Permit �. .
„�, BUILDING PERMIT
CITY OF TIGARD 1 I '''
' - COMMUNITY DEVELOPMENT Permit#: BUP2015-00246
Date Issued: 08/25/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12264 SW SCHOLLS FERRY RD
Project: Diamond Wireless Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: TI-change of occupant., 10/8/2015: REPRINT permit for revised project valuation from$53,000 to$500 and
,reduced permit fees.
Contractor: FIVE STAR PAINTING Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 230822 PO BOX 790830
TIGARD, OR 97281 SAN ANTONIO, TX 78279
PHONE: 503-608-8439 PHONE.
FAX:
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee-Additions,Alterations, 08/25/2015 $53.27
Demolition
Occupancy Grp: M Occupancy Load: 55 12%State Surcharge-Building 08/25/2015 $6.39
Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 08/25/2015 $1.50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0 Plan Review-Building 08/17/2015 $34.63
Value: $500 FLS Plan Review 08/17/2015 $21.31
Floor Areas:
Total Area 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $117.10
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. 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 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: /9/1/ e%oPe-/C4 7 7v
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
CITY OF TIGARD BUILDING PERMIT
14 I • COMMUNITY DEVELOPMENT Permit#: BUP2015-00246
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/25/2015
Parcel: 1 S 134BC00300
Jurisdiction: Tigard
Site address: 12264 SW SCHOLLS FERRY RD
Project: Diamond Wireless Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: TI-change of occupant
Contractor: FIVE STAR PAINTING Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 230822 PO BOX 790830
TIGARD, OR 97281 SAN ANTONIO,TX 78279
PHONE: 503-608-8439 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee-Additions,Alterations, 08/25/2015 $53.27
Demolition
Occupancy Grp: M Occupancy Load: 55 12%State Surcharge-Building 08/25/2015 $6.39
Dwelling Units: 0 Plan Review 08/17/2015 $488.83
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 08/17/2015 $300.82
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 08/25/2015 $1.50
Value: $500 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $850.81
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 it work is suspended for more the 180
days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification rater. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a •• • •- ules or direct questions to OUNC by calling 503.23 .1987 or 1.800.332.2344.
Issued By: Permittee Signature:
'3.639.4175 by 7:00 a.m.for the next available inspe•ion date.
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
Building Permit ApplicaCEIVEJ)
Commercial
City of Tigard AUG 1 7 2015 Received ,r
Permit No.: t?6/5---e0g 4,
111 I/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ik ,
Phone: 503.718.2439 Fax: yy��3 Date lit , _ r, [IA Other Pumrt
�r i� Inspection Line: 503.639.41751' 11VA�� 1 Rj,r., : :ww j�ris
I
EFEHREffill
nternet: w .tigard-or.g0BUILDING DN �
JSIOIk fied/A�tbod: A A. IT 'ill
te 4)44' w. /h, - fil.,.
TYPE OF WORK Permit fees*are based on the value of the work performed.Indicate tht
nearest dollar)of all equipment,materials,labor,overhead,and the pro
❑New construction ❑Demolition on this application.
❑Addition/alteration/replacement ®Other:Cosm Remodel
CATEGORY OF CONSTRUCTION
Valuation: S
❑ I-and 2-family dwelling ®Commercial/industrial Number of bedrooms:
❑Accessory building ❑Multi-family Number of bathrooms:
❑Master builder ❑Other: Total number of floors:
JOB SITE INFORMATION AND LOCATION New dwelling area: square feet
Job site address: 12264 SW Scholls Ferry Road Garage/carport area: square feet
City/State/ZIP:Tigard,OR 97223 Covered porch area: square feet
Suite/bldg./apt.no.:12264 ) Project name:Diamond Wireless Deck area: square feet
Cross street/directions to job site:N/A Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECI
Permit fees*are based on the value of the work performed.Indicate tht
Subdivision: I Lot no.: nearest dollar)of all equipment,materials,labor,overhead,and the pro
on this application.
Tax map/parcel no.: Valuation: 1SSS3,069:nor 5✓
DESCRIPTION OF WORK Existing building area: 2295 square feet
Replaced the carpet and paint,ran electrical for new'outlet locations.
C J� C/ New building area: 0 square feet
�' 'F DCCc-X)C'�7--- Number of stories: 1
❑ PROPERTY OWNER I ® TENANT
Type of construction: Cosmeti Remodel
Name:Diamond Wireless,LLC Occupancy groups:
Address:200 W Civic Center Dr,Suite 202 Existing:
City/State/ZIP:Sandy,UT 84070 New:
801)424-4263 Fax:(801)733-6931 BUILDING G PERMIT FEES*
Phone:
( (Pkrrar rrhrlefee aetrednk)
® APPLICANT ❑ CONTACT PERSON Structural plan review fee(or deposit):
Business name:Diamond Wireless FLS plan review fee(if applicable):
Contact name:Abraham Pack Total fees due upon application:
Address:200 W Civic Center Dr,Suite 202
Amount received:
City/State/ZIP:Sandy,UT 84070 PHOTOVOLTAIC SOLAR PANEL SYSTEM FE
Phone:(801)424-4263 I Fax::(801)733-6931 Commercial and residential prescriptive installation of
E-mail: roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
CONTRACTOR and fire department access,along with the 2010 Oregon
Business name: r, G,r �G;%----41 y�� Solar Installation Specialty Code checklist.
Permit fee(includes plan review
Address: p &,)e 2, •12.„,2 and administrative fees):
City/State/ZIP: / ) / L)2, 91 2-8 1 State surcharge(12%of permit fee):
Phone:($'0 3)6 Q ;0 - ci 113 q 3 r I Fax:( ) Total fee due upon application: 7y 475"
CCB lic.: 2.0/ c;) 6, //a�f//(P This permit application expires if a permit is not obtained
- within 180 days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry
Service Board.
Print name: M 1 Ci t\,6,41 19 I Date: 6— 17 - / j
REQUIRED DATA:1-AND 2-FAMILY DWELLING
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46131(11/02/C OM/WEB)
I
a
City of Tigard
• COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: 0,,_,LP90 LS-00 _LI(6.
Site Address: /4- 261--/ -2k) S'ch //g Suuiitt Bldg#:
Project Name: L)A,?monce_ /o /r SS
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review J
Proposal: /— JnI- /m -z v-e4tPr-4- evA i 4
Existing Business Activity: S27.&- Cf!`C�ft rag-X.4./
Proposed Business Activity: I/ /1
/Verify site address/suite# exists and active in permit systm.
'ver Terrace Nei hborhood: ❑ Yes 1G No
oning:
Y/
ermitted Use: P Yes El No ❑ Spec Space
Infirm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
•
Approved by Planning: , Date: . /,
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: g ! 7
Site Plans: #
Building Plans: # �}
Building Permit#: [Enter building permit#above.
Workflow Routing: fd'Planning (Permit Coordinator ckgrulding
Workflow Sign-off: .2 Sign-off for Planning(include notes from planning review)
Route Application Documents: ,'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician. <��, Date: /7//5.--
1:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.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:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
OK to Issue Permit F/
Approved by Permit Coordinator: Date: dr /c
I:\Building\Fortes\BldgPermitRvw_COM_NoLandUse_0709 I 5.docx
�
i 17 '
TIGARD
City of Tigard
October 8, 2015
Courtesy Painting
Attn: Michael Ho
PO Box 230822
Tigard, OR 97281
Re: Permit No. BUP2015-00246
Dear Applicant:
The City of Tigard has processed a refund for overpayment of permit fees on the above
referenced permit for the following:
/ a6V
Site Address: �W Scholls Ferry Rd
Project Name: Diamond Wireless
Job No.: N/A
Refund: ® Check#218859 in the amount of$733.71.
❑ Credit card"return" receipt in the amount of$ .
❑ Trust account"deposit" receipt in the amount of$ .
Notes: A reduction in the project valuation from$53,000.00 to $500.00 resulted in a
reduction and refund of plan review fees paid.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Coordinator
Enc.
[:\Buil ding\Refunds gAsYra ort\RatfillY4Verpa}�� �G7fl egon 97223 •• 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Requestjbr Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Courtesy Painting DATE: 10/1/2015
Attn: Michael Ho
PO Box 230822 REQUESTED BY: Dianna Howse
Tigard, OR 97281
TRANSACTION INFORMATION: aglil
Receipt#: 202178 Case#: �BUP2015-00246
Date: 8/17/2015 Address/Parcel: j.22 5 SW Scholls Ferry Rd
Pay Method: CreditCard Project Name: Diamond Wireless
EXPLANATION: Refund overpayment of permit fees due to reduction of project valuation from$53,000
to $500.00 for change of occupancy only.
REFUND INFORMATIONc
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Plan Review 230-0000-43106 $454.20
Plan Review- Fire Life Safety 230-0000-43108 279.51
TOTAL REFUND: $733.71
APPROVALS: SIGNATURES/D:TE:
If under$5,000 Professional Staff
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: /e/p/45- By:
4174z-
1:\Building\Refunds\RefundRequest.doc a 09/01/2010
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Request for Permit Action
13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor g City Staff
Check(✓)one
REFUND OR Name: -�
INVOICE TO: (Business or Individual) H t C 146 E L (�
�C) — �:t l2Te,i-DY PA I
Mailing Address: F'D, I�o X Q o> .
City/State/Zip: ?7
Phone No.:
505- 660-039
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
• CANCEL/VOID PERMIT APPLICATION.
2. ' FUND ' ERMIT FEES (attach copy of original receipt and provide explanation below).
• i E FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: I ,Dt.t P a01 5`00 of Li to
Site Address or Parcel#: 19.9-(r Li AA). 6e Li-`3 f11k
Project Name: T�i PS N(�tick (. ±t 2f_Le SS
Subdivision Name: Lot#:
EXPLANATION: CJ H K r c.F ,,S-P-Nf i>> w .
C-Ck 1..I -1-4'r- Al f����cr J tar ail 53,c;tX; 6��v
� L'l C Ref
C Pr'tnST c 3e, 6A PIT eF 5c•cc).
Signature: � �c�l��rv�•n-l-i Date: 0"V/5--
Print Name: 611 i_ R. (A f-i-Sv--,\
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
it
FOR OFFICE USE ONLY
Route to S s Admin: Date Q 6.fr7®E 11511 Route to Records: Date /d B ig.eM
Refund Processed: Date p 'Am B A/41111 Invoice Processed: Date B
Permit Canceled: Date A/ By �'�� Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_092314.doc