Permit (260) CITY OF TIGARD BUILDING PERMIT
a ' COMMUNITY DEVELOPMENT Permit#: BUP2013-00142
T f GAR1? 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2013
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY D
Project: Rite Aid Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: Construct consultation room adjacent to existing pharmacy.
Contractor: JAMES JOHN CONSTRUCTION CO Owner: SN PROPERTIES PARTNERSHIP
1701 SE COLUMBIA RIVER DR 1121 SW SALMON ST
VANCOUVER,WA 98661 PORTLAND,OR 97205
PHONE: 503-283-5365 PHONE:
FAX: •
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB Permit Fee-Additions,Alterations, 08/08/2013 $1,468.35
Occupancy Grp: M Occupancy Load: 610 1 Demolition Stte
12/o State Surcharge-Building 08/08/2013 $176.20
Dwelling Units: 0 Plan Review 06/12/2013 $954.43
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 08/08/2013 $587.34
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 08/08/2013 $278.00
Value: $160,000 DC Provision Review,COM TI-LRP 08/08/2013 $41.00
Info Process/Archiving-Lg$2.00(over 08/08/2013 $18.00
11x17)
Floor Areas: Metro Const.Excise Tax-Commercial 08/08/2013 $192.00
Use
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,715.32
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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: Perm ittee Signature: ,fN ~G/ft 720 v
- 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.
,.Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard LJ Received / I Permit No.: y '/
Er 13125 SW Hall Blvd.,Ti ard,OR 972J UN Date/By: // /3 . ,21 /3 "odl4/�
g I 1 2013 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: . Q 1 l pp
j Other Permit:
TIGARD Inspection Line: 503.639.4175 '�`] �p� Date Ready/By: -///,›/ hiris. la See Page 2 for
Internet: www.tigard-ocgov CITl'OFTIGARD Notified/Method: �3 Supplemental Information
B UILDING DIVISION ✓M id/-f /
TYPE OF WORK REQUIRED DATA: I-AND 2-FAMILY DWELLING
❑Nev l construction ❑ Demolition Permit fees*are based on the value of the work perfo • a.
Indicate the value(rounded to the nearest dollar)of.
X.Ac!ditio a teratio R=.lacement i ❑ Other: equipment,materials,labor,overhead,and the . .fit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
171 I-sand 2-family dwelling Commercial/industrial Valuation: $ le,0 _i®D
❑ Accessory building ID Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors.
;w
Job site address: 144190 v Per ciAt e_ Hwy New dwelling are.. square feet
City/State/ZIP: I"�`�� a� 1112_2 4- Garage/carpo' area: square feet
Suite/bldg./apt.no.: J D Project name: Covered .orch area: square feet
Cross street/directions to job site: L Sw Lr rAG�� ?tot 10 De•• area: square feet
— A %loa P4 C 1 T.I C 1114, Other structure area: square feet
A fr 3l oea� ` sv `Ir_ J REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 2 S 115 A-2,o I q O I' ��_31'7/9 Indicate the value(rounded to the nearest dollar)of all
/ equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF 'ORK work indicated on this application.
Om Sp v ? Co,svf. hvo /'Bath 4,94 c ci.._to .e1e 4 Valuation: $ (&O, ®
PtA-Ova-4 .Aerto-t- 7 7Asetl/-e / lecoletzf �1 e .,tovitie, Existing building area: 21,k,,3 square feet
4cOrtid , 11 e40 efill•k,r. 1-vs r /f- New building area: ...----, square feet
❑ PROPERTY OWNER ,TENANT Number of stories: /
Name: l`efie 4 '1 6.0 ere-N-17,D t7/ 6/el- NI c Type of construction: g
Address: 612.1 5 bore S f-; Occupancy groups:
City/State/ZIP: ter kCwie->d GA- go Existing: /44
Phone:( ) Fax:( ) New: VI
❑ APPLICANT 'CONTACT PERSON BUILDING PERMIT FEES*
/I (Please refer to fee schedule)
Business name: hint)r QGt I'LL G Structural plan review fee(or deposit):
Contact name: tnNAfr-71 ',wt.1.1 1-7
q FLS plan review fee(if applicable):
Address
0'K I 41 S Total fees due upon application:
City/State/ZIP: F-pS, 1.,._ , I M�
YY oa ""1 Amount received:
Phone:( 2-7/ ` i �s--- Fax: :( r 2,7 / 2
E-mail: � ki;s,I b/r.a e �ki 64 S I- > ie f' PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: � � �F, Submit two(2)sets of roof plan with connection details
I i and fire department access,along with the 2010 Oregon
Address: n Q ` SE_ COAUIMlptfi`V,'v e.( Dvl;t/.e___ Solar Installation Specialty Code checklist.
City/State/ZIP: UCIVAt,dvVe(' w ct<66( Permit fee(includes plan review $180.00
696 qua and administrative fees):
Phone:( O) 696- 01)2-7 Fax.(�(p) State surcharge(12%of permit fee): $21.60
CCB lic.: 63 ,6 t
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: 6-- k..041-vev Date: 6"//'a/S3 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-COM PennitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Division
. .
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: av( b- oO/`( - ❑ Expedited Review
Project Name: t i Pr 1 ID
Site Address: l 69,0 +)//-c-t 6 c. Y , Suite/Bldg #:
Plans Routed:
Original Plan Submittal Date: �e �( (/3 Routed By:
1St Revision Submittal Date: Routed By:
2nd Revision Submittal Date: Routed By:
To the Applicant:
➢ If the proposed use is not permitted within the zone,please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718-2439.
If a land use is required and for all other questions,please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact Qrf r-es l Ov40 - at (503) 7182471 or en\n-,,,, @tigard-or.gov)
Pr9pposal: \hn mwJry-o.7 r 'kT) Onn,. t AQ rto re
'C10`2- PxvS-vim ipJV .
Zoning
Permitted Use Yes No ❑
Land Use Required: Yes ❑ No
Notcs:
jE(Approved ❑ Not Approved ❑ DCPR Not Required—No DCPR Fees Due
Date Routed to Building:
1:\CURPLN\Masters\Development Code Provision Review\DCPR_COM_NoLandUse.doc Rev.01/16/13
H.G.KIMURA
ARCHITECT, PLLC
Howard G.Kimura,Principal
REcD
Date: June 10,2013 i ;N 1 1 2013
•CM'OFTZGARD
To: Ms.Debbie Adamski BUILDINGDIVISjpN
Permit Center Building
13125 SW Hall Blvd
Tigard,OR 97223
503.718.2439
From: Howard G.Kimura,
HG Kimura Architect PL
18012 W.Lake Desire Dr.SE
Renton,WA 98058
Tel.425-271-1875
Fax 425-271-2383
RE: Rite Aid 5355 Tenant Improvement
16200 SW Pacific Hwy
Tigard,OR 97224
Transmitting:
Dear Debbie:
Thank you in advance for your assistance once again and for taking these plans via Federal Express
Delivery!
Attached,please find the following:
• 3 sets of full sized plans
• Plan-check fee in the amount of$1,478.35 based on$160,000 valuation
• Building Permit Application
Please process the enclosed for a tenant improvement to an existing commercial building and send a
receipt for the building plan-check fee to hgkimura@comcast.net
Please call with questions.
Thank you.
18012 W.Lake Desire Dr.SE•Renton,WA 98058•425.766.5000•Fax:425.271.2383•email:hgkimura@comcast.net