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Permit 9 , • III '� CITY OF TIGARD COMMUNITY DEVELOPMENT COMMERCIAL MANUFACTURED STRUCTURE PERMIT s T I GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 Permit#: CMS200 Date Issued: 07/24/2000 00001 9 Parcel: 1S1 34 BC00300 Site address: 12210 SW SCHOLLS FERRY RD Jurisdiction: Tigard Subdivision: Lot: 0 Project: Coffee Rush Project Description: Replace existing manufactured structure with like kind. Owner: FEES FW OR-GREENWAY TOWN CENTER LLC Description Date Amount PO BOX 790830 Permit Fee-COM 07/24/2009 $226.95 SAN ANTONIO,TX 78279 12%State Surcharge-Building 07/24/2009 $27.23 PHONE: Plan Review 07/24/2009 $147.52 Park-Commercial and Industrial 07/24/2009 $728.00 Contractor: FLYING H CONSTRUCTION CO PO BOX 2533 WILSONVILLE,OR 97070 PHONE: 503-678-4224 FAX: Specifics: Type of Use: CMS Class of Work: OTR Type of Const: VB Occupancy Group: B Stories: 1 Height: 0 ft Floor Areas: First Floor Area: 319 Second Floor Area: 0 Third Floor Area: 0 Total Area: 319 Required Setbacks: Left: 0 Right: 0 Front: 0 Rear: 0 Total $1,129.70 Required: Parking Spaces: 0 Fire Sprinklers: NO Required Items and Reports(Conditions) 1 Pln Gen TDT&PARKS SDCS Smoke Detectors: No Party Wall: No This permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes- 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, •work is suspended for more the 180 days.ATTENTION:•egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Th.`, rules are set forth in OAR 952-001-001 throw OAR 952-001-0100. You ma obtain a copy of the rules or direct questions to OUNC by callin,503.246.6699 or 1.800.332.2344. Issued By: t i' r t I Permittee Signature: " 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 project. Approved plans are required on the job site at the time of each inspection. f .w CITY OF TIGARD Opp COUNTYWIDE TRANSPORTATION et CO DEVELOPMENT TAX (TDT) ��' NOTIFICATION OF FEE AND PAYMENT OPTIONS Please sign and return with Building Permit Application. This advises you that the TDT for this project is as shown below and outlines the payment options that may be available to you. A copy of the fee calculation works• • -t is atta / e - aunt w increase on July 1 if payment is not received before then. '. . and s b • ed with your application for a building permit. /�i er _, City of Ti:. • Date: Site Address: Z /O �I•i/�U,zDt1� Z 09' Y ,z Project Rua Land Use Case Name: or Permit#: C/1 2 9 2 / Tax TDT Amount: Lot#: / 5 / 3''11/3C CO 034 / �. i� This constitutes my request to use the TDT payment option or combination of options I have selected below. [This selection can be changed up to the time a building permit is issued.] I realize that TDT charges are due and payable at the time a building permit is issued unless those charges are Deferred or are financed through Installment Payments. [Please address questions about TDT or Deferral or Installment Payments to Albert Shields, Permit Coordinator,503-718-2426.] El Cash, Check,or Credit Card,payment due at building permit issuance. Deferral until Occupancy,payment due before issuance of an occupancy permit. Payment of the TDT may be deferred until issuance of the occupancy permit if the TDT is greater than the amount for a single family residence.currently S of/the requesting this option I understand that any deferred TDT must be paid prior to issuance of a Certificate of Occupancy and that the TDT will be recalculated at the time it is actually paid based on the TDT rates prevailing at that time. I further unders A TDT rates may increase each July 1st and at such increases are not subject to appeal. ❑ d Mr--€ -- a l /lowt, a te01K••bia Ile SWac ed��. r i V r (for deve per-built required public improvements, subject to pproval, � completion, and acceptance of creditable improvements.) ) PLEASE NOTE: TDT Credits must be redeemed at the time TDT Payment is due,either at the time the building permit is issued or,if payment is deferred,prior to issuance of an occupancy permit. If you expect to claim TDT Credits be sure the improvements, any creditable payments,and your claim for Credits are complete either before your building permit is to be issued or,if payment is deferred, before you request an occupancy permit. No refund of TDT Payments will be made if Credits are submitted more than 30 days after issuance of the relevant building or occupancy permit. "Bancroft" or Installment Payments (separate application required.) OWNER/APPL CA T OWNER/APPLICANT DATE: x 7/I i 41.? DATE: I:\CURPLN\Permit Coordinator\TDT Forms\TDT Payment Option Form 062209AMS irriCity of Tigard v 1'UT—COUNTYWIDE TRANSPORTATION DEVELOPMENT TAX IF �s Rate Calculation Worksheet APPLICANT a.eie___ �z,ici. - DATE MAILING ADDRESS .2 "3 s� A40 PREPAR BY /1/1 q CITY/ZIP/ PHONE `I f* dd1 &It_ g .106 ?PLANS CHECK j�_M )©9 000 TAX MAP# O Z / 3 1�/� 0 ©d 5°� PROJECT TITLE u Sh1 SITUS#ADDRESS j 2_24 0 "'�_` #vcis S ,_ ti `j� 71:9- , / Cam' /�/ Y dnyeeS' 2- C-4,714 e.a-s-t. eu * FORMER USE(S) USE COD UNITS X RATE = AMOUNT ` DESCRIPTION/NOTES ,f = 4/0 `- )Di� JJ� Ml7 l / .9 �%A , f., 14"-- - ,-,/.E .: x _ irx�v7- L e-N i t s�APAb 499 x = x = TOTAL TDT,FORMER USE(S) PROPOSED USE(S) USE CODE UNITS X RATE = `OUNT - ESCRIPTION/NOTES f 930 CP ?35- _ ‹,✓t -»i.eb- x am /000/1 _ i'esmv/Z/y-N-r, 11/0 -p & x = x = TOTAL TDT,PROPOSED USE(S) 5'7 f� 73'14' de LESS TOTAL TDT,FORMER USE(S) — , --sr ' -�'. -'-P / TDT INCREASE/(DECREASE) 41CREAS - TDT DUE) PAYMENT METHOD ;;�� CASH/CHECK <8,-;.;--214� i(-5 ✓ 9 CREDIT "�/�/Oik GL3�A- / '`�J �� �/ylTTE� �/2pQ5 ". t-t _ �Ti�0-na.t/;Ok/�t B(PROMISSORY T AGREEMENT 0K / P�Hz. -2 7-E S • (PROMISSORY NOTE) �/ i DEFER TO OCCUPANCY V /T56 7 .- j" 72 5, fro ' VOFS/CD/FORMS/TDT Rate Calculation Worksheet.indd(Rev.4/22/09) ' 7 ,4l-/? • Dan Nelson From: Albert Shields Sent: Thursday, July 09, 2009 2:39 PM To: Dianna Howse; Dan Nelson Subject: FW: CoffeeRush/HavaJava Kiosk, CMS2009-00001, MMD2009-00016 -- TIF & Parks SDCs. Attachments: TDTParks070909.pdf; Albert Shields.vcf Dianna, I don't see a TDT pull-down line under B-BUP fees so I haven't entered the TDT in the CMS yet. I did enter the Parks fee. Is there a TDT fee in some other schedule and, if not, can we please add one? Dan, FYI re fees due. From: Albert Shields Sent: Thursday, July 09, 2009 2:36 PM To: 'RonYost @comcast.net Cc: Kim McMillan; Dick Bewersdorff; Hap Watkins Subject: CoffeeRush/HavaJava Kiosk, CMS2009- 00001, MMD2009-00016 -- TIF & Parks SDCs. Ron, attached are estimates of the TDT (Transportation Development Tax) and Parks SDCs for a 319 sq ft coffee kiosk to be placed at 12210 SW Scholls Ferry Road: $4,173.16 for TDT, $728.00 for Parks. The TDT rate of$13,082/thousand sq ft will apply 7/1/09 - 6/30/10 based on the date of building permit issuance. The Parks rate of $364/EE will apply 1/1/09 - 12/31/09 based on the date of building permit application. For the purpose of applying these System Development Charges (SDCs) the fact that you had a coffee trailer/kiosk at the subject location does not qualify as a valid prior use because that use had no permit or Land Use Approval, such as the one you have now received with MMD2009-00016. Also, as you know, a new address was required under the MMD and we have updated your CMS, PLM, and ELC permit applications to show the site-specific address of 12210 SW Scholls Ferry Rd. Please use this address to refer to the kiosk's location. Please let me know if you have any questions. Albert Shields Permits/Projects Coordinator 503-718-2426 Albert Shields III City of Tigard a Permits/Projects Coordinator Albert@tigard-or.gov (503) 718-2426',.o!1: (503)624-3681 F_; 13125 SW Hall Blvd, Tigard,OR 97223 2 Community Development ,\11, Building Plans Route Slip To: Permit oor. 'nator PC Date Routed: �e7By: r Project Name: � � � 6/091/4-1/969 Building Permit #: 3 ••-_ 0000/ Site Work Permit #: c;c4 Land Use Case #: M 246 9 _ LoD Engineering Case #: Building plans meet conditions of approval: /o 6- Planning(initials): Date: 7/4/ Engineering(initials): Date: /`y� PC returns plans to: ✓ Notes: `Tc7 / 4 — _ . #9;F ?(4kwm h S -e izuAlrtiy t•,A 141 de:e_747, lw5 xj„, Aogeee9 4,1 /97,_57 ::.:':a,:'''' 511 Community Development Request for Permit Action RECEIVED T I_;G A R Dr NOV 0 3 2009 TO: CITY OF TIGARD CITY OF TIGARD Building Division Services Coordinator BUILDING DIVISION 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor Er City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) Mailing Address: City/State /Zip: Phone No.: ( PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ,t H 5 71. CANCEL PERMIT APPLICATION. (� 1 REFUND PERMIT FEES (attach receipt, if available). ❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit #: 0 -HO.9409 CCOO Site Address or Parcel #: /a,2 / O o o ,% .&2y' 2, Project Name: e.0466 f KLt Subdivision Name: /aJ /ft Lot #: EXPLANATION: -- p/ eo 0 gi2t.tej vn-C &J i > F,&,)--/ Mig-tJ ,G4crZ4 z, 1 arc G , /tQLt , eib 7t FF£.t Jr / L-rIT �iPt-RCE AuP doo9 -ooao5 • 1- A/Sr�nz A2/fs 66/9/ , Signature: i , I . Date: / / /y Zig 7 // 5 /0 J Print Name: `TJ 4 j/ 2. ADO r � Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80° /n of the land use application fcc when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. c) not more than 80`/o of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. ', ;.: 0- )1 .,: V•.PMf C . ", , FOR F7. 'U CESE LY ", �.t: O N.I :,- ,. ;;! Rte to S s Admin: Date '/ 09 Emma Rte to Bld• Admin: Date jffinill B oiva Refund Processed: Date / / ©® B a nvoice Processed: Date B Permit Canceled: Date / M' B : _�7� Parcel Ta: Added: Date B Recei s t # Date Method Amount $ I:\ Building \Forms \RcgPcrm tAction.doc Rev 07/26/07 1 (''') ,; I ,, Vd Building Permit Application � ' ' Ij S � cli . . • Commercial FOR OFFICE USE ONLY City of Tigard RECEIVED Dateivea ? Permit N.: .711 13125 SW Hall Blvd., Tigard, OR 97223 - � / Phone: 503.639.4171 Fax: 503.598.196(IUL 2009 Plan Revie �' 1l DateB : ..,, BEM Other Permit/, h �0 9_12w _, T I G R D Inspection Line. 503.639.4175 Date Re. • y: ' ' 61 See Page 2 for Internet: www.tigard or.gov CITY OF TIGARD Notified/Method e Supplemental Information BUILDING DIVISION 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 '� 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 ❑ Multi- family Number of bedrooms: N.) ❑ Master builder ❑ Other: Number of bathrooms: O JOB SITE INFORMATION AND LOCATION Total number of floors: Job sit 6 ?. ess: (,ya 5 - ( _s 47 ., New dwelling area: square feet City/State/ZIP: 716, j , o t , )yj Garage/carport area: square feet 1 1./\ Suite/bldg. /apt. no.: Project name: k jC, ti. • t u$t4- Covered porch area: square feet ZA Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Q 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. I'�•ovk. A,�11FixtsTlNz t11U>L1, t.V¢f'Aun LoC4�p (Its N-tu—S P&t -o Valuation: $ Veil t2- 6,0 , ( .XC' tt.5 fSe-1#Y P.)S. i N Tt h,R'Rl> r e -e-m-F -E Ng-,N Existing building area: jay) 9 square feet 3') Pd (r-/Dt tS6i PP 4 A VIt W- 1 i∎ eN to t i Us).- wug-c- � koi-w '-%\ 1 �� New building area: square feet r r ❑ PROPERTY OWNER ❑ TENANT Number of stories: f Name: Type of construction: Gj/t,..,„ I yv, i.e Address: Occupancy groups: A City/State/ZIP: Existing: ' Phone: ( ) Fax: ( ) New: k, ❑ APPL ❑ CONTACT PERSON / .. NOTICE ( 1: 7 ,927 r te �, y / Business name: dr . 2 N e All contractors and subcontractors are required to be Contact name: il / j � /' r /� 7 mo t / licensed with the Oregon Construction Contractors Board .. C l under ORS 701 and may be required to be licensed in the Address: / 2 76 X- ), jurisdictiomin which work is being performed. If the City/State/ZIP: / AF's} Z, hh 7 94419 applicant is exempt from licensing, the following reasons ( V) !!!! d - /% I Fax:: (5'1) 7 ' ii .- , apply: Phone: E -mail: 1 ,fat e) / 9 ��G ¢ of Y� f CONTRACTOR ` Business name: ri__> ts t-1 ■4vr-1 BUILDING PERMIT FEES* Address: paeraX 3 3 (Please refer to fee schedule) Structural plan review fee (or deposit): City/State /ZIP: 'V1111.4uNVILL.4, Ity2_ 91010 Phone: (--"(;,3) 1510 4q l L Fax: (t l 8 3) ( — 4-2,-1-1 FLS plan review fee (if applicable): CCB lic.: ' 0 4 f, 59 t0 Total fees due upon application: Amount received: Authorized signature: This permit application expires if a permit is not obtained Print name: u.,...1 P F.-15S E L Date: �? ;+• • within 180 days after it has been accepted as complete. 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)