Permit (240) INCITY OF TIGARD BUILDING PERMIT
' COMMUNITY DEVELOPMENT Permit#: BUP2019 00173
TtAR.L) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2019
Parcel: 2S110AD90041
Jurisdiction: Tigard
Site address: 14920 SW 109TH AVE
Project: Canterbury Woods Subdivision: CANTERBURY WOODS CONDO Lot: 41
Project Description: Building 6.Remove existing siding on windows at pop-outs;install new siding on rain screen at pop-outs.
Contractor: SEAN GORES CONSTRUCTION INC Owner: COOPER, SOLOMON
PO BOX 1519 14920 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: 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: ` Permittee Signature:
- -..--..........._ -43,0e' -
r -
•1 503.639.4175 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
Cityof Tigard Received ^- i r ' ,(�
g w y: -1'
1 l^ , S Permit No.::� y'VC 1- \ l
Ill 13125 SW Hall Blvd.,Tigard,OR 972 i Date/
By:.
Phone: 503-718-2439 Fax: 503-598- �" Y"1 Date/By:
y: S s Related Permit:
l I G n R D Inspection Line: 503-639-4175 Date eady/By: tis: BI See Page 2 for
Internet: www.tigard-or.gov JUL 16 2019 a ed/Method: `'J i/ Supplemental Information
/.07
TYPE OF:W ''OF j 1GA - REQUIRED DATA:1AND 2-FAMILY DWELLING
❑New construction 130604140 01V1,0 I Permit fees*are based on the value of the work performed.
E]Addition/alteration/replacement ./Other Indicate the value(rounded to the nearest dollar)of all
p QG� equipment,materials,labor,overhead,and the profit for the
CATEGORY`OTS Ct NSTRC1 i , work indicated on this application.
, c- r, .-� �, . Valuation $
❑ 1-and 2-family dwelling 0 Commercial/industrial ���:
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
- JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1(1,110 Ki977.. (qi Ty). I
�i-f 17, I t,I ci i<i I ��i J 1 -bz- New dwelling area: square feet
City/State/ZIP:1' e414), t q-7-1-N f(p p 11j,j j L(1I 3(7' I(„irag G I(�f jil
G�;agg/carport area: square feet
Suite/bldg./apt.#: 1 ,P_r"oject name: >��r�1\( 1 _1(/� V(oODi 44 .1 U` "Covered porch area: square feet
Cross((``ss�treet/directions to job site: qq /p�'/, may^ a"" Deck area: square feet
s*' I5`I*ld * C \t tii l If 1�IJJ f Z7 Other structure area: square feet
REQUIRED DATA COlitRCIAL-'[TSE CHECKLIST,
Subdivision: 1 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
DECRPTION amO_,.#0-04;i7: ,, �.�s �.,
work indicated on this application.cation.
} a ! y-F -c tc-t-N2) ci12tj , ,7VtAlifv/ V AT
Valuation: $
f%P.- dCj INCALfr CIPitV
1' ' C; 4Existing building area:
square feet
i PJP3 i 5
New building area: square feet
Er iRopEriiOWNER 0,TENANT , Number of stories:
Name: TdVU i�
l�YboVV y A , Type of construction:
Address: JL.f"/10 log-to Alp- Occupancy groups:
City/State/ZIP: `r,�6,0,/. (, 9"7 1-74.1 Existing:
Phone: ) f !l��l- Fax _-( ``ll )
New:
0 APPLICANT . O T`A `PERSON ba BUILDINGP�ER. IT FEES*
E
•:, . a- �� - r = - n,M'„''. ?- .#a "�n T.. Ana&'..'-''o -.', ,. r s�.. : A''+
" t't'''- t'�fq, i`scbed ,,,- ,,
Business name: U/ ( � ( INC
�,�n 4 Structural plan review fee(or deposit):
Contact name: t1�1�1 L f S1eottc
Address: ` I fv, t .p�-t'I °axt5� FLS plan review fee(if applicable):
City/State/ZIP: J F+ t(AVK ;�' 4, ° pi(1'7' � Total fees due upon application:
7.
Amount received:
Phone: 14+1 I . ,'I i — 1.II.
E-mail: ...,.... ,
Cr �� 1t� iI� a t s r .. ,, ,` Commercial, and residential prescriptive installation
n of
,,CONrTRACGOA :
. ' -' ,. ,, :_ roof-top mounted Photo Voltaic Solar Panel System.
Business name: Xery4 i ( ? 1 rt 111(t. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: G1 q/A c- ih({' � y Solar Installation Specialty Code checklist. _
City/State/ZIP: M�A ii.,, WILI'F- 0 1/1/E, !, 1" Permit fee(includes plan review $180.00
!V' and administrative feesL
Phone:��1 Z h -,i t�) Fax:q5 i `1` ----- fl1( State surcharge(12%of permit fee): $21.60
CCB Lic_.::t ( („ i G 'J" t "1
UU Vii Total fee due upon application: $201.60
Authorized signature:.,.. /'/1L„`�. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
•
Print name: ��(� �°,�f ,Y11 J Dater .j`�/I,1 * Fee methodology set by Tri-County Building Industry
'" V1 S l/ ��'l� Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)