Permit CITY OF TIGARD BUILDING PERMIT
t COMMUNITY DEVELOPMENT Permit#: BUP2013-00246
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/08/2013
Parcel: 2S 102AA00905
Jurisdiction: Tigard
Site address: 12000 SW MAIN ST
Project: Sierk Orthodontics Subdivision: PAYLESS SHOPPING CENTER Lot: 5
Project Description: Remove interior walls,non-structural partition walls in preparation for new tenant.
Contractor: NORWEST CONTRACTORS INC Owner: HAAGEN, GARY L&CANDACE C TRS
PO BOX 25305 2514 SE 112TH AVE
PORTLAND, OR 97298-0305 VANCOUVER,WA 98664
PHONE: 503-291-6986 PHONE:
FAX: 503-291-7036
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg Permit Fee-Additions,Alterations, 10/08/2013 $134.54
Demolition
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Building 10/08/2013 $16.14
Dwelling Units: 0 Plan Review 10/08/2013 $87.45
Stories: 1 Height: 0 ft Plan Review-Fire Life Safety 10/08/2013 $53.82
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 10/08/2013 $2.00
Value: $3,900 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $293.95
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 b • 503.232.1987 . 32.2344.
Issued By: Permittee Signature
Call 503.639.4175 by 7:00 a.m.for the next available insp=:itf#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.
r
!
.Building Permit Application , '` D . .
' Commercial OCT 8 , FOR OFFICE USE ONLY
Cl of Tigard Received l� p ,arb Permit No� �oi3�0�L'4
City g ITY OF TIGARD DateB : O �t.,4m•
° 13125 SW Hall Blvd.,Tigard,OR 97 2 Plan Review
C' Phone: 503-718-2439 Fax: 503-59B ILDING DIVISION DateB : I-'- o nisi Other Permit:
Inspection Line: 503-639-4175 Date Ready:y: Juris: El See Page 2 for
I I C.i\R D Notified/Method: Su
Internet: www.tigard-or.gov 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(rotnded 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 l-and 2-family dwelling ommercial/industrial Valuation: $
El Accessory building CI Multi-family Number of bedrooms:
El Master builder 11 Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: X20 0 V s 0 I A 4 f tt.. L 1 New dwelling area: square feet
City/State/ZIP: 4 `L A�v O Pt— S(6 ILK, o&—rw D Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area square feet
Cross street/directions to job site: S/ 7/( 0/zTffdbe/VT/GS Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rotnded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
�nn DESCRIPTION OF WORK work indicated on this application.
126 Wlikild 1 IN"t tot re 1 0e 0' SZ AA)G'CVti•■ C---/ Valuation: $ 3�) O. O O
Existing building area square feet
PQvct->•t0a ,,J-'ws
New building area: square feet
' ❑ PROPERTY OWNER . '❑ TENANT Number of stories: i
Name: _Type of construction: , c
Address: ' Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) I
New:
INPPLICANT . ,❑ CONTACT PERSON - BUILDING PERMIT FEES* •
f� U 1 (Please refer to fee schedule)
Business name:
N 1.) 1 /IAI Si 0 4 Z 5 t Cs ti Structural plan review fee(or deposit):
Contact name: 10•45,^..A w) 3o t7 S)e A
FLS plan review fee(if applicable):
Address: •Z,.14 O 5 S' pi t,]6(,%c..M 47 07.
Cit /State/Z1P: Total fees due upon application:
y S 1�IitLIoJDD� Q `l / 4 a Amount received:
Phone:303 ) to'o_ r,4 4 4 I Fax: :( )
E-mail: ^^ 'PHOTOVOLTAIC SOLAR-PANEL SYSTEM FEES* • ,
A�1 rJ Q. — T f1.6 Lt St 0.3 Co*" Commercial and residential prescriptive installation of
(CONTRACTOR . ' roof-top mounted PhotoVoltaic Solar Panel System.
Business name: A �W fe.ST p N Submit two(2)sets of roof plan with connection details
C T. and fire department access,along with the 2010 Oregon
Address: A 0 130 x 2 5 30 5 Solar Installation Specialty Code checklist.
City/State/ZIP: A�t L�r �J p�..)2 Permit fee(includes plan review $180.00
r _1 and administrative fees):
Phone:(cv s) vi t — 619 L Fax:( ) State surcharge(12%of permit fcc): $21.60
CCB lie.: is el
j....
'S Total fee due upon application: $201.60
Authorized signatur : This permit application expires if a permit
is n o obtained
1 within 180 days after it has been accepted as complete.
Print name: 7A^1 ti r Date: I' 1•� * Fee methodology set by Tri-County Building Industry
I:\Building\Pennits\\BUP_COM_PermitApp.doc Rev. 12/11/2012 440-4613T(11//02/COM/WEB)
b
Building Division
I
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 Rev.12/11/2012
Building Division
Plan Submittal Requirements
T 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 ❑ 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.
l:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/11/2012
L
o v 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 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 Rev.12/11/2012
II a Building Division
°..
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: /)Expedited Review O/C,
Project Name: /t A( 0/zy e/v/C S
Site Address: /a0 0 0 Sit) /14,A./.'.J S Suite/Bldg #:
Plans Routed:
Original Plan Submittal Date: to/0.3 Routed By:
1St Revision Submittal Date: Routed By:
2nd 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 111ditIssU GrO&c at (503) 718-liat or YYttf tSSO - @tigard-or.gov)
Proposal: timex Y yemodet � no it w\IA.YI 1— 0.} v s t1 Yh
Zoning 'MU C_Bl7
Permitted Use Yes [3" No ❑
Land Use Required: Yes ❑ No [
•
Notes: .JQk1j A iCU X1111 CO ANL 1 N\ uJl }e,Nnctn impfovv 1142-4/0- (Lf d
ck-pfkij Fr'r 1/1/ /Ivy Mod . at 11/(1 1 -V; -
l"."-Approved ❑ Not Approved ❑ DCPR Not Required—No DCPR Fees Due
Date Routed to Building:
-- - I:\CURPLN\Masters\Development Code-Provision RevieWADCPR_COM_NoLandUse.doc Rev.01/16/13- -_ --- —
Building Division
Over-The-Counter (OTC) Building Permit
T l c n lz D Check List •
Project Description: Ni-Tr=f (
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: Type of Construction:
Type of Use**: ( Xk, Occupancy Load: Oregon Specialty Code: 240
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:
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: ��p
Total Project Valuation: $ J- FEES DUE
f $ DC Prov Rvw,COM TI-Ping
$ DC Prov Rvw,COM TI-LRP
DC Provision Review Fee for COM TI(effective 7/1/2013) $ r -Permit Fee-Add,Alt,Demo
Project Valuation Planning LRP $ b, 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ 867.a -- Plan Review,Structural
$5,000-$74,999 $70.00 $10.00 $ 153 Plan Review,Fire Life Safety
$75,000-$149,999 $174.00 $26.00 $ /•) 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: $ 'Z�?3.4�TOTAL 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
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12000 SW MAIN ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
2014-01-03 00:00:00
BUP2013-00246
PASS - No C of O
Violation Summary:
Inspector Contractor