Permit (106) CITY OF TIGARD BUILDING PERMIT
1111 ' ' COMMUNITY DEVELOPMENT Permit#: BUP2016-00144
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2016
T t G`�r•..p 9 Parcel: 2S110AA00900
Jurisdiction: Tigard
Site address: 14050 SW PACIFIC HWY
Project: Dr.James Dicey&Ellingson/Lassen Subdivision: None Lot: None
Project Description: Fire damage repair of ceiling,walls&exterior windows. Suite 101 and common areas.
Contractor: BELFOR USA GROUP INC Owner: ELLINGSON REVOCABLE INTERVIVOS T
12823 NE AIRPORT WAY BY ELLINGSON,JOSEPH M&JEAN E TRS
PORTLAND, OR 97230 420 W LASSEN AVE
CHICO, CA 95973
PHONE: 503-803-8914 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VBPermit Fee-Additions,Alterations, 05/02/2016 $271.43
Demolition
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Building 05/02/2016 $32.57
Dwelling Units: 0 Plan Review 04/26/2016 $176.43
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 05/02/2016 $108.57
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 05/02/2016 $12.50
Value: $12,500 11x17)
DC Provision Review,COM TI-Ping 05/02/2016 $88.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $689.50
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. Speciatty 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 issua ce, 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 enter. Those rules are set forth in OAR
952-001-0010th • •• OAR 952-.11-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.24 87 or 1.800.332.2344.
Issued =y: i♦ �i / 0 Permittee Signature: \I
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.
e -,
Building Permit Application
Commercial RECEIVED ,01Z 01.I I( I t til: O\1.1
City of Tigard Received U /
Date/By: 7 / Permit No.: O_./_-�`
:� 13125 SW Hall Blvd.,Tigard,OR 'fir' 9 6 2016 Plan R- ,. !!! 4
dGY[v
111 Phone: 503-718-2439 Fax: 503-'':- 6 IO Date/By: 7 II 1 t� Related Permit:
i / l) Inspection Line: 503-639-4175(' -y� ! Date Rea. :y: loris: ® See Page 2 for
Internet: www.tigard-or.gov CI1 TIGARD Notified/Method: / /7(/b I Supplemental Information
BUILDING DIVISION .m.... rik-t
'AP,.,-!--- TYPE OF WORK DEODIDEDDATA:1 AND 2F, ,MILYDWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
K)Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
'..
'' CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling 21 Commercial/industrial Valuation: .5.--a1$es-C'
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
Via JOB SITE INFORMATION,AND LOCATION Total number of floors:
Job site address: (4 bsp )u4 pr,trFIC i. Li,/ New dwelling area: square feet
City/State/ZIP: en(r%A►IL,D p K Garage/carport area: square feet
Suite/bldg./apt.#: I o, q_ Project name: tau-/itd, A / 45j fii 4- Covered porch area: square feet
Cross street/directions to job site: '� .--17464.4 ( Llj`pI.9I Deck area: square feet
0.0o4t'-fe... A es 4-5
0G G i.41--- 114.402- 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.
111 Mtr 004,44444t(t t-fAil1 of C.L.G. tnJMeil1 '� Valuation: $ 1Z I S v-O
Qwl t:� v,rMA Existing building area: square feet
New building area: square feet
-El iPROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) f New:
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: Ore-Ittf Cpl. �yi.0 r1eNt16, t-t.L Structural plan review fee(or deposit):
Contact name: CI}RIc Nix s t flomort.
Address: tbtb 30-1 FLS plan review fee(if applicable):
Ce.O -b& WILLS et,wti,. 1#-1b 4
City/State/ZIP: y ,1L1�N Total fees due upon application: /�
I Amount received: rr 7ce.e7J
Phone:( 'SL'S) 341 - L%O I Fax: :( )
E-mail: Gt1-12 13 >� S L.t�C.N W t o►"i► PHOTOVOLTAIC SOLAR PANEL SYSTEM-FEES*
,. Commercial and residential prescriptive installation of
". , ; CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: 15 elc.,,,,, ?R p ty gQS �V,y„ Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 12t23 (4E Atv-rot&r ‘-i 4,-"? Solar Installation Specially Code checklist.
City/State/ZIP: @ t,lt'I'Lry,1p I p1� 11 1)•7 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(SL)) 2.1 - I i T Fax:( )
State surcharge(12%of permit fee): $21.60
CCB Lic.: 14,411b aj l Total fee due upon application: $201.60
Authorized signature: LtThis permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Ct-fiLIS faVLLL litC 1)/L Date: y vig•,6 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP_COM_PennitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1111 Accessibility: Barrier Removal Improvement Plan
■
Commercial & Multi-Family - Additions or Alterations
I I G A R D 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: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation):
1:ABuildin \Permits\BV1' CU\I_Pcrmit\pp.doc Rcv. 12/18/21114
City of Tigard
lig i S
COMMUNITY DEVELOPMENT DEPARTMENT
T1cARo Building Permit Review — Commercial - No Land Use
Building Permit #: l J u..P a0 ( 40 O(j I `41
/
Site Address: /2-/QC-6Sn,, ,, Suite/Bldg#: /0/
Project Name: ,�r �� I/�.er
(Name of commercial business()ccing the space. If vacant,enter Spec Space.)
Planning Review J
Proposal: /o ex/...c7 *, S- -4 YP /i- 742„_e `.
Existing Business Activity: ii d/ae/06t 41i k__
Proposed Business Activity:
verify site address/suite # exists and active in permit syste .
KVJ:ver Terrace Neighborhood: ❑ Yes qG No
IF ening: c--9)
IlQ I' �
mitted Use: 0 Yes ❑ No ❑ Spec Space
Confirm no land use required.
Business License:
Exists: YJ Yes ❑ No, applicant notified to obtain business license
Notes:
Approved by Planning: ��-' Date: / ,,2 /eo
Revisions (after Building Submittal only) Reviewer Date L
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 1/4[a /1 40
Site Plans: #
Building Plans: # . 3
Building Permit#: enter building permit # above.
\Workflow Routing: planning .2"-Isermit Coordinator fErBuilding
\Workflow Sign-off: Sign-off for Planning (include notes from planning review)
Route Application Documents: uilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
\--4Notes: t,Jz.�_ tr.Q{Jao,� -- ,
By Permit Technician: (---: ") -G(�,, Date: 4/G/lo
I:ABuilding\Fonns\BldgPennitRvw_COMNoLandUse 0709 I 5.docx
i .
Permit Coordinator Review
❑ 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:
DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A
Tigard Trans SDC: ❑ Yes /A
Parks SDC: ❑ Yes ,,i�i��ll;EITOK to Issue Permit
Approved by Permit Coordinator: Date:
L\BuildingvFonns\BldgPennitRvw_COM_NoLandUse_0709I 5.docx
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