Permit CITY OF TIGARD BUILDING PERMIT
Mi 2 COMMUNITY DEVELOPMENT Permit #: BUP2009 -00162
?LG ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/02/2009
. Parcel: 25112AD01000
Jurisdiction: Tigard
Site address: 7007 SW CARDINAL LN 105
Subdivision: Lot: 0
Project: Spec Space
Project Description: Remodel restroom to meet ADA requirements.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - COM 09/02/2009 $366.70
PORTLAND, OR 97224 12% State Surcharge - Building 09/02/2009 $44.00
PHONE: 503- 624 -6300 Plan Review 09/02/2009 $238.36
Plan Review - Fire Life Safety 09/02/2009 $146.68
Contractor:
PACIFIC REALTY ACCOCIATES LP
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 -624 -6300
FAX: 503 - 624 -7755
Specif
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $50,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $795.74
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 through OAR 952- 001 -0100. You may obtain 1 a copy of the rules or direct questions to OUNC by calling 503.246..4 9 or 1. . 32.2 4.
4 0 - 1aL Issued By: (t n l Je\\p , y O /� f� Permittee Signature: l
Call 503.639.4175 by 7:00 a.m. for an inspection th ' usiness . ay.
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.
x
Building Permit Application R ' - iiv E FOR OFFICE USE ONLY ,
i •
City of Tigard Received : PemritNo 4114 .00 . Z
13125 SW Hall Blvd., Tigard, OR 97223 SEP 1 0 Inn Plan Review \ / / 0
Phone: 503.639.4171 Fax: 503.598.1960 oi,u;�; i b�� + � Date/B : t 0 Other Permit:
• Inspection Line: 503.639.4175
SUIT _ Date Read � ® See Attached Checklist for
Internet: www.ci.tigard.or.us `'t d d U/. -( Notified/Method: s , Supplemental Information
®UILDING DI
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.; 3 � =P r Q t d I o At WEL =IN
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❑ N- c onstruction El Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the neatest dollar) of all
►: - Addition/alteration/replacement ❑ Other: . equipment, Materials, labor, overhead, and the profit for the
' work indicated on this aPplicatiom .
❑ 1- and 2- family dwelling ' , ommercial/industrial Valuation: $
❑ Accessory building ❑ Multi - family . Number of bedrooms:
. ❑ Master builder . . ❑ Other: Numt5er of bathrooms:
r '> '" ' A i Total number of floors: -
k. , JQ S ORMATI� . . . LQG Q ;- .
J ob site.address: New dwelli are square feet •
.
•
City/ State/ZIP: t'lr N / 0 Garage/carpoit area • Square feet •
. � •
Suite/bldg_ /apt: no , I Project �)G i1 3. Lj.-- J.5 a, Covered porch area - • square.feet
Cross stieet/directions fo job site: `�' � Deck area: square feet
•
Other: structure area: square feet
d D DABO ° R :• .41 KV! ® IST
'Subdivision: - - • I Lot no.. Permit. fees* are`based on -the value of the work performed.
•
Indicate • the: value (rounded ter the nearest dollar) of all
Tax map /parcel no
. equipment materials labor, overhead, arid.the,pr ifit for the
t *.r = Ij °iC t U 467-N U �' ` work indicatedon this a pplication
Valuation: $
QC " l_ � old el -4• f /rJ/tLS� �� in., -• �,
' ..e .."1-74 fi' 04 Existing building area: • square feet
New building area: square feet
i ROY t O E' L x A.,
' Number of stories:
Name: Type of construction: i }) 0
Address: Occupancy groups: �/ �(*._r.
City/State/ZIP: Existing: 19
Phone ( ) Fax:( ) New: '7,--'
. , . ' ' A M R LTC °1 .. r, Cb 4, ERSO ` , r '" ;I# 's°; w � .
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: Dennis Pagni licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 S.W. Sequoia Parkway, 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: •
dennisp @pactrust.com
CO „ Cri
Business name: 7019c-:71-Pcj5 , ; I N
Address: . •
Please refer to fee schedule.
City/State/ZIP:
Fees due upon application
Phone: ( ) . Fax: ( )
Amount received
CCB lie.: `
Date received: vI
Authorized signature: // / This permit application expires if a permit is not obtained
der,/,-,01-___.--, within 180 days after it has been accepted as complete.
Print name: I i , a ` o."'” ..• ` ! * Fee methodology set by Tri- County Building Industry
Service Board.
1:\ Building \Pemtits \BUP- PermitApp.doc 12/03 440- 4613T(11/02/COM /WEB)