Permit (11) CITY OF TIGARD MASTER PERMIT
114 a ' COMMUNITY DEVELOPMENT Permit#: MST2019-00026
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/21/2019
T f z ,,,,,•R I� g Parcel: 1S125DB00500
Jurisdiction: Tigard
Site address: 9285 SW 70TH AVE
Subdivision: SHADY DELL Lot: 5
Project: HIMAN
Project Description: Adding Supports to existing foundation.
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: $18,000.00 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
Drywell-Trench Drain: 0 Other Fixtures: 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
Furn>=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 add9 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 VB R-3 0
Owner: Contractor:
OTT,JENNIE CONCRETE LIFTING SOLUTIONS LLC Required Items and Reports(Conditions)
HIMAN,HILARY MARTIN PO BOX 4614
9285 SW 70TH AVE TUALATIN,OR 161279
TIGARD,OR 97223
PHONE: PHONE: 503-595-5110
FAX:
Total Fees: $622.54
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, •r if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow •- . ---•ed by the Oregon Utility Notification -hte. •:e rules are set forth in OAR
952-001-0010 thro •• •.R 952-001-0090. • ••- •• •• - . of the rules or• ect questions to OUNC by calling 503. r• .190 or 1.80.332.234x4.
Issued By: ..../_._ —Lt —. i 01111111111111111.111111r- Permittee Signa . /
Call' • .• .4176 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
Residential FOR 01.1'1( I_ t 'NE()NEI
CI of Tigard ,-- t 1; ceived PermitNo.:
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13125 SW Hall Blvd.,Tigard,OR 97223 "`" •'•IanReview hif
' Phone: 503.718.2439 Fax: 503.598.1960 Date/B - �� • er Permit:
1'1 c A R D Inspection Line: 503.639.4175 F 1:1_:,5 a 2 0 19 Date Ready/By: H See Page 2 for
Internet: www.tigard-or.gov Notified/Metho rillyrjSupplemental Information
i # a-: da 8 a°
TYPE'OF'wo UJLD1 NG DivisloN REQUIR.EDDATA.1_-AND2-F Y DWL,LIN
❑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 ®Other:repair equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ �� • w
® 1-and 2-family dwelling 0 Commercial/industrial h�.c Jc %f
❑Accessory building 0 Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9285 SW 70th Ave. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name F mdatinn upp r4 0.,./r1c+'V Covered porch area: square feet
Cross street/directions to job site:SW 70th South of Taylors Ferry Rd. Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-ISE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:1S125DB00500 R23087 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF J work indicated on this application.
ADD SUPPORTS TO EXISTING FOUNDATION Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Himan i A 14,07 ut. ✓z, u 6 Type of construction:
Address:9285 SW 70th Ave. Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) Fax:( ) New:
0`APPI #CANT ❑i;CONTACT PERSON BUILDING P'ERItF'FEES*
Business name:Zarosinski Engineering and Design,Inc. fPlepscir�jerte cher
Structural plan review fee(or deposit):
Contact name:Dean P.Zarosinski PE
FLS plan review fee(if applicable):
Address:1400 NW 15th Circle1 1`_
City/State/ZIP:Vancouver,WA 98685 Total fees due upon application:
Phone:(360)513-2746 Fax::( ) Amount received:
E-mail:dpzski@hotmail.com PHOTOVOLTAIC SOLAR PANEL-SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Concrete Lifting Solutions,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:P.O.Box 4614 Solar Installation Specialty Code checklist.
City/State/ZIP:Tualatin,OR 97062 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)595-5110 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:161279 Y[444,Z O 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:Dean P.Zarosinski PE Date:2/7/19 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)