Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015 00266
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/01/2015
Parcel: 1 S133AD16200
Jurisdiction: Tigard
Site address: 12700 SW NORTH DAKOTA ST 180
Project: Straight Up Chiropratic Subdivision: 1995-073 PARTITION PLAT Lot: 3
Project Description: Create(1)new treatment room. Change of use from restaurant to chiropractic clinic. Fully ADA compliant.
Contractor: SPECIALTY SERVICES Owner: PACIFIC CREST PARTNERS SCHOLLS L
PO BOX 1311 7000 SW HAMPTON ST, STE 130
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE: 503-307-2890 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee-Additions,Alterations, 09/01/2015 $134.54
Demolition
Occupancy Grp: B Occupancy Load: 20 12%State Surcharge-Building 09/01/2015 $16.14
Dwelling Units: 0 Plan Review 09/01/2015 $87.45
Stories: 1 Height: 0 ft Plan Review-Fire Life Safety 09/01/2015 $53.82
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 09/01/2015 $1.50
Value: $3,750 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $293.45
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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 la . 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 I pended "•r more the 180
days • •1: -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thos- les are et forth in OAR
9 -001-0010 through OAR• -01 •I•S You may obtain a copy of the rules or direct questions to OUNC by calling 50 .1987 or 1.804. 2344.
Issued By: • at / ti, I Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio•/•ate.
This permit card shall be kept in a conspicuous place on the job site until co: pletion of the project.
Approved plans are required on the job site at the time of eac inspection.
a
al
Building Permit Application
Commercial kE(i tVEI1 l(,ll t,i I 1( 1 I .I t,rl ,
City of Tigard Date/By: (/ �'5 V Permit No.:1 •06.15---.04910
.. • 13125 SW Hall Blvd.,Tigard,OR 972 f p 1 2015 Plan Review /
Phone: 503-718-2439 Fax: 503-59819 Date/By: m 9/1' /s Related Permit:
1 I;. \I;1) Inspection Line: 503-639-4175 Date Ready/By: IIII Juris. ® See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: Supplemental Information
111.11=Milliiiiiiiiiiiii ., .
❑New construction ❑Demolition Permit fees'are based on the value of the work performed.
Indicate the value(roinded to the nearest dollar)of all
Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
❑ I-and 2-family dwelling ViCommercial/ndustrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
Total number of floors:
Job site address: W New dwelling area: square feet
City/State/ZIP: I 1 ,b'Q ci-7 Garage/carport area: square feet
Suite/bldg./apt.#: 1 "1-� Project name Covered porch area: square feet
Cross street/directions to job site: 0/) \\ Deck area: square feet
,�v t
1 - j rW r lb Other structure area: square feet
_r :r► f ■ IS " • I ' . _i. I ' QUIRED DATA:COMMERCIAL-USE CHECKLIST
wag
Subdivision: Lot#: Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
Z- s1 ALL 3 1 ,,f,1 is -EAT.) ifs el-1 Valuation: $33562W
V.-11.1.4'n e KGB^4.: -4- �.k .h �-- Existing building area 1 934„ square feet
+. - 1,r- ..•I, , .4.0.44, New building area: tl-9�-1�FJ square feet
Number of stories: • ,'
Name: �Z :� ► mi ` ` VIII `�,l�Ir Type of construction:{ ,�'1� e.} _
Address: r �, ���lu' "��!�.•� IEW , Occupancy groups: �"+ `d ,
City/State/ZIP: çACSt.G-)c 3 Existing:
Phone. ) - - 51 '• 262 New:
` ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name= i► S .
' m Structural plan review fee(or deposit):
Contact name: , —
0 '�, I FLS plan review fee(if applicable):
Address:
City/State/ZIP:(pc�(� y) � �coo Cs/ Total fees due upon application:
mot! i
Phone:t 51--. ' � Fax::( ) Amount received: 02 3 .
E-maili,\ fl! ,•.''\ ter �A 1 -e.S K-
-CO CTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
SperyNe._ �C 1 and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: ��JI4' O J Total fee due upon appication: $201.60
Authorized signature:y� , / This permit application expires if a permit is not obtained
Air/\ / Q within 180 days after it has been accepted as complete.
Print name: f ♦� , l� Date:CI /l f * Fee methodology set by Tri-County Building Industry
�� 1 I Service Board
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-46131(11/02/COM/WEB)
•
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
:1h • Accessibility: Barrier Removal Improvement Plan
■
Commercial & Multi-Family - Additions or Alterations
"AR l) 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_PemiitApp.doc Rev.12/18/2014
l
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
i, G Art) 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
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
` Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
• yp .sitttal o ans
(Includes new, additions and alterations.) Required at
_ . Submittal
Demolition Permit
(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
(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_PemvtApp.doc Rev.12/18/2014
•
a!
SpPO Box 1311 •Clackamas,OR 97015•503.860.2917•Fax 503.658.5039•CCB*159484
S E R V I C E S "Your Service Professional!"
September 1st, 2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97233
RE: Building Permit Application
To whom it may concern:
The property is locations South on Scholls Ferry Rd, head East at North Dakota St, located in the
strip mall on your right.
The addition to this suite is an 11'11" X 11'9" office with 9'9" ceilings, which will be located
15'11" from entry of this 1976 Sq Ft vacant space at 12700 SW North Dakota St., Suite 180,
Tigard, OR 97233.
To secure these 3 walls to the floor: Install 2X4 bottom plate with concrete anchor every 2' on
center, install metal track and metal studs.
To secure these 3 walls tq the ceiling: Install 2X4 top rail to be secured to ceiling grid.And --j.Qc.
This will become an office for Straight up Chiropractic, LLC.
This work is valued at $3750.00.
Thank you,
Marci Royal
Specialty Services
PO BOX 1311
Clackamas, OR 97015
Building Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: At--r- Occupancy Group: Type of Construction:
Type of Use**: (CA Occupancy Load: Oregon Specialty Code: _
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: Y1`6 Fire Alarms: N/A- 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: $ FEES DUE - 1
$ DC Prov Rvw,COM TI—Ping
$ x Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ x 12%State Surcharge
Project Valuation $ x Plan Review,Structural
Up to$4,999 $0.00 $ Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $220.00 g, Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $351.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other.
$ Other:
$ Other:
Building Staff: $ Other:
Date/Time: $ TOTAL FEES DUE
" 'YPE OF USE: COM=commercial;CMS=comin Cmanu—fi TuFFd7nt` e""Iu'"ie.
**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_070115.docx
71 City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARU Building Permit Review — Commercial - No Land Use
Building Permit #:
Site Address: ►21 pp SW t'Jo r+h Da.kci-c, 5+. Suite/Bldg#: 150
Project Name: $-{-r 0.i oh+ Up Ch i roprac1-icy
(Name of 6mmercia business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: i ns}a11 3 neA WAAIc -4e,r nevi +re vvmeXv coorfl 4 ek;t3rinl
Existing Business Activity: O-4 i c,e_,
Pro osed Business Activity: �1`�i G� j
2
err permit Y site address suite# and active in ermit s s m.
/River Terrace Nei hborhood: ❑ Yes No
oning. (.-
/'Permitted Use: ❑ Yes ❑ No ❑ Spec Space
/confirm no land use required.
VBusiness License
Exists: Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: i,,,m rba Date: 9 II f
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: 9////S
Site Plans: # %----
Building Plans: # 5
Building Permit#: Enter building pe #above.
Workflow Routing: Planning r ding
Workflow Sign-off: ,0j' off for Planning(include notes from planning review)
Route Application Documents: Z Building: original permit application,site plans,building plans,engineer and
nn beam calculations and trust details,if applicable,etc.
Notes:
f l--
By Permit Technician: ( Date: WS—
I:\Building\Forms\BIdgPermitRvw_COM_NoLandUse 070915.docx
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal on
Revision Notice 1: Date S to Applicant: _
Revision Notice 2: Dat- .ent to Applicant-.
Revision Notice 3: I, e 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
Approved by Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw_COM_NolandUse 070915.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
12700 SW NORTH DAKOTA ST 180, TIGARD,
OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00266
Chip Barnett
Violation Summary:
Inspector Contractor