Permit � rt
CITY OF TIGARD BUILDING PERMIT
'111111 I ' • COMMUNITY DEVELOPMENT Permit#: BUP2015 00228
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2015
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15989 SW 72ND AVE
Project: Dominos Pizza Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Installation of(1)wall sign.
Contractor: GARRETT SIGN CO INC Owner: PACIFIC REALTY ASSOCIATES
811 HARNEY STREET ATTN: N PIVEN
VANCOUVER,WA 98660 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 360-693-9081 PHONE:
FAX: 360-693-5948
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 08/05/2015 $87.17
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 08/05/2015 $10.46
Dwelling Units: 0 Plan Review 08/05/2015 $56.66
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 08/05/2015 $2.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $1,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $156.29
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. NTION: • -'on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 01-0010 through OAR ••2-00 • =0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
ssued By: • % Permittee Signature: AfAle
Call 503.839.4175 by 7:00 a.m.for the next available inspect,�e.
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 Applic4ition -�VED
Commercial i�t►C� FOR OFFICE USE ONI.1
City of Tigard JUL 2 9 2015 DBBy: 7 499 ,s Rte! PermitNo.: ,,Ips0/5--0o) g
II • 13125 SW Hall Blvd.,TigarsI,QR 9'7,2,2,3.`"_- Plan Review
I Phone: 503.718.2439 Faxi...463. 98.19601 IGARD �: (-S 1� other Permit: < ,N� /"y=�9�
Date/By:
i ,i `,,t, Inspection Line: 503.639 j1 ;_rte.' DIVISION Date Read :y: �,; •ns. ®See Page 2for
Internet: www.tigard-or.gov ^ Notj jay ethod: _ , Of D /S Supplemental Information
TYPE OF WORK ) REQUIRED DATA: I-AND 2-FAMILY DWELLING
El 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:Sign equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling Valuation: $
y g ®CommerciaUindustrial
El Accessory building ID Multi-family Number of bedrooms:
El Master builder I:1 Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:15989 SW 72nd Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Domino's Pizza 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: 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.
Installation of(.6 single faced illuminated fascia signs. Valuation: $ 1 1500
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name:Domino's Pizza Type of construction:
Address: 15989 SW 72nd Ave Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:( ) Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee sc
Business name:Garrett Sign Company lreda[eI
Structural plan review fee(or deposit):
Contact name:Jesse Taylor
FLS plan review fee(if applicable):
Address:811 Harney Street
Total fees due upon application:
City/State/ZIP:Vancouver,WA 98660 1
Phone:(360)693.9081 Fax::(360)693.5948 Amount received: -�'
E-mail:jesse@garrettsign.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive• allation of
CONTRACTOR roof-top mounted Photo Voltaic So:- 'anel System.
Business name:Garrett Sign Company Submit two(2)set. .f roof pi:. . • connection details
and fire department a •- : ong with the 2010 Oregon
Address:811 Harney Street Solar Installation Spe, ' Code checklist.
City/State/ZIP:Vancouver,WA 98660 Permit fee ` chides p • review $180.00
d administrativ- 1 -):
Phone:(360)693.9081 Fax:(360)693.5948 State surbharge(12%of permit fee $21.60
CCB lic.:66826 '5091/7 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: �G f , a,/lei✓ Date: 7-Z - 15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15989 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2015-00228
Chip Barnett
Violation Summary:
Inspector Contractor