Permit (100) CITY OF TIGARD BUILDING PERMIT
114
" Permit#: BUP2017-00010
2, COMMUNITY DEVELOPMENT
TI C BARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/30/2017
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD
Project: Currency Exchange Kiosk Subdivision: None Lot: None
Project Description: Installation of kiosk for currency exchange. Kiosk located under escalators to food court.
Contractor: ARCHITECT Owner: PPR WASHINGTON SQUARE LLC
NOVAK ARCHITECTURE INC PO BOX 847
17020 SW UPPER BOONES FERRY RD#200 CARLSBAD, CA 92018
PORTLAND, OR 97224
PHONE: 503-352-4687 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 01/30/2017 $377.90
Demolition
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Building 01/30/2017 $45.35
Dwelling Units: 0 Plan Review 01/19/2017 $245.64
Stories: 1 Height: 0 ft Plan Review-Fire Life Safety 01/19/2017 $151.16
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 01/30/2017 $5.00
Value: $20,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $825.05
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: 4-e�Ir� Permittee Signature:
., ?9a47.-e. 41—, ) -----.1-
dilw
503.639.4175 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 FOR OFFICE I.SE O\LV"
City of Tigard Received 1. Iq 1I 11" P 7—GYb/<J
DatuB Permit No.:
11
13125 SW Hall Blvd.,Tigard,OR 9 223 7 Plan Review j
!t . 9 2.01 i DateB �. �- ether Permit:
Phone: 503.718.2439 Fax: 503.S98.I96 h1 7•: e
T I G A R D Inspection Line: 503.639.4175 Date Read Juris. 0 See Page 2 for
Internet: tti�vw.tigard-or.gov �� 1t i rlAB j Notified hod: i f l //7 - / , Supp1ementa1 Information
l� ('�TY INO 61-+9to\ SI.0N ` �G , k". `�` /�-j�f
TYPE O MtI REQUI: D TA:1-AND 2-FAMILY DWELLING
CI New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
$1 Additionralteration/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 0 Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9585 SW Washington Square New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:/✓/)34 Project name:Currency Exchange Kiosk Covered porch area: square feet
Cross street/directions to job site:Washington Square Mall 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.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Installation of new kiosk near east mall entry/ 1A � — `Valuation: S$20,000.00
6-{��5 Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:Currency Exchange Type of construction:
Address:6675 Westwood Boulevard,Suite 300 Occupancy groups:
City/State/ZIP:Orlando,FL 32821
Existing: M
Phone:( ) Fax:( ) New: M
}g APPLICANT ►.t CONTACT PERSON BUILDING PERMIT FEES*
Business name:Novak Architecture,Inc (Please refer rn fee schedule)
Structural plan review fee(or deposit):
Contact name:Terry Novak
Address: 17020 SW Upper Boos Ferry Road,Suite 200 FLS plan review fee(if applicable):
Booms
Total fees due upon application:
City/State/ZIP:Portland,OR 97224 f
Phone:(503)352-4687 I Fax::( ) Amount received: , �M,A"
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:tnovak*novakarchitecture.com
Commercial:
Debbie Adamski
From: Terry J Novak<tnovak@novakarchitecture.com>
Sent: Friday, January 20, 2017 10:04 AM
To: #Building Permit Technicians
Subject: WA Square kiosk BUP2017-00010
The kiosk installers do not use a GC for their work.They will only have an electrical sub-contractor,who will pick up their
electrical permit. It has been my experience that only a licensed GC(or homeowner) can pick up a building permit.What
are the options for picking up this permit?
TERRY J NOVAK
NOVAK ARCHITECTURE INC
17020 SW Upper Booties Ferry Road I Suite 200
Portland,Oregon 97224
P:503.352.4987
C:503.413.0933
www.novakarchitecture.corn
...always stay humble and kind
1
11111 City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC) Building & Fire Protection System Permit
1, n Appointment Checklist
Permit Record#: t-P1 7 -000`D
Contact Name: Terra" /o d4 k Phone #: C • S- ,-iii 77
Business Name: No jj(,( Gc -' ; p,P L Appt. Date/Time: 11-7 4, ak.lo
Site Address: e4 5$S-S ) 4/ A,kr j ST. Ai. Bldg ulte#:
Project Name: g-ask fr 4 1'
Project Description: („6„0," ,j3-f ( e f A it-,„,s k
Existing Use: New Use: (V1
MMD Required: ❑ Yes Et--iQo Related Record#:
GENERAL INFORMATION
Class of Work: At-r- Occupancy Group: IA Type of Construction:
Type of Use: Occupancy Load: 1 Oregon Specialty Code: !2
SPECIFICS ``
Number of Stories: l 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: l C 7 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:
4-
Total Project Valuation: $ .29 eriD
$ rte. =� ! - i . . Yo r.
$ 77,? Permit Fee-Add,Alt,Demo ft
DC Provision Review Fee for COM TI(effective 7/1/2016) $ A 12%State Surcharge �"
Project Valuation $ f-e---, Plan Review,Structural
Up to$4,999 $0.00 $ — , ( - Plan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ 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 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ ��,/Other:
Date/Time: $ OTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070116.docx