Permit ,, CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2011 -00251
Date Issued: 12/01/2011
T[CAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 333
Project: Anchor Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: TI
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 -624 -6300 PHONE: 503 - 625 -6300
FAX: 503 - 624 -7755
FEES
Specifics:
Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 12/01/2011 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 12/01/2011 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 12/01/2011 $149.75
Stories: 3 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 12/01/2011 $17.97
Value: $5,000 Plan Review 12/01/2011 $97.34
Plan Review - Fire Life Safety 12/01/2011 $59.90
Info Process /Archiving - Sm $0.50 (up to 12/01/2011 $3.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $400.96
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 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 Cente Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rect questions to OUNC by calling 503.232. or 1.800. .2344.
Issued ! •ermittee Signature:
• .•175 by 7:00 a.m. for the next available inspecti 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.
Building Permit Application
Commercial ] , iFOR OFFICE USE'ONLY r , -x1 : .
II City of Tigard RECEIVED Date / 13ea,, /v a t ' Iermit at ♦ Ara ' i " 13125 SW Hall Blvd , Tigard, OR 97223 Plan Revte,ti
Phone: 503.6394171 Fax: 503 598.19�C 1 2011 Date/By?' . .2 i � Other Permit / 90i —c. .5'
TIGARD Inspection Line: 503.639.4175 Date Re3Yiy7By: a See Page 2 for
i Internet: www.ugard or.gov CITY OF TIGARD Notified/Method: ff Supplemental Information
x,
': TYPE OFD , t � . RE UI DATA°• 1 AND 2 F DW LING
�n �,�� ,,..:.er g rt,a � �� , Q
❑ 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
..g , 'R t ', . work indicated on this application.
CATEGORY OF CONSTRUCTION
❑ I- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JO SITE I NFORMATIO N VAND L OCATION g ' Total number of floors:
Job site address: 1 6 _ 6 7 . f it- 1 2 u - 6 4 4 , d d vd ,a,,,-, New dwelling area: square feet
City /State /ZIP: /p.A1 ,2 97�a (f Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ,4 4 �Q . , ed„, ° ed or 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.: 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
1)ESCRIPTION�OF'WO�RK work indicated on this application.
roe_ -,» -s . , a , _ ...... �,..
Valuation: $ s7" 4 1'O el
„.•••,4..., 71-‘,/ e911.3 e Existing building area: square feet
•
New building area: square feet
,❑ I ROPERTY; OWNER , - ,„ - ® ')~FNANT Number of stories:
Name: PacTrust Type of construction: l 2 r ,
Address: 15315350 SW Sequoia Pkwy., Suite 300 Occupancy groups: ,//—
/
City/State /ZIP: , Portland, OR 97224 9'%
Existing:
Phone: (503) 624-6300 Fax: (503) 624-7755 News
a . �. ® f APPLIC Tr + , :" 4 ®CONTACT PER SON 4 , Q � , . t - E .
,Business name: PacTrust All contractors and subcontractors are required to be
Contact Warne: Dennis Pagni licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 SW Sequoia Pkwy 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 -6300
E -mail dennisp @pactrust.com
" k _ , - .,: i;X ,, ; x " CONTRACT,O R . v ,, ,
,,.V
Business name:
�i4ti']"2v3 t �� 0
BU7LDING PERIVIITFEES* �"" _ ���� �`�
Address: .i;t , i (Please zeferrto fee=scheduF�„ , 1.;.
City /State /ZIP: Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: ( ) Fax: ( )
CCB lie.: Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
�
— fi�-� within 180 days after it has been accepted as complete.
Print name: ' r A A e . Date: • * Fee methodology set by Tri- County Building Industry
Service Board.
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