Permit ,
CITY OF TIGARD MASTER PERMIT
1 11 e • ' COMMUNITY DEVELOPMENT Permit #: MST2009 -00215
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/10/2009
Parcel: 1 S 136CA06900
Jurisdiction: Tigard
Site address: 7590 SW SPRUCE ST
Subdivision: Lot: 0
Project: Kennedy
Project Description: Demo roof to top plates and walls to studs. Separate MST permit to be pulled for all other
restoration work.
' BUILDING
Floor Areas Reauired Setbacks Required
Stories: Bedrooms: First: sf Basement sf Left: Parking Spaces:
Height: Bathrooms: Second: sf Garage: sf Front: Smoke
Dwelling Units: Third: sf Right: Detectors:
Total: of Value: $5,000.00 Rear:
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Catch Basins:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Other Fixtures:
Tubs /Showers: Garbage Disp: Water Heaters: Water Lines: Drains:
Bckflw Prevntr:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Fum <100K: Vents: Woodstoves: Gas Outlets:
Fum > =100K:
ELECTRICAL
Residential Unit Service Feeder Temp Sivc/Feeders Branch Circuits
1000 sf or less: 0 -200 amp: 0 -200 amp: W/ Svc or Fdr: •
Ea add'I 500 sf: 20 1-400 amp: 201 -400 amp: 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 401 -600 amp: Ea add'I Br Cir:
601 -1000 amp: 601 +amp- 1000v:
1000 +amp /volt:
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
ROUSE, CHARLES KENNEDY RESTORATION
11916 SW ELEMAR CT 315 SE 7TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
PHONE: 503 -708 -3211 PHONE: 503 - 234-0509
FAX: 503- 234 -4479
Total Fees: $265.06
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 rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By.' ( 1 Permittee Signature: �� -�
Building Permit Application RECEIVED FOR 01FF1(.1 HSI: oNI,1'
City of Ti gard NOV 10 ��
2009 Z �'� / /0 o' Permit No
.74 ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie .S // _ / /s
C ,Phone: 503.639.4171 Fax: 503.598.1960 Date/By: 17/9
t f /f - '/ /0O�pp Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / Juris: See Attached Checklist for
'WARD
Internet;. www.t ardor. ov Notified/Method: Su g g BUI LDING DIVISIO 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/alteratlon/replacement N Other: /A , iecooa;r, equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this appliokr
Ni I- and 2-family dwelling Valuation: • -- a r r . c F � -- .
y g ❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms: 0 17
❑ Master builder ❑ Other: Number of bathrooms:
• ' JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ' S Gv SA s -9- New dwelling area: square feet
City /State /ZIP: 'If G'� ,.. «' » 9 7 22_ .� Garage/carport area: 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: I 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: $
savIQ
0 2/rrie A ��� Q �i �! Existing building area: square feet
Gi 2/4 —) ` f � ' � New building area: square feet
. (SPROPERTY OWNER I ❑ TENANT Number of stories:
Name: (7 4)-- JJ 61.-J(: Type of construction:
Address: -7 b S Gu
Occupancy groups:
City /State /ZIP: 7 - ,4Q, T A 0 r 0.7133 Existing:
Phone: S03 ) 70s - .32 /) Fax: ( ) New:
El APPLICANT , • ❑ CONTACT PERSON
NOTICE
Business name: k e.> edP ee s 7 0,...e iani All contractors and subcontractors are required to be
y
Contact name: �,7 -- 't..--C r licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3/S sf 7 /9 t, jurisdiction in which work is being performed. If the
City /State /ZIP: � /d n q 7L /y applicant is exempt from licensing, the following reasons
J apply:
Phone: (s- ) 2 3 J./ - 0S-0 ci Fax: : (03) Z3 4 —4 1 1 -/ - 19
E -mail:
. ' - . ' CONTRACTOR - s. . _
Business name: Keti ti ee f T or��-,o BUILDING PERMIT FEES* : •
7
Address: 3/ � S � 7 �� (PI€aSerelerrojeeschedrilel....
City/State/ZIP: Structural plan review fee (or deposit):
� i OY 9 /LI
,(Phone: FLS plan review fee (if applicable):
(J° �3) 23 zl -- oS F ax: (3) Z3 q --L /cI 7
B lie.: 3 9c, iI / q fir (Total fees clue upon application: 45, p d
Authorized signatures G� ! pfi47 /T �1 65', 0 (o
This permit application expires if a permit is not obtained
Print name: Date: 11—/C-0
within 180 days after it has been accepted as complete.
7� Fy ��I 1 • Fee methodology set by Tri -County Building Industry
Service Board.
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