Permit 1y p CITY OF TIGARD BUILDING PERMIT
111 I, • COMMUNITY DEVELOPMENT Permit#: BUP2015-00117
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/02/2015
Parcel: 1S 134BC00300
Jurisdiction: Tigard
Site address: 12266 SW SCHOLLS FERRY RD
Project: Pacific Dental Services,LLC Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: TI for a new tenant.
Contractor: BNK CONSTRUCTION INC Owner: FW OR-GREENWAY TOWN CENTER LLC
45 82ND DR, SUITE 53B ONE INDEPENDENT DRIVE, SUITE 114
GLADSTONE,OR 97027 JACKSONVILLE, FL 32202
PHONE: 503-557-0866 PHONE: 503-603-4709
FAX: 503-557-1085
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 07/02/2015 $1,359.63
Demolition
Occupancy Grp: B Occupancy Load: 32 12%State Surcharge-Building 07/02/2015 $163.16
Dwelling Units: 0 Plan Review 04/23/2015 $883.76
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 04/23/2015 $543.85
Bedrooms: 0 Bathrooms: 0 TDT-Transportation Development Tax 07/02/2015 $6,753.00
Value: $141,075 DC Provision Review,COM TI-Ping 07/02/2015 $187.00
DC Provision Review,COM TI-LRP 07/02/2015 $28.00
Info Process/Archiving-Lg$2.00(over 07/02/2015 $28.00
Floor Areas: 11x17)
Metro Const.Excise Tax-Commercial 07/02/2015 $169.29
Total Area: 3135 Use
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $10,115.69
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 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. TION: Ore.•• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 1-0010 through OAR 95 •I .•• You may obtain a copy of the rules or direct questions to OUNC by calling I .1987 or 1.800.332.2344.
• _ 1
Is ued By: �. Permittee Si natur i
&.....
Call 503.639.4175 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 c• pletion of the project.
Approved plans are required on the job site at the time of each inspection.
i uild;:ng Permit Application
Commercial FOR OFFICE USE ONLY
City of Tigard and Received
Date/By:
I 7 Permit No.:((�YY�Jdvl iW
lig
il 7• 131 SW Hal Blvd.,Tigard,0 PDlaan teB Rev:iew C�J I Phone: 503.718.2439 Fax: 50l3t. 6 EI V .D 4 a 2e
f. Other Permit:Air J`i s---,....• i
I I c n ti D Inspection Line: 503.639.4175 2015 Date Ready :•: j/ r ® See Page 2 for
Internet: www.tigard-or.gov APR 21 N�oti/ed//MMethod: O �S (!tea. it _ Supplemental Information
i — L /%t1%i1rf, 9 i Zn �' / i,
TYPE ,� r r c DIV1SION REQ •ED 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:TI equipment,materials,labor,overhead,and the profit for the 117
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: S
❑Accessory building ❑Multi-family Number of bedrooms: 1
❑Master builder ❑Other: Number of bathrooms:
LA
JOB SITE INFORMATION AND LOCATION Total number of floors:
4
Job site address:12266 SW SCHOLLS FERRY RD New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet C
Suite/bldg./apt.no.: Project name. L to* , .f�.ra.ij Covered porch area: square feet 11/4---,
Cross street/directions to job site: Deck area: square feet
% ∎., ••■ Other structure area: square feet
9., REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: \�/, O►N��A,�`�I Lot nor T Permit fees'are based on the value of the work performed. 4.
_,, ,,t ,Y Indicate the value(rounded to the nearest dollar)of all
C Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
2 RESTROOMS,NON STRUCTURAL PARTITIONS,T-BAR CEILING, Valuation: $141,075.00
LIGHTS,OUTLETS,SWITCHES,SINKS,MECHANICAL DISTRIBUTION Existing building area: 3,135 square feet
New building area: 3,135 square feet \
ki ® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name:REGENCY CENTERS Type of construction: VB
Address:5335 SW MEADOWS,SUITE 295 Occupancy groups:
City/State/ZIP:LAKE OSWEGO,OR 97035 Existing: B
;\ Phone:(503)603-4709 Fax:( ) New: B
El APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:PACIFIC DENTAL SERVICES (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:BRANDON WEBB
Address:2044 CALIFORNIA AVE 3
Total fees due upon application:
City/State/ZIP:CORONA,CA 92881
P Phone:(951)582-5758 I Fax::(714)388-3951 FLS plan review fee(if applicable):
Amount received:
E-mail:webbB@pacden.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: D e vi( Submit two(2)sets of roof plan with connection details \
Address: and fire department access,along with the 2010 Oregon
£. c ��1 EiL rk 5-113
Solar Installation Specialty Code checklist.
City/State/ZIP: /1 t � 70?'� Permit fee(includes plan review S180.00
V and administrative feesL
Phone:(5C9,) ' S 7.-d h` Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: I --)53-3—
It's
r Total fee due upon application: $201.60
Authorized signature: jr, +r.∎ This permit application expires if a permit is not obtained
�r/��_�_ �' within 180 days after it has been accepted as complete.
^!` Print name:BRANDON EBB Date:4-20-15 * Fee methodology set by Tri-County Building Industry r
Service Board.
I:\Building\Permits\BUP-COM PerrnitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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. .
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - With Land Use
II(.;1RI)
Building Permit #: tt O/5
Site Address: /am,66 5 c)//S �,-,.i go/ Suite/Bldg#:
Project Name: At c, ` deA7f cre-vm us
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 7 /4, 41-- nu 4e",, [.-7L ? c.-i e4-
site address/suite#exists and active in permit syst . C/5<,r'T� / t �S
`' .ver Terrace Plan District:A, ❑ Yes No
I' and Use Case#: /v!/Abc,QC)/ OCVO 3 647f-42/Aix fit (k5
g Plan Match Approved Land Use:
Site Plan I'landscape Plan Other:
jt p�. rban Forestry Plan elevation Plan /) Q // 00�
VOIRIBuilding Height: Maximum Height `7:� * Actual Height 6765)i-rug d�lU,�U�riO
Okil Conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issua J
"Business Licen :
Exists: [Yes ❑ No,applicant notified to obtain business license
OSPublic Facilities Improvement (PFI)Permit: INo Required: ❑ Yes,applicant was notified Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: C�■''- % Date: lf/cQ3//6--
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: '//)alb s
Site Plans: # 3
Building Plans: # ,,
Building Permit#: E rr building permit#above. _
Workflow Routing: L�'Planning Lngineering L4 ermit Coordinator Li-riuilding
Workflow Sign-off: ❑ Siga t)ff for Planning(include notes from planning review)
Route Application Documents: uilding: original permit application,site plans,building plans,engineer and
£.4,--)-.1.71- beam calculations and trust details,if applicable,etc.
Notes: , .w <-47.2. ( J)C fie~), /vfia J '-J. r/i
iO f iret..k.1 cw e- 11 l 7c op l�vKj'-
By Permit Technician: 4 — ____ ate: #V.2.)1,3
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 0401I5.docx
•
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions"Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of appr val an plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility: , ,
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
Cl NOT Approved by Engineering: Date
Notes: /1/4/0 eNGrNFEO±nlq
Approved by Engineering: Date: . Z 3 • /5
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
❑ Approved,NNOrT- Released: Date:
Date:
Notes: J Z / 4 dJ 11 d /q ��!%J Ci444CCrl t,6 M
�rJlGat-'� Gema
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: '477—V/ S-
I:\BuildineForms\BldgPermitRvw_COM_WithLandUse 0401 15.docx
$1111 I
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARE)
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 per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 141,075.00
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 35,261.25
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 $ COMPLIES
(b) An accessible entrance: $ COMPLIES
(c) An accessible route to the altered area: $ COMPLIES
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ COMPLIES
(e) Accessible telephones: $ N/A
(0 Accessible drinking fountains: and, $ N/S
(g) When possible,additional accessible elements such as storage and
alarms: $ OK
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Permits\BUP-COM PemutApp.doc 03/03/2011
TDT Estimate BUP2015-00117 4/27/2015
Pacific Dental Services, 12266 SW Scholls Ferry Rd. AMS
TDT RATES EFFECTIVE 10/1/14
Former Use
Use# ITE Code # Units Rate TDT Amount Description
1 932 3.14 $19,959 $62,571 3135 sf Restaurant
2 $0
Total TDT Former Use $62,571
Proposed Use
Use# ITE Code # Units Rate TDT Amount Description
1 720 3.14 $28,575 $89,583 3135 sf Dental Office
2 $0
3
Total TDTProposed Use $89,583
Less: Total TDT Former Use $62,571
TDT Increase (Decrease) $27,011
Less 75% Redevelopment Discount $20,258
Net TDT Increase $6,753
Recovery Rate for Proposed Use 29.9%
Estimated Total Impact $90,338
Estimated Unmitigated Impact $63,327
PARKS Estimate
PARKS RATES EFFECTIVE 7/1/14
Former Use
Use# ITE Code # Units Rate TDT Amount Description
1 932 32.00 $446.14 $14,276.48 3135 sf Restaurant *
2
Total Parks Former Use $14,276.48
Proposed Use
Use# ITE Code # Units Rate TDT Amount Description
1 210 9.00 $446.14 $4,015.26 3135 sf Dental Office **
2 $0.00
3
TotalParks Proposed Use $4,015.26
Less: Total Parks Former Use $14,276.48
Parks Increase(Decrease) -$10,261.22 No Parks SDC
* Restaurant EEs provided with plans.
** Health Services Clinic= 350sf/EE, 3135/350=9 Ees
Pacific Dental Services
April 20, 2015
To: City of Tigard
13125 SW hall Blvd,
Tigard Or 97223
503-718-2439
RE: 12266 Sw Scholls Ferry Rd
Tigard, OR
Description:
Enclosed please find for your use and review for our first submittal:
- One (1) Building permit application
- One (1) Electrical permit application
- One (1)Mechanical permit application
- One (1) Plumbing Permit application
- One (1) commercial application checklist
- One (1) payment authorization form
- Two (2) electrical corn check forms
- One (1) Accessibility barrier removal form completed (all shell work on this project is done
under separate permit, please let me know what I need to fill out in this form to comply)
- Three (3) wet signed sets
- Two (2) extra A-0 site plan sheets
If you have any questions please call me at (951) 582-5758.
Sincerely,
Brandon Webb
Project Designer
2044 California Ave.. Corona. CA 92881
Phone (951) 582-5758 • Fax (714) 388-3951
e-mail: webbb(u),pacificdentalservices.com
Branden Taggart
From: Webb, Brandon <webbb @pacificdentalservices.com>
Sent: Thursday, April 23, 2015 8:04 AM
To: Branden Taggart
Subject: RE: Pacific Dental Services Permit Submittal: BUP2015-00117 & MEP's
Hi Branden,
Thanks for contacting me. Lets go ahead and continue with the plans I submitted. Could
you give me a rough estimate of how long the review will take? Also, I will go ahead and
pay the fees by credit online tomorrow when I am back at my desk.
Thanks,
Brandon
- 4
Brandon Webb I Project Designer
Pacific Dental Services
T 951.582.5758
F 714.388.3951 E webbb@ipacden.com
Autodesk'Revit
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From: Branden Taggart [mailto:brandent @tigard-or.gov]
Sent: Wednesday, April 22, 2015 2:58 PM
To: Webb, Brandon
Cc: #Building Permit Technicians; Dan Nelson
Subject: Pacific Dental Services Permit Submittal: BUP2015-00117 & MEP's
Hello Brandon,
We received your permit submittal for Pacific Dental Services located at 12266 SW Scholls Ferry Rd. As you know, the
building plans contained the mechanical, electrical and plumbing pages for review. Ideally, we prefer to have the
mechanical, electrical and plumbing contractors submit separate plans and applications. We have several different
inspectors/plans examiners reviewing each type of permit, and separate plans makes it easier for the permits to be
reviewed concurrently, rather than routing the same set of plans to three different people after each review has been
completed. However, with that being said, we will still process each of your permits since we have received all of the
1
applications, but the mechanical, electrical and plumbing permits will need to be issued before the building permit is
At
picked up. In this situation, plan review will take considerably longer since the permit needs to be routed to each
inspector. Please let me know if you intend to submit additional plans for quicker review, or if you would like us to
proceed with what you submitted.
Also, we no longer accept credit card authorization forms for payment. We shredded your credit card authorization
form for security purposes. If you would rather not mail a check for the plan review amount of$1,427.61, you have the
option of paying the fees online with a credit card form. This fee will need to be paid before we can begin plan
review. To pay the fees online, you can go to our
website: http://www.tigardor.gov/city hall/online permit counter.php. In the lower right hand corner under Quick
Links, select Online Payments. From there, click on the Building tab, enter the permit number in the Record Number
field (BUP2015-00117), and click on Search. Next,you will see the Fees section, and now you can click on the arrow in
front of Fees to expand the list and make the payment. Lastly, select the Pay Fees link to complete your credit card
payment. The city accepts VISA, MasterCard and Discover, but not American Express. Once you pay online, please
notify me, as we do not get an automatic notice when fees have been paid. If you have any questions about this process
please let me know.
Thank you,
Branden Taggart
w City of Tigard
Permit Technician
rs " iii Community Development
13125 SW Hall Blvd
• Tigard. OR 97223
(503)718-2449
brandent @ tgard-or,gov
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule."
2
Albert Shields
From: Albert Shields
Sent: Monday, April 27, 2015 1:20 PM
To: 'webbB @pacden.com'
Subject: TDT Charges, BUP2015-00117, MMD2015-00003
Brandon, regarding your project for Pacific Dental Services, in reviewing the application for building permit BUP2015-
00117 it came to our attention that, because of the change of use from restaurant to dental offices/clinic a
Transportation Development Tax (TDT)assessment of$6,753.00 should be charged to the project. This charge will be
due and payable upon issuance of the building permit although payment can be, upon request, deferred until
occupancy.
I've attached a copy of our worksheet which shows the application of a 75%discount reducing the TDT in this case from
$27,011 to $6,753. The discount applies because the building itself is over 20 years old and redevelopment of the first
5,000 square feet of such a building receives a TDT discount of 75%,.
I apologize for the fact that the applicability of the TDT may not have been discussed in your Minor Modification case,
M M D2015-00003.
rfilli Albert Shields
City of Tigard
in
Permits/Projects
Coordinator
Alper;2U5ar. _ _
;503) 713-2426
(503)624-3681• •
13125 SW Hall 0...c.
'Tigard,OR 97223
1
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
12266 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00117
Chip Barnett
Violation Summary:
Inspector Contractor