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Permit City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 • T I GARD September 12, 2008 Randy & Julie Ann Egli 7990 SW Fanno Creek Dr. Tigard, OR 97224 Re: Permit No. MST2008 -00069 Dear Mr. & Mrs. Egli: The City of Tigard has processed a refund for fees on the above referenced permit(s) for the following Site Address: 7990 SW Fanno Creek Dr. Project Name: Egli Job No.: N/A Refund: ® Check #59290 in the amount of $41.98. ❑ Credit card "return" receipt in the amount of $ ❑ Trust account "deposit" receipt in the amount of $ Notes: Electrical work was removed from permit. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. I:\ Building\ Refunds \Administra tion \LtrRefund- RefundOnly.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 PP I I City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 - 2 weeks for processing. PAYABLE TO: Randy & Julie Ann Egli DATE: 8/26/08 7990 SW Fanno Creek Dr. Tigard, OR 97224 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: 2008 -1824 Case #: MST2008 -00069 Date: 5/29/08 Address /Parcel: 7990 SW Fanno Creek Dr. Pay Method: Check Project Name: Egli EXPLANATION: Electrical work removed from permit. Refund 80% of permit fees. REFUND.INFORMATION: ' : •_ • • • . ' . . Fee: Description From Receipt: =' Revenue Account No:': • ' Refund r Example: [ B U I L D ] P e r m i t Fee .. 6 i i i r i p l e : • 2 - 0000 - 432000: • • . ' . . $ Amount fELPRMT] ELC Permit 220 - 0000 - 431510 $37.48 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 4.50 i TOTAL REFUND: APPROVALS: y� 9? 4 If under $500 Professional Staff 1 / If under $7,500 Division Manager 7 Tlr t If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board f' ': • -';: FOR TIDEMARK SYSTEM ADMINISTRATION.USE.ONLY:! • `:;' Case Refund Processed: I Date: I jZ4 /0 I By: I: \Building \Refunds \RefundRequest.doc 05/23/07 CITY OF TIGARD 8 13125 SW hall Blvd. 8:05:33AM Tigard, OR 97223 503.639.-1171 TIGARD Receipt #: 27200800000000001824 Date: 05/29/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MST2008 -00069 [BUILD] Bldg Permit 245- 0000 - 432000 84.16 MST200S -00069 [TAX] Build 12% State Surchrge 100- 0000 - 207020 10.10 MST2008 -00069 [ELPRMT] ELC Permit 220 - 0000 - 431510 46.85 MST2008 -00069 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 5.62 Line Item Total: $146.73 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check JULIE ANN EGLI DEB 0964 In Person 146.73 Payment Total: $146.73 cReceipI.rpI Paler 1 or 1 Community Development TIGARD Request for Permit Action TO: CITY OF TIGARD RECEIV Building Division Services Coordinator AUG 21 2O'' 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov CITY OF TIGARD FROM: Owner ❑ Applicant ❑ Contractor Li City tan G DIVISION (check one) REFUND OR Name: INVOICE TO: (Business or Individual) PA- I Mailing Address: 7990 Slit/ �hr��v0 Lf27C D✓� City /State /Zip: - 776.7. CJ / sai2- 97 ZZ cf Phone No.: �� 444 Z43-9 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): L PERMIT APPLICATION. 4►. REFUND ' ERMIT FEES (attach receipt, if available). • • • FOR FEES DUE (attach case fee schedule and explain below). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit #: / 57 ^ 0006 9 Site Address or Parcel #: 7990 Sfit/ F'/}- yJ/✓l) Cfe -- D Project Name: �� L Subdivision Name: Lot #: U O EXPLANATION: i_(67.-f-T Fbi 7l )) rvD 1 M oP/ / , a c- -7 • I Signature: Date: /2J�0 Print Name: PAVO - L ) Refund Policy 1 . The Director or Building Official may authorize the refund of: (� a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. �( c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to Sys Admin: Date By Rte to Bldg Admin: Date /j„2 /0e By i! Refund Processed: Date //24,AP By 4 Invoice Processed: Date By Permit Canceled: Date V By vv Parcel Tag Added: Date _ By Receipt #, f —/f 2 y Date '2 eb d �" Method ( s4. Amount $ I: \Building \Forms \RegPemritAction.d c R 07/26/07 1/ ,� q I OF �' ® _' MASTER PERMIT j _ ~ PERMIT ;y: MST2008 -00069 COMMUNITY DEVELOPMENT DATE ISSUED; 5/29/2008 I T I GAKD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112BA -01600 SITE ADDRESS: 07990 SW FANNO CREEK DR • . ZONING: •R - SUBDIVISION: WAVERLY MEADOWS LOT: 037 JURISDICTION: TIG PROJECT: EGLI Project Description: Replacing existing porch and adding eave. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf • FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: s1 RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 4.000.00 REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 'ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'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: CP • LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADOL BR CIR: SIGNAUPANEL: IN PLANT: ""ji MANU HMISVGIFDR: 601 - 1000 amp: 601•amps- 1000v: MINOR LABEL: 1000* amp /volt : PLAN REVIEW SECTION Reconnect only: M > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: 00 ELECTRICAL - RESTRICTED ENERGY i A. SF RESIDENTIAL • B. COMMERCIAL 0 AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: A BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: V j� GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: V HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS: 4) This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable RANDY 8 JULIE EGLI OWNER laws. All work will be done in accordance with approved plans. This 7990 SW FANNO CREEK DR permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97224 it 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- 703 -4662 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 201.43 • REQUIRED ITEMS AND REPORTS . ' Issued By 1� _ I 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. al /c.3 $ Re1rt .t 'i-f - : GTec frf ca( wurk rer ---f-ruv., ecerral ' CITY OF TIGARD MASTER PERMIT II PERMIT #: MST2008 - 00069 COMMUNITY DEVELOPMENT DATE ISSUED: 5/29/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112BA - 01600 SITE ADDRESS: 07990 SW FANNO CREEK DR ZONING: R -7 SUBDIVISION: WAVERLY MEADOWS LOT: 037 JURISDICTION: TIG PROJECT: EGLI Project Description: Replacing existing porch and adding eave. 8/21/2008 Electrical work removed from scope of project. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 4,000 00 REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: WISVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 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 8 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: DATAITELE COMM: NURSE CALLS: TOTAL p 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 RANDY & JULIE EGLI OWNER laws. All work will be done in accordance with approved plans. This 7990 SW FANNO CREEK DR permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97224 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: 503 703 - 4662 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 201.43 REQUIRED ITEMS AND REPORTS Issued By : � ��` % �_. - Permittee Signature : c A d �i am. / h l 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. Buifuing "Permit Application Residential �� FOROFFICE USE ONLY City of Tigard Received I ° .�/� Permit No.: � Date/B : ��q i, Zl� �m57 6 13125 SW Hall Blvd., Tigard, OR 97223 0 r O ■ Phone: 503.639.4171 Fax: 503.598.196 1 � . `� �� Other Permitf�/ Inspection Line: 503.639.4175 `n ` l %late Ready /By: See Page 2 for TIG' Internet: www.tigard or.gov xv O � `Cl v 4+ �`� ® Notifiey ethod: 5 ARAM j Supplemental Information ,k Allib . .ice . • ' TYPE OF WORK i\ , RE t U1RED DATA: 0 AND 2- FAMILY DWELLING ❑ New construction 111 Demolit Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all X ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCT ION' work indicated on this application. X 1 -and 2 -famil dwellin Valuation: $ * ' y g ❑ Commercial /industrial Pr CI 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: 7990 Spy F C 7Z 1,2 New dwelling area: square feet City /State /ZIP: 77 ( z )) e:9 9-7 z Zef Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: �n � . �A f _ p,/� Deck area: square feet (/ ` ,� J, / V Other structure area: square feet q� �� REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 1, 1 l/ �L 1 t74 0 1 5-2„,,, L 5 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. Nffh/ F720yrr 9'C CJ--F -t- Valuation: $ Existing building area: square feet New building area: square feet PROPERTY, OWNER ❑ TENANT' Number of stories: Name: r1/42 E-5--L1 Type of construction: Address: 79- Sh/ . F-6-y1//v(2 `7C Piz, Occupancy groups: City /State /ZIP: 77 Gykyzp �L 97 -Z Cf Existing: Phone: () 703 462 Fax: ( ) New: ❑ APPLICANT ' ❑' 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: C� applicant is exempt from licensing, the following reasons apply: • 1 L Phone: ( ) Fax:: ( ) 1 d • O E -mail: 1 ` CONTRACTOR . Business name: SCZ BUILDING PERMIT FEES* Address: (Please refer (0 .0 schedule) Structural plan review fee (or deposit): L.f Z 0 City /State /ZIP: lI Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: t 'O Amount received: Authorised signature: / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1) r Date: / (g/ (D * Fee methodology set by Tri- County Building Industry Service Board. I:\Building \Permits\BUP - RES PermitApp.doc 11/6/07 440-4613 T( 1 1 /02/C OM/WEB) ' Building Permit Application Checklist One- and Two - Family Dwelling FOR. 'OFFICE US O N L Y City of Tigard Received Permit No.: 74 q 13125 SW Hall Blvd., Tigard, OR 97223 Date /By: .i. . 9 Phone' 503.639.4171 Fax: 503.598.1960 Associated permits: • 24- Hour Inspection Line: 503.639.4175 la ,. ❑ Plumbing ❑ Mechanical TIGARD 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. ❑ Cl ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan El 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. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if El El ❑ 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 El ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, Cl ❑ ❑ 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 CI CI architect licensed in Oreg and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFIC'S 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" 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 City of Tigard ❑ ❑ El 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 accompanied by 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. I \ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(I1 /02 /COM/WEB) Electrical Permit Application RECEIVED FOR,OFFICE USE ONLY City of Tigard Date /B t ° 13125 SW Hall Blvd., Tigard, OR 97223 Pl an `e Permit No. / r g + tr� 6, 9 ' Phone: 503.639.4171 Fax: 503.598.1960 MAY 1 9 2008 Date/By: By: Other Permit: T 1 G A R D Inspection Line: 503.639 � i Date Ready/By: orris: ® See Page 2 for TIGARD Internet: www.tigard O � DNISIOI.y Notified/Method: Supplemental Information TYP OF WO I ll PLAN 'REVIEW El 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 �l - 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: � / . / }_-��'�� // I OOHP or more. occupancy. � �� (/ / q. Y2 �� pd ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: n � yJ (1 97 ❑ Health -care facilities. ❑ Supply voltage for more than �� ` ( _ ' 1 / / ❑ 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: D escription I Qty. I Fee. I Total New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 . - ,DESCRIPTION OF WORK ' ' (with above sq. ft.) 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 (PROPER1Y OWNER, ❑ TENANT .. 201 amps to 400 amps 106.85 2 - Name: /�. �/f) 5r' & L I 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: - c). n S w /0 ( /Z (-, pre Over 1,000 amps or volts 454.65 2 City/State /Z1P: /'Lp / 9 ? • 'l `- Z4 Temporary services or feeders installation, alteration, and/or relocation - Phone: ( ) 70 z 4_‘ 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, leas-, , ore chan cord 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: D a t e: 1f 1O� • J / 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, 46.85 2 first branch circuit Address: Each add'l branch circuit 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 ' . Sign or outline lighting 53.40 2 Business name: Q D� E -7 J Signal panel, or alteration, limited- / ` energy panel, alteration, or Address: extension. Describe: Page 2 2 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 Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ' , ELECTRICAL PERMIT .FEES Suprv. Electrician signature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ' Number of inspections allowed per permit. I:\Building\Permits\ELC- PermitApp doc 05/23/06 440- 4615T(I I /05 /COM/WEB Electrical Permit Application - City of Tigard • . Page 2 - Supplemental Information LIMTI'ED ENERGY PERMTI' FEES: °`R'ESIDENTIIII; Wo.Ricj: LY:' Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: CCI 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 n Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* Fl Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 143uilding \Permits \ELC- PermitApp.doc 03/23/06 l' City of Tigard, Oregon ® 13125 SW Hall Blvd. • Tigard, OR 97223 I1 TIIGAR. September 12, 2008 Randy & Julie Ann Egli 7990 SW Fanno Creek Dr. Tigard, OR 97224 Re: Permit No. MST2008 -00069 Dear Mr. & Mrs. Egli: The City of Tigard has processed a refund for fees on the above referenced permit(s) for the following: Site Address: 7990 SW Fanno Creek Dr. Project Name: Egli Job No.: N/A Refund: ® Check #59290 in the amount of $41.98. ❑ Credit card "return" receipt in the amount of $ . ❑ Trust account "deposit" receipt in the amount of $ . Notes: Electrical work was removed from permit. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, i7 /TT ; , „.,( / `' 4 .. j - Dianna Howse Building Division Services Supervisor Enc. I: \Building\ Refunds\ Administration \LtrRefund- RefundOnly.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 • City of Tigard TI -CARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Randy & Julie Ann Egli DATE: 8/26/08 7990 SW Fanno Creek Dr. Tigard, OR 97224 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: 2008 -1824 Case #: MST2008 -00069 Date: 5/29/08 Address /Parcel: 7990 SW Fanno Creek Dr. Pay Method: Check Project Name: Egli EXPLANATION: Electrical work removed from permit. Refund 80% of permit fees. ''REFUND INFQRMAT.1.0 : .. .. ,. • : ;z � • F ee; Receipt ., Re "venue:Accoui t - No:' �Refund;4= Example [BUILD] sPermit Fee,: , • , } ' Example:' 245 0000` 432OOOr'.:' ".. � $`Ariiounf [ELPRMT] ELC Permit 220 - 0000 - 431510 $37.48 [TAX] ELC 12% State Surcharge 100 0000 - 207020 4.50 TOTAL REFUND: APPROVALS: VA 9? If under $500 Professional Staff fi If under $7,500 Division Manager ; If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board ,WW„' ..``' z, : »; 1" :s1 ;:jFORT SYSTEM :_ADMINIST RAT ION;.U,SE :ONLI t> ". 4x1..: z ' .':`: i {µ: Case Refund Processed: Date: I jzvoi- By: / I: \Building \Refunds \RefundRequest.doc 05/23/07 il ' - CITY OF TIGARD 13125 SW Hall Blvd. 8:05 :3 3AM - • Tigard, OR 97223 5113.639.4171 T,I GARD; Receipt #: 27200800000000001824 , Date: 05 /29/2008 Line Items: Case No "Ilan Code Description Rev enue Account No Amount Paid MST2008 -00069 [BUILD] Bldg Permit 245 -0000 - 432000 84.16 MST2008 -00069 [TAX] Build 12% State Surchrge 100- 0000 - 207020 10.10 MST2008 -00069 [ELPRMT] ELC Permit 220-0000-431510 46.85 MST200S -00069 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 5.62 Line Item Total: 5146.73 Payments: Method Payer User ID Acct. /Check No. Approval No. I-Iow Received Amount Paid Check JULIE ANN EGLI DEB 0964 In Person 146.73 Payment `total: $146.73 JteceIpr Iln I'uue I ul I •► Information Not to Property Owners About Construction Responsi Statemen 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 issue [ORS 701.055 (4)] This statement is required for residential building, electrical, mechanical and plum p ermits. 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 per mit. y c , ' eia '"` w t�, u p s , � r , ,,,,; .. , , ,,4 ,, , x�n� t�',. : tl av ,:-,<.,, t ,1 ! Y I at � 5 ntract O r' K 7 ",a 3 as " t ruc tlon Contra"?' ' � r 9 a «. 4 �:F Y '? ' `'0 r , ti n y `'P 4cfi r " - resider', x s� ._ ,� . �dny�/�.� a:�W a lie 1 gene r'a { . l7� b: "# C e sC with x� s, 11 II a�o6 A e 1. I - > y � a;w g nu xfi ,`� �.. . 4 s : e l' T �, x , !have rea! an '''''=‘, ts a ._ Q -.B a ti , c }, : a e. � 'esponsibiliti ;, on e two p i � - ; � p , ' � , � � 1l. elet @C)I ��q ' . w e e 'h ! � t '{., �ti S d�` FiSS a7 Y ➢w ds� � " te r , M ` as K a- � d p'3 z a a'�'� # `` � 4.. ,17 ,,, mir + , , i ,*! ' "' �. .._ Nom; �,._y ' ., r ', s s'a is a".-.- `"`d"�a'?s'° _ .,: as_ `u.?i 4' u,,.�_ �rxu. "+ <: ~. • Permit #: H i - �n9 This form is supplied to building .F permit offices by the Construction Oregon '% , Address: ? D 1 � r � ff Contractors Board, ;N..,. as required by ORS 701.055 (6) '' r -;. Issued by: Date: This copy to issuing permit office . . � � !pi - a Community Development Request for Permit Action TFGARD OF TIGARD TO: CITY O G O Building Division Services Coordinator AUG 2 1 20; 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard- or.gov CITY OF TIGARD FROM: Owner [II Applicant n Contractor III City DIVISION (check one) REFUND OR Name: p �� INVOICE TO: (Business or Individual) - (, C6-L I Mailing Address: 79,90 S /A7vlvt) 6 s � 2>Z City /State /Zip: - T1614 ,2 0 / 0 97 ZZ cr Phone No.: . '' 3 44 Z.43 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): SAN EL PERMIT APPLICATION. REFUND ERMIT FEES (attach receipt, if available). FOR FEES DUE (attach case fee schedule and explain below). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit #: /1/) <Z 6 9 Site Address or Parcel #: 7990 S(r✓ , _, /t) e j7ie Project Name: E-- L ) Subdivision Name: Lot #: �- EXPLANATION: 6 rfT / 1 E j '-I ^ ' ■vr Ci Oo MOP /f7&477n/- / sz 7flAJ l i' . , , e l • Signature: / 1/J _ Date: (I 2 /( o 0 Print Name: f '- [_) 9 Refund Policy 1. The Director or Building Official may authorize the refund of: (� a) any fee which was erroneously paid or collected. ' ` b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. n( c) not more than 80% of the land use application fee for issued permits. UU d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds ,- FOR 15FFICE ' ` Rte to S 's Admin: Date B Rte to Bld. Admin: Date ?, AP B r i. Refund Processed: Date 8 74, pk B AA Invoice Processed: Date B Permit Canceled: Date if ' B , . jr�— Parcel Ta • Added: Date B Recei. t # /,' —/ 'a A Date 5 . ' Agit Method L 1111111 Amount $ I:\ Building \Forms \RegPermitAction.d.c R - 07/26/07 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -00069 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/ /2008 4 1 1 1 Phone: (503) 639 -4171 l i Inspection Requests (24 Hrs.): (503) 639 -4175 : . INSPECTION WORKSHEET FOR DATE: 9/2/2008 TIME: 7:01AM PAGE: 9 SITE ADDRESS: 07990 SW FANNO CREEK DR CLASS OF WORK: SUBDIVISION: WAVERLY MEADOWS LOT #: 037 TYPE OF USE: PROJECT NAME: EGLI DESCRIPTION: Replacing existing porch and adding eave. 8/21/2008 Electrical work removed from scope of project. OWNER: EGLI, RANDY & JULIE PHONE #: 503-703-4662 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 9/2/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 074931 -01 503 -443 -2439 N Corrections/Comments/Instructions: A 5 ?'ir- M ✓�-) '(G,�,<3 di, Imo. Sa v■.e ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 05 Date: e?aed Phone #: (503) 718- 2 /- 2 7 CITY OF TIGARD . BUILDING DIVISION PERMIT #: ST200B 00069 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 51291200E1 1 ,01101I# Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . .. INSPECTION WORKSHEET FOR DATE: 8/5/2008 TIME: 7 :00AM PAGE: 3 SITE ADDRESS: CLASS OF WORK: 07990 SW FANNO CREEK DR SUBDIVISION: WAVERLY MEADOWS LOT #: 037 TYPE OF USE: PROJECT NAME: ECLI DESCRIPTION: Replacing existing porch and adding eave. OWNER: ECU, RANDY JULIE PHONE #: x-;0 - 7034662 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 8/5/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 073764 -01 603-443-2439 N Corrections /Comments /Instructions: An P / cl r' e e 1cz COL' O P Od 4-\ ',vv.( cr-r (w•Vr ' i c------ I . 6 l( 3 C (WU \ s 'V ...t ej eCi e w tot f P ✓�t1 \ +,. G:..%SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 73S Date: 54,36,5 Phone #: (503) 718- 2%23 CITY, OF.TIGARD - • • BUILDING DIVISION #: MST2008-00069 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /3129/2000 Phone: (503) 639 -4171 /�au l p r r Inspection Requests (24 Hrs.): (503) 639 -4175 fi'I I INSPECTION WORKSHEET FOR DATE: 7/31/2008 TIME: 7 :00AM PAGE: 45 SITE ADDRESS: CLASS OF WORK: SUBDIVISION: 07990 FANNO CREEK DR LOT #: TYPE OF USE: PROJECT NAME: WAVERLY MEADOWS 037 EGLI DESCRIPTION: Replacing existing porch and adding eave. OWNER: EGLI, RANDY & JULIE PHONE #: 503, -4662 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/31/2008 Pour Time: 12 :00 Code # Inspection Description Confirm # Contact # Message 205 Footing 073494 -01 503-703-4662 Y Corrections /Comments /Instructions: . ..•�. " G.i 5 •' ' . Lit 'P —ham dtt • /0so ( /zn e„L,r n- 41 / • . . ei \f- ` — , . -� • // - iILeL�r. _ i� . ' _. .��I -i4_ °v'r' 6iz1z•Jc � A/6‹..___./ V • ASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS I I FAIL El CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED rte ,, Inspector: Date: `7.-- /-d 8 Phone #: (503) 718- 2.4. -4 CITY OF TIGARD - A-. BUILDING DIVISION / PERMIT #: MST2008 -00069 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: &29/2008 Phone: (503) 639 - 4171 011tb4 ih, Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/1W2008 TIME: 7:01AM PAGE: 37 of Ff ADDRESS: 07990 SW FANNO CREEK DR CLASS OF WORK: SUBDIVISION: WAVERLY MEADOWS LOT #: 037 TYPE OF USE: PROJECT NAME: EGLI DESCRIPTION: Replacing existing porch and adding eave. OWNER: EGLI, RANDY & JULIE PHONE #: 503. 703 -46662 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/10/2008 Pour Time: 12:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 071133-01 503- 443 -2439 4 db - g- ?'/ Corrections /Comments /Instructions: �� PAS %J PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL II CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: _ Date: 6 ! " ° G 0 f Phone #: (503) 718 - Z-6 ''