Permit CITY OF TIGARD BUILDING PERMIT
a COMMUNITY DEVELOPMENT Permit#: BUP2022-00042
Date Issued: 3/3/2022
TI G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 310
Project: Healthy Living Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Interior TI-dividing existing suite into two separate suites(Suite 310&330).Minor demo and new casework with
sink.
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: I IB Permit Fee-Additions,Alterations, 03/02/2022 $910,17
Occupancy Grp: B Occupancy Load: 39 Demolition
12%State Surcharge-Building 03/02/2022 $109.22
Dwelling Units: 0 Plan Review 02/10/2022 $591.61
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 03/02/2022 $110.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 03/02/2022 $364.07
Value: $74,000 Info Process/Archiving-Lg$2.00(over 03/02/2022 $12.00
11x17)
Address Fee 02/24/2022 $50.00
Floor Areas:
Total Area: 0
Accessory Struct 0
Basement 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,147.07
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: Edgardo-Ma(4on.a o- Permittee Signature: y2e,ctp p- i GG i Qw
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 '>_ Z r-7 122
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard Received�� ,,11 �' _ �p� �0�
Date/By: �V Permit No.:
r 13125 SW Ha11 Blvd.,Tigard,OR 97223 FEB 0 7 2022 Plan Review
S Phone: 503-718-2439 Fax: 503-598-1960 Date/By: O� p1� a� j, Related Permit:
TI G A R D Inspection Line: 503-639-4175 CITY OF >WIGARD Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION ified/Method: /# it `76-1. Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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.
Valuation: $
❑ 1-and 2-family dwelling ad Commercial/industrial
❑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: 16083 SW Upper Boones Ferry Rd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.#:310 & 330 Project name: Healthy Living TI Covered porch area: square feet
Cross street/directions to job site: SW Upper Boones Ferry Rd. & Deck area: square feet
SW 72nd Ave. 3rd Floor Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot#:2S113AB00500 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.
Interior tenant improvement - including dividing Valuation: $74,000
existing suite into 2 separate suites. Minor Existing building area: 49,963 square feet
demo and new casework with sink. New building area: 0 square feet
® 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: B
City/State/ZIP: Tigard, OR 97224 Existing: B
Phone:(503 639.0108 x 100 Fax:( ) New: B
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: LRS Architects Structural plan review fee(or deposit): 991.691
Contact 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, OR 97209
Phone:(971) 242.8176 Fax: ( ) Amount received:
E-mail: PKim@Irsarchitects.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: Built Enviroment NW Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 135 E Hereford St. Solar Installation Specialty Code checklist.
City/State/ZIP: Gladstone, OR 972027 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)650.4086 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lie.: 79970 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: Pete t11 Date: 02.04.2022 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\PermitsBUP COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
41111111/11111111111.1.111.00 .
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
!Pi p 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] $ 74,000.00
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 18,500.00
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.
1::\Building\Permits\BUP_COM_PerrnitApp.doc Rev.03/05/2019
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T l c A R D Building Permit Review — Commercial - No Land Use
Building Permit #: ZUPZ022 - 00042-
Site Address: 1 , j r 5 51N Urpte PooKe5ttly aSuite/Bldg#: 30 .33)Project Name: ea` tU(.
(Name of corn rcial business occ pying the space. If vacant,enter Spec Space.)
Planning Review Proposal: r f���/ C
1/ /v —
uth
w L.A I C w w k S— S(4,i1
Existing Business Activity:
Proposed Business Activity: -150j . ,
Fp Verify site address/suite# exists and active in permit system.
❑ River Terrace Neighborhood: ,'Yes n No
Zoning 1, — p
r Permitted Use: Yes ❑ No ❑ Spec Space
1a Confirm no land use required.
G,i, Business License:
Exists: fA Yes ❑ No,applicant was provided a business license application
Notes: d t'/ b �lh � re O CCU/ ' /. i / f I / l ✓\ c5'
Approved by Planning: MrliMPLAbl 1 Date: 2/q/240 2;z_,
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: ge7/22-Site Plans: #
Building Plans: #
Building Permit#: le Enter building permit#above.
Workflow Routing: ErPlanning ❑ Permit Coordinator Pliuilding
Workflow Sign-off: 'Sign-off for Planning(include notes from planning review)
Route Application Documents: 'B, Wig: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 00/ ,._
I:\Building\Forms\BldgPermitRvw COM_NoLandUse_111819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to ' :.licant:
Revision Notice 2: Date Sen • Applicant:
Revision Notice 3: Date .-tit to Applicant:
❑ SDC Fees Entered: ash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issu• ermit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx