Permit • q CITY OF TIGARD BUILDING PERMIT
{'! COMMUNITY DEVELOPMENT Permit #: BUP2011 -00267
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12!20/2011
Parcel: 2S112DC00100
Jurisdiction: Tigard
Site address: 15605 SW 72ND AVE
Project: Consumer Cellular Subdivision:HERN PACIFIC TIGARD INDUSTRIAL I Lot: 1 -2
Project Description: TI
Contractor: BNK CONSTRUCTION INC Owner: PACTRUST
45 82ND DR SUITE 53B 15350 SW SEQUOIA PKWY #300
GLADSTONE, OR 97027 PORTLAND, OR 97224
PHONE: 503 - 557 -0866 PHONE: 503 - 624 -6300
FAX: 503 - 557 -1085
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 12/20/2011 $256.00 •
Class of Work: ALT DC Provision Review, COM TI - LRP 12/20/2011 $38.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 12/20/2011 $2,555.55
Stories: 2 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 12/20/2011 $306.67
Value: $340,000 Plan Review 12/20/2011 $1,661.11
Plan Review - Fire Life Safety 12/20/2011 $1,022.22
Info Process /Archiving - Lg $2.00 (over 12/20/2011 $16.00
Floor Areas: 11x17)
Metro Const. Excise Tax - Commercial 12/20/2011 $408.00
Total Area: 0 Use
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $6,263.55
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 do accordance • 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
da . ATTENTION: Oregon =w requires ou to follow the rules adopted by the Oregon Utility Notification Cen - Those rules are set forth in OAR
2- 001 -0010 through OAR 952-04 ou =y;obtain a copy of the rules or direct questions to OUNC by calling 503,232. •8 - or 1.800. . 44.
Issued /4 Permittee Signature: I /
Call 503.639.4175 by 7:00 a.m. for the next available ins • ection da e.
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 Appliltn,
CEIVED ..
Commercial .
. „. FOR OFFICEUSE ONLY. • •. • ' - .,',•,,-;
City of Tigard DEC 2 0 2011 Received
afficm a Permit No.: 4 /0/
Date/B :
” 13125 SW Hall Blvd., Tigard, OR 97223 ' Plan Review ' s
• 1: ... ' Phone: 503.639.4171 Fax:CireOF6PIGARD Date/B : Alrait■ Other Permit.
T [GA . Line. RD Insp Line 503.639. '
A IiifILDING DIVISION Date Ready rr: Jars 0 See Page 2 for
Internet: www.tigaro Notified/Method • Supplemental Information
$:1 7 igle4ifikilitial:'11iAitlii
z : te,,..0,,,.....,„:„......g..,,,,,2--,..v.,4,,,,,,,,,i4,6,:,.--,..,q,.-4::'_.-::,
0 New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
El Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
rgi M lIn work indicated on this application.
`"'S
:
0 1- and 2-family dwelling . Commercial/industnal Valuation $
Number of bedrooms:
111 Accessory building 111 Multi-family
0 Master builder 0 Other: Number of bathrooms:
1,,,,----,-,,-"4--4,----:.r.,,,,,,,,,,R,,,,,,,, .;•r,7%,,,,-,,,,,,ORI,F,t1,,' Total number of floors:
, 94§...1Tr '', ITgQ-MATIC 9 Ni':f. ,, .:::WIeNtI;'* - 2
Job site address: J ,..---/" _ 2,.. AI_b New dwelling area: square feet
City/State/ZIP: ,,,,,. 4.) , A., A 1 ore . 9 "2,,,i:: 5/ Garage/carport area: square feet
Suite/bldg./apt. no.: Project name Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
iiiitilliita:,Wikt6TOIT■iTaftOidalS'aciteargit3
:.1,,,r...-., r
Subdivision: 1 Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.:
, equipment, materials, labor, overhead, and the profit for the
filESE&TIOWTOe ' -'15.14i0 ` 514 ' 1 ''' . work indicated on this application.
: - -1.,,t2 -
Valuation:
$2.4 el
Existing building area: square feet
/./ /2 4-7 '4—)
New building area: square feet
;-7,- awm. ki
:':, Number of stories:
"...,7.-1.4.4.: PgrA -, ,40,:5.: , ;:!,!::,?Y - ,t,.;." ',,,, :,,-3 ca
Name: PacTrust Type of construction:
Address: 15315350 SW Sequoia Pkwy., Suite 300 Occupancy groups: jr .... / ..... c—,i
City/State/ZIP: , Portland, OR 97224 Existing: 3 d '9
/
Phone: (503) 624-6300 Fax: (503) 624-7755 New: --t5C—"'
g„.i.V.-9014jkliU, ON rPieOlitireatfAV.Akioi4V:WA, vlv u.x. VIN .IN -,, i1i0 ,
. *'•: - i*, - A;oslh:,, ',:':=•-.NIT:mtiate*aiVw,:5%—re, --1 242,0 t ,,,: etiE 3i' P-4*•`0 l'j•''''' -,
A.4, 4
. 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 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 I Fax: : (503) 624-6300
E-mail: dennisp@pactrust.com
111 :9,
Business name: 4 , A .., ....." rt 7 ,..... / -7, c " . 4...T e 1..1,k_, Re 4M,:tWiNatiVigla N: att , J ., e. v ,
!E; 614„MtMlaliVrariaail WM' ft i*
Address:
Structural plan review fee (or deposit):
City/State/ZIP:
FLS plan review fee (if applicable):
Phone: ( ) Fax: ( ) ..
CCB lic.: ii, 7 j5-6"--- Total fees due upon application:
- e'" Amount received:
Authorized signature: ,,......' .
_ .. . .
.e.-.:42"7- This permit application expires i
,. f a permit is not obtained
_ ... • sir - within 180 days after it has been accepted as complete.
Print name: - - - ...e .e i Date: / z... 2
..a-ce z. * Fee methodology set by Tri-County Building Industry
--- Service Board.
1:SBuildingTermits\BUP-COM PermitApp.doc 10/01/09 440-4613T(11/02/COM/WEB)
lig . Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: C9'Expedited Review
Plan Submittal Date: i 7�/C/
To the Applicant: /C00c. C W 1 ""
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.
Planni Review (contact at 503- 7182IM or �� @tigard- or.gov)
F Zoning `..1.- -�4---- Permitted Use Yes 'I0- No ❑
I Land Use Re • uired: Yes ❑ No [ (explain below)
Notes: 0 (/� ^ gtihvil / (�1 1 -- iZv dat,p15.
//
V A pp r ov e d ❑ Not Approved Date: / T/2 -r7//'
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Aj
Routed back to Building Division Date:
I: \CURPLN
Iii .
Building Division
. . Over- The - Counter (OTC) Building Permit
T[GARD Check List
Project Description: 1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION _
*Class of Work: =WM Occupancy Group: ,� Type of Construction: Mid
*Type of Use: gap-7 Occupancy Load: Er to Oregon Specialty Code:
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: Y---/7 Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ . 61'0 l FEES DUE
$ 2- Prov Rvw, COM TI — Ping
$ ? , DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ 2 fi5 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ WfLj. �7 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 4 .4 ; 1 Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ 0 02--Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ • ,Oa 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)
$ ,C) Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $---------
— Ot her:
Building Staff: $ Other:
Date /Time: $ (1 T OTAL FEES DU
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial anufacturcd stru - e.
CLASS OF WORK ACS = accessory; ADD = addition; AL = alteration; END = ... dation; DEM = demo;
END = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, . - _ ainin• w, :, ,'gns, awnings or canopies);
REP = repair.
I: \Building \Formss \OTC - BUP.docx 01/13/2011