Permit FOR OFFICE USE ONLY—SITE ADDRESS:
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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
illill
_ ` Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: i4 I 9 t& DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: o{ J o 5drL J U N 06 2022
CITY OF TIGARD
COMPANY: 9UILDING DIVISION
PHONE: a-9 O. 39/7 By:__KA
EMAIL: CCO O r(k n @ ko -'1446 \ , C '-
RE: f;D e 5 5kt, l Z.u)YI C4— M Y zO 2_2 ..7,_/)022 65
(Site Address) (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):(e�
REMARKS: ( ,r l_5/( O be_ Fed,m
Ito n - gee & }z. iddt b0.4-X-ea4k ha 4 L;'tr fRooiv
/ FOR OF ICE USE ONLY
Routed to Pe it Technician: Date: 4.y i 3 Z2 Initials:
Fees Due: Yes ❑ No Fee Descripti n: Amount Due:
$ /7-,U
12 WI aN (\ (.12,Vl.` $
1 $
Special
Instructions:
Reprint Permit(per PE): ❑ Yes CIA. ❑Done
Applicant Notified: Date: Initials:
I:\Building\Forms\Trap smittalLetter-Revisions_073120.doc
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BUILDING DIVISION
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CITY OF TIGARD MASTER PERMIT
`` COMMUNITY DEVELOPMENT Permit#: MST2022-00065
T i GA R rt 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/04/2022
Parcel: 2S111 DB13800
Jurisdiction:
Site address: 15085 SW DAWN CT
Subdivision: LAUNALYNDA PARK Lot: 3
Project: DIKE
Project Description: Add 4'window opening to Family Room
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: $400.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays. 0 Rain Drain. 0 Jnnais
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 SrvclFeeders 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/0 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:
DIKE,GLORIA CHIGOZIE OWNER Required Items and Reports(Conditions)
615 NEW WILLOW ST
TRENTON,NJ 08618
PHONE: PHONE:
FAX:
Total Fees: $94.79
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rule forth in OAR
oc9-nnl_nnin e.rnnnh flAP g59.nn1_nnon Vn„mmr nhtsin re no, ha rnloc nr direM ell iaetinnc In nl IN(^.by neeinn 5ii 939 10/17 nr 1 914d
Issued By: Permittee Signature:
503.639.4175 by 7:00 a.m.for the next available inspects n date.
This permit card shall be kept In a conspicuous place on the Job site until completion of the project.
Approved plans are required on the lob site at the time of each inspection.
Building Permit Application
Residentialwilimommilifii
` , City of Tigard DateBy:s `�/J/i/, rt_ Po mit No.: [4 "')a2n...a�iios—
'14 13125 SW Hall Blvd.,Tigard,OR 9 223 t E I,J C D Plm Review � �,'Q Jr/7I (�
■ Phone: 503.718.2439 Fax: 503.59 .1940 ,:4 V C Dare/BR `'� Other Permit:
T 1 GARD Inspection Line: 503.639.4175 Dam Ready/By: Jaris 61 See Page 2 for
Internet: www.tigard-or.gov Notified/M Sappkmestal Information
MAR 8 2027
TYPE OF WO$ .,, OF TIGARD REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction [,� �I qTi++''i p, ' Permit fees*are based on the value of the work performed.
ILL)I,Nt,, DIVISION Indicate the value(rounded to the nearest dollar)of all
%Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
�� Valuation: •S () -.
1t _and 2-family dwelling ❑Commercial/industrial
0 Accessory building 0 Multi-family
Number of bedrooms: ,(Q1typerAti
❑Master builder ❑Other: Number of bathrooms: -"' 1341 +.445
JOB SITE INFORMATION AND LOCATION Total number of Hoots: /
Job site address: t5Q 8 Sur � _ —
-6, New dwelling area: �� square feet
City/State/GIP: '�y ay.e, a. .. q ?a z 4. Garage/carport area: square feet
Suite/bldg./apt.no.: ifI Project name: 5J;K.€ �� Covered porch area: square feet
Cross street/directions to job site: 5{hDTL�., f q Z to V G e Deck area: square feet
1R.-:c 444J) i...c j r IA) i tic/.1.r f -. .fn.., Other structure area: square feet
gialii bt Area / ✓ ;V- • S L.:A/'rT. lgt/?.' /1.%'. REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*arc based on the value of the work performed.
Tax map/parcel no.: 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.
A' y 4Dx /I 0 4- -i< 1 e2C t,rn� Valuation: $
II JO)I Cg v ilt( ro ate, J1 �Tt7 I / Existing building area square feet
New building area: square feet
pa PROPERTY OWNER ❑ TENANT Number of stories:
Name: (x H . 6' . .V I Type of construction:
Address: /.JrQg5 S(,S 3.)a(/rA'1 Ct Occupancy groups:
City/State/ZIP: 7-('a 4 e2 17 2 2. i Existing:
Phone:(q;7 ) �g'�; 7 /I g Fax:( ) New:
0 APPLICANT OCONTACT PERSON BUILDING PERMIT FEES'
Business name: (Please refer re fee scher le)
Structural plan review fee(or deposit):
Contact name: r G � 011 y D
Address: jet, FLS plan review fee(if applicable):
City/State/ZIP: A[- Total fees due upon application:
p J Amount received:
Phone:(6'j)j Q0-„� c g 9 Fax::( )
E-mail: 6 rap Ps,M 4 I `/�`,/�9 t . cow\ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
1p
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: �y i✓S� 0. � 4, Submit two(2)sets of roof plan with connection details
"� and fine 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 lie.: - Total fee due upon application: $201.60
Authorized signature: WO'
/e'r ' This permit application expires if a permit is not obtained
within 180 days after It has been accepted as complete.
Print name: cirfR7 ` CPC Date: c2.2,8-2 .Fee methodology set by Tri-County Building Industry
Service Board. 4..
l:\Building\Permits\BUP-RESPerrnitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) ' "rl' �
Branden Taggart
From: #Building Permit Technicians
Sent: Monday, March 14, 2022 12:10 PM
To: 'cobranwl@gmail.com'
Subject: Building Permit for Gloria Dike: MST2022-00065 - 15085 SW Dawn Ct.
Attachments: OwnersConstructionResponsibilities.pdf; Invoice.pdf
Hello Richard,
The Building permit for Gloria Dike has been created. The balance due for plan review is$34.63, and I have attached an
invoice above for you to reference. This fee can be paid online now at https://aca-
orod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number MST2022-00065 under the Building
tab.There is a 3%service fee for credit cards, but e-checks do not have a service fee.
Once paid, please email the Permit Technicians at TigardBuildingPermits@tigard-or.gov so that we may begin plan
review.
Please note that we will need to receive a signed Owners Construction Responsibilities form from Gloria before we can
issue this permit.
Thank you,
Branden Taggart
v City of Tigard
u • Senior Permit Technician
Community Development
Tt4MD;
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or:g ov
1