Permit - CITY OF TIGARD BUILDING PERMIT
• 3 COMMUNITY DEVELOPMENT Permit #: BUP2012 -00243
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/05/2012
Parcel: 2S 102AA00490
• Jurisdiction: Tigard
Site address: 12085 SW HALL BLVD 120
Project: Arellano's Market Subdivision: TIGARD HIGHWAY TRACTS Lot: 13
Project Description: Change restaurant to retail
Contractor: ARELLANOS CONSTRUCTION LLC Owner: ARELLANO, OMAR
232 SE OAK 12085 SW HALL #120
PORTLAND, OR 97214 TIGARD, OR 97223
PHONE: 971 - 645 -6825 PHONE: 971- 645 -6825
FAX: 503 - 855 -4691
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review, COM TI - Ping 12/05/2012 $67.00
Occupancy Grp: M Occupancy Load: 59 DC Provision Review, COM TI - LRP 12/05/2012 $10.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 12/05/2012 $564.15
Demolition
Stories: 1 Height: 0 ft 12% State Surcharge - Building 12/05/2012 $67.70
Bedrooms: 0 Bathrooms: 0 Plan Review 12/05/2012 $366.70
Value: $35,000 • Info Process /Archiving - Lg $2.00 (over 12/05/2012 $2.00
11x17)
Plan Review - Fire Life Safety 12/05/2012 $225.66
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0 •
Total $1,303.21
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 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 By: 0i/WZA-- 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 RECEIVED FOR OFFICE USE ONLY
/
City of Tigard DEC 05 2012 Received
Date/By: i /(Y Permit No.: 0 9 o a _ . ece u,b3
q 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review
0 Phone: 503.718.2439 Fax: 503.598.1960 CM' �! Date/By: Other Permit:
l' I G lip Inspection Line: 503.639 Cil 1 OFTIVARD Date ReadyBy: 7� ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISIO Notified/Method: Supplemental Information
TYPE OF WORK 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
A 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: $
❑ Accessory building CI Multi-family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: , 2 d 5" 'a\4`\ M d New dwelling area: square feet
City/State /ZIP: \'• 4i . Garage /carport area: square feet
Suite/bldg. /apt. no.: / Project name: I Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 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.
•M Valuation: $ jS '�
C.. p.Z Re \ � � 1
1 Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER Xr,TENANT Number of stories:
Name: Pa. Ca (c_ kJ' R.Wr5YrIZili Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existin g:
_
Phone: fl-1‘) ,_ / E I � - 4O tZ9 Fax: ( ) New:
jJ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: ' "_ ' ( Q 1_' a e_. r)e. W
.� �~ vi
<V C Y� ` � ` Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address: -2:2,2 �
City /State /ZIP: Qe 4a— - a 12 l y Total fees due upon application:
Phone: (y 6 Fax: : ( ) Amount received: 3�� `7�
E - mail: C t - 4 p r G��� c�Vear_ k- PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: I ... a `\ & ri e S CINNeN �� ", " �" "' * Submit two (2) sets of roof plan with connection details
�- 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: K 1 ( ) Go 4-'5 --( C7 Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: 114 0 3/ 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: ( ' , 4 4 . - . Date: (OG % Z * 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)
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 \BUP -COM PermitApp.doc 03/03/2011
III I
B uilding 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. ❑ map & tax lot # ❑ project name ❑ site address ❑ suite number
❑ 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.
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
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'. Building Division
, Plan Submittal Requirement Matrix
T,1 GA R D Commercial & Multi- Family - New, Additions or Alterations
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 3
(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.
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
111 " Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Project Description: ` ��
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: A Occupancy Group: M Type of Construction:
*Type of Use: C"f7/v1 Occupancy Load: Oregon Specialty Code: .0/0
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: _ 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: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Plan Review, Structural
<$5,000 - $74,999 $67.00 $10.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ / Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ ( x,03 - zl TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC - BUP.docx 07/01/2012
•
lipq Building Division
Development Code Provision Review
TI c A rz b Commercial Projects - No Associated Land Use Case
Building Permit No: r, W' ?-0 (1- 00.3 g r:xpedited Review
Plan Submittal Date: 0./ / / / - - '
1 2 1) 25' 50 k e t4 6 ( kX 1 - 1a, Q
To the Applicant:
If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
➢ If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact at 503 -7182 VVO or _ @tigard- or.gov)
Proposal:
11I r I 0 ' / 1 - t /i v i -
all G! i / i 147
Zoning /Y - D
Permitted Use Yes No ❑
Land Use Required: Yes ❑ No Et
Notes:
Approved ❑ Not Approved Date: j"
REVISED 10/4/12
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard DEC Received
Permit No.:
a 5 Q 2 Date/By:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juri s- ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISIOi Notified/Method: 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 (romded to the nearest dollar) of all
l igkAddition/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 ACC ommerciaUindustrial
Valuation: S
❑ 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: , " O ( 6 N VA \C\\ 13-kv d New dwelling area: square feet
City/State /ZIP: ' N - \ N fr4C4 Garage /carport area: square feet
Suite/bldg. /apt. no.: r� Project name: Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (romded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
\- DESCRIPTION OF WORK work indicated on this application.
cN `ah p..2 Re 5-o..'\-"' -k--25 't Valuation: S ' j
r � �� a �„ \ M ) Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER , TENAiNT Number of stories:
Name: ( c Q.C Ave i1 \-gY`044 Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: Al 6 - 4 O /)Z9 Fax: ( )
�/ New:
)Q APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: \ G 03.— �p � G � (Please refer to deposit):
Contact �' �,��p �r/��` `� Structural plan review fee (or deposit):
Contact name: C \`-' Ce
Address: Z - -Z "`,�� FLS plan review fee (if applicable):
City /State /ZIP: Q8 - Ctr• - %, `ia...- - Ct 1 2 t 4 Total fees due upon application:
^ Amount received:
`7
Phone: 0 Q4a3_A23 � Fax:: ( )
E -mail: CQAf r�` CO.... CA ' PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: r,„„ re `) & r c' S ��.k./ `^ez'' � ...�„'D Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specially Code checklist.
City /State /ZIP: Permit fee (includes plan review
and administrative fees): 5180.00
Phone: Kilt ) G0 4..' --Gs 2 9 Fax: ( )
State surcharge (12% of permit fee): $21.60
CCB lic.: 11403
Total fee due upon application: $201.60
Authorized signature: QiZ., This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: C am. Date: i A-ac * 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)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12085 SW HALL BLVD 120, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2012-00243
Chip Barnett
Violation Summary:
Inspector Contractor