Permit CITY OF TIGARD BUILDING PERMIT
` 2. . COMMUNITY DEVELOPMENT ,.- 4 Permit#: BUP2017-00208
Tf[GA13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2017
r, , C4 67; Parcel: 2S101DA01500
Jurisdiction: Tigard
Site address: 7150 SW FIR LOOP 110
Project: NW Group Subdivision: 72ND BUSINESS CENTER Lot: 5
Project Description: New ADA building entry,new interior wall partitions and break room casework for suite 110 and entire 2nd floor for
the same tenant.
Contractor: PARAMOUNT ELECTRIC CO Owner: FIR LOOP LLC
39085 PIONEER BLVD STE#203 15000 BLUE GUM CT
SANDY, OR 97055 SARATOGA, CA 95070
PHONE: 503-703-2571 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 07/25/2017 $91.00
Occupancy Grp: B Occupancy Load: 68 Permit Fee-Additions,Alterations, 07/25/2017 $827.34
Demolition
Dwelling Units: 0 12%State Surcharge-Building 07/25/2017 $99.28
Stories: 2 Height: 0 ft Plan Review 07/25/2017 $537.77
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 07/25/2017 $330.94
Value: $62,600 Info Process/Archiving-Lg$2.00(over 07/25/2017 $10.00
11x17)
Misc Administration Fee 06/26/2019 $45.00
Floor Areas:
Total Area: 9225
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,941.33
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: No Protected Corridors:
Smoke Detectors: No Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Cod=" and - 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 issua ce, 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 ent-r. Those rules__arer 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 503.23•.19: 0 1.800.33 44.
E
Issued By: QCs✓/`^ ' •• 1 ittee Signature: '_'tA
C.'" i .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 o .
Approved plans are required on the job site at the time of each inspection. i
Building Permit Application
Residential : i_,` I OR 01 1 1( ►: I S►:Oy► 1
NitCity of Tigard h
ggr,a
, ;,, .
R. ° Received
" ' Permit No.:
r Date/B i _L- ii) i% 7... �ILr
13125 SW Hall Blvd.,Tigard,OR 97223 9 y Plan Review
s Phone: 503.718.2439 Fax: 503.598.1960 fitcg Date/B : Other Permit:
t I(,ARD Inspection Line: 503.639.4175 ,,t,„;. Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov camof otified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
V ... ± Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: j 1 equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTIONt 1 work indicated on this application.
❑ 1-and 2-family dwelling 0 Commercial/indus al Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: —2G 52) 5t....j, rf--/1/ /�`, New dwelling area: square feet
City/State/ZIP: 7� ✓p (J�� U� Garage/carport area: square feet
t
Suite/bldg./apt.no.: name: Coveredporch area: square feet
Project �/(� �� q
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.
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.
'-1 _ ,L _ Valuation: $
�[��✓`1� /�/ Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: ,/04-ZI -9[ "' �,�L
/ Structural plan review fee(or deposit):
Contact name: t e E v '�i/
Address: (�6 s w T t c %o� FLS plan review fee(if applicable):
2
City/State/ZIP: '77644.0 (72 Gl -Z—? Total fees due upon application:
Phone:( 10.5) 9
) 91 - 10/0 Fax::( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
��U O�'1' q. �` /- �' C and fire department access,along with the 2010 Oregon
Address: l Ur -''� 5,E- a 1.4 vim,,,,., ( Solar Installation Specialty Code checklist.
City/State/ZIP: l r(0.0 C,,,,,u 97c2t,'"-- Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 6, ) 70'1, _-Z y 7/ Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: ( C(5 7 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: `/'�• 15 6 Date: -- Z *Fee methodology set by Tri-County Building Industry
i! ..e�j �.� /9 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling 101Z iz 0111( 1: 1 51: oil l
City of Tigard ReceivedIP/ Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Associ
I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
TIGARD
Internet: www.tigard-or.gov 0 Other:
THE FOLLOW 1\G lTENIS .%RE REQUIRED FOR PL 1N la:Alt:AV )cs No kik
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ■ ■ ■
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ■ 0 0
3 Verification of approved plat/lot. ■ 0 0
4 Fire district approval required. Name of district: . ■ 0 0
5 Septic system permit or authorization for remodel. Existing system.capacity ❑ , 0 0
6 Sewer permit. ❑ 0
7 Water district approval. ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 ❑ ❑
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 ❑ 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc. ,
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 ❑ 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured-floor/roof truss-design details. ❑ --tJ 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 ❑ 0
architect licensed in Ore.on and shall be shown to be a i s licable to the s ro'ect under review.
it.RISDIC'l'IONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 8 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ CI
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard A ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00208
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2017
T MAR°O g Parcel: 25101 DA01500
Jurisdiction: Tigard
Site address: 7150 SW FIR LOOP 110
Project: NW Group Subdivision: 72ND BUSINESS CENTER Lot: 5
Project Description: New ADA building entry, new interior wall partitions and break room casework for suite 110 and entire 2nd floor for
the same tenant.
Contractor: MAYAS CONSTRUCTION LLC Owner: FIR LOOP LLC
5519 NE 62ND AVE 15000 BLUE GUM CT
TIGARD, OR 97218 SARATOGA, CA 95070
PHONE: 503-334-6111 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 07/25/2017 $91.00
Occupancy Grp: B Occupancy Load: 68 Permit Fee-Additions,Alterations, 07/25/2017 $827.34
Demolition
Dwelling Units: 0 12%State Surcharge-Building 07/25/2017 $99.28
Stories: 2 Height: 0 ft Plan Review 07/25/2017 $537.77
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 07/25/2017 $330.94
Value: $62,600 Info Process/Archiving-Lg$2.00(over 07/25/2017 $10.00
11x17)
Floor Areas:
Total Area: 9225
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,896.33
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: No Protected Corridors:
Smoke Detectors: No 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 er 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 issuanc- .r if w. is suspended for more the 180
days. ATTE e -.on law requires you to follow the rules adopted by the Oregon Utility Notification enter. hose rules are set forth in OAR
952-001-..10 through OA' 152-00 :490, You may obtain a copy of the rules or direct questions to OUNC by calling 503.23`.19'7 0 00.332.2344.
Issu.. By: / ,� Permittee Signature: -"----1114
Call 503.639.4175 by 7:00 a.m.for the next available inspection date./ 19
This permit card shall be kept in a conspicuous place on the job site until completion of th p• ect.
Approved plans are required on the job site at the time of each inspect'T
Building Permit Application 0 TO
Commercial CEIVED
City of Tigard Received
17/ // E ,e'te271f7-e4 Of
,� `, g Date/By: / Permit No.
13125 SW Hall Blvd.,Tigard,OR 97, L 2 5 2017 Plan Review—, "/�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: , "a '— ) :<-/-)..) �1erPe not o /7�®f9OP
TfGAKD Inspection Line: 503.639.4175 l IO , Date ReadyBy: Juris: 63 See Page 2 forInternet: www.tigard-or.gov���� i I (� Notifiethod�t��S�/�7iI Supplemental Information
A/TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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
ki Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling U Commercial/industrial
Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: , t S 0 S 0 -r,yt., L a b P New dwelling area: square feet
City/State/ZIP: -- 10,r1.it,1 o A.. °I, Z Z 3 Garage/carport area: square feet
Suite/bldg./apt.no. ifaj- Project name: IJ 1j G ct O J f' 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.
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.
0 6.t....) A 7 AValuation: $ ( Z , G o o
14,3 pU _. ?A iL-f 1'1 it)v)c,, t LI t3 l I ll A yC j\-Oft CA M ul aAs Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories: 1,.
Name: N,\0 ti,�id u,ii 1 G R.d J t Type of construction: J g
Address: / 150 S 1i 'g t,rte- L o c 'i' Occupancy groups:
City/State/ZIP: ...1.--, L,A4 0 a 1 Z.Z 3 Existing: 3
Phone:( ) Fax:( ) New: N V Go,1t.O L
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: ` (Please refer to fee schedule)
N W G I 51 0 J r 1 N Structural plan review fee(or deposit):
Contact name: ''X(t a 1,0 v 5J►
KA FLS plan review fee(if applicable):
Address: 2.2 L 0S' J Pt otoo./A.S I L7
5 Total fees due upon application:
City/State/ZIP: Sa slims o oo ci ( .4l�
� Amount received:
Phone:(Sb 3 ) G X b - (, 44 4 Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
,�.qq Coubmit two(2)sets of roof plan with connection details
Business name:
►r'A �! l re.2�,..i 1 t3 t. LL(.... and fire department access,along with the 2010 Oregon
Address: 5 5 1 0 V LZ i') A V 4 Solar Installation Specialty Code checklist.
City/State/ZIP: lac,t Z ( � Permit fee(includes plan review $180.00
l..'I LA✓1> u CI and administrative fees):
Phone:(so 3) 3 3 4 . (r 11 \ Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 2 0 4 Q \ Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
..Swithin 180 days after it has been accepted as complete.
Print name: ¶ A.2\ SO v$IL to Date: , iv
1 * 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)
III Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
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 per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
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: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
City of Tigard
III 'I COMMUNITY DEVELOPMENT DEPARTMENT
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #: ,'--12/c) /7 a ,2 e
Site Address: - -/ -qi() I-- LO% Suite/Bldg#: /7 0
Project Name: /4J ) (5)n
(Name of commercial b sines occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 7T/. nI/to l.-TY-I-
Existing Business Activity: 0,T)\C.Q
Proposed Business Activity: f/
2 Verify site address/suite# exists and active in permit system.
V '0''ver Terrace Neighborhood: ❑ Yes ❑ No
zZoning: 0
1 /Permitted Use: Yes ❑ No ❑ Spec Space
01 C irm no land use required.
Business License:
Exists: Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: a --= ajj Date: . .--b.1-S-1/9—
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: "7/ --V/7 Q"TC--
Site Plans: #
Building Plans: # 3
Building Permit#: enter building permit#above.
Workflow Routing: [ -Planning wilding
Workflow Sign off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: j Dater/ 7/7
I:\Building\Forms\BldgPermitRvw COM_NoIandUse_060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: rF`" Date:
Notes:
Revisions (after Building Submittal only
Revision Notice 1: Date Se to Applicant:
Revision Notice 2: Date :ent to Applicant:
Revision Notice 3: :to Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes 0 N/A
Parks SDC: 0 Yes 0 N/A
O OK to Issue P•rmit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPemiitRvw_COM NoLandUse 070915.docx
City of Tigard • BUILDING DIVISION
mi Over-The-Counter (OTC) Building & Fire Protection System Permit
l c n Ez n Appointment Checklist
Permit Record#: / 7 — CO Or
Contact Name: Phone #:
Business Name: Appt. Date/Time:
Site Address: Bldg/Suite#:
Project Name: New Tenant? ❑ Yes 0 No
Project Description:
Existing Use: New Use:
MMD Required: 0 Yes 0 No Related Record#:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work: f�J' Occupancy Group: j3 Type of Construction: v (�
Type of Use: 3 Occupancy Load: 6 49 Oregon Specialty Code: ao J
SPECIFICS
Number of Stories: 2 Building Height: 3 Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: 46)2--Z Accessory Structure: Covered Porch:
Basement Garage: Deck:
Total Square Footage: q aas' 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: A C7 Fire Alarms: 11 Q Smoke Detectors: nQ
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: $ 6 a, 6 o b FEES
$ 9 ,--- DC Prov Rvw,COM TI–Ping
$ .2 L). Permit Fee–Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2017) $ G)C1, XS 12%State Surcharge
Project Valuation $13.7 • 7 7 Plan Review,Structural
Up to$4,999 $0.00 $,3 3 Q, q14- Plan Review,Fire Life Safety
$5,000-$74,999 $91.00 $ )0- -�' Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $226.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $361.00 $ Metro Construction Excise Tax
$ — School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: , $ Other:
Date/Time: $ i g9 63 3 TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070117.docx
City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC) Building & Fire Protection System Permit
r c;11:D Appointment Checklist
Permit Record#: /Q®2-o/7 —OD cad,
Contact Name: — 1 UPhone #: 603 kifp— (009
Business Name: Niz �o la;.1.t�^-`C�e,d` t1 Appt. Date/Time: 745-g lava
Site Address: 7/6-0 gq43 4:4)) "i' Bldg/Suite #:
Project Name: ,, New Te ant? 0 Yes 0 No
Project Description: j L . , a,�P J 1 t- ,
Existing Use: it,, New Use: a
MMD Required: ❑ Yes No Related Record#:
GENERAL INFORMATION
Class of Work: Occupancy Group: Type of Construction:
Type of Use: Occupancy Load: Oregon Specialty Code:
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: 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: $
$ DC Prov Rvw,COM TI-Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2017) $ 12%State Surcharge
Project Valuation $ Plan Review,Structural
Up to$4,999 $0.00 $ Plan Review,Fire Life Safety
$5,000-$74,999 $91.00 $ Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $226.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $361.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070117.docx