Permit p CITY OF TIGARD BUILDING PERMIT
11111 - COMMUNITY DEVELOPMENT Permit#: BUP2014-00282
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/25/2014
Parcel: 1 S136DB02601
Jurisdiction: Tigard
Site address: 11606 SW PACIFIC HWY 200
Project: Greenlight District Subdivision: AZOIC TERRACE Lot: 1
Project Description: TI-Remove failing ceiling,replace with open structure,add exterior furring and new break room sink.
Contractor: ROBERT HAKES CONSTRUCTION Owner: HWY 99 LLC
PO BOX 894 2655 MARYLHURST DR
CAMAS,WA 98607 WEST LINN,OR 97068
PHONE: 503-318-1863 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 11/25/2014 $75.00
Occupancy Grp: M Occupancy Load: 67 DC Provision Review,COM TI-LRP 11/25/2014 $11.00
Permit Fee-Additions,Alterations, 11/25/2014 $256.22
Dwelling Units: 0 Demolition
Stories: 1 Height: 0 ft 12%State Surcharge-Building 11/25/2014 $30.75
Bedrooms: 0 Bathrooms: 0 Plan Review 11/25/2014 $166.54
Value: $12,000 Plan Review-Fire Life Safety 11/25/2014 $102.49
Info Process/Archiving-Lg$2.00(over 11/25/2014 $2.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $644.00
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 Notificati'n Center. Those rules are set forth in OAR
952-00 throug •'R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 '32.1•: or 8'.r 33 .2
Is ued By: 4114 / �j Permittee Signature: k-1
r I
Call 503.639.4175 by 7:00 a.m.for the next available inspection dat I
This permit card shall be kept in a conspicuous place on the job site until completion of the proj
Approved plans are required on the job site at the time of each inspection.
Building Permit Applicati n
Commercial b ri v r FOR OFFICE USE ONLY
City of Tigard DReactee/ived / n J Krum Na:
u Q6 1 -etoAgp.
13125 SW Hall Blvd.,Tigard,OR 97nn V 2 5 1 l
Plan Review 0 I4•
Phone: 503-718-2439 Fax: 503-5m - Date/B : dm/AL -- Related Permit:
T I G A R D Inspection Line: 503-639-4175 �� 1 R3 U Date Ready : Juris ® See Page 2 for
Internet: www.tigard-or.gov loll ,w,n1�1��inr, Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑ ew construction ❑Demolition Permit fees* are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
ddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONS RUCTION 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: + 4Ag New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite Idg.lapt.#: Project name: jj4' Covered porch area square feet
Cross street/directions to job site: D'c z Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION
�/O�F WORK work indicated on this application.
t� DE
_--i SC4 ic, sr►�a*i i t(;::, ( A Valuation: $ 1.7 (t190
_610 �7 u�O.h•- `1 f; ;,,2_ �, FV 9 1iJ�y-r 1i/JQ Existing building area square feet
.'AD �i�� 2_ t T/L'JI�=C .54 ^r1!'`-`-1t'v, 1 =-a New building area: square feet
g PROPERTY OWNER ❑ TENANT pok gaN Number of stories:
Name: j� 1
_
(f ck I L krealiks Type of construction:
Address:• 6:,Z 1 f' a. Occupancy groups:
City/State/ZIP: ,,,- ,„10 cl,Z Gr2Y' Existing:
Phone: ._ Fax:( ) New:
Ng APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Q , k9e,.. viewfee(ordeeosit):rk1
, '1� Structural plan review fee(or deposit):
Contact name: yo 11�
FLS plan review tee(if applicable):
Address: s D. an.)(. :n'
City/State/ZIP: 'ZOt � �� Total fees due upon application:
( 2� ! I .57.Z. Amount received:
Phone: 3 Fax::
E-mail: d 1 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
r� 17.742.6.7.i.4-... _ Co -••-rcial and residential prescriptive installation •
CONTRACTOR roof-top m..• :s PhotoVoltaic Solar Panel •m.
Business name: 't!1/f.} kes ` ,J Submit two(2)set . oof plan with t ection details
J and fire department acce'. •Ion._ • ith the 2010 Oregon
Address: n, r»4_f , L-f Solar Installation Special '.:•checklist.
City/State/ZIP: 0.11.141A/g,'^�t 1C1Cr' 9 Permit fee(inc .es plan re $180.00
and .•ministrative fees):
Phone: •6`� Fax:( State sure•.rge(12%of permit fee): $21.60
CCB Lic.: 7,002.&7
Total fee due upon appication: .111.60
Authorized signature: pp This permit application expires if a permit is not obtained
it within 180 days after it has been accepted as complete.
Print name: \ Dater !E �� * Fee methodology set by Tri County Building Industry
FF "���� Service Board.
1:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(1 1/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
• Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
1 c,A i l) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov
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 percent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
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:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
• alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Pemvts\BUP_COM_PennitApp.doc Rev.04/21/2014
a
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
~ Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
T I G A Ii D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
1. SITE PLAN (3) copies - fully dimensional, drawn to scale and labeled with:
A. ❑ map& tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking, including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the"Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit - based on valuation of project.
4. ADDITIONAL INFORMATION AS FOLLOWS:
A. Fire Department Building Survey with (1) additional full set of architecture
drawings.
I:\Buil ding\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
" Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
I A It t) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
Type of Submittal #of Plans
(Includes new,additions and alterations.) Required at
Submittal
Demolition Permit 3
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing(building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor,City of Tigard,Washington
County,and Tualatin Valley Fire &Rescue),if applicable.
1:\Building\Permits\BUP_COM_PercnitApp.doc Rcv.04/21/2014
City of Tigard
111111 ■
COMMUNITY DEVELOPMENT DEPARTMENT
r 1 G Building Permit Review — Commercial - No Land Use
ARD
Building Permit #: ky.
Site Address: !/126 /oc Al Suite/Bldg#:
6/4.1 ect Name:Prol j6,' 4v al/le Ii
(Name of commercial bu4incss occupying the space. If vacant,enter Spec Space.)
Planning Review / l
Proposal: ei/� /dpif.S/ Iehd14.( If' SPf4t5 (dnrkc�j 4/' L• Jlt* 1 fa Ct�ve
4 Pk Existing Business Activity: �eA+i / h Ate, �he G'� ,
Proposed Business Activity: 1 t AO G 4,4
❑ Verify site address/suite#exists and active in permit system.
❑ Zoning: (16"
❑ Permitted Use: X'Yes ❑ No 1pec Space
Aj Confirm no land use required.
Notes:
,�/ / /Ae).3"/
Approved by Planning: /� Date:
Revisions (after Building bmittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: f!/9,;//$4,
Site Plans: # 3
Building Plans: #
Building Permit#: Enter building permit# above.
Workflow Routing: 2'Planning ❑_ r nator Efrluilding
Workflow Sign-off: O'Sign-off for Planning(include notes from planning review)
Route Application Documents: 4a--Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: P ) , 0 - Date: // /7,I
I:\Building\Forms\BIdgPermitRvw_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:\Bui lding\Fors\BldgPermitRvw_COM_NoLandUse_071514.docx
Building Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description: I I
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: ( Occupancy Group: g-7 Type of Construction:
Type of Use**: 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: 100 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: $ 1 Crn FEES DUE
$ 7-5,c DC Prov Rvw,COM TI—Ping
$ I ,G'�'j DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ 256.c — Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ so 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ �. ' Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ Q 4%T. 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: J 4 f 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