Permit Support Document Building Permit Application
Commercial r i
l" FOR oFI�ICE' ( sl:c)Ni,\
of Tigard
'�" Received {
- 't City5 gDate/By: 1/5/ j■•-- Permit No.: f,J ale'}It -dual.Y
13125 SW Hall Blvd.,Tigard,OR 97223 { �/// �"r J`(/
g 11111
S E P 2 9 2020 Plan Review
Phone: 503-718-2439 Fax: 503-598-1960 Date/By j — ) ) -a) Related'Permit./Q,� i� ��
TIGARD Inspection Line: 503-639-4175 rY OF i ' Date ReadyBV' Juris: RI See'Page 2 for
Internet: ov www.ti ard-or. n Notitied/Method: , Supplemental Information
www.tigard-or.gov r-tt lti r)?I\"r i";I�,.4 i�....
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑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, 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OI CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ElCommercial/industrial Valuation: $
ElAccessory building ®Multi-family Number of bedrooms:
❑ Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13070 Sw Ash St New dwelling area: square feet
City/State/ZIP: Tigard, Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: Alderbrook Apt's Covered porch area: square feet
Cross street/directions to job site: Sw Hill street Deck area: square feet
Other structure area: square feet
REQUIRED DATA::COMMERIL-CSE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Remove and replace 15 decks per existing permit BUP2019-00272 Valuation: $ 52,500
Units#2/3/6/7/18/19/22/23/26/27/30/31/34/35+- 1(47 Existing building area: 30,600 square feet
New building area: square feet
Ll PROPERTY OWNED ',,. „i;... ,
,6 0 T` ��� ,., ,,. =;:.,Ziii Number of stories:
Name: Patrick Carney CO Norris&Stevens Type of construction:
Address: 900 SW 5th Ave 17th Floor Occupancy groups:
City/State/ZIP: Portland, Oregon 97204 Existing:
Phone:( 503)223-3171 Fax:( )
New: .
Ig APPLICANT 0 CONTACT PERSON BUILDING-PERMIT FEES*
Meese refer€o.ee schedule)
Business name: T&H Homebuilders.lnc
Structural plan review fee(or deposit):
Contact name: Simhoni Cohen AKA Jack
- FLS plan review fee(if applicable):
Address: 21611 S,Clearview ct
Total fees due upon application:
City/State/ZIP: Oregon City, Or 97045
Amount received:
Phone:( 503309-1819 Fax: :( )
E-mail: jack@tandhhomebuilders.com PHOTOVOLTAIC 5t1LAItPANEL SYSTEM FEES*
Commercial and residential CONTRACTOR roof-top mounted Photovoltaic Solari Panelve installation of
System.
Business name: Same as above 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
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: 204877 Total fee due upon application: $201.60
. as,
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
* Fee methodologyset byTri-Count Building I Print name: Simhoni ohen Date: 9/15/2020 }' Industry
Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(1 I/02/COM/WEB)