Permit (66) . ii 1CITY OF TIGARD BUILDING PERMIT
i6 - COMMUNITY DEVELOPMENT Permit#: BUP2016 00198
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/15/2016
Parcel: 25101 BB01500
Jurisdiction: Tigard
Site address: 12250 SW GARDEN PL
Project: MedFocus Subdivision: CROW PARK 217 Lot: 3
Project Description: TI-Moving walls for new tenant
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: IIIB DC Provision Review, COM TI-Ping 06/15/2016 $88.00
Occupancy Grp: B Occupancy Load: 49 Permit Fee-Additions,Alterations, 06/15/2016 $332.27
Demolition
Dwelling Units: 0 12%State Surcharge-Building 06/15/2016 $39.87
Stories: 2 Height: 0 ft Plan Review 06/15/2016 $215.98
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/15/2016 $132.91
Value: $16,250 Info Process/Archiving-Lg$2.00(over 06/15/2016 $8.00
11x17)
Floor Areas:
Total Area: 4902
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $817.03
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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 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: _1DDDCCC � �
Permittee Signature: t C \_ L i i
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 FOR OFFICE USE ONLY
City of Tigard DECEIVED Date/44a CO
®� dao/ -6619:
Permit No.:
13125 SW Hall Blvd.,Tigard,Er
OR 97223 Plan Review•
Phone: 503.718.2439 Fax: 503.598.I',� 15 2016
Date/I3 ���®� Other Permit:
J
TI G A R D Inspection Line: 503.639.4175 Date Rea.-77 Juris: EI See Page 2 for
Internet: www.tigard-or.gov RC�'I�T((Y�� OF TIGARD Notified/Method: Supplemental Information
TYPF�� DIVISION REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
AccessorybuildingNumber of bedrooms:
El 0 Multi-family
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12250 SW Garden Place New dwelling area: square feet
City/State/ZIP:Tigard,OR Garage/carport area: square feet
Suite/bldg./apt.no.:Bldg.1 Project name:MedFojcus 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: $$16,250.00
Existing building area: 4902 square feet
New building area: 4902 square feet
0 PROPERTY OWNER 0 TENANT Number of stories: 2
Name:GLP Type of construction: IIIB
Address:One SW Columbia-Suite 950 Occupancy groups:
City/State/ZIP:Portland,OR 97258 Existing: B
Phone:(503)221.9900 Fax:( ) New: B
0 APPLICANT 0 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
FLS plan review fee(if applicable):
Address:7650 SW Beveland-Suite 120
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*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Robert Todd Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4080 SE International Way Solar Installation Specialty Code checklist.
City/State/ZIP:Milwaukie,OR 97222 Permit fee(includes plan review $180.00
and administrative fees): _
Phone:(503)653.5704 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:98517
Total fee due
upon application: $201.60
P
Authorized signature: L " � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Betty K.Sheppeard Date:05.23.16 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1111 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] $ 16250
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 4062
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): $
TENANT SPACE IS FULLY COMPLIANT
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
City of Tigard
IIr COMMUNITY DEVELOPMENT DEPARTMENT
■
T1cAlzD Building Permit Review — Commercial - No Land Use
Building Permit #: -----1-- -„,...p 0.e.)t co_cO[gg
Site Address: /Qc7t ��/J C)7c it. Ao6e Suite/Bldg#:
Project Name: /, d7f 0C4f
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 7/ , k :1----
Existing Business Activity: 6be,e
Proposed Business Activity:
Verify site address/suite# exists and active in permit sysyrm.
/`/"p-ver Terrace Neighborhood: ❑ Yes V No
�oning:
ermitted Use: Vt4es ❑ No ❑ Spec Space
Confirm no land use required.
kBusiness License:,-
Exists: II�J Yes ❑ No,applicant notified to obtain business license
Notes:
C--c
Approved by Planning: =—� Date: //C--/iie
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 /�p
Site Plans: #
Building Plans: # 3
Building Permit#: 0/Enter building permit# above.
Workflow Routing: a-Planning P Per lit ±4-- 1-Building
Workflow Sign-off: Er 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: CD—re,
L
By Permit Technician: gr, ,�,/,, Date: (p/s' /(
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT '.•leased: 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 Applica
❑ SDC Fees Entered: Wash Co Tra 0 ev Tax: ❑ Yes N/A
Tigard Tr. s SDC: E Yes ❑ N
Park ' DC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\B 1dgPermitRvw_COM_NoLandUse_070915.docx
City of Tigard • BUILDING DIVISION
IN 1 li
Over-The-Counter (OTC) Building & Fire Protection System Permit
1 1 A h D Appointment Checklist
Permit Record#: -- ,-&A O 96 I (o — OC)igq
Contact Name: J Phone #: (5--e- .) :221 (— O55
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Business Name: � retie 1)-(1,61 Appointment Date: 6, S /� :