Permit II CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2015-00035
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/11/2015
Parcel: 2S104CC04000
Jurisdiction: Tigard
Site address: 13928 SW HILLSHIRE DR
Subdivision: HILLSHIRE ESTATES NO.2 Lot: 146
Project: Jansson
Project Description: Repair of damaged garage concrete stem wall due to auto impact.
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: $5,000.00 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 Tvoes 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
Fum>=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!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:
JANSSON,BARRY& OREGON HOME IMPROVEMENT CO INC Required Items and Reports(Conditions)
DUFF-JANSSON,INGER 17255 SW PILKINGTON RD
13928 SW HILLSHIRE DR LAKE OSWEGO,OR 97035
TIGARD,OR 97223
PHONE: PHONE 503-635-6248
FAX: 503-636-7183
Total Fees: $267.56
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. • TIO`: . :.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 101-0010 through OA' 152-,• -4 490. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.841.33`- - 44.
I sued By: �/� LI �A`�/_ _ Permittee Signature: & Viblilln
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 RECEIVED nn FOR OFFICE USE ONLY c ��y,
City of Tigard �,1�aa Datee/13ea _,Gm :%� PermitNo.:/71f t S� 3 S.
I : , 13125 SW Ha11 Blvd.,Tigard,0111101R23 3 2015 Plan Revieay
Phone: 503.718.2439 Fax: 503.598.1960 DateB : • a III= Other Permit:
TIGARD Inspection Line: 503.639.41QITY OF TIGARD Date Ready/By: 0 a Page 2 for
Internet: www.tigard-or.gBUILDING DIVISION Notified/Method: , Supplemental Information
11 Pt OF WORK. V.:. Qt IRI I)1).CTA: I-:\\I)2-EANII1\'D'\FI.I.ING
®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
(':1'1'I(.OR's t>F ('(>\51 R(("1 iUV �- work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial
Valuation: $5000.00
❑Accessory building ❑Multi-family Number of bedrooms:
ID Master builder C1 Other:
Number of bathrooms: 3
JOB SITE l I\FOR\I U IO\ A\J) LOCATION Total number of floors: 2
Job site address: 13928 SW Hillshire Dr New dwelling area: n/a square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: 726 square feet
Suite/bldg./apt.no.: Project name:Jansson Residence Covered porch area: n/a square feet
Cross street/directions to job site:See Address Deck area: n/a square feet
Other structure area: n/a square feet
'REQUIRED DATA:('O\IMILRCIAI.-USE CIII.CKLitsT
Subdivision:Hillshire Estates No.2 Lot no.:4000 Permit tees*are based on the value of the work performed.
Tax map/parcel no.: 2S104CC04000 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.
Repair of a damaged garage concrete stein wall due to an automobile impact Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER R ❑ TENANT , Number of stories:
Name:Mr.& Mrs.Jansson Type of construction:
Address:13928 SW Hillshire Dr Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:( ) l-ax ( 1 New:
APPLI(':1\T ❑ (0'11('I' PERSON BtIILDTNOP'ERmIT FEES*
— —
(Please refakiij 4selierlu1)
Business name:'IM Rippe).Consulting Engineers
Structural plan review fee(or deposit):
Contact name:Kyle Kruger
FLS plan review fee(if applicable):
Address:7650 SW Beveland St
City/State/ZIP:Tigard,OR 97223 Total fees due upon application: /�
Amount received: '4 7 (1J
Phone:(503)443-3900 Fax::( ) •
E-mail:kkrugera�tmrippey.com " W)l0 'OLF:UC SOLAR PaNLL 51"11\I FEES'
9 ..,,.: – r .z ;�,;.•:v;,.;' Commercial and residential prescriptive installation of
�� "'"'""`` M,:,, roof-t.•mounted Photovoltaic Solar Panel System.
Business name:0111 Construction Submit t • 2)sets of roof plan with connection detai
and fire depa •-nt access,along with the 201 gon
Address:17255 Pilkington Road Solar Installation daily Code checkl• .
City/State/ZIP: Lake Oswego,OR 97035 Permit Fee(inclu.- plan $180.00
and admini• ., fees):
Phone:(503)635-6248 Fax:( ) State surchar,- %of permit - : $21.60
CCB lic.:34908
otal fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is of obtained
within 180 days after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry
Print name: UGts! �„ j� e V Date: 3/j�//6- Service Board
I:\Building\Permits\BUP--RESPennitApp.doc 02/24/2011 440-4613T(l1/02/COM/WEB) � a_ " -- 44 170-g-'-