Permit • q CITY OF TIGARD BUILDING PERMIT
m COMMUNITY DEVELOPMENT Permit #: BUP2013 -00282
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2013
Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST 110
Project: Frame Central Subdivision: BURNHAM TRACT Lot: 1
Project Description: Installation of (2) wall signs.
Contractor: E S & A SIGN & AWNING Owner: DOLAN & CO LLC
89975 PRAIRIE RD BY FLORENCE T DOLAN
EUGENE, OR 97402 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE 541 - 485 -5546 PHONE
FAX: 541 -485 -5813
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee - Additions, Alterations, 12/02/2013 $241 01
Demolition
Occupancy Grp: U Occupancy Load: 12% State Surcharge - Building 12/02/2013 $28.92
Dwelling Units: 0 Plan Review 12/02/2013 $156 66
Stories: 0 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 12/02/2013 $4.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $11,000 Misc Administration Fee 12/02/2013 $5.00
Floor Areas:
Total Area 0
Accessory Struct: 0
Basement: 0
Carport 0
Covered Porch 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $435.59
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 ,TENTION' Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 -0010 through O AR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calli . , 13 232 1987 or 1.800 332 2344
Issu d By: / / Permittee Signatu e: / ^
Call 503.539.4175 by 7:00 a.m. for the next available inspection ate.
This permit card shall be kept Ina 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 •
• FoR OFFICE USE ONLY
City of Tigard Received , DI Permit No.. .
U PI
° 13125 SW Hall Blvd , Tigard,OR 97223 Plan Review � Fr1 / .v
t7 Phone: 503.718.2439 Fax: 503.598.19 V 2013
Date/B �' /�� , Other Permit.
T I G /1 R U Inspection Line' 503.639.4175 Date Ready
By MEM ® See Page 2 for
Internet: www.tigard - or.gov CITY OFTIGPRD Notified/Method. , 7 1 3 ry mr Supplemental Information
G DIVISION spy ...), / rwdr .J
TYPE O 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
❑ Addition/alteration/replacement %Other: 5/ t7 is/ equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling
XConunercial/industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB 'SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /Z•57.5 5 /0/97 /1/ sr & /[ 0 New dwelling area: square feet
City /State /ZIP: 774 A-71.4) OZ.- 9 71-i 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ,/7 e 'l //72/ r_ 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.
/417 err 7. Wi . /� , /S Valuation: $ r_%
l /` f /p cx�o:
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: • ' Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
if APPLICANT E5 ❑ CONTACT PERSON NOTICE -
Business name: E s 11 / / i )A/ /�(/t a , . All contractors and subcontractors are required to be
Contact name: 4 5 -A//10 Ntw L/i licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be liensed in the
Address: g / 9 7 s p -7 Az / ci go_ jurisdiction in which work is being performed. If the
City /State /ZIP: V.(� 0/2— 771/°2-- applicant is exempt from licensing, the following reasons
apply:
'(`
Phone: (SO3) g6,7 - 7) 14 Fax:: ( )
E -mail: L 4 p1t/ re( LJ CJs5 .60-Yvc
CONTRACTOR BUILDING PERMIT FEES*
Business name: . 9m 14,1 - (Please refer to fee schedule)
Permit fee:
Address: 6a/44-e_
City /State /ZIP: . .a 14- -e State surcharge (12% of permit fee):
FLS plan review (40 %ofpermit fee):
Phone: ( ) ,.,61 .0/1- -? Fax: ( ) (Due upon application.) i _
CCB lic.: /.3 y 7 Q Total permit fees: VI/35
Authorized signature: ' Amount received:
This permit application expires if a permit is not obtained
Print name: $ j 4 Oiv/9 /cif') Date: g_ / (� -/2 within 180 days after it has been accepted as complete.
* Fee methodology set by Trl- County Building Industry
Service Board
I \Buiding\Permits\FPS- PermitApp doc Rev 01/ 05/2012 440- 4613T(I 1 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Mann
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I.\ Building \Penruts \FPS- PennitApp.doc Rev 01 /05/2012 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12550 SW MAIN ST 110, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
2014-01-07 00:00:00
BUP2013-00282
PASS - No C of O
Violation Summary:
Inspector Contractor