Permit CITY OF TIGARD BUILDING PERMIT
111 COMMUNITY DEVELOPMENT Permit #: BUP2011 -00064
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2011
Parcel: 1S136AB05400
Jurisdiction: Tigard
Site address: 10460 SW 72ND AVE
Project: Olney Subdivision: SKORO MLP93 -0008 Lot: 3
Project Description: Solar photovoltaic system.
Contractor: SOLARCITY CORPORATION Owner: OLNEY, JERRY A & BETTY L
6132 NE 112TH AVE PO BOX 231153
PORTLAND, OR 97220 PORTLAND, OR 97281
PHONE: 503 - 964 -0489 PHONE:
FAX: 503 - 926 -9101
FEES
Specifics: Description Date Amount
Type of Use: SF Solar Photovoltaic System 03/31/2011 $180.00
Class of Work: ALT 12% State Surcharge - Building 03/31/2011 $21.60
Dwelling Units: 0 Info Process /Archiving - Sm Sheet (up to 03/31/2011 $4.50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $2,700
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $206.10
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
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 co the rules direct questions to OUNC by calling 503.232.1987 or 1.800.332.23
Issued By: Permittee Signature:
Call - •75 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 RECEIVED
Residential 1(,1:,,1 11( I 1 , .1 ( >v11
City of Tigard MAR 3 1 ,
i
g R Da ace7j affillnIMI Permit No.: , 610 it—,0006
:� • 13125 SW Hall Blvd., Tigard, OR 97223
ITY OF TIGARD � Plan Review��m Other Permit:
Phone: 503.639.4171 Fax: 503.598.1'.. •
- ► �
I 1 , , .\ , 0 Inspection Line: 503.639.4175 t l ILDING DIVISION Date Ready/By: i � � B See Page 2 for
Internet: www.tigard or.gov Notified/Method: '/ ® Supplemental Information
i" • il
TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
El ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
,__,� Valuation: $ 70 0
B 1- and 2- family dwelling ❑ Commercial /industrial � /
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / / 0 72 �/ Are • New dwelling area: square feet
City/State /ZIP: Port o j e Q 72 2 3 Garage/carport area: square feet
Suite/bldgJapt. no.: Project name: 01 ` Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
I - \ CTD1 f� ( ow DESCRIPTION OF WORK S work indicated on this application.
'7 ' 4 „ i i P / v Valuation: $
T u� 1(.W V Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( )
New:
❑ APPLICANT 0 CONTACT PERSON NOTICE
Business name: Ol G2'C c f t,_ / c2 � - All contractors and subcontractors are required to be
Contact name: -'�' iii " J �. C1 licensed with the Oregon Construction Contractors Board
Y � under ORS 701 and may be required to be licensed in the
6I Address: 2 N / 2 / r ' `_ , jurisdiction in which work is being performed. If the
City/State/ZIP: Lay/
C � J D p_ 0 7 2 2 applicant is exempt from licensing, the following reasons
pC / -
apply:
Phone: ( S03) "/J( .0(Dl n ` I F ax: : ( 5.36 . 6051,3
E -mail:
CONTRACTOR /
Business name: 50 >z o 7-y CoR Q��ON BUILDING PERMIT FEES*
Address: 6;/..I �� /72 711- (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/ State/ZEP: o A t d 97
q t/ 'act q z / - 9/ 0 i FLS plan review fee (if applicable)
Phone: ( 503) / 4 s / — ( Fax: ( 503 ) /tf� - —
/ D ` , Total fees due upon application:
CCB lic.: ' 7
Amount received: "Ode. 10
Authorized signature:
` ' � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:cie RM 7 ZONC1 I Date: 3/30 `� I * Fee methodology set by Tri- County Building Industry
� Service Board.
I :\Building\Pennits\BUP -RES PetmitApp.doc 10 /01/09 440- 4613T(I1/02 /COM/WEB)