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)