Permit 1114 Cq
ITY OF TIGARD BUILDING PERMIT
I' COMMUNITY DEVELOPMENT Permit#: BUP2015-00146
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/20/2015
Parcel: 1S136AD04000
Jurisdiction: Tigard
Site address: 11509 SW PACIFIC HWY
Project: Dead God's Tattoo Subdivision: VILLA RIDGE Lot: 7
Project Description: TI for new tenant.
Contractor: KINCAID CUSTOM SURFACE INC Owner: PACIFIC TERRACE COMMERCIAL LLC
3023 NE ROCKY BUTTE RD BY SMITH, EDITA M
PORTLAND, OR 97220 833 NW 170TH DR
BEAVERTON, OR 97006
PHONE: 503-781-6937 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 05/20/2015 $75.00
Occupancy Grp: B Occupancy Load: 16 DC Provision Review,COM TI-LRP 05/20/2015 $11.00
Permit Fee-Additions,Alterations, 05/20/2015 $225.80
Dwelling Units: 0 Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 05/20/2015 $27.10
Bedrooms: 0 Bathrooms: 0 Plan Review 05/20/2015 $146.77
Value: $10,000 Plan Review-Fire Life Safety 05/20/2015 $90.32
Info Process/Archiving-Lg$2.00(over 05/20/2015 $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 $579.99
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 copy of the rules or direct questions to OUNC by calling 5034. .1987 or 1.800.332.2344.
Issued By: � -- ••e Signature:
C .0.4175 by 7:00 a.m.for the next available inspecti• •:te.
This permit card shall be kept in a conspicuous place on the job site until c,• pletion of the project.
Approved plans are required on the job site at the time of eac, inspection.
Building Permit Application
Commercial 1-OIt O1 I I( 1 1 •l O\I.1
Received
City of Tigard Permit No.:
III
ii,
• 13125 SW Hall Blvd.,Tigard,OR 97223 CEI\J E,' Plan Review 111 -1
Phone: 503-718-2439 Fax: 503-598-196 1E Date/By: Related Permit:
T i .,A R D Inspection Line: 503-639-4175 +[ Date Ready :y: J�y ® See Page 2 for
Internet: www.tigard-or.gov MAY q O 201J Notified/Method:$7 1iS Supplemental Information
TYPE OF WORKCI-( O D"AS n REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New struction ❑D ,N Permit fees*are based on the value of the work performed.
Indicate the value(rotnded to the nearest dollar)of all
ddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CON3TR ON work indicated on this application.
❑ 1-and 2-family dwelling CommerciaUndustrial Valuation: $ e.ertr-e-0
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: (1 so 9 S W 'AP1CI F<C H W y New dwelling area: square feet
City/State/ZIP: TI G FARO C)R 97,)a3 _ Garage/carport area: square feet
Suite/bldg./apt.#: (Project name: AM G O9S WfrO() Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
S 71.$)'1 OvJ) . 4 g W 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(rotnded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
ow-,Qn0E._ 1-W O\CAP B V1I-1ROOm1 —rFt..)�dJT
Valuation: $ /0,000. 0 d
I M P R�7J E M EN'f Existing building area Is 6 0 square feet
New building area: 0 square feet
❑ PROPERTY OWNER 1 '0 TENANT Number of stories: el
Name: -10.5EPI-I cio2A(4 1--690 Type of construction: 5 63
Address: 11509 5 cps F 1 C �v...)y Occupancy groups:
City/State/ZIP: 71 G Am) 1 0R 9 aa3 Existing:
Phone:(97!) i'OO ^ OOS(i Fax:( ) New:
❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: l
(Please�awife,cork)
l�)v S �SS4 I 1' S Structural plan review fee(or deposit):
Contact name: S-r v ` S
I FLS plan review fee(if applicable):
Address: I 0 a so 6 . , h NI E Total fees due upon application:
City/State/ZIP: T1c/ARO / 6k 9-7(:;1,1 3
Phone:(5(3) Q/5 _6ta 7 1 Fax: :( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: b N CA,C� � � �� ��Ct< ��C Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 30x3 OE 200(9 Go-r1 RD Solar Installation Specialty Code checklist.
City/State/ZIP: P0R-n AN O a�� Permit fee(includes plan review $18000
and administrative fees):
Phone:(97/ ) 36 3 _ 16 33 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: 16s 9(A Total fee due upon appication: $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: ao j1 i- ni a, /1n 0 Date: S/,2(� /J� * Fee methodology set by Tri-County Building Industry
r S J Service Board
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
' f
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
ill • Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
T 1 G A f:[) 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\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
.71 " Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
T 1 G n It l) 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:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
f !
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1111 m W Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
T t G A R D 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
Building Permit Review — Commercial - No Land Use
, It , Ai: I)
Building Permit #: 64eap s S—0011(P ' f
Site Address: I l5Oq SW Potc c ti C, iA∎iJ\/. Suite/Bldg#:
Project Name: beoLd God s TO .00
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review L I l l of ('
Proposal: -1-1 'COY new 4-encx4-1 I(1G{a i 0 1 re_C' o8el o ces r.•fl)) rPthr t cat
G►.: r1. A DA, ..` /.1/ 1 i ' 0,s, 11 i 1• I
Existing Business Activity: V(a COI,'n`�__"II (ve,v. ?e�(Sono\ 42x1 t[.e s)
Proposed Business Activity: rxGona l Sere t c e,S
1;7/Verify site address/suite#exists and active in permit systt m.
River Terrace Plan District ❑ Yes No
d1 Zoning: C_,---C..7
4 Permitted Use: 131Yes ❑ No ❑ Spec Space
FConfirm no land use required.
Business License/
Exists: M Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: T m L.e ,(ba Gk) Date: 51 2....01 1 5
Revisions (after Building Submittal only) Reviewer Date
Revision 1: Cl Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: ifrli 5—
Site Plans: �f,¢
Building Plans:
Building Permit#: gEnter building permit#above. ,.,�, �
Workflow Routing: �, ning ❑ Permit Coordinator ( Building
Workflow Sign-off: P4-off off for Planning(include notes from planning review)
Route Application Documents: Il ' uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: at
By Permit Technician: t/ Date: 5/111/27—
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:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 031015.docx
III II • Building Division
Over-The-Counter (OTC) Building Permit
`' 1: I' Check List
Project Description: I \
GENERAL INFORMATION
Class of Work*: &(_r Occupancy Group: Type of Construction:
Type of Use**: 'o-AA Occupancy Load: Oregon Specialty Code: 2 )
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: ( , 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: $ efj COO FEES DUE
$ , DC Prov Rvw,COM TI—Ping
$ DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ 5 Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ Z7 ( 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ "L.,- Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ - 'lan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ 4 Ocs 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: $ 519 .99 TOTAL FEES DUE
. . , - • 4 - .'(7.OM=co .�i . 'h `omm ' ,5I ■Ut i ,i ■ ".i" a°.
**CLASS OF WO • AC _= s' , D=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
O s,signs,awnings or canopies).
I:\Building\Forms\OTC_BUP_070114.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
11509 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00146
Chip Barnett
Violation Summary:
Inspector Contractor