Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00101
13125 S H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/03/2009
TIGARD g Parcel: 2S 113AC00103
Jurisdiction: Tigard
Site address: 7204 SW DURHAM RD 300
Subdivision: Lot: 0
Project: Consumer Cellular
Project Description: TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee - COM 06/03/2009 $486.70
#300 12% State Surcharge - Building 06/03/2009 $58.40
PHONE: Plan Review 06/03/2009 $316.36
Plan Review - Fire Life Safety 06/03/2009 $194.68
Contractor:
BNK CONSTRUCTION INC
10730 SE HWY 212
CLACKAMAS, OR 97015
PHONE: 503 - 557 -0866
FAX: 503 - 557 -1085
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $75,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,056.14
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 . • - ith approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is sus. - nded for more the 180
day . • TTENTION: Orego aw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules ar. et f•rth in OA
9 - 001 -0010 through OAR 952-!01-1 00. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.24.6699 • 1.800 2.2344.
I- ued By: / / i Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business •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.
Building Permit Application FO OFFICE USE ONLY • '
•
n City of Tigard Pr��� y. it_ :::::::o.:ffniip, ��
DateB 1 S W Hall Blvd., Tigard, OR 7223 Plan Review �i Phonehone : 503.639.4171 Fax: 503.598.1960 (3 Received DateB : ww, -
TIGARD Inspection Line: 503.639.4175 SUN o 3 2�0 Date Read .y: to -: ® See Attached Checklist for
Internet: www.tigard- or.gov Notified/Method• /. Supplemental Information
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New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
A Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
" -. CATEGOR �L ' , 4 work indicated on this application.
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❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
Ell Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms.
V n--- ` ¢ - JOBVSITE..INFORM LOCATION kt 4, o, ° " Total number of floors:
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Job site address: New _ J - 4 ore-. a 4, •P► New dwelling area: square feet
City/State/ZIP: � ��� r ....-.4, area: square feet
Suite/bldg. /apt. no.: Project namm�� « �'' D�� / Covered porch area: square feet
Cross street/directions to job site: Cam/ Deck area: square feet
j 4 _ Jni T7� _ .,„/ 4,07 Other structure area: square feet
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Subdivisio 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
equipment, materials, labor, overhead, and the profit for the
' '"e ,1 t . _* £ DESC R 1P. t T O = W ORK ' , o % , "1 .a work indicated on this application.
Valuation: $ J L��'dD
Existing building area: square feet
New building area: square feet
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Name: PacTrust Type of construction: / /"�
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
City /State /ZIP: Portland, OR 97224 Existing: � i./
Phone: (503)624 -6300 Fax: (503)624 - 7755 New: /
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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 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: dennisp @pactrust.com
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City/State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
6 Total fees due upon application:
CCB lie.: /C ?5
Amount received:
Authorized signature: ♦r„....-"Lik--•
This permit application expires it a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: DC�d� Dater �r //
/,-� `�/ * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building \Permits \BUP- PevnitApp. doe 03121/06 440- 4613T(1 I /02 /COM/WEB)