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Permit CITY OF TIGARD BUILDING PERMIT 0 • COMMUNITY DEVELOPMENT Permit#: BUP2012 -00043 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2012 Parcel: 2S112DD00200 Jurisdiction: Tigard Site address: 15862 SW 72ND AVE 100 Project: Remmington Center Clothing Subdivision: 1994 -006 PARTITION PLAT Lot: 2 Project Description: TI Contractor: MATTHEW OLSON CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES LP 5320 SW DOVER LN ATTN: N PIVEN PORTLAND, OR 97225 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 892 -0066 PHONE: FAX: 503 - 892 -0067 FEES Specifics: Description Date Amount Type of Use: COM DC Provision Review, COM TI - Ping 03/09/2012 $64.00 Class of Work: ALT DC Provision Review, COM TI - LRP 03/09/2012 $9.00 Dwelling Units: 0 Permit Fee - Additions, Alterations, 03/09/2012 $729.45 Stories: 2 Height: 0 ft Demolition Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 03/09/2012 $87.53 Value: $50,000 Plan Review 03/09/2012 $474.14 Plan Review - Fire Life Safety 03/09/2012 $291.78 Info Process /Archiving - Lg $2.00 (over 03/09/2012 $4.00 Floor Areas: 11x17) Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,659.90 Required: Required Items and Reports (Conditions) Fire Sprinkler: Yes Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Yes 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 a - • _ - ith 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. AT - TION: Orego law r- • -' as you to follow the rules adopted by the Oregon Utility Notification Ce - . Those ru are s I forth in OAR 952 -001 •010 through OAR 95 Of -0090. Y • . may obtain a copy of the rules or direct questions to OUNC by calling 503.232 •87 or 1.800.3 .2344. Issue. By: / /i Permittee Signature: A l Call 503.639.4175 by 7:00 a.m. for the next available inspec o • ate. This permit card shall be kept in a conspicuous place on the Job she until completion of the project. Approved plans are required on the Job site at the time of each Inspection. l d Building Permit Application V Commercial (��'j + FOR OFFICE USE ONLY �`JJ n1 City of Tigard 6 Date /ti : O'�� Permit No.: , / .0-00, 3 Er 111 13125 SW Hall Blvd., Tigard, OR 97223 `eP� q Received �,�`� x Plan Phone: 503.639.4171 Fax: 503.598.1960 Ct` GG �� ` S�O DateB Re : vie a7, �ey�in�© ��K�A Other /rf• TIGARD Inspection Line: 503.639.4175 `' t*l 91 Date Rea.y :y: Jere ® See Page 2 for Internet: www.tigard- or.gov C `\N-' Notified/Method: Supplemental Information �`ti TYPE OF WORK S11° 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. ❑ I- 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: ✓�fl42 �� ✓ /' 2 e l .#t.'C / , New dwelling area: square feet City /State/ZIP: � 7 /�� Q � gf,/ 4/ � Garage /carport area: square feet Suite/bldg. /apt. no.: Pr o ect name:A berl dti /� 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: I 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 DESCRIPTION OF WORK work indicated on this application. �P"� G 7 4;7/r ,i�f-e0 °- Valuation: $ Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: PacTrust Type of construction: J I/.�% g Address: 15315350 SW Sequoia Pkwy., Suite 300 Occupancy groups: / / City /State/ZIP: , Portland, OR 97224 Existing: ...._ . Phone: (503) 624 -6300 Fax: (503) 624 -7755 New: ® APPLICANT ® CONTACT PERSON NOTICE 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 Fax: : (503) 624-6300 E -mail: dennisp @pactrust.com CONTRACTOR Business name: / 9 y J t� DLOL2 � j yh��,, BUILDING PERMIT FEES* Address: // / T (Please refer to fee schedule) City/ State/ZIP: Structural plan review fee (or deposit): Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: 6,(00-70 Total fees due upon application: Amount received: Authorized signature: ` /` _ This permit application expires if a permit is not obtained Print name: Date: within 180 days after it has been accepted as complete. _ _ _ � . /� Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP -COM PermitApp.doc 11/01/09 440- 4613T(I I /02 /COM/WEB) .1 r III ®° Building Division l .K /-vL.0 Development Code Provision Review . T i c n Ez Commercial Projects with Approved Land Use Building Permit No.: 6 u p 501 d `L —046'1 Land Use Cascfile No.: H HD ao I al - -0000y Routed Plans: Submittal Date: 3/9/12-- Submittal Date: Submittal Date: To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. STAFF: please only mark those items on the left side that are approved. Plannin Review (contact P� at 503 - 718 - ayx1 or ja4 •i) �I 1 @ tigard- or.gov) � y I L3 Land Use Approval ❑ Building Plans Match Approved Plan: Yes No ❑ ❑ Maximum Building Height `— ❑ Conditions Met Notes: /14* kJ /UAW oZ0 /2- - Qc'Y Original Plan: Approved d' Not Approved ❑ Date: U,N/ 3 -q- /2 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) ❑ Actual Slope: ❑ PFI Permit # ❑ Conditions Met Notes: Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard- or.gov) ❑ Street Trees ❑ Protected Trees Notes: Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: • Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov) ❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit ❑ Engineering Okay to Issue Permit Notes: Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes ❑ No ❑ , Date Routed to Building: • • • • • • • Page 2 of 2 I N 0 . Building Division Over- The - Counter (OTC) Building Permit T l c n li Check List Project Description: 71 APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: t'ct-1 Occupancy Group: Type of Construction: 5jj7 *Type of Use: CCM Occupancy Load: , 3 _ Oregon Specialty Code: 2.640 SPECIFICS Number of Stories: ..7. 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: wJ Fire Alarms: t '� Smoke Detectors: Parapet: Manual Pull Stations: l Protected Corridors: Total Project Valuation: $ gp, COO FEES DUE $ H On DC Prov Rvw, COM TI — Ping $ q ;. CO DC Prov Rvw, COM TI — LRP DC Provision Review Fee for COM TI $ " = " / Permit Fee — Add, Alt, Demo Project Valuation Planning LRP $ A l .bj 12% State Surcharge Up to $4,999 $0.00 $0.00 $ helain Plan Review, Structural $5,000 - $74,999 $64.00 $9.00 $ 2 EIFfir Plan Review, Fire Life Safety $75,000 - $149,999 $160.00 $24.00 $ • , 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: $ t l i iOTOTAL 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