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Permit
CITY OF TIGARD MASTER PERMIT Iii.- ' 13 , " COMMUNITY DEVELOPMENT Permit #: MST2010 -00027 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/23/2010 T I CrARD Parcel: 1 S 134CA02500 Jurisdiction: Tigard Site address: 11940 SW BURLCREST DR 0 Subdivision: BURLWOOD Lot: 3 t3 Project: Castro 1 1/ G �y Protect Description: Addition of 622 sq ft to habitable space, add (1) bed, (1) bath. I J g O S " ,/ / 1 rl t � vl �� I��� ref � N � y .. BUILDING / O •, Floor Areas Require Setbacks Required Stories: 1 Bedrooms: 1 First: 622 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 140 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $68,958.30 Rear: 15 PLUMBING Sinks: 2 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 1 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 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) CASTRO, EDUARDO AND KAREN DIAMOND NORTHWEST INC 11940 SW BURLCREST DR 3200 SE 150TH TIGARD, OR 97223 Portland, OR 97236 PHONE: 503- 590 -4901 PHONE: 503- 680 -6325 FAX: Total Fees: $2,920.68 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 503. .24 /6.669999 or 1.800.332.2344. /k • �/� Pe rmittee Si nature: �N �✓ ' P � ���� Issued By: 9 k, CITY OF TIGARD MASTER PERMIT 0 COMMUNITY DEVELOPMENT Permit #: MST2010 -00027 TtGAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/23/2010 I, Parcel: 1S134CA02500 Jurisdiction: Tigard Site address: 11940 SW BURLCREST DR Subdivision: BURLWOOD Lot: 3 Project: Castro Project Description: Addition of 622 sq ft to habitable space, add (1) bed, (1) bath (A 3 additional branch circuits i 5/5/2010 BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 622 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 140 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right 5 Detectors: Yes Total: sf Value: $68,958.30 Rear: 15 PLUMBING Sinks: 2 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Drains: 0 Bckfiw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 1 Fum > =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 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: i Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cr ;j 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) CASTRO, EDUARDO AND KAREN DIAMOND NORTHWEST INC 11940 SW BURLCREST DR 3200 SE 150TH TIGARD, OR 97223 Portland, OR 97236 PHONE: 503 - 590 -4901 PHONE: 503- 680 -6325 FAX: 503- 761 -4449 Total Fees: $2,945.61 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 503.246.6699 or 1.800.332.2344. Issued By: I ' t Permittee Signature: )kZ%_ A i))9 L._ < /4_7-1-3.-c."7-t__/1 ti, r� I CITY OF TIGARD MASTER PERMIT ?t >x COMMUNITY DEVELOPMENT Permit #: MST2010 -00027 r Date Issued: 03/23/2010 ",,,TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S134CA02500 Jurisdiction: Tigard Site address: 11940 SW BURLCREST DR Subdivision: BURLWOOD Lot: 3 Project: Castro Project Description: Addition of 622 sq ft to habitable space, add (1) bed, (1) bath. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 622 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 140 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $68,958.30 Rear: 15 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Tvoes Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 1 Fum > =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 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) CASTRO, EDUARDO AND KAREN DIAMOND NORTHWEST INC 11940 SW BURLCREST DR 3200 SE 150TH 672-Of / v Ai �7 L_ TIGARD, OR 97223 Portland, OR 97236 PHONE: 503 - 590 -4901 PHONE: 503- 680 -6325 FAX: Total Fees: $2,864.63 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 thr. gh OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 56.6699 or 1.800.332.2344. J ; /J ' Issued s 4 I/ if Permittee Signature: .%; j'/ �� ' 04/08/2010 12:28 5036849015 WESTERN PLUMBING INC PAGE 01/02 Plumbing Permit Application / 9—Z S 7 V Building Fixtures . { i <� 1l rlc:, i `` c linir ��. ' II Z l 25 W Tigard � OR 97223 natds �� /0 � :���' remit x V7-5 - o7p /!I / n? 7 ® 131zs SW Hall Galva, T APR 0 8 2 010 Da „ �I !R. I a k Phone: 503.639.4171 Fax: 503.5981960 Review c '�" ^ luapectioa Line: 503.639 -4175 BEY Other Penult No.: F 1l.ARF7} u www.,,g ,�, -�,, CITY OF TIGARD aeaarrB: 0 l �r n t: \ Notifed/mahod ' - Z ror {- yi "Y k l y.Sh� ✓t �f ?4: �' .}' „)X.i. ��''A fact, 7�+ < F tf�, F c� �J ^ ,D Aa 1 c3 .why Tom T§ h �: ,... n , ...±tea SuppinRentat Information O New construction . .a�9 S;F{P:kCV,r lt {> L•. 4,) : . . M W”- 4�:' S •t": u .�. N ',Vit 7Ys x 1'� Ci F � '� A i60 `li � �i E7NF 1,4,y :rr t r v ' '. ;. s k iJ ( t #prima, v.4. ?:: ?b \ , i.::J 'SItiA:i`.A . A[ �' 'h's.avi f #.t...i 4•� .,,, j 1 q . �} ar to. . o 1.,,;1 'Demolition. "' B.•Enf. + " 17.0."..38., > }+ �y, ., . . � ° For � •' in , motion Kw ht!ckljsE rtyl Add [� p� e�, r v;: New t - dw Total "+ `�!3n ,' „ii'4 P 's -syS > x:, 'y ,"p' x. - '� -"'^7 �' (iHCfltdes 100 for each =mention) t u "-t' r y ,fy u r� r.. " �d nn�/ i.: filA�%+ ��" rstlnntil? ksti'. i' ���`.. k`# x: Y':; � �. �� 'tdR�'�+cc �� }� , 32.7Q MI 0;4 1- and 2- family dwelling El CoutmercixUindnalrial SFR (2) bath MEI ❑ Accessory building 0 Multifamily SPR (3) bath 500.32 WE ❑ Master builder Each additional bath/kitchen 25.02 MIMI � cam- �©other - "+ , Q' 1�w�� °�1 fl ,,Y M �� , gg � a q Z ! b �,n,�1�3X"wG'"�rM K��'.br1,,.i .. laagc 2 IMIIIII NE 1 . l';1x 1 +i-., # SF, 3 ,r';' )3IN Sf nxJ alt,:: { i rP ?t '�s , k'A . +v(4e;,, owe ut es: _ Job aitc address: 1 f Q 4 . IA., Catch balm or area drain 4 City/State/ZIP. -- ,w V j I Drywall, leach lute, or trench drain MEM Suite/hldg./apt. no.: Project name: `/ • 1 i t • I • - Manufactured hone utilities 50.03 ^ Crass street /directions to job site: files .11111IIIIIMI N. 1 Rain drain conned m1 ,� \ Sanitary sewer (no. linear it.: _ ) �� - Storm ewer (oar- liuear?9 `) ` � Subdivision: Water service (ock linear : Lot no nature or item: l■Plift1111. Tax map/Nivoel no Becl:tlaw pievtmter A ,�1 \,:1���/ ' "t 3 ? kF F � r - y , iN ! ,� +A rm y ° °r f Backwater valve -� �1 1 r , n Y x ✓ ��"f h ("� , �. t. . :', 7tFT„ :w k41 4): : t .. ,�� 13a w �� �� ���.� i �r"�� ti � � �� ... 1.. �?..at7.lh �;?. ;�4�. S [an�:.3,'� � �t � . � ; -'T�i �S�S�e�'�t.rSi ",. .tkY �� �` 1' fl 1�_! C Il ! Clothes washer r'll 25.02 �M � � "' Di shwasher WANE= ■■ - . X1.1 .LM. • ' i7r ibuidaiu `m 25,02 - ,• . xr en+ Ar k [ E� t�- ; ` . 1 ��) E i-Kohp IMUM1 25.Q2 NIMIll �+ �.� y , { n G, / 4: { i�1Mi� ti .� � � YF � � M M 4.t �1 � ��y < . � . ' h { . 7 + t V , f lits r r ` � , n A ��-� �i,�, w h 1(1 c ., �4 a l r . 1 l �? 1 `. sz1 "fi a «y�)k �on tank .EE1. 4 \l -'11 1'i¢ ttre/aeweFF cap r� l , , Address: Ploor drai , .: r sink/hub i NOTAME • M City /State/ZIP: oaiba, ..�'G71 Phony Rose bib 7' . i Li ( ) Fax r't N r� , r'8r"�'w,'A.';7' YN"- p K+ aK ( x ) z A lee n - SM . : pµµppp +b,,yryryy��yy��f,4 l iw� x s i� {" F .y,)i{ �y ! S;i T ,- ' - n i1V" k`' Interceptor/grease �,� 'F . ,, N4..., �`�} . - , YM.YI v, C N. �Wx r A ,, S) ,,, +N l {� ,r -�r� a. <� a., �-. t�^ �. ��, s. �, u+. ��:a7�;`x��rs.aw,n�4�',��t�?=�a Lra ... Business naive: Medical (value: $ ) MILIEU" Contact name: ; ■ Primer - M ®� — . si 4 Roof drain (cos nmercial) �� r� 'w Address: l — .. WI- _ City/State/ZIP: ,� ' • t►k/basinrlavatory //, M �i l/ItI�Si - Solar units (potable water) s' _ IVAMIIIIRIE L' we"owerar Ri /�N. 7 E.,. f 25.02 r �i� N � r nt'� f , rt ry i IS v i r g ,„;,, t t' r i; 'Q y�'� i Y s� t g , ✓ " Jae ctrt`c� ""/` x """ '1 -: Beset l / 25.02 r f ..e�. 218} K,G, +.,2, :,ps r Fjrt±�Md.::::i4 :,,,1..A1. „ ,,. ° nka. r r�.:CY, ;i;�i , ,^Y f aid "` "' w cif' peaty B lir usiness name: e. Western l?Drunbiag,l!nc lie 37.52 Address: 9460 SW Tigard Avenue bite 101 1.If' piping/bWY 36.59 �iiw', . 25 -02 Pity e: (5 /3IP: 9-5296 OR 97223 Tigard, Bulttotal , : �� Min Phone: (503) 639.6296 Fax (503) 6&1 -9015 Mini fee: $72.50 Plan review µ 2S% of erxaitfee ( ► ' Plumb I, no.: 3g29PB � ( P ) EMI Au i • ' ed signature: State surcharge (12% of petard! fee) EiTall ' E'! 1. � I , TOTAL PERMIT FEE I r _ This pernth appgeatlaa ezpirta if a permit to not obtained within t Ae day, Print nargt w, r- attcr it bee Deco occsresi as corapYte. 0 • .'F.. m,thnA -.,nm. ,at H.. ' r3,,Ai,n T A...tn, .C.n,ir. TI,..,-1 D "V, 10 Lti putt'ai \Iiiive /I , 17 ,/ 9 04/08/2010 12:28 5036849015 WESTERN PLUMBING INC PAGE 02/02 r' Plumcir - City of Tigard AApi cation ii bi galyd Page 2 - Supplemental Information Fee Schedule: Residential Fire Su t K f �:- �ra�r, ression S stems: ..t e4. �5� 2t m y`?7 5:37,71.tZ�F�,TX 5. N;a. �T t}P F 6'r ;r',! rti:�7 ?% ?�. : atfr. if ,',:,, . :71;:7 ^N r T t� +f : .., ^ w'::;. �,.t4,' e4 ., w , 1,,,ur.�n ':h �+v1. ;' 4k,: i '. 3!+ att� .; W� i t ,• '!g,, . «; .1.:r a lt +' i f) J 1� r . i S ,i, ,,, .T '3r' �,t,ai,,'x k,,; •.� 1 �� r? 4 d i., .+.rc�,rl._�y° 4 7 ?r.: rl r.:�:.�: �A ar �' 1 . .ruh2..m�ls. ."Sa:'y'.w..t � �f..L �^,, + . r Footing drain -1 100' 50.03 D to 000 $121.90 Footing drain - each additional I00' NM 37.52 ME 2,001 to 3=600 $169.69 - 3 601 to Sewer - e had' � � 7 OI and 7.200 a $233.20 Sewer - each h additional 100' $327.54 Water Service - 1st 100' Water service - each addition! 100' Medical e�leat Gas steins Storm Rain d M i , '.. to 1 ,,,,, P , 3� T f ,�/ Fkr ,._;;1',..;',-..:i S• . r s 3',,' f St Yz73 i5g, r 6p2r .+{nA Stores & lain Detu - 1st 100 � 4 N• oo Ye' w 5 . h ` P ,,, i C:A.4...,,, .„ , 7 rN X ..... . . Y'7 ,,, ,,,,. , y { Y a, MV°Lt:! Storm & 'lain Drain - each addi 100 � sue to $5,000.00 Minimum foe $72.50 �� 55,00I -00 to $10,000.00 $72.50 for tbe first $5,000.00 and $1.52 for ,i .kb t s r ` '. r ; sae i$ Ph , ,',x { ,'� P '�',Y' each additional $100.00 or fraction thereof, to --, .rc a rt ,,, . Rb sBm! zFr_ rn "�:T.1:,,6.Hf*.t,,t's''1 -., �yry.�'��� Yi� end iE�Ghtditt Inspection of existing plumbing or for g $ 10,000.00. which no fee is specifically indicated 90 .00 $14,001.00 to $ $14$ -50 far the £prat $10,000.00 and 51.54 for minimum c c -1/2 hour each additional 5100.00 or fraction thereO� to Inspections outside of nomtiat business 90-00/hr and incht .1 $25,000.00_ hours minimum c , : - 2 hours $23,00100 to $50,000.00 $379.50 for the first 525,000.00 and $1.45 for Reittspecvon Fees 90.00 each additional $100.00 or fraction thereof to Mil and iACludin • 550 000.00. Additional plan review for revisions 90.g0/!a $50,001.00 and up 5742.00 tar the fast $50,000.00 and 51.20 for minimum ch :e - 112 hour 111111 MI each additional $100.00 or fl thereof. Subtotal: 111.1 Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", : - cr y ' ,: + .'S�,I s rgJ r r i t In ".∎' !t` r ' v 1" x ✓s r please indicate work performed by fixture. Failure to Plan re View v iew is required 6 T : .�ermrsi - 0.1. ∎1, ,,..:.L: exdaw,, ,�„'.i..":41 .g Plv for any of the followiung. aecura report fixtures could result is increased sewer fees*. Please check all. that l `'%.N.��`^` „ ` 4 t 's u ` a "E`er ' r 'k ` 0 Any nets comma cal with y 2 " and 1. ° 3 .., ti< • »e ;: rt�. t , :.:u 7th ea t systems gne �Qarrtpeab licensed 8 a:'. /Font Bath ont ewer . =ME 13 New exterior plumbing site utilities for any complex st uctuxe -Jacuzzi/Whirl , .1 � asdeWted;iu OAR91&- '180-0040. Car wawa -Each stall � � Q Medical gas and vacuum systems for bealth care facilities. Dri ,, i � a � �- CI Any multipurpose fire sprinkler d system. . - aor/vVater • : . ,' ;� . Any complex structure as as defined in O.SR918- 780 -0040. Dishwasher - Cammec'cial 111=1111.1..11.111111=1111 - Domestic � �� Submit 1 sets of plans with any of the above. . . 1 , E e Wash 1111.1111=MillnllllIIIIME y„i -y'w- W�u • r try r r^� 1' � �'� 4� n :v , "..4 i�a y . ih t1� ly r' 3°�.w"`'�"w !k � u Floor DratrJsenk 2^ ��� u. ,_ ,c Fr,M • :.:.,rn:4 f ' 'Ii r Mti� s -;�h � :, ' :; Z iVt -•): 3 ; ;INtiNitI 'a - 3" MIN l♦�� II t met e t or user diagram is required for new buildings 4" Min =MI that at inset the s ualtficatlons above. Car Wash Darin MIMMINIMMIIIIM G - Domestic MOM MIIIIlII_ MEI Disposal - Commercial 111111...11MI 1111.1. all= - Ittdctstnial 1.1111111MMEMOOMMII Comments regarding fixture work: zee Mach./Refri: Drain MIMMInillin oil S' a = : or Gas Station Rec. vehicles , . Sather � � MEM EMI Shower -Gang MOM MIIIIBMIIIIMMM -Stall 111 . 11 . 1111 1=lf>l!MINM A 0 .4 - a. s. 3 N A:i. tt , .. IL ....�� I, " �►f Sink �� � 1� ,a► 1� rilA =MI ��� ''Note: lithe fixture work under this permit results in an service increase of sewer 1F.Dlls, a sewer MM MM pt ,s wild be issued and Washer • Clot os fees assessed for the sewer increase must t be paid before the Water Extractor � plumbing permit can be issued. Water Closet - Toilet MEM Urinal 1.11.11111MII Mil other FiXtares: IIIIMMIIIIIIIIIMIMII Electrical Permit ! s, ; l , ( j j t c .1 FOR OFFIC:F L;SE ONLY City of Ti and '/ Permit No.:.. 11 q City g Date/13 . ,=)t) i <b -14 15 0s� 13125 SW Hall Blvd.M•, l'dr015 It ° i � + � � u h y � � Plan Rc 'cw Phone: 503.639.4171 Fax: 50= .59$.1 t)60 ,1)41e/Sy. Other Permit: TIGARD Internet: WWW.t1 �` y/t3 },. luris: H See Page for Notified/Method. Supplemental Information Inspection Line: � �C� ■ D �o1�bd � ; BUILDING DIVISION FLAN ILL1'IEW ❑ New construction Addition /alteration /replacerrlenl (lean chuck all that apply (submit 2 sets of plans w /items chekked below) GAT. URY :0 1 CUNSTRII 101 ❑ Service =ed4 or 0 C a,npO atn v e or ❑ F�t build the stories. DerTlolttioll .. .. ._ E Other: r 17 less LO ground, or >s ards. ❑ ❑ _ where the avail fault current Marinas and b in 6 , , exceed. 1 1,000 El Commercial -use l gl icultural f.4 1- and 2-family dwelling ❑ CUrnrrlercial /tndustrlal ❑ Accessory building amp; !Pr all oilier ii cs1latipn'. buildings. ❑ Multi -fanli ly ❑ Master builder ' ❑ Other: ❑ Fire pump. © Installation o r 75 KVA or -: C f[mergency system, larger .cparatciy coved system. J O B S TYE INFORMAT#ON^A:N1)iOCATION 1 • ❑ Addition of new motor load p - A - , -- Iii" •1 - '1 1001 -P or more occupancy. Job no.: Job site address: //q4,6 . 7.3 11. 4-1e jre ,_4i ❑ Six or more residential units. ❑ Recreational vehicle Darks. El Health-Care facilities. ] Supply voltage for more than City /State /ZI)� 600 volts nom "` `' y "` ❑Hazardous locations. Suite /bldg. /apt. no.: ti P roject name: al � 0 El Sei cc of feeder 600 amps or more. FED' SCHEMA,: . .., Cross strect/direc,'tions to job site: 1 1lrserlpfoo i ory• f Fee. - 1 - o,xt . Ncw residential single- or multi - family dwelling un 5. Includes attached garage. Subdivision: Lot no.: 1 1.000 sq. ft. of less 168.54 4 ' Ea. add' 1 500 3q. ft. or portion 33.92 I 1 _ Tax ma p parcel no.: - 1_ imired energy, residential '' ::.• " . . DESCRIP I ON OF WO '' 1 (with above sq. fl.) - 6�8� LT .�T J_ _ • Limited cncra, multi - family a i re3Aentiel (with above sq. ft.) 67.84 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 1 2 . Q..PROF RTY, Oii . ❑ TLNAWT 201 amps to 400 amp 1?3,Sh 2 "" 401 amps to 600 amps 200.34 1 2 Name: - 601 amps to 1.000 amps 301.04 2 Address: : Over 1,000 amps or vole ` 552.26 1 2 i 'Temporary services or feeders installation, alterahpn, •and /or City/Slate/ZIP: l I relocation 200 amps or less 59.36 I 1 Phone: ( ) Fax: ( • ) , Owner installation_ This installation is being made on property that t own which is not 401 amps to 400 amps 16 5 intended for sale, lease_ rent, or exchange, according to ORS 447, 449. 670, and 701.1 401 amps to 599 snips 163 � 2 2 Branch circuits - new, alteration, or extension, per panel , • Owner signature: Date y A Foe for branch circuits with 1 4 "- feeder fee. above service or fe 7 2 Q APPI.JCAiv:)1' Q(CON'ACT kEf (,» each branch circuit _ Business name: B. Fen for branch circuits without _ _ _ _ - 1 Service cs feeder tee., first 56. I8 2 Contact name: branch Circuit loch add branch circuit 7.42 2 Address: M iscellaneous (ser or feeder not if _ _ _ Each manutactured or modular e7.84 2 ( :ity /Statc/ZlP: j dwelling, service and/or feeder - • Phone: ( ) Fax : : ( ) I Reconnect o nly 67.84 2 . _. Pump or irrigation circle 67.84 2 E - muil: . - 1 i sign or outline lishling 67.84 I 2 CO?1NTRA( 1OR S1 nal cucuit(s) or limited - energy ^ , - panel, ahetatioo, or extension Noe 2 2 Address: Business name: `s._.. LL; f y y Y' - - r .It I j the above 111 Each additional inspection over allowable in anv of ^ " X ) g, I Additional inspection (1 hr mm) 66.25/ hr Ch � _ /� 9 1 lnvcsu ( I, ht min 66.25 / hr C ;fry /State /ZIP�� /�- I .._, Ind ustrial plant (1 hr min) I ' 78.18/ hr Phone: hex: Ins ections for which no tee is 90.00 hr s. citicallvliged( /.lir CCI3 Lie.: 1 ,,, ups Electrical Lic. - lion 1 Suprv. Lic.: �f,Tg Ei.ECTRJCAL'`PERMI'f,1'EES 1 - Subtotal: ,) , S uprv. Electrician signature, required _ Plan review (25% of permit fee): Print name: Late: j State surcharge (12",0 of permit fee): (:r1- re TOTAL t > -1tMTT PEE: Authorized signature: j j This permit application expires if a permit is not obtained within 180 -- 1 flays after it has been Accepted as completes Print name: Date: I • Number of inspections allowed per permit. 1 . 1 Builn ,,, g∎t'ermits\LLC- Pcr 10 /01 /55 4404613T(11tOWf.O!e1n ;1. Z00 /ZOO'd 69E9# 01E3313 S3HII1bS LE89OCZE09 g9 cl OIOZ /90/90 Buil Permit Application Residential RECEIVED I' O R 014 1(4; LE O\ I.1 City of Tigard permit No.: • FEB 2 4 �� D ate/B : _J • • • c_ `. • 13125 SW Hall Blvd., Tigard, OR 97223 P� Review , �� ��tair ' a . Phone: 503.639.4171 Fax: 503.598.1960,, p : e j Other Permit: Line: 503.639.4175 LID( OF TIGARD Date R : 1 's ® See Page 2 for T �'^ R ° BUILDING DIVISION ' 1R ` ` 4 � Supplemeutallatormat Internet: www.tigard-or.gov Notified/Method: ion 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 M Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 0,1- and 2- family dwelling ❑ Commercial/industrial Valuation: ! r ' - 1 ❑ 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: 01 5. y w; i3 4i,;LL r: 2i. %5 % ))/<,/ v New dwelling area: square feet , City/State /ZIP: 64A p / OA 9 7 2 ..3 Garage /carport area: %O square feet 6) Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: SGT /v1,1 / _ M g., It / 2 / ,.. -r/4 6q; Deck area: square feet GI 1 ,t sr 0 i S "lrt,,,l . / L4,. - , e,7" - / / � j 4.9. c.& 7 e ��r a .1 Other structure area: square feet (i ,� v >' It L G i-. f . 5 8 2 2 �� /'1 oi/ 1 C' do J? j „,- . REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: �r3,,� 4 w,,„/ A ) B4c 41,-, 3 r LO 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.: If / 3 1 , 0 as-,AO equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. ` [ . / / J / Valuation: $ G4e.� -.�/ 1Y7 AI � -'re'7 2dC _ /!'LC / !� , /.,O/M 4 ✓ / L� «fh Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: k ,(J /!.F/L /7o L $l- A4.4.4r/L) 4 C > Type of construction: Address:// Iy() %, y4 I /) / /Fitz- fr /✓/9 l , Occupancy groups: City/State /ZIP: 17 kan i U � 9' 7 Z Z_3 Existing: Phone: ( """ r3) > "D yl0 / Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: ,U/r. , I , 0 /V J/lJ, / : Lie_ , BUILDING PERMIT FEES* Address: 3 - Gy 0 f_ , / 5--o,,, (Please refer to fee schedule) Structural plan review fee (or deposit): 5O3 QC City/State/ZIP: Po r LA. N s7, /2 i / FLS plan review fee (if applicable): Phone: (6'(03 6 tD -e 3,c. ,5" Fax: ( ) Total fees due upon application: CCB lic.: j /3 / y$ 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: Date: * Fee methodology set by Tri-County Building Industry Service Board. 1: \BuildingWermits\BUP -RES PermitApp.doc 10/01/09 440- 4613T(11/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling roll ()Ric': I Si: 1/\I.1 114 City of Tigard Received DateB : Permit No.: III 131 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical I' I n l o Internet: www.tigard - or.gov ❑ Other: . f1-IF: FO I - E.iMS .ARE REQUIRED ) FUR PLAN REVIEW 1 e No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ • • 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform Toad. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore_•on and shall be shown to be . , 8licable to the 'ro'ect under review. .1(IRIS1:)I( 1!ON'\L. SI'l (. 11 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\ Building \Permits\BUP- RES- PennitApp.doc 03/ 21/06 440- 4613T(11/02/COM/WEB) 10/24/2009 11:38 5037614 '' DIAMOND NW ., � y� 95 PAGE `' it 1I trt�t i� a tst .I ` t 2S,. I lrs�i 5 -.A 0 4 20 A p az C 41. +1►+r � � MA O ennll No.: � 1" � 1 r t, City of Ta prd •' U kr , 131 Blvd., Tama' OR OF i IGARD Ilan }Invitee Other Sundt t � :� $eaPsga�tor • r, 503.634.4171 Par 503.5. ING DIVISI ® I ` d DatoStvadY�r. a�pp,re Inspection l aria: ,02.639.41 ?s 11a1►6edlMAltted rt w ', lam: www.ae a ter., 1 +n REVIEW -- TYPE OF WO elapse check alt Itud ap (submit; sets a wht ens checked honour): ❑ New construction a Addltionfalsesationneplaoerncnt q sum or feeder 400 amps or rots f B.IldatIti Over Free Shat . , *here lt10 mails teat wueaet ❑ Lavine Ana boatyards. 0 Demolition 0 Other: exceeds 10,000 trap. at I% volts or CI Floating lrot{dleal. CATEGORY OF Crag I IRLJG I`1Qttl test w ground. or exceeds 14,000 In Conuno bw)dI ■pleakage' building f or an t °� buildings, L t - and 2fatnily dwelling ❑ Corrt>rttexcia ndustrlal Q Aeoo9s0t'y !� 810' 0 Fire rely. Q MuIU -tbtnl Q Master b alder Cl teen ■ttatitin 7 of 75 KVA or u Qtltl t : Q gamey system• wear separet decreed *yawn - [] Addition of POW motor load of ° "A ", "B ". "t -2 ", '1%1", JOB TIE INFORMATION AND LOCATION 10011P or more oeoopatey. Job rte.: C� kb addroSA: t r / • : 0 S ix or mo ve reefdontiAl e AEI. ❑ Rccraetweat ve for . t tote e 'N - El Realm -care facilities. O supply � soh* voltage t ❑ flvameaa locations, n GNy/3tmrJZ1P: trl ssrvicv or fo 6%0 amps er wow. SotteIblitg /apt. na.: Project name: • `� FRE SCI •lt Cros5 Street/directions to jab Otte: Ness residential single- or meek' -Emily & ante, Includes attached tiara :e — • 1,000 . , Et or lass 111. 168.54 4 Lot no.. Tie, ad 500 314 R Cr � SSubdivision: •� Tax map/panel no.; e bL9CllIFTI4�V OF WORK limited energy, multi - fatuity Ea 2 rtM fl*i :1 with above ; - ft � F t J_. , . 1 taUEIOn alters iindlor raloea 200 asoni or less IIIIII 100.70 MEM :r to 400 _3� q PROPERTY ovvrlf�>a [ TENANT 401 air to too amps 1.11 200.34 Norm 1 601 ern.- to 1,000am• � 30 �, L , 0 Over L000 snips or volPB Address: Temporary services or feeders installation, alteration, ad dies retoeniba City/State/ZIP: 200 antes or lass 5936 Fax: ( ) 201 400 to amps 125.08 MI Owner installation; This installation is being made On property that 1 own which is not 2 0 i amps to 400 ... < 12. f�i i ntended ci3t sale, least, rent, or exchange, according to a 447, 449, 670, turd 701. 401 circuits - now elterastoa or tension 68.5 or acct b _ File for branch cltrvits wink above service or feeder eirli 111111111111 2 Owner Ai$natgtti' Tate A. 11 Ct I IIt� f POISON each branch t ircuit [:j A ,ICAl47 B. •C0 fat exceed circuits Withput service ar Madnt tea, first l �h, I-g • breach circuit ? 42 - COI1tOCtname: Each arld't branch circuit Address: Miscellaneous 4 der or fettle' t3ctttred OT modular dwell serene Andros filer Phone: metzTP- Fad, ttreaw F.=rzerAIMEECIM fJ Sign or outline bighting 0.8 Q.- mail: C gigot circuit(,) or Moaned- ceetgy � ■ ., - attrrsti• or extension. P:.:. 11 --F111111111.111111 Business =TIC - ._ # L2,4 'r K "...6. s[ �i Etch addtttenal laspeetien over allowable 1st stn ' ��� .. ..! j� N o x 11Q q 5 Additloral - tats a hr ,sin) t II sb �■I Q7.19.-1- ta.a■tl�atiml (t br min) ) �7 / D 9 r Industrial plant (1 hr min) 78,18/ hr II citylStecet�:. � �� •'- lorts for which 110 fee. is Pltolae: ('S cj� ' /6,69' l?ax: .7'.�g listed hr ra ∎ 90.00i in CCB Llc.: B iectzitxll Li Suprv. Lic.: 1,7g,„,6 >l ELECTRICAL PERMIT FM 17 Ctd 5 L1 C ..... Subtotal: I% D �- a. Supra. .. r s ate a 11) Plan review c2s4.1) of permit fee - 7� stag 6urohar�e (12% of paratit): ?Sint name; / ((( i' . Dat I U TOTAL PERMIT Pt31?• 11 . This retell aprataaisa Tcptres It a',swath H not obtained within Ise Authorized signature: ds5I after It has hose tccept as eernptetn Da • tdnnmbar of 'nervations allowed per mood. a:smc; '"°• 4s4:A61YrClves/CVMM t radluestseidat- yeradrAsesevo WOO - - • - _ - �nsz ?R -007 Z 00 /ZOO d LZ8b# 8Ia1�313 S3aIfl�S Lngegn05 19 OLOZ /tO /E0 Mar 17 2010 2:24PM CLIMAT CONTROL INC 5039687224 p. 1 • fi A ECE B V E I� ''��igfi [, " ti nt°r �F?! 't7 F�V. ,'�T . fi , lk ffr x72, • ;� Ik o Mechanical Permit Application ik.4 � n,;� t � 11 Al i I , I , ,l '� rgr� " , h ..,i - i tg wii±s��r��5�.c ��i r. � ,�r� ���:.tr�W�# r�fl � �}w¢vw��u.. � " i���a 1 3' ' , ' City of Tigard Received PeradNo : r 13125 SW Hall B1vd,, Tigard, OR 97223 MAR 7 2010 Plan Review t za 4.441*. i• a 4 Phone; 503.639.4t71 Fax: 503.598.1 1aMeJll Caber Paget: . Internet 1 nLine: 503.639.4175 L ITYOFTIGARD DaKR ody/By: hair id See Page 2for Bard. .gev BUILDING DIVISION Netitieealaaod: supplemental Inrermatlea TYPE OF WORK COMMERCIAL FLE* SCHEDULE - USE CHECKLIST ❑ New constructioat ddition/alteration/replacernent Mechanical permit fees* are based on the value of the work ❑ New c ition /� Other: perflormed, Mote the value (rounded to the newest dollar) of al I mechanical materials, equipment, labor, overhead, and profit. - CATEGORY OF CONSTRUCTION Value; $ ` We- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building RESJDENTiAL BQUIPMIi;1VT /SYSTfCMS rata* 1:: Multi-family ❑ Master builder [] Other: For special information tree checklist Description 1 Qty. r Ea. I Total JOB SITE INFORMATION AND LOCATION Ifeali otln Job aite address: I t C�I4O y ` Qv- � Aar inonlltg - --=- (rwuitm site plan showier' placement) 46.75 City/State/ZIP: ' .► • ar. . v 2 2- 3 Furnace 100.000 BTU (doe tvuta) 46.75 Ftunace 100,000+ BTU (duetelvosts) 54.91 SuitePoldgJapt. no.: Project n aiK ' CiL_■AY0 Heat piurIP___- • 61.06 Cross street/directions to job site: Duct work t q 23.32 '2,3 3 Hydinitic hot water system 23.32 __ - -- Residential boiler (radiator or _ .. hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall. in -duct, suspended, etc. 46.75 Subdivision: I Let Flue/vent tar any of above 23.32 Other: 23.32 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater _... - _ _ '23.32 _ _ . Q , ,, (y Gas fireplace 33.39 Q�{� ! l� J ° Li l 6 � y e UC"'-1 ( -d- Flue vent for water heater or gas c) fb 2-110 r MO �i1C Ui.J `aT TV g ] fueplsce 23.32 AdLEALw f Log IiIJi nee {gee) 23,32 �, /l flenY ,5 / �K . ` l4J Wood/pellet stove 33.39 M 0, 7 J `-' _la i J� 0 { 1G-1 ). Sn ll9 dvtT ) Wood fireplace/insert _ 2132 S r PROPERTY OWN 1 0 nmAr Chinmerdnerlfltee/vesu , 23,32 Name; Other: 23.32 �-_` C �-( Environmental exhaust and ventilation +I Ran hood /other kitchen Address: l\ S —t D .0 r C- ('g ,- equipment _ ' _ 33.39 .,�1 City/State/ZIP: . rt b h\ o cr7 2:2 3 Clothes dryer exhaust 33.39 Single -dud exhaust (bathrooms, Phone: ( ) Fax ( ) toilet compartments, utility rooms) t 23.32 25,:;;7_, a APPLICANT ❑ COMPACT PARSON Anidcrawispace fans 23.32 Business name: cam — Other: 23.32 . � 1 h C _ Feel piping Contact name: 1 (, S $14.1.5 for first four; 91.03 for each additlonal . bt', Address: l toc J - 72"° nu e-- LUrnace, etc. t3as heat pump . City/State/ZIP: p �L) `r 61 r\,A, 0Y On Z 2 y WalUsuapended/unit heater Phone: (5 Lis y gZ Z ( Fax:: (Ii) 9 6 4 - ZZ y Water heater 1 (,, 1 Email: 0 replace I YYla 4 -6 Inc I l)C • C_el oe Range CONTRACTOR Barbecue Business name: Ci r rn a - Cape\ • &-- 1 n c. Clothes dryer (gas) _ c Other: Address: ' (0 5� ?w �7 f 2- Q Vim'. - ^1 MEhCt-IANICAL PI$RMITFEES" - - QIy /State ZIP: - 'o- r-1 e4 , i/! �3 O `r q - ( - Z' Subtotal 4 14 • le. Phone: (jam) $ 9�Z2._ 1 Pax: KO) q & y'7Z-Z "y Mi Phan review (25% of permit fee) CCB lit.: 40 _ Q ■ State surcharge (12% of permit fee) f • v • TOTAL PERMIT FEE 10 ' - 4i' - Authorized signature: 9 , j 'this permit oppltcaden aspires if a permit 1s net obtained Within 180 days otter It has been accepted as conepdate. Print pane: ,, 44 alai. 3 17 � t� a Date: • Fee methodology set by TYi -Cnty Building Industry Service Board iv,. tdis0.„„initrl .p.. ,,,,,. c 'GA HM 44ae617T 0tm2ICOMIWya) Z n-C V 6Q l i'1 '2 7 2Cynaa 1.T 0/17/2009 14:51 5037614487 DIAMOND NW PAGE 02 iu nbin mit A i a CEIVED Building Fixtures FEB 2x2010 m ,4 _ . , l ' tot ' ° � l , , �t , Permit No.: n14 t r2Ct0� Qd City Of Tigard e/n : Penult No. t „ 13125 SW Hall Blvd., Tigard, OR. 9 ' • xx TIGARD y Phone: 501639.4171 Pax: 503.598' L 1! C' Plan Review D atern Other' 4 ' In spection Line: 503.639.4175 B I I�IG DIVISION y' Atuo Ready/Dr. tuck: !a1 8e6 Pages 7; far t t i 1 A +. Internet: www.tigard-or.gov r4y ga gm Noltftied/Method: $upplemantollnformatfon t TYPE OF WORK PEE* SCIJEDULE ] IQe construction 0 Demolition !%or,pectal bt/omra @on rite checklist Description ► ON. .1 11 Total 0 Addition/alteration/replacement 0 Other: ' New 1- 2-family dwellings (includes 100 ft. for cad' utilittconnectionn CATEGORY OF CONSTRUCTION SFR (t) bath 312.70 0 1- anti 2.fhmily dwelling 0 Commtroial/induatrial sFR (2) bath 437.78 0 Accessory building 0 Multi- 111miiy . _ - SFR ) bath 500.32 _..... - Hach additional bath/kitchen 25.02 0 Master builder 0 Other: Firm sprinkler ( sq. ft.) Page 2 l JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: { � ll 10)(4.4t)\- Catch basin or area drain 18 -76 City/State/ZIP: - Drywell. leach lint, or trench drain -- 18.76 M_ Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no r Project name: C. or s Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 -- - Rain drain connector .y' T 18.76 i g,- 76 , Sanitary sewer (no. linear ft.: „"__) Page 2 - - Storm sewer (no. Iincar ft.: ) Page 2 __ Warns service (no. linear ft.: ) Page 2 Subdivision; Lot no.: Fixture or item: preventer _ fax map /parcel no.: Declaim 31.27 .. . _._. Dae . DESCRiPTION OR WORK - Backwater valve 12 51 , ^. . - Clothes washer 25.02 V, tit }tom.! t'' v,�;81ot 6171QWQ.0'a0tvl 1 1`3'+ 1a P-. c M _ 25.02 Dishwasher 1 2 c- ________ ._ _____. Drinking 25.02 13jectors/eump 25.02 ® PROPERTY OWNER 0 TENANT Expansion tank - .. W 12.51. Name: b c ( a,,< T-p Fixture/sewer cap 25.02 Floor drain/floor sinklhub 25.02 Address: 1 ci• Li 0 eU a r Do-. Garbage disposal I 25.02 2 - 5,62-- City/State/ZIP: - VAL, pc- r ^ _2 z 2-3 hose bib 25.02 Z5.0 2 Phone; (5 Sq0 -- tic? 0 Fax: ( ) Ice maker I 12.51. 12 51 0 APPLICANT , g1 CONTACT PERSON Intercepter /greaec trap ,. -_ .. 25.02 Business name: C7 t 1- '+AlC�rv� 1S St-.5 W Medical gas (Value: $ )µ - -_ Page 2 Primer 12.51 Contact name: W t L.-VA vv� 11.-t� ,//��.$ q � �..„ = 1° Roof drain (commercial) 12.51 Addrrss: 2,c,O eS ' C- • .. Sink/basin/lav - -- v s /o /� 3 25.02 •7 City/Slate/ZIP: W c q 7 . at,- Solar units (potable water) 62.54 Phone: (6 ) (r 33-s Fax:: ( ) TublahowerIahowerpsn _ . 12.51 26;02- E-mail: (VI . . Rr, YINct1;r' C- y�,C, . c_o„.„ Urinal 25.02 CONTRACTOR _.. _ Water closet y 25.02 2-5 , O 2 Water heater 1 37,52 _. 37, 5 Z -' Business name: y _ Water piping 56 Addreaa: I / - Other: 25.02 City /State/ZIP: /Ta Subtotal Zf 9s Phone: ( ) ' i 1 r ) Minimum permit fee: $72,30 -- CCB Lic.: Y O l' � f luntbin Lic. n .: Plan review (2596 of permit fie) ..i DatF State surcharge (12% of permit filo) X - Z f Authorized signature: /' , 1 TOTAL PERMIT P -� r O (, Z2 � ' ~--- � 1 � ` TM p er m i r rp pt kntlon expires If a permit is not obtained wit in ta0 days Print name: : after it has bean accepted err complete. I "Pea methodology set by 'MI-County Building Industry Barrios Board. 1 113uIldlniRominl4t .NltlIMrmitADRdoC 1. ' 9'. m a 4o4616T(10/OA,COWW1311) ' 11/12/2009 10:32 5037514487 DIAMOND NW PAGE 02/02 From: RE r .: 1 0 12:10 #331 P. 004/004 rinthisithraimasil. 23 2013 Bui6ldting www.ttofd- 0 Worm CITY __lIr �t ; � R y� r f -n , , ' g / •� �y i lO l' I lfl :`°l � � . ."1... r�t'etw.,' t 1,fr d a .�.le } v. k •d r e p , � ► Hi_ dept IV � iGR Swivel Pnarlttaa ca (o• �I Q�t4 1 ?a Pboaa: btspootion Lbw SO 503,639A171 Fox: 503.998.1968 oberPateitNa: .',��'�r S.6q. 9.017 s NIIK Worm [.81x1` p R mono Her , Stllnplotmlhlctl°irrou 17112 aff WO= PEE* SC1118:1101E ❑ Now oonatniottma 0 Demolition . 1ror + acrd s darkllrt - Addidlul/OUcrdlonhgplanamenr CI Olher: _ et lt► -- :.. Thtai New A- A- tkmlly dpnpl , , 100 It bk w 1 ti oonneoilon) - C.A.1710018tY Ofd L�Otti81llilC ul l $PA(1) ball 312.70 _ 16 1(2) bah O 1- ®d 2`faraily dwelling ❑ gm (3) bath 111111 30022 - D Among banding D 1 44 1 4lmdly - _ Fads additional batliAcitobei Ma 25.02 _ 0 WeUar builder ❑ Other: Fire Sprinkler L _ R MiilliZM - 603 WS 1INFO MAl2f8P AND LOCATION Whims - Job Ina address: t 1 CIA Q E >r Y 10.1( Stir Catch basin or ataa drain 1816 - C1ty/11tal diQ: • Drywall, knob line, or send' irate 18.76 Aoatiat drain (no. linear rt.: __..) Para 2 Suiteibldg.lapt. no.: I Pinion nano: QiILF,Arti m o a m ctured bums m i l i t i a 50,03 __.. t 1 shroaftdbaationS to Job Ake: Manholes 18.76 •-- Rein dodo eonesetor / 18.76 / 76 -- - tionitery sneer (ne. Unger ft: _,1 Pane 2 °'"" T Storm newer t Pap 2 _ Won melee Om lbw A.:,_.) Pave 2 Subdivision: L npC Item � 'Cox naalprpaysol no.: \ Reoktlow preventer - 31.277 _ D 1811uiq OP �i O liar McInnes vatvo M 12.51 Clothes washer 25.02 - - Dishwasher / 25.02 ; 5, t7 _ Dninldn8lboniatn 25.02 _ ootara/wiup NM 1102 0 mummify owr a I 0 =curt 101panatoa tank 12.31 - No mac► 23.02 _. _. Floor drain/Moot atrlh/bub 1111. 25.02 Aid=es. . -- Oarhuge disposal 1M1 23.02 -,_Q 2 Olty/8tate/Z1P: Hose bib / 25•02 , S Phone: ( ) PmPam ( )• - We 1t,aPoer / 12.51 /s �, , _5/ 0 *MACAW . ® CO TACT' 1 lateroeptarigrown trap 111= 25.02 l SuBlnlsa MUM V Medina) gee (veld: 8_ Page 2 -- ---- -1 Primer mw _ _ Comm . - Roof drain (camaieretal) OM __ � Address; SinkIboninInvatary /QA/a 3 25.02 �S, d Co City/$tate/Z1P: Sour unite (potable wets _ IIIIII 62.54 Phone: ( ) Pax : ( ) lrtblehoslmrtabonarpan 'MEM ..2S d &mall: Millet - ME 25.04 Water COiN�lACTOR vine a!i 25.02 a5, 022. / r Wateth mar / 97,52 3?.s2 Business nano: , e 16.frwiw WaterplpltrBflWV 5629 _ 465 444 3 d f,5: 9v, 9 I MI 23.°2 Citytstabalr: C.lie K�' & 1 1119, Pal 1`) t.!~ Subtotal . r , 9.S Plana (fb ?) X .. ,, r' (r0n) . _re).- g j e2 _j Minimum Fault Nix 8x2,50 H I m: .�O © Plumbing Lie. no.: `9 / _ ' f l/ - Pion review (1591 ofpam![ 11)= tftate ear*Uge(1294ofpgnoit fe) 3.2: .7 ' i ►' Authadedi signs • - . 1 F+HRMIT FES / i, as Print name: � i C /P r 7 > �"� Dot J n This wait apgdzafiw mph= tin panda 111 list obeained v.lthJ L00 oars J " after it has twee aweptea AI oompt*M. "Fee malhodolog set by tri -Opmry WINK railmligy Santos Ba nt r. ailr emlla141haPeritAPades 10t01100 wAsorpoolcomewmv \/ 4 . a41 ,�e,iA -X� 0/741-- t,a- 20 ti /L2e (ii Qu) 11/12/2009 10:32 5037614487 DIAMOND NW PAGE 01/02 3200 SE 150 Ave R [' bk°z a thet i � i r PO :. I! •R 97238 4 a w,W , �]famond NW �nc�'�'��, r• dr 503- 880.6325 51 -761 449 2 3 2013 MAR CITY OF KK f '" R �: BU!LQ C Ntesitg t � To: t-.. o r-A ...)67 S t-R. LIT-12 s From William M. Thompson Fax: 3 -,5 1 Pages: Phone: Date: Z - zr- / 0 Re; CC: 0 Urgent For 5tevlew ❑ Please Comment I Please Reply 0 Please Recycle o Comments: _ fie Ff G i� � ✓� „� � c50 777/the A.to !T T6 / ,�� • • P� G� ��� , ,� - -` Elk) 300.00 `n `L A, e•-)W1 ,A, 1 ,/. - j _ E.XIfIIJ b (/I' h; / p j If �� DI M�N�lol�l �' O 1 ` •1 / /XID TIN!� tiS ,y _ i' . 7 * '?'19 10.:) 1 ■ 4 / \ E.L. 2g5•oo is . . ' / El,. 295.00 a . 298. �/ . / , /C) EL : 29 4-(-%: °� RECEIVED FEB. 4 2010 Et, • Z9 Qo' CITY OF TIGARD. BUILDING DIVISION Addition to ..... At Ed and Karen Castro Residence - owners 11940 SW Burlcrest Drive Tigard, Oregon 97223 NORTH Washington County 'Lot 3 Blk. 2 Tax tot 1S134CA02500 ( s a, r4 sit _ ¢ :._ ; SITE PLAN SCALE - 1" = 20 CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: fle\ST26\C) -0002-7 PLANNING DIVISION: z Required Setba5,15: D' Approved. -' ri Not Approved Side: s _... 3 , k: P„,, Front „...,;.. i.f.:F , :D RP' r: Vistri!(_siur Maxui:1 it- 00 c \, `.7,(:- ' :.1.' :' Lnii. _1411//41-tei .1)-' e" LL j4 ' 04.41-4. i , ..H:: 210 1 -S7f° 'ARTME Actual lope 1s1 Approved 0 Not Approved . . Site P n: Ef-Approved 0 Fproved By: Date: 2 - ! - GO Notes: . T2-i&J111, Is (-ILI e a_.- • •. . . , . . .. . -, ' • _ , ejotle . :araa _1 t'zil :p) 0 7\ :43 panoaddy ION , P3Aneddy] ' -tsZi pm,Noic1 . . , - . • - . • panatddv ION 0 ' panould 211 :saati pans 1._. E.000 - Q (0 Z ULI:Ot•1.111411130 °NIGH 1118 /1631A311 NV'IJ 3.11S - CRIV911 Ace Alla .. . •