Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2013 -00174
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013
Parcel: 1 S136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Project: VVnco Subdivision: 1995 -013 PARTITION PLAT Lot: 2
Project Description: Install new self check stands with minor electrical revisions.
Contractor: ENGINEERED STRUCTURES INC A CORP OF IDAHO Owner: WINCO FOOD LLC
3330 E LOUISE DR STE 300 ATTN: TAX DEPARTMENT
MERIDIAN, ID 83642 PO BOX 5756
BOISE, ID 83705
PHONE: 208- 362 -3040 PHONE:
FAX: 208 - 362 -3113
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review, COM TI - Ping 07/16/2013 $70.00
Occupancy Grp: M Occupancy Load: DC Provision Review, COM TI - LRP 07/16/2013 $10.00
Permit Fee - Additions, Alterations, 07/16/2013 $362.69
Dwelling Units: 0 Demolition
Stories: 1 Height: 0 ft 12% State Surcharge - Building 07/16/2013 $43.52
Bedrooms: 0 Bathrooms: 0 Plan Review 07/16/2013 $235.75
Value: $19,000 Plan Review - Fire Life Safety 07/16/2013 $145.08
Info Process /Archiving - Lg $2.00 (over 07/16/2013 $6.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $873.04
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes 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. ATT •L.: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0' -0010 through • :R 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.
Iss • ed By: , _ I d' Permittee Signature: 41/1"
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 ONE)
City of Tigard ?�3'L 1 6 2013 Da<�
eB �s Permit No vDaO /3 —DO/
13125 SW Hall Blvd., Tigard, OR 97 Plan Review
i t; ♦i Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 �D� Daten3: 1tt /Wkly i
TIGARD
Inspection Line: 503.639.4175 TIGARD Date Ready 77: y: la See Page 2 for
-- Internet: www.tigard ocgov BUILDING DIVISION 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
® 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: $
El 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: 7501 SW DARTMOUTH ST New dwelling area: square feet
City /State /ZIP: TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: 4 d Project name: WINCO 23 - SELF CHECK Covered porch area: square feet
Cross street/directions to job site: DARTMOUTH & 72 AVE 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
INSTALL NEW SELF CIIECK STANDS WITH MINOR ELECTRICAL REVISIONS Valuation: $$19,000.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: WINCO FOODS, LLC Type of construction: REMODEL
Address: 650 N ARMSTRONG PLACE Occupancy groups:
City /State /ZIP: BOISE ID 83704 Existing: M
Phone: (208)377 -0110 Fax: (208)377 -0474 New: M
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: ENGINEERED STRUCTURES, INC lPleaserefermfeeschedute)
Structural plan review fee (or deposit):
Contact name: DAVID CHANSILP
Address: 3330 E LOUISE DRIVE, SUITE 300 FLS plan review fee (if applicable):
City/State /ZIP: MERIDIAN ID 83642 Total fees due upon application:
Phone: (208) 362 -3040 Fax: : (208) 362 -3113 Amount received:
E -mail: DAVIDCHANSILP @ESICONSTRUCTION.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Y Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: ENGINEERED STRUCTURES, INC. Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 3330 E LOUISE DRIVE, SUITE 300 Solar Installation Specialty Code checklist.
City/State /ZIP: MERIDIAN ID 83642 Permit fee (includes plan review $180.00
and administrative fees):
Phone: (208) 362 -3040 Fax: (208) 362 -3113 State surcharge (12% of permit fee): $21.60
CCB lic.: / '7/ 6 0
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: DAVID CHANSILP Date: 07 /15/2013 * Fee methodology set by Tri -County Building Industry
Service Board.
l: \Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11 /02 /COM/WEB)
I _ a 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] $ 19000
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 4750
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 $ 0
(b) An accessible entrance: $ 0
(c) An accessible route to the altered area: $ 0
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ 0
(e) Accessible telephones: $ 0
(f) Accessible drinking fountains: and, $ 0
(g) When possible, additional accessible elements such as storage and
alarms: $ 0
TOTAL (shall equal line [2] of Valuation Computation): $ 4750
1: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
s= ° Building Division
Over- The - Counter (OTC) Building Permit
T I G A R D Check List
Project Description: �l
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work *: („^l- Occupancy Group: Type of Construction:
Type of Use * *: �`y JJ` Occupancy Load: Oregon Specialty Code: -70(M
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: `7 Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ ! FEES DUE
$ - 7060 DC Prov Rvw, COM TI — Ping
$ e t.li► DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI (effective 7/1/2013) $ Z. 4 ` Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 'Z S 7 Ian Review, Structural
$5,000 - $74,999 $70.00 $10.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $174.00 $26.00 $ , O6 Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $278.00 $41.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc. Admin Fee
$ Other:
$ Other:
Building Staff: $ Other:
Date /Time: O FEES DUE
*TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
**CLASS OF WORK ACS = accessory; ADD = addition; ADU = accessory dwelling unit; ALT = alteration; DEM = demo; NEW = new;
OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies).
I: \ Building \Forms \OTC - BUP.docx 07/01/2013
Iii .. q
. Building Division
Development Code Provision Review
T I c A R D Commercial Projects - No Associated Land Use Case
Building Permit No: x'0 3 d O / 7y =• Expedited Review D �'
Project Name: GO /Aid-0
Site Address: 7-50/ S-& —e }-2 T/'lJ a 777 , Suite /Bldg #: `OO
Plans Routed:
Original Plan Submittal Date: 7//(0x/3 Routed By:
1St Revision Submittal Date: Routed By:
2" Revision Submittal Date: Routed By:
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 S Looia c at (503) 718,2L42) or A , ' S @tigard-or.gov)
Proposal: I 12.11.V.-- I hi l ' ' - (MI . :•1 d rh01 / ' ' �I - 1 ' _ A..
Zoning Ci�
Permitted Use Yes No ❑
Land Use Required: Yes ❑ No
Notes:
Approved ❑ Not Approved ❑ DCPR Not Required — No DCPR Fees Due
Date Routed to Building:
I: \CURPLN\Masters\Development Code Provision RevievADCPR_COM_NoLandUse.doc Rev. 01/16/13