Permit V CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00124
Date Issued: 04/30/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DC00500
Jurisdiction: Tigard
Site address: 15895 SW 72ND AVE 200
Project: Cida Subdivision: FANNO CREEK ACRE TRACTS Lot: 40
Project Description: TI for existing tenant:Demolition of interior walls.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY#300 ATTN: N PIVEN
PORTLAND, OR 97224 15350 SW SEQUOIA PKWY#300
PORTLAND,OR 97224
PHONE: 503-624-6300 PHONE:
FAX: 503-624-7755
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIIB DC Provision Review,COM TI-Ping 04/30/2015 $75.00
Occupancy Grp: B Occupancy Load: 67 DC Provision Review,COM TI-LRP 04/30/2015 $11.00
Permit Fee-Additions,Alterations, 04/30/2015 $423.53
Dwelling Units: 0 Demolition
Stories: 0 Height: 0 ft 12%State Surcharge-Building 04/30/2015 $50.82
Bedrooms: 0 Bathrooms: 0 Plan Review 04/30/2015 $275.29
Value: $22,100 Plan Review-Fire Life Safety 04/30/2015 $169.41
Info Process/Archiving-Lg$2.00(over 04/30/2015 $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 $1,011.05
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 ••es - • 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 o .- , •r i ork is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Not' -tion Cent- . ,ose 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 cal' g 503.232.19: or 1.8•1.332.2344.
Issued By: relltrittee Signature: 4111111.1 '."%
Call 503.639.4175 by 7:00 a.m.for the next available ins• tion date.
This permit card shall be kept in a conspicuous place on the job site until ompletio o the project
Approved plans are required on the job site at the time of each •-•e •n.
i
Building Permit Application • " . • , ' , . • • ''
Commercial FOR orrice t'SC()\L)
City of Tigard ��D 0 15` :1, PcnwtNo.:`. N. )5_ •
!PI _ 11 13125 SW Hall Blvd.,Tigard,O \ Plan Review tr�u, Other Permit
Phone: 503.718.2439 Fax: 50 ` �_ '� �j
Inspection Line: 501639.4175 �1 01�J. Date Ready °y: / Anir H See Page 2 for
T I G A R D Internet: www.tigard-or.gov pR )� Notified/Me hod //3c J,s ( 77 - '/ . Supplemental Intormation
1 - 1.0
tts emolition Permit fees'are based on the value of the work performed.
D New construction Indicate the value(rotnded to the nearest dollar)of all
►'� Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
Valuation: S
❑ i-and 2-family dwelling pfCommercial/industrial
Number of bedrooms:
❑Accessory building ❑Multi-family
Number of bathrooms:
❑Master builder ❑Other: •
i (• - Total number.of floors:
Job site address: i s--E3 9\c_ 5 W �n - �it, f�O. New dwelling area: square feet
City/State/ZIP:. �-u q,y„d 0 ' .7 ZZ`[- Garage/carport area: square feet. .
Suite/bldgfapt no.: Z t9 I Project name: CA - I Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: •• square feet
Subdivision: l Lot no.: . Permit fees'are based on the value of the work performed
- Indicate the value(rotnded to the nearest dollar)of all
Tax lnap/parcel no.: equipment,materials,labor,overhead,and the profit for the -.
f,1O1;: ,1 •,,,. wo. indicated on this....Wall... .
Valuation $ Z j` r
: Existing building area ) `.:square feet
New building area: ,e square feet
umber of stories: '
? ,3 1 '� �? is f - � '. Z-.
Name: /GILT w Type of construction: 1
Address: 153 ` �^ o 9 Occupancy groups:° . : - .
City/State/ZIP: far f i4
- q:'7 y Existing:•
Phone: �It) /0 (g70'a Fax: ® ) '- --''! New
ii
Business name: Structural plan review fee(or deposit):
Contact name: C V • ' .:
1111111111111 "
1 Y'-� FLS plan review fee(if applicabiej:
Address:
Total fees due upon application:`'
City/State/ZIP: :.
Amount received
Phone:( 3) RI-1_1e, .I Fax..
E-mail: 'r• • .a Ala # II Q • LA Ind Commercial and residential prescripti ye installation Of
Chi-,1 (){--1 roof-top mounted PhotoVoltaic:Solar Panel System.;••
PELT Submit two(2)sets of roof plan with connection details
Business name:
+r and fire department access,along with the 2010 Oregon
Address: Solar Installation . cia! Code checklist.
Permit fee(includes flan review S180.00
City/State/ZIP: and administrative fees :
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: l'c31 I3 • Total fee due upon appication: $201.60
This permit application expires if a permit is not obtained
Authorized signature: Ili within 180 days after it has been accepted as complete.
• Fee methodology set by Tri County Building Industry
Print name: I � � Date: / `S Service Board
_-.-...,... AA 4411T Itm7rrnAerWFR\
City of Tigard
/-• COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - No Land Use
I I(, \ I: I)
Building Permit #: 61,09,?01 5-—00loty
Site Address: 15$95 SW 72 rrl Ave.. Suite/Bldg#: 200
Project Name: CI DA Inc.
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: TI TOE( exi s-A:1% q +enp,rvt
Existing Business Activity: O'i'T'I ce
Proposed Business Activity: same__
[erify site address/suite# exists and active in permit sys�t m.
TToning:Terrace Plan District ❑ Yes [ No
oning: t -P
/Permitted Use: E(Yes ❑ No ❑ Spec Space
m Confirm no land use required.
12 Business License:
Exists: License/ ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: V/Z_TIM Lel)rbo14-1_ Date: 4 13b 115
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: it/3 0/15—
Site Plans: # A,/,r}
Building Plans: #
Building Permit#: ,,_,Winter building permit#above.
Workflow Routing: le. Planning ❑ Permit Coordinator RBuilding
Workflow Sign-off: Q'Sign-off for Planning(include notes from planning review)
Route Application Documents: [ruilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: (...)TC_
By Permit Technician: —70--- =- Date: '47 3 1S
I:\Building\Fotms\BldgPermitRvw_COM_NoLandUse 03I015.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
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:
1:\Buil ding\Forms\BldgPermitRvw_COM_NoLandUse_031015.docx
ppBuilding Division
Over-The-Counter (OTC) Building Permit
T[GARU Check List
Project Description: T(
GENERAL INFORMATION
Class of Work*: [CM Occupancy Group: Type of Construction: als
Type of Use**: N-1— Occupancy Load: (o7 _ Oregon Specialty Code: 26(4,_
SPECIFICS
Number of Stories: Z 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: Cer'---, Fire Alarms: Smoke Detectors: _
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Dens: : Cut Sheets Provided:
Design Area: _
K Factor:
Total Project Valuation: $ -2:2 , FEES DUE
$ 7'5,Co DC Prov Rvw,COM TI-Ping
$ •♦ DC Prov Rvw,COM TI-LRP
DC Provision Review Fee for COM TI (effective 7/1/2014) $ 'MrplYi Permit Fee-Add,Alt,Demo
Project Valuation Planning LRP $ dam_ 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ 27$.2- Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ MEI Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ . are 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:
$ Other:
Building Staff: $ Other:
Date/Time: $ (/ f,)�I( ,o TOTAL FEES DUE
TYPE OF USE: CO '.- r..i ,. -;I., MS.- 'omm is ;:,; ii-d structure. ,.-
**CLASS OF WORK ACS=accessory:ADDS=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
1 signs,awnings or canopies).
I:\Building\Forms\OTC_BUP_070114.docx