Permit CITY OF TIGARD BUILDING PERMIT
q Permit#: BUP2022-00214
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/21/2022
Parcel: 1 S 136AD04001
Jurisdiction: Tigard
Site address: 11539 SW PACIFIC HWY
Project: Burger King Subdivision: VILLA RIDGE Lot: 7
Project Description: Installing a new pole sign.
Contractor: SALEM SIGN CO INC Owner: PACIFIC TERRACE COMMERCIAL TWO LLC
1825 FRONT ST NE 833 NW 170TH DR
SALEM, OR 97303 BEAVERTON, OR 97006
PHONE: 503-371-6362 PHONE:
FAX: 503-371-0901
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: VB Permit Fee-Additions,Alterations, 09/14/2022 $225.80
Occupancy Grp: U Occupancy Load: 0 Demolition
12%State Surcharge-Building 09/14/2022 $27.10
Dwelling Units: 0 Plan Review 08/25/2022 $146.77
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 09/14/2022 $1.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $9,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $401.17
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0f a
„,„----
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. cia Codes othe applica• - law. All work
will be done in accordance with approved plans. This permit will expire if work is not started w' in 180 iss = �r if ork is : .pen•-d for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Uti ity Notifica n Ce. - •ose rules - - .et •rth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a cop or direct questions to OUNC by calling 803., 32.198 :.0 33 •344.
Issued By: Per i nature: A
C 9.4175 by 7:00 a.m.for the next available Inspects s date. ,
, j
This permit card shall be kept in a conspicuous place on the job site unti •m. eti• of thj.roiec r
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial RECEIVED FOR OFFICE IISE ONLY
1� Cityof Tigard ? Received
i 1 g AUG 2.?`2022 Date./By: .Z2.— (4 01.f, . c2/41
" 13125 SW Hall Blvd.,Tigard,OR 97223 plan Revs r�
G Phone: 503.718-2439 Fax: 503-598-19f{q DaleBy: 'a9 -12 r/ Related Permit:
Inspection Line: 503-639-4175 I,ITY OF TIGARD Date Ready/By: lads:
T I({ARI1 P / ® See page2 for
Internet: www.tigard-or.gov BUILDING DIVISIO Notified/Method: ,mo .. Supplemental Information
LL`t
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 ,I Other: S I VI equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling kl Commercial/industrial Valuation: $
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder
❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: it53q SW PAeiT.e- 'N"I New dwelling area: square feet
City/State/ZIP: "nibs QR. glZ23 Garage/carport area: square feet
Suite/bldg./apt.14: 7 Project name: anti. (-44% Covered porch area: square feet
Cross street/directions to job site: 1 Deck area: square feet
Op Ow S'w r444:4. I�v,,� + Sw 1!lr- )Alt Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: l Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel It: 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.
f� Valuation: $ 9S6ry
J.n54.A11 Vey,/ pvte, S1!)n, ter (3t'or. k;ft).
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER Ilief TENANT Number of stories:
Name: Built,r �it' ill Type of construction:
Address: itc3 SW Naked.. 40,7Occupancy groups:
City/State/ZIP: ")4. T, rA, griz3 Existing:
Phone:(3 i3O) 31#--715'Y Fax:( ) New:
Igl APPLICANT ,® CONTACT PERSON BUILDING PERMIT FEES*
f /� // (Please refer to fee schedule)
Business name: JAl!/i/"r\. S,Sr. Li'..-t ( - Structural plan review fee(or deposit):
Contact name: i n 1
p tt l�r, ELS plan review fee(if applicable):
Address: +6� S} EVE
City/State/ZlP: l �1 I N Total fees due upon application:
Phone: Fax:: Amount received:
(565 )37t•Orti ( )
E-mail: } S S\4 r,•cwv., PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
/ Commercial and residential prescriptive installation of
r CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: cd 1 k Co , �nL• Submit two(2)sets of roof plan with connection details
Sand fire department access,along with the 2010 Oregon
Address: it-2S cI�t. 5- �C Solar Installation Specialty Code checklist.
City/State/ZIP: S<-�11__� � ` TT Permit fee(includes plan review
J6►t!/t/ -. 17 ld and administrative fees): $I B0.00
Phone:( )11 I , 3101/ Fax:( ) State surcharge(12%ofpennit fee): $21.60
CCB Lie.: (95710 Total fee due upon application: $201.60
Authorized signature: Ait-----
This permit application expires If a permit is not obtained
1' � `'� ��p,,/ /�'i within 180 days after it has been accepted as complete.
Print name: M(R�"E "-Jin J' Ar Date: 7,4//t.c _ * Fee methodology set by Tri-County Building Industry
Jr Service Board.
1:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)