Permit (33) CITY OF TIGARD #7°`I BUILDING PERMIT
11. COMMUNITY DEVELOPMENT effirf- -Iv 1111
if Permit#: BUP2018 00181
Date Issued: 06/14/2018
T r G AI O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DB90802
Jurisdiction: Tigard
Site address: 15478 SW 114TH CT 80
Project: FOUNTAINS AT SUMMERFIELD Subdivision:MAINS AT SUMMERFIELD CONDO-PHI Lot: 80
Project Description: Repairing dry rot,re-coating solid decking,replacing guardrail 42"code compliant. 6/26/2018: REPRINT permit to
describe work for deck"B"only.
Contractor: JON EDWARD ERICKSON Owner: SMITH, MARYANN
15280 SW 94TH AVE 15478 SW 114TH CT#80
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503-730-9220 PHONE: 858-212-9105
FAX:
Specifics: FEES
Description Date Amount
Type of Use: MF
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/14/2018 $180.17
Demolition
Occupancy Grp: R-2 Occupancy Load: 0 12%State Surcharge-Building 06/14/2018 $21.62
Dwelling Units: 0 Plan Review 06/14/2018 $117.11
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 06/14/2018 $6.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $6,896
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $325.40
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: /L„, _ Permittee Signature: / ,�� ,f
/�+
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.
Building Permit Application
Commercial RECEIVE111.11,11=11
Received �f' ) p.
City of Tigard �� � Permit No. `/��/I� }�`"b/' /6 i
13125 SW Hall Blvd.,Tigard,OR 97223 JUN
?�y Plan Redrew Li
�l(J
' s Phone: 503.718.2439 Fax: 503.598.1960 JUN 7 l.018 Date/By: G•• f 7 •) other Parmit:
E f .,p Inspection Line: 503.639.4175 \ Date Ready/By: huts.y: � See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:&/?f� (FAA, I 18 Supplemental Information
+!13f � �'
TYPE OF m '.'1 f ti I MUDDATA 1-AND'2-FAMII.YDWELLIN[1
❑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.
El1-and 2-family dwelling Valuation: $
❑Commercial/industrial
ElAccessory building ii Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION:AND LOCATION Total number of floors:
Job site address:15478 SW 114x'Court New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.:80 A&B Project name:Deck Refurbishing 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 nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Repair dry rot,re-coat solid decking,replace guardrail with 42"code compliant Valuation:
56896.00
Existing building area: square feet
New building area: square feet
21. PROPERTY OWNER Q TENANT Number of stories:
Name:The Fountains at Summerfield Condominiums Type of construction: SB
Address:15685 SW 116"'Ave#105
Occupancy groups:
City/State/ZIP:Tigard,OR 97224
Existing:
Phone:(858)212-9105 Fax:( )
New:
is APPLICANT El CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Neste refer tofee schedule)
Contact name:Jon Erickson Structural plan review fee(or deposit):
Address:15280 SW 94th Ave FLS plan review fee(if applicable):
City/State/ZIP:Tigard,OR 97224 Total fees due upon application:
Phone:(503)730-9220 Fax::( ) Amount received:
E-mail:jon.evenjobs@gmaiLcom PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES"
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:Jon Erickson Submit two(2)sets of roof plan with connection details
Address:15280 SW 94r"Ave and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Tigard,OR 97224 Permit fee(includes plan review $180.00
Phone:(503)730-9220 Fax:( ) and administrative fees):
State surcharge(12%of permit fee): $21.60
CCB lic.:162397
Total fee due upon application: $201.60
Authorized signature: /0,, �4,./C This permit application expires if a permit is not obtained
within 180 days after It has been accepted as complete.
Print name: Jon Erickson Date:June 7,2018 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
!PI
Transmittal Letter
11(i A it i 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: / 7'<7 // r DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Tov �'iI�G'r ��7DZ- JUN 21 2018
COMPANY: (-6-i-/ r CITY OF TIGARD
PHONE:
523 - 730 - 77-762 BUILDING DWRIn
RE: /S Y 7, -4(,) /// CT Po 4t V 4 /d -OD/e/
(Site Address) (Permit Number)
1fu AT9/A/S 61-7—SG?"7/7 E.7z.11& j
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: / `1 p-7/C 4 -1�� / If /-72erd"7 f72/ '/7—
/L62)-e-
7—
C-€-- lr .r c o�/ / EZ 9�i 9 6 7) *2 V "P
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑Yes ❑No Fee Description: Amount Due:
Special
Instructions:
Reprint Permit(per PE): i� es ❑No ❑ Done
Applicant Notified: 'r s ate: C/2-(4, Initials: ..
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc
CITY OF TIGARD BUILDING PERMIT
'IN Permit#: BUP2018-00181
' COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2018
I' '4 i i' 9 Parcel: 2S110DB90802
Jurisdiction: Tigard
Site address: 15478 SW 114TH CT 80
Project: FOUNTAINS AT SUMMERFIELD Subdivision:TAINS AT SUMMERFIELD CONDO-PHI Lot: 80
Project Description: Repairing dry rot,re-coating solid decking,replacing guardrail 42"code compliant.
Contractor: JON EDWARD ERICKSON Owner: SMITH, MARYANN
15280 SW 94TH AVE 15478 SW 114TH CT#80
TIGARD,OR 97224 TIGARD, OR 97224
PHONE: 503-730-9220 PHONE: 858-212-9105
FAX:
Specifics: FEES
Description Date Amount
Type of Use: MF
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 06/14/2018 $180.17
Demolition
Occupancy Grp: R-2 Occupancy Load: 0 12%State Surcharge-Building 06/14/2018 $21.62
Dwelling Units: 0 Plan Review 06/14/2018 $117.11
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 06/14/2018 $6.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $6,896
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0 •
Total $325.40
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 ar 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 503.23 87 or 1.800.332qS4
Issued By: Permittee Signature: tr
Call 603.639.4175 by 7:00 a.m.for the next available inspection d .
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.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15478 SW 114TH CT 80, TIGARD, OR, 97224 November 20, 2018 at
9:59:48 AM
Record Type: Record ID:
Commercial - Building BUP2018-00181
Inspection Type: Inspector:
299 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
IVED
RE CE
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT J711 I �
Request for Permit Action
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard, OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant /� Contractor ❑ City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) 41.1
7> 5
'
Mailing Address: 6 2 8) (� j -e
City/State/Zip:
re, v<
Phone No.: � j 'Z"
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
❑ CANCEL/VOID PERMIT APPLICATION.
or/`y' REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: u'f 2c3 / r---- 001g(
Site Address or Parcel#: t 7
Project Name: {_ K f ( �,6�v-�._..
Subdivision Name: SL4 41h/1 l ",ate 4e/5 Lot#:
EXPLANATION: gri"I Crl G fG. `1/ �' /�/C ,"� / [ 'i /
//.--4-Z4 C i /0/2-e,..7-E-7, "i' i�/ zZ L4 4--771i,J t— C d y 14 F9/�_ e7
a
Signature: Date: � 7 l 1�
Print Name: G6/
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests. . -/o' e Frif✓�
3 i2c7-u ei i`t=
4 Po 2% /,-:r At-F
FOR OFFICE USE ONLY
Route to Sys Admin: DateBy Route to Records: Date S B �p
Refund Processed: Date /,,+� C Bye/ Invoice Processed: Date By
Permit Canceled: Date Alt By r Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_092314.doc
..IN
I1
TIGARD
City of Tigard
August 9,2018
Jon Erickson
15280 SW 94th Ave.
Tigard, OR 97224
Re:Permit No. BUP2018-00181
Dear Applicant:
The City of Tigard has processed a refund for overpayment of permit fees on the above
referenced permit for the following:
Site Address: 15478 SW 114th Ct, #80
Project Name: Fountains at Summerfield
Job No.: N/A
Refund: ® Check#229381 in the amount of$80.77.
❑ Credit card"return"receipt in the amount of$ .
❑ Trust account"deposit"receipt in the amount of$ .
Notes: Per applicant's request as change in scope of work reduced project valuation
resulting in a refund.
If you have any questions please contact me at 503.718.2430.
Sincerely,
d,,,. .5,(7,„
Dianna Howse
Building Division Services Coordinator
Enc.
I:\Building\Refunds Ufrufii5r Dior . e klitvep b filis1cAegon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
" City of Tigard
T«;n D Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Jon Erickson DATE: 8/3/2018
15280 SW 94th Ave.
Tigard, OR 97224 REQUESTED BY: Dianna Howse
TRANSACTION INFORMATION:
Receipt#: 418744 Case #: BUP2018-00181
Date: 8/2/2018 Address/Parcel: 15478 SW 114th Ct,#80
Pay Method: CreditCard Project Name: Fountains at Summerfield
EXPLANATION: Per applicant's request as change in scope of work reduced project valuation resulting in
a refund of the difference in permit fees.
fi
ae
6 i 4 irR Ai S �� - �C 4 A pY t Y W s m e ea � a i � 4 Ri a �a e r
Cash Over 100-0000-48001 $80.77
•
TOTAL REFUND: $80.77
APPROVALS: SIGNAT ES TE:
If under$5,000 Professional Staff
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
Case Refund Processed: Date:
By:
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
etter
r i,A I, n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 7-Orf /71 r DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: ,TD vt .ro 4-5 JUN 21 2018
COMPANY: Cep, r CITY OF TIGARD
PHONE: 5-03 — 73o— 72'Z 7 BUILDING DWj„• J ,.
RE: /SY 7, .$ ) // / 2j/I1-O /d /
(Site Address) J (Permit Number)
FerW LTi}-/A/S 61—%J-1t AI"?E7
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s)of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: /2-67t10-7/2,_'--- ��r'L , 72j/'i i"E=72 r`f/7
/L .t £ - 07-6_,a,9-7-7 /1,71' of-916 7-6'
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑Yes ❑No Fee Description: Amount Due:
Special
Instructions:
Reprint Permit(per PE): rAi es ❑No ❑Done
Applicant Notified: i J s ate: o.72-,(4, t Initials: ,<r
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc
1,11CITY OF TIGARD RECEIPT
t tlI `. 13125 SW Hail Blvd.,Tigard OR 97223
503.639.4171
T r C_;;'l I?I_
Project Name: FOUNTAINS AT SUMMERFIELD
Site Address: 15478 SW 114TH CT 80
/2- LLA
Receipt Number: 418743 - 08/02/2018
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
B U P2018-00181 $-325.40
Total: $-325.40
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 9494D DHOWSE 08/02/2018 $-325.40
Payor: Jon Erickson
Total Payments: $-325.40
Balance Due: $325.40
Page 1 of 1
•
CITY OF TIGARD RECEIPT
• 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
I[c;ARI)
Project Name: FOUNTAINS AT SUMMERFIELD
Site Address: 15478 SW 114TH CT 80 /e/Isin7091.—
Receipt Number: 417867 - 06/14/2018
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
BUP2018-00181 Permit Fee-Additions,Alterations, 230-0000-43104 $180.17
Demolition
BUP2018-00181 12%State Surcharge-Building 100-0000-24001 $21.62
BUP2018-00181 Plan Review 230-0000-43106 $117.11
BUP2018-00181 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $6.50
11x17)
Total: $325.40
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 9494D JDRINKWATER 06/14/2018 $325.40
Payor: Jon Erickson
Total Payments: $325.40
Balance Due: $0.00
Page 1 of 1