Permit n CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00026
: 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/26/2016
Parcel: 1 S 134AA01900
Jurisdiction: Tigard
Site address: 10115 SW NIMBUS AVE 200
Project: Spec Space Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Landlord work in preparation for T.I. Demising wall and bathroom demolition.
Contractor: SUMMIT CONSTRUCTION Owner: ROBINSON, CONSTANCE A
PO BOX 10345 BY KILLIAN PACIFIC LLC
PORTLAND, OR 97296 500 EAST BROADWAY, STE 110
VANCOUVER,WA 98660
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: Permit Fee-Additions,Alterations, 01/26/2016 $134.54
Demolition
Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 01/26/2016 $16.14
Dwelling Units: 0 Plan Review 01/26/2016 $87.45
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 01/26/2016 $53.82
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 01/26/2016 $7.50
Value: $3,642 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $299.45
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 spended for more the 180
days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rul s are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5 .19 or 1.800.332 344,
Issued By: Permittee Signature:
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 comp) of the project.
Approved plans are required on the job site at the time of each in ction.
Buildine Permit Application
Commercial IMINEIM
City of Tigard �� Received16 Permit No.:
13125 SW Hall Blvd.,Tigard,OV CO Plan Revie
= Phone: 503.718.2439 Fax: 503,F9><. 60 w\P 6j �01 Date/By C Other Permit:
Inspection Line: 503.639.4175 \Pkv � �a Date Ready Jw;s: 13 See Page:2 for
Internet: www.tigard-or.gov J ��`.� , dN Notified/Method: ` Supplemental Information
TYPE OF ` REQT31111T DATA:I-AND?-FAMILY OW MING
❑New construction emolition 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 dwelling Commercial/industrial
Valuation: $
El Accessory buildingNumber of bedrooms:
❑Multi-family
❑Master builder ❑Other: Number of bathrooms:
JOB SM 1114601 "T)IIIN AND LOCATM Total number of floors:
Job site address: 10115 / ' ice. New dwelling area: square feet
City/State/ZIP: U Garage/carport area: square feet
Suite/bldg./apt.no.: Qd Project name: Nl M$v C Covered porch area: square feet
Cross street/directions to job site: 45; ��' Deck area: square feet
eH4(� Other structure area: square feet
RF,df IRlLtD'DATA::COMMKRCIAE 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
DESCRIPTM OF WORK work indicated on this application.
75
iT /�L�-- Drot..Vo Valuation: $ —�
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Z50 /'7 it j ti Occupancy groups:
City/State/ZIP: 0-11$�Q j4Z1: &661 ' Existing:
Phone:X613 I I Fax:W0 ) New:
APPUCANT jr ❑ CONTACT PERSON BUR DING PERMIT FEES'
Business name:
U MY-1 /XIC� (Pleawrewa
fet
Contact name:
Structural plan review fee(or deposit):
�����(�
Address:
06 E FLS plan review fee(if applicable):
City/State/ZIP:
Total fees due upon application:
Phone: .3) ,2� o y Fax::( )
Amount received:
E-mail: C� PEK)TOVOLTAIC SOLAR PANEL SYSTEM TEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ,gam" Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 16 T5657Solar Installation Specialty Code checklist.
City/State/ZIP: vWY7Z Permit fee(includes plan review $180.00
and administrative fees
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.: 0247 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 name: 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)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Commercial - No Land Use
Building Permit #: dw G
Site Address: �,JJ�c— �� �1/Jrt� � �/� Suite/Bldg#:
Project Name:
(Name of commercial business occupying the space. I f vacant,enter Spec Space.)
Planning Review
Proposal: c'
Existing Business Activity:
Proposed Business Activity:
Vr�Verify site address/suite# exists and active in permit system.
ver Terrace Neighborhood: ❑ Yes ❑ No
oning: ��
Vyermitted Use: [I Yes 1:1 No Spec Space
firm no land use required.
Business License:
Exists: Yes ❑ No, applicant notified to obtain business license
Notes:
Approved by Planning: - Date: R6��
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#: -nter building permit# above.
Workflow Routing: Q-�anning ❑ Permit Coordinator E� ui ding
Workflow Sign-off: Q� ��ff for Planning(include notes from planning review)
Route Application Documents: ®�Butldtng: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date:
I:\Building\Fonns\BldgPennit Rvw_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 Pees 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:
I:\Building\Fot7ns\B ldgPennitRvw_COM_No Land U se_070915.docx