Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2011 -00270
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2011
Parcel: 2S102DB00301
Jurisdiction: Tigard
Site address: 13070 SW ASH AVE 6
Project: Alderbrook Apartments Subdivision: BURNHAM TRACT Lot: 8
Project Description: Reroof - Remove and replace for apartment 6.
Contractor: GRIFFITH ROOFING Owner: CARNEY, GEORGE V & GWENDOLYN J
6815 SW 111TH AVE 14185 SW 144TH AVE
BEAVERTON, OR 97005 TIGARD, OR 97224
PHONE: 503 - 643 -1596 PHONE:
FAX: 503 - 644 -1529
FEES
Specifics: Description Date Amount
Type of Use: ME Permit Fee - Additions, Alterations, 12/28/2011 $149.75
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/28/2011 $17.97
Stories: 0 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 12/28/2011 $4.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $4,019 Hourly Building Rate 12/28/2011 $90.00
Hourly Building 12% Surcharge 12/28/2011 $10.80
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $272.52
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: °ermittee Signature:
Call . I :rrl/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.
Building Permit Application
Commercial ',FOR Orr Ic t i t C ` O1� L VY t q '
r4
City of Tigard o a e te/B � ? ' 11
Plan Review Permit No.: /��avl I �?
e 13125 SW Hall Blvd., Tigard, OR !, ! \\
' . C ` Phone: 503.718.2439 Fax: 5 t., , , • .1,) � DateB : Other Permit: •
- 11 C A R.D Inspection Line: 503.639.4175 ..' V O >� Date Ready /By: Jurist la See Page 2 for
In www.tigard- or.gov O <� O � '' S ). � 0 Notified/Method: R Supplemental Information
TYPE OF WOI # > REQUIRED DATA: 1- AND 2-FAMILY DWELLING
❑ New construction El *Mon 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.
❑ I - and 2- family dwelling ❑ Commercial/industrial Valuation: $ tit / 00,00
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND 'LO Total number of floors:
Job site address: / 3o 7o 5 w ASh 4ee New dwelling area: square feet
City /State /ZIP: la, yJ 1. 0 4 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: A 4144./ brook P1.p y,ten Covered porch area: square feet
Cross street/directions t job site: Deck area: square feet
Other structure area: square feet
.REQUIREMDATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
F S - 444d /' !� Ong Valuation: $
744...- off -two 6w�srr o J i-�G ', n
Sea/ in Off (o � eelace Q,H.y ✓Otted dieKr . Existing building area: square feet
/ O /
Gsse i j►d,f 4-041/ i� ".P CO -1 r'Fi)its4 r}"�y 4 r .. New building area square feet
❑ PROPERTY OWNER TENANT Number of stories:
Name: m 4, 5 s , Lrer►/I 0/44L Type of construction:
Address: bp c W f 4yovi p p 5 �� 0.4. Occupancy groups:
dernold k. br, .r -3 ee nr
City /State /ZIP: pr B ✓thy! q ?�` • t ePras
Existing:
Phone: (✓j D3) ?a 3 - 3i 7( Q Fax: (A;o3) a4 ? (3(O New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING'PERMIT FEES*
Business name: . (Please, refer to fee schedule)
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address:
Total fees due upon application: '-�
City /State /ZIP: /� + Si'
Amount received:
Phone: ( ) Fax::( )
E -mail:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ` ri r tit /[ DYI Gj ys (, Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: • (D P1-- sw `( i-k 1-h►l Solar Installation Specialty Code checklist.
Cit City/State/ZIP: 6 f-� ®y.( G and administrative fees): Permit fee ( includes plan review
Y �l�aO $180.00
Phone: (Spy) 6 ii 3 . l s 1(o / F ' . ($03) 6 if q - 1,37,19 State surcharge (12% of permit fee): $21.60
CCB lie.: d 9 — Total fee due upon application: $201.60
Authorized signature: ✓ 60t44.1.oi This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 54M , „, Date j 2 a$- a .p ( , * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \B UP -COM PermitApp.doc 02/24/201 I 440- 4613T(1 I /02/COM/WEB)
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