Permit CITY OF TIGARD BUILDING PERMIT
°. COMMUNITY DEVELOPMENT e 11 Permit #: BUP2009 -00054
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/31/2009
Parcel: 2S 101 DA00100
Jurisdiction: Tigard
Site address: 13010 SW 68TH PKWY 100
Subdivision: TRIANGLE CORPO PA RK Lot: 7
Project: US Bank Equipment Finance
Project Description: TI
Owner: FEES
PACIFIC NW PROPERTIES LIMITED PA Description Date Amount
STERN FAMILY LIMITED PARTNERSHIP &, Permit Fee - COM 03/31/2009 $83.95
STERN, HELEN R REV TRUST, 6600 SW 105TH Tax - 12% State Surcharge 03/31/2009 $10.07
PHONE: Plan Review 03/31/2009 $54.57
Plan Review - Fire Life Safety 03/31/2009 $33.58
Contractor:
RUSSELL CONSTRUCTION INC
20915 SW 105TH AVE
TUALATIN, OR 97062
PHONE: 503 - 228 -4898
FAX: 503- 228 -2770
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $5,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $182.17
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Protected Corridors: No
•
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit . . •• : ••■ to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be , • ne in accordance with = • prov • •lans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the :0 days. ATTENTION: Oreg. • aw re• = you to follow the rules adopted by the Oregon Utility Notification Center. Thof a are set forth i % •
95. 001 -0010 through OAR 95 . 1 0100 may o bta in a w � o f th ru or di ques t OUNC b ca ll' • . 50 r • •1
Iss ed By: `, ��/ 4 J4 1,�� Permittee Signature: IA/
Call 503.839.4175 by 7:00 a.m. for an inspection that bust ass d : .
This permit card shall be kept In a conspicuous place on the Job site until , omp =ti • • e project.
Approved plans are required on the Job site at the time of each inspects, .
Building Permit Application
Commercial RECEI • ��1 " 1 FOR OFFICE IJSE ONL
City of Tigard MAR 31 2009 Received _ �' '�� PermitNo.: • u � ofoj ,
Iii
° 13125 SW Hall Blvd., Tigard, OR 97223 • Plan Review �n
C Phone: 503.639.4171 Fax: 503.598.1960 Date : Other Permit:
Inspection ecti Line: 503.639.4175 CI QF Date/I3 Date R
� y j�'�� J f
T i G n R D � Iii See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISI N otified /Method: VIM Supplemental Information
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
® 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: 13010 SW 68 Parkway, 2 " floor ` 5 10 0 New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: US Bank Equipment Finance 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.: 100 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S101DAOO100 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.
Construction of (1) new office. Valuation: $ St COO
Existing building area: 2.9 33 square feet
New building area: 135 square feet
❑ PROPERTY OWNER I ® TENANT Number of stories:
Name: US Bank Corporate Real Estate Type of construction: VB
Address: 10220 SE Washington Street Occupancy groups:
City /State /ZIP: Portland OR 97216 Existing: B
Phone: (503)431 -6007 Fax: ( ) New: B
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Russell Construction All contractors and subcontractors are required to be
Contact name: Tiffanie 011ison licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 20915 SW 105 Ave jurisdiction in which work is being performed. If the
City /State /ZIP: Tualatin, OR 97062 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 228 -3413 Fax: : (503) 228 -2770
E -mail: Tollison @russellconstruction.com
CONTRACTOR
Business name: Russell Construction BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP:
Phone: ( ) Fax:( )
FLS plan review fee (if applicable):
CCB lic.: 58918 _ Total fees due upon application:
z.\ , 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: Tiffanie son Date: 03/26/09 * Fee methodology set by Tri -County Building Industry
Service Board.
1: \Building \Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02 /COM/WEB)
III e ° Building Division
Over - The - Counter (OTC) Building Permit
T l ci n It ° 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: N ote: 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 ITEMS
Fire sprinkler: ti*-' Handicap access:
Smoke detector: Protected corridors:
Fire alartn: Parking spaces ( #):
Notes:
Total Valuation: $ -j
INSPECTIONS FEES DUE
Footing /foundation Firewall $ `, Permit Fee
Post /beam structural Smoke detector $ I ) State Surcharge
Shear wall Misc. inspection $ ,..5 Plan Review Fee
Masonry Approach /sidewalk $ ...Nu
4111 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:
$ l'Z. 7 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.
T: \Building \Forms \OTC - BUP.doc 08/19/08