Permit CITY OF TIGARD BUILDING PERMIT
a .• COMMUNITY DEVELOPMENT Permit #: BUP2012 -00129
T [ G A R.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/28/2012
Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 120
Project: Phoenix Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30
Project Description: TI for new office
Contractor: MATTHEW OLSON CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES LP
5320 SW DOVER LN ATTN: N PIVEN
PORTLAND, OR 97225 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 892 -0066 PHONE:
FAX: 503 - 892 -0067
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 06/28/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 06/28/2012 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 06/28/2012 $377.90
Stories: 4 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 06/28/2012 $45.35
Value: $19,425 Plan Review 06/28/2012 $245.64
Plan Review - Fire Life Safety 06/28/2012 $151.16
Info Process /Archiving - Lg $2.00 (over 06/28/2012 $4.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $897.05
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 Note .. '• - enter. 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 call' g 50 • :7 or 1.800.332.2344.
Issued By: Permittee Signature: iiiou
Call 603.639.4175 by 7:00 a.m. for the next available Ins. _ cti
This permit card shall be kept In a conspicuous place on the job site until • • «
111110
. • • •roject.
Approved plans are required on the Job site at the time of each inspection.
Building Permit Application �
Commercial ' "' D Foi OFFICE I1S•: oNi.l
City of Tigard IV as 2012 R 4 �p I _ Permit Ni a? d0 0 .0/ _ •
;� ° 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 303.598:196 ,�y F"'1� ^ DateB : ,`
Inspection Line: Ready/By: � �� • erPennit:� .... .... D
Ition Li 503.639.4175 �1W �.Jt�RD Date Juris: / ® See Page 2 for
I I �L D Internet: www.tigard -or.gov BUILD/NO DIVISION Notified/Method: 't S o- Supplemental Information
TYPE OF WORK 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
XAddition/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 gtommercial/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: , 2q c � S. 6 ( 44-. lov_,,,- (2r-) New dwelling area: square feet
City/State /ZIP: TiC/saN.e:A. 6e--- Q(7 223 Garage /carport area: square feet
Suite/bldg. /apt. no.: \2C) Project name: Oe-vit-ic g - 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: I Lot no.: - Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax.rriap /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK - work indicated on this application. -
Teln0.v.4- Ivy 1('O� 1r -cps vv2... +.3 Valuation $ , l / 42 —
Existing building area square feet
New building area: square feet
X PROPERTY OWNER ❑ TENANT Number of stories:
Name: ( S jr- Type of construction:
Address: , t"3S'" 3 6 w setup (0 ,_ jak..00 Li 4 Sot, . - Oc groups:
City/State /ZIP: P f l et T . 4 „,4 ` ("X- c��4 Existing:
Phone: ( 5?), (e L ' wfC _ Fax: ( ) New:
IAPPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business,name: _ Structural plan review fee (or deposit):
Contact name: a,". 1 — % ) W_ FLS plan review fee (if applicable):
Address:
City /State /ZIP: • Total. fees due upon application:
Phone: ( ) Fax; ; ( ) Amount received:
E -mail: l,( MAIN VA v St t (y� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES"
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted PhotoVoltaic Solar Panel System.
Business name: M�4- 4 3 1S W� C u�&. 1 Submit two (2) sets of roof plan with connection details
• // __ ,^, and fire department access, along with the 2010 Oregon
Address: e 3 ZC 6,,,,, b O V � l� Solar Installation Specialty Code checklist. -
City /State /ZIP: ems-+ - (yw"CA o (Z_ 9 '-i2 5— Permit fee (includes plan review $180.00
) Q9Z r' ( S l 00(Q and administrative fees):
Phone: � Fax: State surcharge (12% of permit fee): $21.60
CCB lic.: it , , • 7 Total fee due upon application: $201.60
Authorized signatur i 1 ♦ 41 This permit application expires if a permit is not obtained
• 0� � ryry within 180 days after it has been accepted as complete.
Print name: r a - *�� _ r r Date: / //r�i► J Z * Fee methodology set by Tri -County Building Industry
1 Service Board.
. I:\Building\Permits UP-COM PermitApp.doc 02/24/2011 . 440- 4613T(1 I /02 /COM/WEB) -
C ° Building Division
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: (Expedited Review
Plan Submittal Date: 4f/24/0--
To the Applicant: 42 9°g t'06 4 d /t>
> 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.
Plang Review (contact at 503-718-"W or @ tigard- or.gov)
[E Zoning /NW k Permitted Use Yes ❑ No ❑
EPKand Us#?J ired: Yes ❑ No LET (explain below)
Notes: 0 / J/ ` ,e‘-yd/,' �7a/ g �•2 -
r j a - ' ,
IJ Approved ❑ Not Approved Date: 6 &8 /�
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN
•
o ° Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: ❑ Expedited Review
Plan Submittal Date:
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- or @tigard - or.gov)
❑ Zoning Permitted Use Yes ❑ No ❑
•
❑ Land Use Required: Yes ❑ No ❑ . (explain below)
Notes:
•
❑ Approved ❑ Not Approved Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN
I NI Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List Ati
Project Description: T 1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: ( ,"'r Occupancy Group: V.:// Type of Construction: 1.7 2 *Type of Use: tbLt/L _ Occupancy Load: L Oregon Specialty Code: p10
SPECIFICS
Number of Stories: 4 - 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: Fire Alarms: c %g.`:, Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 1t j � 2 7 FEES DUE
$ ( DC Prov Rvw, COM TI — Ping
$ c '(, CC DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ , 0 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ ' ,7 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ ' • if Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ , Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ , a, 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: $ y7,05 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.
1:\ Building \ Forms \OTC- BUP.docx 01/13 /2011