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Permit
CITY OF TIGARD BUILDING PERMIT ''7 3 COMMUNITY DEVELOPMENT Permit#: BUP2015-00249 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2015 Parcel: 1 S136DD03800 Jurisdiction: Tigard Site address: 11675 SW 66TH AVE Project: City County Insurance Services Subdivision: WEST PORTLAND HEIGHTS Lot: 4-8&27 Project Description: Phased permit-Phase 1: 'Annex'portion of main level. Phase 2: Construct(6)offices in lower level. Contractor: PACIFIC CREST STRUCTURES INC Owner: CITY COUNTY INSURANCE SERVICES 17750 SW UPPER BOONES FERRY RD SUITE 1212 COURT ST NE 190 SALEM,OR 97301 DURHAM, OR 97224 PHONE: 503-968-8949 PHONE: 503-763-3890 FAX: 503-598-6658 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB 12%State Surcharge-Building 09/10/2015 $123.68 Occupancy Grp: B Occupancy Load: Plan Review 08/19/2015 $669.92 Dwelling Units: 0 Plan Review-Fire Life Safety 08/19/2015 $412.26 Info Process/Archiving-Lg$2.00(over 09/10/2015 $14.00 Stories: 2 Height: 0 ft 11x17) Bedrooms: 0 Bathrooms: 0 Additional Plan Review 09/10/2015 $400.00 Value: $55,000 Phased Plan Review 09/10/2015 $103.07 Permit Fee-Additions,Alterations, 09/10/2015 $767.10 Demolition Floor Areas: DC Provision Review,COM TI-Ping 09/10/2015 $88.00 Total Area: 0 12%State Surcharge-Building 09/10/2015 $-31.63 Plan Review 09/10/2015 $-171.30 Accessory Struct: 0 Plan Review-Fire Life Safety 09/10/2015 $-105.42 Basement: 0 Phased Plan Review 09/10/2015 $-26.36 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $2,243.32 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 0 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those -s are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a •py of the direct questions to OUNC by calling 503.232.1987 or 1.800 • 2.2 44. Issued By: -: r ittee Signat . �. Ca 03-.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of . e project. Approved plans are required on the job site at the time of each inspection . Buii'din2 Permit Application r �j Commercial I(tkEIVEP FOR OFFICE USE ONLY City of Tigard Received 5 Permit No.: ip;oise ); C/ . . 13125 SW Hall Blvd.,Tigard,OR Alt, '4 1 9 2015 Plan Review 1. . = Phone: 503.718.2439 Fax: 503. l'60 Date/By: ' r' 1 I Other Permit: TI G A R U Inspection Line: 503.639.4175 S �y Date Ready/By: 1 to la See Page 2 for Internet: www.tigard-or.gov (.ATY Of t l�A[�l� t'led/M' : 1$j ;pi �s Supplemental Information 7±ITTI C r Vill jv_ IA d-1, TYPE O RK REQ t•s-,1 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. ❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $ ❑Accessory building El Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: J Job site address: 11675 66r"Ave New dwelling area: square feet City/State/ZIP:Tigard Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Lower Level Office Build Covered porch area: square feet Cross street/directions to job site:SW Baylor Street Deck area: square feet Y� � Other structure area: square feet /�.'j- REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: j r' Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Phase 1-Minor TI in'Annex'Portion of Main Level- Valuation °'°°°' i Phase 2-Construct(6)offices in Lower Level Existing building area: 13394 square feet New building area: 13394 square feet ® PROPERTY OWNER ❑ TENANT Number of stories: 2 Name:City County Insurance Services Type of construction: VB Address: 1313 Court Street Occupancy groups: City/State/ZIP:Salem,OR 97301 Existing: B Phone:(503)763-3890 F •( 1 -- . - New: B CONTACT PERSON , BUILDING PERMIT FEES' Business name:City County Insurance Services i,� fPls refer~� � Structural plan review fee(or deposit): Contact name:Dana Young G1 • QZl f r' FLS plan review fee(if applicable): Address:1313 Court Street S'O 3- ' 3 ! ,25 a2 A' City/State/ZIP:Salem,OR 97301 Total fees due upon application: Phone:(503)763-3895 f Fax::(503)763-3995 Amount received: y(, `) , i V `- q_OTOVOLTAIC SO y g@ rg YI'14r C�J© j �e�'Cc Commercial and residential prescriptive installation of E-mail:d nun ersor on.o y. CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:TBD Submit two 2)sets of roof plan with co s 'in details Q� t - ti� ti ' and fire dep. . ent access,along .' e 2010 Oregon Address: 11 7 �„j u n ej ,cm_s. f . IS Solar Installatio 'daisy a checklist. �� t(`� Permit fee(i • . plan review City/State/ZIP: ��C�� an' .'mt •,trative fees): $180.00 Phone:(0+3) 9 uts, _ $ PFax:( ) State su arge(12%of pe •'t fee): $21.60 CCB lic.: CPS- Total fee due upon applicatioot $201.60 Authorized signature: ' l� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:Mary Cazier Date:08/18/15 * Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\BUP-COM PetmitApp.doc 02/24/2011 440-46131(11/02/COM/WEB) • 111 . City of Tigard• COMMUNITY DEVELOPMENT DEPARTMENT ■ T I G A R D Building Permit Review — Commercial - No Land Use Building Permit #: U-R 6.-00. 1-19 Site Address: j l (A "I 5 G& + , cv t. Suite/Bldg#: 1. I[T Project Name: Q 1 _ 6u.4 4- v iea.�D (Name of coil ercial business A upying the space. If vacant,enter Spec Space.) Planning Review Proposal: in-#-Zr10 r -1 CA 1,-)1 cc nitrvc-- Co (1cu 1 0 -C ( 1 Existing Business Activity: () (C'+ CQ Proposed Business Activity: 0 C-C7 c e. Verify site address/suite# exists and active in permit system. -River Terrace Neighborhood: ❑ Yes ,e-No ye Zoning: Nil U XPertnitted Use: g Yes ❑ No ❑ Spec Space gf Confirm no land use required. 110 C,1/I01■19 Business License: Exists: ❑ Yes ❑ No,applicant notified to obtain business license Notes: Approved by Planning: /11 0 L17.-6t- Q d O C-ki—,-A.- Date: /3/ 19 h 1 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: b /9 A Site Plans: # Building Plans: # -5 Building Permit#: Er Enter building permit#above. Workflow Routing: 8'Planning [Z Permrmit Coordinator ding Workflow Sign-off: p-Sign-off for Planning(include notes from planning review) Route Application Documents: 12"-Building: original permit application,site plans,building plans,engineer and beam calculations Ph0-444 and trust details,if applicable,etc. Notes: w4�1 �7; , By Permit Technici 1 /sk-4/ 2A .j Date: i S I:\Building\Forms\BldgPennitRvw 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 -'�K to Issue Permit Approved by Permit Coordinator: / 4.ir - Date: 9///5— 1:\Building\Forms\BldgPennitRvw_COM_NoLandUse_070915.docx