Permit rp.. ,. ! t
CITY OF TIGARD BUILDING PERMIT
• . COMMUNITY DEVELOPMENT Permit #: BUP2009 -00164
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/09/2009
Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15495 SW SEQUOIA PKWY 190
Subdivision: Lot: 0
Project: Columbia Soft
Project Description: TI •
•
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee - COM 09/09/2009 $639.10
PORTLAND, OR 97224 12% State Surcharge - Building 09/09/2009 $76.69
PHONE: 503 - 624 -6300 Metro Const. Excise Tax - Commercial 09/09/2009 $132.00
Use
Plan Review 09/09/2009 $415.42
Contractor: Plan Review - Fire Life Safety 09/09/2009 $255.64
BNK CONSTRUCTION INC
45 82ND DR SUITE 53B
GLADSTONE, OR 97027
PHONE: 503 - 557 -0866
FAX: 503- 557 -1085
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $110,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,518.85
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 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 s- orth in OAR
952- 001 -0010 - . • • R 952 -00 -. 00. • u may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6..s • or 1.800.3 . 44.
Issued =
■
� •� � �/ � Permittee Signature: �
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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.
r
Building Permit Applica FOR OFFICE USE ONLY
Cl of Tigard DE CEIVED Received / �)
131 SW Hall lvd., Tigard, OR 97223 Plan Review r11l � /i /„ 0a y g 10- 2 . Phone: 503.639.4171 Fax: 503.5983 is � 0 9 2009 Date/B : r /V and ■ i Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/Bir El See Attached Checklist for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: M! Supplemental Information
BUILDING DIVISION
' TYPE OF WORK . REQUIRED DATA: 1- AND 2- FAMILY DWELLING
0 New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
X Addition/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 ® 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: 5'93' a s New dwelling area: square feet
City / State/ZIP: �� 1 - I • 2 92 ,2o Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name:4av" 6 . , Gz. .....-: ' 1--- - 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.
c f C.-14"7 .f/ '7 __ Valuation: $ ��4P
Up,� 172f••• c C eec,i_ - Existing building area: ? square feet
New building area: ..e9- feet
® PROPERTY OWNER ❑ TENANT Number of stories: /
Name: PacTrust Type of construction: ) JJ
Address: 15350 S.W. Sequoia Pkwy., Suite 300 X
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 I Fax: : (503) 624 -7755
E -mail: dennisp @pactrust.com
CONTRACTOR
Business name:
�,✓X aOet Ls'T�i c v Tr/'/1/ BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/State/ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: /c 755-5— Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
�— within 180 days after it has been accepted as complete.
Print name: 9 /G /�'O -7 0i r Q �j1�i Date: • Fee methodology set by Tri-County Building Industry
J / Service Board.
1: \Building \Permits \BUP•PermitApp.doe 03/21/06 440.4613T(11/02/COM/WEB)
Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Description of Project:
GENERAL INFORMATION
Class of Work:* .( r Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: C - . 7� Second floor: E: W:
Occupancy Group: ' Third floor: Openings Protected Y /N ?:
Occupancy Load: (04 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: t0., Handicap access:
Smoke detector: Protected corridors: 130
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ ( 10, 000
INSPECTIONS FEES DUE
Footing/ foundation Firewall $ O Permit Fee
Post /beam structural Smoke detector $ 111M State Surcharge
Shear wall Misc. inspection $ 41 1M - Z___ Plan Review Fee
Masonry Approach /sidewalk $ 2-5 , d FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ k CC) Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ I - 3e4„,•ESlotal Fees Due
_ 1 3z
L
*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.doc 08/19/08