Permit � a
CITY OF TIGARD BUILDING PERMIT
111
COMMUNITY DEVELOPMENT Permit#: BUP2017-00075
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/29/2017
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 150
Project: Dale Engle CPA Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: TI for new tenant: Office reconfiguration and new breakroom.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
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
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 03/29/2017 $90.00
Occupancy Grp: B Occupancy Load: 27 Permit Fee-Additions,Alterations, 03/29/2017 $575.17
• Demolition
Dwelling Units: 0 12%State Surcharge-Building 03/29/2017 $69.02
Stories: 4 Height: 0 ft Plan Review 03/29/2017 $373.86
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 03/29/2017 $230.07
Value: $35,549 Info Process/Archiving-Lg$2.00(over 03/29/2017 $4.00
11x17)
Floor Areas:
Total Area: 2691
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,342.12
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 cop of-theruues or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 'ermi'ee Signature:
1 + .• 9.4176 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
CommercialCx FOR OFFICE USE ONLY
Cityof Tigard ....,. .\%"1/4, Received Permit No.:g r DateB : J. 17 c..L4� 4. /.Of 7 - 7
- 13125 SW Hall Blvd.,Tigard,OR 97223 : � � �
g D�� Plan Review
II Other Permit:
Phone: 503.718.2439 Fax: 503.598.196t� • (� DateB : _ A.
T I G A R D Inspection Line: 503.639.4175 ��� Date Ready:y: Suns: ® See Page 2 for
Internet: www.tigard-or.gov \` Notified/Method: (, Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILYDWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Z Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
t� work indicated on this application.
��5' � � CATEGORY OF CONSTRUCTION �, ��,. ,�';
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
0 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:12909 SW 68th Parkway#150 New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Dale Engle,CPA Covered porch area: square feet
Cross street/directions to job site:SW 68th and SW Hamilton 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK _+ work indicated on this application.
Office modifications Valuation: $$35,549.00
Existing building area: 2,691 square feet
New building area: 2,691 square feet
® PROPERTY OWNER4 U: 0 TENANT ! Number of stories: 4
Name:PacTrust Type of construction: II-B
Address: 15350 SW Sequoia Parkway#300 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing: B
Phone:(503)624-6300 Fax:(503)624-7755 New: B
6 ►.'APPLICANT,T,#1,„ ® CONTACT PERSON BUILDING PERMIT FEES* ,�
(Please refer to fee schedule) ,E._
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
City/State/ZIP:97224 Total fees due upon application:
Amount received:
Phone:(503)624-6300 Fax: :(503)624-7755
E-mail:lesliel@pactrust.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR
�4 -,„,,";-_-3- 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.
Permit fee(includes plan review
City/State/ZIP:Portland,OR 97224 $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
This permit application expires if a permit is not obtained
Authorized signature: VOW tArIA^
within 180 days after it has been accepted as complete.
Print name: (�L(�Lj Date: MArGo 21 2Q�� * 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
11111 I
q COMMUNITY DEVELOPMENT DEPARTMENT
rlcAlzD Building Permit Review — Commercial - No Land Use
Building Permit #: /3u42)/7!t 75
Site Address: 1 ZqI' l Svc! iveM Pi V 1 Suite/Bldg#: Iso
Project Name: Pi d - i.e OP-A-
(Name of commercial businej occupying the space. If vacant,enter Spec Space.)
Planning Review CL
Proposal: T. I -AU mr rhr4-i c
Existing Business Activity: AC()
Proposed Business Activity: U--fp
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: ❑ Yes No
,a;Zoning: I!L t
Permitted Use: EYes ❑ No ❑ Spec Space
Confirm no land use required.
Business License:
Exists: ❑ YesNo,applicant notified to obtain business license
Notes:
Approved by Planning: T 'VODA Date: -
((1
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved E Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: /941/7
Site Plans: # 4j
Building Plans: # 3
Building Permit#: [4nter building permit#above.
Workflow Routing: alcnning ❑ Permit Coordinator Cuilding
Workflow Sign-off: 0-..*SiEn-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: OTE-
By Permit Technician: , -cie.. ., �� Date: 3/4//7
I:\Building\Forms\BldgPermitRvw_COM_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 ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPennitRvw_COM_NoLandUse 070915.docx
City of Tigard • BUILDING DIVISION
' Over-The-Counter (OTC) Building & Fire Protection System Permit
r 1(, 1) Appointment Checklist
Permit Record#:
Contact Name: j Phone #: 3—off 6,3oU
Business Name: , � Ap t. Date/Time: 5/9.1 l0;00
Site Address: /g g aq 6-12114-4 /5do 7i/y--/ Bldg/Suite #:
Project Name. c-••••5
�p�-mer
Project Description: 4. 4c7-0--P,.ti ,_,yteLf '�„-21 iy40.z1 U U
Existing Use: New Use:
MMD Required: ❑ Yes ❑ No Related Record #:
GENERAL INFORMATION
Class of Work: 1.,T' Occupancy Group: Type of Construction:
Type of Use: C 'LA Occupancy Load: `7 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: 2. , t 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: 1•••M 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: $ •"jam air
(dap/ SOD) $ gly DC Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2016) $ , i 12%State Surcharge
Project Valuation $ It 'Ian Review,Structural •
Up to$4,999 $0.00 $ •r r Plan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ , `a, 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
$ Other:
Building Staff: $ Other:
Date/Time: $ 642,2,12—T I TAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070116.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12909 SW 68TH PKWY 150, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2017-00075
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - CofO
Comments:
Violation Summary:
Inspector Contractor