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Permit CITY OF TIGARD MASTER PERMIT 111 r! COMMUNITY DEVELOPMENT Permit #: MST2012 00232 T ( G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/11/2012 Parcel: 1S134CB08000 Jurisdiction: Tigard Site address: 11190 SW 125TH PL Subdivision: ANTON PARK Lot: 42 Project: Smith Project Description: Add a window to the master bedroom bathroom 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: $350.00 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 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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 add'l 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 0 Owner: Contractor: SMITH, KENT E & OWNER Required Items and Reports (Conditions) SMITH. BRENDA C 11190 SW 125TH PL TIGARD, OR 97223 PHONE: 503 - 590 -8223 PHONE: FAX: Total Fees: $94.79 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 AR 952 -0 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 0.332.2344. Issued By: Permittee Signature: Call 503.639.4175 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 • , rA } FOR OFFICE USE ONLY City of Tigard P. Received Permit No itjO /A.- L ° 13125 SW Hall Blvd Tigard OR 97223 �' g Date /B (( Y OL �3 l� - ., , SEP 1 1 Plan Review ' : Bm� t Phone: 503.718.2439 Fax: 503.598.19 2 12 Date /B : Mr,14�1. i N is- r P Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready c Juris. ® See Page 2 for Internet: www.tigard or.gov CITY Of TIGARD Notified/Method: {p Supplemental Information elJILDIme, oftfierf?r TYPE OF WORK 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 ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. • ® I- and 2- family dwelling ❑ Commercial /industrial Valuation: S350 ❑ 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: 11190 SW 125' PI . New dwelling area: • square feet City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Smith 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: 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 DESCRIPTION OF WORK work indicated on this application. • Add a window to the master bedroom bathroom Valuation: S Existing building area: square feet ' New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Kent Smith Type of construction: Address: 11190 SW 125' Occupancy groups: City /State /ZIP: Tigard, OR 97223 Existing: Phone:•(503)590 -8223 Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: ' Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): • Address: • City /State /ZIP: Total fees due upon application: Phone: ( ) Fax: : ( ) Amount received: E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEtM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: Submit two (2) sets of roof plan with connection details . and fire department access, along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City /State /ZIP: Permit Fee (includes plan review $180.00 . and administrative fees): Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60 . CCB lie.: Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained la:s1 within 180 days after it has been accepted as complete. Print name: Kent Smith Date: 9/11/2012 * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits \BUP- RESPennitApp.doc 02/24/2011 440- 4613T(1 1/02 /COM/WEB)