Permit CITY OF TIGARD BUILDING PERMIT
_ • COMMUNITY DEVELOPMENT Permit#: BUP2022-00054
Date Issued: 3/17/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 450
Project: ACE American Insurance Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Sub-diving an existing space w/remodel work to 4,871 sf of existing office space.Work include selected demo of
nonstructural walls,drywall/metal studs,suspended ceilings,doors/frames,lighting.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES L P
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, 03/16/2022 $804.75
Occupancy Grp: B Occupancy Load: 33 Demolition
12%State Surcharge-Building 03/16/2022 $96.57
Dwelling Units: 0 Plan Review 03/02/2022 $523.09
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 03/16/2022 $110.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 03/16/2022 $321,90
Value: $60,000 Info Process/Archiving-Lg$2.00(over 03/16/2022 $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 $1,866.31
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: Edgard o-(v( da- Permittee Signature: yee Q a h oh
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 fi- *2 2
Commercial FOR OFFICE USE ONLY
City of Tigard RECEIVED Received 2022 �' Per,»itNe.�u w2o2�06064
14a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /
Phone: 503.718.2439 Fax: 503.598.1960 FEB 2 3. 2022 Date/By: ,2.� 7 - . 2._ II/ Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: orris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD i led/Method: //,
Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUI D 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.
Valuation: $
0 1-and 2-family dwelling ®Commercial/industrial
❑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 I,a 4Gte r. Garage/carport area: square feet
Suite/bldg./apt.no.:450 Project name:Ace American Dewt sige- 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(rounded to 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 sub-dividing an existing space w/remodel work to 4,871 SF Valuation: $60,000.00
existing office retained by tenant.Work incl.selected demo of nonstructural Existing building area: 4,871 square feet
walls,drywall/metal studs,suspended ceilings,doors/frames,lighting. New building area: 4,871 square feet
0 PROPERTY OWNER 0 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 fee(or deposit): 523•c,
Contact name:Ryan McGuire
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:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 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:Ryan M 0111111110 Date:2/23/22 * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46I3T(I I/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
i c Building Permit Review — Commercial - No Land Use
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Building Permit #: p20z2-C0054-
Site Address: /29pq S. $44"'Raa2i -Ay Suite/Bldg#: 3oa
Project Name: AC ter-,Ere.tc N /A-fits 2 nce-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T. T•
Existing Business Activity: ikoft
Proposed Business Activity:
Ikr-Verify site address/suite# exists and active in permit system.
❑ River Terrace Neighborhood: ❑ Yes 1 No
,Zoning: C Co
L Permitted Use: 4frces ❑ No ❑ Spec Space
Confirm no land use required.
C10 Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: Date: 7/t'/2Z.
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
inTiMMITItedlittVidNOMMAPW,MSFK/4 +etJit:,M0445MWOfRTAIM INAM':l::741A4)Wirt E:T!4"€rT Y Rpia?";Ci:ikAWitW£.'JtiC,XEFFfAd LltiLi` +uvT flAtih: - . OPI M,SA'"' ZX3W
Building Permit Submittal
Original Submittal Date: W23/2022
Site Plans: # 3
Building Plans: # 3
Building Permit#: [Enter building permit#above.
Workflow Routing: V.Planning ❑ Permit Coordinator Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: &/Ol/2O22—
I:\Building\Fonns\B1dgPennitRvw COM NoLandUse_111819.docx
Permit Coordinator Review
❑ ►•nditions"Met"prior to issuance of building permit
❑ Approve• 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
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Fomis\B1dgPermitRvw COM NoLandUse_111819.docx