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Permit • CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit #: BUP2011 -00020 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2011 Parcel: 2S113AC00101 Jurisdiction: Tigard Site address: 16655 SW 72ND AVE 300 Project: Food Sales Subdivision: PACTRUST BUSINESS CENTER Lot: 0 Project Description: TI Contractor: BNK CONSTRUCTION INC Owner: PACIFIC REALTY ASSOCIATES 45 82ND DR SUITE 53B 15350 SW SEQUOIA PKWY #300 GLADSTONE, OR 97027 PORTLAND, OR 97224 PHONE: 503 - 557 -0866 PHONE: 503 - 624 -6300 FAX: 503 - 557 -1085 % • FEES Specifics: Description Date Amount Type of Use: COM DC Provision Review, COM TI - Ping 01/28/2011 $256.00 Class of Work: ALT Permit Fee - Additions, Alterations, 01/28/2011 $1,589.15 Dwelling Units: 0 Demolition Stories: 1 Height: 0 ft 12% State Surcharge - Building 01/28/2011 $190.70 Bedrooms: 0 Bathrooms: 0 Plan Review 01/28/2011 $1,032.95 Value: $180,000 Plan Review - Fire Life Safety 01/28/2011 $635.66 Info Process /Archiving - Lg Sheet (over 01/28/2011 $10.00 11x17) Floor Areas: Info Process /Archiving - Sm Sheet (up to 01/28/2011 $3.00 11x17) Total Area: 0 Metro Const. Excise Tax - Commercial 01/28/2011 $216.00 Accessory Struct: 0 Use DC Provision Review, COM New- LRP 01/28/2011 $38.00 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $3,971.46 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 Ce rr. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy •. --uestions to OUNC by calling 503.2 .1 7 or . . 344. Issued By: �� Per ittee Signature: - .ice_ / _ ..� Call • by 7:00 a.m. for the next available insp ' n 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. Building Permit Application Commercial 0;AC) FOR OFFICE USE ONLY /jam City of Tigard Date/B a • - Permit No.: .� / ' /U 11.1- 1� 13125 SW Hall Blvd., Tigard, OR 972 1 ' , \ Plan Review 11 Phone: 503.718.2439 Fax: 503.5 ■ +. `1� D : Other Permit: TI G A It D Inspection Line: 503.639.4175 6 9 �, Date Ready/By: ® See Page 2 for w Internet: ww.tigard- or.gov G S_ � ti Notified/Method: ��, Supplemental Information WtQ }a �`",� : ; .: ,. �'�..,� - , L �x .Sawa -. �a� '*? ♦ � � � - J : ,-.er �^ r� � °�. a � �r n - z=i . �'� 3 • t r , —. ,� -; R i. av:'x - .�:� a° :;v �s. � - � �k°5i s r +. s'g` littli AV TYPE aar , . iia r. `ataV , ` , ; kIl UtitED DATA i �AND4e4PAMILilli*V IlVQ 2 _: ❑ New construction ❑ De i • • 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 :-. • 43 : a te, i . }E'' = x' t` work indicated on this application. , h • �,? a-� fCATEGORY C01NSTRUGfION yg 144 dag El 1- and 2-family dwelling Valuation: $ y g ❑ Commerciallindustrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: l $ f ,.' ., ; r, ` a } ` i ttr . ` r m p l Total number of floors: . S Z JO) $ITE rhlrN . TION ANDLLOGATION � , ? w Sk. Job site address: ��/ 4 7� 11'—i) '�D'� New dwelling area: square feet �l Aid d,4 " � �) Q G�'/J' 0V.V' Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: fir < ( 1 c.<5'." Covered porch area: square feet Cross street/directions to job site: Deck area: square feet ,'-../ G �11,7a - % ,,- e Cam. Other structure area square feet ±2 �-- a- Z,/ h ( ,),.s -- v - REI YIIiitii' TA 'CQNIMERC�IAL^ r 3F L1ir.CKL ST, ICJ, /� -2 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 ��., aswta }� equipment, overhead, a and the p e uipmen materials labor, over e an e ofit for the r � 'w w � � `" work indicated on this application. � ttft u a s ... OF 1 ORIt r . - , .t. ' - .. .t. PP Valuation: $' Q� 4d0 Existing building area: square feet New building area: square feet '¢+x: -r efix. r•> r , b- ,v, :. rwt �"` t o ', J§ , r-� iuv t 5 • * ! F PROPERTY OWNER 'I� sa ∎ . Number of stories: 1 ,. - ? # ..±s+.�.:vt, ..k _ ,, ry . xa 44i Yc & e.we«., :rienoa: �. A .a ice. -31 Name: PacTrust Type of construction: jil— Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: . .c: - City /State /ZIP: Portland, OR 97224 Existing: 2f 7 Phone: ( 503 ) 624-6300 Fax: ( 503 ) 624-7755 New: -- . ^ _. � P -zC t ..,;+ M �a, . CO T , I TACT ' . PERS . -P'. � , ? � - NdT E A Business name: PacTrust All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board 1)enni s Pali 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: K. . " 1 CUNTRe�G'IO 4 '„1,.. -? � . Business name: ---�� J c Or''-- # " I3UII 1) G )�ERM1T" ES *' � Address: - ,.,,. ., . (PleaMe =reJa to feasckedu# Structural plan review fee (or deposit): City/State /ZIP: Phone: ( ) F es: ( ) FLS plan review fee (if applicable): Total fees due upon application: CCB iic.: Amount received: 13l q i /, hf/ Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ��� Date: y r * Fe methodology set by Tri Coun Building Indus ,De 2/s -7—:„...,_.— � gY Y tY g trY Service Board. 1:\Building\Permits\BUP -COM PermitApp.doc 09/09/10 440- 4613T(11 /02/COM/WEB) Building Division Accessibility: Barrier Removal Improvement Plan TIGARD REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty -five per -cent (25 %). VALUATION: Total of all renovation, alteration or modification being done, excluding painting and wallpapering: [1] $ MULTIPLIER (25% barrier removal requirement): , x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains: and, $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL (shall equal line [2] of Valuation Computation): $ 70'7 icy Ac e • 1: \Building \Permits \BUP -COM PermitApp.doc 06 /25/08 B uilding Division Over- The - Counter (OTC) Building Permit TIGARD Check List Project Description: Air, D SA L6_, �, 7 APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: .417 Occupancy Group: cg /.5 7 Type of Construction: j, *Type of Use: • CD /v\ Occupancy Load: 1-17N... Oregon Specialty Code: 9..P1 i 0 SPECIFICS Number of Stories: l Building Height: Mixed Use: Number of Dw Units: Number of Bathrooms: Number of Bedrooms: BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES Story Square Footage: Accessory Structure: Covered Porch: Basement: Garage: Deck: Total Square Footage: Carport: Mezzanine: SETBACKS Sideyard Setback - Left Sideyard Setback - Front Sideyard Setback - Right Sideyard Setback - Back CONSTRUCTION Exterior Walls: Openings Protected: Firewall Separation: N: S: N: S: Occupancy Separation: E: W: E: W: Access. Parking Spaces: REQUIRED ITEMS Fire Sprinklers: `"( Fire Alarms: 41r Smoke Detectors: Parapet: Manual Pull Stations: Protected Corridors: Total Project Valuation: $ K K. FEES DUE $ DC Prov Rvw, COM TI - Ping $ 3e DCProvRvw,COMTI -LRP DC Provision Review Fee for COM TI $ ` i 1 c Permit Fee - Add, Alt, Demo Project Valuation Planning LRP $ I g o , 16 12% State Surcharge Up to $4,999 $0.00 $0.00 $ ID 3Q , 4'5-- Plan Review, Structural $5,000 - $74,999 $64.00 $9.00 $ 6,3 5 c6 Plan Review, Fire Life Safety $75,000 - $149,999 $160.00 $24.00 $S- c * Ea -, Info Proc /Arch, Lg (over 11x17 $2.00) $150,000 and over $256.00 $38.00 $ c 5 4.jj.T Info Proc /Arch, Sm (up to 11x17 $0.50) $ `a j 6 Metro Construction Excise Tax i $ School Construction Excise Tax $ Hourly Rate Fee Planning Staff: ?kWh - -4 ,4r it ) ,� =' $ Hourly Rate State Surcharge 1 $ Misc. Admin Fee Permit Coordinator: $ Other: $ Other: Building Staff: $ Other: Date /Time: $ )) ` o ) 1 ) , Hc, 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.docx 01 /13/2011 Building Division -. . . Development Code Provision Review TIGARD Commercial Projects - No Associated Land Use Case Building Permit No: (2o -00,,a4s ErExpedited Review Plan Submittal Date: To the Applicant: ➢ If the proposed use is not permitted within the zone, please contact the Building Division to cancel the permit application. Building Permit Technicians (503) 718 -2439. ➢ If a land use is required and for all other questions, please contact the staff person listed above the Planning Review section. Staff: please check items along left only if approved. Planning Review (contact at 503 -718- or @tigard - or.gov) Zoning — 1 Permitted Use Yes No ❑ E3' Land Use Required: Yes ❑ No, (explain below) N o t e s : / /�i�L !.i , /,�d " " /// �' -! L S dir Approved ❑ Not Approved Date: 0107 / /b1-5 S te) -72 Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) Notes: Routed back to Building Division Date: 2 I: \CURPLN Building Permit Application Commercial FoR (.)Ffl( I. I. SP, ON I.1 City of Tigard Received DateB : Permit No.: i 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: I I v A R I i Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard or.gov , Notified/Method: Supplemental Information TYPE . WORI& REQUIRED'DATA ;11 AND 2 FAMILY DW)ELLIN ; ❑ 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/replacem ent ❑ Other: equipment, materials, labor, overhead, and the profit for the a C4' defiti (fP a i4iiiiJ of ' ^-`` +�. 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 S ITIbt INFORMATI AND L OCATION ' t ` Total number of floors: Job site address: �/ j ' /2 •' � New dwelling area: square feet City/State /ZIP: 1 ,� „ �� i 7.„.../ '17 7P V Garage /carport area: square feet Suite/bldg. /apt. no.: �C`rf) Project name:,%!d, , -, f Covered porch area: square feet Cross street/directions to job site: Deck area: square feet d ('71- /' C 4 J�/l.vv / ��iG°' C. Other structure area: square feet . ✓ (-i7 4=:74:-).. . t2` ,riiq- c' 1t `5" - Q 119104 RRrRr s cJ(L st `+r.+�FaF .� x.. `- ,r:.:: - Y .. , ++5. .,.t.'. ¢ � �.f.n u,ayf.., 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 a x equipment, materials, labor, overhead, d the profit for the p t ad an I � } ' : Q .. , T. F V . tocititeriv Nk o1< O , : , , ,, �-/. t ' yk�Y work indicated on this a lication. n 17...... Valuation: $ OJT r, � Existing building area: J square feet . New building area: square feet ;Q PR $P E RTY OW E , ; , + t x ; 4 r (,, TB . N ,„ : „, rY r s Number of stories: / Name: PacTrust Type of construction: 2" Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: .?S City /State /ZIP: Portland, OR 97224 Existing: /- 2 Phone: ( 503 ) 624-6300 F '"503 ) 624 7755 zi %;�;f" - G drsc �, �t �µ tt � -° tom" � ' .p a New: -754--- V •7k ''.o4 -�e re'•^� _W I f °'+6'`g, "4, ` t t- oti * u M -Tu i ,',- 1 ; - 4 ,A.7 i 3 T r t_ ,. ,�,,, a°r . f"- r SSi i _?rg y . ,,.3' 10.-0 , ..... .4.ts a r i� t VIA -, attic :'�.-�. , -. e. v, _..0" = -a•.k. t. W �' 1 �, x.S'' ` �+^}'. /. nk .. kz , t Business name: PacTrust All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board I)anni s Pali 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 I Fax: : ( 503 ) 624 - 7755 E -mail: i 4sr''' ''fr Ali £rN k ,P ii „ n p .,, ; *artx "''e al .. al n l it 3 � - 4i: , y.TMs „ Business name: /rJ -r �:.� t 7 Address: . Structural plan review fee (or deposit): City/State /ZIP: Phone: ( ) l Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: Amount received: Authorized signature: • This permit application expires if a permit is not obtained r i " within 180 days after it has been accepted as complete. Print name:, fv; y0 c� 1 ,� Q Date: i * Fee methodology set by Tri -County Building Industry � � 1 "`"®/ Service Board. I:\Building\Pemtits\BUP -COM PemtitApp.doc 09/09/10 440 -4613T(1I /02/COM/WEB)