Permit CITY OF TIGARD BUILDING PERMIT
' , ' COMMUNITY DEVELOPMENT Permit #: BUP2011 -00217
• TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 10/18/2011
Parcel: 2S 102AA00602
Jurisdiction: Tigard
Site address: 11960 SW PACIFIC HWY
Project: Tender Care Dental Subdivision: TIGARD HIGHWAY TRACTS Lot: 12
Project Description: TI with change of occupancy from M to B
Contractor: COOK CONSTRUCTION CO Owner: AMAN, WALTER S CREDIT SHELTER TR
5150 NW 149TH TERRACE 19217 SW 119TH AVE
PORTLAND, OR 97229 TUALATIN, OR 97062
PHONE: 503 - 645 -5763 PHONE:
FAX.
FEES
Specifics:
Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 10/18/2011 $256 00
Class of Work: ALT DC Provision Review, COM TI - LRP 10/18/2011 $38.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 10/18/2011 $1,794 51
Stories: 0 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 10/18/2011 $215 34
Value: $213,024 Plan Review 10/18/2011 $1,166.43
Plan Review - Fire Life Safety 10/18/2011 $717.80
Metro Const. Excise Tax - Commercial 10/18/2011 $255.63
Floor Areas: Use
Info Process /Archiving - Lg Sheet (over 10/18/2011 $12 00
Total Area 0 11x17)
Accessory Struct. 0
Basement. 0
Carport: 0
Covered Porch 0
Deck 0
Garage: 0
Mezzanine 0
Total $4,455 71
Required: Required Items and Reports (Conditions)
Fire Sprinkler. No Parapet
Fire Alarm No Protected Corridors -
Smoke Detectors Manual Pull Stations
Accessible Parking: 0
This pe is issue. . bject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be d a in accordance 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
day . ATTENTION' Oregon aw requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
95 - 001 -0010 through OAR 952 -'01 -r • 1 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 333 44
Is ued By: / / Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available in ection 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.
Building Permit Application
Commercial RECEIVED . , . ..
FoR.oi?h:,lCC usj`ONLY • ip City of Tigard 1 8 �!t Received 2011 Date/B �� (r Permit No' .. (4 / C/ ....06„Q, ~ ~
13125 SW Hall Blvd , OR 9 C7 li Plan Review FAN Other Permit
' I .• - Phone 503 718 2439 Fax 503 598 1960 Date /B
.T1 i,i. uw inspection Line 503 639 4175 CITY OF TIGARD Date Re.. : • Juns El See Page 2 for
,__..__ _ Internet www tigard - goy 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
® Addition/alteration/replacement ❑ Other. equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application
❑ I- and 2- family dwelling ® Commercial /industrial Valuation. $
El 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: 11960 SW Pacific Highway New dwelling area. square feet
City /State /ZIP. Tigard, OR 97223 Garage /carport area square feet
Suite/bldg. /apt. no Project name Tender Care Dental Covered porch area. square feet
Cross street/directions to job site SW Main Street 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.: 2S102AA -00602 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.
Interior tenant improvement within previously occupied space. Valuation $$213,024.00
Project entails change of use from M occupancy to B occupancy. Existing building area 4,941 square feet
New building area 0 square feet
❑ PROPERTY OWNER ® TENANT Number of stories 1
Name Tender Care Dental Type of construction 5B
Address' 11960 SW Pacific Highway Occupancy groups.
City /State /ZIP Tigard, OR 97223 Existing-
S
Phone ( ) Fax: ( ) New. B
® APPLICANT ❑ CONTACT 'PERSON BUILDING PERMIT'FEES *' .
Business name Robert Simpson Architect, PC (Please refer to fee schedule
Structural plan review fee (or deposit).
Contact name. Robert C. Simpson
FLS plan review fee (if applicable):
Address. 31177 SW Simpson Road
Total fees due upon application:
City /State /ZiP Cornelius, OR 97113
Phone' (503) 709 -9653 Fax ( ) Amount received:
E -mail RSApcna Frontier.com PHOTOVOLTAIC SOLAR PANELSYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
Business name. Cook Construction Co. Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address. 5150 NW 149 Terrace Solar Installation Specialty Code checklist
City /State /ZIP Portland, OR 97229 Permit fee (includes plan review $180 00
and administrative fees)
Phone. (503) 645 -5763 Fax ( ) State surcharge (12% of permit fee) $21 60
CCB tic.. 33713
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
■ within 180 days after it has been accepted as complete.
Print name. Robert C. Gimpson Date: 10/18/2011 * Fee methodology set by Trt- County Building industry
1 Service Board
1:\Building \Permits\BUP -COM PennitApp doe 02/24/2011 440- 4613T(I I /02 /COM/WEB)
III
Building Division
Development Code Provision Review
TrcARp Commercial Projects - No Associated Land Use Case
Building Permit No: 6u- P / ez ;I 7 lid' l;xpedited Review
Plan Submittal Date: /D/ /4
To the Applicant: NO 4 461 /at 141
A 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.
A 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 of at 503 - 718- 07YYoor _ @ @ tigard- or.gov)
G')
Zoning #4 P Permitted Use Yes V No ❑
Land Use Required: Yes ❑ No V (explain below)
r
"M4 "Gt9 HY k r / / 01 Note oa ile9i p
�'4 -
I/1 1 5 /W/o
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4
8 Approved ❑ Not Approved Date: O ,
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert@tigard-or.gov)
Notes:
Ai ) V
Routed back to Building Division Date:
I. \CURPLN
I ° o 2Ql / -ooa / 7
1. Project Location
11960 SW Pacific Highway
Tigard, OR 97223
2S102AA -00602, Washington Co., OR
2. Applicable Codes & Ordinances
2010 Oregon Structural Specialty Code
3. Project Description
Non-structural interior improvement
4. General Building Description
Building classification: Nonseperated use
Construction type: 5-B
No. of stories: 1
Floor area of building: 4,941 sq. ft.
Fire resistive system: NFPA -13
Occupancy group(s): B
Incidental use areas: None
Accessory use areas: None
5. Height and Area Limit Actual
Height: 40 ft. 16 ft.
Stories: 1 1
Total allowable area: 9,000 4,941 sq. ft.
6. Fire Resistive Const. Requirements Required Provided
Structural frame: 0 0
Exterior bearing walls: 0 0
Interior bearing walls: 0 0/1
Interior non - bearing walls: 0 0/1
Floor construction: 0 2
Roof construction: 0 0
Shaft enclosure: 2 n/a
Exit stair enclosure; 2 n/a
• Corridors: 0 0
T. Exits
Tenant occupancy group: B /S-1
Total floor area of tenant
B occupancy: 3,851 sq. ft.
S-1 occupancy: 1,090 sq. ft.
Total area: 4,941 sq. ft.
Total number of occupants: 29
Number of exits (req'd/provided): 1/3
Minimum egress width (req'dJprovided): 10 inJ144 in.
Common path of travel (allowed/provided): 7511/30 ft.
8. Fire Detection/Alann System
Smoke detection: No
Fire alarm: No
No. and type of fire extinguishers (2 )-2A -10BC
9. Fire Detection/Alarm System
Smoke detection: No
Fire alarm: No
No. and type of fire extinguishers (2 )-2A -10BC
0 Building Code Summary
Required Provided Plumbing
Oc. B S-1 Total Oc. Exit Exit Oc. B B S-1 S-1 Total
No. Name Group Area Area Area % Fact. Oc. Width Width Fact. Oc. Fbd. Oc. Fat. Fbd.
101 Waiting B 473 9.6 100 4.7 4 200 2.4
102 Reception B 152 3.1 100 1.5 200 0.8
103 Consultation B 129: 2.6 100 1.3 200 0.6:
104 Business B 133 2.7 100 1.3 200 0.7
105 Circulation B 637: 12.9 0 0.0 200 3,2 .
106 Operatory 1 B 126 2.5 100 1.3 200 0.6
107 Operatory 2 B 126 2.5 100 1.3 200 0.6
108 Operatory 3 B 126: 2.5 100 1.3 200 0.6
109 Operatory 4 B 143: 2.9 100 1.4 200 0.7 f
110 Operatory 5 B 140: 2.8 100 1.4 200 0.7
111 Lab B 123 ? 2,5 100 1.2 200 0.6
112 Mech. 1 B 47 i 0.9 0 0.0 200 0.2
t
113 Equip.1 B 43 i 0.9 0 0.0 200 0.2
114 Break B 241 i 4.9 100 2.4 200 1.2
•
115 Pan. Alcove B 32 I 0.6 100 0.3 200 0.2 i .
116 Sterilization B 206: 4.2 100 2.1 200 1.0 .
117 Operatory 6 B 139 2.8 100 1.4 F 200 0.7
1
i.
18 Operatory 7 B 115: 2.3 100 1.2 200 0.6
119 Operatory 8 B 113: 2.3 100 1.1 200 0.6
120 Storage 1 B 23 € 0.5 100 0.0 200 0.1
121 Staff Toilet B 67 ' 1.4 100 0.0 200 0.3
122 Office B 87 i 1.8 100 0.9 200 0.4 €
123 Conference B 147 ? 3.0 100 1.5 a 200 0.7
124 Equip. 2 B 33 i 0.7 100 0.0 200 0.2
<
125 Men B 77 1 1.6 100 0.0 200 0.4
126 Women B 116: 2.4 100 0.0 200 0.6
127 Electrical B 56 i 1.1 100 0.0 200 0.3
128 Mech.2 S-1 i 20 0.4 500 0.0 5,000 0.0
129 Storage 2 S-1 i 794 16.1 500 1.6 4 5,000 • 0.2
130 Storage 3 S -1 i 155 3.1 500 0.3 5,000 0.0
131 Storage 4 S-1 i 122 2.5 500 0.2 5,000 0.0
Total 3,851: 1,090 4,941 28.8 9.8 € 144.0 19.3 ! 1.2 0.2 i 0.0 1.2
A Fire and Life Safety Schedule