Permit (40) CITY OF TIGARD MASTER PERMIT
II-
'. COMMUNITY DEVELOPMENT Permit#: MST2016-00479
Date Issued: 01/10/2017
T t GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104DA08500
Jurisdiction: Tigard
Site address: 13111 SW RAPTOR PL
Subdivision: QUAIL HOLLOW-WEST Lot: 71
Project: Pavick
Project Description: Convert portion of garage area to bonus room/office.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 209 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: Yes
Total: 209 sf Value: $18,000.00 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 Rain0 Storm Sewer: 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 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-3 209
Owner: Contractor:
PAVIK,JANICE S RARE QUALITY INC Required Items and Reports(Conditions)
13111 SW RAPTOR PL 16285 SW 85TH AVE SUITE 404
TIGARD,OR 97223 TIGARD,OR 97224
PHONE: 503-330-0020 PHONE: 503-515-5166
FAX:
Total Fees: $872.34
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. A ION: • -•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 -0010 through OAR•5 %' -0i) 0. You may obtainaia copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800. 32. 344.
Issue By: / / /� -I Permittee Signature: , _ _,___--(44-1 _IF
Call 503.639.4175 by 7:00 a.m.for the next available inspection ate.
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
1.11,'I4, ,t' : i`.. ." ` FOR OFFICE 1 SE oy1.1
Ci of Tigard Received Permit No,:�P
ty g Date/By: 1///7//e0' � , S t /4,- y79
11 ° 13125 SW Hall Blvd.,Tigard,ON M 2I. ?lilt) Plan Review
Phone: 503.7182439 Fax: 50i8.1960 Date/By: i" .} Other Permit:
Inspection Line: 503.639.4175 f,,, p t i Date Ready/By: 1 f 1 Saris. I H See Page 2 for
1'I G A K D N g i f Y ' Notified/Method /c 17 Supplemental Information
Internet: www.tigard-or.gov'L. c //ll
Titil Cr, ti' ,
OF WORK REQUIRED DATA 1-AND 2-FAMILY DWELLING
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Jill Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 19))DnO t 0 0
1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms: 0
❑Accessory building 0 Multi-family
❑Master builder 0 Other: Number of bathrooms: 0
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 131( ( 561 Ra P rots P(t4G t New dwelling area: a.0 9� square feet
City/State/ZIP: i1 CAO oilt-c c, i 17l 2.5 Garage/carport area: �r square feet
Suite/bldg./apt.no.: Project name: PAVic.-. 301115 g0d►,n Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
.5.Is/ .aaf-lA(t.C7e- 5'1 -- i& 41-4F , i . Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: -'l.. -40 y\Olith -l`'t-6-1 Lot no.: Permit fees*are based on the value of the work performed.
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.
�! Valuation: $
lnnVitr r e-1a ,01.66- .6Pt4G6 I i i Ortc Acwv / oic r -
Existing building area: square feet
New building area: square feet
1 PROPERTY OWNER 0 TENANT Number of stories:
Name: jo-f•l'(..4- POJ/C�- Type of construction:
Address: 13 i 1 l i,/,1 gj}7f/2 ,DR. Occupancy groups:
City/State/ZIP: ----/T5A,-d o 17ZL I Existing:
Phone:(s-D3 ) 330 - OD2O Fax:( ) New:
RE APPLICANT fit CONTACT PERSON BUILDING PERMIT FEES*
(Please refer wfee schedule)
Business name: ?Aii �va r 1-1 Re wic ot,i_ R nded c, .O`^
Structural plan review fee(or deposit):
Contact name: D,.A 1 ti. 1.14-0,®t,;6T-. FLS plan review fee(if applicable):
Address: iitZ9 So gs-TuAv 4 tI10q
Total fees due upon application:
City/State/ZIP: G.�2..P Op, 1-1.2-z41
Phone: ) 8a, 3 3`%Y ( ) Amount received: p2�•,j• 30
(j-�� Fax:
E-mail: ,,,,,//' / / PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
swot / g�r2� 6�0`' r ( �`"� Commercial and residential prescriptive installation of
CONTRA DR roof-top mounted Photo Voltaic Solar Panel System.
Business name: RtLrx c (, 10,4,/, L Submit two(2)sets of roof plan with connection details
�/ and fire department access,along with the 2010 Oregon
Address: /62,25-f� 7 �a t, �`/8 l Solar Installation Specialty Code checklist.
City/State/ZIP:'77-4,4,0/ . VZ 6972 e Permit Fee(includes plan review $180.00
Yand administrative fees :
Phone:(‘7j3)375",..1-7 (6 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: /5'7"7'2a ///''/I 7 Total fee due upon application: $201.60
Authorized signature: y� This permit application expires if a permit is not obtained
�� 1� i' within 180 days after it has been accepted as complete.
*
Y Y i, Date: Fee methodology set by Tri-County Building Industry
Print name: 'g .il.A,R4 k 57-g ',,� /7./7 t /A Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13111 SW RAPTOR PL, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2016-00479
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor