Permit (7) CITY OF TIGARD BUILDING PERMIT
1,1 q
I. COMMUNITY DEVELOPMENT Permit#: BUP2019 00185
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2019
T[G al R L7 g Parcel: 2S115BA00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY N
Project: Planet Fitness Subdivision: None Lot: None
Project Description: TI for new tenant.
Contractor: DEACON CONSTRUCTION LLC Owner: TECOLOTE RESOURCES INC
901 NE GLISAN ST STE 100 KELLY'S LEGACY LLC, ET AL
PORTLAND, OR 97232 BY HESSLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE: 503-297-8791 PHONE: 503-764-7595
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VBPermit Fee-Additions,Alterations, 09/30/2019 $7,761.95
Demolition
Occupancy Grp: A-3 Occupancy Load: 278 12%State Surcharge-Building 09/30/2019 $931.43
Dwelling Units: 0 Plan Review 07/29/2019 $5,045.27
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 09/30/2019 $406.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 09/30/2019 $3,104.78
Value: $1,500,000 Info Process/Archiving-Lg$2.00(over 09/30/2019 $58.00
11x17)
Info Process/Archiving-Sm$0.50(up to 09/30/2019 $7.50
Floor Areas: 11x17)
Metro Const.Excise Tax 09/30/2019 $1,800.00
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $19,114.93
Required: Required Items and Reports(Conditions)
Fire Sprinkler: 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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r � �
Issued By: " Permittee Signature: if
,Cid
/ Call 503.639.4175 by 7:00 a.m.for the next available inspection dat .
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.
3
Building Permit Application -CE VED
Commercial ('� 2 d
FOR OFFICE USE ONLY
City of Tigard AUG 2 6 2019 DateB d •/ , /( ,/', Permit/slaig :VO l9—e,0 " 3rj`
1,1 . 13125 SW Hall Blvd.,Tigard,OR 9722 ,T'' OF TIGARD Plan Review
Phone: 503-718-2439 Fax: 503-598-1 Date q — i C) Related Permit:
DING DIVISION y:
T I G AR D Inspection Line: 503-639-4175 B Date Ready/By: kris of See Page 2 for
Internet: www.tigard-or.gov otified/Me.,.: -! /,' Supplemental Information
-- ,..76.70.1111.' 1'— -ø
TYPE OF WORK REQUIRED DATA:1-AN.D2-FAMILY DWELLING
•❑New construction ❑Demolition Permit fees*are based on the value of the work perfo , ed.
Indicate the value(rounded to the nearest dollar)o a 1
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the p +fit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-farntly dwelling ®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0Other: Number of bathrooms:
�,f JOB SITE INFORMATION AND LOCATION Total number of floors
i/ Job site address: 16200 SW PACIFIC HWY New dwelling ar-, square feet
JCity/State/ZIP: TIGARD, OR 97224 f 4-Aisi 'T 11.--/TAI E c S Garage/carp• area: square feet
vSuite/bldg./apt.#: 'N' Project name: 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:('Onl11ERCIAL-I,SE CHECKLIST
tlSubdivision: Lot#:16 2 0 0 Permit fees*are based on the value of the work performed.
fax 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 WORK work indicated on this application.
v Valuation: $ 200, 000
RENOVATION OF STOREFRONT @ ENTRANCE/NORTH
ELEVATION OF SUITE 'N' Existing building area:50, 66 6 square feet
New building area: 0 square feet
M PROPERTY OR'NER 0 TENANT Number of stories: 1 STORY
Name: JOHN BELANICH - HESLIN HOLDINGS Type of construction: TYPE III-N
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
® APPLICANT ❑ CONTACT PERSON LIIJILDIISG PERVIIT FEES*
(Please refer to fee schedule)
Business name: TILAND SCHMIDT ARCHITECT !
Structural plan review fee(or deposit): (j,/ L/7
Contact name: FRANK SCHMIDT
FLS plan review fee(if applicable):
Address: 3 611 SW HOOD AVE, SUITE #200
City/State/ZIP: PORTLAND, OR 97239 Total fees due upon application:
Amount received:
Phone:(503) 220-8517 Fax::(503) 220-8518
E-mail: FRANKS CHM I DT@T I LANDS CHMI DT.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*"
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: SD DEACON Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 901 NE GL I SAN ST #100 Solar Installation Specialty Code checklist.
City/State/ZIP: PORTLAND, OR 97232 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503) 297-8791 Fax:(503) 297-8991 State surcharge(12%of permit fee): $21.60
CCB Lie.: OR #134328 Total fee due upon application: $201.60
Authorized signature: jf„ This permit application expires if a permit is not obtained
"' V.2,44•004.
' within 180 days after it has been accepted as complete.
Print name: ieLa dIG_ /Ys ? /..,cc,-I' Date: e -az, /7 * Fee methodology set by Tri-County Building Industry
/ Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
ill
-,"I Plan Submittal Re uirements
q
Commercial & Multi-Family - New, Additions or Alterations
TIGARD
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
1. SITE PLAN (3) copies - fully dimensional,drawn to scale and labeled with:
A. 0 map&tax lot# 0 project name 0 site address 0 suite number
0 zoning 0 applicant name 0 phone 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.
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.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.03/05/2019
• City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
,,1,1 :,-", Plan Submittal Requirements Matrix
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.03/05/2019
City of Tigard
114 e COMMUNITY DEVELOPMENT DEPARTMENT
i
T l A lz D Building Permit Review — Commercial - N o Land U s e
r
Building Permit #: ,66c." / 9 - 00, 3 S
Site Address: 162-00 viii P 7Suite/Bldg#: .J
Project Name: f i,r, - F\i- t
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 2 -i\-1fr. kk P tkGUK I'1.e+t t4iA. la 4.,) C0' z. i\+1V`ttiki h
, :s"% t 23,5 %, y }
Existing Business Activity: �{-n 0.' 6.6411 n
Proposed Business Activity: u K
II/Verify site address/suite#exists and active in permit system.
t� Ijiver Terrace Neighborhood: ❑ Yes V-No
'�+rnoning. C_G G/
Yes Use: Yes ❑ No ❑ Spec Space
PV-Confirm no land use required.
C Business License:
Exists: ❑ Yes 1V\To,applicant notified to obtain business license
Notes: 444 M1)1 t1V►1 ail, l .t l✓t4I1..J j441-411 W IA tt 324.0.04' 4 4ln apply t} .asr-
1^M1/1k-
Approved by Planning: 1.-iii./, Date: g-2.6-ii
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: F'/2-6./f ?
Site Plans: #
Building Plans: #
Building Permit#: B'"Enter building permit#above.
Workflow Routing: 0—Planning ❑ Permit Coordinator - uilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: KI-1ti lding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: c
By Permit Technician: f )) - j--t_2.., Date: Q/L67/7
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permi\\
❑ 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 Applic, t:
❑ SDC Fees Entered: Wash Co Tran •ev Tax: ❑ Yes ❑ N/A
Tigard Tran DC: ❑ Yes El N/A
Parks S•': ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coors' ator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-Cotmty area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
1111
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
TransmittalLetter
A pi, 13125 SW Hall Blvd. •Tigard,Oregon 97223 •503.718.2439• www.tigard-ongov
TO: ( \rY- DATE RECEIVED:
DEPT: BUILDING DIVISION
RECEIVED
FROM: M a` \f\ MA) OCT 2 8 2019
i
CITY OF TIGARD
COMPANY: Ca U0 F".7 + LLC BUILDING
PHONE: C3 wy-3q,5-7 L By:
RE: (SW
'')Of(d, is1W ticp2oi ooi
rem (Permit um )
aet- bd-n(P j or su r vision name an number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: I Copies: I Description:
Additional set(s)of plans. 3 Revisions: '\-20,),Y\ SCA ri-@
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(expla'n):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Tech : Date: ) ) ) — J (1) ; Initials:
Fees Due: 14\Y s No Fee Description: Amount Duet
• rcv • et.•- $
Special
Instructions:
Reprint Permit(per PE): Yes /Xi No Li Dog9,
Applicant Notified: eg.,—Date: Initia
I:\BuiIdingWorms\Transmitta1Letter-Revisionsdoc 05/25/2012
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or_gov
TO: (C}i, DATE RECEIVED:DEPT: BUILDING DIVISION RECEIVED
NOV 12 2019
FROM: ` L t'-`1CC.t' i uV,_ CITY OF TIGARD
BUILDING DIVISION
COMPANY: 1 ,C& C& OCV u
PHONE: `J�J � ��8 - Cl By:
RE: s' C� -00 Bc `r(c On 0P -20I.c CO 1`S5
( ite Address) (Permit Number)
KrG
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. .7 Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: J )— Z J Initials:
Fees Due: [' Yes Fee Description: Amou D :
Special
Instructions:
Reprint Permit(per PE): ❑ Yes o ❑ Don:'
Applicant Notified: 7ILPt;IT
Date: / ( Initials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc