Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2013 -00134
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 06/04/2013
Parcel: 2S 113AA00100
Jurisdiction: Tigard
Site address: 16358 SW 72ND AVE
Project: Pacific Realty Associates Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS A,B
Project Description: Replace existing sign face.
Contractor: OUTDOOR DESIGNS Owner: PACIFIC REALTY ASSOCIATES
PO BOX 879 ATTN: N PIVEN
MIDDLETON, ID 83644 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 208 - 585 -3984 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee - Additions, Alterations, 06/04/2013 $256.22
Demolition
Occupancy Grp: Occupancy Load: 12% State Surcharge - Building 06/04/2013 $30 75
Dwelling Units: 0 Info Process /Archiving - Lg $2 00 (over 06/04/2013 $2 00
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm $0 50 (up to 06/04/2013 $10 00
Value: $12,000 11x17)
Plan Review 06/04/2013 $166.54
Floor Areas:
Total Area 0
Accessory Struct: 0
Basement. 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine' 0
Total $465 51
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 throuoh 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:
, Permittee Sig nature: /r
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.
Building Permit Application
Commercial FOR OFFICE USE ONLY
1,1 City of Tigard RECEIVED Date/B i �com Permit No ,aa �l
Plan Review 13125 SW Hall Blvd., Tigard, OR 97223 ' w
evie
'. Phone: 503.718.2439 Fax 503598.1960UN Date/B . ( � mot Other Permit gGA)�! i 40
T I G A R D Inspection Line: 503.639.4175 4 2 013 Date Ready : y. Juns RI See Page 2 for
Internet www.tigard or.gov Crrvo T� Notified/Method Supplemental Information
{S nN' GARD
TYPE Oitliti 1NG DIVISION 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.
El 1- and 2- family dwelling CO Commercial /industrial Valuation: S
❑ Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16358 SW 72 Ave New dwelling area: square feet
City /State /ZIP: Tigard, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: 1000' South of Upper Boones Ferry Road Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: 00100 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S113AA00100 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.
,i0TraviK� s. 1q .s/I4 v-4 of e .� S f7K S . .1 *pl („E(� Valuation: S IZ
e_ v v Existing building area: il Z" square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 5
Name: Lamar Advertising Type of construction: X+p.cve s'igale
Address: 29345 Airport Road, Suite B Occupancy groups: I
City /State /ZIP: Eugene, Oregon 97402 Existing: cti,,,,plefe igi!((, r d
Phone: (541)684 7939 Fax: (541)684 2312 II /
New: �81✓ Gdu�nn , S Jam , `` l•• �IER ty
® APPLICANT ® CONTACT PERSON BUILDING PERii1T FikES*
Business name: Lamar Advertising (Please refer to fee schedute)
Structural plan review fee (or deposit): Z5 Z Z_
Contact name: Jason Ripp
FLS plan review fee (if applicable):
Address: 29345 Airport Road, Suite B
City /State /ZIP: Eugene, Oregon 97402
Total fees due upon application:
Phone: (541) 684 7939 Fax: : (541) 684 3212
Amount received:
E -mail: jripp @lamar.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
^ _ CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Qafdoer �Nf Submit two (2) sets of roof plan with connection details
((// and fire department access, along with the 2010 Oregon
Address: /? 0 t 3 p �)9 Solar Installation Specialty Code checklist.
City /State/ZIP: j Permit fee (includes plan review
`�� e 4 K_ ) ' � and administrative fees): $180.00
Phone: (Lod' ) P5. 3 f Fax: ( )
State surcharge (12% of permit fee): $21.60
U��4
CCB lic.: 44 Pi 1,1 5-4 Total fee due upon application: $201.60
Authorized signature: 4 // / 1/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: G// V Date: ^.,� '"*....4000 * Fee methodology set by Tri -County Budding Industry
hw.,
Al--1.,_ el !� Service Board.
S r
I. \BuildingWermits\BUP -COM PermitApp.doc 02 4/2011 440- 4613T(I1 /02 /COM/WEB)
!Ipil Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elem:. is to provide under this section, priority shall be given
to those elements that will provide e grea st access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered . re.. $
(d) At least one accessible restroom fo each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building \Permits \BUP -COM PermitApp.doc 03/03/2011
° Building Division
Over- The - Counter (OTC) Building Permit
T I G A R D Check List
Project Description: 6
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: L Z( Occupancy Load: Oregon Specialty Code: 2j I(S
SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOT AGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ t-2-POD 1 FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM 11 $ 245,2-2- Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ , 12% State Surcharge
Project g e g
Up to $4,999 $0.00 $0.00 $ 6 , Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ 'Z,OO Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ ( eno Info Proc /Arch, Sin (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ ,5,S( TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OiR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Bwlding \Forms \OTC - BUP.docx 07/01/2012