Permit CITY OF TIGARD BUILDING PERMIT
11,1 COMMUNITY DEVELOPMENT Permit #: BUP2011 -00013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/25/2011
Parcel: 2S110DA07300
Jurisdiction: TIGARD
Site address: 10666 SW LADY MARION DR
Project: Knebel Subdivision: ERICKSON HEIGHTS Lot: 34
Project Description: Solar photovoltaic system.
Contractor: PRO STAT SERVICES LLC Owner: KNEBEL FAMILY TRUST
2904 E 24TH STREET BY WERNER & INGE B KNEBEL TRS
VANCOUVER, WA 98661 10666 SW LADY MARION DR
TIGARD, OR 97224
PHONE: 503 - 539 -7772 PHONE:
FAX: 360- 718 -7092
FEES
Specifics: Description Date Amount
Type of Use: SF Solar Photovoltaic System 01/19/2011 $180.00
Class of Work: ALT 12% State Surcharge - Building 01/19/2011 $21.60
Dwelling Units: 0 Info Process /Archiving - Sm Sheet (up to 01/25/2011 $4.50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0 Miscellaneous Administration Fee 01/25/2011 $6.75
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 $212.85
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: 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 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
0 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.
Bui Application
R
. FOR USE ONL 1
. .,
. - ';', . . ''' ' - — '''• .
City ,of Tigard Vecj -.- r Received i 1 ic r Penult No.. .
Date/B : 6 f Mt
13125 SW Hall Blyd., Tigard, OR 9722 N. Plan
°.C4) ' C1/4% ' • 41111/Egill Oder Permit:
- Inspection Ltne. 503.639.4175
TIGARD • . . "
:
''.
. Internet: wwwfigard-orgov c,_ ‘‘ 'or.*Ste Ready/ 7" I. M1111MFMI 1 Sei.Page 2 for
C:1‘ 1-Nslx Notified/Method: upplemeatal Information
. _ .
TY PE O ... W ORK NS REQUIRED;DATA:
, . • . „, . .
; `'.."-..... 0 New construction 0 Demolition Perinit on the Cif the Work performed_
,
Indicate.thc value-(rounded to the nearest dollar) of all
•-.. El Addition/aherationfreplacement 0 Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OP CONSI-RUC RUC -:' . " ' • . work .indicated on this application.
-. ' -- "-'''' — •-- - - -'- . '''":,,. . ., . ., _.
Valuation: S2000.00
1 - and 2-farinly dwelling 0 Commercial/industrial
Nuretherof &Mendips:
0 Accessory building 0 Multi-family
.
' 0 Master builder 0 'Other Number of bathrooms:
:ibii;-4iFj INtbiiiv:Ikti6ikrAtiii'jait'iitiCiN ' _,. Total number of floors:
Jolysitc addieSs: 10060 Lady"Marion Dr New dwelling area: square feet
1 City/State/ZIP:" Tigard, OR 97224 Gat area: square feet
Y Suiteibldg./apt.'no.: Peojectriame: KAREL CoVeredporch area: square feet
ti) Cross street/directions to job site: Deck area: square feet
el'a
--1241. Other structure area: square feet
. REQUIREITDATiti COMMERCIA1L-USECUECKLIST '
4 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 inap/pareel no.:
eqnipment,. materials. labor, overhead, and the profit for the . ,
- - WORK :- :- , _ i, . work indicated on this application.
1/4) SOLAR PV :INSTA LLATION Valuation: _ $
(--- ROOF MOUNT 12 PANELS . Existing building area: square feet
(" New building area square feet
. — . , -. , • . . . , ., _ . „
l) ., •, , ., P11,0PEITTY. - ' , .., - - • ": 0 TENANT:. . - :1 . Number of stories:
(1) Name: KNEBEL Type' of ConStruttion:
() Address: 10666 Lady Marion Dr Occupancy groups:
City/State/ZIP: Tigard, OR 97224 Exfsting:
Phone: (503)639;6966 Fax:,( ) New:
AP,P1'."ICANT . ". . 1 ,: -: .:.. .. ;CONTACT.'PEPISON - ' ., - -..,.- .,,. -.: - . , NOTICL
j Business name: PROSTAT SERVICES All contractors and subcontractors arc required to be
‘-' Contact name: :BRANDON KRUEGER .licenseci With the Oregon Con Contractors Board
t
— under.ORS 701 and may be required to be licensed in the
E AddiesS: 2904 E Street' jurisdiction in which work is beingperformed. If the
City/State/ZIP:Vancouver; WA 98661 applicant is exempt froth liceositig the followingreaSons
apply:
Phone: (503) 539-7772 Fax: : (360) 260-7064
E-mail: dale.krueger@,,comcast.net
„ ..
• Business name: PROSTAT SERVICES , . . . -. • .
B111EININGTERIVIIT,FEES,.'
4'
':., .. . (iteareitierritiiiiicireaiiii).:":' - - , • . .
Address: 2904 E 2 Street . Structural plan review fee (or deposa):
City/State/ZIP: Vancouver, WA 98661
FLS plan review fee (if applicable):
Phone: (503) 539-7772 --- Fax: (360) 260-7064
CCB lic.: 189902 Total fees dile OpOrt application:
Amount reecived:
Authorized signature: "1IL, ... ., . This permit application expires if a not obtained
within 180 days after it has been accepted as complete.
Print ,name: Dale Krueger Date: 1/14/11 * Fee methodology set:by Tei-Cotmty Building Industry
Service Etbard.
1:\Building\Perritits\BIJP-RES PermitApp:doe 10/01/09 440-46131111/02/COM/WEB)