Permit •
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00186
T. t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/06/2009
Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15875 SW 72ND AVE
Subdivision: OREGON BUSINESS PARK III Lot: 40
Project: Calypte Biomedical
Project Description: TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - Additions, Alterations, 10/06/2009 $729.45
PORTLAND, OR 97224 Demolition
PHONE: 503- 624 -6300 12% State Surcharge - Building 10/06/2009 $87.53
Plan Review 10/06/2009 $474.14
Plan Review - Fire Life Safety 10/06/2009 $291.78
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: $50,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
•
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,582.90
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. ATTENT • . • • =gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are orth in OAR
952 -001 -r s 0 through O • - 952 -r • • 10. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246. or 1. . 32.2344.
I / / J 4 L � � Permittee Signature:
Issue. By: ,
i 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 the project.
Approved plans are required on the Job site at the time of each inspection.
Building Permit Application Aft , �„ 1 " 1 "73 FOR OFFICE USE ONLY
Mill City of Tigard Date/B� 100 J PennitNo.: /� pi`J� ���g
q 13125 SW Hall Blvd., Tigard, OR 972P3 E' Plan Revi
Z. Phone: 503.639.4171 Fax: 503.598.1960 ,� =N OM N, Other Permit:
rr 11 Dat : /
TIGARD
Inspection Line: 503.639.4175 U �' l Date Ready :y: y: ® See Attached Checklist for
Internet: www.figard-orgov Notilied/Method: G� TIGA
p Notiliied/Method: Supplemental Information
CIV
TYPE OF WQI �G DIvIS10 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
A 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: .5' ."2`--_riL/ 9„Z2,4%., 7 New dwelling area: square feet
City/State /ZIP: p ,). j e(L ( 4 ,f /, Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: /� 1 U7 . J lI overed porch area: square feet
Cross street/directions to job site: L' 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.
� Valuation: $ `3 ' Z /
V' ''_ Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PacTrust Type of construction: iii q_7
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
City /State /ZIP: Portland, OR 97224 Existing: 6/ 99/
Phone: (503)624 -6300 Fax: (503)624 -7755 New: ---E5r---"
® 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: . z. BUILDING PERMIT..FEES': •
Address: (Please refer to fee schedule) . . r.
Structural plan review fee (or deposit):
City/State/ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
/ Amount received: /5 • 960
Authorized signature: / I .C/��, This permit application expires if a permit is not obtained
f� within 180 days after it has been accepted as complete.
Print name: ' / l( Date /�j /Q 9 • Fee methodology set by Tri -County Building Industry
J Service Board.
1:\ Building \Permits \BUP- PermitApp,doc 03/21/06 440- 4613T(II /02/COM/WEB)
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7 : Building Division
Over- The - Counter (OTC) Building Permit
TIGAKD Check List
`
Description of Project: ' �
t
,A GENERAL INFORMATION
Class of Work: * Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: a Second floor: E: W:
Occupancy Group: I S Z Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: 1� _ 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: 1 1'C' • Handicap access:
Smoke detector: Protected corridors: KYCJ
Fire alartn: te(-7 Parking spaces ( #):
Notes:
Total Valuation: $ W)
INSPECTIONS FEES DUE .
Footing /foundation Firewall $ °� Permit Fee
Post /beam structural Smoke detector $ ���w State Surcharge
Shear wall Misc. inspection $ Plan Review Fee
Masonry Approach /sidewalk $ �� 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:
$ a Total Fees Due
/ S$A .96
*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.
1: \Building\ Forms\ OTC-BUP.doc 08/19/08