Permit � p
'` CITY OF TIGARD BUILDING PERMIT
1 I COMMUNITY DEVELOPMENT Permit#: BUP2015-00108
'TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/14/2015
Parcel: 2S 101 AA09700
Jurisdiction: Tigard
Site address: 12587 SW 68TH AVE
Project: Nielsen Insurance Subdivision: 1996-024 PARTITION PLAT Lot: 1
Project Description: TI for existing tenant:Office remodel that includes moving interior partitions.
Contractor: D&B COMPANY Owner: PARAGON PROPERTIES LLC
5521 SE WOODSTOCK BLVD 12585 SW 68TH AVE
PORTLAND, OR 97206 PORTLAND, OR 97223
PHONE: 503-232-1974 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg DC Provision Review,COM TI-Ping 04/14/2015 $75.00
Occupancy Grp: B Occupancy Load: 44 DC Provision Review,COM TI-LRP 04/14/2015 $11.00
Permit Fee-Additions,Alterations, 04/14/2015 $377.90
Dwelling Units: 0 Demolition
Stories: 1 Height: 0 ft 12%State Surcharge-Building 04/14/2015 $45.35
Bedrooms: 0 Bathrooms: 0 Plan Review 04/14/2015 $245.64
Value: $20,000 Plan Review-Fire Life Safety 04/14/2015 $151.16
Info Process/Archiving-Sm$0.50(up to 04/14/2015 $3.50
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $909.55
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
952-001-0010 through OAR 952-001-0090. You may obtain a cop rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection te.
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.
a
Building Permit Application
Commercial �� I(HZ O1.1.I( I. I ',1 l)N I 1
(� 1
City of Tigard u� Received 15 Qom- Permit No.: t�_ /•13125 SW Hall Blvd.,Tigard,OR 9728_ 01�
Plan Retie,, �®
III
a Phone: 503-718-2439 Fax: 503-598-1960 ,�� `.t 1` I% � Related Permit:
V Date/B
TI c;.1 R h Inspection Line: 503-639-4175 PQ� ,I ri r ate •ea.), t y: Juris: ® See Page 2 for
Internet: www.tigard-or.gov ���`�,v,,``,cxOotified/Method: I. I ■ j. �ay Supplemental Information
TYPE OF WORI�'�� ,›- REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑De�``ttion� Permit fees*are based on the value of the work performed.
❑New construction i
Indicate the value(rounded to the nearest dollar)of all
je Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit : the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
CI Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floo.:.
Job site address: ) 2-587 Sek1 1p�''` /3 vc New dwelling . •a: square feet
City/State/ZIP: -11kvi1'n-0 i.,,/1 4,7"L13 Garage/ . ..rtarea: square feet
Suite/bldg./apt.#: Project name: Covere• porch area square feet
Cross street/directions to job site: De area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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 OF WORK work indicated on this application.
Valuation: $r0 t p•p
I r��101 I- Existing building area 14)°) ' square feet lki
New building area: — square feet
jig PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: N ILLS to.) 4jJ1 tll1-Ao✓C t% Type of construction:
Address: i_-Z„ 5" ?) s V,.) b$ Ft V C Occupancy groups:
City/State/ZIP: t (p A4-40 U vt 9 7 b Existing:
Phone:( ) Fax:( ) New:
tir APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: CAST e�1, Y 0\-ei i► (TS
lam` ( r deposit):
`k)
Structural plan review fee(or deposit):
Contact name: 1 t-)ti WY rt<t z rif
Address: FLS plan review fee(if applicable):
1433 4/ ivy) t Lz I� ii)l,r 1, --
City/State/ZIP: ? ,x V,-1 ! 7 2 Lq Total fees due upon application:
Phone:( £63) j 2 t S.03 D Fax: :( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: �pt3 c /x7- /L?U-" t T,/, Ga„�
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Q 4 1, C b• Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: g, Z I f e t,.)00 q fro q . j)1...v9 Solar Installation Specialty Code checklist.
q r Permit fee(includes plan review
City/State/ZIP: P J( I ZD 1p and administrative fees): $180.00
Phone:(� 23/'L 11 7 (! Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: I b 711
/ 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: --R„..% L�w Date: )./I fr— * Fee methodology set by Tri-County Building industry
l""r �(L fl 1 Service Board.
I:1 Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-46131(11/02/COM/WEB)
r
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
IIIAccessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
l 16 A R[) 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] $ *0 1 00()
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 5—o oD
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:\Buil ding\Permits\BUP_COM_PcrmitApp.doc Rev.12/18/2014
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. " Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
T<G A Et a 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. El map&tax lot# El project name ❑ site address ❑ suite number
El zoning El applicant name El 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:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
.71 ` Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
T G R u 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 2
(site plan is required showing location and square footage
of all buildings to be demolished,erosion control plan and
tree protection,if applicable)
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
Solar Photovoltaic 2
(Requires check list for prescriptive installation. If not
prescriptive installation,engineering is required.)
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.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
r l c n o Building Permit Review — Commercial - No Land Use
Building Permit #: 81.4620<5"--03 fog
Site Address: 125(6 7 SA 68+h Suite/Bldg#:
Project Name: Nei<son I nemscvnce.
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review r
Proposal: (> e.X l o{ T1 4o ' exls 'n5 +e,na
Existing Business Activity: ice,
Proposed Business Activity: t Le.
,Aerify site address/suite#exists and active in permit syst n.
[I 1 River Terrace Plan District ❑ Yes U►' No
5 Zoning: MUE ,
Y
ermitted Use: E es ❑ No ❑ Spec Space
Confirm no land use required.
Business License:
Exists: Lir Yes ❑ No,applicant notified to obtain business license
Notes:
`ji --y- L r1_ H 1'� 1
Approved by Planning: j„ I �rY1 � Io0'1, Date: 1 I 15
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: #
Building Plans: # 3
Building Permit#: r building permit#above.
Workflow Routing: ,fining ❑ Permit Coordinator ding
Workflow Sign-off: a� �ign- ff for Planning(include notes from planning review)
Route Application Documents: P'Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: v7--
By Permit Technician: Date: Ws--
I:\Building\Forms\BldgpermitRvw_COM_NoLandUse 031015.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
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\BI dgPermitRvw_COM_NoLandUse_03 1015.docx
1 • Building Division
Over-The-Counter (OTC) Building Permit
T l c n x Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: Type of Construction:Type of Use**: ker-
>'(/L _ _ Occupancy Load: Oregon Specialty Code: 0(A.
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: 5: 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: $ � coo FEES DUE
$ `?5 APO DC Prov Rvw,COM TI-Ping
$ I O/1 DC Prov Rvw,COM TI-LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ 'y/ ''Q Permit Fee-Add,Alt,Demo
Project Valuation Planning LRP $ 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ AWLIVA Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ 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: $ cio r,�5 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