Permit (25) CITY OF TIGARD BUILDING PERMIT
,t1:11111 I ' • COMMUNITY DEVELOPMENT Permit#: BUP2016 00079
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/15/2016
Parcel: 1 S134BC00200
Jurisdiction: Tigard
Site address: 12198 SW SCHOLLS FERRY RD
Project: Baja Fresh Subdivision: None Lot: None
Project Description: TI for new tenant: New restaurant in spec space. Tenant is relocating from within complex.
Contractor: WELL DONE ELECTRIC Owner: ATLAS GREENWAY LLC
17045 SE ROYER RD 333 NW NINTH AVE, STE 1009
DAMASCUS, OR 97089 PORTLAND, OR 97209
PHONE: 503-209-4006 PHONE:
FAX: 503-558-1297
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 03/15/2016 $88.00
Occupancy Grp: A-2 Occupancy Load: 69 Permit Fee-Additions,Alterations, 03/15/2016 $729.45
Demolition
Dwelling Units: 0 12%State Surcharge-Building 03/15/2016 $87.53
Stories: 1 Height: 0 ft Plan Review 03/15/2016 $474.14
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 03/15/2016 $291.78
Value: $50,000 Info Process/Archiving-Lg$2.00(over 03/15/2016 $36.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,706.90
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those ru- 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 503.232.1987 or 1.800.33 '4.
Issued By: jW6. 'e e Signature:
Call I 4175 by 7:00 a.m.for the next available inspection e.
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.
it‘
ilding Application
A lication
Commercial RECEIVE!) FOR OFFICE USE ONLY 3 ''""
City of Tigard ReceiveDate/By:
Z' / 4%2 ( Permit No.: 14/)� �f_
, "I 13125 SW Hall Blvd.,Tigard,OR 97223 t? Plan Revie ' l'� O �
■ � �� ��" v (I Related Permit:
Phone: 503-718-2439 Fax: 503-598-19ti0 Date/By:� I �
T I c; R D Inspection Line: 503-639-4175 q s Date Rea.• ,y: 111 Jura: ® See Page 2 for
Internet: www.tigard-or.gov ����01' 1I( t1 Notified/Method: ������� Supplemental Information
TYPE OF WORK REQUIRED DATA: 1-AND 2-FAMILY DWELLING
❑New construction 0 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 111 Other: equipment,materials,labor,overhead,and the profit for the
\ CATEGORY' OF CONSTRUCTION work indicated on this application.
0 1-and 2-family dwelling —Commercial/industrial Valuation: $
ElAccessory building 0 Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12/ (/ ' , s, Nil ;'f. t/ ) Ail New dwelling area: square feet
"TiCity/State/ZIP: / &- 46.-- 0 `, Garage/carport area: square feet
Suite/bldg./apt.#: Project nal fiCovered porch area: square feet
Cross street/directions to job site: / Lf f 1��V1// p�� ,SN. / Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTIONrpOF WORK work indicated on this application. /�� /'�
�,� i' / `V (-ifi Valuation: $ �i C/CJ lJ
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Nance: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:( ) I Fax: :( )
Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mount-d PhotoVoltaic Solar Panel System.
Business name: kG� ; >�� �rr� 1 ///I�� Submit two(2)s. of roof plan with con tion details
I`� !sem and fire departmen. . cess,along w. e 2010 Oregon
Address: ..9 _ S',e 2 PV. AALSolar Installation S;eci> . C checklist.
City/State/ZIP: iMARFA tM` Permit fee(inc -s p . eview $180.00
a.• ..mini strative e..):
Phone:�V 1J) 'f— Ve Fax:L"03 Si' — / State surcharge(12%of permit fee): $21.60
CCB Lic.: afir Y,
Total fee due upon application: $201.60
Authorized signature: C--"--_, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:7711i0 7 'y 0 (( v Date03-0 /� * Fee methodology set by Tri-County Building Industry
/ Service Board.
I:\Building\Permits\BUP_COM_PertnitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
114 ■ Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
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 percent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 579 d o 'a
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
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: S
(c) An accessible route to the altered area: S
(d) At least one accessible restroom for each sex or a single unisex
restroom: S
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): S
I:\Building\Pemuts\BUP_COM_PermitApp.doc Rev.12/18/2014
City of Tigard
'PI ■ COMMUNITY DEVELOPMENT DEPARTMENT
i
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: *A/026, b--C COY
Site Address: ( Z 1 9c6 S w S Cit o l l s Fe;r- Suite/Bldg#:
Project Name: 13 UJ O. (,-)
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T .L—
Existing Business Activity: Co(VY)(11 -C-4 eck.,
Proposed Business Activity: DO YY) (YLQT(AJ(_
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: ❑ Yes No
7 Zoning: C— (�
)2' Permitted Use: ,Yes ❑ No ❑ Spec Space
Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: 7)/7 ( K'Lt L &i)o Date: 3 / 1 S / / b
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: /,5
Site Plans: #
Building Plans: #
Building Permit#: nter building permit# above.
Workflow Routing: n--.§..c.-off
'Ise mit Coordinatorg
Workflow Sign-off: 1� Si -off for Planning(include notes from planning review)
Route Application Documents: Lc-]'Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: Z:577
By Permit Technician: Date: �/3 J/6
1:\Building\Forms\BldgPennit Rvw_CO M_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 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:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
' City of Tigard • BUILDING DIVISION
II
Over-The-Counter (OTC) Building & Fire Protection System Permit
T I G A R D Appointment Checklist
Permit Record#: gj,�► 0 4�- -71' _ ��
Contact Name: --''/ / , ' L aut Phone #: 'Jo3-o� - 7�O
Business Name: LT2Q '2-'1- rim Ap, ,oiintment Date: £4S c V 2C)
� gn
Site Address: igi%� , i%u-gQ,d Q.i.t yf- /�.dl• Bldg/Suite #:
Project Name: --7-0 '6t., (1
Project Description: — l
Existing Use: u r- New Use: j—
�t L ,�• -1
MM I :equired: ❑ Yes 111 No oak
Related Record #:
�CJ _ to —_• --0000`3- �_-k ' . _,L_i 61X.•- •�__a•
GENERAL INFORMATION
Class of Work: Lr Occupancy Group: Z_ Type of Construction:
- ?X4—
Type of Use: Occupancy Load: .,1,4? Oregon Specialty Code:
SPECIFICS
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
Sideyard Setback–Left Sideyard Setback–Front
Sideyard Setback–Right Sideyard 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: $ ) w.. TY,a ' •1 :i
$ r v F i. ' '' $.
DC Prov Rvw,COM TI–Ping
$ 2/.. `S Permit Fee–Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ t 5 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 $ °^ ,GD 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
$ er:
Building Staff: $ Other.
Date/Time: $ I 7ft0I'OT FEES DUE
I:\Building\Forms\OTC_BUP_FPS_020916.docx
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
12198 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2016-00079
Jeff Grove
Violation Summary:
Inspector Contractor