Permit ' CITY OF TIGARD BUILDING PERMIT
' +r T` .
a COMMUNITY DEVELOPMENT Permit #: BUP2010 -00110
7IiGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 05/28/2010
Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY, STE# 150
Subdivision: PACIFIC CORP CENTER Lot: 0
Project: OnOne Software
Project Description: TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 05/28/2010 $1,347.55
PORTLAND, OR 97224 Demolition
PHONE: 503- 624 -6300 12% State Surcharge - Building 05/28/2010 $161.71
Metro Const. Excise Tax - Commercial 05/28/2010 $168.00
Use
Contractor: Plan Review 05/28/2010 $875.91
MATTHEW OLSON CONSTRUCTION Plan Review - Fire Life Safety 05/28/2010 $539.02
5320 SW DOVER LN
PORTLAND, OR 97225
PHONE: 503 - 892 -0066
FAX: 503- 892 -0067
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $140,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,092.19
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 ordance i approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is spended for • e 180
days TENTION: Oregon la e• ' - ou to follow the rules adopted by the Oregon Utility Notification Center. Those rule set fort ' •AR
95 - 001 -0010 through OAR 95 1101 -010'. may obtain a copy of the rules or direct questions to OUNC by calling 503 • •699 • 1.800.332.23
sued By: / � �� Permittee Signature: ` _
CaII 503.639.4175 by 7:00 a.m. for an inspection that •usiness 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 " VED FOR OFFICE USE ONLY
RE
I
City of Tigard ��+t Received / 10 P ermitNo.:' p,.(0-.0.,
III . DateB : o
" 13125 SW Hall Blvd., Tigard, OR 97223 MAY 8 Plan Review ►��
Phone: 503.639.4171 Fax: 503.598.1960 2 g 201 Date/Bv: I�AIM�� a , Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Read•': luris: ® See Attached Checklist for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
I ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
A Additiorilalteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms: \
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: � ' 5J7 S New dwelling area: square feet
"
City/State /ZIP: /F 11) w ry # 7 7 / y Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 4 DNS S ,, � , , 4 qe . 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: I 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: $ Z , //f,.7V
#7[700,77 Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
/
Name: PacTrust Type of construction: 11-1• -
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
O
City /State /ZIP: Portland, OR 97224 Existing: / �QQ�
Phone: (503)624 -6300 Fax: (503)624 -7755 New: J — e*
® 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: ,nn-n ' I - oit., �irx f ry-- BUILDING PERMIT FEES*
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 signature: s This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: , /.4 , 7 1 r f R ' Date: j /�4.- ) * Fee methodology set by Tri-County Building Industry
t(f J Service Board.
1: \Building \Permits \BUP- PermitApp.doc 03/21/06 440. 4613'x(11/02 /COM/WEB)
mi Building Division
Over- The - Counter (OTC) Building Permit
TI G AR D Check List
Description of Project: 11
GENERAL INFORMATION
Class. of Work:* kl_T Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use :" c.cr First floor: N: S:
Type of Construction: - 21 Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: t P)j Total sq ft.: N: S:
Stories: 1 Note: Combine total floor area for _E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor sq. ft. Fire Retardant:
Basement: Basement: - Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS • Fire sprinkler; T rL-'_-, , Handicap access:
Smoke detector: Protected corridors: 00
Fire alarm: 1 1 7 6-5 ' Parking spaces ( #):
Notes:
Total Valuation: $ /40 66 .
INSPECTIONS - . FEES DUE
Footing /foundation Firewall $ 4 7 5 Permit Fee
Post /beam structural Smoke detector $ itilkl State Surcharge
l�
Shear wall Misc. inspection $ Plan Review Fee
Masonry Approach /sidewalk $ ' ,'•' •,Ow FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ U(0 . °C' Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
• $ Other:
$ ` Total Fees Due
'i.U4a. tq
*OPTIONS: '
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation;'DEM = demo; •
FND = foundation; 'FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I: \Building \Forrns \OTC - BUP.doc 08/19/08