Permit (35) CITY OF TIGARD
II
COMMUNITY DEVELOPMENT BUILDING PERMIT
;� Permit#: BUP2016-00137
�
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/20/2016
Ti G A 1:1) g Parcel: 2S101AA08100
Jurisdiction: Tigard
Site address: 12480 SW 68TH AVE
Project: HAYDEN CONSULTING ENGINEERS Subdivision: WEST PORTLAND HEIGHTS Lot: 4
Project Description: TI for existing tenant:Construction of a new conference room.
Contractor: GTM CONSTRUCTION INC Owner: KELSCOR LLC
17735 MARDEE AVE 12716 SW 116TH
LAKE OSWEGO, OR 97035 TIGARD, OR 97223
PHONE: 503-635-2059 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM Permit Fee-Additions,Alterations, 04/20/2016 $70.22
Class of Work: ALT Type of Const: VB Demolition
Occupancy Grp: B Occupancy Load: 30 12%State Surcharge-Building 04/20/2016 $8.43
Dwelling Units: 0 Plan Review 04/20/2016 $45.64
Stories: 1 Height: 0 ft Plan Review-Fire Life Safety 04/20/2016 $28.09
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 04/20/2016 $1.00
Value: $1,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0 1
Garage: 0
Mezzanine: 0
Total $153.38
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 rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy oflbe.rules or direct questions to OUNC by calling 503.232. •87 or 1.80,.33:.2344.
- - ,2 L_
frit
Issued By: ig.. Permift—e€Signature:
39.4175 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 e • .j.
Approved plans are required on the job site at the time of each inspection.
t
Building Permit Application 4`VAN.4
Commercial �/ eD FOR OFFICE USE ONLY
Cl of Tigard �+�/�� V Received /
`J g V�./ Date/B : ammo I' �'
• 13125 SW Hall Blvd.,Tigard,OR 972 Cj Plan Review ►�%
C Phone: 503-718-2439 Fax: 503-598-1 .�t p Q 1- Date/B : �Sf�� n�t Related Permit:
T I G A R t) Inspection Line: 503-6394175 pQS P �r Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov �� ``GPI``�tified/Method: r� ,jt/A�s %. Supplemental Information
v
TYPE OF W00.111''S) 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
RAddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ ..------
❑ 1-and 2-family dwelling [Commercial/industrial _
0 Accessory building 0 Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: \zLiso � �S � /"'t0 New dwelling area: square feet
City/State/ZIP: __,_,..19_,A ,R.... G'7 z_2_3 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: 1 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
--r i3 1 Valuation: $ `0 Or, .
tco
® i �3 , Existing building area: square feet
%Lr_ cr 0
New building area: NtI square feet
E . PROPERTY OWNER 0 TENANT Number of stories: ' 5-� 1
Name: 4o A 44 ,_ ,..,,,,14-41S " „�, { Type of construction: c M v �, 6 0 4
Address: 17 1.-I GG,,..�� J Lk Occupancy groups: (ll
City/State/ZIP: V (0Z 9--i-z_2_ Existing:
Phone:( i ,1,,,R 919 4 Fax:( ) New:
171,APPLICANT 1 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedul
Business name: &71%1 C®ry .'4'i'••••-d-1.0 AI _Loa r Structural plan review fee(or deposit):
Contact name: C`i Y
...1_. :)_ FLSPP
lan review fee(if applicable):
Address: 171
P
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J a cam /--}
Total fees due upon application:
City/State/ZIP: L p Q Q Q 7 O3�
1� 7(( '\ 1 Amount received:
�O
Phone: 3 Fax::( ) P
E-mail: <Q a�+ ry1 _01+-,A ..... 111® of �I C.a PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
J — Commercial and residential prescriptive installation of
CO RACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: �pc �`._pv Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB Lic.: ^ cs-s----7
Total fee due upon application: $201.60
Authorized signature: ,A1 4 , This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: CA �� jilifvxlil
Date: * Fee methodology set by Tri-County Building Industry
Service Board.
I:ABuilding\Permits\BUP_COM_PermitApp.doc Rev.0421/2014 440-4613T(I I/02/COM/WEB)
S 1
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
la III Accessibility: Barrier Removal Improvement Plan
I
Commercial & Multi-Family - Additions or Alterations
T I G A R D 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] $
MULTIPLIER(25%barrier removal requirement): a .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] S
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: S
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(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): $
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
11 11 Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
1. SITE PLAN (3) copies - fully dimensional, drawn to scale and labeled with:
A. ❑ map&tax lot# 0 project name 0 site address 0 suite number
0 zoning ❑ applicant name 0 phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans,details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit-based on valuation of project.
4. ADDITIONAL INFORMATION AS FOLLOWS:
A. Fire Department Building Survey with (1) additional full set of architecture
drawings.
I:\Building\Permits\BUP_COM_PemritApp.doc Rev.12/18/2014
•
•
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan is required showing location and square footage
of all buildings to be demolished,erosion control plan and
tree protection,if applicable)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Solar Photovoltaic 2
(Requires check list for prescriptive installation. If not
prescriptive installation,engineering is required.)
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor,City of Tigard,Washington
County, and Tualatin Valley Fire& Rescue),if applicable.
I:\Building\Pemvts\BUP_COM_PemutApp.doc Rev.12/18/2014
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
s
TIGARD Building Permit Review — Commercial - No Land Use
,G�
Building Permit #: 6tie;2i(0•_oo/ 3-7
Site Address: ( 2.'- 3 0 E W 6, V 44' Cl Y`€ Suite/Bldg#:
Project Name:
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T n te/l'1 lir Tr - Ifl w of- 7 C1L WOO L1
Existing Business Activity: 0 141 a
Proposed Business Activity: 0 kk (Q,
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ Yes XI No
Zoning: M u e
,Permitted Use: ,"Yes ❑ No ❑ Spec Space
Confirm no land use required.
— —iiimsinPcc T.icense:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: /11,0V1 i/GI 6 i 1 Date: Q/ 2 �%' / / to
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: I(p
Site Plans: #�A,
Building Plans: # 1.___
Building Permit#: nter uilding permit#above.
Workflow Routing. [3f'ning ❑ Permit Coordinator 5-13M—ling
Workflow Sign-off: Z.Igin-off for Planning(include notes from planning review)
Route Application Documents: ding. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
:;::rmit
Technician: collet,./Loe,_. Date: `f/) i//‘,
1:\Building\Forms\BldgPermitRvw_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 Fees Entered: Wash Co Trans Dev Tax: 0 Yes ❑ N/A
Tigard Trans SDC: El Yes El N/A
Parks SDC: 0 Yes 0 N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw COM_NoLandUse_07091 5.docx
L
la 4 City of Tigard • BUILDING DIVISION
' Over-The-Counter (OTC) Building & Fire Protection System Permit
111;ARD Appointment Checklist
Permit Record#: M-Y6—a.)/37 _
Contact Name: Phone #: 7O3— 6 35--305--
Business Name: i Appointment Date: y/.'to/D 1Q1Gp
Site Address: I o1LFcr6 Le r4- 6_,,A.
_ Bldg/Suite #:
Project Name: , 0_,-,, .r
Project Description: / S) p,,,, J� ()9zQ2�Q_0,4_44) '�`�� ,
C L
Existing Use: c New Use: ___
MMD Required: ❑ es ❑ No Related Record #: "��
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work: L(_( Occupancy Group: 4'- Type of Construction: _ 6-13Type of Use: t:'.,�7(A Occupancy Load: 0 Oregon Specialty Code: '21)K.—
SPECIFICS
Number of Stories: l 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: 00 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: $ t, OC• C. FEES L UE
DC Prov Rvw,COM TI—Ping
./4-
$ 70,L a 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 $220.00 ✓$ l .CC) 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:
Building Staff: $ Other:
Date/Time: $ OTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_020916.docx (7-5 :3• 3f