Permit (7) CITY OF TIGARD BUILDING PERMIT
11111 ' COMMUNITY DEVELOPMENT Permit#: BUP2016 00123
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/06/2016
Parcel: 2S113AB00600
Jurisdiction: Tigard
Site address: 16125 SW 72ND AVE
Project: St.Jude Medical Center Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: TI for existing tenant:Wall construction with double doors and a new suspended ceiling.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES LP
15350 SW SEQUOIA PKWY#300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-624-6300 PHONE:
FAX: 503-624-7755
Specifics: FEES
Description Date Amount
Type of Use: COM DC Provision Review,COM TI-Ping 04/06/2016 $88.00
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: B Occupancy Load: 132 Permit Fee-Additions,Alterations, 04/06/2016 $619.25
Demolition
Dwelling Units: 0 12%State Surcharge-Building 04/06/2016 $74.31
Stories: 1 Height: 0 ft Plan Review 04/06/2016 $402.51
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 04/06/2016 $247.70
Value: $40,000 Info Process/Archiving-Lg$2.00(over 04/06/2016 $4.00
11x17)
Floor Areas:
Total Area: 0
Accessory Structs 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,435.77
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: 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 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 1.800.332.2344.23
1111110
Issued By: ,gzei4.00„e__ `� •• .r"ttee Signature:
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Call 503.639.4175 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 4//'/kw
Commercial O\NI
VReceived �/ / FOR OFFICE: ILSE()NIA
City of Tigard DateIB : S� j^ Permit No.: ` i a 6/4••J0/IN " 13125 SW Hall Blvd.,Tigard,OR 9722 ^ Plan Review
Phone: 503.718.2439 Fax: 503.598.19 6 1-016 l��1,,,
r�� Other Permit:
Date/B
T I( n R D Inspection Line: 503.639.4175 1\\) k ��1 late'easy �.' Ed See Page 2 for
Internet: www.tigard-or.gov o�IliGPS`al fied/Method: , A� rr� Supplemental Information
tNi
-.� Q1v REQUIRED;DATA'1 AND 24'0411Y DWELLING
"�, TYPE OF WO ,a ,�� iA �� ' �
❑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
®Addition/alteration/replacement 0 Other:
� equipment,materials,labor,overhead,
ad,and the profit for the
` t , � ,< � � to� ��aTEG� YOFt .P i�OzN `� ,t � �i� work indicated on this application.
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB_SITE`INFORMATION;;AND LOCATION R`. Total number of floors:
Job site address: 16125 SW 72"Ave. New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:NA Project name:St.Jude Medical/AMS 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.
Added wall with double doors,drop ceiling including lighting and mechanical Valuation: $$40,000.00
Existing building area: 20000 square feet
New building area: 20000 square feet
PROPERTY OWNER 0 TENANT.-,;'' Number of stories: 1
Name:PacTrust Type of construction: III-B
Address: 15350 SW Sequoia Parkway#300 Occupancy groups: 1
City/State/ZIP:Portland,OR 97224 Existing: B,S-2
Phone:(503)624-6300 Fax:(503)624-7755 New: B,S-2
(83A;APPLICANt ® CONTACT PERSON BUILDING,,PERMIT'FEES*
Business name:PacTrust (Please refertofeeschedule)
Structural plan review fee(or deposit):
Contact name:Leslie Louis
FLS plan review fee(if applicable):
Address:15350 SW Sequoia Parkway#300
City/State/ZIP:97224 Total fees due upon application:
Phone:(503)624-6300 Fax: :(503)624-7755 Amount received:
E-mail:lesliel@pactrust.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
` ' CONTRACTOR Commercial and residential prescriptive installation of
- roof-top mounted PhotoVoltaic Solar Panel System.
Business name:PacTrust Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 15350 SW Sequoia Parkway#300 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,OR 97224 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)624-6300 Fax:(503)624-7755 State surcharge(12%of permit fee): $21.60
CCB lic.: 153913
Total fee due upon application: $201.60
Authorized signature: ‘5;401;,A Ar \,-yfa U This permit application expires if a permit is not obtained
V v ` within 180 days after it has been accepted as complete.
Print name: L..e 5 t e L D U�/7 Date: AcrYl\ . l Z D l * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
III City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: /VdlcW(a —CW-3
Site Address: 2 S 1 w 7 Zn� CAn/-L, Suite/Bldg#:
Project Name: SA' . ery clit.. of tst ct ccJ
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 7(/) i-ei t)r Tr , a ctd Vil ouck. , 6.0o r, (I c3�t 1'1 • "Iv-v) .
E.xisting Business Activity: nktd l(4JC 0 rte -OL
Proposed Business Activity: Ofle—C ,((Fit - 0 t i Vt Q ukotAct
�
;z" Verify Vcrify site address/suite# exists and active in permit system.
yRiver Terrace Nghborhood: ❑ Yes No
Zoning: 11J
/Permitted Use: ❑ Yes ❑ No ❑ Spec Space
Zr Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No, applicant notified to obtain business license
Notes:
Approved by Planning: /' (/v 0-1-1-e.\___ zg'1i/ Date: q/ &
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: VA"
Site Plans: #
Building Plans: #
Building Permit#: tt building permit# above.
\Vorkflow Routing: L7"Planning it .00r nator Cuirding
Workflow Sign-off: l i—Sii -off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: erc
By Permit Technician: Date: 0"
I:ABuilding\Fonns\BldgPennitRvw_COM_NoLandUse_0709I 5.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
El Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:ABuilding\Fonns\BIdgPcnnitRvw_COM_NoLandUse 0709I5.docx
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16125 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2016-00123
Chip Barnett
Violation Summary:
Inspector Contractor