Permit 11 CITY OF TIGARD BUILDING PERMIT
III
I COMMUNITY DEVELOPMENT Permit#: BUP2020-00027
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/12/2020
T I G,1 R.I3 g Parcel: 1 S 134BC00200
Jurisdiction: Tigard
Site address: 12180 SW SCHOLLS FERRY RD
Project: One Medical Group Subdivision: None Lot: None
Project Description: (1)new 4.5 sq.ft.blade sign above entrance.
Contractor: HANNAH SIGN SYSTEMS INC Owner: ATLAS GREENWAY LLC
1660 SW BERTHA BLVD 333 NW NINTH AVE, STE 1009
PORTLAND, OR 97219 PORTLAND, OR 97209
PHONE: 503-946-8373 PHONE:
FAX: 503-206-4900
FEES
Specifics:
Description Date Amount
Type of Use: COM Permit Fee-Additions,Alterations, 02/12/2020 $77.00
Class of Work: ALT Type of Const: VB Demolition
Occupancy Grp: B Occupancy Load: 0 12%State Surcharge-Building 02/12/2020 $9.24
Dwelling Units: Plan Review 02/12/2020 $50.05
Stories: Height: ft Info Process/Archiving-Sm$0.50(up to 02/12/2020 $4.00
Bedrooms: Bathrooms: 11x17)
Value: $1,200
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $140.29
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: Ore•: .w requir- you follow the es adopted by the Oregon Utility Notification ,Center. Those rules are set forth in OAR
952-001-0010 through O•- -001-01•.. You m obtain a cop the les or direct questions to OUNC by calling 03.232.1987 or 1,800,332.2344.
r
Issued By: P..ti..;ttee Signature:
V
Call 503.639.4175 by 7:00 a.m.for the next available inspection date:il
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.
Building Permit Application
Commercial FoR oFFicl. I SE( vLv
City of Tigard r)FCEIVED
Date Ar ived
Permit No.:
III 2 13125 SW Hall Blvd.,Tigard,OR 97223 r�ry Plan Review
�}
Phone: 503-718-2439 Fax: 503-598-1960 , 3 020 Date/B : _ -- . ^ ii Related Permit: y 4 /' f?,:.r,
TIGARD Inspection Line: 503-639-4175 I-� Date Ready/By:. �/' Juds 6 See Page 2 for
Internet: www.tigard-or.gov ' r,/ ryt TIfARD y. ed/Metho.. r�! '7. ;7 Supplemental Information
TYPE OF WORK 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: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation:
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms.
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12180 SW Scholls Ferry Rd New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.#: Project name:One Medical Covered porch area: square feet
Cross street/directions to job site: 121 st Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#:1 S134BC00200 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.
I blade sign Valuation: $ /Z-DO —
Existing building area: square feet
_/I/D �lG-,)6,;/-2.1
New building area: square feet
❑s PROPERTY OWNER 1,TENANT Number of stories:
Name:One Medical Type of construction:
Address:12180 SW Scholls Ferry Rd Occupancy groups:
City/State/ZIP:Tigard, OR 97223 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Hannah Sign Systems (Please refertofee schedule)
Structural plan review fee(or deposit):
Contact name:Dave Lanphere
Address: 1660 SW Bertha Blvd FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Portland, OR 97219
Phone:(503 )946-8373 Fax: :(503 )206-4900 Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: davel@hannahsignsystems.com
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Hannah Sign Systems Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1660 SW Bertha Blvd Solar Installation Specialty Code checklist.
City/State/ZIP:Portland, OR 97219 Permit fee(includes plan review $180.00
and administrative fees):
Phone:( 503)946-8373 Fax:503 )206-4900 State surcharge(12%of permit fee): $21.60
CCB Lic.: 203638 i 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:Dave Lanphere Date: /,1c.)/2_,_) * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP COMPermitApp.doe Rev.04/21/2014 440-4613T(I1/02/COM/WEB)