Permit CITY OF TIGARD BUILDING PERMIT
1111 • COMMUNITY DEVELOPMENT Permit#: BUP2015-00064
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/09/2015
Parcel: 15136D802400
Jurisdiction: TIGARD
Site address: 11642 SW PACIFIC HWY
Project: Champion Building Subdivision: 2000-025 PARTITION PLAT Lot: 2
Project Description: Permitting work previously done without permit. Installation of fascia for placement of wall signs,
Contractor: OWNER Owner: CHAMPION, RONALD V& ROBERTA E
ROBERTA CHAMPION 16449 LEXINGTON CT
16449 LEXINGTON CT LAKE OSWEGO, OR 97034
LAKE OSWEGO,OR 97034
PHONE: 503-997-1608 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Vg DC Provision Review,COM TI-Ping 04/09/2015 $75.00
Occupancy Grp: A-2 Occupancy Load: DC Provision Review,COM TI-LRP 04/09/2015 $11.00
Permit Fee-Additions,Alterations, 04/09/2015 $149.75
Dwelling Units: 0 Demolition
Stories: 0 Height: 0 ft 12%State Surcharge-Building 04/09/2015 $17.97
Bedrooms: 0 Bathrooms: 0 Plan Review 04/09/2015 $97.34
Value: $5,000 Info Process/Archiving-Sm$0.50(up to 04/09/2015 $2.50
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $353.56
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
952-001-00 • •.. 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.
Issue. By: • ;t(1,f,t-L,L4e., Permittee Signature:
V V i
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.
w
#-Building Permit Application
Commercial 1.0R ()I.I.I( I 1 .1 0\I l
City of Tigard RECEIVED Received:_ m�em Permit No.: / , 5— „r ,j
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie r ��
Phone: 503.718.2439 Fax: 503.5981'.m 16 2015 D�e�a -11 ��7 Other Permit:
I I -�R t) Inspection Line: 503.639.4175 Date Ready: : Juris. ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: ,5 1, Supplemental Information
• BUILDING DIVISION co "t` 6.,),, • -
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.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:11642 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldgJapt.no.: Project name:'Nvnr-Ch.timiP,0x) L bhoi0 Covered porch area: square feet
Cross street/directions to job site:From 1-5 South,exit#294 Tigard/Newberg Deck area: square feet
heading west on Hwy 99,building is on left.Main tenant is George's Giant Other structure area: square feet
Hamburgers REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1S136DB02400 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.
Construct new fascia on existing building for sign mounting Valuation: $ �' (300 , «)
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Roberta Champion Type of construction:
Address: 16449 Lexington Ct Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97034 Existing:
Phone:(503)997-1608 Fax:( ) New:
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Slater Architecture (Please refer
to fee uie�r/e)
Structural plan review fee(or deposit):
Contact name:Lisa Slater
FLS plan review fee(if applicable):
Address:8900 NE Livingston Mtn Rd
Total fees due upon application:
City/State/ZIP:Camas,WA 98607
Phone:(360)817-2737 Fax::( ) Amount received: ,-�^
E-mail liva@shttersrchitecture.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive ins lation of
CONTRACTOR roof-tot • ted Photo Voltaic Solar P: - System.
Business name: tic- 0 f--2—. Submit two( •ts of roof plan wi • Innection details
and fire departm- • - ,aloe_with the 2010 Oregon
Address: Solar Installation Spec, 'ode checklist.
City/State/ZIP: Permit fee(Intl .- p : iew $180.00
and .. inistrative fees .
Phone:( ) Fax:( )
States .e(12%of permit fee): $21.60
CCB lic.:
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: C,t E`( 8E /49.421 Date: 3_ 1E, .15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\PermitsBBUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
A II
From: Ron Champion <ronchamp52 @yahoo.corn>
To: "caseysbernard @yahoo.com" <caseysbernard @yahoo.com>, "slaterarch @hotmail.com"
<slaterarch @hotmail.com>
Sent: Fri, Mar 30, 2012 14:32:39 GMT+00:00
Subject: Re: Commercial building on Pacific in Tigard
Good morning.
If I understand your requirements, the following should be all you need. If not, please let me
know and I will provide whatever other info you require.
I, as part owner of the commercial building on Pacific Highway in Tigard, authorize Casey
Bernard to sign for me for permits that apply to this project.
RON CHAMPION
25884 SW CANYON CREEK RD. #J302
WILSONVILLE, OR 97070
503/228-6868
ronchamp52(a�yahoo.com
Have a great day,
Ron iD
11111 City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review - Commercial - With Land Use
,6•
Building Permit #: et( O?Qf$= OW&
Site Address: illpzioR sic) )C,1 cs 1/24y Suite/Bldg#:
Project Name: ( ch ea e f
(Name of confinercial business occupying the spa . If vacant,enter Spec Space.)
Planning Review /
Proposal: / )e/0s/A I Lt3 c:+ ppe,vioits . _� 4(1( L ,/M ' "-
�� . , i. i _„ i. wit
li Verify site address/suite#exists and active in permits stem.
!II/River Terrace Plan District: El Yes E No
1/ Land Use Case#: /10f/j 00/3 - 060/8
1a Plans Match Approved Land Use: .
NOSite Plan 11 4 andscape Plan Other: Sj`' it ,b4.
`�, IA j rban Forestry Plan l'. Elevation Plan ci
NI 1 tuilding Height: Maximum Height 1--/5P1: Actual Height E&SJ1'
onditions Met:
CI Prior to Submittal CI n
Prior to Permit Issuace
Lid Business Li,ce se:
Exists: qQ Yes ❑ No,applicant notified to obtain business TIAPilublic Public Facilities Improvement(PFI) Permit: /
Required: El Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: - S7� Date: 3-/S-L5—
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved El Not Approved
Building Permit Submittal
Original Submittal Date: 4 /e.0`)
Site Plans: # 0
Building Plans: Vd"
Building Permit#: Enter building permit#above.
Workflow Routing: la fining `ngineering Ej...i erri`t Coordinator Building
Workflow Sign-off: SSi f for Planning(include notes from planning review)
Route Application Documents: utlding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: <t-, C�za.-A.--f Date.
1:\Building\Forms\BldgPermitRvw_COM_W ithLandUse 0304 1 5.docx
4
Engineering Review
•cctual Slope: AVA
"5-131-.1 Permit#:
ifiConditions Met
❑ NOT Approved by Engineering: Date
Notes:
A)o 6,,ci t 1 s-jv es
Approved by Engineering: 7�! Date: 3• /q '15
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
sw
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
K to Issue Permit /
Approved by Permit Coordinator: v Date: g
(:\Building\Forms\BldgPerm itRvw_COM_W ithLandUse_0204 I 5.docx