Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2014-00197
Date Issued: 11/24/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 1358A00102
Jurisdiction: Tigard
Site address: 10230 SW WASHINGTON SQUARE RD
Project Panera Bread Subdivision: OAKBURG Lot: 9
Project Description: Convert portion of a former bookstore into a Panera Bread restaurant.
Contractor: WILCOX CONSTRUCTION INC Owner: PPR SQUARE TOO LLC
234 5TH AVE S PO BOX 847
EDMONDS,WA 98020 CARLSBAD, CA 92018
PHONE: 425-774-4185 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 11/24/2014 $4,030.95
Demolition
Occupancy Grp: A-2 Occupancy Load: 120 12%State Surcharge-Building 11/24/2014 $483.71
Dwelling Units: 0 Plan Review 08/18/2014 $2,620.12
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 11/24/2014 $1,612.38
Bedrooms: 0 Bathrooms: 0 TDT-Transportation Development Tax 11/24/2014 $10,041.00
Value: $600,000 DC Provision Review,COM TI-Ping 11/24/2014 $278.00
DC Provision Review,COM TI-LRP 11/24/2014 $41.00
Info Process/Archiving-Lg$2.00(over 11/24/2014 $126.00
Floor Areas: 11x17)
Info Process/Archiving-Sm$0.50(up to 11/24/2014 $10.00
Total Area: 4502 11x17)
Accessory Struct: 0 Metro Const.Excise Tax-Commercial 11/24/2014 $720.00
Basement. 0 Use
Carport: 0 Park-Commercial and Industrial 11/24/2014 $2,944.52
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $22,907.68
Required: Required Items and Reports(Conditions)
Fire Sprinkler: 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 ' .ance 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
da . ATTENTION: • -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
2-001-0010 through OAR• -001-01• You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: , ,` ',1`A ! l 7 Permittee Signature: '.__• G
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.
B?ilcillrl a Permit Application
Commercial RECEIVE') FOR OFFICE USE ONLY
111 Received `
City of Tigard DateB : t 0 f • Permit No.: it�Lt�i /y, caD 17
• 13125 SW Hall Blvd.,Tigard,OR 97223 p Plan Review �y�. 1�
= Phone: 503.718.2439 Fax: 503.598.A.,10€ 1 8 2014 Date/B : 4�4 y O ll f` . Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Date Ready: : / tuns: ® See Page 2 for
Internet www.tigard-or.gov CITY OFTIGARD Notified/Method: l0 i 3/�t�( • Supplemental Information
TYPEB:Ink/M irgt DIVISION cry' 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. T .
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ r•-•
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 0
Job site address: 10230 SW Washington Square Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Panera Bread Covered porch area: square feet rNx
Cross street/directions to job site:SW Greenburg Road Deck area: square feet
Other structure area: square feet
per
,{45 REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: gl Lot n .: 102 Permit fees*are based on the value of the work formed.
Tax map/parcel no.:Tax Map 1 S135BA Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the M
DESCRIPTION OF WORK work indicated on this application.
TI of a portion of a former bookstore for a new Panera Bread restaurant. Valuation: $$600,000.00
Existing building area: 450,)1 square feet ‘;\<
New building area: 45031, square feet
❑ PROPERTY OWNER I ® TENANT Number of stories: I
Name: Panera,LLC Type of construction: VB
Address:3630 S.Geyer Road,Suite 100 Occupancy groups: C UN_ OCC 1•2?
City/State/ZIP: Sunset Hills,MO 63127 Existing: M
Phone:(314)984-1000 Fax:(314)909-3300 New A-2
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Panera,LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:John Sturges
Address:3187 Airway Avenue,Suite A FLS plan review fee(if applicable): —
Total fees due upon application:
City/State/ZIP: Costa Mesa,CA 92626 9l�S4�7
( 6� '7�'7 ( ) Amount received:
Phone:(714)966-9400 /t� Fax: :(949)258-5655
E-mail: rsi.johns @gmail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: lA. l L ey W �u e%%O to /)6e,. – Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: a Zj q 5 A-(- Solar Installation Specialty Code checklist.
City/State/ZIP: eA r,-)-1-- S LOA- `�S0o� Permit fee(includes plan review $180.00
( as) /��� ( ) and administrative fees):
Phone: 17a y Fax: State surcharge(12%of permit fee): $21.60
CCB lie.: j/ / / p ��3d />(p
l f 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: I Date: ' Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)
• i►
City of Tigard
illilr COMMUNITY DEVELOPMENT DEPARTMENT
l ■
•
TI G n R D Building Permit Review — Commercial - With Land Use
Building Permit #: �a/,9_0R4- co/9-2
Site Address: /o0 3o 6c... (.orf6k,t3coTot 3 -k-v , Suite/Bldg#:
Project Name: �ANt_ Pf.µ..ay
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review 'r , /
Proposal: L Qr' MUtFica--hov► -.//4/1/0 or zJ sL /
Zr Verify site address/suite#exists and active in permit system.
Land Use Case#: M a U 14 - o o o a
.0' Plans Match Approved Land Use:
Site Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
..I2'Building Height: Maximum Height ►.l j A Actual Height
.0r Conditions Met: ❑ Prior to Submittal 1 ❑ Prior to Permit Issuance
Notes:
Approved by Planning: '1 '4 $4),G(A Date: 9, 1 14
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: j`r/c2g//i/
Site Plans: # /144.
Building Plans: # ehad&—c019 7
Building Permit#: J.—Eater building permit#above.
Workflow Routing: [,.Punning 0—Btrglneering Ei'Icimit Coordinator 1:1uilding
Workflow Sign-off: EY5'"----- 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: '73c:)//"..7
L\Building\Forms\BIdgPermitRvw_COM_WithLandUse 0429I4.docx
r _
Engineering Review
❑ Actual Slope:
❑ PFI Permit#:
❑ Conditions Met
Notes:
Approved by Engineering: r_,, _ —____ Date: /0 - --/ 7
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:
)K to Issue Permit
/
Approved by Permit Coordinator: - ' �l Date: !O Z /
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 042914.docx
October 2, 2014
RE: TENANT IMPROVEMENT
Project Information
Building Permit: BUP2014-00197 Construction Type: 5-B
Address: 10230 SW Greenburg Rd. Occupancy Type: A-2
Area: 4502 Sq. Ft. Stories: 1
Name: Panera Bread Sprinklers: Yes
The plan review was performed under the State of Oregon Structural Specialty Code
(OSSC) 2014 edition; 2014 Oregon Fire Code. Please respond to conditions below.
1 ) Provide lateral design and calcs for RTU platforms and attachment to
structure.
When responding, provide an itemized letter stating in what way each numbered
issue has been addressed in the revision.
When submitting revised drawings or additional information, please attach a copy of the
enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City
of Tigard in tracking and processing the documents.
Respectfully,
Dan Nelson
Senior Plans Examiner
(503) 718-2436
dann @tigard-or.gov
U.4D/•mac— Pe e V
Ar 40)17 4/c,77DPr �Lcv1A71 o
111 q City o f Tigard
'1 DT—COUNTYWIDE TRANSPORTATION DEVELOPMENT TAX
TIGARD Rate Calculation Worksheet
APPLICANT �/$(-L2/q t Z-1--c__ DATE /U 2 /i4
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MAILING ADDRESS 36 0 c� c-e`(e2 I I[�0 PREPARED BY /p."!/ s
CITY/ZIP/PHONE /
�v�����}�c�s /Y0 6 3/ 2 7- PLANS CHECRTor2014_c0/eq.
TAX MAP# / -3 S 3 �� D PROJECT TITLE !�
SITUS#ADDRESS !>�ere.24 �' A
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FORMER USE(S)
USE ITE # TDT
# CODE UNITS X RATE = AMOUNT DESCRIPTION/NOTES
= /
x
x -
x
TOTAL TDT,FORMER USE(S) it: / , 6 '5-3
PROPOSED USE(S)
USE ITE # IX AMOUNT
RATE _ DESCRIPTION/NOTES
# CODE UNITS
i 93 Z 1/c x l'/9, 9-59 = / i 576 44 6-/-f--%v2A/, S/T o r, /
x =
x = /
TOTAL TDT,PROPOSED USE(S) / i, 2/4 h/,arc- 76-70 ith*v pNfn!7—
LESS TOTAL TDT,FORMER USE(S) — f -
/U 3 /D/ off! �-
TDT INCREASE/(DECREASE) DT DUE)
PAYMENT METHOD 2KS /
CASH/CHECK ,- 2 Z ZS g�
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415-03 �` 2-Z5 Of ;LQ e S
CREDIT 6
,r S r7■lG 'z 2e714/.1-... .= pp '/£F
BANCROFT AGREEMENT •5(5.6 a t 7vc) 6. 4
(PROMISSORY NOTE)
DEFER TO OCCUPANCY /3.67 X $16,./- / �(J6/ 60 7, se-P�2(s
I/OFS/CD/FORMS/TDT Rate Calculation Worksheet.indd(Rev.4/22/09) !� -�
RS( GROUP RECEIVED
AUG 1 8 2014
CITY OF TIGARD
BUILDING DIVISION
LETTER OF TRANSMITTAL
August 15, 2014
Debbie Adamski
City of Tigard I Community Development
13125 SW Hall Blvd.,Tigard,OR 97223
503-718-2450
RE: Panera Bread-Tigard
Debbie:
Please accept these items as our 1'round submittal for Plan Check and Permit Approval.
Enclosed you shall find the following items:
Items
1) 3 Complete Set of Plans
2) 3 Sets of Structural Calculations
3) Commercial Application Checklist
4) Building Permit Application—Commercial
5) Plumbing Permit Application—Building Fixtures
6) Plumbing Permit Application—Site Utilities
7) Electrical Permit Application
8) Mechanical Permit Application
9) Check# 1311410 in the amount of$3,965.27
Please email us a confirmation of the receipt of payment to rsi.assist @gmail.com. Or you may mail us a
receipt to our office 3187 Airway Ave STE A,Costa Mesa,CA.
If you should have any questions or concerns,feel free to give us a call.
Thank you,
• en' o,saa j
Director of Development
3187 Airway Avenue • Suite A • Costa Mesa, CA 92626 • T: 714-966-9400 F:949-258-5655
I
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
10230 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00197
Chip Barnett
Violation Summary:
Inspector Contractor