Permit BUILDING PERMIT
a CITY OF TIGARD
I: COMMUNITY DEVELOPMENT Permit #: BUP2010 00041
• T E G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/05/2010
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7228 SW DURHAM RD, STE# 100
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Style Shock
Project Description: Interior TI, add restrooms.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 03/05/2010 $1,407.95
PORTLAND, OR 97224 Demolition
PHONE: 503 - 624 -6300 12% State Surcharge - Building 03/05/2010 $168.95
Metro Const. Excise Tax - Commercial 03/05/2010 $180.00
Use
Contractor: Plan Review 03/05/2010 $915.17
PACIFIC REALTY ACCOCIATES LP Plan Review - Fire Life Safety 03/05/2010 $563.18
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 624 -6300
FAX: 503 - 624 -7755
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $150,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,235.25
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: No 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 coopy the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
l��
Issued By: , J? J LX 'A y� (� v � � ` l \W `. Permittee Signature: Q \�P
L� ��� JJJ Call J 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 the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application REC F OR OFFICE USE ONLY r ;
City of Tigard �� Received _%� permit No.: I �� I
rr
13125 SW Hall Blvd., Tigard, OR 97223 MA Plan Re : S ` `.
g ®r Plan Review Other Permit:
Inspection Line: 503.639.4175 �
Phone: 503.639.4171 Fax: 503.598.19 DateB : I
TIGARD � Y (Q', Date Ready /By: ® See Attached Checklist for
77
Internet: www.tigard -ocgov BUf�� !NNlr� G/ R YA Notified/Method: an Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
ID 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: i z ., 9 Q g _ 2 4./ �,,,,. d „a_ - J,� New dwelling area: square feet
City/State /ZIP: ,7:• ��J 11/tt ,r/0__, 9 7 y Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 Project name.4.,;2> /e._2 'J �j�� G ' Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
4 1"/.9- 7 ? co`—'T /. - /°'ie_. ,ei 442 aL`G/J Other structure area: square feet
d ( > - e — S - 4 , a' j t+ - i� 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 work indicated on this application.
Valuation: $ "`) 41�v
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: /
Name: PacTrust Type of construction: JJ
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
City /State /ZIP: Portland, OR 97224 Existing: s 'Y / 49' Phone: (503)624 - 6300 Fax: (503)624 - 7755 New: ��
® APPLICANT ® CONTACT PERSON
NOTICE
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: Dennis Pagni licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 S.W. Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 624 -6300 Fax: : (503) 624-7755
E - mail: dennisp @pactrust.com
CONTRACTOR
Business name: �_jg / ' BUILDING PERMIT FEES* .
Address: ' � i=r (Please refer to fee schedule)
City/State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: Total fees due upon application:
Amount received: 3a35. a 15
Authorized signature: . This permit application expires if a permit is not obtained
��' r within 180 days after it has been accepted as complete.
Print name: �{ � n�L� Q "A, Date * Fee methodology set by Tri-County Building Industry
Service Board.
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