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Permit ,,f4 ;!:,7„:,.: , ,,,',,,,1-'' `,„; : -�, , MASTER PERMIT '` A q CITY OF TIGARD ;' CO MMUNITY DEVELOPMENT Permit #: MST20 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639:4171 Date Issued: 06/02/2010 Parcel: 2S1.04DB00300 - Jurisdiction: Tigard Site address: 13159 SW BROADMOOR PL Subdivision: AMESBURY HEIGHTS Lot: 3 Project: Tsuruta Project Description: Bump- outaddition to dining room. '7/7/10, adding (2), ;additionalibranch circuits. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 40 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 13 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $3,918.00 Rear: 0 PLUMBING Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Catch Basins: Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Other Fixtures: Tubs /Showers: Garbage Disp: Water Heaters: Water Lines: Drains: Bckflw Prevntr: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers: Heat Pump: N Hoods: Other Units: Furn <100K: Vents: Woodstoves: Gas Outlets: Furn > =100K. ELECTRICAL Residential Unit ServicelFeeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 -200 amp: 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 addl 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) TSURUTA, !SAO IQ CONSTRUCTION & REMODELING 23 HILLSIDE 11447 SE SHERMAN CT EAST HANOVER, NJ 07936 Portland, OR 97216 PHONE: PHONE: 503 - 327 -4612 FAX: Total Fees: $409:67 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. ATT • •. - - •on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -08, -0010 through OAR • •2 -'' 0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1. 0.332.2344. 1 / Iss. By: / / Ot t • if A Permittee Signature: l g' ' `�- CITY OF �����® MASTER PERMIT ,x - c COMMUNITY DEVELOPMENT Permit #: MST2010 -00088 rt « Date Issued: 06/02/2010 ,1G, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S104DB00300 Jurisdiction: Tigard Site address: 13159 SW BROADMOOR PL Subdivision: AMESBURY HEIGHTS Lot: 3 Project: Tsuruta Project Description: Bump -out addition to dining room. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 40 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 13 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $3,918.00 Rear: 0 PLUMBING Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Catch Basins: Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Ram Other Fixtures: Tubs /Showers: Garbage Disp: Water Heaters: Water Lines: Drains: Bckflw Prevntr: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers: Heat Pump: N Hoods: Other Units: Furn <100K: Vents: Woodstoves: Gas Outlets: Fum > =100K: ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 -200 amp: 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) TSURUTA, !SAO IQ CONSTRUCTION & REMODELING 23 HILLSIDE 11447 SE SHERMAN CT EAST HANOVER, NJ 07936 Portland, OR 97216 PHONE: PHONE: 503- 327 -4612 FAX: Total Fees: $393.05 This permit is i uPr1 %ubjject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done i accordance with 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. TENTION: Oregon law re. ' -- you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 -0010 through OAR 952 -001 00. You m- obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332. 44. ■ /�/ Issue / �1_ / �L11 ►� Permittee Signature: Y Ca,....-:4 , , Building Permit Application ]� Y — I e.0 r T t Residential RECEIVED lU i 1z �'.' 1 , c,L l . .' iY , ;:''J F. i r I1, Y � ' OR OI I I(I { U S l O��l 1 , ' a '• . r , 1111 City of Tigard 4W 2 0 DateB d 5 420 id pm Permit No.: H.( ,A., _ �� 0� � 6 '� 13125 SW Hall Blvd., Tigard, OR 9T2 23 1 Plan Revie -- /� P • hone: 503.639.4171 Fax: 503 1960 Date/By: ''\„ r . Le, t o� Other Permit: I I c A R ' 6' Inspection Line: 503.639.4175 lA Y OF TIGARD Date Ready : y: /// n funs 0 See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISION Notifie ethod: f / /d 1 / L�({' Supplemental Information .,— A)/ i I • TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY. DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all e( Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. • 0 , 1- and 2- family dwelling 0 Commercial/industrial Valuation: $ 6 9/6 . �0 ❑ 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: / 5 j 5- 5 w 4004 © AL New dwelling area: 0 square feet City /State /ZIP: Cr e>/ Chi 7 ZZ Ili Garage /carport area: square feet JJ — Suite/bldg. /apt. no.: I Project name: / c e. c:TG Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet .REQUIRED DATA: COMMERCIAL -USE CHECKLIST,' Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the ' - DESCRIPTION OF WORK work indicated on this application. 1 / f .( Valuation: $ e c5 Existing building area: square feet t 14 [ s'ic ,cd V c14 J 1) k C ' r New building area: square feet ' ■ PROPERTY OWNER: - • ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax:( ) New: .. ❑ - APPLICANT '.0 -CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax::( ) E -mail: CONTRACTOR Business name: ( 9 + t ' Lc( 1 `p 1 -- -A fr .. BUILDING PERMIT FEES* Address: / / - 2 1.�✓ ✓4 �i ✓t (Please refer to fee schedule) ' n Structural plan review fee (or deposit): 0 7. �5 City/State/ZIP: . R i7�V Y't�9� FLS plan review fee (if applicable): Phone: (3' ))) 7 ) 2 7 - -6 < 7 _ I ( ) Total fees due upon application: ( �C� ` �� `-'` -^ � Amount received: n Authorized signature: This permit application expires if a permit is not obtained Print name: j 5/00/e0/ O within 180 days after it has been accepted as complete. ��� Cp�(� 1 � Date: * Fee methodology set by Tri- County Building Industry l �" Service Board. I: \Building\Permits\BUP -RES PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB) Building Permit Application Checklist ; I o One- and Two- Family Dwelling R O ; 1 1 l(I 'u5H ONLY C ity of Tigard Received Permit No.! Date/By. 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: t C .- Phone: 503.639.4171 Fax: 503.598.1960 ' 24- Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical sI'IGA' - . _.._. Internet: www.tigard- or.gov ❑ other: � llE � , ' A4S .. . :121 (�UI °N , . . : SRI V_, - .. I . . � « ; , , ��t _. w\ 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 oflegible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ f ❑ ❑ 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. 1 1 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 ap plicable to the •ro'ect under review. URISDIC1IONAI_ SII;C II. ICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 1 1" 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 Ciiy 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(1 I /02/COM/WEB) �. c ^`; i . 1 A `Ic,� p-,i dP: �w f in rs iU "iT far °rx y"Srd'� i r Electrical Permit Application .,: ,kt , �a, „���t = � l� , � a ` r, , ,, lu g �; ��� (� fk. „ Ia `�G� d V'a I OR CJI,I I( I, litil O�\1 Alit 1 �M.�n�k`fG,;�n}�,. i�do .�:�lnrM�'4N�rR;�w'�.M!1"?�air imp sVCifG.4�"b:^I1rN.S.ItiB ss ..T4in itw�X.'d'nu;M e�tii�>5 ±� �8 ,rl ,d� N..n� !. �ti�ti }� �p "�,,� 4*T:I CIir Of T igard Received t lo"vc,.t/ U i�l `' oa ° 13125 SW Hall Blvd., Tigard, OR 97223 Date/B n R Permit No.: 1 Plan Review Other Permit: w ® ,�ti`; Phone: 503.639.4171 Fax: 503.598.1960 Date/B t�I”l iN Internet: www.ti and or. ov Notified/Method: d luris: S See Page Supplemental Information g g Supplemental nformation TYPE OF WORK PLAN REVIEW ❑ New construction I 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. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural m 1- 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 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: "3 / / 54� „." 4/ IOOHP or more. occupancy. Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: l I ` q yyy 7 z ❑ Health -care facilities. ❑ Supply voltage for more than J p / � ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: Ts ) /Q L / ❑ Service or feeder 600 amps or more. 111 �' FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add' 1 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 67.84 2 DESCRIPTION OF WORK (with above sq. ft.) n L� �;. �i ( cal, / ^� Limited energy, multi - family CA' r yy `t t c �,��a(,��(, J lc ele ' 0 residential (with above sq. ft.) 67.84 2 //() ` Services or feeders installation, alteration, and/or relocation v ` ( t ©d r/^_" 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address:. Over 1,000 amps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first Contact name: branch circuit 56.18 2 Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City /State /ZIP: dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax :: ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 4 Signal circuit(s) or limited - energy Business name b® U e -Jr/ G � / t panel, alteration, or extension. Page 2 2 G Each additional inspection over allowable in any of the above Address: i0149 /-ef Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr CityfState /ZIP: f�Grs� ti n 9702 . Industrial plant (1 hr min) 78.18/ hr Phone: ( ) i7° 2 , s Fax: Inspections for which no fee is ( � o �; N �� ' ' �� specifically listed (%Z hr min) 90.00/ hr CCB Lic.: / 5 9-mil ` Electrical Lic.: 39 �A Suprv. Li c.: L. 7" 5 ELECTRICAL PERMIT FEES \\ ) Subtotal: Suprv. Electrician signature, required: / P ` / loll Plan review (25% of permit fee): Print name: ��G�tct r / " f_'p1r/ 9r • I Date: lZz y0 State surcharge (12% of permit fee): Authorized signature: C - // / ' • / TOTAL PERMIT FEE: f ' This permit application expires if a permit is not obtained within 180 Print name: CAi, ( Ot't ' 4 } Date: S/z / r VI days after it has been accepted as complete. !h Number of inspections allowed per permit. 1 : \Building\Permits\ELC- PermitApp.doc 10 /01/09 440- 4615T(II /05 /COM/WEB . i - — — — — — — — --r o — . — — — — =r— — — — I0 r 12_,a, ° ECEIVED 4TFV or TIGARD - SITE PLAN REVIEW _ o O , I +1 PUtU)ING ItRMIT NO: 0 :1 E Pp En MAY 2 0 2010 NEW / DN OF MATERIALS. Street Thee: Approved CI Not App roved ADDITION CITY OF TIGARI3 STRUCTURAL ENGINEER Protect�d.Tt�e Approved Nat Approved r 07, e�yt' , f a L ( 1 ! y�r Date: / Nd� 1 MS HAVE BEEN / BUILDING IGISION / / SITE INFORMATION: 7- 4 RE AREA. ADDRESS: 13159 SW BROADMOOR PL. / TAX MAP: 2S104DB00300 REAL PROPERTY ACCOUNT #: R2068103 w -.� b � BUILDING SQUARE FOOTAGE: 2780 1 q -0 A DDITION SQUARE FOOTAGE: 51 Q co g / z I O� EXISTING HOUSE O� I � CITY OF TIGARD - S TE PLAN REVIEW BUILDING PERMIT NO.: 1111. 61RW r_.r:ai / I PLANNING DIVISION: Required Setbacks: ❑ Approved 7 , ❑ Not Approved / ' Side: 5 _ Street Side: 0 /.� Front. Garage: Rear: 14_ I Visual Clearance: 0 Approved ❑ Not Approved Maximum Building Height• _10 feet I CWS Service Provider Letter Required: ❑ Yes ❑ No ❑ Received Actual . :lope: I B y : 'l.t r x Date: ( I I I d , ENGINEER N D EPARTMENT: + 4 � % /o 61 Approved ❑ Not A roved - , pp App Site P n: Eh-Approved El pproved *' 24-0'± B : Date: 5 Z 1 h-K- . T�ir _ � TE BATCHING SHALL BE �' — — 127.04' — — � _ BE PROVIDED. f \ SITE PLAN 10048-SM MAP.OWG SCALE: 1".10 H: 48 BAR DIAMETERS (2'