Permit (8) CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit #: BUP2011 -00003
Date Issued: 01/12/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S1016B00401
Jurisdiction: Tigard
Site address: 11880 SW PACIFIC HWY
Project: Russ Auto Subdivision: Lot: 0
Project Description: Replacing existing 25 ft. tall pole sign with 15 ft. tall pole sign off of Hall Blvd.
Contractor: YESCO LLC Owner: KNAUSS, WAYNE ET AL
20100 SW 112TH AVE C/O HUMBERSTON, RUSSELL D
TUALATIN, OR 97062 REVOCABLE TRUST
PO BOX 4300
BEAVERTON, OR 97076
PHONE: 503 - 612 -6672 PHONE:
FAX: 503 - 612 -0914
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 01/05/2011 $119.33
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 01/05/2011 $14.32
Stories: 0 Height: 15 ft Plan Review 01/05/2011 $77.56
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm Sheet (up to 01/12/2011 $3.50
Value: $2,500 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $214.71
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspen.9d for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification c -nt -r. Those rules i r-fe set forth in OAR
952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. f . : c or 1.800.33 - - • .
Issued By: � / r I Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
3 ujid i'r g ''t r°,u?r`f: /-..ripI r�,2.f:io,;:
Residential �� , :; r r w W • O _ 10E US ON y "t t , * 4 j
k , ,
11B.71 7r. .1 Received
! City �Ib$YCfl �� Date/B i ® �� �' Permit No.: L � ,d i i . C)
t 13125 SW Hall Blvd.. -
T igard, OR 1 Plan Review '
t y ; fjj�Ai� Other Permit: �. - - ° ,;= Phone: 503.639.4171 Fax: 503.5 ` +..` 60 �Gj Date /B
-' TeTG'ARD Inspection.Line: 503.639.4175 V Date Ready /By: , j i 7y" •7 El See Page 2 for
.,t -.",5_ ::,, Internet: www.tigard- or.gov J� O eVG� Cl�� Notified /Method /' 7 i t /le , Supplemental Information
�S �- H,r " �f�
z . TYPE OF R tYtk R
� � >t QUIRED A a
. ND , F ., 4v NAv E LI 't4 6
., Fu.. , . ..r .,., l.,.. ,i. .. , , r ,r w_ -xs�� .rs �. � .. .., -a 3A =k .. , .: , fi D t" . ° ... r, _ ...<f.;:
['New construction ❑� Permit fees* arc based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
,,Addition /alterati replacement • ❑ Other: equipment, materials, labor, overhead, the profit for the
i a' F n 1 t work indicated on this application.
C.e FEGOR O
I I - and 2- family dwelling ,Commercial /industrial Valuation: $
El Accessory building ID Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE I MA TI[ON AND L'O&TION Total number of floors:
Job site address: Al 6 eo C 2,...„ ',[,-,
,E+�- u �`„� New dwelling.area: square feet
City /State /ZIP: n " �, . . Garage /carport area: square feet
Suite /bldg. /apt. no.: J Project name: p uss A u:-.1-0 111 d Covered porch area: square feet
Cross street/ditections to job site: Deck area: square feet
•
Other structure area: square feet
•
REQUIRED DATA COMMERCL U
IASE CIIECtLIST
- ..
Subdivision: - Lot no.: Permit fees* are based on the value of the n9ork performed. - -
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no equipment, materials, labor, overhead, and the profit for the
<.<
1' F r 7 °` �.,;. D,ESCRIP FION \O
OFRhsz , a work indicated on - this application.
P ep i / Valuation: $ 2 saw
W S� S� S // b/C S h / ' Existing building area: square feet
�/ / 5
New building area: square feet
•
l k -- b'g 9 X V-'y T -
. 11,61l✓RTY OWNER r '� TENA1 5 .- . Number of stories: -
•
Name: Pu A L,..4r7 (SVeve Rods) Type of construction: .
Address: // s•g--d SW )Q1c__ di*C. ` J/ Occupancy groups:
City /State /ZIP: T,• 4 , ,- j 02 Existing:
Phone: (5,3) / /c, Fax: ( ) New: -
,R APPLICA. T t; ri i g CONTACT PERSON4 - a '
,,...w .� NO � A'� ��
Business name: y,ECa 1_ L C. _ All contractors and subcontractors are required to be •
Contact name: licensed with the Oregon Construction Contractors Board
FI r k ►vt S under ORS 701 and May be required to be licensed in the
Address: 2.0 /OD s-� l / 2 tti A ve. _ . jurisdiction. in which work is being performed. If the _
_ .applicant is exempt from licensing, the follow_ ine reasons
City /State /ZIP:
/G/ ��:/ i 1 OR.
apply:
Phone: ( 5 0 3 )753 ` /Q,tP1/ Fax: : ( 33)G.,/ 09 /4 -
E-mail l r K1 N-S !r yeSGD nO✓n•
a CONTRACTOR; s n .
11 ,AVA44:444:441,VAN ;] 4:444
Business name: YES-(6 LL C ' iBUILDINC PERGIIF FEES*,
,, , - , m (Plea refeea fee schedriiO ' . , 3
Address: Opp S Ala -t- Ave • . .
City /State /ZIP: Structural plan review fee (or deposit):' r I a . 33
TGf4',� 7 nle•
plate review fee (if applicable): "7 2. 5t
Phone: (563) 75 /0/.0 Paz ( 5D3 ) �PJ2 -C17�q {� - -
` D f . Totn� eet` due upon applicati �9, ` 2 -
CCB lic.: I � y / .. .
-----'/ -----'/ Amount received: l ;II d..1
• Authorized signature: - This permit application expires if a permit is not obtained
'� - within 180 days after it has been accepted as complete.
Print name: I' ' Date:
10 0. S - if * Fee methodology set by Tri -County Building Industry
Service Board. -
I:ABuilding \Permits \BUP -RES PermitApp -doe 10/01/09 440- 4613T(11 /02 /COM /WEB)
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