Permit (67) III CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00439
13125 SW Hall Blvd.,Ti Date Issued: 11/03/2016
T!i Al2f� and OR 97223 503.718.2439 9
Parcel: 2S112CC04401
Jurisdiction: Tigard
Site address: 15770 SW 80TH AVE
Subdivision: BOND PARK NO.3 Lot: 72
Project: JOHNSON
Project Description: Voluntary underpinning using(3)helical piers and(4)push piers.
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: $15,000.00 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
Other Fixtures: 0
Drywell-Trench Drain: 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 add9 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-2 0
Owner: Contractor:
JOHNSON,GREGORY C&MARYBETH TERRAFIRMA FOUNDATION SYSTEMS Required Items and Reports(Conditions)
15770 SW 80TH AVE 7910 SW HUNZIKER ST 1 Special inspection
TIGARD,OR 97224 TIGARD,OR 97223 required...Pilings,Drilled
PHONE: PHONE: 503-443-6866
FAX:
Total Fees: $544.77
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 sett forth in OAR
952-001-0010 through OAR 952-001-009. -. •- • ntl€ai-aaeov aCtlie rules or direct questions to OUNC by calling 50 32.1987 j 1.80.332.2344.
Issued By: ,.- s, -.0.---""'" Permittee Signature: 4111111Psewr /2774 /7
..�0 3.639.4175 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
City of Tigard , y` Received g
Date/By: I V J cjT-- Permit No.: 2
11111 13125 SW Hall Blvd.,Tigard,OR 97223 t o ��1 1 '"' f 13 �� C� c��
F Plan Review
I Phone: 503.718.2439 Fax: 503.598.19 0 t ` Date/By: 1 n-31- C �) Other Permit:
I I(;ARD Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov R, Notified/Method:/ 4 /� -73:;� I Supplemental Information
\1 (ty...17e= 17---
TYPE OF WORI�v� iC� Ila REQUIRED DATA:1-AND 2-FAMILY DWELLING
C
0 New construction 0 De i \s4 Permit fees*are based on the value of the work performed.
g SCl Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Otter: ei a` equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONS \ION work indicated on this application.
® 1-and 2-family dwellin Valuation: $15,000
g ❑Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:15770 SW 80th Ave. New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Johnson Underpinning 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.
t
Indicae the value(rounded to the nearest
Tax map/parcel no.:W249997 dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Voluntary residential underpinning using 3 Helical piers and 4 Push Piers Valuation: $
Existing building area: square feet
New building area: square feet
CI PROPERTY OWNER 0 TENANT Number of stories:
Name:Greg Johnson Type of construction:
Address:15770 SW 80th Ave. Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing:
Phone:(503)620-7582 Fax:( ) New:
0 APPLICANT Z CONTACT PERSON BUILDING PERMIT FEES*
Business name:TerraFirma Foundation Systems (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Scott Kovalik
FLS plan review fee(if applicable):
Address:7910 SW Hunziker St.
Total fees due upon application:!R,T ., Rv
City/State/ZIP:Tigard,OR 97223
Phone:(541)817-4873 Fax: :(503)941-5301 Amount received:
E-mail:skovalik@terrafirmafs.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:TerraFirma Foundation Systems Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:7910 SW Hunziker St. Solar Installation Specialty Code checklist.
City/State/ZIP:Tigard,OR 97223 Permit Fee(includes plan review
and administrative fees): $180.00
Phone:(503)443-6866 Fax:(503)941-5301 State surcharge(12%of permit fee): $21.60
CCB lic.:173547
Total fee due upon application: $201.60
Authorized signature: Ai This permit application expires if a permit is not obtained
n
1 within 180 days after it has been accepted as complete.
Print name:Scott Kovalik Date: 10-28-16 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)