Permit CITY OF TIGARD BUILDING PERMIT
11,1
• . COMMUNITY DEVELOPMENT Permit#: BUP2022-00116
Date Issued: 6/14/2022
T I G A It p 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S115BA00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY M
Project: Tigard Town Square Subdivision: None Lot: None
Project Description: Non-structural demolition.
Contractor: PSR WEST COAST BUILDERS Owner: TECOLOTE RESOURCES INC
3458 MT DIABLO BLVD KELLY'S LEGACY LLC ET AL
LAFAYETTE, CA 94549 BY HESLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE: 925-299-0518 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions.Alterations, 05/18/2022 $1,060.77
Occupancy Grp: B Occupancy Load: 0 Demolition
12%State Surcharge-Building 05/18/2022 $127.29
Dwelling Units: 0 Plan Review 05/18/2022 $689.50
Stories: 0 Height: 0 ft Info Process/Archiving-Lg$2.00(over 05/18/2022 $2.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $94,000 DC Provision Review,COM TI-Ping 05/18/2022 $274.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,153.56
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 OA 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by callmg543.232.1987 or 1. 0,432.2344.
Issued By: 1,-, LZ17I j71\ I� PermitteeSignature: ;�� /
Cal 503.639.4175 by 7:00 a.m.for the next available in �ec on ate. '
i
This permit card shall be kept in a conspicuous place on the job site riritil c pletion o4he oject.
Approved plans are required on the job site at the time of each inspection.
` Building Permit Application
Commercial FOR OFFICE USE ONLY
1111 - City of Tigard RECEIVED Received 'J /e2 7.2- .f a)/go'
ece e'
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503-718-2439 Fax: 503-598-1 PR 2 $ 2022 Date/By: �'' 9 • al Related Permit:
T I GARD Inspection Line: 503-639-4175 Date Ready/By: nuts: 1 See Page 2 for
v Internet: www.tigard-or.gov CITY OF TIGARU eifiediMethod: Supplemental Information
''I' n�K�f �J_�1;_ jy • i
TYPE O#WbK G DIVISIOI,
REQ IRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 1rDemolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling .ig Commercial/industrial Valuation: $
-
❑ Accessory building ID Multi-familyNumber of bedrooms:
❑ Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: Jlfl Z t Ss� p ✓�,_
" y 4rp New dwelling area: square feet
City/State/ZIP: —0/ 49,Q q 72 0 Garage/carport area: square feet
Suite/bldg./apt.#: 49 Project name: 72 /b v aJ.: J4,r'�S Covered porch area: square feet
Cross street/directions to job site: >Q �v ,/,s>y 7/7 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.
Valuation: $ ,...c.c..
/ Existing building area: square feet
New building area: square feet
t'PROPERTY OWNER 0 TENANT Number of stories: iP.C.1/
Name: (-.�L)U .�,..I-i2 J,L� Type of construction: 11`,
15,
Address: 2 3 si2) s f .PAL DAL, Occupancy groups:
City/State/ZIP: LA.‘0,7vda%� s4/ c_.a_S / <4. Existing:
Phone:(q l L 27 7— lie{6O Fax:( ) New:
((APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
'J (Please refer to fee schedule)
,..r'CY�
Business name: . /
S ���"'CCCC I� -7- �-�'T ' ��T`5 •�� Structural plan review fee(or deposit):
Contact name: '-fo,,, _ d r"7','T
FLS plan review fee(if applicable):
Address: r(o)D i -St? 72 '-ho A11., . lastYJ�r7
p 7 Total fees due upon application:
City/State/ZIP: er,�-1-L4.Ajt, , 0.p` I 2
Phone:(�juy 2�/,ems51 Fax::( .-- )---- Amount received:
E-mai )� 7 p PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
NQ r.IS h rat a hC�tt�c�9+ r G vH.1 Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: /'Jr Submit two(2)sets of roof plan with connection details
a �. and fire department access,along with the 2010 Oregon
Address:
`45o n- , D„yr��„, 2_�e, , Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
�`/A'� erg, G4 and administrative fees):
Phone:(92 S Z q e/„c 5 i�� Fax:( ) State surcharge(12%of permit fee): $21.60
' 7 CCB Lie.: / 7 (' � 7U 7%/L) 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.
'� 57.c4 Print name: 7;s4 Date: , /+�Z * Fee methodology set by Tri-County Building Industry
i�T 2 Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
T 1 GARD 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] $
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: $
(1) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
1:\Building\Permits\BUP_COM_PcrmitApp.doc Rev.03/05/2019
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
lig " Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
TIGARI) 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.
I:A Building\Permits\BLIP_COM_PernitApp.doc Rev.03/05/2019
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
N . . .
Plan Submittal Requirements Matrix
- Commercial & Multi-Family - New, Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
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:\Building\Permits\BUP_COM_Pcrmit9pp.doc Rev.03/05/2019
illhCity of Tigard
4 COMMUNITY DEVELOPMENT DEPARTMENT
it l Building Permit Review — Commercial - No Land Use
e ms.: - - - z.'.2.1 A s.-- R..attaditA,.; .•, r�s s: : - ._ TK+: m aitS _ _._. ,
Building Permit #: /(..1�„2U j//fp
Site Address: 1/6'200 Svc CPGICt - ffvUy Suite/Bldg#: /v,
Project Name: Sec S .e,
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review 'rL,,
Proposal: IAfe.,C dlr dQ,44 0 TO(' ✓�u.l ""e,VtavI� `✓ta Vte4tJ C(/LCLyd-- i l/1rit)Ve144 )
Existing Business Activity: 3feX.- " /Sp i,,e, CPrrvI ev4y &roceir )
Proposed Business Activity:
lib Verify site address/suite#exists and active in permit system.
❑ River Terrace Neighborhood: 0 Yes El No
g zoning C
K Permitted Use: 0 Yes 0 No (x Spec Space
Zt Confirm no land use required.
Business License:
Evists: glYes 0 No,applicant was provided a business license application
Notes: 06 ‘l4eti`-b +e Vl\ (VUtrf kiLel/`er'►'+ AVuL0 ii t'( it,(S Ovlly
Approved by Planning: J, /, 4 Date: -//A/70 2.-2..Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: S'-- 27,2-2_
Site Plans: # 3
Building Plans: #
Building Permit#: •ifl-E ter building permit#above.
Workflow Routing: ' Planning 0 Permit Coordinator Building
Workflow Sign-off: $-Sign-off for Planning(include notes from planning review)
Route Application Documents: _El-guilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: �/
/2Z By Permit Technician: /4„.. .
� Date: ,� /LY
1:\Building\Fonns\BldgPermitRvw_COM NoLandUse_111819.docx
RECEIVED
APR 2 8 202Z
401 Co CITY OF TIGARD
BUILDING DIVISION
PS R Trader Joe's #000 Tigard Towne Square
‘DERS '
Apr 19,2022
Proposal -Demolish Permit Scope
PSR West Coast Builders Inc.
Scope Total Notes
•
Demolition of existing Toilet Rooms,fixtures,&finishes;Cut&cap of existing
Sewer line to existing Toilet Rooms;Saw-cut&removal of concrete for the
Demolition $88,300.00 new underground Plumbing lines for Trader Joe's Toilet Rooms,Breakroom,
Mop Sink,&Demo Prep Area;Saw-cut and removal of concrete for new
Freezer Slab;Saw-cut and removal of concrete for new underground
Electrical Walker Duct trench for Trader Joe's Check Stands.
Subtotal $88,300.00
G.C.Fee @ 6% $5,298.00
Bid Amount $93,598.00
Owner
Contractor
PSR West Coast Builders
Peter Schadek
3458 Mt.Diablo Blvd
Lafayette,CA 94549
925.299.0518
925.299.0517