Permit (87) CITY OF TIGARD BUILDING PERMIT
1111
COMMUNITY DEVELOPMENT Permit#: BUP2019-00016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/07/2019
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD
Project: AT&T Subdivision: None Lot: None
Project Description: 100 sq.ft. kiosk including retail fixtures,flooring,and prefabricated finishes.
Contractor: ROEBBELEN CONTRACTING INC Owner: PPR WASHINGTON SQUARE LLC
1241 HAWKS FLIGHT CT PO BOX 847
ELDORADO HILLS, CA 95762 CARLSBAD, CA 92018
PHONE: 916-939-4000 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 02/04/2019 $241.01
Demolition
Occupancy Grp: M Occupancy Load: 3 12%State Surcharge-Building 02/04/2019 $28.92
Dwelling Units: 0 Plan Review 01/25/2019 $156.66
Stories: 0 Height: 0 ft DC Provision Review, COM New-Bldg 02/04/2019 $194.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 02/04/2019 $6.00
Value: $11,000 11x17)
Info Process/Archiving-Lg$2.00(over 02/04/2019 $6.00
11x17)
Floor Areas:
Total Area: 150
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $632.59
Required: Required Items and Reports(Conditions)
Fire Sprinkler: 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 co. . - - or direct questions to OUNC by calling 503.232.1987 or 0.332.2344.
Issued By: -errlittee.S.igj ture:
- —, rte` —
Ca 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 FOR OFFICE USE ONLY
. City of Tigard ' .. Deis Ci Pemut No.:067�I/�_ `ce
13125 SW Hall Blvd.,Tigard OR 97223 plan Reyvi Other Permit: O
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: )1:1 g-I C
T I G A R D �p�on Line: 503.639.4175 JAN 1 7 2019 Date Ready/By: / loris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: l 3)/I-1
, 75 Supplemental Information
TYPE op3itsmic REUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 Demolition re)4 iitiiPermit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
►1 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
ElAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9585 SW Washington Sq.Rd. New dwelling area: square feet
City/State/ZIP:Portland,Oregon 97223 Garage/carport area: square feet
Suite/bldgiapt.no.: Project name:ATT Kiosk Covered porch area square feet
Cross street/directions to job site:SW GreenBurg RD Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 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.
Installation of free standing ATT Kiosk in common/public area of center.Kiosk Valuation: $$11,000.00
measures 10'x10'&includes retail fixtures,flooring&prefabricated fmishings Existing building area: square feet
New building area: 100 square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name:AT&T Mobility Type of construction:
Address:4404 Goose Rock Dr. Occupancy groups:
City/State/ZIP:Indianapolis,In.46239 Existing:
Phone:(317)919-7600 Fax:( ) New: M
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Property Service
(Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Gary Palmer
Address:POB 23534 FLS plan review fee(if applicable):
Total fees due upon application: (5?0,.G 6,_
City/State/ZIP:Eugene,Oregon 97402
Phone:(541)603-4191 Fax::( ) Amount received:
E-mail:psexpediting®aim.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Roebbelem Contractiong Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1241 Hawks Flight Drive Solar Installation Specialty Code checklist
City/State/Z1P:El Dorado Hills,CA.95762 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(916)939-4000 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:124156 (A I i.3 pi/
/� Total fee due upon application: $201.60
Authorized signature: 4 \ This permit application expires if a permit is not obtained
V j \ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name: 0 Date: y+� Service Board.
I:1Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Property Service
RECEIVED Building Permit Expediting
Consulting& Management
JAN 1 7 2019 Post Office Box 23534
,r.r Eugene, Oregon 97402
OF-Plat t
>�r
January ir, 2019
City of Tigard Oregon
Building Dept./Permit Center
13125 SW Hall Blvd.
Tigard, Oregon 97223
To Whom it May Concern :
Enclosed area sets of plans, permit application 8t related departmental documents
for a kiosk project at the Washington Square Center.
I'd like to have the enclosed submitted into plan review for approval 8t permits, if
you have any questions my contact information is as follows:
Gary Palmer
541-603-4191
psexpeditinq(&aim.com
I will follow up with the permit center once this has been delivered for plan check
fees 81.to answer any questions.
Thank you,
Gary Palmer
City of Tigard
11111 " COMMUNITY DEVELOPMENT DEPARTMENT
T 1 CARD Building Permit Review — Commercial - No Land Use
(- ,
Building Permit #: a,,,,,,/,_66b,,,
Site Address: ISN S`w \ARIS d Suite/Bldg#:i vruc a Suite/Bid #:
Project Name: A11 Kick
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
n'
Proposal: 1^41-xlttII LL 0C "344,ing` STT b k in Cim,keihabl'it a of Ctrl, ki7ik rtitkpiti
to '`10 nr
& 1 .t✓�(.S K-`Ai 1-11-1v/t-I j TIal"sj ,1 pt.Pl6rr2411 .�'j1�1i1hiky,
Existing Business Activity: 1
Proposed Business Activity: Saty 0r+11,- til
II/Verify site address/suite#exists and active in permit syste .
er Terrace Neighborhood: ❑ Yes No
Ver
[ining: kV
C rmitted Use: I� Yes ❑ No ❑ Spec Space
lIX Co firm no land use required.
usiness License: /
Exists: CI Yes Lid No,applicant notified to obtain business license
Notes:
Approved by Planning: )Lo..nvvtttt CP - Date: I-L9`(9
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: 0 Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: / /
Site Plans: ## idt
Building Plans: #
Building Permit#: L `ter building permit#above.
Workflow Routing: 13---Ptinning E- Coordinator u ing
Workflow Sign-off: gYS�gn- f for Planning(include notes from planning review)
Route Application Documents: wilding: original permit application,site plans,building plans,engineer and
Qo
beam calculations and trust details,if applicable,etc.
Notes: J&Cc i Cje / yr l 0, / -, l cd✓ :..; ii /igrs,V dA/ / ag' '''. r, b+r
By Permit Technician: Date: /AO/ >
1
1:\Building\Forms\BIdgPermitRvw 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:
/VSDC Fees Entered: Wash Co Trans Dev Tax: es ❑ N/A
Tigard Trans SDC: I .Yes ❑ N/A
Parks SDC: [ Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 7/3//'r
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx