Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
Permit#: MST2019-00426
Date Issued: 11/26/2019
T I G AR n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S114AB01000
Jurisdiction: Tigard
Site address: 16095 SW 92ND AVE
Subdivision: None Lot: None
Project: CRONE
Project Description: Load-bearing wall removal and beam installation in kitchen.
BUILDING
Floor Areas Required Setbacks Required
Stories: 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: $40,000.00 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!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 N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
CRONE,MICHAEL D&DEBORAH M SUMMIT CONTRACTORS GROUP Required Items and Reports(Conditions)
16095 SW 92ND AVE PO BOX 493
TIGARD,OR 97224 STAYTON,OR 769-4333
PHONE: PHONE: 503-769-4333
FAX:
Total Fees: $1,102.07
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 - spended for more the 180
days. ATTENTION: Oregon law requires you/ follow the rules adopted by the Oregon Utility Notification Cent r. T e r es are set forth in OAR
952-001-0010 through OAR 95 -0090. You m- btain a c.. of the rules or direct questions to OUNC by calling 503.232 98 or 1;0 ',2344.
/ ?r :D
Issued By: :f/ / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection .
This permit card shall be kept in a conspicuous place on the job site until completion of the p •/ect.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR OFFICE USE ONLY
Cityof Tigard Received
g Date/By: II /C�
�77Permit No.:/enn sr-i7;)
---/...",1/04
i 13125 SW Hall Blvd.,Tigard,OR 972
Phone: 503.639.4171 Fax: 503.598.1 ECEIVED Other Permit:
Inspection Line: 503.639.4175 Date Read/BYH See Pae 2 for
(,}{{ZI) Internet: www.tigard-or.gov tified/Me da(
NnV2 2019 :Turis/ Supplemental Information
V1111110;111,
j� �� TYPE OF V4'ORi� !���� REQtiIREDD ELLING
[]New construction tieinDittlsG DIVISION 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
�, `I T ',ir,� w�, ,; '>>� work indicated on this application.
GAT OF C01 � ` 111pk i�6�� ,,1
® 1-and 2-family dwelling Valuation: $40,000
❑Commercial/industrial
ElAccessory building 111Multi-familyNumber of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND l'OCATION
Total number of floors:
Job site address:16095 SW 92id Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:JCL2062 Crone Fire Damage Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
EMIFIEIANRNNFUFIIROIIIIIIEIEPZSNIVPTPFV iliirrilf.i'iNTIRSVANSMBIEW14511141111Kwork indicated on this application.
Scope of work involves removal of an existing stud wall between the kitchen and Valuation: $
dining room, replacing it with a ceiling beam.Additionally,an existing beam Existing building area: square feet
across the middle of the kitchen ceiling will be replaced and upgraded. New building area: square feet
,I t, PROPERTY OWNER ❑ i&-ANT-:-,11111011FNumber of stories:
Name:Deborah Marie Crone Type of construction:
Address:16095 SW 92"d Ave Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:( ) Fax:( ) New:
96 C'ON TACT PERSON y ir�� I
Business name:West Coast Forensics All contractors and subcontractors are required to be
Contact name:Michael Atmadja licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed m the
Address:3835 SW Kelly Ave jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97239 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)957.2360 I Fax::(503)232.5372
E-mail:michael@wcfore.com
Business name:Summit Reconstruction&Restoration
Address:7215 SW Bonita Rd
Structural plan review fee(or deposit):
City/State/ZIP:Tigard,OR 97224
Phone:(503)451.3544 Fax:( ) FLS plan review fee(if applicable):
CCB lie.:153107 Total fees due upon application:' 4/O1.5 i
Amount received:
4
Authorized signature:
This permit application expires if a permit is not obtained
(� dn n�� ( within 180 days after it has been accepted as complete.
Print name:1 lackg�`' /� riq U Date' l (� * Fee methodology set by Tri-County Building Industry
y 1 Service Board.
I:\Building\Permits\BUP-RES PermitApp.doc 11/6/07 440-4613T(I1/02/COM/WEB)