Permit 1 9 Q CITY OF TIGARD BUILDING PERMIT
4 ffi COMMUNITY DEVELOPMENT Permit #: BUP2012 -00219
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/05/2012
Parcel: 1 S 135BC00900
Jurisdiction: Tigard
Site address: 10855 SW CASCADE AVE
Project: The Design Studio Subdivision: HILLSBORO Lot: PTS 1 -2
Project Description: (1) cabinet sign installation
Contractor: RAMSAY SIGNS INC Owner: PAULSON LIMITED LIABILITY CO
9160 SE 74TH AVE BY RICHARD G PAULSON SR
PORTLAND, OR 97206 10855 SW CASCADE BLVD
TIGARD, OR 97223
PHONE: 503 - 777 -4555 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 11/05/2012 $119.33
Class of Work: ALT Type of Const: •
Demolition
Occupancy Grp: Occupancy Load: 12% State Surcharge - Building 11/05/2012 $14.32
Dwelling Units: 0 Plan Review 11/05/2012 $77.56
Stories: 1 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 11/05/2012 $2.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $2,600
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $213.71
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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: DI' v/ ` � Permittee Signature:
�w _�� /`
r 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 i ' FOR OFFICE USE ONLY
Rec eived l u � ���
City of Tigard P ermit No.: rJ
1111 • tY g DateB : t I - ( '
13125 SW Hall Blvd., Tigard, OR 97223 NOV 0 1 2012
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review DateB : i e�� t�ll 'ME ether Permit: F1,�,,MAr'pO o ir
T I G AR D
Inspection Line: 503.639 r N I G Date Ready ~ Juris: El See Page 2 for
Internet: www.tigard- or.gov CITY • • �T" " ' ^'� Notified/Method: � Y� Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING 0
® New construction ❑ Demolition Permit fees* are based on the value of the work performed. g
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the i g
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial
Valuation: $ Y
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: ..1
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10855 SW Cascade Ave New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: The Design Studio 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.
Valuation:
Instal 1 Cabinet Sign $ ,CCJ
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: See Attached Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Ramsay Signs Inc. (Please refer ro fee schedule)
Structural plan review fee (or deposit):
Contact name: Garrett Gibson
FLS plan review fee (if applicable):
Address: 9160 SE 74 Ave
City /State /ZIP: Portland, OR 97206 Total fees due upon application:
Phone: (503) 777 -4555 Fax: : (503) 777 -0220 Amount received: 3 -
E -mail: GarrettG @RamsaySigns.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Ramsay Signs Inc Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 9160 SE 74th Ave Solar Installation Specialty Code checklist.
City /State /ZIP: Portland, OR 97206 Permit fee (includes plan review $180.00
and administrative fees):
Phone: (503) 777 -4555 Fax: (503) 777 -0220 State surcharge (12% of permit fee): $21.60
CCB lic.: 63422 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: Garrett Gibson Date: / / /J/PZ.-- * Fee methodology set by Tri -County Building Industry
Service Board.
L\Building\Permits\BUP -COM PerrnitApp.doc 02/24/2011 440- 4613T(I 1 /02 /COM/WEB)
"Ill ' II Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description: ; /( bap d.01?-006)-(1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: Occupancy Load: Oregon Specialty Code: 20( C)
SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 'Z 603. C ° FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ 1k w Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ _Z 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ ~j Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ `2_,�j[� Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ 2-( ? TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
1'ND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
L: \ Building \Forms \OTC- BUP.docx 07/01/2012