Permit CITY OF TIGARD BUILDING PERMIT
.1114
o COMMUNITY DEVELOPMENT Permit #: BUP2010 00221
T 1 G A R. l) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/06/2010
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 215
Subdivision: PACIFIC CORPORATE CENTER Lot: 0
Project: Umpqua Bank
Project Description: TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 10/06/2010 $955.35
PORTLAND, OR 97224 Demolition
PHONE: 503 - 624 -6300 12% State Surcharge - Building 10/06/2010 $114.64
Plan Review 10/06/2010 $620.98
Plan Review - Fire Life Safety 10/06/2010 $382.14
Contractor:
MATTHEW OLSON CONSTRUCTION
5320 SW DOVER LN
PORTLAND, OR 97225
PHONE: 503 - 892 -0066
FAX: 503- 892 -0067
Specifics:
Type of Use:
Class of Work:
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $80,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,073.11
Reauired: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
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 dot= • - ccordance • 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
d= • s. ATTENTION: Oregon la. re• • re you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are se • , h in 0
•52- 001 -0010 through OAR 95 '01-0 $0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6.: • 1.800. 32.2344.
ssued By: 1frJ J� _ Permittee Signature: , `
Call 503.639.4175 by 7:00 a.m. for an inspection that busin . 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 , ' ea t et �'7 l I to —00,9A
n b Date /B �� i 0 .:L Pemtit No.: A e
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review � /
_ Phone: 503.639.4171 Fax: 503.598.1960 OCT T D _ Ark' 6 !'I. 13 Other Permit:
T I GARD Inspection Line: 503.639.4175 Date Ready/By: luris: ® See Attached Checklist for
Internet: www.tigard - or.gov ,�s �p C` • Tie. , tbod: Supplemental Information
'1si E 1 4 f .,ri. L-
BULD i.0 Di \I 1iO:\:
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: de 7 2 ' P dc.A., 00 d ,/,_ xid - ate /) New dwelling area: square feet
City /State/ZIP: Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: vM p y va. V , k„.. 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.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
11 DESCRIPTION OF WORK work indicated on this application
d e fled .,7 0 N / .C/j�C Rr�r't_ Valuation: $ �� 0 —
Existing building area: square feet
p et 2 4"/ sot. D .vs /C/L C.o.' t c.. // /7C./C//3
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: _3
Name: PacTrust Type of construction: /��
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: Q
City/State/ZIP: Portland, OR 97224 Existing: �L/
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: rn 447--)4e44...., L�L 7 Li f 0/12 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 Iic.:
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: 72p n V � Date: /� /j� * methodology by ty Building try
,C1 ,/� Fee methodolo set b Tri -Conn Buildin Indus
Service Board.
1:\ Building \Permits \BUP- PermitApp.doc 03/21/06 440- 4613T(1I /02/COM/WEB)
I ° Building Division
Over- The - Counter (OTC) Building Permit
T i e n iz n Check List
Description of Project: 1 1
GENERAL INFORMATION
Class of Work:*
L-Or I Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: 7 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 ITEMS
Fire sprinkler: *_ Handicap access:
Smoke detector: Protected corridors:
Fire alarm: ier. Parking spaces ( #):
Notes:
Total Valuation: $ 16
INSPECTIONS FEES DUE
Footing /foundation Firewall $ .r 35 Permit Fee
Post /beam structural Smoke detector $ Ewa" State Surcharge
Shear wall Misc. inspection $ • A; Plan Review Fee
Masonry Approach /sidewalk $ . vL 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:
$ 2673, + 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