Permit CITY OF TIGARD BUILDING PERMIT
III
• COMMUNITY DEVELOPMENT Permit #: BUP2012 -00111
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/27/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY, STE# 010
Project: National American University Subdivision: VARNS ACRES Lot: 9
Project Description: TI
Contractor: SD DEACON CORP OF OREGON Owner: TRIANGLE POINTE LLC
901 NE GLISAN ST SUITE 100 901 NE GLISAN ST, #100
PORTLAND, OR 97232 PORTLAND, OR 97232
PHONE: 503 - 297 -8791 PHONE: 503 - 297 -8791
FAX: 503 - 297 -8997
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 06/27/2012 $2,615.95
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 06/27/2012 $313.91
Stories: 4 Height: 0 ft Plan Review 05/30/2012 $1,700.37
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 05/30/2012 $1,046.38
Value: $350,000 DC Provision Review, COM TI - Ping 06/27/2012 $256.00
DC Provision Review, COM TI - LRP 06/27/2012 $38.00
Info Process /Archiving - Lg $2.00 (over 06/27/2012 $20.00
Floor Areas: 11x17)
Metro Const. Excise Tax - Commercial 06/27/2012 $420.00
Total Area: 0 Use
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0 •
Garage: 0
Mezzanine: 0
Total $6,410.61
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
Smoke Detectors: Yes Manual Pull Stations: Yes
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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: / //,� t `Ci `
____a
Call 503.839.4175 by 7:00 a.m. for the next available Inspection date.
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 FOR OFFICE USE ONLY
City of Tigard E D D � 5 .60 =WI Permit No.: 1 (2aol, -� 1a/
I iii 13125 SW Hall Blvd„ Tigard, OR 972 Plan Review '
e ` Phone: 503.7182439 Fax 503.598.1 ,j Da R : /i.E/ Other Permit
Inspection Line: 503.639.4175 Date ReadyBy. 0, Z Iwiv. BI See Page 2 for
T 1 G A R D Internet www.tigard -or.gov MAY 3 0 27..7- Notifi:, ethod: Ve 0(0 42 (Cd
( �� Supplemental Information
1 - ' N)( �•
TYPE OF W QP TIC ' . / REQUIRED DATA: 1= AND 2-FAMILY DWELLING
M DIVISION Permit fees' are based on the value of the work performed.
❑ New construction
NUM
Indicate the value (rounded to the nearest dollar) of all
'J Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION . work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling tp Commercial mdustrial
•
❑ 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: 13333 S U 1, S i- 4/ .6 4 ,I New dwelling area: square feet
City/ State/ZIP: 1 t Q ,d oft_. 1 1-7-2-3 Garage/carport area: square feet
Suite/bldgiapt. no.:e/D Project name: 1■14.14bika i Aorkiia." U" "'4'7 Covered porch area: square feet
Cross street/directions to job site: � Deck area: a 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
DESCRIPTION OF WORK work indicated on this application.
•4s,tto t.Q fi3 t9 !" G0..rle". 1.,e�(C 6al.j4Mte".0 Valuation: $ '35 D, O a('
-
Existing building area rtfun square feet
New building area: 1 2. 2. ‘ 1 square feet
IF, PROPERTY OWNER ❑ TENANT Number of stories: I
Name: T e A bur f? I ^T LLC— Type of construction: ( (
Address: CIO 1 MAC &LISAIA SA- , Occupancy groups:
City/ State/ZIP: e arctati.13 D1 ql 232 Existing:
Phone: (03) 2 c j ^ 61 at 1 . Fax: (g13 ) 2`11 ^ e `I 4 .. New:
APPLICANT • ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: S' 'N tc14t (Please refer to fee schedule)
‘,#„1 Stru ctural plan review fee (or deposit):
Contact name: M Ager r in_ •
FLS plan review fee (if applicable):
Address: i 0 I Ni 6e.. m si - Total fees due upon application: fa 74 76
City/State/ZIP: `p 0 2t1.+ 7 0 (L en 232—
Amount received:
Phone: (503 ) Zg 7 el / ( Fax: : (s 3) 2 47 - 43 9 4'l
E -mail: N1 w,,� �t ��lcr , �� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
s~ too-. Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
Business name: 6 `�� Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: ei 0 ( mg. 1,. S.pr„ • t. Solar Installation Specialty Code checklist.
City/ State/ZIP: Permit fee (includes plan review $180.00
and administrative fees):
Phone: (5b3) 29'1 - $' / Fax: (93) 29 -7 - bq 4 1 State surcharge (12% of permit fee): $21.60
CCB lic.: 134 s2_9 Total fee due upon application: $201.60
Authorized signature: / / /�� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: M i r r n tes J Lv /M Date: S'. 2 1 'L * Fee methodology set by Tri-County Building Industry
� .. Service Board.
I:\Building\Permits\BUP -COM PennitApp.doc 02/242011 440-4613T(11 /02/COM/WEB)
•
,3333 CP fokwy ove
!PI
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: / cju r H.D � ooI I I ❑ Expedited Review
Plan Submittal Date: ; / —.
To the Applicant:
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 o ly if approved.
Planni ng Review (contact at 503 -718,2 )or A@tigard-or.gov)
Zonin g W r / Permitted Use Yes No ❑
Ai(Land Use Required: Yes ❑ No [ (explain below)
Notes: JI ��..�i / �/ I i .. . /4A/
iJil NIffeWINFLAFINNIM
lld' A roved ❑ Not Approved Date
Pp pP : ��
Permit Coordinator Review (contact Albert Shields 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
•
I: \CURPLN