Permit II illCITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2021-00165
Date Issued: 8/2/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOON ES FERRY RD 200
Project: Amica Mutual Insurance Company Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Interior tenant improvement for new tenant to include minor demo of existing partitions,new private offices,
conference room and training room. Re-use existing conference room,open office areas and staff break room.
Contractor: BUILT ENVIRONMENTS NORTHWEST Owner: G&S FC LLC
PO BOX 160 16083 SW UPPER BOONES FERRY RD,
GLADSTONE, OR 97027 STE 120
TIGARD, OR 97224
PHONE: 503-650-4084 PHONE:
FAX: 503-650-4104
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 07/29/2021 $1,709.95
Occupancy Grp: B Occupancy Load: 179 Demolition
12%State Surcharge-Building 07/29/2021 $205.19
Dwelling Units: 0 Plan Review 07/13/2021 $1,111.47
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 07/29/2021 $434.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 07/29/2021 $683.98
Value: $200,000 Info Process/Archiving-Lg$2.00(over 07/29/2021 $24.00
11x17)
Metro CET 07/29/2021 $240.00
Floor Areas: Tigard CET-Non-Residential-Admin 07/29/2021 $80.00
Total Area: 0 Tigard CET-Non-Residential-AH 07/29/2021 $1,920.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $6,408.59
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Holly Van'LVe4 Vtiefie Permittee Signature: 0V1 Applf carbon
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit ApplicationRECElVED (i lr )l -5
• Commercial JUN 2 5 2021 FOR OFFICE:USE ONLY
Cityof Tigard Received 7 2 1d �/� S
g tTY OF TLGARD Date/By: /`"7 Permit NSate9;C 21.d? ik
111 " 13125 SW Hall Blvd.,Tigard,OR 97223� Plan Review
S Phone: 503-718-2439 Fax: 503-598B43ILDING DIVISION Date/By: /—a$—ebL 1 r, Related Permit:
T 1 Cr A R D Inspection Line: 503-639-4175 Date Ready/By: // luris: ® Sec Page 2 for
Internet: www.tigard-or.gov �otified/Method: CV /d/ _ Supplemental Information
•
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 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 0 Commercial/industrial
Number of bedrooms:
ElAccessory building El Multi-family❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16083 SW Upper Boones Ferry Rd New dwelling area: square feet
City/State/ZIP: Tigard, Oregon 97224 Garage/carport area: square feet
^ Suite/bldg./apt.#:200 Project name:Amica Mutual Insurance Co. Office T.I. Covered porch area: square feet
1 Cross street/directions to job site: Deck area: square feet
SW Upper Boones Ferry Rd&SW 72nd Ave. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Cloo Subdivision: I Lot#: W248495 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the
Ai DESCRIPTION OF WORK work indicated on this application.
yInterior tenant improvement: minor demo of existing interior partitions. New private Valuation: $ 200,000
Qoffices, small conference room, and training room. Re-use existing conference Existing building area: 46,963 square feet
cl. room, open office areas,and staff break room. New building area: 0 square feet
0 PROPERTY OWNER 0 TENANT Number of stories: 3
Name: Parkland Development, LLC-Sejin Kim Type of construction: II-B
Address: 16083 SW Upper Boones Ferry Rd, Suite 120 Occupancy groups:
City/State/ZIP:Tigard,Oregon 97224 Existing: B
Phone:( 503) 639.0108 ext. 100 Fax:( ) New: B
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: LRS Architects �/
Structural plan review fee(or deposit): //l, / 7Contact name: Peter Kim
FLS plan review fee(if applicable):
Address: 720 NW Davis St, Suite 300
Total fees due upon application:
City/State/ZIP: Portland, Oregon 97209
Amount received:
Phone:( 503 )221.1121 Fax: :( 503) 221.2077
E-mail: pkim@Irsarchitects.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Built Environments Northwest Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 135 East Hereford St, Solar Installation Specialty Code checklist.
City/State/ZIP: Gladstone,Oregon 97027 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503 )650.4086 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: 79970 3 //7/2 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.
/' * Fee methodology set by Tri-County Building Industry
Print name: Peter Kim Date: 06.25.2021
Service Board.
I:\Building\Permits\BUP_COM_Permit App.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
a
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
N 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 1 $ 200,000
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 50,000
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): $
The building is fully accessible.
No further ADA upgrade is required
I:\Building\Permits\BUP_COM Pern itApp.doc Rev.03/05/2019
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - No Land Use
TIGARD
Building Permit #: 'Lt P ev9-U,2-/ — 00/a,5.
Site Address: 16083 SW Upper Boones Ferry Rd Suite/Bldg#: 200
Project Name: Amica Mutual Insurance
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
PlannirtR I,tetriet>lr
Proposal: TI
Existing Business Activity: Office
Proposed Business Activity: Office
® Verify site address/suite# exists and active in permit system.
g] River Terrace Neighborhood: E Yes 1 No
E Zoning: I-P
EX Permitted Use: ® Yes ❑ No ❑ Spec Space
® Confirm no land use required.
® Business License:
Exists: ki Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: ATIMDate: 7/8/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date:
Site Plans: # 3
Building Plans: # ,3
Building Permit#: trEnter building per '.t# above.
Workflow Routing: [ l lanning t o -LEI 13ui1ding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: a-wilding: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
��sL'
By Permit Technician: Date:� ,
1:\Building\Forms\BldgPermitRvw_COM_No LandUse_111819.docx
-• 't Cootdinatot-ReVieiV
❑ Conditio . " et"prior to issuance of building permit
❑ Approved,NO _ -ased: D
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Appli
Revision Notice 3: Date Sent toe .s 'cant:
❑ SDC Fees Entered: W o Trans Dev Tax: ❑ Yes ❑ N
igard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to •. 'e Permit
. •roved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx