Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 -00234
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/26/2010
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 460
Project: Bjorkland & Montplasir Subdivision: Lot: 0
Project Description: TI. 12/15/10, reprint permit for phasing of project.
Contractor: PACIFIC CREST STRUCTURES INC Owner: WISCO REAL ESTATE EQUITY
17750 SW UPPER BOONES FERRY RD SUITE FUND I LTD PARTNERSHIP
190 BY WYSE INVESTMENT SRVS CO
DURHAM, OR 97224 1501 SW TAYLOR ST STE #100
PORTLAND, OR 97205
PHONE: 503 - 968 -8949 PHONE:
FAX: 503 - 598 -6658
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 10/26/2010 $641.29
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 10/26/2010 $76.95
Stories: 5 Height: 0 ft Plan Review 10/26/2010 $416.84
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 10/26/2010 $256.52
Value: $42,000 Additional Permit 12/15/2010 $200.00
Phased Plan Review 12/15/2010 $64.13
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,655.73
Required' Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 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
dG-OO1 Orego w requir you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9h OAR 952 -00 1 Y u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80 .332. 44.
I Permittee Signature: 'tea
i
Call 503.639.4175 by 7:00 a.m. for the next available inspectio date.
This permit card shall be kept in a conspicuous place on the job site until com n of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial
�j Re v
mod' cet ed
Cit f Tig !d Ito v Permit No
h g QQ 1� Date/B
° 13125 SW Hall Blvd., Tigard, OR 97223 P� V Plan Review
B Phone: 503.639.4171 Fax: 503.598.1960 Date/By : �4 Other Permit:
Inspection Line: 503.639.4175 .�J �,GP�O Date Rea y 1uri ® See Page 2 for
Internet: www.tigard or.gov CM bo S,o otified/Method: Supplemental Information
1NG
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: 9020 SW Washington Square Road New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 460 Project name: Pacific tt a mew Covered porch area: square feet
Cross street/directions to job site: SW Scholls Ferry Road Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: 01500 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.: 1S1266C equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Alteration to existing tenant improvement within previously defined suite. Valuation: $$42,000.00
Existing building area: 92315 square feet
New building area: 0 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 5
Name: WISCO Real Estate Equity Fund Type of construction: 11 -11
Address: 1501 SW Taylor Street, Suite 100 Occupancy groups:
City /State /ZIP: Portland, OR 97205 Existing: B
Phone: (503)294-0400 Fax:(503)227 -2507
New: B
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Robert Simpson Architect, PC All contractors and subcontractors are required to be
Contact name: Robert C. Simpson licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 31177 SW Simpson Road jurisdiction in which work is being performed. If the
City /State /ZIP: Cornelius, OR 97113 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 709-9653 Fax::( )
E -mail: rsapc@frontier.com
CONTRACTOR
Business name: Pacific Crest Structures BUILDING PERMIT FEES*
Address: 17750 SW Upper Boones Ferry Road, Suite 190 Please refer to fee schedule
Structural plan review fee (or deposit):
City /State /ZIP: Durham, OR 97224
Phone: (503) 968 -8949 Fax: (503) 598 -6658 FLS plan review fee (if applicable):
CCB lic.: 66915 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: Robert C. 'mpson Date: 10/26/2010 • Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(I1/02/COM /WEB)
CITY OF TIGARD BUILDING PERMIT
I: COMMUNITY DEVELOPMENT Permit #: BUP2010 00234
T [G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/26/2010
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 460
Subdivision: Lot: 0
Project: Pacific NW Title
Project Description: TI
Owner: FEES
WISCO REAL ESTATE EQUITY Description Date Amount
FUND I LTD PARTNERSHIP, BY WYSE Permit Fee - Additions, Alterations, 10/26/2010 $641.29
INVESTMENT SRVS CO, 1501 SW TAYLOR ST Demolition
PHONE: 12% State Surcharge - Building 10/26/2010 $76.95
Plan Review 10/26/2010 $416.84
Plan Review - Fire Life Safety 10/26/2010 $256.52
Contractor:
PACIFIC CREST STRUCTURES INC
17750 SW UPPER BOONES FERRY RD SUITE
190
PHONE: 503 - 968 -8949
FAX: 503 - 598 -6658
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 5 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $42,000
I
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,391.60
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 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 rules adopted by the Oregon Utility Notification Center. Those - - s are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. Yo _ ii = _ of the rules or direct questions to OUNC by calli • ! r ..246.6.9 1.800.332.2344.
Issued B _ Perm S � 1� I ,`
Call 503.639.4175 by 7:00 a.m. for an inspection that bus' ess day.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercia R eceived
✓ g FOR OFFICE USE ONLY of Ti and ! tl �Co t o Permit No.:
" � QQ �
° 13125 SW Hall Blvd., Tigard, OR 97223 �� 9j V ��� DateB Plan Review ► �I 1 we
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : / `i /� • Oth er Permit:
l' I G n R u Inspection Line: 503.639
� O?'"GR�O Date Rea. : y: Fa See Page 2 for
Internet: www.tigard - or.gov �` n otified/Method: 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: 9020 SW Washington Square Road New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 460 Project name: Pacific NW Title Covered porch area: square feet
Cross street/directions to job site: SW Scholls Ferry Road Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: 01500 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 1S126BC 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.
Alteration to existing tenant improvement within previously defined suite. Valuation: $$42,000.00
Existing building area: 92315 square feet
New building area: 0 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 5
Name: WISCO Real Estate Equity Fund Type of construction: 11 -B
Address: 1501 SW Taylor Street, SUite 100 Occupancy groups:
City /State /ZIP: Portland, OR 97205 Existing: B
Phone: (503)294 -0400 Fax: (503)227 -2507 New: B
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Robert Simpson Architect, PC All contractors and subcontractors are required to be
Contact name: Robert C. Simpson licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 31177 SW Simpson Road jurisdiction in which work is being performed. If the
City /State /ZIP: Cornelius, OR 97113 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 709 -9653 Fax::(
E -mail: rsapc @frontier.com
CONTRACTOR
Business name: Pacific Crest Structures BUILDING PERMIT FEES*
Address: 17750 SW Upper Boones Ferry Road, Suite 190 (Please refer ro fee schedule)
City /State /ZIP: Durham, OR 97224 Structural plan review fee (or deposit):
Phone: (503) 968 -8949 Fax: (503) 598 -6658 FLS plan review fee (if applicable):
CCB lic.: 66915 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: Robert C. 'mpson Date: 10/26/2010 * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 10/01/09 440-461 3T( 1 1 /02/COM/WEB)
0 ° Building Division
Over- The - Counter (OTC) Building Permit
ricnFZD Check List
,
Description of Project: 1 1
GENERAL INFORMATION
Class of Work:* .(r Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* C M First floor: N: S:
Type of Construction: 2 Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: `f - 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: W'S Handicap access:
Smoke detector: Protected corridors:
Fire alarm: l K Parking spaces ( #):
Notes:
Total Valuation: $ -4-2 err)
INSPECTIONS 1 FEES DUE
Footing /foundation Firewall $ 61 3(1 , 2,' Permit Fee
Post /beam structural Smoke detector $ , State Surcharge
Shear wall Misc. inspection $ Merit Plan Review Fee
Masonry Approach /sidewalk $ ,52.... 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:
$ t 1 , icio 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.
1: \Building \Forms \OTC - BUP.doc 08/19/08