Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 -00247
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/19/2010
T1ARL?' Parcel: 2S110DA08100
Jurisdiction: Tigard
Site address: 10677 SW LADY MARION DR
Project: Wang Subdivision: ERICKSON HEIGHTS Lot: 42
Project Description: Photovoltaic system.
Contractor: PRO STAT SERVICES LLC Owner: WANG, PERRY P & KAREN C
2904 E 24TH STREET 10677 SW LADY MARION DR
VANCOUVER, WA 98661 TIGARD, OR 97224
PHONE: 503 - 539 -7772 PHONE:
FAX: 360- 718 -7092
FEES
Specifics: Description Date Amount
Type of Use: SF Solar Photovoltaic System 11/10/2010 $180.00
Class of Work: ALT 12% State Surcharge - Building 11/10/2010 $21.60
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $2,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $201.60
Required' Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: No Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 - • •ance proved 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. P ENTION: Oregon la requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 )01 -0010 through OAR 952 - 001 -10 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I -sued By: ��� Permittee Signature: 41111.,/
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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application ,� 4; i 0 f c:1,,.�.
Residential ����'
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° 4 City of Tigard (10-6\ Rece ived f PermrtNo.: ' ll U I 1,
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; � Date /6 �1 Il.
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review h p�
r f! Other Permit: U ' r, U
t , - Phone: 503.639.4171 Fax: 503.598.19600 , o� Date/B : [ !�
IG `Q` Date Ready /ey: luny � ® See Page 2 for
tXTIGARD Inspection Line: 503.639.4175
� � � ^ r! � J " O Notified/Method: . 1 — e s Supplemental Information
Internet: www tigazd or.gov Q `DD
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4
TYPE: O
F • • W , . REQUIRED, DATA: 1- A ND 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.
Valuation: $2,000.00
►Z1 1- and 2- family dwelling ❑ Commercial/industrial
Number of bedrooms:
❑ Accessory building ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION -AND' LOCATION; • Total number of floors:
Job site address: 10677 SW Lady Marion Drive New dwelling area: square feet 4
City/State /ZIP: Tigard, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: WANG 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
•DESCRIPTION OF WORK ; ' work indicated on this application.
SOLAR PV INSTALLATION Valuation: $
ROOF MOUNT --10 PANELS Existing building area: square feet
New building area: square feet
® 'PROPERTY OWNER ❑ TENANT Number of stories:
Name: WANG Type of construction:
Address: 10677 SW Lady Marion Drive Occupancy groups:
City/State /ZIP: Tigard, OR 97224 Existing:
Phone: (503)927 -1442 Fax: ( ) New:
® APPLICANT ' • ® CONTACT PERSON
. NOTICE
Business name: PROSTAT SERVICES All coutractors and subcontractors are required to be
l Contact name: BRANDON KRUEGEK licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 2904 E 24' Street jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: Vancouver, WA 98661 apply:
Phone: (503) 539 -7772 Fax: : (360) 260 -7064
E -mail: dale.krueger@comcast.net
CONTRACTOR'
Business name: PROSTAT SERVICES BUILDING PERMIT FEES*
(Please refer. to. fee scheduIf)
Address: 2904 F, 24`" Street
Structural plan review fee (or deposit):
City /State /ZIP: Vancouver, WA 98661 —
FLS plan review fee (if applicable):
Phone: (503) 539-7772 Fax: (360) 260-7064
Total fees due upon application: ' hi
1.4,
LCCB lie.: 189902 �
Amount received: Sv v I (i, v
Authorized signature: This permit application expires if a permit is not obtained
,Within 180 days after it has been accepted as complete.
Print name: Dale Krueger Date: L l * Fee methodology set by Tri County Building Industry
Service Board.