Permit y q CITY OF TIGARD BUILDING PERMIT
C COMMUNITY DEVELOPMENT Perrri BUP2015-00352
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/30/2015
Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12540 SW MAIN ST 202
Project: Dolan-Recovery Works Subdivision: BURNHAM TRACT Lot: 1
Project Description: Removal of non-structural walls
Contractor: SUMMIT CONSTRUCTION Owner: DOLAN &CO LLC
PO BOX 10345 BY FLORENCE T DOLAN
PORTLAND, OR 97296 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-223-9703 PHONE:
FAX: 503-242-3841
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 12/30/2015 $88.00
Occupancy Grp: B Occupancy Load: 60 Permit Fee-Additions,Alterations, 12/30/2015 $149.75
Demolition
Dwelling Units: 0 12%State Surcharge-Building 12/30/2015 $17.97
Stories: 2 Height: 0 ft Plan Review 12/30/2015 $97.34
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 12/30/2015 $59.90
Value: $5,000 Info Process/Archiving-Lg$2.00(over 12/30/2015 $2.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $414.96
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No 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. A on 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 2-001-X09/0You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 332.2344.
(ssedBy: Permittee Signature: L
�WCY/ 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 RELEIVEP
City of Tigard rr Date/Bed �11�/ Permit No.:y. (,tPaa�s-�35�
13125 SW Hall Blvd.,Tigard, 2`.9,72232 2015 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B :<' � Other Permit:
Inspection Line: 503.639.4V71'1'V 0� �'�1d '� Date Ready Juris' El See Page 2 for
Internet: www.tigard-or.go d ll N g U Notified/Method: Supplemental Information
BUILDING DIVISIT
TYPE OF WORK REQUIRED 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.
❑ 1-and 2-family dwellingValuation: $
®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12540 SW Main St. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:202 Project name:Dolan-Recovery Works Demo Covered porch area: square feet
Cross street/directions to job site:SW Main st.near SW Burnham St. Deck area: square feet
(BMDA Bldg.) Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.:700 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:21-2-AC Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Removal of non structural interior walls.
Valuation: $5,000.00
Existing building area: 14115 square feet
New building area: 14115 square feet
® PROPERTY OWNER ® TENANT Number of stories: 2
Name:Dolan Type of construction: V-B
Address: 1919 NW 19"St. Occupancy groups:
City/State/ZIP:Portland,OR 97209 Existing: M,B
Phone:(503)225-9009 Fax:( ) New: M,B
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:CIDA,Inc. Please refer to fee schedule
Structural plan review fee(or deposit):
Contact name:Tara W.Lund
Address:15895 SW 72"`'Ave. FLS plan review fee(if applicable):
City/State/ZIP:Portland,OR 97224 Total fees due upon application:
Phone:(503)226-1285 Fax: :( ) Amount received:
E-mail:taral@cidainc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Business name:Summit Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1335 NW 20th Solar Installation S ecialry Code checklist.
City/State/ZIP:Portland,OR 97296 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)223-9703 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB he.:63249 I Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
r v within 180 days after it has been accepted as complete.
Print name: Date:Date: * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
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(259/6).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 5000
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 1000
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: $ -
(0 Accessible drinking fountains: and, $ -
(g) When possible,additional accessible elements such as storage and
alarms: $ -
TOTAL(shall equal line [2] of Valuation Computation): $ -
L\Building\Permits\BUP-COM PermitApp.doe 03/03/2011
r
City of Tigard
COMMUNITY DEVEHLOPML.NT DEPARTMENT
Building Permit Review — Commercial - No Land Use
Building Permit #: �ju Po�G 1 s-vo 3 5
Site Address: 0 y 0 SW Main Si. Suite/Bldg#: 202,
Project Name: Recovery VJofk(;
CNanu of cnnun eiel business Occup)'ing the space. If vacant,enter Spee Spacc.)
Planning Review -- II__
Proposal: demo on\V DreuAki nl ' or+VcOm1 M -�oy- �ne-W +eno'n+
Existing Business Activity: V0,.00.Y*
Proposed Business Activity: CC)4i tm Gtr" 71 st&6yi i Q'
Vverif,site address/suite# exists and active in permit s)rstem.
River Terrace Neighborhood: ❑ Yes No
Zoning: K U —C
9- crniitted Use: ElYes 11No EV Spec Space
Confirm no land use required.
—El'Business License:
Exists: ❑ Yes ❑ No, applicant notified to obtain business license
Notes: fe\ j eW Dr2V16V1S VS P'foAoSp_� y,-se a-+ -Tl SArn; +oJ
Approved by Planning: Tim Date: l 22 k S
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: / yy
Site Plans: # 3
Building Plans: # 13
Building Permit#: [�-I3ntcr building permit# above.
\\/orkElo\v Routing: E�_Planning C]-43t7ilding
Workflow Sign-off: P 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: l
By Permit Technician:(-/\,-). ( / Date:
I:\Building\Fornns\BldgPermitRvw_COM_Nol-vidUsc_070915.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, Released: Date:
Notes:
Revisions (after Building Submittal only
Revision Notice 1: Date Sent to App a
Revision Notice 2: Date Sent to App ant:
Revision Notice 3: Date Sent to i plicant:
❑ SDC lees Entered: Wash 1Tans Dev Tax: ❑ Yes tATi d Trans SDC: ElYes ElNarks SDC: ElYes ElN
❑ OK to Issue Permit
Approved by P mit Coordinator: Date:
I:\Building\Forms\BIdgPennitRvw_COM_NoL.andUse_070915.docx
Building Division
Over-The-Counter (OTC) Building Permit
--- Check List
Project Description: 1 1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: L Occupancy Group: T pe of Construction:
Type of Use**: Oregon Specialty Code:
SPECIFICS O
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
Side and Setback—Left Side and Setback—Front
Side and Setback—Right Side and 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: Fire Alarms: 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
$ DC Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ 12%State Surcharge
Project Valuation $ • ' 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 $ 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: $ Othe
p
Date/Time: tA-.I.�j T FEES DUE
*TYPE OF USE: COM=commercial;CMS=commercial manufactured-structu . — - '� '
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;D1-.M=demo;NEW=new;,
011t=other use for fences,decks;.retainin 'walls,signs,awnin s,,or,cano ies.
1:\Building\Forms\OTC_BUP_070115.docx