Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2021-00266
Date Issued: 11/23/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 500
Project: Lifestance Subdivision: ASHBROOK FARM Lot: 5
Project Description: Tenant build out and improvements.
Contractor: PACIFIC CREST STRUCTURES INC Owner: KING CAPITAL INVESTMENTS LLC
17750 SW UPPER BOONES FERRY RD SUITE ATTN KING,THOM
190 19250 NE PORTAL WAY
DURHAM, OR 97224 PORTLAND,OR 97230
PHONE: 503-968-8949 PHONE:
FAX: 503-598-6658
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 11/19/2021 $2,537.43
Occupancy Grp: B Occupancy Load: 27 Demolition
12%State Surcharge-Building 11/19/2021 $304.49
Dwelling Units: 0 Plan Review 11/02/2021 $1,649.33
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 11/19/2021 $434.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 11/19/2021 $1,014.97
Value: $336,400 Info Process/Archiving-Lg$2.00(over 11/19/2021 $54.00
11x17)
Metro CET 11/19/2021 $403.68
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $6,397.90
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: J Va-0., De 1n/ege, Permittee Signature: A
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 4) 7 , ,
Commercial RECEIVE II
9,� I ( 1{t)FFJt_'I: 1'N1_UV'i,l'
City of Tigard Received Z ZOO/ ��/ �OPw2('- ,y
2 6 ry Re a Received
g^� i, hermit No.: (ap
d 13125 SW Hall Blvd.,Tigard,OR 97223 J UL 2021 plan Review
I Phone: 503-718-2439 Fax: 503-598-1960 Date/By: ) — 8-.2.) :0, Related Related Permit:
T1 GA It D Inspection Line: 503-639-4175 CITY OF TIGARD Date Ready/By: '04 Iuris: 0 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION No'fied/Method: / /, Supplemental Information
TYPE OF WORK tEID DATA:I-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
2P•ddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ''Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOR SITE INFORMATION ION AND LOCATION Total number of floors:
Job site address: C1 koO skooax . 1_ New dwelling area: square feet
City/State/ZIP:T ce cia42 oe. CI,/I 1..a 3 Garage/carport area: square feet
Suite/bldg./apt.#: SDC7 Project name: L1 k%TeL r'e_+ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CRECKLIST
Subdivision: 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.
XNL blil\OL c71 Valuation: $ '33c ' WO
Existing building area: L-k®,Z square feet
I
New building area: square feet
PROPERTY OWNER. 0 TENANT Number of stories: 1 0 h
Name: V.si ti l‘kfac..,,0).D.s Type of construction: 11 g
Address: `O `u 4_ Occupancy groups:
City/State/ZIP: leo( &CL (JIl. /'�1 1
Existing: '�
b Phone:(6u ) �-t t�ei V�'—� Fax:( )
New:
i APPLICANT [ CONTACT PERSON RIMMING PERMIT FEES*
Cs7a. eralua kJ.
Business name: pr.(f.Si avl V)tr .1 t's.
Structural plan review fee(or deposit): /6,0 3;
j Contact name: Di L Ulf 3
FLS plan review fee(if applicable):
Address: I s---- _
�#04- S}-g,
l Total fees due upon application:
' City/State/ZIP: Wt 1 0 A-4 Lk& u/1
1 1 e , `'l "1 `_ , t(� /�i Amount received:
i Phone:(Qv ti „._4.2a Fax: :(VVe) N'l).,,, 6 t
E-mail: k l Pl'IOTOVOLTAIC SOLAR PANEL SYSTEM FEES*kte,Ct G`S� \ Commercial and residential prescriptive installation of
I C°N I It(iCTOR roof-top mounted PhotoVoltaic Solar Panel System.
AA" Business name: Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.:
Total fee due upon application: $201.60
Authorized signature: IatittioiA____.
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 1 y tsDate: -�p . * F set by Tr-County Building Industry
4< _ PJeJ61 Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard
111 It
COMMUNITY DEVELOPMENT DEPARTMENT
•
T1cARD Building Permit Review — Commercial - With Land Use
Building Permit #: 30P202.1 --OO26(0
Site Address: WO SW da ic_5 f Suite/Bldg#: Sfe g60
Project Name: /il&S4-6kA.0
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review 1 I i/ rr '
Proposal: -1-6( ,G, IOU I 1 4 otQ— �- 416' ii i USA ( t 4i c i/ 'c 2,
) Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: ❑ Yes ) No
Land Use Case#: ,l1/r,M, 2 ZQ?A 000 4 0
Plans Match Approved Land Use:
pSite Plan El Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
R-13414ivig Height: Miiititnum I Icight Actual Heighr— MQ G
-ea riaiTS-Mei. Flo C K.r
R Business License:
Exists: J Yes ❑ No, applicant was provided a business license application
Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified Q No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: 4iijt. 4/1/014e1 Date: // Z/Zo 2/
Revisions (after Building Submittal only) Reviewer < Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: Cl Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 0/1-4/102/
Site Plans: # 3
Building Plans: #
Building Permit#: Et-Enter building permit#above.
Workflow Routing: Et-Planning Et-Engineering R'Permit Coordinator 'Building
Workflow Sign-off: I I Sign-off for Planning(include notes from planning review)
Route Application Documents: p'Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: //O2/102-1
1:\Building\Forms\BldgPermitRvw_COM_WithLandUse l 11819.docx
Engineering Review
Slope at building pad: 2-VD
[ PFI Permit#:
Y.-Conditions "Met"prior to issuance of building permit ii
I"Easements (encroachments) per engineering conditions of approval and plat(not typical on SDR/CUP)
Et/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes R'No
Assess Water Quantity Fee in-lieu: ❑ Yes Q'No
LIDA Facility on lot: ❑ Yes 12'No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: j5,,Z jt,e.,� Date: (t /17/Z0 2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
4-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 xr N/A
Tigard Trans SDC: 0 Yes 0 N/A
Parks SDC: ❑ Yes ,Z N/A
71 OK to Issue Permit
Approved by Permit Coordinator: Date: (i (i J rl
1:\Building\Forms\BldgPermitRvw_COM_WithLandUse 1 118 19.docx
NOISUIIO ONiO1118
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w'Anilil' . PRECISION PERMITSERVICES Q3/11 j
75 - 60TH STREET SW • WYOMING, MI 49548
"Ia,.
7/22/2021
To: City of Tigard Building Dept
Commercial Plan Review
Re: Lifestance
9755 SW Barnes Rd
Enclosed for your use in reviewing the above referenced project for our building permit are:
3 Sets of Plans
Building Permit Application
Mechanical Permit Application
Electrical Permit Application
Plumbing Permit Application
If you should have any questions please do not hesitate to contact me.
Thank you,
Amy Diekevers
amvd@precisionpermits.com
616-493-9334 p
616-493-9351 f