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Permit CITY OF TIGARD BUILDING PERMIT ill 11 3. COMMUNITY DEVELOPMENT Permit#: BUP2020-00001 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/05/2020 Tlf'r4R.[7 g Parcel: 2S101AC01300 Jurisdiction: Tigard Site address: 7105 SW HAMPTON ST Project: Kaiser Dental Subdivision: BEVELAND NO.2 Lot: 18-19, P Project Description: Interior remodel of sterilization and OHAP work space for existing dental clinic. Contractor: VIKING ENGINEERING AND CONSTRUCTION Owner: KAISER FOUNDATION HEALTH PO BOX 33532 PLAN OF THE NORTHWEST#838 PORLAND, OR 97292 ATTN PROPERTY ACCOUNTING 500 NE MULTNOMAH ST PORTLAND, OR 97232 PHONE: 503-489-9968 PHONE: 503-348-6291 FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 02/05/2020 $1,172.39 Demolition Occupancy Grp: B Occupancy Load: 100 12%State Surcharge-Building 02/05/2020 $140.69 Dwelling Units: 0 Plan Review 01/02/2020 $762.05 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 02/05/2020 $254.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/05/2020 $468.96 Value: $110,250 Info Process/Archiving-Lg$2.00(over 02/05/2020 $50.00 11x17) Metro CET 02/05/2020 $132.30 Floor Areas: Tigard CET-Non-Residential-Admin 02/05/2020 $44.10 Tigard CET-Non-Residential-AH 02/05/2020 $1,058.40 Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $4,082.89 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 t . 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 copy o e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344 Issued By: �� Permittee Signature: 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 I)1: IC'I:USE ON A City of Tigard n L� Laecare ived /11,4 U/r� iO�pIa 13725 SW Hall Blvd.,Ti ard,OR 97223 h5 y. / /g eviewRelated Permit:Phone: 503-718-2439 Fax: 503-598-146 .. 2y: Inspection Line: 503-639-4175 "i, t '�s i'L;:AR D Date Ready Hy: w 0 See Page 2 for 1iGARD BUILDING DIVISION ,.f_� a) Internet: www.tigard-or.gov ifiedlMe dd: /‘e. OKi Supplemental Information TYPE OF WORK REQUIRED DATA:I-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 X,Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CO.'lR1 C1'tt:)!+ work indicated on this application. Valuation: $ ❑ 1-and 2-family dwelling X Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1Q GJUV hi 4r E New dwelling area: square feet City/State/ZIP: 2 4.41--[5 Garage/carport area: square feet u Stiite/bldg./apt.#: I Project name: Viret t. Covered porch area: square feet Cross street/directions to job site: RACICircidoDeck area: square feet . j'� y 2i}1_ St ' Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision; , Lot#: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the t�,�,gy�� DESCRIPTION OF WORK r T Y work indicated on this application. -alv ,51"s c op t/6 F 7'1:[�I "7) f 1//`► n Valuation: S l i Q S*o .00 6' , ! WO!le-9—p,i C •s) og. ve^-r-r A/'_ y F 1 Existing building area: square feet OA t4)e. * Sr��j uF�' t ►t'u� New building area: square feet i jgPROPERTY OWNER d itTENAN`i` Number of stories: Name: ' Ali4 y,�y : Type of construction: Gf Address: dC �•',� © 1#4+ Occupancy groups: City/State/ZIP: P.r Q 411 g.3' " Existing: Phone:(93 I Fax:l 1 New: X APPLICANT CONTACT PERSON BUILDING PERMIT FEES* Business name: / .( p/� f!'4'ase refer w fit srbrdntcl " '' -- k'�' Structural plan review fee(or deposit): y a QS Contact name: ��,,.�� � -�- FLS plan review fee(if applicable): 4a �' 31 0Us �U Cfii .907) f�rr�� //*'��� Address: P application: 1 Grj., tl,J, 6 x ft qi '-' �+ Total fees due upon City/State/ZIP: � � u q+� ._- Phone:(�� 2•�- 31 f Fax::I ) Amount received: ' ,r���,,., et .1�'�/�ci- rryl PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: li G/lf c..,1' 1 W 1 • ��1 7 CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: A (`rj ' i no-!i 1'+t i Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: ' ) r i .*35 , Solar Installation Specialty Code checklist. City/State/ZIP: F Q f 1 1. 1 Permit fee(includes plan review $180.00 !!! g and administrative fees): Phone:(� � t Fax:( ) State surcharge(12%ofpermit fee): $21.60 CCB Lic.: ` 1 f f A Total fee due upon application: $201.60 Authorized sill/fit ` �/J This permit application expires if a permit is not obtained ' air"; I within ISO days after it has been accepted as complete. Date: q____51 * Fee methodology set by Tri-County Building Industry Print name:(�/` (� Service Board I:\Building\Permits\BUP_COM PennitApp.doc Rev.04/21/2014 440-4613T(lI/02/COM/WEB) City of Tigard IIr COMMUNITY DEVELOPMENT DEPARTMENT N T l c A R D Building Permit Review — Commercial - N o Land U s e Building Permit #: 6 ii 19a,a -(i- / Site Address: 9/Qr /9 ib Suite/Bldg#: Project Name: , , r- ,, i,, eI (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: 7/ -€ 'j- j 7 Existing Business Activity: 2�t 4/ e: �5"C.C7 Propo d Business Activity: i` II VVeri site address suite#exists and active inpermit s ste . fY / III�'' er Terrace Neighborhood: El Yes No g es CIP ltted Use: Y No ❑ Spec Space irm no land use required. ya iness License: Exists: NJ Yes ❑ No,applicant was provided a business license application Notes: Approved by Planning: -- Date: // :2 0/ Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: 0 Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: nter building permit#above. Workflow Routing: Planning lilirit Coordinator Building Workflow Sign-off: Sign-off for PlaitWing(include notes 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: Date: / L 4,4‘ Z /_2_____ C\Building\Forms\BldgPermitRvw_COM_NoLandUse 111819.docx 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: IZDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes LT N/A Tigard Trans SDC: ❑ Yes Parks SDC: ❑ Yes 1N/A OK to Issue Permit Approved by Permit Coordinator: � / Date: G '3/2°) I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx