Permit (15) CITY OF TIGARD BUILDING PERMIT
1114
I. COMMUNITY DEVELOPMENT Permit#: BUP2022-00224
Date Issued: 9/15/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CB02300
Jurisdiction: Tigard
Site address: 13240 SW PACIFIC HWY
Project: Westside Surgery Center Subdivision: FREWING'S ORCHARD TRACTS Lot: 8
Project Description: New emergency diesel generator.
Contractor: NEENAN COMPANY Owner: WESTSIDE BUILDING PROPERTIES LLC
3325 SOUTH TIMBERLINE RD SUITE 100 BY VALLABHANATH, PRASHANTH
FORT COLLINS,CO 80525 11086 SE OAK ST
MILWAUKIE, OR 97222
PHONE: 970-493-8747 PHONE:
FAX: 970-493-5869
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-COM-New Construction 09/15/2022 $809.42
12%State Surcharge-Building 09/15/2022 $97.13
Occupancy Grp: B Occupancy Load: 0 Plan Review 09/15/2022 $526.12
Dwelling Units: Misc Administration Fee 09/15/2022 $7.50
Stories: Height: ft
Info Process/Archiving-Sm$0.50(up to 09/15/2022 $28.00
Bedrooms: Bathrooms: 11x17)
Value: $100,000
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $1,468.17
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:
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: l Permittee Signature: / tl( J
Call 503.639.4175 by 7:00 a.m.for the next available insp ion 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 USE ONLY
City of Tigard ReceivedDateB : Permit No.: - go'l 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �� �� /tv
11 Phone: 503-718-2439 Fax: 503-598-1960 Date/B : 1 a.."11111 Related Permit:0 ,,,,/„1 , i et
Inspection Line: 503-639-4175 ate ReadyBy: . ® See Pa e 2 for
T!GAR()
Internet: www.tigard-or.gov RECEIVE �eeyyo��tified/Meth�od:/�I'��;% ;� ` Supplemental Information
>,x^.. r xxi x.
TYPE OF WORK QUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition r j Permit fees*are based on the value of the work performed.
p ❑OtttCr!�LU�N��DIVISION
Indicate the value(rounded to the nearest dollar)of all
El Addition/alteration/replacement 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: $
ElAccessory building El Multi-familyNumber of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13240 SW PACIFIC HIGHWAY, New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: Westside Surgery Remodel Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Pacific Highway and SW Park St Other structure area: square feet
10 ,es. }es,,, 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: $ 100,000
Project consists of the installation of a new emergency generator with
above ground fuel tank of 250 gallons. Existing building area: NA square feet
f ,,.;,xr .1 >� I„r New building area: square feet
El PROPERTY OWNER ,.
TENANT Number of stories: 1
Name: WESTSIDE SURGERY CENTER, LLC. Type of construction: NA
Address: 13240 SW PACIFIC HIGHWAY, Occupancy groups: NA
City/State/ZIP: Tigard, OR 97223 Existing: NA
Phone:( ) 503-639-6571 Fax:( ) New: NA
0 APPLICANT El CONTACT PERSON BUILDING PERMIT FEES*
Business name: The Neenan Company (Please refer to fee schedule)
Ot t t J t4 t`T Ot)t i i Structural plan review fee(or deposit):
Contact name: Joe Ashcraft Csv3 7 LO-73(25
FLS plan review fee(if applicable):
Address: 3325 S Timberline Rd. Suite 100 1 a J- 8-�
Total fees due upon application:
City/State/ZIP: Ft Collins, CO 80525
I
Phone:( 303-710-1844 Fax: :( )
Amount received:
E-mail: joe.ashcraft@neenan.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: The Neenan Company Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 3325 S Timberline Rd. Suite 100 Solar Installation Specialty Code checklist.
City/State/ZIP: Ft Collins, CO 80525 Permit fee(includes plan review $180.00
and administrative fees):
Phone:( 303 710 1844 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lie.: b (/% x t i� 'i Cy /i f/
;ii.„. 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: Joe Ashcraft Date: 6/13/22 * Fee methodology set by Tri-County Building Industry
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
T 1 G A R D Building Permit Review — Commercial - With Land U s e
Building Permit #: / G
Site Address: 13Z Yip c j �jgu�r LHivy Suite/Bldg#:
Project Name: kj Flo SoeGeQ- / (,b Jv—
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: /,,A 4c:L Gerve-ATOt2
Verify site address/suite# exists and active in permit system.
❑ River Terrace Neighborhood: ❑ Yes GYvl'o
4-nd Use Case#: VI Pi9Zo22 —C'Dv 2 y
lans tch Approved Land Use:
Site Plan El Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
Building Height: Maximum Height Actual Height
Conditions Met: ❑ Prior to Submittal El Prior to Permit Issuance
Business License:
Exists: El Yes ❑ No,applicant was provided a business license application
Public Facilities Improvement (PFI)Permit:
Required: ❑ Yes,applicant was notified El No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: Date: g /22
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved CI Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Building Permit Submittal
Original Submittal Date:
Site Plans: # 5
Building Plans: #
Building Permit#: Ci-risgr building permit#above. __//
Workflow Routing: Planning ie'Engineering ia.-.1 mlt Coordinator ut ing
Workflow Sign-off: sign-off for Planning(include notes from planning review)
Route Application Documents: g: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 9/71�)._,
I:\Building\Forms\BldgPermitRvw COM WithLandUse_111819.docx
Enfiineenng Review
• Slope at building pad:
PFI Permit#: /✓//4
gi Conditions "Met"prior to issuance of building permit y/i.
Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP).1.41
• Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes Ql-No
Assess Water Quantity Fee in-lieu: ❑ Yes o
LIDA Facility on lot: El Yes L7 No Add Fee: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: '�„��� Date: /l i`lULL
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
0-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 % N/A
Tigard Trans SDC: ❑ Yes 4 N/A
Parks SDC: ❑ Yes %N/A
LIDA Fee: ❑ Yes gr N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 011 Ili IZoZ2
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