Permit CITY OF TIGARD BUILDING PERMIT
f
COMMUNITY DEVELOPMENT Permit#: BUP2016 00222
T R A.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/12/2016
Parcel: 2S 101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 440
Project: Discovery Practice Management Subdivision: None Lot: None
Project Description: TI for new tenant:New walls and doors.
Contractor: PACIFIC CREST STRUCTURES INC Owner: GK TRIANGLE CORPORATE PARK III L
17750 SW UPPER BOONES FERRY RD SUITE ATTN KBS REALTY ADVISORS
190 P O BOX 28270
DURHAM, OR 97224 SANTA ANA, CA 92709
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: IIB DC Provision Review,COM TI-Ping 07/12/2016 $90.00
Occupancy Grp: B Occupancy Load: 43 Permit Fee-Additions,Alterations, 07/12/2016 $377.90
Demolition
Dwelling Units: 0 12%State Surcharge-Building 07/12/2016 $45.35
Stories: 5 Height: 0 ft Plan Review 07/12/2016 $245.64
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 07/12/2016 $151.16
Value: $20,000 Info Process/Archiving-Lg$2.00(over 07/12/2016 $6.00
11x17)
Floor Areas:
Total Area: 4202
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $916.05
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
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232'987 or 1.800.332.2344.
Issued By: Ar. / _ .- mittee Signature:
—..�4710—
03.639.4175 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 irt_
Commercial t FOR OFFICE USE ONLY
City of Tigard Received Permit No.: L
Date/Bec �" �_ �___
III13125 SW Hall Blvd.,Tigard,OR . 2 23 `r .?1,111=
Plan Review ti� �T / r_ / f
Phone: 503.718.2439 Fax: 503.598.1960 Date/B :
0/4111411111191E, Other Permit:
T I GA RD Inspection Line: 503.639.4175 Date Ready' IMI
11■ ® See Page 2 for
Internet: www.tigard-or.goy y : Notified/Method: // �; ° Supplemental Information
:..
TYPE OF WORT REQUIRED DATA AND2:-FA ILY DWELLING--,--
El 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
C `TEGORY OF CONSTRUEIION
workindicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
CIAccessory building 111Multi-familyNumber of bedrooms:
❑Master builder El Other:
Number of bathrooms:
.. . number
JOB SITE INFORMATION AND LOCAATION ' Total offloors:
Job site address:13221 SE 68TH Parkway New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:440 Project name:Discovery Practice Management Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA',P.9 MERCIAL 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 dI+' WORD work indicated on this application.
Interior tenant improvements to include new walls,doors and relites. Valuation: $20,000.00
Existing building area: 4202 square feet
New building area: 4202 square feet
►® PROPERTY:OWNER ❑ TENA1-, Number of stories: 5
Name:CBRE(Mary Dillon) Type of construction: I-B
Address:1300 SW 5th Avenue,Suite 3000 Occupancy groups:
City/State/ZIP:Portland,OR 97201 Existing: B
Phone:(503)221-4836 Fax:(503)221-4873 New: B
r®e !APPLICANT:` `. ❑:CONTACT I'ERSOI+1 BUILDING PER IT"FEES*
Business name:Mackenzie fI'Jr f4)efertofeeschedule)i
Structural plan review fee(or deposit):
Contact name:Dina Radzwillowicz
FLS plan review fee(if applicable):
Address:1515 SE Water Ave Suite 100 Total fees due upon application: .7/6- ,c-
City/State/ZIP:Portland,OR 97214
Phone:(503)224-9560 Fax::(503)228-1285 Amount received:
E-mail:dmr@mcknze.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*.. .
. -. of
Commercial and residential prescriptive installation
CONTRACTOR .: .
roof top mounted Photovoltaic Solar Panel System.
Business name:Pacific Crest Structure,INC. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:17750 SW Upper Boones Solar Installation Specialty Code checklist.
City/State/ZIP:Durham/OR/97224 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)968-8949 Fax:(503)598-6658
State surcharge(12%of permit fee): $21.60
CCB lic.:66915
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
���j within 180 days after it has been accepted as complete.
Print name:Sang-yoon Byun Date:07/12/16 * Fee methodology set by Tri-County Building Industry
_ Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
UPI
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: �P, C)tt4,--00 a
Site Address: 13 2.21 5-t1/ ft i Suite/Bldg#: 44 0
Project Name: ('I SGoV PoCd7`Z11._. MAn a rr Q cit
(Name of commer ial business occupying the space. If vacant,enter Spec Space.)
Planning Review _
Proposal: Tr)-1-e-‘,-19 f -T L
Existing Business Activity: 00 i✓Y7r1.12rc(6-1,.,
Proposed Business Activity: (x)enrrt prc 1'c✓L-
XVerify site address/suite#exists and active in permit system.
)2' River Terrace Neighborhood: ❑ Yes ,2"-No
Zoning: INA U E
Permitted Use: /Er Yes ❑ No ❑ Spec Space
Confirm no land use required.
-u—Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: ,M 01/0G1 /i 1 od4... - Date: 7J 1211 !o
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: ), I4
Site Plans: #� /'�
Building Plans: ##
Building Permit#: Linter building permit#above.
Workflow Routing: ming ❑ Permit Coordinator
Workflow Sign-off: El--3li-off for Planning(include notes from planning review)
Route Application Documents: wilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: - t.----
_ ' Date: 7 L
•
I:\Building\Forms\B1dgPermitRvwCOM NoLandUse 060116.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 ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC) Building & Fire Protection System Permit
Appointment Checklist
Permit Record#: f31iP'd J(,-UO
Contact Name: - p _O� U.y‘_ Phone #: `. 03-r�a4-cgs-(Q O
Business Name: 1�1cL� w Appointment Date: 7//A/i& & 7o:e0 9>'-j
Site Address: I z�;1al�� j 1 P t. Bldg/Suite #: i/q
Project Name: .R e._ .p.,-0_...L.--
Project
pa-0_.Project Description: "✓\ €496-1 -4, c9 a -2e/clizo
Existing Use: --i2a,-- New Use: Pa-.
MMD Required: 0 Yes L No Related Record#:
GENERAL INFORMATION
Class of Work: Occupancy Group: Type of Construction:
Type of Use: Occupancy Load: Oregon Specialty Code: `C
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: 420 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: 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: $ e:96/ DDb
$ " 6 0 r DC Prov Rvw,COM TI—Ping
$ ra,,,Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ r in, 12%State Surcharge
Project Valuation $ I'ig: Plan Review,Structural
Up to$4,999 $0.00 00 $ mat_ Plan Review,Fire Life Safety
$5,000-$74,999 $8 :96- 9.0 - $ ) Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $226:60 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $35tt7t1 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ , i COTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_020916.docx