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Permit
CITY OF TIGARD BUILDING PERMIT s a x COMMUNITY DEVELOPMENT Permit #: BUP2010 -00039 T I G *RD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/04/2010 Parcel: 2S113AB01201 Jurisdiction: TIGARD Site address: 16505 SW 72ND AVE Subdivision: PACTRUST BUSINESS CENTER Lot: 0 Project: Liberty Mutual Project Description: Interior TI. Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 03/04/2010 $509.05 PORTLAND, OR 97224 Demolition PHONE: 503- 624 -6300 12% State Surcharge - Building 03/04/2010 $61.09 Plan Review 03/04/2010 $330.88 Plan Review - Fire Life Safety 03/04/2010 $203.62 Contractor: BNK CONSTRUCTION INC 45 82ND DR SUITE 53B GLADSTONE, OR 97027 PHONE: 503 - 557 -0866 FAX: 503 - 557 -1085 Specifics: Type of Use: COM Class of Work: ALT Dwelling Units: 0 Stories: 2 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $29,165 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,104.64 Required: Required Items and Reports (Conditions) Fire Sprinkler: Yes Parapet: Fire Alarm: Yes Protected Corridors: No 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 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 0 1.800.332.2 •4. Issued By: n � Q n \ n v H im "`-' / Permittee Signature: / / Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of t • project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Commercial, FOR OFFICE use ONLY R eceived , Permit ` City of Tigard �n 13125 SW Hall Blvd., Tigard, OR 97223 MAR 0 4 2010 Date/ g Plan Review 3 ' Phone: 503.639.4171 Fax: 503.598.1960 DateB : [ r �� a v J�© Other Permit: TI G A R D Inspection Line: 503.639.4175 ® Date Ready / : • ' See Page 2 for ` ,� Notified/Method: Supplemental lnformation Internet: www.tigard or.gov ' • • , ; , , � i ti:�, rt�t �,. • .. .. , �vi , �� " , ); , i TYPE OF WORK REQUIRED DATA: 1- 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/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $ ❑ 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: 16505 SW 72 Ave New dwelling area: square feet City /State /ZIP: Tigard, OR 97224 Garage /carport area: square feet Suite/bldg. /apt. no.: 2" Floo 1 Project name: Liberty Mutual Covered porch area: square feet Cross street/directions to job site: Cross Street is SW Durham Road Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Pennit 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. Interior partition demolition, new electrical, paint and carpet Valuation: $29,165.00 Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: PacTrust Type of construction: Address: 15350 SW Sequoia Pkwy Suite 300 Occupancy groups: City /State /ZIP: Portland, OR 97224 Existing: Phone: (503)624 -6300 Fax: (503 - )624 -7755 New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: BnK Construction, Inc. All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: Rick Shandy under ORS 701 and may be required to be licensed in the Address: 45 82 " Drive Suite 53B jurisdiction in winch work is being performed. If the applicant is exempt from licensing, the following reasons City /State /ZIP: Gladstone, OR 97027 apply: Phone: (503) 888 -0231 Fax: : (503) 557 -1085 E -mail: shandy @bnkconstruction.com CONTRACTOR Business name: Same as above BUILDING PERMIT FEES* (Please refer to fee schedule) Address: Structural plan review fee (or deposit): City /State /ZIP: FLS plan review fee (if applicable): Phone: ( ) Fax:( ) Total fees due upon application: CCB lic.: Amount received: , l Cy ts L Authorized signature: This permit application expires if a permit is not obtained 1 ► within 180 days after it has been accepted as complete. Print name: e\A A � W uv, � Date: 3 -3_to * Fee methodology set by Tri- County Building Industry Y Service Board. I: \Building \Permits\BUP -COM PermitAap.doc 10/01/ 440- 4613T(11/02/COM/WEB)