Permitr-
CITY OF TIGARD BUILDING PERMIT
n
COMMUNITY DEVELOPMENT Permit#: BUP2016-00024
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/26/2016
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: TAP Plastics Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: TI or new tenant. Change of use from indoor entertainment(Yoga)to retail(TAP Plastics).
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-624-6300 PHONE:
FAX: 503-624-7755
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: 1116 DC Provision Review,COM TI-Ping 01/26/2016 $88.00
Occupancy Grp: M Occupancy Load: 64 Permit Fee-Additions,Alterations, 01/26/2016 $842.40
Demolition
Dwelling Units: 0 12%State Surcharge-Building 01/26/2016 $101.09
Stories: 0 Height: 0 ft Plan Review 01/26/2016 $547.56
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 01/26/2016 $10.00
Value: $64,844 11x17)
Plan Review-Fire Life Safety 01/26/2016 $336.96
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,926.01
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtai a rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
al 3.639.4175 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.
M
Building Division
Over-The-Counter (OTC) Building Permit
Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: &d
Occupancy Group: e of Construction:
Type of Use**: Occupancy Load: Ore on Specialty Code: y
SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: I 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) $ d 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 $ Q� y 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- $ ther:
Date/Time: $ ® TOTAL FEES DUE
*TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
OTR=othcr use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Fomes\OTC_BUP_070115.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Commercial - With Land Use
Building Permit #: �j� / =4rxY 2ty
Site Address: -7 S .2L1 u� Suite/Bldg#:
Project Name: /4 ,n Ale,,f oLrci
(Name of c mmercial business occupying the space. If vacant,enter Spec Space)
Planning Review
Proposal: T_
L;YVerify site address/suite# exists and active in permit s stem.
MA�iver Terrace Neighborhood: ❑ Yes No
Z2,ad Use Case#: ��� o1-o 1(9-C �.l-)s MM tch Approved Land Use: 64�e_/16_
L:1 z Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
--E4-Building Height: Maximum Height Actual Height
-El—(:onditions Met: AV ❑ Prior to Submittal ❑ Prior to Permit Issuance
2 Business License: �
Exists: 'Yes [VN-o, applicant notified to obtain business license
Ly'Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes, applicant was notified L'9'No Applied For: ❑ Yes ❑ No, stop intake
Notes:
Approved by Planning: Date:
Revisions (after Building Sub aonly) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: j oro
Site Plans:
Building Plans: # _
Building Permit#: nter building ermit#above.
Workflow Routing: lanning toor ma or ®- iirrg,
Workflow Sign-off. `o�ff for Planning(include notes from planning review)
Route Application Documents: �g: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: C�
By Permit Technician: Date: /
1:\13uiIding\Fonns\I31dgPer nitRvw_COM_W ithLand Use_070915.docx
I
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
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 Dee 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\Fonns\BldgPennitRvw_COM_WithLand Use_070915.docx
Buildiniz Permit Application
Commercial FOR OFFICE USE ONLY
Received
City of Tigard Date/By: Permit No.:
�l�
13125 SW Hall Blvd.,Tigard,OR 97 '�6 Plan Revie x /
= 0 Other Permit: `
Phone: 503.718.2439 Fax: 503.598. Oat
6� DeB : , luris: ® See Page 2 for
a Inspection Line: 503.639.4175 to Read
Internet: www.tigard-or.goV �P o�-��G�S� Stified/Method: (p Supplemental Information
TYPE O t�. REQUIRED DATA:1-AND;,FAMILY DWELLING
,�.
❑New construction ❑D Ilion 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
11 It
work indicated on this application.
u CATEGORY OF`
®,
-
Valuation: $
❑ 1-and 2-family dwellingCommercial/industrial
❑Accessory building ❑Multi-family
Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMA"I1�OA� T)TN Total number of floors:
Job site address: 15957 SW 72"d Ave. New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:NA Project name:TAP Plastics Covered porch area: square feet
Cross street/directions to job site:SW Upper Boones Ferry and SW 72°d Ave. Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST_ .
Subdivision: 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 OE WURF "; '' work indicated on this application.
i. «_
Demolition,build out for retail Valuation: $64,844
Existing building area: 3,782 square feet
New building area: 3,782 square feet
r
P�RtPERTY OWNER �a �a �,,. Number of stories: 1
Name:PacTrust Type of construction: III-B
Address:15350 SW Sequoia Parkway#300 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing: M,S-1
Phone:(503)624-6300 Fax:(503)624-7755 New: M,S-1
( 'APPLICANT ` •® 40NTiGT:)pERSON BUILDING PERMIT FEES*
Please refer to feesehedule
Business name:PacTrust
Structural plan review fee(or deposit):
Contact name:Leslie Louis
FLS plan review fee(if applicable): I
Address: 15350 SW Sequoia Parkway#300
Total fees due upon application:
City/State/ZIP:97224
Amount received:
Phone:(503)624-6300 Fax::(503)624-7755
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:lesliel@pactrust.com
CONTRACTOR Commercial and residential prescriptive installation of
�� i . roof-top mounted Photovoltaic Solar Panel System.
Business name:PacTrust Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:15350 SW Sequoia Parkway#300 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,OR 97224 Permit fee(includes plan review $180.00
and administrative fees
Phone:(503)624-6300 Fax:(503)624-7755 State surcharge(12%of permit fee): $21.60
CCB lic.: 153913 Total fee due upon application: $201.60
Authorized signature: 1 This permit application expires if a permit is not obtained
°y within 180 days after it has been accepted as complete.
Print name: Date:J titn• S Z,0 L * Fee methodology set by Tri-County Building Industry
�S 1 Service Board.
l:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 4404613T(11/02/COM/WEB)
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
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Building
299 Final inspection
PASS - C of O
BUP2016-00024
Jeff Grove
Violation Summary:
Inspector Contractor