Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2020-00092
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T I CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/29/2020
Parcel: 2S 113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 130
Project: Siemens Subdivision: None Lot: None
Project Description: TI to reduce size of suite to 2,118 sf to be occupied by existing tenant. Work includes demolition of interior
nonstructural walls,new walls,doors/frames, paint,HVAC zone split and lighting.
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
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Specifics: FEES
Description Date Amount
Type of Use: CRT
Class of Work: ALT Type of Const: IIIB Permit Fee-Additions,Alterations, 04/28/2020 $301.85
Demolition
Occupancy Grp: B Occupancy Load: 18
12%State Surcharge-Building 04/28/2020 $36.22
Dwelling Units: 0 Plan Review 04/08/2020 $196.20
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 04/28/2020 $102.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 04/28/2020 $120.74
Value: $14,200 Info Process/Archiving-Lg$2.00(over 04/28/2020 $6.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $763.01
Required: Required Items and Reports(Conditions)
Fire Sprinkler: 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 ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
rr
Issued By: Permittee Signature: SC/7SC/7G/ ("t"Gt.75A7
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.
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Building Permit Application
Commercial FOR OFFICE USE ONLY
of Tigard VED
Received t� tlj
• City g p 2 b 2020 Date/By: //4/ZL ► Permit No.43 aQ ^/7 c rt6�
13125 SW Hall Blvd.,Tigard,OR 97223 MA:\ Plan Rev �( vw�
II Phone: 503.718.2439 Fax: 503.598.1�}� Date/By: j3-. f Other Permit.
TIGARD Inspection Line: 503.639.4175 VIIYUF T,Porkti0 Date Ready/By. J r°ds_- ® See Paget for
Internet: www.tigard-or.gov IN DIVISION
N` Notified/Method: JJ Supplemental Information
BUILDING iJ�4I��®�'9 !/ZeI/� t� PP
1�f Ay ,'
TYPE OF WORK REQDHLEQ DATA,L-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/replacenicnt ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONS'IRLClION work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION ,:.3 l H„ 1' Total number of floors:
Job site address: 16101 SW 72"d Ave New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:130 Project name:Siemens Downsize Covered porch area: square feet
IF 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 .bvr: work indicated on this application.
Project consists of demising current space w/tenant downsizing into 2,118 SF. Valuation: $14,200.00
Work incl.select demo existing nonstructural walls,nonstructural drywall/metal Existing building area: 2,118 square feet
studs walls,doors/frames,paint,HVAC zone split,and lighting New building area: 2,118 square feet
® PROPERTY OWNER El TENANT Number of stories: I
Name: Pacific Realty Associates,LP. Type of construction: III-B
Address: 15350 SW Sequoia Parkway,Suite 300 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing: B
Phone:(503)624-6300 Fax:(503)624-7755 New: B
® .APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Pacific Realty Associates,LP.
(Please refer to fee schedule)
Structural plan review fee(or deposit): ,/q1 ,20
Contact name:Ryan McGuire (9503 707 /Fry
FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Parkway,Suite 300
Total fees due upon application:
City/State/ZIP:Portland,OR 97224
Amount received:
Phone:(503)624-6300 FRX::(503)624-7755
E-mail:permits@pactrust.com PHOTOVOLTAIC SOLAR PANEL SYS'I'EM FEES*
� Commercial and residential prescriptive installation of
O I'KACFO , r
' roof-top mounted PhotoVoltaio Solar Panel System.
Business name:Pacific Realty Associates,LP. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:15350 SW Sequoia Parkway,Suite 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 lie.: 153913
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Ryan Mc it Date: * Fee methodology set by Tri-County Building Industry
'�5 2 b Service Board.
I.\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(i l/02/COM/WEB)
City of Tigard
lig COMMUNITY DEVELOPMENT DEPARTMENT
a . .
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: d LCioo,p .2p -Q(]0?a.-
Site Address: alp 1D 1 5\J 12 6f ;fie. Suite/Bldg#: /3s
Project Name: SIocaonS DaAms
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T, I UC-t.l1 S - a- - 'irci.,-'} S ic-2 -
Existing Business Activity: ( 1Cp
Proposed Business Activity:
KVerify site address/suite#exists and active in permit system.
.:River Terrace Neighborhood: ❑ Yes St No
tg Zoning: l— P
Permitted Use: K.Yes D No ❑ Spec Space
gConfirm no land use required.
Business License:
Exists: -Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: AO 1n A. d\--, Date: 3/) 1-20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 3/2..s/ Z-
Site Plans: #
Building Plans: #
Building Permit#: €'Enter building permit# above.
Workflow Routing: teri3lanning Cl Permit Coordinator °Building
Workflow Sign-off: -Sign-off for Planning(include notes from planning review)
Route Application Documents: 'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 40 /0€1/Lr..(2YQ'�S--1 Date: r/j/Z4D
I:\Building\Forms\BldgPennitRvw_COM_NoLandUse_111819.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 Appli .nt:
Revision Notice 2: Date Sent to A. cant:
Revision Notice 3: Date Sent to 'pplicant:
❑ SDC Fees Entered: Wash C. rans Dev Tax: ❑ Yes ❑ N/A
Tigarc rans SDC: ❑ Yes ❑ N/A
P. SDC: 0 Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
L:\Building\Forms\BldgPermitRvw_COM_NoLandUse_l 11819.docx