Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00298
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/20/2015
TIGARLb Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15495 SW SEQUOIA PKWY 100
Project: Fidgets2Widgets Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Demolition of 2 offices,create new offices/classrooms for new tenant.
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: IIB DC Provision Review,COM TI-Ping 10/20/2015 $88.00
Occupancy Grp: E Occupancy Load: 212 Permit Fee-Additions,Alterations, 10/20/2015 $729.45
Demolition
Dwelling Units: 0 12%State Surcharge-Building 10/20/2015 $87.53
Stories: 1 Height: 0 ft Plan Review 10/20/2015 $474.14
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/20/2015 $291.78
Value: $49,721 Info Process/Archiving-Lg$2.00(over 10/20/2015 $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 $1,676.90
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This perm' ued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be •.ne in accordan 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 95 :r -6090. You may.obtain as copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344.
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Issued By: / Permittee Signature: \-tom V V)-14/1/-/
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Call 503.639.4175 by 7:00 a.m.for the next available inspection 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 RECEIVES / i;oi OFF!( 1: i til:0.\L1
1111 - City of Tigard Date/B : /' A//6 Permit No.: "5":;27/6.---0,0,,a96;
• - • 13125 SW Hall Blvd.,Tigard,OR 972 T 2 0 Z J�� Plan Review - TrE.a
Phone: 503.718.2439 Fax: 503.598.1 Date/ : /'�
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready :y: _furls ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: 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
®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: 15495 SW Sequoia Parkway,Suite 100 New dwelling area: square feet
City/State/ZIP:Portland,Oregon 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: 100 Project name:Fidgets2Widgets Covered porch area: square feet
Cross street/directions to job site:Carman Dr.and Sequoia Pkwy 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.
Demolition of two offices,new offices/classrooms,carpet and paint where shown. Valuation: $$49,721.00
Existing building area: 8,377 square feet
New building area: 8,377 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name:PacTrust Type of construction: II-B
Address: 15350 SW Sequoia Parkway#300 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing: B
Phone:(503)624-6300 Fax:(503)624-7755 New: B
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:PacTrust (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Leslie Louis
FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Parkway#300
City/State/ZIP:97224 Total fees due upon application:
Phone:(503)624-6300 Fax: :(503)624-7755 Amount received:
E-mail:lesliel @pactrust.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: PacTrust Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 15350 SW Sequoia Parkway#300 Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,OR 97224 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)624-6300 Fax:(503)624-7755 State surcharge(12%of permit fee): $21.60
CCB lie.: 153913
Total fee due upon application: $201.60
Authorized signature: 1��/1 1 L. was This permit application expires if a permit is not obtained
1� r` within 180 days after it has been accepted as complete.
O a Fee methodology set by Tri-County Building Industry
Print name: 1{ 0 u Date:V � �,��
1 Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46613T(I 1/02/COM/WEB)
IIICity of Tigard
r COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Commercial - With Land Use
Building Permit #: �Jc l Pao/5-0(:). 9't
Site Address: /5-1--/9 s .34) l,,,,, pia, Suite/Bldg#: /Oa
Project Name:
(Name o mercial business occ yi g the space. If vacant,enter Spec Space.)
Planning Review // / /_
Proposal: /E'W,.�/17" / �'L,e-%/LCD/ 4— rte.et ) ` Ieft- (71—
Verify site address/suite#exists and active in permit system.
0' I;'ver Terrace Neighborhood: ❑ Yes No•
110 and Use Case#: illin23,QC/S- 000, --R
Pla,_nsatch Approved Land Use:
1 Site Plan iiVil^andscape Plan /they:
Olt 4Jrban Forestry Plan elevation Plan
1► Building Height: Maximum Height l Actual Height �xksA
1/i ' onditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuanc
,'I Business Licens :
Exists: "Yes ❑ No,applicant notified to obtain business license
!/*Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified c' No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: - Date: 0 c2 d /g—
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: /040//C
Site Plans: #
Building Plans: # 75
Building Permit#: erEnter building pei • above.
Workflow Routing: E Planning gee / mit oordina r ,W tuilding
Workflow Sign-off: i -off for Planning(include notes from planning review)
Route Application Documents: di,g: original permit application, site plans,building plans,engineer and
,f�bea calculations and trust details,if applicable,etc.
Notes: 1112A k KleJv� ,✓Ytp C?� ,_.4,-
-"4 c�
By Permit Technician: D e: /06/'.
I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_070915.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroach ents)per engineering conditions of approval and pla not typical on SDR/CUP)
❑ Water Quality/Quan. p Facility:
Assess Water Quali Fee in-lieu: ❑ Yes ❑ No
Assess Water Quanti ee in-lieu: ❑ Yes ❑ N.
LIDA Facility on lot: ❑ Yes • o
❑ NOT Approved by Engineeri Date
Notes:
Approved by Engineering: Date:
Revisions (after Building Su a mittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
El Conditions "Met"prior to issu. ce of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal on
Revision Notice 1: Da - .-nt to A..licant:
Revision Notice 2: ID ate Sent to Ap. 'cant:
Revision Notice 3: Date Sent to App ant:
❑ SDC Fees Entered: :sh Co Trans Dev ,x: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPemvtRvw_COM_WithLandUse_070915.docx
1 • Building Division
Over-The-Counter (OTC) Building Permit
T l G n lz Check List
Project Description: 7(
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: j Occupancy Group: Type of Construction: 7�.'-�%