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Permit Support Document (54) ___.. \if 0 I D ..._ RECEivith pR X 0 2017 ih ," City of Tigard •• ctJA1.tt'N7'1"1'[�L VELOt'xlItNT DI;PAR'1'MIENTti auk-. ©p�!GA,� Request for Permit Action pay Ticrowitti 13125 SWC'1 Tall Blvd.•Tigard,Oregon 97223•503-718-2439•www.rigard-or.gov TO: CITY OF TIGARD Building Division 13125 Sia`11311 1311 d.,Tigard,OR 97223 Phone: 503-718-2.1.39 fax 503-598-1960 TigardBuildingPermirs{a,tigard-or.gov FROM: ❑ Owner \r alicant Ell Contractor E] City Staff REFUND�r � OR Name: r, INVOICE Y OII. TO: 03lit e r In ti�'ictlrt! ..0 JJM1\ (jam•-�^ J/'�' r/ C `\\ .. ..*r"-. 4,{? Z �. LJI CJsA.. ( l.J.t, -7�'t �`-t.3 l Mailing„Address: 9 '}9 Cr-' C-\ C."-)ct A' . City/State/Zip:' (`7 n Phone No.: t:1•5 •5 81,0. ' '4 2.p?-C-7 PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED(✓): P CANCEL/V011)PERMIT*APPIACM—ION. is EFUND PERMIT FEE.,,s(attach copy of original receipt and provide explanation below). $ INVOICE FOR FEES DUE(attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE Ct)N I RAC:T()lt ON PERMIT(do not cancel permit). Permit ft: (3,'% 'he t' ©©Q (- Site Address or Parcel#: 7•j o 0 S tAi NI(.(4;1710„4- S' 'r 1 C ... Project Name: -- ' (- i- t_ �C Subdivision:Name: i of if: EXPLANATION: __ iii:/JiYJt"t.Lt t '`r',,-2 / .es : . TA 50 1> mato- Signature: \ '•�� Date: k tO 1.71._ Print Name: _ . .64-14,r, ;�11411 1. The :ity's Community( ea ch:pram:Duct Mr,leggyg f/thud or taty lag;inccr n tr authorize the refund:rt. • Any Ceti which was erronoitule paid or collected. • Not more than Sr WS of the'application or pian recfew fee when an application is withdrawn or canceled before review of fort has been expended. • Not:note than 51)d,of the application or permit fcc fur issued petnuts prior to am:inspection requests. d. 111 aetunds will he return to the original payer in:he:iron of a check via VS postai setvice. i. 1 e.n c tilmt 3 1 neck ter,prucesgm,n,rc•1Lnd retiuece. ' FOR OFFICE USE ONLY' Rollie tra SVS plain Date -ei• 3t "1' Route to Records:. Date /7 / li0�� :air! Refund Processed: Dat / B _..,41 invoice Processed:set:: Dtuc fir Permit Canceled: Date $/./7I�....Be dellirarcel Tag Added: !)rue 13y 1:Stpe Iduxl,;f nmu\li<.9Pt l crtn: ct:t_( y,;u ,4(,c-r — -- --_ ...--- Pl./97VA 674.1 S�3 �'1 P X fele /21q;11146 q146 yif 7 cm's le"g4 9e .ery 'Is3 ef , V? 1� .. V TIGARD City of Tigard May 2,2017 Case Design Group Attn: Carter Case 232 SE Oak St Portland, OR 97214 Re: Permit No. BUP2017-00072 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 7700 SW Dartmouth St., #110 Project Name: Fidos Job No.: Refund Method: ® Check#224341 in the amount of$328.47. ❑ Credit card"return"receipt in the amount of$ . 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 parent company Walmart will submit their own plans. Refund 80% of plan review,less development code review already completed. If you have any questions please contact me at 503.718.2430. Sincerely, e' er 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 IN V 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 forPerinitAction 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: Case Design Group DATE: 4/17/2017 Attn: Carter Case 232 SE Oak St REQUESTED BY: Dianna Howse Portland, OR 97214 TRANSACTION INFORMATION: Receipt#: 409669 Case#: BUP2017-00072 Date: 3/28/2017 Address/Parcel: 7700 SW Dartmouth St. #110 Pay Method: Check Project Name: Fidos EXPLANATION: Per applicant's request as parent company Walmart will submit their own plans. Refund 80% of plan review,less development code review completed. z,..,-;,,f.-;,-;;33sf' a # '''';"0:77.':`1'-7ix d ! ti"'C- ,... a ` ,.v7 „r.' 6 .n :'Y ( i;i fi kx'js. # `, ct Y 4 '. , ' r ' ' a s ' ' a ..?� .. �){. -..1,-_,sed• hss.zas" ,r„R'n.�Zn ' ,_•, Plan Review 230-0000-43106 �. $328.47 TOTAL REFUND: $328.47 APPROVALS: SIG TU S DATE: If under$5,000 Professional Staff 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 Case Refund Processed: Date: I 02/„L3 / B "' ' ` YI I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT R 2' 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Fido's Tap House Site Address: 7700 SW DARTMOUTH ST 110 e-y IReceipt Number: 415782 02/23/2018 I CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID BUP2017-00072 $-328.47 Total: $-328.47 PAYMENT METHOD CHECK# CC AUTH.CODE Check ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT 224341 DHOWSE Payor: Case Design Group 02/23/2018 $-328.47 Total Payments: $-328.47 Balance Due: $418.47 Page 1 of 1 CITY OF TIGARD RECEIPT 111; I! 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 409669 - 03/28/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER BUP2017-00072 Plan Review PAID 230-0000-43106 $523.09 < Total: $523.09 PAYMENT METHOD CHECK# CC AUTH.CODE Check ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT 200 Payor: Carter Jay Case BTAGGART 03/28/2017 $523.09 Total Payments: $523.09 Balance Due: $0.00 Page 1 of 1 ii t V i"! t Building Permit Application Commercial 1-7//77/4-2 :r- IOR0► ► RI: l.S►.O.A1.1 City of Tigard `� Received 13125 SW Hall Blvd.,Tigard, � "v 1 : DateBy: 3 0 Permit No.: /34 Ci (z )7,A ilh Phone: 503-718-2439 Fax: 503-598-1960 Plan Review Inspection Line: 503-639 4175 2 ' ""{ Date/By: Related Permit: 1 I G A R D p ( ,,t(� b 1 li Date Ready/By: Internet: www.tigard-or.gov J""S I See Page for yy K{ Notified/Method: Supplemental Information TYPSMISIING DI REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction 0 Demolition Permit fees*are based on the value of the work performed. Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling "'VCommercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ler0 .G.4,.. ZAskerNsINN> "") New dwelling area: square feet City/State/ZIP: � o Garage/carport area: square feet Suite/bldg./apt.#: itO Project name: Fl�0 s t.(„„"`_r' /c C Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet Subdivision: REQUIRED DATA:COMMERCIAL-USE CHECKLIST I Lot#: Permit fees*are based on the value of the work performed. Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK 1 work indicated on this application. 1 t br - e 1Qt•Alc i...Z. t% Valuation: $ CO Existing building area: square feet New building area: square feet p<PROPERTY OWNER 1 0 TENANT Number of stories: Name: 1.1.E M `, I Type of construction: Address: City/State/ZIP: Occupancy groups: Phone:( ) Existing: Fax:( ) APPLICANT New: 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: CIG,... \.Se �-^��� (Please refer to fee schedule) Contact name: C Va *t r�<CC$`5 Structural plan review fee(or deposit): Address: Z 2,r2.. ©tam` �� FLS plan review fee(if applicable): City/State/ZIP: Pt , g it ,� 4, 1 1... !l `• Total fees due upon application: Phone:(13119 Ol" '._'1' �4r .G%r� '�7 '86 3 q.Z,3� I Fax::( ) Amount received: E-mail: �rr]t®. �' �,, �� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* 1�"f' CONTRACTOR Commercial and residential prescriptive installation of Business name: roof-top mounted Photo Voltaic Solar Panel System. 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 Phone:( ) Fax:( ) and administrative fees): $180.00 CCB Lic.: State surcharge(12%of permit fee): $21.60 < .,�. Total fee due upon application: $201.60 Authorized signa � � ��� This permit application expires if a permit is not obtained Print name: I within 180 days after it has been accepted as complete. fi r"(O,. I Date: 3 2 4U I 1 I * Fee methodology set by Tri-County Building Industry Cil Service Board. IABuildingTermits\BUP COM_PermitApp.doc Rev.04/21/2014 440-4 613 T(11/02/C OM/W EB) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT . Accessibility: Barrier Removal Improvement Plan :' Commercial & Multi-Family - Additions or Alterations TI GARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov 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 percent(25%). VALUATION: Total of all renovation,alteration or modification being done, $ / �2 excluding painting and wallpapering: [1] x ` MULTIPLIER(25%barrier removal requirement): .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ k 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 $ 2...255.41) alarms: TOTAL(shall equal line [2] of Valuation Computation): $ 4 J_, I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014 1 ' City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ° Plan Submittal Requirements z r c n u v Commercial & Multi-Family - New, Additions or Alterations 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov 1. SITE PI (3) copies - full dimensional, drawn to scale and labeled wi A. IV map&tax lot# ❑project name Erite address suite number 0 zoning Errivlicant name ❑- none number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Setbacks. F. Parking,including disabled access. G. Finished floor elevations. 2. EROSION CONTROL PLANS AND DETAILS. \J t p IL ( e.• a,. 3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of plans required based on submittal type (no redlines or tape-ons accepted). All details listed below shall be incorporated into the plans: A. Scale (architectural or engineering only). B. Foundation plan. C. Floor plan(s). D. Cross sections. E. Reflective ceiling plan. F. Seismic bracing detail for suspended ceiling. G. Roof plan. H. Exterior elevations. I. Structural calculations,plans, details and specifications. J. Accessibility barrier removal worksheet. K. Deposit-based on valuation of project. 4. ADDITIONAL INFORMATION AS FOLLOWS: A. Fire Department Building Survey with (1) additional full set of architecture drawings. I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014 4. • City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT p Plan Submittal Requirements Matrix m' Commercial & Multi-Family - New, Additions or Alterations TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov Type of Submittal # of Plans (Includes new,additions and alterations.) Required at Submittal Demolition Permit 2 (site plan is required showing location and square footage of all buildings to be demolished,erosion control plan and tree protection,if applicable) Site Work 3 (must include location of all accessible parking) Plumbing(site utilities) 2 Building 3 Fire Protection System 3 Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Solar Photovoltaic 2 (Requires check list for prescriptive installation. If not prescriptive installation,engineering is required.) Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington County,and Tualatin Valley Fire&Rescue),if applicable. I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014 V f' '' City of Tigard ,, dIII COMMUNITY DEVELOPMENT DEPARTMENT /.(7//7 T I G A R D Building Permit Review — Commercial - No Land Use Building Permit #: ,x/2-ctb 7r Site Address: 22 •'/,) 1 90172c�� A Jil- Suite/Bldg#: Project Name: -.-de.) 'S , �-cftt--- (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: �7 Agit) 40414 -- Existing Business Activity: /L, - , )l. C Pro sed Business Activity: g:0 ' ' l7�11 ^ j i - Verify site address/suite#exists an active in ermit s ` ;le.g- c.afi` ' c/ re p Ys ' 1 Ill ,, ver Terrace Nei hborhoo : ❑ Yes A No oning: ) ermitted Use: Yes iJ ❑ No 0 Spec Space nfirm no land use required. Business License: Exists: Yes El No,applicant notified to obtain business license Notes: Approved by Planning: �-'— Date: (._ //.2j3.)/,'7.._ Revisions (after Building Submittal only) Reviewer Revision 1: 0 Approved El Not Approved Date Revision 2: El Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Building Permit Submittal Original Submittal Date: SA 4#/7 Site Plans: # 4/4 Building Plans: # Building Permit#: Pnter building permit#aove. Workflow Routing: [.tea Hing ermit Coordinator ['3—$0g Workflow Sign-off: 119--r ff for Planning(include notes from planning review) Route Application Documents: LJ Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: t� v� Date: f 7 I:\Building\Forms\BldgPermitRvw COM_NoLandUse 060116.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: El SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes El N/A Parks SDC: El Yes ❑ N/A ❑ OK to Issue Permit Approved by Permit Coordinator: Date: IABuilding\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx