Permit CITY OF TIGARD MASTER PERMIT
111111 I. COMMUNITY DEVELOPMENT Permit#: MST2019-00367
TIC;AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2019
Parcel: 1S135DB10500
Jurisdiction: Tigard
Site address: 11090 SW 95TH AVE
Subdivision: ASHBROOK FARM Lot: 22
Project: KASINGER
Project Description: Bathroom smoke and water restoration and remodel. Non-structural.
BUILDING
Floor Areas Required Setbacks Required
Stones: 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: $80,000.00 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
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<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 add'I 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:
KASINGER,STEVEN JR JOHNSON Required Items and Reports(Conditions)
11090 SW 95TH AVE 9425 N BURRAGE AVE
TIGARD,OR 97223 PORLAND,OR 97217
PHONE: 503-268-7458 PHONE: 503-240-3388
FAX:
Total Fees: $1,693.477)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes • -I other applicar e law. All work will
be done in accordance with approved plans. T is permit will expire if work is not started within 180 days of issuanc=, or if ork is suspe<ded for more the 180
days. ATTENTION: Orego law require you to foll the rules adopted by the Oregon Utility Notification ;Center. Those r -s are set forth in OAR
952-001-0010 through 0' -0btai a copy of the rules or direct questions to OUNC by calling 503.232.1987• 1.801 - 34..
i 1
Issued By: Permittee Signa (�/,/�( ,
Call 503.639.4175 by 7:00 a.m.for the next available insp.ction date. a'
This permit card shall be kept in a conspicuous place on the job site until completion of e project. 1
Approved plans are required on the job site at the time of each inspection.
Buildine Permit Application
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City of Tigard SEP 1 0 2019
13125 SW Hallialvd,Tigard,.01t.97223 (,,r.,„
Phone: 503.718.2439 Fax: 503.598.1960 ° :C.,;•AlIC DareBY:Flankievei:46.smohod,Itcyjemrd. - 41.-"Efe7,7),"„),A47,,,, ,,th-dea,:ipenni t/ - -
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Inspection Line: 503.639.4175
Internet www.tigard-or goy 'if.DING DrViiC . Date ReadYIBY: - 12/ la Iiii See Page 2 for
Supplemental botormation
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0New constriction D Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
6 ., Additiontaltenticakeplacement 0 Other: equipment,materials,labor,overhead,and the profit for the
i.' walk indicated on this application
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Valuation: $ SO or3C>
' j 1-and 2-family dwellkg 0 Commercial/industrial I
Number of bedrooms: Z.
0 Accessory building 0 Multi-family
0 Master builder 0 Other: Number of bathrooms: z,.
witemekmam44.--, - ,,-, '-ux-, .u0T-tiwfvugnw,"&r,,A!/,'-terelow,..0,1 Tolul-number of floors: i
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kb site address: ft0410 514 RST*4 A‘..1 MOE New dwelling area: 95 square feet
City/State/ZIP: -ri G,ti„,l'i?Or og. Garage/carport area: square feet
Suite/bldg/apt.no.: I Project name: le.A.S I 14‘614. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: _ „ equipment,materials,labor,overhead,and the profit for the
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5 tAc1V-€ VJATeie acs-rogit.-Tt.c$14 21% Valuation: $
ir.to A- st ROCCPL gA-r1-1424Pc4-1. gelvtob CI— Existing building area: square feet
New building area: square feet
— vs
Number of stories:
.Name: srre'v E K-A-st r-4(4)CE. Type of construction:
Address: I t CI 0 45 vj 4:1 51 ASA,1 E Occupancy groups:
City/State/ZIP: Ti G Aw r) p(2. Existing:
Phone:41:07) 2,fa,8,--7 . Fax:( ) New:
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Business name: EC_EC...-
Structural plan review fee(or deposit):
Contact name: EC01,4"121) ca06.1364.0(4-1
FLS plan review fee(if applicable):
Address: (i CPC) i4E- 2-e:r"A Ue t&•2 iz.
Total fees due upon application:
City/State/ZIP: P0111....,441,1) t .
Amountreceived:
Phone:( D3) 704" •-IS 8.0 I Fax::( )
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E-mail: eat & eric - .a - Is CO
Commercial and residential prescriptive installation of
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Business name: ...) g 3c44-eas 044 LL ._,CSubmit two(2)sets of roof plan with connection details
1 and fire department access,along with the 2010 Oregon
Address: i4eLT /44 Bo fe-C.P•GE p Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
$180.00
City/State/ZIP: poe.-x-LA,,,,11) ,,e.
and admini,strative fees):
phone:(503) 2.44 ,.. 33 ?::, Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 2.z (56,‘
Total fee due upon application: $201.60 i
This permit application expires ifa permit is loot obtained
within 180 days after it has been accepted as complete.
a tset by Tri-County
Fee mehodolow Building Industry
Print name: Ed ir^ et 0.5 Date: 10.512.4. 7(9 Service Board,
I:\Building\Pennits\BUP-RESPennitApp.doc 02/24,2011 440-4613T(l 1/02/COM/WEB)
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