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Permit
°fv;P CITY OF TIGARD MASTER PERMIT 1 1,, : !„ ' ' " - COMMUNITY DEVELOPMENT Permit# MST2009 -00214 `' `°'' 13 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/09/2009 ?I G A R© Parcel: 2S104DB00800 Jurisdiction: Tigard Site address: 13039 SW BROADMOOR PL Subdivision: AMESBURY HEIGHTS Lot: 8 Project: Liles Project Description: Minor kitchen remodel, remove load bearing wall and replace with beam and posts to foundation. 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: Yes Total: sf Value: $6,000.00 Rear: 0 PLUMBING Sinks: 2 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain 0 Other Fixtures: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Bckflw Prevntr: 0 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 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc /Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add' Br Cir: 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: Owner: Contractor: Required Items and Reports (Conditions) LILES, TODD V & SUSAN R CUSTOM BUILT INC. 13039 SW BROADMOOR PL 22865 NW YOUGEN RD. TIGARD, OR 97223 Hillsboro, OR 97124 PHONE: PHONE: 503- 648 -4411 FAX Total Fees: $376.05 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling X03.246.5699 or 1.800.332.2344. / I \I Issued By: OA / Permittee Signature: " • 1-✓ i • Plumbing Permit Application FOR OFFICE USE. .ONLY Dat eiv d y `_ F .0v , r ill City of Tigard Re eiv Permit No. r 1l' [ l q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review • _ - - Phone: 503.639.4171 Fax: 503.598.1960 Date Other Permit No: TIGARD Inspection Line: 503.639.4175 Date Ready/By Juris Ei See Page 2 for Internet: www.tigard - or.gov Notified /Method: Supplemental Information TYPE OF WORK • • • , FEE* .SCHEDULE. ❑ New construction ❑ Demolition For special information use checklist Description Qty. Ea Total ❑ Addition /alteration /replacement ❑ Other: New 1 - 2 dwellings (includes 100 ft. for each utility connection) . .. '' CATEGORY OF CONSTRUCTION - SFR (1) bath 312.70 ❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi- family Each additional bath /kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. 0.) Page 2 JOB SITE INFORMATION AND 'LOCATION . • , • Site utilities: 1 Catch basin or area drain 18.76 Job site address: 130as' ( moor' P ` Drywell, leach line, or trench drain 18.76 City /State /ZIP: Footing drain (no. linear ft: _) Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _ ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no linear ft.: _ ) Page 2 Subdivision: i Lot no.: Fixture or item: ax map/parcel no.: Backflow preventer 31.27 . :.AESCRIPTION OF ' WORK Backwater valve 12.51 ' I Clothes washer 25.02 K ( 4C V/- In P-Q 01.0etif 1 Dishwasher f 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ® P OWN , I . p. TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain /floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ':; ❑ - APPLICANT • ' ••• ❑ .CONTACT'PERSON., Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin /lavatory ,- 25.02 City /State /ZIP: Solar units (potable water) 62 54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 . - Water closet 25.02 • CONTRACTOR ■ -. Water heater 37.52 - Business name: j1,4 P 4.,..),,,,,, ,�� / 1 v i ,,,�,b ►tee Water piping/DWV 56.29 1 Address: , 0 ,. / . . i 6 2 Other: 25.02 City /State /ZIP: A t t ( •j L 0,19 0.7 ” ( 2. i- Subtotal Phone: ( Fax: Minimum permit fee: $72.50 3) � L 4 ( ) Plan review (25% of permit fee) i CCB Lie.: J \i U V j Plumbing Lic. no.: 3 ¶t ., > 4 106 P o State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE y This permit application expires if a permit is not obtained within 180 days Print name: x) r" 0,./ �/p�,� Date. after it has been accepted as complete. I "Fee methodology set by Tri- County Building Industry Service Board. 1\Building \Permits \PLMU- PermnApp dot 10/01/09 440- 4616T(10 /02 /COMAVEB) Building Pe Application 'v Commercial RECEIVE i 1.. t �.<wNt r� ): n,r1� "a "Ir�3 .0 U .1IIV 4, W,I if City of Tigard Date Bea Permit No.: 312 009' , • 21 1 : 13125 SW Hall Blvd., T OR 97223 NOV 0 6 2009 Plan Review 4 LJIJ�I F `cnp t ' ` • C B .?.00 Phone: 503.639.4171 Fax: 503.598.1960 Date : Other Permit: I 1 I I C n it f Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for . Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: NM Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all la Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1- and 2- family dwelling Valuation: $ b ego °. 00 ❑ Commercial /industrial ly ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: i 3 0 3 7 S LJ B r Pi New dwelling area: square feet City /State /ZIP: — 1 , a_, o& 6, 1) z z 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 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: S K- U rn / Z A mor1Q l Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax::( ) E -mail: • . CONTRACTOR . Business name: U -Ct�O OA. A (., 11 irV C BUILDING PERMIT FEES* Address: a 2 8 6 S tow U ;,....5 eM, (Please refer to fee deposit): schedule) y kg 1 ( .. o 0,- 9 7 1 Structural plan review fee (or deposit): City/State/ZIP: FLS plan review fee (if applicable): Phone: (. ,O ) 6-403_44 i I Fax: ( ) CCB lie.: 4 , s-' Total fees due upon application: Amount received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: j`f3. • ,j l bi , ail Date: I (— b - 0 5 * Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02 /COM/WEB) r ' Building Division Accessibility: Barrier Removal Improvement Plan REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five per -cent (25 %). VALUATION: Total of all renovation, alteration or modification being done, excluding painting and wallpapering: [1] $ MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains: and, $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL (shall equal line [2] of Valuation Computation): $ is \ Building \ Permits \BUP -COM PermitApp.doc 06 /25/08 145T C Z-1 '( Building Division Plan Submittal Requirements • T G A ti D Commercial & Multi- Family - New, Additions or Alterations 1. SITE PLAN (fully dimensional, drawn to scale) labeled with: A. ❑ map & tax lot # ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Setbacks. F. Parking, including disabled access. G. Finished floor elevations. 2. EROSION CONTROL PLANS AND DETAILS. 3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of plans required based on submittal type (no redlines or tape -ons accepted). - All details listed below shall be incorporated into the plans: A. Scale (architectural or engineering only). B. Foundation plan. C. Floor plan(s). D. Cross sections. E. Reflective ceiling plan. F. Seismic bracing detail for suspended ceiling. G. Roof plan. H. Exterior elevations. I. Structural calculations, plans, details and specifications. J. Accessibility barrier removal worksheet. K. Deposit - based on valuation of project. 4. EXTRA SET OF THE FOLLOWING: A. Two (2) copies of site plan to include vicinity map. B. One (1) copy of erosion control plan with details. C. Fire Department Building Survey, and full set of architecture drawings. 1:\ Building \ Permits \BUP -COM PermitApp.doc 06 /25/08 Building Division Plan Submittal Requirement Matrix [ G t■ R b, Commercial & Multi- Family - New, Additions or Alterations Type of Submittal # of Plans (Includes new, additions and. alterations.) Required at -Submittal Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 2 Fire Protection System 2 Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue) l: \Building \Permits \BUP -COitl PermitApp.doc 06/25/08