Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00039
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/03/2016
Parcel: 1 S 136AD06505
Jurisdiction: Tigard
Site address: 10998 SW 68TH PKWY
Project: Golsan Scruggs Subdivision: WAY LEE Lot: B
Project Description: TI-Adding(2)new offices to existing open office. Relocating(2)relites and patching interior finishes to match.
Contractor: PACIFIC CREST STRUCTURES INC Owner: BAILEY GOLSAN BUILDING LLC
17750 SW UPPER BOONES FERRY RD SUITE 10998 SW 68TH PKWY
190 TIGARD, OR 97223
DURHAM, OR 97224
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: IIIB DC Provision Review,COM TI-Ping 02/03/2016 $88.00
Occupancy Grp: B Occupancy Load: 49 Permit Fee-Additions,Alterations, 02/03/2016 $241.01
Demolition
Dwelling Units: 0 12%State Surcharge-Building 02/03/2016 $28.92
Stories: 2 Height: 0 ft Plan Review 02/03/2016 $156.66
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/03/2016 $96.40
Value: $11,000 Info Process/Archiving-Lg$2.00(over 02/03/2016 $2.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $612.99
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
952CBy: ��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.
Iss 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.
Building Permit Application
Commercial �������� Re���ea O' OO
NLY
City of Tigard Date/By /0 Permit No.: P�` tp 0�3
" 13125 SW Hall Blvd.,Tigard,OR 972 Plan Revi
Phone: 503.718.2439 Fax: 503.598.1 �B 2016 DatelB : it) Other Permit.
Inspection Line: 503.639.4175CITY OF 1'IGAFiD Date Read B . 1uris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
DIVISION
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 dwellingIS Valuation: $
Commercial/industrial
❑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: 101-70 SW G6" PAX4kVAV New dwelling area: square feet
City/State/ZIP: Ti&^oto , dA 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:6OLSAP4 CcAvGGS 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.
5 Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: 34APO G 50 5 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
AV011V6 Two NEW orn e'cx TD AN (r),OPEN Valuation: $ 111000
oFFrCV. RELocAnNG i lW'_) R 6 LI.�f AWP Existing building area: 2 3 9 Z square feet
/1Z417NG IME1UOIL FI NI S Wf 78 AAA'mt+. New building area: -G— square feet
❑ PROPERTY OWNER TENANT Number of stories: 7—
Name: GOLSADv SGRUGevS Type of construction:
Address: 101 18 SW C,e&F FAIR-KWAY Occupancy groups:
City/State/ZIP: "1'j d OIC 87223 Existing: 5
Phone:( ) Fax:( ) New: 13
M APPLICANT 4F CONTACT PERSON BUILDING PERMIT FEES*
Business name: C IPA Please refer to eesckedule
gR� PAYA4 I Structural plan review fee(or deposit):
Contact name: 7 �'�V
Address: 1,50-15v Z" FLS plan review fee(if applicable):
Sw '7ZNO S
City/State/ZIP: O0-P491MAWP, 41/7�Z Total fees due upon application:
— I
Phone:(503) 22(/ 128$ 1 Fax::(S63) ZZO — 1670 Amount received:
E-mail: b� n C e um PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR y�1/✓� roof-top mounted Photovoltaic Solar Panel System.
Business name: AAGI flG GRA- S`A(1 C'I GJ Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 17760 SyV Up EZ jV01V15Jff4& Solar Installation Specialty Code checklist.
City/State/ZIP: PGR1,. Permit fee(includes plan review
Ml4 � 9722 and administrative fees): $180.00
Phone:(t�p3) �j q•E Fax:(r'o3>51$/6 GSa' State surcharge(12%of permit fee): $21.60
CCB lic.: 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: �E >r�F p*Y Date:Q Zq/ I G * Fee methodology set by Tri-County Building Industry
Service Board.
L\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
REQUIREMENT: OREGON REVISED STATUTE(ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Pemrits\BUP-COM PermitApp.doc 03/03/2011
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Commercial - No Land Use
Building Permit #: —)�)L P a0/& dDU 3q_
Site Address: 10 qci $ fw (A H- PG's►t*VVt'"0 Suite/Bldg#:
Project Name: Gi o) �C'4 n C r U !22 ! �
(Name of commercial business occupying the space. if vacant,enter Spec Space.)
Planning Review
Proposal: r) f-tfr(-u TT 14dd f" !) Z r1e v 1 0( 64 LP 1
Existing Business Activity: C- C1 0 L�I.�C U C/4 0 rl le
Proposed Business Activity: (_ - C1 0
XVerify site address/suite# exists and active in permit system.
Pr River Terrace Nei hborhood: El Yes No
A Zoning. � — C
Permitted Use: [ Yes ❑ No ❑ Spec Space
Confirm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: '\') Vl Date:
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#: 2Enter building permit#above.
Workflow Routing R'Planning .0'$uilding
Workflow Sign-off: ET_Sign-off for Planning(include notes from planning review)
Route Application Documents: Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Com' Date: I&
1:\Building\Forms\B1dgPermitRvw_COM_NoLandUse_070915.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building StateSent
Revision Notice 1: Appli nt:Revision Notice 2: ApplicanRevision Notice 3: Applicant:SDC Fees Entered: ns Dev Tax: ❑ Yes ❑ N/A
SDC: ❑ Yes El N/A
Parks SDC: Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
l:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
E ._ '' Building Division
Over-The-Counter (OTC) Building Permit
Check List
—1---
Project Description: t�
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: Type of Construction:
T e of Use**: Occupancy Load: Oregon Specialty Code:
SPECIFICS
Number of Stories: Budding Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Foota e: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Side and Setback—Left Side and Setback—Front
Side and Setback—Right Side and 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: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor: ff
Total Project Valuation: $ 1 Ono FEES DUE
$ DC Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ 12%State Surcharge
Project Valuation Plan Review,Structural
Up to$4,999 $0.00 $ Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ '2—.ate 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:
Date/Time: $ TOTAL FEES DUE
*TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;AL'r=alteration;DEM=demo;NEW=new;
OTR=other use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC_BUP_070115.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
10998 SW 68TH PKWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2016-00039
Chip Barnett
Violation Summary:
Inspector Contractor