Permit CITY OF TIGARD BUILDING PERMIT
111111 COMMUNITY DEVELOPMENT Permit#: BUP2014 00006
T 1(.;AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2014
Parcel: 2S110DB01300
Jurisdiction: Tigard
Site address: 15298 SW ROYALTY PKWY
Project: EyeHealth Northwest Subdivision: 1996-010 PARTITION PLAT Lot: 2
Project Description: TI
Contractor: BNK CONSTRUCTION INC Owner: TIGARD INVESTMENT PROPERTIES LLC
45 82ND DR, SUITE 53B 11086 SE OAK ST
GLADSTONE, OR 97027 MILWAUKIE,OR 97222
PHONE: 503-557-0866 PHONE: 503-344-5100
FAX: 503-557-1085
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 02/24/2014 $2,766.95
Demolition
Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 02/24/2014 $332.03
Dwelling Units: 0 Plan Review 01/14/2014 $1,798.52
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 01/14/2014 $1,106.78
Bedrooms: 0 Bathrooms: 0 Metro Const.Excise Tax-Commercial 02/24/2014 $450.00
Value: $375,000 Use
DC Provision Review,COM TI-Ping 02/24/2014 $278.00
DC Provision Review,COM TI-LRP 02/24/2014 $41.00
Floor Areas: Info Process/Archiving-Lg$2.00(over 02/24/2014 $36.00
11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $6,809.28
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 . •1g R 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 :y: 4 a 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 APPlicatiltECEIVED
Commercial Il d, FOR OFFICE USE ONLY
City of Tigard JAN 1 3 2014
Received B : /m�r PermitNo.: j fdC/ —G '�('
1111 .
o " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review J r
Phone: 503.718.2439 Fax: 503.59S-111960,1 : , '1 , Other Permit:
TIGARD Inspection Line: 503.639.4175 ' OF TIGARD Date Ready/By: ,/ ) Sufis: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION
Notified/Method: �71, f Supplemental Information
{?7U-e -o. I , eQ
TYPE OF WORK RE- WED 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
G'Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling Pff Commercial/industrial Valuation: S
❑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: , • ° New dwelling area: square feet
latest •. _�_�.. 2._. ll .Ifl
Mr ' D - Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: �f:' / H� 31115113=11 Covered porch area: square feet
Cross street/directions to job site: 4 gr, '4 'I �� I v Deck area: square feet
\/,, I��U � �, .
, ` /�� /_ , 21 Other structure area: square feet
q,.f, : ,D i y ,..!MMERCIAL-USE CHEC. .,
Subdivision: Lot no.: Permit fees*are based on the value of the work performed
Tax map/parcel no.: 2S'if 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#./
' III I) illi '.,7l 1.A1 'IA • IL1 40 /,./, $ -1-2-On Valuation: $ I6t I
MI 1 l 7I•r • I . • L.I 1 1_� tj �, �1 Existing building area:l'3,6 square feet
L� i i t 'I • ;EM1 • New building area: r-. square feet
Number of stories:0, - .,a - -:,.;.,:t..-u
ME M
el i X11 i[�.Rlls 1 Type of construction: "e,
Address: IIOSe % 14. r Get Occupancy groups: B
City/State/ZIP: f J�`I M /�'e Oi ''� 2 Existing:
'Phone:( ^Jr, YiVi+, .. 5 00 Fax:(^I' ) iL 0 New
❑ CONTACT PERSON BUILDING PERMIT FEES*
- (Please refr to fee schedule)
1�I 4- 1' 1d •to% • ....
1 la . I '`,ii ' Structural plan review fee(or deposit):
Contact name:
n w y� + FLS plan review fee(if applicable):
Address: l ,II Q��Q+,1����a n,�J ) q1/J I
� •"1 ,`_ r�T I�r ` C� Total fees due upon application:
City/State/ZIP: /J-r . ,.i v= 1
Phone:(9b� 2?D_. i i Fax: (5.5) 7,7im(/ r 73! 7 Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: I lot '.� .!I i' I7 / j I ' ; -• it
Commercial and residential prescriptive installation of
CONTRACTOR
Ofi roof-top mounted PhotoVoltaic Solar Panel System.
Business name Po;`'y` Co Z1-11 la ue.1/UN /'N('_, Submit two(2)sets of roof plan with connection details
Irv-
5- ga p� and fire department access,along with the 2010 Oregon
Address: ae, , 63 Solar Installation Specialty Code checklist.
City/State/ZIP: as-,ja za'rbAC.t Q(L, C170a,7 Permit fee(includes plan review $180.00
�
and administrative fees):
Phone:(501) 57"o S ede • Fax:(5/33 ) 7-100"c
Y State surcharge(12%of permit fee): $2].60
CCB lie.: l0 55-5--
A Total fee due upon application: $2$0211.6600
201 60
Authorized signature:fp, Air g p, This permit application expires if a permit is not obtained
(�'/ within 180 days after it has been accepted as complete.
/�Print name: ' ,E I/, r � e • _rQR * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Perm;ts\BUP-COM Pe nitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
Building Permit Number: j3aPaol`/-600e4
511111 • ' Building Permit Review
Commercial Project-No Associated Land Use Case
TIGARD
Siy Address: 1Sa ci $ SG,-) o� a ( plc,,,.,
b Verify
site address is valid.
Project Name : f€ he aI-KA N 0,-W1 e s-i-
Planning Review
Proposal: -- ,-,4e,,-i o, ver•-,3c\c-( Oc • C d.c (;. I 0-C-kCe $eau1
Zoning: C -6 (ll))
giPermitted Use g Yes ❑ No El Spec Space
11 Land Use Required ❑ Yes ICI No
Notes: No iav,d u.se re 5,t.t i,.cd Ioec&Luc QII -{- -id 1( id J o/k- a ^d
no e. a v i e o c -e y_ Paul i LM o e f ,s-t.-' u-I e
Approved by: L■ki.t-t C • C CtiAa Date: 1 -1'3 --14
Revisions (after Building Submittal only) Reviewer Date
Revision 1 Approved ❑ Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
Building Permit Submittal
Original Plan Submittal: Date: By:
Site Plans: #
Building Plans: #
Create Case Record#: ❑ Enter case# above for Building Permit Number.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning staff,including notes from planning review(page 1)
Route Application Documents: ❑ Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
❑ Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Reviewed By: Date:
Notes:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_123013.docx
T R A N S M I T T A L
TO: City of Tigard ADDRESS: 13125 SW Hall Blvd.
Building Department Tigard, OR 97223
FROM: Breeze Clark DATE: 01.13.14
Project Manager
RE: EyeHealth Northwest SENT VIA: By Hand
Tigard Medical Office Building
CC: AD File PROJECT NO.: AD 13-127
THE FOLLOWING ITEMS ARE TRANSMITTED:
ITEM # QUANTITY DATE DESCRIPTION
1 3 01.07.14 Full size construction document set, 2 copies, 1
wet stamped/signed
2 1 01.07.14 Building Permit Application
3 1 12.31.13 Plan Review Fee Check-$2,905.30
El For Your Approval ❑ For Review and Comment x For Your Use
❑ Urgent El Please Contact Sender Upon Receipt ❑ Hard Copy to Follow by Mail
REMARKS:
To whom it concerns,
Included are three full size construction document sets for the EHNW Tigard project. One set is wet
stamped and signed per submittal requirements.
Please contact bclark @ADarchitects.com if you have any questions.
Thank you,
Breeze
ANDERSON DABROWSKI ARCHITECTS, LLC
1430 SE 3rd Avenue, Suite 200
Portland, Oregon 97214
Tel 503.239.7377 Fax 503.239.7327
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15298 SW ROYALTY PKWY, TIGARD, OR, 97224
Commercial - Building
299 Final inspection
2014-04-18 00:00:00
BUP2014-00006
PASS - C of O
Violation Summary:
Inspector Contractor