Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00004
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/08/2016
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD
Project: Talk N Fix Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Installation of pre-wired kiosk(designated location as KK21)adjacent to space H07.
Contractor: OWNER Owner: PPR WASHINGTON SQUARE LLC
PPR WASHINGTON SQUARE LLC PO BOX 847
PO BOX 847 CARLSBAD, CA 92018
CARLSBAD, CA 92018
PHONE: PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 02/08/2016 $464.97
Demolition
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Building 02/08/2016 $55.80
Dwelling Units: 0 Plan Review 01/06/2016 $302.23
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 02/08/2016 $185.99
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 02/08/2016 $88.00
Value: $26,000 Info Process/Archiving-Sm$0.50(up to 02/08/2016 $5.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,101.99
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: p r
Call 603.639.4176 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
IIuildlh2 Permit Application
Commercial `\ISO 1 oR 01l l( I. ( ,,I Oyi ,
Ci of Tigard l .0 Received permit No.: p^�
13125 SW Ball Blvd.,Tigard,OR 972 Date/By: I 51/6 41/"/GU� -T Z-1/./
Phone: 503.718.2439 Fax: 503.598.1960 N 5 016 Pan Rev
. 1."'1\'
� Date/By: 4 -� / 1 2- �' — Other Permit:
i i `iii Inspection Line: 503.639.4175 P i9) Date Ready : , ..(I Juris: ® See Page 2 for
Internet: www.tigdnl or.gov o \�+\c`a lotificd/Method: j� i -r --e. Supplemental Information
`_?�`' '$�"'`J"I e ;� r n F,t,r4i: . ,.� I 7 .y. Alt • � " (,` r' # a y y k`
'� '' i t s r�[t 1 .�` ' � t} i` 0 '�• I,'1,o >a r e ,� k
" rsIF:R+' .4�iz9�3\T`"'
❑New construction 0 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:Retail Kiosk equipment,materials,labor,overhead,and the profit for the
;rn' "+,1,,t$1 '.'",„t'-'171 „'.,,Y` �t ,'='' ., V%4.,‘4.
x ' `z v work indicated on this application.
1211-and 2-family dwelling ❑Commercial/industrial Valuation: S
Number of bedrooms:
ElAccessory building ❑Multi-family
❑Master builder ®Other:Wired Cab. Number of bathrooms:
/., 4,110R14� r* _.._ ,.°l/�• t ,..,,. ° Total number of floors:
Job site address:9585 SW Washington Sq.Road New dwelling area: square feet
City/State/ZIP:Portland,OR Garage/carport area: square feet
Suite/bldg./apt.no.:J \2( Project name:Talk N'Fix Kiosk Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
� ) 4 tgg+;ww s'hA;G lel t y'1,,,A`,4 l 1, 1 ,. .,ra
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
DESCRIPTEON1O ' ` ►ol r "}kf- ey ext`r ' ' �"'t.,` '"4. work indicated on this application.
Y ,
Installation of pre-wired retail kiosk Valuation: $26,000.00
Existing building area: square feet
New building area: 81 square feet
I?RDPER Y OWN R ' '` »' -1140y#01
A�-T,a £� Number of stories: I
:.+wx,,�...,,:e.,:�r z.,.cta4 .was.
Name:Mike Arfi Type of construction: Wired Cabinet
Address:16001 Collins Ave Occupancy groups:
City/State/ZIP:Sunny Isle Beach,FL 33160 Existing:
Phone:(305)842-9770 Fax:( ) New:
`i. =Ld-.,r ta.lr_�SY.a 4• ;i;..i k�Qi9 , x F ; Y j XNai' jg i•
Business name:Icon Mfg,LLC
.7,,w 3 2 .w, 0M r0'ea tr .t. „r, i 3 i
Structural plan review fee(or deposit): $346.98
Contact name:Joe DeWtt Or McT1 J Er-Gael L-t)
FLS plan review fee(if applicable): 0
Address:5560 Harlan St.
Total fees due upon application: $346.98
City/State/ZIP:Arvada,CO 80002
Phone:(303)593-0529 Fax::( ) Amount received: { 4F6 IV
2'q
E-mail:nandrent@yahoo.com ` `. �Fi� u .� gi d;�M r3. • x
k aeti •,i yy qr ��, ^r ‘, i; . A r t,40) 4,14.;t¢t tr yyv 0 Commercial and residential prescriptive installation of
.^ ,. kr .. , _ . . roof-top mounted Photo Voltaic Solar Panel System.
Business name: on Mfg,LL D O 13 E— Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:5560 Har n S Solar Installation Specialty Code checklist.
City/State/ZIP:A ,CO 80002 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(303) 93-0529 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: Total fee due upon application: $201.60
Authorized signature: / - t T
Lp This permit application expires if a permit is not obtained
1 within 180 days after it has been accepted as complete.
Print name: 4/f t .../..„e„.77,.,-- Date:
/� ,��-6 * Fee methodology set by Tri-County Building Industry
CiService Board.
I:\Building\Pennits\Bt1P-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
j' a
City of Tigard
114 U
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: 15(,,20140_, ,
Site Address: q535 SJ Wasir,,v-- (.3 _ Rd Suite/Bldg#:
Project Name: T/ff ili Fi X
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: lii- 2J/ 7T-o-IUi/.2r: ' , 'os,L
Existing Business Activity: �i�4S— ,,,: ce i i/
Proposed Business Activity: 4 4' //
Verify site address/suite# exists and active in permit syst .
rd ','.ver Terrace Neighborhood: ❑ Yes Id No
L .oning:
Vi ermitted Use: fie
es ❑ No ❑ Spec Space
IG Confirm no land use required.
Business License:/
Exists: Lld" Yes ❑ No, applicant notified to obtain business license
Notes:
Approved by Planning: c:::::::, ---..="'" //e2ke
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: 3
Site Plans: # N/-
Building Plans: 4�
Building Permit#: n_____Uter utlding permit above.
Workflow Routing: [�Y1hia�nning B'�'ermit Coordinator '"Building
Workflow Sign-off: E'Sign off for Planning(include notes from planning review)
Route Application Documents: tiding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: /`6/!(p
I:\Building\Fonns\BldgPennit Rvw_COM_NoLand Use_0709I 5.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: ❑ Y,esN/A
Tigard Trans SDC:
❑ Yes
Parks SDC: ❑ YesN/A
( to Issue Permit
Approved by Permit Coordinator: Date: /1/4'/I4
I:\Building\Forms\B IdgPennitRvw_COM_N o Land U se_0709I 5.docx