Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 00146
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/01/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9477 SW WASHINGTON SQUARE DR A07
Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project: Best Buy Mobile
Project Description: TI
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O Permit Fee - Additions, Alterations, 09/01/2010 $1,256.95
CARLSBAD, CA 92008 Demolition
PHONE: 12% State Surcharge - Building 09/01/2010 $150.83
Plan Review 09/01/2010 $817.02
Plan Review - Fire Life Safety 09/01/2010 $502.78
Contractor: Metro Const. Excise Tax - Commercial 09/01/2010 $150.00
SD DEACON ENTERPRISES Use
901 NE GLISAN ST #100
PORTLAND, OR 97232
PHONE: 503 - 297 -8791
FAX: 503 - 297 -8997
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $125,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,877.58
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
T.' permit is issued subje • the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other appli = .le law. All w• will
•e done in accordance with app •ved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspe •ed for more , e 1 : 1
days. ATTENTION: Oregon law re• • res •u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set '•rth in • • -
952- 001 -0010 through OAR 9 -00 010•. • • may obtain a copy of the rules or direct questions to OUNC by calling 503. •• 6.66• : or 1 :10.3 . • •4.
By:
Issued B Permittee Signature: / / i ,
Cali 503.639.4175 by 7:00 a.m. for an Inspection that business day. _
This permit card shall be kept in a conspicuous place on the job site until completion of . project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial FOR OFFICE USE O \`L1'
C g �7
1,1 City of Ti and REC EIVED Received A � 0 permit No �. MO— � /11 4 , g
° 13125 SW Hall Blvd., Tigard, OR 97223 Da Plan n R Review
' .v& I �7 Other Permit:
Phone: 503.639.41 Fax: 503.598.19�q A' 2 g �} + DateB 4` /t1� `
TIGARD Inspection Line: 503.639 v I `t G `J L U 14 Date Rea. may: J am;' See Page 2 for
Internet: www.tigard - or.gov N. ,fie. ethod: I ICp Supplemental Information
CITY OF TIGARD - J d 101, 1, 1, / , L ,-
TYPE &G DI 1 ` / REQUIRED > 7 TA: 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
® 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:
91/7 7 JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: BettftagieWashington Square - Sgt New dwelling area: square feet
City /State /ZIP: Portland, OR 97223 Garage /carport area: - square feet
Suite/bldg. /apt. no.: A07 Project name: Best Buy Mobile Covered porch area: square feet
Cross street/directions to job site: Hwy 217/ Greenburg, Hall & Scholls Ferry Deck area: square feet
Exits Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this application.
Tenant Improvement at mall- demolition, new finishes, fixtures, lighting, etc. Valuation: $$125,000.00
Existing building area: 1412 square feet
New building area: 1412 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 1
Name: Best Buy Mobile- Contact Nicole Jasper Type of construction: II A
Address: 7601 Penn Ave. S. Occupancy groups:
City/State /ZIP: Richfield, MN 55423 Existing: M
g�
Phone: (612)291 -7511 Fax: ( ) New: M
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: CMA All contractors and subcontractors are required to be
Contact name: Brian Niehaus licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 219 N. 2 ° St. Suite 301 jurisdiction in which work is being performed. If the
City /State /ZIP: Minneapolis, MN 55401 applicant is exempt from licensing, the following reasons
apply:
Phone: (612) 547-1370 Fax: : (612) 338-2995
E -mail: bniehaus @cmarch.com
CONTRACTOR
Business name: lot,. 6 g,c - BUILDING PERMIT FEES*
Address: gD N L , yA .) �;
I f (Please refer to fee schedule)
/ �0 Structural plan review fee (or deposit):
City /State /ZIP: p f L r D / L 9 7 A., 5 9- FLS plan review fee (if applicable):
CCB lic.: .
Phone: (50 7 g? `1L Fax .3 ) 7.97 - g`? —
7? g 75
Total fees due upon application: 5599.09
Amount received: 599.09
Authorized signature This This permit application expires if a permit is not obtained
� within 180 days after it has been accepted as complete.
Print name: `�� L'11L�. ".J✓ N Date: aw 0 * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 10/01/09 440 -4613 (11 /02/COM/WEB)
RECEIVED
Commercial Application Checklist
JUN 2 5
City of Tigard Zt�'�`�+
, � e ° 13125 SW Hall Blvd., Tigard, OR 97223 CITY OF TIGARD
Phone: 503.639.4171,_ Fax: 503.598.1960 BUILDING DIVISION
- I c A K D Internet address: www.tigard - or.gov
PROJECT INFORMATION
Project name: Best Buy Mobile Washington Square Date: 6/24/10
Address: 9585 SW Washington Square Rd. Space A07 City: Portland State: OR ZIP: 97223
Scope of work: Tenant Improvement
Reference no.: Map and tax - lot no.:
Contact person name: Brian Niehaus Company: CMA
Phone: 612- 547 -1370 Fax: 612- 338 -2995
Cellular phone: E -mail: bniehaus @cmarch.com -
NOTES AND INSTRUCTIONS
• The purpose of this checklist is to help define a complete submittal package for the scope of work. Plan
review will not take place until a complete package is submitted.
• This checklist can be used for all commercial construction projects, including new construction, additions,
alterations and tenant improvements.
• For complex projects, applicants should use the "location" space to note the item's location and page
number from the plans or the specification book.
• It is not necessary to duplicate submittal information, even if it is asked for in multiple sections.
• In the checklist, "Required" means that the applicant must provide this information for plan review.
• In the checklist, "P" means —
• if checked by the applicant — the information is provided for the plan review.
• if checked by the plans reviewer — this information is required for the plan review.
• In the checklist, "NA" means that the information does not apply.
• Choose only those sections of the checklist that apply to your scope of work. Section 1.0, "General Project
Data," must be included with each .roject submitted.
PRE PROCESS
An applicant may request a pre - submittal meeting with representatives of the jurisdiction in which the project
will be built. The meeting may take place during the conceptual, schematic, or in- progress phase, or when the
applicant has completed plans.
INDEX OF CHECKLIST SECTIONS
1.0 General project data Page 2 7.0 Mechanical data (Types I and II
2.0 Civil data Page 2 kitchen -hood permits) Page 6
3.0 Architectural data Page 3 8.0 Plumbing data Page 7
4.0 Structural data Page 4 9.0 Electrical data Page 8
5.0 Mechanical data (new construction, tenant 10.0 Fire - suppression data Page 9
improvement, gas- piping permits) Page 5 11.0 Fire - detection and fire -alarm data Page 9
6.0 Mechanical data (additional or replacement 12.0 Re -roof installation data Page 10
rooftop - equipment installation permits) Page 6 13.0 Jurisdictional requirements Page 10
This checklist is for building department jurisdictions in Clackamas, Multnomah, and Washington counties.
440 -2734 (8 /01/WEB /COM)
1:\Building \Forms \COM- Checklist.doc 06/24/10
.SECTION 1.0 — GENERAL PRO.IECT! DATA
Construction documents Location (sheet number or spec section)
1.1 ® Required No. of sets of plans: New: 1 TI: 2
1.2 ® Required Cover sheet title block CS -1
1.3 ® Required Cover sheet vicinity map CS -1
1.4 ® Required Cover sheet plan index CS -1
1.5 ® P ❑ NA Code summary CS -2
1.6 ® P ❑ NA Deferred submittal summary CS -2 general note 8
1.7 ® P ❑ NA Professional stamp and signature All sheets
1.8 ❑ P ® NA Fire and life- safety-plan
1.9 ❑ P ® NA Landscape plan
1.10 ❑ P ® NA Landscape specifications
Supporting documents Notes
1.20 El P ® NA Land -use or planning actions
1.21 El P ® NA Required fire -flow calculations
1.22 ❑ P ® NA Fire- hydrant flow -test report
1.23 ❑ P Z NA Fire department or fire district building survey report
1.24 ❑ P ® NA Material safety data sheets (MSDS)
SECTION 2.0 — CIVIL DATA
Construction documents Location (sheet number or spec section)
2.1 ® Required Site plan N/A
2.2 ® Required Site utility plan N/A
2.3 ® Required Grading plan N/A
2.4 ® Required Erosion - control plan N/A
2.5 ❑ P ❑ NA Utility -vault location and details
Supporting documents Notes
2.20 ❑ P ® NA Geotechnical /soil engineer report
2.21 El P ® NA Storm -water calculations
2.22 ❑ P ® NA Site retaining -wall structural calculations
2.23 ❑ P ® NA "Assurance of Compliance" with environmental rules ....
440 -2734 (8 /01/WEB /COM) Tri-County Commercial Application Checklist 2
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
I:\ Building \Forms \COM- Checklist.doc
•
SECTION 3.0 — ARCHITECTURAL DATA
Construction documents Location (sheet number or spec section)
3.1 ® Required Floor plan(s) A-1
3.2 Z Required Transverse and longitudinal cross sections - N/A
3.3 ® Required OSSC Chapter 11 accessibility requirements AA = 1
3.4 Z P ❑ NA Interior elevations A-7
3.5 Z P ❑ NA Exterior elevations A -10B
3.6 ❑ P ® NA Roof plans
3.7 ❑ P - ® NA Exterior wall sections and details
3.8 ® P ❑ NA Reflected ceiling plan(s) A-4
3.9 ❑ P ® NA Fire -rated construction details
3.10 ❑ P ® NA Energy code compliant construction details and
specifications
3.11 ® P ❑ NA Door schedule A-2
3.12 ❑ P ® NA Glazing schedule
3.13 ® P ❑ NA Furniture plan F-1
Supporting documents Notes
3.20 ® P ❑ NA Energy code compliance forms /calculations
3.21 ❑ P ® NA Material safety data sheets (MSDS)
3.22 ❑ P • ® NA Hazardous materials inventory statement (HMIS)
3.23 ❑ P ® NA Hazardous materials management plan (HMMP)
3.24 ❑ P ® NA Written fire and life - safety evacuation plan for area
of rescue assistance
3.25 ❑ P ® NA Active and passive smoke - control information
440 -2734 (8/01/WEB /COM) Tri -County Commercial Application Checklist 3
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\ Building \Forms \COM- Checklist.doc
SECTION 4.0 — STRUCTURAL DATA
Construction documents Location (sheet number or spec section)
4.1 ® Required Structural cover sheet N/A
4.2 ❑ P ® NA Foundation plan
4.3 ❑ P ® NA Under -slab mechanical plan
4.4 ❑ P ® NA Under -slab electrical plan
4.5 ❑ P ® NA Under -slab plumbing plan
4.6 ❑ P ® NA Floor framing plan
4.7 ❑ P ® NA Roof framing plan
4.8 ❑ P ® NA Structural elevations
4.9 ❑ P ® NA Structural details and cross sections
4.10 ❑ P ® NA Standpipe information
4.11 ❑ P ® NA Special inspector /structural observation matrix
Supporting documents Notes
4.20 ❑ P ® NA Geotechnical /soil engineer report
4.21 ❑ P ® NA Site - specific seismic hazard report
4.22 ❑ P ® NA Design narrative
4.23 ❑ P ® NA Structural calculations
440 - 2734 (8/01/WEB /COM) Tri-County Commercial Application Checklist 4
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
1:\ Building \Forms \COM- Checklist.doc
SECTION 5.0 — MECHANICAL DATA (New construction, tenant improvement. gas piping permits)
Construction documents Location (sheet number or spec section)
5.1 ® Required Floor plan M -1
5.2 ® Required Equipment schedule M -1
5.3 ❑ P ® NA Site plan
5.4 ❑ P ® NA Under -slab mechanical plan
5.5 ❑ P ® NA Roof plan
5.6 ❑ P ® NA . Fuel gas piping plan
5.7 ® P ❑ NA HVAC equipment and duct plan(s) M -1
5.8 ❑ P ® NA Roof access details
5.9 ❑ P ® NA Duct smoke detector plans
5.10 ❑ P ® NA Fire /smoke damper locations
5.11 ❑ P ® NA Smoke control plan
5.12 ❑ P ® NA Outside air (OSA) table
5.13 ❑ P ® NA Refrigeration equipment and piping plan
5.14 ❑ P ® NA Kitchen equipment plan
5.15 El P ® NA Type I and/or Type II kitchen hood plan
(see Section 7.0 — Mechanical Data)
5.16 ❑ P ® NA Fume /vapor hood plan
5.17 ❑ P ® NA Process piping/product and/or exhaust- conveying
duct plan
5.18 El P ® NA Fire -rated construction details
5.19 ❑ P ® NA Equipment hanger /fastener details
Supporting documents Notes
5.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds N/A
5.21 ❑ P ® NA Equipment manufacturers' catalog "cut sheets"
or specifications
5.22 ❑ P ® NA Outside air (OSA) calculations
5.23 ❑ P ® NA Smoke - control calculations
5.24 El P ® NA Combustion air calculations
5.25 ❑ P ® NA Fuel gas piping sizing calculations
5.26 ❑ P ® NA Make -up air calculations
5.27 ❑ P ® NA Energy code compliance forms
5.28 ❑ P ® NA Boiler information
440 - 2734 (8 /01/WEB /COM) Tri -County Commercial Application Checklist 5
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\Building\Forms\COM-Checklist.doc
'SECTION 6.0 — MECHANICAL DATA] (Additional or replacement rooftop installation permits)
Construction documents Location (sheet number or spec section)
6.1 ® Required Roof plan N/A
6.2 ❑ P ® NA Roof framing plan
6.3 ❑ P ® NA Fuel gas piping plan
6.4 ❑ P ® NA Roof access details
Supporting documents Notes
6.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds N/A
6.21 ❑ P ® NA Equipment manufacturers' catalog "cut sheets"
or specifications
6.22 ❑ P Z NA Fuel gas piping sizing calculations
6.23 ❑ P ® NA Energy code compliance forms
SECTION 7.0 — MECHANICAL DATA (Type 1 and Type 11 kitchen hood permits)
Construction documents Location (sheet number or spec section)
7.1 ® Required Site plan
7.2 ® Required Floor plan(s)
7.3 ® Required Kitchen equipment plan
7.4 ® Required Kitchen equipment and hood elevations
7.5 ❑ P ❑ NA Roof plan
7.6 ❑ P ❑ NA Cross sections through hoods, ducts and shafts
7.7 El P ❑ NA Fire -rated construction details
7.8 ❑ P ❑ NA Fire suppression details
Supporting documents Notes
7.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
7.21 ® Required Make -up air calculations
7.22 El P ❑ NA Equipment manufacturers' catalog "cut sheets"
or specifications
7.23 ❑ P ❑ NA Hood/grease extractor listing documentation
7.24 ❑ P ❑ NA Hood/grease duct sizing calculations
7.25 El P El NA Fire suppression information
440 -2734 (8 /01/WEB /COM) Tri -County Commercial Application Checklist 6
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
I:\Building\Fonms \COM- Checklist. doc
•
SECTION 8.0 — PLUMI3INC DATA
Construction documents Location (sheet number or spec section)
8.1 ® Required Floor plan(s) N/A
8.2 ® Required Piping and material schedule N/A
8.3 ® Required Equipment layout plan N/A
8.4 ® Required Fixture schedule N/A
8.5 ❑ P ® NA Site utility plan
8.6 ❑ P ® NA Building cross section
8.7 ❑ P ® NA Rise diagram
8.8 ❑ P ® NA Roof plan
8.9 ❑ P ® NA Back flow prevention location
8.10 ❑ _ P ® NA Irrigation plan
8.11 ❑ P ® NA Fire -rated construction details
8.12 ❑ P ® NA Under -slab plumbing plan
Supporting documents Notes
8.20 ® Required . Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds N/A
8.21 ❑ P ® NA Equipment manufacturers' catalog "cut sheets"
or specifications
8.22 ❑ P ® NA Utility maintenance agreements
8.23 ❑ P ® NA Water supply calculations
8.24 ❑ P ® NA Sanitary system calculations
8.25 ❑ P ® NA Irrigation demand calculations
8.26 ❑ P ❑ NA Roof drain and storm water calculations
•
440 - 2734 (8 /01/WEB /COM) Tri-County Commercial Application Checklist 7
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\Building \Forms \COM- Checklist.doc
•
•
SECTION 9.0 — ELECTRICAL DATA
Construction documents Location (sheet number or spec section)
9.1 ® Required No. of sets of plans: 2
9.2 ® Required Floor plan(s) E_1
9.3 ® Required Electrical load calculations EE = 1
9.4 ® Required One line diagram E_1
9.5 ® Required Feeder riser diagram EE =1
9.6 ® Required Available fault current information E
• 9.7 ® Required Panel schedule(s) E_1
9.8 ❑ P ® NA Site electrical plan
9.9 ❑ P Z NA Fire -rated construction details
9.10 Z P ❑ NA Lighting plan EE =1
9.11 ® P ❑ NA Emergency power system and emergency lighting plan E_1
9.12 ❑ P ® NA Under -slab electrical plan
Supporting documents Notes
9.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds N/A
9.21 ® P ❑ NA Energy code compliance forms and calculations
for lighting
9.22 ® P ❑ NA Emergency power system specifications EE = 2
9.23 ® P ❑ NA Feeder riser information
9.24 ® P ❑ NA Lighting equipment manufacturers' catalog
"cut sheets" or specifications EE = 1
440 -2734 (8 /O1/WEB /COM) Tri-County Commercial Application Checklist . 8
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
I:\Building\Forms \COM- Checkl ist.doc
SECTION 10.0 - FIRE SUPPRESSION DATA
Construction documents Location (sheet number or spec section)
10.1 ® Required Floor plan(s) Deferred submittal
10.2 ® Required Sprinlder piping plan(s) Deferred submittal
10.3 El P ❑ NA Site plan
10.4 ❑ P ❑ NA Standpipe information
10.5 ❑ P ❑ NA Back flow prevention information
10.6 ❑ P ❑ NA Reflected ceiling plan(s)
10.7 ❑ P ❑ NA Transverse and longitudinal cross sections
10.8 ❑ P ❑ NA Fire -rated construction details
10.9 ❑ P ❑ NA Specialty fire suppression system plans
and list of systems
Supporting documents Notes
10.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
10.21 ® Required Equipment manufacturers' catalog "cut sheets"
10.22 ❑ P ❑ NA Hydraulic calculations
10.23 ❑ P El NA Specialty fire suppression system information
SECTION 1 1.0 - FIRE DETECTION AND ALARM DATA
Construction documents Location (sheet number or spec section)
11.1 ®Required Floor plan(s) Deferred submittal
11.2 ❑ P ❑ NA Site plan
11.3 ❑ P ❑ NA Reflected ceiling plan(s)
11.4 ❑ P ❑ NA Transverse and longitudinal cross sections
11.5 ❑ P ❑ NA Wiring schematic
11.6 ❑ P ❑ NA Elevator recall information
11.7 ❑ P ❑ NA Operational matrix
11.8 ❑ P ❑ NA Fire -rated construction details
11.9 ❑ P ❑ NA Standard electrical notes
Supporting documents Notes
11.20 ® Required Structural calculations for vertical loads and lateral
loads for equipment weighing over 400 pounds
11.21 ® Required Equipment manufacturers' catalog "cut sheets"
11.22 ® Required Installer certification information
11.23 ❑ P ❑ NA Battery calculations
11.24 ❑ P ❑ NA Sample fire alarm log book
11.25 ❑ P ❑ NA Emergency power system specifications
11.26 ❑ P ❑ NA Monitoring station information
11.27 ❑ P ❑ NA Voltage drop calculations
440 -2734 (8 /01/WEB /COM) Tri- County Commercial Application Checklist 9
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\BuildingWorms\COM-Checklistdoc
SECTION 12.0 — RE -ROOF INSTALLATION DATA
Construction documents Location (sheet number or spec section)
12.1 ® Required Site plan or building location map
12.2 ® Required Occupancy classification
12.3 ® Required Type of construction
12.4 ® Required Minimum roof class required
12.5 ® Required Class of roofing to be installed
12.6 ® Required Roof plan
12.7 ❑ P ❑ NA Parapet and scupper cross section(s)
Supporting documents Notes
12.20 ® Required Pre -re -roof inspection report
12.21 ® Required Roofing system listing information
12.22 ® Required Roofing manufacturer's catalog "cut sheets"
12.23 ❑ P ❑ NA Structural calculations
12.25 ❑ P ❑ NA Structural engineer's report
SECTION 13.0 — JURISDICTIONAL – SPECIFIC REQUIREMENTS
Construction documents Item Location (sheet number or spec section)
13.1 ❑ P ❑ NA ❑ Required
13.2 ❑ P El NA ❑ Required
13.3 ❑ P ❑ NA ❑ Required
13.4 El P El NA ❑ Required
13.5 El P ❑ NA El Required
13.6 ❑ P ❑ NA El Required
13.7 El P ❑ NA ❑ Required
13.8 El P ❑ NA ❑ Required
13.9 El P ❑ NA ❑ Required
13.10 El P ❑ NA ❑ Required
440 -2734 (8 /O1/WEB /COM) Tri-County Commercial Application Checklist 10
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
I :\Building\Forms \COM- Checklist. doc