Permit 151 CITY OF TIGARD MASTER PERMIT
�~ ' COMMUNITY DEVELOPMENT Permitlt MST2022-00460
Date Issued: 11/10/2022
T I i;A I'.17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134AC06200
Jurisdiction: Tigard
Site address: 10822 SW 109TH AVE
Subdivision: HARTS LANDING Lot: 33
Project: Feebeck
Project Description: Voluntary replacement of Thermoply sheathing and replacing with 1/2" CDX plywood.
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: $9,620.00 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
Fum>=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'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:
FEEBECK,PAULINE D TRUST A CUT ABOVE EXTERIORS INC Required Items and Reports(Conditions)
10822 SW 109TH AVE 12985 NW CORNELL RD
TIGARD,OR 97223 PORTLAND,OR 97229
PHONE: PHONE: 503-639-7172
FAX: 503-639-9755
Total Fees: $252.90
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and II othe 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 is an or if rk is suspended for more
the 180 days. ATTENTION- Oregon law requires you to follow the rules adopted by the Oregon Utility Notification nter Th rules are set forth in OAR
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Issued By: o,1.l-✓I C1V Permittee Signature:
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 complet n of the project.
Approved plans are required on the fob site at the time of each inspection.
Building Permit Application
Residential FOR OFFI( 1_ I f tl.l ,
City of Tigard Received
71 Date/:
• 13125 SW Hall Blvd.,Tigard,OR 97223 lii
Is IIJti.— .1 .r
Phone: 503.7182439 Fax: 503.598.1960 Plan Review
Date/B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: uric: id See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 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.
Addition/alteratiorl/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
land 2-family dwelling ❑Commercial/industrial Valuation: $ f/ivo20
ElAccessory building ID Multi-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16$),Z r5i.1 to`}itl Ave.... New dwelling area: square feet
W
City/State/ZIP: n
T / �� ! o 7j Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: rec.,bakes yt4._ Covered porch area: square feet
Cross street/directions to job site: Deck area:
square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are 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
r(F "DESCRIPTION OF WORK work indicated on this application.
-Tear O 1 f)C YWIfJ Ply G1'V ay.P11 '(,P','[J�t'0 CX. Valuation: $
LA'.i O� `iat' G p x )�� wn(xA I Existing building area: square feet
Cr PROPERTY
building area: square feet
I I PROPERTY OWNER 0 TENANT Number of stories:
Name: P, `,
" ^`S V\>� � k 4IQType of construction:
Address: I D 8) S vJ )C)`lk AV-t,
Occupancy groups:
City/State/ZIP:Tl fA colk aye (�—7 23
7 Existing:
cl
Phone:(503) `fit\b-'3 I-3 Fax:( ) New:
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: Cs�.\- Nno J e L LQr,o, (Please refer to fee schedule)
Contact S6 T Q ` Structural plan review fee(or deposit): 4)5 r1 '
name: Z j {�Y V 1 C1 r0\cC� �[ }�) FLSplan review fee(if applicable):
Address: I t D` S tki kit it e S 1/.-7 JpiA
d l! PP ):
City/State/ZIP: Pocl )0,it/4, a/ )'of �l Total fees due upon application:
Phone:(3 ) ) i Fax::( 7 )
(o b 7 -yr9 3 Amount received:
E-mail:JUST t 6 0.\0L\NQ 1_I1a'5 i C�.�m PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: nv� Submit two(2)sets of roof plan with connection details
Address: and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review
Phone.( ) Fax:( )
and administrative fees): $I80.00
State surcharge(12%of permit fee): $21.60
CCB lic.: t5 31.. Ia131/e
Total fee due upon application: $201.60
Authorized signa i This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: *Fee methodologysetby tyBuilding
Date:1(-.)0 - 2-6 a.� Service Board. Td-Coon Industry
I:1Building\P 'ts\BUP-RESPetmitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)