Permit (130) RECEIVED
DEC 10 2019
CITY OF TIGARD
UjLDI DIVISION
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
P/
111 . " I D
. Request for Permit Action
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant Contractor 0 City Staff
cheek(✓)one
REFUND OR Name:
INVOICE TO: (Business or individual) Tube Art Group / I lalev Arnell
Mailing Address: 4241-A Sl? International Way
City/State/Zip: 144ilw•wkie c)1Z 97222
Phone No.: 5(13.653.1133 / 917.205.7780
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CANCEL/VOID PERMIT APPLICATION.
REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
Permit#: x 1Inp7t119-(1()2(,1:7.2__
Site Address or Parcel#: 76i00 SW Atlanta St. #IS136CI)01501
Project Name: Public Storap,,
Subdivision Name: Lot#:
EXPLANATION: Pftble', 54urMt l/1 tr,f ('a iievHeal if// -1/1•74/t , 7241
61.94 y bt,„1 Le J, Li T,ee✓ 6e,i th -is e%'#nf rrejret `i65
b ert tf.,-I t e// G/,
Signature: Date: 12-9-19
Print Name: lalev A fncll
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.�,3 /•e? yam.of 4,-7 = A94 .01-a-
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1SI .-dam �/ S� //ems, 40
FOR OFFICE USE ONLY
Route to Sys Adtnin: Date By Route to Records: Date ?j`y/ By '/
D.F....A D.....,<e...A. Tl.ae/,477k' R., .; T......iee.Dee...........A. 7-1,,.. / it..
TIGARD
City of Tigard
January 28, 2020
Tube Art Group
4243-A SE International Way
Milwaukie, OR 97222
Re: Permit No. BUP2019-00266
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 7600 SW Atlanta St
Project Name: Public Storage
Job No.: N/A
Refund Method: /ZI Check#234524 in the amount of$475.85.
❑ Credit card "return"receipt in the amount of$
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account"deposit"receipt in the amount of$
Comment(s): Per applicant's request as job was cancelled. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
iii
City of Tigard
r ARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Tube Art Group DATE: 1/17/2020
4243-A SE International Way
Milwaukie, OR 97222 REQUESTED BY: Dianna Howse
TRANSACTION INFORMATION:
Receipt#: 426034 Case#: BUP2019-00266
Date: 9/25/2019 Address/Parcel: 7600 SW Atlanta St
Pay Method: Check Project Name: Public Storage
EXPLANATION: Per applicant's request and job was cancelled. Refund 80% of permit fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Building Permit 230-0000-43104 $424.87
12%State Surchage 100-0000-24001 50.98
TOTAL REFUND: $475.8i4'
APPROVALS: SIG A JR / ATE:
If under$5,000 Professional Staff SC//" y�—
If under$12,500 Division Manager -
If under$25,000 Department Manager
If under$100,000 City Manager
If over$50,000 Local Contract Review Board
FOR ACCELA SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: .9?3A-,` By: z/
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
CITY OF TIGARD RECEIPT
'` s 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
Ti GARD
Project Name: Public Storage
Site Address: 7600 SW ATLANTA ST
r�A/1.6
Receipt Number: 436195 - 09/03/2021
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
BUP2019-00266 $-475.85
Total: $-475.85
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 234524 DHOWSE 09/03/2021 $-475.85
Payor: Tube Art Group
Total Payments: $-475.85
Balance Due: $475.85
Page 1 of 1
CITY OF TIGA ` D RECEIPT
13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TI ;;�IZ,fr;
Project Name: Public Storage
Site Address: 7600 SW ATLANTA ST A
,e-1 6/
Receipt Number: 426034 - 09/25/2019
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
BUP2019-00266 Permit Fee-Additions,Alterations, 230-0000-43104 ef 147 $531.09 t
Demolition
BUP2019-00266 12% State Surcharge- Building 100-0000-24001 e '70 $63.73,
BUP2019-00266 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $10.50
11x17)
Total: $605.32
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 4229 BTAGGART 09/25/2019 $605.32
Payor: Tube Art Displays, Inc.
Total Payments: $605.32
Balance Due: $0.00
Page 1 of 1
CITY OF TIGARD BUILDING PERMIT
■''
COMMUNITY DEVELOPMENT Permit#: BUP2019-00266
Date Issued: 09/25/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S136CD01501
Jurisdiction: Tigard
Site address: 7600 SW ATLANTA ST
Project: Public Storage Subdivision: None Lot: None
Project Description: Sign installation consisting of (3) 171 sf ft and(1)267 sq ft illuminated channel letter on aluminum panels.
Contractor: TUBE ART SIGNS &SPORTS DISPLAYS Owner: TRAILBLAZER DEVELOPMENT LLC
4243-A SE INTERNATIONAL WAY BY CPS ASSET MANAGEMENT LLC
MILWAUKIE, OR 97222 333 S STATE ST STE V-144
LAKE OSWEGO, OR 97034
PHONE: 503-653-1133 PHONE:
FAX: 503-659-9191
FEES
Specifics: Date Amount
Description
Type of Use: COM Permit Fee-Additions,Alterations, 09/25/2019 $531.09
Class of Work: ALT Type of Const: VB Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 09/25/2019 $63.73
Dwelling Units: 0 Plan Review 09/17/2019 $345.21
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 09/25/2019 $10.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $32,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $950.53
Required Items and Reports(Conditions)
Required:
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. 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 By: Ll
0(Aa
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 project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial FOR OFFICE USE ONLY
City of Tigard BECElV Pe /�
n 13125 SW Hall Blvd.,Tigard,OR 97223 7 Date
Review -�► Y Imo.
m Phone: 503.718.2439 Fax: 503.598.1960 SEP 1 2 �CSate/By: ��a �9 Other Permit:
Inspection Line: 503.639.4175 Ready/By: I I orisIZI See Page 2 for
www.tigard-or.gov dl //f
, Supplemental Information
rmation 1
'4P
BUILDINFG DV
TYPE OF WORK REQUIR'D DATA:1-AND 2-FAMILY DWELLING
'!\New construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
I Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION - work indicated on this application.
0 1-and 2-family dwelling Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:7600 SW Atlanta St New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Public Storage Covered porch area: square feet
Cross street/directions to job site:Dartmouth St 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.:R0284285 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.
Lij
MFG&Install Three(3)171sq.ft.Illuminated Channel Letter on Aluminum Panels Valuation: $ 3aI(J o,
MFG&Install One(1)267.9sq.ft.Illuminated Channel Letter on Aluminum Panels Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER • TENANT` Number of stories:
Name:Public Storage Type of construction:
Address:7600 SW Atlanta St Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing:
Phone:( ) Fax:( ) New:
APPLICANT [ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Tube Art Group
!`` (Pleaserejerto(eeschedule)
Structural plan review fee(or deposit):
Contact name:Haley Arnell
FLS plan review fee(if applicable):
Address:4243-A SE International Way
Total fees due upon application:
Amount received:
Phone:(971)205.7780 Fax::(503)659.9191
E-mail:harnell@tubeart.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Tube Art Group Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4243-A SE International Way Solar Installation Specialty Code checklist.
City/State/ZIP:Milwaukie Or 97222 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)653.1133 Fax:(503)659.9191 State surcharge(12%of permit fee): $21.60
CCB lic.:70956
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Haley Arnell Date: 1:12_4 /9 * 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)