Permit 11/19/2010 10:05 5036454719 CONDON AND ASSOC PAGE 01/01
RECEIVE*
NOV ! 9 2010
Community Development
CITY OF TIGARD
� I G� A R � Request for X'e nit Action BUILDING DIVISION
TO: CITY OF TIGARD �M � G' CX>'ZC��
Building Division Services Coordinator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503398.1960 www.tigard- or.gov
FROM: Z Own.ex [] Applicant ❑ Contractor . ❑ City Staff
(cheel: one)
REFUND OR Name: Sarah Condon, Bright Day, LLC
INVOICE TO: (Business o, i ndividual)
Mailing Address: 16727 NW norwalk DR
City /State /Zip: Beaverton, OR, 97006
Phone No: 503- 330 -2588
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
® CANCEL PERMIT APPLICATION. V 0 1 D
[] F UNI '.l~RMrr FEES (attach receipt, if available).
►1 INVOIC FEES DUE (attach cast fee schedule and explain below). //02 /
3. /0
VI 0 E CONTRACTOR FROM PERMIT (do not cancel ermit).
Permit #: f\'\ - F D \) £ 0 c5
Site Address or Parcel #: 12865 SW Beagle Ct, Tigard y �^
Project Name:
Subdivision Name: Quail Hollow West Lot #: 92
EXPLANATION: Permit was filed to permit a deck that built probably around 2000 or
r 1
2001. After plans examiner looked at permit, it was determined that this deck was inspected and
a roved from an earlier . er n ut #MST2009 -00118 - final a. royal 2/24/10
Signature: / Date: 19 November 2010
� /`�
Sarah Con on - Bright Day LLC
Print Name:
Rrfund Policy
1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 60" /o of the and use application fee when an application is withdrawn or canceled before any review effort has been expended.
r,or more than 80% of the hand US& application fee for icrued vox - mite.
d) not more than 80% of the building plan revic v fee when an application is canceled before any plan renew effort has been expended.
el not more than 130:% of the building permit fee for issued permits prior to any inspection requests.
2.
lidund- will be rtturntd to the original Payer in the same method in which payment, was received. Please allcnv 1 -2 wee.lts for processing refund.
FOR OFFICE USE ()NIX
Rte to Sys Admin: Date By Rte to Bld Admin.! Date / „2 to By
Refund Processed: Date #'!Y — B oTZW Invoice Processed: Date j .s2s /� B U�
Permit Canceled: Date ,23 • B % /�r� 'steel Tag Added: Date N/,9- By
Receipt 44772 77 Dare /' /i.r /0 Method (' Amount $ /
l: \Building \Form• RegPetmitAction.doc Rev 07/26/07
Building Permit Applicatio //� . l , . � " . ,
Residential V 0 .,
FOROFF ICE-USEO \ll , 4 of Tigard Ci tl, i ',, ;
f
�j r _a k. Lar_ . . :a IIL�.' ms
���i" "'± ty l ' CEJVED Received
Penn
it n DateB �/ / n No.: H, AlD`e� 0'20
. tilli
r 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
. _ Phone: 503.639.4171 Fax: 503.598.1960 N 0 V 1 2 Other Permit:
n
3 T 1 G A &RD Inspection Line: 503.639.4175 Q U Date/By: Date Ready/13y: Iuris :la See Page 2l for
.: . .. Internet: www.tigard - or.gov Notified/Method: �G pplementallnformation
CITY OF TIGARD
, X�
& 5we E ': a � , :ra . a },'�- 7f l�9 9 '!.. .4� .; i ° °@ I tF' 4 r `"1" '"� i . : :,;, ', ' `rN a f� zX, n..."g31 s.. ` ;f opt .....,: sttk r.,+ :' x 4
l': ;.:1 .5. l .;w.� i1:. .�; YP 0o,. .. ° , . 4, `, *.m, ',: 1 1 140 , "a'Wi � .: ,� (2�.ED I A'iA 1 ,,, 2 I<+'AA1 :X r ELT TNG
..>, �'. ^�Rvl.,..._', =!mR ra a&�n1 »�x..a3�3 . � < s to .tM ..e
❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
,it , `'"th4' �"t� °T'��" 1 4> work indicated on this application.
:, � ��r . ,10.1 . i2 �DF ` G S R U 0 41 r........1' ..Y .°, _.
.4 and 2- family dwelling ❑ Commercial /industrial Valuation: s/76
❑ Accessory building 1.] Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
y am ., . ti � , fp $ ,, offe. Fg r ',VL iro g o f Total number of floors:
Job site address: /,9, ' , S S i-!.J G )� New dwelling area: square feet
City /State /ZIP: � G. (� , ,. U a, ! � � z - . 3 Garage /carport area: square feet
Su ite /bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: ; 2 square feet
Other structure area: /� square feet (T
li F PRA A R L` �V , x-R IA V S- YF }E .§7 4
Subdivision: (X U. C. ` t 1 „- fl . ,...4e..9-,--- Lot no.: i Z Permit fees* are based on the value of the work performed.
Tax map /parcel no ti a -- ? 1 ` hl Indicate the value (rounded to the nearest dollar) of all
�+ V `e equipment, materials, labor, overhead, and the profit for the
V.: P �: s D SC * '' t �' ' work indicated on this a lication.
.�a_.<,5�.�«�. �t�aas �_,..�„s �� am kNo ±w ».+
v x a..��.,,.
. ,5.# .. `�fi"t�,'�, w� tfi�; PP
D C � - AA_ ck v. -- ci--In Valuation: $
Existing building area: square feet
New building area: square feet
eit ,,T, _ .3 . i)`PER ,. ... IR A: , a.t a T . . , : j z Number of stories:
Name: u -y D Axt l L�� 1 Type of construction:
Address: ( -J ).1 :I w �kU t ,2_,..0, c 1cz 1cj Occupancy groups:
City/State/ZIP: c y) �'r f- ts-■/N 5) q '(E 40 Existing:
Phone: ( )5) 3 .: �� j ) �; � 5 ti --7 I j
;, ? �.` `� `� t�i)P �','�. ._; WW. � F (� � F �� � ��t � c,.,w�ra. �s«t�y�h�a �� .: New: �s
:n N 51 t ' "s f T 74 c ..a„ .�, � a rb'a� x � ; ��G ;r ,?, 9` fi r� r n� - k iVU >iCF gnVz ?viii
Business name: , 6 1,.4
Ai. , � (__,C All contractors and subcontractors are required to be
Contact name: ` licensed with the Oregon Construction Contractors Board
` 2 " 4 �� 0.3..y\ under ORS 701 and may be required to be licensed in the
Address: 1 (c .--- --- pj �V�rO _ t , jurisdiction in which work is being performed. if the
City /State /ZIP: ►> y-� ��� j applicant is exempt from licensing, the following reasons
C.:, ku apply:
1 Phone: (51) ?7) 5 5 t! 0 ' 5 p Fax: : ( ) (fG 1. 5 4" 1 ( l
Email k..it� {B-L r C CC f s 1 L r & ,e L-c &
S+x
i Business name: $01, 1.$CYr E rft1 r "
.. .- ''k. 44: sehelitej ' t :,et t ' a
Address: Y/ n: : _.,:
City /State /ZIP:
Structural plan review fee (or deposit): 6/. C3 7
Phone: ( ) Fax: ( )
FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
wt
Amount received:
Authorized signature: , r
IA-
/ • This permit application expires if a permit is ppt obtained
(�_�� within 180 days after it has been accepted as complete.
Print name: , l—Ctl�.O,k--\ t G, Date: i ( i iJ /0 * Fee methodology set by Tri- County Building Industry
Service Board.
1: \ Building \ Permits \BUP -RES PermitApp.doc 10/01/09 440- 461 3T(11 /02 /COMIWEB)
z 3'
S IT E - - --- ?L, A. J•J
i!: CEIVED
NOV 1 2 2010
CITY OF TIGARD
l■ BUILDING DIVISION
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