Permit (200) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2018-00154
'
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/02/2018
TIGARD Parcel: 2S103DD01100
Jurisdiction: Tigard
Site address: 13939 SW PACIFIC HWY
Project: Providence Retail Clinic Subdivision: None Lot: None
Project Description: Tenant work to build out(2)exam rooms in existing shell space inside Walgreens.
Contractor: WALSH CONSTRUCTION CO/OREGON Owner: WALGREEN CO#5780
2905 SW 1ST AVE PO BOX 901
PORTLAND, OR 97201 DEERFIELD, IL 60015
PHONE: 503-222-4375 PHONE:
FAX: 503-274-7676
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 06/28/2018 $553.13
Demolition
Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 06/28/2018 $66.38
Dwelling Units: Plan Review 05/17/2018 $359.53
Stories: Height: ft Wash Co Trans Dev Tax 06/28/2018 $2,882.00
Bedrooms: Bathrooms: Parks SDC Improvement 06/28/2018 $156.00
Value: $34,000 Parks SDC Reimbursement 06/28/2018 $28.00
Info Process/Archiving-Lg$2.00(over 06/28/2018 $18.00
11x17)
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $4,063.04
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
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 •• oft - -s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
40'
Issued By: •a nature: -•.►� �L r
a
175 by 7:00 a.m.for the next available ins.ection 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 Applicatio �j
Commerciale FOR OFFICE USE ONLY
City of Tigard Mry ry Date/Bea v„ '7 ar t,/ Permit Tgj.(lO /e /f/
- 13125 SW Hall Blvd.,Tigard,OR 97223 �� '` y p J
,I4 gPlan Review. •
Phone: 503.718.2439 Fax: 503.598. OF Date/B : 13-+p�� � OtherPer� /!�'��l/—S
T I G ARD Inspection Line: 503.639.4175 j r Y TIGARDDate Ready/By: //�� Juris: ® See Page 2 for
Internet: www.ti ard-or. ov • Notified/Methodk, /�o Supplemental Information
g g BUILDING DIVISION ,.,� ,2/L
❑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 ®Other:TI equipment,materials,labor,overhead,and the profit for the
a;, work indicated on this application.
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
Number of bedrooms:
ElAccessory building 0 Multi-family
ElMaster builder 0 Other: Number of bathrooms:
W a t-
Total number of floors:
Job site address:13939 SW PACIFIC WAY New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:PROVIDENCE RETAIL CLINIC Covered porch area: square feet
Cross street/directions to job site:SW MCDONALD ST Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:
equipment,materials,labor,overhead,and the profit for the
-`` ,r`f ` `-moo O q * ' �� * work indicated on this application.
k tom Pf•F40„y x
THIS PROJECT CONSISTS OF(2)EXAM ROOM BUILD-OUTS IN AN EXISTING Valuation: $34,000.00
SHELLED SPACE Existing building area: 15070 square feet
OF THE WALGREENS FACILITY. THE EXAM ROOMS WILL INCLUDE ELEC,
MECH,AND PLUMBING New building area: 258 square feet
Number of stories:
.. ,,. . ..* . �-. ,, :, ` .. ` .0 ., .. -- ,r" ... Type of construction: V-B
Name:Jordann Smith
Occupancy groups:
Address:600 Broadway Suite 304
Existing: M
City/State/ZIP:Seattle,WA 98122
New: M
Phone:(206)215-2692 Fax ( )
Business name:NAC ARCHITECTURE Structural plan review fee(or deposit):
Contact name:JILL KURTZ FLS plan review fee(if applicable):
Address:1203 W.RIVERSIDE AVE Total fees due upon application:
City/State/ZIP:SPOKANE,WA 99201 Amount received:
Phone:(509)838-8240 Fax::( ) .. i � . I,ti# a - ;;,4
E-mail:JKURTZ@NACARCHITECTURE.COM Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
' Submit two(2)sets of roof plan with connection details
Business name: / i Q c and fire department access,along with the 2010 Oregon
1 ►!� + l � y‘_NI-�Lf" '�`^ '"°i' Solar Installation Specialty Code checklist.
ddress: ' G 0c
W ',r�-4-. 14 V-^ -„ Permit fee(includes plan review
(y. r1 �j and administrative fees): $180.00
ity/State/ZIP: ��,.�. 0 t2.. 't 7 TL 0
) State surcharge(12%of permit fee): $21.60
Phone:(503) a y- Li-3--) S Fax:( ) '•
k CCB lic.. '" Total fee due upon application: $201.60
• This permit application expires if a permit is not obtained
Authorized signature:
within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name: J111 y_tifil Date. .kok. 11
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
RI 1111
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(shallqual line [2] of Valuation Computation): $
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
City of Tigard
II COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 c A R o Building Permit Review – Commercial - No Land U s e
Building Permit #: 6/60ar - eoi5-
Site Address: /3q9 �c/,0 Ac,,247�1 Suite/Bldg#:
Project Name: roitih et n /fin g
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review , /
Proposal: /-f 9,,1r7�- I prve me/4 '— `_2,1.7 - 10er/
Existing Business Activity: �,�'G�`S`— E91�'- i�
Pro sed Business Activity: 1/ 1/ /,
Verify site address/suite# exists and active in permit syste
ver Terrace Neighborhood: ❑ Yes No
A oning:
itid rmitted Use: Yes ❑ No ❑ Spec Space
4VCo no land use re wired.
Business License:
Exists: Yes ❑ No,applicant notified to obtain business license
' ` /r, r IA 8 � A ��
Notes: � L C9 CCell . - _!8 YIi ..�
//. r°/ -, .c i' /
Approved by Planning. - ��w Date: 44 s
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: -sy;4,/d'`
Site Plans: # 3
Building Plans: #
Building Permit#: B Enter building permit#above.
Workflow Routing: C'-Planning g1-15-e-rmit Coordinator D•-Building
Workflow Sign-off: 0-Sign-off for Planning(include notes from planning review)
Route Application Documents: .ILL-T"iulding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: /'/ dB - Date: 001-
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
0 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:
C Fees Entered: Wash Co Trans Dev Tax: Yes 0 N/A
Tigard Trans SDC: 0 Yes )N/A
Parks SDC: lYes 0 N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: /2-ji 78
I:\Building\Fonns\BldgPennitRvw_COM_NoLandUse 070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13939 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2018-00154
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor