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Permit Support Document VOID 4/ 0 , Building Permit Application ��Y/ ` d`2tl Residential R.ECEwE �'�,,�/� City of Tigard Datc/Bed l ,y Permit No.:/5-7- Y`� - /Ltl "� r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review JAN 14 2020 Other Permit Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 1'f G A R Cs Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: % a!i Supplemental Information BUU DING DIVISION Indicateenniteb._. the ❑New construction ❑Demolition Pen-nit fees*are based on the value of the work performed. the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,mate .Is,labor,overhead,. d the profit for the workindicated N . application. 1.1 0 I-and 2-family dwelling 0 Commercial/industrial vuatio �t $ , ❑Accessory building ❑Multi-family v,i` bri.. i ooms: , 0 Master builder 0 Other: Nur 9�''e?��bathroor OZ,'. ., 14 IMeO 4�,4.TIO! 1D LO' ll N. -Oi% RR �; a ��Ztairrumber o' oors: Job siteaddress: `' . 1 OS Sj 0 Lc, rt � u �' �` New dwell g area: / tK2z) square feet City/State/ZIP: 1r 1 - (� /i0 `V .� Garag- arport area: ' Ji(3 square feet f Suite/bldg./apt.no.: 1 Project name: // Co ered porch area: square feet .i. Cross street directions to job site: N. /\ �V Deck area: square feet ON. V„� L/ , S Other structure area square feet \ 11KVV/ ,. ... _'iCOMMERCIAL-USE CUE C UST Subdivision: t no. li 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.: equipment,materials,labor,overhead,and the profit for the s t lQ� work indicated on this application. _..x..— 1 itra et LL 9 EP c y. . k. k91L9.Q-.w.. J,r � '� Valuation: $ c�ri — AZ. v✓Ncn n ' (v ems^ ��o� �1` Existing building area: square feet efDil New building area: square feet - Number of stories: Name: t©g L,o Li_(.> Type of construction: Address: pQ go < , --?'- Occupancy groups: City/State/ZIP: cic ✓et-C,r f 5 i 0/C ' 33 Existing: Phone:I `2, ,_.6 ct Fax ( ) New: . AN t ACT PERSON � � 0 - Business nan e: �' Structural plan review fee(or deposit): Contact name: /*late/ �I' FLS plan review fee(if applicable): Address: ,fe F)7G ( City/State/ZIP: arX�' 0 L 9 Total fees due upon application: y Lv V f S Amount received: Phone:( ec sitr 2'>0-`f, " 1- Fax::( ) P.1.40110s Email PICo�B5fz 2s, �l)4 l l- � " . . M ..,, ,x. ., ,,.. . . , roof-top mounted Photo' > � r residential prescriptive installation of __ _ oltarc Solar Panel System. Business name: DDf+lx<.�� : Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: e0 e �1,( l,( \ l 6 Solar Installation Specialty Code checklist. y r i�e v� O k `'a k Permit Fee(includes plan review $180.00 City/State/ZIP: N' � `f and administrative fees): / i Phone:(c>'4 O 'Zco --�.7 it 7 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: ( '3 ?) 1 4 Lt t Total fee due upon application: $201.60 Authorized signature:/ v `� ,tk._ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: &Iv . _ ie.esc Date: ( /(Ii I.2t, *Fee methodology set by Tti-County Building Industry Service Board. I:1Boilding\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)