Permit 1111 r q CITY OF TIGARD BUILDING PERMIT
I, COMMUNITY DEVELOPMENT Permit#: BUP2015 00017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/29/2015
Parcel: 2S 113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 200
Project: Perlo Construction Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: TI for existing tenant:Demolition and new walls.
Contractor: PERLO CONSTRUCTION LLC Owner: PACIFIC REALTY ASSOCIATES LP
16101 SW 72ND AVE SUITE 200 ATTN: N PIVEN
TIGARD,OR 97224 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-624-2090 PHONE:
FAX: 503-639-4134
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 01/29/2015 $75.00
Occupancy Grp: B Occupancy Load: 116 DC Provision Review,COM TI-LRP 01/29/2015 $11.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 01/29/2015 $744.51
Demolition
Stories: 0 Height: 0 ft 12%State Surcharge-Building 01/29/2015 $89.34
Bedrooms: 0 Bathrooms: 0 Plan Review 01/29/2015 $483.93
Value: $52,000 Plan Review-Fire Life Safety 01/29/2015 $297.80 '
Info Process/Archiving-Lg$2.00(over 01/29/2015 $8.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,709.58
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. 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 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 calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: / 6„
vl, �
• s 39.4175 by 7:00 a.m.for the next available inspe • n date.
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
Commercial FOR OFFICE USE ONLY
City of Tigard RECEIVED Received -�
IIII
• 13125 SW Hall Blvd.,Tigard,OR 97223 P�Review e`pa e ! "r
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : �'��� Other Permit:
JAN S 9 2015
i ,�, Inspection line: 503.639.4175 Date Resdy/By: la See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE O1 kDING 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
®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 Valuation: $
®CommerciaUindustrial
❑Accessory building 12 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
` . JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:16101 SW 72ee Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:200 1 Project name:Perlo Construction Covered porch area: square feet
Cross street/directions to job site:Cross street:SW Upper Boones Ferry Road 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.
Work to include demolition,new walls,doors and relites. Valuation: $52,000
Existing building area: 1680 square feet
New building area: 1680 square feet
❑ PROPERTY OWNER I ® TENANT Number of stories: 2
Name:Elissa Looney Type of construction: II
Address:16101 SW 72oe Ave,Suite 200 Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing: B
Phone:(503)264-2090 Fax:( ) New: B
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie (Plesse refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Lauren Rohde
FLS plan review fee(if applicable):
Address:1515 SE Water Ave Suite 100
Total fees due upon application:
City/State/ZIP:Portland,OR 97214
Phone:(503)224-9560 Fax::(503)228-1285 Amount received:
E-mail:Irohde @mcknze.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:Perlo Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:16101 SW 72oe Ave,Suite 200 Solar Installation Specialty Code checklist.
fee(includes plan review
City/State/ZIP:Tigard,OR 97224 Permit and administrative fees): $180.00
Phone:(503)624-2090 Fax:(503)6394134
State surcharge(12%of permit fee): $21.60
CCB lic.:189245
Total fee due upon application: $201.60
Authorized signature. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Lauren ohde Date:01/29/2015 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
III
DEVELOPMENT DEPARTMENT
iiiihil T �; x D Building Permit Review — Commercial - No Land Use
Building Permit #: Q&ANo(5-CVO! -7
Site Address: /&_)‘ S'GU ��naQ /91/Q. Suite/Bldg#: Qo0
Project Name: Peep a ,/j
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: .7/ /? Z>//72i , /Wit' 14,0//C J (i
Dorg c , Mt-le S
Existing Business Activity: aWcp
Prop sed Business Activity: Q'c
lld V rify site address suite #exists and active in permit system.
fY � P Y
11Q o in 1,
g /
Eermitted Use: Yes ❑ No ❑ Spec Space
Confirm no land use required.
Notes:
A pp roved by Plannin g: �i Date:
/M/S-
Revisions
(after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: //141/45-
Site Plans: #
Building Plans: # 3
Building Permit#: ❑"Enter building permit# above.
Workflow Routing: Ll.-15nning ❑ Permit Coordinator C,I—Bting
Workflow Sign-off: S/ign ff for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: D%Z_
By Permit Technician: ✓ Date: ' /"7/5"-
1:\Building\Forms\B1 dgPermitRvw_COM_NoLandUse_071514.docx
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\B ldgPerm itRvw_COM_NoLandUse_071514.docx
w Building Division
Over-The-Counter (OTC) Building Permit
T l G A R D Check List
Project Description: I
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION , _
Class of Work*: (�- Occupancy Group: Type of Construction: yC -rT
Type of Use**: C�yt� Occupancy Load: Oregon Specialty Code: -
SPECIFICS
Number of Stories: 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: C-2 Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ `?��-1CY`) FEES DUE
$ ��► DC Prov Rvw,COM TI-Ping
$ ,I DC Prov Rvw,COM TI-LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ 7,10re Permit Fee-Add,Alt,Demo
Project Valuation Planning LRP $ :AM 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ ,1(, Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ tr. Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ ' 1 Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $299.00 $44.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
r:
Building Staff: $ Other:
Date/Time: $ ,`7( 'OTAL FEES DUE
*TYPE OF USE: COM=commercial;CMS=commercial manufactured struc
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
O1R=other(use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC_BUP_070114.docx