HomeMy WebLinkAboutRES2025-0027 APPLICATION Building Permit Application
Residential FoRO1,Fic i.: usEONI.)
Received Permit No.:
City of Tigard Date/B :
II g 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Other Permit;
Phone: 503.718.2439 Fax: 503.598.1960 Date/B
Inspection Line: 503.639.4175 Date Ready/By: Juris: FA See Page 4 for
C I G A it l) p 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.
Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION '
Valuation: $ Gj
' -and 2-family dwelling ❑Commercial/industrial y t��(�(�
Number of bedrooms:
ElAccessory building 0 Multi-family
Other: {� Number of bathrooms:
❑Master builder 56 bt LL ee pla/1,7) 4
JOB SITE INFORMATION AND LOCATION Total number of floors:
New dwelling area: square feet
Job site address: 15 iso to tsw A st e,aS j QYn �1 i/(1
City/State/ZIP: '`r j O( (i be q 7 a ). Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 2.)00.171 ��L(L Covered porch area: square feet
Cross street/directions to job site: Deck area: az) square feet
dL0 `��^ ' I��ii„�LJ . �i J t Other structure area: square feet
I REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: 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.: '7 y i. 0 S‘D VL. equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
L L L-Ch J )
r�>inL� 4.4„ish,e r1�!
I `' �,, Existing building area: square feet
CI L-� '►7 `�a` �� r2��� New building area: square feet
0 PROPERTY OWNER
0 TENANT Number of stories:
Name: V .a.(1 SO ,, Z. b14.(i Type of construction:
Address: nStei)c i D 6) Dr! i/G Occupancy groups:
City/State/ZIP: -Fl Ct ici 0 p g 7 Z 23
Existing:
Phone:( ) Fax:( ) New:
„OfAPPLICANT 1 ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: ��� \''' G�i or Li c. Structural plan review fee(or deposit):
Contact name: 1-4Lict.i St atry., FLS plan review fee(if applicable):
Address: 22 I`3-1 S. J)aycf- /ornet.J i2e1 Total fees due upon application:
City/State/ZIP: LI S 1 tun d, D 2 0702 3 Amount received:
Phone:(5 D3) to3b- (p�I`� (p I Farx1::( ) / PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: (1 eft L1'S . 7,ecl61to. i-' r cog.meal,'. I mc- ) Commercial and residential prescriptive installation of
�" CONT CTOR roof-top mounted PhotoVoltaic Solar Panel System.
� Submit two(2)sets of roof plan with connection details
ll
Business name: J6 y4.1 l_�v/j Ne(,t' c and fire department access,along with the 2010 Oregon
Address: 1 3 3 �� .�tv r�J .c\ A)) )i p
Solar Installation Specialty Code checklist.
Permit Fee(includes plan review $180.00
City/State/ZIP: T et LL 44L no o o1 70 Z? and administrative fees):
Phone:(CT7l) 60,6 - I c -I r Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: t2 i5a 29t. Total fee due upon application: S201.60
Q /j�J This permit application expires if a permit is not obtained
Authorized signature: �j� within 180 days after it has been accepted as complete.
j —►'/ 1 *Fee methodology set by Tri-County Building Industry
Print name: S/ j i/j -I m I Date: Jj j�� Service Board.
I:\Building\Pe/rmTits\BUP-RESPermitApp.doc 01/25/2023 440-4I613T1(11/02/COM/WEB)