Permit ` r g BUILDING PERMIT
71 ,,�, CITY OF TIGARD
s q
s ' COMMUNITY DEVELOPMENT Permit #: BUP2010 00038
3 Date Issued: 03/04/2010
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72ND AVE 140
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Trinity University
Project Description: Interior TI.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 03/04/2010 $225.80
PORTLAND, OR 97224 Demolition
PHONE: 503- 624 -6300 12% State Surcharge - Building 03/04/2010 $27.10
Plan Review 03/04/2010 $146.77
Plan Review - Fire Life Safety 03/04/2010 $90.32
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: $10,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $489.99
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 -re set forth .•
952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503. , •.6699 • .800.332. 344.
Issued By: (\ 0 u0 C \ V A io Permittee Signature: /y
all 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.
Building Permit Application FOR OFFICE USE ONLY
v RECEIVED Received
City of Tigard I �d eL - i1 A t Date/B : . r 1120 `e
ir I
av
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �i
Phone: 503.639.4171 Fax: 503.598.1960 E Date : �11ta2� Permit No Other Permit:
TIGARD Inspection Line: 503.639 MAR O 4 _ f Date Ready/By: - Juris: ® See Attached Checklist for
Internet: www.tigard- or.gov ` t ' " ' I Notified/Method: Supplemental Information
cm° OF Ti GARZ4
TYPE OF vilaiLDING DIVISION 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.
❑ 1- and 2- family dwelling Z 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: , / � S /7 A-1- J 4-4/7 New dwelling area: square feet
City /State /ZIP: ✓ . ), J ,- ;72.. „ �a y Garage /carport area: square feet
Suite/bldg./apt. no.: Protect name: - 7"..-3 t x/ 77 -' j V ( • oil/ 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. //��
! /2crC - — /."4-e d /1- 7/4"e--..71?" 4- 7,7,1_, G Valuation: $ / C/lJ U
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PacTrust Type of construction: 'v_7,g
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
City /State /ZIP: Portland, OR 97224 Existing:
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: S BUILDING PERMIT FEES*
�t�c� �'(lr�✓s'�17� U j /G
Address: (Please refer to fee schedule)
City/State /ZIP: Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: ( ) Fax:( )
CCB lic.: Total fees due upon application:
Amount received:
Authorized signatur r This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name l4 11 t f ' Date: �r/ F L /// Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits \BUP- PcrmitApp.doc 03/21/06 440- 4613T(I 1 /02/COM/WEB)