Permit CITY OF TIGARD BUILDING PERMIT
.74
COMMUNITY DEVELOPMENT Permit #: BUP2010 00224
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/28/2010
Parcel: 2S102CB01802
Jurisdiction: Tigard
Site address: 13407 SW PACIFIC HWY
Subdivision: Lot: 0
Project: AutoZone
Project Description: (1) freestanding 15' pole sign
Owner: FEES
BAR -AM, LLC Description Date Amount
BY GODFATHER'S PIZZA, 1416 THIRD AVE Permit Fee - Additions, Alterations, 10/28/2010 $164.96
SEATTLE WA, 98 Demolition
PHONE: Plan Review 10/14/2010 $107.22
12% State Surcharge - Building 10/28/2010 $19.80
Contractor:
MEYER SIGN CO OF OREGON
15205 SW 74TH AVE
TIGARD, OR 97224
PHONE: 503 - 620 -8200
FAX: 503 - 620 -7074
Specifics:
Type of Use: COM
Class of Work: OTR
Dwelling Units: 0
Stories: 0 Height: 15 ft
Bedrooms: 0 Bathrooms: 0
Value: $5,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $291.98
Reauired: 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 OA'
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a co., - rules or direct questions to OUNC by c. • - 503.246.6699 or 1.800 ' ..2344.
r / Issued By: � _ _ Permittee Signature:
Cy 75 by 7:00 a.m. for an inspection that bua ess da .
This permit card shall be kept in a conspicuous place on the job site un completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application RECEIVED
Commercial FOR OFFICE USE ONLY
T :, Received
City of Tigard OCT r1 4 (i:10 C DateB : /a Al Permit N - c
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review '��
C Phone: 503.639.4171 Fax: 503.598.196 OF TIGARD DateBy � a Other Perm ivaXe/D ..-610/690
T I G A 12 D Ins Line: 503.639 Date Ready : y: Juris ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: 0 ?II t f l '76-- Supplemental Information
4) LV" Ir J iy(QAr'
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
K 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.
El 1- and 2- family dwelling Commercial /industrial Valuation: $
Accessory building Number of bedrooms:
El ry g ❑ Multi - family
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address t 34-1 1 •N �' yn I & rA V New dwelling area: square feet
City /State /ZIP: ` k:' t DP, ( V \t Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: cl `► / ADM Covered porch area: square feet
Cross street/directions to job site: �1 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.
f � L + � Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: p� \o equipment, materials, labor, overhead, and the profit for the
-r DESCRIPTION OF WO work indicated on this application. n
\ c0.� \0\ oc 1 «one () \ \t �1!'l % �I _ % Valuation: $ 5 w
0
�-�-0 •
eJ4\70%k.)%'`^ Existing building area: square feet
New building area: square feet
PROPERTY OWNER I ❑ TENANT Number of stories:
Name: _ 4 (X \ ` ( �
, Type of construction:
Address: `.St\ "-"` tt • Occupancy groups:
City /State /ZIP: \. . c %1D`
` Existing:
—
Phone: (A) ( 1 R o Fax: ( ) New:
',APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: \�� S licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: �\ C a * • \ • S� jurisdiction in which work is being performed. If the
City/State /ZIP: �p� � bock �l
��y�� `� applicant is exempt from licensing, the following reasons
`r ` �, U � apply:
Phone: `�.L�� �.. \` 1 Fax:: ( .. �tJ'\
—
E -mail: —
p 1 u s @ - Irna f - - 4►s-,- h r os.C.•o VY1
CONTRACTOR y (�
Business name:vp s �,� 1 tr4 f rl QZ BUILDING PERMIT FEES*
Address: \ r \41 `J " (Please refer to fee schedule)
✓ , ��aa Structural plan review fee (or d / 0 �
City /State /ZIP �• oZa�
Phone: Ea) f „ � b Fax: (3) N4 _ 41.Is— FLS plan review fee (if applica
I ' V � l I 1 Total fees due upon application:
CCB lic.: -
Amount received: /Q 7 A 2
Authorized signature:
4,_,cji_i____/ T his permit application expires if a permit is not obtained
I within 180 days after it has been accepted as complete.
Print name: �J a / p, P W l.[.. La Date: 0 — !a _ / D * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -COM PermitApp.doc 10/01/09 440-4613T(1 I /02/COM/WEB)