Permit y q CITY OF TIGARD BUILDING PERMIT
I"! ' COMMUNITY DEVELOPMENT Permit#: BUP2014-00054
Tic;A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/01/2014
-r
Parcel: 25101 DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 100
Project: Fullhart Insurance Subdivision: 72ND BUSINESS CENTER Lot: 13
Project Description: TI: Existing tenant relocating to different space.
Contractor: VANOSDEL CONSTRUCTION Owner: PNWP LLC#2
PO BOX 1057 BY PACIFIC NW PROP LTD PTNSP
BATTLEGROUND,WA 98604 PO BOX 2206
BEAVERTON, OR 97075
PHONE: 360-687-8636 PHONE:
FAX: 360-687-7677
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 04/01/2014 $70.00
Occupancy Grp: B Occupancy Load: 29 DC Provision Review,COM TI-LRP 04/01/2014 $10.00
Permit Fee-Additions,Alterations, 04/01/2014 $819.81
Dwelling Units: 0 Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 04/01/2014 $98.38
Bedrooms: 0 Bathrooms: 0 Plan Review 04/01/2014 $532.88
Value: $62,000 Plan Review-Fire Life Safety 04/01/2014 $327.92
Info Process/Archiving-Lg$2.00(over 04/01/2014 $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 $1,862.99
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 I•• •h 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.
Issu=• By: , Permittee Signature:` h� ���r =�cAs
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 Application
Commercial 1 ()R OFFICE I1SE ONLY
1,1 ((����;;rr Received
City of Tigard �1EI..GIVt DateB,� ' t M , �P. tr
•
13125 SW Hall Blvd.,Tigard,OR 97223 !' Plan Review ir,■ im �' a
Phone: 503.718.2439 Fax: 503.598.19 Date/B : �/�r� t
i-I G A li D Inspection Line: 503.639.4175 Date Read OF la See Page 2 for
Internet: www.tigard-or.gov
MAR -6 2014 Notified/Method: IIM Supplemental Information
TYPE OF W VAT OFTIGARD REQUIRED DATA 1-AND 2-FAMILY DWELLING
❑New construction !� i�'• j Mc DiviSIAN Permit fees*are based on the value of the work performed.
i III 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 ®Commercial/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:13535 SW 72nd Ave.-Suite 100 New dwelling area: square feet
City/State/ZIP:Tigard,OR Garage/carport area: square feet
Suite/bldgiapt.no.: Project name:Fullhart Insurance Covered porch area: square feet
Cross street/directions to job site:SW 72"&Cherry Deck area: square feet
Other structure area: square feet
REQUIRED DATA COMMERCIAL-USE CHECKLIST
Subdivision: l 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.
Inteior Tenant Modificaiton Valuation: $62,000
Existing building area: square feet
New building area: 2,860 square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: 2
Name:Pacific NW Properties Type of construction: II-B
Address:6600 SW 105th Ave. Occupancy groups:
City/State/ZIP:Beaverton,OR 97005 Existing: B
Phone:(503)626-3500 Fax:(503)671-0211 New: B
El APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:MDG (Please refer to fee sch.dslt) `
Structural plan review fee(or deposit):
Contact name:Betty Sheppard —
Address:7650 SW Beveland-Suite 120 FLS plan review fee(if applicable):
City/State/ZIP:Tigard,OR 97223 Total fees due upon application:
Phone:(503)244-0552 Fax::(503)244-0417 Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM flFS
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:VanOsdel Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:PO Box 1057 Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP:Battle Ground,WA 98604 $180.00
and administrative fees):
Phone:(360)687-8636 Fax:(360)687-7677 State surcharge(12%of permit fee): $21.60
CCB lic.:164073
�j�,�J�/..� f1 �. Total fee due 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:Betty K.Sheppeard Date:03/06/2014 * Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Permit Number: et,09Ad/ti-00v5-y
IN • • Building Permit Review
Commercial Project -No Associated Land Use Case
TIGAR[)
Site Address: 13535 s w 12'1'1 A-0e -Sui 4c too
'Verify site address is valid.
Project Name :
Planning Review
Proposal: 4 - ck Tema." - YY1G d.i f.i c&h C%') ; tena,v14 May l v19 -35 Yvai] Sui#e..
vJt mirn soant lout'ldiv .
'Zoning: Cr V
,'Permitted Use Er Yes ❑ No ❑ Spec Space
2 Land Use Required ❑ Yes ErNo
Notes: FV4lhC tntewfar,“ pnbvi✓1g to Y1L2u) S)i •
Approved by: JQXicS& G r.oft s3 Date: 11(, 1 1 4
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: /3-j
Site Plans: #
Building Plans: # 3
Create Case Record#: 11,...-B6-ter case#above for Building Permit Number.
Workflow Routing: Vining ❑ Engineering ❑ Permit Coordinator 11—$61
Workflow Sign-off: S 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:\Building\Forms\BldgPerm itRvw_COM_NoLandUse_123013.docx
Building Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description: I
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: Type of Construction:_4(k Type of Use**: Occupancy Load: Oregon Specialty Code: -z (0
SPECIFICS
Number of Stories: '1/ 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: y, 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: $ 672- `C FEES DUE
$ C •/pio DC Prov Rvw,COM TI—Ping
$ Mgr 11 DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2013) $ tsTAINd Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ 44W 2%State Surcharge
Up to$4,999 $0.00 $0.00 $ �jyiral .'Ian Review,Structural
$5,000-$74,999 $70.00 $10.00 $ Mare Plan Review,Fire Life Safety
$75,000-$149,999 $174.00 $26.00 $ ' f Oa 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: $ (JLZC1TOTAL 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