Permit . BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2004 -00225
�I� DEVELOPMENT Tigard, 639 -4171 D ATE ISSUED: 5/18/2004
SITE ADDRESS: 13545 SW PACIFIC HY PARCEL: 2S102CC -00600
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: 5: 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: 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: $ 11,000.00
Remarks: Pole sign
Owner: Contractor:
DDHK VENTURES, LLC LUMINITE SIGNCRAFT INC
12604 SW 60TH CT 9033 SW BURNHAM
PORTLAND, OR 97219 TIGARD, OR 97223
Phone: 503- 977 -0578
Phone: 503 - 639 -4910
Reg #: LIC 116449
FEES REQUIRED INSPECTIONS
Description Date Amount Foot/Found Insp
[BUILD] Permit Fee 5/18/2004 $148.90 Final Inspection
[BUPPLN] PIn Rv 5/18/2004 $96.79
[TAX] 8% State Surcharl 5/18/2004 $11.91
Total $257.60
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.
Issued By: ti
Permittee / Signature: � / / /.�
Call 639-4 75 by 7 p.m. for an inspection the next business day
4
Building Permit A lication FOR OFFICE USE ONLY
City of Tigard R .4 F ' Date/By: Permit No. a ( 0P�do ap Z 2,45.- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1,Q6q)' 1 �p 2001 �� *�y {, p i t Date/By: ,�.1 R - G �/ Other Permit: S( 41 y.., /,i
Inspection Line: 503.639.4175 ;v.G��. ,L 01 ° Y ■ F' .. Date Ready/By: Juris: ® See Attached Checklist for
Internet: www.ci.tigard.or.us ^IT TIGARD Notified/Method: Supplemental Information
��� t t YY E O ®WO
�/ REQUIRED DATA: 1 - AND 2- FAMILY DWELLING.
New construction ❑Demolition Pemut 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.
• c] 1- and 2- family dwelling �CotnmercialIindustrial Valuation: $
❑ Accessory building �/ M ulti- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
• JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 6' 3/6- no 5ric,„ -�;l t New dwelling area: square feet
City/State/Z1P: '�/ _ f / " /409 Garage/carport area: square feet
Suite/bldgiapt. no.: r p Project name: ��� A, j 4 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 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.
Jt�111 iii// if F,y�/ 0,59,v Valuation: $ // NJ&
Existing building area: square feet
New building area: square feet
. ❑ PROPERTY OWNER ❑ TENANT Number of stories: `
Name: / () tL y� Type of construction V /V '
Address: , ? i / ✓ � C fi v y j C ,� C' vi t7 Occupancy groups: '
City/State/ZIP: �. ✓ ✓ A90 9 62,1 q7; Existing:
Phone: ( ) Fax: ( ) New: 1
❑ X PERSON NOTICE " '
Business name: � /� / /,� bAi All contractors and subcontractors are required to be
A na licensed with the Oregon Construction Contractors Board
Contact name: h 0- ft� `e.d' 4L/y under ORS 701 and may be required to be licensed in the
Address: 7/ a �v `' Ldam Al ' jurisdiction in which work is being performed. If the
City/State/ZIP: 14 i. ®�� f v � v , Cii, 971970
applicant is exempt from licensing, the following reasons
Phone: 6:3) z ' v D (A l 3 2 Fax: : (510 ,,,70 (J / 3 r
E- mail:
CONTRACTOR
Business name: A any/ ii �
�/If � . - BUIILDING PERMIT FEES*
Address: R' /a( 5 L41 Q 1 9"/(/
' (dda4„.
P / ��� Please refer to fee schedule
City/State/ZIP: I, A 1 { / 7 Silt 9'i ®.�
w _ Fees due upon application
Phone: (51 1 ) 3--° �I D t / q 7 Fax: ( )
CCB lic.: J Amount received O� i1 3 /_ b
Date received: 1P
Authorized signature: , � ./ 1.4 �_ This permit application expires if a permit is not obtained
0 � , within 180 days after It has been accepted as complete.
•
Print name: `/I� ,,i
i. i, L Date: Fee methodology set by Tri -County Building Industry •
� Service Board.
i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
k. ar
Building Division
.4_41711i( Plan Submittal Requirement Matrix
Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal V # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(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 is 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.
i:\Building \Forms \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION p1VISION Business Line: (503) 639 -4171 MST
BUPA -Z5
Received tt te
D,ate,Reeques d AM PM BUP
Location t Pk e--- • y Suite MEC
Contact Person Ph ( ) PLM
Con Ph ( ) SWR
Tenant/Owner ELC
ooting
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall A i
Fire Sprinkler
Fire Alarm
Susp'd Ceilin�
Roof 6,^
Other
irerIT
A PART FAIL '
PLUMBING 4 _ /=
Post & Beam i Under Slab .
Rough -In
J■ 4 ..
Water Service •
Sanitary Sewer
Rain Drains J
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL