Permit (40) CITY OF TIGARD BUILDING PERMIT
IN I COMMUNITY DEVELOPMENT Permit#: BUP2016-00171
Tigard OR 97223 503.718.2439 TI
13125 SW Hall Blvd.,Ti Date Issued: 05/19/2016[;r112T? 9
Parcel: 2S101 DB00104
Jurisdiction: Tigard
Site address: 7300 SW HUNZIKER RD 100
Project: Easter Seals Subdivision: None Lot: None
Project Description: Demolition of existing office partitions and build new partitions for additional private offices.
Contractor: ROBINSON CONSTRUCTION Owner: HILLTOP BUSINESS CENTER LLC
21360 NW AMBERWOOD DR HUNZIKER LLC
HILLSBORO, OR 97124-9321 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503-645-8531 PHONE:
FAX: 503-645-5397
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 05/19/2016 $88.00
Occupancy Grp: B Occupancy Load: 20 Permit Fee-Additions,Alterations, 05/19/2016 $347.48
Demolition
Dwelling Units: 0 12%State Surcharge-Building 05/19/2016 $41.70
Stories: 2 Height: 0 ft Plan Review 05/19/2016 $225.86
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 05/19/2016 $138.99
Value: $17,100 Info Process/Archiving-Lg$2.00(over 05/19/2016 $6.00
11x17)
Cash Over 05/19/2016 $12.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $860.03
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
952-001-0 rou h-Q R 952-001-0090.OLA4_,L.Ay
You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Iss d By: Permittee Signature: c-
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.
Building Permit Application
Commercial RECEI%TE FOR OFFICE ISE ONLY
City of Tigard ReceivedDate/B '�, // , )Permit No.: ��/6 GUi 7
13125 SW Hall Blvd.,Tigard,OR 97223 MAY 19 2016 Plan Review �►
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : ijg Other Permit:
TI G A R D Inspection Line: 503.639.4175 l I rt I � ` + Date Ready Jur s: ® See Page 2 for
Internet: www.tigard-or.gov I OF (� 1J Notified/Method: Supplemental Information
BUILDING DIV1,�IO1\
TYPE OF WQRK 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
®Addition/alteration/replacement 0 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: $
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:7300 Hunziker Rd,Suite* New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no. / O Project name:Easter Seals Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)
Tax map/parcel no.:2S101DB00104 of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OE.WORK' work indicated on this application.
Tenant Improvement:Existing SuiteH(city records have it under suite 100). Valuation: $$17,100.00
Demolition of existing office partitions and building new partitions for Existing building area: 1980 square feet
additional private offices. New building area: 1980 square feet
= PROPERTY`OWNER 0 TENANT Number of stories:
Name:Robinson Construction Type of construction: III-B
Address:21360 NW Amberwood Dr Occupancy groups:
City/State/ZIP:Hillboro,OR 97124 Existing: Group B
Phone:(503)645-8531 Fax:(503)645-5357 New: Group B
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:CIDA,INC.
(Pkaserejtrm}dsehedrrk)
Structural plan review fee(or deposit):
Contact name:Gavin Russell
Address: 15895 SW 72"d Ave,Suite 200 FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP:Portland,OR 97224
Phone:(503)226-1285 Fax::(503)226-1670 Amount received:
E-mail:gavinr@cidainc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Robinson Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:21360 NW Amberwood Dr Solar Installation Specialty Code checklist.
City/State/ZIP:Hillsboro,OR 97124 Permit fee(includes plan review
and administrative fees): $180.00
Phone:(503)645-8531 Fax:(503)645-5357 State surcharge(12%of permit fee): $21.60
CCB lic.:63147
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: ri{ /V/^ /IC e,,c<5� Date: 5_/p_ /6 * Fee methodology set by Tri-County Building Industry
�T /" Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)
City of Tigard
lig ■ r COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: t3 Lt pal) Ito- CSU 171
Site Address: ?` Sk7 t 072-j /- ied Suite/Bldg#: )O
Project Name: Ea7`e-/- . C
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 7:-/- ' nau -A,,,,,,..,-/----•
Existing Business Activity: 0/40P
Proposed Business Activity: J/
Verify site address/suite# exists and active in permit syst .
II °' 'ver Terrace Neighborhood: El Yes v No
oning: C—P
r ,,_/
mitted Use: 1f Yes I=1 No CI Spec Space
Confirm no land use required.
Con
Business License,
Exists: la Yes ❑ No,applicant notified to obtain business license
Notes:
:: __S
Approved by Planning: Date: S// c9/1 ,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal l
Original Submittal Date: 5/j i(142
Site Plans: # 3
Building Plans: # 55
Building Permit#: R.—Enter building permit#above.
Workflow Routing: [-Planning t auilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: [ Building: original permit application, site plans,building plans, engineer and
��— beam calculations and trust details,if applicable, etc.
Notes: OTT_
c.-
By Permit Technician: C Date: 5/5/0
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_0709I 5.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issu. e of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applica .
Revision Notice 2: Date Sent to Ap. : ant:
Revision Notice 3: Date Sent to 'pplicant:
❑ SDC Fees Entered: Was 'o Trans Dev Tax: ❑ Yes ❑ N/A
...rd Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Pe . t
Approved by Permit Coordinator: Date:
1:\Building\Forms\B1dgPermitRvw_COM_NoLandUse_0709I 5.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
7300 SW HUNZIKER RD 100, TIGARD, OR,
97223
Commercial - Building
275 Framing
PASS
BUP2016-00171
Jeff Grove
Violation Summary:
Inspector Contractor
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
7300 SW HUNZIKER RD 100, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2016-00171
Chip Barnett
Violation Summary:
Inspector Contractor
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1111 II
Request for Permit Action
i I&,n i D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard, OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor is City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) —Ro 6,► „at,13 C.c»s-ti-2Lx.cn atJ
Mailing Address: 02 t 3 C,o Ni„) Ait-1gE/L1.0oo13 'b2
City/State/Zip: 14_,U6 PDo Qo, 0Q, 911 A 4-q-
Phone No.: tio71- to457- 531
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
U _...t.,. '__ VOID PERMIT APPLICATION.
t '4 -.RMTI'FEES (attach copy of original receipt and provide explanation below).
!
FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMPT (do not cancel permit).
Permit #: ` LLP 9-p l is— 00 1 1 I
Site Address or Parcel #: 7300 o`LA 1.1u.rl7_,t 4,f 2. R--1- .1`I00
Subdivision Name: Lot #:
EXPLANATION:t�� —1�s,;u 1st) `k 19,•`� 0L)€_,/2_A-e,s_ cm) C.l{-cc.lr� I o 2
tr/.,a-t t i I%4.f.,5 .
Signature: _ e j, Date: �119114,
Print Name: DOA1 t P...- 41.3A tt5 KA
Refund Policy
I. The city's Community Development Director,Building()fticial or City I?ngineer may authorize the refund of:
• .Any fee which was erroneously paid or collected.
• Nor more than 800'0 of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80°'0 of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via I'S postal service.
3. Please allow 3-4 weeks for processing refund requests.
Route to Sys_Admin: Date 191 B Route to Records: Date 4 3 /b By
Refund Processed: Date i /(o By Invoice Processed: Date By
Permit Canceled: Date 41 By It" Parcel Tag Added: Date By
I:ABuilding\Dorms\ReyIknnit Action_n9_3I4.doc
II Cno
TIGARD
City of Tigard
June 3, 2016
Robinson Construction
21360 NW Amberwood Dr.
Hillsboro, OR 97124-9321
Re:Permit No. BUP2016-00171
Dear Applicant:
The City of Tigard has processed a refund for overpayment of permit fees on the above
referenced permit for the following:
Site Address: 7300 SW Hunziker Rd., #100
Project Name: Easter Seals
Job No.: N/A
Refund: ® Check#221215 in the amount of$12.00.
❑ Credit card"return" receipt in the amount of$
❑ Trust account"deposit" receipt in the amount of$
Notes:
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Coordinator
Enc.
l:\Building\Refun � n t \RANCO raig4 l���egon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
IN
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mi
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts,documentation and the Request for Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Robinson Construction DATE: 5/26/2016
21360 NW Amberwood Dr.
Hillsboro, OR 97124-9321 REQUESTED BY: Dianna Howse
DA
TRANSACTION INFORMATION:
Receipt#: 404010 Case#: BUP2016-00171
Date: 5/19/2016 Address/Parcel: 7300 SW Hunziker Rd.,#100
Pay Method: Check Project Name: Easter Seals
EXPLANATION: Refund overpayment of permit fees.
.v,; . ..,, :. „.,,,,„ ...;„.,..
I�gveitue Accbunti Nor .1117;
) �e.lb §cfrfpii Fxom:R6ceipt` ti` t' :'
P4anipfe. Buufdit g Permit Fee' Eganif ':23�-43104 s ;- <.).,. ::f '',i.:
Cas
'-
Cash Over 100-0000-48001 $12.00
TOTAL REFUND: $12.00
APPROVALS: SIGNAT ' I AT :
If under$5,000 Professional Staff Or ea --
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM : 1 MINISTRATION USE ONLY
Case Refund Processed: Date: „i 6/3/40. By: 4:71,-
1:\Building\Refunds\RefundRequestdoc
x 09/01/2010