Permit (12) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00216
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/05/2016
Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15353 SW SEQUOIA PKWY 100
Project: PacTrust Subdivision: PACIFIC CORPORATE CENTER Lot: 3
Project Description: TI for existing tenant relocating to space: New office space,restrooms,and breakroom.
Contractor: PACIFIC REALTY ASSOCIATES LP Owner: PACIFIC REALTY ASSOCIATES LP
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 07/05/2016 $351.00
Occupancy Grp: B Occupancy Load: 95 Permit Fee-Additions,Alterations, 07/05/2016 $1,643.51
Demolition
Dwelling Units: 0 12%State Surcharge-Building 07/05/2016 $197.22
Stories: 1 Height: 0 ft Plan Review 07/05/2016 $1,068.28
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 07/05/2016 $657.40
Value: $188,400 Info Process/Archiving-Lg$2.00(over 07/05/2016 $20.00
11x17)
Metro Const.Excise Tax 07/05/2016 $226.08
Floor Areas:
Total Area: 9425
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $4,163.49
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
yooetalirr p7 f h rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: VAlit
all 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.
City of Tigard
u COMMUNITY DEVELOPMENT DEPARTMENT
TICARD Building Permit Review — Commercial - With Land Use
Building Permit #: d/(0- 7 )
Site Address: j S 35'3 Sot Se c2AJ3 P Suite/Bldg#: 100
Project Name: pig v i
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T'C n o n}- i : -- p -o n-Lc41-'
Verify site address/suite# exists and active in permit system.
%River Terrace Neighborhood: ❑ Yes ❑ No
Land Use Case#: M MO W/('' -- 000 2,0
Plans Match Approved Land Use:
Site Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
fV
ut c ing Height: Maximum Height Actual Height i "
nditions Met: iv/A ❑ Prior to Submittal ❑ Prior to Permit Issuance
-0"13-usiness License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
-B--Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No, stop intake
Notes:
Approved by Planning: Q V l 1?.�i, ��)0 .,�-�iv�� Date: -7/5"/ io
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: 7/5-/A
� /Cv
Site Plans: #
Building Plans: #
Building Permit#: mer building permit#above.
Workflow Routing: Planning ❑ Engineering ❑ Permit Coordinator Z.—Butt-ding
Workflow Sign-off: Toff for Planning(include notes from planning review)
Route Application Documents: ng: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: _ Date: "7`5"//x,
I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_0709 I 5.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
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:
I:\Building\Forms\BIdgPermitRvw_COM_WithLandUse 070915.docx
Building Permit Application • S
Commercial ���� FOR OFFICE USE ONLY
CityRof Tigard
r Received //
g Date/B /�l�(/ •10:11417
Permit No.: P I
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie '
_ s Other Permit: fy�,,
' Phone: 503.718.2439 Fax: 503.598.1960 JUL L b 2016 Date/B �, �� J '►"I �� At.,
Inspection Line: 503.639.4175 Date Rea: it Juris iii See Page 2 for
TIGARD Internet: www.tigard-or.gov �,TY OF IAD Notified/Method: / . 'p Supplemental Information
i IIIc
t , t . i�� REQUIRED DATA:.1-AND 2-FAMILY DWELLING
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
Number of bedrooms:
ElAccessory building 0 Multi-family
❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:15353 SW Sequoia Parkway New dwelling area: square feet
City/State/ZIP:Portland,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:100 Project name:Inspired Results Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
I4EQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New office space,restrooms,break room Valuation: $$188,400.00
Existing building area: 9,425 square feet
New building area: 9,425 square feet
® PROPERTY OWNER 0 TENANTNumber 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: B
Phone:(503)624-6300 Fax:(503)624-7755 New: B
Z APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
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
Total fees due upon application:
City/State/ZIP:97224
Amount received:
Phone:(503)624-6300 Fax::(503)624-7755
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:lesliel@pactrust.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic 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 lic.:153913 Total fee due upon application: $201.60
Authorized signature: ` .9 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: J
LeR�6 e- L.0\)17 Date: j V�N G) 201 b * Fee methodology set by Tri-County Building Industry
r Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Nq City of Tigard • BUILDING DIVISION
' Over-The-Counter (OTC) Building & Fire Protection System Permit
r G A R D Appointment Checklist
Permit Record#: i64/% 3/ QO i9.l(o
Contact Name: L.0 a,l LE_) Phone #: 5-o3-Lo g.4-(y 30O
Business Name: —t-v Appointment Date: 7/,,f/16, @ lo:oo
Site Address: /53 53 g,,,� �uot�., P&L,/ Bldg/Suite #: /UO
Project Name: -1-s
Project Description: o f€LC_c_ rd-[10-est. /2 moae-e- o/ IQ A �
Acrer-
Existing Use: 13 t) New Use: B
MMD Required: X,Yes c,,No Related Record#: lst H O leo-
cco„Ic
it,-,,.:,:tiz,4:7:.7! 21;i:PtiwtriWT,:i' ,..JIEVOSiTablirailtiliTailiW,Lii0,-„,:,',: ::„..:. .f VT 1- l'E•'- • ;,.
GENERAL INFORMATION
Class of Work: KILT- Occupancy Group: Type of Construction: r4• j
Type of Use: (LC7�1 Occupancy Load: r.,":5" Oregon Specialty Code: ?-C`kA...
SPECIFICS
Number of Stories: I 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: 942.4S". 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
r
Fire Sprinklers: YkD 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: $ , ,P ,,C " - ,r--:!..?'-'1's
$ ' s-j JW'DC Prov Rvw,COM TI—Ping
$ ( (c, if.),59 Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ r 12%State Surcharge
Project Valuation $ 06f5. 40. Plan Review,Structural
Up to$4,999 $0.00 $ Ale Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ ce'N 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 $ '77�s�CIetro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee ,
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ 4 6•-:J 4a(TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_020916.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
15353 SW SEQUOIA PKWY 100, TIGARD, OR,
97224
Commercial - Building
299 Final inspection
PASS - C of O
BUP2016-00216
Jeff Grove
Violation Summary:
Inspector Contractor