Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2011 -00022
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/01/2011
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 200
Project: DQ of the Pacific NW Subdivision: Lot: 0
Project Description: TI
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: 503 - 294 -0400
FAX: 503 - 598 -6658
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 02/01/2011 $149.75
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 02/01/2011 $17.97
Stories: 0 Height: 0 ft Plan Review 02/01/2011 $97.34
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 02/01/2011 $59.90
Value: $4,300 Info Process /Archiving - Lg Sheet (over 02/01/2011 $6.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $330.96
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 don • accordance 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 I- - • •• - ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 001 -0010 through OAR 95 • *1 *090. . •u ay obtain a copy of the rules or direct questions to OUNC by calling 503.2 2.1987 or 1.800.332.2344.
I sued By: 1/ i�� �/� Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection di te.
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 FOR OFFICE USE ONLY
City of Tigard RECEIVED Received A , tiler&
Permit No.: jr P24,1 t
Date/B :
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
_ : Phone: 503.639.4171 Fax: 503.598.1960 0 1 2011 Date /B : 4wrair� Other Permit:
TI G A RD Inspection Line: 503.639.4175 Date Ready /By: Juris El See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
flilSl(��
TYPlei 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.
Valuation: $
❑ 1- and 2- family dwelling Z Commercial /industrial
❑ Accessory building CI Multi-family Number of bedrooms:
ID 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.: 200 Project name: DQ of the Pacific NW 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.: 1S126BC 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: S4,300.00
Existing building area: 92315 square feet
New building area: 0 square feet
ED PROPERTY OWNER ❑ TENANT Number of stories: 5
Name: WISCO Real Estate Equity Fund Type of construction: H -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
S 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):
Total fees due upon application:
CCB lic.: 66915
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. impson Date: 2/1/2011 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 10/01/09 440 4613T(I l /02 /COM /WEB)
B uilding Division
Over - The - Counter (OTC) Building Permit
f IGARD
Check List
Project Description: �l
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: A Occupancy Group: Type of Construction: "Z
*Type of Use: Occupancy Load: Oregon Specialty Code: Zp (CD
SPECIFICS
Number of Stories: 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: Yes Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ C (=CI FEES DUE •
$ DC Prov Rvw, COM TI — Ping
$ — DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ r49', 5 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 41 1/ , • Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ , Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ (P , CO Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admit' Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ . 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
• ;IN
Building Division
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: k 1 &ID ( 1 " a 2- ❑ Expedited Review
Plan Submittal Date: c ` 1 11
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 04 Ploy1 at 503-718-0 or JoIis'f/ @tigard- or.gov)
❑ Zoning MK' Permitted Use Yes No ❑
❑ Land Use Required: Yes ❑ No ,' (explain below)
Notes: /00 C447 of VJG
1°l Approved ❑ Not Approved Date: FL j o2 0 1
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
i 0f C �
Routed back to Building Division Date:
I: \CURPLN