Permit .� 1 . CITY OF TIGARD BUILDING PERMIT
14
"' 13. t. COMMUNITY DEVELOPMENT Permit#: BUP2015 00294
t A 13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439 Date Issued: 11/02/2015
TT�/1 gD Parcel: 2S 113AB00500
Jurisdiction: TIGARD
Site address: 16083 SW UPPER BOONES FERRY RD 320
Project: Bridgeport Family Medicine Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Installation of(1)new wall sign.
Contractor: TUBE ART SIGNS&SPORTS DISPLAYS Owner: G&S FC LLC
4243-A SE INTERNATIONAL WAY 16083 SW UPPER BOONES FERRY RD,
MILWAUKIE, OR 97222 STE
TIGARD, OR 97224
PHONE: 503-653-1133 PHONE:
FAX: 503-659-9191
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 11/02/2015 $53.27
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 11/02/2015 $6.39
Dwelling Units: 0 Plan Review 11/02/2015 $34.63
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 11/02/2015 $1.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $0
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage 0
Mezzanine: 0
Total $95.79
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 0 I PermitteeSignature: C,...______s2___-Titk)z__
__Latlawatiofia.: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 Applicat
'� - IVY
Commercial FOR OFFICE USE ONLY
OCT .l 9 2015
yA Received City of Tigard DateB 4' /4 / Permit No.:L/ 7, = /5I
Ili
13125 SW Hall Blvd.,Tigard,QIz� ��g, gp qy Plan Revze
,i� a Phone: 503.718.2439 Fax: 3.5 950" g lS��®� Date B : ��' MIS Other Permit: �a0/S--�I17
t rb � Inspection Line: 503.639.416 ILDg N IS1 �. Date Read : _ Jur,s: 0 See Page 2 for
,Te[GrlltU g g JNGD� O Notified/Method: l A, I5 ' Su
Internet: www.ti and-or. oV Supplemental Information
+ iNitk Q j01 t4.
TYPE OF WORK
M New construction Print name:
❑Demolition
❑Addition/alteration/replacement ❑Other: REQUIRED DATA:1-AND 2-FAMILY DWELLING
Permit fees*are based on the value of the work performed.
CATEGORY OF CONSTRUCTION Indicate the value(rounded to the nearest dollar)of all
❑ 1-and 2-family dwelling ®Commercial/industrial equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
❑Accessory building ❑Multi-family Valuation: $
❑Master builder ❑Other:
Number of bedrooms:
JOB SITE INFORMATION AND LOCATION
Number of bathrooms:
Job site address: 16083 SW Upper boones Ferry Rd.
Total number of floors:
City/State/ZIP: Tigard,OR 97224
New dwelling area: square feet
Suite/bldg./apt.no.: 320 Project name: Bridgeport Family Medicine
Garage/carport area: square feet
Cross street/directions to job site: SW 72nd
Covered porch area: square feet
Deck area: square feet
Subdivision: Lot no.:R51 31 53 Other structure area: square feet
Tax map/parcel no.: 25113AB00500 REQUIRED DATA:COMMERCIAL-USE CHECKLIST
DESCRIPTION OF WORK Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Install One (1) Set of Halo Lit Channel Letters and Logo equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
Valuation: $ 6000.
Existing building area: square feet
❑ PROPERTY OWNER ❑ TENANT
New building area: square feet
Name:
Number of stories:
Address:
City/State/ZIP: Type of construction:
Phone:( ) Fax:( ) Occupancy groups:
❑ APPLICANT ❑ CONTACT PERSON Existing:
Business name: Tube Art Group New:
Contact name: Deborah TOIke BUILDING PERMIT FEES*
(Please refer to fee schedule)
Address: 4243-A SE International Way Structural plan review fee(or deposit):
City/State/ZIP: Milwaukie, OR 97222 FLS plan review fee(if applicable):
Phone:(503)653-1133 Fax: :(503) 659-9191 Total fees due upon application:
E-mail: dtolke @tubeart.com Amount received:
CONTRACTOR
. PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Business name: Tube Art Group Commercial ..d residential prescriptive installation of
Address: 4243-A SE International Way roof-top mounte. ' otoVoltaic So • '. e ysteni.
Submit two(2)sets o .:•> • an with connection details
City/State/ZIP: Milwaukie,OR 97222 and fire de..•- -n access,a.•_with the 2010 Oregon
Phone:(503) 653-1133 Fax:(503) 659-9191 S. nstallation Specialty Code ''ecklist.
Permit fee(includes plan revie $180.00
CCB lic.: 70956 and administrative fees):'-
Authorized signature: 00,1--_T� State surcharge(12%of permit fee): $21.60
I:\Building\Pennits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(l 1/02/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
16083 SW UPPER BOONES FERRY RD 320,
TIGARD, OR, 97224
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2015-00294
Jeff Grove
Violation Summary:
Inspector Contractor