Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2013-00255
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/26/2013
Parcel: 2S 110DCO2200
Jurisdiction: Tigard
Site address: 15570 SW PACIFIC HWY
Project: Safeway Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: Installation of(2)wall signs.
Contractor: SECURITY SIGNS INC Owner: TRC MM LLC
2424 SE HOLGATE BLVD 5973 AVENIDA ENCINAS STE 300
PORTLAND, OR 97202 CARLSBAD, CA 92008
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 11/26/2013 $180.17
Occupancy Grp: U Occupancy Load: 1 Demolition Stte
12/o State Surcharge-Building 11/26/2013 $21.62
Dwelling Units: 0 Plan Review 11/26/2013 $117.11
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 11/26/2013 $4.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $7,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $322.90
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 952-001-0090. 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 Signature:
3.639.4175 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 1014 OFFICE USE ONLY
City of Tigard Received r'� off/ /5 ��, Permit No.: /�u
13125 SW Hall Blvd.,Tigard,OR 97223 OCT 2013 X610/3—l,2Jo�SS
NI M. g Plan Review �� �� l ^/2�6��
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : �h�L ( Other Permit: ,t1::9 J 7 p�
TIGARD Inspection Line: 503.639.4175 On O TIGARD Date Ready a y: orris: El See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method:I /6 / J� Supplemental Information
BUILDING
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®Ne construction El 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 1
t work indicated on this application.
CATEGORY OF CONSTRUCTION
—
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $ 1,
El Accessory building 111 Multi-family Number of bedrooms: C
O,
❑Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: IjS� Q C,1 ?Del( 11CI New dwelling area square feet
City/State/ZIP: �lJ ` v �'e"�^` , "^' Garage/carport area: square feet Ct
Suite/bldg./apt.no.: Project name: aci Covered porch area: square feet
Cross street/directions to job site: 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.: 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: $
‘--ge r
(.0a-ti, i1 M�v ^ Existing building area: square re feet
*Mount Only*
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
—
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Security Signs (Please refer ro fee schedule)
Structural plan review fee(or deposit):
Contact name:Melissa Hayden
FLS plan review fee(if applicable):
Address:2424 SE Holgate Blvd
Total fees due upon application:
City/State/ZIP:Portland OR 97202
Phone:(503)546.7114 Fax: :(503)230.1861 Amount received:
E-mail:Melissa @SecuritySigns.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Security Signs Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lie.: 122809
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:Melissa Hayden Date: * Fcc methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46I3T(I 1/02/COM/WEB)
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 elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for 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