Permit (25) CITY OF TIGARD BUILDING PERMIT
11111 COMMUNITY DEVELOPMENT Permit#: BUP2016-00190
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
Parcel: 25101 BB01400
Jurisdiction: Tigard
Site address: 12176 SW GARDEN PL
Project: FastSigns Subdivision: CROW PARK 217 Lot: 2
Project Description: TI
Contractor: ROBERT TODD CONSTRUCTION INC Owner: ICON OWNER POOL 1 WEST LLC
4080 SE INTERNATIONAL WAY B113 BY RYAN
MILWAUKIE, OR 97222 PO BOX 460169
HOUSTON,TX 77056
PHONE: 503-653-5704 PHONE:
FAX: 503-653-5729
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 06/02/2016 $88.00
Occupancy Grp: B Occupancy Load: 22 Permit Fee-Additions,Alterations, 06/02/2016 $271.43
Demolition
Dwelling Units: 0 12%State Surcharge-Building 06/02/2016 $32.57
Stories: 1 Height: 0 ft Plan Review 06/02/2016 $176.43
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/02/2016 $108.57
Value: $12,200 Info Process/Archiving-Lg$2.00(over 06/02/2016 $4.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $681.00
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
952-0e -0 I • eh OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ued By: / `7 0,, / Permittee Signature:
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 RECEIVED FOR OFFICE['SE ONLY
City of Tigard Date/Bed• r, i` (p OM Permit No.: �,i, I 404 `/l
Ill - ° 13125 SW Hall Blvd.,Tigard,OR 97 Plan Revi \
Phone: 503.718.2439 Fax: 503.59 WD 4 2 '016 Date/ i! �r Other Permit:
TIGARD Inspection Line: 503.639.4175 { `/ { Date Rea:"' Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING c1I J (ii 11( ARDNotified/Method: Supplemental Information
TYPE WODIVISION 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 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: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12176 SW Garden Place New dwelling area: square feet
City/State/ZIP:Tigard,OR Garage/carport area: square feet
Suite/bldg./apt.no.:Bldg.3 Project name:FastSigns Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Park 217 at Hwy 99 and SW Garden Place Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Interior tenant improvement Valuation: $$12,200.00
Existing building area: 4030 square feet
New building area: 4030 square feet
® PROPERTY OWNER 0 TENANT Number of stories: 1
Name:GLP Type of construction: VB
Address:One SW Columbia-Suite 950 Occupancy groups:
City/State/ZIP:Portland,OR 97258 Existing: A/B/F/S
Phone:(503)221.9900 Fax:( ) New: A/B/F/S
® APPLICANT g CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mildren Design Group,P.C. (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Betty Sheppeard
Address:7650 SW Beveland-Suite 120 FLS plan review fee(if applicable):
City/State/ZIP:Tigard,OR 97223 Total fees due upon application:
Amount received:
Phone:(503)244.0552 Fax: :( )
E-mail:betty@mdgpc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel Syste• .
Business name:Robert Todd Construction Submit two(2)sets of roof plan with connec .: details
and fire depar ent access,along with t = 010 Oregon
Address:4080 SE International Way Solar Installation .ecialty Code ch-• list.
City/State/ZIP:Milwaukie,OR 97222 Permit fee(incl .- plan iew
$180.00
and administr.- e fees):
Phone:(503)653.5704 Fax:( ) State surcharge(12'.of permit • : $21.60
CCB lie.:98517 Total fee .ue upon application: $201.60
Authorized signature: R This permit application expires if a permit is nndRobtained
!/'v"v� t/ within 180 days after it has been accepted as complete.
Print name:Betty K.Sheppeard Date:0.5:24:T6 (#.. Z•(Ci * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)
J
11,1
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
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 per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 12,200
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 3,050
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 $ 0.00
(b) An accessible entrance: $ 0.00
(c) An accessible route to the altered area: $ 0.00
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ 0.00
(e) Accessible telephones: $ 0.00
(f) Accessible drinking fountains:and, $ 0.00
(g) When possible,additional accessible elements such as storage and
alarms: $ 0.00
TOTAL(shall equal line [2] of Valuation Computation): $
Add vertical grab bars to existing accessible restrooms $300
I:\Building\Permits\BUP-COM PemiitApp.doc 03/03/2011
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
INs
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: Li P aO 1 Lo-po/QD
Site Address: /Q/, S �� ,42C, Suite/Bldg#:
Project Name: iS-)4..S� S
(Name of com(416tial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 7:-/ AelA -e, 2L
LI/ Verify site address/suite#exists and active in permit syst .
/•':ver Terrace Neighborhood: ❑ Yes NNo
L%
/and Use Case#: /14/1/i .2C))(0 000f g
Plaans/Match Approved Land Use:
IV Site Plan P} andscape Plan ACIMUrban Forestry Plan tevation Plan
DV Building Height: Maximum Height 4-/S-i Actual Height //.. .3
IS /, •nditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuan1
II Business Licens :
Exists: Yes ❑ No,applicant notified to obtain business license
PIublic Facilities Improvement(PFI) Permit:
Required: ❑ Yes, applicant was notified 14/No Applied For: ❑ Yes ❑ No, stop intake
Notes:
Approved by Planning: i,..Z. Date: Off/
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#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
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:
By Permit Technician: Date:
I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_0709I 5.docx
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 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_W ith LandUse_0709I 5.docx
City of Tigard • BUILDING DIVISION
1111 Over-The-Counter (OTC) Building & Fire Protection System Permit
1 1, \R D Appointment Checklist
Permit Record#: 73 LLP Obi 6 -cc ( 9 6
Contact Name: '13_, Cum- Phone #: 56'7'x4/4-055-2-
Business Name: IM.� ta-y-- ` ,ti-- Appointment Date: - (o/al q_,_ c All
Site Address: 1 ;L( 7 (, &w rb/4\(?>L, Pt. Bldg/Suite #:
Project Name: f,,T- �i
Project Description: - Off t e_t_ ;11-o 0--t-
Existing Use: -8 New Use:
MMD Required: ❑ Yes No Related Record #: N( H b' lit-UDC/g
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION _
Class of Work: L Occupancy Group: Type of Construction: �j��
�
Type of Use: (,` Occupancy Load: y Oregon Specialty Code: -.I,,t1c..
SPECIFICS
Number of Stories: 1 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: K., 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: $ (2_i 2-C', FEES DUE
$ ` _4411111 DC Prov Rvw,COM TI—Ping
a- ,y1 $ •rmit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) 5a,5 $ _ ' 12%State Surcharge
Project Valuation /7I/ $ file- Plan_ Review,Structural
Up to$4,999 $0.00 /d 7,57 $ Lf�tr Ian Review,Fire Life Safety
$5,000-$74,999 $88.00 $ A , ) 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:
Building Staff: $ Other:
r
_C_Date/Time: $ TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_020916.docx Z al.UD
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
12176 SW GARDEN PL, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2016-00190
Chip Barnett
Violation Summary:
Inspector Contractor