Permit (4) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2019-00349
T t ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2020
Parcel: 1 S 134AA01900
Jurisdiction: Tigard
Site address: 10105 SW NIMBUS AVE
Project: Burger King Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Install new window canopies.
Contractor: SALEM SIGN CO INC Owner: ROBINSON, JERRY CHRISTOPHER TRUS
1825 FRONT ST NE DIETRICH, NANCY BISHOP
SALEM, OR 97303 9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-371-6362 PHONE:
FAX: 503-371-0901
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VBPermit Fee-Additions,Alterations, 01/21/2020 $210.59
Demolition
Occupancy Grp: B Occupancy Load: 49 12%State Surcharge-Building 01/23/2020 $25.27
Dwelling Units: Plan Review 12/23/2019 $136.88
Stories: Height: ft Info Process/Archiving-Sm$0.50(up to 01/23/2020 $3.00
Bedrooms: Bathrooms: 11x17)
Value: $9,000 Misc Administration Fee 01/23/2020 $5.00
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $380.74
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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.
Issued By: el ,.
rPermittee Signature: 7 /
Call 503.639.4175 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 Applicatio ECEI VE
Commercial DEC 2 3 2019 FOR OFFICE USE ONLY
Cityof Tigard Received e n7, j i3 r ,
b ReDate/B �ZApior Permit N (, e
- ■ 13125 SW Hall Blvd.,Tigard,QS
�ppj) OFTtGARD��^
14�DIVISION DateBevicw �Z� l�
Phone: 503-718-2439 Fax: 5 ,. Related Permit:
TIGARD Inspection Line: 503-639-4175 Date Ready/By: „/� /MEM See Page 2 for
, Internet: www.tigard-or.gov Notified/Method; -.4:'. Supplemental Information
7... :7;,1"7/-- /1'1.1.7
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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
0 I-and 2-family dwelling [l Commercial/industrial Valuation: $
0 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: 10105 Cif i\1 11 V S f e r,Ol New dwelling area: square feet
City/State/ZIP: 11904,p (,r?223 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: BVc5Ir 14,1 coi .R Covered porch area: square feet
Cross street/directions to job site: (pow- a- S� t'j A 7 Ate--— Deck area: square feet
G^"IL SW 54A 01�f Frtf i R u . Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot 4: Permit fees*are based on the value of the work performed.
t
Indicae the value(roundedto the nearest
Tax map/parcel#: dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTIONjOF WORK work indicated on this application.
9ezo,,,_4 -A 11 nt?w. j\1:"�1, Ch\4? Q t , Valuation: $
Existing building area: square feet
New building area: square feet
(k PROPERTY OWNER 0 TENANT Number of stories:
Name: NI�V�VS\' Cgv� A55 c4 S LLL Type of construction:
Address: col leg i,„,,,.., s'.4. Occupancy groups:
City/State/ZIP: PI/23z Existing:
Phone:(95 ) 97-) . 1190 Fax:( ) New:
APPLICANT xf CONTACT PERSON BUILDING PERMIT FEES*
Business name:
• (Please refer to fee schedule)
So ���(,,a/., Tilt Structural plan review fee(or deposit):
Contact name: Mt .}- Inl-it,�i
)72$ R-6/4.
1 77��"�' FLS plan review fee(if applicable):
Address: {� -f'
yI30
I _ n a1 ( Total fees due upon application:
City/State/ZIP: - `/
Phone:(S )37I.4•362,,, Fax::( ) Amount received:
E-mail: t"'o`t l IJn56,4,„,..s-,1f, ,(,�V� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CO RACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: Skiv\^ S; ‘IN W,) Zn 4 - Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 621 4c4 S)- NE Solar Installation Specialty Code checklist.
City/State/ZIP: 441 ‘ 09 q-no 1 Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) .63(oz.,/ Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lie.: (9c2 -7
yTotal fee due upon application: $201.60
Authorized signature: l/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: M k� Date: * Fee methodology set by Tri-County Building Industry
`^°I �y�l g Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
C
T1cARD Building Permit Review - Commercial - With Land Use
Building Permit #: 6 u U / 9 - 00-24/9
Site Address: /0/0,j ,0 "V>4L,5 /4fre prySuite/Bldg#:
Project Name: g„..,..4‘2,-- k‘„--,5
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: r✓1S 4-c1/1
1,1 ct2 U/ nc'r'/
ow c c: r,r-0_5
.2'-Verify site address/suite#exists and active in permit system.
L-River Terrace Neighborhood: ❑ Yes 1:1'&--o
.Land Use Case#: /1IMP tOq-J ? r—
Plans Match Approved Land Use:
,B'`Site Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan Elevation Plan
-"Billlzitig Height: Maximum Height Actual Height
0-Conditions Met: ❑ Prior to Submittal E Prior to Permit Issuance
p.-Business Liceen5. --
Exists: ..-'1"1111 Yes ❑ No,applicant was provided a business license application
,a Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: . Date: c�/�3/moi
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: /Z/a 3/i Gj
Site Plans: #
Building Plans: # 3
Building Permit#: E'Enter building permit#above.
Workflow Routing: eilanning ❑ Engineering ❑ Permit Coordinator le-8uilding
Workflow Sign-off: a-`'sign-off for Planning(include notes from planning review)
Route Application Documents: silding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: 91:47-zerd.C.---_ Date: /2/23
L\Building\Forms\B ldgPermitRvw_COM_W ithlandUse_111819.docx
Engineering Review
El Slope at building pad:
El PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
El Easements (encroachments)per engineering conditions of approval and plat(not typical on S '/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: El Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes El No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: X4
Date:
♦AI
Revisions (after Building Submittal only) A, 'eviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
El Conditions "Met"prior to issuance of buil.'r g permit
E l Approved,NOT Released: '/
Date:
Notes:
i
/./
Revisions (after Building Submittal only)
Revision Notice 1: D e Sent to Applicant:
Revision Notice 2: ate Sent to Applicant:
Revision Notice 3: ate Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes El N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue P mit
Approved by P rmit Coordinator: Date:
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