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Permit > '. CITY OF TIGARD MASTER PERMIT 4 r ` ' f COMMUNITY DEVELOPMENT Permit #: MST2010 00039 TiGAR b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2010 Parcel: 1S135CA09500 Jurisdiction: Tigard Site address: 11448 SW 96TH AVE Subdivision: SOLERA Lot: 4 Project: Solera Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 665 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 953 sf Garage: 218 sf Front 20 Smoke Dwelling Units: 1 Third: 420 sf Right: 5 Detectors: Yes Total: sf Value: $217,300.53 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: a Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <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: 3 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 addl 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) GREENBURG TERRACE LLC EVERETT CUSTOM HOMES INC 1 MST Ersn Cntrl 503 - 681 - 4444 735 SW 158TH #180 735 SW 158TH #180 BEAVERTON, OR 97006 Beaverton, OR 97006 PHONE: 503 - 332 -7167 PHONE: 503 - 348 -5602 FAX: 503 - 726 -7106 Total Fees: $14,718.59 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 obt- a copy of th rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: % /- . Permittee Signature: Building Permit Applica ;' '' CEO j ± ,. 4 ?+v z . •`}.i � .'y�.?5:: �' kn ��'�°'�, `? G�z erE�S+�'�` '^`�"x t.Y,�� �1 ^kSt't ..�� Residential F = u >� FOR O I 1 ICL USC ONLI A, MAR 1 g ? Q 10 ..., --; ti ,rs .._ ,:1 � � :. ( r ','y Received p ;: Cll Of Ti Date/B � D IC �� Permit No.l ` b, IA 1 ,; ° 13125 SW Hall Blvd., Tigard, Plan Review QQ��pp'� /! Other Permit f Phone: 503.639.4171 Fax: SD3'5 1 TI(iARD Date/Bv: 1 (Q -.ere) r1+" Inspection ins p Line: 503.639,41 BUILDING DIVISION See Page 2 for l IC A-R'D ��1 !1 Date Ready /By: lust ® ""� . A xD Internet: www.tigard- or.gov Notified /Method: h /� Supplemental Information TYPE OF WORK REQUIRED DATA: 1 -AND 2- FAMILY DWELLING Ig 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. Valuation: 5 2 , 1 7 , 53 -""' ❑ 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: r (/ 4 g . I ) t 4 t K Z.vE- New dwelling area: 2638 square feet City /State /ZIP: - 11A1 4 ^ O / 7 g g 3 Garage /carport area: 2% square feet Suite /bldg. /apt. no.: Project name: tom) 4- Covered porch area: ,ty T square feet 1.6 -Z Cross street/directions to job site: Ac u . Deck area: square feet „CS Other structure area: 2: square feet 2 � � REQUIRED DATA:'COMMERCIAL =USE CHECKLIST..• Subdivision: s, , Lot no.: 4__. 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. t1. t I t *afoul jit Ic te) m � - `'6�i L� 1G1J ` 1(/�+6 Valuation: $ a Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: L°� Type of construction: f>,.J Address: . 1951D^ l to Occupancy groups: City /State /ZIP: 3 J O/Q Dg. eriex, 6 Existing: Phone: 609 3 2 7 2 -7167 Fax: (503 - 716 °o 1106 New: • 17,APPLICANT i fg. CONTACT PERSON . r-. NOTICE: Business name: pr D DJ C.. All contractors and subcontractors are required to be Contact name: r 4 licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: -7 5I~ '1 110 jurisdiction in which work is being performed. If the o y � / applicant is exempt from licensing, the following reasons City/State /ZIP: 1 ` t� t 2 n L /�$ /� apply: -�� �-� Phone: (� 7 !4 ` 1 ' W 1 Fax: (0 I 7 1 1 � 1)0 t �..1 -- 620 ikt3 E -mail: Iv ,vk O e 06#, . ,it koM&sfl w. toss 00 cj - W — CONTRACTOR • Business name: g , kl C 0 . S } 0.” 0 'r-1/50 • BUILDING PERMIT FEES* Address: 1 s S •W S f v p (Please refer. to fee schedule) ` Structural plan review fee (or deposit): City /StateiZIP: 5 Cp Y- CM GO 00 t FLS plan review fee (if applicable): Phone: (SO)) 3 1_\g C, ca 2 Fax: ( ) Q Total fees due upon application: I CCB lic.: o, t}..t},-1 1 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: M tG s s , Q � Date: L L. i •Z (`0 * Fee methodology set by Tri- County Building Industry ` ` 1 Service Board. l: \Buildine \Permits\BUP -RES PermitAon.doc 10/01/09 440- 4613T(11 /02 /COM/WEB) Building Permit Application Checklist • . ' 'ly''dr._ ,919!'s"kt':+'T M fr *t, drz One- and Two-Family Dwelling ' u 1 � ; l olz onract;�t:isc,oNl �., ° ; . City of Tiga Received Date/B Permit No.: v_;:. f.. a 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: ® Phone: 503.639.4171 Fax: 503.598.1960 l .. A I w�l tl±e - ' 3 i) 24- Hour Inspection Line: 503.639.4175 ❑ Electrical El Plumbing ID Mechanical l sawn Internet: www.tigard- or.gov ❑ Other: ;'t . 7 fTitfLOWIN� ATttCIPATf± iFgf itiT) FOR PEA RF ; IFW �' ; c rT ' °s �`: 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ EJ . 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. -. M ° 10 3 Complete sets of legible plans. Must be drawn to scale, showing confotilmie to applica�ile'local4 state _ , ., 0 ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or etN•separgte full site f I • sheet attached to the plans with cross references between plan location and devils. ,Plan review bannot be completed if' ' copyright violations exist. '• -D-..4 -7 . .r 11 Site /plot plan drawn to scale. The plan must show lot and building set elirnegsiopslroDert•c ec,4I (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines lit interVals)!Iod'aticifrdf 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. it , • • 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details; }'erii size.l . PQ' ❑ ❑ 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 grid sp1cfh$ suoh' ii jl9or beams; jreadersp joists,'stib 1 ❑ • • "• "` floor, wall construction, roof construction. More than one cross section niay be required to clearly portray tw ' " • 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. ❑ 0. ❑ 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 r at h rlh tb ` 1! ' '„ t � - f 4 . • " • " 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indleatl clgt s and lalptitygnsifor nop- • • °, 11, •❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standings. • • . ) i..4 - e :-w 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicatlifig ntet1ib' r Sizing pacin fnc�t'�i(t2tr�tg ; ± ' : ❑ ❑ locations. Show attic ventilation. •a, • ' • , t .t • $ 4 ...... ' ' • ` • -• I •, ,. • • -+,. 18 Basement and retaining walls. Provide cross sections and detail showing'ptae'ement of rebar. For engineered / ' • `0: p '' • ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current.eode design Yalu ,s.for all ,creams gnd` multit7la'jois .0 E over 10 feet long and /or any beam /joist carrying a non - uniform l ' • r • t• , ' ; • 4 • A -.4. ,� 20 Manufactured floor /roof truss design details. - ; , ._ t 1 21 Energy Code compliance. Identify the prescriptive path or provide calculab7dns. A gas Thilag `s'e(jematic istegyirt„ , - -. J ❑ ❑ for four or more a. s Iiances. r . ' 22 Engineer's calculations. When required or provided, (i.e., shear wall,'rooPtvtls ) shall be .tamped by anlen: neir .fw=:i' h ❑ ❑ architect licensed in Ore• on and shall be shown to be a..Iica5le t6 - eeit Ltndef•review. ' ' ' 1' y '•:• *.• ,. > t t 5 f -ra i. ea V r4'7 • 4 4''> eA . I l�1R[ SD[ , C [EI ONAL SPEGGFICS •4 ± 11:0 1te ; r ; , fx, rYitN:. ', 4 i0V 6 i"4 0 23 Three (3) site plans are required for Item 11 above. Site plans must be 8- I/2 "'x•1 t dr•hi" )f l7'l ' "• ' . ' % ■ ' ❑ t ❑ 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, driplincs, . ❑ ❑ ❑ and protection measures must he drawn to scale and must include the project arborist's signature of approval. • 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment lorm 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. L \iinildin ern,iI,\1111I'- RI3s- 1'cnuil App.doc 03/21/06 .1 - •16 11'1'(1 I /02 /COM /Wlin) , " 4k/97211 4 1.0 08 PA 21 5035981960 503-651-354a TV OF Vi phase electric PAGE 1 +63/02 �IIDilcatip1i1 Py a La I , 11 1 Vii, I I I ' , t ( 1 t t lectr Pew_ _ City Qf Tigard 13123 SW Hall Blvd., Tigard, OR 97223 Phmm: 708.634.4171 Fax: :t03 39E,1960 .. -- Other Permit: lnspeatlon Lino 503.639.4175 Dam Ready/By Jn' 19 gee Pepe 2 ibr Internet: www.tigardror.iyov Notiaod!Merhad: 3sppleaastallrrfbrtaetioe n New construction CI Ad ditiodalteralion/roptacemant (lase Meek all that apply (submit k sets of ohms wiltaea chocked blow): © Sar.ise or fabler 400 empa or mare 0 Sullen obese these atoeim- ❑ Demolition • Other wham the evrpbble feel: current 0 Miming ad boalyaas. ' i ,; '.— T ` meads 10,000 /ups at 1S0 vain or 0 9Ioalnp buildinat . . .... lean to almond, or exceeds 14,000 ❑ Comlatlrrldklt/ IEriaalhtral ti 1- and 2- family dwelling ■ CommoraialMdustrial M Accessory building amps fW ,m ether ileetilatimn. build. 0 Mnhi fimi) • Master builder ® Other: ❑Fire pomp_ Li lraalletien el! KVA err ❑ �arag000y bratsoa• haver separately derived Teem. , ... - i ,..,,....., ',',: 1 ❑ Addltlon of n w molor load of CI - A", "C". lanlrPormere. Job no.; Sob site address: 1( .011/4,v-14' El Six or more residential nits. Rearealloc eetlonel vdtldle pain. City/Butte/ZIP: ,,, ' '� Pa , ., CI Heom.roe £wilitics. 0 Supply velteao for rue" than Cllimodons !weary.. 600 voila nominal. Su)to/bldg. /8pt. nn.: - insovjee feeder dadamp%ormare Cross street/directions to job site_ ■ w" R'mitAI ICJrOMill !stew residential Ilaple or ma}ti-i'amlly dwelling salt Includes attached e. Subdivision: 501 0.4.• Lotuo.: i t>♦ r 0 TOz map /parcel no 161'1 ltld energy, resldtmttal on IFM 3392 1.1111.111 r C ; , i '.1 , rdlava fi a 67.84 Llmilad energy. oaks - family trosidtntinl v _1. fi ■ 67.64 ION© =ervhesorieederstestalM. atterattan and/o r , ,; ,' 200 eat of 1180 t' 100.70 —© ` 201 Imps so 400 amps Ill. 133.55 IIIIMIE1 401,• •s to 600 ME 100.34 — Name: amps �13 601 amps to 1,000 am 301.04 Address: Overl.000 :.: orvolta = 1E1 City/State/ZIP: Temporary lorvicee ur feeders Installation. altcrattoc. andlFr relocation Phone: ) 200 amps to cit Ices NM 59 11.11M11 Owner Inatafatlon: This Inslallatiml is being made on properf' drat 1 own which lE not 301 amps to 309 161.04 © intended for sale, lease, rent or e xchange, a ae0rdin2 to ORS 447, 449, 670. and 701. 401 amps b 1P4 amps 168.54 , El Ic • At. . — mew eltcratkm or exteasioa ' . sal Owner signature Date: A_ Fee or b c is - with a . C 7" -- r , ice or feeder fee, -___ —� r '. a circuit IIIIII _ � • , service or feeder fix, first 56.18 Colltaot name: branch circuit °� Beth add') branch circuit = 7.42 —© Address: ' 3 \ 5 $ x'^ M 1 • . ,, , , . feed not lull • -, CI /State/Zla': hmam>fac6acdormodular 1.1 67.34 _ Phone: ( S 4' ) e. -S.. Pax : :( ) Pump or irrigation onolo 1111 67.84 M1111© E-mail; / . . . ...", li A a .. , - r -- Sign m arrtlitre }i ., ■' ■ : 67.E4 — ` ,,. , + ; sr• , .� _ � ? , • "" i Signal cirouir(a) or lmmilmdgenmEy IIIIERIIIIM IN liminess name: - / �' . at•- ,..Lv. ■ annum, - } r Each additional 1 ,. Iles ewer allowable tea eat abrave Additional inspection (1 hr min) ■ 66.25/ hr — Cit P o . ...e. Q \ 7 • � �� Phone: ( ( ) 0 — ♦ 1I Fax: ( 5 ) 'l €1- .. ; Z. Industrial plant (1 hr min) - 73.1 e/ hr MIS Suprv. L1a: 33 06.001 hr _. z I � , u. 5uprv. Electrician signature. required: ++ 0�.0 -.«, .c! 44 ?. ? /° / /D { , ' ' , �_:.�._. _ ....,�.Y _ • • ► ,L t1 t 1 b Date: Plan review 25% of , errnit fee); Authorized signature: e:.7. ' State surcharge ()2% ofpr.unu flea ; CISE: ' Dine. . TOTAL PERMIT PEE. MIME I. t numdlnt.Pemite•Etc.rertnitA ¶G01Aro M14M111T(I /1111 VKWP-n Plumbing Permit Application Building Fixtures roll O(FRI USE ONLY City of Tigard Received g Date/By: Permit No.: lig 4 1 13125 SW Hall Blvd., Tigard, OR 97223 a Phone: 503.639.4171 Fax: 503.598.1960 an Review DateJBy: Other Permit No.: Inspection Line: 503.639.4175 T I G n R D Internet: www.ti and -or. ov Date Ready/By: luris: ® See Page 2 for g g Notified/Method: Supplemental Information '; TYPE' OR WORK 0E SCH>;,DUt,E`. ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. I Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) _ CATEGC)RY' Oa + CONSTRY. ' , SFR (1) bath 312.70 • dwelling SFR (2) bath 437.78 ❑ 1- and 2-family g ❑Commercial /industrial ❑ Accessory building ❑ Multi - family SFR (3) bath JC 500.32 Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 ''JOB SITE' ITE 1NFORMA1JON AND LOCATION Site utilities: Job site address: 11�r4 S W - GI 6 fI Catch basin or area drain 18.76 / Drywell, leach line, or trench drain 18.76 City/State /ZIP: -\ 1 9 0 ,- 4 0 1 12 3 Footing drain (no. linear ft.: - ) Page 2 Suite/bldg. /apt. no.: I Project name: g (1 e. Manufactured home utilities 50.03 Cross street/directions to job site: Cr r LZ\tx 19 v-v1 Manholes 18.76 Rain dram connector 1C 18.76 _ Sanitary sewer (no. linear ft.: 3c) Page 2 Storm sewer (no. linear ft.: ) 3 0 Page 2 Water service (no. linear ft.: 3 Page 2 Subdivision: S k 0, f Lot no.: 11 Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 a ate DESCRIPTION OF WORK c r valve 12.51 Clothes washer \ 25.02 Dishwasher \ 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 Ex ansion tank 12.51 ❑ PROPERTY OWNER ii 1, C� _TENANT P , 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 .APPLICANfi `- - E ' CONTACT PERSON - Interceptor /grease trap 25.02 t Medical gas (value: $ ) Page 2 Business name: e , t,r , 1 A_ (/ ,n S cC , f t 1 6 v_Pn g - J Primer 12.51 Contact name: M kf \ c C s t Roof drain (commercial) 12.51 Address: 13 S S (n5 , S x� Sink/basin/lavatory 5 25.02 City/State /ZIP: t e Q,_, `v . \ 0 „ Solar units (potable water) 62.54 Phone: ( ) 3 yt . , 0 ,� Fax: : ( ) Tub /shower /shower pan 12.51 E-mail: I Urinal 25.02 M cm - ki �f t Iv a (-6v, Water closet 1 25.02 CONTRACTOR.. Water heater 37.52 Business name: , ^` V \ t 0 :tt.1t e>` h tN� Water piping/DWV �j P P �� 1 56.29 Address: ' 10 7 S W , \ <5�'�r',L, Lo \.,.r. r it, e, ..48r \..Vo'( Other: 25.02 City/State /ZIP: -X- . t A,Ot- c)6A2 0104, Q Subtotal - Phone: Minimum permit fee: $72.50 ( s V', ) 60 - l t , Fax: ( c5 ) b •j _R s A ` Plan review (25% of permit fee) CCB Lic.: k 1 - Plumbing Lic. no. -*CDF:EgleiK State surcharge (12% of permit fee) Authorized signature: (11T4" a ,� � 1,.. Date: -• IAA Q t, TOTAL PERMIT FEE VA Print name: DatC: This permit application expires if a permit is not obtained within 180 days �� r after it has been accepted as complete *Fee methodology set by Tri-County Building Industry Service Board. I:\ Building \Permits\PLMU- Pe,mitApp.doc 10/01/09 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: (minimum charge - 1/2 hour) Site Utilities Q Y '0'0 'Tatal. Subtotal: Footing drain - 1' 100' 50.03 Footing drain - each additional 100' 37.52 Residential Fire Suppression Systems: ; :Square. Footage ' '...Permit, tee ' . Sewer - 1st 100' I 62.54 0 to 2,000 $121.90 Sewer - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Water Service - 1st 100' l 62.54 7,201 and greater $327.54 Water Service - each additional 100' 37.52 Medical Gas Systems: Storm & Ram Drain - 1st 100' 62.54 V a h ia ti on ' : F ee;,: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Dram - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to Other Inspections or Fees qty` Fee (ea) Total and including $10,000.00. $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Inspection of existing plumbing or for each additional $100.00 or fraction thereof, to which no fee is specifically indicated 90.00/hr and including $25,000.00. (minimum charge - 1/2 hour) $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspections outside of normal business 90.00/hr each additional $100.00 or fraction thereof, to hours (minimum charge - 2 hours) and including $50,000.00. Reinspection Fees 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Additional plan review for revisions 90.00/hr Urinal Other Fixtures: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by (Fxture) Work Ferformed an eview for l'lutnl!><ng nstaHations Fixture Type; • Zeplace " Plan review is required for any of the following. Previoas , Canoed Added • .:Existing . Baptistry/Font Please check all that apply. Bath - Tub /Shower ❑ Any new commercial building with water service 2" and - Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" Car Wash Drain $.(1M ett7C oriise>r "!I) }ugra>ai Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial that meet the qualifications above. - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes Water Extractor *Note: If the fixture work under this permit results in an Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Macintosh HD: Users :WhitePony:Documents:Microsoft User Data: Saved 2ttachments:PLMF- PermitApp.doc 7 t , 7 F c r9EFi c c u se , �. a Mechanical Permit Application R . ��arh� Received Permit No.: ` � City MAR 1 8 2010 of Tigard o3 $ ( �J — . 4r90 /o 7 g Date/By / / 1 111 �`" ° 131 SW H all Blvd., Tigard, OR 97 Plan Review ra Phone: 503.639.4171 Fax: 503.59P ' OFTIGARD Date/By: Other Permit: l 90/0 ,3g t GAIT D I nspection Line: 503.639.417 BUILDING DIVISION Date Ready /By: luris: E See Page 2 for &lie:A:kW Internet: www.tigard or.gov Notified /Method: Supplemental Information TYPE OF WORK . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work A New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* )N and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating /cooling 1 / t /// �y Air conditioning Job site address: I `(T rj ''‘4‘) a 61 (requires site plan showing placement) 46.75 City /State /ZIP: kille-- l q O 7 "' Furnace 100,000 BTU (ducts /vents) ( 46.75 '4(C.7 ,�` 100,000+ BTU (ducts /vents) 64.01 Suite /bldg. /apt. no.: Project name: 6 Heat Heat pump um 61.06 Cross street/directions to job site: ' ., Duct work 23.32 , Hvdronic 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 Flue /vent for any of above 23.32 Subdivision: 1 1 Lot no.:� 23.32 Other: Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater l 23.32 2 3 ` � � Gas f 33.39 '�j. (l N vent Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 PROPERTY OWNER I ❑ TENANT Other: 23.32 Name: � 0 /� -- Fee-#1 . e-e_ � f_�• Environmental exhaust and ventilation Range hood /other kitchen Address: 7,1 5w ` � tg■ equipment 33.39 . City/State /ZIP: gjC ''�N ®� CV Wb Clothes dryer exhaust \ 33.39 ''2. ( S) ' VV T 1 t ? (503) /SC sit toilet comp rtments (bathrooms, utility rooms) Phone: f � ` Fax: r toilet corn artments, utilit>� rooms) 23.32 «le , 4- 0 qt. APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: E-vciaeri cuperat..1 Rama, 9 ,c_ • Fuel I io PP g Contact name: tli( E 514.15 for first four; 54.03 for each additional Address: IwJ b Y 45 5• 6 23 yl No Furnace. etc. \ 1 � ye �/� Gas heat pump City /State /ZIP: �V e' ® I` �,q CIO Wall/suspended/unit heater i r Phone: (50) ) '3 1 I / 1 Fax: : (4911) i74 a li ag. Water heater ) Fireplace I E -mail: J ,(4.1( e �.e h tont slut,. co", Range l CONTRACTOR Barbecue r ^ Clothes dryer (gas) Business name: AWAki .6.1 y/ _- .ii. Other: Address: v _I )-st SE 105 U MECHANICAL PERMIT FEES* City /State /ZIP: Partic U �_ q. ?fit (0 Subtotal -0 TOTAL PERMiT ,` x Minimum Phone: ( 505 ° l t o00 Fax: (5 ) `9-g?r -7CoC Plan review (25 permit fee %of permit feel 7� CCB lic.:tiy ;•-- //g State surcharge (12 %of permit feeFEE ) �, r ) ($90.00) J This permit application expires if a permit is not obtained within 180 Authorized signatur days after it has been accepted as complete. Print name: is 1 f r Date: * Fee methodology set by Tri- County Building Industry Service Board 1 Nrediaiiitall'ermit - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: - rerniit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and • $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.0904 $2.54 for each additional $100:10 or fraction thereof, to and including „.„ , A N. $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,0b0.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plan?. .ff. • 4 : ts• • Cot . •11.14r: (% ').* j t ' ' S : 4 .14 131 • 7 4 'e14 j ; 1 • Z,„ 1 ` P y "4! •44 y , ) • -.4 ." • . e ' > • f. P• k .L.-r.. , • 1:\13uil(ling\Permits\MEC-PertnitApp.doc 10/01/09 2 • • ; This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. BUILDING DIVISION II m a T IG A R D' ' NSMI'TTAL. LETTER TO: 'f . . DATE RECEIVED: DEPT: B 0 ING DIVISION 1 r El vE D MAY - 42010 cFROM: j M n, c- v Q r CITY OF TIGA BUILDING DIVI ON TOMPANY:� v zrr R C v.S i \n a v By a �PHONEs� � p3'3 kg,- 5 607, (Site Address) � / / (Permit/Case Number) h .—eel (�� 4—(7 oject name or sue .IN/Lion name ans of nu ter ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. A Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: FOR FFICE USE ONLY Routed to Permit Technici : Date: � (�, ('/ J, Initials• ) Fees Due: ❑ Yes [i]'No Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: I:\Building\ Forms \TransmittalLetter- Revisions.doc 4/4/07 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS 01- Permit No.: 2®' 0 _ 0 3 p Jurisdiction: 1 a Site Address: 1 s i \ A Subdivision/Lot #: C' 1 Qom I T 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: Date: \ 0 (2- I I Owner /General Contractor /Authorized Agent Print Name: M ( i\c_ t 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. 1:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, , am the general contractor or the owner - builder at the following address: Site Address: \ LA, s .� City: Permit #: I0" -000 Subdivision/Lot #: S o \ k 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 weight of dry framing members. Signature: ` Date: 1 Z e//0 eneral Contractor or Owner- Builder I:\Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 ... . .1.... , STREET TEIEE cERTIFicArioN ,....4„.„..„..f,,,,,,,,,,,,:o.....„,,,,..„..„...1.....„......„...„1_,,,,...„.......,*„..,,,..„...„, i,..„.„,..:„..,i..,.„, ...,....„..,...v.,,,..:...,,,...,,,,,,,..,,.,,,,,;ts,,,43.q...„,-, 7 r ,-..'•-•,• ';').' ': .••,.:•:-'-,%. i!,-',..:',..'e.f. ..•',4::".-4,1;,-.7,2,,,.. ,..:5....,..*.,P-1. .,,.• .A ,*. -....,,- . - PA%,-- • • p• L j.•: ; i ,i,,‘,-,, 1 ‘f. '.'". 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',....7 .,. do herebjiii?e'r.,:ti that theYY,O111)wzngelbeation meets ..„...,,,,,...,,,,,,,,,,, ., ,:,. .6 lig,1 1,1 . ..C , .1 crg ..re.,..1,,, Cio of Tzg'ilr'd'''Planel id de?veloflkint standards ,., ,;., . :. : . ,,,,,, : , 0 “.P1 , 1 , ,, 44 ,,,giv.i.t,N-,, , , ; ,„ .,41---,, 7 7.:k1 7!6A,I,.,e't0 • for street:tree-installation ana.vs,4 ....„,,,„.,,, ,:liv?p;+,4-4!...,.: „ , -- , _a- , .:i:-:, j , -- ,i'A Witl);fstPe#apj)ro,ye;astte,ypram:.foil; :.&-t * . r; . ; ......,-, .4 ',..,'., -- : , . , X ..1 rz '1;7 • ..s, ' - ' A.. :: '' ri[N : ,,i.'' , .-' . ... '.;.4.... ...?":47,:, t. ,'.. ..ai..• :14.,t;r:' - ,...t . ' "i: '. ' •....- "/-':: :e...'"`7, '% 1... ,..,- '..; , y , l''.;.;''.4 .,;:.,:.:.1 ,..Y.,:. .,c'. ''i !';':..tt,, :3.% :, : ''',, : , .- - ,s,:t..v. ''.;."4:! A.T. . _.-; rit:,=1, . -;,-..,., , i'i#, -, ' , 7 4 , -?-:Ai ,. e;44'.i:,140,1'.V14, , ,ei.'"a:;:i , , ,- .4',, , ':;.',.•:;30?'.'", , ,';' , . - "::: , ::1::. P& ', '='':.:.-V"'P -- ..-- 4 ,-,' - '0,,, - ,:' ; '":, , , , z.„,'''4..'' , 4 , 4-1 rti -,,',,,,. ,.,'.;, ir” , '4^ 1:1"'. ■ ' e 'i SITE ADDRESS: \ ,,, SUBDIVISION: 5 0 0 LOT #: /r/X t SIGNATURE: - DATE: ... (OWNER/AGENT) RECEIVED & VERIFIED BY DATE: . (CITY OF TIGARD) Tree locat ve per approved site plan. I: \ Building \ Forms \ StreetTreeCertificate 07/01/2010