Permit a C1TY OF TIGARD BUILDING PERMIT
f' PERMIT #: BUP2007 -00638
COMMUNITY DEVELOPMENT DATE ISSUED: 12/14/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 100 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: TIGARD TRIANGLE 082
Project Description: Interior demolition of interior walls in a portion of Suite 100, all of Suite 250 and replace corridor door in
Suite 400.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING: 0
VALUE: $ 9,500.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LANE
PORTLAND, OR 97224 PORTLAND, OR 97225
Phone: Contact #: PRI 503 - 892 - 0066
FAX 503 - 892 - 0067
Reg #: LIC 66070
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/14/2007 $119.70
[TAX] 8% State•Surcha 12/14/2007 $9.58
[BUPPLN] Pln Rv 12/14/2007 $77.81
[FLS] FLS Pln Rv 12/14/2007 $47.88
Total $254.97
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 than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the
Oregon "' Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of =se rules or • -ct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
i7
Issued By: _ . Permittee Signature: /
`r -
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.
Building Permit Application FOR OFFICE USE ONLY
City of Tigard I ECE i -_
Permit No.: v 007— di, . 6
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Lt ' • 1 4 200 Date : A 7� 'N-1) Other Permit:
TIGARD Inspection Line: 503.639 l� 1 B Date Ready/By: ® El See Attached Checklist for
Internet: www.tigard- or.gov ii ' ii ethod: Supplemental Information
CI1 Y Vr nu- ,•
TYPE O ; . * D1NU 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
A 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 ® 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: / Q 5x g A y�� New dwelling area: square feet
City/State/ZIP: 41,i... t � �� 99,2 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 7e J AN e�' le . Ppv Covered porch area: square feet
Cross street/directions to job site: J 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.
) - L4td A... --PC,/"/A.19 / * -r/l1 valuation: $ �SQd
rt4 CC 4 ' O n� _f/ It./ i Existing building area: square feet
w Pt Lam. ..f UA.° 4I A t--- New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: PacTrust Type of construction: /// rU
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: /�/ , 4 �_ �/ 5 ' 1 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.: ( 7 n Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
°d f2 within 180 days after it has been accepted as complete.
•
Print name: Date: •Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building \ Permits \BUP- PermitApp.doc 03 /21/06 440- 4613T(1I /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #• LUP2007 -00638
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/14/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 I
INSPECTION WORKSHEET FOR DATE: 7/30/2008 TIME: 7:01AM PAGE: 28
SITE ADDRESS: 12909 SW 68TH PKWY 100 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE 082
DESCRIPTION: Interior demolition of interior walls in a portion of Suite 100, all of Suite 250 and replace corridor door
in Suite 400.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: OLSON CONSTRUCTION, MATTHEW PHONE #: 503- 8910066
Inspection Request Scheduled For: Date 7/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 073457 -01 (— 503 - 956-6290 Y
Corrections /Comments /Instructions:
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rf PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: :So I CV, Phone #: (503) 718- 2 2 3
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I3UP2007 -00638
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/14/2007
Phone: (503) 639 -4171 J.
Inspection Requests (24 Hrs.): (503) 639 -4175 . 1 ..
INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 59
SITE ADDRESS: 12909 SW 68TH PKWY 100 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE 082
DESCRIPTION: Interior demolition of interior walls in a portion of Suite 100, all of Suite 250 and replace corridor door
in Suite 400.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: OLSON CONSTRUCTION, MATTHEW PHONE #: 503- 892 -0066
Inspection Request Scheduled For: Date: 7/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 072756.01 503.956-6290 Y
Corrections/Comments/Instructions:
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C I. :ON. , 'F a'
774— c o �-
❑ PASS / -ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
(fgD) VI CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
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Inspector: — 41111111111 Date: 7 i il 4 j Phone #: (503) 718 - L I c/r