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Permit FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT !14 _ " Transmittal Letter T i G A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATEnwn DEPT: BUILDING DIVISION JUN 2 3 2021 FROM: A N,D2E 0 / OCkE CITY OF TIGARD COMPANY: 4,, eEtt/ A,,, CP,,lsTu c-T N BUILDING DIVISION By. �'I.CIA- PHONE: �5b 3 7t 3 7S 1 EMAIL: ./�`�W10Dr. !taliL sJ+ @ `'�YI'lct,t ! . Cow RE: C 50 bc1T- /j, )13U.? 2o2 I 000'70(Site Address) (Permit Number) tt5 x./ift4r©e_s (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Z Revisions: 1L00(L Qt.A Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: AFTek DE,v -rye 1 u r Lo D LAJEeS ter—W0 7'0 4 bb i9- ecsrie.cofil To THE rev Fr6-U 12-Es S Pi'C 5", 1r11y5. 5 i Nc it/ill) tLGbe- PLPro , Alo 5iizgcrLL e.4L CH4116-e FOR OFFICE USE ONLY Rout to Permit Technician: Date: 7 f-1 Initials: Fees Due: Yes ❑No Fee Description: Amount Du . p-J r p �% l'—<\/Thke., $ $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes No ❑ Done Applicant Notified: Date: Initials: CITY OF TIGARD BUILDING PERMIT I COMMUNITY DEVELOPMENT Permit#: BUP2021-00090 T t 1 A R 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/10/2021 Parcel: 2S 101 AD02800 Jurisdiction: Tigard Site address: 12665 SW 69TH AVE Project: US Investors Subdivision: WEST PORTLAND HEIGHTS Lot: 9 Project Description: Reconfiguring office space Contractor: ANDREW MOORE Owner: OMEGA ALPHA LLC 29965 S VIRGIL RD 760 NE 23RD AVE COLTON, OR 97017 CANBY, OR 97013 PHONE: 503-703-7570 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 05/05/2021 $955.35 Occupancy Grp: B Occupancy Load: 67 Demolition 12%State Surcharge-Building 05/05/2021 $114.64 Dwelling Units: 0 Plan Review Stories: 0 Height: 0 ft 04/15/2021 $620.98 DC Provision Review,COM TI-Ping 05/05/2021 8257.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 05/05/2021 382.14 Value: $80,000 $$14 Info Process/Archiving-Lg$2.00(over 05/05/2021 $14.0000 11x17) Tigard CET-Non-Residential-Admin 05/05/2021 $32.00 Floor Areas: Tigard CET-Non-Residential-AH 05/05/2021 $768.00 Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $3,144.11 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: T-1o77y VoLo.9DPl weito D rvAppL%c a,tw-n 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 /1 0_9 15 2 Commercial RECEIVED ED FOR OIll( I: tSI:0y1.1 Cityof Tigard I �J LL.... Y VV Received ''II 5 fit' / -41 B pzo2.i_00 7O g i DateBy 07 I5 LLU Permit No.:GJ�.t LV l/�/ `� IIIII • 13125 SW Hall Blvd.,Tigard,OR 97223 APR1 J ':.Ji Plan Revie C ' Phone: 503-718-2439 Fax: 503-598-1960 � DateBy. 7 Related Permit. TIGARD Inspection Line: 503-639-4175 CITY OF TIGARD Date Ready/By: .!1uri ® See Page 2for Internet: www.tigard-or.gov N•. ed/Method: ye�,� ��� r Supplemental lnformafion 3UILDING DIVISION, / . , 117/w_. TYPE OF WORK ' QUIRED DATA:1-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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ 1-and 2-family dwelling Commercial/industrial ElAccessory building El Multi-familyNumber of bedrooms: ElMaster builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /Z4,66- 5 iiii be! TN Ave New dwelling area: square feet City/State/ZIP: --7-L ARE" /SR q7Z2.-3 Garage/carport area: square feet Suite/bldg./apt.#: Project name: U5 AI buts r ozs 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: I I,ot#: Permit fees*arc based on the value of the work performed. Tax map/parcel#: 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. i ccoiVi'4&M t u2G OFFZG SPACE Valuation: $ 80, 000 Existing building area: '1/square feet New building area: 0 / square fee`t� 0 PROPERTY OWNER 0 TENANT Number of stories: 2. Name: CyClistaLeAtier'1 Type of construction: / o L Address: I /��qn'1 ) Vtl Occupancy groups: , City/Stattee//ZIP: T��y/'�i►(AI'U ,t IDC Cif 2GeJ ( f I Existing: Phone:(56 .2TT[\. L_ l7- Fax:(, 1j)) '03-01 o New: .APPLICANT 0,CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: AAf oft le MoaRe C Al STie CTX� t1 Structural plan review fee(or deposit): (,20-90 - — Contact name: AA)402e u f Ationce Address: ZCf ,5 S j e.6.,.LL FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP: tee`U,v' (lg. esf 70 / 2 Amount received: Phone:($,?) r Z0 3 ,�s-70 Fax: :( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: al,11 occe b 1 in.t- Q, j ill,„,,, r , Co Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photovoltaic Solar Panel System. Business name: Au aK6 k.( 4/41.4 .C,5 F-4)C-�Z Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 2,7 6 S S VC e&Z 1_ i4) Solar Installation Specialty Code checklist. City/State/ZIP: (6`•T-O Al 0' ,2- 616� Permit fee(includes plan review $180.00 Phone:(,Sp3) 3 75- 70 Fax:( ) and administrative fees): State surcharge(12%of permit fee): $21.60 CCB Lie.: //0 � Lj`J/l2Z 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: A,ii i2e vf/ /4060,24c Date: /S/ ,0Z i * Fee methodology set by Tri-County Building Industry /` Service Board. I:\Building\Permits1BUP_COM_PermitAppdoc Rev.04/21/2014 440-4613T(1 I/02/COM/WEB) NCOMMCity of Tigard UNITY DEVELOPMENT DEPARTMENT .4 TIGARD Building Permit Review — Commercial - No Land Use Building Permit #: 5UP2.02.1 -000CJ0 Site Address: 12665 SW 69th Ave Suite/Bldg#: Project Name: US Investors (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: T.I. new tenant Existing Business Activity: Office Proposed Business Activity: Office ell erify site address/suite#exists and active in permit system. N. ''vet Terrace Neighborhood: ❑ Yes Li No ff zoning: TMU ElPermitted Use: U Yes U No U Spec Space ❑ Confirm no land use required. QBusiness License: Exists: ❑ Yes ❑r No, applicant was provided a business license application Notes: Approved by Planning: �_ Date: 4/15/21 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: Q /572021 Site Plans: # 3 Building Plans: #ry 3 Building Permit#: CI Enter B building permit# above. n� Workflow Routing. ❑'Planning ❑ Permit Coordinator L� uilding Workflow Sign-off: ❑",Sign-off for Planning(include notes from planning review) Route Application Documents: ID-Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: / "/By Permit Technician: Date: D7` /,id2/ 1:1B uilding\Forms1B l dgPermitRvw_COM_NoLandUse_I 11819.docx Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Appli'ant: Revision Notice 2: Date Sent to Ap. cant: Revision Notice 3: Date Sent to ' .plicant: ❑ SDC Fees Entered: Wash Co T 4 ns Dev Tax: ❑ Yes ❑ N/A Tigard Tr,ns SDC: ❑ Yes ❑ N/A Parks S C: ❑ Yes ❑ N/A ❑ OK to Issue Permit Approved by Permit Coordi .tor: Date: :1Building\Forms\BldgPermitRvw_COM_NoLandUse_l 11819.docx All