Permit r,
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00337
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/30/2015
Parcel: 1 S136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Project: VWnco Subdivision: 1995-013 PARTITION PLAT Lot: 2
Project Description: Install sushi kiosk within store
Contractor: ENGINEERED STRUCTURES INC A CORP OF IDAHO Owner: WINCO FOOD LLC
3330 E LOUISE DR STE 300 ATTN:TAX DEPARTMENT
MERIDIAN, ID 83642 PO BOX 5756
BOISE, ID 83705
PHONE: 208-362-3040 PHONE:
FAX: 208-362-3113
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 12/30/2015 $1,030.65
Demolition
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Building 12/30/2015 $123.68
Dwelling Units: 0 Plan Review 11/23/2015 $669.92
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 11/23/2015 $412.26
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 12/30/2015 $220.00
Value: $90,000 Info Process/Archiving-Lg$2.00(over 12/30/2015 $22.00
11x17)
Info Process/Archiving-Sm$0 50(up to 12/30/2015 $80.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,558.51
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- through OA 52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ued By: Permittee Signature:
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.
ce' 'V
Building Permit Application
Commercial FOR OFFICE USE ONLY
City of Tigard RECEIVED
Permit No.: 0
`swQp337}
'1 13125 SW Hall Blvd.,Tigard,OR 97223 cq Plan Revt
Phone: 503.718.2439 Fax: 503.598.1 NO V 17 2 015 Date/By- Other Permit.
!` a Inspection Line: 503.639.4175 Date Ready/By: lu is ® Se
OF
e Page 2 for
Internet: www.tigard-or.gov CITY OC I IGAFID Notified/Method: � 15_iSupplemental Information
BUILDING DIVISION C.
t Y i aJ
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New constructionPermit fees*are based on the value of the work performed.
❑ Demolition 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.
[II-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: ?j�6( t::� S,-. New dwelling area: square feet
City/State/7_IP:'� gnxL Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions tojob site:'sW JEl�;=tr_ 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.:
I�I 2 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.
r Valuation: $ 6 000
L
5 Existing building area: square feet
New building area: square feet
n PROPERTY OWNER ❑ TENANT Number of stories:
Name: W 11 0 FcoU--l— Type of construction:
Address: Occupancy groups:
City/State/7_11': ((] Existing:
Phone:(21-Z )5-77-OI(o Fax:(j")67Z -Z('46 New:
❑ APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
Business namePlease refer to fee schedule
• 3
Structural plan review fee(or deposit):
Contact name: � �� � 5
Address:
FLS plan review fee(if applicable):
�G� `..
A 9. T Total fees due upon application:
City/State/"LIP:
''f - Amount received:
Phone:(�$) -H19SZ Fax: :(1*44 -
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Email: clau�rl_C S3 Y1/1 '
Commercial and residential prescriptive installation of
CONTRACTOR roof top mounted PhotoVoltaic Solar Panel System.
Business name: �� - �t���Q�I � ��,Q�s / Submit t 2)sets of roof plan with connec' etails
Address: and fire depa t access,along wi 010 Oregon
33 1-4 t4 l s`G I 2. 46 Solar lnslallalion alto c ecklist.
City/State/"LIP: /Zr 7)r�N /7, �7�
Permit fee i e n review
$180.00
administrativ es):
Phone:(�' V q� 3ll�-3o y0 Fax:( )
S surcharge(12%of permit fee): $21.60
CCB lic.: 77%0
Total fee due upon application: $201.60
Authorized signature: A / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri-County Building Industry
4hkService Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613"1'(11/02/COM/WE13)
f 1,
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMEN'f
C
Building Permit Review — Commercial - No Land Use
Building Permit #:
Site Address: -7 SO SW �Dari(Y1oeA, S-i Suite/Bldg#:
Project Name: WIflC0
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Reviews 1 I/ --� ''II�
Proposal: Ins-oM sus6 kiosk W f1�1\n qb exi sKnA W ►nco ls+of e,
Etiisting Business Activitt:
Proposed Business Activit),: Saynw--
Verify site address/suite # exists and active in permit s}�st t
-�IZiver'terrace Neighborhood: ElYes No
LJ Zoning: ( -
Permitted Use: 9Yes ElNo ❑ Spec Space
(Confirm no land use required.
L10 Business Llcetlsse:
Exists: LY Yes ❑ No, applicant notified to obtain business license
Notes: nO eX+e'r 1 D V' 6)0-h9P-S 00Y- C, 0.C-n aP., V'5 e--,-
Approved by Planning: Y�KY4�&& Date: Itl �-
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:
Site Plans: #
Building Plans: #
Building Permit#: 'Enter building permit# above.
Workflow Routing: QPlanning B-T)-crmit Coordinator 2-Vuilding
Workflow Sign-off: 2-Sign-off for Planning(include notes frons planning review)
Route Application Documents: [? -Building: original perp"it application, site plans,building plans, engineer and
beam calculations and trust details, if applicable, etc.
Notes:
By Permit TechniciaDate: &Z /'--
I:\BuiIding\Ponns\Bldg Penn itRvw_COM_NoLand Use_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: ❑ Yes �rN/A
Tigard Trans SDC: ❑ Yes __N/A
Parks SDC: El Yes `�N/A
OK to Issue Permit /
Approved by Permit Coordinator:
I:\Building\Fonns\BldgPennitRvw_COM_NoLandUse_070915.docx
P E T E R S E N e S T A G G S LETTER OF TRANSMITTAL
ARCHITECTS LLP
NCARB CERTIFIED
5200 W.STATE STREET,BOISE, IDAHO M 3 IV DATE: 11/12/2015 JOB NO: 1502
PHONE:(208)345-1462 FAx:(208)34 3
EMAIL:psa(Wpsarch.com ATTENTION:
NOV 17 2015
TO: Plan Review / Brandon
(503)7182439 CITY OF TIGARD
City of Tigard - Building Division BUILDINS IUISION RE:
13125 SW Hall Blvd. Tigard, Oregon
Tigard, Oregon 97223 Store #23
ITEMS SENT ARE:Z Attached El For Pick UpE] Sent via Fed Ex
COPIES DATE DESCRIPTION
1 -- $1121 .71 Plan Review Fees
1 Building Permit Application
3 Sets Plans
3 Specifications
1 Set Structural Calcs
ITEMS SENT ARE:
OFor your use P1 As requested Z For review and comment Other
COMMENTS:
Please let me know if i need to provide additional information.
Thank you, Dawn Marie Cardwell
COPIES: File SIGN ( `
PLEASE NOTIFY PSA IF ENCLOSURES ARE NOT AS NOTED.