Permit q CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00006
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2016
Parcel: 1 S135DB06200
Jurisdiction: Tigard
Site address: 11290 SW 95TH AVE
Subdivision: O'NEEL ACRES Lot: 2
Project: Tucker/Tuggy
Project Description: Install sliding door(10'x6'8")
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:
Total. 0 sf Value: $5,000.00 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
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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
Furn<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 add'I 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&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:
ALT SF 0
Owner: Contractor:
TUCKER,WANDA KELMAN CONSTRUCTION Required Items and Reports(Conditions)
TUGGY,HELEN 20225 SW JAYLEE ST
11290 SW 95TH AVE ALOHA,OR 97007
TIGARD,OR 97223
PHONE: 503-348-2230 PHONE: 503-997-5298
FAX:
Total Fees: $267.06
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 Notificationenter. 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 50 2.1987 or 1.8 32. 44.
Issued By: ermittee Signature:
Call 503 7:00 a.m.for the next available inspectio a
This permit card shall be kept in a conspicuous place on the job site until c ion of
Approved plans are required on the job site at the time of each inspection.
Buildina Permit Appli � �
Residential
City of Tigard ''//��np,, D may' /1f�� Permit No.:M5 f�1(p(0d(e
13125 SW Hall Blvd.,Tigard,OR'972A 9 2 016 Plan Review
Phone: 503.718.2439 Fax: 503.59/8.1960 Date/By: jj)g Other Pernut:
Inspection Line: 503.639.41`75 1 P Of 11GAM) Date Ready/By: / L Juris: _IdSee Page 2 for
Internet: www.tigard-or. Notified/Method: vII f� �— I Supplemental Information
WILDING,DIMS-IM, t4 46A494
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
®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: $ 5000
❑Accessory building ❑Multi-family
Number of bedrooms: 15
❑Master builder ❑Other: Number of bathrooms: r
JOB SITE INFORMATION AND LOCATION Total number of floors: I
Job site address: 112-90 S V✓ 9'STW A-1FV fE New dwelling area: square feet
City/State/ZIP: TGAtp1D OR 9722-3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 7WC,*--0,4? �lGj Ofl Covered porch area: square feet
Cross street/directions to job site: Sy11 6l 1Q6EN8 R 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
n/577'ALL— L 001 '1 X. t r1 Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: N/ N UG E Type of construction:
Address: //2�5)b S vv AyF,'jLj6Occupancy groups:
City/State/ZIP: iZD b 7 223 Existing:
Phone:(So 3)3 AIS- 2.'7.3 O Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Please refer to ee scbedale
Business name:
Structural plan review fee(or deposit):
Contact name: Q N bio
FLS plan review fee(if applicable):
Address: 2 5AVE— �/E
City/State/ZIP: 7,3 Total fees due upon application:
7,3
Phone:(50:5),3 4 9. 2-Z3D Fax::( ) Amount received:
E-mail: t4r. WanQ1
r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commer ial and residential prescriptive installation of
NTRACTOR , / roof-top unted PhotoVoltaic Solar Panel S m.
Business name: "r GT /v i Submit two sets of roof plan with tion details
and fire departm access,alo th the 2010 Oregon
Address: 3 Solar Installation S e Code checklist.
City/State/ZIP: rPermit feeiewF
$180.00
and administrative
Phone:( 03) ' - 5792 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 14 2-7 12- 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.
*zFee methodology set by Tri-County Building Industry
Print name: WA Ali'lA Date: O Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
II
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11290 SW 95TH AVE, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00006
David Young
Violation Summary:
Inspector Contractor