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Permit
CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit #: BUP2010 -00172 T t{GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2010 Parcel: 2S113AB00101 Jurisdiction: TIGARD Site address: 16101 SW 72ND AVE 200 Subdivision: PACTRUST BUSINESS CENTER Lot: 0 Project: Sunset Mortgage Project Description: TI Owner: FEES PACTRUST Description Date Amount 15350 SW SEQUOIA PKWY SUITE 300 Permit Fee - Additions, Alterations, 07/21/2010 $993.00 PORTLAND, OR 97224 Demolition PHONE: 503- 624 -6300 12% State Surcharge - Building 07/21/2010 $119.16 Plan Review 07/21/2010 $645.45 Plan Review - Fire Life Safety 07/21/2010 $397.20 Contractor: OWNER PHONE: FAX: Specifics: Type of Use: COM Class of Work: ALT Dwelling Units: 0 Stories: 2 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $85,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $2,154.81 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 . -s adopted by the Oregon Utility Notification Center. Those rules a t forth in 0 952- 001 -0010 through OAR 952- 001 -0100. Y • . ay obt� - or direct questions to OUNC by calling 503.24' • • • 9 or 1.8 .332.2344. Issued By: / r / � Permittee Signature: / ' 3.639.4175 by 7:00 a.m. for an inspection that . - l oess .. • . 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 AA a� `- FOR OFFICE USE ONLY Clt of Ti and `` 1 5X` ` ```` P Received y g `�� s4 �`y r a y: f N �. Permit No.: �, w (p Ili ° 13 125 SW Hall Blvd., Tigard, OR 97223 a� 4 � Plan Review �� j ©1 u - Phone: 503.639.4171 Fax: 503.598.1960 %\:.'' ` " date B �/ Other Permit TIGARD Inspection Line: 503.639.4175 ,*' to Ready /By: ® See Attached Checklist for Internet: www.tigard- or.gov in otified/Methed: !t -� Supplemental Information c0 TYPE OF WORK 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 ■1 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1=1 1- and 2- family dwelling Z Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder 1:1 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 0/„ / _5-et, �f New dwelling area: square feet City /State /ZIP: ii,„ ( Garage /carport area: square feet Suite/bldg. /apt. no.: ?to Project name: 4, �L0 yr& '`/ p� 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. Valuation: $ 9 dC) v -, dP i c , / / d G v Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: PacTrust Type of construction: l�,_, Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: Portland, OR 97224 Existing: ..././' 9D ' Phone: (503)624 -6300 Fax: (503)624 -7755 New: / .....0 V ® 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: 2 ( A S BUILDING PERMIT FEES* Address: /� (Please refer to fee schedule) City/State/ZIP: Structural plan review fee (or deposit): Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: / Total fees due upon application: Amount received: Authorized signature: This permit application expires if a permit is not obtained ��— within 180 days after it has been accepted as complete. Print name: , , . Date: * Fee methodology set by Tri-County Building Industry Service Board. I:\ Building \Permits \BUP- PermitApp.doc 03/21/06 440- 4613T(II /02 /COM/WEB) Building Division • Over- The - Counter (OTC) Building Permit ricnEin Check List ( Description of Project: 1 GENERAL INFORMATION Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* First floor: N: S: Type of Construction: Second floor: E: W: Occupancy Group: Third floor: Openings Protected Y /N ?: Occupancy Load: Total sq ft.: N: S: Stories: Note: Combine total floor . area for E: E: . ' Height: all floors above third floor and Roof Construction: Floor Load: add to the third floor s . ft. Fire Retardant: Basement: Basement: Area Separation Rated: Mezzanine: Garage: Occu. Separation Rated: REQUIRED TrEMS Fire sprinkler: LeE5 Handicap access: ,� qq,,� Smoke detector. Protected corridors: p� �C.� Fire alarm: 1 ( v J Parking spaces ( #): Notes: Total Valuation: $ } l INSPECTIONS FEES DUE Footing /foundation Firewall $ -' Permit Fee Ptist /beam structural Smoke detector $ , State Surcharge Shear wall Misc. inspection $ i ', Plan Review Fee Masonry Approach /sidewalk $ 11 FLS Plan Review Fee Framing $ Additional Permit Fee Insulation Sprinkler rough -in ' $ Additional Plan Review Fee Gyp board Fire alarm $ Metro Construction Excise Tax Suspended ceiling Sprinkler final $ School Construction Excise Tax Final inspection $ Misc. Fee $ Hourly Rate Fee $ Hourly Rate. State. Surcharge $ Other: $ "Z 1 '5A t 8 I Total Fees Due *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 \Forms \OTC- BUP.doc 08/19/08