Permit u CITY OF TIGARD BUILDING PERMIT
IL
I 2 : COMMUNITY DEVELOPMENT Permit #: BUP2012 00261
TI G'ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/08/2013
Parcel: 2S 110AD90025
. Jurisdiction: Tigard
Site address: 14880 SW 109TH AVE '
Project: Canterbury Woods Condominiums Subdivision: CANTERBURY WOODS CONDO Lot: 25
Project Description: Building 4 - Structural repair of post & beams in crawl space for unit addresses:14880, 14882, 14884, 14886, .
14888, 14890, 14892 & 14894 SW 109th Ave.
Contractor: EVERGREEN PACIFIC INC Owner: THOMPSON, MARY F
9117 SW BURNHAM ST 14880 SW 109TH AVE
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 624 -1337 PHONE: ,
FAX:
Specifics: FEES
Description Date Amount
Type of Use: MF
Class of Work: REP Type of Const: VB Permit Fee - Additions, Alterations, 01/08/2013 $347.48
Demolition
Occupancy Grp: R -2 Occupancy Load: 12% State Surcharge - Building 01/08/2013 $41.70
Dwelling Units: 0 Plan Review 12/17/2012 $225.86
Stories: 0 Height: 0 ft Info Process /Archiving - Sm $0.50 (up to 01/08/2013 $17.00
Bedrooms: .. 0 Bathrooms: 0 11x17)
Value: $18;000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0 •,,
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $632.04
Required: Required Items and Reports (Conditions
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
I
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 - - • 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
I days. • NTION: Oregon - , re• • es yo follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 0
• ,?,e,./,(. (
952 -• %1 -0010 through OAR 952 -00 090. Yo - obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
' Is ued By: ( ell Permittee Signature: t
Call 503.639.4175 by 7:00 a.m. for the next available inspec ' • • ate.
This permit card shall be kept in a conspicuous place on the Job site until • • • letion of the project.
Approved plans are required on the job site at the time of ea inspection.
Building Permit Application RECEIVED
Commercial FOR OFFICE USE ONLY ky ^^
City of Tigard DEC 17 2012 Received / permit No.: 19A7/01-,--e6694)/ p19A7/01-,--e6694)/ � //
Date/By: /.
q 13125 SW Hall Blvd., Tigard, OR 97223 I^sDn Plan Review
Phone: 503.718.2439 Fax: •503.598.19 ®`� � TF1�flf li./ Date/By: /.-"Y //,:X, Other Permit:
TIGARD Inspection Line: 503.639 BUILDING DIVISION Date Rd / Metho : _ J � O / 1 Juris: ® See Page 2 for
Internet: www.tigard or.gov DUI 11 Ui V 11J Notified/Method: d { / ai Supplemental Information
• i—F w @C .cam_
TYPE OF WORK REQUIRED DATA: 1- AND 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
K Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this application. � rV
CATEGORY OF CONSTRUCTION /p O /
Valuation: $ ocj
❑ I- and 2- family dwelling ❑ Commercial /industrial /
El Accessory building 1E1 Multi- family r o e K �, )�j Number of bedrooms:
❑ Master builder ❑ Other: 1tU 0 / � " Number of bathrooms:
JOB SITE INFORMAT D LOCATION Total number of floors:
Job site address: A gI04 • y C w w q +k AvE I y • --) New dwelling area: square feet
City /State /ZIP: - 1") 6 i 0 Q? a 1 `} 1Bgb 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
S W Ro y l t. Ty PKt.' y 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.
5 ra, -4 - RcpAi.2s ro Pof 4 /F6-nr..+ Valuation: $
.
,,.i c2.► 14 s E Existing building area: square feet
New building area: square feet
C8. PROPERTY OWNER ❑ TENANT Number of stories:
Name: CA Hm¢.go,ey (AlooOJ' 16mb OwNEQt / Type of construction:
Address: 9./05 SE 97% Ave. Occupancy groups:
City /State /ZIP: f' 6R - 9 7; y Existing:
Phone: ( S 233 - 030 6 Fax: (5 ) 2 33 - 888 New:
91 APPLICANT .8. CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: • VEX 42Et') p4 of Ft G iMG . Structural plan review fee (or deposit):
Contact name: G AA'- O t.P WA No
FLS plan review fee (if applicable):
Address: 9 /17 5 t1/ /3uRAtirn, -. ST
Total fees due upon application:
City /State /ZIP: T 4Alt:A/ OR J7 0 23 pry
Amount received: .49))- ' Phone: (go3 ) 61'/— /337 Fax: : ( 5o3) G 31f - / /s
r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E -mail: Da;l a tve e a
vggen c -i-c∎c in C. COW Commercial aresidential prescriptive installation of
CONTRACTOR roof -top mounted.PhotoVoltaic Solar Panel Syste
Business name: EVER4t2EfN f k c I Ft /nl Submit two (2) set . f roof plan with connect'. • . etails
and fire department a ess, along wit • 010 Oregon
Address: 9 /I 7 5 t ,./ r3 ua..iy.t n t 5 . Solar Installation Specr• Co - ecklist.
Permit fee (inclu•: • •• an review
City /State /ZIP: '77 6 nia -n OR 9 i $180.00
.�ministra' efees): $180.00
Phone: (So 3 ) 6,.2.'/ - / 337 ) G ay - //J 7 State surcharge (12% of permit : $21.60
CCB tic.: ,/ 5 ' •2 / ° •) 4-� Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date:
/2t Z/ * Fee methodology set by Tri- County Building Industry
(� A i O Lo N A �y Service Board.
1: \Building\Permits \BUP -COM PermitApp.doc 02/24/2011 440 -4613 /WEB)