Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00082
Date Issued; 05/14/2009
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 410
Subdivision: Lot: 0
Project: Spec Space
Project Description: TI
Owner: FEES
WISCO REAL ESTATE EQUITY Description Date Amount
FUND I LTD PARTNERSHIP, BY WYSE Permit Fee - COM 05/14/2009 $76.80
INVESTMENT SRVS CO, 1501 SW TAYLOR ST Tax - 12% State Surcharge 05/14/2009 $9.22
PHONE: Plan Review 05/14/2009 $49.92
Plan Review - Fire Life Safety 05/14/2009 $30 72
Contractor:
PACIFIC CREST STRUCTURES INC
17750 SW UPPER BOONES FERRY RD STE 190
DURHAM, OR 97224
PHONE: 503 - 968 -8949
FAX: 503- 598 -6658
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 5 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $3,120
Floor Areas:
Total Area 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $166.66
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 s b•ect to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work
will be done i ccordance wi pproved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 d s. ATTENTION Oreg. : • requ e • • to follow the rules adopted by the Oregon Utility Notification Center Thos- rules are set forth in OAR
952 -001 0010 through OAR 952 -r • 1 -0100. obtain a copy of )e e rules or direct questions to OUNC by calling 503. • • :.669• or 1 : 00 ti 32 2344.
Issue By: � / Permittee Signature: ,
Call 503.639.4175 by 7:00 a.m. for an Inspection that busine_ s • ay.
This permit card shall be kept in a conspicuous place on the job site until completi • n of the project.
Approved plans are required on the job site at the time of each inspec on.
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
RECEIVED ,
City of Tigard Date/B Received 7Z 9 RPM Permit No & u o�00? p00g
� `
° 13125 SW Hall Blvd., Tigard, OR 972
31 Of 1 2009 . Plan Revie 1t,
Phone: 503.639.4171 Fax: 503.598.1'..1 Date/B . /mom i � Other Permit
T I G A It. D CITY OFTIGARD RD DIVISION Notified/Method lLp. Supplemental Information
BUI' WING
TYPE OF WORK 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 Valuation: $
® C ommercial /industrial
❑ 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: 9020 SW Washington Square Road New dwelling area: square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no. /410 Project name'44$C ddgQ____ a e- Covered porch area: square feet
Cross street/directions to job site: SW Scholls Ferry Road 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.
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.
Alteration to existing tenant improvement, demising off a portion of the Valuation: $$3,120.00
tenant's suite that the tenant no longer wishes to occupy. Existing building area: 92219 square feet
New building area: 0 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 5
Name: One Embassy Partners c/o Wyse Investment Services Type of construction: II -B
Address: 1501 SW Taylor Street, Suite 100 Occupancy groups:
City /State /ZIP: Portland, OR 97205 Existing: B
Phone: (503)294 -0400 Fax: (503)227 -2507 New: B
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Robert Simpson Architect, PC All contractors and subcontractors are required to be
Contact name: Robert C. Simpson licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 31177 SW Simpson Road jurisdiction in which work is being performed. If the
City /State /ZIP: Cornelius, OR 97113 -6201 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 709 -9653 Fax:: ( )
E -mail: rsapc @verizon.net
CONTRACTOR
Business name: Pacific Crest Structures BUILDING PERMIT FEES*
Address: 17750 SW Upper Boones Ferry Road, Site 190 (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP: Durham, OR 97224
Phone: (503) 968 -8949 Fax: (503) 598 -6658 FLS plan review fee (if applicable):
CCB lic.: 66915 Total fees due upon application:
Amount received:
Authorized signature: ` This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Robert C. impson Date: 5/14/2009 * Fee methodology set by Tri -County Building Industry
Service Board
I: \Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(I l /02 /COM/WEB)
1114 a Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $ 2,496
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 624
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $ 0
(b) An accessible entrance: $ 0
(c) An accessible route to the altered area: $ 0
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ 0
(e) Accessible telephones: $ 0
(f) Accessible drinking fountains: and, $ 0
(g) When possible, additional accessible elements such as storage and
alarms: $ 624
TOTAL (shall equal line [2] of Valuation Computation): $ 624
I: \Building \Permits \BUP -COM PermitApp.doc 10/30/07
B uilding Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Description of Project:
GENERAL INFORMATION
Class of Work:* Lr Floor Areas (sq. ft.): Exterior Wall Construction.
Type of Use.* First floor: N. S:
Type of Construction• Second floor: E. W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: Note: Combine total floor area for E: E. _
Height: _ all floors above third floor and Roof Construction: _
Floor Load: add to the third floor s ft Fire Retardant:
Basement: Basement. Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: 1.? Handicap access:
Smoke detector: Protected corridors: KY)
Fire alarm: l Parking spaces ( #):
Notes:
Total Valuation: $ 3, ( 2 ,er
INSPECTIONS FEES DUE
Footing /foundation Firewall $ — ,,80 Permit Fee
Post /beam structural Smoke detector $ , Z.. State Surcharge
Shear wall Misc. inspection $ CIA 2_, Plan Review Fee
Masonry Approach /sidewalk $ '3 C).-27- FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ ' GO , ( Total 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.doc 08/19/08