Permit , CITY OF TIGARD BUILDING PERMIT
114 COMMUNITY DEVELOPMENT Permit #: BUP2011 -00166
TIGAR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/26/2011
Parcel: 2S 101 DCO39O0
Jurisdiction: Tigard
Site address: 7150 SW SANDBURG ST
Project: Progressive Insurance Subdivision: Lot:
Project Description: TI
Contractor: SUMMIT CONSTRUCTION Owner: PROGRESSIVE CASUALTY
PO BOX 10345 INSURANCE COMPANY
PORTLAND, OR 97296 REAL ESTATE NOTIFICATIONS
CLEVELAND, OH 44101
PHONE: 503 - 223 -9703 PHONE:
FAX: 503 - 242 -3841
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 07/26/2011 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 07/26/2011 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 07/26/2011 $487.01
Stories: 2 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 07/26/2011 $58.44
Value: $27,500 Plan Review 07/26/2011 $316.56
Plan Review - Fire Life Safety 07/26/2011 $194.80
Info Process /Archiving - Lg Sheet (over 07/26/2011 $12.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,141.81
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Yes 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. ATT e': •r-• • law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -08 -8010 through OAR 952-:81-00:8. . u .y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332. • 4.
Is- ed By: / Permittee Signature: 4 / +
Call 503.639.4175 by 7:00 a.m. for the next available in section date,
This permit card shall be kept in a conspicuous place on the job site un completi . n of the project.
Approved plans are required on the job site at the time of eac inspec ion.
B Permit Application
Commercial RECEIVED ED FOR OFFICE USE ONLY
Received n J r
City of Tigard JUL 26 20 Date/By. 0-4, (/ P ermi t No.: �� o /l G�7/ 0
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 11
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 7 (' Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Read Juris: ei See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2=•AMILY DWELLING
❑construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
dition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CO NSTRUCT[ work indicated on this application.
❑ 1- and 2- family dwelling ercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors � ,Q� ��
Job site address: `�� �' �( in- �► /� New dwelling area: square feet
City /State /ZIP: 776 # 4,441 ®A 0 ?7L j— Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: P ,,,,,e %.S, Covered porch area square feet
Cross street/directions to job site: / Deck area: square feet
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
DESCRIPTION OF WORK work indicated on this application.
�1��1_iA 2..--ii oo.a
7 ' /. — , 1V1'"'�- '"``°'o (_59A-de �x./O�Gs � J �D�I .J Valuation: $ � • -
e Svc /� _ / p /�„ vG ��� 4 4 , -� Existing building area square feet
�J S ,C e/S / � / v � ie�eN J ' New building area: square feet
LW. PROPERTY OWN ER � 'arTENANT Number of stories:
Name: Jn(eSjve / e ,, f; .,i t Type of construction:
Address: C 480 Wt.') Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( )
,...,�{{ � New:
.E4 PLICANT ii-CON-TACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: 4NkrO �s.gI J pUUTf� )41..41117:15546-
t ul1 Structural plan review fee (or deposit):
Contact name: L /:t., c541.47/4-)
Address: (Q7Z 0 SO) ���,q.p FLS plan review fee (if applicable):
City /State /ZIP: T Total fees due upon application:
Phone: f 2 icy - 7iod Fax: : ( 3 2 T: 6--r -2710 Amount received:
E -mail: t 11,5' C7,71 as PHOTOVOLTAIC SOLAR,PANEL SYSTEM FEES* • Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
Business name: v`'L,M � Cal Submit two (2) sets of roof plan with connection details
1.1!D and fire department access, along with the 2010 Oregon
Address: K I 0
'2 4. tJ Solar Installation Specialty Code checklist.
City /State /ZIP: ,N) (L-p �� 00_ / 7 9-5
Permit fee (includes plan r $180.00
and administrative fees):
Phone: (6 2 z - 974 . 3 Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: le) Total fee due upon application: $201.60
Authorized signat ...ca W This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 6,013 i� Date: 7 . Z{o / / * Fee methodology set by Tri- County Building Industry
Service Board
I: \Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11 /02 /COM/WEB)
1 ^.
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
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 maybe 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] $
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): $
I:\ Building \Permits \BUP -COM PermitApp.doc 02 /24/2011
•
Building Division
Plan Submittal Requirements
T [GARD 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.
1: \Building \ Permits \BUP -COM PemmitApp.doc 02/24/2011
Buildinn g Division
•
Plan Submittal /Requirement Matrix
T I G A RD Commercial & Multi- Family - New, Additions or Alterations
Type of Submittal # of .Plans
(Tncludes 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
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building
Fire Protection System (3 J
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), if applicable.
I: \Building \Permits \BUP -COM PermitApp.doc 02 /24/2011
II II
I Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: PtPki ( -DO (( IJ Expedited Review
Plan Submittal Date: 2' —1/
To the Applicant:
If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact� /r at 503-7182!' 4A@tigard-or.gov)
or
l Zoning f Permitted Use Yes U2"
No ❑
E Land Use Required: Yes ❑ No 0 (explain below)
Notes: 7ti- ,LA�v r '7 /1.14e/4 ^
leer ld ViZt-e:-
C7 Approved ❑ Not Approved Date: - 7 '6 - 1/
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov)
Notes: r- -
N I Routed back to Building Division Date:
I:ACURPLN
1, " Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Project Description: I C
•
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction: 1
*Type of Use: ('CAA Occupancy Load: /j Oregon Specialty Code: 7 (r)
SPECIFICS
Number of Stories: ' 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: 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
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 2 ? } FEES DUE
$ � � ED DC Prov Rvw, COM TI - Ping
$ raliF , ('V DC Prov Rvw, COM TI -LRP
DC Provision Review Fee for COM TI $ 't,0 Permit Fee - Add, Alt, Demo
Project Valuation Planning LRP $ , .r 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ - / Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ , y r Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ ( .,, S Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate.State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ i 81 TOTAL FEES DUE
*OPTIONS:
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.docx 01/13/2011