Permit (235) 111 CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2019-00171
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2019
Parcel: 2S110AD90025
Jurisdiction: Tigard
Site address: 14880 SW 109TH AVE
Project: Canterbury Woods Subdivision: CANTERBURY WOODS CONDO Lot: 25
Project Description: Building 4. Remove existing siding on windows at pop-outs;install new siding on rain screen at pop-outs.
Contractor: SEAN GORES CONSTRUCTION INC Owner: THOMPSON, MARY F
PO BOX 1519 14880 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: ,411r 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.
•
/,iL ke\l5, IA--
Building Permit Application
Commercial FOR OFFICE USE ONLY
City of Tigard Received \ Permit No. ?�;1G-�: i1.1
"III 13125 SW Hall Blvd.,Tigard,OR 972 3 -- Plan Review
Phone: 503-718-2439 Fax: 503-598-1960 Date/By: -S• Related Permit:
1 1 t,Alt n Inspection Line: 503-639-4175 J U L 1 6 ?-1113 Date Ready/By: / i Jvris: gl See Page 2 for
Internet: www.tigard-or.gov •'o'fied/M�400 ( Supplemental Information
CITY (.If HO -
TYPE OF I, 4 4 ING DIVISION- - REQUIRED DATA::i-AND 2-FAMILY DWELLING
❑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 equipment,materials,labor,overhead,and the profit for the
� * ' work indicated on this application.
_ �r: CATE+t;O�tY' OF �?1SUC'I'i�i�t F � a�� , /� y� lb
...r ,_, .. Valuation.: $ /l/1)�6U;
❑ 1-and 2-family dwelling 0 Commercial/industrial v�
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
'JOB SITE INF I NATIO AND 1 OCATI()N Total number of floors:
Job site address:I4'QQ Di t g , f .g f gree fp �,1,0(y0 1((,ygcro illy_New dwelling area: square feet
City/State/ZIP:110 /0 t/ q�"��jf tL (o'V (D9` 1 I Garage/carport area: square feet
Suite/bldg./apt.#: 0 v°P—r-oject name: r4N.�f (�'T" ( 1�1' �,I 0 Covered porch area: square feet
Cross street/directions to job siite: �{f'/rye'/, Deck area: square feet
5;1d [riq 41/ * c{' 1 12 1/e44- ST Other structure area: square feet
R) VIRED DA`CA:COMM RCIrI U USI CIUEC£LzTTT:<
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 theDESCRIPTION a0} o� x i `rig ‘'..',°',.,:::,T,`:::1-0[0:', work indicated on this application.
xs .. ,,,, Saar , r v :r, bp--.I t -ua .. .
r.t ,1p �iCi/ t-i. 91 clol hl'�_ fly. KiwrOI1nr,S AT Valuation: $
file- arc ;C1 i N9 L fA 1 i 'CI c'l v l v 11't ( 41 1 V c tto Existing building area: square feet
i Pd P. d 1 roc T� New building area: square feet
fl PCROPERTY OWNER ..- L u 1.' ;=TENANt gq, „ ,,^ Number of stories:
Name: (41V1 d%f)OVV 1460. Type of construction:
Address: Jtt1l0 QtY 1)g1V ,t(- Occupancy groups:
City/State/ZIP: --rt F76 9
! 7-_ _ Existing:ing:
Phone: ) Pn� (cazY Fax ( ) New:l''.•AyefLXCAIT= 4 x 44�467AC ' re 6N .0=-..11,0
EE�FEEt
Business name: J� U xGr�V 1L 1 Nr Structural plan review fee(or deposit):
Contact name: q�'w1,ly"`1. ( GI( !
r�� "" ,,p��n' f� FLS plan review fee(if applicable):
Address: Ø / �� I'M ie aief` t
�f i ? Total fees due upon application:
City/State/ZIP: lI 1��/1 AVc11. d 7/ L
Amount received:
E-mail: cl l mat 6014,6 R4;,,,,�,,/R Commercial and residential prescriptive installation of
`"`' ~' A -t :<, _ °` ^ „ . ,.,e-: - '' roof-top mounted Photovoltaic Solar Panel System.
Business name: ( � ell ZIN( Pt Submit two(2)sets of roof plan with connection',,,,
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� and fire department access,along with the 2010 Oregon
Address: ���� �['r INI' 'p� �V MAI J Solar Installation Specialty Code checklist.
City/State/ZIP: u�/y�i j. 11,E tet" Permit fee(includes plan review $180.00
{�/)� rr1 `' ��v�� and administrative fees):
Phone:Corj 1� --76r)
7 � Fax:(.'�1 \1_ `t)O State surcharge(12%of permit fee): $21.60
U'
CCB Lic.: ` co 6.--G � `°
t /�J� Total fee due upon application: $201.60
Authorized signature:,;r:; .,1,ie::!J This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: I�trC`U �'lJ�f �y Date: * Fee methodology set by Tri-County Building Industry
i /1 l1j/j Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(i I/02/COM/WEB)