Permit CITY OF TIGARD BUILDING PERMIT
j COMMUNITY DEVELOPMENT Permit#: BUP2022-00305
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/20/2022
Parcel: 2S 115ABO 1900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY J1
Project: Chipotle Mexican Grill Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: Install illuminated northeast facing wall sign(N1).
Contractor: INTEGRITY SIGNS OREGON Owner: SN PROPERTIES PARTNERSHIP
PO BOX 88 1121 SW SALMON ST
HUBBARD, OR 97032 PORTLAND, OR 97205
PHONE: 503-981-3743 PHONE:
FAX: 503-982-8153
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: VA Permit Fee-Additions,Alterations, 12/20/2022 $87.17
Occupancy Grp: U Occupancy Load: 0 Demolition
12%State Surcharge-Building 12/20/2022 $10.46
Dwelling Units: 0 Plan Review 12/20/2022 $56.66
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 12/20/2022 $2.00
11x17)
Value: $1,480 Misc Administration Fee 12/20/2022 $5.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $161.29
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. 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 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: Permittee Signature:
Ca1NM139.4175 by 7:00 a. ,for the next available inspection date.
This permit card shall be kept in a cons ' uous 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 RECEIVE FOR OFFICE USE ONLY
City Tigard Received
Date/By: la ? as Permit ()0305
" 13125 SWW Hall Blvd.,Tigard,OR 97223 DEC 0 � ZU22 plan Review
Phone: 503-718-2439 Fax: 503-598-1960 '= : j — Related t��;1C���" —00(3
a Inspection Line: 503-6394175 Daze Ready/By: orris: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: 113- Supplemental Informadou
_ BUILDING DIVISION G,ia,trr
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑D olition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition alteratiom'replacement Other: s I (p pJ equipment,materials,labor,overhead,and the profit for the
CATEGORY OF ONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling Commercial/industrial
Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Outer; Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1(,42-00
New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.#: ji I Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
1, Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed
Indicate the value rounded to the nearest dollar of all
Tax map/parcel#: B equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
u- Valuation: $ I O
Existing building area: square feet
rl)MC4 NRS
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: — Type of construction: C
Address: 1 ZC)V.-, Occupancy groups:
City/State/ZIP: n2 Existing:
Phone:<tl C New:
APPLICANT ONTACT PERSON BUILDING PERMIT FEES*
Business name: --
Please-fjrr to ee schedule)
Contact name:
Structural plan review fee(or deposit):
�j
FLS plan review fee(if applicable):
Address: d , X BIB
City/State/ZIP:
Total fees due upon application:
Phone:(� ) Z_e1 Fax:;( ) Amount received:
E-mail: rPHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*t �,n-F� rl' �� c
Commercial and residential prescriptive installation of
ONT CTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: — Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: o Solar Installation Specialty Code checklist.
City/State/Z : C7�A 3 Z Permit fee(includes plan review $180 00
and administrative fees
Phone:( Cf 7 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: Total fee due upon application: $201.60
Authorized signature-,— This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: If Fee methodology set by Tri-County Building Industry
Service Board.
1:1BuildinglPermitslBUP_COM_PetmitApp,doc Rev.04/21/2014 440-4613T(l1/02/COM/WEB)