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Permit (2) CITY OF TIGARD SITE WORK PERMIT � II 7111 � COMMUNITY DEVELOPMENT Permit#: SIT2020-00001 T I G A Ft o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/29/2020 Parcel: 1S134AA01900 Jurisdiction: Tigard Site address: 10105 SW NIMBUS AVE Project: Burger King Subdivision: (KOLL BUSINESS CENTER,TIGARD Lot: B Project Description: New accessible path of travel to public way,reworking accessible parking stall,removing and repairing existing concrete and asphalt,and re-striping parking lot. Contractor: KBBL Owner: ROBINSON, JERRY CHRISTOPHER TRUS 12308 CHECKERBOARD ROAD NE DIETRICH, NANCY BISHOP GERVAIS, OR 97026 9701 SE MCLOUGHLIN BLVD MILWAUKIE, OR 97222 PHONE: 503-586-3767 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-Site Work 01/29/2020 $199.04 Plan Review 01/16/2020 $129.38 Type of Use: COM 12%State Surcharge-Building 01/29/2020 $23.88 Class of Work: ALT Plan Review-Fire Life Safety 01/29/2020 $79.62 Info Process/Archiving-Lg$2.00(over 01/29/2020 $6.00 Project Valuation: $12,000.00 11x17) Site Specifics: Excavation Volume: cu.yd. Fill Volume: cu.yd. Impervious Surface: 499 sq.ft. Engineered Fill: No Soil Report Required: No Paving: Yes Grading: No Landscaping: Yes Site Prep: No Storn Drains: Retaining Wall: No Fire Underground: No Accessible Parking: Yes Fence: No Total $437.92 Required Items and Reports(Conditions) 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. hose rules are set forth i .•AR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to 0. . callin. 503.23.. 487 or :' 0.332.2344. // Issued By: . Permittee Signature: (") 4----(----(-1---- 7::.----r,'"1 --N- _ — 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 Application Site Work RECEIVED FOR OFFICE USE ONLY City of Tigard , `EC Date/By: /Yin 667," `� Iliir 13125 SW Hall Blvd.,Tigard,OR 97223 Permit No.: r`+/'''jp1P��.lF'�� = g I.� Plan Review Phone: 503.718.2439 Fax: 503.598.19CAN S 2020 1^ ) Other Permit:,�/�/ (��f q Date/By: � � /J"9' ""°��'�p�� TIGARD Inspection Line: 503.639.4175 Date Ready/By: Loris: 1 1 See Page 2 for L Internet: www.tigard-or.gov CITY OF TIGARD _I ptifiedimetho ,, Supplemental Information BUILDING DIVISION ,, TYPE OF WORK t20r/k4OUJI REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑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. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ElAccessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10105 SW Nimbus Avenue, Tigard, OR 97223 New dwelling area: square feet City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: N/A Project name:Bu rger King Covered porch area: square feet Cross street/directions to job site: Deck area: square feet SW Nimbus Ave/ SW Scholls Ferry Rd Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: 1 S 134AA01900 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. Remove and Repair existing concrete and asphalt flat work Valuation: $ 12,000 (14_,. .t existing accessible parking stall and drive through lane. Existing building area: 3,768 square feet New accessible path of travel to public way. 1�'_ "IPI, New building area: 0 square feet ® PROPERTY OWNER ❑ TENANT !� iefNumber of stories: 1 Name: Nimbus Center Associates, LLC c/o Hillian Pacific Type of construction: V-B Non sprinklered Address: 101 East 6th Street, Suite 350 Occupancy groups: A-2 City/State/ZIP: Vancouver, WA 98660 Existing: A-2 Phone:(360)567-0626 Fax:( ) New: N/A ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: Armet Davis Newlove Architects All contractors and subcontractors are required to be Contact name: John Dodson licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 1 330 Olympic Blvd. jurisdiction in which work is being performed.If the City/State/ZIP: Santa Monica, CA 90404 applicant is exempt from licensing,the following reasons apply: Phone:(310)452-5533 X 204 Fax: :( ) E-mail: Dodson@adnarch.com CONTRACTOR Business name:TBD BUILDING PERMIT FEES* Address: /z SV 6 _/.1_,z_,k_..,,pbd, d /e 4 /t/� (Please refer to fee schedule) City/State/ZIP: ' ` Structural plan review fee(or deposit): (; e�I%/4/3 n n '7 7dz� - Phone:($v 3) y4/Z— —2,2493 ( ) FLS plan review fee(if applicable): Fax: Total fees due upon application: CCB lic.: 37� �. Amount received: Authorized signature: This permit application expires if a permit is not obtained John Dodson 1/06/20 within 180 days after it has been accepted as complete. Print name: Date: S * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 440-4613T(11/02/COM/WEB) City of Tigard 1111 11 COMMUNITY DEVELOPMENT DEPARTMENT 0 T1cARD Building Permit Review — Commercial - With Land Use Building Permit #: .1---7—da71.0...-0()00/ Site Address: /0/0 ,g/t;) Aiirn. u,q p ' Suite/Bldg#: Project Name: £Ur. r— ,L (Namef mmercial busine s ccupying the space. If vacant,enter Spec Space.) Planning Review, n Proposal: Cis 4 1tx r� 7<r /9)/2 ft / / ca4,%_1 pSIR, 7_,, 2 V fy site address/suite# exists and active in permit syste 61 ' :'ver Terrace Neighborhood: ❑ Yes1� No Il►. end Use Case#: difr j q-- 00(1,12 © Plans atch Approved Land Use: Site Plan a Landscape Plan her: VitWrban Forestry Plan 10$ levation Plan NO :uilding Height: Maximum Height Actual Height OVconditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance rid/Business Licenn : Exists: L✓J Yes ❑ No,applicant was provided a business license application Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified Lid No Applied For: ❑ Yes ❑ No, stop intake Notes: witin Approved by Planning: / / Date: ®zc) 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: / ; t Site Plans: # Building Plans: # Building Permit#: G nor building permit . above. 111 Workflow Routing: le-Planning ngineering ermit Coordinator g Workflow Sign-off: Lign-off for Planning(include notes from planning review) Route Application Documents: ding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: eZ6.— (----?7,-‘6" — Date: V1 /.1.> 1:\Building\Fonns\BldgPermitRvw_COM_WithLandUse_111819.docx Engineering Review [Slope at building pad: ' ❑ PFI Permit#: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP) 11--Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Er-No Assess Water Quantity Fee in-lieu: ❑ Yes E No LIDA Facility on lot: ❑ Yes C7-No ❑ NOT Approved by Engineering: Date Notes: Approved by Engineering: Date: t//4 /2v2.0 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: P/SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes L1 N/A Tigard Trans SDC: ❑ Yes I N/A Parks SDC: ❑ Yes LJ N/A OK to Issue Permit Approved by Permit Coordinator: 41Date: 1/>3/>0 I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_l 11819.docx Armet Davis Newlove, AIA Architects 1330 Olympic Boulevard • Santa Monica, CA 90404-3726 ' ''` Phone: 310-452-5533 Fax: 310-450-4742 L. t Transmittal Date: Tuesday, January 7, 2020 RECEIVED To: City of Tigard Building Department JAN $ 2020 13125 SW Hall Blvd Tigard, OR 97223 CITY OF TIGARD Cc: Ambrosia QSR, Jonnathan Padilla BUILDING DIVISION From: John Dodson (dodson@adnarch.com) Sent Via: Mailed Regarding: BK Tigard 10105 SW Nimbus Ave Tigard, OR 97223 We are submitting the following for review: Item Quantity Sets of Plans 3 Site Work Application Form 1 Comments: Please, send invoice for Plan Check fees.