Permit _ Y I
q CITY OF TIGARD MASTER PERMIT
IIIII PERMIT #: MST2009 - 00016
COMMUNITY DEVELOPMENT DATE ISSUED: 2/5/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 104 DA -19600
SITE ADDRESS: 13275 SW KINGSTON PL ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - SOUTH LOT: 022 JURISDICTION: TIG
PROJECT: RINEHART
Project Description: Replace entry landing and rear deck ledger board.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SEA 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 of 1,501.00 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: W /SVC OR FDR: 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 # 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
SUZANNE RINEHART ASPEN RIDGE CONSTRUCTION INC laws. All work will be done in accordance with approved plans. This
13275 SW KINGSTON PL 15615 SW 74TH AVE STE 190 permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97224 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: Contact #: PRI 503 624 - 9060 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
FAX 503- 624 -3632
Reg #: LIC 156998 PLAN IN FILE FOR 13235 KINGSTON PL
TOTAL FEES: $ 110.63
REQUIRED ITEMS AND REPORTS
i l , ! . ! a
Issued_By-:__ _ - f, - Permittee Signature.: ila �'m�r -- —
7 / Call 503.639.4175 by 7:00 a.m. for an inspection that busines- day.
' -
/
- This •ermit card shall be kept in a conspicuous place on the job site until c' pletion s the project.
Approved plans are required on the job site at the time of each nspection.
Building Permit Application RECEIVED
. .
Residential FOR OFFICE USE ONLY
City of Tigard JAN 2 9 2009 Received 24 Ct Permit Nor15'�j ZOOe�, coo
q Deceive:C
13125 SW Hall Blvd., Tigard, OR 97223 ^�+
Plan Revi;a a /�
` Phone: 503.639.4171 Fax: 503.598.196tv OF TIGARD v. 4- u t Other Permit:
Date /By: /
f 1 G A R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/B). luris. El See Page 2 for
Internet: www.tigard- or.gov Notified /Metho -C„)• ( e l \, Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® 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 Valuation: 51501
g ❑Commercial /industrial
❑ 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: 13275 SW Kingston PL. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: R t r.t 0 k153 r .+ Covered porch area: square feet
Cross street /directions to job site: off of SW' Greenfield Dr., Turn East on Deck area: 20 square feet
street "B" then north on Kingston PL. Other structure area square feet
' REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Quail Hollow South PH 1 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.
!move and replace entry landing and guard rails with same. Replace existing Valuation: S
nandrails w/ same @ entry stairs. Brace and detach rear balcony and replace Existing building area: square feet
Ledger board with P1' 2 x existing board and re attach. New building area: square feet
❑ PROPERTY OWNER ❑ TENANT . Number of stories:
Name: Home OwnersAsseciatioJ -Precidrnt- N1ark.EI4S(A ?Qnn .pinvheir�- Type of construction:
Address: ( / A - Occupancy groups:
City /State /ZIP:
(
Existing:
Phone: (503) 590 - 5226 Fax: ( ) New:
. A APPLICANT ® CONTACT PERSON NOTICE
Business name: Western Architectural All contractors and subcontractors are required to be
Contact name: Justin Barnhart licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 10220 SW Greenburg Rd., Suite 125 jurisdiction in which work is being performed. If the
City/State/ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 297 -0665 Fax: : (503) 297 -0757
E -mail: justin @westernarchitectural.com
CONTRACTOR .
Business name: Aspen Siding & Windows BUILDING PERMIT'FEES* '
Address: 15615 SW 74' Ave., Suite 190 (Please refer io fee schedule)
City /State /ZIP: Tigard, OR Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: (503) 624 -9060 Fax: (503) 624 -3632
TB lie.: 156998 _
Total fees due upon application:
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: Andy Leisman Date: 01 /29/2009 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02/COM /WEB)
Plumbineermit Application - -
. Datereceived: Permit no. 15 ar vvO (o
City of Tigard
j , ) `J Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City ofTigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
Land use approval: Case file no.: Payment type:
;4: i TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family 0 Tenant improvement
O New construction 0 Addition/alteration /replacement 0 Food service U Other:
' , , JOB SITE INFORMATION , = FEE SChEDULE (for special information use checklist)
Job address: (32 1)S S (,13 k._ ∎ c „. a I a_cc Description Qty. Fee (ea.) Total
Bldg. no.: Suite no.: New 1- and 2-family dwellings only:
('mdudes 100 ft. for each utility connection)
Tax map/tax lot/account no.: SFR (1) bath
Lot: 2 2 (Block: ( Subdivision: SFR (2) bath
Project name: SFR (3) bath
City/county: I ZIP: Each additional bath/kitchen
Description and location of work on premises: Siteut lities:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain
` 'PLUMBING CONTRACTOR Footing drain (no. lin. ft )
Manufactured home utilities
Business name: Manholes -
. " - - --. Rain drain connector
Wolcott Plumbing Sanitary sewer (no. lin. ft.)
PO Box 2007 Storm sewer (no. lin. ft.)
Gresham OR 97030 -0594 Water service (no. lin. ft.)
503- 667 -1781 Fixture or item:
CCB:23847 PLM #:26 -208PB Absorption valve
Back flow preventer
Print name: Date: Backwater valve -
r: CONTACT PERSON Basins/lavatory
Name: Clothes washer
Dishwasher
Address: Drinking fountain(s)
City: ( State: ( ZIP: Ejectors/sump /
Phone: Fax: E -mail: Expansion tank
,,, . f .,, e 0∎1Ntlt " . Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): Garbage disposal
Mailing address: Hose bibb
City: I State: I ZIP: Ice maker
Phone: I Fax: l E -mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump
e,, ; „ s , .- ^ • ► f; t , -,,,,^;-, Tubs/shower/shower pan - -
Urinal
Name: Water closet
Address: Water heater
City: I State: ( ZIP: Other:
Phone: (Fax: (E-mail: Total
Not as jutisdc =opt ept actin ands, ptame call finis fiction fa MOM information. Notice: This permit application Minimum fee $
O Visa t] MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit within 180 days after it has been State surcharge (8 %) .... $
Expires Name of txtdhotder as glows m txedir acid accepted as complete. TOTAL $ $
Can: Molder Wyman Amaamt 440-4616 (6,V01C0M)
Mechanical Permit Application L . - f
Date received: Permit no.: 5 „ ,, q_ e / ,
'1 Y 'i
ji City of Tigard �j1: � .. tY g Projecdappl. no.: Expire date:
Ciry Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
T%PE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other.
,. JOB SITE INFORMATION ; -, COMMERCIAL VALUATION SCHEDULE '
Job address: t 32,93 G o E. „�. s 4 10 i , c ,_ c , Indicate equipment quantities in boxes below. Indicate the dollar.
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $ .
Lot: `Z 2. I Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: 1 & 2FAMILY DV4'ELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COM MERICAIIINDUSTRIM. EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res.only
Tenant improvement or change of use: IIVAC:
Is existing space heated or conditioned? O Yes ❑ No Air handling unit CFM
space insulated? ❑ Yes 0 No Alt conditioning (site plan required)
Is existing P Alteration of existing HVAC system
.: ' 11MEC11ANICAL 'CONTRACTOR Boiler /compressors
_ - - State boiler permit no.:
JEROME ELECTRIC HP Tons BTU/H
Fire/smoke dampers/duct smoke detectors
PO BOX 751
HILLSBORO OR 97123
Heat pump (site plan required)
Install/replaceftunace/burner BTU/H
503-648-514
Including ductwork/vent liner 0 Yes 0 No
Instal l/replace/relocate heaters - suspended,
CCB: 36051 ELC: 34 -119C SUP: 2877S wall, or floor mounted
tvame (please print): - Vent for appliance other than furnace
Refrigeration:
4,x ' ,. i , - CONTACT PERSON . Absorp u BTU/H
Name: Chillers HP .
Co v ressors HP
Address: itbvunumt exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: . E - mail: Dryer exhaust
., - '" =., OWINER : , . " Hoods, Type l/ II/res. kttchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I S I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel • i • ing each additional over 4 outlets
.;
T> a it. . o ,. ' D ENGINEER Y= 'fi ^'` ` ' . p p (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: State: ZIP: Insert - type
Phone: I Fax: E -mail: Woodstove/pellet stove
Other.
Applicant's signature: I Date: Other:
Name (print): —
Na as jurisdictions accept aorEt cards, please call jurisdiction for more information. Permit fee $
Notice: This permit application Minimum fee $
0 visa 0 MasterCard ex if a permit is not obtained
Plan review (at _ %) $
--- - - -- E xp 1 ta - within 180 days after it has been
Name ar eatdbolda ar'bown co credit cane accepted is complete. State surcharge (896) .... $
. $ _ TOTAL $
Cardholder signature Amount 440.4617 (ypppppn
, • .
..
1
Electrical Permit Application -
Date received: _
Permit no Meery ,repo.
g j j ti : I City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
O New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: S _ a A Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: `ZZ, Block: Su.. ivision:
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
_,CONTRACTOR APPLICATION 's °
_, _ =; - :- . -. . ,. FEE SCIIEDL>I:E -:' -' .� '- - ;.
Job no: Fee Max
_ _ -- _ _ _ Description Qty. (ea.) Total no. insp
Streamline Electric New residential -thigleormultitamily per
DBA La Valley Corporation dwellingunil. Includes attached garage.
6025 East 18 St Service included
Vancouver WA 98661 1000 sq. ft. or less 4
360-993-5080 Each additional 500 sq. ft. or portion the reof
Limited energy, residential - 2
CCB:116514 ELC#: 34-432C SUP #: Lim;iedenergy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect name (print): License no: Services or feeders - installation
alteration or relocation:
, , . 't - PROPERTY OWNER ' . _ ... ' . 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servicesorfeeders -
which is not intended for sale, lease, rent, or exchange according to a on, t alterattoo,orrelocation: 2 ess
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
Branch circuits - new alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
' Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
'i E *- PLAN REVIEW ( Please check all that apply) : - - , . Misc. (Servce or feeder not Included)
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* - - 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description: •
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other: Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _- %) $
Credit card number: - - — — — / /- within 180 days after it has been State surcharge (8%) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6A0/COM)