Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2018-00178
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2018
G�tik•l 9 Parcel: 1S135DCO2000
Jurisdiction: Tigard
Site address: 11905 SW 91ST AVE
Project: Greenburg Oaks Apartments Subdivision: None Lot: None
Project Description: Reroof-remove and replace. Removing all roofing to decking,and installing versa shield solo fire retardant
underlayment GAF 60 Mil TPO single ply membrane roofing.
Contractor: INTERSTATE ROOFING INC Owner: VILLA LA PAZ LIMITED PARTNERSHIP
15065 SW 74TH AVE BY COMMUNITY PARTNERS FOR
PORTLAND,OR 97224 AFFORDABLE HOUSING INC
PO BOX 23206
TIGARD, OR 97281
PHONE: 503-684-5611 PHONE:
FAX: 503-639-3056
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 06/13/2018 $586.19
Demolition
Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 06/13/2018 $70.34
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $36,804
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $656.53
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344,issued By: / •ermi =- elute: 45ZA. "-4— C..P
Call•'3.:39.4175 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
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City of Tigard i V .1 Received Date/By: 67 l) 11 ,/ - Permit No.:e,t,,yo0?0)j tr)I7 '
--m 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review Related Permit:
u Phone: 503-718-2439 Fax: 503-598-1960 Date/By:
t i t, Inspection Line: 503-639-4175 JUN Z O 1�i Date Ready/By: huts: 65 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 7X-6 Supplemental Information
It,
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❑New construction tiitl r mo ition Permit fees*are based on the value of the work performed.
Indicate the value(romded to the nearest dollar)of all
❑Addition/alteration/replacement :4 Other: equipment,materials,labor,overhead,and the profit for the
, �� r ,,= "27.��r qta , 4., work indicated on this application.
AP,. z 4 xz5j, at aEs . '''av-,ii 2 . • a . ., t
Valuation: $
❑ 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
0Master builder Other: Number of bathrooms:
" '' " . 7I ;')i f: k' o : � ted 4X.,vt14 ,z4 .. > x?t Total number of floors:r t °.• , '' a
! p,3" t5 L J y.,5 rd di-id .. New dwelling area: square feet
Job site address: //
City/State/ZIP: "r/ G- /1,Q, D�'i' , ci7„.:?Z3 Garage/carport area: square feet
Suite/bldg./apt.#: Y Project name:‘ FL'A-3 i.L/?C 0 A kS 41b, Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
— Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the
$ d 1 81 in:h $:. t � 9 r'�� S', ;;..WC ., r app
work indicated on this application.
44%' , r. K,f1-t t7t=�. . ro,x ^! . �" ra,d,.5 0%,. .:, ,3sx ,�e� „t�t4.�k^s.w.'.;k, t7a ,,,-.1,e.,.0.„'.„. a:
R riy •.t�- AL. h'o cFir��-
r2> •-,, <'t ".. ./t/.4, /111.574:
LG. � � Valuation: $ .2 G,8o Al
5%�jt=L.ra Se.:cv //i'E !�c=Trm?.04 irako0c' Existing building area square feet
��� �, �f /t��M AsP �, "p���/ti, & New building area: square feet
.r. r y .to p, c ,' '*-,,• t ;t' a
6:a1). '1'<:=174-2- 7--e14-46,-A '1..;',4 )' 1 ,, -4-'7,�� � r x,s ,'-'4('-.: � Number of stories:
•i$�' � <a� �' '°�"'e�'� .=tf., '��i.,,^:: �is_ �',.,;t;4:.,S ,r�"�,�as,t,-.� r'�1 i"�, :'„ .x,.
Name: /A i Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
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Business name: it -7-4--:-/ 3''477 /Gear-0 n7/f G- Structural plan review fee(or deposit):
Contact name: ,(Ci L G,4Z,til ELAS
FLS plan review fee(if applicable):
Address: jJ 4 4,6- -5 e"-4 7 /1"-h' 44/6
Total fees due upon application: 6,76-
City/State/ZIP: /,L, ,L Tt,NO3 , 6/ , %7:22 '
Amount received
Phone:(5' S 3) G ' -.5'4// Fax::(S.o3) 4. �'' - 3 U 5 G' � xr ''7“-
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E-mail
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,, Commercial and residential prescriptive installation of
,-.F.:,,-.?„,,,:„ ,� ;; i-t• _ $ ' 1�',,• • ,4 ••.• .: ; roof-top mounted Photovoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
j/1i -,es r 'G�/=i� and fire department access,along with the 2010 Oregon
Address: /,_5-0 (,,3" -s'c.- 7 /""i74 A L11=• Solar Installation Specialty Code checklist.
City/State/ZIP: j Permit fee(includes plan review
$180.00
Y c:5 h° ?1, 4/�A, G 7-z a Y and administrative fees):
Phone:(5'4,3) L, g y 5"L, // Fax:($ 13) to 3 7', 3 Ca S 6 State surcharge(12%of permit fee): $21.60
CCB Lic.: .5'..5.,&'.S Total fee due upon application: $201.60
gn ,r/� A j This permit application expires if a permit is not obtained
4uthorized si ature: -�„ti;y ((�',i �41.E within 180 days after it has been accepted as complete.
Date: w'D-j 3
* Fee methodology set by Tri-County Building Industry
Print name: 1,S �"`,�/,; LASie Service Board.
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R..i1A;,,eAParmitARTIP CAM Permit Annrinr Rau nAn1 )01A
City of Tigard COMMUNITY DEVELOPMENT DEPARTMEN
Request for Permit Action
q
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov 4/40
,-
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard, OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor Q-.Cl'ty Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
City/State/Zip:
Phone No.:
PLEASE TAS ACTION FOR THE ITEM(S) CHECKED (1):
M CAN
b OID PERMIT APPLICATION.
II REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: 814/g001 r x n- r
Site Address or Parcel#: //10 ' 7A) e J /i
Project Name: 6 e,4f ( 1 S_4pevi YrNa•L U
Subdivision Name: Lot#:
EXPLANATION: l .49,v)i ,irk . G c i i iatifv)
_5 ,� A" t )/• —00 •
Signature: _ Date:
r
.c.�s _ �// 5//
Print Name: #� / 40 �
,70
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to Sys Admin: Date . I /3 By Route to Records: Date /.3 /J By
Refund Processed: Date /i/ .^ By Invoice Processed: Date By
Permit Canceled: Date ex 2 By *arca Tag Added: Date By
I:\Building\Forms\RegPermitAction_0 314. c