Permit CITY OF TIGARD BUILDING PERMIT
1111 " COMMUNITY DEVELOPMENT Permit #: BUP2011 -00077
TI G AR. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/20/2011
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 350
Project: Primary Residential Mortgage Subdivision: ONE EMBASSY CENTRE Lot:
Project Description: TI
Contractor: PACIFIC CREST STRUCTURES INC Owner: WISCO REAL ESTATE EQUITY FUND I
17750 SW UPPER BOONES FERRY RD SUITE 1501 SW TAYLOR ST STE 100
190 PORTLAND, OR 97205
DURHAM, OR 97224
PHONE: 503 - 968 -8949 PHONE:
FAX: 503 - 598 -6658
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 04/20/2011 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 04/20/2011 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 04 /20/2011 $819.81
Stories: 0 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 04/20/2011 $98.38
Value: $61,500 Plan Review 04/20/2011 $532.88
Plan Review - Fire Life Safety 04/20/2011 $327.92
Info Process /Archiving - Lg Sheet (over 04/20/2011 $16.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,867.99
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 Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0090. You -rrray obtain a cop t questions to OUNC by calling 3.232.1987 or 1.800.332.2344.
I
Issued By: / � e rmittee Signature: /V J �[
• . ll , . 75 by 7:00 a.m. for the next available inspec n date.
This permit card sha a ept in a conspicuous place on the job site until c mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application ^ 4�
Commercial .'�� FOR OFFICE USE ONLY
City of Tigard ���''�' � � Received ETA cm G f
III " 13125 SW Hall Blvd., Tigard, OR 3 p ate B : Permit N o.: I
_ Phone: 503.718.2439 Fax: 503.5 8.1960R�� '\
Inspection DateB Re
V J
1e 4 V /r�
Other Permit
TI G A R D Inspection Line: 503.639 p' ♦ ` Date Read '" VI See Page 2 for
Internet: www.tigard - or.gov A Sj Notified/Method. FIRM Supplemental Information
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TYPE OF WORt 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.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ 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.: 350 Project name: Primary Residential Mortg Covered porch area: square feet
Cross street/directions to job site: 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.
Tax map /parcel no 1 S126BC Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $$61,500.00
Existing building area: 92,31 square feet
New building area: 0 square feet
Si PROPERTY OWNER ❑ TENANT Number of stories: 5
Name: WISCO Real Estate Equity Fund Type of construction: 2 -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
►Z4 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Robert Simpson Architect, PC (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: Robert C. Simpson
Address: 31177 SW Simpson Road FLS plan review fee (if applicable):
City /State /ZIP: Cornelius, OR 97113 -6201 Total fees due upon application: � - aJ
Phone: (503) 709 -9653 Fax: : ( ) Amount received: �r1 , 7. q4
E -mail: RSApc @Frontier.cm PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted Photo Voltaic Solar Panel System.
Business name: Pacific Crest Structures Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 17750 SW Upper Boones Ferry Road, Suite 190 Solar Installation Specialty Code checklist.
City/State /ZIP: Durham, OR 97224 Permit fee (includes plan review $180.00
and administrative fees):
Phone: (503) 968 -8949 Fax: (503) 598 -6658
State surcharge (12% of permit fee): $21.60
CCB lic.: 66915
Total fee due upon application: $201.60
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Authorized signs 6, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Robert C. Simpson Date: 4/20/2011 * Fee methodology set by Tn-County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T( I I /02 /COM/WEB)
B uilding Division
T [ GAR U Over- The - Counter (OTC) Building Permit
Check List
Project Description:
Ti
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: < Occupancy Group: 1�% Type of Construction:
*Type of Use: C0I4. Occupancy Load: �., Oregon Specialty Code: 2C4 0
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: l Fire Alarms: yes r Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ ()
,--e0 FEES DUE
$ + /j DC Prov Rvw, COM TI — Ping
$ .. ;9s DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ {L' i Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ «.r <! 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ Div Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ 1 4 Ian Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ 17, 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. Admin Fee
Permit Coordinator: $ Other:
$ Other.
Building Staff: $ Other:
Date /Time: $ 1 pl., 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 .1 Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: Er pedited Review
Plan Submittal Date: 1/[
To the Applicant: p u/" 5 44 s7)
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)
Ll Zoning l /ti c,- Permitted Use Yes iV No ❑
Land Use Required: Yes ❑ No g' (explain below)
Notes: , ,--- p ,ifiAt y z 4� 2 --
NJ Approved ❑ Not Approved Date: API
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
[ 1\)
Routed back to Building Division Date:
i
I: \CURPLN