Permit •
CITY OF TIGARD BUILDING PERMIT
14
8 COMMUNITY DEVELOPMENT Permit #: BUP2012 -00120
T [ G A R.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/12/2012
•
Parcel: 1S134BC00300
• Jurisdiction: Tigard
Site address: 12282 SW SCHOLLS FERRY RD
Project: Boardwalk Burger Subdivision: WINDSOR PLACE Lot: 32
Project Description: TI to previous Pizza Schmizza space
Contractor: CANDEN DEVELOPMENT LLC Owner: FW OR- GREENWAY TOWN CENTER LLC
2546 NE 45TH AVE PO BOX 790830
PORTLAND, OR 97213 SAN ANTONIO, TX 78279
PHONE: 503 - 307 -9321 PHONE:
FAX: 503 - 281 -1676
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 06/12/2012 $160.00
Class of Work: ALT DC Provision Review, COM TI - LRP 06/12/2012 $24.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 06/12/2012 $1.068.30
Stories: 0 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 06/12/2012 $128.20
Value: $95,000 Plan Review 06/12/2012 $694.40
Plan Review - Fire Life Safety 06/12/2012 $427.32
Info Process /Archiving - Lg $2.00 (over 06/12/2012 $20.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,522.22
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. 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r
Issued By: kaki-4/ Permittee Signature: `r" ,/ -
Call 603.839.4175 by 7:00 a.m. for the next available inspection date. li
This permit card shall be kept In a conspicuous place on the job site until completion of t he t.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application •
Commercial REcEivED FOR OFFICE USE ONLY
Received I • /) �a' ` - ,
City of Tigard Date : Permit No. r e �
13125 SW Hall Blvd., Tigard, OR 97223
C g I Plan Review 7 , �E� a
Phone: 503.718.2439 Fax: 503.598.I960 1 2 202 Date /B :L,/ Ii
TIGARD Inspection Line: 503.639 Date Ready /: y: � See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified /Method: i Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: I- 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: TI project equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling ® Commercial /industrial
Valuation: $
kccessory building ❑ Multi- family Number of bedrooms:
U Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12282 S.W. Scholls Ferry Road New dwelling area square feet
City /State /ZIP: Tigard Oregon 97223 Garage /carpo . rea: square feet
Suite/bldg. /apt. no.: 12282 Project name: BOARDWALK Burgers Covered • .rch area: square feet
Cross street/directions to job site: Dec. area: square feet
r. ther 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.
Tenant improvement to previous Pizza Schmizza Tenant space (currently vacant) Valuation: $95,000
Existing building area: 2,096 square feet
New building area: 2,096 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: I
Name: Luck Patel Type of construction: 3B
Address: 6700 SW 105 Ave. Suite 315 Occupancy groups:
City/State /ZIP: Beaverton OR 97008 Existing: A2
Phone: (503)352 -5690 Fax: (503)352 -5934 New: A2
®• APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: LEEKA Architecture and Planning (Please refer ro fee schedule)
Structural plan review fee (or deposit):
Contact name: Neil Lee
FLS plan review fee (if applicable):
Address: 1402 SE Cora St.
City/State /ZIP: Portland, OR 97202 Total fees due upon application:
Phone: (503) 644 - 4222 I Fax: : (503) 208 - 2246 Amount received:
E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel Syste
Business name: CAMDEN 17 aV of N-r Submit two (2) sets of roof plan with connect • setails
and fire department access, along with • 010 Oregon
Address: 2 5440 / ` p � 45 G g vE Solar Installation Specialty Cod - ecklist.
Permit fee (include , an review
City/State /ZIP: peye an d a. nistrative fees): 1721.3 $180.00
Phone: ($23) 307 .1 Z I 1 (32 7.. ti • f 4 74 State surc . • e (12% of permit fee): $21.60
CCB lic.: /6 46 ? d
(<1A1> otal fee due upon application: $201.60
Authorized signature: j This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: N L r ( L. - C Date: 611 Z // Z * Fee methodology set by Tri- County Building Industry
f Service Board.
I: \Building \Permits \BUP -COM PennitApp.doc 02/24/2011 440 4613T(1 I /02 /COM /WEB)
III
e ° Building Division
Development Code Provision Review
T I G n R D Commercial Projects - No Associated Land Use Case
Building Permit No: r.. X 1 gD I - [H' Expedited Review
Plan Submittal Date: "WPM v
To the Applicant: /Z-- o Z c/ , 7 ‘0A /5
> 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 omit/ I at 503-71? 1 `l
or am( @tigard - or.gov)
14 Zoning (' G (M) J Permitted Use Yes ❑' ❑
(D'Land Use Required: Yes ❑ No LAY (explain below)
Notes: ( X1/1// AJ
/iv dq-
roved ❑ Not Approved Date: 0 //7..1 r2
j-j-4
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
/ t) / 6/-.
Routed back to Building Division Date:
I: \CURPLN
Building Division
.11111 q
Over- The - Counter (OTC) Building Permit
TIGARD Check List &V / GO/3
Project Description: { (
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction: 3I
*Type of Use: QZ(A Occupancy Load: Oregon Specia Code C (O
SPECIFICS
Number of Stories: 1 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: $ — 1 �- O FEES DUE
$ ( CC DC Prov Rvw, COM TI — Ping
$ 2' QG DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ I Ot ? lPermit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ f' � '- 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ 27. Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ -sac 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: $ - . -) TOTAL FEES DUE
2-‘41-A. a.Z- S-t
*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.
l: \Building \Forms \OTC - BUP.docx 01/13/2011