Permit CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit #: BUP2010 -00207
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/23/2010
Parcel: 2S 101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE# 100
Subdivision: FARMERS INSURANCE Lot: 0
Project: ACS
Project Description: Single tenant spec space on entire 1st floor and partial 2nd floor.
Owner: FEES
TRIANGLE POINTE LLC Description Date Amount
901 NE GLISAN ST #100 Permit Fee - Additions, Alterations, 09/23/2010 $1,426.07
PORTLAND, OR 97232 Demolition
PHONE: 503 - 297 -8791 12% State Surcharge - Building 09/23/2010 $171.13
Plan Review 09/23/2010 $926.95
Plan Review - Fire Life Safety 09/23/2010 $570.43
Contractor: Metro Const. Excise Tax - Commercial 09/23/2010 $183.36
SD DEACON ENTERPRISES Use
901 NE GLISAN ST #100
PORTLAND, OR 97232
PHONE: 503 - 297 -8791
FAX: 503 - 297 -8997
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 5 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $152,800
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,277.94
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
Smoke Detectors: Yes Manual Pull Stations: Yes
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 pended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rule/ ar-- set forth in OAR
952 - 001 -0010 through 0 952 - 001 -0100. You ma • • -'• -• • • • • the rules or direct questions to OUNC by calling 50 4-.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
1 �
Call 6 by 7:00 a.m. for an Inspection that business da .
This permit card shall be kept in a conspicuous place on the job site until completion of the proje •.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application TENANT IMPROVEMENT
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard /D /0 ,
Permit ^te pAcie...oQa,r
° 13125 SW Hall Blvd., Tigard, OR 97223cEP 10 2010 Plan Review - 1 /1 /Mim
ii Phone: 503.639.4171 Fax: 503.598.19 Date /B : ♦ ` Other Permit: r I G A R D ;
Inspection Line: 503.639.4175 �..�.�
I Date Ready /B ` laris: ® See Page 2 for
Internet: www.tigard- or.gov 1 NG TIGARD DIVISION Notified/Method: L LS / Supplemental Information
B
VW f ice U Hgi/-
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Pcrmit 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.
dwelling Valuation: S
❑ I- and 2-family g ®Commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Mastcr builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13333 SW 68 PARKWAY New dwelling arca: square feet
City /State /ZIP: TIGARD, OR Garage /carport area: square feet
Suite /bldg. /apt. no.: MO Project name: ACS 11 AT TRIANGLE POINTE Covered porch arca: square feet
Cross street/directions to job site: SW 68 PKWY AND 1 -5 Deck area: square feet
Other structure arca: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
24,367 SF TENANT IMPROVEMENT Valuation: $152,800
Existing building arca: 10240 square feet
New building arca: 10240 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 5
Name: TRIANGLE POINTE, LLC Type ofconstniction: 11 -A
Address: 901 NE GLISAN ST Occupancy groups:
City /State /ZIP: PORTLAND, OR 97232 Existing:
g�
Phone: (503)2978791 Fax: (503)2978997 Ncw: B
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: SAME AS ABOVE All contractors and subcontractors are required to be
Contact name: KENDRA HOWELL licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: SAME AS ABOVE jurisdiction in which work is being performed. If the
City /State /LIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax::( )
E-mail:
CONTRACTOR
Business name: SD DEACON ENTERPRISES BUILDING PERMIT FEES*
Address: 901 NE GLISAN ST
(Please refer wjeeschedalr)
Structural plan rcvicw fcc (or deposit): $680.22
City /State /ZIP: PORTLAND OR 97232
Phone: (503) 2978791 Fax: (503) 2978997 FLS plan review fcc (if applicable): 306.10
CCB tic.: 77875 Total fees due upon application: 986.32
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: KENDRA OWELL Date: 9.10.10 s Fee methodology set by 'Fri-County Building Industry
Service Board.
I: \Building \Permits \BUP -COM PemutApp.doc 10/01/09 440.4613T(1 I /02/COM/WEB)