Permit CITY OF TIGARD BUILDING PERMIT
� '-', COMMUNITY DEVELOPMENT Permit#: BUP2014-00244
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/22/2014
Parcel: 2S102AC00700
Jurisdiction: TIGARD
Site address: 12550 SW MAIN ST 120
Project: All Tech Subdivision: BURNHAM TRACT Lot: 1
Project Description: TI for new tenant: Adding office partion walls,(2)bathrooms,and a breakroom.
Contractor: SUMMIT CONSTRUCTION Owner: DOLAN&CO LLC
PO BOX 10345 BY FLORENCE T DOLAN
PORTLAND, OR 97296 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-223-9703 PHONE:
FAX: 503-242-3841
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 10/22/2014 $75.00
Occupancy Grp: B Occupancy Load: 47 DC Provision Review,COM TI-LRP 10/22/2014 $11.00
Permit Fee-Additions,Alterations, 10/22/2014 $804.75
Dwelling Units: 0 Demolition
Stories: 1 Height: 0 ft 12%State Surcharge-Building 10/22/2014 $96.57
Bedrooms: 0 Bathrooms: 0 Plan Review 10/22/2014 $523.09
Value: $60,000 Plan Review-Fire Life Safety 10/22/2014 $321.90
Info Process/Archiving-Lg$2.00(over 10/22/2014 $10.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,842.31
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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 Cente. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a _•• rules or direct questions to OUNC by calling 503.232.19: or 1.80".332.23••.
c
Issued By: / Per • -= ignature: /`
CFA
-.."•.4175 by 7:00 a.m.for the next available ins•- •• ate.'
This permit card shall be kept in a conspicuous place on the job site until completion of the pro-ct.
Approved plans are required on the job site at the time of each inspection.
City of Tigard
11111 COMMUNITY DEVELOPMENT DEPARTMENT
TrcA.1zD Building Permit Review — Commercial - No Land Use
e .za,J7.:-v��..r....: .a,;z:irsrx!:s.aaaai,.n�^:uremcu°ud:;jm:a•.�r..msmm.�r�rs�. - aar�rf-�sx:��:,.:cnm^•9a•? .Kacti;:,.adn.a.�Ana: s.icrcn
Building Permit #: ea i&()(L --oc ,i 2 0
Site Address: 12550 SW NUM St, Suite/Bldg#: —
Project Name:
(Name of commercial business occupying the space. if vacant,enter Spec Space.)
Planning Review
Proposal: I nor r 1I7 ovtn( is
Existing Business Activity: \W/it rLt
Proposed Business Activity: (f
❑ Verify site address/suite #exists and active in permit system.
.Zoning: I V►U C/DD
.1 Permitted Use: , Yes ❑ No ❑ Spec Space
,iirConfirm no land use required.
Notes:
Approved by Planning: d(te,Gt Date: I017-1 ) (
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: r a/ fL
Site Plans: # I
Building Plans:
Building Permit#: 3 nter building permit��# above.
Workflow Routing: arming E-- er-mtt Coordinator ding
Workflow Sign-off: [ 1 off for Planning(include notes from planning review)
Route Application Documents: uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: /u/,x„2.//!7
—`.
1:\Building\Forms\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:
I:\Building\Forms\B IdgPermitRvw_COM_NoLandUse_071514.docx
Building Division
•
Over-The-Counter (OTC) Building Permit
T[GARD Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occu.anc Grou : mum! i
��� ��� Type of Construction: i►
Type of Use**: A Occupancy Load: Oregon Specialty Code: zit'_
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: kA0 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: ff p�rryy
Total Project Valuation: $ ('��-/) FEES DUE
$ 7'- e DC Prov Rvw,COM TI—Ping
$ 1 ( ,CD DCProvRvw,COMTI—LRP
DC Provision Review Fee for COM TI (effective 7/1/2014) !(,7$"$ •-Cri# 6 Permit Fee—Add,Alt,Demo
Project Valuation Planning LRI4 y- $ Mall 12%State Surcharge
Up to$4,999 $0.00 $0.0011 $ :` Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 "j,j,rc,p$ Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ 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: rsit&gritt 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).
l:\Building\F orms\OTC_B U P_070114.do cx
Building Permit Application
Colllrnerclal FOR`OFFICE USE ONLY Received city f Tigard �� Permit No.: I /, 0 _ a..
illhiY g Date/B : '1 / i
° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718._439 Fax: 503.598.1960 Da[e/B Other Permit:
T1GAR`D Inspection Line: 503.639.4175 ,` t Date Ready/ H See Page 2 for
Internet: www.tigard-or.gov etkN
Notified/Method: 0 i 1 Supplemental Information •- '_ • 5- - .°TYPE OF WORK REQUIRED DATA:,1=•AND 2;FAMILY DWELLING'.
n t Permit fees*are based on the value of the work performed.
❑ New construction
❑Demolition.h� ��� p
� �� ®� Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Othetj,t 1.11015 equipment,materials.labor,overhead,and the profit for the
work indicated on this application.
= CATEGORY OF CONSTilko io .
El I-and 2-family dwelling CZ Commercial/industrial Valuation: $ /
El Accessory building 111 Multi-family Number of bedrooms:
❑Master builder El Other: Number of bathrooms:
'.JOB'SITE.INFORMATION,AND'LOCATION ' Total number of Floors:
Job site address: 12.S S•O v1/4/ I/4.,-41 s{% New dwelling area: square feet
City/State/ZIP: ii,1 aro 0 /-7' 22;Z, Garage/carport area: square feet
Suite/bldg./apt.no.: 7B IZO Project name: A-I I - rt,,t1 1 T. I. 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.: C 0 ri 7-co Permit fees*are based on the value of the work performed.
Q Z $ O dZ f�G 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. - work indicated on this application.
Valuation: $ 0 000
Azu..fly,, OF 09/4.C.1.. _./4.,. 1177 t/,WtIts. /MI ti{- nap S, 1
et..Q .. I.n..kvr.w, 4re.. (,v4V'"t C.ak.t,h.k-V 4 Sikk. Existing building area: (bt��s-square feet
New building area: 1 bl li s- square feet
K PROPERTY OWNER - ❑_TENANT': _ Number of stories: '_
Name: Pm 1 Dc IQ n Type of construction: t 11 - Ki
Address: 11(9 NW )11-.42 S{,. Occupancy groups: t
City/State/ZIP: ppr +L,,,Q, OR- 1-4 201 Existing: AA g
t
Phone:(5o3 ) 22S - 'I 007 Fax:( ) New: tNl I $
■"APPLICANTr�a " -," ® :CONTACT:PERSON ' '° BUILDING PERMIT'FEES* :=
Business name: 1 sD , tv�c. -- . _. (Please°r'efe,-to fee schedule)'
Structural plan review fee(or deposit):
Contact name: -1-,t„x L H,td
Address: 7 5� FLS plan review fee(if applicable):
ISs s- 2-=4 /%A.. 5µ:t-c. 2�
City/State/ZIP: (a,.} 1,,,,1l oV, °[� 2 y } Total fees due upon application:
Amount received:
Phone:(5p3 ) 2 z(e - 12$c--- Fax: :(93 ) Z 210 _ I L To _
E-mail � // PHOTOVOLTAICSOLAR'PANELSYSTEM FEES*
Commercial and residential prescriptive installation of
-_. _, .. _. __ .: . -. l '.CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: 5 u �;I Co,,y�,t to h-)1/4 Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Po g ox (O 3 4-S Solar installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP: Pp,f la-..1 t 0R. 13 21 (o $180.00
and administrative fees):
Phone:( 'o3 ) 2 2 3- `i-7-0 S Fax:(5-o3 )24-Z- 3S 4-I
State surcharge(12`7x,of permit fee): $21.60
CCB lie.: (,3 'Z 4-1
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: TA- 44 LA.)1441, Date: IO/yo/t g- * Fee methodology set by Tri-County Building Industry
f Service Board.
I:\Building\Pennits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
111 q Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent (25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ (0t 0Ov
MULTIPLIER (25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ (S r pv v
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given •
to those elements that will provide the greatest access. Elements shall be provided in the
following order: r(
(a) Parking $ erroillrt
(b) An accessible entrance: $ Prvv�gC.{
(c) An accessible route to the altered area: $ I
(d) At least one accessible restroom for each sex or a single unisex n
restroom: $ 1- pv,Z(a
(c) Accessible telephones: $ i1/4)/^
(f) Accessible drinking fountains: and, • $ J f A
(g) When possible,additional accessible elements such as storage and
alarms: $ N/A
TOTAL (shall equal line [2] of Valuation Computation): $
L\Building\Permits\BUP-COM PerrniiApp.doc 03/03/21)11
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
12550 SW MAIN ST 120, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00244
Jeff Grove
Violation Summary:
Inspector Contractor
CITY OF TIGARD BUILDING PERMIT
� '-', COMMUNITY DEVELOPMENT Permit#: BUP2014-00244
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/22/2014
Parcel: 2S102AC00700
Jurisdiction: TIGARD
Site address: 12550 SW MAIN ST 120
Project: All Tech Subdivision: BURNHAM TRACT Lot: 1
Project Description: TI for new tenant: Adding office partion walls,(2)bathrooms,and a breakroom.
Contractor: SUMMIT CONSTRUCTION Owner: DOLAN&CO LLC
PO BOX 10345 BY FLORENCE T DOLAN
PORTLAND, OR 97296 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-223-9703 PHONE:
FAX: 503-242-3841
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 10/22/2014 $75.00
Occupancy Grp: B Occupancy Load: 47 DC Provision Review,COM TI-LRP 10/22/2014 $11.00
Permit Fee-Additions,Alterations, 10/22/2014 $804.75
Dwelling Units: 0 Demolition
Stories: 1 Height: 0 ft 12%State Surcharge-Building 10/22/2014 $96.57
Bedrooms: 0 Bathrooms: 0 Plan Review 10/22/2014 $523.09
Value: $60,000 Plan Review-Fire Life Safety 10/22/2014 $321.90
Info Process/Archiving-Lg$2.00(over 10/22/2014 $10.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,842.31
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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 Cente. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a _•• rules or direct questions to OUNC by calling 503.232.19: or 1.80".332.23••.
c
Issued By: / Per • -= ignature: /`
CFA
-.."•.4175 by 7:00 a.m.for the next available ins•- •• ate.'
This permit card shall be kept in a conspicuous place on the job site until completion of the pro-ct.
Approved plans are required on the job site at the time of each inspection.