The URL can be used to link to this page

Permit CITY OF TIGARD I MASTER PERMIT 2 • COMMUNITY DEVELOPMENT Permit #: MST2009 -00121 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/16/2009 Parcel: 2S112CC22600 Jurisdiction: Tigard Site address: 15793 SW 81ST AVE Subdivision: GAGE FOREST Lot: • 33 Project: Gage Forest Project Description: New SFR. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 861 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1278 sf Garage: 408 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $235,073.86 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 0 Catch Basins: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvciFeeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 4 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I 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) JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION 12600 SW 72ND AVE #200 12600 SW 72ND AVE #200 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: PHONE: 503- 639 -2639 FAX: 503 -624 -0239 Total Fees: $14,801.43 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344 Issued By: 6A CU 1 RAC i SAA Permittee Signature: I- i_j Oregon Residential Specialty Code R318.2 MMOISTURE CONTENT ACKNOWLEDGEMENT FORM O4vrn .'vszd Porce AVM 6C/1, I, 0 /ji) C',0/1/s7'. , am the general contractor or the owner- builder at the following address: Site Address: / 5773 54/ I s! City: 77,6/7/20 Permit #: / 0 00l2 Subdivision/Lot #: / � J � � 3 and/or itTRE �/ 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: 4`1/,f� Genera Contractor or '.' mei- Builder /d/SriinE / � i#ii 7; $-p g,zSt4h /'MIX' // I:\ Building \Form\RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: ni o Jurisdiction: �✓ 1)-, Or. )2-'‘-/l/le Site Address: y ev ft,5' Subdivision/Lot #: 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: /l A:09 Owner /General Contra�;�uthorized Agent Print Name: 4/5 ,�‘./ 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 Buildini erlmit Application Residential D FOR OFFICE 1SE ()NIA 1 � j j Received n, �^ 11, City of Tig r �%� DateB : , • „ 7 0 Imo Permit No.: , , O (i( • 13125 SW Hall Blvd., Tigard, OR 9 7223 Plan Review • III Phone: 503.639.4171 Fax: 503.598.1960 ' s, 2009 7 2009 DateB : a ft' 1 ' , �� tuner Permit: I" I G It D Inspection L 503.639.4175 Date Ready /By: ® See Page 2 for Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: nal Supplemental Information TYPE OF W WORK C DIVISION 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 ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $24441"- 230 ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: 2.5 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: 15793 SW 81 New dwelling area: 2,139 square feet City/State/ZIP: Tigard OR, 97223 Garage/carport area: 408 square feet Suite/bldg. /apt. no.: Project name: Covered porch area: 42.5 square feet Cross street/directions to job site: HaWLangtree Deck area: 0 square feet Other structure area: 0 square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Gage Forrest I Lot no.: 33 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. Construction of new single family residence Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: J.T. Roth Const. Inc. Type of construction: Address: 12600 SW 72 Occupancy groups: City/State/ZIP: Tigard, OR 97223 Existing: Phone: (503)639 -2639 Fax: (503)624-0239 New: ❑ APPLICANT ® CONTACT PERSON NOTICE Business name: J.T. Roth Const. Inc. All contractors and subcontractors are required to be Contact name: David Jensen licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 12600 SW 72 jurisdiction in which work is being performed. If the City/ State/ZIP: Tigard, OR 97223 applicant is exempt from licensing, the following reasons apply: Phone: (503) 806-0602 Fax: : (503) 624 -0239 E -mail: davidj @jtrothinc.com CONTRACTOR Business name: J.T. Roth Const. Inc. BUILDING PERMIT FEES* Address: 12600 SW 72 °d. (Please refer to fee schedule) City/ State/ZIP: Tigard OR, 97223 Structural plan review fee (or deposit): Phone: (503) 639 -2639 Fax: (503) 624-0239 FLS plan review fee (if applicable): CCB lic.: 31700 Total fees due upon application: Amount received: Authorized signatur This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: David Jensen Date: May 21, 2009 + Fee methodology set by Tri-County Building Industry • Service Board. 1 c�d l:\Building\Pemtits\BUP -RES Permi p.doc 11/6/07 440- 4613TO 1 /02/COM/WEB) _____._ • Plumbing. Pe "rmit Application Building Fixtures FOR OFFICE 1 S ONLY 1 Received City of Tigard Date/By: Permit No.: • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review G : Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.: T I G Alt D Inspection Line: 503.639.4175 Date Ready/By: Juris: ' ® See Page 2 for 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 ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ►5 1- and 2- family dwelling ❑ Commercial/ industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 1 399.00 3co Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: ' Fire sprinkler ( sq. ft) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 15793 SW 81". Catch basin or area drain 16.60 City/ State/ZIP: Tigard OR 97223 Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: HalULangtree Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: 20 ) Page 2 Storm sewer (no. linear ft.: 20) Page 2 Subdivision: Gage Forest I Lot no.: 33 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 Plumbing of new single family resisdence Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: J.T. Roth Const. Inc Expansion tank 16.60 Address: 12600 SW 72 Fixture /sewer cap 16.60 City/ State/ZIP: Tigard OR 97223 Floor drain/floor sink/hub 16.60 Phone: (503)639 -2639 Fax: (503)624 -0239 Garbage disposal 16.60 ❑ APPLICANT ® CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: J.T. Roth Coast. Inc. Interceptor /grease trap 16.60 Contact name: David Jensen Medical gas (value: $ ) Page 2 Address: 12600 SW 72 °1 . Primer 16.60 City/State/ZIP: Tigard OR 97223 Roof drain (commercial) 16.60 Phone: (503) 806-0602 I Fax: : (503) 624-0239 Sink/basin / lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: davidj @jtrothinc.com Urinal 16.60 CONTRACTOR Water closet 16.60 • Business name: Malmedal Enterprises Inc. Water heater 16.60 Address: PO Box 207 Other: C rt City/ State/ZIP: Banks OR 97106 Subtotal 3 Minimum permit fee: $72.50 Phone: (503) 324-0759 Fax: (503) 324 -0580 Residential backflow minimum permit fee: $36.25 CCB Lic.: 102535 Plumbing Lic. no.: 34 -276PB Plan review (25% of permit fee) State surcharge (12% of permit fee) 7, f548, Authorized signature`s J TOTAL PERMIT FEE �( Print name: /iris ,,,,,,/ � / Date :�� , 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:\ BuildingTermits \PLMF- PermitApp.doc 12/27/06 440.4616T(1 /07/COM/WEB) A Mechanicaa Permit Application Folz of i ic1. t sly ONLY City of Tigard Received 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 G A I: D Inspection Line: 503.639.417 Date Ready/By: tom: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ® 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: $ $3,800.00 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. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 15793 SW 8151. Air conditioning or heat pump (requires site plan showing placement) 1 14.00 1¢— City/State/ZIP: Tigard OR 97223 Furnace 100,000 BTU (ducts/vents) t 14.00 •"TTb Furnace 100,000+ BTU (ducts/vents) 17.90 I Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site:Hall/Langtree Duct work - 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Gage Forest Lot no.: 33 Flue/vent any of above 6.80 Other: I 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 1 10.00 ( o Gas fireplace 1 10.00 (O HVAC installation of new single family resisdence 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 PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: J.T. Roth Const. Inc. Environmental exhaust and ventilation Address: 12600 SW 72°d. Range hood/other kitchen equipment 1 10.00 (O City/State/ZIP: Tigard OR 97223 Clothes dryer exhaust 1 10.00 IC) Single -duct exhaust (bathrooms, Phone: (503)639 -2639 Fax: (503)624-0239 toilet compartments, utility rooms) 6 6.80 4•e0 ❑ APPLICANT ® CONTACT PERSON Attic/crawlspace fans 10.00 Other: 10.00 Business name: J.T. Roth Const. Inc. Fuel piping Contact name: David Jensen $5.40 for first four; $1.00 for each additional Address: 12600 SW 72°d. Furnace, etc. Gas heat pump City/State/ZIP: Tigard OR 97223 Wall/suspended/unit heater Phone: (503) 806 -0602 Fax: : (503) 624-0239 Water heater J� Fireplace r E -mail: davidj@jtrothinc.com Range CONTRACTOR Barbecue Business name: B&M Heating Clothes dryer (gas) Other: Address: PO Box 1111 MECHANICAL PERMIT FEES* City/ State/ZIP: Boring OR 97009 Subtotal Phone: (503) 515 -5763 Fax: (503) 637 -5244 Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: 124757 State surcharge (12% of permit fee) 1 3 ,'70 TOTAL PERMIT FEE 1 T.9 Q Authorized Signature: This permit application expires if a permit is not obtained within 180 / days after it has been accepted as complete. Print name: Bruce White Date: J2/ G� * Fee methodology set by Tri-County Building Industry Service Board I:lBuilding1Permits MEC- PermitApp.doc 01/19/07 440 -461 (11 /02/C /OM/WEB) 4. Electrical,Permit Application FOR OFFICE list ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' C . Phone: 503.639.4171 Fax: 503.598.1960 Date/0 : Other Permit: Inspection Line: 503.639.4175 Date Ready/By: ions: ® See Page 2 for f I G A K D Notified/Method: S Internet: www.tigard- or.gov Supplemental 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): ❑ 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 ® 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. A o ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 15793 SW 81°'. loo[iPormore. ey. ['Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: Tigard OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Hall/Langtree Description I Qty. I Fee. I Total I • New residential single- or multi -family dwelling unit. Includes attached garage. Subdivision: Gage Forest Lot no.: 33 1,000 sq. ft. or less _ 1 145.15 (4.4.4 Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion �• 33.40 (' , ld[. 1 Limited energy, residential I 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) 7 Wiring of new single family residence Limited energy, multi -family 75.00 2 g fil g Y residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 0 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: J.T. Roth Const. Inc. 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: 12600 SW 72 °d . Over 1,000 amps or volts 454.65 2 City/State /ZIP: Tigard OR 97223 Temporary services or feeders installation, alteration, and/or relocation Phone: (503)639 -2639 Fax: (503)624 -0239 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with 0 APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: J.T. Roth Const. Inc. B. Fee for branch circuits Contact name: David Jensen without service or feeder fee, 46.85 2 first branch circuit Address: 12600 SW 72 °d. Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Tigard OR 97223 Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: (503) 639 -2639 Fax: : (503) 624-0239 Reconnect only 66.85 2 E -mail: davidj @jtrothinc.com Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal panel, or alteration, limited- Business name: Grizzly Electric energy panel, alteration, or Address: 8002 NE Hwy. 99 PMB #248 extension. Describe: Page 2 2 City/State /ZIP: Vancouver WA 98665 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (360) 909 -4080 Fax: (360) 694-8939 Investigation per hour (1 hr min) 62.50 CCB Lic.: 186218 Electrical Lic.: 37446C Suprv. Lic.: 2643F Industrial plant per hour 73.75 4 . 1 t Z+ t ` I A i ( 3 , I t s a ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 2 Plan review (25% of permit fee): Print name ft Nel : 0....... Date: May 19, 2009 State surcharge (12% of permit fee): # 33 .4.0S Authorize s'fg3ta I • • • .. - TOTAL PERMIT FEE: 2) 2 �C / _ This permit application expires if:a permit is not obtained within 180 Print • : • : (. Date: days after it has been accepted as complete. p (` • Number of inspections allowed per permit. �ydc 1: 1Buldding \Permits\ELC- PermitApp.doc 05/ •/06 440- 4615T(II /OS /COM/WEB (b � t bLT (.- 5- °° 1 9 .cx , • • c 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: ® Audio and Stereo Systems* ❑ Burglar Alarm ® Garage Door Opener* ® Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ 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 ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El 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\Pamits\ELGPamitApp.doc 03/23/06 ST t` li 1 TION .E CERTIFIC 0/// 5 Owner/Agent for ri TWl>7/3/. 6/Viiilciara (PLEASE PRINT) (PERMIT HOLDER) Do hereby certify that the following location meets City of Tigard land use and development standards for street tree installation. I✓ ADDRESS: /y S / 7- 7 41 SUBDIVISION: LOT: 33 F SIGNATURE: DATE: (y ,P; ,P; /AGENT) RECEIVED BY: DATE: (CITY OF TIGARD) I:\ Building \Forms \Street I'recCertificate 01 / 19/07