Permit (246) CITY OF TIGARD BUILDING PERMIT
''' COMMUNITY DEVELOPMENTiii
Permit#: BUP2019-00168
TP ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2019
Parcel: 2S 110AD90001
Jurisdiction: Tigard
Site address: 14820 SW 109TH AVE
Project: Canterbury Woods Subdivision: CANTERBURY WOODS CONDO Lot: 1
Project Description: Building 1.Remove existing siding on windows at pop-outs; install new siding on rain screen at pop-outs.
Contractor: SEAN GORES CONSTRUCTION INC Owner: SANCHEZ, SYLVIA
PO BOX 1519 14820 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-2 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: P_a__rapet:____.
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.
'-'e?-j-lr-- 2-----' '
Issued By: cr...0.‘/"..r.ii__,
Permittee Signature: /y / _ ��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. f'
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.
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Building Permit Application
Commercial � F012 OFFICE USE ONLY
City of Tigard E€ie
( & {� '� Permit No3ct_honeSlv9TigardOR 9722 �� } � y Pl � I _ l 9 T9
Phone: 503-718-2439 Fax: 503-598-1960 Date/By: / Related Permit:
Inspection Line: 503-639 4175 ` gi See Pae 2 forTIGntD I ' } Crp` "tt DatefReadye/By:: / rar s:
Internet: www.tigard-or.gov
Supplemental Information
31JILDING DIVISION
TYPE OF WORK REQUIRED DATA:1AND 2-FAMILY DWELLING
0 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
0 Addition/alteration/replacement Other equipment,materials,labor,overhead,and the profit for the
- CAS +CRY, ,,,,, , x work indicated on this application.
4t11�I5T1+kil�O�t
Valuatiort: $ J �fOU,�j; lb
❑ 1 and 2-family dwelling ❑Commercial/industrial
❑Accessory 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 addressa9l)! I ifSz-z I I r';' tI IIIJ,I,'lc itf iOai t New dwelling area: square feet
City/State/ZIP:11 8400 r Z q���� "I bml:7 Lt'co ( IC-tM.AVF Garage/carport area: square feet
Suite/bldg./apt.#: r �l Project name: �� (J Li„
vst op& �.)� Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
51`"�u In`(`I*14 $, cf id�1ry t u"'174- Or Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE"CIIEECKLIST
Subdivision: I 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
-.;,, ,p.Es RPTIONF WO .[,. ,,,,....!,,t.,....„,,,,,,,,.:;;s , work indicated on this appli
cation.
td ,� ris ' vl cl.D1Nei IN
1
6114vjOrSrtf Valuation: $
file- c , tNiAlrx Tri cipoG fl Existing building area:
square feet
PJP-dill
New building area: square feet
PROPERTY OWNER
; 1Z�T g; ' Number of stories:
Name: (4141710/NKoOig yo.
Type of construction:
Address: I t//10 at' I I $ - Occupancy groups:
City/State/ZIP: `riiN di. 9 7`1/61 Existing:
Phone: ) (Ogg i z_ Fax _( _I )
New:
s;4 ,,0 APPLitii, ;, re-4,t;,,,,."2.',„,4‘,- ,,,"..,. 0 CO `ACT�P,,I RR'SON `q m _ , BUILDING PERMIT FEES*;
Business name: 61012:N t•'I ] � rd �Aediel
0,100:c INCL Structural plan review fee(or deposit).
Contact name:
Address: >I I i(�i' o � rUNFLS plan review fee(if applicable):
Total fees due upon application:
City/State/ZIP: lu f tvyA [.,)Kis I d 9 7 ---Z
Phone:(n 1 19 Fax::,,,,,,r-Az _ `�',q,/{y Amount received:
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�� _ �" �" roof-top mounted Photovoltaic Solar Panel System.
Business name: Atirt,VA. cfio- 1 �1 ( i Submit two(2)sets of roof plan with connection details
/" and fire department access,along with the 2010 Oregon
Address: oI g9,1 G' Ii' f i�, '�, yvii\I Solar Installation Specialty Code checklist.
1, i"`� Permit fee includes plan review
City/State/ZIP: {{J�ikv/ j�'� Q( ria, ( p $180.00
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�� and administrative fees):
Phone:�' 17,h `-Ji j do Fax:(1J" 11&--1 §1f State surcharge(12%of permit fee): $21.60
IICCB Lie.: & 60 Total fee due upon application: $201.60
Authorized signature:�� ,......45"--- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
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Print name: �i(f 6 �, / Date:1 .(i_/I
11 * Fee methodology set by Tri-County Building Industry
v 6 '�'ly1j Service Board.
I:\Building\Permits\BUP_COM_PetmitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
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