Permit CITY OF TIGARD BUILDING PERMIT
IN -■ Permit#: BUP2022-00271
COMMUNITY DEVELOPMENT
T I[ A Ir.t) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2022
• Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 455
Project: Mission Increase Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: TI for new tenant:Demolition, new walls and doors.
Contractor: SAGE CONTRACTORS INC Owner: PACIFIC REALTY ASSOCIATES L P
14785 S LOTUS LANE ATTN: N PIVEN
OREGON CITY, OR 97045 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-558-1009 PHONE:
FAX: 503-558-8009
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: I IB Permit Fee-Additions,Alterations, 12/12/2022 $864.99
Occupancy Grp: B Occupancy Load: 27 Demolition
12%State Surcharge-Building 12/12/2022 $103.80
Dwelling Units: 0 Plan Review 10/31/2022 $562.24
Stories: 0 Height: 0 R DC Provision Review,COM TI-Ping 12/12/2022 $110.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 12/12/2022 $346.00
Value: $68,000 Info Process/Archiving-Lg$2.00(over 12/12/2022 $12.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,999.03
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 o her 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
Of
952-001-0010 through OAR 952-001-0090. You may obtain avF�e les or direct questions to OUNC by calling 503.232.1987 or 1.8 .332. 344.
Issued By: /\ Permittee Signature:
CC 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.
Permit Coordinator Review
t. Conditions "Met"prior to issuance of permit
❑ Approved,NOT Released: Date:
E ENG Revisions Required: Date:
Notes:
Zr SDC Exemption E Applied for ❑ Received /Does not apply
gr Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ,12.N/A ❑ Deferred
Tigard Trans SDC: ❑ Yes 7'N/A ❑ Deferred
Parks SDC: ❑ Yes Z/N/A ❑ Deferred
LIDA Fee: ❑ Yes ��
W-OK to Issue/Approved by Permit Coordinator: Ark
Date: )1 � 11
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 ApprovedApproved
❑ Not A roved
Revision 3: ❑ Approved 0 Not Approved
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