Permit (43) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00136
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2017
Parcel: 2S102BD01200
Jurisdiction: Tigard
Site address: 12825 SW PACIFIC HWY
Project: Mobil Sign Permit#1 Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 8
Project Description: Replacing canopy fascia,and installing new Mobil signs.
Contractor: DOUBLE R PRODUCTS/DEL J INC Owner: CSD TIGARD STATION LLC
901 NW E STREET 2300 NE BRAZEE ST
GRANTS PASS, OR 97526 PORTLAND, OR 97212
PHONE: 541-476-1387 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 06/14/2017 $564.15
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 06/14/2017 $67.70
Dwelling Units: Plan Review 06/01/2017 $366.70
Stories: Height: ft Info Process/Archiving-Sm$0.50(up to 06/14/2017 $1.50
Bedrooms: Bathrooms: 11x17)
Value: $34,349
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $1,000.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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: A/' ` A
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 Application
Commercial
;_ FOR orrlcr Isr.()NIA
City of Tigard Received
.111 III 13125 SW Hall Blvd.,Tigard,OR 97.4'' 1 DateB : "� �rJI Permit No.: /
■ Phone: 503.718.2439 Fax: 503.598. . s w Plan Review v. �% .i
T t G A R D Inspection Line: 503.639.4175 Dale R : �tf� I�] � Other Permit:
Internet: www.figard-or.gov `�c\ i Date Ready/:' ?C 17 C
1�� Notified/Method: See Page 2 for
J " M Supplemental Information
TYPE OF WO iiit .1 ,` '+
0 New construction - t� REQUIRED DATA:I-AND 2-FAMILY DWELLING
It i� , 'tk+ Permit fees*are based on the value of the work performed.
(Addition/ Iterati+ replacement K ' Indicate the value(rounded to the nearest dollar)of all
❑.• er:
equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
CI1-and 2-family dwelling (l Commercial/industrial Valuation: $ co❑Accessory building 3 7 9
0 Number of bedrooms:
❑Master builder
0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION
Total number of floors:
Job site address: 1 28 2
6•w c. H ;k New dwelling area:
City/State/ZIP: —rsquare feet
le_, 0 3 Gara e/
Suite/bldg./apt.no.: g arport area: square feet
Project name:
Cross street/directions to job site: Covered porch area: square feet
-..S,u 14- � at.— r'� _R__ O Deck area: square feet
■ Other structure area: square feet
Subdivision: REQUIRED DATA:COMMERCIAL-USE CHECKLIST
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
DESCRIPTION OF WORK equipment,materials,labor,overhead,and the profit for the
work indicated on this d++lication.
Valuation: $
17._ 11
Existing building area: square feet
IIMMMMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII New building area: square feet
0 PROPERTY OWNER 0 TENANT
Number of stories:
Address: 7 �- Type of construction:
kt 11 Ate e
City/State/ZIP: 1 � Occupancy groups:
Phone:( 2,) 957 - ici. Fax:( )
181 APPLICANT New:
❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: ,OL'. ...,E. Zi, ' ti.' C-
Planer erto eescheda/e
Contact name: = lc Structural plan review fee(or deposit):
EM
Address: +® pL) FLS plan review fee(if applicable):
Kai E cs-rp_—
City/State/ZIP: 12 .. rS r. c 6I, ca(7Total fees due upon application 's
Phone:
(5-4/ ) 762. 138 7 Fax::( j ) a `« Amount received:
E-mail: (L� d oc r's rbauc
S PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
Business name: ' i� ( roof-top mounted Photo Voltaic Solar Panel System.
1` i�L3 T Submit two(2)sets of roof plan with connection details
Address: -, VV and fire department access,along with the 2010 Oregon
City/State/ZIP: Solar installation Srecial Code checklist.
r' -r.� ' ' c s review
7 Permit fee(includes plan revi
Phone:( .r ) $180.00
Fax;( 1 )
and administrative fees):
CCB lie.: 0 State surcharge(12%ofpermit fee): $21.60
Authorized signature: Total fee due upon application: $201.60
s,..,. This permit application expires if a permit is not obtained
Print name: within 180 days after it has been accepted as complete.
t�-"� It ou.4 e Date: 4` iJ * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 /
440-46I3T(l 1/02lGOMlWEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12825 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2017-00136
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor