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Permit
p CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2014-00068 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/27/2014 Parcel: 1 S135BD00300 Jurisdiction: TIGARD Site address: 9735 SW SHADY LN 203 Project: Child Eye Care Association Subdivision: ASHBROOK FARM Lot: PTS 5& Project Description: Relocate interior walls for new exam rooms. Contractor: ROBERT TODD CONSTRUCTION INC Owner: MCFADDEN,ARTHUR L 4080 SE INTERNATIONAL WAY B113 BY SKLARZ, ERIC MILWAUKIE, OR 97222 621 SW MORRISON ST, STE 800 PORTLAND,OR 97205 PHONE: 503-653-5704 PHONE: FAX: 503-653-5729 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 03/27/2014 $70.00 Occupancy Grp: B Occupancy Load: 39 DC Provision Review,COM TI-LRP 03/27/2014 $10.00 Permit Fee-Additions,Alterations, 03/27/2014 $804.75 Dwelling Units: 0 Demolition Stories: 3 Height: 0 ft 12%State Surcharge-Building 03/27/2014 $96.57 Bedrooms: 0 Bathrooms: 0 Plan Review 03/27/2014 $523.09 Value: $60,000 Plan Review-Fire Life Safety 03/27/2014 $321.90 Info Process/Archiving-Lg$2.00(over 03/27/2014 $8.00 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,834.31 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. ATTE ON:___Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0 010 through 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by callin 'iL2.1987 or 1 8,0. 3 2344. ♦I , ssued By: ��,�, � � Y` Permittee Signature: /� I�' 1! I Call 503.839.4175 by 7:00 a.m.for the next available inspection`� I 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 „ ,c0io Commercial 4-11 1 ",.._ -- 1OR 0141( L l I. e)\l.1 City of Tigard IAK 21 2014 Received n" OA*" -eelet6:17 De eiv O Permit No.: 4 l 13125 SW Hall Blvd.,Tigard,OR 9722Y Plan Revie 1,I S7 ilq 1 Phone: 503.718.2439 Fax: 503.598�Q�Qt oi. f`�,pRp DateB : !ems<t � Other Permit: TI G A R D Inspection Line: 503.639.4175 i c n Date Ready i y: Juris. E5 See Page 2 for Internet: www.tigard-or.gov ^'1�Q nt��� „'�•'�`'� Notified/Method Supplemental Information TYPE OF WORK REQUIRED DATA: I-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 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 XCommercial/industrial 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: 113G .i5411 v E New dwelling area: square feet 1„j City/State/ZIP: ,j�7 toy ` _Garage/carport area: square feet Suite/bldg./apt.no.: �'J Project name: 14) C4 . 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. Indicate the value(rounded to the nearest dollar)of all Tax map.parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK GG'' 14125(4_, work indicated on this application. „n� �ei 4E. !J till- 5Vtt/ Valuation: $ (�Qr( � .1� � + ..l01ms Existing building area: L` square feet T�EV' 1�11�L5F New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: _ • 11/462l7-1 5 +d3rrsAhai5 Type of construction: Address: 4 G I yaW tT .. 'QQ Occupancy groups: City/State/ZIP: !- '25 Existing: Phone:(59 2... :3 do 5171 Fax:(53 •2 New: —_ 54 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Q _ ` (Please refer to fee deposit): schedule) Business name: � �. Structural plan review fee(or deposit): Contact name: y..le� Address: Pte. l FLS plan review fee(if applicable): City/State/ZIP:4Sp_11..�19 CA Z-• CV/L/40 Total fees due upon application: Phone:(VS SZ;ce.61747 Fax::(605 2-X,^.7Z 1 Amount received: E-mail: ,26,44 e or sic, , ,Co w PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: lEtr_ L�.i � _ Submit two(2)sets of roof plan with connection details C�V T� and fire department access,along with the 2010 Oregon Address: 4C12,e, ...1 1.4'«3 p�/4' 04A.t.^ Solar Installation Specialty Code checklist. City/State/ZIP: MI �� Zrzz. l — Permit fee(includes plan review $180 00 ( and administrative fees): Phone:( ) t053 ..1. '7d Li Fax: ".J State surcharge(12%of permit fee): $21.60 CCB lie.: Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained.errelA within 180 days after it has been accepted as complete. • Print name: 171,j / Date: 77 i Q II * Fee methodology set by Tri-County Building Industry /"_ r Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Number: c a`e 9o/4-©006 g III Building Permit Review Commercial Project —No Associated Land Use Case TIGARD Si e Address: 1735 Sivali Li-ia 6 Z0 3 1Verify site address is valid. Project Name : Planning Review L • Proposal: (� /I 9 / /L/& i 4'2ç A,) / wa g N- EU Zoning: DrPermitted Use ❑ Yes No ❑ Spec Space 2�Land Use Required ❑ Yes No Notes: /id (12 itillLlr) l,4 Approved by: cr 42---....-------t Date: ./2-1//171" 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: ❑ Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Reviewed By: Date: Notes: I:\Bui(ding\Forms\B IdgPermitRvw_COM_NoLandUse_123013.docx Building Division Over-The-Counter (OTC) Building Permit I `' \P " Check List Project Description: APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION Class of Work*: lm7a-r Occu.anc Grou.: �%' Type of Construction: *r T j.e of Use**: ,�1� ' Occu.an Load: 11.1fitiM Ore Ion S.ecial Code: 40 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: 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: $ 60)ay FEES DUE / C>,00 DC Prov Rvw,COM TI—Ping $ Y,Q V DC Prov Rvw,COM TI—LRP DC Provision Review Fee for COM TI(effective 7/1/2013) $ ,'7.j Permit Fee—Add,Alt,Demo Project Valuation Planning LRP $ °N 7' 12%State Surcharge Up to$4,999 $0.00 $0.00 $ g' Plan Review,Structural $5,000-$74,999 $70.00 $10.00 $ / Plan Review,Fire Life Safety $75,000-$149,999 $174.00 $26.00 $ gp,//r 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: 173ZALts21 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 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 9735 SW SHADY LN 203, TIGARD, OR, 97223 Commercial - Building 299 Final inspection PASS - C of O June 13, 2014 at 7:55:19 AM BUP2014-00068 Chip Barnett Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 9735 SW SHADY LN 203, TIGARD, OR, 97223 Commercial - Building 299 Final inspection PASS - C of O June 13, 2014 at 7:55:19 AM BUP2014-00068 Chip Barnett Violation Summary: Inspector Contractor