Permit lit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 00268
TIGARD 1'3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2010
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15951 SW 72ND AVE
Project: Miller Paint Subdivision: OREGON BUSINESS PARK III Lot: 38
Project Description: TI. 12/21/10, reprint to change contractor of record. 1/21/11, reprinted for increase in project valuation.
Contractor: MATTHEW OLSON CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES
5320 SW DOVER LN 15350 SW SEQUOIA PKWY #300 .
PORTLAND, OR 97225 PORTLAND, OR 97224
PHONE: 503 - 892 -0066 PHONE: 503 - 624 -6300
FAX: 503 - 892 -0067
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/10/2010 $1,287.15
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/10/2010 $154.46
Stories: 1 Height: 0 ft Plan Review 12/10/2010 $836.65
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 12/10/2010 $514.86
Value: $140,000 Info Process /Archiving - Lg Sheet (over 01/21/2011 $4.00
11x17)
Info Process /Archiving - Sm Sheet (up to 01/21/2011 $6.00
11x17)
Floor Areas: Metro Const. Excise Tax - Commercial 01/21/2011 $168.00
Total Area: 0 Use
Accessory Struct: 0 Building Permit - COM 01/21/2011 $60.40
12% State Surcharge - Building 01/21/2011 $7.25
Basement: 0 Plan Review - Building 01/21/2011 $39.26
Carport: 0 FLS Plan Review 01/21/2011 $24.16
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,102.19
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit i • . •' -ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don- n accordance with a. .roved 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 rules are set forth in OAR
952 -101- 0010th ough OAR 952- 001 -01''. ' ou . -y obtain a copy of the rules or direct questions to OUNC by calling 503.232.19:7 or 1.800.3 .
I
Issu d By: /Oil / Permittee Signature:
P
Call 503.639.4175 by 7:00 a.m. for the next available insp‘ ction date.
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.
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 -00268
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2010
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15951 SW 72ND AVE
Project: Miller Paint Subdivision: OREGON BUSINESS PARK III Lot: 38
Project Description: TI. 12/21/10, reprint to change contractor of record.
Contractor: MATTHEW OLSON CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES
5320 SW DOVER LN 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97225 PORTLAND, OR 97224
PHONE: 503 - 892 -0066
PHONE: 503 - 624 -6300
FAX: 503 - 892 -0067
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/10/2010 $1,287.15
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/10/2010 $154.46
Stories: 1 Height: 0 ft Plan Review 12/10/2010 $836.65
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 12/10/2010 $514.86
Value: $130,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,793.12
Required: 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 done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, o if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce r' Those =s -. e set forth in OAR
952 -0 - 10 throug : :R 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 c or 1.800 2.2344.
I sued By: r, I /' �" - ' Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available i :.ectionr.
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.
, q OF TIGARD BUILDING PERMIT
:..,. COMMUNITY DEVELOPMENT Permit #: BUP2010 -00268
13 125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2010
•T1 . .- Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15951 SW 72ND AVE
Project: Miller Paint Subdivision: OREGON BUSINESS PARK III Lot: 38
Project Description: TI
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 PORTLAND, OR 97224
PHONE: 503 - 624 -6300
PHONE: 503 - 624 -6300
FAX: 503 - 624 -7755
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/10/2010 $1,287.15
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/10/2010 $154.46
Stories: 1 Height: 0 ft Plan Review 12/10/2010 $836.65
Bedrooms: 0 Bathrooms: 0 Plan Review- Fire Life Safety 12/10/2010 $514.86
Value: $130,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,793.12
Required: 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 done in - • • fiance ith— 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. • ENTION: Oregon lawjequires you to follow the rules adopted by the Oregon Utility Notification Ce•ter. Those rules are set forth in OAR
952 .01 -0010 through OAR 952 -001 -1 t •. i may obtain a copy of the rules or direct questions to OUNC by calling 503.23_ :87 or 1.801- -'.` 4. • , Permittee Signature: �
Lsued By: 1 f g _
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
1\
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Building Permit A licatio � ' "` "� s „ pig _ ,, < ' FO R , QFF,, osE O NLY t s
City of Tigard / p DD
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Date/By. /d` / �,Pemiit No �, ��� •
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Er
. Phone: 503.639.4171 Fax: 503.598.19 C 0 2010 Date /B : Other Permit.
TIGARD Inspection Line: 503.639.4175 Date Ready /By: IA See Attached Checklist for
Internet: www.tigard- or.gov CITY OF TIGARD Notified Method: Supplemental Information
BUILDING DIVISION._ ,
TYPE OF "WORK . R E Q UIRED D A T A: 1 A F D
0 New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
g Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION :, work indicated on this application.
❑ I- and 2- family dwelling ® Commercial /industrial Valuation: $
•
El Accessory building ❑ Multi- family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: _._,--r-‘:
��,� JO SITE INFORMATION AND LOCATION Total number of floors •
. _ ms s _ :.; : ( , ... � r �.. _ . s . 1 M..._,n . to:
Job site address: / /� 5 9 A e_.--- New dwelling area: square feet
City /State /ZIP: '%� ,/ � &� p2 G9. V;5_5/ Garage /carport area: square feet
Suite/bldg. /apt. no.: /, �/ Project name: ,, ,9-7, // ' y - Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED,1DATA COMMERCIAL- USE
Subdivision: 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
. DESCR[ PTION OF WORK w ork indicated on this application.
A_ F —SA v it Valuation: $ � � e 2O
f Existing building area: square feet
- �'— - �s,
New building area: square feet
w ® TPROPERTY 1 , 5d , ® , TENA N T S t - > i ! Number of stories: /
Name: PacTrust Type of construction: J
Address: 15350 S.W. Sequoia Pkwy., //�
q wy., Suite 300 Occupancy groups:
City /State /ZIP: Portland, OR 97224 Existing: 9
Phone: (503)624 -6300 Fax: (503)624 -7755 New:
,£ ®'AP1i 1CANT ' . ,.. htil . Z ip. ® CONTACT PERSON , ;e r .i .
NOTICE h 4 +'
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: k
°- .1,`.:
2 .4 7 L_&5 BUILDING PERMIT FEES * ` -:
11�� sete , e it � `
Address: " .. �.�., (Plea, refer to fee sch -T,e
City/State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: Total fees due upon application:
,4_.... 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: _' - , 1 f Date: -7..... 6) Ai * Fee methodology set by Tri- County Building Industry
-
Service Board.
t: \Building \Permits \BUP- PermitApp.doc 03/21/06 440- 4613T(11 /02 /COM/WEB)
IN : .. •
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Description of Project: f -a L L ut_ p, r n
GENERAL INFORMATION
Class of Work:* 14,L Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* CAM 'First floor: N: S:
Type of Construction: floor: E: W:
Occupancy Group: t �_ Third floor: Openings Protected Y /N ?:
Occupancy Load: 3 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-sq. ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: 7 Handicap access:
L i
Smoke detector: AI Protected corridors: WA
Fire alarm: A/ Parking spaces ( #):
Notes:
Total Valuation: $ 130 K
INSPECTIONS FEES DUE
Footing /foundation Firewall $ Permit Fee
Post /beam structural Smoke detector $ State Surcharge
Shear wall Misc. inspection $ Plan Review Fee
Masonry Approach/ sidewalk $ 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:
$ 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.
L\ Building \ Forms \OTC - BUP.doc 08 /19/08
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
II .1 BUILDING DIVISION
a
TIGARD TRANSMITTAL LETTER
TO: DATE B k ' D
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DEPT: BUILDING DIVISION JAN 19 2011
CITY OF TIGARD
FROM: , 2 2 c>n iii s
BUILDING DIVISION
COMPANY: G .77 vs f—
PHONE: J 6.„9 By :
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RE: �f �) ermi " S�i✓ !�� �U a _� z r
rte ress F ase lum.er
'roject name or su.. ivision name an of num.er
ATTACHED ARE THE FOLLOWING ITEMS:
Copi s ,'- , Description Copies Descr ptio'n.,, a
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and /or lateral analysis.
Floor /roof framing. Basement and retaining"walls.
Beam calculations. Engineer's calculations.
Other (explain):
REMARKS: v _ loci ✓ L
•
V, (q grr%cil) - (Q k- 1- 1- 1-- /z& CAP v' 7 %
:FOR 0 F e _ iTSE _QNLY
Routed to Perm TTechnician: Date: ( I \ Initials.
Fees Due: es ❑ No Fee Description: Amount ue:
ti 1,6 Viikwrk 4 $ /3/. 0
= vui_r i'�� -5 $ / P. 07V
c.K ( VE_ $ / , cf7)
07 bur$ 9. 02
Special
Instructions:
Reprint Permit (per PE): es ❑ No / ❑ Pone j
Applicant Notified: ?&tf.+v/ / $ D ate: /gyp f /j '` .Initials:
/c c') / //1/T • Ae /v (S C E 96 9t"J
l: \Building rdT�1STTit l r- Revisions. doe 4/4/07 <L``�A°% E
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