Permit i „ CITY OF TIGARD BUILDING PERMIT
s COMMUNITY DEVELOPMENT Permit#: BUP2021-00226
Date Issued: 10/18/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136CD00101
Jurisdiction: Tigard
Site address: 11675 SW PACIFIC HWY
Project: AFC Subdivision: None Lot: None
Project Description: Interior TI for American Family Care
Contractor: JOSEPH HUGHES CONSTRUCTION INC Owner: COLUMBIA STATE BANK
11125 SW BARBUR BLVD PO BOX 2156 MS 3300
PORTLAND, OR 97219 TACOMA,WA 98401
PHONE: 503-624-7100 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 10/14/2021 $1,347.55
Occupancy Grp: B Occupancy Load: 40 Demolition
12%State Surcharge-Building 10/14/2021 $161.71
Dwelling Units: 0 Plan Review 09/29/2021 $875.91
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 10/14/2021 $274.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/14/2021 $539.02
Value: $140,000 Info Process/Archiving-Lg$2.00(over 10/14/2021 $52.00
11x17)
Metro CET 10/14/2021 $168.00
Floor Areas: Tigard CET-Non-Residential-Admin 10/14/2021 $56.00
Total Area: 0 Tigard CET-Non-Residential-AH 10/14/2021 $1,344.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $4,818.19
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: Ho- V De, were, Permittee Signature: Qw AtatoLix_a4izryta
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 i_q 20 2
Commercial RECEIVED FOR OFFICE USE ONLY
- Cl g of Tigard Received Q 2/ Permit No.VU P21�t�
.�c� �'
SEP 2 0 2021 Date/Bv !
"III 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie
Phone: 503-718-2439 Fax: 503-598-196 Date/By: IC,'" 13— Related Permit:
TIGARD Inspection Line: 503-639 4I75 ulTY OF TIGARD Date Ready/ y ® See Page 2 for
F. Internet: www.tigard-or.gov BUILDING DIVISION N 'ied/Method /` 1 � Supplemental Information
TYPE OF WORK RE UIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 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.
❑ I-and 2-family dwelling ElCommercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11675 SW Pacific HWY New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: Covered porch area: square feet
Cross street/directions to job site: SW Pfaffle/SW Pacific Hwy Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot#: Permit fees*are based on the value of the work performed.
1 S136CD00101 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.
New TI for Medical Facility. Valuation: 140,000
Existing building area:6,094 square feet
New building area: 0 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 1
Name: AMERICAN FAMILY CARE Type of construction: VB
Address: 11675 SW PACIFIC H WY Occupancy groups: g
City/State/ZIP:Tigard, OR 97223 Existing: g
Phone:( ) Fax:( )
New:
2 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Faster Permits
Structural plan review fee(or deposit): 875 9'/
Contact name: Ryan Pickrel
FLS plan review fee(if applicable):
Address: 2000 SW 1st Ave, STE 420
Total fees due upon application:
City/State/ZIP: Portland, OR 97201
Amount received:
Phone:(503)580-3845 Fax: :( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: ryan@fasterpermits.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: TQ BID, ��s yam`„ ,j ( , ,,`� Submit two(2)sets of roof plan with connection details
` JI e C i`,) and tire department access.along vv ith the 2010 Oregon
Address: `'I'2S . i.3 ,elrb,,,r %\l)b Solar Installation Specialty Code checklist.
City/State/ZIP: pc�rr`4n'\ �V Q11 Zt Permit fee(includes plan review S180.00
U ` and administrative fees):
Phone:(ib� 1,1 -1k 03 Fax:( ) State surcharge(12%of permit lc
CCB Lie.:
Total fee due upon applicati.
Authorized signature: �� This permit application expires if a
within 180 days after it has been i
Prim name: Ryan Pickrel (Owner's Agent) Date: 9-20-2021 * Fee methodology set by Lri-County
Service Board.
I:\Building\Permits\BUP_COM_PemtitApp.doc Rev.04/21/2014 440-4613T(1 I/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • w\\tir.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] $
MULTIPLIER (25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
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): $
l:ABuilding\Permits\BUP_CONL]crmit.APP.doe RCN'.03/05/21 19
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
" Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
1. SITE PLAN (3) copies - fully dimensional, drawn to scale and labeled with:
A. ❑ map & tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only)..
D. Street names.
E. Setbacks.
F. Parking, including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit - based on valuation of project.
L\Building\Pcrrnit BUP CO\[ krmit\pp.duc Rc,.113 u6 2I)19
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
T I GARD
e, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • wAN.ti4gard-or.t�uv
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
-- Demolition Permit 2
(site plan is required showing location and square footage
of all buildings to be demolished,erosion control plan and
tree protection,if applicable)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Solar Photovoltaic 2
(Requires check list for prescriptive installation. If not
prescriptive installation,engineering is required.)
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington
County, and Tualatin Valley Fire & Rescue),if applicable.
I: Budding Permits _ \I_ �r mit\rr.���c Ru L' S/2
t Il J
City of Tigard
111 COMMUNITY DEVELOPMENT DEPARTMENT
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #: 120E M22.4
Site Address: SUJ W+C1FiC- f4w( Suite/Bldg#:
Project Name: AfC
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: I MR-10 elrIllAMr
Existing Business Activity: n (J�
Proposed Business Activity: �117
"'Verify site address/suite# exists and active in permit system.� m.�
rRiRiver Terrace Neighborhood: CI Yes I�No
P G mg: C
IVfief-mitted Use: Yes ❑ No ❑ Spec Space
Id Confirm no land use required.
Is Cusiness License:
Exists: ❑ Yes Ia No,applicant was provided a business license application
Notes:
Approved by Planning: Date: / 23/21
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*20/2
Original Submittal Date: 02/
Site Plans: #
Building Plans: #
Building Permit#: [ Enter building pe,,,miit#above.
Workflow Routing: 1 Planning I(/1 Permit Coordinator IBuilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: VT-Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: j/%67,71' Date: 19/29/1D2i
I:\Building\Forms\BldgPennitRvw_COM NoLandUse_111819.docx
Permit Coordinator Review
Conditions "Met"prior to issuance of buildingpermit
❑ 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 )Zr'N/A
Tigard Trans SDC: 0 Yes /N/A
Parks SDC: ❑ Yes C/N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 30 22
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx