Permit (111) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00258
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2017
T(GARD Parcel: 1S135BD00300
Jurisdiction: Tigard
Site address: 9735 SW SHADY LN 201
Project: Whole Body Health Physical Therapy Subdivision: None Lot: None
Project Description: TI for new tenant to Tigard:New walls for medical clinic consultation rooms.
Contractor: ROBERT TODD CONSTRUCTION INC Owner: TIGARD MEDICAL MALL LLC
4080 SE INTERNATIONAL WAY B113 PO BOX 98
MILWAUKIE, OR 97222 POULSBO,WA 98370
PHONE: 503-653-5704 PHONE:
FAX: 503-653-5729
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB Permit Fee-Additions,Alterations, 10/03/2017 $575.17
Demolition
Occupancy Grp: B Occupancy Load: 15 12%State Surcharge-Building 10/03/2017 $69.02
Dwelling Units: 0 Plan Review 09/25/2017 $373.86
Stories: 3 Height: 0 ft DC Provision Review,COM TI-Ping 10/03/2017 $91.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/03/2017 $230.07
Value: $36,000 Info Process/Archiving-Lg$2.00(over 10/03/2017 $2.00
11x17)
Floor Areas:
Total Area: 1488
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,341.12
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No 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 • i-.uance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi .tio 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 5:3. 1 19:7•r 1 ;00.33 ..344.
Issued By: �—
-.0 a Permittee Signature:
41111
/ ���
/� lir ,, ,
. 503.639.4175 by 7:00 a.m.for the next available inspection ,a e'.
This permit card shall be kept in a conspicuous place on the job site until completion oft • pr•,ect.
Approved plans are required on the job site at the time of each inspection.
- Building Permit Application
Commercial ti LCq: 1 FOR OIII( I CSF: O\1.1
`J g Date/BReceived 6 /? /� I2 'l/I ? acr
Ci of Tigard , 2017 y_ / Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 S E.P 2 :� Plan Review Q
' 2 Phone: 503-718-2439 Fax: 503-598-194Q Date/By: 1 I l7 . Related Permit:
Inspection Line: 503-639-4175 L, I Y 4,,,1 y- i i., 1,;'r Date Ready/By: loris: ® See Page 2 for
l IGARD p p g
Internet: www.tigard-or.gov :3 Ai 1! J➢ i)1 1 s Q;n otified/Method: `C,1 ,j 1,j1 7 Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
El1-and 2-family dwelling Commercial/industrial
ElAccessory building ElMulti-familyNumber of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
f
Job site address: " 33 C� //.t New dwelling area: square feet
City/State/ZIP: 4,,"'2 ( 91 Garage/carport area: square feet
Suite/bldg./apt.#: �� Project name: H. .- Covered porch area: square feet
Cross street/directions to job site: �f ` Deck area: square feet
UiVi
n`-/. Other structure area: square feet
Sc id d /�cm q tl r� REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: yeeli, `r ire►IL #: Permit fees*are based on the value of the work performed.
l "6-4,-- Indicate the valuerounded to the nearest dollar)of all
Tax map/parcel#: value(
/ . equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
j� `. CC~Le. Valuation: $.. .,.."-,;000
"�= Existing building area: square feet
New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name d 17 C.j-t Type of construction:
Address: l 3V •Fr i+. i04t)' - Occupancy groups:
City/State/ZIP: ��D /NZ . ".1TZZ/T Existing:
i
Phone: �'� Fax:
�c r.:7'�1��� ( ) New:
'APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:6-� i la 74 t-.G j� Structural plan review fee(or deposit):
Contact name: �.-'3-1144_ yjl,\l,Ie°, �
Address: T !� ,�� �'Let j FLS plan review fee(if applicable):"
City/State/ZIP: KID , Total fees due upon application:' 313 y j
Phone:( '7 1 Fax::( � ) Amount received:/ +�,
17 *
��. '4 i
PHOTOVOLTAIC SOLAR PANEL SYS'I'iJM"FEES
E-mail:lAco _ �(� i re%(( k7�� - Commercial and residential prescriptive installation of
CONTRACTOR
roof-top mounted Photo Voltaic Solar Panel System.
Business name: �"'.1-.'- -may lea ' t NI Submit two(2)sets of roof plan with connection details
If ;�),�` �^ i and fire department access,along with the 2010 Oregon
Address: 4e: ��"- YlflS`f �113 Solar Installation Specialty Code checklist.
City/State/ZIP:_ `'�,,,�r f�)k..) 1L„ 11Z Permit fee(includes plan review $180.00
r C and administrative fees):
Phone:( 3S36 „,3- -57e,Al Fax:('3 — 7s� State surcharge(12%of permit fee): $21.60
Gibs'CCB Lic.: '-"
/ Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
4y� `i ;t/L_.------ within 180 days after it has been accepted as complete.
Print name: / f Date: ! ` i` * Fee methodology set by Tri-County Building Industry
c� 1 Service Board.
I:\Building\Permits\BUP_COM_PertnitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
114 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] $
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 Rev.12/18/2014
City of Tigard
RI
IN COMMUNITY DEVELOPMENT DEPARTMENT
t:
T 1 c A R i) Building Permit Review — Commercial - No Land U s e
r,
Building Permit #: #5fi�,,W/ ?-0:),046-1?
Site Address:
��� .C7k) 0 � �_; Suite/Bldg#: c�0/
Project Name: �(_ AO-e i f'�/Y P�jZ S I 17L�.
(Name of commercial bus' ess occupying the space. If va a t,enter Spec Space.)
Planning Review
Proposal: "r/ /L U
Existin; 5 siness Activity: Ad' /Ch1 Li c 4
Prot.sed Business Activity: // //
VA Verify site address/suite#exists and active in permit syst
11 et ver Terrace Neighborhood: ❑ Yes No
ALoning:
ermitted Use:
Yes El No ❑ Spec S ace
p
nfirm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: Date: ?h___S-179.-
Revisions
(after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved 0 Not Approved
Revision 3: El Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: '1/ 5//i
Site Plans: #
Building Plans: # _JC
Building Permit#: [- Y ter building permit#above.
Workflow Routing: [ ening hermit Coordinator ding
Workflow Sign-off: Diign-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: _.. Date: /72-4/i 7
I:\Building\Forms\BldgPermitRvw_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
7OK to Issue Permit
Approved by Permit Coordinator: Date: /l
I:\Building\Forms\BldgPermitRvw_COM_NoL.andUse 070915.docx