Permit , CITY OF TIGARD BUILDING PERMIT
1
: ' COMMUNITY DEVELOPMENT Permit #: BUP2012 00008
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Date Issued: - 01/20/2012
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 300
Project: PacTrust Corporation Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: Construct conference room.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 624 -6300 PHONE: 503 - 624 -6300
FAX: 503 -624 -7755
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 01/20/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 01/20/2012 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 01/20/2012 $377.90
Stories: 3 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 01/20/2012 $45.35
Value: $20,000 Plan Review 01/20/2012 $245.64
Plan Review - Fire Life Safety 01/20/2012 $151.16
Info Process /Archiving - Lg $2.00 (over 01/20/2012 $8.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $901.05
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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. 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. .1987 or . 0.332.2 4.
Issued By: / Perm ittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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
R
Commercial 4
City of Tigard 20 12 DateB , / ? 4 14 Pao I.2 -ems b'
JA N 1 I Permit No
1 111
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review °�1
' a _ Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD Date/B : / `A �� her Permit:
T I Ci i\ R I) Inspection Line: 503.639.4175 Ready r ® See Page 2 for
' Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: / ,gyp /2- Supplemental Information
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' s:; , = TYE ; OF °:WORK: - - 7 > , }a-
R E UIRED DArA 1
y
❑ D emolition Permit fees* are based on the value of the work performed.
❑ New construction Indicate the value (rounded to the nearest dollar) of all
K Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
- -.- s:, - _ g _ °��i il` - � : -,=a - ,.. " work indicated on this application.
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Valuation: $
❑ 1- and 2- family dwelling ommercial/industrial
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
- _ �
.: it tsar, = '. 3„ ;. -*.,: . - , i ` ,: a:, c .k,- ? f. _ - - - -
”; r'2< 90 -- _ ,. : q m , Y; Total number of floors:
J( JB '�52'Ft•EOVIAFIQI!TE(}r,A'1€IOI -i., >.:s , . ,::r,.
Job site address: ��5 — e_ Sly 4,,,i ��w� 4/ y ew dwelling area: square feet
City/State /ZIP: .0 ��C� 4 9 .7,„ /� Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 2� ? 7s red porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
066166 Iikik'COi}1113 tC_I) Sl m - `IS'll t
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
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- ,e '�" "�`" work indicated on this application.
/✓ J Valuation: $
:i A....t.r-rp,._.„--- � � Existing building area: square feet
//J? New building area: square feet
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it�;i mss..';= - - - - -_ .a�4, "`'r`:;., ; °�� =::a'x" - -. �,',-.,
.- ];_. 'CIvPY'A -4 ° Number of stories:
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Name: PacTrust Type of construction: ... ,,,,....- ) 7 .... 7 .
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups: r'
Cit /ZIP: Portland, OR 97224 Existing: `�d�
Phone: (503) 624-6300 Fax: ( 503 ) 624 -7755 New:
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Business name: PacTrust All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
Denni t; Pagti 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 I Fax:: ( 503 ) 624 - 7755
E-mail:
f fS
fib... —4 ". -^x �"3+. `..x'z ir T` l -�. 'a:, ,:di McEtT'T i'� ",
,r�i�'.��.�, � `�:�,.y .rte ls-:-Ia&liagiCVM0.P.IliWA �.�IO.,r
Business name: r� 9..0-- 47� �! .".. r 1- ,, t tl� /∎ . 7� ? ' � `
Address: `� C t.�
Structural plan review fee (or deposit): '
City/State/ZIP: -
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB fie.: Total fees due upon application:
- Amount received: '90 1. e'
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: , � ....0 `, Date: * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 09 /09/10 440- 4613T(11 /02/COM/WEB)
X 300
° Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: P o o ! Ps -OGGn g ❑ Expedited Review
Plan Submittal Date: V/9// 7
To the Applicant:
➢ If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
➢ If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact at 503 -718- — orr @ tigard- or.gov)
❑ Zoning 7 - I Permitted Use Yes [ No ❑
❑ Land Use Required: Yes ❑ No L! (explain below)
Notes: _ Spec. Sp4ct geinj G/Gv{vt — ne G , i, int
5 Approved ❑ Not Approved Date: `AA
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN
II ' ' Building Division
- Over- The- Counter (OTC) Building Permit
TIGARD
Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Nrisa Occu.anc Grou.: all. Type of Construction: Wj
*Type of Use: j Occupancy Load: Oregon Specialty Code: b(®
SPECIFICS
Number of Stories: S Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: _ Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: e� Fire Alarms: ( f23 Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ Z0) FEES DUE
$ +a, DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI —LRP
DC Provision Review Fee for COM TI $ `377>i0 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ AP5 '3'5 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ �, , i Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ , ' o Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ jD , Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ 9011 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.docx 01/13/2011