Permit (29) CITY OF TIGARD BUILDING PERMIT
Ill '� Permit#: BUP2018-00099
I ' COMMUNITY DEVELOPMENT
Date Issued: 04/05/2018
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101DA00101
Jurisdiction: Tigard
Site address: 13190 SW 68TH PKWY 130
Project: Kimsa Subdivision: VARNS ACRES Lot: 9
Project Description: TI for new tenant:Adding(1)conference room,(1)office,and(1)coffee bar.
Contractor: VANOSDEL CONSTRUCTION Owner: PACIFIC NW PROPERTIES LIMITED PA
PO BOX 1057 STERN FAMILY LIMITED PARTNERSHIP
BATTLEGROUND,WA 98604 STERN, HELEN R REVOCABLE TRUST
6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 360-600-9916 PHONE:
FAX: 360-687-7677
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 04/05/2018 $91.00
Occupancy Grp: B Occupancy Load: 28 Permit Fee-Additions,Alterations, 04/05/2018 $475.99
Demolition
Dwelling Units: 0 12%State Surcharge-Building 04/05/2018 $57.12
Stories: 0 Height: 0 ft Plan Review 04/05/2018 $309.39
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 04/05/2018 $190.40
Value: $26,302 Info Process/Archiving-Lg$2.00(over 04/05/2018 $4.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,127.90
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. Yo •• • of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B ��``P'ermittee Signature:
C7:00 a.m.for the next available inspection date. ��
Call 503.639.4175 by p
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
�; - r
Commercial Ft L I, { 1 ,H FOR OFFICE USE ONL1
City of Tigard
Date/B Hr� �' Permit No.:C, # 1±—
i� Received
13125 S W Hall Blvd.,Tigard,OR 97223 P P 5 2 013 `
Phone: 503.718.2439 Fax: 503.598.1960 A Plan Review
Date/B : y Other Permit
TI G A R D Inspection Line: 503.639.4175 H , t % late 'ea.y :y: ® See Page 2 for
Internet: www.tigard-or.gov tt k{ h �. b .'- i*I .. Notified/Method: f / ° BM Supplemental Information
illi C P
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:13190 SW 68th Parkway New dwelling area: square feet
City/State/ZIP:Tigard,Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: 130 Project name:Kimsa TI 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.
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.
Tenant Improvement construction including new walls,doors,relites at office, Valuation: $26,302.00
new cabinetry and sink at coffee bar Existing building area: 2748 square feet
New building area: - square feet
® PROPERTY OWNER 0 TENANT Number of stories: 2
Name:Pacific NW Properties Type of construction: IIIB
Address:6600 SW 105th Ave Occupancy groups:
City/State/ZIP:Beaverton Oregon 97005 Existing: B
Phone:( ) Fax:( )
New: B
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mildren Design Group (Please refer tofee schedule)
Structural plan review fee(or deposit):
Contact name:Curt Trolan
FLS plan review fee(if applicable):
Address:7650 SW Beveland St,Ste 120
Total fees due upon application:
City/State/ZIP:Tigard,Oregon 97223
Phone:(503)244-0552 Fax::(503)244-0417
Amount received:
E-mail:curt@mdgpc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Van Osdel Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:PO Box 1057 Solar Installation Specialty Code checklist.
City/State/ZIP:Battle Ground,WA 98604 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(360)687-8636 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:164073
Total fee due upon application: $201.60
Authorized signature: /!lf t � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Curt Trolan Date:4/5/2018 * 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
III ■ ' COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: /990/ '-)J?'
Site Address: 1 3 1 9 0 S\V G S Pgrtiw i Suite/Bldg#: 130
Project Name: k.j( SO '—rt
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: l' nfit?mb r TL , r1 ei v ci t j 1 / doors reure..i
C U b at trt3 e C0 -u-- b o r.
Existing Business Activity: 0 (h(L
Proposed Business Activity: — At CM 01 i G)€
7Verify site address/suite# exists and active in permit system.
izi River Terrace Neigh.borh od ❑ Yes No
Zoning: U
Permitted Use: ❑ Yes ❑ No ❑ p
Spec Space
Confirm no land use required.
7i Business License:
Exists: ❑ Yes 2No,applicant notified to obtain business license
Notes:
Approved by Planning: Al ^--- Date: 1 / S //9
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: 9/ //ir
Site Plans: # /tin
Building Plans: # 3
Building Permit#: firer building permit#above. ,_,_, -------
Workflow Routing: [ ening CI Permit Coordinator Et"Building
Workflow Sign-off: a---81140,-off for Planning(include notes from planning review)
Route Application Documents: LBuilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
V1.
By Permit Technician: -/.5 //r'
Date: 11
I:\Building\Forms\BldgPemiitRvw_COM_NoLandUse_060116.docx
Permit Coordinator Review
E 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:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
11 q City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC) Building & Fire Protection System Permit
T I c,A I.F) Appointment Checklist
Permit Record#: 8t6P.?()ta—abcoi
Contact Name: 6.4 r.-}- Phone #: , V-aLik -05-5-a
Business Name: Irl lv-cA! Oea, f\/ Appt. Date/Time: '{,ti , 4/5-ir A Ar,e,
Site Address: /3/qo sL-ti 6 X/4"-, Bldg/Suite #: /a)
Project Name: - ''}3154 New Tenant? X.Yes 0 No
Project Description: 6i_04,l 4,„y (2)a41r�ce._/24 l(7) 4'ciiviA 0 6d. e_e_6.,
Existing Use: g New Use: L9
MMD Required: 0 YesGI�-IC115' Related Record#:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work: ) T Occupancy Group: LA Type of Construction: 1 ) j } 8
Type of Use: Occupancy Load: a. $ Oregon Specialty Code: 10 l (4,-
SPECIFICS
4.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: )9i no"0 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: \ / e S Fire Alarms: Smoke Detectors:
Sprinkler Type: J 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: $ o),6 i 3 O Q fPEES]UE
$ 9}-- DC Prov Rvw,COM TI—Ping
$4 7S, c 9 Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2017) $ S 7. la_ 12%State Surcharge
Project Valuation $.3 o q, �q, Plan Review,Structural
Up to$4,999 $0.00 $ } J0 ,Li O Plan Review,Fire Life Safety
$5,000-$74,999 $91.00 $ `t -- Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $226.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $361.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ y a7,9 O TOT FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070117.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13190 SW 68TH PKWY 130, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2018-00099
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - CofO
Comments:
Violation Summary:
Inspector Contractor