Permit 111 CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2023-00004
Date Issued: 4/18/2023
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 1 S136CD02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Subdivision: PALMER ACRES Lot: 3
Project Description: New 1187 sq.ft, breakroom mezzanine over existing locker room.
Contractor: PACIFIC NORTHERN ENVIRONMENTA LLC Owner: COSTCO WHOLESALE CORPORATION
1121 COLUMBIA BLVD PROPERTY TAX DEPT 111
LONGVIEW,WA 98632 999 LAKE DR
ISSAQUAH,WA 98027
PHONE: 360-636-2544 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ADD Type of Const: VB Permit Fee-Additions,Alterations, 04/18/2023 $4,005.50
Occupancy Grp: M Occupancy Load: 10 Demolition
12%State Surcharge-Building 04/18/2023 $480.66
Dwelling Units: 0 Plan Review 01/10/2023 $2,603.58
Stories: 0 Height: 0 ft Wash Co Trans Dev Tax 04/18/2023 $25,512.19
Bedrooms: 0 Bathrooms: 0 Tigard Trans SDC Improvement 04/18/2023 $19,296.43
Value: $594,298 Tigard Trans SDC Reimbursement 04/18/2023 $1,113.33
Parks SDC Improvement 04/18/2023 $997.25
Parks SDC Reimbursement 04/18/2023 $181.47
Floor Areas: DC Provision Review,COM TI-Ping 04/18/2023 $434.00
Total Area: 1187 Info Process/Archiving-Lg$2.00(over 04/18/2023 $30.00
Accessory Struct: 0 11x17)
Basement: 0 Info Process/Archiving-Sm$0.50(up to 04/18/2023 $64.00
Carport: 0 11x17)
Covered Porch: 0 Metro CET 04/18/2023 $713.16
Deck: 0 Tigard CET-Non-Residential-Admin 04/18/2023 $237.72
Tigard CET-Non-Residential-AH 04/18/2023 $5,705.26
Tig-Tual School CET-Non-Residential 04/18/2023 $854.64
Garage: 0
Mezzanine: 1187
Total $62,229.19
Required: Required Items and Reports(Conditions)
1 Special Inspection(see plans)
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 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 3 7 or 1.800.332.2344.
Issued By: ! /21,1-1 1{.---- Permittee Signature:
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.
Estimated Unmitigated Impact $113,226 $0
•
TDT=County Transportation Development Tax
TSDC Citywide=City of Tigard Transportation System Development Tax(TSDC-Imp&TSDC-Reim)
TSDC RT=River Terrace Transportation System Development Tax Overlay
Extended Combination SDC Calculator-091018-I:\Community Development\Permit Coordinator\SDC Calculators
Parks-Imp=Parks Improvement,Citywide including River Terrace
Parks-Reim=Parks Reimbursement,Citywide including River Terrace
Neigh-Imp=Neighborhood Parks Improvement Outside River Terrace
Neigh-RT=Neighborhood Parks Improvement Inside River Terrace