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Permit (122) \In 0 1 D fref,... .,....., City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT V IN RequestPermit q Action oc r 1 7.018 TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 •www.ti ara.=nr, 4 1111 fi RD TO: CITY OF TIGARD BUILDING DIVISION Building Division 13125 SW Hall Blvd.,Tigard, OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner 0 Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) s i5v1 Cr + s t5,' ns Mailing Address: Pp r,c,x ,131,j4, City/State/Zip: 7;) r a c ?.),,s2 1 Phone No.: S1-3 tc,c(i-`-f 9 i Q Drb, Cell # St=-3•lif1-"-itcrtz:> PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): 1 CANCEL/VOID PERMIT APPLICATION. REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: ,...,....sag•rmoi, _00' AS>.aR I Site Address or Parcel #: tSSt,° 2 017-0Q. cZ 3 �� ©S ��� Pc�I�t� /vt,3�/ l et c'f T Project Name: /it-. Beishr� 6;4 i2.° tx.17�, C L.L.isine. Subdivision Name: IS/3 G, CM 11016c) Lot#: aE4XPLANATION:11 i Gk..,,} iine(a C;�i�. t.t�Qt,.": fj"ibt'n, l:.neta_�- fhi) ,i,.:--,q, 0._ t /e=.;j.-_ Wti5 +in es cf .q42- -It> Cn,. dlTf 3.r..":'�' y,. (10 t- .F,o , co...,"4. Its �..9 1 '-.t3 f C� r'.,}tiL his.... Signature: \--De-1'v St.---t# Date: clrt7Cig Print Name: pzkii Sf...t0- 5,2r)t re;-t+ 5.5►-)s Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. ,.`3 �� —5-6 .7_ / - 6 2 7/ ; es' r /Y, FOR OFFICE USE ONLY Route to Sys Admin: Date war /V By '1.- . Route to Records: Date L/ /Z /5 By Refund Processed: Date /0(,�f- B i#a Invoice Processed: Date By Permit Canceled: Date ////p/i. - B - . Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_012314. oc . q TIGARD City of Tigard November 29,2018 SignCraft Signs,LLC Attn: Debi Scott PO Box 23636 Tigard, OR 97281 Re: Permit No. BUP2017-00323 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 11705 SW Pacific Hwy Project Name: Al-Basha Gyros Job No.: N/A Refund Method: ® Check#230488 in the amount of$56.84. ❑ Credit card"return"receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit"receipt in the amount of$ Comment(s): Per applicant's request as customer cancelled signs under this business name. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, / Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov City of Tigard TI c A R D Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Signcraft Signs,LLC DATE: 11/16/2018 PO Box 23636 Tigard, OR 97281 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 414648 Case#: BUP2017-00323 Date: 12/20/2017 Address/Parcel: 11705 SW Pacific Hwy Pay Method: Check Project Name: Al-Basha Gyros EXPLANATION: Per applicant's request customer cancelled signs under this business name. Refund 80% of permit fees. . k m w ., s a R a ay� e $ 4 • ibrt g Tara 14}, w.; a" ta3 e�� "u `��a ®..�a �c s. � " ,�+- ` ,:' � 6�a Ssre�.z �����=�"s�"v� �taiyiit ��" Buildin: Permit Fee 230-0000-43104 $50.75 12%State Surchar.e 100-0000-24001 6.09 TOTAL REFUND: $56.84 APPROVALS: SIGNA U' -_ DATE: If under$5,000 Professional Staff `,� i If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board Case Refund Processed: Date: 1/ /2 /, By: I 4 4 I:\Building\Refunds\RefundRequest.doc x 09/01/2010 1111 CITY OF TIGARD BUILDING PERMIT 8 COMMUNITY DEVELOPMENT Permit#: BUP2017-00323 T t cl A P L-) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/11/2018 Parcel: 1 S136CD00100 Site address: 11705 SW PACIFIC HY X Jurisdiction: Tigard W Project: AI-Sasha Gyros Project Description: Installing(1)30 sq.ft.illuminated wall sign. Subdivision: None Lot: None Contractor: SIGNCRAFT SIGNS LLC 8900 SW BURNHAM, E109 Owner: PACIFIC CROSSROADS PROPERTIES IN TIGARD, OR 97223 BY WYSE INVESTMENT SERVICES CO 1501 SW TAYLOR ST STE 100 PORTLAND, OR 97205 PHONE: 503-639-4910 PHONE: FAX: 503-639-4999 Specifics: FEES Type of Use: COM Description Date Amount Permit Fee-Additions,Alterations, 12/20/2017 $63.44 Class of Work: ALT Type of Const: Occupancy Grp: U Demolition Occupancy Load: Dwelling Units: Plan Review 12%State Surcharge-Building 12/20/2017 $7.61 Stories: Height: ft 12/20/2017 $41.24 Bedrooms: Info Process/Archiving-Sm$0.50(up to 12/20/2017 Bathrooms: 11x17) $1.00 Value: $750 Floor Areas: Total Area: Accessory Struct: Basement: Carport: Covered Porch: Deck: Garage: Mezzanine: Total $113.29 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 -- • e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By roc f Permittee Signature: ®5� Aar .r Cal .03.639.4176 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. Builtling Permit Application Commerciala ,Nw � �= FOR OFFICE 1 SE ON 1.) City of Tigard DEC 7 Received _ 13125 SW Hall Blvd.,Tigard,OR 97223 �� 1 DateBy: 1�/$40 if 1 / PermitNo.:�a���/) �/�� ? Phone: 503.718.2439 Fax. 503.598.1960 III Plan Re w & !/(/ T I GA R D Inspection Line: 503.639.4175 i, Date/By: i i l(� Other Permit:S�See Page /) /`4 I y t / ff rrII q Internet: Www.tigard-or.goV Vit_ j r^+ (F, L� e, Date Ready: Juris: L t t1� otified/Me d: 1 J6 ` I ® See Page 2 for Supplemental Information TYPE WOR£ ' . g's New construction REQUIRED DATA:1-1- ! 2-FAMILY DWELLING 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all E]Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. $ El1-and 2-family dwelling Valuation: ®Commercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:11705 SW Pacific Hwy New dwelling area: square feet City/State/ZIP:Tigard OR 97281 Garage/carport area: square feet Suite/bldg./apt.no.: ' x I Project name:Al-Basha GYROS Cross street/directions to job site:Hwy 99&SW 78`h Ave Covered porch area: square feet Deck area: square feet Other structure area: square feet Subdivision: 1REQUIREI)DATA:COMMERCIAL-USE CILECKLI,ST Lot no.: Permit fees*are based on the value of the work performed. � PP Tax map/parcel no.: i S li 3 4,C„ D t, 10© / 'l p 25c4/1Indicate the value(rounded to the nearest dollar)of all y equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK, work indicated on this application. Manufacture and Install one illuminated Channel Letter signrwith Valuation: $ separate modules over top and botton of the word GYROS Existing building area: square feet New building area: square feet ® PROPERTY OWNERNANT I 0 TE � � Number of stories: Name:Pacific Crossroads Properties,LLC by Wyse Invest Address:810 SE Belmont St,Ste 100 Type of construction: City/State/ZIP:Portland OR 97214 Occupancy groups: Phone:(503)595-9689 Existing: Fax:( ) :.APPI ICAIi New: 0 CONTACT PERSON BUILDING-PERMIT FEES* Business name:Al-basha GYROS Lebanese Cuisine (Please reJerdofeeseheikki Contact name:Debi(SignCraft for customer) Structural plan review fee(or deposit): Address:11705 SW Pacific Hwy FLS plan review fee(if applicable): City/State/ZIP:Tigard OR 97223 Total fees due upon application: Phone:(503)639-4910 I Fax::( ) Amount received: E-mail:info@signcraftpdx.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of Business name:SignCraft Signs,llc roof-top mounted Photovoltaic Solar Panel System. Address:PO Box 23636 City/State/ZIP:Tigard OR 97281 Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. Permit fee(includes plan review Phone:(503)639-4910 I Fax:(503)620-9568 and administrative fees): CCB lic.:155420 State surcharge(12%of permit fee): Authorized signature: 11 Total fee due upon application: I f i +r If � This permit application expires if a permit is not obtained y within 180 days after it has been accepted as complete. Print name:John Scot I Date: rit'.,'(, I * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)