Permit (34) CITY OF TIGARD BUILDING PERMIT
"11111-1: COMMUNITY DEVELOPMENT Permit#: BUP2023-00168
T t(;A R t 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/27/2023
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY G2
Project: The Joint Chiropractic Clinic Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: TI for new tenant: New interior partition walls,doors and ADA restroom.
Contractor: WALEN CONSTRUCTION Owner: SN PROPERTIES PARTNERSHIP
20915 SW 105TH AVE 1121 SW SALMON ST
TUALATIN, OR 97062 PORTLAND, OR 97205
PHONE: 503-718-6680 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Tenant Improvements in Existing 09/27/2023 $123.00
Occupancy Grp: B Occupancy Load: 8 Development
Dwelling Units: 0 Permit Fee-Additions,Alterations, 09/27/2023 $902.64
Demolition
Stories: 1 Height: 0 ft 12%State Surcharge-Building 09/27/2023 $108.32
Bedrooms: 0 Bathrooms: 0 Plan Review 09/27/2023 $586.72
Value: $72,500 Plan Review-Fire Life Safety 09/27/2023 $361.06
Address Fee 09/27/2023 $50.00
Floor Areas: Info Process/Archiving-Lg$2.00(over 09/27/2023 $20.00
11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,151.74
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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. Th 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 5 .232.1987 or 1.80 .3 2.2344. r
Issued By: � - Permittee Signature: al4 !! /
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
.J Commercial FOR OFFICE USE ONLY
City of TigardEG
Lw tf 6,w Received �/` n'rI v v73_col(.'
Date/By: j Permit No.: /tJY ]7
" 13125 S W Hall Blvd.,Tigard,OR 97223 Plan Review �^�Iy pt^ O
1711
Phone: 503-718-2439 Fax: 503-598-1960 SEP 2 7 2023 Date/By: 21 2,s ,J'J Related Permit:
Inspection Line: B 03-63 B 4l 75 Date Ready/By: (((z.4/ / Jnds:
TIGARD Y Y / See Page 2 for
a Internet: www.ti and-or. ov Notified/Method: ?-7 2 3 TX-1,/ Supplemental Information
CITY OF TIGARD
TYPE OF W REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
M 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 M Commercial/industrial Valuation: $
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder of Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16200 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.#: Suite G2 Project name: The Joint Chiropractic Clinic Covered porch area: square feet
Cross street/directionsto job site: 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 t work indicated on this application.
Tenant improvement for Joint Venture Chiropractic clinic consisting of Valuation: $ 72,500
new interior partition walls, doors and new partial height wall to separate Existing building area: 1,164 square feet
reception from treatment area. New ADA compliant restroom. New building area: no change square feet
0 PROPERTY OWNER ® TENANT Number of stories: 1 story
Name: Joint Ventures, LLC Type of construction: V-B
Address: 3700 Barron Way Occupancy groups: B / M
City/State/ZIP: Reno, NV 89511 Existing: B
Phone:(775)200-9928 Fax: ( ) New: B
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: MDG Architecture I Interiors (Please refer tn fee schedule)
Structural plan review fee(or deposit):
Contact name: Tamra Lindstrom
FLS plan review fee(if applicable):
Address: 4875 SW Griffith Drive, Suite 300
City/State/ZIP:Beaverton, OR 97005
Total fees due upon application:
(503)244-0552 ( ) Amount received:
Phone: Fax:
E-mail: tamraQamdgpC.COm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR =,K'; Commercial and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Business name: Walen Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 16655 SW 72nd Ave, Suite 200 Solar Installation Specialty Code checklist.
City/State/ZIP: Portland, OR 97221 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)519 9675 Fax:( ) State surcharge(12%of permit fee): $21.60
ece Lic.:223805
Total fee due upon application: $201.60
Authorized signature: c.1211�0 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Tamra Lindstrom Date:08.23.23 * Fee methodology set byTri-County Building Industry
Service Board.
I:\Building\Permits\BUP_COM_PennitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
Vt.5 'P
+57) 11`) ---
City of Tigard
IICOMMUNITY DEVELOPMENT DEPARTMENT �iQf✓
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: 4�p �-'3 --�i 6,3
Site Address: )&o20b Ski ?ik c--- t-it4>e Suite/Bldg#: 2--
Project Name: j P 1' COI(2-OP(LhCTI C- GU N' t—
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: r N&J 1 h i 1012 pA.R.nn on NA4.A.c ' `
Existing Business Activity: CS4i,e5
Proposed Business Activity: Me°ICAL CrrFl GC
LYVfy site address/suite#exists and active in permit system.
g Ri er Terrace Neighborhood: ❑ Yes
tted Use: es ❑ No ❑ Spec Space
i irm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes: l e(Thtl iJbtC mops P, 4 L til iLlet Wt�ir• �jl/1Pe0 Afpuumj1�
SflC Coos'of nATbr. eAn'r<+.cr 7a perbzm In e S PC gets
Approved by Planning: Date: C /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:
Site Plans: #
Building Plans: #
Building Permit#: L.-SS-ter building permit#above. ����
Workflow Routing: nning El Permit Coordinator $131tiding
Workflow Sign-off: .-Sign-off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: Ti-
By Permit Technician: -301,c2 Date: 5/p/i)
I:\Build ing'Porm s\B1dgPermitRvw_COM_NoLandUse_09072022.docx
En.:-. eering Review
• Slope a : ding pad: -
▪ PFI Permit#:
❑ Conditions "Met"prior suance of permit
❑ Easements (encroachments)pe -.• neering conditions of approval and plat(not typical o. .it '/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: Yes _ ❑ No
Assess Water Quantity Fee in-lieu: ❑ - ❑ No
LIDA Facility on lot: ❑ Yes ni Add Fee: ❑ Yes ❑ No
0 NOT Approved by Engineering: Date
Notes: •
'
Approved by Engineerin Date:
Revisions (after B ng Submittal only) Reviewer Date
Revision 1: Approved ❑ Not Approved
Revisi. : ❑ Approved ❑ Not Approved
sion 3: 0 Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of permit
❑ Approved,NOT Released: Date:
❑ ENG Revisions Required: Date:
Notes:
❑ SDC Exemption ❑ Applied for ❑ Received ❑ Does not apply
❑ Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A ❑ Deferred
Tigard Trans SDC: ❑ Yes ❑ N/A ❑ Deferred
Parks SDC: ❑ Yes ❑ N/A ❑ Deferred
LIDA Fee: ❑ Yes ❑ N/A
❑ OK to Issue/Approved by Permit Coordinator: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_08162022.docx
City of Tigard • BUILDING DIVISION
,11111
Over-The-Counter (OTC) Building & Fire Protection System Permit
TIGARD, Appointment Checklist
Permit Record#: 64 f)var a>p(0 e
Contact Name: -retvAira Linc{4frotm Phone#: 9c) -.33-{'I'(-O5$ l
Business Name: /1(p(7 Appt. Date/Time: y4:1'.6 ("0 (!, :oMivl
Site Address: (6.200 5 ti/ Pqc;AO fbil Bldg/Suite#: G.2
Project Name: J o 14 - ancoe r4 c(-;c C(;h;C New Tenant? 0 Yes 0 No
Project Description: Ti for Inew ¢ tt44.4n+'. litetti 101 e(eZ1i^ pari-;f+on Wry.((5, doori, 4414
vnaW fia /r ,a( he;7kk Luct 1,4 , NJ f" AD4 [otM c'+ f(,`ew t,fl roew� .
Existing Use: 6 / New Use:
MMD Required: 0 Yes 0 No Related Record#:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION T
Class of Work: iL i Occupancy Group: Type of Construction: 1,S
Type of Use: Occupancy Load: A Oregon Specialty Code: a coa.
SPECIFICS
Number of Stories: 1 Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: C 1 IIIA Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback—Left Sideyard Setback—Front
Sideyard Setback—Right Sideyard Setback—Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access.Parking Spaces:
REQUIRED ITEMS e �
Fire Sprinklers: r' Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Gales Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ 7'-I SOU FEES DUE
$, {a DC Prov Rvw,COM TI—Ping
ith
toll Permit Fee—Add,Alt,Demo
Tenant Improvements in Existing Development $ I i t,V. 12%State Surcharge
Project Valuation $ 5100.7� Plan Review,Structural
Up to$4,999 $0.00 $ 3l,OD Plan Review,Fire Life Safety
$5,000-$74,999 $123.00 $ AI,Cif Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $307.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $489.00 $ Metro CET(over$100,000)
$ School CET(new square footage)
$ Tigard CET($50,000 or more)
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
Building Staff: $ , > Other: L(v-c i i fC�__
Date/Time: $ 2i is-i, 71 TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS 012523.docx