Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00233
tJ D AR '. 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10105/2015
Parcel: 1 S136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Project: Wnco Subdivision: 1995-013 PARTITION PLAT Lot: 2
Project Description: Relocating(1)existing refrigerated case and installing(2)new dual temperature cases.
Contractor: ENGINEERED STRUCTURES INC A CORP OF IDAHO Owner: WINCO FOOD LLC
3330E LOUISE DR STE 300 ATTN:TAX DEPARTMENT
MERIDIAN, ID 83642 PO BOX 5756
BOISE, ID 83705
PHONE: 208-362-3040 PHONE:
FAX: 208-362-3113
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Cons[: VB Permit Fee-Additions,Alterations, 10/05/2015 5564.15
Demolition
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Building 10/05/2015 567.70
Dwelling Units: 0 Plan Review 08/04/2015 $366.70
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 08/04/2015 $225.66
Bedrooms: 0 Bathrooms: 0 DC Provision Review.COM TI-Ping 10/05/2015 $88.00
Value: S35,000 Info Process/Archiving-Lg$2.00(over 10/05/2015 510.00
11x17)
Info Process/Archiving-Sm$0.50(up to 10/05/2015 $50.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,372.21
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work wilt
be done in accordance with approved plans. This permit will expire if work is not staled within 180 days of issuance. or if work is suspended for more the 180
days. ATT., •N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-' -0010 through•-+ 952-001-00900, You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
ssued By: Permittee Signature: // /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial a I FOR OFFICE USE'oNLY -
III City of Tigard r��cE. �/ED �t ,�j, • i
'r 13125 SW Hall Blvd.,Tigard,OR z Plan Review r
Phone: 503.71 R.2439 Fax: 503.598.1960 R 2015 Date/ : var. (,J 6 Other Permit:
'FICA lib
Inspection Line: 503.639.4175 pUG 3 Dale Ready/B. /��%: Pi See l'oge2for
InterncC www.ligard-or.gov NRD Notitied/Methal: //r" Supplemental Information Min
'TYPE. O�G I$n OF DM st�� 0 r� REQUIRED DATA:1-AND 2-FAMILY DWELLING
El
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.
ID 1-and 2-family dwelling t71 Commercial/industrial Valuation: S
El Accessory.building 111 Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SI'Z'E INFORMA'I'ION AND LOCATION Total number of floors:
Job site address: -7,5 1 OA -- oUT-i_Sr New dwelling area: square feet
City/State/ZIP: rrGe Garage/carport area: square feet
'r�/4,rz1� cam. °1722�i
Suite/bldg/apt.no.: ILO 1 Project name:W1Neo re.w5 Covered porch area: square feet
Cross street/directions to job site: x1.1 ac(plc �c .I L- Ay Deck area: square feet
�V W'° Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit foes'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: 151540e°Z6O3 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application. _
Valuation: S xx
Ire- I/A\ r .:i ' C ' •i N �1 I'JJr 't
0 2 N 0{ cuAL T P G�F '!f� Existing building area: square feet
New building area: square feet
g PROPERTY OWNER ❑ TENANT Number of stories:
Name: W tt(_,D P com 1 u� I ype of construction:
Address:4E0 N AricA rr Ea... Occupancy groups:
City/State/ZIP: #fre2i4i�1 In 6?Ji - Existing: Herzes,ITTLa
Phone:(ZQ 77 b1 tO Fax:(2j)67Z_z W.
New: , t
Vil APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: hG� AT,.aGfi "pal /t,r4
Structural plan review fee(or deposit):
Contact name: GHlyr, Of l .lea
PIS plan review fee(if applicable):
Address: 62ee,W. s-1-ATE.Si T
City/State/ZIP: Ie- it 0110 total fees due upon application:
Phone:nog)544_ 14(02. Fa.x: :(/I48,) Amount received:
E-mail:
/_13� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
II CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: E9 N F F 2k b 1ri ,7-w2rC4, ',Jb- h4/710 Submit two(2)sets of roof plan with connection details
- - - -- and lire department access,along with the 2010 Oregon
Address: 3330 E. . Let-tl S CDt 4T4.. isoo Solar ln,viallafion.Specialty Code checklist.
City/State/ZIT': NJE2r-pf 03 93ic y2 Permit fee(includes plan review $180.00
and administrative fees):
Phone: o$) (
1aa ofd Fax:( )
J State surcharge(12%of permit fee): $21.60
CCB lie.: 771 leo
Total fee due upon application: $201.60
Authorized signature. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print natty:0444114 Cb.a.jo IA Date:o ,4_i 42o1 * Fee methodology set by Tri-County Building Industry
1� Service Board.
I:\Building\Pemtits\BUP-COM PermitApp.doc 02/24/2011 440-4613'f(11/02/COM/WEB)
City of Tigard
COMMUNITY IY DEVELOPMENT DEPARTMENT
o . .
TIGARD Building Permit Review — Commercial - Igo Land Use
Building Permit #: tl' P°/ ' t. 00 233
Site Address: 750/ 5c ?rirchnm c.,77-. ,L. Suite/Bldg#: j'9
Project Name: t'J(WIQ
(Name of commercial business occupying the space. I f vacant,enter Spec Space)
Planning Review
Proposal: Ln if-tell( Ch (nncy e-J
Existing Business Activity: C G Lo vI rn r-al
Proposed Business Activity: CG cx)awl in_e`ti
Verify site address/suite# exists and active in permit system.
i River Terrace Neighborhood: ❑ Yes / No
V Zoning: c_C1
,V5 Permitted Use: 0 Yes ❑ No El Spec Space
XJ Confirm no land use required.
Business License:
Exists: Yes ❑ No, applicant notified to obtain business license
Notes:
Approved by Planning: A'l O wiZr1 e Date: `:`S /
Revisions (after Building Submittal only) Reviewer Date
Revision I: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date
Site Plans: # tin
Building Plans:
Building Permit#: \cr building permit # above.
Workflow Routing: g t Coordinator 13$iuiding
Workflow Sign-off: ,E JtgrToff
for Planning(include notes from planning review)
Route Application Documents: wilding: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Notes: ' l/ S(/ Ati Ii,.
By Permit Technician: �• _ Date: d/ fk-
I:\Building\Forms\BldgPennitRvw_COM_NoL ndUse_0709l 5.docx
Permit Coordinator Review
❑ Conditions "Met" prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice I: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Der Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
OK to Issue Permit
((((((
/
Approved by Permit Coordinator: gD ate: VV ,
I:A Building A Forms\BIdgrermilR ew_COM_NolandUse_o7o9I idocs
CPPETERSEN • STAGGS LETTER OF TRANSMITTAL I
ARCHITECTS LLP
NCARB CERTIFIED
5200 W. STATE STREET, BOISE, IDAHO 83703 DATE: 07.28.2015 JOB NO: 1 502
PHONE:(208)345-1462 FAx:(208)345-1532
EMAIL:psarcrpsarch.com ATTENTION:
TO: RECEIVED Brandon
City of Tigard - Building Department AUG 3 2015 RE:
13125 SW Hall Blvd. CITY OF TIGARD T. I. Plan Review
T BUILDING DIVISION
Tigard, OR 97223
WinCo Store #23 Bakery Alcove
ITEMS SENT ARE: IN Attached P1 For Pick Up IN Sent via Fed Ex
COPIES DATE DESCRIPTION
3 Sets CD's
2 Specifications
1 Plan Review Check for $592.36
1 Application
ITEMS SENT ARE:
IFor your use 9 As requested 151 For review and comment 9 Other
COMMENTS:
Please inform us of any additional information or items you may require.
Thank You,
COPIES: File SIGNED:
PLEASE NOTIFY PSA IF ENCLOSURES ARE NOT AS NOTED.