Permit =r :.,.. CITY OF TIGARD BUILDING PERMIT
° COMMUNITY DEVELOPMENT Permit #: BUP2009 -00227
TAR L? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/16/2009
Parcel: 1S126DCO5000
Jurisdiction: TIGARD
Site address: 9385 SW LOCUST ST, BLDG# 1
Subdivision: Lot: 0
Project: Fisher Chiropractic
Project Description: TI
Owner: FEES
TSE INVESTMENTS LLC Description Date Amount
PO BOX 1754 Permit Fee - Additions, Alterations, 12/16/2009 $464.97
LAKE OSWEGO, OR 97035 Demolition
PHONE: 12% State Surcharge - Building 12/16/2009 $55.80
Plan Review 12/16/2009 $302.23
Plan Review - Fire Life Safety 12/16/2009 $185.99
Contractor:
JA SWEE DEVELOPMENT CO INC
16120 SW KESSLER LN
TIGARD, OR 97224
PHONE: 503 - 307 -2963
FAX: 503- 579 -5192
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $26,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,008.99
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: No Protected Corridors: No
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit i - • • • . - to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don= accordance with ap • •ved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
day ATTENTION: Oregon law re• ire . ou • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95. 001 -0010 through OAR 952 -001 ••100. You ry obtain a copy of the rules or direct questions to OUNC by calling 50 = •99 or 1.800.332.2344.
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Is ed By: /� / ij ` Permittee Signature: „�� Ac
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Call 503.639.4175 by 7:00 a.m. for an inspection that b - ay.
This permit card shall be kept in a conspicuous place on the job site until • • • pletion of the project.
Approved plans are required on the job site at the time of a inspection.
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Building Permit Application
Commercial
RECEIVED k . a. ,� „.. I ()R ( I ICI tUS %'; -� ;
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71 City of Tigard DateBya••j� 1G G7 L Permit No.: ,1 eM� a7
13125 SW Hall Blvd., Tigard, OR 97223 D EC 1 2009 Plan Red
' Phone: 503.639.4171 Fax: 503.598.1960 DEC : X ' Ib Other Permit:
T � ; � , �� Inspection Line: 503.639.4175 CITY OF TIGARD Date Re. • l: . Juris• ® See Page 2 for
- Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK . 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
A Addition/alteration/replacement ❑ Other: 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: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ci 3 C Y S ,..3 4 be vs (. -217 New dwelling area: square feet
City /State /ZIP: 77. a. Q2 , J 9 7z Z 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: AA CA 1 Y1, r vet Grh C Covered porch area: square feet
Cross street/directions to job site: - f " rA) t C QS - f -- O ? ! O f a �.e., Deck area: square feet
per tb J..O c v 3+ S 1` rl Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
i DESCRIPTION OF WORK work indicated on this application. (l / 00Q
-(� At n e I p / � / / - 190[$ . S t 2�C d
1 Valuation: $ f
/ 7 `'
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER i tit TENANT Number of stories:
Name: Rs 4„.,, Ch v D ( D vqc /- C Type of construction:
9 385 Sc,J
Address: oci.)s Si:- Occupancy groups:
City /State /ZIP: ; 1 e .. Q V �, ., - 9 72 z3 Existing:
Phone: (5 / 7S--. / 7 .. 5 --- .... c Fax: ( ) 4sg-/ -Q /8 . New:
APPLICANT . ❑ CONTACT PERSON NOTICE
Business name: S "-c,` D-e-ve- , C t All contractors and subcontractors are required to be
Contact name: ''� licensed with the Oregon Construction Contractors Board
/ n1 W Ce • under ORS 701 and may be required to be licensed in the
Address: /4. 1 Za S /,J /` c-SS � Y /ate t jurisdiction in which work is being performed. If the
/State /ZIP: � �� Z applicant is exempt from licensing, the following reasons
City/State/ZIP: 77;) li q / 9 7 y apply:
Phone: (663) 3a / (3 Fax: ( ) s---77_37 2 Z
E -mail: .a 7 ILl S w e e 6, tJ, I Zo-✓ ' eve, /-
CONTRACTOR
Business name: � l A - ,...c 4,.., c ee , 6Lo c. Q. T,,., C t BUILDING PERMIT FEES*
Address: / 1 7-40 kC S l
S - 4 " /6yN (Pleaseref(rrofe �
City /State /ZIP: T cE . 04, 97zZy
Structural plan review fee (or deposit):
` 7 FLS plan review fee (if applicable):
Phone: (-03) 30 Fax (;S$.) S � 7 9 Z
4 z / 4/ g /q / Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
- within 180 days after it has been accepted as complete.
Print name: Date: /O/Z 1, 2 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Pe , :: UP -COM PermitApp.doc 2/23/07 440 4613T(i l /02 /COM/WEB)
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� Building Division
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Accessibility: Barrier Removal .Improvement Plan
T 1GARD •
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 per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $ ��i r
/
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ (0 7...—--
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: $ if2T5 D
(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 \Permits \BUP -COM PermitApp.doc 06/25/08
e a Building Division
TIGARD Over -The- Counter (OTC) Building Permit
Check List
Description of Project: --"
GENERAL INFORMATION
Class of Work:' N L Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: 513 Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: Note: Combine total floor area E: E:
for
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor sq. ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: 11- Handicap access:
Smoke detector: Protected corridors: 00
Fire alarm: OD Parking spaces (#):
Notes:
W (■ OC3 CD
Total Valuation: $
INSPECTIONS FEES DUE
Footing /foundation Firewall $44 Permit Fee
Post /beam structural Smoke detector $ ;F- State Surcharge
Shear wall Misc. inspection $ '302_25 Plan Review Fee
Masonry Approach /sidewalk $ ', FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ 1 Total Fees Due
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TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls,
signs, awnings or canopies); REP = repair.
I: \Building\Forms \OTC - BUP.doc 08/19/08
II
° Building Division
Plan Submittal Requirements
-T'i'G A R D Commercial & Multi- Family - New, Additions or Alterations
1. SITE PLAN (fully dimensional, drawn to scale) labeled with:
A. ❑ map & tax lot # ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking, including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape -ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C.. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations, plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit - based on valuation of project.
4. EXTRA SET OF THE FOLLOWING:
A. Two (2) copies of site plan to include vicinity map.
B. One (1) copy of erosion control plan with details. _
C. Fire Department Building Survey, and full set of architecture drawings.
//(F f
I: \Building \Permits \BUP -COM PcrmitApp.doc 06 /25/08
Building Division
Plan Submittal Requirement Matrix
T1 G A tZ D'' Commercial & Multi-Family New, Additions or Alterations
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 2
Fire Protection System 2
•
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington
County, and Tualatin Valley Fire & Rescue)
I:\ Buildin \Pcmvts \BUP -COM PcrmitApp.doc 06 /25/08