Permit rr CITY OF TIGARD BUILDING PERMIT
i COMMUNITY DEVELOPMENT Permit #: BUP2012 -00249
Date Issued: 12/11/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 150
Project: Diana Harrison CPA Subdivision: 1996 - 048 PARTITION PLAT Lot: 2
Project Description: TI for expansion.
Contractor: MATTHEW OLSON CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES
5320 SW DOVER LN ATTN: N PIVEN
PORTLAND, OR 97225 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 892 -0066 PHONE: 503 - 624 -6300
FAX: 503 - 892 -0067
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review, COM TI - Ping 12/11/2012 $67.00
Occupancy Grp: B Occupancy Load: 39 DC Provision Review, COM TI - LRP 12/11/2012 $10.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 12/11/2012 $362.69
Demolition
Stories: 3 Height: 0 ft 12% State Surcharge - Building 12/11/2012 $43.52
Bedrooms: 0 Bathrooms: 0 Plan Review 12/11/2012 $235.75
Value: $18.350 Plan Review - Fire Life Safety 12/11/2012 $145.08
Info Process /Archiving - Lg $2.00 (over 12/11/2012 $4.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $868.04
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 0'. pecialty Codes an. all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 80 days : issua -, or if .rk is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility 'otification , enter. Th.se 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 OU • . calling 503. 2.1987 or 1.800. 32.2344.
Issued By: ` r _ Permittee Signatur = 1`
-_
Call 503.639.4175 by 7:00 a.m. for the next available i.spe• . ..te.
This permit card shall be kept in a conspicuous place on the job site u it co . • etion of the pro ect.
Approved plans are required on the job site at the time of eac rasp 'on.
BuildinE Permit Application
Commercial ism 014 icy I sF: 0y1.v
1 01 1 R ECEIVE , eceived y ��. `
City of Tigard aateBy: �0�lib -� 1. �� ® Permit — DO�y�!
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
■ 2012 j _ � �' I • her Permit:
Phone: 503.718.2439 Fax: 503.598.1960 DateB
r I _ 1` I) be" Inspection Line: 503.639.4175 DEC 1 1
(� p� Date Ready : y: Juris: See Page 2 for
Internet: www.tigard - or.gov CITY
OF TIGARD Notified/Method: / Supplemental Information
TYPE OF WORP UILUIN J MINION 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
t4 Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling /ErCommercial/industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: \ S Sk,,..) si n v O 1 G ,. ,p ,, New dwelling area: square feet
City /State /ZIP: ` >0 - aM Ck. 042- G 7 221.4- Garage /carport area: square feet
Suite/bldg. /apt. no.: t S-o Project name: W 0.!A(/.. s u v v ,v,v. co 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: 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.
.. f ` S;a" 7 , Valuation: $ t t j i '�� -
�- Existing building area square feet
New building area: square feet
/
[PROPERTY OWNER ❑ TENANT Number of stories:
Name: ?0,C c ru S I- Type of construction:
Address: 1 c'3SO suj Spy vb, e 4'3(0 Occupancy groups:
City /State /ZIP: +6„,d, 911z 4 1 �(` Existing:
Phone: (9)3) (i7 ....(1 op Fax: (Xss) IJL24 7SS New:
F APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: S—
Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
A d d Contact ress: name: ■e lC(.ln C( lJ\‘9-e-.
City /State /ZIP: Total fees due upon application:
(� Amount received:
Phone: (�3) 1 0-1 - (fa 44 Fax:: ( )
E -mail: Y u a q� 1��G�VS� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
J r Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: I vlt!` 0 k te & yu di W„ Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City /State /ZIP: Permit fee (includes plan review $180.00
and administrative fees):
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: I oji h , ,
Total fee due upon application: $201.60
Authorized signatu
l � `_ This permit application expires if a permit is not obtained
w ithin 180 days after it has been accepted as complete.
Print name: y P � 1 V `�� Date: h Z `\ * Fee methodology set by Tri- County Building Industry
Service Board.
t
I: \Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440-461 3T(11 /02 /COM/W EB)
° Building Division
Development Code Provision Review
T [ G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: ❑ 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.
D. 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.
Planning Review (contact 41,26 &O ' It 503 -718- Z`fj or r P @tigard- or.gov)
/
Proposal: p - 1 C {= �� X,1 Jf,U. 7�t ��i �
Zoning i - P
Permitted Use Yes,U No ❑
Land Use Required: Yes ❑ No.-Et
Notes:
roved ❑ Not Approved Date: /2 ^ l REVISED 10/4/12 10/4/12
;I • ' Building Division
Over - The - Counter (OTC) Building Permit
1R,AI:l)
Check List
Project Description: --- Ti
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: AcL� Occupancy Group: Type of Construction:
*Type of Use: COMA Occupancy Load: c am ( Oregon Specialty Code: `z� C.3
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: C Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ fe, FEES DUE
$ { p ' 7 , 60 DC Prov Rvw, COM TI — Ping
$ • ,00 DCProvRvw,COMTI —LRP
DC Provision Review Fee for COM TI $ ,"z • Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ '2 , '7Z 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 237.75 Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ 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:
Date /Time: $ Z, , — TO AL 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 07/01/2012