Permit (52) CITY OF TIGARD MASTER PERMIT
`' I COMMUNITY DEVELOPMENT Permit#: MST2017-00028
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2017
Parcel: 2S 103C B09700
Jurisdiction: Tigard
Site address: 12290 SW QUAIL CREEK LN
Subdivision: QUAIL HOLLOW-EAST Lot: 55
Project: Wyatt
Project Description: Voluntary residential underpinning using(9)push piers and (4)helical 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: $26,000.00 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
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 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:
\WATT,COREY R TERRAFIRMA FOUNDATION SYSTEMS Required Items and Reports(Conditions)
12290 SW QUAIL CREEK LN 7910 SW HUNZIKER ST 1 Piles/Caissons
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: 503-957-6523 PHONE: 503-443-6866
FAX:
Total Fees: $632.60
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 R 952-001-0090. Yo •• ••a'. e rules or direct questions to OUNC by calling 503.232.1987 or 1.800,332.2344.
Issued By: G— . —s Permittee 5fgnature: a-\C( t/(
....4.70.639.4175 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
ResidentialRECti FOR 01 l IC L 1 SE OM 1
City of Tigard Received j'a3 /7 �� K5r2O/7 �s
Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review!Pi
C Phone: 503.718.2439 Fax: 503.594A$0 2 3 2 Q 1 Date/By: �"d3 -1-7
11- Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: 1 / Juris: I
® See Page 2 forTIi; 11:1-1 Notified/Method: /g3 �7 t� Supplemental Inf
ormationInternet: www.tigard-or.gov CITY , GAB
z iliDIVION RE91
1)A'TA 1- FAMII Y a "c
❑New construction 0 Demolition Permit fees*are based on the value of the work performed. I
Indicate the value(rounded to the nearest dollar)of all
'Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
. 0 work indicated on this application.
w L: ....� ?�,f
1 s;.,,u r,r,!/-t,x4.-, f .:,,4 . `
, ....41 ,•;,,,,Q, 4,3f.
1-and 2-family dwelling 0 Commercial/industrial
Valuation: $ :2 4, 0 on
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
,:,-,',2,'L""'"'' )1 ?� '7t y i ,A : .std i ty , ' Total number of floors:
Job site address: 6�] l 0^ 5 4;�( � � r New dwelling area: square feet
City/State/ZIP: P014 I 0 `1`7A -3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Wy,411-fe&Sttf.� wr i111Covered porch area: square feet
-eiCross street/directions to job site: Deck area: square feet
Other structure area: square feet
ATA COM CIMMSI .1
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
w 1 ON work indicated on this application.
V ` A-n" y 49.{ 7.11�1. V ey f ty� t)(›` Valuation: $
`Ci) Qt),, ` 1 i t f`A/l f)1 4) 'ei 4-,..x. ,(�i � J Existing building area: square feet
1 ` J \ t New building area: square feet
Pik TV 43Cr ANT 5 �' Number of stories:
Name: l ? "yo,'�' Type of construction:
Address: t O 5w1 ova 1 C''eeJ.< LI. Occupancy groups:
City/State/ZIP: fimadamviodt 't 3 '�
7 i A. Existing:
Phone:
c6 ) 7 Fax ( )
New:
IC �,j : *n
}
Business name'l�.11.;arr���rWAc� Ot :�c,�y�t1l✓1 St r,c
{tae refer :e*chedtrtel, w..
�_` ,_ S � Structural plan review fee(or deposit):
Contact name: 5,cI ,l v ot,'r
J FLS plan review fee(if applicable):
Address: 7.1 10 9‘i. .i .te_f S
City/State/ZIP: ��! (irk /"1 a"�a.-�
Total fees due upon application:
4i Phone:(5L f J )x(1--7 � l� Fax::(�3)G�ii i —5 30 I Amount received:
E-mail: l cobD j s
PHOTOVOLTAIC PANEL Stti lM FEES*
5r PLA- r `'°"`�Es 'rY Commercial and residential prescriptive installation of
RAcioR roof-top mounted Photo Voltaic Solar Panel System.
Business name: le.v 4-„. l (� . :),,,„,‘,104. < C„,� Submit two(2)sets of roof plan with connection details
l ,( 01/1 "'7 j and fire department access,along with the 2010 Oregon
Address: 7'.(0 N ftc/i,iZ:4 V Li- 4{.- Solar Installation Specialty Code checklist.
City/State/ZIP: i_ c� Permit Fee(includes plan review
`� "� 9�. and administrative fees): $180.00
Phone:(5p'3) t f4 3, & gci e Fax:( qLj I .... 53o 1 State surcharge(12%of permit fee): $21.60
CCB lic.: 1 2 3 ` /04///g /"
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
/P- within 180 days after it has been accepted as complete.
Print name: SC va_Get6` Date: t-- 9.,0 -- 1-7 *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)