Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2014-00195
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/13/2014
Parcel: 25101 DC03800
Jurisdiction: TIGARD
Site address: 7190 SW SANDBURG ST 10
Project: Burkhart Dental Offices Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Interior partition walls to create new office,storage and IT closet.
Contractor: BNK CONSTRUCTION INC Owner: MCCORMACK PROPERTIES LP
45 82ND DR,SUITE 53B 7190 SW SANDBURG ST
GLADSTONE, OR 97027 TIGARD, OR 97223
PHONE: 503-557-0866 PHONE: 503-624-4649
FAX: 503-557-1085
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 08/13/2014 $75.00
Occupancy Grp: B Occupancy Load: 68 DC Provision Review,COM TI-LRP 08/13/2014 $11.00
Permit Fee-Additions,Alterations, 08/13/2014 $475.99
Dwelling Units: 0 Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 08/13/2014 $57.12
Bedrooms: 0 Bathrooms: 0 Plan Review 08/13/2014 $309.39
Value: $26,800 Plan Review-Fire Life Safety 08/13/2014 $190.40
Info Process/Archiving-Lg$2.00(over 08/13/2014 $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 $1,122.90
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. 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- throug •R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 2.1987 or 1.800.332.2344.
Iss ed By: - �� �/ Permittee Signature:
r Call 503.639.4175 by 7:00 a.m.for the next available inspection ate.
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.
L
Building Permit Application
Commercial FOR Oil I( I 1 .l=O\I 1
City of Tigard RCEIVFE) / PermitNo.: O(9/
N _ • 13125 SW Hall Blvd.,Tigard,O Plan R ew r „'
Phone: 503.718.2439 Fax: 503.598. Date/B : ,�C k .4 �, l r Fermin.
A1320'.�
T I G A R D Inspection Line: 503.639.4175 Date Re. furs: 0 See Page 2 for
Internet: www.tigard or.gov CITY O I 3ARD Notified/Method: Supplemental Information
l
TYPE' t onstO REQUIRED 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
®Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El I-and 2-family dwelling ®Commercial/industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:7190 SW Sandburg St New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: 10 Project name:Burkhart Dental Offices 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.
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.
Interior Partition Walls,to create new Private Offices,Storage and IT Closet Valuation: $26,800.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I 0 TENANT Number of stories: I
Name:McCormack Properties Type of construction: VB
Address:7190 SW Sandburg St Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing: B
Phone:(503)624-4649 Fax:( ) New: No Change
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Mose
Business name:NW Precision Design ( ►eldrafasctiedrre�
Structural plan review fee(or deposit):
Contact name:Darin Bouska
FLS plan review fce(if applicable):
Address:22605 SW Pinehurst Ct.
City/State/ZIP:Sherwood OR 97140 Total fees due upon application:
Phone:(503)680-64444 Fax::( )
Amount received:
E-mail:Darin@NW-Precision.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:BNK Construction,Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:45 82"d Drive,Suite 53B Solar Installation Specialty Code checklist.
City/State/ZIP:Gladstone OR 97027 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)557-0866 Fax:(503)557-1085
State surcharge(12%of permit fee): $21.60
CCB lie.:107555 74 f(P Total fee due upon application: $201.60
Authorized signa This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Darin B Date:8/12/2014 * Fee methodology set by Tri-County Building Industry
Service Board.
L\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
'Pig •■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: (,c P(90 /z/-e)O(9S—
Site Address: 71% 5W Sa ncibufg S-f'• Suite/Bldg#: IC)
Project Name: Burkhart be a\ oCf tic s
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review r(+
Proposal: jn1rerio{ Of r--j+ion • is f0 cr'• - ne,W pr'1vc&e, �ices7
tit. .4.•.- 0,141 It l._:a rrh�ov - - "1i • 0i . e k.C-'
Existing Business Activity: eorp0rcd-e 4-f ice, wi-,-h C c% SSof\I o
Sfa3
Proposed Business Activity: Co(po(a±p 101111'1 OKice. W.141 accessorAl s orxtee ,
dVerify site address/suite #exists and active in permit system. `1 J
IV Zoning: I-P �
12/Permitted Use: 2 Yes ❑ No ❑ Spec Space
L/Confirm no land use required.
Notes:
Approved by Planning: •_ II 'J As OA.,I Date: $1131 11-1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1 1 ......\_ 41 41
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: El Planning ❑ Permit Coordinator ❑ Building
Workflow Sign-off: El Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date:
1:1 BuiIdinglForms\BldgPermitRvw_COM_NoLandUse_071514.docx
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\BldgPerm itRvw_COM_NoLandUse_071514.docx
Building Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: T Occupancy Group: Type of Construction: )j
Type of Use**: COu& Occupancy Load: PP Oregon Specialty Code: 2C){r)
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: $ ier.3 FEES DUE
$ �5,C t) DC Prov Rvw,COM TI—Ping
$ ( ,00 DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ S` Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ 7, 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ o_r 'j�j" Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ C_ • Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ At. Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $299.00 $44.00 $ 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: $ ( ?2.'WTOTAL 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\Foams\OTC_BUP_070114.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
7190 SW SANDBURG ST 10, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00195
Chip Barnett
Violation Summary:
Inspector Contractor