Permit (169) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT
71
Permit#: BUP2016-00322
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/15/2016
T WARD Parcel: 2S112DA01300
Jurisdiction: Tigard
Site address: 6640 SW REDWOOD LN 300
Project: Portland Clinic Subdivision: 1996-048 PARTITION PLAT Lot: 1
Project Description: TI for existing tenant:Clinic,conference room,and breakroom improvements.
Contractor: REIMERS&JOLIVETTE INC Owner: PACIFIC REALTY ASSOCIATES
2344 NW 24TH AVE ATTN: N PIVEN
PORTLAND, OR 97210 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-228-7691 PHONE: 503-624-6300
FAX: 503-228-2721
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIA Permit Fee-Additions,Alterations, 11/15/2016 $2,887.75
Demolition
Occupancy Grp: B Occupancy Load: 60 12%State Surcharge-Building 11/15/2016 $346.53
Dwelling Units: Plan Review 11/15/2016 $1,877.04
Stories: Height: ft Plan Review-Fire Life Safety 11/15/2016 $1,155.10
Bedrooms: Bathrooms: Info Process/Archiving-Lg$2.00(over 11/15/2016 $16.00
Value: $394,588 11x17)
Metro Const.Excise Tax 11/15/2016 $473.51
DC Provision Review,COM TI-Ping 11/15/2016 $357.00
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $7,112.93
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 Cent- 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 503.232.19:7 or 1.800.332
Issued By: / mittee Signature: �4 A 4 A i A J
.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 Se
Commercial rOk (/I I I( I l Si. 0\l.\
City of Tigard �O Received — PemtitNo.:
a .N DateB : �'1�� 4
" 13125 SW Hall Blvd.,Tigard,OR 97223,,` 0 Plan Review „
I Phone: 503.718.2439 Fax: 503.598.196 ^x/ `', Date/B : y,1) s� , Other Permit: '"" ` ,
I i G;\-k D Inspection Line: 503.639.4175tt# yy ] , Date Ready/By: A� '� See Page 2 for
Internet: www.tigard-or.gov ¢ �` .Tt Notified/Method: SupplementalTnformation
TIME III 9 ' , „' , IIIVII6MIIIIATAtI.414024,0111X1PNIZIING
❑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:TI remodel equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CON9 "
work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
Bin owcaeviAnoN';ANti LOCATIONTotal number of floors:
Job site address:6640 SW Redwood Lane,suite 300 New dwelling area: square feet
City/State/ZIP:Portland,Oregon 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:300 Project name:The Portland Clinic Covered porch area: square feet
Cross street/directions to job site:South Bound on 5,Carmen Exit,Right Deck area: square feet
First Stop Light,Destination on Right Other structure area: square feet
RE! JA'I'A:c'om I,t ,,OHECIMIST..
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
0 o`rt o work indicated on this application.
Tenant Improvement of 3'a floor,scope of work is installation of systems office Valuation: $394,588
office furniture,conference room and staff break room. Existing building area: 9,842 square feet
New building area: 0 square feet
CI PRO ARTY QW$I R �< ANT Number of stories: 3
Name:The Portland Clinic Type of construction: IIA
Address:800 SW 13th Avenue Occupancy groups:
City/State/ZIP:Portland,Oregon 97205 Existing: B med office
Phone:(503)221-0161 Fax:( )
New: 0
.t AnytICANT 114.>CONTACT PI ON, :i3InotNo`'ERMIT 1$E
(saw
atrkad+de)
Business name:Grayscale*works Structural plan reviewe
Contact name:Mathieu Jacobs
FLS plan review fee(if applicable):
Address:3045 NE 34th Avenue p application: j a
Total fees due upon t G
City/State/ZIP:Portland,Oregon 97212
Phone:(503)575-5141 Fax::( ) Amount received:
E-mail:mjacobs@grayscaleworks.com
PHOTOYOI:.TAIC SOLAR PA L.$VS't M S'
Commercial and residential prescriptive installation of
(/N' RACtOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Reimers and Jolivette - Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:2344 NW 24th Avenue Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,Oregon 97210 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)228-7619 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 1/4C/t../ Total fee due upon application: $201.60
Authorized signature: /,y This permit application expires if a permit is not obtained
I(}'" within 180 days after it has been accepted as complete.
litl
Print name:Mathieu J Date:11!14/16 * Fee methodology set by Tri-County Building Industry
Service Bard.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC) Building & Fire Protection System Permit
Appointment Checklist
Permit Record#: It?P &O1(p-W 3.201
Contact Name: :t ) n,,,,,,, Phone #: 3-' 75- 5-lit 1
Business Name: Appointment Date: 11//5 /0:00
Site Address: 66 4 o �� i..�o-e.10 Lx. BldgSuite #: ZoD
Project Name: i'6..4-1-\--8-.A.,..1 Q- -
Project Description: T - am,. ,16,:t.,_, c;,,,,..,--416_,,,-„:, N ,, i4,ra1-# di IU.c.
Existing Use: J New Use:
MMD Required: 0 Yes o Related Record#:
GENERAL INFORMATION
Class of Work: AiLr Occupancy Group: Type of Construction: 21/9
Type of Use: CuA Occupancy Load: 6 Oregon Specialty Code: AQ O 4
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
Fire Sprinklers: f 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: $
$ 3 .0D DC Prov Rvw,COM TI—Ping
$ X Permit Fee Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ K 12%State Surcharge
Project Valuation $ K. Plan Review,Structural
Up to$4,999 $0.00 $ 2S Plan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ $<,00 Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $224.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $357.00 $ . ,x Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: Other:
Date/Time: $ .7 I A.q TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070116.docx
City of Tigard
IIIII " COMMUNITY DEVELOPMENT DEPARTMENT
rlcaRo Building Permit Review — Commercial - No Land Use
Building Permit #: Q/. /6;,--`t j0 34_,
Site Address: (p 640 W Re ccwooc LarLe- Suite/Bldg#: 300
Project Name: lhe_ (tort ici n d G (;rl i c
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: I Y){ i o i Ts
Existing Business Activity: CIO IN)AUX-&t uA.. i MAL.C cv(
Proposed Business Activity: citi vytrYte,reretk, / ()At GU Cup(.
rQ Verify site address/suite# exists and active in permit system.
71 River Terrace Neighborhood: ❑ Yes ❑ No
,Zoning: '-t
Permitted Use: El Yes ID No ❑ Spec Space
.Confirm no land use required.
46 Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: M 6"-A--.1. 6 ,-e^^ Date: ( i f t S 1 I Co
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: ///61/6
Site Plans: # /I,/
Building Plans: # 73
Building Permit#: �er building permit#above.
Workflow Routing: 13-151nning ❑ Permit Coordinator 8-finning
Workflow Sign off: C�r .S—i-off for Planning(include notes from planning review)
Route Application Documents: C7 Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: Oa
By Permit Technician: r/` _
_
Date: ///15 r2la
I:\Building\Forms\B1dgPermitRvw_COM_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
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6640 SW REDWOOD LN 300, TIGARD, OR,
97224
Record Type: Record ID:
Commercial - Building BUP2016-00322
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor