Permit 111 a CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2009 -00029
COMMUNITY DEVELOPMENT„ DATE ISSUED: 2/24/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112AD-01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 1.80 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER • LOT: JURISDICTION: TIG
PROJECT:. SCS ENGINEERS
Project Description: TI
REISSUE: . FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2N : - sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 24 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 40,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES EMERICK CONSTRUCTION CO
15350 SW SEQUOIA PKWY #300 -WMI P.O. BOX 66100
PORTLAND, OR 97224 PORTLAND, OR 97290
Phone: Contact #: PRI 503 - 777 -5531
FAX 503 - 771 -2933
Reg #: LIC 10723
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/24/2009 $310.80
[TAX] 12% State Surch 2/24/2009 $37.30
[BUPPLN] Pln Rv 2/24/2009 $202.02
[FLS] FLS Pln Rv 2/24/2009 $124.32
Total $674.44
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 than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the
Oregon ' ' • ► otification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of th- :e rules or .' -ct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
//1 , i i
Iss ed By: 1111 / Permittee Signature: el '
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 FOR OFFICE USE ONLY
RECEIVE E iv ^ d# 6' �� ��
IN City of Tigard RECL/ I Dale Receed iv p( OS i ,/ �».
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie "'
2 Phone: 503.639.4171 Fax: 503.598.1960 Date/B : 11 IR r i g j s Other Permit:
TIGARD
Inspection Line: 503.639.4175 FEB 2 4 2009 Date Read : � El See Attached Checklist for
Internet: www.tigard- or.gov Notified/Method: I � Supplemental Information
CITY OFTIGARD
TYPE OF wo �0 DIVISION 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.
❑ I - 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: . ,/ � ,s ./ 3J/5 S JS � vaf.4- �� y /,ge New dwelling area: square feet
City/State /ZIP: ;' y.../4, n.de /L
v ,/,a ?t/ Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: SC,s e:,„iic.,ti c. ,, t .S 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: 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: $
7 i- .1.0'./7-7 �`� ,�f a ,4Q., � Existing building area: square feet
0Om7 New building area: square feet
• ® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PacTrust Type of construction:
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
City /State/ZIP: Portland, OR 97224 Existing:
Phone: (503)624 -6300 Fax: (503)624 -7755 New:
® 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: E1 /Z G / G \
� ' �o11.lTt'�!l �/ D.t , BUILDING PERMIT FEES*
Address: (Please refer to fee schedule
City/ State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) I Fax: ( ) FLS plan review fee (if ayplicable):
CCB lic.: /0 9,23
Total fees due upon application:
..(."_
Amount received:
Authorized signature:
�e .,,� This permit application expires if a permit is not obtained
— " �/ �/J ` within 180 days after it has been accepted as complete.
Print name: —Pt, n • f 4 � � ,, _ Date:a Fee methodology set by Tri-County Building Industry
Service Board.
1:\ Building \ Permits \BUP- PermitApp.doc 03/21/06 440.4613T(t1 /02/COM/WEB)
•
' Pi e 'Building Division
Over- The - Counter (OTC) Building Permit
T I G t1 R D Check List
Description of Project: ( L
GENERAL INFORMATION
Class of Work:* 1t,'T Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: � 11 Second floor: - E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: 2A- Total sq ft.: N: S:
Stories: I 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: (t2e' Handicap access: `�
Smoke detector: Protected corridors: I�
Fire alarm: Tt. ? . Parking spaces ( #):
Notes:
Total Valuation: $ 40 1 00
I INSPECTIONS FEES DUE
Footing /foundation Firewall $ '2 ( (D, HO Permit Fee
Post /beam structural Smoke detector $ 37 ?,p State Surcharge
Shear wall Misc. inspection $ - 202,Q2, Plan Review Fee
Masonry _ Approach /sidewalk $ 1ZA— 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:
$ (974. Al Total 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; MR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I: \ Building \Forms \OTC - BUP.doc 08/19/08