Permit (12) CITY OF TIGARD BUILDING PERMIT
' COMMUNITY DEVELOPMENT Permit#: BUP2022-00202
Date Issued: 10/6/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103DD00850
Jurisdiction: Tigard
Site address: 13815 SW PACIFIC HWY 50
Project: Avalon Massage Subdivision: None Lot: None
Project Description: (1)illuminated wall sign.
Contractor: MEYER SIGN CO OF OREGON Owner: D W SIVERS CO
15205 SW 74TH AVE 4730 S MACADAM AVE#101
TIGARD, OR 97224 PORTLAND, OR 97239
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VA 12%State Surcharge-Building 09/15/2022 $16.14
Occupancy Grp: U Occupancy Load: 0 Plan Review 08/10/2022 $87.45
Dwelling Units: 0 Permit Fee-Additions,Alterations, 09/15/2022 $134.54
Stories: 0 Height: 0 ft Demolition
Info Process/Archiving-Sm$0.50(up to 09/15/2022 $2.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $3,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $240.13
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 OAR 952-001-0090. You y obtain a copy o the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 4/,.v.,40110. Permittee Signature: c f
Call 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 RECEIVE
CEIVE l FOR OFFICE USE ONLY
C!sT16O
of Tigard Received `
Date/By: 6- I' , Permit No.: ..� �
$ -�� Related Permit:
p DateBy:
T I GAKD Inspection Line: 503-639-4175 cm( OF TtGAR ate Ready/By: Juris: ® See Page 2 for
s Internet: www.tigard-or.gov .,,,, fll\I1 t •' ed/Method:� Supplemental Information
TYPE OF WORK REQUIRE 1-AND 2-FAMILN DWELLING
❑New construction Permit fees*are based on the value of the work performed.
❑Demolition
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.
El1-and 2-family dwelling [Commercial/industrial Valuation: $
IDAccessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATI N AND LOCATION Total number of floors:
Job site address: Am/5 S , �/r�f C fj(t t,) New dwelling area: square feet
City/State/ZIP: '176,4P) e/t. 1II- Garage/carport area: square feet
Suite/bldg./apt.#: Project name: AIM f,/hi•J Nig-55/4-6, Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 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.
//0S-r7/-// / /A/raid/1-//y /!j/l rliA/#J/4-1() // Valuation: $ 35O 0 a v
114-0i,ut-'T 6,1J rtp/h ''YS 5 iv pi ain 09'y70/-J• Existing building area: square feet
New building area: square feet
iPROPERTY OWNER ❑ TENANT Number of stories:
Name: Du) ii tit-M 6, Type of construction:
Address: 47 0 .1 /nil(A?),¢in /�-(J,f AM/ Occupancy groups:
City/State/ZIP: "0 14-yt i/, l`i�. 9715r - 407 Existing:
Phone:( ) Fax:( )
New:
L"APPLICANT ET/CONTACT PERSON BUILDING PERMIT FEES*
Business name: /17rz y6� �i Cis 1 eActic (Please refer to fee schedule)
Structural plan review fee(or deposit): ;7 4 j
Contact name: �C Niiend c/Lin 1 C (._
FLS plan review fee(if applicable):
Address: / Ze5` f.tx.) "pity pe.
City/State/ZIP: / `7 G 4 O 17 A-y t� Total fees due upon application:
/
Phone:( ) ///• j07- Fax: :( ) Amount received:
E-mail: jt-l LI-J e mE(/�'C f/t' i d J C�Zj,� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: / /Z i f/5-4, SiC��;' Ca. E e7 /t' J` Submit two(2)sets of roof plan with connection details
/i ' 9 and fire department access,along with the 2010 Oregon
Address: /
,J Z S J•IA. . 7 n Solar Installation Specialty Code checklist.
City/State/ZIP: GA /1/1-- 1lypi Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) i 7/ - J Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic qti /G t.i-&Tef' e /yl/ z6, tt�Je't to AA .
d/��, Y Total fee due upon application: $201.60
Authorized signa re: Z 79?e,,, , . This permit application expires if a permit is not obtained
t within 180 days after it has been accepted as complete.
Print name: / '" / L t 7J 1 do Date: lj * Fee methodology set by Tri-County Building Industry
/ Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)