Permit CITY OF TIGARD BUILDING PERMIT
III 2 COMMUNITY DEVELOPMENT Permit#: BUP2020-00232
Date Issued: 11/18/2020
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S103DD00850
Jurisdiction: Tigard
Site address: 13815 SW PACIFIC HWY 10
Project: Domino's Pizza Subdivision: None Lot: None
Project Description: Installation of(2)illuminated building signs on West and South elevations
Contractor: GARRETT SIGN CO INC Owner: D W SIVERS CO
811 HARNEY STREET 4730 SW MACADAM AVE#101
VANCOUVER, WA 98660 PORTLAND, OR 97239
PHONE: 360-693-9081 PHONE:
FAX: 360-693-5948
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: VA Permit Fee-Additions,Alterations, 11/13/2020 $134.54
Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 11/13/2020 $16.14
Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 11/13/2020 $2.00
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $4,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $152.68
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 wit 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,th`rough 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: J \j cin(,t�_( Permittee Signature: y\ o9p i LGZ Y\
��`��,���JJJ111 t-+ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. Y
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 Applications ��CB
' Commercial ��'110-�''°°2tJ
Od�J FOR OFFICE. ( sr o�Li
City
ReceivedDateB a O5 2020 `%� Permit No.:l3Glf�ZO�p'Oe032
• 13125 SWW Tigard Hall Blvd.,Tigard,OR 97223 04ITHDF tl Plan Review R'
I Phone: 503.718.2439 Fax: 503.598.;. Date/B : " r— * -. a Other Permit:
a;,t
"t l G A R D Inspection Line: 503.639.4175 Date Ready/By: !/ 7w 1uris� 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: rr I i ur A(] Supplemental Information
01,97 t- , 671g
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®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 ❑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:
IDAccessory building ❑Multi-family
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:13815 SW Pacific Hwy. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Domino's Pizza Covered porch area: square feet
Cross street/directions to job site:SW Pacific Hwy.near SW Gaarde St. 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:2S103DD00850 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Installation of(2)illuminated building signs on West and South elevations. Valuation: $4,000.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name:Domino's Pizza Type of construction:
Address:13815 SW Pacific Hwy. Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(360)489-2549 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer ro fee schedule)
Business name:Garrett Sign Co.
Structural plan review fee(or deposit):
Contact name:Jesse Taylor
FLS plan review fee(if applicable):
Address:811 Harney St.
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660
Amount received:
Phone:(360)693-9081 Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:permitting@garrettsign.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Garrett Sign Co. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:811 Harney St. Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver,WA 98660 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(360)693-9081 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:66826 Total fee due upon application: $201.60
Authorized signature: a „� Thisipermit apdays
has bsenf a permitcepeis not obtained
i� within 180 days after it has been accepted as complete.
Print name:Jesse Taylor Date:9/8/20 * Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Pemtits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) /5 -4 ,F
A.
III
C ,Ill
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering. [II] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Pcrmits\BUP-CO\1 Pcrmialpp.doc 03/03/2011
II14
I Building Division
Plan Submittal Requirements
T I G A RD Commercial & Multi-Family-New,Additions or Alterations
1. SITE PLAN (fully dimensional, drawn to scale) labeled with:
A. 0 map& tax lot# ❑ project name El site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit- based on valuation of project.
4. EXTRA SET OF THE FOLLOWING:
A. Two (2) copies of site plan to include vicinity map.
B. One (1) copy of erosion control plan with details.
C. Fire Department Building Survey, and full set of architecture drawings.
l:\Building\Permits\BUP-COAL Permit Ap.doc 03/03/2011
_ Building Division
Plan Submittal Requirement Matrix
T I G A RD Commercial &Multi-Family -New,Additions or Alterations
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington
County, and Tualatin Valley Fire &Rescue), if applicable.
I:\Building\Pctmits\HUP-CO\1 PcrtnitApp.doc 03/03/2011
City of Tigard
III iii COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: A , 20 20 •—0p 3..2.,,
Site Address: 13815 SW Pacific Hwy Suite/Bldg#: 10
Project Name: Dominoes Pizza
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 2 illuminated wall signs
Existing Business Activity: Fast food eating & drinking establishment
Proposed Business Activity: Fast food eating & drinking establishment
❑e Verify site address/suite#exists and active in permit s stem.
❑o River Terrace Neighborhood: ❑ Yes l:J No
O Zoning: C-G
❑' Permitted Use: U Yes U No U Spec Space
❑e Confirm no land use req ed.
❑o Business License:Q
Exists: ❑ Yes ❑ No, applicant was provided a business license application
Notes:
•
Approved by Planning: .--_ Date: 11/5/20
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: #
Building Permit#: ❑ Enter buildin ermit# above.
Workflow Routing: ElPlanning U Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date:
1:\Building Worms\BldgPermitRvw_COM_NoLandUsc_l 11819.docx
Permit . •ordinator Review
❑ Conditions " . "prior to issuance of building permit
❑ Approved,NOT Re :.sed: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applic.
Revision Notice 3: Date Sent to A • cant:
❑ SDC Fees Entered: Wash Co rans Dev Tax: ❑ Yes ❑ N/A
Tia : Trans SDC: ❑ Yes /A
arks SDC: ❑ Yes ❑ N/
❑ OK to Issue Permit
Approved by P= mit Coordinator: Date:
i:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx