Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00011
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/12/2016
Parcel: 2S113AA00100
Jurisdiction: Tigard
Site address: 16342 SW 72ND AVE
Project: Bridgeport Distribution Subdivision: ROSEWOOD ACRE TRACTS Lot: PTSA,B
Project Description: Create new restroom
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:
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 01/12/2016 $88.00
Occupancy Grp: S-2 Occupancy Load: 30 Permit Fee-Additions,Alterations, 01/12/2016 $225.80
Demolition
Dwelling Units: 0 12%State Surcharge-Building 01/12/2016 $27.10
Stories: 0 Height: 0 ft Plan Review 01/12/2016 $146.77
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 01/12/2016 $90.32
Value: $9,623 Info Process/Archiving-Lg$2.00(over 01/12/2016 $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 $583.99
Required: Required Items and Reports(Conditions)
Fire Sprinkler: 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. ATTE Oregon law requires you to fallow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 10 through R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.7987 or 1.800.332.2344.
Isetl By: Permittee Signature: L
Cell 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
City of Tigard RECEIVED !Date/B /a �4► Pe mitNo.: ur �ll
• 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
0 Phone: 503.718.2439 Fax: 503.598.( N 1 2 2016 DatuB : AV Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: lurly ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Noti5eWethod: 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: S
❑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: 16342 SW 72°d Ave. New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garagelcarport area: square feet
Suite/bldg./apt.no.: Project name:Bridgeport Distribution Covered porch arca: square feel
Cross street/directions to job site:SW Upper Boones Ferry and SW 72ed Ave. 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.
Build single hole restroom with rough in for future restroom. Valuation: S$9,623.00
Existing building area: 15000 square feet
New building area: 15000 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: PacTrust Type of construction: III-B
Address: 15350 SW Sequoia Parkway#300 Occupancy groups:
City/State/ZIP:Portland,OR 97224 Existing: S-2
Phone:(503)624-6300 Fax:(503)624-7755 New: S-2
® CONTACT PERSON BUILDING PERMIT FEES*
Please ergo ee Sc
Business name:PacTrust
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: les lieln pac[rustco m
PHOTOVOLT: G SOLAR PANEL SYSTEM FE "
a: eu Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhutoVoltaic 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/nr(allation Specialty Code checklist.
City/State2lP:Portland,OR 97224 Permit fee(includes plan review $18000
and administrative fees):
Phone:(503)624-6300 Fax:(503)624-7755 State surcharge(12%of permit fee): $21.60
CCB lic.:153913 Total fee due upon application: 5201.60
Authorized signature: I �/n ,( Vv /\A This permit application expires if a permit is not obtained
v^ within 180 days after it has been accepted as complete.
Print name: .0 re 'e 1.1 b Date: /(h, a— 210 I V ' Fee methodology set by Tri-County Building Industry
Service Board.
I:tBuildingtPennitstBUPCOM PermitApp.doc 02242011 440.4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Commercial - No Land Use
Building Permit #: 12 k PO Co -00011
Site Address: 163L[2. SW -72riJ Ave, Suite/Bldg#:
Project Name: rladeDoy " N sAa pI i an
(Name< commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: -11 +r new 6-�nroom ccon*rLA4i Vn
Existing Business Activity: WQY�I10(I$P,ITYe1g1Tt YIIDVCYY1Yt1T
Proposed Business Activity: sQmP.
2(
Verify site address/suite# exists and active in permit system.
/River Terrace Nei hboxhood: El Yes "19 No
`GZoning: '
ermitted Use: ElYes El No El Spec Space
�
Confirm no land use required.
l�Business Licens
Exists: ;Yes ❑ No,applicant notified to obtain business license
Notes: j 71
I /
Approved by Planning: —�' m [e�AqDate: Z U
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:
Site Plans: #
Building Plans: # 3
Building Permit#: 2—Enter building permit# above.
Workflow Routing: 2—Planning wilding
Workflow Sign-off: R�Sign-off for Planning(include notes from planning review)
Route Application Documents: O'Building. original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: CD 1 2—
By Permit Technician: �Cc�GL, Date: / i'-
I:\Building\Fotms\BldgPermitRvw_COM_NotandUse_070915.dmx
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:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Fonns\BldgPennitRvw_COM_NotandUse_070915.dmx
Building Division
Over-The-Counter (OTC) Building Permit
Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: —a Type of Construction,
Type of Use**: pA Occupancy Load:
Oregon Specialty Code: (11
SPECIFICS
Number ofStories: BuddingHeight: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Foot Accessory Structure: Covered Porch:
Basement: Gan Deck:
Total S one Footage: Carport Mezzanine:
SETBACKS
Side and Setback—Left Side and Setback—Front
Sideyard Setback—Right
Side and Setback—Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: I N: S: Occupancy Separation:
E: W: E: W: Access.Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: 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. 1 0
Total Project Valuation: $ FEES DUE
$ DC Prov Rvw,COM TI—Ping
$ K Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ i' 12%State Surcharge
Project Valuation $ < Plan Review,Structural
Up to$4,999 $0.00 $ X Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ 3 Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $220.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $351.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other.
$ Other.
$ Other.
Budding Staff: $ Other.
Date/Time: ; TOTAL FEES DUE
*TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
OTR=other use for fences decks retaining walls signs,awnings or canopies).
1:\Building\Fomes\OTC_BUP_070115.docx
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16342 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2016-00011
Chip Barnett
Violation Summary:
Inspector Contractor