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Permit r q CITY OF TIGARD MASTER PERMIT `�'## COMMUNITY DEVELOPMENT Permit#: MST2021-00444 Date Issued: 12/07/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134C1302000 Jurisdiction: Tigard Site address: 12145 SW SUMMER CREST DR Subdivision: SUMMER HILLS PARK Lot: 19 Project: Randall Project Description: Installing non load bearing walls to form small hallway and laundry room. Relocating closet wall, installing exterior door from bathroom and 24"window in water closet. Trade permits to be pulled 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: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $8,500.00 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 Drains: 0 Storm Sewer 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 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'l 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: RANDALL.SEAN A&LENORA R Required Items and Reports(Conditions) 12145 SW SUMMER CREST DR Q )`r-N TIGARD,OR 97223 PHONE: PHONE: FAX: Total Fees: $374.24 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 1 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 oc9-nn 1-nnl n throne h nap ac9-nnl-nnan Vnn may nhfain a rnnv of the n!lac nr r1irerf nuaeflnne to ni IN(`by nallinn cn1 919 10R7 nr'I Ann 119 91d4 Issued By: HoU,y Uo ©e- We-9e- Permittee Signature: OI'L'A Call 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 iob site at the time of each inspection. ... ding Permit Applicat CEIVED 43 Residential LL.. FOR OFFICE USE ONLY OCT 1 12021 Received MS 2o2/-Oa�lt4f City of Tigard /D//�(Z021 Permit No.: ,11111 .1 13125 SW Hall Blvd.,Tigard,OR 9 Date/By: I g tv OF TIGARU Plan Review I I Phone: 503.718.2439 Fax: 503.59 Date/By: 6°7jfQ/ IA Other Permit: I WARD Inspection Line: 503.639.4175 3UILDING DIVISION Date Ready/By: ( � Juris: la See Page 2 for Internet: www.tigard-or.gov Notifie d: /2 Supplemental Information TYPE OF WORK REQUIRED DATA:1-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 e `Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1-and 2-family dwellingValuation: $ 5 OD 0 Commercial/industrial i, ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: f Job site address: 1,2. 1 " iann>Of C r Dr i V- New dwelling area: ,,a-- square feet City/State/ZIP:�) y(1 0 Z. Garage/carport area: square feet ,�' Suite/bldg./apt.no.: -�"` Project name Covered porch area: square feet Cross street/directions tojob site: 1 • 2 Deck area: square feet Other structure area: square feet ,T/ REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision'. 1 , c' Lot no.: k,C�i Permit fees*are based on the value of the work performed. Tax map/parcel no.:n —' 2 Indicate the value(rounded to the nearest dollar)of all y equipment,materials,labor,overhead,and the profit for the 1 . # �"' F s s T �!#;!., ;Iv f &. °.0,1;: ,Irr fiir t tl ijt �s top` �d J, iki ate ik t? ,,(w r 4-•II=4•',i , •;� 1<<.,a work indicated on this application. • Valuation: $ h Wi14 rl n oat' bea(ing tct 5 • Cal Sma \COW a�) `�u-'a ro Ur 1 ( csA0�S3-ei+ Existing building area: square feet �� (Ih 4 i( New building area: square feet ,,,_: „ � " NANT Number of stories: Name: S e G�- o>r , 4 Mil Type of construction: Address:l2( LS ��ti't ��m i /3 I�\� Occupancy groups: City/State/ZIP:"—c\• A.) d_ (lQ (�l 3 y�� 9 Existing: Phone:(5, 3) 3 i► 2 i ii( ►, Dl �'`1/ S K� V ) New: Business name: A Structural plan review fee(or deposit): /34•8X' Contact ` . / ' ilk I ii,I i 1 / r % FLS plan review fee(if applicable): Address: F �+_ r�4 f_ 91�1 Total fees due upon application: City/State/ZIP: 0.,�-(i Fax A ll�`` Amount received: Phone:( ) Fax::( ) �(') f deli, ^ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: 5 Cil l i C. 5ma 1 l• corn Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: �l f��(�/" Submit two(2)sets of roof plan with connection details C/ and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review and administrative fees): $180.00 Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 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. Print name: S.Qay> R antiA Date: (0/i 1 j *Fee methodology set by Tri-County Building Industry 2_ Service Board. I:\Building)Permits\BUP-RESPcrmitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) li 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 _ 11 Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: I'LI O t\ CU"mYOr)O) DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: gQC.h * Ler or&- 6thcla.l( OCT 21 2021 COMPANY: CITY OF TIGARD PHONE: S. "3�C) -L /9 } J 5 C j i g BUILDING DIVISION BY EMAIL: Vie•h rorid czi l (-W c ra.;I LQ.11 Of a .(1-(h 1 0 0)n•Ni l r C Q a RE: 121(45 S ) SurnmQ1' C SC- Oil v"2- MST2021'004411 (Site Address)—t1 6 (412c.9 (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Q!4141 Additional set(s) of plans. 1( 3 Revisions: GS w idO J • Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. f Engineer's calculations. - Other(explain): e,(PC*1 CCII `�QY hr11k —L-C 2021 -O� 5 1 s 1^Pd .-fit r ) 7-1 d an ION/21 - wQ I it REMARKS: 4�b 1 h��� rn �� Ski)h���Cd � �� r�SUI�rn {�- S C �(an1� ro(). s0Oc cat-Ti Ins rL1hc W >S. 1 eew vs 0 e1 ,,.r ;Dec r t/ il9 .'"C:«bIt- e.4td ��+L 4r:,.� .61(VP^difia �e,12,.�1 Oiw £r )ter . .��,� 411 st 44 r '�'� CZ{1'�'► /j..6(1 'r i.�►"'tr'S-c�tiY•t,s` P'�CS�.fM-�'1f FO OF ICE USE ONLY Routed to Permit Technic : D . D� 'Z1 Initials: Art" Fees Due: ❑ Yes [1]N� ee Description: Amount Due: DIJ $ Special Instructions: Reprint Permit(per PE): ❑ Yes [✓No ❑ Done Applicant Notified: Date: /i (3/_L j Initials: Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be 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 I 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 Applicant ® /( I (z t Signature Ap plicant Date Permit#: CIF O� Address: (V" Issued by: Date: 59 This Copy for Permit Offices