Permit CITY OF TIGARD BUILDING PERMIT
INS ' COMMUNITY DEVELOPMENT Permit#: BUP2016-00178
EG,ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2016
Parcel: 25101 DD00400
Jurisdiction: Tigard
Site address: 6825 SW SANDBURG ST 100
Project: Collective Church Subdivision: SALEM FREEWAY SUBDIVISION Lot: 2
Project Description: TI for new tenant. Change of use from B occupancy to A-3 occupancy.
Contractor: TODD HESS BUILDING CO Owner: VIGILANT
9414 SW BARBUR BLVD SUITE 150 6825 SW SANDBERG ST
PORTLAND, OR 97219 TIGARD, OR 97223
PHONE: 503-220-5953 PHONE:
FAX: 503-222-2670
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 05/26/2016 $301.85
Demolition
Occupancy Grp: A-3 Occupancy Load: 490 12%State Surcharge-Building 05/26/2016 $36.22
Dwelling Units: 0 Plan Review 05/26/2016 $196.20
Stories: 2 Height: 0 ft Misc Administration Fee 06/09/2016 $50.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 05/26/2016 $120.74
Value: $14,400 DC Provision Review,COM TI-Ping 05/26/2016 $88.00
Info Process/Archiving-Lg$2.00(over 05/26/2016 $4.00
11x17)
Floor Areas:
Total Area: 11667
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $797.01
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 :copy of - es or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / .• ignature:
00, /.
t.:41111111503.1339.4175 by 7:00 a.m.for the next available inspection . te.
This permit card shall be kept in a conspicuous place on the job site until comple n of the project.
Approved plans are required on the job site at the time of each inspection.
-v- ',11 iii\. e._* - tkikt ‘.4_ y;
Bildin2 Permit Application
Commercial RECEIVED FOR OFFICE ISE ONLY
City of Tigard Received 5�� ��ty: No
13125 SW Flail Blvd.,Tigard,OR 9
Ian Revie
' II m
m Phone. 503.718.2439 Fax: 503.598.196,01 1 - .r/•,0 Other Permit: l6 ,e.\
T I G A RD Inspection Line: 503.639.4175 MAY 8 Z016 Date Reay a /' / j 4,' loris ® See“Page 2 for 1
Internet: www.tigard-or.gov Notified/Method.�p// X110 �� Supplemental Information
' / u
CTYOFTIGA T�
RD �
:,,-1.i,1,,,y . riPE .., 1(;$1-, I iE 1 BATA 1-AND 2-FAMILYD1Alifi,;i.ING
❑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
tATEGOR ''fly e(IST'RIi I'ION :' work indicated on this application.
0 1-and 2-family.dwelling [ZI Commercial/industrial4
Valuation: $
0 Accessory building ❑Multi-family Number of bedrooms:
❑ Master builder 1]Other:
Number of bathrooms:
JOB SITE INFORMATION AND:LOCATION Total number of floors:
IS °
b site address:6825 SW Sandburg St. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: 100 Project name:Collective Church T.I. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
SW Sandburg St.&SW 72nd Ave. Other structure area: square feet
REQI ED iDA�L :CO RCIAL USE CIiEC ICI:IST
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
' 'DESCRIPTION-OF WORK , , `o,,. work indicated on this application.
71 . Tenant Improvement:Change of usage from'B'occupancy to'A-3'occupancy Valuation: $$14,400.00
Install new building sprinkle system per code requirement. Existing building area: 12013 square feet
New building area: 0 square feet
. -FE PROPERTY,OWNER 0 TENANT Number of stories: 2
Name:Vigilant-Counsel for empolyers Type of construction: V-B
V kAddress:6825 SW Sandburg St. Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing: B
18 Phone:(503)620-1710 Fax:(503)620-3935 New: B&A-3
4
;.,<tkl APPLICANT ':.- , • ” ❑'CONTACT PERSON . BUTLDINGPERMIT";FEES*
(Pfease"refer-;tofee seke+ )
Business name:Toni King&Associates
Structural plan review fee(or deposit):
Contact name:Peter Kim
FLS plan review fee(if applicable):
Address:1327 SE Division St.
' t .
City/State/ZIP:Portland,OR 97202 Total fees due upon application:
-►
Amount received:
AO Phone:(503)235-0243(#4) Fax: :(503)546-5698
E-mail:pk��tonikingassociates.com PIIOTOVOLTAIC`SOLAR PANEL SYSTEM FEES*
, Commercial and residential prescriptive installation of
AC
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Todd Hess Building Company Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:9414 SW Barbur Blvd.,Suite 150 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,OR 97219 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)220-5953 Fax:(503)222-2670
State surcharge(12%20/o of permit fee): $21.60
/CCB lie.:66821
Total fee due upon application: $201.60
Authorized signet ' 1111
P--/01"--..._..........-------.......00.......� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name: 'eter M.Kim Date:May 17,2016
Service Board.
I:ABuildingAPermits\BUP-COM PemlitA...doc 02/24/2011 440-4613T(11/(12/COM/WEB)
° 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] $ 14,400
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 3,600
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: $
(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): $
ci/tttd:j.-- LS `0
d 61X(63/3 19le .
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I:ABuilding\Pcmiits\BUP-CONI Permitapp.doc 03/03/2011 �r
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
i II ■
T 1 G A R D Building Permit Review — Commercial - With Land Use
Building Permit #: 6Gfj0 //o--a)/7�
Site Address: 68,2g— S'`o ia4a 24 Suite/Bldg#: /o C)
Project Name: /z 4- ,4_
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 1. rXr Cyt,, vigit 7
jVeiir site address/suite# exists and active in permit system.
1 II '.ver Terrace Neighborhood: ❑ Yesa" CI No
I nd Use Case#: 7nt6(2Ol(„(i— (1')OJU
Plans,Match Approved Land Use:
Site Plan �aandscape Plan ?'Ther:
/Urban Forestry Plan elevation Plan
Building Height: Maximum Height /( Actual Height EY13 h
onditions Met: El Prior to Submittal ❑ Prior to Permit Issuanc
w,
Business Licens
Exists: iYes Cl No,applicant notified to obtain business tollAublic Facilities Improvement(PFI) Permit: . /
Required: ❑ Yes,applicant was notified ler No Applied For: ❑ Yes ❑ No,stop intake
Notes:
-12-
Approved by Planning: --2: % Date: `
��
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-g (p
Site Plans: #
Building Plans: #
Building Permit#: nt uilding permit
�above. � Ll 11
Workflow Routing: Tanning ngineering Permtt Coordinator g
Workflow Sign-off: [l—Sign- f for Planning(include notes from planning review)
Route Application Documents: g: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: 49y(7 --e4 Ct9t'— 444 rt-3.3 (JG S cr-r-e, / o/U 611-E./t,
By Permit Technician: ,� Date: 5—h-c ,
y
N
I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_070915.docx
/ ill,
ngineering 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)
0 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:
�a l"r"
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:
L_ DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A
Tigard Trans SDC: ❑ Yes EKN/
Parks SDC: ❑ Yes /A
OK to Issue Permit
Approved by Permit Coordinator: *, Date: 00/4
/ lam"
I:\Building\Forms\BldgPermitRvw_COM_W ith landUse_0709I 5.docx
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
6825 SW SANDBURG ST 100, TIGARD, OR,
97223
Record Type:
Commercial - Building
Inspection Type:
299 Final inspection
Result:
PASS -CofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
B U P2016-00178
Inspector:
Jeff Grove
Contractor