Permit • e
CITY OF TIGARD BUILDING PERMIT
.
a.-,• COMMUNITY DEVELOPMENT Permit #: BUP2009 -00097
T I G A R L) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/02/2009
Parcel: 2S113AA01100
Jurisdiction: Tigard
Site address: 16596 SW 72ND AVE, BLDG# B11
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: Spec Space
Project Description: TI office.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee - COM 06/02/2009 $305.21
#300 • 12% State Surcharge - Building 06/02/2009 $36.63
PHONE: Plan Review 06/02/2009 $198.39
Plan Review - Fire Life Safety 06/02/2009 $122.08
Contractor:
DURUS CONTRUCTION LLC
15806 UPPER BOONES FERRY RD
LAKE OSWEGO, OR 97035
PHONE: 503 - 320 -8601
FAX: 503 - 244 -4318
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $39,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $662.31
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 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 spended for
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those are set in OAR
952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 9 or 1. 0.332.23 .
Issued By: Permittee Signature:
`
Call 503.639.4175 by 7:00 a.m. for an inspection that b nes y. — `
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), , , I � FOR OFFICE USE ONLY
k I' , 7 14 Received
City of Tigard U �'
y g i 7 I ! I DateB • 4 Permit No.: fp • . / A i • 10 ` n`ij r
° 13125 SW Hall Blvd., Tigard, OR 97223 � evie R � t a ��'
Phone: 503.639.4171 Fax: 503.598.19IN 4 2 2009 Plan Plan R • �\i `
Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Remy :y: / See Attached Checklist for
InterrleC www.tigard or.gov e 0 -: : • 1 _,Y p� NotifiedlMethod: � IMI Supplemental Information
X 1 P T. . % t , • � .
.. ' ' ., 1 t il,I0aR .
TYPE OF WORK .,' REQUIRED DATA. l; AND:2 FAMILYDWELLING
❑ 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
_ t F . iv: - work indicated on this application.
. CATEGORY - `OF CONST) UCTION ..>
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: 5
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB '$ITE INEORMATION 'AND LOCATION Total number of floors:
Job site address: / 6 5 ' Y ( - it , 2 r'C17 G New dwelling area: square feet
City /State/ZIP: ®� �� O2 Gj /7�*` Garage /carport area: square feet
Suite/bldg. /apt. no.: rProject name: 4. p rti Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED 'DATA COMMERCL4 L USA OH'ElY IST,
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
-- ' .•DEESSCRIPTION. OF WORK, work indicated on this application.
c •
s ue/ ArI GI"' Valuation: $ 7 �y
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ` TENANT . ` Number of stories:
Name: PacTrust Type of construction: 4
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: /S,� /_
City /State /ZIP: Portland, OR 97224 Existing: /
Phone: (503)624 -6300 Fax: (503)624 -7755 New
• 0 APPLICANT 0. CONTACT. PERSON N OTICE ,
Business name: PacTrust Ail 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
> C - - `
Business name: /� rx TM^ fl
De,/ e w . s s 4 00.00 G P- It1 , E r + ^� l5,
Address: s .. ... . (7'firi yo - kq.A:vc 4 4i _ , s �4,
City/State/ZIP: Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: ( ) Fax: ( )
CCB lic.: ( g7 V arc Total fees due upon application:
Amount received: l Q a t. 1
Authorized signature: , This permit application expires if a permi s not obtained
within 180 days after it has been accepted as complete.
Print name: 4 Date * Fee methodology set by Tri-County Building Industry
Service Board.
I Building \Permits \BUP- PermitApp.doc 03/21/06 440- 4613T(11 /02 /COM/WEB)
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