Permit q CITY OF TIGARD BUILDING PERMIT
�, COMMUNITY DEVELOPMENT Permit#: BUP2013-00256
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718.2439 Date Issued: 10/22/2013
Parcel: 1 S 136 DD03400
Jurisdiction: Tigard
Site address: 11740 SW 68TH PKWY 250
Project: Oregon Health Care Association Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: TI:New office and storage room on second floor for existing tenant.
Contractor: PERLO CONSTRUCTION LLC Owner: HEALTH CARE ASSOCIATES LLC
7190 SW SANDBURG ST 11740 SW 68TH PKWY
PORTLAND, OR 97223 TIGARD,OR 97223
PHONE: 503-624-2090 PHONE:
FAX
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 10/22/2013 $70.00
Occupancy Grp: B Occupancy Load: 46 DC Provision Review,COM TI-LRP 10/22/2013 $10 00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 10/22/2013 $256.22
Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 10/22/2013 $30.75
Bedrooms: 0 Bathrooms: 0 Plan Review 10/22/2013 $166 54
Value: $12,000 Plan Review-Fire Life Safety 10/22/2013 $102 49
Info Process/Archiving-Lg$2.00(over 10/22/2013 $4.00
11x17)
Floor Areas:
Total Area 0
Accessory Struct: 0
Basement: 0
Carport. 0
Covered Porch 0
Deck. 0
Garage 0
Mezzanine. 0
Total $640 00
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 wit
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 co•�direct questions to OUNC by calling 503.232.1987 or 1 800 332.2344
Issued By: ermittee Signature: ��V lA .1..:‘•
_'9.4175 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
Commercial �:�° FOR OFFICE USE ONLY
City of Tigard �_ ? Date/Bed .to ) )i 3 (,j V
Permit No `(^p ( i dZSto
° 13125 SW Hall Blvd.,Tigard,O' er 0 �,
�J Plan Review 7h _
Phone. 503 718 2439 Fax• 503 : 1960 CO3� Date/B ���,,-ID��
T I G A R D
Inspection Line' 503.639 4175 ` ��� Date Ready/By ® El See Page 2 for
Internet: www.tigard-or.gov ( J ��e �\C \®� Notified/Method ' Supplemental Information
A
TYPE OF W0161, �1 . REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑ t 61t ion Permit fees*are based on the value of the work performed.
1 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=1 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11740 SW 68th Parkwy New dwelling area: square feet
City/State/ZIP:Portland,Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no...,)90"-°..0 Project name.Interior Remodel for OHCA Covered porch area. square feet
Cross street/directions to job site:SW 68th Parkway&SW Clinton St. 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.
Addition of a new office and a new storage room on the second floor. Valuation: $$12,000.00
Existing building area: 4,575 square feet
New building area: 4,575 square feet
® PROPERTY OWNER ® TENANT Number of stories: 2
Name.Oregon Health Care Assoc. Type of construction: IIIB
Address:11740 SW 68th Parkway-Suite 250 Occupancy groups:
City/State/ZIP:Portland,Oregon 97223 Existing: B
Phone.( ) Fax-( ) New: B
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mildren Design Group,P.C. (Please refer to fee schedule
Structural plan review fee(or deposit):
Contact name:Betty Sheppeard
FLS plan review fee(if applicable):
Address:7650 SW Beveland St.-Suite 120
Total fees due upon application:
City/State/ZIP:Tigard,Oregon 97223
Phone:(503)244.0552 Fax :(503)244.0417 Amount received:
E-mail:betty @mdgpc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Perlo Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:16101 SW 72nd Ave.-Suite 200 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,Oregon 97223 Permit fee(includes plan review $180.00
and administrative fees):
-
Phone:(503)624.2090 Fax:(503)639.4134
State surcharge(12%of permit fee) $21.60
CCB tic.:1892-45 Total fee due upon application: $201.60
Authorized signature: "2"'l' This permit application expires if a permit is not obtained
1 within 180 days after it has been accepted as complete.
Print name:Betty K.Sheppeard Date: 10/22/2013 * Fcc methodology set by Tn-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp dos 02/24/2011 440-4613T(l 1/02/COM/WEB)
Building Division
T 1 G n li Over-The-Counter (OTC) Building Permit
Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: /1/4 CT Occupancy Group: for Type of Construction:
Type of Use**: Occupancy Load: 46 Oregon Specialty Code: -c2O IO
SPECIFICS
Number of Stories: 'Ji 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: 5'"7 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: $ r��Cap. ' FEES DUE
$ "(0,Cr) DC Prov Rvw,COM TI—Ping
$ Q ,OD DCProvRvw,COMTI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2013) $ 22—Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ ,75- 12%State Surcharge
Up to$4,999 • $0.00 $0.00 $ ij.' — Plan Review,Structural
$5,000-$74,999 $70.00 $10.00 $ j 82AC( Plan Review,Fire Life Safety
$75,000-$149,999 $174.00 $26.00 $ ,co 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: $ ,Q(,) TOTAL FEES DUE
'"'TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC-BUP.docx 07/01/2013
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: (3cAP ao(3— aS(o xpedited Review (jstz._
Project Name: O c n) 71-m 1. curt.it Ci scSac;a�`Vr'/
Site Address: !/740 S-c,) C nay c5�,. dSb , Suite/Bldg #:
Plans Routed:
Original Plan Submittal Date: /6/413 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 if approved.
Planning Review (contact C l ie r I ec,•,vi eJ at (503) 718- 't37 or altrud eg C @tigard-or.gov)
Proposal: eCOft-A y to e%t n5 O`fi c.e sea c., • mo c.L-o ,c v 0C use
Zoning M
Permitted Use Yes J No ❑
Land Use Required: Yes ❑ No I�
Notcs:
Approved ❑ Not Approved ❑ DCPR Not Required—No DCPR Fees Due
ate Routed to Building:
1:\CURPLN\Masters\Development Code Provision RevieHADCPR_COM_NoLandUse.doc Rev.01/16/13
CITY OF TIGARD
BUILDING DIVISION PERMIT #:j3uP2oc-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: po zs�
Phone: (503) 639-4171a° U
Inspection Requests (24 Hrs.): (503) 639-4175 I�..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS:1174/0 i lc/4/y Zia CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections/Comments/Instructions:
FFS zoo— Oo/, . cr)e KLLK
z_Q(T - 00 Lifoi
P'SS PA PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
E. Al ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
yInspector: Date: //— f5;- /5 Phone #: (503) 718- 00/
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11740 SW 68TH PKWY 250, TIGARD, OR, 97223 2013 - 12 - 03 00:00:00
Record Type: Record ID:
Commercial - Building BUP2013 - 00256
Inspection Type: Result:
299 Final inspection PASS - No C of 0
Comments:
Violation Summary:
Inspector Contractor