Permit IL CITY OF TIGARD MASTER PERMIT
r ' COMMUNITY DEVELOPMENT Permit#: MST2020-00095
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/31/2020
Parcel: 2S103DA05100
Jurisdiction: Tigard
Site address: 10635 SW COOK LN
Subdivision: FANTASY HILL Lot: 8
Project: BORNE
Project Description: Voluntary foundation repair.
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: $28,970.00 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 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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
Fum<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 addl 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:
BORNE,CORY A&LORI T RAMJACK OF SOUTHERN OREGON LLC Required Items and Reports(Conditions)
10635 SW COOK CT PO BOX 11701 1 Special Inspection Required-
TIGARD,OR 97223 EUGENE,OR 97440 Piles/Cassons
PHONE: PHONE: 541-501-8940
FAX:
Total Fees: $886.01
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 ma obtain a co of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.,
�Issued By: Permittee Signature: ff "s-
03.639,4175 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
Residential ` FOR OFFICE LSE ONLY
City of Tigard U 1 Vem.`'"y: '' PeamtNo.o►'1 .21/0— s,
'II • 13125 SW Hall Blvd..Tigard,OR 97223 Plan ReYIeW ���
m° Phone: 503.718.2439 Fax: 503.598.1960 MAR 1 9 2021 Day' Other Permit:
],tt�.,i4Il. Inspection Line: 503.639.4175 Date Ready/B / Jails � See Page 2for
Internet: www.tigard-or.gov CITY TIG my ,Notified/Method: / Supplemental Information
/� TYPE OF W OFPU�j1� M REQUIRED DATA:1-AND 2-FAMILY DWELLING
V ❑New construction ❑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 E Other 1,r- equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ `L 8940
„RI-and 2-family dwelling ❑CommerciaUmduatrial
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: k^3 k i o .£ ) (iv New dwelling area: square feet
°�
City/State/ZIP: Etc° ,` u Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: R(7 rIVC Covered porch area: square feet
Cross street/directions to job site: . .'1`I akae.; S{ l 1 c{dv,(„" "k,4f' Deck area: square feet
' k s t y a )6- .v� pNe tr Other structure area: square feet
1 REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 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
DESCRIPTION OF WORK work indicated on this application.
-yeri, ..,
/ 0^ Valuation: $
y Existing building area: square feet
New building area: square feet
1il PROPERTY OWNER ❑ TENANT Number of stories:
Name: CPQS w Type of construction:
Address: a 0c cc-, Occupancy groups:
City/State/ZIP: I t c ,.:( '' C, c1'q-22 Existing:
Phone:(SOB , 9- Fax:( t ) New:
IX APPLICANT LTV CONTACT PERSON BUILDING PERMIT FEES*'
('tress refer&fee schedule
Business name: g,u , (;((°. ....... 7 Structural plan review fee(or deposit):
Contact name: .-e„,4-)4 -iE iCz t-.R FLS plan review fee(if applicable):
Address: bX `V 9-0\ Total fees due upon application:
City/State,/yZIP: r �''f"Se, ,, tp ^'t L( Jy Amount received:
Phone:( ,�) ) "� 4 / [/y 142.C) I Fax '( ) e I r
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES'
1 C `. - *-a y{c,_ - Commercial and residential prescriptive installation of
CONTRA R roof-top mounted PhotoVoltaie Solar Panel System.
Business name: t'n & G 2S\— Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Po ( ,�� � Solar Installation Specialty Code checklist.
tr, t 4a ggyyPermit Fee(includes plan review $180.00
City/State/ZIP: . 0\9_"1(--� s.and administrative feePhone:(, l q(o Fax:( )i ( ., `�Tl ck I State surcharge(12%of permit fee): $21.60
CCB lic.: 1 Li (p C Q(,e) Total fee due upon application: $201.60
Authorized signature: -- , 3r--—°-'— This permit application expires if a permit is not obtained
within 180 days after It has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Print name: ,s,�Q Cy, Date: 1� ,,,_,� Service Board.
I:\Buildingwermits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)