Permit CITY OF TIGARD • BUILDING PERMIT
•
COMMUNITY DEVELOPMENT � Date rmiit#: 0: 9 P2010150275
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
' Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 92
Project: Bon Baguette Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Interior TI for deli for new tenant. 10/22/15,REPRINTED to change contractor of record.
Contractor: WHITE DOG RESTORATIONS INC Owner: ROIC OREGON LLC
1526 NE ALBERTA ST#216 8905 TOWNE CENTRE DR, STE 108
PORTLAND, OR 97211 SAN DIEGO, CA 92122
PHONE: 503-320-2962 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg DC Provision Review,COM TI-Ping 09/17/2015 $88.00
Occupancy Grp: B Occupancy Load: 25 Permit Fee-Additions,Alterations, 09/17/2015 $887.58
Demolition
Dwelling Units: 0 12%State Surcharge-Building 09/17/2015 $106.51
Stories: 1 Height: 0 ft Plan Review 09/17/2015 $576.93
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 09/17/2015 $355.03
Value: $70,200 Info Process/Archiving-Lg$2.00(over 09/17/2015 $6.00
11x17)
Wash Co Trans Dev Tax 09/17/2015 $3,776.00
Floor Areas: Parks SDC Improvement 09/17/2015 $1,835.00
Total Area: 0 Parks SDC Reimbursement 09/17/2015 $330.00
Misc Administration Fee 10/22/2015 $45.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $8,006.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No 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 by calling 503.232.1987 or 1.800.332.2344.
Issued y: e L/j Permittee Signet , D�f� (.N
Call 503.639.4175 by 7:00 a.m.for the next available inspect•n 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.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
01
Request for Permit Action
TIGARD 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @tigard-or.gov
FROM: ❑ Owner ® Applicant ❑ Contractor ❑ City Staff
Check(✓)one
REFUND OR Name: NW Precision Design
INVOICE TO: (Business or Individual)
Mailing Address: 22605 SW Pinehurst Ct
City/State/Zip: _Tigard OR 97140
Phone No.: 503-680-6444
PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED (✓):
❑ CANCEL/VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
® REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: BUP-2015-00275 - Bon Baguette
Site Address or Parcel #: 13500 SW Pacific Hwy., Suite 92,Tigard OR 97223
Project Name: Bon Baguette
Subdivision Name: Tigard Marketplace Lot#:
EXPLANATION: New General Contractor Eft TT 4tH H emo
Signature:
.120,4444_ Date: 10/21/2015
Print Name: Darin Bouska
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to Sys Admin: Date to PO is-- 13 ' Route to Records: Date By
Refund Processed: Date By Invoice Processed: Date By
Permit Canceled: Date By Parcel Tag Added: Date By
I:\Building\Forms\RcgPcrmitAction_0923I4.doc
NW PRECISION DESIGN
Architectural Design Consultiny
MEMO
TO: CITY OF TIGARD
ATTN: City of Tigard I Community Development
FROM: Darin Bouska
RE: BUP-2015-00275
DATE: OCTOBER 22, 2015
Please change the General Contractor, on the above mentioned permit.
WHITE DOG RESTORATIONS, INC.
dba White Dog Construction
1526 NE Alberta St. #216 Portland, OR 97211
Telephone: 503-320-2962
OR CCB: 124564
i'/,21/ i ewe.
If you have any questions, please contact me.
Thank you,
,c6)ct jest_
Darin Bouska
NW Precision Design
22605 SW Pinehurst Court,Sherwood OR 97140
Voice: 503.680.6444,email:darin(dnw-precision.com
III CITY OF TIGARD BUILDING PERMIT
''1 I COMMUNITY DEVELOPMENT Permit#: BUP2015-00275
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2015
Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 92
Project: Bon Baguette Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Interior TI for deli for new tenant.
Contractor: THANH H DO CONSTRUCTION Owner: ROIC OREGON LLC
9002 NE PRESCOTT ST 8905 TOWNE CENTRE DR, STE 108
PORTLAND, OR 97220 SAN DIEGO, CA 92122
PHONE: 503-421-1987 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB DC Provision Review,COM TI-Ping 09/17/2015 $88.00
Occupancy Grp: B Occupancy Load: 25 Permit Fee-Additions,Alterations, 09/17/2015 $887.58
Demolition
Dwelling Units: 0 12%State Surcharge-Building 09/17/2015 $106.51
Stories: 1 Height: 0 ft Plan Review 09/17/2015 $576.93
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 09/17/2015 $355.03
Value: $70,200 Info Process/Archiving-Lg$2.00(over 09/17/2015 $6.00
11x17)
Wash Co Trans Dev Tax 09/17/2015 $3,776.00
Floor Areas: Parks SDC Improvement 09/17/2015 $1,835.00
Total Area: 0 Parks SDC Reimbursement 09/17/2015 $330.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $7,961.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No 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 Notific • Center. Those ru 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 by cal g 503.2 .1987 or 32 34�.
Issued By: �irL2 Permittee Signature:
iwo �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 RECEIVED
Commercial 1 OR ()I I Il I l si,ONLI
City of Tigard ?/� , Permit N.� -�� �a 2S
Fr
1 3125 SW Hall Blvd.,Tigard,OR 97223 €p 17 2015
Plan Review 1�LI
Other Perini �1
Phone: 503.7182439 Fax: 503.598.1960 C Date/8 : PAL , ita,A/S'vQ
TIGARD Inspection Line: 503.639.4175 CITY OFTI( ARD DateReady/By: J� 63 SeePage2for
Internet: www.tigard-or.gov BUILDING DIVISION Nunfied/Metlad. 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.
❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: S
❑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:13500 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldgiapt.no.:92 Project name:Bon Baguette Covered porch area: square feet
Cross street/directions to job site: 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.
Interior Partition Walls,Plumbing,Electrical&Mechanical for new Deli Valuation: SS70,200.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: I
Name:R.O.C.I. Type of construction: VB
Address:21410 Salomo Dr Occupancy groups:
City/State/ZIP:West Linn OR 97068 Existing: B
Phone:( ) Fax:( ) New: B(No Change)
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:NW Precision Design (tease refer
to fee
schedule)
Structural plan review fee(or deposit):
Contact name:Darin Bouska
FLS plan review fee(if applicable):
Address:22605 SW Pinehurst Ct
Total fees due upon application:
City/State/ZIP:Sherwood OR 97140
Phone:(503)680-6444 Fax::(503)217-0933 Amount received:
E-mail:Darin @NW-Precision.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: : , . • • ' . . _. , , Submit two(2)sets of roof plan with connection details
l and fire department access,along with the 2010 Oregon
--I
Address:9002 NE Prescott St 771 V/9 # &O CO/✓S77ett e-770 . Solar Installation Specially Code checklist.
City/State/ZIP:Portland OR 97220 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)421-1987 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:122765 3120 !j (Q n // Total fee due upon application: $201.60
Authorized signature 1 // This permit application expires if a permit is not obtained
--�� within 180 days after it has been accepted as complete.
Print name:Darin Bouska Date:9/16/15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
:I I U Building Division
Over-The-Counter (OTC) Building Permit
T[GAR D Check List
Project Description: T s
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Group: �j Type of Construction:
Type of Use**: Occupancy Load: -2_45— Oregon Specialty Code: 27(
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 FOOT AGES
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: /i Fire Alarms: i 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:
i
Total Project Valuation: $ `7O1 f2W•�, FEES DUE
$ --`" ,l. DC Prov Rvw,COM TI-Ping
$ OP . 8,ermit Fee-Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ Cd- - 12%State Surcharge
Project Valuation $ - "lan Review,Structural
Up to$4,999 $0.00 $ - C" • - flan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ ,M Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $220.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $351.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other:
$ Other:
Building Staff: $ Other:
f
Date/Tune: $ 21O O 3'OTAL 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;
O'IR=other(use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC_BUP_070115.docx
114 City of Tigard
. COMMUNITY DEVELOPMENT DEPARTMENT id/7 7
T G A It D Building Permit Review — Commercial ---Land Use
Building Permit #: ,6GUPo20/-<-D0o27_5.
Site Address: / X40 PC //tt/V Suite/Bldg#:Project Name: //��
Project �,1 /JaSve ��
(Name of commercial busilptss occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: i Gy _ �c UdG 1[ e
g0l/. duv( dn
' f 4d�4.e4
e� i m n �.p� '- d at � iJ
Existing Business Activity: filjoN4, I fe■vfa,
Proposed Business Activity: p'l� // i1. A.
Verify site address/suite#exists and active in permit system. i,?.(y
IR River Terrace Ne hborhood: ❑ Yes 'No
Zoning: --6 -5 v
❑ Permitted Use: Yes ❑ No ❑ Spec Space
teSktonfirm no land use required. ,,/ ^� �J' /�
❑ Business License: �`�� �D/`� (Z'2 ' l�0 CO»rc/earl
Exists: ❑ Yes No,applicant notified to obtain business license
Notes:
Approved by Planning: j �� Date: l`771�
Revisions (after Building Submittal Reviewer
( ng only) Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 9//7//5
Site Plans: # d'L
Building Plans: # A-
Building Permit#: `Enter building permit#above.
Workflow Routing. /C3 Planning Permit Coordinator Building
Workflow Sign-off: `Sign-off for Planning(include notes from planning review)
Route Application Documents: 'FPBuilding. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: OTC
By �y ��dW1-e- Date: 9/ /77
B Permit Technician:
I:\Buil ding\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
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:
SDC Fees Entered: Wash Co Trans Dev Tax: tb Yes ❑ N/A
Tigard Trans SDC: ❑ Yes RINN/A
Parks SDC: Yes ❑ N/A
/OK to Issue Permit
Approved by Permit Coordinator: r.// Date: 5 /Y/S-
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
TDT Estimate Bon baguette 9/17/2015
13500 SW Pacific Ave. AMS
TDT RATES EFFECTIVE 7/1/15
TSDC CITYWIDE&TSDT RT OVERLAY RATES EFFECTIVE 7/1/15 INSIDE RIVER TERRACE
0 Yes
Project is in River Terrace ? ® No
Former Use
Rate Type Use# ITE Code #Units Rate TDT Amount Description
TDT 1 820 1.68 $11,140 $18,671 General Retail
TSDC-Imp 1 $0 Shopping Center
TSDC-Reim 1 $0
TSDC-RT 1 $0
Total TDT and TSDCs Former Uses $18,671
Proposed Use
Use# ITE Code #Units Rate TDT Amount Description
TDT 1 932 1.68 $20,151 $33,773 High-turn Restaurant
TSDC-Imp 1 $0
TSDC-Reim 1 $0
TSDC-RT 1 $0
TDT 2 $0
TSDC-Imp 2 $0
TSDC-Reim 2 $0
TSDC-RT 2 $0
TDT 3 $0
TSDC-Imp 3 $0
TSDC-Reim 3 $0
TSDC-RT 3 $0
Total All TDTs&TSDCs Proposed Uses $33,773
Less: Total All TDTs&TSDCs Former Uses $18,671
Total All TDTs&TSDCs Net Increase $15,102
Total Net County TDT $15,102
Less 75% Redevelopment Discount $11,327
Total Net County TDT $3,776
TDT TSDC Imp+ Reim
Target Recovery Rate 28.0% 30%
Estimated Total Impact $40,453 $0
Estimated Unmitigated Impact $25,351 $0
All TDT&TDSC TSDC RT Overlay
Target Recovery Rate 37% 30%
Estimated Total Impact $40,453 $0
Estimated Unmitigated Impact $25,351 $0
TDT=County Transportation Development Tax
TSDC Citywide=City of Tigard Transportation System Development Tax(TSDC-Imp&TSDC-Reim)
TSDC RT=River Terrace Transportation System Development Tax Overlay
•
Parks Estimate Bon baguette 9/17/2015
AMS
ALL PARKS RATES EFFECTIVE 7/1/15
O Yes
Project is in River Terrace ? ® No
...._..........................................._..
Note: All Neigh-Imp# Units entries= 0 if project is in River Terrace;
All Neigh-RT# Units entries=0 if project is elsewhere in the city.
Former Use
Rate Type Use# ITE Code # Units Rate Parks Amount Description
Parks-Imp 1 710 2.5 $367 $918 General Office
Parks-Reim 1 710 2.5 $66 $165 General Office
Neigh-Imp 1 710 2.5 $0 $0 General Office
Neigh-RT 1 $0
2 $0
Total Parks Former Use $1,083
Proposed Use
Use# ITE Code # Units Rate Parks Amount Description
Parks-Imp 1 720 7.5 $367 $2,753 Medical Offices
Parks-Reim 1 720 7.5 $66 $495 Medical Offices
Neigh-Imp 1 720 7.5 $0 $0 Medical Offices
Neigh-RT 1 $0
Parks-Imp 2 $0
Parks-Reim 2 $0
Neigh-Imp 2 $0
Neigh-RT 2 $0
Parks-Imp 3 $0
Parks-Reim 3 $0 ' 4
Neigh-Imp 3 $0 O
Neigh-RT 3 $0 3 3
Total Parks Outside RT Proposed Uses $3,248
Less: Total Parks Outside RT Former Uses $1,083
Total All Parks Outside RT Net Increase $2,165
Prior Use: General retail = 700sf/ee; 1676/700= 2.5 ees.
Proposed Use: Restaurant= 225sf/ee; 1676/225 =7.5 ees.
Parks-Imp = Parks Improvement, Citywide including River Terrace
Parks-Reim = Parks Reimbursement, Citywide including River Terrace
Neigh-Imp = Neighborhood Parks Improvement Outside River Terrace
Neigh-RT= Neighborhood Parks Improvement Inside River Terrace
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
13500 SW PACIFIC HWY 92, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00275
Chip Barnett
Violation Summary:
Inspector Contractor