Permit 11 CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2022-00233
Date Issued: 11/10/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 250
Project: Tru Independence Subdivision: Lot: 2
Project Description: Demising an existing office space into(2)separated spaces&remodel work to retained 4,578 sq ft.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW 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, 11/09/2022 $317.06
Occupancy Grp: B Occupancy Load: 49 Deo olition
12/o State Surcharge-Building 11/09/2022 $38.05
Dwelling Units: 0 Plan Review 09/27/2022 $206.09
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 11/09/2022 $110.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 11/09/2022 $126.82
Value: $16,000 Info Process/Archiving-Lg$2.00(over 11/09/2022 $8.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $806.02
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: ( /�'f� Permittee Signature:
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
CommercialRECEIVE FOR OFFICE USE.ONLY
��'eceived
- City W Tigard DateBy: 1�i�LZ i 1/ olGZZ72-233
-° 13125 SW Hall Blvd.,Tigard,OR 97223 S E P 2 6 ZQ�; Plan Revie Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 1 •a '2,2, A
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: ® See Page 2 for
8 g BUILDING DIVISION Notified/Method: 1 °I e.- i Supplemental information
Internet: www.[i and-or. ov 1( PP
FL'n tZo_ rotef l f aced rr{ I III V---'a,
TYPE OF WORK REQUIRED DATA:I-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.
❑ I-and 2-family dwellingValuation: S
®Couunercial,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: 15350 SW Sequoia Parkway New dwelling area: square feet
City/State/ZIP: Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:250 Project name:Tru Independence 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
DESCRIPTION OF WORK work indicated on this application.
Project consists of demising an existing office space into 2 separated spaces& Valuation: $16,000.00
remodel work to retained 4,578 SF.Work in remaining space under separate permit Existing building area: 4,578 square feet
Work incl demo,drywall/metal studs walls,doors/frames,elect.distr.,lighting New building area: 4,578 square feet
® 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.(5031624-7755
New: B
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer ru fee schedule)
Business name:Pacific Realty Associates,LP.
Structural plan review fee(or deposit):
Contact name:Jake Gerard
FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Parkway,Suite 300
City/State/ZIP:Portland,OR 97224 Total fees due upon application:
Amount received:
Phone:(503)624-6300 Fax: :(503)624-7755
E-mail:permits@pactrusLcom 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:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:153913 /44
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:Jacob Gerard Date: 9/26/2022 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits1BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
.II0
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: 0 ,,, G�z-620.23 ?
` . Suite Bld #:
Site Address: Ci / 2Sr)
, � / , , r,�
Project Name: PO�C 1 .. n
(Name of commercial business occupying the space. If vacant,enter Spec Space.) Q - ,
Planning Review
�p,,,, �/�
Proposal: 1 r 1C�1 / `o f- reCeA lIl( 1Gr1 ( / )
J
Existing Business Activity: C(1
Proposed Business Activity: 1y
to Verify site address/suite# exists and active in permit system.
0 River Terrace Neighborhood: ❑ Yes No
f 1 Zoning: '�P
Permitted Use: ?I' Yes 0 No ❑ Spec Space
Confirm no land use required.
19 Business License:
Exists: 0 Yes ❑ No, applicant was provided a business license application Q\\ � .),(--
Notes: CO-WO -'1(1 ' kCe 031' br ify9rv,,c4 CC7!'1v@At4—
`S r P -i 2 Iye t.J -fth"W (00 So 0( c-e
Approved by Planning: A 110V Date: q. (j2 Z7.--
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: 7-/e2 /l�?
Site Plans: #
Building Plans: # -73
Building Permit#: 'Enter building permit#above.
Workflow Routing: 'Q Planning Pe • r • 4o — ,-g--Building
Workflow Sign-off: 'Sign-off for P ntng(include notes from planning review)
Route Application Documents: .,..fa—Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: �i
By Permit Technician: Date:
G 6,7L2
•
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_09072022.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of permit
❑ Approved,NOT Released: Date:
❑ ENG Revisions Required: Date:
Notes:
❑ SDC Exemption ❑ Applied for ❑ Received ❑ Does not apply
❑ Fees Entered: Wash Co Trans Dev ax: ❑ Yes ❑ N/A ❑ Deferred
Tigard Trans SD . ❑ Yes ❑ N/A ❑ Deferred
Parks SDC: ❑ Yes ❑ N/A ❑ Deferred
LIDA Fee: ❑ Yes ❑ N/A
❑ OK to Issue/Approved by P- 't Coordinator: Date:
Revisions (after Building Sub ttal only) Reviewer Date
Revision 1: ❑ App .ved ❑ Not Approved
Revision 2: ❑ A..roved ❑ Not Approved
Revision 3: ❑ pproved ❑ Not Approved
I:\Building\Forms\B1dgPermitRvw_COM_NoLandUse_08162022.docx