Permit
o PERMIT
BUILDING
Zll'o /&0 TY ~IPGARD
COMMUNITY DEVELOPMENT Permit#: BUP2010-00023
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72 AVE
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Common Area
Project Description: Demo interior partition and install new ADA ramp.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 02/03/2010 $256.22
PORTLAND, OR 97224 Demolition
PHONE: 503-624-6300 12% State Surcharge - Building 02/03/2010 $30.75
Plan Review 02/03/2010 $166.54
Plan Review - Fire Life Safety 02/03/2010 $102.49
Contractor:
DURUS CONTRUCTION LLC
15806 UPPER BOONES FERRY RD
LAKE OSWEGO, OR 97035
PHONE: 503-320-8601
FAX: 503-244-4318
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $11,875
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $556.00
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
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
952-001-001 g 52-001-01 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.600.332.2344.
Issued Permittee Signature:
t,f Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
a CITY OF TIGARD BUILDING PERMIT
Ilii °.. C OMMUNITY DEVELOPMENT Permit #: BUP2010 -00023
T [GA D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72 AVE
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Common Area
Project Description: Demo interior partition and install new ADA ramp.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 02/03/2010 $256.22
PORTLAND, OR 97224 Demolition
PHONE: 503 -624 -6300 12% State Surcharge - Building 02/03/2010 $30.75
Plan Review 02/03/2010 $166.54
Plan Review - Fire Life Safety 02/03/2010 $102.49
Contractor:
PACIFIC REALTY ACCOCIATES LP
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 624 -6300
FAX: 503- 624 -7755
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $11,875
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $556.00
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
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 i • - -• • - : . ith 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
day • TENTION: Oregon =w requir= you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in 0
95 - 001 -0010 through OAR 95 •1-01 I. • u may obtain a copy of the rules or direct questions to OUNC by calling 503.24 • • or 1.8 32.2344.
I sued By: j / Permittee Signature: "je `
Call 503.639.4175 by 7:00 a.m. for an Inspection that busine .
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.
. . : ii k..
Building Permit Application FOR OFFICE USE ONLY
City of Tigard RE Received ') )
DateB : Permit No.: • • /� i
g
I I M ° 13125 SW Hall Blvd., Ti ard, OR 97223 Pl
... tom �' d t ' , ��
Phone: 503.639.4171 Fax: 503.598.1960 FEB 0 3 2010 Dat an R R ev : iew •� � il`'.t�1 � Other Permit:
T I GARD Inspection Line: 503.639.4175 Date ReadyBy: ® See Attached Checklist for
Internet: www.tigard - or.gov CITY OF T "GARD Notified/Method: I - Supplemental Information
Bill! niNG DIVISION
• TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
ED New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
X 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 dwelling ® Commercial /industrial
Valuation: $
❑ 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: New dwelling area: square feet
City/State/ZIP: �� Garage/carport ort square feet area: s
ry �O /r - 1 , 1 e..-1. t i �� // 7 7 Gara g rP q
Suitelbldg. /apt. no.: Projedname• 6d vram /, , 1l✓ ,G � Covered porch area: square feet
Cross street/directions to job site: 4j 3rein.d P) 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.
Valuation: $ ., g �
/G „�� , :� j. / j � Existing building area: square feet
II/ 1 New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: d
Name: PacTrust Type of construction: 11 J �47
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: E
City /State/ZIP: Portland, OR 97224 Existing: .V/ PD'
Phone: (503)624 -6300 Fax: (503)624 -7755 New: /
® APPLICANT ® CONTACT PERSON
NOTICE
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: Dennis Pagni licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 S.W. Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
City / State/ZIP: Portland, OR 97224 • applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 624 -6300 Fax: : (503) 624 -7755
E -mail: dennisp @pactrust.com
CONTRACTOR
Business name: 7 e -7?? t . TL_-- BUILDING PERMIT FEES*
Address: �T (Please refer to fee schedule)
City/ State/ZIP: Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: ( ) I Fax: ( )
CCB lic.: Total fees due upon application:
Amount received: bpy .00
Authorized signature: �„�� This permit application expires if a permit is not o
�'� within 180 days after it has been accepted as complete.
Print name: 0 hn„.5., �o� _) Date: * Fee methodology set by Tri-County Building Industry
Service Board.
1:\ Building \Permits \BUP- PermitApp.doc 03/21/06 440- 4613T(11 /02/COM/WEB)