Permit y ,, CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2013 00001
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/07/2013
Parcel: 1 S 136CD00100
Jurisdiction: Tigard
Site address: 11705 SW PACIFIC HVVY E
Project: Baskin Robbins Subdivision: 2006 -016 PARTITION PLAT Lot: 3
Project Description: Replace (2) damaged signs
Contractor: YESCO LLC Owner: NOFFZ, JOHN
20100 SW 112TH AVE 15170 SW FINIS LN
TUALATIN, OR 97062 TIGARD, OR 97224
PHONE: 503 - 612 -6672 PHONE: 503 - 407 -1101
FAX: 503 - 612 -0914
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee - Additions, Alterations, 01/07/2013 $164.96
Demolition
Occupancy Grp: U Occupancy Load: 12% State Surcharge - Building 01/07/2013 $19.80
Dwelling Units: 0 Plan Review 01/07/2013 $107.22
Stories: 0 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 01/07/2013 $1.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $5,100
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $292.98
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This perm' '- - - • subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d• e in accordance • 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
d -. s. ATTENTION: Oregon requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9.2- 001 -0010 through OAR 952 -0'' • • ; You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I sued By: g I,- �/ ,, / Permittee Signature: ///
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 ' ' P13 1.
Commercial I�
Received I
City of Tigard Date/By: PermitNo.: Pa - D I ,a --0Ot0 /
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review + r ( � f 'J�
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: I ` l ( J Other Permit:
TI GA RD
Inspection Line: 503.639.4175 Date Ready y. Juris. ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 1 I t Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
*ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
CI 1- and 2- family dwelling .gCommercial/industrial Valuation: $ / p p
ID Accessory building ID Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: // 205" fw P4 ,;; iL y ,,,,. 5,p/7'c. 1 New dwelling area: square feet
City /State /ZIP: 7i, e,/ p d Garage /carport area: square feet
Suite/bldg. /apt. no.: J Project name: Es g SK: , a 11. $1 _ Covered porch area: square feet
Cross street/diredions to job site i j n , `v� r u .c..) Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: A),A 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 L work indicated on this application.
Et .... 2 G. g ic..1•.• Ro - % , S%P1-✓ j Valuation: $
4..r- l� c , !�� G g3 ) ✓ Existing building area square feet
�/ New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: 7-;/„.,,, N G Z Type of construction:
Address: J S J 7 0 ‘5,..„..) T f w I`s 1., r..1 Occupancy groups:
City /State /ZIP: 77 s ,r d 7R., 9 7 2 y Existing:
Phone: (SD,3) go? 1) p ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: e" (Please refer to fee schedule)
cp' v+4,,.. tiS e � `'~� � f — Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address:
City /State /ZIP: Total fees due upon application:
Phone: ( ) F ( ) Amount received:
E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name:
yeS G Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City /State /ZIP: Permit fee (includes plan review $180.00
and administrative fees):
Phone: ( ) Fax: ( ) o
� � State surcharge (12% of permit fee): $21.60
�U
CCB lic.: I U
Total fee due upon application: $201.60
Authorized signature: /� d WI "/,' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: � O 44., N o f - . . _ - - Date://27/ 7,,,... * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T(11 /02 /COM/WEB)
Building Division
•
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011