Permit 1114 CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00106
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/23/2015
Parcel: 2S102AC01704
Jurisdiction: Tigard
Site address: 12720 SW PACIFIC HWY
Project: Nueva Esperanza Chiropractic Clinic Subdivision: BURNHAM TRACT Lot: 1
Project Description: Installing(1)internally illuminated sign.
Contractor: MEYER SIGN CO OF OREGON Owner: LARAWAY, JOSEPH CHARLES TR
15205 SW 74TH AVE 3370 RACHEL WAY
TIGARD, OR 97224 HOOD RIVER, OR 97031
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: Vg Permit Fee-Additions,Alterations, 04/23/2015 $104.12
Demolition
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Building 04/23/2015 $12.49
Dwelling Units: 0 Plan Review 04/13/2015 $67.68
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 04/23/2015 $2.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $2,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $186.79
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. ATTE •.• Oregon law requires you to follow the rules adopted by the Oregon Utility Notification •- ter. Those rules are set forth in OAR
952-1• -1010 through O•' •52-00 :191. You may obtain a copy of the rules or direct questions to OUNC by calling 503 987 •r 1.800.332.2344.
197 C
sued By: +I �'�!i Permittee Signature: —`w,
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 th- project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application S GI a 01 S--000 SO
Commercial FOR OFFICE USE ONLY
Received
City of Tigard R1C1 %VIX Permit No.: . ; 0 i C 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review �
Phone: 503.718.2439 Fax: 503.598.1960 DateB : �`r ,, 4 io Other Permit:
t `t,I Inspection Line: 503.639.4175 A Ix fy p 1 3 2.0 Date ReadyReady/By: Juris: 61 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: rM ey,�- —Kr(; Supplemental Information
TYPE OF NC �1�l r REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction Non 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 CONSTRUCTIO i .; work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
MIIMIP JOB SITE INFORM T1ON AND LOCATION Total number of floors:
Job site address: /,27L0 ,..64.) /A-G/!'i-C ilk)/ New dwelling area: square feet
City/State/ZIP: —776R tz , ok 1722-3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: A/ve/4 aigaig-p}jam( Covered porch area: square feet
Cross street/directions to job site: g�y g y i ine-K_XAf jam/ 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: $2,0°6. 00
/hf,S�l L / !/JfE rt-,��,�//y /t� J�t.0 i/v ,4 r�'0 (A/3tr.)(.l~ .
elk) a ,,,,L._6 in-t b ATA ti.!SR M Xe o 1 , Existing building area: square feet
New building area: square feet
PROPERTY OWNER _ ® TENANT Number of stories:
Name: P 3 E�L/ C(/ /L(l- it.k I J/h/ r/l-!J Type of construction:
Address: 53 7 t9 / 4�/( ) 1 Occupancy groups:
City/State/ZIP: der 'O Xi at---x_16/_ 97 '3 / Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON 1 BUILDING PERMIT FEES* lir
Business name:Meyer Sign Co (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name: Tony McCormick
FLS plan review fee(if applicable):
Address:15205 SW 74th Ave
City/State/ZIP:Tigard,OR 97224 Total fees due upon application: -7,�'
Phone:(503)620-8200 I Fax::(503)620-7074 Amount received:
E-mail:permits @meyersignco.cum PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
IF CONTRACTOR
roof-top mounted Photovoltaic Solar Panel System.
Business name:Meyer Sign Co Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:15205 SW 74th Solar Installation Specialty Code checklist.
City/State/ZIP:Tigard,OR 97224 Permit fee(includes plan review $180.(H)
and administrative fees):
Phone:(503)620-8200 I Fax:(503)620-7074
State surcharge(12%of permit fee): $21.60
CCB lic.:64014 '2/y/1 Total fee due upon application: $201.60
((((��J1ll
Authorized signature: �m((r This permit application expires if a permit is not obtained
l within 180 days after it has been accepted as complete.
Print name: /Tony Mc ,.rmick Date: it /3115 15 * Fee methodology set by Tri-County Building Industry
/// Service Board.
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