Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00420
�y, 'DEVELOPMENT SERVICES DATE ISSUED: 7/22/03
13125 SW Hail Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10998 SW 68TH PKWY PARCEL: 1S136AD -06505
SUBDIVISION: WAY LEE ZONING: C -G
BLOCK: LOT: 003 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: 20 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,400.00
Remarks: Construction of (1) wall and (1) free standing sign.
Owner: Contractor:
BANK OF SALEM MEYER SIGN CO OF OREGON INC
PO BOX 847 15205 SW 74TH
SALEM, OR 97308 TIGARD, OR 97223
Phone: 503 - 585 -5290
Phone: 620 -8200
Reg #: LIC 64014
FEES REQUIRED INSPECTIONS
Description Date Amount Foot/Found Insp
[BUILD] Permit Fee 7/22/03 $81.70 Final Inspection
[TAX] 8% State Tax 7/22/03 $6.54
[BUPPLN] Pln Rv 7/22/03 $53.11
Total $141.35
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 than 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
I
Issue • By: '� I ' / 0" ,
�d /
Pe mt itfee
Signature:
war
Call 639 -4175 by 7 • for an inspection the next business day
lo rig so a'`" p/Awy
- Building Permit Application FOR OFFICE USE ONLY
Received Building
Date/By: 7 - / - C 3 , D V Permit No,p(J (»O3 - oat l 2.O
V I' Planning Approval Other
City of Tigard = � ,, �" \''�� Date/By: Permit No.:
'�
13125 SW Hall Blvd. . Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 50398 1+ 60 t(-- ' . ' v �M riP �� Date/By:
Post o
Internet: www.ci.tigard.or.us ‘; I-N _ -} I r ,"
� °- Contact Juris.: (81 See Page 2 for
24 - hour Inspection Request: 50341914`x , t 9 ON Name /Method: _ Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
❑ Addition/alteration/replacement Other: 6tCA/
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling E. Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: /0 eilg �Lu 6g POI I Total number of floors
New dwelling area (sq. ft.)
Suite #: I Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: 4 6,1,k1 k of 7 i'j -2.J Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
/ bjk Cc.- /� , / - '` Other structure area (sq. ft.)
� (( J � - � ' � t REQUIRED DATA:
COMM
' I (M t C�1� - 2U S� COMMERCIAL - USE CHECKLIST .
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK i the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this ap
; R -f�'ls It 4- Valuation $ 3'io_` —
1 t� Existing building area (sq. ft.)
(/) �QA///,Y7,44 , (D- \ y, � New building area (sq. ft.)
/ 9hi f r c. U Number of stories
(-PROPERTY IONVIER II NANT Type of construction
Name: / � 4 ._ /s . r Occupancy group(s): Existing:
>� New:
Address: (ofi) 0 /// '�6o -
City/State/Zip:
hone: Z340 Fax: NOTICE: All contractors and subcontractors are required to be
P
P APPLICANT I CONTACT PE ON licensed with the Oregon Construction Contractors Board under
// provisions of ORS 701 and may be required to be licensed in the
Business Name: �4yy/tp CDflry jurisdiction where work is being performed. If the applicant is exempt
Contact Name: p QCs AALL2e 4/y from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: I Fax:
BUILDING PERMIT FEES*
E- mail: Please refer to fee schedule.
CONTRACTOR
Business Name: /Kk`(�12. 6(e-Ai a, - - J ciaa Fees due upon application $
Address: ISZo.S ,t.) 7 /t .
City /State /Zip: -ri vA 0 R . q 7 2 -- q Amount received $
Phone: G w 4 2 I Fax: 6, ZO — 707 Date received:
CCB Lic. #: 6 s T & Ja
\ �� �
A utho ri zed Notice: This permit application expires if a permit is not obtained within
Si gnature: _ - ,ft - 180 days after it has been accepted as complete.
OM _
1 t ' r ! /U.(.4 0 if *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name) _
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03
•
,
Commercial Plan Submittal
Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 * *
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review 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).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \forms \COM- matrix.doc 9/24/01