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Permit /(// 2-69 ---2- e- l a--ft.-0-F --1 -0t-e)Qe-t° "i5 e--t-d_ 5-40-fe. GOo14_ - ca CITY OF TIGARD MASTER PERMIT IN v Permit #: MST2009 -00003 a COMMUNITY DEVELOPMENT 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/17/2009 T f t, A R L? Parcel: 1 S 134 DCO2200 Jurisdiction: TIG Site address: 11670 SW 114TH PL Subdivision: Lot: Project: OLSON Project Description: 577sq. ft. addition. 6/4/09 ADDED Mate's as electrical contractor. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 577 sf Basement: sf Left: Parking Spaces: Height: 12 Bathrooms: 1 Second: sf Garage: sf Front: Smoke Dwelling Units: 1 Third: sf Right: Detectors: Yes Total: sf Value: $60,812.23 Rear: PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 1 Rain Drain: Catch Basins: Lavatories: 2 Dishwashers: 1 Floor Drains: Sewer Lines: SF Rain Other Fixtures: Tubs /Showers: 1 Garbage Disp: 1 Water Heaters: Water Lines: Drains: Bckftw Prevntr: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 3 Clothes Dryers: 1 NAT Heat Pump: N Hoods: 1 Other Units: Fum <100K: Vents: Woodstoves: Gas Outlets: 2 Furn > =100K: ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 -200 amp: 1 0 -200 amp: W/ Svc or Fdr: Ea add] 500 sf: 20 1-400 amp: 201 -400 amp: 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 401 -600 amp: Ea add! Br Cir: 601 -1000 amp: 601 +amp- 1000v: 1000 +amp /volt: 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) CINDY OLSON T & P WINDOWS DOORS & MORE 11670 SW 114TH PL 1333 SE 148TH AVE TIGARD, OR 97223 PORTLAND, OR 97233 PHONE: PHONE: 503- 347 -5715 FAX: 503 - 255 -3315 Total Fees: $2,276.74 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 ce 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. ENTION: 0 gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 001 -0010 through OAR 9 -r .1 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 5 .246.6699 or 1.800.332.2344. i Iss d By: V d� / ' Permittee Signature: C. C ITY OF TIGARD MASTER PERMIT l: PERMIT #: MST2009 -00003 COMMUNITY DEVELOPMENT DATE ISSUED: 2/17/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134DC-02200 SITE ADDRESS: 11670 SW 114TH PL ZONING: R -4.5 SUBDIVISION: 114TH PLACE LOT: 015 JURISDICTION: TIG PROJECT: OLSON Project Description: 577sq. ft. addition. BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 577 at BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: of RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: 1 BATH: 1 TOTAL: 577 sf 60,812.23 REAR: PLUMBING SINKS: 1 WATER CLOSETS: 1 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: 1 VENT FANS: 3 CLOTHES DRYER: 1 NAT FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 4 SIGNAUPANEL: IN PLANT: MANU HM /SVC/FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CINDY OLSON OWNER laws. All work will be done in accordance with approved plans. This 11670 SW 114TH PL permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 2,094.42 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issue• By : / _ , ��� ,,4 A Permittee Signature , � _ j�� Call 503.639.4175 by 7:00 a.m. for an inspection that business d - This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 1` wilding Permit Application Residential RECEIV . FOR OFFICE USE ONLY City of Tigard 13125 SW Hall Blvd., Ti at i ved n„ • Permit No.: I r 1 O Tigard, OR 97223 i Date/By: �' �� ' g Plan Rev ' / /`� Other Permit Phone: 503.639.4171 Fax: 503.598.1960 JAN N L v [ i i DateBy: �..h ` ea t TI G A K D Inspection Line: 503.639.4175 Date Ready/By: q uri 0 See Page 2 for Internet: www.tigard - or.gov CITY OF TIGARD otified/Method: /0 ( // C Supplemental Information A a a A , _ � � % 1. ' f ..:r.,...,. ..:r.,...,. - . TYPE OF WO •. }� ` a REQUIRED I ATA: 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 0 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ® 1- and 2- family dwelling ❑ Commercial /industrial �, $) Z • Z3 ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: .2 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 1 GA 0 s W 1 %Li - pLA c.z New dwelling area: 5 7 T-7 square feet City /State /ZIP: 1 - \ G, A 2 D O R °C'12. Z 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: O t_Sc N / t„t,,, rz.„, w Ri GN Covered porch area: 2 to Z square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: 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. Valuation: $ Existing building area: square feet New building area: square feet K PROPERTY OWNER ❑ TENANT Number of stories: Name: c t N V1 Ci t. vrl ei. W I LLt Pct M A 1211 NI Type of construction: Address: I (('DI° 5 W. I14' rt -Ac..E. Occupancy groups: City /State /ZIP: rt G-A al> CS2 0 11223 Existing: Phone: ( 5t3 ) S9 , - - 110 I Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: � ^,w licensed with the Oregon Construction Contractors Board f �J�J (� 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: (��) 34-/ 57 I., Fax: : r;(:)) 2`5? 70 E -mail: CONTRACTOR Business name: /� � � BUILDING PERMIT FEES* Address: U / U (Pkase refer to fee schedule) Structural plan review fee (or deposit): 379 A City /State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: Amount received: Authorized signature: v This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1,,,j1, ,4 t ,, t t ..t a,��— t ( , 4 Date: I 20 c.r-I Fee methodology set by Tri- County Building Industry Service Board. I: \Building\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02 /COM/WEB) i t r Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY Received City of Tigard Received Permit No.: I I I 1 3125 SW Hall Blvd., Tigard, OR 97223 = Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: T I G A R D 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/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. 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 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 Ore. on and shall be shown to be applicable to the •ro'ect under review. !URISDIC1 ZONAL SPECIFICS ' T ee (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ wo (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- PermitApp.doc 03/21/06 440- 4613T(1I /02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received Date/By: Permit No.: • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: T I Ci A R D Inspection Line: 503.639 Date Ready/By: luris: 0 See Page 2 for Internet www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST 1:1 New 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. CATEGORY OF CONSTRUCTION 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. I Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: r.. Air conditioning or heat pump / (r1 S p� . 41 . y A O . (requires site plan showing placement) I 14.00 / 4 , City/State /ZIP: Cc j p . 2Z3 Furnace 100,000 BTU ( ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: OLSo> t ' 1 , 490 . 2 ,- ; - 143 AD ®tToY.i Gas heat pump 14.00 Cross street/directions to job site: Duct work I , 10.00 /603 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 Subdivision: Lot no.: Flue/vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 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 Gi PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: C,11.1pN Ot,...5or1 4 W lut, MgtL-ne -I Environmental exhaust and ventilation Range hood/other kitchen Address: 11(610 S W 1 11 - 171H PLI'iC.( equipment 10.00 City/State /ZIP: .. n 0, 21, 0 12. . to 22.3 Clothes dryer exhaust I 10.00 (arm Single -duct exhaust (bathrooms, Phone: ( 503) 598 - 1101 Fax: ( ) toilet compartments, utility rooms) 3 6.80 ❑ 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 Address: Furnace, etc. Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range I CONTRACTOR Barbecue I Clothes dryer (gas) Business name: - �- W t.teSG W S d. wv,,,, Other: Address: 1333 S,t. - 142). Ac/G • MECHANICAL PERMIT FEES* City/ State/ZIP: Subtotal 4 . 042. 9`1233 Minimum permit fee ($72.50) 72.5) Phone: ( 513) 3 1 _ 51( 5 Fax: (5t3) 255- 331 S Plan review (25% of permit fee) CCB lic.: I i 8 % 53 9 / e (p 4 State surcharge (12% of permit fee) .70 t J TOTAL PERMIT FEE ,20 This permit application expires if a permit is not obtained within 180 1.)./iviix,, Authorized signa ture: days after it has been accepted as complete. Print name: W , N„` M a62 Date: • Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 440 -4617T (11102ICOM/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. I: \Building\Permits\MEC- PermitApp.doc 01/19/07 2 Electrical Permit Application FOR OFFICE USE ONLY 'I City of Tigard Received Date/By: Permit No . 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review II Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: I Line: 503.639.4175 Date Ready/By: Jas• 0 See Page 2 for TIGARD Notified/Method: Su Internet: www.tigard-or.gov pplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories. where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: - O zr 100HP or more. occupancy. (D �7/U • `{ vIrAGz ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: - 6,, Q p _, c (Z on z23 ❑Health-care facilities. 0 Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: p ,,t) t`1or Q.�a ADDoIOr4 0 Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family 75.00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 Q PROPERTY OWNER El TENANT 201 amps to 400 amps 106.85 2 Name: C.t�Dy O`er 401 amps to 600 amps 160.60 2 W t t t-t aM Ma2� 1 r1 601 amps to 1,000 amps 240.60 2 Address: 11 (91 p SW . , Tw P�►c.� Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and /or �l Es(t b A t U 2 g 223 relocation Phone: ( 5 JV3) S9 a .11 ■ 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 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee, I 46.85 2 first branch circuit Address: Each add'l branch circuit 4 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR . -7 7 Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: energy panel, alteration, or Address: extension. Describe: Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above Phone: (56 ) _ I Fax: ( 563) . Per inspection 62.50 Investigation per hour (1 br min) 62.50 CCB Lic.: , Electrical Lic.: I Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 7 3 /V3 Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): re. I Authorized signature: j � tli1w TOTAL PERMIT FEE: 8 Z, a b This permit application expires if a permit is not obtained within 180 Print name: W t tom• artµ vA T, Date: 1 �u I d9 days after it has been accepted as complete. * Number of inspections allowed per permit. 1: \ Building \Pennits\ELC- PermitApp.doc 05/23/06 440- 46151(11 /0S /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received ` 7 ll Date/By: No.: lilt 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Date/By: Other Permit No.: Inspection Line: 503.639.4175 Date Read /B )aria: Fig See Page 2 for T I G A K D Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total El 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 El Commercial /industrial SFR (2) bath 350.00 El Accessory building ❑ Multi - family SFR (3) bath 399.00 El Master builder Each additional bath/kitchen 45.00 ❑ Ot her: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: y I k. S V.i I I y i 71....%,- Catch basin or area drain 16.60 City /State /ZIP: -n LsAr2 OR q1 ,3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Footing drain (no. linear ft.: _) Page 2 Project name: 0 Lso J/ M tactn,4 t m c1.1 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: , ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 Backwater valve 16.60 Clothes washer I 16.60 1 to. (.yD Dishwasher ( 16.60 (l . ( (yt PROPERTY OWNER ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: C.11.t ' 1 a_Sv.rt• 6 \ i 4 - \ 2 r t i - 1 Expansion tank 16.60 Address: (1 ( S vi. \ ) "0 P 1.�C.L. Fixture /sewer cap 16.60 City /State /ZIP: T1 Gr q rz.,, (ye 9 - 1 2 Floor drain/floor sink/hub 16.60 Phone: (S3) 59 t, 11i 1 Fax: ( ) Garbage disposal I 16.60 ((c, bO _ ❑ APPLICANT ❑ CONTACT PERSON Hose bib Z 16 .60 "2� ? Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: 1 ani ` L t ( Medical gas (value: $ ) Page 2 Address: _ - - Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: (/j)3) 7 ..571--- Fax:: (� -t-� `207 Sink /basin/lavatory J� /2 16.60 Tub /shower /shower pan ' 16.60 1 ( •(rQ E -mail: . Urinal 16.60 CONTRACTOR -"Igb Water closet 16.60 t (0. (00 Business name: 0 (4,.'1r) 14' Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 , n Phone: (5 ) Fax: (5) , r ,. , Residential backflow minimum permit fee: $36.25 1012413 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) _le--• State surcharge (12% of permit fee) 2 ( . Authorized signature: „,..� TOTAL PERMIT FEEZO ( Print name: W " Nlr�rrtT t� Date: (I 2: 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. 1:\ Building \ Permits \PLMF- PermitApp.doc 12/27/06 440- 46I6T(10/02 /COM/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 - 1' 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 and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Commercial Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing futures? 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 *. 0 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" 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:\ Building \Permits\PLM- PermitApp.doc 12/27/06 r 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 70t055 (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. \ ✓i.6 (.0 S CY) Print Name of Ihermit Applicant Signature cePermit Applicant Date Permit #: ` a — (DODO l 167o � :�..� Cl I� G, • �` Address: - ,� • f�a-21 CA q7 as3 I ssu by: ate: 4 1 /74 E t< This Copy for Permit Offices Electrical Permit Application �� do • C a A �� ' U �t C F(IItc1FF1(1 I':l ()NIA 972 . Phone; 503.639,4! 71 131 SW Halt Blvd City of Tigard O ar Ti o l n _ Received Y . 25 ., g Fax: d 503.598.196 23 , I f g�c� Permit No.: H57 2 (�G+1 C�_ OQa g I ^ `'� ply Review Inspection Line: 503.639,4175 �/ Date/Br Other Permit; l ICf,ll:1> pc Date ReadyBy Internet: www.tigard or,gov f�' Rf See Page 2 tar Notified/Method; Snpplemmtal Information TYPE OF WORK r PLAN REVIEW ❑ New construction /i Addition /alteration/replacement Please check all that apply (submit E set of plans cutters sheeted below); ❑ Demolition Other: r3 or feeder 40(1 amps or more LI Building over throe stories. where the available fault current 0 Marinas and boatyards, 1 "--• CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volt or ❑ Floating Moldings, ❑ I. and 2 family dwelling Co lttm ereial/industrial less to 8to und, or exceeds tio 14,000 [] A ccessory building am for all other installans, 0 Cornmeeaial -use agricultural Multi - family 0 Master builder [J Other 1:117.1 re pump, 01nnstallation of 75 KVA or JOB SITE INF'ORMAT'ION AND 0 Bmergenc system larger separately derived system. LOCATION y 1 I Addition of new motor load of Job no,; Job site address: � ` f 6 70 7 , `� 741 _ 10()HP or moot. "1-2", °1 -3° City/State/ZIP: /zrp ❑ Six or more residential unite. ❑ Recreational vehicle parks. s _ ❑ Health -care facilities. U Supply voltage for more than Suite/bldg./apt. no. Project name: 0Harardous locations. 604 volts nominal, ID service or feeder 6OO amps Or more Cross street/directions to job site: PEE SCHEDULE - Description 1 Fee 1 Total r . New residential single- or mum- family dwelling unit. Includes attached garage. Subdivision: Lot no.; 1,000 sq, ft, or less 145,1.5 4 Tax map /parcel no.: Est. add'] 500 sq. ft. or portion 33.40 1 _ DESCRIPTION OF WORK Limited energy, residential (with above sq. ft. 75.00 2 _2-e4. t/ 5- Vl /, L Limited energy, multi- family 75.00 2 �` �!� M `ti-c( residential (with above sq. ft.) - Services or feeders installation, alteration, and /or relocation ID PROPERTY OWNER 200 amps or Is 80,30 2 ❑ TENANT _ 201 amps to 400 amps _ 106.85 - Name: 401 amps to 600 amps 160,60 II Address: 601 amps to 1,000 amps 240.E Ell —`- Over 1,000 amps or volts 454.65 2 City /State /ZIP: _ Temporary se or feeders installation, alteration, and/or Phone: ( ) relocation LFax; ( ) _ 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 10030 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps W U Owner signature: ______________Date: ate: Brooch circuits - new, alteration or extension, r panel ❑ APPLICANT A Fcc for branch circuits wit - - � ❑ CONTACT PERSON above service or feeder fee, Bugin.css name; each branch circuit 6,65 2 B. Fee for branch circuits - Contact name: without service or feeder fm, first branch circuit 46.85 2 Address: Each add'1 branch circuit r 6,65 2 City /State/ZIP: Miscellaneous service or feeder not Included) Each manufactured or modular Phone: ( ) Fair : ( ) dwelling ,service and/or feeder 90.90 E-mail: - Reconnect only 66,85 CONTRACTOR Pump or irrigation circle EM 53.40 I Sign or outline lighting 53,40 2 Business name: tgt:11• s e f AV" I •C _ /1! r Signsl circuit {s) or limited- Address: energy panel, alteration or 2 . 4 �1/, ft'a /S e ")114 /J 6 T extension, Describe: Page 2 2 City /State /ZIP: /74)/e_7-1-401,-/-3 Ole. el 7 2e 0 Each additional ins .action over allowable in any of the above Phone: (_4'uf) [)— - - Per inspection i 6 �- 4lft Fax:(Ci) j) G qr — 6e E 3 _ 62.50 CCB Lic. Invcstigall per hour (1 hr min) 62.50 :/ 9 37 / E Lic.: 1 Suprv. Lic.: 3 9Q' Industrial plant per hour 73.75 Suprv. Electrician signature, required: L ELECTRICAL PER1yIT FEES 2 . Print name: /� • Subtotal: ✓ �� ,4 �Q - i Z � y Date: � -z 8 - _ Plan review (25% of permit fee): Authorized signature: State surcharge (12% of permit fee): Print name: ii , ' � - _ TOTAL PERMIT FEE; ii �/ - V 474 $ T ? n G g " O? 77tis permit application expires if a perms not Obtained within i.80 I days after it has been accepted ■s complete. I: lBuiloitlgtPermitsleLC- Pcrmitapp.dac n5/23/06 ' Number of inspections allowed per permit 4404615T(11,05 /COM/WE2 Electr permit A licatjOli F(t12.(1F1 ICI: I NI' ()NIA City of Tigard RIKeived w t3)259W Hall Blvd -, Tigard,alt�� y !►!(7 I DacoRS : PcrmlfNo.! HST 2 001— O� 0' Phone; 503,639,417l Fax: 503_ . F Plen Review i i c:; ■ i In ccdon Line: 503.639,4175 D ory r Other Permit; . 1 s Dare R iAdy/By Internet: www.tigard- or,gov MAR 2 7 2009 Nott led/Mct60d; n'r "' Sec Pnfic far S:t .leruentx# Information HYPE OF s ' PL REVIEW ri M• t �: O New ooristnrcl:ion i~ Addition /:. M' • � • MT • � . Plelsa chcak aN that apptY (btettttl l acts Opines w/{tam Oaken below): Demolition t_ 1 - 1 1, l ; I Icny t p other: ❑ Service or feeder 400 amps or mom ['Building over throe stories, CATEGORY CONSTRUCTION where the availat�te fault currant El M,irinas and boatyards, (=made 10,000 mum at 150 volts or 0 Mention bnild#npn, I p 0 1- and 2- 'Fa mily dwelling ❑ Co ❑ Accessor buildiq tv d, or cxcaeda ,00 0 p r,r ;nl -vac agricultural 0 Multi fhrnily 0 Mester builder P lei ima ibrnll groun a6er 6 tntn11nr1o 14 nn, I � nstal l atio 0 Other: la ,r #toe pump, r, (a nstAlatioll of 7S Kvn or `ms 't iposmA 1 on AND LOCATION Emergency system- largt r Mulvey M#ved 'wren", Job no.: % / 70 - Madeira] fl0X p or ma Ga ofnew motor load of [] °A ^, •) "1-2", "1 -3 Job site address: 6 70 w I k " _ loop mom. occupanc City /State /ZIP: 7 — ❑Six or molt residential units. ❑ Rset the aI v�lliolo panics, ❑Health -care the#ittfea. 0 9npply voltage for more than Sttite/bldg,Ja}st no.; Project name: r_ C,11•Istarduus locations. 600 volts nominal, ©C ^tv;ec of Feeder 000 sat • s or more, Cross street/directions to job site: SCHEDULE — Now residential single. or m niti•family dw ni 4'II1ir • Subdivision: �� Ineladcs attached :arm c. 1,OS, no.: Ea. s•. R„ or less ~� Tax maP /pnrct:i O0_ Ea. ad51 500 sq. R. ornerio residential 75.00 DESCRXPTION OF WORK Glmitad =arm p with alive s.. ft - 5 - 01 -4,/ 9•- V/!' C'e t / f ,?' residential l itnl Clergy, with above fiii,. 15.00 �' wiflt sha A • . tt . - ervices or feeders Iestallatio niter- 'Ion i,,r,d /or re *ratio Q PROP R7 X d ]ER I Q Z00 amps or less R0.30 _ 201 amps to 400 amps r 106.89 � � Natnc: v 01 stn • s to 600 amps 160,60 n Andress: 601 amps to 1,000 amps MI 240 -60 Millfil City/State/ZIP: Over 1,000 steams orvolCq 11111 454 - 65 Man Temporary, acrvielte or [ceders intrtntJntion, alteration, aPd /or Phone: ( ) relocation Fax: ( ) 200 amps or less Owner ingtallation: This installation is being made on property that I own which is not 66 35 l intended for sale, lease, rent, or exchange, according to OR S 4 7 , 449, 670, and 701. 401 amps to 99 amps 100.30 2 Owner signature: Branch cite hen Hero, a „I ptlnn ors h r � Date: APPLICANT A. Fee for branch circuits with — ❑ CONTACT PERSON ebotm serrlica or l i t ith MIN Business name: each branch *insult Contact name B. Fee for branch circuits without serous or Ihedar fee, 1 Address: -- first branch circuit Each add branch circuit M11 6.65 MIEN City/State/ZIP: — — Miscellaneous service or feeder n included Fnoh mnrorfte ured or rnodeli r Ph ortc; ( ) fax: ^ ( dwell #n,, service std /or Raeder 90.90 � � P Reconnect only 66,86 MEM CONTRACTOR Sign Pump o i r lrri. gift Circle 53,40 Liusiness ntsmo: �4/1 l circuit(e) o r i 40 limited. 53, mows sig �d-'r, C. / !V G signal tlreuit(t:) ar limited. I Address: /� /� energy panel, alteration or ,01,21e 64 7L7 extension „ Describe: City /Stare/ZIP: O, e__FL- 44 QVe eV'.7 2 « c? Each additional isle. eceioe aver £dIowable #n an ' of the above Phone: (f(1) 576 r , �_ v! Pcr inspection / Z Fax: (. j) 3 62.50 CCB Lie.: /5q 3 7 / Electrical Lie.: .. . 1 11 vcstigatlonperIlour ( i ltrmin) 1• ' um �= VCRS 2.1 � Suprv. Lie.: � GJ'C�' .2.. cor�l :Wpm Electrician signature, required: /� EXEC ICAL PERMIT dJC�✓Z� � �� pp - Do _z e a p r Print name; Authorized signature: dtxte surcharge (12% of permit fee); minumin _____ _ -- AC Print ostrtta: 4 4 INOTAL PERMIT FEE; Date; �- �7 p � Thi permrlt application eapi� ifs pE1mlt lx not nbtninnl within 1 I: Termini ~ - �s days after it has been accepted as complete. stfs,aea oar2 5s • Number oft rium:titme stowed per permit, 4A0-4R157(t I ow/mamma FAX TRANSMISSION Dan Mates T 503.516,4142 F 503.695.6263 MATES ELECTRIC RELY ON ME ruat :%c(y boo,cam CCB 90071 8/29/2007 From: Phone: 503.516.4142 Fax: 503.695.6263 Company Name: Mates Electric To: airy n t r . , Phone: Fax; 5-6) 1 q 6 O Company Name: Comments: P/ o ... r p ev-vvez 1'7 44 5 1001-00003 4 o m £ c /mac i ry 1 r.0 -r .2 Urgent 1 For Review fl Please Comment Li Please Reply fl Please Recycle City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 January 29, 2009 RE: RESIDENTIAL IMPROVEMENT (FOUNDATION SUPPORT) Project Information a ' Building Permit: MST2009 -00003 Class of Work: Add Address: 11670 SW 114 PL Lot Number: NA Area: 577 Sq. Ft. Stories: 1 Builders Name: William Martin Subdivision: NA The plan review was performed under the State of Oregon Residential Specialty Code (ORSC) 2008 edition. Please respond to conditions below. 1) Provide footing and floor support detail for attachment to existing footing. 2) Provide 2 copies of engineered truss details. 3) Show connections of existing exterior walls and new girder truss to new wall framing. 4) Provide details for roof frame over existing roof. When responding, provide an itemized letter stating in what way each numbered issue has been addressed in the revision. When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Respectfully, DAO, Dan Nelson Senior Plans Examiner �� � (503) 718 -2436 1 L FOs km , y(A - To dann @tigard - or.gov � WST1� G - 13 elk) a icr t /0c_ &41 tfc., P )i Oak) Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 • ' PI Building Division One & Two - Family Dwelling T I G A R D Fees Checklist PERT IIT IN BMATION: Permit #: w\-r- « -0q - COC C) 2 Plan #: Date: Site Address: I 1 .4(1) I ( A-- 'p Parcel #: Subdivision: Lot #: Zoning: Jurisdiction: T (_ Setbacks: Front: Rear: Left Right Class of Work: Pktn== Stories: I First Floor:, 57Z — Type of Use: REz Height: Second Floor: Construction: , St3 Floor Load: ') / ` Third Floor: Occupancy Group: P:3 Dwelling Units: I Bonus Room: Valuation: (0 8( 73 Bedrooms: ( Total Floors: Bathrooms: I _ Basement: Decks: '2 C`z_ Garage: Porches: Other: FEES: Description Fee Amount: Amount Paid: Balance Due: Plan Check: Building: -'.21) = 7 '37-6 :7S Extra Set: Permit: Building: < Z .74- Tax: ( , (94" Metro CET: School CET: 4577 ,C0 Mechanical - 72,'"X) Tax: . Z0 Plumbing: (52 ( 2!) , Tax: Z-e ■ Q t Electrical: `3 "V Tax: g. a t Low Voltage: Tax: CDC: CDC Ping. Rev.: Atft,,O3 CDC LRP Fee: (n , 32) SDC: Parks: TIF Res.: TIF MT: Erosion Permit: O. CC= Erosion CWS: (3 . OO Erosion COT: (3 . ©© Water Quality: Water Quantity: SUB - TOTAL: Sewer: Permit: Inspection: SUB - TOTAL: TOTAL MST & SWR: I:\ Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 1 PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems) Description 1 Qty. I Fee(ea.) I Total Description - I Qty I Fee(ea.) I Total New 1- & 2 family dwellings Heating/Cooling (includes 100 ft. for each utility connection) Air conditioning or heat pump* 14.00 SFR (1) bath 249.20 Furnace 100,000 BTU (ducts/vents) 14.00 SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts /vents) 17.90 SFR (3) bath 399.00 Gas heat pump 14.00 Each additional bath/kitchen 45.00 Duct work 10.00 Rain Drain, single family dwelling 65.25 , Hydronic hot water system _ 14.00 Fire sprinkler - sq. ft. 0 to 2,000 115.00 Residential boiler Fire sprinkler - sq. ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00 Fire sprinkler - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric) Fire sprinkler sq. ft. 7,200 and greater 309.00 (in wall, in -duct, suspended, etc.) 14.00 - . Site Utilities Flue /vent (for any of above) 6.80 Catch basin/area drain 16.60 . Repair units 12.15 Drywell /leach line /trench drain 16.60 Other Fuel Appliances Footing drain - 1 100' 55.00 Water heater 10.00 Footing drain - each additional 100' 46.40 Gas fireplace 10.00 Manufactured home utilities 110.00 Flue vent (water heater /gas fireplace) 10.00 Manholes 16.60 Log lighter (gas) 10.00 Rain drain connector 16.60 Wood/Pellet stove 10.00 Sanitary sewer - 1' 100' 55.00 Wood fireplace /insert 10.00 Sanitary sewer - each additional 100' 46.40 Chimney /liner /flue /vent 10.00 Other: 10.00 Storm sewer - 1' 100' 55.00 Environmental Exhaust & Ventilation Storm sewer - each additional 100' 46.40 Range hood/other kitchen equipment 10.00 Water service - l' 100' 55.00 Clothes dryer exhaust 10.00 Water service - each additional 100' 46.40 Fixture or Item Single duct exhaust Absorption valve 16.60 (bathrooms, toilet compartments, Backflow preventer 27.55 utility rooms) 6.80 Backwater valve 16.60 Attic /crawl space fans 10.00 Clothes washer 16.60 Other: 10.00 Dishwasher 16.60 Fuel Piping Drinking fountain 16.60 * *($5.40 for first 4, $1.00 each additional) Ejectors /sump 16.60 Furnace, etc. ** Ga s heat Expansion tank 16.60 Gas pump Wall/suspended/unit heater * * Fixture /sewer cap 16.60 Water heater ** Floor drain/floor sink/hub 16.60 Fireplace ** Garbage disposal 16.60 Range ** Hose bib 16.60 BBQ ** Ice maker 16.60 Clothes dryer (gas) ** Interceptor /grease trap 16.60 Other: * * Primer 16.60 Total: Roof drain (commercial) 16.60 Mechanical Permit Fees Sink/basin/lavatory 16.60 Subtotal: $ Tub /shower /shower pan 16.60 Minimum Permit Fee $72.50 $ Urinal 16.60 Plan Review Fee (25% of Permit Fee) $ Water closet 16.60 State Surcharge (12% of Permit Fee) $ Water heater - 16.60 TOTAL PERMIT FEE $ Other: Other: Plumbing Permit Fees ELECTRICAL FEES (residential single- or multi - family) Subtotal $ Descriptio Qty. Fee Total Insp - Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less 145.15 4 Plan Review (25% of Permit Fee) $ Ea. add'! 500 sq. ft. or portion 33.40 1 State Surcharge (12% of Permit Fee) $ Limited energy, residential 75.00 2 TOTAL PERMIT FEE $ Each manufactured or modular dwelling, service and/or feeder 90.90 2 Electrical Permit Fees Subtotal: $ Plan review (25% of permit fee) $ State surcharge (12% of permit fee) $ TOTAL PERMIT FEE $ I: \Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 2 TRANSMISSION VERIFICATION REPORT TIME : 01/2912009 12:37 NAME : TIGARD BUILDING DEPT FAX : 5036243681 TEL . SER.# : BROD4J479592 DATE,TIME 01129 12:36 FAX NO. /NAME 5032577077 DURATION 00 :00 :24 PAGE(S) 01 RESULT OK MODE STANDARD ECM City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 January 29, 2009 C J . RE: RESIDENTIAL IMPROVEMENT (FOUNDATION , SUPPORT) TIGARD Project Information Building Permit: MST2009 -00003 Class of Work: Add Address: 11670 SW 114 PL Lot Number: NA Area: 577 Sq. Ft. Stories: 1 Builders Name: William Martin Subdivision: NA The plan review was performed under the State of Oregon Residential Specialty Code (ORSC) 2008 edition. Please respond to conditions below. 1) Provide footing and floor support detail for attachment to existing footing. 2) Provide 2 copies of engineered truss details, 3) Show connections of existing exterior walls and new girder truss to new wall framing, 4) Provide details for roof frame over existing roof. When responding, provide an itemized letter stating in what way each numbered issue has been addressed in the revision. When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Respectfully, i, � r t Nelson Senior N Senior PA�nn FYArriir1CP .V. RECEIVED I y JAN 1 U 2OU 41 I ' E .' , CITY OFTIG � 3� b . 4 3IJI1t1ING DIVISIO al p a 3j1 iii2 1111311 "Pi Ail IN r'l 'fill!' 41! ® I ti i e mmm j , a ° 113 r � •ems , s' �' Ili! bki t a ill 1112N1 iii g ig ii U II b 9 II II n e 1r7rnTmr T/7 II 111114 11 f / /111 //1,I/, > = � 11 11 //! 1//////1//I1u,111�) I f ///// ///////11//, 111111 9a / / / / /II / 111/11// /If e 9 ///// I/ IIIIII /1 / /I /I /// /1/IIIIlIII1Il� ' �9 g 31111 ; E PIllllJlll /IIIIl,II /I /II t // I/// / /I / / / / /I / / / /I / /I /JI / / / / / / / / /// 14111 1I.1lt.ia;_ I�LSI1.I1 LIal,11.WL l L11lli Iryy g 9 rib 9 ° A t! /\ , ° I 7 IDc161•6 ( 1& 40 W °o j L I G � ^ • ` r L J —4, 111 T ow ..� R h I z It 5W 114 TI-I PLACE PLOT PLAN .c. d.. r-dr 8610 SW 114 TN PLACE OITr of TIGARD WASHINGTON COUNTY STATE of OREGON A 11-34 OI_SON / MARTIN CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: (Y15?2. 00 q• o PLANNING DIVISION: Required Setbacks: ❑'A ❑ Not Approved Side: '‹. Street Side: /5 Front. _ 2b _ Garage . .._-_-)-12.. Rear: /S Visual Clearance: Ef Approved ❑ Not Approved I�� Maximum Building Ilei:;ht• feet CWS Service Provic er Letter Required: ❑ Yes ❑ No 0 Rece !d 13): ti: i 4' Date: (I 9 ENGINEEkIN DEPARTMENT: Actual Slope: 6 % VI Approved ❑ Not Approved Site PIA ( Approved ❑ of pproved By: Date: / 2 / Zola `j Notes: ale?t,e-u-/-02. l CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: NI t2.00ci - 00 Street Trees: Approved ❑ Not Approved Protected . r: Approved Approved By: 1 od Zi Date: Fi Notes: a , s S�j