Permit (44) CITY OF TIGARD BUILDING PERMIT
111 I COMMUNITY DEVELOPMENT Permit#: BUP2016-00199
T f GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/16/2016
Parcel: 2S104BB07900
Jurisdiction: Tigard
Site address: 14300 SW BARROWS RD
Project: Albertsons Subdivision: RUSSELL'S SCHOLLS FERRY Lot: A
Project Description: TI for new tenant:Relocating cases,new cabinetry,and a new partition wall.
Contractor: KENDALL CONSTRUCTION Owner: SPIRIT SPE HG 2015-1 LLC
PO BOX 550 BY HAGGEN OPCO SOUTH LLC
TROUTDALE, OR 97060 2211 RIMLAND DR, STE 300
BELLINGHAM,WA 98226
PHONE: 503-665-5047 PHONE:
FAX: 503-661-3577
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 06/16/2016 $351.00
Occupancy Grp: M Occupancy Load: Permit Fee-Additions,Alterations, 06/16/2016 $1,558.95
Demolition
Dwelling Units: 0 12%State Surcharge-Building 06/16/2016 $187.07
Stories: 0 Height: 0 ft Plan Review 06/16/2016 $1,013.32
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/16/2016 $623.58
Value: $175,000 Info Process/Archiving-Lg$2.00(over 06/16/2016 $16.00
11x17)
Metro Const.Excise Tax 06/16/2016 $210.00
Floor Areas:
Total Area: 39998
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,959.92
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
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 .t44.
Issued By" Permittee Signature: u =�
Cal 3.639.4175 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 Ap licatlo,, CEIVE
Commercial FOR OFFICE USE ONLI
City of Tigard JUN 1 6 2016 Received � /to y� Permit No.: AI ,4, , ••
13125 SW Hall Blvd.,Tigard, 97223 Date/B : / �((,
Phone: 503.718.2439 Fax: ' 1'yG Date/B�eW � gnu Other Permit:
T I G A R D Inspection Line: 503.639. it l�1 �1 � Date Ready :y: a See Page 2 for
Internet: www.tigard-or g Phi ':'�„ rj/1 fi, Notified/Method. Cp it:, `., ip ,= Supplemental Information
TYPE OF WORK 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling Z Commercial/industrial Valuation: $
❑Accessory building ElMulti-familyNumber of bedrooms:
❑Master builder 111Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14300 SW Barrows Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Albertsons 3542 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 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 work indicated on this application.
Minor interior remodel Valuation: $$175,000.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Albertsons/Safeway,Inc Type of construction:
Address: 16300 SE Evelyn St Occupancy groups:
City/State/ZIP:Clackamas,OR 97015 Existing:
Phone:(503)780-7505 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Kendall Construction,Inc. (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Jaime Craun
Address:P.O.Box 550 FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP:Troutdale,OR 97060
Phone:(503)665-5047 Fax::(503)661-3577 Amount received:
E-mail:jaimecraun@kendallconstruction.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR
roof-top mounted Photovoltaic Solar Panel System.
Business name:Same as applicant 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 lie.:29680 Total fee due upon application: $201.60
Authorized signature: (AV This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Jaime Craun Date:5.27.16 * 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)
City of Tigard
114 COMMUNITY DEVELOPMENT DEPARTMENT
III
T I G n RD Building Permit Review — Commercial - No Land Use
Building Permit #: 8c,,,P C)l(D--00l��
Site Address: /1--/S00 „sZt) &,/72x,,s „ec Suite/Bldg#:
Project Name: .0/ ong
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review //
Proposal: 77l ,r le/,r '7`
Existing Business Activity: _� S — 0».'p,n Qc iWcz-i � /De_.,e07)
Proposed Business Activity: //
I�Verify site address/suite#exists and active in permit syst m.
Cdf i ver Terrace Neighborhood: ❑ Yes 0 No
1M idoning: bo-e
[ ,Permitted Use: Or/Yes ❑ No ❑ Spec Space
2 Confirm no land use required.
Business Licens
Exists: inYes 0 No,applicant notified to obtain business license
Notes:
Approved by Planning: ��k�� Date: /W/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: a/46
Site Plans: #
Building Plans: #
Building Permit#: cl..--E1'fer building ermit#above.
Workflow Routing: nningtng
Workflow Sign-off: 11--51-ii-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.
Notes:
By Permit Technician: A Date: (//(.,//4,
�I
l:\Building\Forms\BIdgPermitRvw_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: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
L\Building\Forms\BldgPermitRvw_COM_NolandUse 070915.docx
t iii City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC) Building & Fire Protection System Permit
T I G A R D Appointment Checklist
Permit Record#: 3ttPa0/(o--tzl vq
Contact Name: 7- - .562 -e ^/W Phone #: 6 0--q 3�
Business Name: � CF� 5 cKi-w ?A Appointment Date: ( //(//(, 6/ `wo
1 Site Address: ltt-ac)c: 544) 84yi?/-,..)3 Bldg/Suite #:
Project Name: GI/Je WI-
Project Description:
/ ,.72 k" rl t[I...1 7i-e',/,.vis. 4.4:r.,7tiry e ,„),...._)- i J14ti./ e ,,!,...r7k/, s
Existing Use: /1') -to �v-}, New Use: /1
MMD Required: El Yes L��1Qo Related Record #:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work: i\LT Occupancy Group: L'\il Type of Construction: t
Type of Use: ()Cnl:,\ Occupancy Load: Oregon Specialty Code: --�� 'j'`
SPECIFICS
Number of Stories: t 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: c' 9-! IC 3 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: _ r `_D 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-7. -(t-"C‘., FE.; UE
$ ca,-[ ,re's s DC Prov Rvw,COM TI-Ping
$ - Permit Fee-Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ - e) 12%State Surcharge
Project Valuation $ B .n Review,Structural
Up to$4,999 $0.00 $ " "" Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ C 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 $ 2! 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