Permit (242) CITY OF TIGARD BUILDING PERMIT
F' COMMUNITY DEVELOPMENT Permit #: BUP2013 00022
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2013
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY A
Project: Anytime Fitness Subdivision: 1994 -028 PARTITION PLAT Lot: 2
Project Description: Demo in preparation for interior alteration
Contractor: GREEN DECONSTRUCTION INC Owner: SN PROPERTIES PARTNERSHIP
2519 NE ARGYLE ST, SUITE B 1121 SW SALMON ST
PORTLAND, OR 97242 PORTLAND, OR 97205
PHONE: 503 - 710 -0753 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee - Additions, Alterations, 01/28/2013 $301.85
Demolition
Occupancy Grp: Occupancy Load: 12% State Surcharge - Building 01/28/2013 $36.22
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $15,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $338.07
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. ENTION: Orego -w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 - 001 -0010 through OAR 952 -0' - 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800, _ .2
• 4.
Is ed By: ' P % i � 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.
X
Building Permit Applicat + ,., I CovED
Commercial FOR OFFICE USE ONLY
JAN 2 8 2013 Received
City of Tigard DateB : � ; �� Permit No.: . id 0 ' �D� v-
li
13125 SW Hall Blvd., Tigard, OR r l ll�'P1Il1J Plan Review '
® Phone: 503 -718 -2439 Fax: 50 - - j Date/By: Other Permit
"ill GA <R Inspection Line: 503 -639 -4175 I LUIIVG DIVISION Date Ready/By: Juri s: ® See Page 2 for
o Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK . • REQUIRED DATA: I- AND 2- FAMILY DWELLING •
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value ( romded 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 Valuation: $
❑ Commercial /industrial
❑ Accessory building El Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 1? 0 S 14 / PA- c ! k= - ( 14 ( 7 a� 14-Al 1 New dwelling area: square feet
City /State /ZIP: t / r4 ,Lf 0 � q 7 a , �j Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 4,.. y I L( „? t Al 7 s J 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
Subdivision: 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.
.4�rv.0 t ... t "`--'C �.p.( o✓t ( t�✓L Go"K Valuation: $ 5-woe, � �
Y Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: 4_-y /r ,.z t:• ,L,, f Type of construction:
Address: (a /' / t A4 it / r Uo ,4 ,/ ( Occupancy groups:
City /State /ZIP: 1 44_ f ./( „�, /1 4/ SS 0 3 3 Existing:
Phone: 6 c ) y 3g ..... sr- d ej Fax: ( ) New:
❑ APPLICANT ( ❑ CONTACT PERSON BUILDING PERMIT FEES* ■
(Please refer to fee schedule)
Business name:
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address:
Total fees due upon application:
City /State /ZIP:
Phone: ( ) Fax:: ( ) Amount received: 3%.0 7
E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial : d residential prescriptive installation of
CONTRACTOR roof -top mount =. PhotoVoltaic Solar Panel Syste
Business name: 6 n C r / rV ( , -5 �'t L � / it Submit two (2) se . of roof plan with connecti etails
r l f and fire department .- cess, along with the : 0 Oregon
J
D Address: 4 A/ A— / y �/ /c 5 � ,, )LC 15 Solar Installation Spe "Illy Code chec .
7 F S
City /State /ZIP: 0 P L 4 LA. 4 lei D/ i « 7.. �/ 2 Permit fee (inclur • plan rev' $180.00
and administ :liv' ees):
Phone: (5031 7 0 —D 7 5- 3 F ( ) State surcharge (12% o .e 't fee): $21.60
(9
CCB lic.: 1 6 LR c �7 - (I, Total fee due , pon applicatio • $201.60
Authorized signature: . [ �� This permit application expires if a perm' of obtained
? within 180 days after it has been accepted as complete.
Print name: l j, (h e / , Date: 76 �j Fee methodology set by Tri -County Building Industry
/ Service Board.
I:\ Building \Permits\BUP_COM_PermitApp.doc Rev. 12/11/2012 440 -4613T(11 /02 /COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
•TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty -five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide. under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $ •
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
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I: \Buil ding \Permits \BUP_COM_PermitApp.doc Rev. 12/11/2012