Permit (50) INNCITY OF TIGARD MASTER PERMIT
1 ' ` COMMUNITY DEVELOPMENT Permit#: MST2016-00366
T IIGA.R 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/22/2016
Parcel: 1S134CB16600
Jurisdiction: Tigard
Site address: 12438 SW ANTON DR
Subdivision: ANTON PARK NO.2 Lot: 93
Project: THOMPSON
Project Description: Repair to garage due to vehicle 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: 1 Third: 0 sf Right: 0
Detectors: No
Total: 0 sf Value: $10,000.00 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
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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'I 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:
THOMPSON,BECKY L GREAT WESTERN RESTORATION Required Items and Reports(Conditions)
12438 SW ANTON CT PO BOX 489
TIGARD,OR 97223 OREGON CITY,OR 97045
PHONE: PHONE: 503-655-4739
FAX: 503-655-5845
Total Fees: $402.17
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. Yo • ••• c•• _ - es or direct questions to OUNC by callin• • - - . .:•a 32.2344.
I
Issued By: /it,`,L.„..A ' — .�.rtoo' -- ` -- '••ature:
C. 175 by 7:00 a.m.for the next available inspection date. Wrr
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 FOR OFFICE 1 SI O\1.1
eit) Received
City of Tigard ` DateBy: I . ) /(p / �— Permit No.:reurd.r,r ce3f:J!
I Oa - 13125 SW Hall Blvd.,Tigard_y'.l' 2 Plan Review C' // vV ((�((�'
Phone: 503.718.2439 Fax: '-'7. '' .60 ryQ16 Date/By: 9 -o�) ' b er Permit:
T l -AID Inspection Line: 503.639.417 ', 1. Date Ready/By: '1/411//6
,/ luris: ' g See Page 2 for
Internet: www.tigard-or.gov �S[ �60 Notified/Method: /s 1 f/y 0,, ^�e Supplemental Information
TYPE O,,,,D REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ' lt&emolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $10,000
Accesso buNumber of bedrooms: 0
0 ryildin g ❑Multi-family
0 Master builder 0 Other: Number of bathrooms: 0
JOB SITE INFORMATION AND LOCATION Total number of floors: 1
Job site address:12438 SW Anton DR New dwelling area: 0 square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: 380 square feet
Suite/bldg./apt.no.: Project name:Thompson Covered porch area: 0 square feet
Cross street/directions to job site:Sw Anton Dr and Sw North Dakota St Deck area: 0 square feet
_ Other structure area: 0 square feet
„p ri va ) ' REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: ,i 0 I Lot no.: Permit fees*are based on the value of the work performed.
1111 Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Repairs to garage due to a vehicle impact Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:Becky Thompson Type of construction:
Address:12438 Sw Anton Dr Occupancy groups:
City/State/ZIP:Tigard OR 97223 Existing:
Phone:(503)381-3893 Fax:( ) New:
0 APPLICANT i 4 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee sckedule)
Business name:
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application: �J�� 4A-
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Great Western Restoration Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1001 Molalla Ave Solar Installation Specialty Code checklist.
City/State/ZIP:Oregon City OR 97045 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(971)219-9461 Fax:(503)655-5845 State surcharge(12%of permit fee); $21.60
CCB tic.:99149 /� Total fee due upon application: $201.60
Authorized signature: / This permit application expires if a permit is not obtained
/4///' within 180 days after it has been accepted as complete.
Print name:Kevin Rutherford Date:9/20/16 *Fee methodology set by TriCounty Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)