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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. CrCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT . Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: riAjV S VRVIN DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: A MAR 15 YOU COMPANY: 1\tV*! Jr kf tc'l e-v OA) L;I1 Y OF TIGARD PHONE: ' 71) - +4-1,3 , is-3"L 7 3UILDING DIVISION By: • EMAIL: SPqqCtk- [to i5T @ N-wv--m d\I u k,M RE: 137-4't0 SW C' a'ti=lam fW1/f BU ' f1Zl — G(l (Site Address) (Permit Number) O V\ b 0 SU-►'(rAt/4 .-c..or, (Project name or subdivision name and lot n mber) "-- ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 4 Additional set(s) of plans. 3 Revisions: r-4%Ul5 ON -`v i3if l► /dr Cross section(s) and details. Wall bracing and/or lateral analysis. elj(pn,il t Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: 3 $I31-S Of f—v iS V-b p ;vviprAc) • FOR OFFICE USE ONLY Routed to Permit Technician: Date: 3 - - Z,-1._ Initials:- ' Fees Due Q Yes _ No Fee Description: Amount Due: .s pi rt../;e_ $ ----- a-J t, r.t.:v; 4v- $ --- $ $ -t-c- — 'tr- Special 7/„ /jt Instructions: -3-: Reprint Permit(per PE): ❑ YesL+1 No ❑ Done Applicant Notified: 4i4_. • f/LDDaattee: c3 i}t Ir. Initials: 9y 1:\Building\Forms\TransmittalLetter-Revisions U7312U ee) CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENTIII Permit#: BUP2021-00196 T IG ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/26/2021 Parcel: 2S102CB02300 Jurisdiction: Tigard Site address: 13240 SW PACIFIC HWY Project: Westside Surgery Center Subdivision: FREWING'S ORCHARD TRACTS Lot: 8 Project Description: TI-demo existing physical therapy space and accommodate a new operating room,recovery space,sterilization and administration space. Contractor: NEENAN COMPANY Owner: WESTSIDE BUILDING PROPERTIES LLC 3325 SOUTH TIMBERLINE RD SUITE 100 BY VALLABHANATH, PRASHANTH FORT COLLINS, CO 80525 11086 SE OAK ST MILWAUKIE, OR 97222 PHONE: 970-493-8747 PHONE: FAX: 970-493-5869 Specifics: FEES Type of Use: COM Description Date Amount Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 08/26/2021 $8,138.24 Occupancy Grp: B Occupancy Load: 49 Demolition Dwelling Units: 0 12%State Surcharge-Building 08/26/2021 $976.59 Stories: 0 Height: 0 ft Plan Review 08/17/2021 $5,289.86 DC Provision Review, COM TI-Ping 08/26/2021 $434.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 08/26/2021 $3,255.30 Value: $1,610,466 Info Process/Archiving-Lg$2.00(over 08/26/2021 $82.00 11x17) Floor Areas: Metro CET 08/26/2021 $1,932.56 Tigard CET-Non-Residential-Admin 08/26/2021 $644.19 Total Area: 0 Tigard CET-Non-Residential-AH 08/26/2021 $15,460.47 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $36,213.21 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 952-00,170090. 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: j L , l ( 'Ji bt ( �/ — .. Permittee Signature: f% �G.r �+/2)7©/1 J 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. 8 . Commercial FOR OFFICE USE ONLY ~\, �� Cl of Tigard Dateived�to 2/,q �/ /y� p/, Plan eview .... 1 '/l Permit No.:�v/.��41^W/ /Io IhoneSWHa18-2439 Fard,OR 97223 AUG OJ 2021 P1saReve e Phone: 503-718-2439 Fax: 503-598-1960 Date/By: 0• I7— J Related Permit:IlGARU Inspection Line: 503-639-4175 CiTY OF IGARD DateReadyB �"y: r ® See Page 2for Internet: www.tigard-or.gov BUILDING DIVISIONNot' /t1i�/Method: Et / � Supplemental Information TYPE OF WORK t6 r REQUIRED D 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 IX'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 ElCommercial/industrial Valuation: $ ElAccessory building ❑Multi-family Number of bedrooms: El Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Qj Job site address: 13240 SW PACIFIC HIGHWAY, New dwelling area: square feet if, City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet ASuite/bldg./apt.#: Project name: Westside Surgery Remodel Covered porch area: square feet kklCross street/directions to job site: Deck area: square feet Pacific Highway and SW Park St Other structure area: square feet (4 REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot#: 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 DESCRIPTION OF WORK work indicated on this application. Valuation: $ 1,610,466 Project consists of the interior demolition of an existing physical therapy and IT space to accommodate a new operating room, recovery space, Existing building area: 7,785 square feet sterilization and administration space. No exterior work. New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: 1 Name: WESTSIDE SURGERY CENTER, LLC. Type of construction: 5-B Address: 13240 SW PACIFIC HIGHWAY, Occupancy groups: B &S2 City/state/ZIP: Tigard, OR 97223 Existing: B& S2 Phone:( ) 503-639-6571 Fax:( ) New: B ❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: The Neenan Company �Z89 Structural plan review fee(or deposit): Contact name: Joe Ashcraft FLS plan review fee(if applicable): Address: 3325 S Timberline Rd. Suite 100 City/State/ZIP: Ft Collins, CO 80525 Total fees due upon application: Phone:( 303-710-1844 Fax: :( ) Amount received: E-mail: joe.ashcraft@neenan.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: The Neenan Company Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 3325 S Timberline Rd. Suite 100 Solar Installation Specialty Code checklist. City/State/ZIP: Ft Collins, CO 80525 Permit fee(includes plan review $180.00 and administrative fees): Phone:( 303 710 1844 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB Lic.: 16,r 7 �'J� �� 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: Joe Ashcraft Date: 8/2/21 * Fee methodology set by Tri-County Building Industry Service Board I:\Building\Permits\BIJP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB) City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT Ii lig TIGARD Building Permit Review — Commercial - No Land Use a;: Building Permit #: UP2o2J-0019(p Site Address: 13240 SW Pacific Highway Suite/Bldg#: Project Name: Westside Surgery Center/Eye Health Northwest (Name of commercial business occupying the space. If vacant,enter Spec Space.) Piarv/ille.Review Proposal: TI Existing Business Activity: medical office Proposed Business Activity: medical office ® Verify site address/suite #exists and active in permit system. ® River Terrace Neighborhood: ❑ Yes n No 7 Zoning: C-G ® Permitted Use: ® Yes ❑ No ❑ Spec Space E Confirm no land use required. E Business License: Exists: ® Yes ❑ No,applicant was provided a business license application Notes: Approved by Planning: PTV) V r A Date: 8/5/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: E Approved ❑ Not Approved Revision 2: E Approved ❑ Not Approved Revision 3: 0 Approved ❑ Not Approved .8uilcki a Pet/bit Sirbrlittai / Original Submittal Date: 08 D5 20Zf Site Plans: # 3 Building Plans: # 3 Building Permit#: LVEnter building permit# above. Workflow Routing: 2--Planning Permit Coordinator 2-Building Workflow Sign-off: R.-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: es;40492( 1:\Building\Forms\BldgPermitRvw COM_NoLandUse_111819.docx -•_'t Coordinator Revie - ❑ Conditio . " et"prior to issuance of building permit ❑ Approved,NO - = ased: 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 to ; .. cant ❑ SDC Fees Entered: W - o Trans Dev Tax: ❑ Yes ❑ N • igard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A ❑ OK to se Permit • . roved by Permit Coordinator: Date: I:1Building\Forms\B1dgPermitRvw_COM NoLandUse_111819.docx