Permit CITY OF TIGARD BUILDING PERMIT
I COMMUNITY DEVELOPMENT Permit#: BUP2021-00264
Date Issued: 12/23/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S101AD02900
Jurisdiction: Tigard
Site address: 12755 SW 69TH AVE 100
Project: WHSB Law Subdivision: WEST PORTLAND HEIGHTS Lot: 33
Project Description: TI-minor interior modification proposed including new conference room, copy room and break area.All work in
interior to building.
Contractor: GSI BUILDERS Owner: FAIRWAY VIEW GROUP LLC
1750 SW SKYLINE BLVD STE 105 BY WOOD SMITH HENNING & BERMAN LLP
PORTLAND, OR 97221 ATTN FACILITIES DEPT
10960 WILSHIRE BLVD 18TH FL
LOS ANGELES, CA 90024
PHONE: 971-407-4436 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 12/23/2021 $1,498.55
Occupancy Grp: B Occupancy Load: 20 Demolition
12%State Surcharge-Building 12/23/2021 $179.83
Dwelling Units: 0 Plan Review 12/23/2021 $974.06
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 12/23/2021 $434.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 12/23/2021 $599.42
Value: $164,124 Info Process/Archiving-Lg$2.00(over 12/23/2021 $22.00
11x17)
Metro CET 12/23/2021 $196.95
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,904.81
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: Eol ya-rol,o-N)a,o(ov,,a.do- Permittee Signature: St-e,
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
Commercial FOR OFFICE LSE()NIA'
City of Tigard E C E I V E C DateBy: r/ 02 2o21 1 , Permit No.:13UP2OZ(-OO2(Q�'J�
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review f
' 3 Phone: 503-718-2439 Fax: 503-598-1960 DateB : .elated Permit:
y l�-lS—al
T I<'A R D Inspection Line: 503-639-4175 OCT 12 2021 Date Ready/By: / I / a. H See Page 2 for
Internet: www.tigard-or.gov �//� y Not' d/Method:l� Supplemental Information
CITY OF TIIGARL
TYPE OF 14..DING DIVISION 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
E Addition/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 El Commercial/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: 12755 SW 69th Ave New dwelling area: square feet
City/State/ZIP: Tigard, Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.#: Suite 100 I Project name:WSH&B Tenant Improvement Covered porch area: square feet
Cross street/directions to job site: 69th and Hampton Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
. equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
(.1)Minor interior modifications proposed including new Valuation: S i 01 t ti.0 y
conference room, copy room, and break area. All work in Existing building area: 1,937 square feet
interior to building New building area: N/A square feet
IS PROPERTY OWNER 0 TENANT Number of stories: 2
Name: Fairway View Group, LLC Type of construction: V_B
Address: 10960 Wilshire Blvd Occupancy groups: B
City/State/ZIP:Los Angeles, California 90024 Existing: B
Phone:(310)756-7105 Fax:( ) New: B
Lq APPLICANT TSJ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer so fee schedule)
Business name:HBX Studio Structural plan review fee(or deposit): ` 7 .0 to
Contact name: Melissa Skiles
FLS plan review fee(if applicable):
Address:2505 SE 11th Ave
City/State/ZIP:Portland, Oregon 97202 Total fees due upon application:
Amount received:
Phone:(317)430-8145 Fax::( )
E-mail:
melissa@hbx-studio.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: GSI Builders Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1750 SW Skyline Blvd #105 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland, Oregon 97221 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(971)407-4436 Fax:( )
` State surcharge(12%of permit fee): $21.60
CCB Lic.: X 2 T ,) 11 Total fee due upon application: $201.60
Authorized signs e: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: S e Q-4CY-35 Date: cyi p Il a,I * Fee methodology set by Tri-County Building Indushy
Service Board.
l:\Building\Pennits\BUP_COM PeumitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard
11111 COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A u n Building Permit Review — Commercial - No Land U s e
Building Permit #: ,3" V P2021- 0020
Site Address: 12'Sr 5(A) & qi 11^ MV6 Suite/Bldg#: /a
Project Name: h)S y. A, `g
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: /Nf}2.16K T. t
Existing Business Activity: /A. (�pic)
Proposed Business Activity: "
Verify site address/suite# exists and active in permit system.�
Riiver Terrace Neighborhood: ❑ Yes I/r No
L. mg: TMJ
rmitted Use: .l.J Yes ❑ No ❑ Spec Space
�l C irm no land use required.
Business License:
7
Exists: [ Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: Date: /D e?h(
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: //��1.2/ZQZ/
Site Plans: #
Building Plans: #
Building Permit#: Enter building permit#above. ��
Workflow Routing: Planning ❑ Permit Coordinator ar uilding
Workflow Sign-off: Pi Sign-off for Planning(include notes from planning review)
Route Application Documents: CV-Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: /1/02/202!
1:\Building\Fonns\BldgPermitRvw_COM_NoLandUse_l 11819.docx
- it Coordinator Review
❑ Condit. - "Met"prior to issuance of building permit
❑ Approved,NO ' eleased: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applica .
Revision Notice 2: Date Sent to Ap. : ant:
Revision Notice 3: Date Sent to pplicant:
❑ SDC Fees Entered: Was. -o Trans Dev Tax: ❑ Yes N/A
'gard Trans SDC: 0 Yes ❑ N
Parks SDC: 0 Yes 0 N/A
❑ OK to Issue Pe it
Approved : Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw COM_NoLandUse_111819.docx
Branden Taggart
From: Melissa Skiles <melissa@hbx-studio.com>
Sent: Tuesday, October 26, 2021 4:22 PM
To: #Building Permit Technicians
Subject: Re: WSH&B and GNS Permit Submittals - 12755 SW 69th Ave. Suites 100, 202
Follow Up Flag: Follow up
Flag Status: Completed
Categories: Branden
Warning!This message was sent from outside your organization and we are unable to verify the sender.
Hi Branden,
I apologize for my delayed response, this got held up in my outbox.
Valuations are listed below, thanks!
Suite 100
$164,124
Suite 202
$184,124
Melissa Skiles
Senior Interi0r Designer
317,430.8145
On Tue, Oct 12, 2021 at 1:32 PM #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>wrote:
Hi Melissa,
We received the permit submittals for WSH&B and GNS, located at 12755 SW 69th Avenue Suites 100 and
202. However, we are missing the valuations for each tenant improvement. What are the valuations? Once we
receive this information we will be able to proceed with plan review.
Thank you,
1
. ~
. '
�
�
/
Branden Taggart
City of Tigard
0 Senior Permit Technician
�j Community Development
13125 SW Hall Blvd
Tigard, OR 97223
bra ndent@tigard-or,gov
\
DISCLAIMER: E-mails sent or received by City of'Tigard employees are subject to public record laws. If requested, e-
mailmay be disclosed ho another party unless exempt from disclosure under Oregon Public Records Law. E-r nails are
� retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention
� Schedule."
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Branden Taggart
From: #Building Permit Technicians
Sent: Tuesday, October 12, 2021 1:32 PM
To: 'melissa@hbx-studio.com'
Subject: WSH&B and GNS Permit Submittals - 12755 SW 69th Ave. Suites 100, 202
Importance: High
Hi Melissa,
We received the permit submittals for WSH&B and GNS, located at 12755 SW 69th Avenue Suites 100 and
202. However, we are missing the valuations for each tenant improvement. What are the valuations? Once we receive
this information we will be able to proceed with plan review.
Thank you,
Branden Taggart
City of Tigard
Senior Permit Technician
Community Development.
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
branderit tigard-c .gov
1