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Permit CITY OF TIGARD BUILDING PERMIT 2 COMMUNITY DEVELOPMENT Permit#: BUP2015-00171 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2015 Parcel: 1 S134BC00200 Jurisdiction: Tigard Site address: 12196 SW SCHOLLS FERRY RD Project: Mod Pizza Subdivision: GREENWOOD TERRACE CONDO Lot: 17 Project Description: Landlord work to prepare space for new tenant. Contractor: WESTERN CONSTRUCTION SERVICES INC Owner: ATLAS GREENWAY LLC 2300 E 3RD LOOP SUITE 110 333 NW NINTH AVE, STE 1009 VANCOUVER,WA 98661 PORTLAND, OR 97209 PHONE: 360-699-5317 PHONE: FAX: 360-694-7818 Specifics: FEES Description Date Amount Typo of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/25/2015 $917.70 Demolition Occupancy Grp: M Occupancy Load: 12%State Surcharge-Building 06/25/2015 $110.12 Dwelling Units: 0 Plan Review 06/17/2015 $596.51 Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 06/17/2015 $367.08 Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 06/25/2015 $187.00 Value: $75,000 DC Provision Review,COM TI-LRP 06/25/2015 $28.00 Info Process/Archiving-Lg$2.00(over 06/25/2015 $14.00 11x17) Floor Areas: Info Process/Archiving-Sm$0.50(up to 06/25/2015 $12.50 11x17) Total Area: 2592 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $2,232.91 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 obtain a c•• • - or direct questions to OUNC by calling 503..232..11987 or 1.800 332.2344_ Issued By: - • rmittee Signature: ff�' Call -0056 y 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 ONLY City of Tigard , EL) Received /' L _ jig - .�, Date/B _ V�J�— Permit No.:1 fit • r S /�ti •• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan R Phone: 503.718.2439 Fax: 503.598.1960 Date/B : +��/ Other Permit: Inspection Line: 503.639.4175 JUN 17 2015 Date Ready :'y: ^ 0 See Page 2 for T I G A R D Internet: www.ti and-or. ov Noti6 od: p� 4 g g 01- I.Ir ARD _i 'E�. Supplemental Information CITY ∎�t..t��_ / aWie!Mr TYPE OF W 7.' t+ B il: ■ tai ' ' s IRED 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: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 12196 SW Scholls Ferry Road New dwelling area: square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Landlord Work for MOD Covered porch area: square feet Cross street/directions to job site:SW 121"Avenue 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. 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. Landlord work to prepare space to turn space over to tenant for tenant's Valuation: 8$75,000.00 own improvements under separate permit. Existing building area: 2,592 square feet New building area: 0 square feet ® PROPERTY OWNER ❑ TENANT Number of stories: 1 Name:Atlas Investments Type of construction: 5B Address:333 NW Ninth Avenue,Suite 1010 Occupancy groups: City/State/ZIP:Portland,OR 97209 Existing: B Phone:(503)709-9918 Fax:( ) New A-3/B ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:Robert Simpson Architect,PC (Please refer to fee schedule) Structural plan review fee(or deposit): Contact name:Robert C.Simpson Address:31177 SW Simpson Road FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP:Cornelius,OR 97113 Phone:(503)709-9653 Fax::( ) Amount received: t�; E-mail:R.Simpson.808 @GMail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name:Western Construction Srvices,Inc. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:2300 E Thrd Loop,Suite 110 Solar Installation Specialty Code checklist. City/State/ZIP:Vancouver,WA 98661 Permit fee(includes plan review $180.00 and administrative fees): Phone:(503)519-7870 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 9j7 i 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:Robert C.Simpson Date:6/17/2015 * Fee methodology set by Tri-County Building Industry l Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) . . City of Tigard / COMMUNITY DEVELOPMENT DEPARTMENT ■ Building Permit Review — Commercial - With Land Use I I (, \ 1: I) Building Permit #: Rip jl 5--00 1 71 auite/Bldg#:Site Address: / ?/9(0 3k) . j// Project Name: /kob AaPe (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review n J Proposal: / . /. ??g,r' iv-a) 7`Q/,iaft.. Verify site address/suite#exists and active in permit cyst . t / ver Terrace Plan District: ❑ Yes 1 No Lld and Use Case#: M/ btQ0/ Co67 es / 4/J Plan/Match Approved Land Use: g Site Plan Phlandscape Plan ❑ Other: Pdi4Jrban Forestry Plan bq,ievation Plan ❑ Building Height: Maximum Height 'is Actual Height 19 4 flonditions Met: ❑ Prior to Submittal CI Prior to Permit Issues..,, Business Licen Exists: Yes ❑ No,applicant notified to obtain business license AtA5ublic Facilities Improvement (PFI) Permit: Required: El Yes,applicant was notified liNo Applied For: ❑ Yes ❑ No,stop intake Notes: i Approved by Planning: , _ �1 Date: r Aff 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: 61/ 7/5' Site Plans: # Building Plans: # Building Permit#: E building pe above. �P Workflow Routing: L� g Engineering t Coordinator uilding Workflow Sign-off: Si -off for Planning(include notes from planning review) Route Application Documents: [ 4uilding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: G//7//r I:\Building\Fonns\BIdgPermitRvw_COM_W ithLandUse_040115.docx Engineering Review ❑ Slope at building pad: ❑ PFI Permit#: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP) ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes No Assess Water Quantity Fee in-lieu: I=1 Yes /,J No LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date Notes: Approved by Engineering: M.l tzA'L Date: / Z ,� Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ 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: Xf/OK to Issue Permit Approved by Permit Coordinator: ei - Ca). �U-✓ Date: I:\Building\For ms\BldgPerrnitRvw COM_WithLandUse 040115.docx