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Permit
CITY OF TIGARD BUILDING PERMIT 11111 C OMMUNITY DEVELOPMENT P ermit #: BUP2010 00278 TtGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010 Parcel: 1S126BC01506 Jurisdiction: Tigard Site address: 9020 SW WASHINGTON SQUARE RD 430 Project: Farmers Insurance Subdivision: Lot: 0 Project Description: TI. 2/3/11, reprint to correct project name. Contractor: PACIFIC CREST STRUCTURES INC Owner: WISCO REAL ESTATE EQUITY 17750 SW UPPER BOONES FERRY RD SUITE 1501 SW TAYLOR STREET, SUITE 100 190 PORTLAND, OR 97205 DURHAM, OR 97224 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, 12/22/2010 $362.69 Class of Work: ALT Demolition Dwelling Units: 0 12% State Surcharge - Building 12/22/2010 $43.52 Stories: 5 Height: 0 ft Plan Review 12/22/2010 $235.75 Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 12/22/2010 $145.08 Value: $18,500 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $787.04 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 suspended for more the 180 days. ATTE e on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0 0 through OAR - 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. • Issued y: ' Permittee Sig lure: g/) ev( Call 503.639.4175 by 7:00 a.m. for the next available inspectio • • ate. 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 CITY OF TIGARD BUILDING PERMIT F _ :: - COMMUNITY DEVELOPMENT Permit #: BUP2010 00278 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010 TIGARD Parcel: 1S126BC01506 Jurisdiction: Tigard Site address: 9020 SW WASHINGTON SQUARE RD 430 Project: State Farm Subdivision: Lot: 0 Project Description: TI Contractor: PACIFIC CREST STRUCTURES INC Owner: WISCO REAL ESTATE EQUITY 17750 SW UPPER BOONES FERRY RD SUITE 1501 SW TAYLOR STREET, SUITE 100 190 PORTLAND, OR 97205 DURHAM, OR 97224 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, 12/22/2010 $362.69 Class of Work: ALT Demolition Dwelling Units: 0 12% State Surcharge - Building 12/22/2010 $43.52 Stories: 5 Height: 0 ft Plan Review 12/22/2010 $235.75 Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 12/22/2010 $145.08 Value: $18,500 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 • Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $787.04 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 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- 001 -0010 thr ugh AR 952 -001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: i ` (� Permittee Signature: ��/�` ,( ./ 4 P::... 2. ____...,_____, Call 503.639.4175 by 7:00 a.m. for the next available inspecti date. This permit card shall be kept in a conspicuous place on the job site until co pletion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application COm`merCial RECEIVED FOR OFFICE USE ONLY 1,1 - City of Tigard D 13125 SW Hall Blvd., Tigard, OR 972 , R /p Wit Permit No.: u 7.: �EC 2 2 2010 dl / : Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Date/B l Other Permit: Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for TIGARD Internet: www.tigard or.gov CITY OF TIGARD Notified /Method: Supplemental Information BUILDING DIVISION " TYPE OF WORK s.' 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 � work indicated on this application. " CATEGORY OF CONSTRU CTION, I=1 1- and 2- family dwelling Z Commercial /industrial Valuation: $ ❑ Accessory building El Multi-family Number of bedrooms: ❑ 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.: 430 Project name: State Farm 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 "i;DATACOMMEI2CIAL USE CHECKLIST Subdivision: Lot no.: 01500 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 1S126BC Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the j > ,* DESCRIPTION OF WORK work indicated on this application. Alteration to existing tenant improvement within previously defined suite. Valuation: $18,500.00 Existing building area: 92315 square feet New building area: 0 square feet $ a" ®PROPERTY OWNER w ❑TENANT Number of stories: 5 Name: WISCO Real Estate Equity Fund Type of construction: II -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 +, *r ®" APPLICANT, :w ` - ❑' CONTACT PERSON; v gNOTICE �. 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 x fr q CON Business name: Pacific Crest Structures • Address: 17750 SW Upper Boones Ferry Road, Suite 190 (Rleas`ereje> c&du e) �- City /State /ZIP: Durham, OR 97224 Structural plan review fee (or deposit): FLS plan review fee (if applicable): Phone: (503) 968 -8949 Fax: (503) 598 -6658 CCB he.: 66915 Total fees due upon application: Amount received: Authorized signature:X � �� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Robert C. Si q. son Date: 12/22/2010 * Fee methodology set by Tri- County Building Industry Service Board. 1: \Building\Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(I I /02 /COM /WEB) Building' Division Over- The - Counter (OTC) Building Permit T I G A 1Z D Check List ` Description of Project: 1 . ' 'ry ti ,''`. R Pie s, ltaVEE.. INIV ,®_I L1� IUON , ; r �, 1 "V ` . ' ti r �. �: .. ;: = ,,T = Class of Work:* ( ',y ,' Floor Areas (sq. ft.): � Exterior Wall Construction: Type of Use:* •• F� � s ' First floor: N: S: , Type of Construction: 7_ t_ Second floor: 'r4 E W: Occupancy Group: E ir Y.F ', � 1`, Third floor: F yc Openings Protected Y /N ?: . Occupancy Load: U„ "S Total sq ft.: x h? N: S: Stories: ';;ry :' Note: Combine total floor area for E: E: I- Ieight: h.A; ,.- all floors above third floor and - * Roof Construction: Floor Load: ; ; U add to the third floors ; . ft. �1•, Fire Retardant: Basement: !.::,1e_:?; Basement: I Area Separation Rated: Mezzanine: , Garage: Occu. Separation Rated: �� N vi: ' - U � �'. �_ . _ ,. � ' -, f:�l � it +� - - - . .. _ _ _._ �.� _ �. 34 Fire sprinkler: ;7117 Handicap access: Smoke detector: ,�_, ,. j�`_! Protected corridors: PO Fire alarm: .j _W,- ; Parking spaces ( #): Notes: Total Valuation: $ ( , ,-GXD e . _ :Y I +N�SP.EC2TI N__ . s = , ��}} r o ' ± FEIJS DUE V? 'ir Y '7 r ::4 : Footing/ foundation Firewall $ 6 Permit Fee Post /beam structural Smoke detector $ ,'_ State Surcharge Shear wall Misc. inspection $ -- 2.--"D. ?' Plan Review Fee Masonry Approach /sidewalk $ 1 4.E., :Qg3 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: $ 7i e Total Fees Due TYPE Mile. ;C©M o i" . ard$4.fCS►�i ° commercial manuf n a w�.. 1 ,� N , ,; 4 . : /£ , 4' 'tic 3 y WQRK% accessoryo D D . addinolhi "1 alteration FN) 8 foundatio 1 )EM ; d e m o e r ` - tt . FND foundation �_ fire protection system ,� ¢ decks, xetaiiung walls, >� _ 1 ' (' T' ri ' 3 i i c oo i i or, cnopies);'l�P�:�. repair ., k .�E , . . , , �,�� 1 i � r L� i�,i, rt.t�.� • ` 4'� , � . 1 � ivk :A , 4 . I: \ Building \Forms \OTC - BUP.doc 08/19/08