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Permit '-)(\ Buildintz Permit Application 37/ 3 Residential RE FIVV ":, FOR DFDit IC t sly.(l.l.1 �L' City of Tigard R` Date/By p82a. 20 Permit No.:pf��aaX -e021/ II • 13125 SW Hall Blvd.,Tigard,OR 9722$I y n3 20�� Plan 2� II Phone: 503.7182439 Fax: 503.598.1 1 Plan Review ( Other Permit: Inspection Line: 503.639.4175 � 4;y Date Ready/By: Juris: E See Page 2 for 1 I t'A I`D Internet w .tigardor.gov C I T t OF f i C.)}-1 I ti Notified/Method: tG/ /7 Supplemental Information ,�.t it7'ww )) W YYLI`fot r eW TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all rkt Addition/alterationlreplacement 0 Other: equipment,materials,labor,overhead,and the profit for the "'Y CATEGORY OF CONSTRUCTION work indicated on this application. (03,6771 Valuation: $ FL I-and 2-family dwelling 0 Commerciallindustrial ', ❑Accessory building 0 Multi-family Number of bedrooms: (� ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 1, Job site address: ) S?7 5 t.J 5e.:r-�. Ds" New dwelling area: _'I O square feet City/State/ZIP: )11 ye&..d o g- 617 y2 9 Garage/carport area: - square feet Suite/bldg./apt.no.: ) Project name: cc// Covered porch area: — square feet Cross street/directions to job site: 1 To t k. .4 )7„,,,i JZ 5f`r ct+- Deck area: — square feet Other structure area: — square feet f REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: e;1j V /tvJ Ce..Le CS�o-t/� .s I Lot no.: C- Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: p • equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK I (F./ -Lrp(1✓ � work indicated on this application. ' I GGffrra Valuation: $ Existing building area: square feet t-ar✓ez Eyt bni .( 0,-----*-- r C'.'pa+, , t/tfa ew br V' ( s pAtL J j(A_ werli o rics &New building area: square feet er. roof/v..;PROPERTY OWNER 0 TENANTo�jo Number of stories: Name: f7>vt 4,,.1 ( .a/hn t, Type of construction: Address: i 7 cr 4,4 ; -e./rt-L ! ✓ - Occupancy groups: City/State/ZIP: /f ebb. d. oiL '722.7 Existing: Phone:(503)Zj -O$22-i" Fax:(5-j03) 2.l7-- G a g r New: fgf APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedate) Business name: Structural plan review fee(or deposit): /q ., Contact name: 3 r. j d,,r. 6,0 II l r) FLS plan review fee(if applicable): Address: /53 7 ,.. -t.�% 'e.r t4, 2e . Total fees due upon application: City/State/ZIP: l i e e,t, c t7 fl, 4722'‘{ Amount received: Phone:(45,3 ) 17e:j,-' ...°? ) Fax::(50 ) 2.13-' 40 GT PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: Iota l/rrJS ;r Govnce.,S '- rG-4. Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: cp.,r-,e,-' Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 tY and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: 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. Date: �3 I *Fee methodology set by Tn-County Building industry Print name: i3� P , �� ��✓I Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02h4/2011 440-4613T(11l02/COM/WEB) Property Owner Statement ` Regarding Construction Responsibilities AUG3 2020 Oregon Law requires residential construction permit applicants who are not licensed with the ' lGMoID Construction Contractors Board to sign the following statement before a building permit can be_)y\J S Okl issued. (ORS 701.325 (2)) This statement is required for residential building,electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or XI will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. • Print Name of Permit Applicanjt , 2/2-0 Signature of Permit Applicant Date Permit#: 57 3 1 —G d11 �l Address: 63 7a2 SA) Se4te a- Issued by: kitE Date: 10151202 ) This Copy for Permit Offices We received a Residential Building Permit Application in person to finish an unfinished basement. However,we did not receive plans to review with the application. We will need to receive (3) copies of a floor plan drawn to scale,showing the following information: V Square footage of the basement. ( F V E L) ( Type of insulation. �/� f Bedrooms-- if applicable.r AUG 13 2020 Smoke detector location(s). pl Window egress or emergency escape.— NA GIN OF TICA'J C'rl 1 1 ))!Nr. M)S:O)'I Additionally,we will need you to sign the application for us to proceed with plan review. I have attached the application above for you to resubmit with the plans when you have them. We are going to recycle this application. Please let me know if you have questions. Thank you, 1 Brandon Taggart City of Tigard It Senior Permit Technician Community Development TIC ARC). 13125 SW Hall Blvd Tigard,OR 97223 (503)71B-2449 brandent©tigard-or.g ov Branden Taggart From: Branden Taggart Sent: Friday, October 2, 2020 4:00 PM To: 'bcolling@comcast.net' Subject: Building Permit: MST2020-00249 - 15372 SW Seine Dr. Attachments: Invoice.pdf Hi Brian, Your Building permit is ready to issue now. The balance due is$2,279.71,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 (M5T2020-00249) 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 our open Permit Center conference room for you to pick up between the hours of 8:00 a.m. and 5:00 p.m., Monday through Thursday. We are closed on Fridays. Thanks, Branden Taggart City of Tigard ■, Senior Permit Technician. Community Development 13125 SW Hall Blvd Tigard,OR 97223 1503)718-2444 b randent©tigard-or.gov 1