Permit (6) CITY OF TIGARD BUILDING PERMIT
11COMMUNITY DEVELOPMENT Permit#: BUP2019-00316
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/21/2019
TIGARD g Parcel: 2S115BA00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY N
Project: Planet Fitness Subdivision: None Lot: None
Project Description: Installing(2)north elevation wall signs and(3)west elevation wall signs.
Contractor: INTEGRITY SIGNS OREGON Owner: TECOLOTE RESOURCES INC
PO BOX 88 KELLY'S LEGACY LLC ET AL
HUBBARD, OR 97032 BY HESLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE 503-981-3743
PHONE: 949-297-4460
FAX: 503-982-8153
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 11/21/2019 $164.96
Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 11/21/2019 $19.80
Dwelling Units: 0 Plan Review 11/19/2019 $107.22
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 11/21/2019 $12.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $5,220
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $303.98
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 ollow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952 s r 1-0090. You may•• -in a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
O
Issued By: 4 i J/ /� Signature: -a CA.A.CA—A•----"
Call 503.639.4175 by 7:00 a.m.for the next available inspecti n dat
This permit card shall be kept in a conspicuous place on the job site until corn on of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial '~ r.::!v177, FOR OFFICE IJSE()NIA
City of Tigard Received
DateBy: (9, /- 7 ."/ ,Arzt w
II 13125 SW Hall Blvd.,Tigard,OR 97223 N OV 1 9 2019 Plan Review 1 I
II "1 Phone: 503-718-2439 Fax: 503-598-1960 Date/By: J' '19— , 14 Related Permit:
TI GARD Inspection Line: 503-639-4175 l „A z. Date Ready/By: I / Juris. ® See Page 2 for
Internet: www.tigard-or.gov k ,., NotiMethod: [(�l (///\, Supplemental Information
TYPE OF WORK • QUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ,Other: 51 bo equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling 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: 1 t,am S bs) A0: „ c New dwelling area: square feet
City/State/ZIP: --'j't �� '�"` Garage/carport area: square feet
Suite/bldg./apt.#: l Project name: @.t.,t> y Covered porch area: square feet
Cross street/directions to job site: -� ,qa �'�DuryACLQ_ Deck area: squareuare feet
'n0)1+ e- kr'ip
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: l Lot#: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: 52_ c
_Lti atk scciy,-4: C) west;c,5 4 - diti) '!Nt';1- S,
Existing building area: square feet
•
New-lilding-area square feet
ROPERTY OWNER 0 TENANT Number of stories:
Name: Te Le-A a t)CLU,`�� rk Type of construction:
Address: )34 a .1 , 't'//'))C�l i_ :\--).{. 5�'si# a-7 0 Occupancy groups:
City/State/ZIP: om-
/ZIP: a Yr4 ( I l S 1 C S 9a.(o 3 Existing:
Phone:(94-19 -acii 1. 1'1 ioO, Fax:(CHCI).aQ^7 —'i..4 4 83 New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
—h Y) 3 (ntv' Structural plan review fee(or deposit):
Contact name: I- - '
�Q I.A.AFLS plan review fee(if applicable):
Address: .D
.i� Total fees due upon application:
City/State/ IPc— 1„),rx.„.A � 9'-)p'
Phone:q,,,3) 9 fa` _311.13 Fax::(y9-7- Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: 1 +'t S �� Submit two(2)sets of roof plan with connection details
r1 and fire department access,along with the 2010 Oregon
Address: .U c8 Solar Installation Specialty Code checklist.
City/State/ZIP: ] j�3 Permit fee(includes plan review $180.00
u h�j(L 1 and administrative fees):
Phone:(51 3)CI c) _3-714.3 Fax:(• State surcharge(12%of permit fee): $21.60
CCB Lic.: 1 q 4.1. f Total fee due upon application: $201.60
Authorized signature:1-04152,,fe... This permit application expires if a permit is not obtained
1(-)
within 180 days after it has been accepted as complete.
Print name: rDate: * Fee methodology set by Tri-County Building Industry
� i �Q Q �� 1� Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)