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Permit EJ CITY OF TIGARD MASTER PERMIT 1 . a _ ._ COMMUNITY DEVELOPMENT Permit #: MST2009 -00099 Date Issued: 07/09/2009 T1(".rAR:D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102DCO3200 Jurisdiction: Tigard Site address: 13883 SW BRAYDON CT Subdivision: MCDONALD WOODS Lot: 5 Project: McDonald Woods Project Description: New SFR. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms' 4 First: 1878 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1315 sf Garage: 731 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right 5 Detectors: Yes Total: sf Value. $355,041.74 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc!Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr. 0 Ea add'I 500 sf: 6 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 Descnption: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) WINDRIDGE HOMES INC OWNER 11401 NW SKYLINE BLVD PORTLAND, OR 97231 PHONE: PHONE: FAX: Total Fees: $16,830.27 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 for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cent . Those rules are set forth in OAR 952- 001 -0010 throu.h OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6 9 or 1 4. 800.332.2 I . f i ( �� Issued By: i&..._4 � I. - ■ Permittee Signature: • Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: // 0 � OOO Jurisdiction: Site Address: /353 Sa) 8.e f et/(1 c Subdivision/Lot #: APo'/t/.4zp /J®e Ps LOT S and /or Map and Tax Lot #: By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) Signature: % , ,�'f Date: /0-22- Owner /General Contractor/ uthorized Agent Print Name: f Way: ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final .inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. I:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, Aleie 1h /t/Fz , am the general contractor or the owner- builder at the following address: Site Address: l3e6 3k) 1 K Gi City: Permit #: Subdivision/Lot #: /& 70 /1//��� /J D5 and /or Map and Tax Lot #: • To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture - sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weigh of dry framing members. Signature: . / Date: / 2Z -O9 General Contractor or Owner der 1:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 Building Permit Application . R sideniial RECEIVE .11 FOR OFFICE USE ONLY • City of Tigard Received DateBv: " ( Permit No.: 2QQ4 , o oo'9 � � _ ST 13125 SW Hall Blvd., Tigard, OR 97223 MAY 0 8 2009 Plan Revie 014.' _ t � Phone: 503,639.4171 Fax: 503.598.1960 Date/B : w Ir Other Permit: T I G ARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready '.y' kids: See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISIO Notified/Method: �p ' [2 ® Supplemental Information •+ c Ke u )/ Im e l(- ' TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ^ 01 New construction ❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Nrl- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ao , 000 ID Accessory building ❑ Multi - family Number of bedrooms: ii ❑ Master builder ❑ Other: Number of bathrooms: 2 JOB SITE. INFORMATION AND LOCATION . Total number of floors: Z Job site address: /333 510 6,eifyp ,4i LT, New dwelling area: 3195- square feet City /State /ZIP: - rm� ,e0 ore f 7Z24 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: /. i R4-5/DE/t/ Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Ai- L. //le pe,Nft'4-/7 Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: S Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 4// Gt) ,P�5 /17 z 57a/e �/ Valuation: $ Existing building area: square feet New building area: square feet X PROPERTY OWNER ❑ TENANT . . Number of stories: Name: XII.e,L/ ,40,44 . Type of construction: Address: ' /124(7 S ; <) / 36, 77 - Occupancy groups: City /State /ZIP: Kt C /Ft/ / 6,e 1 7 z zzli �/ �^ Existing: Phone: ( )3) 5 /�� L/ Fax: (S ) 4 .S� _2c /!f New: RI APPLICANT ( • ❑ CONTACT PERSON NOTICE' . Business name: ¢ 5 A5 jile®(/E 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: Illiitee 4041/r f/fgoo _ CO/ CONTRACTOR Business name: J 6 1Md4/E- . - BUILDING PERMIT FEES* Address: (Please refer to fee schedule) Structural plan review fee (or deposit): City/State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: _ Total fees due upon application: Authorized signature: /l4 ° Amount received: This perm application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: i Ain vFGE Date: s -5 pel * Fee methodology set by Tri -County Building Industry Service Board. 1:\Building \Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02/COM /WEB) Building PerlmitApplication Checklist , One- and Two-Family Dwelling , _ FOR .OFFICE USE ONLY City of Tigard Received Permit No.: 1111 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: TIG 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard - or.gov ❑ Other: THE 'FOLLOWING ITEMS ARE REQUIRED: FOR PLAN REVIEW ` Yes ' No N/ 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. RI ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. I ❑ ❑ • 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, U U ❑ 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 load. 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 Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS . • V 23 Five (5) 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 accompanied by 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. I:\ Building 'Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(11/02 /COM/WEB) Numbing Permit Application Building Fixtures FOR OFFICE USE ONLY ' } City of Tigard Received g Permit No.: q 13125 SW Hall Blvd., Tigard, OR 97223 Re I l i f Phone: 503 639.4171 Fax' 503.598.1960 Plan Date Review Date/13y. Other Permit No Inspection Line: 503.639 4175 TIGARD y > Date Read /B Janis. Se Page 2 for ov N Internet: www tigard-or.gov otified /Method. Supplemental Information TYPE OF WORK FEE* SCHEDULE in New construction ❑ Demolition For special information use checklist. Description I Qty Ea Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ID Accessory building ID Multi-family SFR (3) bath i 399 00 - . 6 k, El Master builder ❑Other: Each additional bath/kitchen 45 00 Fire sprinkler ( sq ft) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: /3o$3 $) , ,e4f dc'// C Catch basin or area drain 16.60 City/State /ZIP: 7 ,te r 0,e 772.z'/ Drywell, leach line, or trench drain 16 60 Suite/bldg. /apt. no.: Project name: WA°Fie re - ive ( Footing drain (no. linear ft. ) Page 2 Manufactured home utilities 1 10.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.:k ) 1 Page 2 Storm sewer (no. linear ft ttO ) 1 Page 2 , / � L p ` t> 5 I Water service (no. linear ft '(( t) Page 2 G Subdivision: .,✓ Lot no.: Fixture or item Tax map /parcel no.: Absorption valve 16.60 /614.14)/18/4 Backflow OF WORK Backflow preventer Page 2 Backwater valve 1 16.60 Clothes washer 1 16.60 Dishwasher ' 16.60 PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 M � '' 71, - f Ejectors /sump 16.60 Name: Gl / !/ Expansion tank 16 60 Address: /72. . Ti) /36 me Az"ijz-- Fixture /sewer cap 16.60 City/State /ZIP: , efrae Z C /7 p 97z 241 Floor drain /floor sink/hub 16.60 Phone: (,53) s *969 / Fax: ( ) Garbage disposal ' 16.60 [l APPLICANT / ❑ CONTACT PERSON Hose bib 2 16.60 Ice maker i 16.60 Business name: 5/f/)?,E M ifevE Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) VC 16.60 Phone: ( ) Fax:: ( ) Sink/basin/lavatory / (2 16 60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet . 16.60 Business name: _ -• - _ Water heater "' 16.60 Address: Other. City /State /ZIP: Subtotal 3, Minimum permit fee: $72 50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: n Plumbing Lic. no.: Plan review (25% of permit fee) / State sur , o fpermit fee) 47 At Authorized signature: A[�'� AL PERMIT FEE NIA-C,,E56 Print name: ///,',/,,e/ /J/9dFLE Date: 5 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i' \Building\Permits \PLMF- PermtApp doc 12/27/06 440- 4616T(I0 /02 /COni/WEB) Plumbing Permit Application - City of Tigard • - Page 2 - Supplemental Information • •- Fee Schedule: Residential Fire Suppression Systems: • Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1s' 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160 00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 • Sewer - each additional 100' 46.40 Water Service - 1st 100' 55 00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46 40 $5,001.00 to $10,000 00 $72.50 for the first $5,000 00 and $1.52 for each Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46 40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1 54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000 00 Rain Drain, single family dwelling 65 25 $25,001.00 to $50,000.00 $379.50 for the first $25,000 00 and $1.45 for Inspection of existing plumbing or each additional $100 00 or fraction thereof, to specially requested inspections - per hour 72 50 and including $50,000.00. Subtotal: $50,001 00 and up $742 00 for the first $50,000 00 and $1 20 for each additional $100 00 or fraction thereof Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash - Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. - Drive Thru - Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. - 3" - 4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i \Bmiding\Permns \PLM- PermnApp doc 12/27/06 Electrical Permit Application FOi O - FI C E;t S O . • ' City of Tigard Received Date /Bv: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan II - Phone: 503 639.4171 Fax: 503.598.1960 Date/B Review Other Permit . T:FGARD Inspection Line: 503.639.4175 Date Ready/By. inns ® See Page 2 for Internet: www.tlgard or.gov Notified/Method: Supplemental Information - :. :-r, ;: c ' A - - „ v ;f.:h ," ( ' at.s g ,. z ,. ,.. d t+ ' a , :t . ` # ",> k:: � 4r-t 2 t .:� _- .." • '. -'F,ar 3,:E� :,..,: �..:ti: „,�, r, ., -e-r^. �...w .- .:TYPE =OF. � ORK . .r t- <: <w >., ts,,' .. �, '�PLAN'f;REVTEWrt ^ , it �. �. . .: 2: :,�,,..._.��:,:,�- �r.,.,.��t,.T ,�, � ,., r „t._,;�.. �:�r.., Viz.... - r,.�:� �� °''mot s � -. ..>~,. _i „�,,,: _ ,< � :,r,.,..:.,.,.w <.:.��,..,..,, _� ,. - ;I.s���..� -. M =� t.. ,:.��`F��+xa,r:k.:r .,: -e° %=;�r:�s, t:' 3�a �x s,:�< > ,:� y ,a>e���, . �.,.,� � ., xz.- ¢:�t��:r =' X New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. y' +fir j :;?: .:4 ' 5: - ;"A,� u,.» '- -tr. ..;>s,T.:. e*.;:a.:�-.. .�-nc.. i - .:' :° '” - c f;:` „� �.�t z t�. - K'4„"”' a s, ':at: .e,;. s .- '.,i?ts, =_`::-;, :.' °rsi,,-,i exceeds 10,000 ❑ buildings a> Awe CATEG OF „ ONSTRiICTIOI\_., - ' ", * ",,''- ` :` ir amps at 150 volts or Floating s g a less to ground, or exceeds 14,000 ❑ Commercial -use agricultural XI- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ E s = °er °r a c.w "- Emergency system, larger separately derived system - �1p . , ,4. t ,. n .w.� t ,.ou ,3s'. �n.z� °. - . 1 ':::i'; RT,. s t�k` g g P Y Y 'JAB SPTE-. INFORMA'TIO� : .-. ..4�I;OCATION , ::', F�' ,a>r, K,�`; ='d'1_ . , . , .:.*fi t �xxsr..._ r. =�: -..z M. x>;,,..s. .�;....w ,..+.. ., ea-n�ttrd:a�p.�i"s ` ^`rt;,�. i' =:'.. �,: = <s.`°';�', - - �;:„��_,��" a ❑Add of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: X3 $ $3 _s ) i Six or more e rest occupancy. �IUr �LJ� � � ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: 1 /'/9-4p ne 9 72 z 4 ❑ Health -care facilities. ❑ Supply voltage for more than 7 ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: /(J ,f „F,..L , ❑ Service or feeder 600 amps or more itr'll UEN:z Bttl$: HaffE .: il171-, .. kn t Cross street/directions to job site: Description j Qty. I Fee. I Total I ' New residential single- or multi - family dwelling unit. Includes attached garage. Subdivisi J Lot no.: 1,000 sq. ft. or less i 145.15 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion .. 33.40 ,401 Limited energy, residential a 7 DESCRIPTiON OTrr _ ?QRKd 'f _ . a; ` " ` k _:` (with above sq ft.) 7.5 2 �` / A /C ©� x �� Limited energy, multi - family V // residential (with above sq. II 75.00 2 Services or feeders installation, alteration, and /or relocation ;A 200 amps or less 80.30 2 A,._. C A ' P O )EIt t x . r E E. - 'TENANT w ', .1 r 2 01 amps to 4 00 amps 106.85 2 Name: / /deft C,04,tJ�Le 401 amps to 600 amps 160.60 2 l/ 601 amps to 1,000 amps 240.60 2 Address: 7 4 7 3 7 6, r# Over 1,000 amps or volts 454.65 2 City/State /ZIP: kii(j GI 71-1 Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with V,NM:. , ;.�.A a s: s,3»..„ `' ' " *'" +„°..-,x : ,:t • a ..a . . . ........ :.....I.x. , <r w,:rrc; '> r `,,Y -A- , - , . ® Ay t ;,,, A ° , � _ � R avCU P RSO ,S” t 4 above service or feeder fee, " , '� each branch circuit 6.65 2 Business name: B. Fee for branch circuits without service or feeder fee, Contact name: first branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: ( ) Fax. . ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 °3` -�. , t � ,.s X �„ ,,. „ Sir. ..- .:ua°' ".`fite:s~ i:,_aa =� " " es�i',''�c VZIM ; s.ur` , t : COI�TRAC 0iMi iMelAm .....-',r;trr I Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited- energy panel, alteration, or Address: extension. Describe: Page 2 ! 2 ,4tDlo City/State /ZIP: Each additional inspection over allowable in any of the above Phone: Per inspection 62.50 hone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: Electrical Lie.: Suprv. Lic.: Industrial plant per hour 73.75 " ...> .. _.< _ .;- ,E;T E,C'1' IPARPER T t;at$:S NE F s , Suprv. Electrician signature, required: Subtotal: F ,rj4j Plan review (25% of permit fee): Print name: Date: 4`7 State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name. Date. days after it has been accepted as complete. * Number of inspections allowed per permit 2'�' �- 7. , I: \Building\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(I I /05 /COM/WEB LOGO Electrical Permit Application - City of Tigard Other Page 2 - Supplemental Information Total number of commercial systems: LIMITED ENERGY PERMIT FEES: No licenses are required. Licenses are requir for all other installations Fee for all residential systems $75.00 combined Check Type of Work Involved: 71 Audio and Stereo Systems" Burglar Alarm Fr Garage Door Opener* R i f Heating, Ventilation and Air Conditioning System" Vacuum Systems Other: , ":0 : ',OWEA:601#;07a: Fee for each commercial $75.00 system (SEE OAR 918-309-0000) Check Type of Work Involved: Audio and Stereo Systems Boiler Controls Clock Systems 7 Data Telecommunication Installation Fire Alarm Installation I JHVAC Instrumentation I I Intercom and Paging Systems Landscape Irrigation Control" I I Medical Nurse Calls 7 Outdoor Landscape Lighting" I I Protective Signaling \Builchng\Permits\ELC-PermitApp doc 03/23/06 Mechanical P ermit Application . F OR O U O ,' . City of Tigard Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 Received CIF Plan Review Permit No.: Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit. 4/6'A RD Inspection Line: 503.639.4175 Date Ready /By: Juris: 65 See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information • - TYPE OF WORK COMMERCIAL- FEE* SCHEDULE,— USE CHECKLIST 2rNew construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CA TEGORY OF'C ONSTRUCTIoN Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. Total ' ' JOB, SITE''INF,ORMATION „AND'LOCATION Heating/cooling Job site address: Air conditioning or heat pump / 3 ��3 Slav � ' A/ G j (requires site plan showing placement) , 14.00 fm4 C� � City /State /ZIP: 7�/�� C >, ? Z 047 t Furnace 100,000 BTU (ducts/vents) 1 14.00 1 • o Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: 6.170%/ GD /( 'CJO 17:5 Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 /!,G �d��t� �� Lot no.: Flue /vent for any of above 6.80 Subdivision: / Other: 10.00 Tax map /parcel no.: Other fuel appliances ” ` ' " ' - ''DESCRIPTION, 'WORK ' am: Water heater 1 10.00 /O.C, ,�/ Gas fireplace ) 10.00 iv. Co /V .45Fpe Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 . PRO OWNE '` . ` „ ' . '.❑ TENANT Other: 10.00 Name: ,/j/J - Environmental exhaust and ventilation �� ` ! Range hood/other kitchen Address: / 7z , ./7 5 ( 2 / i /% ,(/ equipment I 10.00 racE`t City /State /ZIP: i{/,,,, G'L Tf/ ee Q7ZZli` Clothes dryer exhaust 14 1 10.00 ,U.,GU / ! Single -duct exhaust (bathrooms, Phone: (5o3) .571/4/ ���!� Fax: ( ) toilet compartments, utility rooms) 4/ 6.80 2 ❑ ,APPLICANT' ' ' ❑ CONTACT PERSON ' Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Furnace, etc. I 'j, Address: Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: ( ) Water heater / Fireplace E -mail: Range i . CONTRACTOR: " " ' . Barbecue Business name: ,/ rz we ,,C /1L J Clothes dryer (gas) n Other: Address: t5Q l 1 NE, I r -t 1r1 ? 100 MECHANICAL.PERMIT FEES* City /State /ZIP: \I a no o_.V,�- /" '' 1 j k._ q f n S 2 Subtotal (0.60 Phone: ( Q (a3 . 4Q 7 � Fax: ( ) `� Minimum permit fee ($72.5 V v Plan review (25% of permit fee) ) CCB lie.: State surcharge (12% of permit fee) + ... . _ TOTAL PERMIT FEE 12- • g 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 )Building \Permits \MEC- PermitApp.doc 01/19/07 440 -4617T (11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard . Page 2 - Supplemental Information Commercial Fee Schedule: Total. Valuation:'; Permit Fee:. $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. l:\ Building \Permits \MEC- PennitApp.doc 01/19/07 2 -• ,.-- --- -• - .. ... .. _.................... ..... • - • • - riea(3 y ..Fs'?). L. >11 12; ..• 4 . _ 1 A ,1 g • . I li il I qisErk ....._,„,_.__ ..., ...._. . f . i 1 1 . , , k, I i ). l I ° — 7...... t..A 5 (e) -,.......y9 • I ,1 . 0,,i3 10_ Leia ( 11 I , t I 41 1 I . 1 i K - I L___ ' ---. i • \ , \ ( ______. , - • . , • - . , ''k ..*• ,./ -,,''' ' ic i ii •c ,,) I V ------ ' / '/ E• / , s , // 1 ., NI)---- ! i i ( 1 / / = t'5 , : _,---;:>-=--'--• 1 i t _,,- • l i 4 ecri r‘z., - 7 - 4i0-' il --------- - gAhVp0A.J ...„--, • ... , _ • . • _ , . 115 1 • _ _, . • I '7'-'7)--d-: ,c-e-t-•.4-1--- ',. ,....-- cb---v- t -') • •,,. , ‘,0 a . _ . Scale I" = 20' 13883 SW Braydon Ct., Tigard, OR • , 0 • fi .k • t €� a ^ ' 4 - Q era's ' i • ": '#4f ; b �y g ^' • n G 9 1.:' p Y T,y7:1(�yl V iJ @L1.1�I s iNji F • S. vzsit • sJ QH ti ' ROUSE 3195 S.F. • Y • • • • • • £ !, , . GARAGE i a • • i S e s DRIVEWAY a , � } • • • • NI' r a a • • � • � . e ✓ /�� NI • i ■ - • u I.. a ` SW Y J.?. ii DOI `YiOURt { -" C „A :_�. . 'M1 Rfff�2+ya WI Ai A. LOT 5 MCI =IN D W • 1 i S L. a la , :; SW 8rrryd CL, Tig oi, (13 < 97224 x SCALE; (''> 20 - . '~ 1 . . , ... , • . . . . . . . aitillialLM ....f. : S 7 .;`,:t11- v44 - . • 0 WA- d 77PMT PATT :: ---- _ --- - - - ------. "TFONFITTICT;r7.717-- ----'----------- ----------; o Requir.% , 4 S -i A;•; C:: .`,, ,;\ ,. ,‘. - ,!2!), - -.:' i 5-D t•q 'J..L ,,,•,,, ,: ,_ .., ,::::•,_,• ,..,, .-,-... „...„ r 1 : .._:....._:: . &I 1 4. ; ::.; ' ,,'.'.,-:; ‘: - I: ' A r :,,,r:::;•.: , od ' ! ?;,..4,-, ............. 1.•,;::-.' --L: . ; - • .. - -, L ''.." '-'.' ' - 2 .; : ...;-,; -' • . . ,S,i '1': t 4 i - i3( j, 1 1Y , Frk.);: !'' - "=..'-::. - ;-:- . :•q:, - ...77: -7;";' i-...-:" : , L-IL• . _ . •m- Aippfmal -.w ...4: qii. L .,..., ... .,-... gi §w VEREd . . _ CITY OF TIGARD .SITE PLAN REVIEW BUILDING PERMIT NO.: ' PLANNING DIVISION: Required Seti Er Approved - 0 Not Approved i> Sidf:: _..._._ Street Side: .....___ i...C' • , From .,..2.1...... Garage: Rear: --_ ',1:1 Clearance: TrApproved 0 Not Approved • po :.:,..n;1 9) feet - ..:1./..:.: ,,:,„:„ 1...,,,,,ze- Letter Required: 0 Yes 0 No . ' 0 Received t , _ ..„ jAAA- Date: 51-1 /1.4 ' ENGiNEERiNG - HARPY E\1 1. 1 4 Actual Slope:_i_% A • -• ed 0 Not Approved Site Pla : r.: • pproved 0 Not Appro ed . B: 1 i _, _...-,.;,-.. Date: _ — Notes: a A fo , A ____, rrt..rli-' , . . . , • • CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: ILIAST C3C) Street Trees: Approved 0 Not Approved Protected Trees; Inl Approved Not Approved BY: - 70 r Phi cf Date: 9-ca?_o 'Notes: Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. LoaLt \€ Print Name of Permit Applicant /IA 7+61. 7 Signature of Permit Date Permit #: PA& 2ccR• e 9 9 - CA Address: • A, •.� , i� • ►( '""1i4aF • Issued by: \ Date: � � Q - oct •859 This Copy for Permit Offices 07/19/2009 19:53 5035405616 VICON MECHANICAL #5154 P.001 /001 RECEIVED CITY OF TIGARD JUL 2 20 • COMMUNITY DEVELOPMENT : rcGnxb CITY OFTIGARD 1312 S W Hall Blvd., Tigard, OR 57223 503 - 639.4171 BUILDING DIVISION Plumbing Signature Form IMPORTANT PERMIT NOTICE 4 � _ (. 6 Ai .4/ - 1,7 F Permit #: Y11 S1 2 G* • G C S a Date Issued: Parcel: Site Address: \S8 .51.3 sti✓(3,JCk� Ct Subdivision: Lot: Jurisdiction: T �cd' Zoning: Project Name: ty\�00nQ \d lvppds • Description: A e_, sF • Your company has been indicated as the plumbing contractor for the permit referenced above, In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503,r538. ict k C) ' If you have any questions please call 503.718.'2 43 j No plumbing. inspections will be authorized until this completed form is received OWNER: f Roy &tlV PLUp NG CONTRA TOR: Phone #: ,S set7 - 7 /0/ Phone*: Reg #: AN INK SIGNATURE IS REQUIRED ON THIS FORM AA 2� D7- STREET TREE CERTIFICATION 0 RM.D I, Ne fir, � �' `- , Owner /Agent for CITY OF TIGARD BD'L ONG DIVISION Do hereby certify that the following :location meets City of Tigard land use and development standards for street tree installation. ADDRESS: l_33 3 gt Af'Ir'1;7-/ (.777 ��. SUBDIVISION: �'����� ti3 LOT: �5 SIGNATURE: °� / 1 DATE: 1 P (O ER /AGENT) RECEIVED BY: 0,-nniU, . 1 1,t,kA,' DATE: , r 7.O? (CITY OT TIC.112D) I. \Building \Forms \StreetTreeCertificate 01/19/07 .e4 STREET TREE CERTIFICATION I , //1 C Gch9C/ , Owner /Agent for /1?it& 40 W/2 (PLEASE PRINT) (PERMIT HOLDER) Do hereby certify that the following location meets City of Tigard land use and development standards for street tree installation. • /7s7 . 7-,o ( ' ADDRESS: j.330.3 -5e4) B D 4 1 7 c% T6A,er7 a,2 `27zzi/ SUBDIVISION: if LOT: SIGNATURE: ///,/ G DATE: /G -z z -09 (O �V R /AGENT) RECEIVED BY: DATE: (CITY OF TIGARD) 1: \Building \Forms \Street1 reeCertificate 01/19/07