Permit (9) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2019 00277
Date Issued: 10/02/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S112DC01400
Jurisdiction: Tigard
Site address: 15875 SW 74TH AVE
Project: NW Mothers Milk Bank Subdivision: FANNO CREEK ACRE TRACTS Lot: 4
Project Description: TI for new tenant: Minor demolition and new partitions.
Contractor: PACIFIC CREST STRUCTURES INC Owner: JDS LLC
17750 SW UPPER BOONES FERRY RD SUITE CRITERION CREEKVIEW LLC
190 BY SPECTRUM REAL ESTATE ADVISORS
DURHAM, OR 97224 1125 SE DIVISION ST#209
PORTLAND, OR 97202
PHONE: 503-968-8949 PHONE:
FAX: 503-598-6658
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VA DC Provision Review, COM TI-Ping 10/02/2019 $254.00
Occupancy Grp: B Occupancy Load: 30 Permit Fee-Additions,Alterations, 10/02/2019 $1,256.95
Demolition
Dwelling Units: 0 12%State Surcharge-Building 10/02/2019 $150.83
Stories: 1 Height: 14 ft Plan Review 10/02/2019 $817.02
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/02/2019 $502.78
Value: $124,725 Info Process/Archiving-Lg$2.00(over 10/02/2019 $10.00
11x17)
Metro Const. Excise Tax 10/02/2019 $149.67
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,141.25
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: i� Permittee Signature: ,�i � _6« G may_ _ /I/ .41Lmo=t
/ all 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.
t-`1Ti ilding Permit Application
Commercial .,w e, FOR OFFICE USE ONLY
£"t) woe a Received /
City of Tigard '} Date/By: � !L y Permit No.: ,f }c,t*ti,__c), 7 7
'PI13125 SW Hall Blvd.,Tigard,OR 97223 +� d1y Plan Review j o ✓ 1 C
' ■ Phone: 503.639.4171 Fax: 503.598.1960 OC 1 W �"
Date/By: (! Other Permit:
Inspection Line: 503.639.4175 a t" Date Ready/By: luris. B See Page 2 for
TIGARI) p '1'-'1'''3
Internet: www.tigard-or.gov CIt .'t�: Notified/Method: SnpplementalInformation
TYPE'OF 41RK 1 ( '
REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 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: $
0 1-and 2-family dwelling XCommercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /5.O 7 5 S� Nil.? �h /r New dwelling area: square feet
City/State/ZIP: �e/4?,,,,, , . Garage/carport area: square feet
Suite/bldg./apt.no.: - P ) ..
roject name:A/W/1/0f1 Mi/,k. Covered porch area: square feet
Cross street/directions to job site: Botije-74. Deck area: square feet
SGl/D, Vki
i -t. /20 S Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.
il>/hi,n /fry► ill,4,1�4? ' Gf/ /�7i1VOS'' C/01”11 Valuation: $ 24,,7 7i�. 01�
N/LI/ f L7S 4? -:- .7
�I he
, TL c-` ��71 Existing building area: G��� square feet
D�7L fj�1 �'j D New building area:Ao ,h a quare feet
0 PROPERTY OWN TENANT Number of stories:
Name: j_e_S/e " 171,4 d& ,� /
A 1 wfro Type of construction: VE
Address: ! f 7 SW it 7 -'eta- /05--S Occupancy groups:
City/State/ZIP: /2f-7 O/cj 2-7-C-
Z C ' Existing:
Phone:(5-"b 3 %) 1/ , d 9 Fax:( ) New:
Pj APPLICANT 0 CONTACT PERSON NOTICE
Business name: 7"! be-cr i,1,1 6 FO p All contractors and subcontractors are required to be
Contact name: i___,//7js licensed with the Oregon Construction Contractors Board
Ll���-- /' / under ORS 701 and may be required to be licensed in the
Address: p,0 » D 6 /p [-�— jurisdiction in which work is being performed.If the
City/State/ZIP: L1. � i � ,-1,. q 7-J apply;
picant is exempt from licensing,the following reasons
L
Phone:(513) 70/ 40,71// Fax::( )
E-mail:I sin/ e aC / Crj771 Of
R
Business name: P4ti* 4 CSS SI-7. rah u.,✓s BUILDING PERMIT FEES*
(Please refer to fee schedule
Address: /7 7 sQ Sbu'v/tio4 I )2#'IGS �'►�, /�a� �g�
16
`_ J Structural plan review fee(or deposit):
City/State/ZIP: b�j/h b,- '7- - 1
Phone:( q q q Fax:( ) FLS plan review fee(if applicable):
`� v ` 9 Total fees due upon application:
CCB lic.: 1,(a I`S-
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
/ � '7 within 180 days after it has been accepted as complete.
Print name: Lib/1 of l4. S/�fip`/,, -- Date: !Os 7, f * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 2/23/07 440-4613T(11/02/COM/WEB)
City of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
T1caRD Building Permit Review — Commercial - No Land Use
Building Permit #: a 9 /c -oD Ti?
Site Address: 1WTS SW ?tt Av-ti\vt• Suite/Bldg#:
Project Name: ilkikkkdl dk. dci�tt
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review f
Proposal: 'I �,,:��, & r ,� ,,t,„, �o� - SwiZc �0 ss,,,„,
,(�
lArkt it4R { Ali Aff
Existing Business Activity: 0Q-11t.
Proposed Business Activity: 4 1Si4-r4
Ilt erify site address/suite# exists and active in permit system.�
[ River Terrace Neighborhood: El Yes [2' No
Zoning:
to -rmitted Use: Lod'Yes ❑ No ❑ Spec Space
IP Confirm no land use required.
Business License:
Exists: ❑ Yes I No,applicant notified to obtain business license
Notes: Nitta in pGe�,°n c1eM O ?rz. 1 1.t3 J-r. o,[.
Approved by Planning: Tni. Date: tQ l l'f
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: /(1/21,11
Site Plans: # /yr.
Building Plans:
Building Permit#: nter building permit#above.
Workflow Routing: Tanning ❑ Permit Coordinator la--Rrriti
Workflow Sign-off: � �gn ff for Planning(include notes from planning review)
Route Application Documents: L. wilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: (/
By Permit Technician: /"2 — Date: Jd/1//ti
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 0 N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPerntitRvw COM_NoLandUse 070915.docx
City of Tigard • BUILDING DIVISION
■
■ Over-The-Counter (OTC) Building & Fire Protection System Permit
TI(;A R D Appointment Checklist
Permit Record#: i l,3/`,2 )l -00)177 7
Contact Name: i_ii-1.cref Jit..4 r• , Phone #: Sr& 7 7] (i ?,/
Business Name: 7710r,S 15k. 61U-4- O Appt. Date/Time: /0/2.//9 /0:00 ,,
Site Address: t c775-S w 74/771 Bldg/Suite #: ----
Project Name: ,,1/ 7 ,2 jH /S Wig. ioC,�ANew Tenant? ❑ Yes ❑ No
Project Description: ,f J1p I r 1v 7>e-vt) lt'w t //j 6( -d fl'-Gri f'...-/,* S-
Existing Use: f'S New Use: A
MMD Required: ❑ Yes ❑ No Related Record#:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work: `, Occupancy Group: g .
Type of Construction: Ni Pc
Type of Use: eb/1\ j Occupancy Load: SO Oregon Specialty Code: 2,elii
SPECIFICS
Number of Stories: Building Height: t Li Mixed Use:
Number of Dw Units: Number of Bathrooms: 1 Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Sto S.uare Foota!e: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: I Carport: Mezzanine:
SETBACKS
Side and Setback—Left I Sideyard Setback—Front
Sideyard Setback—Right I Sideyard Setback—Back .
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: I S: N: S: Occupancy Separation:
E: W: E: W: Access.Parking Spaces:
REQUIRED ITEMS
Fire S.rinklers: I Fire Alarms: I Smoke Detectors:
EMENZIEMMIIIIIIIIIr IIMMECIIMMI Protected Corridors:
Stand.i.e Re.uired: I— I Pull Stations Re.uired: 1 Parapet: _
Hazard Group: I Battery Calcs Provided:
Densi : I Cut Sheets Provided: I
Desi: Area: I—
K Factor:
Total Project Valuation: $ FEES DUE
$ .- DC Prov Rvw,COM TI—Ping
$ i,, o,?.5— Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI-Effective 7/1/2019 $ j,v .j 12%State Surcharge
Project Valuation $ fi 7. Plan Review,Structural
Up to$4,999 $0.00 $ r2 —> Plan Review,Fire Life Safety
$5,000-$74,999 $102.00 $ 4).0,. Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $254.00 $ -- Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $406.00 $ /'-t 1. G ) Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ 3 /11 J, —TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070119.docx
Julie Drinkwater
From: Julie Drinkwater
Sent: Wednesday, September 18, 2019 7:12 AM
To: 'Linda Smith'
Cc: #Building Permit Technicians
Subject: RE: request for an over the counter appt with commercial plans examiner
Good morning Linda
Excellent! I have scheduled the OTC to take place on Wednesday, October 2, at 10:00. We will see you then.
Thank you
Julie Drinkwater
Permit Technician
City of Tigard 1 Building Department
13125 SW Hall Blvd
Tigard, OR 97223
503-718-2804
From: Linda Smith [mailto:Ismith@tidesigngroup.com]
Sent:Tuesday, September 17, 2019 6:49 PM
To:Julie Drinkwater<JulieD@tigard-or.gov>
Subject: Re: request for an over the counter appt with commercial plans examiner
Warning! This message was sent from outside your organization and we Allow sender I Block sender
are unable to verify the sender.
Julie,
Thank you very much!
No suite number, they will be occupying a stand alone building.
Thanks again for your help!
Linda
On Sep 17, 2019, at 5:06 PM, Julie Drinkwater<JulieD cr,tigard-or.gov> wrote:
Hello Linda
I will be happy to schedule the OTC for Wednesday, October 2, at 10:00am. Is there a suite
number associated with the address for Northwest Mothers Milk Bank?
Thank you
Julie Drinkwater
Permit Technician
City of Tigard Building Department
13125 SW Hall Blvd
Tigard, OR 97223
503-718-2804
From: Linda Smith [mailto:lsmith@tidesigngroup.com]
Sent:Tuesday,September 17, 2019 4:16 PM
To:Julie Drinkwater<JulieD@tigard-or.gov>
Subject: Re: request for an over the counter appt with commercial plans examiner
Hi Julie,
If possible I would like to change my request to October 2 at loam.
Thank you!!!
Linda
On Sep 17, 2019, at 3:34 PM, Linda Smith<lsmith@tidesigngroup.com>wrote:
Hi Julie,
Thursday October 3 at 10 would be great.
Thank you!
Linda Smith
TI Design Group
503.781.6791
On Sep 17, 2019, at 2:03 PM, Julie Drinkwater<JulieD@a,tigard-or.gov> wrote:
2
Front1 DSTS
Subject: Linda Smith, TI Design Group, 503-781-6791, 15875 SW 74th
Location: CR=_3_Permit_Center
Start: Wed 10/2/2019 10:00 AM
End: Wed 10/2/2019 11:00 AM
Recurrence: Weekly
Recurrence Pattern: every Tuesday,Wednesday, and Thursday from 10:00 AM to 11:00 AM
Meeting Status: Meeting organizer
Organizer: -Building_OTC
Resources: CR_-_3_Permit_Center
SCOPE OF WORK: Minor demolition, new walls, and new relites
TENANT NAME: Northwest Mother's Milk Bank
EXISTING USE: B
NEW USE: B
1