Permit CITY OF TIGARD BUILDING PERMIT
111111 COMMUNITY DEVELOPMENT Permit#: BUP2015 00086
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/31/2015
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 190
Project: Professional Eye Care Associates of America Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Interior TI: new offices,conference room&IT room.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-624-6300 PHONE: 503-624-6300
FAX: 503-624-7755
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 03/31/2015 $75.00
Occupancy Grp: B Occupancy Load: 49 DC Provision Review,COM TI-LRP 03/31/2015 $11.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 03/31/2015 $857.46
Demolition
Stories: 3 Height: 0 ft 12%State Surcharge-Building 03/31/2015 $102.90
Bedrooms: 0 Bathrooms: 0 Plan Review 03/31/2015 $557.35
Value: $66,400 Plan Review-Fire Life Safety 03/31/2015 $342.98
Info Process/Archiving-Lg$2.00(over 03/31/2015 $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 $1,954.69
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 • iss .• e, o ork is suspended for more the 180
day • EN • •. •regon law requires you to follow the rules adopted by the Oregon Utility No •= ion Cen -r. Th• = rules are set forth in OAR
• 2-001-0010 through 0 - 952-•• 1090. You may obtain a copy of the rules or direct questions to OUNC by call ' 32.19: or 1.800.33 . 344.
Issued By: ', /, `� ' �� Permittee Signature:
• -.6_�`
Call 503.639.4175 by 7:00 a.m.for the next available inspec •n date.
This permit card shall be kept in a conspicuous place on the job site until co = io • he project.
Approved plans are required on the job site at the time of each inspection.
Building Permit • . . . . '
Commercial ECEI y 7 FOR OFFICE USE ONE) . 4• .
lteeeived r / /
City of Tigard 1 2015 °.� • //��!"�i Permit No.: t • s• .
_ ty g g �,- �Ilo
13125 SW Ball Blvd.,Tigard,OR 97223! 3 Plaa R ew 1j� Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: !
Inspection Line: 503.639.4175 Ci t V OF f IGARD Date Ready : : Jurir: H See Page 2 for
T i G A K D
Internet www.tigard-or.gov Notified/Method: Supplemental Information
BUILDING DIVISION. .
---- i0tgXd9 i jo_il r1, r),_ .j) , .6" 0_i4 :,ion et+i,a V(+-
❑Demolition Permit fees'are based on the value of the work performed.
❑New construction Indicate the value(rounded to the nearest dollar)of all
►,i Add ition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
• work indicated on this application.
Valuation: S
❑ 1-and 2-family dwelling jirCommercialfindustrial
Number of bedrooms:
❑Accessory building El Multi-family
Number of bathrooms:
❑Master builder ❑Other •
1:1'< ti , Y \ Total number of flours:
Job site address: 12_"09 (ti 6,9) o (ii,, New dwelling area: square feet
City/State/ZP: "1-7.61 7�!� Garage/carport area: square feet
Suite/bldgfapt.no.: l C
. r Project name: P E C -A_ -T-! Covered porch area square feet
Cross street/diredions to job site: Deck area: square feet
Other structure area: square feet - •
Subdivision: I 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
t ,(11,,.,+1 ;,r;3, Work indicated on this.....Iicativ{ .
d aim $ • ! + z S ✓ .C(Try��r _ , Valuation $ .,A_ , .
Existing building area Li s square feet
New building area: square feet
a r t yt „�.5, *t l :: Itrmber of stories: : •
Name: J Type of construction: I t - SI•
Address: %S.3S � f „3 '4 U atC.. '/ • - . Occupancy groups: .
-City/StateZIP: Vac FL0,41 . S"7224
- Existing: R •..
Phone: 414) y®_• ..-taxro • Fax: , 0, ) •.-71.M New: g ,
Business name: _s '' f
c ' Structural plan review fee(or deposit):
•
Contact name: /t CA.V t if?° FIS plan review fee(if aiplicable):
Address: ..
Total fees due upon application:
City/State/ZIP: - . .
Amount received.
Phone:( ) 7-01-1.€44 I Fax::.( ) . •
E-mail: N-- ► q -'. _� Y\i�
• .I A� � Commercial and residential prescriptive installation:of
S r.. li 'Cr __ roof-top mounted Photo Voltaic Solar Panel System.,
/ r� - Submit two(2)sets of roof plan with connection details
Business name: and fire department access,along with the 2010 Oregon
Address: Solar Installation , cia! Code checklist.
Permit fee(includes plan review 5180.00
City/StatelLIP: and administrative fees :
Phone:( ) I Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: t.-3,01 ( ,' Total fee due upon appication: $201.60
Authorized signature. ,� This permit application expires ilia permit is not obtained
��=`-A within 180 days after it has been accepted as complete.
�1Mj� c�f l Date: "�//I, ----- • Fee methodology set by Tri-County Building Industry
Print name: . 3�� Service Board
. __....--. AAA Ac,vrdI 1inWrYIAA/R/RRl
City of Tigard
UPI COMMUNITY DEVELOPMENT DEPARTMENT
■
TI G n o Building Permit Review — Commercial - No Land Use
Buildin g Permit #: b4-1-19,(90/5-'6°
Site Address: 1O9O/ 'GCS &OA_ pi,,,,,,q__ Suite/Bldg#: /90
Project Name: `1 dc,zalP
(Name of commercial business occu6Ing the space. If vacant,enter Spec Space.)
Planning Review
Proposal: /Th enCr 7 A ,Le kJ cA
ces e .-P/( r2:Or1/ 17— P DCI,
Existing Business Activity: '
Proposed Business Activity: U' - 'e;
'
I'. Verify site address/suite# exists and active in permit s_y_st��n.
J i'-ver Terrace Plan District El Yes M No
►'1lZoning: MUE-
•
Ig ermitted Use: 0/Yes ❑ No ❑ Spec Space CO/V no land use required.
L1/ Business License:
Exists: [Yes ❑ No, applicant notified to obtain business license
Notes:
Approved by Planning: �� Date: 3-3I-f S_ ----<-'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: s5/ //‘
Site Plans: # "'
Building Plans: # 7
Building Permit#: enter building permit#above.
Workflow Routing: -ErPlanning attoor_, Ei T uilding
Workflow Sign-off: 0.---Sin-off for Planning(include notes from planning review)
Route Application Documents: O'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
I
By Permit Technic' n: _ Date: /
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 031015.docx
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building S •mittal only)
Revision Notice 1: .to Sent to Applicant:
Revision Notice • Date Sent to Applicant:
Revision Noti • 3: Date Sent to Applicant:
❑ OK to sue Permit
Appri ed by Permit Coordinator: Date:
1:1Bui Iding\Forms\BldgPcrm itRvw_COM_NoL andUsc_031015.docx
ErBuilding Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description: 1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: kLT- Occupancy Group: Type of Construction: '2.76,
Type of Use**: ( '\, Occupancy Load: 49 Oregon Specialty Code: -2014—
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: Mann 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: $ ��A4 a FEES DUE
$ , •■ DC Prov Rvw,COM TI–Ping
$ .OO DC Prov Rvw,COM TI–LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ SMET Permit Fee–Add,Alt,Demo
Project Valuation Planning LRP $ / ;►r 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ "21',- '1an Review,Structural
$5,000-$74,999 $75.00 $11.00 $ ' ice Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ 1 /r 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: $ ( l-A. ( 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
12909 SW 68TH PKWY 190, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00086
Chip Barnett
Violation Summary:
Inspector Contractor