Permit CITY OF TIGARD MASTER PERMIT
Ili.ri COMMUNITY DEVELOPMENT Permit#: MST2021-00015
Date Issued: 02/17/2021
TtGARI7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134DA07400
Jurisdiction: Tigard
Site address: 11220 SW BUFFALO PL
Subdivision: DAKOTA MEADOWS Lot: 7
Project: Fraser
Project Description: Replace fire damage roof trusses, sheathing,floor and deck framing. Replace rated walls and
interior finishes.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: Q sf Front: 0 Smoke Yes
Right: 0 Detectors:
Dwelling Units: 0 Third: 0 sf Ri 9
Total: 0 sf Value: $75,000.00 Rear: 0
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 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0
Drywall-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 SrvcfFeeders 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 N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT
SF VB R-3 0
Owner: Contractor:
DONALDSON,TERRY PURE ENVIRONMENTAL NW Required Items and Reports(Conditions)
11220 SW BUFFALO PL 8206 N FESSENDEN ST
TIGARD,OR 97223 PORTLAND,OR 97203
PHONE: PHONE: 503-569-8425
FAX:
Total Fees: $1,638.33
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: 4" ol►'ATIN t W"C- ..A.... Permittee Signature: _V\ r t C ck\V•-••
all 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 /r1 _A
Residential w�v / , ; ,„ , I, , , ;,,,
City of Tigard E V V may: aZ 2/ '� Permit x0.N(s�7-O.ZLYS
13125 SW Hall Blvd.,Tigard,OR 97 Plan Review1 n r '
8 Phone: 503.718.2439 Fax: 503.598.1960 DardBy_ !�1 Permit:Inspection Line: 503.639.4175 TAN 19 2021 Dn�e Ready/By: kris. GI See e 2 rerwrnro
Internet: www.tigardor.gov /
t:1TY 0 TIGARL; sapp{m.earmarte.
Me OF WILDING DIVISION REQUIREDDA A:1-AND 2-FAIMILYDWELLING
❑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
❑Addition/alteration/replacement &YOthet: Ptge O,*fMCve equipment,materials,labor,overhead,and the profit for the
/ CATEGORY OF CONSTRUCTION work indicated on this application.
and 2-family dwelling 0 Commercial/industrial Valuation: $ /SI�Q —
@
❑Accessory building ETMulti_family Number of bedrooms: Z
❑Master builder 0 Other. Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
lob site address: 1 l Z2_0 SW Is.t a1'tc, pc_ . New dwelling area: 14 square feet
City/State/ZIP: Gana e/ca o
'T"l 4 f� 0 Q 41 la g rp r area: square feet
Suite/bldgiapt.no.: Project name: Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
- i _ Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: 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.: 1 S 13 4 "Dh01 ii-00
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
"QEPIhCE F.
R\ � pXrrae4,Gt+ TWOP. -(r-Vas 6c t $H-E�?>kt►ret Valuation $
FL-+�Q A►JD /JE(.1L PI 4-rc a•14 t2`C.PA1 p�-TC_D W 1,1 > Existing building area: square feet
R+r'A^ I 1 f.BtoG,
(d Q tout 5f(FS ��G ina�. S?1]�:.t't9�"\Q \.UNew building area: square feet
'PROPERTY OWNER TENANT -lumber of stories:
Name: f.lztSF..R_. Type of construction:
Address: j l ZZ,p SW g(Urigkto 1'C Occupancy groups:
City/State/ZIP: -7—i44,0.0 e R- 1*L.q,3 Existing:
Phone:( ) Fax:( ) New:
:erAPPUCANT (2 CONTACT PERSON BUILDING PERMIT FEES*
Business name: '�p IS L C Meese Mar role.awe `)
Structural plan review fee(or deposit): 696,.5i
Contact name: rse tLEGA" Hh'iDBN
Address: 33 4 �' NE -2-5 a-4� FLS plan review fee(if applicable):
City/State/Z1P: rci 4��y). 0 S'•}ZtZ,
Total fees due upon application:
Phone:(573) 6$0 • l 0 1 1- Fax::( ) Amount received:
E-mail: OQ,�,Aki d, T L tHrr rori L L . u+tit PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PbotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: �t!rm. (6 I•a 4 I eetz M E p.n..,f.
and fire department access,along with the 2010 Oregon
Address: S Zd4 N FEs S r✓OD Et, Sr Solar Installation Specialty Code checklist.
City/State/ZIT): ?MT usko. d ji, i LA 3 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:(Ss b) S 65. g Q vs- Fax:( ) State surcharge(12%of
/ permit fee): 521.60
CCB lie.: 121 4s 6 3 a/'q( Total fee due upon application: S201.60
Authorized signature: This permit application expire'if a permit is not obtained
r within ISO days after It bat been accepted as complete.
Print name: t ��� Date:ellI i''j,02.( +Fee methodology set by in-County Building Industry
Service Board.
\Buildin 'ts1BUP-RESPenni .doc 02124/2011 440.4613T(I1/02/COM/WEB)