Permit CITY OF TIGARD BUILDING PERMIT
o • COMMUNITY DEVELOPMENT Permit #: BUP2012 -00098
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/10/2012
Parcel: 1 S136DB00201
Jurisdiction: Tigard
Site address: 11565 SW PACIFIC HWY
Project: Chase Bank Subdivision: 2000 -025 PARTITION PLAT Lot: 2
Project Description: In -store remodel
Contractor: ROBERTSON & OLSON CONSTRUCTION Owner: FRED MEYER INC
16821 SE MCGILLVRAY BLVD #210 STORE #375
VANCOUVER, WA 98683 -3404 1014 VINE ST
PROPERTY TAX 7TH FLOOR
CINCINNATI, OH 45202
PHONE: 360 - 699 -4724 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee - Additions, Alterations, 07/10/2012 $1,558.95
Demolition
Occupancy Grp: B Occupancy Load: 15 Plan Review 05/14/2012 $1,013.32
Dwelling Units: 0 Plan Review - Fire Life Safety 05/14/2012 $623.58
Stories: 0 Height: 0 ft DC Provision Review, COM TI - Ping 07/10/2012 $256.00
Bedrooms: 0 Bathrooms: 0 DC Provision Review, COM TI - LRP 07/10/2012 $38.00
Value: $175,000 12% State Surcharge - Building 07/10/2012 $187.07
Info Process /Archiving - Lg $2.00 (over 07/10/2012 $26.00
11x17)
Floor Areas: Info Process /Archiving - Sm $0.50 (up to 07/10/2012 $4.50
11x17)
Total Area: 0 Metro Const. Excise Tax - Commercial 07/10/2012 $210.00
Accessory Struct: 0 Use
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,917.42
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0 - 4 / (t' iI 010 throug • . R 952-011-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ued By: Permittee Signature: ��
Call 503.639.4175 by 7:00 a.m. for the next available inspection 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 NOISIAIQ Di mlifl
Commercial 7 Q�Id0� d00 FOR OFFICE USE ONLY
City of Tigard `�lOt� I IVW Received
n �� � Permit No.: �� 01)
_ Date R evi •w : _
13125 SW Hall Blvd., Tigard, OR 97223 Plan R WPM
' �
Phone: 503.718.2439 Fax: 503.598.19 0 A r � Date /B : /1NA% a IN Other Permit:
TIGARD Inspection Line: 503.639 �i d_�1 DateReadv /:� G Juris el See
www.tigard- or.gov N • to ethethod:5 3 /2. Supplemental Information
c� 7 wy . T7
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
❑ Addit ion /alteration/replacement ErOther: TEt4AMT I MPRONEME4IT . equipment, materials, labor, overhead, and the profit for the .
work indicated on this application. (�
CATEGORY OF CONSTRUCTION ( � l �
Valuation: $
El I - and 2- family dwelling [✓J Commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: �y
JOB SITE INFORMATION AND LOCATION Total number of floors: `
Job site address: x(56: 511"/ Fo.0 FIG NVV'•( New dwelling area: square feet
City /State/ZIP: TICAIZ•D OR '11223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ( �� aOyJK (P( — GJ rDR . Covered porch area: square feet 0
Cross street/directions to job site: Deck area: square feet 1 0\
1 Md e4T S pfeE 1t1SlQli FR,ev 016.ye Z TORE.. Other structure area: square feet ti
LOCd 1 IOhl OF EXI STla1Co 1:31ZA14Chf . REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. rz
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.
1141 -e21oi TI;'dea.rr LMPtacelEME. Fog A 1;44-I SF Valuation: E5T $ 115
`}('P,sE 13P4- 131 GN 1 0 F FRCP Existing building area: square feet
MEYER yroge, New building area: 1)44.1 square feet
❑ PROPERTY OWNER [r TENANT Number of stories: (
.g Name: G.+pG e. fjpt• le, Type of construction: f )CI9j
Address: (001i 61 LAIC OR eN Occupancy groups:
City /State/ZIP: L.P V1/'OQ v (Q: ge4g9 Existing:
Phone: (25$) - 6o34 -- Fax: ( ) New: (?j
[✓APPLICANT ✓[r CONTACT PERSON BUILDING PERMIT FEES*
Business name: C AGI ATE. (
(Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: OeDvie.1 64.446.W
FLS plan review fee (if applicable):
Address: 12.13c E. M t Rd i3E .0 PKw' ( 6rE. lob
City /State/ZIP: a , roKCD{J6 011.1,„e WA %214, Total fees due upon application:
Phone: (CM) 458 — (0840 Fax: : (G ) 45B — 0344-
Amount received: $ 1 / lo'Sfo. 9D
E -mail: _ 1ohn4kaW e Gtc.as ttc,. corVt PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
V Commercial and residential prescriptive installation of
CONTRACTOR /1_ roof -top mounted PhotoVoltaic Solar Panel System.
Business name: F4-
�Q-r e 1.. rao
et Oe rJ w �" r ! [0e, Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
S olar Installation Specialty Code checklist.
Address: t a, ( � Ho (o t [t t Jai 7. , . are.... 41-4p4 6 P ry
Permit fee (includes plan review
City / State/ZIP: ii'"fze_• 1, 1/4m at sus $180.00
and administrative fees):
Phone: (5 G4q `4621 Fax:'( ,s Z 37 -670 State surcharge (12% of permit fee): $21.60
CCB lie.: (46 8300
Total fee due upon application: $201.60
Authorized signature: e, 5 0 - This permit application expires if a permit is not obtained
within IS0 days after it has been accepted as complete.
Print name: eilDWI4 E l — ✓bf Date: $ - - 12 * Fee methodology set by Tri- County Building Industry
Service Board.
1: \Building \Permits \BUP -COM PermitApp.doc 02/24/201 I 440 4613T(11/02/COM /WEB)
0 /74gr e c- /t
85-Zv 3 a per - /
o ° Building Division
Development Code Provision Review
T I G n R D Commercial Projects - No Associated Land Use Case
Building Permit No: P 4i O�- S ( ❑ Expedited Review
Plan Submittal Date: 5 7// //
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 (4% n e at 503 - 718 - a 431 or eke @tigard - or.gov)
y ` 1 Zoning L — C7 Permitted Use Yes 0 No ❑
Land Use Required: Yes ❑ No I (explain below)
Notes: •*,nSriov r- .mow JR o • 2y n 6 6.^1c- Sef,„et • IV0
a,.^d -s- re 15ui et,t.
Ci Approved ❑ Not Approved Date: 4e 5 - 14- !a
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date: 5 - 14 - /a
I: \CURPLN
-11
12730 E. MIRABEAU PARKWAY, SUITE 100 RECE I ��e �� SPOKANE VALLEY, WA 99216
P 509.458.6840
F 509.458.6844 MAY 1 4 2012
WWW.CLCASSOC.COM
CITY OF TIGARD C LC ASSOCIATES
BUILDING DIVISION
TRANSMITTAL
TO: City of Tigard — Community Development DATE: May 7, 2012
13125 SW Hall Blvd FROM: John Shaw
Tigard, OR 97223
PROJECT: Chase — Tigard, OR
ATTN: Debbie Adamski PROJECT NO: 12 -0065
PHONE: 503- 718 -2450
ENCLOSED:
•
DOCUMENTS: X CD /DVD: PRINTS: X REPORTS: OTHER:
COPIES DESCRIPTION
1 Chase Interior Tenant Improvement Building Permit Application w/ Energy Efficiency Certificates
3 Chase Interior TI Permit Drawings
1 Check for Review Fees
REMARKS:
For Chase Bank located inside Fred Meyer at 11565 SW Pacific Hwy
FOR YOUR USE X FOR YOUR REVIEW FOR YOUR APPROVAL I I PER YOUR REQUEST
SENT VIA: FEDEX AVAILABLE VIA:
X EXPRESS MESSENGER U.S. MAIL PICK UP
X 1ST DAY
2ND DAY
D E N V E R I P H O E N I X I S A L T L A K E C I T Y I S P O K A N E