Permit (238) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2019-00175
T[GAR rj 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2019
Parcel: 2S 110AD90061
Jurisdiction: Tigard
Site address: 14960 SW 109TH AVE
Project: Canterbury Woods Subdivision: CANTERBURY WOODS CONDO Lot: 61
Project Description: Building 8. Remove existing siding on windows at pop-outs; install new siding on rain screen at pop-outs.
Contractor: SEAN GORES CONSTRUCTION INC Owner: DEVRIES, LINDA J
PO BOX 1519 14960 SW 109TH AVE
CLACKAMAS, OR 97015 TIGARD, OR 97224
PHONE: 503-723-7500 PHONE:
FAX: 503-723-7504
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 08/07/2019 $475.99
Demolition
Occupancy Grp: R-3 Occupancy Load: 0
12%State Surcharge-Building 08/07/2019 $57.12
Dwelling Units: 0 Plan Review 07/30/2019 $309.39
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 08/07/2019 $3.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $26,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $845.50
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parpet:_ _ - _ -
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: 1,0, ... '� Permittee Signature:
Ca 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 FOR OFFICE USE ONLY'
y��t
Cl of Tigard t k !t to "S Received Al c C Permit No.: C \
a 13125 SW Hall Blvd.,Tigard,OR 972 3 Plan Review J
■ Phone: 503-718-2439 Fax: 503-598-1960 Date/By: on•'S' 9/1-'7 Related Permit
1 I c.n R l) Inspection Line: 503-639-4175 t.,L i b .019 Date R By: uris: ® See Page 2 for
Internet: www.tigard-or.gov Not ethod: '' Supplemental Information
CITY OF- TIGARD ,
TYPE of: '• ,,,,,,ING.0 tylsipi.4 :,-:',-...-:,,,,,,i, REQUIRED DATA:1 AND;2-FA111(1L`Y DWELLING
0 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
4
CATEGORY of CCO .f RttbiiL , , work indicated on this application.
Valuatioit. $ Itii-6O1
❑ 1-and 2-family dwelling 0 Commercial/industrial (,,1'
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
SITE INFO MATIONAND LOCATION +i Total number of floors:
Job site address:I t''uU t t �1 I L l w(I it. �(i )rt"1 I 11.4q-70I I q,'L New dwelling area: square feet
City/State/ZIP: I , t xq- i' i�'1Jt (qt2 6 i�4k1 Garage/carport area: square feet
Suite/bldg./apt.#: O Project name: r/pt,( ti W 6 �'` Covered porch area: square feet
�.I Crosss'sstreet/directions to job site: M ��ll� `°" Deck area: square feet
5 N 139-41.�'Z-1 -47 cid �� J b 4 Other structure area: square feet
tE IR ID:*t*Col is;. rCI`S) ti4L,1 r,
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DCRPT. ION
`Zwork indicated on this application.cation.
. , >. . ".,,..,,t, ..': s : ^s „w c �. .z�. aL 1 r , , w..hz4; n aw �a''
r, � -yGTicYI' ciVit IN i/\IYwry✓irivSAt Valuation: $
f 34nGAINctAlfrGIP!N4 ;t! �ttVVal Existing building area:
square feet
' 7j Pd
New building area: square feet
`` 0=PROPERTY' OW1 ERTENANT k�` :. F c Number of stories:
Name: CYC arP V\16-61g Type of construction:
Address: lit 110 `4 Y 11 f) ALF- Occupancy groups:
�/�
City/State/ZIP: 1[1��v. a, 9_1`rExisting:
Phone: ) t9.-r" !2� Fax ( ) New:
4:❑.&t.f CAt k s ," ,, *rte a t P* ;, b •'€'i I DIN P ITyES*{-'''''',',0'k''4,'
Business name: �i I Wi x��/ if Vr, Structural plan review fee(or deposit):
Contact name: tkI/r' /i Civ • !
i :++ lam,, —® ,tA��� FLS plan review fee(if applicable):
Address: `2ji IgNiT]►�''(� vY`tt-
City/State/ZIP: E I,•L-V'IfAVKI&I PI-17Z-� Total fees due upon application:
Phone: Amount received:
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Commercial and residential prescriptive installation of
,,, n. CO O _j.' ,. x.,..a,/u,. n, .r roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ](cL 1 r( ON)i Submit two(2)sets of roof plan with connection details
'/'� j �,,� `�� j � and fire department access,along with the 2010 Oregon
Address: Of t��Jl El �K�l P4 - jY II Solar Installation Specialty Code checklist.
City/State/ZIP: M 1,41,(�'�- 0�//1/� l` Permit fee(includes plan review $180.00
Phone: h ` ten Fax: _--1 and administrative fees):
1 +� State surcharge(12%of permit fee): $21.60
CCB Lie.: t 0 I 6.-G-
Total fee due upon application: $201.60
Authorized signature: /�:f t/ - This permit application expires if a permit is not obtained
�� within 180 days after it has been accepted as complete.
Print name: (r t;�[ 014.11-:'
YI1 t Dater /1 /j I * Fee methodology set by Tri-County Building Industry
'v R vvbb V J °1'l� Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)