Permit 1.
CITY OF TIGARD BUILDING PERMIT
c t COMMUNITY DEVELOPMENT Permit #: BUP2009 -00154
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/03/2009
T I BARD. Parcel: 1 S135BC01100
Jurisdiction: Tigard
Site address: 11101 SW GREENBURG RD
Subdivision: Lot: 0
Project: Greenburg Building
Project Description: Repair and alter exterior of existing building, change of occupancy, install insulated doors and
storefront, new entrance canopies, reroof, and ADA improvements.
•
Owner: FEES
ROBINSON FAMILY TRUST Description Date Amount
PO BOX 91305 Permit Fee - COM 09/03/2009 $505.90
PORTLAND, OR 97291 12% State Surcharge - Building 08/11/2009 $60.71
PHONE: Plan Review 08/11/2009 $328.84
Plan Review - Fire Life Safety 08/11/2009 $202.36
Contractor: Permit Fee - COM 09/03/2009 $267.96
ROBINSON CONSTRUCTION 12% State Surcharge - Building 09/03/2009 $32.15
21360 NW AMBERWOOD DR Plan Review 09/03/2009 $174.17
HILLSBORO, OR 97124 -9321 Plan Review- Fire Life Safety 09/03/2009 $107.18
Metro Const. Excise Tax - Commercial 09/03/2009 $141.79
PHONE: 503- 645 -8531 Use
FAX: 503 - 645 -5397 CDC Bldg Review, COM 09/03/2009 $143.50
CDC Plan Review, COM 09/03/2009 $143.50
Specifics: CDC Plan Review, COM - LRP 09/03/2009 $42.00
Type of Use: COM Additional Plan Review 09/03/2009 $200.00
Class of Work: ALT Additional Plan Review 09/03/2009 $200.00
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $118,160
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,550.06
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet: No
Fire Alarm: Yes Protected Corridors: No
Smoke Detectors: Manual Pull Stations: No
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 a R 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332 2344.
ik . Issued By: /j / I Permittee Signature:
v ` Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the r • ct.
Approved plans are required on the job site at the time of each inspection.
l�u?lreing Perm Applicatio `\ 0 I1 7 ,
)2 •c) CCO5. T •* , I 0 6
,Commercial FOR OFFICE USE ONLY
City of Tigard R ECEllVt: e.l ived aftBy Permit No.:
illii
" 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 AUG 1 1 200' Date/B : " r Other Permit u , ,�• .0002
T 1 G A RD Inspection Line: 503.639.4175 Date Ready/By: luris: 65 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIC r R „ Notified/Method: T I (_ Supplemental Information
" AJtel:hl.f1ttil liVIOR 'i
TYPE OF W OR K . `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.
El 1- and 2- family dwelling ® Commercial/industrial Valuation: $
❑ 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: 11101 SW Greenburg Rd New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Greenburg - 244temedel AL Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
NW corner of intersection at SW Greenburg Rd, SW Tiedeman Ave and Other structure area: square feet
SW North Dakota St RE
QiJI, REDDATA : USEGHECKLIST.
Subdivision: Lot no.: 1100 Permit fees* are based on the value of the work performed.
ax map /parcel no.: 1S135BC Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
' , DESCRIPTION:OF'WORK . ...n • work indicated on this application.
Repairs and alterations to exterior of existing building and change of occupancy Valuation: $$118,160.00
for existing tenant space. Work includes new insulated doors and storefront, Existing building area: 69017 square feet
ici, new entrance canopies, re- roofing with new insulation and ADA site improvments New building area: 0 square feet
®r PROPERTY OWNER r : u❑ TENANT . Number of stories: 1
Name: Robinson Family Trust Type of construction: III -B
Address: 21360 NW Amberwood Dr Occupancy groups:
City /State/ZIP: Hillsboro, OR 97124 Existing: M & S -2
Phone: (503)645 -8531 Fax: (503)645 -5357 New: A -3
®APPLICANT 0 CONTACT PERSON ;NOTICE .
Business name: CIDA, Inc All contractors and subcontractors are required to be
Contact name: Kim Walmer / Kourtney Strong licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4445 SW Barbur Blvd Suite 200 jurisdiction in which work is being performed. If the
City / State/ZIP: Portland, OR 97239 applicant is exempt from licensing, the following reasons
apply:
IP one: (503) 226 -1285 Fax: : (503) 226-1670
E -mail: kimw @cidainc.com / kourtneys @cidainc.com
CONTRACTOR' ., b �
Business name: Robinson Construction BUILDING'PERMITTEES* :
Address: 21360 NWAmberwood Dr = `(Pleaser'eferw■jee;sched K' .
City /State /ZIP:. Hillsboro, OR 97125 Structural plan review fee (or deposit):
` Phone: (503) 645 -8531 Fax: (503) 645 -5357 FLS plan review fee (if applicable):
CCB lie.: 63147 Total fees due upon application:
• Amount received:
Authorized signature: CY This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Kourtney S rong __ Date: 07.30.09 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 2 /23/07 440- 4613T(11 /02 /COM/WEB)
r • ti ,1
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $ 118,160.00
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 29,540.00
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $ 12,010.00
(b) An accessible entrance: $ 15,200.00
(c) An accessible route to the altered area: $ 2,330.00
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $ 29,540.00
1:\ Building \ Permits \BUP -COM PermitApp.doc 10/30/07
Commercial Application Checklist I Fin \I F
u v7.�-
City of Tigard AUG 1 1 2009
° 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171, Fax: 503.598.1960 CITY OF TIGARD
TIGARD Internet address: www.tigard- or.gov I3uLD
1 ING DIVISION
PROJECT INFORMATION
Project name: Greenburg Rd Remodel Date: 07.31.09
Address: 11101 SW Greenburg Rd City: Tigard State: OR ZIP: 97223
Scope of work: Exterior remodel and repairs with related site upgrades
Reference no.: Map and tax -lot no.: 1 S135BC #1100
Contact person name: Kourtney Strong Company: CIDA, Inc
Phone: 503.226.1285 Fax: 503.226.1670
Cellular phone: E -mail: kourtneys @cidainc.com
NOTES AND INSTRUCTIONS
• The purpose of this checklist is to help define a complete submittal package for the scope of work. Plan
review will not take place until a complete package is submitted.
• This checklist can be used for all commercial construction projects, including new construction, additions,
alterations and tenant improvements.
• For complex projects, applicants should use the "location" space to note the item's location and page
number from the plans or the specification book.
• It is not necessary to duplicate submittal information, even if it is asked for in multiple sections.
• In the checklist, "Required" means that the applicant must provide this information for plan review.
• In the checklist, "P" means —
• if checked by the applicant — the information is provided for the plan review.
• if checked by the plans reviewer — this information is required for the plan review.
• In the checklist, "NA" means that the information does not apply.
• Choose only those sections of the checklist that apply to your scope of work. Section 1.0, "General Project
Data," must be included with each .ro'ect submitted.
PRE- SUBMITTAL PROCESS
An applicant may request a pre - submittal meeting with representatives of the jurisdiction in which the project
will be built. The meeting may take place during the conceptual, schematic, or in- progress phase, or when the
applicant has completed plans.
INDEX OF CHECKLIST SECTIONS
1.0 General project data Page 2 7.0 Mechanical data (Types I and II
2.0 Civil data Page 2 kitchen -hood permits) Page 6
3.0 Architectural data Page 3 8.0 Plumbing data Page 7
4.0 Structural data Page 4 9.0 Electrical data Page 8
5.0 Mechanical data (new construction, tenant 10.0 Fire - suppression data Page 9
improvement, gas - piping permits) Page 5 11.0 Fire - detection and fire -alarm data Page 9
6.0 Mechanical data (additional or replacement 12.0 Re -roof installation data Page 10
rooftop- equipment installation permits) Page 6 13.0 Jurisdictional requirements Page 10
This checklist is for building department jurisdictions in Clackamas, Multnomah, and Washington counties.
440 -2734 (8 /O1/WEB /COM)
I:\Building \Forms \COM- Checklist.doc 07/31/09
SECTION 1.0 - GENERAL PROJECT DATA
Construction documents Location (sheet number or spec section)
1.1 ® Required No. of sets of plans: New: 1 TI: 2 2
1.2 ® Required Cover sheet title block CS1
1.3 ® Required Cover sheet vicinity map CS1
1.4 ® Required Cover sheet plan index CS1
1.5 ® P ❑ NA Code summary CS1 & A1.1
1.6 ® P ❑ NA Deferred submittal summary CS1
1.7 ® P ❑ NA Professional stamp and signature All Sheets
1.8 ® P ❑ NA Fire and life- safety plan A1.1
1.9 ® P ❑ NA Landscape plan L1.1
1.10 ❑ P ® NA Landscape specifications
Supporting documents Notes
1.20 ❑ P ® NA Land -use or planning actions
1.21 ❑ P ® NA Required fire -flow calculations
1.22 ❑ P ® NA Fire - hydrant flow -test report
1.23 ❑ P ® NA Fire department or fire district building survey report
1.24 ❑ P ® NA Material safety data sheets (MSDS)
SECTION 2.0 - CIVIL DATA
Construction documents Location (sheet number or spec section)
2.1 ® Required Site plan A0.1
2.2 ® Required Site utility plan A0.1
2.3 ® Required Grading plan A0.2
2.4 ® Required Erosion - control plan A0.2
2.5 ❑ P ® NA Utility -vault location and details
Supporting documents Notes
2.20 ❑ P ® NA Geotechnical/soil engineer report
2.21 ❑ P ® NA Storm -water calculations
2.22 ❑ P ® NA Site retaining -wall structural calculations
2.23 ❑ P ® NA "Assurance of Compliance" with environmental rules ....
440 -2734 (8 /01/WEB /COM) Tri- County Commercial Application Checklist 2
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
[ \Building \Forms \COM- Checklist.doc
SECTION 3.0 — ARCHITECTURAL DATA
Construction documents Location (sheet number or spec section)
3.1 ® Required Floor plan(s) A1.1
3.2 ❑ Required Transverse and longitudinal cross sections N/A
3.3 ® Required OSSC Chapter 11 accessibility requirements A1.1
3.4 ❑ P ® NA Interior elevations
3.5 ® P ❑ NA Exterior elevations A2.1
3.6 ® P ❑ NA Roof plans A1.2
3.7 ❑ P ® NA Exterior wall sections and details
3.8 ❑ P ® NA Reflected ceiling plan(s)
3.9 ❑ P ® NA Fire -rated construction details
3.10 LI P ® NA Energy code compliant construction details and
specifications
3.11 ® P ❑ NA Door schedule A1.3
3.12 ® P ❑ NA Glazing schedule A1.3
3.13 ❑ P ® NA Furniture plan
Supporting documents Notes
3.20 ❑ P ® NA Energy code compliance forms /calculations
3.21 ❑ P ® NA Material safety data sheets (MSDS)
3.22 ❑ P ® NA Hazardous materials inventory statement (HMIS)
3.23 ❑ P ® NA Hazardous materials management plan (HMMP)
3.24 ❑ P ® NA Written fire and life- safety evacuation plan for area
of rescue assistance
3.25 ❑ P ® NA Active and passive smoke - control information
440 -2734 (8/01 /WEB /COM) Tri- County Commercial Application Checklist 3
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
i:\Building\Forms\COM-Checklist.doc
SECTION 4.0 — STRUCTURAL DATA
Construction documents Location (sheet number or spec section)
4.1 ® Required Structural cover sheet SO.1
4.2 ❑ P ® NA Foundation plan
4.3 ❑ P ® NA Under -slab mechanical plan
4.4 ❑ P ® NA Under -slab electrical plan
4.5 El P ® NA Under -slab plumbing plan
4.6 ❑ P ® NA Floor framing plan
4.7 ® P ❑ NA Roof framing plan S1.1
4.8 ❑ P ® NA Structural elevations
4.9 ® P ❑ NA Structural details and cross sections S2.1
4.10 ❑ P ® NA Standpipe information
4.11 ® P ❑ NA Special inspector /structural observation matrix SO.1
Supporting documents Notes
4.20 ❑ P ® NA Geotechnical /soil engineer report
4.21 ❑ P ® NA Site - specific seismic hazard report
4.22 ❑ P ® NA Design narrative
4.23 ® P ❑ NA Structural calculations
440 -2734 (8 /01/WEB /COM) Tri- County Commercial Application Checklist 4
For use in building department jurisdictions in. Clackamas, Multnomah, and Washington Counties
I:\Building \Forms \COM- Checklist.doc
SECTION 12.0 — RE -ROOF INSTALLATION DATA
Construction documents Location (sheet number or spec section)
12.1 ® Required Site plan or building location map A0.1
12.2 ® Required Occupancy classification A1.1
12.3 ® Required Type of construction A1.1
12.4 ® Required Minimum roof class required A1.3
12.5 ® Required Class of roofing to be installed A1.3
12.6 ® Required Roof plan A1.3
12.7 El P ® NA Parapet and scupper cross section(s)
Supporting documents Notes
12.20 ® Required Pre -re -roof inspection report
12.21 ® Required Roofing system listing information
12.22 ® Required Roofing manufacturer's catalog "cut sheets"
12.23 ® P El NA Structural calculations
12.25 El P ® NA Structural engineer's report
SECTION 13.0 — JURISDICTIONAL – SPECIFIC REQUIREMENTS
Construction documents Item Location (sheet number or spec section)
13.1 El P El NA ❑ Required
13.2 ❑ P ❑ NA ['Required
13.3 ❑ P El NA ❑ Required
13.4 El P ❑ NA El Required
13.5 ❑ P ❑ NA El Required
13.6 ❑ P ❑ NA ❑ Required
13.7 ❑ P ❑ NA El Required
13.8 El P El NA ❑ Required
13.9 El P El NA El Required
13.10 El P ❑ NA El Required
440 -2734 (8 /01/WEB /COM) Tri- County Commercial Application Checklist 10
For use in building department jurisdictions in Clackamas, Multnomah, and Washington Counties
I:\B uilding \Forms \COM- Checklist.doc
Site Address: ! 1101 SW GREEN BURG RD.
I Building Division
li l i A IZ D Deferred Submittal Transmittal Letter
TO: DAN NELSON DATE RECEIVED:
DEPT: BUILDING DIVISION
RE. �+r ! s " D .
FROM: OCT ( 2 1 no
COMPANY: 04�y 0'� 9�aARD
PRONE: RE: DIVISlC!'1By:
RE: 11101 SW GREENBURG RD. BUP2009 -00154
. ite Address) — — (Permit/Case Number)
A
ROBINSON BUILDING
I
oject name or subdivision name and lot number)
i
Valuation of Deferred Submittal: $ 2„ o O Q
ATTACHED IS THE FOLLOWING DEFERRED SUBMITTAL ITEM:
I ma mma, y ° Nu tt y ^�+�, yN�fag P " ' T r r Ayy��tFFy F
a b o`� `.a .a'��� +A�� k � �� r. � ,. � �Y ? � d�A o m��.a 4j_4i;e *3�r�a F'�
2 I SUBMIT METAL STAIR SHOP DRAWINGS
Remarks: PRIOR TO INSTALLATION
NOTE: Documents fcr deferred submittal items shall be submitted to the registered design professional in
responsible charge who shall review them and forward them to the building official with a notation indicating that
the deferred submittal documents have been reviewed and been found to be in general conformance to the design of
the building. The deferred submittal items shall not be installed until the design and submittal documents have been
approved by the building official. Oregon Structural Specialty Code Section 106.3.4.2
Routed to Permit Technician: Date: r • ��. ' , - .711
Fees Due: • Yes I" o Fee Descri scion: Amount Due ji• •
Y w $ . , -- Deferred Submittal Fee: $ ) --
I .44.::, '*'t'' ' .14!!-? t Additional fee based on valuation: Q
: + k mot, t Other: $
�� �i��' 9 Total Fees Due: $
Special
Instructions:
Reprint Permit 9 er PE): U Yes Z'No ❑ Done
Applicant Notified: I' Date: a, ; . 6 c Initials: , ,
The fee for processing and reviewing deferred plan submittal shall be an amount equal to 65% of the bui sing based
on the valuation of the particular portion or portions of the project with a minimum $200.00 fee. This fee i s in
addition to the project plan review fee based on the total project value.
l•Building\Fonns \Transmittal Letter- DefrdSubmtl.doe 04 /04/07
Site Address: 1 1 101 S W G ree burg Rd.
Building Division
TIGARD Deferred Submittal Transmittal Letter
TO: DAN NELSON DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
OCT 0 6 2009
FROM:
CITY OF COMPANY: BUILDING D VI RD
N
PHONE: By.
RE: 11101 SW Greenburg Rd. BUP2009 -00154
(Site Address) (Permit/Case Number)
Robinson Building
(Project name or subdivision name and lot number)
Valuation of Deferred Submittal: $ 1 b CCO
ATTACHED IS THE FOLLOWING DEFERRED SUBMITTAL ITEM:
Copies: Description:
2 SUBMIT AWNING SHOP DRAWINGS
Remarks: PRIOR TO INSTALLATION
NOTE: Documents for deferred submittal items shall be submitted to the registered design professional in
responsible charge who shall review them and forward them to the building official with a notation indicating that
the deferred submittal documents have been reviewed and been found to be in general conformance to the design of
the building. The deferred submittal items shall not be installed until the design and submittal documents have been
approved by the building official. Oregon Structural Specialty Code Section 106.3.4.2
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: lo('T (C Initials:
Fees Due: 1 Yes ? No Fee Description: Amount ue:
Deferred Submittal Fee: $ C
Additional fee based on valuation: $
Other: $
Total Fees Due: $
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
The fee for processing and reviewing deferred plan submittal shall be an amount equal to 65% of the building based
on the valuation of the particular portion or portions of the project with a minimum $200.00 fee. This fee is in
addition to the project plan review fee based on the total project value.
l:Building\Forms\Transmittal Letter- DefrdSubmtl.doc 04 /04/07
l < ICJ aeet,thu �2� p � ',-p L C,Y-D / ' �.�L:.. ! s !0`d zc���. ,
' C.C.)
c I
ROBINSON
CONSTRUCTION CO. RECEIVED
MAR 1 8 `,? ii'
FAX COVER CITY OFTIGARD
BUILDING DIVISION
TO : Mr. Mark Vandomelan - Building Official
FAX #
FROM : Geoff Larrance
JOB NAME : Greenburg Building
JOB PHONE : 503 849 4510
JOB FAX # : 503 645 5357
RE Permit Extension- Greenburg Building
PI is
Number of Pages including this one : 1 6 JA Niel' A 1,4 MO'
REMARKS:
Robinson Construction is requesting a 180 day permit extension for the
following permits to allow construction to continue through October 9, 2010.
BUP2009 -00154
SIT2009 -00016
Please call Geoff Larrance with any questions, or if any additional information
is needed.
Thank You,
Geoff Larrance
geoffl@robcon.com