Permit (41) . .t
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00354
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/23/2015
Parcel: 2S113AB00600
Jurisdiction: Tigard
Site address: 16160 SW UPPER BOONES FERRY RD
Project: Phytelligence Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: TI-New framing,sheetrock,restroom modifications/expansion,doors,hardware&finishes.
Contractor: DURUS CONSTRUCTION LLC Owner: PACIFIC REALTY ASSOCIATES LP
15806 UPPER BOONES FERRY RD ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-320-8601 PHONE: 503-624-6300
FAX: 503-244-4318
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 12/23/2015 $88.00
Occupancy Grp: B Occupancy Load: 122 Permit Fee-Additions,Alterations, 12/23/2015 $696.39
Demolition
Dwelling Units: 0 12%State Surcharge-Building 12/23/2015 $83.57
Stories: 1 Height: 0 ft Plan Review 12/23/2015 $452.65
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 12/23/2015 $278.56
Value: $46,950 Info Process/Archiving-Lg$2.00(over 12/23/2015 $8.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,607.17
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 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 ATT regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-LBy:
gh OA 52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 1987 or 1.800.332.2344
Issu ` Permittee Signat
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.
Buildini Permit Application CE V FOR OFFICE USE ONLY
Com-mescal Rn
Received �y a3 Permit No.:
City of Tigard , Date/By:
a 13125 SW Hall Blvd.,Tigard,OR 97223 r, B 3 ?o''1 Plan RevicPW/_
u Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/B
a Inspection Line: 503.639.4175 Cal a1� 1'��� � Date ReaI�+*IsSee Page 2.for
Internet: www.tig-d-or.gov Illlll VYNotified[Wethod:/ 3 / Supplemental Information
EMS
❑Demolition Permit fees*are based on the value of the work performed.
❑New construction Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement Other:
equipment,materials,labor;overhead,and the profit for the .
work indicated on this application.
e a
Valuation: $
❑ 1-and 2-family dwelling Commercial/mdustrial
Number of bedrooms:
❑Accessory building [JAilti-family .
❑Master builder ❑.Other•.
Number of bathrooms:
a Total number.of floors:
Job site address ` ��.V d f New dwelling area: square feet
City/State/ZIP:. Garage/carportarea square feet.
Suite/bldgJapt no.: a f (� Project name: r` Covered porch area: square feet
Cross streetidirections to job site: Deck area: square feet
/ Oiher structure area: - square feet .
Subdivision: Lot no:: Permit fees*are based ori the value of the work performed:".:`r .:
Indicate the value(rounded to.the riearest dollar)of al[
Tax map/parcel no.; ;equipment,materials;
labor,overlietld;:and the profit for tbe.;
work indicated on this. .1ic_atioii:
..Valuation $
fJ S r .00
Existing building area 1'L 1$ square feet
r0 uP-,w�.�t4-•t�- New building area: square feet
r `')`Titntber of stories: 1.
Name: _'" v -
Type of construction:• 1�`•
Address: ' 1� Occupancy groups:
S
I : Existing:
�7
_Phone: ) . �30'a. Faac:( 3j +— ! New
Business name
:�$truotural plan review fee.(9r'deposit):
Contact name: V 1.. (if applicable):
_ _ FLS plan review fee
Address:
Total fees due upon.application:`
City/State/ZIP: -7 Amounf received:
Phone:( )
E-mail:
�f Commercial and residential presixipttye:insfallatioli:of
ioof-top moumted PhotoV. dlW&S-t larPanel system.
Submit two(2)sets of roof plan with connection details
Business name: V,�V S G� and fire department access,along with the 2010 Oregon '
Address: Solar Installation Specialty Code checklist:
Permit fee(includes plan review $t80.00
City/State/l and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: ( Total fee due upon application: $201.60
This permit application expires if a permit is not obtained
Authorized signature: within 180 days after it has been accepted as complete.
_ • Fee methodology set by Tri-County Building Industry
Date:
Print name: tr••e— 1Z (` Service Board
City of Tigard
COMMUNITY D1=?VELOPMENT DEPAR'rMENT
Building Permit Review — Commercial - No Land Use
Building Permit #:
Site Address: S VJ U ppe-C Q ao r) e-j f:- rr j Suite/Bldg#:
Project Name: exi 0—
(Name of conunereial business oecuhying the space. 1 f vacant,enter Spec Space)
Planning Review
Proposal: N eNy Py74V►rl I 'n T , 'fI A-M u rn n-?o cb G, CGr f l b t'l
Existing Business Activity: 1 1 1n"f .
Proposed Business Activity: p f !1 d f -n--?"L
Verify site address/suite# exists and active in permit system.
,� ver'rerrace Neighborhood: ❑ Yes ❑ No
Zoning:
Permitted Use: IKYes ❑ No ❑ Spec Space
Confirm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: ! V I/U ��V ��`J` `�` Date: G 2-/-Z-3/�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:
Site Plans: #
Building Plans: #
Building Permit#: 0]'rater building permit# above. /
Workflow Routing: Planning e o d' for 0 Building
Workflow Sign-off.- Er-,�Sin-off for Planning(include notes from planning review)
Route Application Documents: LTJ Building: original permit application, site plans, building plans, engineer and
��11 beam calculations and trust details,if applicable, etc.
Notes: C� (:!-
By Permit Technician: c Date:
1:\Building\Forms\BldgPel'n11tR VN'_COM_NoLandUse_070915.docx
Permit Coordinator Review
❑ Conditions "1\4et" prior to issuance of building pernut
❑ 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
Approved by Permit Coordinator: Date:
se-0 070915.docx
I:\Buildin \Foi7ns\BId PermitRvw COM Nolan dU
Building Division
Over-The-Counter (OTC) Building Permit
� Check List
Project Description:
7-1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Grou Type of Construction:
Type of Use**: 'LL Occupancy Load: Oregon Specialty Code: ZG
SPECIFICS
Number of Stories: BuildingHeight:
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:
Sp rinkler 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 $ 2,( Ian Review,Structural
Up to$4,999 $0.00 $ M-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:
$ 11ier.
Building Staff: �$ Other:
Date/Time: $ TOTAL FEES DUE
*TYPE OF USE: COM=commercial;CMS= ommercial m factured structure.
**CLASS OF WORK: ACS=accessory;ADD=addition;ADU=ac eP1-dwelli}ig4ffi1, =alteration;DEM=demo;NEW=new;
01R=other use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\O'1'C_BUP_070115.docx
CITY OF TIGARD FEE AND PAYMENT HISTORY
13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
BUP2015-00354 - 16160 SW UPPER BOONES FERRY RD, TIGARD, OR 97224
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
DC Provision Review, COM TI- Ping 100-0000-43112 $88.00 $88.00 $88.00
Permit Fee-Additions,Alterations, 230-0000-43104 $696.39 $696.39 S696.39
Demolition
12%State Surcharge-Building 100-0000-24001 $83.57 $83.57 $83.57
Plan Review 230-0000-43106 $452.65 $452.65 $452.65
Plan Review-Fire Life Safety 230-0000-43108 $278.56 $278.56 $278.56
Info Process/Archiving-Lg $2.00(over 230-0000-43135 $8.00 $8.00 $8.00
11x17)
Totals for Fees $1,607.17 $1,607.17 $0.00 $1,607.17
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
Total Payments: $0.00
Balance Due: $1,607.17
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
16160 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00354
Jeff Grove
Violation Summary:
Inspector Contractor