Permit CITY OF TIGARD BUILDING PERMIT
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a .-..••• COMMUNITY DEVELOPMENT Permit #: BUP2009-00144
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/04/2009
- Parcel: 2S113AA00300
Jurisdiction: Tigard
Site address: 16316 SW 72ND AVE B3
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: Spec space
Project Description: Demo existing, and construct new warehouse office and restroom.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - COM 08/04/2009 $472.30
PORTLAND, OR 97224 12% State Surcharge - Building 08/04/2009 $56.68
PHONE: 503- 624 -6300 Plan Review 08/04/2009 $307.00
Plan Review - Fire Life Safety 08/04/2009 $188.92
Contractor:
PACIFIC REALTY ACCOCIATES 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: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $72,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,024.90
• 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 • = set forth in • • -
952- 001 -0010 through AR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.. • 6.:699 or :.0.332.234..
Issued By: (� �, �I�� Q \ A /AblA Permittee Signature:
` � ;)
Call 503.639.4175 by 7:00 a.m. for an inspection that „ si ess . y. L
This permit card shall be kept in a conspicuous place on the job site until c. pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Applicatio l FOR OFFICE USE ONLY
City of Tigard ' Calif tt Received
" MEN . • zo s • f go q
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review i ` f
Phone: 503.639.4171 Fax: 503.598.1960 Ae:w i" plan ; Other Permit:
Inspection Line: 503.639.4175 ' Date Ready/By: See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: 8 ` � S S ® upplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ N w construction ❑ Demolition Permit fees* are based on the value of the work performed.
ja
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 CO UCTION • work indicated on this application.
❑ 1- and 2- family dwelling mmercial/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: ./!.- y ? ,./t/ SLt� �. , e ______. New dwelling area: square feet
City/State/ZIP: N1 4 Q� ' Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: ✓ 420) ,JJ d �G ) _'ye,�ed pgrch area: square feet
Cross street/directions to job site: ' Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: I 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: $ , dQ
r" 1 i*.- T' 4it.. "dr.e Itdi,j - t i t C-L
d� `_�/. V � . _.....0' '72z? /S 4, Existing building area: square feet
7 �� New building area: square feet
• IX OWNER I ❑ TENANT Number of stories:
Name: 7� ,Tiec_t_s Type of construction: 2 / .P
Address: Occupancy groups: 270 ca
City/State/ZIP: Existing: . 7 1 . , . , .
Phone: ( ) Fax: ( ) N ew:
❑ 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 Parkway, Suite 300 jurisdiction in which work is being performed. If the
Ci /State/ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
ty apply:
Phone: (503) 624 -6300 I Fax: : (503) 624 -7755
E -mail: dennisp @pactrust.com
CONTRACTOR
Business name: BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City/State/ZIP:
Fees due upon application
Phone: ( ) I Fax: ( ) 1 ,\ 1 � q
Amount received q•
CCB lic.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
d--t---s— within 180 days after it has been accepted as complete.
Print name: ,..0 n ,- ) , - --7,oa nom / - I Date: C/4 ` • Fee methodology set by Tri- County Building Industry
Service Board.
is\ Building \Permiu\BUP- PermeApp.doc 12/03 440.4613T(1I/02/COM/WEB)