Permit (121) CITY OF TIGARD BUILDING PERMIT
b.
PIIIIIIermit#: BUP2019-00040
■ ' COMMUNITY DEVELOPMENT Date Issued: 03/12/2019
T Ii;A i=.1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DC90231
Jurisdiction: Tigard
Site address: 15565 SW 114TH CT 23
Project: FOUNTAINS AT SUMMERFIELD Subdivision:TAINS AT SUMMERFIELD CONDO-PH Lot: 23
Project Description: Removing old and installing new siding.
Contractor: ONE WAY QUALITY CONSTRUCTION Owner: STEVENS, JOHN A
10451 NE 5TH CIR WHEELER, PEGGY L
VANCOUVER,WA 98669 15565 SW 114TH CT#23
TIGARD,OR 97224
PHONE: 503-535-9979 PHONE: 858-212-9105
FAX:
FEES
Specifics: Date Amount
Description
Type of Use: MF Permit Fee-Additions,Alterations, 03/11/2019 $83.78
Class of Work: ALT Type of Const: Demolition
Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 03/11/2019 $10.05
Dwelling Units: 0 Plan Review 02/26/2019 $54.46
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 03/11/2019 $1.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $1,360
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $149.29
Required Items and Reports(Conditions)
Required:
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 Notifi -tion 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 - ing 50 32.1987 or 1.800.332. .
Issued By: /`� ,- i` ,yA/� 'Jry Permittee Signature:
/ v `- r
Call 603.639.4175 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 ,- �,,;,
Commercial FOR 01 121( t SI Oyl.l 1i'
City of Tigard F.r } ' Date/13y:Received p, ( / I r ti / f'j oo0
tic,
13125 SW Hall Blvd.,Tigard,OR 97223 y.l Nan Revie
Phone: 503.718.2439 Fax: 503.598.1960 DDate/By: Other Permit
IN II
T I c n R 1) Inspection Line: 503.639.4175 =''Date ReadyBy: 1 Doris: 0 See Page 2 for
Internet: www-ti d-or. ov otified/Meth l ,/4/ 0 Supplemental Information
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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
Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
P .,, '' ', , work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
❑Accessory building pi.Multi-family --
0 Master builder 0 Other: Number of bathrooms:
m �, � .f. ,” Total number of floors:
Job site address:15,65 5ta 114"2* C I Liv 1T5 3-2C. New dwelling area: square feet
City/State/ZIP: -ft 6*,IN pZ qi 1.2.4 Garage/carport area: square feet
Suite/bldg./apt.no.: 1 Project name: rouw'r Al IuS rm..& ,1N04 f 1- , Covered porch area: square feet
Cross street/directions to job site: . Deck area: square feet
Other structure area: square fee f
a� ? c I
Subdivision: I 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
� � ,� , �4A14.4;1711”, work indicated on this application.
Re-e-t4+6 G Pt-t o C C:‘'‘) S I.0 INIo 1, IP S'T`�3 W/fn.0Q at Valuation: ‘,(1,00 ---.
$K� S 11�IN Existing building area: square feet 1
il H
New building area: square feet
ash � e �, ` ,,t. � ' s ;
s < R '''''.2''' " �a4 ,- Number of stories:
''�fi �`:w�3���`�'-,� � P. ..�.
Name:-me q5s» mFuwvin owvseRs of Cltii w'm N5 !►T5yw1 4,4Typeofconstruction:
Address: 1 'Sa 6®5 s W t\g* A.vrt . PITS 105 . Occupancy groups: —
City/State/ZIP: -ribtZQk_ 9722'+ Existing: --
Phone:(Vic.) its-O3yk. Fax:( ) New:
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Business name:
Structural plan review fee(or deposit):
Contact name: ;raj L 3Rot,K -�
FLS plan review fee(if applicable):
Address: 15645 SW I%I1 GT *Z
Total fees due upon application:
City/State/ZIP:--649.4 d R 111.-1.4- —
1 Amount received:
Phone:( se, 2.1 1I0 5 Fax ( )
—
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Business name: 00ite. w{S.tl� -104 t - vGItI4 (.(„C, Submit two(2)sets of roof plan with connection details
.l erand fire department access,along with the 2010 Oregon
Address: i Oil.51 Ne„ 5tik cif Solar Installation Specialty Code checklist.
City/State/ZIP: u COUV PAL WEN i4�'�` Permit fee(includes plan review $180 00
p and administrative fees): _
Phone:(503) r ls...cm7i Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 7.\Cy Total fee due upon application: $201-60]
Authorized signature: r1.) , , cn..\ .,.."P*,..• This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: FA J L w a,oc,K Date: 2a Za 19 * Fee methodology set by Tri-County Building Industry
II Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 4404613T(11/02/COM/WEB)