7 2.2 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: Ca pl!Iy5rc4_L 77>»)' Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
/)c, _ /s-t ,1,4 -re/ 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.
Tax map /parcel no.: 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.
5 /^ L Valuation: $ 4 , 000
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I tr TENANT Number of stories:
Name: Co /,rte t -OnRIl• Type of construction: 1— /^
Address: 3 $'c "V ti (. � -5T -r. v�Bs+� f , -" Co Occupancy groups: g
City/State/ZIP: 4 i i1/ t7 d2 1. 1 e €1
Existing:
Phone: ( ) Fax: ( )
New:
C ' APPLICANT I,J� CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: i� 4 3 rGN s 77-74c..TIA„•
Contact name: Structural plan review fee (or deposit):
Address: z O G -- 't 1.- 4.) t.,i at .. y- i 14-0 61.) 441-•--- FLS plan review fee (if applicable):
City/State/ZIP: # ( 0 - 4_ q 7 227....5, Total fees due upon application:
Phone: (ST) 3) 5 - 1 9 _ g Z -- E I Fax:: ( ) Amount received:
E -mail: A J 0 s � .{ ®6�' o , /�r. _ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
1 " cL J C r ONTRACTOR � �l Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: (ye 1 - , J o , IVAA Submit two (2) sets of roof plan with connection details
Address: / and fire department access, along with the 2010 Oregon
�� aO -7 2 .A ) L (am 11 //o 1(d� di- Solar Installation Specialty Code checklist.
City/State/ZIP: A n S / C r l 1 - -, 2z Permit fee (includes plan review
' and administrative fees): $1 80.00
Phone: ( ) I Fax: ( )
�� State surcharge (12% of permit fee): $21.60
CCB lic.:
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 nam �e l Date: 1 / _ � - 2_
6 ` * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PerrnitApp.doc 02/24/2011 440.4613T(11 /02/COM/WEB)
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description:
•
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction: 613
*Type of Use: Occupancy Load: j Oregon Specialty Code: 2D(0
SPECIFICS
Number of Stories:
1 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
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 26) dC I FEES DUE
$ (.,7, oo DC Prov Rvw, COM TI — Ping
$ L , ®X, DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 41:7 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ 51 , _ Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ 2 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: $ .0 TOTAL 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;
I ND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
L \Building \ Forms \OTC - BUP.docx 07/01/2012
i
lh Building Division
Development Code Provision Review
T i c a RD Commercial Projects - No Associated Land Use Case
Building Permit No: ! 1.A off! a -6C ? 17 ❑ Expedited Review
Plan Submittal Date: q/' b '
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 DUM'G+ WI ss at 503 - 718 - i' dLe "bt @ tigard or.gov)
Proposal) 1 ee..,,. LPr,,vc.. -..,. Se c-h...ko 2 Cam• moo*. s / hrr Z ,� _
Zoning C -- C‘ `P1) )
Permitted Use Yes - A No ❑
Land Use Required: Yes ❑ No f
Notes: 1 i;-t-1' / j k-bc — SeIvi e,a-'
a Approved ❑ Not Approved Date: 1 /i/ 20 /2-
REVISED 10/4/12