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
111
Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Tom Hochstatter DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Gavin Russell OCT 13 2021
COMPANY: CIDA CITY OF TIGARL
PHONE: 503-226-1285
BUILDING DIVISIO
EMAIL: gavinr@cidainc.com
RE: l fc I4.6 SA/OPER P OONt;s rzsRRy pp BUP2021-00074
(Site Address) (Permit Number)
Kiddie Academy-Tigard
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
3 Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. 3 Engineer's calculations. is
Other(explain):
REMARKS' Revised foundation detail for on site light poles. The concrete strength specification on S0.1 (3000 psi).
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: 1 o— ) g .24 Initials:
Fees Duj Yes ❑No Fee Description: Amount Due:
j-'r 6D J w rev'.,
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes NNo ❑ Done
Applicant Notified: ( o,, Date: /o/7(/j-i Initials: T
# CITY OF TIGARD BUILDING PERMIT
' •. . COMMUNITY DEVELOPMENT Permit#: BU P2021-00074
T l C;ARL) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/16/2021
Parcel: 2S113AB00701
Jurisdiction: Tigard
Site address: 16145 SW UPPER BOONES FERRY RD
Project: Kiddie Academy Subdivision: CIRCUIT PARTITION Lot: 2
Project Description: New 10,864 sq.ft.daycare facility with parking lot and play areas.
Contractor: ROBERTSON &OLSON CONSTRUCTION Owner:
16821 SE MCGILLVRAY BLVD#210
VANCOUVER,WA 98683-3404
PHONE: 360-699-4724 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: NEW Type of Const: VB Permit Fee-COM-New Construction 06/16/2021 $6,466.82
Occupancy Grp: E Occupancy Load: 206 12%State Surcharge-Building 06/16/2021 $776.02
Plan Review 06/02/2021 $4,203.43
Dwelling Units: Plan Review-Fire Life Safety 06/02/2021 $2,586.73
Stories: 1 Height: 23 ft Parks SDC Improvement 06/16/2021 $3,982.95
Bedrooms: Bathrooms: Parks SDC Reimbursement 06/16/2021 $726.45
Value: $1,360,000 Info Process/Archiving-Lg$2.00(over 06/16/2021 $68.00
11x17)
DC Provision Review,COM New-Bldg 06/16/2021 $205.00
Floor Areas: DC Provision Review,COM New-Ping 06/16/2021 $205.00
Total Area: 10861 Metro CET 06/16/2021 $1,632.00
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $20.852.40
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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: Holly Va,,-t.t we Permittee Signature: pf l gpplica-,,an
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 _ .Al /
Commercial FOR OFFICE USE ONLY
1 Cl of Tigard ECEIVE, Received Permit
Ill " 13125,SW Hall Blvd.,Ti ard,OR 9722, Date/By: 3 01���) ,O /'(Ll,�
g Plan Review
i Phone: 503-718-2439 Fax: 503-598-1960 a A qn Date/By: —15—�) Related Permit:Jd 11?,—(1 fU
Inspection Line: 503-639-4175 MAR 1 4 `u21 Date Ready/By: Juris:
• TIGARD P Y Y 1j / / Seepage 2 for
, Internet: www.tigard-or.gov Notified/Method: 1.0 D�11ej) , Supplemental Information
OF TIGARD lid Ce. kiev
" ` TY�a� of WQ
AC ING DWlSI REQUIRED DATA:1-AND 2-FAMILY DWELLING
,...X1 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
I, 141 ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
) ` ` CATEGORY!,OF CONSTRUCTION ! work indicated on this application.
ElI-and 2-family dwelling RI Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
`1 Job site address: 16145 SW Upper Boones Ferry Rd New dwelling area: square feet
kf City/State/ZIP: Tigard/OR/97224 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: Kiddie Academy-Tigard Covered porch area: square feet
Cross street/directions to job site: SW Upper Boones Ferry Rd Deck area: square feet
�.�� Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST a
Subdivision: Lot#: 00701 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
If,
Tax map/parcel#: 2S113AB00701 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
"'4 New 10,861 SF daycare facility with parking lot and play areas. Valuation: $ 1,360,000
�,(''7 Existing building area: n/a square feet
�+ New building area: 10,861 square feet
PROPERTY OWNER Number of stories: 1
is.Name: Kalvi LLC Type of construction: VB
Address: 8821 NW Savoy Ln. Occupancy groups: E
" Cityistate/zIP: Portland/OR/97229 Existing: n/a
ri\ N Phone:(503 )577-3822 Fax ( ) New: n/a
❑ APPLICANT CONTACT PERSON ` BUILDING PERMIT FEES*
Z'' (Please refer to fee schedule)
Business name: CIDA Inc.
Structural plan review fee(or deposit):
Contact name: Gavin Russell
t} FLS plan review fee(if applicable):
c,,�„ :� Address: 15895 SW 72nd Ave., Suite 200
`: Total fees due upon application:
City/State/ZIP: Portland/OR/97224
Phone:(503)226-1285 Fax::( )
Amount received:
"E-mail:gavinr�cidainc cOm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Tee vW\x r�Sdr 8, 0\Sp I►\ Submit two(2)sets of roof plan with connection details
N. 'za• and fire department access,along with the 2010 Oregon
1 4 Address:`to C3Z\ St 1.('1c t.-\\v(a1 7\0 Solar Installation Specialty Code checklist.
1 st w Q Permit fee includes plan review
`!1* City/State/ZIP:\)cir\cCjV V LAIN,. u�3 ( r $180.00
e ,� and administrative fees):
p' Phone:(`��G'e et— �1Z Fax:( ) o
p, h State surcharge(12/o of permit fee): $21.60
k tY CCB Lie.: Total fee due upon application: $201.60
Authorized signature: "Z:l...—,_ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Gavin Russell Date: 12/22/2020 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pemuts\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
r, City of Tigard
li
COMMUNITY DEVELOPMENT DEPARTMENT
I
TIGAKD Building Permit Review — Commercial - With Land Use
41,
Building Permit #: e,,,, ?1-,.-)a37i,
Site Address: /4;/hi oi,LI (.4 / 5 72& ,,4, Suite/Bldg#:
(ice Project Name: X rdi1,� 4 cad e
(Name of commercial business occupfing the space. If vacant,enter Spec Space.)
1 IA Planning Review
Proposal: hAlu vloj 1 Oty ie
"I
.;.k:,
, ,,,L
Verify site address/suite# exists and active in permit system.
,� River Terrace Neighborhood: ElYes ® No
[$: Land Use Case#: St)Q.Z020- Occ O2
10 Plans Match Approved Land Use:
4CJ�Site Plan t 'Landscape Plan ❑ Other:
•' "N Urban Forestry Plan K. Elevation Plan
Al vt. Building Height: Maximum Height 4S Actual Height 24
gConditions Met: X Prior to Submittal ®Prior to Permit Issuance
3 'EA Business License:
Exists: ❑ Yes Ig( No,applicant was provided a business license application
-F Public Facilities Improvement(PFI) Permit: Pr 12.p20-C)4S(o
.1 Required: Yes,applicant was notified ❑ No Applied For: tif Yes El No, stop intake
--,*.i Notes:
Approved byPlanning: ksl,
�
-`. Date: 3(301202.1
ZRevisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved III Not Approved
Revision�: ❑ Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 3/PiA�f 822--
Site Plans: # 3
Building Plans: # 3
Building Permit#: nter building— permit#above. ��
Workflow Routing: g eering P Vernut Coordinator g
Workflow Sign-off: ign-off for Planning(include notes from planning review)
Route Application Documents: g: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: „3:4'/3/
1::\Building\Fonns\BldgPermitRvw_COM_WithLandUse 111819.docx
Engineering Review 3
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
NOT Approved by Engineering: Date g s z/
Notes: / 4'//' frt- P G40/-474.4`
•
Approved by Engineering: ,See- GtiktrAuci tputh.) SlL.p Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
iConditions "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:
gSDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A 113T l IS ( Ues-L-
Tigard Trans SDC: Yes ❑ N/
Parks SDC:( NitI ix pa.) /Yes ❑ N/A rP/Cet, •
/
L�OK to Issue Permit
Approved by Permit Coordinator: �., Date: **CM
4
1:\Building\Forms\B1dgPermitRvw_COM_W ithLandU se_111819.docx
,,,„
City of Tigard
11,1 ■
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - With ; nd Use
(4 Building Permit #: Nit0-02,1-ao
Site Address: 16145 SW Upper Boones Ferry Rd Sui /Bldg#:
, .
Project Name: Kiddie Academy
(Name of commercial business occupying the space. If vacant,ente ,pee Space.)
V Piaui-link_Review
q Proposal: New daycare
t
N Verify site address/suite# exists and active in permit system.
N River Terrace Neighborhood: El Yes N No
N Land Use Case #: SDR2020-00002
IZ Plans Match Approved Land Use:
' N Site Plan Cta Landscape Plan ❑ Other:
NZCal Urban Forestry Plan Kl Elevation Plan
0
liaBuilding Height: Maximum Heigh 45 Actual Height 24
KI Ir,
Conditions Met: ® Prior to Subttal Prior to Permit Issuance
• NI Business License:
Exists: ❑ Yes ii No,applicant as provided a business license application
k VE Public Facilities Improvement (PFI) Pe ',t: PFI2020-00486
,.k Required: ® Yes,applicant was no ''ed ❑ No Applied For: $] Yes ❑ No, stop intake
Notes: Meet conditions prior to ,,ermit issuance.
Approved by Planning: ArA OetiKetrb Date: 01/05/2021
Revisions (after Building Sub - ittal only) Reviewer Date
Revision 1: ❑ Approve. E Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Appr. ed ❑ Not Approved
$trildiri Permit Submittal / ,
Original Submittal I te: /A/2e/-9Q20
Site Plans: # C.3
Building Plans: # &
Building Perm' #: [17—Enter building permit# above.
Workflow R. ting: [Planning C'Engineering [Permit Coordinator [Building
Workflow 'ign-off: l- Sign-off for Planning(include notes from planning review)
Route A..lication Documents: Building: original permit application,site plans,building plans, engineer and
beam calculations and t..st details,if applicable,etc.
Not s: /
By/ ermit Technician: y/,i///J7/ Date: //,?) .Za,
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_111819.docx
th
'neerir _Review
[J Slope at building pad: ..3
[k P I Permit#: f P/2 Y'0D 12I
V onditions "Met"prior to issuance of building permit
tyEasements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP)
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: E Yes 'No
Assess Water Quantity Fee in-lieu: ❑ Yes [ "No
LIDA Facility on lot ❑ Yes Imo'No
❑ NOT Approved by Engineering: Date
Notes:
T_ '
Approved by Engineering: Date: __2
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator-Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date: x
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 ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Forms\BldgPern»tRvw_COM_W ithLandUse_111819.docx
DocuSign Envelope ID:A84AE08C-EE86-484F-90CB-CBEB4F9192F3
City of Tigard
Transportation Development Tax (TDT)
TIGARD Notification of Fee and Pa ment Options
Please sign and return prior to building permit issuance.
This advises you that the TDT for this project is as shown below and outlines the payment options that may
be available to you. This form is to be signed and submitted prior to issuance of a building permit.
City of Tigard
Date: 4/8/2021 Site Address: 16145 SW Upper Boones Ferry Rd
Project Kiddie Academy Land Use Case BUP2021-00074
Name: or Permit #:
Tax 2S113AB00701 TDT Amount: $191,486
Lot#:
This constitutes my request to use the TDT payment option or combination of options I have selected
below. [This selection can be changed up to the time a building permit is issued.] I realize that TDT charges are due
and payable at the time a building permit is issued unless those charges are deferred or are financed through
installment payments.
❑ Cash, Check, or Credit Card,payment due at building permit issuance.
Deferral until Occupancy,payment due before issuance of an occupancy permit.
Payment of the TDT may be deferred until issuance of the occupancy permit if the TDT is greater than the
amount for a single family residence. In requesting this option I understand that any deferred 1'DT must be
paid prior to issuance of a Certificate of Occupancy. I further understand that the amount of 1'DT due on
deferred obligations shall be the amount in effect at the time of issuance of the building permit. For a deferral
request to be accepted both the Property Owner and the Developer must sign this request.
❑ Credit Voucher (for developer-built required public improvements, subject to approval,
completion, and acceptance of creditable improvements.)
PLEASE NOTE: TDT Credits must be redeemed at the time TDT Payment is due,either at the time the
building permit is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to
claim TDT Credits be sure the improvements, any creditable payments, and your Request for Credits is
complete either before your building permit is to be issued or,if payment is deferred,before you request an
occupancy permit. No refund of TDT Payments will be made if Credits are submitted more than 30 days after
issuance of the relevant building or occupancy permit.
❑ "Bancroft" or Installment Payments (separate application required.)
c—DocuSigned by: DocuSigned by:
er'aleaMar kurtyrinuA,
‘—F2114P7130E8114.P3, 136148708E23116...
PROPERTY OWNER DEVELOPER
4/13/2021 4/13/2021
DATE: DATE:
DocuSign Envelope ID:A84AEO8C-EE86-4B4F-90CB-CBEB4F9192F3
City of Tigard
Transportation System Development Charge (TSDC)
TIGARD Notification of Fee and Payment Options
This advises you that the total TSDC for this project is as shown below and outlines the payment options that may be
available to you. This total includes charges for TSDC-Improvement,TSDC-Reimbursement, and TSDC-River
Terrace,if relevant.
This form is to be signed and submitted no later than the time of building permit application or, if no
building permit is required, then upon land use application (TMC 3.24.080, as amended by Ordinance No.
20-02).
City of Tigard
Date: 4/8/2021 Site Address: 16145 SW Upper Boones Ferry Rd
Project Kiddie Academy Land Use Case or BUP2021-00074
Name: Permit #:
Tax 2S113AB00701 Total TSDC $153,188.80
Lot#: Amount*:
*Total TSDC amount is the sum of$144,823.60 for TSDC-Improvement and$8,365.20 for TSDC-Reimbursement.
This constitutes my request to use the TSDC payment option or combination of options I have selected below. [This
selection can be changed up to the time a building permit is issued.] I realize that TSDC charges are due and payable at the lime
a building permit is issued unless those charges are Deferred or are financed through Installment Payments. [Please
address questions about TSDC Payment Options to Permit Coordinator, 503-718-2426.]
❑ Cash, Check, or Credit Card,payment due at building permit issuance.
EE Deferral until Occupancy,payment due before issuance of an occupancy permit.
Payment of the TSDC may be deferred until issuance of the occupancy permit. In requesting this option,I understand
that any deferred TSDC must be paid prior to issuance of a Certificate of Occupancy or final inspection. For a deferral
request to be accepted both the Property Owner and the Developer must sign this request.
❑ Credit Voucher for developer-built required public improvements, subject to approval, completion,and
acceptance of creditable improvements.)
NOTE: TSDC Credits must be redeemed at the time TSDC Payment is due,either at the time the building permit
is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to claim TSDC Credits be
sure the improvements,any creditable payments,and your Request for Credits is complete either before your building
permit is to be issued or,if payment is deferred,before you request an occupancy permit. No refund of TSDC Payments
will be made if Credits are submitted more than 30 days after issuance of the relevant building or occupancy permit.
is
❑ "Bancroft" or Installment Payments (separate application required.)
—DocuSigned by: DocuSigned by:
[72rediatar
—F7R6FCFAQFAR4F7 1 354487D8F43 415...
PROPERTY OWNER DEVELOPER
4,/16941 4/13/2021
DATE: DATE:
1:\Community Development\Permit Coordinator\SDC Forms\TSDC Combination Payment Option Form 112718 AMS
Parks Estimate Kiddie Academy 3/22/2021
16145 SW Upper Boones Ferry Rd AML
ALL PARKS RATES EFFECTIVE 7/1/18
Q Yes
Project is in River Terrace ? ® No
Note: All Neigh-Imp# Units entries=0 if project is in River Terrace;
All Neigh-RT# Units entries=0 if project is elsewhere in the city.
Former Use
Rate Type Use# ITE Code # Units Rate Parks Amount Description
Parks-Imp 1 0 $477 $0 Vacant
Parks-Reim 1 0 $87 $0 0
Neigh-Imp 1 0 $0 $0
Neigh-RT 1 $0 0
2 $0
Total Parks Former Uses $0
Proposed Use
Use# ITE Code # Units Rate Parks Amount Description
Parks-Imp 1 565 8.35 $477 $3,982.95 Day Care Center
Parks-Reim 1 565 8.35 $87 $726.45 10,861SF
Neigh-Imp 1 565 8.35 $0 $0
Neigh-RT 1 $0
Parks-Imp 2 $0
Parks-Reim 2 $0 0
Neigh-Imp 2 $0 0
Neigh-RT 2 $0 0
Total Parks Outside RT Proposed Uses $4,709.40
Less: Total Parks Outside RT Former Uses $0.00
Total All Parks Outside RT Net Increase $4,709.40
Total Parks RT Proposed Uses $0
Less: Total Parks RT Former Uses $0
Total All Parks RT Net Increase $0
Total Parks-Imp $3,983
Total Parks-Reim $726
Total Neigh-Imp $0 No Neigh-Imp
Total Neigh-RT $0 No Neigh-RT
For Non-Residential Calculations:
Prior Use: Vacant
Proposed Use: Day Care Center=1300sf/EE;10861/1300=8.35EEs.
Parks-Imp=Parks Improvement,Citywide including River Terrace
Parks-Reim=Parks Reimbursement,Citywide including River Terrace
Neigh-Imp=Neighborhood Parks Improvement Outside River Terrace
Neigh-RT=Neighborhood Parks Improvement Inside River Terrace
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Branden Taggart
From: Branden Taggart
Sent: Tuesday, June 15, 2021 5:15 PM
To: Gavin Russell
Subject: Kiddie Academy Building Permit: BUP2021-00074 - 16145 SW Upper Boones Ferry Rd.
Attachments: Invoice.pdf
i
i Hello Gavin,
The Buildingpermit for Kiddie Academyis readyto issue now. The balance due is 14 062.24 and I have attached an
$ a
invoice above for you to reference. These fees can be paid online now at https://aca-
prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number BUP2021-00074 under the Building
tab. There is a 3%service fee for credit cards, but e-checks do not have a service fee.
Once paid, please email the Permit Technicians at TigardBuildingPermits@tigard-or.gov so that we may issue this
permit and make it available for pick up. Additionally, we will need to receive contractor license information prior to
the issuance of this permit. Please let me know if you have questions.
Thank you,
Branden Taggart
IlN , q City of Tigard
i-' Senior Permit Technician
Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or,gov
1