Permit FOR OFFICE USE ONLY-SITE ADDRESS: (a7&„, I700 S&) ‘4j2n/S
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
= r1,111 •
Transmittal Letter
r i ,1 u n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: /41:4y,ve-
COMPANY:
PHONE: - 3 �,d 1-7e,---6 Brf'l f
RE: (Site Address) 60°,,
"(Permit N j b/) — 7 y ��
/cl'b4 o AJ A2E--60.7,47
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: 1 opies: Description:
Additional set(s)of plans. ►, Revisions:
Cross section(s) and details. I Wall bracing and/or lateral analysis.
Floor/roof framing. ( Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain): 4 ) , v
REMARKS: t \�J 4.14,41-,5f-7C,- r'i t* .4:1-C
FOR OfCE USE ONLY
Routed to Permit T; hnici. •. Date: ( k c--7 Initials:,-- 4* j
Fees Due: ❑ Y: E o Fee Description: Amount ►ue:
$
$
$
Spec'.1
I e: ctions:
Reprint Permit(per PE): ❑ Yes [No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions 061316.doc
CITY OF TIGARDt
orotrBUILDING PERMIT
COMMUNITY DEVELOPMENT ��s, Permit#: BUP2017-00084
Date Issued: 06/12/2017
-f-l c3aetR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ' Parcel: 2S101 DA01900
Jurisdiction: Tigard
Site address: 7000 SW VARNS ST
Project: Madrona Recovery Subdivision: VARNS ACRES Lot: 3
Project Description: TI for new tenant: Interior remodel of an existing commercial office building to change to an inpatient rehabilitation
medical center. Remodel includes installation of a kitchen,patient rooms,bathrooms,administrative offices,and
treatment and activity spaces.9/12/17:REPRINT to change address from 6996 to 7000.
Contractor: PREMIER REMODELING& DESIGN LLC Owner: NELSON VIAL LLC
1725 COMMERCIAL ST 7155 SW VARNES ST#120
SALEM, OR 97302 TIGARD, OR 97223
PHONE: 503-209-3578 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/12/2017 $3,195.79
Demolition
Occupancy Grp: R-4 Occupancy Load: 36 12%State Surcharge-Building 06/12/2017 $383.49
Dwelling Units: Plan Review 04/07/2017 $2,077.26
Stories: 2 Height: ft DC Provision Review,COM TI-Ping 06/12/2017 $357.00
Bedrooms: 12 Bathrooms: Plan Review-Fire Life Safety 06/12/2017 $1,278.32
Value: $445,182 Info Process/Archiving-Lg$2.00(over 06/12/2017 $46.00
11x17)
Info Process/Archiving-Sm$0.50(up to 06/12/2017 $12.50
Floor Areas: 11x17)
Metro Const.Excise Tax 06/12/2017 $534.22
Total Area: 6948 Additional Plan Review 07/12/2017 $45.00
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $7,929.58
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: Yes
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 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: 0 Permittee Signature: r l�ru/f`04,
((( Call 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.
CITY OF TIGARD BUILDING PERMIT
'' 2..' COMMUNITY DEVELOPMENT Permit#: BUP2017-00084
T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1/1% Date Issued: 06/12/2017
Parcel: 2S101DA01900
f ,i Jurisdiction: Tigard
Site address: 7000 SW VARNS ST -
Project: Madrona Recovery Subdivision: VARNS ACRES Lot: 3
Project Description: TI for new tenant: Interior remodel of an existing commercial office building to change to an inpatient rehabilitation
medical center. Remodel includes installation of a kitchen,patient rooms,bathrooms,administrative offices,and
treatment and activity spaces.9/12/17:REPRINT to change address from 6996 to 7000.
Contractor: PREMIER REMODELING&DESIGN LLC Owner: NELSON VIAL LLC
1725 COMMERCIAL ST 7155 SW VARNES ST#120
SALEM, OR 97302 TIGARD, OR 97223
PHONE: 503-209-3578 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/12/2017 $3,195.79
Demolition
Occupancy Grp: R-4 Occupancy Load: 36 12%State Surcharge-Building 06/12/2017 $383.49
Dwelling Units: Plan Review 04/07/2017 $2,077.26
Stories: 2 Height: ft DC Provision Review,COM TI-Ping 06/12/2017 $357.00
Bedrooms: 12 Bathrooms: Plan Review-Fire Life Safety 06/12/2017 $1,278.32
Value: $445,182 Info Process/Archiving-Lg$2.00(over 06/12/2017 $46.00
11x17)
Info Process/Archiving-Sm$0.50(up to 06/12/2017 $12.50
Floor Areas: 11x17)
Metro Const.Excise Tax 06/12/2017 $534.22
Total Area: 6948 Additional Plan Review 07/12/2017 $45.00
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $7,929.58
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: Yes
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: 1
ic r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD BUILDING PERMIT
74a.. . COMMUNITY DEVELOPMENT Permit#: BUP2017 00084
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/12/2017
Tt ta'�F$° g Parcel: 25101 DA01900
Jurisdiction: Tigard
Site address: 6996 SW VARNS ST
Project: Madrona Recovery Subdivision: VARNS ACRES Lot: 3
Project Description: TI for new tenant: Interior remodel of an existing commercial office building to change to an inpatient rehabilitation
medical center. Remodel includes installation of a kitchen,patient rooms,bathrooms,administrative offices,and
treatment and activity spaces.
Contractor: PREMIER REMODELING&DESIGN LLC Owner: NELSON VIAL LLC
1725 COMMERCIAL ST 7155 SW VARNES ST#120
SALEM, OR 97302 TIGARD, OR 97223
PHONE: 503-209-3578 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/12/2017 $3,195.79 -
Demolition
Occupancy Grp: R-4 Occupancy Load: 36
12%State Surcharge-Building 06/12/2017 $383.49
Dwelling Units: Plan Review 04/07/2017 $2,077.26
Stories: 2 Height: ft DC Provision Review,COM TI-Ping 06/12/2017 $357.00
Bedrooms: 12 Bathrooms: Plan Review-Fire Life Safety 06/12/2017 $1,278.32
Value: $445,182 Info Process/Archiving-Lg$2.00(over 06/12/2017 $46.00
11x17)
Info Process/Archiving-Sm$0.50(up to 06/12/2017 $12.50
Floor Areas: 11x17)
Metro Const. Excise Tax 06/12/2017 $534.22
Total Area: 6948
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $7,884.58
Required: Required Items and Reports(Conditions)
Fire Sprinkler: . Yes Parapet:
Fire Alarm: Yes Protected Corridors: Yes
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 Center. Those - _ - et 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 c= ' e 03.232.1•• or -.:.32.2344.
/"
Issued By: j -'--- •ermittee SI n
9 huts:
ow-
Call
Call 503.539.4175 by 7:00 a.m.for the next available inspecti• •ate.
This permit card shall be kept In a conspicuous place on the Job site un' ompletlon of the project.
Approved plans are required on the job site at the time• each inspection.
Y
e•.
Building Permit Application
Commercial I Ult()11 It I. 1 ` I t)\L1
City of Tigard 4- 4i;a l`,,' Duds d .. ; .!k ��Tt�'iL
Ived .
ll
a 13125 SW Hall Blvd,Tigard,OR 972 ' ' Plan Revie -.� �� ,r '
Phone: 503.718.2439 Fax 503.598.1960 pang ; t aI Other Permit: /Pio, —Qty -
1 1 t,n 1t t, Inspection line: 503.639.4175 �± Date Ready 1` � l Ri�See Page 2 for
Internet: www.tigard-or.gov u�u p [)y 2017 Notiffed/Mcrltod: • /;'�*� Supplemental Information
TYPE OF *ON i' t 14 r A n REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 3 l ellttj "i-,'"!F-10'.:A Permit fees*are based on the value of the work performed.
u y° - Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
CI1-and 2-family dwelling ®Commercialindustrial Valuation: S
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Sob site address:6996 SW Yarns Street-Building A New dwelling area: squire feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:A Project name:Madrona Recovery Covered porch area: square feet
Cross street/directions to job site:SW 72°d Ave Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:25101DA-01900 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.
Interior remodel of and existing commercial office building to change to medical Valuation: 35445,182.00
center-inpatient rehabilitation. Remodel Includes installing commercial Existing building area: 6,948 square feet
kitchen,patient rooms,bathrooms,treatment,activity&administrative spaces. New building area: 0 square feet
0 PROPERTY OWNER ® TENANT Number of stories: 2
Name:Madrona Recovery Center Inc,DEA Madrona Recovery Type of construction: V-B
Address:1566 SE Linn Street Occupancy groups:
City/State/ZIP:Portland,OR 97202 Existing: B
Phone:( ) Fax:( ) New: R-4
® APPLICANT • CONTACT PERSON BUILDING PERMIT FEES*
(Neese refer leail
Business name:CB Two Architects *i
Structural plan review fee(or deposit):
Contact name:Gretchen Stone
FLS plan review fee(if applicable):
Address:500 Liberty Street SE,Suite 100 jq,r'
City/State/ZIP:Salem,OR 97301 Total fees due upon application ��LV'�,0"?,r
Phone:(503)480-8700 Fax::(503)480-8701 Amount received: y41
t PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES'
E-mail:gretchen@ebtwoarchitects.com 1btu^{°4 V r .�d�MA.t (4M
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: P�. ci3Oj i- 10 7 I II e, Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):,
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
(
CCB lie.: q
O
1 47.42_ Total fee due upon application: 5201.60Authorized signature: / Tars persNt application e=pires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:John Thor Date: G�/y4.7..,
• Fee methodology set by Tri-County Building Industry
Service Board
1:\Building1Permits\BUP-COM PennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
I' COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Commercial - With Land Use
Building Permit #: 6 ,47d/7 C iXbi
Site Address: Mock.74:2 pee veri einiers Suite/Bldg#:
Project Name: 39 O--"›< gic) Varng S?
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ��
�/ � C�� Y���� / ��Xl�'��� r'^` Art/� � ),� /l�t•PC�.1Ccw�
C7.€� c V J
E(Verify site address/suite#exists and active in permit syst .
rd °.ver Terrace Neighborhood: ❑ Yes No
and Use Case#: GG>' c i(.a– COCO ✓ati�sC)Ila - CO
Pla s Match Approved Land Use: t�yy
itlbite Plan A&\landscape Plan Nther:
ban Forestry Plan I ‘.1t.levation Plan 2 ,
Building Height: Maximum Height —1"Lt 3)LL Actual Height /x/S7/
❑ onditions Met: ❑ Prior to Submittal El Prior to Permit Issuanc
Business Licen e:
}�E(xists: Yes ❑ No,applicant notified to obtain business license
Va{L'iablic Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified I No Applied For: ❑ Yes ❑ No,stop intake
Notes:
7
Approved by Planning: 6'.6Date: 7-,4 -/
Revisions (after Building Submitta o y _". Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Building Permit Submittal
Original Submittal Date: LiAl;7
Site Plans: # i
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: anning C` 'Engineering Coordinator Bding
Workflow Sign-off: Ili''S-ign-off for Planning(include notes from planning review)
Route Application Documents: ding original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: `; ,tte. s,C,.._,, Date: 4/ /,7
I:\Building\Forms\BldgPermitRvw_COM_W ithIandUse_060I 1 6.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
El Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP)
El Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes El No
Assess Water Quantity Fee in-lieu: El Yes ❑ No
LIDA Facility on lot: El Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: h ,....0 Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
pproved,NOT Released: 1�����i� "ate: �1����.
(Notes: 42 Crit2� vy.� 2s tc
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:
ISDC Fees Entered: Wash Co Trans Dev Tax: El ►�E/A
/ _ Tigard Trans SDC: ❑ Yes NO /A
Parks SDC: ❑ Yes riA
K to Issue Permit
Approved by Permit Coordinator: /6Date: S A f ----
I:\Building\Forms\B1dgPennitRvw_COM_WithLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7000 SW VARNS ST, TIGARD, OR, 97223 November 21 , 2017 at
7:27:16 AM
Record Type: Record ID:
Commercial - Building BUP2017-00084
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - CofO
Comments:
Violation Summary:
Inspector Contractor