Permit CITY OF TIGARD BUILDING PERMIT
ligs COMMUNITY DEVELOPMENT Permit#: BUP2021-00065
13125 SW Hall Blvd.,Ti Date Issued: 4/5/2021
Tti;,41iD and OR 97223 503.718.2439 9
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 110
Project: Spec space Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25, PT
Project Description: TI demo nonstructural walls,lighting,finishes
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
PORTLAND, 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, 04/01/2021 $195.38
Demolition
Occupancy Grp: B Occupancy Load: 14 12%State Surcharge-Building 04/01/2021 $23.45
Dwelling Units: 0 Plan Review 03/18/2021 $127.00
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 04/01/2021 $103.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 04/01/2021 $78.15
Value: $8,000 Info Process/Archiving-Lg$2.00(over 04/01/2021 $2.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $528.98
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: }tallyVet ��wP Permittee Signature: OWApp �yi.
cfe
Call 503.639.4175 by 7:00 a.m.for the nest 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 13_3 ‘5 Zl
Commercial RECEr FOR OFFICE USE ONLY
City of Received
Tigard Permit No..
g MAR 15 2021 Date/By.Plan Re 3`1a`z� �tV BUP?Az Vio000vS
13125 SW Hall Blvd.,Tigard,OR 97223 vie a7"�l, NIPhone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T 1 G A R U Inspection Line: 503.639.4175 CITY OF TIGAR Date Ready/By: ari See Page 2 for
Internet: www.tigard-or.gov BUILDING L}IVISI mfied/Methed: � ®Supplemental Information
.41..mid
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 0 Other: equipment,materials,labor,overhead,and the profit for the
i
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling [ElCommercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
.1013 SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12909 SW 68'h Pkwy New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:110 Project name:ppc082-110 Spec >//�� t D 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.
Indicate the value(roundedto the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Project consists of remodel work to 1,335 SF of existing office space.Work Valuation: $8,000.00
shall include but not be limited to selected demo of existing nonstructural Existing building area: 1,335 square feet
walls,lighting,and finishes.All work to meet ADA requirements. New building area: 1,335 square feet
Z PROPERTY OWNER ❑ TENANT Number of stories: I
Name:Pacific Realty Associates,LP. Type of construction: II-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
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Pacific Realty Associates,LP.
Structural plan review tee(or deposit):
Contact name:Dick Krippaehne
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
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:permits@pactrust.com
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.
City/State/ZIP:Portland,OR 97224 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)624-6300 Fax:(503)624-7755 State surcharge(12%of permit fee): $21.60
CCB lie.:153913 Total fee due upon application: $201.60
p meta Lc- tL&-xltr�^( 0f1foG1.tiTe5r (_P. This permit application expires ifa permit is not obtained
Authorized signature: l3
1 Zi 6—(/� (Z. within 180 days after it has been accepted as complete.
Print name:Richard J.Krippaehne L Date: 3 (50.0 al * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
-31 15 lzj
ill
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
IFil ■ -
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: ' J?2O Z \— 000Co 5
Site Address: 12909 SW 68th Parkway Suite/Bldg#: 110
Project Name: ppc082-110 Spec
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Plannir .407 el/-
Proposal: TI
Existing Business Activity: n/a
Proposed Business Activity: n/a
al Verify site address/suite # exists and active in permit system.
]R River Terrace Neighborhood: ❑ Yes gl No
I Zoning: TMU
® Permitted Use: E Yes ❑ No ® Spec Space
® Confirm no land use required.
a Business License:
Exists: E Yes ❑ No,applicant was provided a business license application
Notes:Approved by Planning: Ar Q C/QQ��
Date: 3/16/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: 0 Approved ❑ Not Approved
Iluildlok Permit Slrbolittal
Original Submittal Date: 3\\ IZA
Site Plans: # 'S
Building Plans: # 3
Building Permit#: E'Enter building permit# above.
Workflow Routing: [?Planning ❑ Perm t Cvvrdisiaior. ['Building
Workflow Sign-off: Y.-Sign-off for Planning(include notes from planning review)
Route Application Documents: [v�Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: \\ __
By Permit Technician: '�0\1 \J G r e\../..)e- Date: 3`\B\2 i
I:1 Building\Forms\BldgPermitRvw COM_NoLandUse_111819.docx
- • 't CbordinatorReview
❑ Conditio ` et"prior to issuance of building permit
❑ Approved,NO •ased: .
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
EI OK to • s e Permit
• roved by Permit Coordinator: Date:
I:1Building\Forms\BldgPermitRvw_COM_No LandUse_111819.docx