Permit CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit#: SIT2020-00009
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/3/2021
Parcel: 2S102CB00100
Jurisdiction: Tigard
Site address: 12850 SW GRANT AVE
Project: Broadway Rose Theatre Subdivision: NORTH TIGARDVILLE ADDITION Lot: 43
Project Description: Engineered aggregate pier system for East and West additions.
Contractor: GEOTECH FOUNDATION COMPANY WEST Owner: TIGARD-TUALATIN SCHOOL
214 SE WALNUT ST DISTRICT 23J
HILLSBORO, OR 97123 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-640-1340 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 04/29/2021 $1,056.37
Plan Review 04/29/2021 $686.64
Type of Use: COM 12%State Surcharge-Building 04/29/2021 $126.76
Class of Work: ADD Info Process/Archiving-Lg$2.00(over 04/29/2021 $4.00
11x17)
Project Valuation: $155,000.00 Info Process/Archiving-Sm$0.50(up to 04/29/2021 $10.50
11x17)
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: 1 cu.yd.
Impervious Surface: 0 sq.ft.
Engineered Fill: No Soil Report Required: No
Paving: No Grading: No
Landscaping: No Site Prep: No
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: No
Fence: No
Total $1,884.27I
Required Items and Reports(Conditions)
1 Piles/Caissons
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
5033.2323322.1987 or 1.800.332.2344. /� y
Issued By: GJ' 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 RECEIVE FOR OFFICE USE ONLY
City of Tigard Date/B // fiij Permit No.:
/�
lir13125 SW Hall Blvd.,Tigard,OR 97223 MAR 19 2020 Plan Revie e t+a� /J Related Perm t:g{�`✓ v!
Phone: 503-718-2439 Fax: 503-598-1960 Date/By: 7 '- rF/'r'� /®J
Inspection Line: 503-6394175 Date ReadyBy: / ) Jrt,1 /�_� kris: See Page 2 for
TIGARD CITY OF TIGARD Notified/Method.`1l pc7f'2` 87f ,"2,j Supplemental loformadou
Internet: www.tigard-or.gov RI ill nIme,DIUis(nr _ If
1 '''�1
TYPE OF WORK DATA:I-AND 2-FAMILY DWELLING
❑New construction ❑ Demolition Pe fees*are based on the value of the work performed.
Indica e value(rounded to the nearest dollar)of all
•Addition/alteration/replacement ❑Other: DEFERRED SUBMITTAL equipmen aterials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicat on this application.
Valuation: $
❑ t-and 2-family dwelling I.Commercial/industrial
Number of bedroo
❑Accessory building
❑Multi-family
❑Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12850 SW Grant Ave New dwelling area: quare feet
City/State/ZIP: Tigard/OR/97223 Garage/carport area: sq feet
Suite/bldg./apt.#: Project name: Broadway Rose Theatre Addition Covered porch area: square
Cross street/directions to job site: Hwy 99W/SW Pacific Hwy to SW Walnut St to SW Grant Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot 4: 8700 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: WCTM 2S102CB00100 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 1. • I j1v0o,6.--
Installation of engineered aggregate pier system(geopier). ���
Existing building area: 10,981 square feet
New building area: 4,164 square feet 8
D PROPERTY OWNER •TENANT Number of stones: 1
Name: Broadway Rose Theatre Attn:Sharon Maroney+Dan Murphy Type of construction: VA
Address: 12850 SW Grant Ave Occupancy groups:
City/State/ZIP: Tigard/OR/97223 Existing: A-1,B,E
Phone:( 503)603.9862 Fax:( 503 )670.8512 New: A-1,F-1, B
IN APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee sekedelr)
Business name: B&G Builders Attn:Greg Capen Structural plan review fee(or deposit):
Contact name: Greg Capen
FLS plan review fee(if applicable):
Address: 4213 NE Alberta Street
Total fees due upon application:
City/State/ZIP: Portland/OR/97218
Amount received:
Phone:( 503)839.4030 Fax::( 1 -
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: greg@bngbuilders.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Geotech Foundation Co Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 214 SE Walnut Street Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP: Hillsboro,OR 97123 and administrative fees):
Phone:(503 )640-1340 Fax:( ) State surcharge(12%of permit fee):
CCB Lic.: 146399 it i'3' Total fee due upon application:
Authorized signature: Greg Capen This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name: lire
g Ca Pen Date: 3/18/2020 Service Board.
I:1Building`Permits\BUP_COM_PettnitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
a
•
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
;11,1 Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
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 percent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%bather 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): $
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.03/05/2019
City of Tigard
III 4 COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial -With Land Use
TIGARD ...mom
Building Permit #: _ ___. 01,
Site Address: i 2(691) ,c\nl Gr tv + AVe, Suite/Bldg#:
Project Name: 122YDG WA -f i Rose I V K-�/
(Name of commercial b siness occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: S-tYUtC*k. l ro,,Q - or dcdiovn 1' nv1 M
7"Verify site address/suite# exists and active in permit system. `
O. River Terrace Neighborhood: ❑ Yes 14 No
g Land Use Case#: M k D OV 2-42i
XPlans Match Approved Land Use:
Bis Site Plan MA-Landscape Plan ❑ Other:
-I Trban Forestry Plan 0 Elevation Plan
/I :uilding Height: Maximum Height ,,_ . Height
►: Conditions Met 4 Prior to Submittal ❑ nor to Permit Issuance
X,Business License:
Exists: ' Yes 0 No,applicant was provided a business license application
y Public Facilities Improvement(PFI)Permit:
Required: Yes,applicant was notified 0 No Applied For: X Yes 0 No,stop intake
Notes: Do noi- (Sia..1.e l tnth\ CEYY�-t+\C .e\S
Approved by Planning: goLs— Date: 4/i j/2.-4(1)
Revisions (after Building Submittal Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: J f/ j
Site Plans: #
Building Plans: # _
Building Permit#: nter building permit ve. �., ^ ..�
Workflow Routing: anning ngineering ermit Coordinator Ld � g
Workflow Sign-off: '12.-Sriign-off for Planning(include notes from planning review)
Route Application Documents: tilling: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: ' [1fY �t �a rri- Gt/c�yLl �4- �LCc).p / ',,•F ' .
By Permit Technician: 7,70/
Date:
I:\BuildingWorms\BldgPertnitRvw_COM_WithLandllse_111819.docx
Engineering Review
ISI Slope at building pad: 3'%
v PFI Permit#: Zoi — 00 1-15S
Conditions "Met"prior to issuance of building permit
!" Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP)
JRI Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 51 Yes E No
Assess Water Quantity Fee in-lieu: % Yes f No tot KG�U(Ko. l
LIDA Facility on lot: 7 Yes /❑ No
❑ NOT Approved by Engineering: I Date
Notes:
n
Approved by Engineering: c5redy $ Date: 7-12 - Z,p ye>
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: D Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
��C❑//J Approved, NOT Released: VIAOv>/„ WI Orval-h&c t-iii�pphxfaS Date: 9131'7p
Notes: l
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes A N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
4 OK to Issue Permit i.,l D Pr
Approved by Permit Coordinator: A-- Date: 4i wl2,02
I:\Building Toms\B1dgPennitRvw_COM_WithlandUse 1118I9.docx