Permit (Ole //O 1...ti.1" r --t
v. -
CI OF TIGARD
C? BUILDING PERMIT
114 0 .. COMMUNITY DEVELOPMENT Permit#: BUP2010 -00226
T I G A R D 13125 SW Hail Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/15/2010
Parcel: 2S113AA00300
Jurisdiction: Tigard
Site address: 16320 SW 72ND AVE B3
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: SERVICE PARTNERS
Project Description: TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 10/15/2010 $955.35
PORTLAND, OR 97224 Demolition
PHONE: 503 - 624 -6300 12% State Surcharge - Building 10/15/2010 $114.64
Plan Review 10/15/2010 $620.98
Plan Review - Fire Life Safety 10/15/2010 $382.14
Contractor:
DURUS CONTRUCTION LLC
15806 UPPER BOONES FERRY RD
LAKE OSWEGO, OR 97035
PHONE: 503 - 320 -8601
FAX: 503 -244 -4318
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $80,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,073.11
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. ATT N: Oregon - , requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 through OAR 95 4 :.1 -0 00. You may obtain a copy of the rules or direct questions to OUNC by callin • • 3.246.6699 or [800.332.2344.
Issu d By: ` / 1j. Permittee S' nature: 6, .e,, ��
Call 503.639.4175 by 7:00 a.m. for an inspe % • s nes' • ay. 1
This permit card shall be kept in a conspicuous place on the Job site un ' ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD BUILDING PERMIT
1111 o COMMUNITY DEVELOPMENT Permit #: BUP2010 00226
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/15/2010
Parcel: 2S113AA00300
Jurisdiction: Tigard
Site address: 16320 SW 72ND AVE B3
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: SERVICE PARTNERS
Project Description: TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 10/15/2010 $955.35
PORTLAND, OR 97224 Demolition
PHONE: 503 - 624 -6300 12% State Surcharge - Building 10/15/2010 $114.64
Plan Review 10/15/2010 $620.98
Plan Review - Fire Life Safety 10/15/2010 $382.14
Contractor:
PACIFIC REALTY ASSOCIATES LP
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: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $80,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,073.11
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 wit expire if work is not started within 180 days of issuance, or if work is s ended for • : - •
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules = • - -t forth i. •AR
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a les or direct questions to OUNC by calling 503.2. • • • •9 or 1 ;00.332.2344.
i
Issued By � - r i . Permittee Signature:
i " T503.639.4175 by 7:00 a.m. for an Inspection that busine. 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 FOR OFFICE USE ONLY •
•
Cl Of Tl and , - -- ` / Received B ^���
1114 `� g l tl: � � Date n3 Permit No.: 1 t,1 l - t 0 a) ,
13125 SW Hall Blvd., Tigard, OR 97 \ l Pla n Review A Phone: 503.639.4171 Fax: 503.598. ., 1- 1� \� Date/B Aft Q
: A, 0 Other Permit:
TIGARD Inspection Line: 503.639.4175 C--\ Date ReadyB •: Loris: El See Attached Checklist for
Internet: www.tigard - or.gov ;� Notified/Method: 1 Supplemental Information
TYPE OF WORRC,,•; ' REQUIRED DATA: 1- AND 2- FAMILY DWELLING
1, Permit fees* are based on the value of the work performed.
ED New construction El Demolition P
Indicate the value (rounded to the nearest dollar) of all
X 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: r d __Qti ..9z "PP New dwelling area: square feet
City/State/ZIP: ! o ve // S / 0 t 9' 9 � - Garage/carport area: square feet
Suite/bldg./apt. no.: Project name:
j f jec,,i e � i 4 f--w�� Covered porch area: square feet
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 work indicated on this application.
Valu
.�� o 7'D� /. '/ J ?oo -s /fie , h f - '- t E' $ 2V j /1a'
xtsting building area: square feet
'Clip& z/Z r /. , , .// r2' t 4 r 22e ,1"—', �l e. /4— New building area: square feet
Es PROPERTY OWNER ❑ TENANT Number of stories:
Name: PacTrust Type of construction: jjr
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: , g S/
City/State/ZIP: Portland, OR 97224 Existing: i'l
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 � /1
Business name: 7�G7—�� s I- /P f 1- 4 - C. I G si . Gi-f j a BUILDING PERMIT FEES*
Address: 15 3 c Sul- q u o t q i-) J � (Please refer to d e : feL
<T" Structural plan review fee (or d
City/ State/ZIP: fav kt e1 (112 1 7 1
I FLS plan review fee (if applicable):
Phone: (D/ 2 ) (p ).4 .-(93 Fax: (
Total fees due upon application: 1 0) 3 , ' /
1
CCB lic.: 1 53' 3 _
Amount received: (2-0.73.111
Authorized signature: This permit application expires if a permit i not ;: ;ed
0 -0G%-. _ within 180 days after it has been accepted as complete.
/�
� , 14,
Print name: rl e , Date: // �S methodology by Building *Fee methodolo set b Tri County Buildin Indus try
Service Board. ``
I:\ Building \Permits\BUP- PennitApp.doc 03 /21/06 440- 4613T(I I /02/COM/WEB) 4 3 SI V k
III e 1 Building Division
Over- The - Counter (OTC) Building Permit
T i c n R Check List
•
Description of Project: T(
GENERAL INFORMATION
Class of Work:* ` LT Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* i First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: itr ( Third floor: Openings Protected Y /N ?:
Occupancy Load: / � Total sq ft.: N: S:
Stories: Note: Combine total floor area for _ E: E: _
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: Yr Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ R I
INSPECTIONS 1 FEES DUE
Footing /foundation Firewall $ ' S Pemmit Fee
Post /beam structural Smoke detector $ A State Surcharge
Shear wall Misc. inspection $ e Plan Review Fee
Masonry Approach /sidewalk $ 1 . ` FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final • $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ 2 :II Total Fees Due
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I: \ Building \ Forms \ OTC-BUP.doc 08/19/08