Permit � q CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT • Permit#: BUP2013 00221
Date Issued: 08/29/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 111Vd�
�, Parcel: 1 S135DD01800
Jurisdiction: Tigard
Site address: 11565 SW HALL BLVD 160
Project: Acupuncture Clinic Subdivision: METZGER ACRE TRACTS Lot: 32
Project Description: TI. 9/3/13, reprinted to correct suite address to#160.
Contractor: EMMETT PHAIR CONSTRUCTION Owner: BKB PROPERTIES LLC
16650 FIR LANE 11255 SW DAVIES RD,APT 1014
LAKE OSWEGO, OR 97034 BEAVERTON, OR 97007
PHONE: 503-572-8606 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 08/29/2013 $70.00
Occupancy Grp: B Occupancy Load: DC Provision Review,COM TI-LRP 08/29/2013 $10.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 08/29/2013 $362.69
Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 08/29/2013 $43.52
Bedrooms: 0 Bathrooms: 0 Plan Review 08/29/2013 $235.75
Value: $18,500 Plan Review-Fire Life Safety 08/29/2013 $145.08
Info Process/Archiving-Lg$2.00(over 08/29/2013 $2.00
11x17)
Floor Areas: Misc Administration Fee 08/29/2013 $1.50
Misc Administration Fee 08/29/2013 $3.75
Total Area: 0 Misc Administration Fee 09/03/2013 $250.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,124.29
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No 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
952-001-0 : rou. • 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.
I
Issue�d By: k 1 / !i i / Permittee Signature: \ ' A ,Lett
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.
CITY OF TIGARD BUILDING PERMIT
I! COMMUNITY DEVELOPMENT Permit#: BUP2013-00221
T[GiARO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2013
Parcel: 1 S135DD01800
Jurisdiction: Tigard
Site address: 11565 SW HALL BLVD
Project: Acupuncture Clinic Subdivision: METZGER ACRE TRACTS Lot: 32
Project Description: TI
•
Contractor: EMMETT PHAIR CONSTRUCTION Owner: BKB PROPERTIES LLC
16650 FIR LANE 11255 SW DAVIES RD,APT 1014
LAKE OSWEGO,OR 97034 BEAVERTON,OR 97007
PHONE: 503-572-8606 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 08/29/2013 $70.00
Occupancy Grp: B Occupancy Load: DC Provision Review,COM TI-LRP 08/29/2013 $10.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 08/29/2013 $362.69
Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 08/29/2013 $43.52
Bedrooms: 0 Bathrooms: 0 Plan Review 08/29/2013 $235.75
Value: $18,500 Plan Review-Fire Life Safety 08/29/2013 $145.08
Info Process/Archiving-Lg$2.00(over 08/29/2013 $2.00
11x17)
Floor Areas: Misc Administration Fee 08/29/2013 $1.50
Total Area: 0 Misc Administration Fee 08/29/2013 $3.75
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $874.29
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No 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 '�f ermlttee tgnature: A uh, t
19�
C. 5 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 - ENED
Commercial FOR OFFICE USE ONLY
AUG 2 9 ?O?3 Received G I
Ci of Ti and O Permit No.:
n 13125,SW Hal Blvd.,Tigard,OR 97 Plaan Revie ���u • r.Ilpg
Phone: 503.718.2439 Fax: 503.598OFTIGARD DateB .!�
( Other Permit:
T i GA R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: bids: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: ./--f'f9 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
([X Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling g CommerciaUindustrial Valuation: $
❑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: 45(D S fA) RAcu..., BL b• New dwelling area: square feet
City/State/ZIP: -r'i tvtia-D ` 0 R12 2 3 Garage/carport area: square feet
Suite/bldg./apt.no.: C Project name: Acu/D 14 t. ru lel Covered porch area: square feet
Cross street/directions to job site: a.Lt ►.J t.C_' 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
1 DESCRIPTION OF WORK ` 1 work indicated on this application., p�
N.e.m.) `1,V'►�f t-4't in' `�-i4i 0 t., v►�DL`is NCW Valuation: $ �U1 �(J
wail i 1 1� S.61 s / NJ-e.g.) A i{ ] _ Existing building area: Ii Z�1 square feet
V1.0�0 �� /`TVST 4G New building area: i 174-I square feet
roit PROPERTY OWNER ❑ TENANT Number of stories:
Name: V„,114.4 1:70 Type of construction: Yj NiDij.wie4lue ..r
Address: t`G.,1_5 SL) g LA,p ` 4-�, Q Occupancy groups: "�W
City/State/ZIP: TIA1Pa ..I71 O k.. R?t-1.--3 Existing: (3
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT,FEES*
(Please refer to fee schedule)
Business name: ......„,,t+......„,,t+ P vs,4 V co v,s'4- tru D h _
Structural plan review fee(or deposit):
Contact name: T�A GL I FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:(S4() c2,1- /1010 I Fax::( )S 31 -off Amount received:
E-mail: a emme0rhs u 1..',Co „., PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR ^ _ roof-top mounted P •toVoltaic Solar Parr "ystem.
Business name: �'lIY�IG H. r .V (..D1'1S blL�`F 7�0 , Submit two(2)sets o' Hof plan with .nnection details
and fire department acces , .Ion: .tth the 2010 Oregon
Address: Solar Installation Specialty C ., checklist.
City/State/ZIP: Permit fee(include .Ian re .-w $180.00
and as tstrative fees .
Phone:4,4-1 sm.. lb(W I Fax:(WO $-S1— DS(O to State surcharge 2%of permit fee): $21.60
CCB lie.: ttt✓?4,2-/ Total fe- .ue 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: TAFA /'Q.Ar Date: . , 15 * Fee methodology set by Tri-County Building Industry
L._ V Qt v. Service Board.
L\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
111111 Q Building Division
Over-The-Counter (OTC) Building Permit
TIGAR° Check List
Project Description: t I
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION •
Class of Work*: 'r— Occupancy Group: P Type of Construction: 513
, Type of Use**: Occupancy Load: Oregon Specialty Code: 26(O
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: P Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
• Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided: .
Design Area:
K Factor:
•
Total Project Valuation: $ is,,5 '. FEES DUE
$ .70.(N DC Prov Rvw,COM TI—Ping
$ DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2013) $ Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ 'j. 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ 2 .7` Plan Review,Structural
$5,000-$74,999 $70.00 $10.00 $ Lmi Plan Review,Fire Life Safety
$75,000-$149,999 $174.00 $26.00 $ _ NP Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $278.00 $41.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ . Other:
$ Other:
Building Staff: $ Other:
Date/Time: $ 1eq, _.-.1 - OTAL FEES DUE
*TYPE OF USE: COM=commercial;CMS=commercial manufac ... tru
'*CLASS OF WORK ACS=accessory;ADD=addition;ADU=access.ry.welhng.unitrsll-1' Iteration;DEM=demo;NEW=new;
OTR=other(use for fences,decks,retaining walls,signs,awnings or can 'es). \
7q
I:\Building\Forms\OTC-BUP.docx 07/01/2013 i
liII
g Building Division
° Development Code Provision Review
-T4 GAR D Commercial Projects - No Associated Land Use Case
Building Permit No: -----r 6 D / (3u P a c) c›,—,,,,, i Expedited Review O%h_
Project Name: �u P L i 12`c L, 0 I (
Site Address: I l 5615- 44 mot_ 6Lfb , Suite/Bldg #/:
--II.A -sic,J E-j
Plans Routed:
Original Plan Submittal Date: -'I,5 Routed By.
1st Revision Submittal Date: Routed By:
2nd Revision Submittal Date: Routed By:
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 I approved.
Planning Review (contact at (503) 718-;NI/Oor A@tigard-or.gov)
Proposal: ; j f.
� . -AI u .4. °. 1 . 1r% i A f, '., -.1- h.,.. L
Zoning C' p
Permitted Use Yes L9K No ❑
Land Use Required: Yes ❑ No [
Notes:
CV-Approved ❑ Not Ap r ved ❑ DCPR Not Required-No DCPR Fees Due
Date Routed to Building: 1i1'61/ 3
1:\CURPLN\Masters\Development Code Provision RevieWOCPR_COM_NoLandUse.doc Rev.01/16/13