Permit CITY OF TIGARD BUILDING PERMIT
IN li
i . COMMUNITY DEVELOPMENT Permit#: BUP2020-00019
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/29/2020
T t[;;\R D g Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 300
Project: Therapeutic Associates Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Build out of(1)private office to include L-shaped drywall assembly.
Contractor: BUILT ENVIRONMENTS NORTHWEST Owner: G&S FC LLC
PO BOX 160 16083 SW UPPER BOONES FERRY RD,
GLADSTONE, OR 97027 STE
TIGARD, OR 97224
PHONE: 503-650-4084
PHONE: 503-443-1600
FAX: 503-650-4104
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 01/29/2020 $102.00
Occupancy Grp: B Occupancy Load: 1 Permit Fee-Additions,Alterations, 01/29/2020 $164.96
Demolition
Dwelling Units: 0 12%State Surcharge-Building 01/29/2020 $19.80
Stories: 0 Height: 0 ft Plan Review 01/29/2020 $107.22
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 01/29/2020 $65.98
Value: $5,426 Info Process/Archiving-Sm$0.50(up to 01/29/2020 $2.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $461.96
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 o follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 001;009;w You -y obtain a cop.•f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
/..
4 0 '
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
Commercial FOR OFFICE USE ONLY
City of Tigard . CEI `, Receivedeiv �� I I
x� i ✓.it PriMMLIII
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �
' Phone: 503-718-2439 Fax: 503-598-1960 Date/B : i/d] ,/V Related Permit:
Inspection Line: 503-639-4175 JAN 2 8 2020 Date Ready/By Juris: ® See Page 2 for
TI( :1 ft D Notified/Method: Su lemental Information
Internet: www.tigard-or.gov i .,,,r.,, PP
t (j Ci €�"4
TYPE OF �OR#c-F'l= 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
[I Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
0 1-and 2-family dwelling ]Commercial/industrial Valuation:
0 Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: &GO raj 50 v PPee— ( . 4C_•5 re-I -P--.A 1p New dwelling area: square feet
City/State/ZIP: 174,i ►-fel 40,12... 077)12_41 Garage/carport area: square feet
Suite/bldg./apt.#: Project name:1ta455:44 Of IX"%eil Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
V(/I 1,1 A. : Jf tC 2 - 13ee.".re 4 Other structure area: square feet
1
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 2 4 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.
2_1...0 0.1.4- C (1) y�c�� *C "Fico To Valuation: $ S-.411Z1-0
Existing building area:111;037 square feet
rsuGwr� L-SKr' -?G—?cD�lw�+c1�t_ 0��'t"lv�f3tr1
New building area: f!f 331 square feet
❑ PROPERTY OWNER X TENANT Number of stories:
Name:Tr/GeaL`tiT1C_ f�.fjC)Cl Type of construction: ri
Address:MOOS-3 ANN( U P(G 1.. ' 41.1t'S .� p v_I 2.4) . e.• Occupancy groups:
City/State/ZIP:T&•IE�-U,O.� �"]2.Z7 l Existing:6
Phone:(cf/?)443•icoo Fax:(95 r 69°,4641 New: S
x APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: 1 1....T +ENV t Qs>�Mg -vT'S 14 (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name: M t1L>r JAS FLS plan review fee(if applicable):
Address: a 3 S .c a F'f'{.i #.0 ,ir•-" Total fees due upon application:
City/State/ZIP: C O Ici1 6 - emir?
Phone:4)(o 5t �) owe Fax: :( )(o$?? ii leg Amount received:
E-mail: AA(�E `Ci w�,.i., . Le yN PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
J Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Apeix.,,,kT' Submit two(2)sets of roof plan with connection details
i. and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.:"Ai etiU 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:10 Date: l /Zl/1 41 * 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
,
q COMMUNITY DEVELOPMENT DEPARTMENT
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #: 4u 1020,2-o-ceo
Site Address: 16 0 83 EW U Pet r Q 00(1,2) Cerrj Suite/Bldg#: 300
Project Name: rctpev+iG OSs0Gicn-Ye s T
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ZniCt10 r TZ buil ou f pelva4e o6G,'c¢.
Existing Business Activity: 0 Pr.;(.(, — I\O Cih.Cl( C j e.
Proposed Business Activity: 1 f I
C�I Verify site address/suite# exists and active in permit system.
❑ River Terrace Neighborhood: ❑ Yes A No
czr Zoning: I ID
AL1 Permitted Use: Yes ❑ No ❑ Spec Space
Confirm no land use required.
X.Business License:
Exists: Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning:- vim— Date: I, Z 6 /2P2-43
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: //247/02.0
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planningermit Coordinator uilding
Workflow Sign-off: Sign-off for Planning(include notes fro Tanning 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: i41 Date: ( /1)-7„2
I:\Building\Forms\BldgPennitRvw_COM_NoLandUse_111819.docx
f/
/
i
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 •. Applicant:
Revision Notice 2: Date Se' to Applicant:
Revision Notice 3: Date .ent to Applicant:
❑ SDC Fees Entered: •sh Co Trans Dev Tax: ❑ Yes ❑ N/A
igard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permi
Approved by Pe it Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse l 11819.docx
City of Tigard • BUILDING DIVISION
,11111 41
Over-The-Counter (OTC) Building & Fire Protection System Permit
TIGARD Appointment Checklist
Permit Record#: /SvtP440Ooo/7
Contact Name: 1-f//Le"-_;/ ,9-r7 3 Phone #: .S22 3 7/3 -.3 4/7,'
Business Name: sat-/4 - iiia eVc7 JTI' A' iJ Appt. Date/Time: 0t1/2v & lt',pz .9y
Site Address: 4 0,,R3 ,c2,-1) ji4()E2. 3C0/✓ES/= ,ey BBldg/Suite #: &)e,Project Name: ,O Zt7( iy '9--7 New Tenant? ❑ Yes /02^No
Project Description: /1-2S,6 1;c1,9---1-6-5 76 G', T- 4/C7-c.) Chi h d.�-
Existing Use: e/ /,i ee New Use: ,Qpf`,
MMD Required: ❑ Yes No Related Record #:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work: Occupancy Group: Type of Construction: V$
Type of Use: el" Occupancy Load: t Oregon Specialty Code:
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: • Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: 11(337 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: NPV5 Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
' f pb
Total Project Valuation: $ 5 , V I . FEES DUE
$ j19-4 DC Prov Rvw,COM TI-Ping
$ l k.04 69 V Permit Fee-Add,Alt,Demo
DC Provision Review Fee for COM TI-Effective 7/1/2019 $ I',$v 12%State Surcharge
Project Valuation $ in. 2-' Plan Review,Structural
Up to$4,999 $0.00 $ v4,q 4 Plan Review,Fire Life Safety
$5,000-$74,999 $102.00 $ 2,, a" Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $254.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $406.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Tigard Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
Building Staff: $ Other:
Date/Time: $ 9(,1 1 1, TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_010120.docx