Permit (28) CITY OF TIGARD MASTER PERMIT
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'` COMMUNITY DEVELOPMENT Permit#: MST2017-00207
13125 SW Hall Blvd.,Ti Date Issued: 06/13/2017
T[ta and OR 97223 503.718.2439 9
Parcel: 1 S 134C D03400
Jurisdiction: Tigard
Site address: 11995 SW 119TH AVE
Subdivision: LERON HEIGHTS NO.3 Lot: 65
Project: GARLAND
Project Description: Replacing(2)damaged trusses, and repairing rafters and wall.
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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Drains: 0
gWater Lines: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 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'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:
GARLAND,JOHN BRANDEN PACWEST RESTORATION Required Items and Reports(Conditions)
RINGNALDA,CAGNEY 13732 SW MARCIA DR
11995 SW 119TH AVE TIGARD,OR 97223
TIGARD,OR 97223
PHONE: PHONE: 971-229-9463
FAX:
Total Fees: $537.27
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 : --.re the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fort' in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33.234•.
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AIssued By: Permittee Signature: — P*_
all 503.639.4175 by 7:00 a.m.for the next availab ion 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 i OR cri i it i I t t i ‘
City of Tigard vel Permit No
III � 7 , — sr-
13125 SW Hall Blvd.,Tigard,OR 97223 ,+" evrew r' 7
Phone: 503.718.2439 Fax 503.598.1960 iltj ,, d *, ,y ' b- )1 Other Permit:
1-1�;A K D Inspection Line: 503.639.4175 Date Readymy: / , i/ nom: R, P 2,ler
Internet: www.tigard-or.gov 4 1 hod:("/ / ;-C tai information
JUN I Z1 ,? UM )//'6CIa-.r
TYPE OF [WORK �� tr,-et.r\it.k1'4
111)Q 1 DDATA:I-AND 2-FAMILY DWELLING
❑New construction DemolitAt g g t i x 1 i Permit fees*are based on the value of the work performed.
Addition/alteration/replacement 'Other:` 1 j Y / Indicate the value(rounded to the dollar)of all
i, equipment,materials,labor,overheat and the profit for the
CATEGORY OF CONSTRUCTIONwork indicated on this application.
13 l-and 2-family dwellin Valuation: $ ov°
g Commereialfindustrial I S t i
Q Accessory building 0 Multi-family Number of bedrooms:
0
Master builder Other: Number ofbathroomrs:
JOB sin, INFORMATION AND LOCATION Total number of fours:
Job site address: 119 4 S so 115 '121 New dwelling area: square feet
City/State/ZIP: -n - (y,().• Garagea/catport area:. square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
C'fL.K f 2 0 4c it) 7 R.c:`sSSS . 2.vp Outer structure area: square feet
(i-''h-Z- fT' 4� ?+�11 5 Qt DATA:�' E IC11 3SE GRIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: the value founded to the dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIP'T'ION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:.
Name: 4 Ike1Q Type of construction:
Address: I I q q 5 3 W It S j Occupancy groups:
city/State/ZIP: -ri t0 6 2 9 2.Z 3 Existing:
Phone:( ) Fax:( )
,�/ Nevv':.
t=1 APPLICANT EflCONTACT PERSON
BUILDING PERMIT FEES*
Business name: ! bfa
Structural plan review fee(or deposit):
Contact name: 12-°&;01-- N1JE-‘-f D%/!J
FLS plan review fee(if applicable):
Address: 23 4-4 WE 2.S A\I.
City/State/ZIP: — Total fees due upon application: 7j 1
City/State/ZIP: ? t4A,p 042_
Phone:(_ ) ('1 gV 108-1_ Fax::( ) Amount reivad:
E-mail: o IL 4e 1�11124 6111- Gr l`1fTi-MM4d.• PHOTOVOLTAIC SOLAR PANELSYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection>details
f R 4W t5T (2 WS J and fire department access,along with the 2010.Oregon
Address: 12-E3 O S W like.L g Nt it i Solar htstullat/nn Specially Code efiecktist.
,City/State/ZIP: n. Permit Fee(includes plan;review
GA-t 0-{V. qLl, card administrative fees): $180:00
Phone:(0 3), 7. 344, Fax:( ) State surcharge(12%of permit.fee): $21.60,
CCB lie.: 3 4C3
Total,fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 511\4. l ok U Date: el 1910�/ *Fee methodology set by Tri-County Building Industry
` J �� Service Board.
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