Permit (64) 111 CITY OF TIGARD BUILDING PERMIT
'! I COMMUNITY DEVELOPMENT Permit#: BUP2016-00208
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/22/2016
Parcel: 2S101AD03000
Jurisdiction: Tigard
Site address: 6969 SW HAMPTON ST
Project: Peterson Kolberg&Associates Subdivision: WEST PORTLAND HEIGHTS Lot: 19-26&
Project Description: TI for existing tenant.
Contractor: WILSHIRE CONSTRUCTION LLC Owner: KF LLC
14845 SW MURRAY SCHOLLS DR STE 110-324 7407 SW HUNT CLUB DR
BEAVERTON, OR 97007 PORTLAND, OR 97223
PHONE: 503-320-2100 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 06/22/2016 $351.00
Occupancy Grp: B Occupancy Load: 97 Permit Fee-Additions,Alterations, 06/22/2016 $2,132.75
Demolition
Dwelling Units: 0 12%State Surcharge-Building 06/22/2016 $255.93
Stories: 0 Height: 0 ft Plan Review 06/22/2016 $1,386.29
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/22/2016 $853.10
Value: $270,000 Info Process/Archiving-Lg$2.00(over 06/22/2016 $34.00
11x17)
Metro Const.Excise Tax 06/22/2016 $324.00
Floor Areas:
Total Area: 10340
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $5,337.07
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 r 1.800.33
Issued By: - / Permittee Signature:
3 -.- — G
-. 1503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial REGENED FOR OFFICE USE ONE)
Received A. /n I'
City of Tigard N 2 2016 DateB : CY ���`� Permit No.: `J _ A- _V J_
Ill . q 13125 SW Hall Blvd.,Tigard,OR 97i�$ Plan Review►4
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : _AM, `141 Other Permit:
1 iVi � Juris: ® See Page 2 for
Inspection Line: 503.639.4175 ����( �t 1 Date Ready/By:
T I G A R D n t� 01\11;711%)"` Notified Method: �Q 1 Supplemental Information
Internet: www.tigard-or.gov 3uILD1"3ii'
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Z Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:6969 SW Hampton St New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Tenant improvement of existing office space Valuation: $270,000.00
Existing building area: 10000 square feet
New building area: 10000 square feet
® PROPERTY OWNER 0 TENANT Number of stories: 2
Name:KF,LLC Type of construction: V-B
Address:6969 SW Hampton St Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing: X
Phone:(503)968-6800 Fax:(503)968-6860 New:
El APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:KF,LLC
Structural plan review fee(or deposit):
Contact name:Steve Kolberg
FLS plan review fee(if applicable):
Address:6969 SW Hampton St
Total fees due upon application:
City/State/ZIP:Tigard,OR 97223
Amount received:
Phone:(503)968-6800 Fax: :(503)968-6860
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:steve@pkaarchitects.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Wilshire Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 14845 SW Murray Scholls Dr#110-409 Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton,OR 97007 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)624-1600 Fax:(503)624-7119 State surcharge(12%of permit fee): $21.60
CCB lic.:193342 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.
c
Print name:Steve Kolberg Date: (.O
D— z Z 2£n * 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)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
I
a Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
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 percent(25%).
VALUATION: Total of all renovation,alteration or modification being done, Z.�� 000
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 6"71 5'0 O
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: $ $-01 ba O
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: R� � 'npN ��$ IC $ !1/ ST O
TOTAL(shall equal line [2] of Valuation Computation): $ ( 1 5 l7
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/02/2013
City of Tigard
III COMMUNITY DEVELOPMENT DEPARTMENT
S
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: ,11 o/(o--0[3,908'
Site Address: (9G( W rn& S f-. Suite/Bldg#:
Project Name: 4t9eM .IXS
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: tnt ' tole, yeryivcW of C,S`f1n (Aral i-i"CC4 a - t-p
Existing Business Activity: (p
Proposed Business Activity: ._
Verify site address/suite#exists and active in permit system.
0 River Terrace Neighborhood: ❑ Yes ,Z: No
Zoning: in u
/Permitted Use: Yes ❑ No ❑ Spec Space
Confirm no land use required.
XBusiness License:
Exists: 'Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: jJ V, "�' gui Date: J22 I k
yy l
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: �Q /
Site Plans: #
Building Plans: #
Building Permit#: mie building permit# above.
Workflow Routing: Manning ❑ Permit Coordinator wilding
Workflow Sign off:
g•-"S":„. ":.!.� -off for Planning(include notes from planning review)
Route Application Documents: d'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: �// Com- �►'
By Permit Technician: 3 � � Date: ‘.7Z,37/(o
1:\Building\Forms\BidgPermitRvw_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: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes E N/A
Parks SDC: E Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
C\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
Ilig . City of Tigard • BUILDING DIVISION
' Over-The-Counter (OTC) Building & Fire Protection System Permit
< w \K l) Appointment Checklist
Permit Record#: $'i/ ;? l r o
Contact Name: Phone #: 62 3- 96$-dof1D0
Business Name: q 6,9 ,,,v [�.6-,,v�ro,-..�. Appointment Date: 1,4,7 .�j0 cz lO:oo
Site Address: , � fly-A..o.,g v CL.a..r!-cc_. Bldg/Suite #:
Project Name: « �� Y
Project Description: �_-77 ,..a7k----- L.„- --71-
Existing Use: 6- New Use: .74—
MMD Required: ❑ Yes ❑ No Related Record#:
PIU: _ a r . i s)0 �
,�,�..�€ ' .mak ,x �� � � :A
GENERAL INFORMATION
Class of Work: Occupancy Group: Type of Construction: 60
Type of Use: rfOccupancy Load: Oregon Specialty Code: {tk
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 FOOTAGES
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 � q�
Fire Sprinklers: I�C.J 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:
Total Project Valuation: $ 70/ v. '
, 2 J, ;, ...7. �
$ ter) DC Prov Rvw,COM TI-Ping
$ ( J Permit Fee-Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ _r eet 12%State Surcharge
Project Valuation $ �A Plan Review,Structural
Up to$4,999 $0.00 $ cap , Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ % Q, 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 $ `J 2-4- Ietro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ 37 7TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_020916.docx