Permit (87) CITY OF TIGARD BUILDING PERMIT
' s : COMMUNITY DEVELOPMENT Permit#: BUP2018-00229
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2018
T I '' p Dg Parcel: 1 S 134AD06200
Jurisdiction: Tigard
Site address: 10565 SW NIMBUS AVE 100
Project: Progressive Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: A
Project Description: Demolition of suites 100&105.
Contractor: PACIFIC CREST STRUCTURES INC Owner: DIETRICH, NANCY BISHOP
17750 SW UPPER BOONES FERRY RD SUITE ROBINSON,JERRY CHRISTOPHER TRUST
190 ROBINSON, LYNN ET AL
DURHAM, OR 97224 9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-968-8949 PHONE:
FAX: 503-598-6658
Specifics: FEES
Description Date Amount
Type of Use: COM DC Provision Review,COM TI-Ping 08/14/2018 $98.00
Class of Work: ALT Type of Const: IB
Occupancy Grp: B Occupancy Load: 274 Permit Fee-Additions,Alterations, 08/14/2018 $453.95
Demolition
Dwelling Units: 12%State Surcharge-Building 08/14/2018 $54.47
Stories: Height: ft Plan Review 08/14/2018 $295.07
Bedrooms: Bathrooms: Plan Review-Fire Life Safety 08/14/2018 $181.58
Value: $25,000 Info Process/Archiving-Lg$2.00(over 08/14/2018 $6.00
11x17)
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $1,089.07
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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. S Gialty Codes and al otrer applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 d s fof issuance, or if •r is susp-4 ded for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility gfification Center. u•se rule- -re 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 (ling 5 .232.1987 or 1 '0.332.2
Issued By: p� Permittee Signature: I — :L
v� �O
Call 503.639.4175 by 7:00 a.m.for the next available ins ecti n 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 5-1 i'1,r- 0 c r,
11.t-I„,1.7.:1 ,,,,,, 4,.. ii, '
Commercial FOR OFFICE USE ONLY
City of Tigard AUG 14 Z018 Received c.—/
Permit No 0 -,
, ''' 13125 SW Hall Blvd.,Tigard,OR 97221 ,,,--,-‘,,, - •,- , ' Plan Review
' "
' ' Phone: 503.718.2439 Fax: 503.598.1960 i 1 '4j;- ;'--.74-': "' Date/B : 1
iip„, Date/B : 6, l( i i „de .0 ........
„, .4111;111- " Other Perldio / 0 /
, „ ,",.r' '
Inspection Line: 503.639.4175 !I'M.jILO!;'',',--, ,,..,^14'-' Date Ready/By: Juns: EZI See Page 2 for
TIGARD
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
.,i:kieai,:lkalik,.., , ,,---,,,, , ,-, , ":"..' , :ftwiiiyiliiiii,.:047i,i„:::.A0--14*Lf;:o. :::itt44,,,,....,:i:
0 New construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
,„,„. , ,” „”' „ , ,,) work indicated on this application.
0,F. voNtS^T*.uenoN -' - ' ,' , ;.,-, ,
"== ”
Valuation: $
0 1-and 2-family dwelling [2]Commercial/industrial
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
vr,ibt:grit, ,m0010,tosirm,6 tocArrog,,,,, t>21 ,,,,,, .< :•:',1,,=, = Total number of floors:
Job site address:10565 SW Nimbus Ave.Bldg S,Suite 100&105 New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:100&105 Project name:Progressive Covered porch area: square feet
Cross street/directions to job site:SW Scholls Ferry Rd.&SW Nimbus Ave. 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
04 ,, ,=,,,,,,f.,.: , ,.,,,,',,,,,,, L,,z,,c%:„ work indicated on this application.
Valuation:
Demolition of both Suites 100&105. *(l' itukt2S 0300.
trs'
i
Existing building area: 27394 square feet
New building area: N/A square feet
4i4ilitidi,ii:44,, „ :,J, ;'; ,;= , ' ti Tii4,;‘14,„ ,:-;., ,,,„ r"."..",,:, Number of stories: 1
- ,v,,` .`' - - , , ,, , ,
Name:Kyle Latta Type of construction: I-B
Address: 10240 SW Nimbus Ave,Suite L-3 Occupancy groups:
City/State/ZIP:Portland,OR 97223 Existing: B
Phone:(503)598-9980 Fax:( ) New: N/A
I:3 .APPLICOIT " U CONTACT PERSON , , '' ' ' ;',„ tumougaptitA4.11`FEES*
trieae*a rtoieesOfiedtil0
Business name:Ankrom Moisan Architects
Structural plan review fee(or deposit):
Contact name:Bethanne Mikkelsen
FLS plan review fee(if applicable):
Address:38 NW Davis,Suite 300
Total fees due upon application:
City/State/ZIP:Portland,OR 97209
Amount received:
Phone:(503)952-1593 Fax:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:bethannem@ankrommoisan.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Pacific Crest Structures Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 17750 SW Upper Boones Fry#190 Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP:Portland,OR 97224 $180.00
and administrative fees):
Phone:(503)278-1740 Fax:(503)598-6658 State surcharge(12%of permit fee): $21.60
CCB lic.:66915 227, 7/i Total fee due upon application: $201.60
Authorized sip-It e: This permit application expires if a permit is not obtained
iwithin 180 days after it has been accepted as complete.
Print name:. , . i / Iliteditfr........, Date: 13 1 13 1 i * Fee methodology set by Tri-County Building Industry
ill Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard • BUILDING DIVISION
ill o
° Over-The-Counter (OTC) Building & Fire Protection System Permit
T[GARD Appointment Checklist
Permit Record#: /r--00)-
Contact
UContact Name: j C ,/A/g /'/e LS^Q,/ Phone #:-50...51-f /,j9.3
Business Name: qW/L,/f i,> /47, 4r,,,,/tc; 6,W , Appt. Date/Time: criy0�e✓ /7,
Site Address: /o 4o._5-Src) 4//,/aes Bldg/Suite #: / e /DS S�
Project Name: /b/Z40 &SS',1/6- C ,/-G.7/4/S New Tenant? , Yes ❑ No
Project Description: /AfriE7Z/,g, -A--&--7-76,4-,77,04/ /"V ,A�- 4j7,,-7--77eA/ 77'x,
T '97v7/9,/20�f 7.
Existing Use: O/ G6 New Use: .ew,Gc
MMD Required: ❑ Yes No Related Record #:
rA !li Tik!;! i,. "' ...,. . lii:-4 eacu,......' tea,... ,!"i ;i r 4 .. A ..,. _ . ``'4
�3�.. . ." Aa "� �°' °.;� tld4�,a 41C�ia�>U! R�'s�+si �`�?'".�� a�.
GENERAL INFORMATION
Class of Work: A) Occupancy Group: 4� Type of Construction: 13
Type of Use: 13 Occupancy Load: 3 T Oregon Specialty Code: �0) (_,
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: \)'.+.5 - 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: $a600 O �F 4�,' "� '
$ 9 g DC Prov Rvw,COM TI-Ping
$ r„3. Permit Fee-Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2018) $ 1 12%State Surcharge
Project Valuation $ _ • . 44 Plan Review,Structural
Up to$4,999 $0.00 $ : 1 . .s- I Plan Review,Fire Life Safety
$5,000-$74,999 $98.00 $ . --- Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $243.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $388.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ 1089 ,O 7 TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070118.docx
City of Tigard
•T
Address and Commercial Suite Application
i GARD
..-A •. 0}a'Rw:.r uha nn,�.. 'k. .MYX NA-#..- tta tw.r 4..xcriY ',Ivy.= il
Addresses and suite numbers are assigned by the City of Tigard. Once a new address/suite is issued,the city
notifies 911,USPS,Washington County and various utility providers.This does not change any account information
or replace a"change of address" form.
Directions To Submit Form
►Fill in form ►Via email:OscarC@tigard-or.gov
Attach Site Map or Suite Layout Map(see below) ► In person:Permit Center Building Counter
1 Fees will be charged when new address is assigned (13125 SJV Hall Blvd.,Tigard,OR)
/Per address$50 Oscar Contreras,Public Works Department
/Per suite$50 OscarC@tigard-or.gov
/ Suite or address to be retired—no charge 503-718-2687
/Re-activating suites in our system—no charge
REQUIRED
Attach Site Map or Suite Layout Map
For Site Maps—show location of building on lot,front entrance and location of driveway along street.
/ For Suite Maps—show the locations of current active suites,new suites and suites to be retired.
Site Information
Parcel Number or Current Address:
0 Residential Property–OR– 0 Commercial Property Number of New Addresses:
Building Name(if applicable):
Is this property currently in the land use process (i.e.partition,site development review)? 0 Yes 0 No
Contact Information
*Please sketch the building layout with address
Property Management Company(if applicable): locations:
Contact Person:
Phone: Email:
I &C/PublkWorks/AddressAPplication Form For more information,please visitnnvwCigard!-orgov
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
'Pi .
T I G A R D Building Permit Review — Commercial - No Land U s e
NIIIIIIIIIIIIIENNIESSIIIIIIIIIIIIIIII
Building Permit #: A GG 'Q 2l.,-- oo c►
Site Address: !() S kk/ f J M ijJS ( Suite/Bldg#: l QQ 1 1 QS
Project Name: Q.rt jrt GcuatL1 Ir.Jra-.Ce
(Name of commercial busin ss occupying the space. If vacant,enter Spec Space.)
Planning Review ))��
Proposal: J Jj-it j+wd t'kln IA ON.p ktr fur n3.w 7�r,J. '(.^yr 1 v(rr47
`'Existing Business Activity: ( k
Proposed Business Activity:Verify@)1/
site address/suite# exists and active in permit system.
[ver Terrace Neighborhood: ❑ Yes Lid No
LV Zoning: hU E-
14 ermitted Use: tE Yes ❑ No ❑ Spec Space
C�J Confirmno land use required.
usiness License: T�
Exists: CI Yes LY No,applicant notified to obtain business license
Notes: C'1tzi l C.ntifpx if' A-km.4 (.4 is rt ✓frot
Approved by Planning: Cprj,-- Date: f 11-1e 1-)5
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: R(eil7,--
Site Plans: #
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: 'Planning ❑ oordinator V-Building
Workflow Sign-off: il"-" gn-off for Planning(include notes from planning review)
Route Application Documents: C- :uilding: original permit application, site plans,building plans,engineer and
,/� eIrGtedi-Gf
beam calculations and trust details,if applicable, etc.
Notes: /"Z'/ - 4/O Gti,e°,,Pl cS -ts-- RV,./.e i`Y_‘- '•
By Permit Technician: - 0�1 _ Date: /G�/lI
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_060 1 16.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: 9 Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant: 7-7
Revision Notice 2: Date Sent to Applic
Revision Notice 3: Date Sent to A cant:
❑ SDC Fees Entered: Wash rans Dev Tax: ❑ Yes ❑ N/A
T. rd Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue P it
Approv by Permit Coordinator: Date:
I:\BuildingForms\BldgPermitRvw_COM_NoLandUse 070915.docx