Permit p CITY OF TIGARD BUILDING PERMIT
11111 • COMMUNITY DEVELOPMENT Permit#: BUP2015-00003
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/08/2015
Parcel: 2S 112DC00500
Jurisdiction: Tigard
Site address: 15895 SW 72ND AVE 120
Project: Dr.Thistle Subdivision: FANNO CREEK ACRE TRACTS Lot: 40
Project Description: TI for new tenant:Wall demolition,and construction of an x-ray room and window.
Contractor: MATTHEW OLSON CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES
5320 SW DOVER LN ATTN: N PIVEN
PORTLAND, OR 97225 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-892-0066 PHONE:
FAX: 503-892-0067
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 01/08/2015 $75.00
Occupancy Grp: B Occupancy Load: 14 DC Provision Review,COM TI-LRP 01/08/2015 $11.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 01/08/2015 $332.27
Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 01/08/2015 $39.87
Bedrooms: 0 Bathrooms: 0 Plan Review 01/08/2015 $215.98
Value: $16,400 Plan Review-Fire Life Safety 01/08/2015 $132.91
Info Process/Archiving-Lg$2.00(over 01/08/2015 $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 $811.03
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 -•ce, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No -• '•ter. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co s or direct questions to OUNC b :/ling •03.23 . or 1.800.332.2344.
Issued By: .-rmittee Signature: 411. =�''
C I :41151114k 5 by 7:00 a.m.for the next available insp• tion da`
This permit card shall be kept in a conspicuous place on the job site until c• -• - ••\of the projec
Approved plans are required on the job site at the time of each inspection.
Building Permit Application ', ' , .:; j, '. .p • • • . ' •-'• ••- •_.•
.
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard DR .-,�f Permit No.: / , 1 S' 1
IN13125 SW Hall Blvd.,Tigard,OR 97223 2015 Plan Review Ink
. Phone: 503.718.2439 Fax: 503.598.1960' " 0 8 Date/By: 7�' /0) Other Permit:
Inspection Line: 503.639.4175 Juris ® See Page 2 for
T I G A R D CITY F TI G NofeBodInternet www.tigard-or.gov
/ " Supplemental Information
BUILDING.DIVISION
_" sElsl-a�O \a(,-)44: , , -t 1 , ,, i ;; , ..•. 1 h�(t_
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
gil Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
. y�i� �'{ work indicated on this application.
-'4-,,lSk Y-�3s -454, ,"d sfle?fer'`s„ i.0 ON40 m_(F 0�� 1∎1 qtr �.�. t..aa� ....`.
_ �t..a.'s k rV L�._.,v,v......t .. . .... -..,,s�.....a.i...v_. Valuation: S_.
❑ 1-and 2-family dwellingCommer'cialrmdustrigl
❑Multi-family
of bedrooms:
11:1 Accessory building
❑Master builder ❑Other: Number of bathrooms:
e t u t a t .. Total number.of floors:
Job site address 1S"-SR.S 4c -7 Z N' ,'v e-- New dwelling area: square feet
City/State/ZIP: "I.0 Gt OR- 17 22-4 • Garage/carport area square feet
Suite/bldglapL no i iz6, r Project name: Dr 11114 HA, Ti Covered porch area square feet '
Cross street/directions to job site: . Deck area: square feet
/ Other structure area, square feet •
• Subdivision: 1 Lot no . - Permit fees*are based on the value of the work performed •--
• Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no • . • - - equipment,materials,labor,overhead,and the profit for the.
.{
work indicated on this :.ettcstion.
D etnA O ( tw1 _ i C.6Jt 6 ty v t^ih(!v� ' .I��W Valuation: $ .1(a 14 •
Existin buildin area feet
Existing g � Z� •-s4�
New building area --1 Zit square feet
.. 11111Nrailligrniffialffnillillilli
'-dumber of stones: 12►
Name: •Type of construction: tl{ .•
'- Address: 1 s S7C S L4VQ li. 914141 Vic groups: .
.City/State/ZIP: f - t 4 q-172)+,
• Existing:
Phone: w/S) t/ . 1 Cr/30V Fax: St' ) , if-—77S-3- -..: New: - . . .--..,..1-•
- .
• Business name: 1,,•" :`.`. :, . .
c, -'Z't-.1 - ?. 'Stnzctural plan review fee(or deposit):
i ir: .; . •Contact Hama . /\ �.' 1 Y°• •••- FIS plan review fee(if applicable):
Address: .. . 11111111111.11. ..
Total fees due upon doC
Phone:(3) 701_%e,4-4 .1 Fax.:.( ,:j . ,
Amount reoetved.•
. . , 1;Or ,v.t�1_& ';u .
E-mail: - e i . Q, v 4
Commercial and residential prey riptive.ii> �:d
roof-top mounted Photo Voltaic Solar Panel System.
Business name: iM 1 C(S tM 1 ry •.1.) Submit two(2)sets of roof plan with connection.h 20de god -
and fire department access,along with the 2010 Oregon
Address: Solar Installation . cial Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
Y and administrative fees:
Phone:( ) I Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: .-' 9 ' 7 /6f Total fee due upon application: S201.60
This permit application expires if a permit is not obtained
Authorized signature: '�=-A within 180 days after it has been accepted as complete.
Print name: A • Fee methodology set by Tri-County Building Industry
_`I.1.�. Date: I g S Service Board
r-‘n.„i.i.....,p,.,,.,;ttnr rprnm PrrmitAnn("Inc (12/24/2011 440-46I3T(11/02/COM/WEB)
11111111 ' Building Division
i II Over-The-Counter (OTC) Building Permit
I-1`' ,vR" Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: i v. Occu•anc Grou.: OP Type of Construction: /1..j
Tre of Use**: Alarm Occu.an Load: gni Ore.on S.ecial Code: - •
SPECIFICS
Number of Stories: mil/ 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
Sidcyard 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: YCt7 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: $ (k 14 CPO I _ FEES DUE
$ OA. DC Prov Rvw,COM TI—Ping
$ Wi'P DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ -IrorW Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ `i-i 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ Awr. Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ KIM Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ • ail 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: $ 811 ,c)'-j 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_B U P_070114.docx
City of Tigard
•
•
COMMUNITY DEVELOPMENT DEPARTMENT
T G Building Permit Review — Commercial - No Land Use
IARD
Building Permit #:
Site Address: /5-(5. S S t n, Suite/Bldg#: loo
Project Name: 74r.vV
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review /
Proposal: 7YI /r-i - T- ` /Vdv ety- /eao ,
Existing Business Activity: /44$ /' Ofik
Proposed Business Activity: /1(e%c4/ ogee
Verify site address/suite #exists and active in permit system.
Zoning: 7 P
❑ Permitted Use: ''Yes ❑ No ❑ Spec Space
Confirm no land use required.
Notes: /id C/4477. UJ.[i
Approved by Planning: �� Date: / '/LS--
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:
Site Plans: # 0-
Building Plans:
Building Permit#: LL�'E nter building permit#above.
Workflow Routing: ning 5W-it-nit Coordinator ding
Workflow Sign-off: L3-Stg off for Planning(include notes from planning review)
Route Application Documents: KI$—ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: � _ j Date: /0_3—
I:\Bui Iding\Forms\BldgPerm itRvw_COM_NoL andUse_071 5 14.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 Iding\Forms\BldgPermitRvw_COM_NoLandUse_071514.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
15895 SW 72ND AVE 120, TIGARD, OR, 97224
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00003
Chip Barnett
Violation Summary:
Inspector Contractor