Permit y U CITY OF TIGARD BUILDING PERMIT
IN 1 , . COMMUNITY DEVELOPMENT Permit#: BUP2015-00177
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/23/2015
Parcel: 2S 101 AA08700
Jurisdiction: Tigard
Site address: 12511 SW 68TH AVE 100
Project: It's Just Therapy Subdivision: WEST PORTLAND HEIGHTS Lot: 34
Project Description: TI for new tenant:Interior wall partitions and a new door.
Contractor: NORWEST CONTRACTORS INC Owner: TIGARD TRIANGLE PROPERTIES LLC
PO BOX 25305 3232 SW FAIRMOUNT BLVD
PORTLAND, OR 97298-0305 PORTLAND, OR 97239
PHONE: 503-291-6986 PHONE:
FAX: 503-291-7036
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 06/23/2015 $75.00
Occupancy Grp: B Occupancy Load: 17 DC Provision Review,COM TI-LRP 06/23/2015 $11.00
Permit Fee-Additions,Alterations, 06/23/2015 $347.48
Dwelling Units: 0 Demolition
Stories: 2 Height: 0 ft 12%State Surcharge-Building 06/23/2015 $41.70
Bedrooms: 0 Bathrooms: 0 Plan Review 06/23/2015 $225.86
Value: $18,000 Plan Review-Fire Life Safety 06/23/2015 $138.99
Info Process/Archiving-Lg$2.00(over 06/23/2015 $2.00
11x17)
Floor Areas: Misc Administration Fee 06/23/2015 $50.00
Total Area: 0
Misc Administration Fee 06/23/2015 $50.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $942.03
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 at other applicable law. All work wit
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 suspen•-d for more the 180
days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules : ' 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 cal •50 . 32.1987• .:00.332e34
Issued By: - mittee Signature: C Alk
. ,3.839.4175 by 7:00 a.m.for the next available inspection e.
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.
r
Buildin2Permit Application
Commercial 1 < It ti I I( I l I ()NI 1
City of Tigard �� 1 V d
lig *1 `J Date/ft : 1S ) Permit No.: ` )�4I a da P
13125 SW Hall Blvd.,Tigard,OR 97223 Plan gam, ►-
Q Phone: 503.718.2439 Fax: 503.598.1960 A1 r'1 `�0, &g : ,!k b f� Other Permit:
T I G n K D Inspection Line: 503.639.4175 ,ulv 1 Reaay • B See Page Z for
Internet: www.tigard-or.gov ^�Z1G ed/Method: _ ? t •J� /. Supplemental Information
V EMI
TYPE OF WORK BU i��N 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.
El 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other:
Number of bathrooms:
SOB SITE INFORMATION AND LOCATION Total number of floors:
Job site addres // 68"Avenue New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: (3 'T� . �.L - l_r_j" ' Covered porch area: square feet
Cross street/directions to job site: u�u1 , '��✓v Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 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.
Interior Wall Partitions,new door Valuation: $518,000.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ® TENANT Number of stories: 2
Name:Tigard Triangle Properties,LLC Type of construction: VB
Address:3232 SW Fairmont Blvd Occupancy groups:
City/State/ZIP:Portland OR 97239 Existing: B
Phone:( ) Fax:( ) New: B(No Change)
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:NW Precision Design Ike )
Structural plan review fee(or deposit):
Contact name:Darin Bouska
Address:22605 SW Pinehurst Ct FLS plan review fee(if applicable):
City/State/ZIP:Sherwood OR 97140 Total fees due upon application:
Phone:(503)680-6444 Fax::( ) Amount received:
E-mail:Darin@NW-Precision.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Norwest Contractor's,Inc Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:PO Box 25305 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland OR 97298 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)291-6986 Fax:(503)291-7036 State surcharge(12%of permit fee): $21.60
CCB lie.:89425
Total fee due upon application: $201.60
Authorized sign.. , This permit application expires if a permit is not obtained
i within 180 days after it has been accepted as complete.
Print name:Dario Bouska Date:6/172015 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
IN ' Building Division
1 ic„\Rl)
Over-The-Counter (OTC) Building Permit
Check List
Project Description: ( (
GENERAL INFORMATION
Class of Work*: Occupancy Group: Type of Construction:
Type of Use**: Occupancy Load: —7 Oregon Specialty Code: 'Z�O(
SPECIFICS
Number of Stories: '1/ 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:
I lazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ Ie1eCCf ) ' lEr FEES DUE
$ 'S.CO DC Prov Rvw,COM TI-Ping
$ ( ,v DC Prov Rvw,COM TI-LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ 1 ._ Permit Fee-Add,Alt,Demo
Project Valuation Planning LRP $ `lr .-IP 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ 5 i'�Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ -2_, ') 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: $ 042.b3 TOTAL FEES DUE
*TYPE OF US". a'■2 .ui• . ,1,CMS >•,,•-• .,,;i ? .r • r :■ it•iI : ;...:
**CLASS OF WO R •.A 8=accessory;ADD=addition;ADU=accessory dwelling unit;AI:T=alteration;DEM=demo;NEW=new;
s,retakailailiks,awnings or canopies).
I:\Building\Forms\OTC_BUP_070114.docx
City of Tigard
• COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - No Land Use
11 ( , Ai' I)
Building Permit #: / ,e0Z/5" ..,z i
Site Address: .12.51 \ SW 6S-Oh PkwAi W Suite/Bldg#: 1 03
Project Name: Ws J us+ The:rap
(Name of commercial business occ p g the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T1 f0Y new +enar4 — i n+eY 1 of pari-i-fi oy-17 neW doo{
Existing Business Activity: C j CQ. (meA 1 CA.1 )
Proposed Business Activity: Same,
R /Verify site address/suite#exists and active in permit sysyin.
iiRiver Terrace Plan District ❑ Yes No
o�tg: M�]C
ermitted Use: Yes ❑ No ❑ Spec Space
Confirm no land use required.
iY Business License: /
Exists: ❑ Yes M No,applicant notified to obtain business license
Notes:
Approved by Planning: T fir) Le)n f\g d J Date: 6 123 ! 1 S
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: 7 4//1
Site Plans: # /U
Building Plans:
Building Permit#: nter building permit#above.
Workflow Routing: ail—arming ❑ Permit Coordinator ia—Bttiding
Workflow Sign-off: ['Sig-off for Planning(include notes from planning review)
Route Application Documents: g: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: e/Z
/2
By Permit Technician: _ _h_- Date: 60_03'
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:
❑ OR to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BIdgPermitRvw COM_NoLandUse 031015.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
12511 SW 68TH AVE 100, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
July 17, 2015 at 9:15:25 AM
BUP2015-00177
Chip Barnett
Violation Summary:
Inspector Contractor