Permit (34) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00163
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
T I�'1�Tz O 9 Parcel: 1S 135CA90152
Jurisdiction: Tigard
Site address: 11150 SW GREENBURG RD 152
Project: Ash Creek Apartments Subdivision: ASH CREEK PARK CONDO Lot: 152
Project Description: Fire damage repair. This permit is for units 152 and 256 in the same building.
Contractor: KENNEDY RESTORATION Owner: PHILLIPS, DAVID A
315 SE 7TH AVE 622 B ST
PORTLAND, OR 97214 INDEPENDENCE, OR 97351
PHONE: 503-234-0509 PHONE:
FAX: 503-234-4479
Specifics: FEES
Description Date Amount
Type of Use: MF
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/02/2016 $301.85
Demolition
Occupancy Grp: R-2 Occupancy Load: 12%State Surcharge-Building 06/02/2016 $36.22
Dwelling Units: 0 Plan Review 05/12/2016 $196.20
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 06/02/2016 $120.74
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 06/02/2016 $2.50
Value: $15,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $657.51
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 .. 0 through*AR 952-'' -0090. You may obtain a copy of the rules or direct questions to OUNC by callin. .. .2 . 987 or 1.800.332.2344.
Is ued By: Vg0/
_ / Permittee Signature: /
Call 503.639.4175 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.
r
Building Permit Application
Commercial REE!)
Received FOR OFFICE USE ONLN
Cityof Tigard g
DateB .
a f6 i
Permit No.:
• 1 125 SW Hall Blvd.,Tigard,OR 97223 t. 63
3Plan R ' /—
111111 ' Phone: 503.718.2439 Fax: 503.598.1960 Datemy: �A I �� '( V:, Other Permit:
TIGARD
Inspection Line: 503.639.4175 MAY 12 2016 Date R .t : • / /r ® See Page 2 for
Internet: www.tigard-or.gov Notified/MethadJ �� I6 �T Supplemental Information
CITY 01 TIGARD
TYPE OF WrILDING DIVISION • REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $
0 Accessory building ®Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:11150 SW GREENBURG ROAD New dwelling area: square feet
City/State/ZIP:TIGARD,OREGON Garage/carport area: square feet
Suite/bldg./apt.no.:152,256 Project name:ASH CREEK APARTMENTS 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: 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.
REPAIR DAMAGED RATED GYP Valuation: $$15,000.00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:PROPERTY DAMAGE SOLUTIONS,LLC (Please refer rofee sckodnte� 1
Structural plan review fee(or deposit):
Contact name:CHRIS NESTLERODE
FLS plan review fee(if applicable):
Address:2850 SW CEDAR HILLS BLVD#106 � ` 610Total fees due upon application: `/f,'�
City/State/ZIP:BEAVERTON,OREGON 97005
Phone:(503)341-6801 Fax::( ) Amount received:
E-mail:CHRIS(a3PDSLLCNW.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:KENNEDY RESTORATION Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:315 SE 7TH AVE Solar Installation Specialty Code checklist.
City/State/ZIP:PORTLAND,OREGON 97214 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)572-3063 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:3402 Total fee due upon application: $201.60
Authorized signatt This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
C tig 1, �� l ` * Fee methodology set by Tri-County Building Industry
Print name: Date: 0
S 1� Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)