HomeMy WebLinkAboutRES2025-0036 APPLICATIONS Building Permit Application
Residential
City of Tigard R E C E I\ Pemat No.:
;� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review --
Phone: 503.718.2439 Fax: 503.598.1960 JUL 1 6 2; Y: Other Perna:
Inspection line: 503.639.4175 V U
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ram,: Seep elfor
Internet: www.tigard-or.gov Notified/Method: l I ®
Supplemental Information
CITY OF TIG.A7
TYPE OF WORK 31JtW1NG DP/Islim - I REQUIRED DATA;I-AND 2-FAMILY DWELLING
❑New construction
El Demolition _ Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: S
Iffl 1-and 2-family dwelling 0 Commerciavndustrial .
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other Number of bathrooms: 1
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10915 SW Fairhaven Way New dwelling area: 138 square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg.apt.no.: Project name:Melo Bathroom addition Covered porch area: square feet
Cross street/directions to job site: _ Deck area: square feet
r:- and 110th Other structure area: square feet
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 a]]
Tax map/parcel no.: i equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
'9n of bathroom Valuation: $
existing building area: 138 square feet
_ New building area 138 square feet
® PROPERTY OWNER 0 TENANT Number of stories: 1
Name:Dereck and Talia Melo Type of construction:
Address:toots swF•eKmwltwa mast oa5rm - --
Occupancy groups:
City/State/ZIP:Tigard OR 97223 i -
-- Existing:
Phone:(360)608-0209 Fax:( ) New: -
❑ APPLICANT- ® CONTACT PERSON BUILDING PERMIT FEES*
—
Business name:American Legacy Homes "�°'m "i"a` - -
I Structural plan review fee(or deposit):
Contact name:Jeremy Gissell -
- - FLS plan review fee(if applicable):
Address: _
City/State,/ZIP: Total fees due upon application:
- _ - -
Phone: Amount received:
( ) Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
e-mail:
americanlegacyhomes@aol.coFEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:American Legacy Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address- Sola_rI_nstallation Spec cal Code checklist.
Permit Fee in Ciry/StateJZIP: - - -- - {' eludes plan review ]AO . �
and administrative fees): $180.00
Phone:(503)342^$61 Fax ( ) / State surcharge(12%of permit fee): $21.60
CCB lic.: 196705 _ Total fee due upon application: $201.60
Authorized signature: f�i�,/` �.� This permit application expires if a permit is not obtained
���� within 180 days after it has been accepted as complete.
Print name:JeremyI, r�� Hate:6/27/25 •Fec methodology set by Tri-County Building industry
_ � Service Board.
I:N.Building\Permits\BUP-RES•- ter pp-doe 012511r 440-4613T(11/02/COM/WEB)
Plumbing Permit Application
Building Fixtures RECEIVE !. FOR t)FFICF 11SF t>N1.1
City of Tigard Received
Date/By: Permit No.:
III U 13125 SW Hall Blvd.,Tigard,OR 97223
Y Phone: 503.718.2439 Fax: 503.598.1960 J U L 1 6 2025 Re
view
eview
Plan Other Permit No.:
I I c;n It a Inspection Line: 503.639.4175 OF Date Ready/By: laris: g
Internet: www.ti and-or. ovla See Page 2 for
g 8 CITY T'GARf Nolified/Metl is Supplemental Information
TYPE OF WOIUCBUILDING DIVISION FEE* SCHEDULE
special For in orma_lion use checklist
❑New construction ❑Demolition � -
- -- ---- ---- Description j Qty. I Ea. 1 Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling : 0 Commercial/industrial SFR(2)bath - 437.76
❑Accessory buildingMulti-family SFR(3)bath 500.32
0
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
___ l_ .__. _... Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
City/State/ZIP: Drywell,leach line,or trench drain 18.76
j', o ✓,, qi 7 2.2 Footing drain(no.linear ft.: ) ! Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 n
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear fl.: ) Page 2
_
--- - ---4
Water service(no.linear ft.:_ ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
r ---- - --
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
era-7 4.-L -f.9/ -, ; / - . Dishwasher 25.02
Drinking fountain - �_ _ 25.02
- ~Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
-
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: - -Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: „ •,,_.,,, ,, [(5.,,,," /jCr+K 1 Primer 12.51 -Contact name: -5er Y ,/ G, T sr / Roof drain(commercial) 12.51
Address: _ Sink/basin/lavatory 2 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:(SG') 3`T Z - /S Fax::( ) Tubishower/shower pan - j 12.51
E-mail: � Urinal 25.02
�MC,-? 1/1 iG. rG1.-�/ UM inr S e ,wlL,. C O/'1 -_
III s Water closet / 25.02
CONTRACTOR
Water heater 37.52
~
Business name: Water piping/DWV 56.29
- -- '
Address: Other, 25.02
--City/State/ZIP: Subtotal
~ Minimum permit fee: $72.50
Phone:( ) Fax:( ) ----- - --
CCB Lic,: /96 7 0 j--- Plumbing Lie.no.: - - Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name/ �7 1 Date: Tbls Permit application expires if a permit Is obtained within 180 days
l I after It has been accepted as complete.
L 'Fee methodology set by Tn-County Building Industry Service Board.
I\Building\PermitstPLMU-PermitApp.doc 10/01109 440-4616T(10/02/COMIWEB)