Permit (64) CITY OF TIGARD BUILDING PERMIT
111 ' . COMMUNITY DEVELOPMENT Permit#: BUP2016-00129
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/26/2016
7 r ;:�R C� 9 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9516 SW WASHINGTON SQUARE RD H05
Project: Ben Bridge Jeweler Subdivision: None Lot: None
Project Description: Wall signs
Contractor: TUBE ART SIGNS&SPORTS DISPLAYS Owner: PPR WASHINGTON SQUARE LLC
4243-A SE INTERNATIONAL WAY PO BOX 847
MILWAUKIE, OR 97222 CARLSBAD, CA 92018
PHONE: 503-653-1133 PHONE:
FAX: 503-659-9191
Specifics: FEES
Description Date Amount
Type of Use: COM Permit Fee-Additions,Alterations, 04/26/2016 $301.85
Class of Work: ALT Type of Const: IIB Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 04/26/2016 $36.22
Dwelling Units: 0 Plan Review 04/26/2016 $196.20
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 04/26/2016 $7.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $15,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $541.77
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 in 503.232.1987 or 1.800.332.2344.
Issued By: • .ittee Signature:41.
.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.
I
0
Building Permit Application
Commercialt .- ,, ', t ti FOR OFFICE USE oNLI
City of Tigard Received DatePlanBRevy: 7, /4: Permit No.: r u��a,..cot aQ
IN13125 SW Hall Blvd.,Tigard,OR 97223 ., ie"Pt �? .,
Phone: 503.718.2439 Fax: 503.5 8.1960 Date/By: *ii .I /, Other Permit: fidev4 -/
t Inspection Line: 503.639.4175 Date Ready/By: / , Juris ® See Page 2 for
Internet: www.tigard-or.gov I1'a +��i� i l a.\t j; Notified/Method: if/i6 /Ip / Supplemental Information
TY' 0Niki9() 1N
®New constructionPrint name:
0 Demolition
0 Addition/alteration/replacement 0 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
equipment,materials,labor,overhead,and the profit for the
❑ 1-and 2-family dwelling El Commercial/industrial
work indicated on this application.
0 Accessory building 0 Multi-family
Valuation: 9
0 Master builder 0 Other:
Number of bedrooms:
JOB SITE INFORMATION AND LOCATION
Number of bathrooms:
Job site address: 9516 SW Washington Square Road Total number of floors:
City/State/ZIP: Portland,OR 97223
New dwelling area: square feet
Suite/bldg./apt.no.: H05 Project name: Ben Bridge
Garage/carport area: square feet
Cross street/directions to job site: SW Greenburg Road
Covered porch area: square feet
Deck area: square feet
Subdivision: Washington Square Mall Lot no.: Other structure area: square feet
Tax map/parcel no.:1 S 1 260000300 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 three (3) internally illuminated signs mounted equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
to interior fascia. Valuation: $ `
�j1000.—
® PROPERTY OWNERExisting building area: square feet
0 TENANT
New building area: square feet
Name: PPR Washington Square LLC
Number of stories:
Address: PO Box 847
City/State/ZIP: Carlsbad,CA 92018 Type of construction:
Occupancy groups:
Fax:
Phone:( ) ( )
® APPLICANT 0 CONTACT PERSON Existing:
Business name: Tube Art Group
New:
BUILDING PERMIT FEES*
Contact name: Deborah Tolke
Please refer to fee sehedu/e
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) 1653-1133q ``--,, Fax::(503)659-9191 Total fees due upon application:
E-mail: CI 0 I k4 e TU b•Q -i-• co," —�'""
'�' "`/// Q� Amount received:
CONTRACTOR
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Business name: Tube Art Group Commercial and residential prescriptive installation of
Address: 4243-A SE International Way roof-top mounted PhotoVo .ic Solar Panel stem.
Submit two(2)sets of roof p .• with coy •ction details
City/State/ZIP: Milwaukie,OR 97222 and fire department access,alone• the 2010 Oregon
Phone:(503)653-1133 Fax:(503)659-9191 Solar Installation Special .%e ch• list.
Permit fee(inc :-s plan review
CCB lic.: 70956 1/3//3 an, .sministrative fees): $180.00
Authorized signature: State sure arge(12%of permit fee): '• 1.60
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)