Permit gi y a CITY OF TIGARD MASTER PERMIT
l l COMMUNITY DEVELOPMENT Permit #: MST2011 -00062
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2011
Parcel: 1 S134DA00800
Jurisdiction: Tigard
Site address: 11030 SW 106TH AVE
Subdivision: NORTHERN PINE Lot: 8
Project: RICHARDS
Project Description: Reframing (3) windows.
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: No
Total: 0 sf Value: $3,129.00 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
Drywell- Trench Drain: 0 Other Fixtures: 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 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:
RICHARDS LIVING TRUST A CUT ABOVE EXTERIORS INC Required Items and Reports (Conditions)
RICHARDS, JOHN A & JULIE A 12985 NW CORNELL RD
11030 SW 106TH AVE PORTLAND, OR 97229
TIGARD, OR 97223
PHONE: PHONE: 503 -639 -7172
FAX: 503- 639 -9755
Total Fees: $242.13
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty • 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 is- a / e, or if work is suspended for more the 180
days. ATT• • ': ; -gon I- requires you to follow the rules adopted by the Oregon Utility Notifica.on ' enter. Those rules are set forth in OAR
952 -001 ■010 through OA• •5 - 001 -r0 • You may obtain a copy of the rules or direct questions to OUNC by calling ' 03 .1987 or 1.800.332.2344.
/ i P i j �
Issued =y: I J Permittee Signature: ■ _ �:
Call 503.639.4175 by 7:00 a.m. for the next available inspect'. n d. e.
This permit card shall be kept in a conspicuous place on the job site until • .1- io of the project.
Approved plans are required on the job site at the time of each inspecti. n.
Building Permit Application jll;:, E 4 , v e ,
Residential °TEA I Ai ti) ierd ii USE ONLY
City of Tigard yi Received /
� Date/B : "l Permit No.: m i „L I ,�',
13125 SW Hall Blvd., Tigard, OR 97223 q 01 1 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 A' R 2 2 2 Date/B , � ' \ Other Permit:
ARD Inspection Line: 503.639.4175 Date Ready /By: Juris: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: ar Supplemental Information
- rP i eN
TYPE OF W6 tei REQUIRED DATA: I- 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
x Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1- and 2- family dwelling 111 Commercial /industrial
Valuation: $ 3 ( aq . 00
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: z
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 103 C) stk.) I Oi -I h , Ave New dwelling area: square feet
City/State /ZIP: i X7 1 , Ct 2 23 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 12,� 5 Covered porch area: square feet
Cross street/directions to job site: North 3G, a Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Nlor+ke rn pi ne.. Lot no.: g Permit fees* are based on the value of the work performed.
Tax map /parcel no.: (ZQq $ ) 02.1 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
6iLt`\Q- W OS - RQ cMff\k. 3 �lndmnl Valuation: $
O (\A_INSS u1 t 'C (\Q L� h � , C , • — •
C/1 New building area: square feet
Z3 PROPERTY OWNER ❑ TENANT Number of stories:
Name: ` AU f 21 al U rj5 Type of construction:
Address: `l‘ SuJ 'DD-14-1 V_e_ , Occupancy groups:
City /State /ZIP: `T; rr t 0.9._ (1 3 Existing:
Phone: (5 03) g'O 5 Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: ks, Q) A 1, XA. 2ri (Nis All contractors and subcontractors are required to be
Contact name: 0 h,e S\e- 6j-
I� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: \/ O 4 5 Nu C0.cy uV jurisdiction in which work is being performed. If the
City /State /ZIP: c30.--._0 c30.--._0 I en C� applicant
Phone: c503) is- l ant is exempt from licensing, the following reasons
� rr�� ` , 3 Q apply: 1 V --1 c5 -1 Fa x:: ( 5g ) 10 -9 �
E -mail: VI \. Sh(& R-6 \ N ) , ( •(Y\
CONTRACTOR
Business name: ` R 0, C CJvf J n,....€ BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State /ZIP:
Structural plan review fee (or deposit):
Phone: ( ) Fax: ( )
FLS plan review fee (if applicable):
lic.: Total fees due upon application:
5? .)T -'�-
������ Amount received:
._. U) ,/ \:L1), \..j Authorized signature:
Thi permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: c ,V p ., - ` 1- . Date: 1 g jp ti * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02 /COM/WEB)
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
BUILDING DIVISION
TIGARD TRANSMITTAL LETTER
a
TO: K DATE RECEIVED:
DEPT: BUILDING DIVISION
RF('
FROM:
C s 4 1(16-7--- APR 2 7 2011
CITY OF TIGARD
COMPANY: BUILDING DIVISI0, —,
PHONE: B y m /
i.
RE: 1 105n loco �— )`e— N iZO ((— 4 009 AN
rte ess (Permit/Case Number)
�2�5
(Project name name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: I Description: Copies: I Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
V Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):
REMARKS: CL,0 L.tpV
FOR FFIC� USE ONLY -
Routed to Permit Techi Date: k ! ' ( Initials. 7
nic
Fees Due: El Yes [ To Fee Description: Amount ue:
$
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\ Building\ Forms \TransmittalLetter- Revisions.doc 4/4/07