Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00191
13125 SW Hall Blvd.,Ti Date Issued: 07/13/2017
Tf,G 1 and OR 97223 503.718.2439 9
Parcel: 2S1026D01200
Jurisdiction: Tigard
Site address: 12825 SW PACIFIC HWY
Project: Mobil Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 8
Project Description: One(1)freestanding sign with electronic message center.Sign is over 6 feet tall.
Contractor: TUBE ART SIGNS&SPORTS DISPLAYS Owner: CSD TIGARD STATION LLC
4243-A SE INTERNATIONAL WAY 2300 NE BRAZEE ST
MILWAUKIE, OR 97222 PORTLAND, OR 97212
PHONE: 503-653-1133 PHONE:
FAX: 503-659-9191
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: IA Permit Fee-Additions,Alterations, 07/13/2017 $301.85
Demolition
Occupancy Grp; U Occupancy Load: 12%State Surcharge-Building 07/13/2017 $36.22
Dwelling Units: Plan Review 07/13/2017 $196.20
Stories: Height: ft Info Process/Archiving-Sm$0.50(up to 07/13/2017 $4.50
Bedrooms: Bathrooms: 11x17)
Value: $15,000
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $538.77
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 B(4,.........%. 4.61,444...4_ 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.
r
Building Permit Application
Commercial
ECEI‘l �`--�1 FOR OFFICE USE ONLY
R. - Received /�
City of Tigard Date/By. 7 S t'7 I PennitNo.: 161 of7.do /9/
;� 13125 SW Hall Blvd.,Tigard,OR 9724 Plan Review
Phone: 503.718.2439 Fax: 503.5988'' b 2017 Date/By:
����-)7 �! Other Permit: i ��j�/�m�7�
1:c; ,c i;h Inspection Line: 503.639.4175 IDate Ready/By. Juris: H See Page 2 for
Internet: www.tigard-or.gov OF���� ` Notified/Method. fz. �7 / I Supplemental Information
BUDDING DIV,ci ij ,.0
TYPE OF WORK
®New construction Print name:
❑Demolition
0 Addition/alteration/replacement ❑Other: REQUIRED DATA:1 AND 2 FAMILY DWELLING
Permit fees*are based on the value of the work performed.
CATEGORY OF CONSTRUCTION Indicate the value(rounded to the nearest dollar)of all
❑ 1-and 2-family dwelling ®Commercial/industrial equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
❑Accessory building ❑Multi-family Valuation: $
❑Master builder 0 Other:
Number of bedrooms:
JOB SHE INFORMATION,,
AND LOCATION
Number of bathrooms:
Job site address: 12825 SW Pacific Hwy Total number of floors:
City/State/ZIP: Tigard,OR 97223
New dwelling area: square feet
Suite/bldg./apt.no.: Project name: Mobil
Garage/carport area: square feet
Cross street/directions to job site: SW Walnut
Covered porch area: square feet
Deck area: square feet
Subdivision: Lot no.:R464385 Other structure area: square feet
Tax map/parcel no.: 251026 D01 200 REQUIRED DATA:COMMERCIAL-USE CHEyCKLIST
=rz, Permit fees*are based on the value of the work performed.
r DESCRIPTION OF WORK'
~, :.. : _..- a. .., :, Indicate the value(rounded to the nearest dollar)of all
Install One (1) Flag Mounted Pole Sign equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
Valuation: $15,000.
Existing uild g area: square feet
® PROPERTY OWNER ❑ TENANT
New building area: square feet
Name: D&C Fowlkes
Number of stories:
Address: 2300 NE Brazee St.
Type of construction:
City/State/ZIP: Portland,OR 97212
Phone:(503)381-7482 Fax:( ) Occupancy groups:
r APPLICANT 0 CONTACT PERSON 1, Existing:
Business name: Tube Art Group New:
Contact name: Deborah TOI ke BUILDING PERMIT FEES*
(Please refer to fee schedule)
Address: 4243-A SE International Way Structural plan review fee(or deposit):
City/State/ZIP: Milwaukie,OR 97222 FLS plan review fee(if applicable):
Phone:(503)653-1133 Fax::(503) 659-9191 Total fees due upon application:
E-mail: dtolke@tubeart.com Amount received: .--69"—'
CONTRACTOR; "'
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Business name:Tube Art Group Commercial and residential prescriptive install. ion of
Address: 4243-A SE International Way roof-top mounte. PhotoVoltaic Solar Pane 'ystem.
Submit two(2)se -of roof plan with s nection details
City/State/ZIP: Milwaukie,OR 97222 and fire department a. ess,along . the 2010 Oregon
Phone:(503) 653-1 133 Fax:(503) 659-9191 Solar Installation Spec, i Co,• checklist.
Permit fee(includes . .n review $180.00
CCB lic.: 70956 and admi, strativ- ees):
Authorized signature: State surcharge( ,'o of permit -e): $21.60
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)