Permit CITY OF TIGARD BUILDING PERMIT
° COMMUNITY DEVELOPMENT Permit #: BUP2009 -00096
T [ G A R L) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/02/2009
Parcel: 2S113AA01100
• Jurisdiction: Tigard
Site address: 16592 SW 72ND AVE, BLDG# B11
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: Spec Space
Project Description: TI office.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee - COM 06/02/2009 $198.35
#300 12% State Surcharge - Building 06/02/2009 $23.80
PHONE: Plan Review 06 /02/2009 $128.93
Plan Review - Fire Life Safety 06/02/2009 $79.34
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: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $21,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $430.42
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: 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 suspe ad-go more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T r le re set forth i OAR
952 -001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 5!,. :.66 or 1.800.332. 44.
Issued By: Permittee Signature: 4 •
Call 503.639.4175 by 7:00 a.m. for an inspection that bus ess 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
' " City of Tigard Received 4,„ic...t=4.1111111WI
Pennit No.: E o
,ff , gal .000
13125 SW Hall Blvd., Tigard, OR 97
2 w „,n,...tic Plan Ret-e—lict ,-
1 ill 2 . Phone: 503.639.4171 Fax: 503.598. ■ f! di Ilf ED Date/B : EMI .2 - 0 ir Other Perrnit
TIGARD :
Inspection Line: 503.639.4175 . , , 1 ._ _
Date Read ‘":. y:
n l0 See Attached Checklist for
Internet: www.tigard - Or. gOV
JUN 0 2 2009 Notified/Method: ,,,. Supplemental information
• •. ' TYPE OF: *0( .. ,''.-; . '-.. . - -: - •-, .....REQUIRED.DAT'Ai; I.:1ND:2 '
New construction
0 64Olitloill'i VISION
CD Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
*Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
.';'; ' 'Cklik6 . O . itii ; :ii - C6rsistilijaioN -7 . , .::'''. - ?:: : =• ' '.:: ' ','?";` . .,...:: work indicated on this application.
Valuation: $
0 1- and 2-family dwelling El Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
of batluooms:
0 Master builder C1 Other: Number
013 INFORMATION AND LOCATION '', ..- I". , '.-.- • ... -.. ''' Total number of floors:
Job site address: /45 I' New dwelling area: square feet
City/State/ZIP: ge ri? 41, A ace 9.'7,VV Garage/carport area: square feet
Suite/bldg./apt. no.: Project name: G r fp c ..... . Covered porch area: square feet
Cross street/directions to job site: Deck area square feet
Other structure area: square feet
REC/IJIRED
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.:
equipment, materials, labor, overhead, and the profit for the
- ' ' . : - . • ' :DESCRIPTION OF WORK. ,,. .;• — .'-.:,;. • . • : . - ,..,,. .. :: work indicated on this application.
Valuation: $ C
02-/ (P.f)
,014In trati 4
Existing building area: square feet
New building area: square feet
,.., .. , .
. - raorpapooy■NEK: .:,= :: .:.:- :' ,:-.- :12 '',!''.-,';'.:' i-. Number of stories: I
Name: PacTrust Type of construction: jA2r
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: g
City/State/ZIP: Portland, OR 97224 Existing:
Phone: (503)624-6300 Fax: (503)624-7755
New
, .. 0 APPLICANT . . ' • .. a CONTACT PERSON, - ',.. • .' ' ' .'' . : .:'; . .. 5.,' N OT1 0E
Business name: PacTrust All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Dennis Pagni
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
::-.-'?':::'' s ,.'' .;...':- " • %. '6 =:;.'-'.
., A4 '1 • 1: . • - ., - :. •■•■:? ' • ',' • ." . ''''': -■t. r :i! • , ' 1;4: r . 0 ;,,. 'i , '''' .. , • ., lei Y 1 ..:':, 'f,..i!'' . - .. ' 1.. `'' ..'::' , ;,' s . : `
Business name: ,P0/pc.i.,5 '.) i-0400,04
Address:
Structural plan review fee (or deposit):
City/State/ZIP:
FLS plan review fee (if applicable):
Phone: ( ) Fax: ( )
CCB lic.: L iis, * 44 )
„:71
, 9 * Total fees due upon application:
Amount received: 40 4 3 . . D ,
accepted ,
Authorized signature: t This h p i e n r permit application a c t e xhpaisr been e i fn a te mit d is as not
complete.
Print name: DateWl.0 obtained
.....
, effeedr....hr„, •
Fee methodology set by Tri-County Building Industry
Service Board.
IABuilding 3 Ferrnits \ BUP-PermitApp.doc 03/21/06 440-4613T(I I/02/COM/WEB)