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Permit FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ii 2 Transmittal Letter r i c A R r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Dianna L. Omelas D T HIV D: DEPT: BUILDING DIVISION AUG 2 8 2020 1 FROM: Alex Kushniryuk CITY OF TI GA RD ICOMPANY: Kush CarpentryLic BUILDING DIVISION N PHONE: (360)213-5529 By: ,C1 1 EMAIL: kushcarpentry©gmail.com RE: 16276 SW 104th Tigard, Oregon MST2020-00214 (Site Address) (Permit Number) Billy banner (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: hieght revision Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: F07 7FICE USE ONLY Routed to Permit Techni 'an: Date: 9 i Z0� Initials: 44 Fees Due: ❑Yes No Fee Description: Amount Due: kf\-- P (-5-1:- $ g Special Instructions: Reprint Permit(per PE): Yes 'No Done Applicant Notified: 4)0y Date: `!l}s—/ Initials: /2.7. I:\Building\Forms1TransmittalLetter-Revisions 073120.doc Branden Taggart From: Branden Taggart Sent: Friday, September 25, 2020 3:32 PM To: kushcarpentry@gmail.com Cc: Allyson Armstrong;Jeremy Burrows Subject: Porch Height Calculations: MST2020-00214 - 16276 SW 104th Ave. Attachments: Benner Porch Calculations.pdf Hello Alex, Our Residential Plans Examiner approved your letter regarding the calculations for the porch roof height change for Billy Benner, residing at 16276 SW 104th Ave Avenue. I see that our Inspector has already passed the Final Inspection, so I have attached the approved calculations above for your records. I have also placed the stamped Site Copy set in the mail to you. Thank you, Branden Taggart n City of Tigard P, Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent@tigard-or.gov 1 OFFICE COPY RECEIVED AUG 2 5 2020 DAN GREEN ENGINEERING, INC. CITY OF TIGARD BUILDING DIVISION 3230 Triangle Drive S.E. Salem, Oregon 97302 Phone(503) 391-2309 Fax(503)566-8660 rns`r202b - 00-2_1y REVISION I IQ1-7(.4, SW AlA -- City of Tigard August 24, 2020 Approved Plans Re: Benner Porch Roof(Job#200613) oy A-is- Date //(/ZOZD Attn. Mr. Alex Kushniryuk ((( rt Per your request we have reviewed the proposed change of raising the porch roof 12" higher than originally specified. We have reviewed our calculations and this change, raising the roof 12" higher, will not affect any of our original work. No additional modifications required. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Thank you, 4�1�Ti�,a W ur,v Dan Green SE ;.' C'4 is �,• , - President/principal engineer S EXPIRES (a 3aJ -i1 " •N ,, CITY OF TIGARD MASTER PERMIT a COMMUNITY DEVELOPMENT Permit#: MST2020-00214 T(G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: Aug 11 2020 12:00AM Parcel: 2S114BB08800 Jurisdiction: Tigard Site address: 16276 SW 104TH AVE Subdivision: SWANSON'S GLEN Lot: 29 Project: Benner Project Description: Install patio cover over existing deck and attached to house. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 0 sf Value: $8,480.76 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT ACS VB R-3 0 Owner: Contractor: BENNER,BILLY&BRITTANY NICOLE KUSH CARPENTRY LLC Required Items and Reports(Conditions) 16276 SW 104TH AVE 17107 NE 2ND ST PORTLAND,OR 97224 VANCOUVER,WA 98684 PHONE: PHONE: 360-213-5529 FAX: Total Fees: $484.74 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 obtai .the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �- Permittee Signature: ~ � /.lirfif—;✓ eary, C,P��39.4175 by 7:00 a.m.for the next available inspection date. 'J/� 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 RECEIVE Co d Residential City of Tigard JUN 2 4 2020 Received DedelBy:7 2 p 4) ParmaNHS7-2p j-JO./y IN _ .1 13125 SW Hall Blvd.,Tigard,OR 97223 p�ReYKw Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD DateiB . Other Permit: FIGARD Inspection Line: 503.639.4175 BUILDING DiVISIO Date Ready/By: hat: El See Paget for Internet: www.tigard-or.gov Notified/Method:� j t)i,h / 77 Suppkmentsl Information 1Cl r ''r "rd°, l l TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction El Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 11/ 4 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead alit sofit for the work indicated on this application. co CATEGORY OF CONSTRUCTION Valuation: $ ' CV t1-$der (6.1-and 2-family dwelling 0 Commercial industrial ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder ❑Other Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 16 `d? �/2 5W t 04i k gder New dwelling area: square feet City/State/ZIP: GI 72 a�aLkCC 1 nl c� o N Garage/carpart area: square feet Suite/bldg./apt.no.: Project name: /Co.._,r./ 8vverr square feet Cross street/directions to job site: p �pver'"'Y"� Deck . u, 3� �� square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: 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 equipment,materials,labor,overhead,and the profit for the tt DESCRIPTION OF WORK work indicated on this application. �V`4r[�// pa[irto411 1"swler 04tr exsi+kJ &04. R acl Valuation: $ tb I7 err St• Existing building area: square feet �/ New building area: square feet Id PROPERTY OWNER 0 TENANT Number of stories: Name: C�iN�y 7E11Ar Type of construction: Address: t 6 d1-7(e 50 , +1n kit., Occupancy groups: City/State/ZIP: q 72a� Ti90 4 (ee3,,,7 Existing: Phone:(J11) d11'ti 175'5 l Fax:( )// New: (APPLICANT pd'CONTACT PERSON BUILDING PERMIT FEES* Business name: Cos Pe n k / L L (Please refer to fee schedule) y Strucnaalplanreviewfee(ordeposit): /3 , pp/ Contact name: 0 le k 5� +�za1G u- , '� FLS plan review fee(if applicable): Address: 17775 S M:\N V\eu" b\u (A3r 307 Total fees due upon application: City/State/ZIP: \jewto \it r v A 1 6%2) Amount received: Phone:(160)2ti. -S 2,9 Fax::( ) E-mail:l(J S�cQC>J�t r} /0� i`.tom PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: kJ5106, l J s i,e„ C., Submit two(2)sets of roof plan with connection details j ` l and fire department access,along with the 2010 Oregon Address: 1777 % ytaP1\ i'lain D\`Je M r 3 elf Solar Installation Special&Code checklist City/State/ZIP:va with .- k,* q r Permit Fee(incltdesplanreview $180.00 and administrative fees): Phone:(3O) v2 -Lj 5 a :( ) State surcharge(12%of permit fee): $21.60 CCB lie:: rZ 9.. S8il i l /4* Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: ie1e k..1SA,r ti.ik Date: (a-/.2-ZGZO Service Board. 1:\Building1Pennits\BUP-RESPerntitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB) I Building Permit Application Checklist One— and Two—Family Dwelling FOR OFFICE USE ONLY City of Tigard Received 2 g AS,_ Permit No.: ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: a Phone: 503.7182439 Fax: 503.598.1960 T I c A R D 24-How Inspection Line: 503.639.4175 CI Electrical 0 Plumbing 0 Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING iTF.AIS ARE REQUIRED FOR P1 1\ 12F1 1F11 ",, "0 ''' I Land use actions completed. See jurisdiction criteria for concurrent reviews. • ■ ■ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 ❑ 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: 0 ❑ 0 5 Septic system permit or authorization for remodel. Existing system capacity . El Si ❑ 6 Sewerpermit 0 I 0 7 Water district approval. 0 ® 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ El ■ 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- (� © 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-fl.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 ❑ 0 and location. 13 Floor plans. Show ail dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. l5 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendum showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0 prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required A 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0 architect licensed in Ore and shall be shown to be licable to theprojectunder review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 1 I"or 11"x 17". 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 25 Building plans shall not contain red lines or tape-ors. "Mirrored"building plans will not be accepted. [r 0 ' 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. �,/ ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. lr 0 ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,dripiines, ❑ 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0 including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:1Building�PeunitslBUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ry of Tigd (e ill Ci d COMMUNITY DEVELOPMENT DEPARTMENT T 1 c n R n Building Permit Review — Residential r. Building Permit #: l'') r 749 20 00 2/9 Site Address: 2 git) /p2/4 A%.e .. Project Name: / -eerier 74 j -+?T' Lot #: Planning Review Pro sal: A/ ✓ A) 2 ?,— Verify address/suite# active in Accela. pr.Ki River Terrac : No ❑ Yes,River Terrace RevienwAddendum Sit Plan Elements: lion Control copies of site plan on 8-1/2"x 11"or 11 x 17"paper rained trees with drip line and tree protection measures loawn to scale (standard architect or engineer scale) : tprint of new structure(including decks) and FFE rth arrow ty locations&easements(required for new and additions) S' e address,project or subdivision name and lot number Sid walk/driveway approach pplicant information(name and phone number) cation of wells/septic systems ri . dimensions and building setback dimensions eet tree size,type and location 111.•uare footage of buildings to be demolished Str t names Vi sting structures on site rner elevations(2'contours if more than 4'differential) Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shownlj es No ❑ Clean Water ' rvices—Service Provider Letter (lot platted prior to 9/10/1995): ��111111��,��, 'equired: Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No I. iS Water Meter Fixture Unit Worksheet—Additiytiirs,Remodels and ADUs 4quired: ❑ Yes,applicant was notified R No Received: ❑ Yes ❑ No DC Exemption for ADU applied for: ❑ Yes ISd No Received: ❑ Yes ❑ No i ublic Facilities Improvement (PFI) Permit: R-quired: ❑ Yes,applicant was notified No .applied For: ❑ Yes ❑ No,stop intake 0, and Use Case#: Zoning: eL2_ '4 quired Setbacks: Front: �jRear: / Side: c— Street Side: r\1J ' Garage: Nl ilding Height: Max. Height: Actual Hei/h�t: ICJ Landscape Area: 02 C9 % Lot Coverage Max: 't/ Ai° � V Entrance t back no more than 8'from street-facing wall ❑ Parallel to s or offset 4.5/degrees or less Windows ❑ Minim 2%of area of all street-facing facades Garage El Garage door is widest street-facing wall Yes ❑ No,one of the following is met: ❑ Door extends no mo an 5'from wall a ere is a covered porch extending beyond garage. ❑ Door extends no more than all and there is a 12 sq ft.window above garage on 2' floor. ❑ Garage door width is ❑ 1 ' ess ❑ or less of facade ❑ 60%or less and includes 7 of following: ❑ Covered porch Recessed entrance ❑ ffset ❑ 1'Roof eave ❑ Roof offset ❑ Fire s es ❑ Lap Siding ❑ Roof pitch le,hip,or gambrel roof ❑ Dormer ccent siding endow trim ❑ Window recess ' dow projection ❑ Balcony isual Clearance rban Forestry an Sensitive Lands: ❑ Yes iZI No Type: o ditions met prior to issuance of building permit No s: Approved By Planning: ^—r- Date: .ZC7 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: ❑ Approved ❑ Not Approved 1:\Building\Forms\BldgPermitRvw RES I 22419.docx Building Permit Submittal Original Submittal Date: 4'/Z i//ZQ Site Plans: # 3 Building Plans: # Building Permit#: Enter building permit#above. Workflow Routing: g--Planning g-'Engineering Permit Coordinator 1—uilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: ❑--Engineering. (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Imo'building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: �/ Date: ��Y�2'D Engineering Review 'Slope at building pad: 2 41.4 'Conditions "Met"prior to issuance of building permit ti Gr- E'Easements (encroachments)per engineering conditions of approval and plat 4 A- a-Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ffis'No Assess Water Quantity Fee in-lieu: ❑ Yes i"No LIDA Facility on lot: ❑ Yes Er No C" Final Plat Recorded: 1444- ❑ NOT Approved by Engineering: Date: Notes: '�' U."Approved by Engineering: /` yy Date: 710-12kza Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review V4 -Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: SDC Exemption: ❑ Received Does not ap ly SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A Tigard Trans SDC: 0 Yes N/A Parks SDC: ❑ Yes N/A LIDA ❑ Yes N/A xr OK to Issue Permit Approved by Permit Coordinator: A Yam/— Date: 1(�co("2,0 (:\Building\Forms\BldgPermitRvw_RES_122419.docx Branden Taggart From: Branden Taggart Sent: Monday, August 10, 2020 6:14 PM To: kushcarpentry@gmail.com Subject: Patio Cover Permit for Billy Benner: MST2020-00214 - 16276 SW 104th Ave. Attachments: Permit.pdf Hello Alex, The patio cover permit for Billy Benner is ready to issue now. The balance due is$347.86,and I have attached an invoice above for you to reference. The permit fees can be paid online through our website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit number (MST2020-00214) in the Record Number field,and click Search. Once paid, please notify us at TigardBuildingPermits@tigard-or.gov, and I will place this permit in the conference room, adjacent to the outer Permit Center lobby, for pickup between the hours of 8:00 a.m. and 5:00 p.m., Monday through Thursday. We are closed on Fridays. Thank you, Branden Taggart 14 a City of Tigard rya Senior Permit Technician Community Development TICARD 13125 SW Hall Blvd Tttgard, OR 97223 (503)718-2449 brandent@trgard-or.gov 1 Building Permit Application RECEIVE Residential City of Tigard JUN 2 4 2020 Deceive 7/1 l20 �?(� P NHSTZo2o-©0�/y ;, •• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960pCITY OrF±TIGARD Dates Other Permit: 1 l t . I,I, Inspection Line: 503.639.4175 BUILDING DIVISIONDate Rcady/8y: Jam ® See Page 2 for Internet www.tigard-or.gov Notified/Method: Snppk festal Information TYPE OF WORK REQUIRED DATA1-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 4 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. q lduws (ell-and 2-family dwelling ❑Commercial/industrial Valuation: $ 1,000 . ❑Accessory building 0 Multi-family Number of bedrooms: 1 ❑Master builder 0 Other: Number of bathrooms: i. JOB SITE INFORMATION AND LOCATION Total number of floors: a Job site address: 16 47 (. 5\ loco), ode, New dwelling area: square feet City/State/ZIP: 912�1 t,1C T,,,, (�,e�leN Garage/carport area: square feet Suite/bldg./apt no.: rroject name: Covered porch area: square feet Cross street/directions to job site: pa. C..led- Deck area: square feet Other structure area: square feet REQUIRED DATA:CQMMERCIAL.VSE CHECKLIST Subdivision: 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 equipment,materials,labor,overhead,and the profit for the DESCIUPTION OF WORK work indicated on this application. tz 'PA Valuation: $ LV`e\t 'P io; CTIar r7Ver GXsilNk Ceti- CIAlcteltebt Existing building area: square feet tet h(,,st.• New building area: square feet PROPERTY OWNER 0 TENANT Number of stories: Name: 1�t1,/ 01 tCnue r Type of construction: Address: vaat/le 5v) ‘ +M P Y4t Occupancy groups: City/State/ZIP: qn`l Trr� tel U{ ac3ot') Existing: Phone:(54 I) CA ill 1/5-5 Fax:( )jj New: Fa/APPLICANT �� CONTACT PERSON BUILDING PERMIT FEES* incas vire Business name: oo Cost Peni I LC. viewere/errdeposit): r7 Structural plan review fee(or deposit): Contact name: 0lrv. kJS\e.r4CV4IC J FLS plan review fee(if applicable): Address: 1777s sti M:\\ P\\Gn N:Ava. iaei- 307_ Total fees due upon application: City/State/ZIP: Voh rover %..)ilt. Co g5 Phone:(?40)a) - v 2,9 I Fax::( ) Amount received: // PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: KJS`1 Cat-Qtri(l7'Mgi1.0 CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: KJ Jn CaCQerA.Y l_L(� Submit two(2)sets of roof plan with connection details j and fire department access,along with the 2010 Oregon Address: 17775 7 K G Yvt'l\ eleili., \aG All- 301 Solar Installation Specialty Code checklist. City/State/ZIP:v ah J,f t� q g 3 $180.00 Permit Fee(includes plan review 8 and administrative fees): Phone:(.lie) �t' -66 aq Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: rZ j S?Ai Total fee due upon application: $201.60 Authorized signature: (/J/1,Q/ This permit application expires if a permit is not obtained IYYYIWWW__!!! WWrr I"� within 180 days after it has been accepted as complete. 1/ *Fee methodology set by Tri-County Building Industry Print name: $41,e:� I<JS,hC,JILL Date: 6-1 /-2020 Service Board. I:\Building\Permils\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)