Permit (32) CITY OF TIGARD BUILDING PERMIT
114
8 • COMMUNITY DEVELOPMENT Permit#: BUP2016-00233
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/19/2016
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9536 SW WASHINGTON SQUARE RD H13
Project: Kay Jewelers Subdivision: None Lot: None
Project Description: TI for new tenant:Temporary occupancy.
Contractor: JAG BUILDING GROUP INC Owner: PPR WASHINGTON SQUARE LLC
5227 SW 27TH PLACE PO BOX 847
CAPE CORAL, FL 33914 CARLSBAD, CA 92018
PHONE: 239-540-2700 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 07/19/2016 $225.80
Demolition
Occupancy Grp: B Occupancy Load: 15 12%State Surcharge-Building 07/19/2016 $27.10
Dwelling Units: 0 Plan Review 07/19/2016 $146.77
Stories: 1 Height: 0 ft Plan Review-Fire Life Safety 07/19/2016 $90.32
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 07/19/2016 $2.00
Value: $10,000 11x17)
DC Provision Review,COM TI-Ping 07/19/2016 $90.00
Floor Areas:
Total Area: 460
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $581.99
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 c., . e ru es. : ect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1110
Issued By: 4 _....
Q,'
n� -e ignature: OL .' iiairYlLi
5 3.6 .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
. ........„...._. .
ommereial .. FOR OFFICE USE ONLY
"sk 'IN tir , R„„,,,cd ,
,..... City of Tigard in c:,( 47 ti:,1 %,4 o :,ii,: t 14 i, Permit No: GLAPAiiki - $V,--" 13125' SW Hall Blvd.Tigard.OR 97r1, -., '"-• Plan ii.e,«Tcw 't A .
:,!`. : !.'' Phone: SO-718-2439 Fax: 503-508-1960 IN\b Dale By: -,r 1 '7 141 (kRclated Perna
_
44,6XID Inspection Line: 503-639-4175 3\.- - 9 Rae Ready :, See Page 2 for
Internet: www itgard-orgov ,A.BID Notated Method: Supplemental Information
0 .'
GM( e_..„ DINRS‘00
TYPE OF y..ZittipMk., REQUIRED DATA:I-AND 2-FAMILY DWELLING
1 Permit fees*are based on the value of the work performed.
0 New construction ftriieinolition
Indicate the\alue(rounded to the nearest dollar)of all
0 Additiowalteration'replacement ckr Other: 1.e.mip „4 pace, equipment.materials,labor.oNerhead.and the profit for the
work indicated on this application, I
CATEGORY OF CONSTRUCTION i
.----- I
o i-and 2-family dValuation: S /0
welling XCommercialiindustrial / coo
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
QED&JOB SITE INFORMATION AND LOCATION Total number of floors:
lob site address: -...- 41-61•4 S. w. t,/(./A 0//rii 4 yr 581.4 a re. gd New dwelling area: square feet
City,State,ZIP: (-pc etia pi of t og. Garageicarport area: square feet
Suitefbkiglapt. .;: g/3 Project name: 104(1)t Veakry -7-einp• $lace 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#: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map,,parcel 9:
equipment.materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
RValuation: $UA he t t f (Airat4 1 e(I`€A-m 11, 4 its,bett 4e , Hifi,e`
elf ci-v(c a %. (h i i-a-tiir,h rn (2-, Ql.e weitry di i tr. Existing building area: square feet
New building area: square feet
airtOPERTY OWNER 0 TENANT Number of stories:
Name: irketac 4,ir/4A Type of construction:
Address: 1/19/ /Aft(i ji t v 64/44. , $c,...4e I-40 Occupancy groups:
____
City/State/ZIP: .5a4 j ,, ik.4 i AI to,..., C/4 ?o Ye I Existing:
Phone:(3(0) 79 ti— 40 I 0 Fax:( ) New:
g APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: 5;ale.71 ch (Please'refer in fee schedule)
.06,4-4 i'V
Structural plan review fee tor deposit):
I
Contact name: 401 iNfav _ Z4 Apo»
-i FLS plan review fee(if applicable):
Address: ;7 5 6Pie4,4 e..acQ
Total fees due upon application:
City,StatelZIP: Mr.,etwl , P 14 443;77
Amount reethed:
Phone:156) 6,4,5 - 61 (00 , Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: 1,4 K 6 fo,,ci 0 Q ./c(Ai e 15 , a.rr,
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel Ssstern.
Business name: 0724 „ /314,1 L.O/Aier 6//0449 Submit two(2)sets of roof plan ssith connection details
and fire department access,along with the 2010 Oregon
Address: cAgq, 6-14) A7 711 Iliac-it Solor installation Soecialiy Code checklist.
City/State:ZIP: Cfailt C.,9 yok,t i t ç . 13 f,t/ Permit fee(includes plan review
s180.00
and administrative fees):
Phone:td3+, 4-4740...0/76 ti.) 5,4 21,Fax:t 3
State surcharge(12":a of permit fee): $21.60
CCB tic: dog 9...7
Total fee due upon application: $201.60
§,
Authorized signature: V _ <le ..y7k iiii
This permit application expires if n permit is not obtained
1" i 9e
„... V%ithin ISO days alter it has been accepted as complete.
Print name: C A 21/41 (_7(2/rn e S
t 1 1 Date: -? e -/ ‘ i - Fee methodology:,et by Tri-County Building Industry
Sr'.ice Board.
I. Building Pefillib t3LP,CON1yennitApp.doe Rea.04 21 2014 440-4o131(it 02,'C(SM WEB)
City of Tigard
II COMMUNITY DEVELOPMENT DEPARTMENT
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #: 3A/0 Ari —000.33
Site Address: 15-3 St-c,) 1.,(3Pcs t 5q Suite/Bldg#: H /3
Project Name: (< A (E—)t,L 6;
(Name of Jnmercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Ti6-11j) Re I oLit-7/°ivy W f l(LE 'vvic.3OEZ.//1/G
Existing Business Activity: 4 L S
Proposed Business Activity: t• `t
❑ Verify site address/suite# exists and active in permit system. 7
River Terrace Neighborhood: ❑ Yes ) No
❑ Zoning: 1M Li
❑ Permitted Use: ' Yes ❑ No ❑ Spec Space
'FI Confirm no land use required.
❑ Business License:
Exists: Yes ❑ No, applicant notified to obtain business license
Notes:
Approved by Planning: Date: 7- I 1 I
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: 7 /4 /e/
Site Plans: #
Building Plans: ##
Building Permit#: nter building permit#above.
Workflow Routing: QPring ❑ Permit Coordinatori g
Workflow Sign-off: t�t�.-8t i off 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: ______ t'��� s1t. -
By Permit Technician: �
Date: 7 k
1:\Building\Forms\B1dgPermitRvw COM NoLandUse 060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
ElApproved,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\BidgPermitRvw_COM_NoT andUse_070915.docx
4-6,
Itq City of Tigard • BUILDING DIVISION
' Over-The-Counter (OTC) Building & Fire Protection System Permit
Tit,n P 1) Appointment Checklist
Permit Record#: - , , (�'rt?'-'( .
/~ a
Contact Name: 0,0,7 (y„-,;;,mss_ Phone #: $)3 -- y0,7-4r-
Business Name: jig t�yL„'�;1 � Appointment Date: /0 tic) 71 I/10
Site Address: . .• ,,i Bldg/Suite #: 11/3
Project Name: kA� TG -te,-S
Project Description: C.�a, of Cacpt-c'vCti✓
Existing Use: , New Use: /71
MMD Required: ❑ Yes EY No Related Record #:
} e. : G .. ' , ') ar + $`g Sr .1‘,:e:;,/6. )1N-41.. -*'-:1.1%,
10',.M-•'.;
GENERAL INFORMATION ,.--
Class of Work: Occupancy Group: k2 Type of Construction: zf3
Type of Use: (' Occupancy Load: i.. ... Oregon Specialty Code:
SPECIFICS !
Number of Stories: ! 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: Y6 ,-;/ 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: $ ( k � e .
$ " ,AYD DC Prov Rvw,COM TI—Ping
$ 2-2- 7,e36.)Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI (effective 7/1/2015) $ 27.td 12%State Surcharge
Project Valuation $ /44 '77 Plan Review,Structural
Up to$4,999 $0.00 $ q'Z ,',� Plan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ 2,On Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $224.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $357.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
Other:
Building Staff: $ . er:
Date/Time: $ t TOT• FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070116.docx N.