Permit CITY OF TIGARD MASTER PERMIT
a ' COMMUNITY DEVELOPMENT Permit #: MST2012 -00099
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/05/2012
Parcel: 1 S125DB09500
Jurisdiction: Tigard
Site address: 7060 SW LOLA LN
Subdivision: RAZBERRY PATCH, THE Lot: 15
Project: Jeffrey
Project Description: Foundation underpinning /stabilization
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: No
Total: 0 sf Value: $10,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea addl 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +amp /volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio 8 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:
OTR SF VB R - 3 0
Owner: Contractor:
TANAKA. NAOKO TERRAFIRMA FOUNDATION REPAIR INC Required Items and Reports (Conditions)
JEFFERY, JAMES T 1308 NW PARK ST
7060 LOLA LN ROSEBURG, OR 97470
TIGARD, OR 97223
PHONE: 503 - 894 -0306 PHONE: 541 - 229 -4049
FAX: 541 - 229 -4051
Total Fees: $405.67
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all er a dicable 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 '" rk is uspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thos= rules are set forth in OAR
952- 001 -0010 throug R 952 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 , 4 .87 . ,i 0. 32.2344.
Issued By: u' �-( Permittee Signature: � /.
Call 603.839.4175 by 7:00 a.m. for the next available Inspection date. i Dr
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
Residential }�� MR O11 l'St. ()NIA
City of Tigard - _"CE�ED Received /" /G /4
Plan 116a047 -M1,5? Ph SW Hall .2 39 Tigard, 03 98.1 Plan eview��� % gyp 1
• Phone: 503.718.2439 Fax: 503.598.1 Y 1 6 2 012 Date/By: Re �L YJ�-� Other Perms`:
Inspection Line: 503.639.4175 Date Ready/By. ` kris: ® See Page 2 for
T I C. n R D Internet: www.tigard- or.gov CITY OF TIGARD Notifi ethod: ✓ . Supplemental Information
B b ► 1 _ .. _:O-r . _ _ /J /7!.►OW
TYPE OF WORK RE t i1 ' 4 1 4 I ATA: 1- • ;1 -FAMILY - 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: &IJD►''r[te,J S f u7 equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
l and 2- family dwelling ❑ Commercial/industrial Valuation: $ /c QQQ -----
Number of bedrooms: Y
❑Accessory building ❑ Multi- family
❑ Master builder ❑ Other: T Tn o...1 6 N L-1, Number of bathrooms: Z ,$
JOB SITE INFORMATION AND LOCATION Total number of floors: a-
Job site address: - 70 (,0 s h..) LA (a} New New dwelling area: square feet
City/State/ZIP: - 7 - / 4 j-iz_ _ vtZ . ? 2Z.- 3 Garage/catport area: square feet
Suite/bldg. /apt. no.: I Project name: - S02h/ 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 ne: • t dollar) of all
equipment, materials, labor, overhead, d the profit f. e
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ / 0 0 0 4 - "°
lf DPrT7 o,J uk- )out- P /c -a1.•.) 4
/LI
Existing building area: square eet
New building area: square fee
V PROPERTY OWNER ❑ TENANT Number of stories:
Name: q ES - 1 rc-4, Type of construction:
Address: ? b&) 5j 144.4 (J. Occupancy groups:
City/ State/ZIP: 7 OR 9 7Z Existing:
Phone: (563 ) 0 lY - 0306 t Fax: ( ) New:
VI APPLICANT CONTACT PERSON -- BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:
TerraFirma Foundation Systems
Contact name:
Geoff Larrance (Cell # 503-894-0306) Structural plan review fee (or deposit):
Email: GLarrance @terrafirmafs.com FLS plan review fee (if applicable):
Address: 19800 SW 129th Terrace, Tualatin, OR 97062
City/State/ZIP: Phone: 503 - 691 -0272 Fax: 503- 612 -0323 Total fees due upon application: �l -- //
ty CCB: 173547 Amount received: +/ /4 '
Phone: ( )
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercr and residential prescriptive installation of
CONTRACTOR
l- roof -top mo 1 - d Photo Voltaic Solar ' : el System.
Business name: ( TerraFirma Foundation Systems Submit two (2) - of roof plan wi • •nnection details
I Geoff Larrance (Cell # 503-894-0306) and fire department - , al...: with the 2010 Oregon
Address: I Solar Installation Speci • • ode checklist.
Email: GLarrance @terrafirmafs.com Permit Fee C des p review
City/ State/ZIP: I 19800 SW 129th Terrace, Tualatin, OR 97062 $180.00
... administrative ):
Phone: ( ) Phone: 503 - 691 -0272 Fax: 503 - 612 -0323
CCB: 173547 States : ge (12% of permit fee): $21.60
CCB lic.: Total fee due upon application: $201.60
Authorized signa 1) This permit application expires if a permit is not obtained
. within 180 days after it has been accepted as complete.
I Print name: &&-o birL
• F ee methodology set by Tri-County Building Industry
LC I Date: s �7 /f Service Board.
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