Permit (174) CITY OF TIGARD BUILDING PERMIT
'I * • COMMUNITY DEVELOPMENTII
Permit#: BUP2019-00134
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2019
Tic_ rL R f.7 9 Parcel: 2S115BA00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY M
Project: Tigard Town Square Subdivision: None Lot: None
Project Description: Construction of interior demising wall and full heights fur-out of perimeter walls with insulation.
Contractor: DEACON CONSTRUCTION LLC Owner: TECOLOTE RESOURCES INC
901 NE GLISAN ST STE 100 KELLY'S LEGACY LLC, ET AL
PORTLAND, OR 97232BY HESSLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE: 503-297-8791 PHONE: 949-297-4460
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 08/14/2019 $2,011.95
Occupancy Grp: A-3 Occupancy Load: 100 Demolition
12%State Surcharge-Building 08/14/2019 $241.43
Dwelling Units: 0 Plan Review 05/23/2019 $1,307.77
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 08/14/2019 $804.78
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 08/14/2019 $40.00
Value: $250,000 11x17)
Info Process/Archiving-Sm$0.50(up to 08/14/2019 $77.50
11x17)
Floor Areas: Metro Const.Excise Tax 08/14/2019 $300.00
DC Provision Review,COM TI-Ping 08/14/2019 $388.00
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $5,171.43
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alen: Protected OorrTdors'
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 ma obtain a of the rul s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /L� �_ Permittee Signature: /G ., r
w Call 503.539.4175 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 Applicationr f ya
1J,my
Commercial SsVS 3T_y,
„ FOR OFFICE USE ONLY
City of Tigard MAY 2 3 2019 Received
Date/By: 3 /9, ,/ P iyt°a,Z()/1-0c1/-3 S/
1111 " 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review' If Related Permit:
' Phone: 503-718-2439 Fax: 503-598-C466 Date/By:
Inspection Line: 503-639-4175 0 Lr41, t ..-.)
. Date Ready/By: /� �I .r El See Page 2 for
TIGARD Internet: www.tigard-or.gov Nd/Method: i� G //r Supplemental Information
i
'.o,. ,. 'T tairb W(JRK � 6.., ^; ' --f IRR, DATA.I P MILVD-"h .; 1 If
,
❑New construction 0 Demolition Permit fees*are based on the value of the work perfo • ed.
Indicate the value(rounded to the nearest dollar)o : 1
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the •••fit for the
CATEGORY OF CONSTRUCTION j , 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 floor
Job site address: 16200 SW PACIFIC HWY New dwelling ar-.. square feet
City/State/ZIP: TIGARD, OR 97224 Garage/carp area: square feet
Suite/bldg./apt.#: M & N Project name:TIGARD TOWN SQUARE Covere• porch area: square feet
Cross street/directions to job site:SW PACIFIC HWY & SW DURMAH RD D= area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#:162 0 0 Permit fees*are based on the value of the work performed.
Tax map/parcel#: 2 S 115 BAO 010 0 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORT{ work indicated on this application.
CONSTRUCTION OF INTERIOR DEMISING WALL & Valuation: $ 250, 000
FULL HEIGHT FUR-OUT OF PERIMETER WALLS Existing building area: 50, 666 square feet
WITH INSULATION. New building area: 0 square feet
121 PROPERTY OWNER - '. 0 TENNumber of stories: 1 STORY
Name: JOHN BELANICH - HESLIN HOLDINGS Type of construction: TYPE III-N
fr. Address: 23421 SOUTH POINTE DR, SUITE #270 Occupancy groups:
City/State/ZIP: LAGUNA HILLS, CA 92653 Existing: B-2
Phone:(949) 297-4460 Fax:(949) 297-4483 New:A-3
a APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: TILAND SCHMIDT ARCHITECT (Pleaserefer mfee s kedule}
Structural plan review fee(or deposit):
Contact name: FRANK SCHMIDT
FLS plan review fee(if applicable):
Address: 3611 SW HOOD AVE, SUITE #200
City/State/ZIP: PORTLAND, OR 97239
Total fees due upon application:
Phone:(503) 220-8517 Fax::(503) 220-8518
E-mail: FRANKS CHMIDT@TILANDS CHMIDT.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR, ,,...f, roof-top mounted Photo Voltaic Solar Panel System.
Business name: TBDI,
-r-excoil
Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: go( t(}E �/�„,•'t ,/.- i6e/G2% Solar Installation Specialty Code checklist.
City/State/ZIP: /2e,..-J j,vs o, 97 5,4 Permit fee(includes plan review $180.00
ty / / � and administrative fees):
Phone:(f.". .,3) 297ax: c ) p
" `��`�l F (S � G'�7 ' �� [ f State surcharge(12%of permit fee): $21.60
CCB Lic.: 1,72.�J1,/
`l /7 72-0 ( Total fee due upon application: $201.60
Authorized signature: ✓ This permit application expires if a permit is not obtained
> within 180 days after it has been accepted as complete.
Print name: itoV:IA 11/1a It /- Date: 5 -23' -/1 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP_COM_PennitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
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City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
i
T i c A RD Building Permit Review — Commercial - With Land Use
Building Permit #: /LP!
J /��j' O ___
Site Address: 1 gg
` L' � ,, i'4 Suite/Bldg#: h t p
Project Name: Iito,.�Cl IGvn,c ,Ce.,,„t fit a d,1
(Name f commercial busines`occupying the space. If vacant,enter Spec Space.)
Planning Review crPro osal: t iP C.,b^��vt,�� i� ti� ,,�;�;,,� ;w�li �► �,(f ►�L�h�` l-vr--�"v�- k �� �c� ;,A4 11S L.1 R � i(ififl
[!(y rift'site address/suite#exists and active in permit syste
[ River Terrace Neighborhood: ❑ Yes E1 No
Wand Use Case#: \V\O 1,()lq —000+L
Ltd PlanyMatch Approved Land Use:
Site Plan Jdandscape Plan ❑ Other:
rban Forestry Plan t Elevation Plan
wilding Height: Ma jmum Height '"IS Actual Height Ili v,
y/Zi 1- r
nditions Met: to Submittal ❑ Prior to Permit Issuance
L►G Business License:
�xists: ❑ Yes Ly'No,applicant notified to obtain business license
[ Public Facilities Improvement
(PFI) Permit:
Required: ❑ Yes,applicant was notified LW No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: Lisk_ Date: c_
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:
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planning Engineering 'Permit Coordinatoruilding
Workflow Sign-off: Sign-off forll'lanning(include not( from planning review) —
Route Application Documents: Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 4 -ra _. II ate: 1 , „
I:\Building\Forms\BldgPennitRvwCOM WithLandUse 060116.docx
En ineering Review
Yr 0
Slope at building pad: T
❑ PFI Permit#: NIA
0Conditions "Met"prior to issuance of binding'permit NIA
B/Easements (encroachments) per engineeringconditions of approval and plat (not typical on SDR/CUP)
12 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes Q(No
Assess Water Quantity Fee in-lieu: ❑ Yes D No
LIDA Facility on lot: ❑ Yes ['Yo
❑ NOT Approved by Engineering: Date
Notes:
►Approved by Engineering: Date: S' - 2 Y • !`1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
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:
/
I� SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes L'N/A
Tigard Trans SDC: 0 Yes 1/NJ1
/ Parks SDC: ❑ Yes LE
OK to Issue Permit
Approved byPermit Coordinator: ate: 6731/
PP
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 070915.docx