Permit (11) F
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2023-00057
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/22/2023
Parcel: 1 S126DB02800
Jurisdiction: Tigard
Site address: 9370 SW GREENBURG RD 204
Project: Washington Square Endodontics Subdivision: 1991-018 PARTITION PLAT Lot: 1
Project Description: TI for existing tenant:New partitions,suspended ceiling,casework,and finishes.
Contractor: NORWEST CONTRACTORS INC Owner: FRANKLIN COMMONS ASSOCIATES LLC
PO BOX 25305 BY NORRIS&STEVENS
PORTLAND, OR 97298-0305 900 SW 5TH AVE STE 1700
PORTLAND, OR 97204
PHONE: 503-291-6986 PHONE:
FAX: 503-291-7036
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 05/22/2023 $210.59
Occupancy Grp: Occupancy Load: Demolition
12%State Surcharge-Building 05/22/2023 $25.27
Dwelling Units: 0 Plan Review 04/27/2023
Stories: 0 Height: 0 ft $136.88
Tenant Improvements in Existing 05/22/2023 $123.00
Bedrooms: 0 Bathrooms: 0 Development
Value: $8,500 Plan Review-Fire Life Safety 05/22/2023 $84.24
Info Process/Archiving-Lg$2.00(over 05/22/2023 $6.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $585.98
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 obtai the rules or direct questions to OUNC by callinr .03.232.1987 or 1.800.332.2344.
Issued By: .' Permittee Signature: ■ Air
1111/
all 503.639.4175 by 7:00 a.m.for the next available inspe!on da
This permit card shall be kept in a conspicuous place on the job site until complet 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
I V ceived
City of Tigard �/ +,'.telly, 44/0).J 7 Permit No.:��lQ,2 ?._0i-)C 5 74 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review T r f! :.7r-�17
i Phone: 503-718-2439 Fax: 503-598-1960 D m y Date/By: C 3 Related Permit:
Inspection Line: 503-639-4175 APR 2 I 2ULJ Date ReadyBy: M� turn: ® See P 2 for
7iG/t1tC) 04 Supplemental www.tigard-or.gov No dfMethod:5 Su lemeatat Information
CITY nF MARI)
TYPE OF WORKBUILDING DIVISION REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑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 ®Other: Tenant Improvement equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
0 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: 9370 SW Greenberg Rd New dwelling area: square feet
City/State/ZIP: Portland,OR 97233 Garage/carport area: square feet
Suite/bldg./apt.#: Suite 204 Project name: Washington Square noties -ittll L,Covered porch area: square feet
Cross street/directions to job site: Corner of SW Greenberg Road and Deck area: square feet
SW Hall Boulevard Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 8,500
Remodel of work area into dental treatment room
Existing building area: 7,262 square feet
New building area: 0 square feet
0 PROPERTY OWNER 0 TENANT Number of stories: 1 story
Name: Dr Kenneth Wiltbank Washington Square Endonotics Type of construction: V-B
Address: 9370 SW Greenberg Rd Suite 204 Occupancy groups: B professional
City/State/ZlP: Portland,OR 97233 Existing:
Phone:( ) 503-246-4499 Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: Grayscale works (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name: Mathieu Jacobs
Address: 2045 NE 34th Avenue FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP: Portland,OR 97212
Amount received:
Phone: ( ) 503-575-5141 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:mjacobs@grayscaleworks.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Norwest Contractors Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 7235 SW Stephen Lane Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review
Y Portland,OR 97225 and administrative fees): $180.00
Phone:( ) 503-291-6986 Fax.( ) State surcharge(12%of permit fee): $21.60
CCB Lie.: 89425 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
d/� �r► �� within 180 days after it has been accepted as complete.
Print name: ACtArL_ / Date(9�- �-crl- * Fee methodol y set by Tri-County Building Industry
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1:\Building\Pennits'BUP_COM_PermitApp.doc Rev.04/21/2014 44011613T(11/02/('OM/WEE)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
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] $ 8,500
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 2,125
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): $
I:\Building\Per its\BUP_COM_PernvtApp.doc Rev.03/05/2019
III City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
1
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: Z SP 2OZ -(55c)C 7
Site Address: q`3 7 t7 5 w 6r e4 bu r [Z& /Bldg#: -dI
Project Name: IJiL,. 511)(re E„ o T .
icS I"--.171 .
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: cy J f rt'-r, W' _ °n , I*J a ??a-1' '\-'
' vn5 Ce i GIs --;k- 9-- 501c t-s ,
q,e t,-). K , M i s-1 S, 1 U A-C. o p t.,1"'1 Wl_. r e to ri./`i C'1 I.
Existing Business Activity: /14,ect i tq , . ;c..
Proposed Business Activity:
IJ Verify site address/suite#exists and active in permit system.
E River Terrace Neighborhood: ❑ Yes "/No
2/Zoning: /iw a - Z \)A- Siva 0.Qivnal 3 \ Ceni-2r F141 0 /ic`�
5`
,,// ermitted Use: 2 Yes ❑ No ❑ Spec Space
ier Confirm no land use required.
lEr Business License:/
Exists: g Yes ❑ No,applicant was provided a business license application
Notes: Po Gin J -t. )\)c e es;6-1 LiJc J '. ) ..)C) .aalJ o _ 17t,,`vti.9.
Approved by Planning: - Date: 14 /a7 /�o 3-
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: 2,
Site Plans: #
Building Plans: #
Building Permit#: Enter building p_e... 1 it#above.
E
Workflow Routing: Planning Di Permit Coordinator Building
Workflow Sign-off: gn-off for Planning(include notes from planning review)
Route Application Documents: Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 6 ie..-Gj Date: ‘517// 7//
I:\BuildingWonns\B1dgPennitRvw COM NoLandUse 09072022.docx
gineering Review
❑ S . e at building pad:
❑ PFI Pe • 't#:
❑ Conditions ` 4 et"prior to issuance of permit
❑ Easements (encr.; hments)per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ Water Quality/Quan I Facility:
Assess Water Quality in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee •-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No Add Fee: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Review- Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved N
Permit Coordinator Review
\fD '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
I(j OK to Issue/Approved by Permit Coordinator: , foe:ADate: $
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\B1dgPermitRvw_COM NoLandUse_08162022.docx