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Permit "' ' ;' s _ MASTER PERMIT !� ° CIT OF T. )ARD - . COMMUNITY DEVELOPMENT PERMIT #: MST2007 -00138 DA TE ISSUED: 6/10/2008 T iGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 U PARCEL: 2S103BB - 09001 SITE ADDRESS: 12245 SW WALNUT ST ZONING: R -4.5 SUBDIVISION: LAKE TERRACE LOT: 017 JURISDICTION: TIG PROJECT: PARKER Project Description: Addition to existing (several areas).Trusses Deferred. - BUILDING • REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 22 FIRST: 896 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 1,068 sf GARAGE: sf FRONT 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 TMIAD'. 51 RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,954 sf 260,575.00 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 0 SF RAIN DRAINS: . 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: 1 BOILJCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 NAT FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 20 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 5005F: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADOL BR CIR: SIGNAL/PANEL: 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 V A. SF RESIDENTIAL _ B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNOSC LT: 8 BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: ` GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: �/�a HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: ( ��O This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CRAIG & CHERYL PARKER OWNER laws. All work will be done in accordance with approved plans. This 5100 SW SW DOGWOOD permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97225 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: 503- 244 -0883 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 4,091.91 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Bolts in concrete Structural welding ( — C t ? it (ItA,..._,.._ Issue B�1 y : ,,, f'i _ Permittee Signature :k, Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. <' n „ ' <14 ► CITY OF T ,A ® _ MASTER PERMIT gi COMMUNITY DEVELOPMENT 1 PERMIT #: MST2007 -00138 r N T DATE ISSUED: 6/10/2008 T IGARQ: 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103BB - 09001 SITE ADDRESS: 12245 SW WALNUT ST ZONING: R - 4.5 SUBDIVISION: LAKE TERRACE • LOT: 017 JURISDICTION: TIG PROJECT: PARKER Project Description: Addition to existing (several areas).Trusses Deferred. - BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 22 FIRST: 896 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 1 066 sf GARAGE: 51 FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 51 RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1 51 260,575.00 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 0 SF RAIN DRAINS: , 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 'BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: 1 BOILJCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 NAT FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 . , ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 • 0 - 200 amp: W /SVC OR FDR: 20 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st WIO SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: " MANU HM /SVC /FDR: 601 - 1000 amp: 601•amps- 1000v: MINOR LABEL: �!!! 1000 amp /volt PLAN REVIEW SECTION 8 Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: .444. ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AA AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: y BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: ]/V HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a 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 CRAIG & CHERYL PARKER OWNER laws. All work will be done in accordance with approved plans. This 5100 SW SW DOGWOOD permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97225 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: 503- 244 -0883 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. - Reg #: TOTAL FEES: $ 4,091.91 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 • Bolts in concrete Structural welding ( 11/4' Issue By : ! ` I ',I,/ : .° _ " Permittee Signature : -- V Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. to g , MASTER PERMIT ;M :II'n TY OF T, ,A ® _ 711 ° ., l COMMUNITY D E V ELOPMENT PERMIT #: M 10/200 00138 4 DAT ISSUED: 6/10/2008 ',TI: 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103BB - 09001 SITE ADDRESS: 12245 SW WALNUT ST ZONING: R -4.5 SUBDIVISION: LAKE TERRACE LOT: 017 JURISDICTION: TIG PROJECT: PARKER Project Description: Addition to existing (several areas).Trusses Deferred. - BUILDING • REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 22 FIRST: 896 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 1,06g sf GARAGE: s1 FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,964 sf 260,575.00 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 0 SF RAIN DRAINS: . 1 • CATCH BASINS: TUB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: .1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 NAT FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: •0 - 200 amp: 1 0 - 200 amp: W /SVC OR FOR: 20 PUMP /IRRIGATION: PER INSPECTION: EA, ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVC /FOR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADOL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FOR: 601 - 1000 amp: 601.amps- 1000v: MINOR LABEL: 1000• amp /volt PLAN REVIEW SECTION 8 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 It STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: 8 BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM, NURSE CALLS: TOTAL I1 SYSTEMS: ( ��Y This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CRAIG & CHERYL PARKER OWNER laws. All work will be done in accordance with approved plans. This 5100 SW SW DOGWOOD permit will expire if work is not started within 180 days of issuance. or PORTLAND, OR 97225 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: 503- 244 -0883 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 4,091.91 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 • Bolts in concrete Structural welding l ' (Alt^,,.., Issue By : / - „„- • .� !' /� Permittee Signature : Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. r i MASTER PERMIT II - o „Jury OF TIGARD PERMIT #: MST2007 -00138 COMMUNITY DEVELOPMENT DATE ISSUED: 6/10/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103BB - 09001 SITE ADDRESS: 12245 SW WALNUT ST ZONING: R -4.5 SUBDIVISION: LAKE TERRACE LOT: 017 JURISDICTION: TIG PROJECT: PARKER Project Description: Addition to existing (several areas).Trusses Deferred. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 22 FIRST: 896 at BASEMENT' sf LEFT' 5 SMOKE DETECTORS: Y TYPE OF USE' SF FLOOR LOAD: 50 SECOND' 1,068 of GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS' 1 THIRD. sf RIGHT 5 VALUE: OCCUPANCY GRP. R3 BDRM: 3 BATH 3 TOTAL. 1,964 sf 260,575 00 REAR' 15 PLUMBING SINKS' 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS. RAIN DRAIN: 100 TRAPS. LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES 0 SF RAIN DRAINS: 1 CATCH BASINS. TUB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES' BCKFLW PREVNTR: GREASE TRAPS. OTHER FIXTURES. 1 MECHANICAL FUEL TYPES FURN < 100K: 1 BOILICMP < MP: VENT FANS: 3 CLOTHES DRYER: 1 NAT FURN > =100K: UNIT HEATERS. HOODS' 1 OTHER UNITS' 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS' 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS. 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 20 PUMP/IRRIGATION. PER INSPECTION. EA ADD'L 500SF. 201 - 400 amp' 201 - 400 amp. 1st W/O SVC /FDR: SIGN /OUT LIN LT' PER HOUR' LIMITED ENERGY. 401 - 600 amp' 401 - 600 amp. EA ADDL BR CIR• SIGNAL/PANEL 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 0 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 CRAIG & CHERYL PARKER OWNER laws All work will be done in accordance with approved plans This 5100 SW SW DOGWOOD permit will expire if work is not started within 180 days of issuance, or PORTLAND, OR 97225 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: 503- 244 -0883 Contact #: questions to OUNC by calling 503 246 6699 or 1 800 332 2344 Reg #: TOTAL FEES: $ 4,091.91 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Bolts in concrete Structural welding A. . Issued B y : MIM,JR . _ Pe rmittee Signature : I „� Call 503.639.4175 by 7:00 a.m. for an inspection that business day. I 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. .. r DZar' re i v im Building Permit Applicatia . j E -, 9 , -- 'F012'OFFICE USE ONL1 City of Tigard ce a� /pi �� Pernvt No s� j7.{�o 1 lig • 13125 SW Hall Blvd, Tigard, OR 97223 J U L 2 U 2001 Phone: 503.639.4171 Fax: 503.9 Pig Revtew i 2 / / f l Other Pennit .1960 � Date/By: rlr'� as. 0 See Attached Checklist for Inspection Line: 503.639.4175 C,j 1 , e •h Dare Reedy/By G / T I G A K n Internet: www.t;gard- or.gov.� T , - r -, l• r` F N 'ii►� 4 %� + '•' , , ' , Supplemental Information -- TYPE OF WORK' . / ' Q I) DATA: 1- AND 2-FAMILY DWELLING ❑ New construction p Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all p it - Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. I ,'1- and 2- family dwelling ❑ Commercial/ industrial Valuation: $ a,t 5 7 S Number of bedrooms: 3 ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: I a. 2.9 S S w W oi \ S N. nee. - New dwelling area: ' C 0 ,..4 square feet City /State/ZIP: -- r: CS p r a, , Q R. Garage /carport area: -- square feet Suite/bldg. /apt. no.: Project name: \/, e r Lc\(� \--\( t S.Q. Covered porch area: a 0 C, square feet Cross street/directions to job site: Deck area: square feet q "\ e. To v..) L-VUtwT Other structure area: square feet REQUIRED DATA COMMERCIAL -USE CHECKLIST Subdivision: LaM, f "Te rC G C - - I Lot no.: 16 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.: a S ' . 3 GB-090o \ equipment, materials, labor, overhead, and the profit for the Il k DESCRIPTION OF WORK , I work indicated on this application. 9 e fro d..e..l ol,■-s , N-& Qeprox I q V� Nev.) Valuation: $ a a.Z:.V. on. — Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: C. ra: 4- C) € r t . \ P ci -\‘ tt' _ Type of construction: Address: 510 SW S o sw o o h L n.. y Occupancy groups: C City /State/ZIP: DAN- \ G� J R. C11 'a.2. J Existing: Phone: (sp' ?4 y - 0 $$'S Fax: (SDrb (p 44 __ 0 k () New. `] APPLICANT ' CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: ; N•• 1.�.) qW L r under ORS 701 and may be required to be licensed in the Address: 3) O S 1Ni E k-/Jsk ; & \er S jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /State/ZIP: () c -1 \ t'r l& (5 9._ c11 "*."3")..s apply: Phone: (509 7O x 33 Fax::( 503 2,v5eFS- i( E-mail: • - r,r1 `w o.\ r ) GC ry Cal. .'r -k • • CONTRACTOR — Business name: "1 / 1\ 0,00 E- v BUILDING PERMIT FEES* (Please refer to fee schedule Address: Structural plan review fee (or deposit): City /State/ZIP: FLS plan review fee (if applicable): Phone: ( ) I Fax : ( ) Total fees due upon application: CCB lic.: „ �� i 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: \� • ‘r------.- Date: * Fee methodology set by i n - County Building Industry Service Board. • • • • • • • ..0 I • • . . . • . • • X11 - -- - - av9 'O/ � b - ti � 1 - � 10 .h h1H ' Ele €tricad Permit Application FOR OFFICE USE ONL UPI City of Tigard ED Permit No 10 —06 • q 13125 SW Hall Blvd., Tigard, OR Plan Review Other Permit: Phone: 503.639.4171 Fax: 503.598.123 960 2 Date/By Inspection Line: 503.639.4175 JUL 2 r 2001 Date Ready/By tare l See Page 2 for f I G 1 R l� Internet: www.tigard- or.gov Notified/Method Supplemental Information .TY OF T! f,AR17 TYPE OF l j DiviSsC*' PLAN REVIEW ❑ New construction ddition/al eta ! 1 e p Please duck all that apply (submit 2 sets of plans w /items checked below) rpacell�IIt ❑ Service or feeder 400 amps or more ❑ Building over three stones. ❑ Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards. exceeds 10,000 amps at 150 volts or ❑ Floating buildings CATEGORY OF CONSTRUCTION less to ground, or exceeds 14,000 ❑ Commercial -use agncultural 11• d 2- family dwelling ❑ Commercialindustrial ❑ Accessory building amps for all other installations buildings ❑ Fire pump ❑ Installation of 75 KVA or • Multi -family ❑Master builder ❑ Other: ❑ Emergency system. larger separately denved system - JOB SITE INFORMATION AND LOCATION ❑ Addition ofnew motor load of ❑ "A ", "E ", "1 -2 ", "t -3 ", r � 100HP or more occupancy Job no.: Job site address: f ♦ 4■ S S (� ��\ • (.J %.'k • ❑ Six or more residential units ❑ Recreational vehicle parks ❑ Health -care facilities ❑ Supply voltage for more than City /State /ZIP: G �. / U �` — ❑ Hazardous locations 600 volts nonunai Suite/bldg. /apt. no.: O Project name: P� �".... L \At: ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. 1 Total I • New residential single- or multi - family dwelling unit. t F k W c....\ (Nt.A.- Includes attached garage. Lot no.: 1,000 sq. ft or less 145.15 4 Subdivision: �". r t �- A �� d `� Ea add'l 500 sq. ft or portion 33.40 1 map/parcel Tax no : T S L `S (\ 'J —U -I 00 I Limited energy, residential 75.00 2 DESCRIPTION OF WORK with above .. _ L Limited energy, multi- family 75.00 2 , M.Q C` „ f �� � � 1 9 b Lf residential (with above sq ft ) W Services or feeders installatio i. alteratio i - , Nor relocation J -* : s % °P s-- - 200 amps or less I 80.30 2 OROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 — 401 amps to 600 amps 160.60 2 Name: C, rG ■ r Cr - c < 1 601 amps to 1,000 amps 240.60 2 Address: 5 \ 0 0 O o (f- o LoN-c, Over 1,000 amps or volts 454.65 _ 2 Temporary services or feeders installation, alteration, and/or City / State/ZIP: �p�-��C O 12 '),.% S relocation Phone: (SO " 2 _ 44 0 �G'1 Fax: (sell co t '7 r y _ 0 200 amps or less 66.85 1 �' 6 201 amps to 400 amps 100.30 2 Owner installation: P1tf • i stallation is be' r g made on property that I own which is not 401 amps to 599 amps _ 133.75 2 intended for sale, lea • , ;: t, ore . i ge : d' g to ORS 447, 449, 670, d 701. Branch circuits - new, It eratiot� r extension, per panel Owner signature: ,.,1[4,4, ,.,1[4,4, Date: 0 1 A. Fee for branch circuits wiiTh APPLICANT , I yONTACT PERSON above service or feeder fee, al 0 6.65 2 each branch circuit of Business name: B. Fee for branch circuits without service or feeder fee, 46.85 2 Contact name: C ..A : � r. c-V, e. r" first branch circuit Address: C Each add'l branch circuit 6.65 2 �1 l� C� J �� Q (3 w c(._ n - Miscellaneous (service or feeder not included) City /State/ZIP: ?( (` T \ t:/� V (L 4 - 1 a,e-A Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( 503) 24 Lt _ p $ 8'S Fax: : (So) (p L( Li _U t - 1 O Reconnect only 66.85 2 E -mail: (.... \ P e 4 - c r AS' le ( +'15 f1 • CA) t'v■-.., Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Ek / Signal circuit(s) or limited- Business name: energy panel, alteration, or ),..)0 `// extension. Describe: Page 2 2 Address: City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Plan review (25% ofpermit fee): Print name: Date. State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • we .....a,.. ..r._.. ........ - ... _u....._a .... ...._..... 0 U ,. ,,, Plumbing Permit cr'gCEIVED ' CE V - -- 1 on UFFlCE US ONLY City of Tigard Received Permit NoA f 1-0 p/_ nd l31 IN v 13125 SW Hall Blvd., Tigard, OR 97223 i i i i t ! 5 gm/ Plan Review Other pemut No . 0 : - Phone: 503.639.4171 Fax: 503.598.1960 - Dete/By Inspection Line: 503.639.4175 �+ Suns' ® See Page 2 for P I G A R D CITY OF Tir Date Ready/By Supplemental Information Internet: www.tigard- or.gov IL®i {V4a1 ry1 /ieRY(� Notified/Method TYPE OF W IdVtaaZ tilt J V 81 t FEE* SCHEDULE ❑ De molition For special information use checklist. Di New construction 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 and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 SFR (3) bath , 399.00 ❑ Accessory building ❑ Multi - family Each additional ba tch' 45.00 ❑ Master builder ❑ Other: Fire sprinkler (____ Page 2 (-_ sq. ft) JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 101 4 S S G ) (, c. \ (1 k - k . Catch basin or area drain 16.60 City /State/ZIP: p C.•.(- & 0 (2 Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. no.: R Q � c a - Footing drain (no. linear ft: _� Page 2 Project name: pr. e-- P'G.i Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 q ci E- -1 0 \,.i c.\ n i.,-N- -Rain drain connector 9 16.60 F.. Sanitary sewer (no. linear ft: _) Page 2 F, Storm sewer (no. linear ft: ) Page 2 p Water service (no. linear ft: _) Page 2 Subdivision: Te ('c-�G I Lot 16 d k Fixture or item i Tax map /parcel no.: a S "'. R -0 q DUI Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 M.4.53.12., , d- r424-.0 4 A. 3 . I, i 0 --. - Backwater valve 16.60 Clothes washer I 16.60 Dishwasher 1 16.60 Drinking fountain 16.60 2 rSPROPERTY OWNER I 0 TENANT Ejectors/sump 16.60 Name: (,..(-(.A. ; (i.r \ Q r `` II Expansion tank 16.60 Address: S l 0 O `, O d W 60 O l (...e., Fixture/sewer cap 16.60 City /State/ZIP: P rx- s" \ C ( J C7 �, )-,9, Floor drain /floor sink/hub 16.60 Phone:$ '2 k.. -Q � Fax: (S ( 4 14 --0 1/4"-i b Hose 1 16.60 1 1 16.60 y ZPAPPLICANT ❑ CONTACT PERSON lees 1 16.60 Business name: Interceptor /grease trap 16.60 Contact name: C rC^ : pcs- V, e Medical gas (value: $ ) Page 2 Address: 5'. U O S (..J 1 J O c t.J WD1 La i _Primer 16.60 \ (1.--- / R d (commercial) 16.60 City /State /Z1P: �bt�� C��` / ��as �{ C Sink /basin lavatory 16.60 Phone: ( p5 Z4 4 - 0 O 1 Fa x.. (SO�) (0 ({ (4-0 \ - 1 O - Tub /shower /shower pan 5 16.60 m E -ail: ? a*-\ 6 ¢Cf'0k c t-k Q (' S n . C.11 fr%_. _ _ -- Urinal 16.60 CONTRACTOR Water closet 3 16.60 Business name: s. _I.- A _ t Water heater 16.60 V Other. Ils Address: Subtotal City / State/ZIP: Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: Plu bin Lic. no.: Plan review (25% ofpennit fee) State surcharge (8% ofpermit fee) Authorized signature: g TOTAL PERMIT FEE Print name: R"'4i l.. (Z Na_ - !L I Date: 7 7 1 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. r, Mechanikal Permit V Application FOR OFFIC E � Permu No SE ONL1 - -- — - ` ib�I C of Tigard / �`�� � Received 5 607 de S II e 13125 SW Hall Blvd., Tigard, %t " z23 Plan Review 'II Phone: 503.639.4171 Fax: 503.598. ( 0 �� C 2041 p�r/gy. Other Permit T I : A K I) Inspection Line: 503.639.4175 S ® Date Ready/By tom See Page 2 for Internet: www.tigard or.gov - TIGN lD Non fied/Method Supplemental Information TYPE rf 5 -- 'C' '■ ' COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 11 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 Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* Xl - 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: Air conditioning or heat pump e ' 4 S S w L � \ rt,.-� S r r e e k (regimes site plan showing pl 14.00 City /State/ZIP: �` G. V 1, Furnace 100,000 BTU (duuT 2,10 14.00 f , 1 L• _ > `/- Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt no.: Project name: oz--- \„4 e r- �'`€- ' 0' I- Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 n Hydronic hot water system 14.00 �; v im\ "N-0 LC- \ r1 LA Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 1 10.00 Subdivision: L Q. T rr- (/. C.e Lot nal(p•1-n 10.00 Other Tax map /parcel no.: v 91 3 Q _ 09 00 I Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 9 „`e,.. &` , LL .k.. t) ti Flue vent for water heater or gas fireplace 1 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 Chimney/liner/flue /vent 10.00 jk PROPERTY OWNER ❑ TENANT Other 10.00 Name: C :t 7c.r - �e_,r Environmental exhaust and ventilation Range hood/other kitchen Address: 5- ` 00 S Lo O .. k . ,.,)0 0 1:3, 1...(j R 4.__ equipment 1 10.00 City /State/ZIP: ? V e-A- \Gr\d O C i a,2. � Clothes dryer exhaust 1 10.00 , Single -duct exhaust (bathrooms, Phone: (503) Cj (C _ S a s 9 Fax: (51) ( 4 4 _. 1 toilet compartments, utility rooms) 3 6.80 APPLICANT JCONTACT PERSON Attic/crawlspace fans 10.00 Other 10.00 Business name: Fuel piping Contact name: CCci ? G \< Q r $5.40 for first four; $1.00 for each additional & ) - Furnace, etc. Address: s' k 0 O 1,,J Q. o �I ,0Op t3. (.Ji n - ¢..-- Gas heat u P mP City /State/ZIP: ?i7 -A -\ qt\(,. , O l C% '"?. c Wall/suspended/unit heater Phone: ( 5-00 "I ( , $ M b I Fax: : ( 50'9 to 4 W - O 1' O Water heater Fireplace E-mail: - Range 3 \ CONTRACTOR Barbecue o Business name: Q o \ 1� e / - Clothes dryer (gas) 3 a t (/ Vc� 14 ` Other. Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Minimum permit fee ($72.50) Phone: ( ) Fax: ( ) Plan review (25% ofpennit fee) CCB lic.: //^ State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: ll / � �J � � This permit application safterit has accceptedhav ompplete. within 180 Pint maws, maws, `„ I urP. I * Fee methodoloev set by Tri- County Buildina Industry Service Board C il 0 -Atcr PA4ALEA- - 7 /2c %1 CleanWater Services Our commitment is clear. November 29, 2006 Cami Walker 3105 NE Weidler St. Portland, OR 97232 RE: Addition to single family residenc° located at 12245 SW Walnut St., Tigard, OR CWS file 06- 003121 (Tax map 2S103BB, Tax lot 09001) Clean Water Services has received your Sensitive Area Certification for the above referenced site. District staff has reviewed the submitted materials including site conditions and the description of your project. Staff concurs that the above referenced project will not significantly impact the existing Sensitive Areas found near the site. In light of this result, this document will serve as your Service Provider letter as required by Resolution and Order 04 -9, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. This letter does NOT eliminate the need to protect Sensitive Areas if they are subsequently identified on your site. If you have any questions, please feel free to call me at 503 - 681 -3605. Sincerely, Chuck Buckallew Environmental Plan Review Attachments (2) 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 Phone: (503) 681 -3600 • Fax: (503) 681 -3603 • www.CleanWaterServices.org Construction Contractors Board Permit #: MSrapo7 =d0 3 g 700 Summer St NE Suite 300 Addre .. - `t't 5W L A- Liv 0, J-T- 0 ' PO Box 14140 ■ � t Salem OR 97309 -5052 /� Iss ed by:. _ I ,/ , L�., 00/6 � Date: ? Phone: 503- 378 -4621 Web Address: www.ccb.state.or.us Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) 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. 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. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ❑ 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR yr 3B. I will be my own general contractor. 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 contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Pr 1 1 erty Owners about Construction Responsibilities on the reverse side of this form. \ t - th.-C, /0 (Signa 4. f permit applicant) (Date) (White copy to issuing agency permit file, pink copy, to applicant.) Property_owner.doc 06 -01 -04 Actling no Y®tur Own G neri.11 CContil met© ? • INFORM TEO WOTICE TO P; - OPERTY OWNE[`'S ABOUT CONSTRUCTION RESPONSI -.DUTIES NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Emplloyer r<esponsibiuties You will, in most instances,.be ruled to be an "employer" and the - contractors you contract with will be "employees" if . you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503- 378 -4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503- 947 -1488. • The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and • Unemployment Insurance Tax. To file for a BIN, call 503- 945 -8091 or www .dor.state.or.us /formspay.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance; you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division' at the Department of Consumer and Business Services at 503- 947 -7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. - You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1- 800 - 829 -4933 or visit their web site at www.irs.gov. Other Responsi b liti es and Areas of oncer m s, Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. V Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503- 378 -4621) or write the agency at PO Box 14140, Salem, OR 97309 -5052. Property_owner.doc 06 -01 -04 ./ c : ..akv‘. „ i \ •\ \ ,\ N. (E) POND • CITY OF TIGARD - SITE PLAN REVIEW \•'�. -�. / BUILDING PERMIT NO.: 0) aflm • OO I , ' �0 PLANNING DIVISION: Q / '-'\ � Required Setbacks: Approved ❑ � Not Approved N) ADDITION � \ Side: Street Side: CI ;/ „ / \ 'w . Front. 2/r-.) Rear: l.< _ / / / ' Visual Clearance: ❑ Approved El Not Approved (E) UPP R DECK I ' ^ O Maximum Building Height feet p \ CVS Service Provider Letter Required: ❑ Yes ❑ No , 50' BUFFER EDGE y y ,, \ El Received I I I (APPROX.) L 6: Date: % t l /t 7 LOR /' � (E) DEC a NENGINE DEPARTMENT: DECK ie ,' � Actual Slope: //o E Approved ❑ Not Approved f ❑ N t rov ' 'N By: !'�'L, (,(�`— Date: / « ° 7 / s/' i ' -\ �!� '�� j _ '�, CITY OF TIGARD - SITE PLAN REVIEW i' '�\ , BUILbiN PERMIT NO: rn,S1 AeM _ 40 1,11 / \ +s �h � ' s. / 1 ti (E) HQUSE FO te; i /J l c, 7 i ' •V I ("71:3 N / 0 Th ( DRIVEWAY " ter' `' ' / / _■,/ / /" —_ = - jam; - / \ . . S i 0 - \ ,/ O SITE PLAN •'\ i SCA 1- = 15' -0- ' '\ '- 1 � ,..- A pp ro ved . / !, \. �-' Clean Water Services PARKER HOUSE '\. (E) PAVED ROA j - \ . ' 12245 SW WALNUT STREET By Date ir�z9�06 ', -y TIGARD, OR 97223 .-- _, a DATE: NOVEMBER 13, 2006 )- • .