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Permit
• CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit #: BUP2012 -00265 Date Issued: 12/19/2012 T I G A.RD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 2S101 DA00105 Jurisdiction: Tigard Site address: 13009 SW 68TH PKWY C Project: Homestead Village Subdivision: VARNS ACRES Lot: 9 Project Description: TI to convert 16 suites into 8 suites Contractor: JADE GROUP INC Owner: BRE /HV PROPERTIES LLC 1870 BUFORD HWY TAX DEPTARTMENT DULUTH, GA 30097 EXTENDED STAY HOTELS 100 DUNBAR ST SPARTANBURG, SC 29306 PHONE 678 - 209 -0999 PHONE: FAX: 678 - 209 -0997 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: Vg Permit Fee - Additions, Alterations, 12/19/2012 $453.95 Demolition Occupancy Grp: R -2 Occupancy Load: 12% State Surcharge - Building 12/19/2012 $54 47 • Dwelling Units: 0 Plan Review 12/19/2012 $295 07 Stories: 2 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 12/19/2012 $2 00 Bedrooms: 0 Bathrooms: 0 11x17) Value: $25,000 Floor Areas: Total Area. 0 Accessory Struct 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine' 0 - Total $805.49 Required: Required Items and Reports (Conditions) Fire Sprinkler. Yes 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. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available Inspection 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. 1111 ' Building Division Over - The - Counter (OTC) Building Permit I i`' ARI) Check List Project Description: I l BU f)41 a'oa;_ip 5- APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: ( ( Occupancy Group: f'_ Type of Construction: 155 *Type of Use: EW Occupancy Load: Oregon Specialty Code: Zi D (C3 SPECIFICS Number of Stories: —2. 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: V Fire Alarms: Smoke Detectors: Parapet: Manual Pull Stations: Protected Corridors: Total Project Valuation: $ -` I FEES DUE $ DC Prov Rvw, COM TI – Ping $ DC Prov Rvw, COM TI – LRP DC Provision Review Fee for COM TI $ • A ,'"Permit Fee – Add, Alt, Demo Project Valuation Planning LRP $ 'S 12% State Surcharge Up to $4,999 $0.00 $0.00 $ 0 "" ,O7 Plan Review, Structural $5,000 - $74,999 $67.00 $10.00 $ Plan Review, Fire Life Safety $75,000 - $149,999 $167.00 $25.00 $ Info Proc /Arch, Lg (over 11x17 $2.00) $150,000 and over $268.00 $39.00 $ Z(.2:::) 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: $ t)5 A/ 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; I ND = 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 07/01/2012 Building Permit Application Commercial RECEIVED hOR OFhI( I: I SI: O\ll \ Received S� LJGI T 3U1 a — GiD Ci}� of Tigard Q /y PertnitNo.: City g pc-IC 1 9 20 2 DateB : I '7 /.)— 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie ■ Phone: 503- 718 -2439 Fax: 503 -598 -1960 Date/B : A`�l © la Other Permit: T I A R n Inspection Line: 503 -639 -4175 CITY OF TIGARD Date Ready : : ]u 's: El See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Ti ( 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 p i Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1:1 1- and 2- family dwelling If Commercial /industrial Valuation: $ ❑ Accessory building El Multi-family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 oo' S 64.74 1 -r 7 New dwelling area: square feet City /State /ZIP: / ' A,o pX 1 7 13 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: #7,44tTre,44, v, / /0t, C 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. -ruJ0 .Sv i ns conitl gt ° 7 O'Je 5U( /(c RIXXIS %a Valuation: $ s G9DQ Avt ' 3n 2 1 304 3l 320 i 3SY 3S2 46 ,i' 70 Existing building area square feet New building area: square feet ❑ PROPERTY OWNER I ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer tojee schedule) Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): Address: City /State /ZIP: Total fees due upon application: Amount received: Phone:( ) Fax::( ) E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System. Business name: ji.fe 6Fo . r LNG Submit two (2) sets of roof plan with connection details , and fire department access, along with the 2010 Oregon g—) Address: ' AJ�, g_c C ,, Solar Installation Specialty Code checklist. City /State /ZIP: V U L v I r► r 7 Permit fee (includes plan review `j 3 D 1 / and administrative fees): $180.00 Phone: ( ) (o'��- 2.o' / i `i Fax: (( 711 20 7 _ 0 7 7 7 State surcharge (12% of permit fee): $21.60 CCB lic.: ii 3 7o2._ Total fee due upon application: $201.60 Authorized signature: / J This permit application expires if a permit is not obtained --- LLL /// ^ within 180 days after it has been accepted as complete. Print name: G Al ` yS o,v Date: /21 I �l li a * Fee methodology set by Tri- County Building Industry Ser vice Board. I:\ Building \Permits\BUP_COM_PermitApp.doc Rev. 12/11/2012 440- 4613T(11/02 /COM/WEB) Building Division Accessibility: Barrier- ,Removal Improvement Plan TIGARD �itt�':„ • 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 may be 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: $ (0 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_PernutApp.doc Rev. 12 /11/2012 ° Building Division I Plan Submittal Requirements T I G A R D 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. I:\ Building \Pernuts \BUP_COM_PermitApp.doc Rev. 12/11/2012 Building Division :111 m Plan Submittal Requirement Matrix T I G A R D Commercial & Multi- Family - New, Additions or Alterations Type of Submittal # of Plans (Includes new, additions and alterations.) Required at Submittal Demolition Permit 3 (site plan required showing location and square footage of all buildings to be demolished) Site Work 3 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 3 Fire Protection System 3 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 \Pernuts \BUP_COM_PemvtApp.doc Rev. 12/11/2012 • JADE GROUP, INC Nationwide Hospitality Contractors RECEIVED : 1 9 2012 CITY OFTIGARD BUILDING DIVISION Jade Group, Inc. 5150 Sunrise Blvd, D4 Fair Oaks, CA 95628 To Whom it May Concern: We, Jade Group, Inc. and responsible license holder, Kevin Cavanagh, authorizes Gary Robinson to perform on our behalf the tasks required to pull permits. License, insurance, and worker's compensation are all on file with the Oregon Contractors State License Board, license number 173702. Please see the attached for further information. Signed, / 7 . ,--- /Z- ` . • Kevin Cavanagh, President Jade Group, Inc. kcavanagh(a iadegroupinc.com Phone: 916.671.5848 Cell: 916.997.1200 Fax: 916.671.1717 CCB License Summary for license: 173702 https: / /ccbed.ccb. state .or.us /ccb_frames /consumer info /search results... CCB LICENSE SUMMARY FOR: RECEIVED JADE GROUP INC 1 1 9 2012 License Number: 173702 ,__ _GENERAL INFORMATION BUILDINGDNISION License Number: 173702 L i License Status: ! Active i i • Date First Licensed: 1/4/2007 Name: JADE GROUP INC Final Orders Discharged in ' 00 Bankruptcy: $0 ; [ Go l I Unpaid DRS Final Orders: $0.00 Go Orders Or Arbitration Awards 0 on Appeal: Delinquent Disciplinary Final Orders: $0.00 iGol r Click the following summaries: r CCB Business Detail Record: Go] CCB Disciplinary Actions: (Go CCB Administrative License Go J CCB Dispute Resolution Services (DRS) Go Actions: Summary: Summary of Unpaid CCB Orders: Go i For additional license information: Associated licenses for plumbing and electrical- Building Codes Division Search licenses for landscape businesses- Landscape Contractor Board Search Workers Compensation Insurance Data (DCBS Web Site) CLOSE WINDOW 1 of 1 12/17/2012 3:42 PM