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Permit Support Document CITY OF TIGARD BUILDING PERMIT i COMMUNITY DEVELOPMENT Permit#: BUP2021-00102 Date Issued: 7/20/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135BA00102 Jurisdiction: Tigard Site address: 10120 SW WASHINGTON SQUARE RD Project: Sim Golf -TI Subdivision: OAKBURG Lot: 9 Project Description: TI to create a Sin Golf play simulator space w/bar and food.Proposed project is to combine two(E)spaces into one address at 10120 SW Washington Square Rd. Contractor: BNK CONSTRUCTION INC Owner: PPR SQUARE TOO LLC 45 82ND DR, SUITE 53B BY MACERICH RET GLADSTONE, OR 97027 PO BOX 4085 SANTA MONICA, CA 90411 PHONE: 503-557-0866 PHONE: FAX: 503-557-1085 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/30/2021 $2,917.95 Occupancy Grp: A-2 Occupancy Load: 114 Decmolition 12/o State Surcharge-Building 06/30/2021 $350.15 Dwelling Units: 0 Plan Review 06/30/2021 $1,896.67 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 06/30/2021 $410.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/30/2021 $1,167.18 Value: $400,000 Info Process/Archiving-Lg$2.00(over 06/30/2021 $38.00 11x17) Info Process/Archiving-Sm$0.50(up to 06/30/2021 $10.50 Floor Areas: 11x17) Total Area: 0 Metro CET 06/30/2021 $480.00 Accessory Struct: 0 Tigard CET-Non-Residential-Admin 06/30/2021 $160.00 Basement: 0 Tigard CET-Non-Residential-AH 06/30/2021 $3,840.00 Carport: 0 Address Fee-per lot/suite(up to first 20) 06/30/2021 $50.00 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $11,320.45 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 m obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ��i Permittee Signature: �Cr'� �y� '6 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 13— Commercial RECEIVED FOR OFFICE USE ONLY City of Tigard RceeB� N ��� . y: (/`t ZS/�(JL-f) 4fie Permit No.: P�L/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie Phone: 503-718-2439 Fax: 503-598-1960iIZ ?� DateBy: — c'o� Related Permit TIGARD Inspection Line: 503-6394175 Date Ready/By: �uq� ® see Page 2 for e Internet: www.tigard-or.gov CITY OF TIGARD Notifi /Method: /.1/ i Ile" Supplemental Information BUILDING DIVISION TYPE OF WORK RE DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Pe '. fees*are based on the value of the work perfor .-d. 1 Indicat- e value(rounded to the nearest dollar)of ®Addition/alteration/replacement ❑Other: equipment, i .terials,labor,overhead,and the pr, it for the CATEGORY OF CONSTRUCTION work indica on this application. ❑ 1-and 2-family dwelling Valuation: $ ®Commerciallindustrial • ❑Accessory building ❑Multi-family Number of bedroo ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10120 SW Washington SQ RD, Suite A07 New dwelling at-•• quare feet City/State/ZIP: Portland, OR 97223 Garage/cargo• area: sq .,- feet Suite/bldg./apt.#: Suite A07 Project name: Sim Golf T.I. Covered.orch area: square fe- Cross street/directions to job site: WA Square II D: . area: square feet •ther structure area: square feet I REQUIRED DATA:CO1y L-JSE CHECKLIST Subdivision: Lot#: Permit fees*are 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. enant Improvement to create new Sim Golf play simulator space w/bar valuation: S 400,000 and food. Proposed project is to combine two (E)spaces into one Existing building area: 6300 square feet address at 10120 SW Washington Sq Rd. - New building area: - square feet 0 PROPERTY OWNER ® TENANT Number of stories: 1 Story Name: Nick Kassab Type of construction: V-B Address: 10120 SW Washington SQ RD, Suite A0- Occupancy groups: A-2 City/State/ZIP: Portland, OR 97223 Existing: A-2 Phone:( ) 503.880.8400 Fax:( ) New: A-2 IN APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: ORANGEWALLstudios Architecture & Planning . Structural plan review fee(or deposit): Contact name: Jeff Erwin Architect Address: FLS plan review fee(if applicable): 3450 N Williams, Suite 07 Total fees due upon application: . City/State/ZIP: Portland, OR 97227 Phone:( ) 503 998 9434 Fax: :( ) Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: jeffe@orangewallstudios.com CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: BNK Construction Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 45 82nd Dr, Suite 53B Solar Installation Specialty Code checklist. City/State/ZIP: Gladstone, OR 97027 Permit fee(includes plan review $180.00 and administrative fees): Phone:( ) 503-557-0866 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB Lic.: 0107555 : j 171 Zy 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: Jeff Erwin Date: 4/14/21 * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BIJP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(I l/02/COM/WEB) RECEIVED ii A 21 7a rpli ,t City of Tigard BCITY OF TIGAD UILDING D V SRON Address and Commercial Suite Application TIGA `" ....... -: ..,. Addresses and suite numbers are assigned by the City of Tigard. Once a new address/suite is issued, the city notifies 911, USPS,Washington County and various utility providers.This does not change any account information or replace a"change of address" form. Directions To Submit Form ► Fill in form / Via email:OscarC@tigard-or.gov ► Attach Site Map or Suite Layout Map (see below) / In person: Permit Center Building Counter ► Fees will be charged when new address is assigned (13125 SIV Had Blvd.'ri OR) ► Per address $50 Oscar Contreras,Public Works Department ► Per suite S50 OscarC@tigard-or.gov ► Suite or address to be retired— no charge 503-718-2687 ► Re-activating suites in our system—no charge REQUIRED Attach Site Map or Suite Layout Map ► For Site Maps—show location of building on lot, front entrance and location of driveway along street. ► For Suite Maps—show the locations of current active suites,new suites and suites to be retired. Site Information 10120 SW Washington Square Rd, Portland OR 97223, A06 and AO7A Parcel Number or Current Address: New: 10120 SW Washington Square Rd, Portland OR 97223, A07 0 Residential Property—OR— ® Commercial Property Number of New Addresses: Building Name (if applicable): Washington Square Too Is this property currently in the land use process (i.e. partition,site development review)? 0 Yes ® No Contact Information *Please sketch the building layout with address Property Management Company (if applicable): locations: Macerich Contact Person: Maria Halstead, Property Manager ■ 1r Phone: 503-639-8865 F,maihMaria.Halstead@macerich.com ,� Address ,.„,„,c Wa'kvAGCie FADViC.,a'.Form For molt itOrmatiod.please its/I uww.lgan Or.. , City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT TIGnRn Building Permit Review — Commercial - No Land Use Building Permit #: `50 P2021 -0 O't O 2- Site Address: 10120 SW Washington Sq Rd Suite/Bldg#: Project Name: Sim Golf (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: T.I new tenant Existing Business Activity: Fast food eating & drinking establishment Proposed Business Activity: Indoor entertainment V rify site address/suite#exists and active in permit s'sstem. 61° .ver Terrace Neighborhood: ❑ Yes El No ❑o Zoning: MUC '�,� 0 Permitted Use: U Yes U No U Spec Space QConfirm no land use required. ElBusiness License: Exists: El Yes ❑ No,applicant was provided a business license application Notes: Approved by Planning: Date: 4/22/21 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: Site Plans: # 3 Building Plans: # ,3 Building Permit#: -Enter building ermit# above. Workflow Routing: ©"Planning Permit Coordinator Er3uilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ��I Date: / ZO?// 1:\Building\Forms\BldgPermitRvw_COM_NoLand se_111819.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 Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes p N/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes N/A OK to Issue Permit Approved by Permit Coordinator: kp,)4A/` Date: CJI 312024 I:Building\Forms\BldgPermitRvwCOM_NoLandUse1I 1819.docx I