Permit CITY OF TIGARD BUILDING PERMIT
N . . COMMUNITY DEVELOPMENT Permit#: BUP2021-00043
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/22/2021
T I t'rti k(7 g Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 400
Project: Spec Space Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: TI-work includes demo of nonstructural walls,drywall/metal studs walls,suspended ceilings,doors/frames,
painting,elect,distr and lighting.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY#300
TIGARD, OR 97224
PHONE: 503-624-6300 PHONE:
FAX: 503-624-7755
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee-Additions,Alterations, 02/17/2021 $520.07
Demolition
Occupancy Grp: B Occupancy Load: 28 12%State Surcharge-Building 02/17/2021 $62.41
Dwelling Units: 0 Plan Review 02/08/2021 $338.05
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 02/17/2021 $103.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/17/2021 $208.03
Value: $30,524 Info Process/Archiving-Lg$2.00(over 02/17/2021 $10.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,241.56
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: V--\50\t1 �jPermittee Signature: cfr\ 'Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application —$_ i 28 �1
Commercial FOR OFFICE FSE ONLY
of Tigard RECEIVED Received p �/
Cityipl g Date/By: LI L[/d" 41
Permit No. 2 ��
13125 SW Hall Blvd.,Tigard,OR 97223
43
® g Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 JAN 2 8 2021 DateBy: c , 16 a Other Permit:
TIGARD Inspection Line: 503.639.4175 Date RcadyBy: uris H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notifi ethod: 7/ c' Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑ 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: 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: $
El Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION_AND LOCATION Total number of floors:
Job site address: 12909 SW 68th Parkway New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:400 Project name:ppc082-400Spec , ' 1�i G g eke.... - Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
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.
Remodel work to 4,758 rentable SF of existing,vacant office space.Work incls. Valuation: $30,524.00
selected demo of existing nonstructural walls,nonstructural drywall/metal studs Existing building area: 4,758 square feet
walls,suspended ceilings,doors/frames,painting,elect.distr.&lighting New building area: 4,758 square feet
® PROPERTY OWNER ❑ TENANT: Number of stories: I
Name:Pacific Realty Associates,LP. Type of construction: Il-B
Address: 15350 SW Sequoia Parkway,Suite 300 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing: B
Phone:(503)624-6300 Fax:(503)624-7755
New: B
E APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:Pacific Realty Associates,LP.
Structural plan review fee(or deposit): .35c 5
Contact name:Robert Bumcrot
FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Parkway,Suite 300
Total fees due upon application:
City/State/ZIP:Portland,OR 97224
Amount received:
Phone:(503)624-6300 Fax::(503)624-7755
E-mail:permits@pactrustcom PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Pacific Realty Associates,LP. Submit two(2)sets of roof plan with connection details /
and fire department access,along with the 2010 Oregon
Address: 15350 SW Sequoia Parkway,Suite 300 Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP:Portland,OR 97224 $180.00
and administrative fees):
Phone:(503)624-6300 / Fax:(503)624-7755 State surcharge(12%of permit fee): $21.60
CCB lie.: 153913 1 /` i-//2 Z Total fee due upon application: $201.60
1, Digitally signed by Robert Bumcrot
Authorized signature: Robert} J Bumcrot DN,D=US,E=robertb@pactrust.com, This permit application expires if a permit is not obtained
Dae.2021 0CN 16:46:t 3umcr0' within 180 days after it has been accepted as complete.
-'-Date:2021.01.2616:46:63-08'00' p P
Print name:Robert Bumcrot Date: 1/26/2021 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
i2i7-t
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
1
T1cARD Building Permit Review — Commercial - N o Land Use
Building Permit #: e3UP2()2 I-000 43
Site Address: 12909 SW 68th Parkway Suite/Bldg#: 400
Project Name: PPC082-400 Spec
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Plannir1R-Re Piety
Proposal: TI
Existing Business Activity: n/a
Proposed Business Activity: n/a
k7 Verify site address/suite # exists and active in permit system.
® River Terrace Neighborhood: ❑ Yes n No
E Zoning: TMU
A Permitted Use: ❑ Yes ❑ No Gd Spec Space
Confirm no land use required.
fe& Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: PINA fAftlebfb Date: 2/1/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
iluildiri Permit Submittal
Original Submittal Date: VZg/22/
Site Plans: # 3
Building Plans: # ,3
Building Permit#: Ig--Enter building permit# above.
Workflow Routing: .Planning ❑ Permit Coordinator O'"Building
Workflow Sign-off: [--Sign-off for Planning(include notes from planning review)
Route Application Documents: CO--Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: 02/60°2(
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_l 11819.docx
- t Cooreti'nator JJeviety
❑ Conditio ` et"prior to issuance of building permit
❑ Approved,NO •ased: D .
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Appli .
Revision Notice 3: Date Sent to = .. cant:
❑ SDC Fees Entered: W o Trans Dev Tax: ❑ Yes ❑ N
igard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to •. s e Permit
. •roved by Permit Coordinator: Date:
I:\Building\Fonns\B1dgPermitRvw_COM NoLandUse_111819.docx