Permit CITY OF TIGARD BUILDING PERMIT
13 COMMUNITY DEVELOPMENT Permit #: BUP2013 -00140
Date Issued: 06/11/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 120
Project: Meridian Tech Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT
Project Description: Interior partition wakks, doors, frames & finishes.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SE 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
Class of Work: ALT Type of Const: IIB DC Provision Review, COM TI - Ping 06/11/2013 $67.00
Occupancy Grp: B Occupancy Load: 29 DC Provision Review, COM TI - LRP 06/11/2013 $10.00
Permit Fee - Additions, Alterations, 06/11/2013 $797.22
Dwelling Units: 0 Demolition
Stories: 3 Height: 0 ft 12% State Surcharge - Building 06/11/2013 $95.67
Bedrooms: 0 Bathrooms: 0 Plan Review 06/11/2013 $518.19
Value: $58,400 Plan Review - Fire Life Safety 06/11/2013 $318.89
Info Process /Archiving - Lg $2.00 (over 06/11/2013 $6.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,812.97
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. Spec': • •yes - • other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 • • of issuance, or if w• k is suspended for more the 180
days. A o Oregon law requires you to follow the rules adopted by the Oregon UV No - Th. se rules are set forth in OAR
952-4s -0010 through O • ' 952-1. :190. You may obtain a copy of the rules or direct questions to OUN' by • -fling 503.232.1987 or . %0.332.2344.
Issue By: 0 /i / Permittee Signa ure:
Call 503.639.4175 by 7:00 a.m. for the next avail to Inspe•Von date.
This permit card shall be kept In a conspicuous place on the Jobs • until : pletion of • Approved plans are required on the Job site at the time of e • • -
Building Permit Application
Commercial loR OrriCE USE ONE)
City of Tigard Da te ��'! P / v
:ly.A. Permit No.: u �Q
11 1
C a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review-74.747 M. m Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : !
T I G A i; a Inspection Line: 503.639.4175 Date Ready ! rurir Id See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
- 1113% (OF WORK • - - IlLQQWREDIDAITA:1- .01D2-4 FAMILY(DSPELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value ( rouded to the nearest dollar) of all
j g Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
l : ti1ZGORY (OF (coNSTRUCFION - - ' _ work indicated on this application.
and 2- family dwelling 10Commercial/ndustrial Valuation: S
❑ I -
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
0frK 0�� �mO�u
N�1r �m'. TEI A,`�N) ,CATIO1y ; Total number of floors:
n } '4,-,-. 1 ,.a ;,�. ll'M ,'g7x� : , w�4v�+'l�layvr� , ' :'�++� O -" .� .. . .. � �
Job site address: ‘2_a1001 5 (S {'L" () y ..... , LA A New dwelling area: square feet
City/State/ZIP: T pt,� (L q2�3
ok ds-7 Garage/carport area: square feet
Suite/bldg. /apt. no.: ‘ I Project name: Kew! term --[ l% Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
IIEQIIIIIRPONICOMIHERCIAL4USE :CHECKLIST '
Subdivision: I 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
1 , i , . . . LON (
SCIUP I t wr0 . �, ` _ - , 'Y work indicated on this application.
1, 1' l U� i a)/ VI h cisn u3(A\ \c i ono W c� i i Valuation: S 4 2) 1 a'e2 1 + / Existing building area square feet
New building area: square feet
° y' , ril*HOITAIAT tOWNER .I. " l �1 •.. , Number of stories:
Name: eaCi yj Cal— Type of construction:
Address: % TISD S W V ° a . 9V-LAJ I Occupancy groups:
City/State/ZIP: *e - 44 ®Q„ 9 1224 rr rr Existing:
Phone: (....95g) ) �-- ( f) Fax: ( ` la+
S3) 77sZ New:
_ • • APPLICANT . ,. ci ,fl CCON r- +P11ilWQ$, ,, . - BUIIIDING PERMIT 'FI)ES* •
Business name: ; ' t WeTerJo P erdheedl0
Structural plan review fee (or deposit):
Contact name: claw, vve �v 1 1 l��
FLS plan review fee (if applicable):
Address:
Total fees due upon application:
City/State /ZIP:
Phone: (so) -0-4_ e I Fax: : ( ) Amount received:
E -mail: II`HOTOVOttligteg.01 -AR PANELSMSTEM FEES* , 4
i, ;. ;i . , ,i Commercial and residential prescriptive installation of
• ' g ( CO NIDJ3 A C1FOR - t. roof -top mounted Photo Voltaic Solar Panel System.
Business name: ?G , Ir -- Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/ State/ZIP: Permit fee (includes plan review $180.00
and administrative fees):
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): S21.60
CCB lic.: 1st - 2 j q, Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
j within 180 days after it has been accepted as complete.
Print name: ; V-(--. I Date: / (� / * Fee methodology set by Tri- ounty Building Industry
{ Service Board
L\Building\Permits\BBUP -COM PermitApp.doc 02/24/2011 440- 4613T(11 /02/COM/WEB)
IN Building Division
° Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: ---P D - CA-4 ° 9O i 3 ---6:'° ! 46) ''Expedited Review O" C
Project Name: Ai €72-/&/4A/ C-//
Site Address: /ago 9 S A, 6 (F /° e4))" , Suite /Bldg #: /a2.O
Plan Submittal Date: 0//-
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 o y if approved.
Planning Review (contact at 503 - 718 - 2 1 4 40 or kr__@tigard
Proposal:
411.4 re I �/f%W see e
Zoning t L � Permitted Use Yes No ❑ I V'
Land Use Required: Yes ❑ No
Notes:
Approved ❑ Not Approved Date: �! /// 3
I: \CURPLN\Masters\Development Code Provision Review■No Land Use Comm.doc REVISED 10/4/12
III _ ° Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description: Tf
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: 7r Occupancy Group: T.• Type of Construction: 23
*Type of Use: r Oat Occupancy Load: 2FZ Oregon Specialty Code: 2/)1(
SPECIFICS .
Number of Stories: r� 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 G
Fire Sprinklers: Yes Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $. 40:3 ,OCI I FEES DUE
$ 67. en DC Prov Rvw, COM TI — Ping
$ In. CO DCProvRvw,COMTI — LRP
DC Provision Review Fee for COM TI $ 9'7.22 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ , 7 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ .$ Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ irjffit Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ ,, r " 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)
$ 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: $ 1612.57 TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; END = foundation; DEM = demo;
END = 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