Permit CITY OF TIGARD BUILDING PERMIT
• 5 ., COMMUNITY DEVELOPMENT Permit #: BUP2009 -00122
.T i G AR I? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/28/2009
Parcel: 2S101AA00101
Jurisdiction: Tigard
Site address: 12150 SW 68TH PKWY
Subdivision: Lot: 0
Project: Landmark
Project Description: Install New aluminum composite fascia panel covering.
Owner: FEES
CORLISS, JAMES L & CORA K Description Date Amount
LEASE TO: FORD LEASING, DEVELOPMENT Permit Fee - COM 07/28/2009 $390.70
CO, PO BOX 23970 Plan Review 07/01/2009 $96.40
PHONE: Plan Review - Fire Life Safety 07/01/2009 $59.32
Plan Review 07/28/2009 $157.56
Contractor: Plan Review - Fire Life Safety 07/28/2009 $96.96
MEYER SIGN CO OF OREGON INC 12% State Surcharge - Building 07/28/2009 $46.88
15205 SW 74TH AVE
TIGARD, OR 97224
PHONE: 503 -620 -8200
FAX:
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $55,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $847.82
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332. 4
Issued By: -)610 n/t Q C Q t Pennittee Signature: �
OFW
��(► Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
, ( ,)(Dl Kt=t D 12 '50 CO (33
Building Permit Application RECEIVE t
Commercial JUL FOR OFFICE US[: ONLY
1,1 City of Ti gard � t 0 2009 Date /B : ` Permit No.: y Wei .. v
° 13125 SW Hall Blvd., Tigard, OR 97223 ^A Plan Review `i �
la . Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIW1RD Date/B : 101 �. Other Permit:
Inspection Line: 503.639.4175 Date Read B 1L,16 ® Supplemental Information
Internet: Line: gard- or.gov ( / �$�
4 TYPE OF WORK OFT - ' 1 1QUIRED 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.
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
El Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12150 SW 68 Ave. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Landmark Ford Covered porch area: square feet
Cross street/directions to job site: SW 68` Ave & SW Dartmouth St. Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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: G30 •"'e14 nh fln
Install new aluminum composite fascia panel covering. f
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ® TENANT Number of stories:
Name: Landmark Ford Type of construction:
Address: 12150 SW 68 Ave. Occupancy groups:
City /State/ZIP: Tigard, OR 97223 Existing:
Phone: (503)639 -1131 Fax: ( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name: (Same as contractor) All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax: : ( )
E -mail:
CONTRACTOR
Business name: Meyer Sign Co. of Oregon, Inc. _ BUILDING PERMIT FEES*
Address: 15205 SW 74`h Ave. (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP: Tigard, OR 97224
FLS plan review fee (if applicable):
Phone: (503) 620 -8200 Fax: (503) 620 -7074
CCB lic.: 64014 Total fees due upon application: 155 , 702
IW . WIT Amount received:
Authorized signature: . `- � ' v This permit application expires if a permit is not obtained
l within 180 days after it has been accepted as complete.
Print name: Steve Murphy \ Date: 6 -30-09 • Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building \Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(I I /02 /COM/WEB)