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Permit CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2012 -00060 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/27/2012 Parcel: 2S110DC00500 Jurisdiction: Tigard Site address: 11455 SW SUMMERFIELD DR Project: Schwindt Medical /Dental Office Subdivision: WILLOW- BROOK -FARM Lot: 17 Project Description: New 3,815 square foot medical /dental officebuilding. Contractor: PHAIR CONSTRUCTION COMPANY Owner: CDBK PROPERTIES LLC PO BOX 4722 11565 SW DURHAM RD BLDG F 100 SALEM, OR 97032 TIGARD, OR 97224 PHONE: 503 - 545 -9583 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee - COM - New Construction 06/27/2012 $3,278.92 Class of Work: NEW 12% State Surcharge - Building 06/27/2012 $393.47 Dwelling Units: 0 Plan Review 03/28/2012 $2,131.30 Stories: 1 Height: 0 ft DC Provision Review, COM New- Ping 06/27/2012 $129.00 Bedrooms: 0 Bathrooms: 0 DC Provision Review, COM New - LRP 06/27/2012 $38.00 Value: $650,000 DC Provision Review, COM New - Bldg 06/27/2012 $129.00 Info Process /Archiving - Lg $2.00 (over 06/27/2012 $18.00 11x17) Floor Areas: Info Process /Archiving - Sm $0.50 (up to 06/27/2012 $28.50 11x17) Total Area: 3815 Erosion Control 06/27/2012 $184.00 Accessory Struct: 0 Erosion Plan Review CWS 06/27/2012 $59.80 Basement: 0 Erosion Plan Review COT 06/27/2012 $59.80 Carport: 0 Metro Const. Excise Tax - Commercial 06/27/2012 $780.00 Covered Porch: 0 Use Deck: 0 Tig -Tual School CET - Non Residential 06/27/2012 $2,060.10 Park - Commercial and Industrial 06/27/2012 $1,286.11 Garage: 0 Additional Plan Review 06/27/2012 $200.00 Mezzanine: 0 Total $10,776.00 Required: Required Items and Reports (Conditions) 1 Ersn Cntrl 681 -4444 Fire Sprinkler: No Parapet: Yes 2 Special Inspection (see plans) Fire Alarm: No Protected Corridors: No 3 Structural Observation (See Smoke Detectors: No Manual Pull Stations: No plans) Accessible Parking: 1 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 B : . 60, / Permittee Signatur • 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 ... 1 , Commercial FOR OFFICE USE ONLY CI of Ti and Received �J g Date /B : • t Afll• n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review - " I VAINAIM II - Phone: 503.718.2439 Fax: 503.598. C Date /B : Other Permit. 1 T I G A R D Inspection Line: 503.639 q S {, Date Ready /B See Page or Internet: www.tigard- or.gov f� . Notified /Method>� q �i� ® Supplemental Information P ��� TYPE OF WORK t ` ' REQUIRED DATA: I- AND 2- FAMILY DWELLING ❑ New construction ❑ Dentlea G� 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 ri CATEGORY OF CONSTRUCTION work indicated on this application a ❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: y� ❑ Master builder ❑ Other: Number of bathrooms: ��A / l % 5 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site addressM4rSW Summerfreld Dr New dwelling area: square feet City /State /ZIP: Tigard Oregon, 97224 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Swhwindt Dental Office Covered porch area: square feet ('t1 Cross street/directions to job site: SW Durham Rd Deck area: square feet V • Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: 500 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2S1 W IODC 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. Demolish existing building and construct new office, parking lot, and associated Valuation: $$650,000.00 site improvements Existing building area: square feet New building area: 3,815 square feet ® PROPERTY OWNER I ❑ TENANT Number of stories: I Name: CDBK Properties LLC Type of construction: VB Address: 11565 SW Durham Rd, Bldg F, Suite 100 Occupancy groups: City /State /ZIP: Tigard OR 97219 Existing: Phone: (503)322 -8450 Fax: ( ) New: B ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: KASA Architects (Please refer ro fee schedule) Structural plan review fee (or deposit): Contact name: Kevin Saxton FLS plan review fee (if applicable): Address: 4119 NE Cesar E Chavez Blvd Total fees due upon application: City /State /ZIP: Portland, Oregon 97211 Phone: (503) 284 -6917 Fax:: ( ) Amount received: ,¢a r ' 31 E -mail: ksaxton @kasapdx.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: Emmett II Phair Construction Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: PO Box 4722 Solar Installation Specially Code checklist. City /State /ZIP: Salem, Oregon 97032 Permit fee (includes p lan review $180.00 and administrative fees): Phone: (503) 545 -9583 Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: 6-707 14111- l Total fee due upon application: $201.60 Authorized signature: ��� T his permit application expires if a permit is not obtained 4 t — within 180 days after it has been accepted as complete. Print name: Kevin Sax on Date: March 27, 2012 * Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Permits \BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11 /02 /COM /WEB) \\ ' J 11111 ° 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] $ MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ . 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 $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ , (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): $ I: \ Building \Permits \BUY -COM PcrmitApp.doc 03 /03/2011 I N p Building Division Plan Submittal Requirements T I G A R D Commercial & Multi- Family - New, Additions or Alterations 1. SITE PLAN (fully dimensional, drawn to scale) labeled with: A. El map & tax lot # ❑ project name El site address ❑ suite number El zoning El applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Setbacks. F. Parking, including disabled access. G. Finished floor elevations. 2. EROSION CONTROL PLANS AND DETAILS. 3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of plans required based on submittal type (no redlines or tape -ons accepted). All details listed below shall be incorporated into the plans: A. Scale (architectural or engineering only). B. Foundation plan. C. Floor plan(s). D. Cross sections. E. Reflective ceiling plan. F. Seismic bracing detail for suspended ceiling. G. Roof plan. H. Exterior elevations. I. Structural calculations, plans, details and specifications. J. Accessibility barrier removal worksheet. K. Deposit - based on valuation of project. 4. EXTRA SET OF THE FOLLOWING: A. Two (2) copies of site plan to include vicinity map. B. One (1) copy of erosion control plan with details. C. Fire Department Building Survey, and full set of architecture drawings. 1: \Building \ Permits \BUP -COM PcrmitApp.doc 03/03/2011 114 _ ° Building Division Plan Submittal Requirement Matrix T I G A R D Commercial & Multi- Family - New, Additions or Alterations Type of Submittal # of Plans (Includes new, additions and alterations.) Required at Submittal Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) • Site Work 3 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 3 Fire Protection System 3 Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue), if applicable. 1: \ Building \ Permits \BUP -COM PermitApp.doc 03 /03/2011 P This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard tY g Building Division TIGARD TRANSMITTAL LETTER TO: 6-f- NI DATE `! ' r' ttED DEPT: BUILDING DIVISION MAY' - 3 2.012 CITY OF TIGARD FROM: TAB C . i w BUILDING DIVISION COMPANY: 1 }j ( e-4 PHONE: 6n 3 - 2?,S - a?_4 )(T - 24k-- RE: 4 kk) 1` F1 4 n h P— NA, \1 12 - C00 (o 0 (Site Address) (Permit Number) (Project name or subdivision name•and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: I Copies: Description: Additional set(s) of plans. 2- ) Revisions: ( KIT 1. () - l N 1 . i. Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): V) k), ), � VS-} v1.3 REMARKS: htgl, ; ■ — I Ai A -. . !.L _ _ 1 - F ct-tkg-sck(5 FOR O FI E USE ONLY Routed to Permit Tech�nici Date: 1 5111 I (2-- Initials: Fees Due: ❑ Yes IN 1 o Fee Description: Amount Due: Special Instructions: Reprint Permit (per PE): ❑ Yes I ❑ No ❑ Done Applicant Notified: Date: Initials: (:\Building\ Forms \TransmittalLetter - Revisions.doc 02/08/2011 r 7111 ■ Building Division Development Code Provision Review T 1 G A R D Commercial Projects with Approved Land Use Building Permit No.: 5 1 i d a o JC) (o O Land Use Casefile No.: ,SD an I I - (X)Cn3 okep S(,t ✓m r1- A.rr /AA Routed Plans: Y _ Submittal Date: /'//)- Submittal Date: Submittal Date: To the Applicant: - Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. STAFF: please only mark those items n the left side that are approved. Planning Review (contact ! at 503-718-.2 or l @tigard- or.gov) ❑ Land Use Approval ❑ Building Plans Match Approved Plan: Yes ❑ No ❑ ❑ Maximum Building Height ❑ Conditions Met Notes: • / , a Original Plan: Approved ❑ Not Approved Date: / )_ z_ © /1 / I / i Re 1: Approved Not Approved ❑ Date: , Revision 2: Approved ❑ Not Approved ❑ Date: 1 i ,, I Engineering Review (c ntact Mike White at 503- 718 -2464 or MikeW @tigard- or.gov) / I ❑ Actual Slope: ❑ PFI Permit # ❑ Conditions Met Notes: Original Plan: Approved Rr Not Approved ❑ Date: i s I Z Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: I (Review Continues on Page 2) Page 1 of 2 • •• City borist Review (contact Todd Pra• er at 503 - 718 -2700 or todd @tigard- or.gov) City Trees / r ail PR- ' ` A' c� LY1 Protected Trees Notes: /9/14/A— ' �,/ /1) 1 Original Plan: Approved ❑ Not Approved ❑ Date: 57/0, Z— Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Perm • Coordinator Review (contact Albert Shields at 503 - 718 -242 or albert @tigard- or.gov) Planning Okay to Issue Permit Arborist,Okay to Issue Permit ❑ Engineering Okay to Issue Permit 5 Notes: i t I / ' p A -- ./ A 1 v i / . D 1 Z- 000) r r Original Plan: Date Sent to Applicant: i Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant _ Okay to Issue Permit: Yes No ❑ Date Routed to Building: / f • • Page 2 of 2 City of Tigard Z K r9 ra_ TDT — COUNTYWIDE TRANSPORTATION DEVELOPMENT TAX TIGA Rate Calculation Worksheet D APPLICANT t/4-S• 4 � ( Q JL ��', L - DATE 3 zp J Z v� MAILING ADDRESS ,C) / / 4 n � r� s � ` i ✓Q� 472 PREPARE B Y /4/7"45 CITY / ZIP / PHONE �(r, 05 c ' e � / , L i i PLANS CHECKa�Di/ -r0D5 � z 1 t o� c -- TAX MAP # '/ O � ' PROJECT TITLE a U / SITUS # ADDRESS 1 I 4 /S '6 6u 144 4/:;146 - :- FORMER USES) . • U CODE UNITS X RATE = , DESCRIPTION /NOTES / 91 / ,ck O, l x � oee = 4 3 9'0. 66 .w ,q ex-- x = x = x = TOTAL TDT, FORMER USE(S) PROPOSED USES) / r7, /b•p/ f/1/7 -- A7P /c 4 7 A( W0/ -‘/3,0/ Z USE ITE # TDT # CODE UNITS X RATE = AMOUNT DESCRIPTION /NOTES / fz03,DS X 23 7o = / 3 /q / S. 3, vi if iff -lam re:-‹— x = 7-5- v1 rid t f x = X TOTAL TDT, PROPOSED USE(S) 63/ / LESS TOTAL TDT, FORMER USE(S) - 1 1 1 / 3 q 0 7 TDT INCREASE /(DECREASE) " ' / I (INCREASE = TDT DUE) PAYMENT METHOD - c- V/�2i; .S CASH /CHECK F au Le. / 3 5 o0 f. CREDIT 5S = /.48 EE BANCROFT AGREEMENT /�i �o )O e 2 ire,' i u�4` //LM) GOQ 9ljze (PROMISSORY NOTE) .- h5 4 .. = 6 • 3 0 e, e g �(/ DEFER TO OCCUPANCY )4 /� I /OFS /CD/ FORMS /TDT Rate Calculation Worksheet.indd (Rev. 4/22/09) / ,z a Zp v //