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Permit
CITY OF TIGARD BUILDING PERMIT 71COMMUNITY DEVELOPMENT Permit#: BUP2016 00189 T IGA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/19/2016 Parcel: 1 S135BC00700 Jurisdiction: Tigard Site address: 10831 SW CASCADE AVE Project: Rose City Futsal Subdivision: None Lot: None Project Description: Interior remodel. Contractor: JH KELLY LLC Owner: ICON IPC PROPERTY OWNER POOL 2 L 2311 E 1ST STREET BY INDCOR PROPERTIES VANCOUVER,WA 98661 2 NORTH RIVERSIDE PLAZA, STE 235 CHICAGO, IL 60606 PHONE: 360-423-5510 PHONE: FAX: 503-285-0812 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 07/19/2016 $3,219.95 Demolition Occupancy Grp: A-4 Occupancy Load: 445 12%State Surcharge-Building 07/19/2016 $386.39 Dwelling Units: 0 Plan Review 06/02/2016 $2,092.97 Stories: 1 Height: 0 ft DC Provision Review,COM TI-Ping 07/19/2016 $357.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 07/19/2016 $1,287.98 Value: $450,000 Info Process/Archiving-Lg$2.00(over 07/19/2016 $34.00 11x17) Info Process/Archiving-Sm$0.50(up to 07/19/2016 $15.00 Floor Areas: 11x17) Metro Const.Excise Tax 07/19/2016 $540.00 Total Area: 30250 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $7,933.29 Required: Required Items and Reports(Conditions) Fire Sprinkler: Yes Parapet: Fire Alarm: Yes 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 k is suspended for more the 180 day ENT• •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. .se - are -t forth i OAR • 2-001-0010 through OA" 952-001-00!S. You may obtain a copy of the rules or direct questions to OUNC by calling 50 1987 or :40.3 • / ued By: iii Permittee Signature: 'W� Iss illiAllik. ' Ai.— " Call 503.639.4175 by 7:00 a.m.for the next available inspection date. Py 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 IED Commercial H . Folz Ol i i(l. Lsl: oy11 City of Tigard JUN 2 2016 Received /�` Permit No Date/B : ,� / 1 � ece d/6—Oeyccp/ lig 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revr �'- s 1X Phone: 503-718-2439 Fax: 503-59� OF C IGARD Date/B : iiir" •=llFFRelated RelatedPennli ,' l 9//ci—CJa9/7 t-i t A},j) Inspection Line: 503-639-4175 BUILDINiG DIVISION late 'easy/: : ® See Page 2 for Internet: www.tigard-or.gov �J V Notified/Method:7 6, f�„, 171. Supplemental Information ,t vl 1-4.( 1-0-41--4.TYPE OF WORK i.-404.4 r)ve,REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction "'— .• Permit 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: / r equipment,materials,labor,overhead,and the profit for the N CATEGORY OF CONSTRUCTION work indicated on this application. 0 1-and 2-family dwelling -Commercial/industrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder El Other: Number of bathrooms: \./"/) JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /O&5/ ‘5C.4..) eascoris:7 e AVC, New dwelling area: square feet City/State/ZIP: Ti94 r0 02 972, Z y Garage/carport area: square feet Suite/bldg./apt.#: ,/ 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: I Lot#: 74,C> Permit fees*are based on the value of the work performed. Tax map/parcel#: (.-r-frf ./.5.2,5S--,gC - Indicate the value(rounded to the nearest dollar)of all l' equipment,materials,labor,overhead,and the profit for the DESCRRIPTION OF WORK work indicated on this application. V i 7'L"-ic, " i8G�.,tod/-C/ 0/4 �,-717'1/LOf1� Valuation: $ 9'S � C7© 0Al 4//s I'a' ' ®i• TD,:T 74 fT,7X'7u�"'IC$, Existing building area: „3y s quare feet New building area: •.------"" square feet 0,4 PROPERTY' OWNER ❑ TENANT Number of stories:.,..de--'Name: Type of construction: ,13 i Address: Occupancy groups: A-y 1. , City/State/ZIP: Existing: $i/ 'S Z Phone:( ) Fax:( ) 4( � New: A- -OAP'APPLICANT CONTACT PERSON BUILDING PERMIT FEES* Business name: L Are.' j (Please refer to fee sclsedul� / Structural plan review fee(or deposit): 1I Contact name: . 14' /,4 lc 44C`--t! ,( FLS plan review fee(if applicable): Address:3Z00 5 e //yA t" -vc 5-7-e 3 OZ — . 4786 83 Total fees due upon application: City/State/ZIP:> VQK � � 'V c r/ ` Amount received: Phone:(7O8) Z$0-22540 Fax::( ) 4461.i 0;bit'"�-Ce.e iA oe Q.CQIy PHOTIIVC)LTAIC SOLAR PANEL SYSTEM FEES* E-mail: Commercial and residential prescriptive installation of CONTRACTOR /h .'4��y✓ t mounted PhotoVoltaic Solar Panel System. Business name:Q'�k e4, L ltkfritiC�R i. Susi t 4vo(2)sets of roof plan with connection details 1 and fire department access,along with the 2010 Oregon Address: 23// c_ /Si' °7,tsnee Solar Installation Specialty Code checklist. City/State/ZIP:'a n,C p(.�/C' , (4,4 tair`C( Permit fee(includes plan review $180.00 and administrative fees): Phone:(*gyp) y,Z j " 5�r/O Fax:( ) y State surcharge(12%of permit fee): $21.60 CCB Lie.: //75' J 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: 4 $ j .i c Lc t/t Date: ,(s/2//` * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP_COM_PennitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT a Accessibility: Barrier Removal Improvement Plan Commercial & Multi-Family - Additions or Alterations TIGARD 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, excluding painting and wallpapering: [1] $ 3cc),000 MULTIPLIER(25%barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 175;000 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: $ Vis Aate 000 (c) An accessible route to the altered area: $ /V/A" (d) At least one accessible restroom for each sex or a single unisex restroom: $ Yes 34 00a (e) Accessible telephones: $ /V/A (f) Accessible drinking fountains:and, $ yes .21s-Do (g) When possible,additional accessible elements such as storage and jr oefpa - 5; alarms: $ /r 1 • yoi ocro TOTAL(shall equal line [2] of Valuation Computation): $ 9?/510 0 I:\Building\Pen is\BUP_COM_Per tApp.doc Rev.12/18/2014 -ti, it I ngineering Review Slope at building pad: PFI Permit#: Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP) Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date Notes: Approved by Engineering: L. D Date: b-Z—/Z Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 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: ��DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ?2 /A Tigard Trans SDC: ❑ Yes G N/A Parks SDC: ❑ Yes 'N/A 1K to Issue Permit Approved by Permit Coordinator: Date:4'_"1,, / I:\Building\Forms\B1dgPermitRvw_COM_WithLandUse_070915.docx a l , 4 City of Tigard lig ■ a COMMUNITY DEVELOPMENT DEPARTMENT r 1 c A R D Building Permit Review — Commercial - With Land Use Building Permit #: 06 V.,o267/67 AQ(2/f Site Address: 0a-S1 ,g11 ) (944Zzsoch Suite/Bldg#: Project Name: a a )7 (Name of commercial mess occupying the space. If vacant,enter Spec Space.) Planning Review J� �,1 Proposal: Ie (EJ <:7it l '7`t;.-- (Lai° -24 (Verify site address/suite# exists and active in permit s . pp ver Terrace Neighborhood: CI Yes syste No "Pand Use Case#: Jj/f jy�,6�(�1 j, --0[;�)j lan Match Approved Land Use: 14 Site Plan in° andscape Plan they: - - Jrban Forestry Plan .klevation Plan Tr Building Height: Maximum Height Actual Height 0'), onditions Met: yBusiness Lice e: ❑ Prior to Submittal ❑ Prior to Permit Issuanc ��IJJJ Exists: Yes ❑ No,applicant notified to obtain business license 1` ublic Facilities Improvement(PFI) Permit: 0 Required: ❑ Yes,applicant was notified VNNo Applied For: ❑ Yes ❑ No,stop intake Notes: Approved by Planning: L____ Date: _&___//t.Z//_et 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: ;/.2./7C..1 Site Plans: # 3 Building Plans: # .3 Building Permit#: Enter building permit#above. Workflow Routing: ,E1-Planning [)Engineering11ermit Coordinator 1-Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: t uilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: 6/�/, I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 070915.docx CITY OF TIGARD FEE AND PAYMENT HISTORY IN"'it . 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 T[G.ARD BUP2016-00189 - 10831 SW CASCADE AVE, TIGARD, OR 97223 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due Permit Fee-Additions,Alterations, 230-0000-43104 $3,219.95 $3,219.95 $3,219.95 Demolition 12%State Surcharge-Building 100-0000-24001 $386.39 $386.39 $386.39 Plan Review 230-0000-43106 $2,092.97 $2,092.97 $2,092.97 6/2/16 Credit Card 404246 $0.00 DC Provision Review, COM TI-Ping 100-0000-43112 $357.00 $357.00 $357.00 Plan Review-Fire Life Safety 230-0000-43108 $1,287.98 $1,287.98 $1,287.98 Info Process/Archiving-Lg$2.00(over 230-0000-43135 $34.00 $34.00 $34.00 11x17) Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $15.00 $15.00 $15.00 11x17) Metro Const. Excise Tax 230-0000-24010 $540.00 $540.00 $540.00 Totals for Fees $7,933.29 $7,933.29 $2,092.97 $5,840.32 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount 404246 Credit Card Antionette Lettiere, EL 06/02/2016 $2,092.97 Architects Total Payments: $2,092.97 Balance Due: $5,840.32 FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 111 r, Transmittal Letter , 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov c---7 TO: _ DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED - JUL 62016 FROM: �wo e`,etr=tr/ COMPANY: 6Zc/, tcCITY OF ill" . A✓ is BUILDING DIVISION 080 -ZS�O C PHONE: �D�- RE: k)-A /O 63/ Cw Cas«Aa4 11.,/c. -_ 1ep- 401gf (Site Address) ermtt �umber) CGsca10(•C i to( c (JJ x-1-3 A. i (Project name or subdivision name anot number) • ATTACHED ARE THE FOLLOWING ITEMS: Additional set(s) of plans. Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. c Lou t)Gb ( ./ Other(explain): (3 ruL.t_ se-rS- Any 5. ALi. C 1-t1c&C-,ES HAVE R-CEA.) REMARKS: Routed to Permit Technician: - WATAM Fees Due: ■ Yes fro Fee Descri.tion: Amounts e: $ $ $ $ Special Instructions: Re•rint Permit .er PE : ❑ Yes ❑No ❑ Done A. •licantNotified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 10831 SW CASCADE AVE, TIGARD, OR, 97223 Record Type: Commercial - Building Inspection Type: 299 Final inspection Result: PASS -CofO Comments: Previous corrections completed Violation Summary: Tel: 503.718.2439 Inspection Date: February 14, 2017 at 10:47:05 AM Record ID: BUP2016-00189 Inspector: Chip Barnett Inspector Contractor