Permit CITY OF TIGARD BUILDING PERMIT
1 . COMMUNITY DEVELOPMENT Permit#: BUP2021-00134
T I G A 12 f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/12/2021
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 200
Project: CNA Insurance Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Remodel work existing office space.Work incl.selected demo to nonstructural walls,nonstructural drywall/metal
studs walls,suspended ceilings,doors/frames,painting,electrical distribution,lighting&plumbing.
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: 11E1 Permit Fee-Additions,Alterations, 07/07/2021 $1,577.07
Occupancy Grp: B Occupancy Load: 60 Demolition
12%State Surcharge-Building 07/07/2021 $189.25
Dwelling Units: 0 Plan Review 06/16/2021 $1,025.10
Stories: 0 Height: 0 ft Address Fee-per lot/suite(up to first 20) 06/16/2021 $50.00
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-Ping 07/07/2021 $434.00
Value: $178,000 Plan Review-Fire Life Safety 07/07/2021 $630.83
Info Process/Archiving-Lg$2.00(over 07/07/2021 $10.00
11x17)
Floor Areas: Metro CET 07/07/2021 $213.60
Total Area: 0 Tigard CET-Non-Residential-Admin 07/07/2021 $71.20
Accessory Struct: 0 Tigard CET-Non-Residential-AH 07/07/2021 $1,708.80
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $5,909.85
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: 1-I.& y Vc vvDe,Weige, Permittee Signature: O Ili App/I—cc.. a- n
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. wtM�
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 eo •(,(3 Zi
Commercial RECEIVE 9 FOR OFFICE USE ONLY
City of Tigard JUN 03 2021 y:d bH 15 zbzl Permit No. &1pzp�-dp t3 if
DateBReceive
_j)
0° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r
• Phone: 503.718.2439 Fax: 503.598.1960 DTIGARDate/By: '—J 2)� Other Permit:
TIGAR D Inspection Line: 503.639.4175 CITY OF DIVISION
Date ReadyBy: / /4 Jg El See Page 2 for
Internet: www.Ngard-or.gov BUILDING DIVISION NoC d Mc hod: � Supplemental Information
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.
0 I-and 2-family dwelling ®Commercial/industrialValuation: $
❑Accessory building ❑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.:200 Project name:CNA Downsize 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
. ', '.' n DESCRIPTION OF WORK work indicated on this application.
Remodel work to 8,891 SF of existing office space.Work incl.selected demo of Valuation: $178,000.00
existing nonstructural walls,nonstructural drywall/metal studs walls,suspended Existing building area: 8,891 square feet
ceilings,doors/frames,painting,electrical distribution,lighting,&plumbing New building area: 8,891 square feet
0 PROPERTY OWNER ❑ TENANT Number of stories: 1
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
El APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Pieuse refer to fee schedule
Business name:Pacific Realty Associates,LP.
Structural plan review fee(or deposit): ,e -1/s
Contact name:Robert Bumcrot —
Address:15350 SW Sequoia Parkway,Suite 300 FLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP:Portland,OR 97224
Phone:(503)624-6300 Fax::(503)624-7755 Amount received:
E-mail:permits(a pactrust.com 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.
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
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Robert B mcrot Date: 6.1.2021 * 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)
City of Tigard
i COMMUNITY DEVELOPMENT DEPARTMENT
S
TIGARD Building Permit Review — Commercial - No Land Use
.,
Building Permit #: -8v202i-0013y-
Site Address: 12909 SW 68th Pkwy Suite/Bldg#: 200
Project Name: Continental Casualty Company
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Downsizing suite
Exi 'ng Business Activity: Office
Pr.posed Business Activity: Office
El V rify site address/suite# exists and active in permit sys m.
1j t' ver Terrace Neighborhood/: ❑ Yes C❑J7 No
FVoning:d TMUUse:
tte Yes U No U Spec Space
onfirm no land use required.
Business License:
Exists: ❑ Yes No, applicant was provided a business license application
Notes:
�Approved by Planning: �— __ Date: t-E`/9 0 l
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: O(a'C3-2021
Site Plans: # 0
Building Plans: # ,3
Building Permit#: —7 Rater buildin permit#above. �7�
Workflow Routing: R Planning Permit Coordinator 1 Building
Workflow Sign-off: Q�Sign-off for Planning(include notes from planning review)
L�'
Route Application Documents: iuilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ,s Date: A4.15 2-02/
I:\Building\Forms\B I dgPermitRvw_COM_NoLandUse_I 1 1819.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 pplicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Se to Applicant:
❑ SDC Fees Entered: Was o Trans Dev Tax: ❑ Yes 0 N/A
Tip.rd Trans SDC: ❑ Yes 0 N/A
C,rks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit C ordinator: Date:
1:1Buildingll'orms\BldgPermitRvw_COM_NoLandUse_111819.docx