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Permit CITY OF TIGARD BUILDING PERMIT ''. COMMUNITY DEVELOPMENT Permit #: BUP2011 -00102 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/03/2011 Parcel: 1 S 136DB00600 Jurisdiction: Tigard Site address: 11635 SW PACIFIC HWY Project: Taco Bell Subdivision: Lot: 0 Project Description: Freestanding drive -thru menu board replacement. Contractor: VANCOUVER SIGN COMPANY INC Owner: TYSON FAMILY TRUST & 2600 NE ANDERSEN RD #50 LARSON, RAYMOND K/EILEEN FRANCIS VANCOUVER, WA 98661 BY TBC #016600 PO BOX 35370 LOUISVILLE, KY 40232 PHONE: 360- 693 -4773 PHONE: FAX: 360- 693 -2747 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee - Additions, Alterations, 05/24/2011 $164.96 Class of Work: ALT Demolition Dwelling Units: 0 12% State Surcharge - Building 05/24/2011 $19.80 Stories: 0 Height: 9 ft Plan Review 05/24/2011 $107.22 Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm Sheet (up to 06/03/2011 $8.00 Value: $5,600 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $299.98 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. A I ION: Ore.= law re.uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0s -0010 through OAR 95 00 091. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.805.332. 44. Is.ued By: k r O/ Permittee Signature: - i/ • Call 503.639.4175 by 7:00 a.m. for the next available inspection . ate. 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. — r . Building Permit Application FOR OFFICE USE ONLY City of Tigard 0,. �� Received / n f y i� 114 q Date /By: 1 Permit No.: , ♦° 1 v�/ ��!_ 13125 SW Hall Blvd., Ti ard, OR 97 ?. g Plan Review Phone: 503.639.4171 Fax: 50 :j' ' t . p1 Date/By: 1 ) Other Permit: TIGARD Inspection Line: 503.639.4175 t ` t, Date Ready /By. • /�.� Jurist 0 See Attached Checklist for Internet: www.tigard- or.gov 0 Ij Notified/Method: (o/? /!! / I' Supplemental Information pV . GP* O\A 4) e - tom,, f..t )-A � ` `' , •• , " ' . TYPE fit' W 11 �� ( 5 � - - ,REQUIRED` DATA: 1- AND F , .1. New construction �[ition 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. El 1- and 2- family dwelling N Commercial /industrial Valuation: $ El Accessory building ❑ Multi- family , Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE' INFORMATION AND 'LOCATION Total number of floors: Job site address: ) 1 e. 3 S S l.J 1 0 0 , 2 ,', Q; ` a v, New dwelling area: square feet City /State /ZIP: -r a. ,,, el.... OR Garage /carport area: square feet Suite /bldg. /apt. no.: Project name: 'TOk-C.O Q e ' I Covered porch area: square feet Cross street/directions to job site: ' I Deck area: square feet 1 f (A 3 S 5 Ltd Pa.G Ft I ct G u )l� Other structure area: square feet JJ REQUIRED DATA :COMMERCIAL- USEsCHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 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. s 1 Y 1 e: �.� l �) P. '�� 'Cu Valuation: $ S ( 0 (/) f- r P.p. -tune OA :1i i I b o C.L. r C A . Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER .,. , - - TENANT . Number of stories: Name: Trw.GO B e. 1 1 Type of construction: Address: 1 ( 3 S ` , e..) Pac. 1 �t I L N W , + Occupancy groups: City /State /ZIP: V\ t (�,(' , Q r1 " Existing: Phone: ( ) U Fax: ( ) New: - _ -.❑ :APPLICANT ' - .. ❑ CONTACT PERSON • - NOTI'C' Business name: Vancouver Sign Co All contractors and subcontractors are required to be Contact name: °t✓ licensed with the Oregon Construction Contractors Board f�- O -O C under ORS 701 and may be required to be licensed in the Address: ZIoOO- Al E A v lce-be. Rd 5 U jurisdiction in which work is being performed. If the City /State /ZIP: Vancouver WA 986b.:1 applicant is exempt from licensing, the following reasons apply: Phone: (360) 6934773 Fax: : (360) 6932747 E xr -mail: ,(`e.iC,US 0 voutsi nGo. GC7rn - C TRACTOR �` Business name: Vancouver Sign Co Z6 0© C �1 . : ' ` BUILDING PERMIT FEES* Address: ' V G A t Mot C &Se r AI -' . - • . (PleasiFefer to _ • City /State /ZIP: Vancouver WA 98661 Structural plan review fee (or deposit): Phone: (360) 6934773 Fax: (360) 6932747 FLS plan review fee (if applicable): CCB lie.: 63951 Total fees due upon application: —_ Amount received: Authorized signature/ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: P f S - t - v VY1 Date: * Fee methodology set by Tri- County Building Industry Service Board. ' 1:\ Building \Permits \nUP- PermitApp.dac 03/21/06 440-4613T( I I /0?JCOM/Wlin)