Permit (143) CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit#: SIT2016-00023
13125 SW Hall Blvd.,Ti Date Issued: 11/30/2016
Tfa.1 R. and OR 97223 503.718.2439 9
Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15575 SW SEQUOIA PKWY
Project: PacTrust Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Parking improvements and ADA upgrades.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-624-6300 PHONE:
FAX: 503-624-7755
FEES
Description Date Amount
Specifics: Plan Review 11/30/2016 $150.36
12%State Surcharge-Building 11/30/2016 $27.76
Type of Use: COM Permit Fee-Site Work 11/30/2016 $231.32
Class of Work: ALT Erosion Control w/Development 11/30/2016 $80.70
Project Valuation: $15,000.00 Info Process/Archiving-Lg$2.00(over 11/30/2016 $4.00
11x17)
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Soil Report Required:
Paving: Grading:
Landscaping: Site Prep:
Storn Drains: Retaining Wall:
Fire Underground: Accessible Parking:
Fence:
Total $494.14
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009a. You may obtain a copy of the rules
or direct questions to OUNC by calling 50 • or 1.800 .
Issued By: Aire ' / rte - -••,•- Signature:'
Call 503.• 9., 5 by 7:00 a.m.for the next available insp=ction date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application�/
" i C Lim '` FOR OFFICE USE ONLY
A
Cityof Tigard „'-0,-t**,,,,,, Received �� Si__"'"."'",::
g ,r DateB // ��; Permit No.:
111 "I 13125 SW Hall Blvd.,Tigard,OR 97223 „.r' Plan Rx:e
_ Phone: 503.718.2439 Fax: 503.598,1�.-- `10�� Date/B �j'j� Other Permit:
TI G A R D Inspection Line: 503.639.4175 >{„° *,late Rea'":' El See Page 2 for
Internet: www.tigard-or.gov `(J`1. r.;`,cs-,:`, -,nk';‘$otified/Method: MI Supplemental Information
3L°i9 r'Vi_ }t ; `?n Sap *FRC ( i i , & %-.,..*:q,5. -I
%s,.. ” , n tlt : ,rs 074 SE¢
❑
New construction 0 Dgebgttjn 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,and the profit for the
0.T.,-1:40-.449"` yv1 aI ? ` fr
a 7 work indicated on this application., ' � , i4� .m _r 'Zf7 f ,ss>� r�m - i =
_, Nr , 'g
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
' : *i l ia' �D ik 'i ` i Total number of floors:
, mi�1 ,
Job site address:15575 SW Sequoia Parkway New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.;,.171r Project name:Sitework(exterior) Covered porch area: square feet
Cross street/directions to job site:SW Sequoia Parkway Deck area: square feet
Other structure area: square feet
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
, . r �t : v� �
> k� 3) l' �I�' WO ®,, !� t� work indicated on this application.
Exterior work including ADA upgrades Valuation: $15,000
Existing building area: ext square feet
New building area: ext square feet
►
Number of stories:
b �'F aa r� � a°M ;w 74-411'417445E•-
, �` * "" , P" F
Name:PacTrust Type of construction: III-B
Address:15350 SW Sequoia Parkway#300 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing: varies
Phone:(503)624-6300 Fax (503)624-7755
New: varies
,,�,;, 4V104,-,- , -Y.-,:'''''''''''.1.,
„ ';L�r r ! O A4.,J. PER d crisp x„ ! vhJih.,.,y ..
1 Business name:PacTrust
Structural plan review fee(or deposit):
Contact name:Leslie Louis
FLS plan review fee(if applicable):
Address:15350 SW Sequoia Parkway#300
Total fees due upon application:
City/State/ZIP:97224
Amount received:
Phone:(503)624-6300 Fax::(503)624-7755 iT O
E-mail:lesliel@pactrust.com ,, ., A "1 EL TI 0 ,
big , : p,n,R:,y,,,:z,,, ,,morm2.31 Commercial and residential prescriptive installation of
Ya rrq � '1 r Y,,
�, w��uu �,�r , . � � '':: mr7,� 4� a n _.W= 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
R Total fee due upon application: $201.60
Authorized signature: \g"�,(� S This permit application expires if a permit is not obtained
`� within 180 days after it has been accepted as complete.
Print name: 1.- -t�i l e L._0 vt S Date: N , ;10Z 01.b * Fee methodology set by Tri-County Building Industry
t Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard • BUILDING DIVISION
It
Over-The-Counter (OTC) Building( ) Bucling & Fire Protection System Permit
< < , [ Appointment Checklist
Permit Record#: . . #j(Q-- OQ? 3
Contact Name: • , [�> Phone #: 5,3– 6,24-L ,30 b
Business Name: ,et-.-1–T c f– Appt. Date/Time: ((1 gc @ l0:cam i
Site Address: ( S7 5— StAD —a`. p,(,�w` ., Bldg/Suite#:
Project Name: pre.-rfa•5�,-fi e/!.e� 7
Project Description: ;,,, ,),._• L� A +15 A-b,9- cera
Existing Use: New Use:
MMD Required: T', Yes ❑ No Related Record#: r-(14-(1)0a40/40 -6033
GENERAL INFORMATION
Class of Work: Occupancy Group: 6 Type of Construction:
Type of Use: C( (Al Occupancy Load: Oregon Specialty Code: -2,,,./
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: Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ b i .631 .
_
t reakf .� •rov Rvw,COM TI—Ping
'�.1 � ��
;--. 1./?`-- •. I•si•
DC Provision Review Fee for COM TI(effective 7/1/2016)R.1(o ( .7)"" "-_, `� ' Surcharge
�„� ...ice''/o State Surchar e
Project Valuation I Sb,3 p i , 1% Plan Review,Structural
Up to$4,999 $0.00 /1.. r` .�v ' . 1 .'- , - L. - •.
$5,000-$74,999 $90.00 $ A it") Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $224.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $357.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ .70 Other: I;'O 24) CCiA7✓d
Building Staff: $ Other:
Date/Time: $144TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070116.docx l ii .`
IIICity of Tigard
p COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: 5'7-7-t6e , -
Site Address: 1S 51 S S"4 Se cy0 e t c Pcir k w, Suite/Bldg#: < U
Project Name: P cii c, s i- C''X}e. o c
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: e X-k-6,1) r* ADA u p Y i CA-e
Existing Business Activity: iv/A c o kr r c:.r,. . 0 LGt
Proposed Business Activity: N/ A CO m truLe-L4-c, o -€_
Verify site address/suite# exists and active in permit system.
pRiver Terrace Ne hborhood: ❑ Yes ❑ No
,A Zoning: 1 (--)
,I Permitted Use: ❑ Yes ❑ No ❑ Spec Space
0 Confirm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: 0't/-k.� 8cam--
Date: 11/ 3o 1 1 6
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: ///30/f a
##
Site Plans:
Building Plans: ## �
Building Permit#: nter buuilding permit#above.
Workflow Routing: al anning ❑ Permit Coordinatording
Workflow Sign off: [3-.511'-off for Planning(include notes from planning review)
Route Application Documents: [ fig: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: i., _ Date: .I/Z,3t)M.I
I:\Building\Forms\B1dgPermitRvwCOM NoLandUse 060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ 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 CI
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw_COM_NolandUse_070915.docx