Permit CITY OF TIGARD BUILDING PERMIT
1111 £ COMMUNITY DEVELOPMENT Permit#: BUP2015-00033
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2015
Parcel: 25101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 500
Project: University of Phoenix Subdivision: VARNS ACRES Lot: 9
Project Description: TI for existing tenant.
Contractor: PACIFIC CREST STRUCTURES INC Owner: GK TRIANGLE CORPORATE PARK III L
17750 SW UPPER BOONES FERRY RD SUITE BY THOMSON REUTERS INC
190 ATTN: MEGAN DOWLING
DURHAM, OR 97224 PO BOX 130174
CARLSBAD, CA 92013
PHONE: 503-968-8949 PHONE:
FAX: 503-598-6658
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 02/19/2015 $75.00
Occupancy Grp: B Occupancy Load: 43 DC Provision Review,COM TI-LRP 02/19/2015 $11.00
Permit Fee-Additions,Alterations, 02/19/2015 $475.99
Dwelling Units: 0 Demolition
Stories: 5 Height: 0 ft 12%State Surcharge-Building 02/19/2015 $57.12
Bedrooms: 0 Bathrooms: 0 Plan Review 02/19/2015 $309.39
Value: $26,200 Plan Review-Fire Life Safety 02/19/2015 $190.40
Info Process/Archiving-Lg$2.00(over 02/19/2015 $8.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,126.90
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. 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 obtai a rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1 /
Issued By: _Permittee Signature: • ZF r
all 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 FOR OFFICE USE OM.1
City of Tigard RECEIVE!) a m - —7- Permit No.: , . ,
Ill
• 13125 SW Hall Blvd.,Tigard,OR 97223 ;; \��_ r
Phone: 503.718.2439 Fax: 503.598.1960 J Other Permit:
r I( \I:I, Inspection Line: 503.639.4175 FEB 19 2015 Date R-. OP: n El See Paget for
Internet: www.tigard-orgov t, �+ Notified/Method: d- T Sapplemeatal Information
TYPE OF OF `� REQUIRED DATA:1-AND 2-FAMILY DWELLING
�1�`j DIVISION Permit fees*are based on the value of the work performed.
❑New construction
' ❑ljemohtron
Indicate the value(rounded to the nearest dollar)of all
X.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 PICommerciaVindustrial
Valuation: S
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: /3 221 S r,i 6,e)4-- P,44104;a y New dwelling area: square feet
City/State/ZIP: Ti h /had I O2 97 a Z'3 Garage/carport area: square feet
Suite/bldgJapt.no.: Project name: /PI✓. o FPNO C sJ I)e S'"Ft 00t2 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
So, .714 et.) S k.5 (" Pita K...JA--it kb._ 'rt{-t Other structure area: square feet
I U T-e LS ec i'@ NJ u/ S'W l+4fn?Tv AI Sr• REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: N/ A 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. _
t N p-N r z Valuation: $ 2(p 2-00
- N p 12-01)C M is &I j 1
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction: 7EN4NT I rl PRovt;•64‘NT
Address: Occupancy groups:
City/State/ZIP: Existing:
g
Phone:( ) Fax:( ) New:
%APPLICANT Pif CONTACT PERSON BUILDING PERMIT FEES*
Business name: P/)L/F c c QE Sr S C'
tvTV/ee r l `rdpbferse `10
Structural plan review fee(or deposit):
Contact name: STe✓C CC-c S F
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:(c,"03) S'30 . GI 817 (Ce) Fax::( ) Amount received: -
E-mail: Stay Q G @ P4 c IT•c cif e s - n to-if b• C o. PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: ?AC/Fie- c REST STai1 Cru i 6 S I -2-1,-/c• Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 17 7.To SW J PPS 6vNl 5 fe+tit`J RA• 4/9 0 Solar Installation Specialty Code checklist.
City/State/ZIP: DV 21-079-N4 0 it 9 7 2 2 K Permit fee(includes plan review $180.00
and administrative
(..0 3) 96,8 . 0944 Fax:(5b3)59g (p 6 administrative fees):
State surcharge(12%of permit fee): $21.60
CCB lic.: &C09 /S
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: 5 T-g7 VC C 1-O S C Date:2. o9. /s" * 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)
IN City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: e(,t fJ 0/5,,..,cy.4}33
Site Address: 13aat SW 6 a4- Pk_ Go 1 Suite/Bldg#: 50c)
Project Name: U.in;ors; of Rio,e n i K
(Name of commercial Business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: DC rv10 ey..t.f-l-irli waits , erce ,-\f brc&L raowl . N‘s, 'eYPc-Uf6/1
of —46._14-►e1 Ll..)-C_
Existing Business Activity: LLh Vt r J , 04-f;Cy
Proposed Business Activity: S a.ev,e-
X( Verify site address/suite #exists and active in permit system.
r,ii Zoning: 1.46(E.
IX Permitted Use: 0 Yes ❑ No ❑ Spec Space
KConfirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: a . eei,c:✓`a..--- Date: c - /c7-15
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submi tal
Original Submittal Date: 02 / /5
Site Plans: #
Building Plans: # 7
Building Permit#: '' nester-building permit#above.
Workflow Routing: Lg_ �1 nmg ❑ Permit Coordinator Erlra ing
Workflow Sign-off: unr Si -off for Planning(include notes from planning review)
Route Application Documents: E uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: C)77-
By Permit Technician: � Date: G2/jc,/,S
I:\Building\Forms\BldgPermitRvw COM_NoLandUse_020415.docx
Permit Coordinator Review
El Conditions Met-Prior to Issuance of Building Permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 0204 I 5.docx
IMI I Building Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description: 1 (,
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Asa— Occupancy Group: G
Type of Construction:
Type of Use**: Occupancy Load: A'�j Oregon Specialty Code: lam)
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: 17 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: $ 21c)2 - FEES DUE
$ 7.5",eto DC Prov Rvw,COM TI–Ping
$ ( ,O DC Prov Rvw,COM TI–LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ • r Permit Fee–Add,Alt,Demo
Project Valuation Planning LRP S WV/ 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ j, j Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ •0 -,y Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ 8,c!D Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $299.00 $44.00 $ 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: $ (.0 T(47,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_070114.docx
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
13221 SW 68TH PKWY 500, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2015-00033
Chip Barnett
Violation Summary:
Inspector Contractor