Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2014-00153
T I(.A Ft C) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/10/2014
Parcel: 2S102AA00490
Jurisdiction: Tigard
Site address: 12085 SW HALL BLVD 130
Project: Arellanos Market Subdivision: TIGARD HIGHWAY TRACTS Lot: 13
Project Description: Automatic smoke detection alarm system approved as alternate method in lieu of exit access separation.
Contractor: ARELLANOS CONSTRUCTION LLC Owner: HALL STREET CROSSING LLC
PO BOX 2225 BY MR&MRS ROGER W TOM
WILSONVILLE,OR 97070 8067 SW RIGERT COURT
BEAVERTON,OR 97007
PHONE: 971-645-6825 PHONE:
FAX: 503-941-9975
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 07/10/2014 $271.43
Demolition
Occupancy Grp: A-2 Occupancy Load: 75 12%State Surcharge-Building 07/10/2014 $32.57
Dwelling Units: 0 Plan Review 07/10/2014 $176.43
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 07/10/2014 $108.57
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 07/10/2014 $2.00
Value: $12,500 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $591.00
Required Required Items and Reports(Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Yes 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 •ordance • 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. • ENTION: Oregon - requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-#11-0010 through OAR 952-01 -#0:I. •u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344.
1
I -ued By: 4/i Permittee Signature: ^_ _ ,
—
Call 503.639.4175 by 7:00 a.m.for the next available InspectionCd—atee.YYt
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
Fire Protection System ,iUlbitAU;AU Mlt FOR OFFICE USE ONLY
irrCity of Tigard e""`'�-' _�1�I Date/By: 7 /0 /4/ (&. Permit No.:1 uP6 / -et)1153
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review putt permit: /
Phone: 503.718.2439 Fax: 503.598.196C O Z 0 1 i n I' Date/By:
TI G A R D Inspection Line: 503.639.4175 _ Date Ready/By: Lurie: IE See Page 2 for
Internet: www.tigard-or.gov
(J /l I13 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 RI/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: New dwelling area: square feet
12085 S(� Hr.lf Qiuc� Sts��tr.
City/State/ZIP: -- 0J Or 9 7 a z 3 / Garage/carport area: square feet
Suite/bldg./apt.no.: v Project name: A r elk np•S SPn r+s Bar Covered porch area square feet
Cross street/directions to job site: N buy 9 9 c, (J 14.1( 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.
Ncui nc r Valuation: $ J a, S0G
t� Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/LIP: Existing:
Phone:( ) Fax:( ) New:
Itl APPLICANT ❑ CONTACT PERSON NOTICE
Business name: n rc I(c no S S pc,r 4 s Ro r All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: rYt rr r (roll c pa 4 under ORS 701 and may be required to be licensed in the
Address: 1 2.0 P,5 Sw 14t,,i I R I u c) so,t r 13c jurisdiction in which work is being performed.If the
City/State/ZIP: plicant is exempt from licensing,the following reasons
Ti,, '!i G rj r apply:
Phone:(q 31 ) f%tl s- 68 es Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name:
1-I r Con refer ro fee schedule/
rellonns on5frucf.nzi LLC Permit fee:
Address: p,U Bny Br' d 2 2 25
State surcharge(12%of permit fee):
City/State/ZIP: L , Icon\1.1 1 c Or CI 3e)4 U FLS plan review(40%ofpermit fee):
Phone:(C(71) G Li S- 61•x.2 5 _ Fax:(503) q&4 .. 99 75 (Due upon application.) ,
CCB lie.: I o c Total permit fees:
Authorized signature: e rtie. Alai,— received:
r
This permit application expires if a permit is not obtained
Print name: Date: within 180 days after it has been accepted as complete.
',Or re N an v �ii lc_ 1`l * Fee methodology set by Tri-County Building Industry
Service Board.
1:\BuildingWermitdFPS-PermitApp.doc Rev 01/05/2012 440-4613T(I1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) El New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
_ 2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation(see fee schedule): $
Permit fee based on square footage(see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\Building\Permits\FPS_PermitApp.doc Rev 01/05/2012 2
Building Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description: 14 A7)r -r• /■ r : L.Aa T h,.i
6R(P2GvLL As .P11-Tkic' A rk t4 1I/C', V F EX-TT /1-a 5k-,r24,‹ Ar
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: � }� Occupancy Group: Type of Construction: V i
Type of Use**: �/A Occupancy Load: Oregon Specialty Code: .,,(.
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: 1 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: $ p FEES DUE
$ �,t/\ DC Prov Rvw,COM TI—Ping
/" DCProvRvw,COMTI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ Plan Review,Fire Life Safety
$75,000 $149,999 $187.00 $28.00 $ i Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $299.00 $44.00 $ Info Proc/Arch,Sm(up to I 1x17$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: $ 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_070114.docx
71 City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Commercial - With Land Use
Building Permit #: 414 P cC/' -O4/S 3 /X)
Site Address: t2-C)8S SIN i--la( ( gItjd. Suite/Bldg#: J
Project Name: Ar'llahos SPOT-1— it-r.-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ti-e24_ V{StAuVAV+ \V) 6(10 yn ,ptC -.
XVerify site address/suite #exists and active in permit system.
R4-and Use Case#: M M D 20114- 00013
Tans Iatch Approved Land Use:
Lid"Site Plan ❑ Landscape Plan ❑ Other:
� �❑ Urban Forestry Plan CI Elevation Plan
L 'Building Height: Maximum Height Actual Height
D Conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance t_!„
Notes: NP.fdS +7 Meek- efoot,1i pnOr-to -Ern ( OCC,L it ricid • C anymtcl.ctrAth
t
Approved by Planning: /M 4J4,4_- Date: 1101)114
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 Submittal Date: .7//07#
Site Plans: # / Y/t
Building Plans: # / j
Building Permit#: 8" Enter building permit# above.
Workflow Routing: lanning 'Q Lngi rig" Building
Workflow Sign-off: le Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application, site plans,building plans, engineer and
y -� beam calculations and trust details,if applicable,etc.
Notes: e/ r
By Permit Technician: / 4 Date: 747/r"
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 042914.docx
Engineering Review
❑ Actual Slope:
❑ PFI Permit#:
❑ Conditions Met
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Forms\BldgPermitRvw COM_WithLandUse_042914.docx
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
12085 SW HALL BLVD 130, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00153
Chip Barnett
Violation Summary:
Inspector Contractor