Permit CITY OF TIGARD BUILDING PERMIT
"l °' COMMUNITY DEVELOPMENT Permit#: BUP2020-00091
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/29/2020
Parcel: 2S 113AB01201
Jurisdiction: Tigard
Site address: 16575 SW 72ND AVE
Project: FaxBack Subdivision: None Lot: None
Project Description: TI of existing office space including interior demolition of nonstructural walls,new walls,doors/frames,painting,
electrical distribution 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
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB Permit Fee-Additions,Alterations, 04/24/2020 $423.53
Demolition
Occupancy Grp: B Occupancy Load: 52 12%State Surcharge-Building 04/24/2020 $50.82
Dwelling Units: 0 Plan Review 04/07/2020 $275.29
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 04/24/2020 $102.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 04/24/2020 $169.41
Value: $22,152 Info Process/Archiving-Lg$2.00(over 04/24/2020 $8.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,029.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA 2-001-0090. Y ay obtai cop of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: f J Permittee Signature: Sr
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr74,-9-
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
CI of Tigard Received 4f _
`J b MAR 2 5 2020 Date/By: / 7/2 o Permit no.-: .yt/o�o 000y
'a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
1 a' Phone: 503.718.2439 Fax: 503.598. DatcB y� Other Ferric.
1$b�Y OF TIGARD r
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date ReadyBy: /�/ Lurie 0 See Paget for
Internet: www.tigard-or.gov Notified/Method:9'. ' '0 a Supplemental Information
Aili L 71s6r T
TYPE OF WORK REQUIRED DATA: 1-AND 2-FAMILY DWELLING
0 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/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ®Comercial/industrial Valuation: $
m
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16575 SW 72""Ave New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: FaxBack TI Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
I__
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: r 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.
Remodel work to 5,203 of existing office space.Work includes selected demo of Valuation: $22,152.00
space
existing nonstructural walls,nonstructural drywall/metal studs walls,doors/ Existing bn+id'ing area: 5,203 square feet
frames,painting,electrical distribution,and lighting. New Uui area: 5,203 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name:Pacific Realty Associates,LP. Type of construction: Ill-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*
Meuse refer to fee schedule)
Business name: Pacific Realty Associates,LP.
Structural plan review fee(or deposit): d2 7 , A 9
Contact name:Robert Bumcrot
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 Fax: :(503)624-7755
E-mail:permitsgpactrust cnm PHOTOVOLTAIC SOLAR PANEL.SYSTEM FEES"
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic 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 lic.: 153913 Total fee due upon application: $201.60
olghally sgned by" x,eumaN
Authorized signature:
Robert Bumcrot °""-us.E. ""M"`"""c o.racuuu.u+.acte" This permit application expires if a permit is not obtained
Date 030.03R5,G4331 07'00 within 180 days after it has been accepted as complete.
Print name:Robert Bumcrot Date: 3/25/2020 * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-COM PcrmitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
City of Tigard
III
COMMUNITY DEVELOPMENT DEPARTMENT
14 1
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: ,844469,0a0 - 0009/
Site Address: ((05"15 SvJ 7 i Pcvte-- Suite/Bldg#:
Project Name: 1r,,jk
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ¶ .
Existing Business Activity: (' CQ
Proposed Business Activity: o-(.C(
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ Yes KNo
ig. Zoning I—„p
Permitted Use: lYes 0 No 0 Spec Space
Confirm no land use required.
Business License:
Exists: Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: Oeco_iL— Date: ?j/ I'0
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: 3/2-5/2 0
Site Plans: # .3
Building Plans: # _3
Building Permit#: jEr Enter building permit#above.
Workflow Routing: Planning 0 Permit Coordinator 1,,gr3Building
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: dj5. 6 J Date: • /7/2-®
1:\Building\Forms\B1dgPermitRvw_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 Applica :
Revision Notice 2: Date Sent to Apy,Idant:
Revision Notice 3: Date Sent to/Applicant:
❑ SDC Fees Entered: Wash Co/frans Dev Tax: ❑ Yes ❑ N/A
Ti Trans SDC: ❑ Yes 0 N/A
P ks SDC: ❑ Yes 0 N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
C\Building\Fomvs\BldgPermitRvw_COM_NoLandUse_111819.docx