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MMD2016-00032 I D City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 3,/�0 /7 411 Request for Permit Action T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor ® City Staff Check(✓)one REFUND OR Name: Darin Grimes INVOICE TO: (Business or Individual) Mailing Address: 13320 SW Genesis Loop City/State/Zip: Tigard, OR 97223 Phone No.: (503) 683-2746 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): ® CANCEL/VOID PERMIT APPLICATION. ® REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: MMD2016-00032 Site Address or Parcel#: 12925 SW Pacific Hwy Project Name: Bomb Coffee Subdivision Name: N/A Lot#: N/A EXPLANATION: Applicant requests to withdraw application. Please refund 80% of original application fee. (80% x $300 = $240) Date: 2/8/17 • Signature: !Waft Print Name: Lina Smith Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. l 3. Please allow 3-4 weeks for processing refund requests. dCrU O"9 •�O 02 re(f:= (p 0, C v FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date 2 Zr/ /7 • �. Refund Processed: Date 4/op 7 By / Invoice Processed: Date By Permit Canceled: Date ,4,/f 7 Bp i Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_0`9/31 .doe '. ' TIGARD City of Tigard March 15,2017 Darin Grimes 13320 SW Genesis Loop Tigard, OR 97223 Re: Permit No. MMD2016-00032 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 12925 SW Pacific Hwy Project Name: Bomb Coffee Job No.: N/A Refund Method: ® Check#224103 in the amount of$240.00. ❑ Credit card "return"receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account "deposit"receipt in the amount of$ Comment(s): Per applicant's request as application was withdrawn;refund 80% of application fees. If you have any questions please contact me at 503.718.2430. Sincerely, '47/ Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Darin Grimes DATE: 3/10/2017 13320 SW Genesis Loop Tigard, OR 97223 REQUESTED BY: Dianna Howse LS TRANSACTION INFORMATION: Receipt#: 407359 Case #: MMD2016-00032 Date: 11/10/2016 Address/Parcel: 12925 SW Pacific Hwy Pay Method: Check Project Name: Bomb Coffee EXPLANATION: Per applicant's request to withdraw application;refund 80% of application fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Minor Modification to an Approved Plan 100-0000-43116 $240.00 TOTAL REFUND: $240.00 APPROVALS: SIGNATJ U: P ATE: If under$5,000 Professional Staff 674}-y‹._—.- If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: -572-41/7 By: #(977-- \Buikhng\Refunds\RefundRequest.doc ( -\Building\Refunds\RefundRequest.doc x 09/01/2010 4 't -4 '-id tii r_1 n F4 x C/1 -4 RECEWED City of Tigard 3 ��/�� , NOV 10 2016 ii D " COMMUNITY DEVELOPMENT DEPARTMENT IGARD • GINEERING TIGARD Minor Modification Type I Application 40 aro--*nom.-.41m xtt w:waxaatvraz, e,,,,,,,AMB s.„ax,. .aa, a.......wamv^,.. >v ay.+c-.;.,: . al11.wxs :ya s.a sw.2W PROPOSAL SUMMARY (Brief description) REQUIRED SUBMITTAL Relocation of coffee stand with drive through window to existing ELEMENTS parking lot in the C-G zone. No work is proposed in, or connecting to, ,l<Owner's Signature/Written the right of way. Authorization Title Transfer Instrument or Deed 'Site Plan(2 large plans drawn to scale and one reduced to 8.5"x11'/2") Property address/location(s): 12925 SW Pacific Highway Applicant's Statement/Narrative (2 copies)Address criteria in: Tigard, OR 97223 TDC. 18.360.o50.B.t-11 Tax map and tax lot #(s): 2S102BD02600 KFiling Fee Site size: 0.86 acres FOR STAFF USE ONLY Applicant": Darin Grimes BVI M p -000 2- Case No.: Address: 13320 SW Genesis Loop Related Case No.(s): City/state: Tigard, OR Zip: 97223 503.683.2746 darin i rimes.com Application Fee: X� Phone: Email: @�9 Application accepted: PROPERTY OWNER/DEED HOLDER(S)* 1:1 Same as Applicant By: Date: ti k((Lc Name: Penney Kim Application determined complete: Address: 395 NW Silverado Drive By: Date: City/state: Beaverton, OR Zip: 97006 I:\CURPLN\Masters\Land Use Applications Rev.11/24/2014 Contact name: Penney Kim Phone number: 503.997.1207 •When the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner or an agent of the owner.The owner(s) must sign this application in the space provided on the back of this form or submit a written authorization with this application. APPLICANT'S STATEMENT The applicant's statement must include a summary of the proposed changes. Criteria in either 18."IN).050(B) or 18.330.020(B)(2) must be addressed with a detailed response to each criterion. Failure to provide the information needed to process the application would be reason to consider an application incomplete and delay review of the proposal. In addition,the Director must find that the proposed change is in compliance with all applicable requirements of Tide 18 of the Tigard Development Code.To complete this review,the Applicant's proposal must include a discussion indicating how the site expansion/change will continue to comply with the maximum setback,building height,parking,and landscaping standards. Other requirements of this tide such as clear vision,solid waste storage,non-conforming situations, signs,and tree removal may also be applicable depending on the type and location of the proposed modifications. ,... .ys.,M.. S City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 2 APPLICANTS To consider an application complete,you will need to submit ALL of the REQUIRED SU$MITTALELEMENTS as described on the front of this application in the"Requited Submittal Elements"box. THE APPLICANT(S) SHALL CERTIFYTHAT: `'- e • Illy q .t e allovc rcucti.,es ni it Vlq date.n>dila iestrittii Hthat bt attached t('or inlpolcti uponth . .subie u ptuppala. • If the application is granted,the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. • All of the above statements and the statements in the plot plan,attachments,and exhibits transmitted herewith,are true;and the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such statements are false. • The applicant has read the entire contents of the application,including the policies and criteria,and understands the requirements for approving or denying the application. ATURES o -.• , o, ner of the subject property required. J DA/PM) g ' Ml ex /o �/ _____ -- //e0 Applicant's signature Pnnt name Dat E , •c I 1 t //CA/4% ' �r A'/,7 ,-) / / i// (" t byrat's signurs Pt�int name Date Owner's signature Print name Date ADDITIONAL OWNER/DEED HOLDER INFORMATION Name: Name: Address: Address: City/state: Zip: City/state: Zip: Signature: Signature: MINOR MODIFICATION APPLICATION City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwugard-or.gov • 503-718-2421 • Page 2 of 2 NS Washington County,Oregon 2002-043332 r� i-'.- 04/11!2002 03:20:1 S PM 0L�C�r K� ID•DDS Cnt■f Stn■22 RECORDSI I $5.00$6.00$11.00 •Total.S22.00 Grader's Pam.and Address __ �' ? Y king r . 00083318200200433320010017 111111 i 'Ill 111111111 1111111111i IIII �'r './/� •- i1Vp V I Q_Q ��i�-' I „any Hinson,Director of A mint and Taxation //�� J and Ex-Officio County Clerk for Waahington County, ,�` N�C 1��r✓1 C/t �� �7 a Ci /f'' y's do hereby certify that the within instrument of wrRln Grantee's Nam.and Address :id=and recorded In the 6o N o!retorda of i::,!,..:7:*" SPACE RESERVED ,9 : Afar }/{('alyfll t0�(CNMM,Address,Z1/p�). J }�•vJti. : J?'•• S`� Itl�l FOR ' .� PA`� - RECORDERS USE Jerry R.Haman,Director mint and Taxation, '! Ex-0ttleloCountyClsrk_ -n-_4►_!__.sill Yc�- ILS__ rte. _ r' &TELA/ • /11_ - V t• p 6 Witness my hand and seal of County 1� affixed. UntilofMrwlse,send all tax statements to(Name.Address,Zip); e-ndiey ow NAME TITLE _3)/__C' ' LSI Z17 iii-al 0 Pie- __4t2.K :=?f __e Ct r-=--y''u c 4 __ _--- By , Deputy. BARGAIN AND SALE DEED—STATUTORY FORM -) 1 (INDIVIDUAL GRANTOR) _g 0/3 -/Z-/- ,k 1 M 4 k, 2 N A c- L/ice f e'I A-, ---- --------------- - ---,Grantor, conveys to --_--------- pe-4)A 57Y kik-1 , Grantee, the following real property situated in __L�4 d!/!'CZ TP''�%r____._ County,Oregon,to-wit: r r Pi ( (-- L-c'-r n / A.i ?-p-/ 77 7 0 rd i/I II.a ,y cid i.4.;c i) , i i^, Mc: ).-.e.Cru 1 fy Lt GlC7i"'S CI) ,f�//c! _s ci-f2 C : , �' y0t exc_cp-,-,.J 411 e,,-e., t'ir;:•yl 1 / , 5- -Pee-/- en 4 i eC-os 0 h at be ;."iq pc vi 1/c 1 LL -H Lc �S-, /1- �' r-fig %;Jgrc4ciIIa I i.4 c-71 , JQ('sc S4i-te c: Cf:e.c'-1 .Tcr 1.1iyhLt)I pc 1-pcse.s k y 042ec:11 L?& -* '' .-75::, /- ? L c y (IF SPACE iNIJFFIW2NT,CONTINUE DESCRIPTION ON REVERSE) The true consideration for this conveyance is$___f._, . (Here,comply with the requirements of ORS 93.030.) a Dated this day of , 19 THIS INSTRUMENT WILL NOT ALLOW USE OF THE PROPERTY DESCRIBED IN THIS INSTRUMENT IN VIOLATION OF APPLICABLE LAND USE LAWS AND REGU- NoaC•f 7 kiA--/ LATIONS. BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON ACQUIRING FEE TITLE TO THE PROPERTY SHOULD CHECK WITH THE APPRO- PRIATE CITY OR COUNTY PLANNING DEPARTMENT TO VERIFY APPROVED USES ---t / PRACTICESAND TO AS DEFINED IN ORS 0.9 ORMINE ANY LIMITS ON W .eSUITS AGAINST FARMING OR FOREST - _�:,L _ ��_ STATE OF OREGON,County of _ th11-.:,-'1 * _ ____)sS. Allis instrument was acknowledged before i on _ 1.2c, / C% ,39-2-CO by ___, Q•,r-±--.5-` M �) ��= .r` .;AI_SEAL �— --� / i ---L-1 /'�1 1 -. rJ 4 SARA'- I.. ,RAZ ROMERO / y --�1__ ::fi�.ZZ_ `11/}+/. r 1 NOT?!CI '(L; -OREGON ) Notary Public for Oregon .} 1 air Cr,'ri':; !4.323923 MY COMMiSSiCi •I'::.ES JUNE 28,20036 ‹My-commission expires __NI_k�44s_ G_ _ ec�3____ - - - - - - - - - - - - - e _ a - r 0 I a I I /(E) PARKING I (E) BUILDING I / REMOVE (E)--<- l- - - 'S STRIPING 1 I — I (E) RETAIL BUILDING I - J -6. \\\\\\\ I I I I I I I (E) PAR/ KING 0 0 0 0 0 0 III _ (E) DRIVE AISLE (E) DRIVE AISLE SW PACIFIC HWY. RECEIVED NOV 10 2016 CITY OF TIGARD BOMB COFFEE STAND PLANNING/ENGINEERING Q o 12965 SW PACIFIC HWY N CI 1991 EXISTING SITE PLAN 15895 SW 72ND AVE SUITE 200 Z2u = 1>_Dr, - ARCHITECTURE UENGINEERING PORTLAND, OREGON 97224 LJW 1/32" PLANNING T E L : 5 0 3 . 2 2 6 . 1 285 10.28.2016 160258.01 INTERIORS FAX : 5 0 3 . 2 2 6 . 1 670 © 2016 CIOA, INC.ALL RN;fifS RESERVED - - - - - - - - - - - I 0 0 I 1 - _ _ - _ I / I I I - - NEW GUARDRAIL I //I- �\0 I ROOF OVERHANG / -\\ `I\ I NEW COFFEE STAND Ii II ii 1 ri ek. ------ \\\\\\\ _�I - J II SERVICE WINDOW iI 4 I I I 4•-• L J ii „, „,, , .,„, , , , , I _ _ ____4,_ ..., NEW STRIPED DRIVE AISLE SW PACIFIC HWY. 33'-0” RECERIED NOV 10 2016 BOMB COFFEE STAND CITY OF TIGARD Q PLANNING/ENGINEERING A 12965 SW PACIFIC HWY CI 1991 N PROPOSED SITE PLAN 15895 SW 72ND AVE SUITE 200Ø - ARCHITECTURE LJW 1/32" = 1 -0" U ENGINEERING PORTLAND, OREGON 97224 PIAN NTNG TEL : 503 . 226 . 1 285 10.28.2016 160258.01 INTERIORS FAX : 5 0 3 . 2 2 6 . 1 6 7 0 © 2016 CIDA, INC.ALL RIGMS RESERVED Date: 10/17/2016 Minor Modification - NarraitEimtil loikE �D Subject: Narrative for Minor Modification NOV 1 0 2016 CITY TIGAR Project Title: Tigard Coffee Stand PLANNI GO NG NEER► NG Project No: 160258.01 15895 SW 72ND AVE By: Leslie Worthey SUITE 200 PORTLAND,OR 97224 To: Planning Director, City of Tigard PHONE:503.226.1285 FAX:503.226.1670 The Minor Modification proposed relocates a coffee stand with a drive through window to an INFO@CIDAINC.COM existing parking lot located at 12957 SW Pacific Highway within the C-G zone. No work is VVWW.CIDAINC.COM proposed in, or connecting to,the right of way. 18.360.050 Major Modification(s) to Approved Plans or Existing Development B. Evaluation criteria. The director shall determine that a major modification(s) will result if one or more of the following changes are proposed. There will be: 1. An increase in dwelling unit density, or lot coverage for residential development; Response: Not applicable: The proposed development is located in the general commercial zone (C-G) and has no impact on residential development. 2. A change in the ratio or number of different types of dwelling units; Response: Not applicable: The work is located on commercial property and therefore not associated with any residential development. 3. A change that requires additional on-site parking in accordance with Chapter 18.765; Response: The existing parking lot is currently over-parked. Based on the use of the existing building, and including the addition of the coffee stand, on-site parking will comply with the requirements of Chapter 18.765 without additional parking. On-site retail uses and associated parking requirements are as follows: Parking Rates Required Existing Uses Area Per 18.765 Parking Stalls Sales oriented: 4,110 SF 3.0/1,000 SF 12.33 Repair oriented: 620 SF 3.3/I,000 SF 2.046 Personal service: 5,470 SF 2.5/1,000 SF 13.675 New Sales (coffee stand): 200 SF 3.0/1.000 SF 0.6 Total: _ I L400 SF 28.651 The existing site currently has 40 parking stalls. Eight of those stalls will be removed to facilitate the relocation of the coffee stand, resulting in a total of 32 provided parking stalls. 4. A change in the type of commercial or industrial structures as defined by the Uniform Building Code; Response: No change to the existing building is proposed. F:\GENADMIN\PROJECTS\16\0258.01 Tigard Coffee Stand\Minor Mod Narrative I0.I7.16.docx 5. An increase in the height of the building(s) by more than 20%; Response: No work is proposed to the existing building. The total height of the new coffee stand (I I'-6") is lower than the existing building. No increase in height is proposed. 6. A change in the type and location of access ways and parking areas where off-site traffic would be affected; Response: No, all work is contained within the existing paved yard. No work is proposed to the type or location of access drives or connecting to the right of way 7. An increase in vehicular traffic to and from the site and the increase can be expected to exceed 100 vehicles per day; Response: Based on information available in the 9`h edition of the Trip Generation Manual and Handbook, in conjunction with historical information about the performance of the coffee stand in its previous location, we expect approximately 70 vehicles to visit the stand daily. The expected increase to traffic on the adjacent street will be approximately 8 to 10 vehicles because the majority of trips will be generated by pass-by traffic, as defined in the ITE Trip Generation Handbook. During the previous year the coffee stand has averaged approximately 50 — 70 drive-up customers in its previous location. This information is consistent with ITE Code 938 use. 8. An increase in the floor area proposed for a nonresidential use by more than 10% excluding expansions under 5,000 square feet; Response: The area of the proposed coffee stand is 200.75 square feet, and increases the floor area of existing building on the site by under 2% 9. A reduction in the area reserved for common open space and/or usable open space which reduces the open space area below the minimum required by this code or reduces the open space area by more than I 0%; Response: No, the proposed modifications do not impact the extent of open space on the site. 10. A reduction of project amenities below the minimum established by this code or by more than 10%where specified in the site plan: a. Recreational facilities; b. Screening; and/or c. Landscaping provisions. Response: The proposed modifications do not reduce any of the listed site amenities. 1 I. A modification to the conditions imposed at the time of site development review approval which are not the subject of paragraphs 1 through 10 of this sub-section. Response: Not applicable. Sincerely, Leslie Worthey F,\GENADMIN\PROJECTS\16\0258,01 Tigard Coffee Stand\Minor Mod Narrative 10.17.16.docx 0 Z Lll c, EW LL1 ' ,ti tee ; f� 1 , ( 4. , :,...]::-.•,:. ---- -----;•11:- • a -s/"�� � ;.;: / SEM M_MI et • f - _ r -KM Bill l�z ' � ,rte • ...smx�.ezu4=sam»Am w �,�. - • k 4 . .9Pp moi _ a .._....... . . • .......,...t . ,,,,A ....,:h . .., ,,,, , . (.........,........___ .. •,.. , ' ..,,iii.---:=44.04.1..,!..!---„,,,,....et—. .„ow. w — -1 in' • *a CURRENT EXISTING BUILDING TENANTS DELOACH KBA NORTHWEST WATCH S.W. Pacific Highway LLC CRICKET VENUS TORCHED AI ' `` SERVICE U. . r Level SALON ILLUSIONS Service t Gc.12955 `_ ' • • i ! 12961 - inactive , , _ - , . ,,-ic r---r Ii i ialr-Feces V ,-. is Trac=Express i Toho- rens icss Tay Service 6-teele=1 P i Pte -, ,5b + . .s i )40 41- .. 12971 - Vacant r . Sales Repair Service Sales so AN�' i ! RSONN & SSOC I Lower Level Service ` 129/) —inactive 12v// lmpacto Latino HILLER'S E ° , :_ /4 )- 2-s0 ' '01 0 rcli dei, LA ESPIGA LATINA Service Sales - acan RECEIVED AN R SON NOV 10 2016 GIPf Gr T IGAR[ �� PLAN NING/ENGINEERING Service