HomeMy WebLinkAboutRES2025-0047 BUILDING PERMIT APPLICATION RESIDENTIAL - FILLED Building Permit Application
Residential FOR OFFICE USE ONLY
City of Tigard Received
By: Permit No.:
II ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 4 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK 11 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
■ 1-and 2-familydwellingValuation: $40 QQQ
❑ El
❑Accessory building El Multi-familyNumber of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12828 SW Walnut St. New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: 528 square feet
Suite/bldg./apt.no.: Project name: 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
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Carport attached to garage -
Existing building area: square feet
New building area: square feet
❑■ PROPERTY OWNER ❑ TENANT Number of stories:
Name:Brian Lewis Type of construction:
Address:12828 SW Walnut St. Occupancy groups:
City/State/ZIP:Tigard, OR 97223 Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
ii (Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax: :( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:brianlewispdx@gmail.com
li Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:SJ PDX Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:sean@sjpdx.com Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 971777-1260 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:247484 Total fee due upon application: $201.60
Authorized signature: ( i-, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Brien Lewis Date:JUly 8, 2025 Service Board.
I:\Buildmg\Permits\BUP-RESPermitApp.doc 01/25/2023 440-4613T(11/02/COM/WEB)