Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2012 -00192
Date Issued: 10/11/2012
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel: 25112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 150
Project: RTM Investments Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: TI
Contractor: MATTHEW OLSON CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES LP
5320 SW DOVER LN ATTN: N PIVEN
PORTLAND, OR 97225 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE. 503 - 892 -0066 PHONE' 503 - 624 -6300
FAX 503 - 892 -0067
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee - Additions, Alterations, 10/11/2012 $1,450 23
Demolition
Occupancy Grp: B Occupancy Load: 99 12% State Surcharge - Building 10/11/2012 $174 03
Dwelling Units: 0 Plan Review 10/11/2012 $942 65
Stories: 1 Height: 0 ft Plan Review - Fire Life Safety 10/11/2012 $580 09
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Lg $2 00 (over 10/11/2012 $8.00
Value: $156,400 11x17)
Metro Const Excise Tax - Residential 10/11/2012 $187 68
Use
Floor Areas: DC Provision Review, COM TI - Ping 10/11/2012 $268 00
DC Provision Review, COM TI - LRP 10/11/2012 $39 00
Total Area 0
Accessory Struct: 0
Basement: 0
Carport 0
Covered Porch: 0
Deck: 0
Garage 0
Mezzanine: 0
Total $3,649.68
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet
Fire Alarm: 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 Speci- • •• -s 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 • - s • ce, • if work is suspended for more the 180
days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utili •otification •=nter 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 • ca : 03 23 1987 or 800.332.2344
Issued By: dI """ Permittee Signature: _
Call 503.639.4175 by 7:00 a.m. for the next available ins. > Lion da
This permit card shall be kept In a conspicuous place on the job site until co • Ion of the project
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial FOR OFFICE: USE ONLY
/ I
City of Tigard Received
Date/By. roI � t I I a— Permit No ifklpaofa -c 9) -
. ° 13125 SW Hall Blvd , Tigard, OR 97223 Plan Revie /� I lb : her Permit'
Phone: 503 718 2439 Fax: 503.598.1960 Date/By. /S� `
1 . t �, tt D Inspection Line. 503.639.4175 Date Ready y tuns ® See Page 2 for
A
Internet: www.tigard - or.gov Notified/Method TI c 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
p ddition/alteration/replacement T' CI Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El m
1- and 2- family dwelling gComercial/industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1(4.41 1.. SW ( V ow. . 4 . New dwelling area: square feet
City /State /ZIP: T( ' !7 Garage /carport area: square feet
Suite/bldg. /apt. no.: I r'7) � Project name: 2r ‘ lo w a +., ,,{- 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. ,q,�
7 oc- Q-K is .1-1 4 �DAc- Valuation: $ ' S � r 4 V
1_ 1 Existing building area square feet
New building area: square feet
( SPPROPERTY OWNER ❑ TENANT Number of stories:
Name: T O1/4LTY• Jrs,'- �ti�' t' $C' 1 tY�. Type of construction:
Address: S3 �� Dl � � Ir # 30� Occupancy groups:
el f N
City /State /ZIP: Nt� q f_
1 '722 I Existing:
Phone: (m) 74._ oar:, Fax: (o3) to - 77S& New:
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: SO � (Please refer tojeeschedule)
9---01-AA ��� Structural plan review fee (or deposit):
Contact name: V `V'e..•
FLS plan review fee (if applicable):
Address:
City /State /ZIP: Total fees due upon application:
Phone: ( t /0 .. t$`t4 I Fax: : ( ) Amount received:
E -mail: r rOv. Wt Q__ V U s 4- t L1 AYV\ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
` N Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: lilt D ok &cam C_(),/1cS T �e u G h on Submit two (2) sets of roof plan with connection details
�3Z0 t .) tbO�.� (.....404.4e0
and Code with the Oregon
Address: Solar Installation tron Specialty Codde chhecklilist. .
City /State /ZIP: p __ ' O t 1 2:2-5- Permit fee (includes plan review $180.00
and administrative fees):
Phone: (SDI rj, a r , , Fax: ( ) State surcharge (12% of permit fee): $21.60
iriiih
CCB lie.: Total fee due upon application: $201.60
Authorized signa This permit application expires if a permit is not obtained
g �--�, within 180 days after it has been accepted as complete.
Print name: y _,1 � • Date: ( ® 2 * Fee methodology set by Tri- County Building Industry
- Service Board.
I: \Building\Permits\BUP -COM PermitApp doc 02/24/2011 440- 4613T(I 1/02 /COM/WEB)
111111 1e Building Division
T 1 cA R D Over - The - Counter (OTC) Building Permit
Check List
Project Description: 11 &LP a-al o- - D!, 1 9 (9--
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: 4 , Type of Construction: 2_ iS
*Type of Use: 1A Occupancy Load: Oregon Specialty Code: ZO(j�
SPECIFICS
Number of Stories: I 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: L Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 5 J FEES DUE
$ Z 6g,QO DC Prov Rvw, COM TI — Ping
$ — , O DCProvRvw,COMTI —LRP
DC Provision Review Fee for COM TI $ '4 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ Qi ,Q 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 1 Z. Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ L , Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $j, Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ r 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: $ 4i ,6e)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; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC - BUP.docx 07/01/2012
I N Building Division
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: 611. aO ( - ODD q a' expedited Review
Plan Submittal Date: /D — Il —/ y
,i/ / 5 S V ) / 4 / / If ,' o
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. JJ
Planning Review (contact / at 503 -718 1 ) or ha- @ tigard- or.gov)
D Zoning ---- Permitted Use Yes P No ❑
lW Land Use Required: Yes ❑ No 0" ----- (explain below)
Notes:
// _- . , - _ - -
/Approved ❑ Not Approved Date: /0 — //'/2-
?f
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov)
Notes:
A ll 1P1
Routed back to Building Division Date:
I \CURPLN