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Permit
CITY OF TIGARD MASTER PERMIT a. COMMUNITY DEVELOPMENT Permit #: MST2009-00082 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/30/2009 Parcel: 1S134DCO5200 Jurisdiction: TIG Site address: 11700 SW 113TH PL Subdivision: Lot: Project: STILSON Project Description: 480 sq. ft. addition. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 480 sf Basement: sf Left: 5 Parking Spaces: Height: 10 Bathrooms: 1 Second: sf Garage: sf Front: 20 Smoke Dwelling Units: 0 Third: sf Right: 5 Detectors: Yes Total: sf Value: $0.00 Rear: 15 PLUMBING Sinks: Water Closets: 1 Washing Mach: Laundry Trays: Rain Drain: Catch Basins: Lavatories: 2 Dishwashers: Floor Drains: Sewer Lines: SF Rain Drains: Other Fixtures: Tubs /Showers: 1 Garbage Disp: Water Heaters: Water Lines: Bckflw Prevntr: MECHANICAL Fuel Types Air Conditioning: Vent Fans: 1 Clothes Dryers: Natural Gas Heat Pump: Hoods: Other Units: 1 Furn <100K: Vents: Woodstoves: Gas Outlets: Furn > =100K: ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 -200 amp: 0 -200 amp: W/ Svc or Fdr: Ea add'I 500 sf: 20 1 -400 amp: 201 -400 amp: 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 401 -600 amp: Ea add'I Br Cir: 601 -1000 amp: 601 +amp- 1000v: 1000 +amp /volt: ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: HVAC: Security Alarm: Vaccuum System: Garage Opener: All Other: Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD Single Family VB R -3 480 Owner: Contractor: Required Items and Reports (Conditions) JOHN STILSON ROOPER CONSTRUCTION 11700 SW 113TH PL 3749 N MELROSE DR TIGARD, OR 97223 Portland, OR 97227 PHONE: 971 -506 -5850 PHONE: 503 - 481 -2154 FAX: (503)281 -5271 Total Fees: $1,627.03 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 one in acc• .ance 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 80 days. ATTENTI• • e. egon I requires you to follow the rules adopted by the Oregon Utility Notification nter. Those rules are set forth in OAR 95 001 -0010 through OA' • • - -001-1 I r ou may obtain a c py of the rules or direct questions to OUNC by calling 503.246 99 or 1.800. 2344. Iss ed By: ` ( . Signature: if %, CITY : OF TIGARD BUILDING DIVISION PERMIT #007 1,009 .00 % ' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ...'' INSPECTION WORKSHEET FOR DATE: - O TIME: PAGE: SITE ADDRESS: II I t L . CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: • PHONE #: Inspection Request Scheduled For: Date: 6-1 ®q Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments/ Instructions: Vi )0 V a.‘ bax` ko.2I"• lIO. 3 (A, C I \ Weft- i S r k s e w ► (Li AZI 4 i s', t4Q) 2 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS OVAL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • MG Date: 611 Phone #: (503) 718- 111LO's . .. . . . . . . . . . . . . . . . . ._ . ,- . .. . . . , ' r-1,i' `cji ' rcr li 'ck - if" r .1 --,=. 'Wis f lif.L ' r..„—_ .. ri '-a ' - . . . . , - • .' I a l, ,-.„-f ;IA 1 0 ','--- ..,',.• ■ : g http:/1wv, s t . X , .1 :,. :;, ,,, File Edit View Favorites Tools Help ..? ‘1 qi ' El ifign - a , Page ■ - 1:1), Tools ■ 00 ■ , i,„ ; , -- ' 4 .3 11700 SW 113TH PL -- .. . _ . , ,... . . ...... Pnaperty ,,, ••• , . . , __ - • i ' . 1 • i • 1 a _ .., - . , „.. . . . 1 _ _ , z _ 1 J■ '1 , ..., . . . .... - - ... ( - 1' 1111111111Prliiiiii".‘' , — — - __ r. . . _ . . TIGARD ST ‘ , 1 . . _ . rja • . 0 • ,.* 1 .-"). ' -•• ,, , . i 11 . 1 ' •-, ' i• . 1- i; w - -- ; . -_ ■ ; > 1 1 a z ... i I! ' - 2 • •-- i `.- - . 1 , , , 1 eV ---r—i' 0 - WALNUT ST Lu 1 P . . L e n) r) rJ3 ; . r . _ Fu Me( STS _ - DAWNS CT . 1 . , . . i - , > - < 113 Prace Greer) way i . X ■-•3 . . . . 1— • - 4Tea do peg raae i Property Owner Info Tax ID Number: 1S13. Tax Acccunt Number: 'R.27033-1 Site Address: 11700 S; 113TH PL Site City: Site 7 I?: 97223 Cvner 'Address: _ .....________ Done 9 Internet (.+: 100% • .. , -----_---- Inspection List :,---; Inbox - Microsoft .. L ... • .. .,..... • 'W1did;; isi sfi Etir • _ _ IA14 https:/, - - - File Edit View Favorites Tools Help d'• 0 Ltl]' Page ■ Tools ■ a .3 - CAP ID: IVIST2009 Help _ f:GoTo Summary CAP ASI - Building A SI - Electrical ASI - Mechanical ASI - Plumbing Activities (0) Activity Summary .. 1 . 1 E File Date: c •-•a• Application Status: - .ss.;.•c, Application Detail: Deta Application Type: Type: Euilci,; • s Address: Owner Name: ;o-r •:: Owner Address: L :::T G . c cr 7223 Application Name: STILSON Parcel No.: Contact Info: - - — • -- Licensed Professionals Info.: Primary License Number License Type Name Business Name • Yes :3021 CC E- ROOPER CONSTRUCTION Electrical OWNER Plumbing OWNER. • Description of Work: Job Value: .- – Total Fee Assessed: Total Fee Invoiced: Balance: Application Spec Info.: 0 Internet :+ 100% - n Inspection List Inbox - Microsoft 1 6 0 ervw .5;1 gg tit 7 :13 AM . . • • . : ---p , .1 l - - I i W I n d r_iii.' . iii (_n:_-?? El: Ell rjrt=?! _ _—__ _ - - -- -- - • .. . ii0V, - ,„ ■ 0 https://ay.accela.cornijetspeed/portal/media-type/htmlluser/TIGARD.GNOBLEIpacieldefault.psmIljsk; 5 ; , 41. , X :,.. : - - : P ..._,- . . .. File - Edit View Favorites Tools Help - - - - --- - -- Ei :,1 ' L Page ■ '.f,} Tools ■ Ii4 L', ."'.. 0 - 200 amp: - 201 400 amp: ---1 _ 401 - 600 amp: ■ 601 - 1000 amp: _ ! 1000+ amp/volt: _ TEMPORARY SERVICE FEEDER - • -= 0 - 200 amp: ---_-_=- 201 - 400 amp: -- 401 - 600 amp. - 601 - 1000 amp: _ -,__--, BRANCH CIRCUITS 4 With Service or Feeder: -.._.=-. Without Service and Feeder: ,....._.--= -._,----. ._ < RESTRICTED ELECT RESIDENTIAL -- 1 Audio/Sterec: _ Security Alarm: _ • I r 'I :----,__ --__---= Garage Door Opener: _ :;-_---_- HVAC: - .:-_----_- Vacuum System: _ r Other: ' Other Description: , , All Encompass _ ing: := 1 • -=----: .= 0 Internet 1 :: 100% - . s a ' . Inspection List I , 2..1,-,' Inbox Microsoft , ill 716 AM A Information Notice to Owners About 4:' Construction Responsibilities N r_ r : (ORS 701.055 (5)) Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: • Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: • Oregon's Withholding Tax Law: Employers 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: Employers 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. • Oregon's 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 go to http: / /www.oregon.gov /DOR /BUS /docs /211- 055.pdf for the appropriate forms. • Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation Insurance for their 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 workers 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. • Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from employee wages. You may 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 website at www.irs.gov. Other Responsibilities of Homeowners: • Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. • Property Damage and Liability Insurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation Insurance. • Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough -in and finish trades. CONSTRUCTION CONTRACTORS BOARD 700 Summer St NE, Suite 300, PO Box 14140, Salem, OR 97309 -5052 Telephone: 503 - 378 -4621 — Fax: 503 - 373 -2007 Website Address: www.oregon.gov /ccb f /property_owner adopted 12 -04 -07 This Copy for Permit Applicant ► RECEIVED Property Owner Statement FEB 2 6 2009 Regarding Construction Responsibilities CITY OFTIGARD Oregon Law requires residential construction permit applicants who are not licensed w8U1th8ING DIVISION Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) 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. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: ( 7t) VI- C(1w 0041CT►v11 S30 2( 4/713/° Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. 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 select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. 1 . - ) o r� Prin me of Permit App scant _ Z — 2.9 - o Signat re of Permit Applicant Date Permit #: 1 — t 01- 9 , 0C9 Address: 1 M 1 C • ft.7 �; �1 /r a; 02 97 ,.2 -3 ; t .h.., � Issued by: Date: 1.1. This Copy for Permit Offices j idin2 Permit Application RECEIVED Residential FOR OFFICE USE ONLY City of Tigard FEB 2 3 2009 Received : Q --1' Permit No.: o , . 0: a. 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 2 CITY OF TIGARD ' II Phone: 503.639.4171 Fax: 503.598.19 DateBy: ( i ' 3 I Ocher Permit: TI G A R D Inspection Line: 503.639 Date Ready/By: 2 /� s: 0 See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION N ot' ied/Method :e ( fos T 1 C 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 g Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. L{ CATEGORY OF CONSTRUCTION (4'78.CO Valuation: g 1- and 2- family dwelling ❑ Commercial /industrial "T ❑ 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: / ( 700 s t. ( 15 e t v New dwelling area: 40 square feet City /State /ZIP: T1q 4 4,(N O2 y -117, Garage /carport area: square feet Suite/bldg. /apt. no.: 1 Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: y e4' square feet 5 i.) T I 1 A CA> sr. Le-f-- 0A) 03 Pc Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the 11 DESCRIPTION OF WORK work indicated on this application. 0 9 A z 0 OM- Soo R 1 AO b t Al g d Valuation: $ 5.14 i DA. tifVf il C1as�e4 Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: A ( S S} t L 5..9'0 Type of construction: Address: (11 D 0 ,f LA S (1 ; t - , Occupancy groups: City /State /ZIP: It ,‘1,,, 0,41 DP-- Existing: Phone: (11) 50b 545 Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: V.l%4D )'ili. Gds VW. LT 1a , j All contractors and subcontractors are required to be Contact name: c.640,--rr R in-- licensed with the Oregon Construction Contractors Board nap P under ORS 701 and may be required to be licensed in the Address: c T 3T Ir, 0 (M f L .O 51... be, jurisdiction in which work is being performed. If the City /State /ZIP: t ` I r ( �Q O ZZ'� applicant is exempt from licensing, the following reasons apply: Phone: (' )3) 44 l ..- 2_1 S S Fax:: ( 5b3) Z g I - s-2 E -mail: Sroof ( Co-.c,"4- . 1 CONTRACTOR Business name: p f Ct. &G X ) 3 TR.t. h' BUILDING PERMIT FEES* Address: C (Please refer to fee schedule) _ City /State /ZIP: Structural plan review fee (or deposit): FLS plan review fee (if applicable): Phone: ( ) J Fax: ( ) CCB lie.: J d0A ( 7"A /D Total fees due upon application: 320. L IS Authorized signature: )Ca Amount received: Thi perm ap plication expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Se 0? r Avi AC.- Date: L / L 1 /0 9 * Fee methodology set by Tri- County Building Industry Service Board. I: \Building\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(l1/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Date/By: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 0 Electrical ❑ Plumbing 0 Mechanical 1 it,A.:U Internet: www.tigard- or.gov 0 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. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets 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 ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore • on and shall be shown to be ap • licable to the project under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1 /2" x 1 1 or 11 - x 17'. ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440.4613T(I1 /02/COM/WEB) Electrical Permit Application FOR OFFICE USE ONLY �jq� (% 111111 • City of Tigard Date/By: No.: rj Zf�OO 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit: TI G A R D Inspection Line: 503.639.4175 Date Ready/By: tuns: 0 See Page 2 for Internet: www.tigard - or.gov Notified/Method: tat 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. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 11100 S ta,; 11 3 if aj 'Pe, 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: 1 p...0 p ,p (Z Q 1 ZZ El Health-care facilities. ❑ Supply voltage for more than 'l © 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: 1 - k..4$ -TA � Ri) SJ . k Description I Qty. I Fee. 1 Total (� I New residential single - or multi- family dwelling unit. Lf, {,�f a v. (t 3 1-s P Liter f Tit 3 Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'l 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 `it.{, aka }td,. -e 1 I Al`iJ; residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 gir PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: '� c4-_,....500 601 amps to 1,000 amps 240.60 2 Address: ((.1 to S t,,y (1 3 e LA-4.,e, Over 1,000 amps or volts 454.65 2 City /State /ZIP: 1 ©� _I /: Temporary services or feeders installation, alteration, and/or 1 relocation Phone: ( el 1 ) Spc, - t1 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This in ation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for se, ren' i ge, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature. � Branch circuits — new, alteration, or extension, per panel ture -`�S D Z'2 �' A. Fee for branch circuits with rI APPI)ICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name. B. Fee for branch circuits Contact name: without service or feeder fee, ! 46.85 4 2 first branch circuit Address: Each add'l branch circuit / 6.65 L.6 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: e) &) E u Signal circuit(s) or 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: 6 5-U' Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): .,k2, Authorized signature: TOTAL PERMIT FEE: q Z 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(11/05/COM /WEB 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* H Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation n F ire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ O utdoor Landscape Lighting* ❑ P rotective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\ Building \Permits\ELC- PermitApp.doc 03/23/06 Plumbin Per g mit Application • Building Fixtures FOR OFFICE USE ONLY City of Tigard Received i' �� Permit No.: Nyn r y Date/By: g �� 1114 ■ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review = Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit No.: TI G A R D Inspection Line: 503.639.4175 Date Ready /By: Juris: 0 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 Qty. 1 Ea. 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 g I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building El Multi-family SFR (3) bath 399.00 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: f/ 70t) S (A) // 3 / - 4 f Catch basin or area drain 16.60 City /State /ZIP: • 77 940 1 7 7 y 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: 1 Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: _) Page 2 Subdivision: I Lot no.: 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 e (o. n j, s (,oto€,., y',� ; 4 z ✓u , J7 C o uk r Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ,`PROPERTY OWNER I 0 TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: jot+ NJ 51I G / Expansion tank 16.60 'O s-44) Address: // 7 ) /I) / 4 (i Fixture /sewer cap 16.60 City /State /ZIP: 77 1 4, a• o ti en 7 - y 3 Floor drain/floor sink/hub 16.60 Phone: 6 7/) 5© 5 5 ■ Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State /ZIP: Roof drain 16.60 Phone: ( ) Fax: : ( ) Sink/basi atory 2- 16.60 Tub /shoe er pan ` 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet l 16.60 1 r t Business name: c Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 7Z. .12) CCB Lie.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature � P-.;;"7,0 TOTAL PERMIT FEE s t jL,(2) Print name: A N Sil le-s0 4V Date: 2 - Zl _0 ci 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. I:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440 -4616T(I0 /02 /COM/WEB) • Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 t 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Commercial Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. -3" - 4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet _ Urinal Other Fixtures: is\ Building \Permits\PLM- PemritApp.doc 12/27/06 '. Mechanical Permit Application RECEIVE I FOR OFFICE USE ONLY City of Tigard Receive e/B d , • • • Ct , Permit No.: u e 1 4 1O� 0008 ■ III 13125 SW Hall Blvd., Tigard, OR 97223 FEB 2 3 2009 Plan Review = Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: T I c; A R D Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: rin 0 See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISIO otified Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction ❑ Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ® Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* Et I- 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: 1 00 `� 3 1►, p / Air conditioning or heat pump 5 ( t 7 1 1/ (requires site plan showing placement) 14.00 City /State /ZIP: T% 1 604) O 4-77-2,1 Furnace 100,000 BTU (ducts /vents) 14.00 1 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 l Hydronic hot water system 14.00 50 1 -Qd S T. .44- , + .44- 0 -fh Pi, • Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Flue /vent for any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 0 ` f� //` Gas fireplace 10.00 il A talk 4 - W I - o eA c ( t 1149 A�1t, 044 ALPS 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 Cif J Other 10.00 Name: To tJ S T , LS01..) Environmental exhaust and ventilation l 7 Sl s) H {b Range hood /other kitchen Address: � - �, . equipment 10.00 City /State /ZIP: T i(VQ D 0 ti a 772.-3 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (et?? ) 5-6-0 Fax: ( ) toilet compartments, utility rooms) 1 6.80 g APPLICANT ❑ CONTACT PERSON Attic /crawls ace fans 10.00 Business (n� Other: 10.00 usiness name: go Cp 444- Co nG 7 R U I (L Fuel piping Contact name: Scp-n- Rcv n t G _ $5.40 for first four; $1.00 for each additional Address: x74: N ME I, go Sq D4, Gas h ea t etc. Gas heat pump City/State /ZIP: p 4..( v J of e . 77. Z. Wall /suspended/unit heater Phone: (9,3) Li t ( 2.4 � II Fax: : (5,2) Z.' I 52.7 ) Water heater Fireplace E -mail: c Y'Ob Q e rAw.er -‘. ( , we-4 Range CONTRACTOR Barbecue Business name: r// Co 1u -. /OA Clothes dryer (gas) Q Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: State surcharge (12% of permit fee) TOTAL PERMIT FEE / — Authorized signature: , ,0-40- 7 This permit days after t has been accepted as competed within 180 Print name: CO Tr i �pfA— D ate: �l3 ;/ p!� " Fee methodology set by Tri- County Building Industry Service Board 1:\ Building \Permits\MEC- PermitApp.doe 01/19/07 440-4617T (1 1 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2 N( RECEIVED �v� � �F 2 3 2 ELEV 24' 1 1 3 �VA1LL3 Sc . l % �� } I ELEV 48- BUILDING DIVISI ®N ELEV o ELEV sr . f L \ ......whu s _ - erosion co 4roJ fence PGE tra - • -. r 3" rain _ 1 d- Late \ ■ • : FFE 45" concrete driveway and 4pproach addition GARAGE 'trio-- — — I FFE 54" i FFE 54 ., f 1 concrete yea& .. _ -_._. _ N \ \ \\\\\ 4 = 4 concrete waik I t *\,., �1i � ` `t � •' i I area deck \ -t, , \ . — — — — — . 3.ra. wale rr,eter / ■ ■ i / ELEV0- ELEY EV 24" 4 t +� C k 1 {n (� Pt Le- tCEV 48' 5'-r-, 1)flQ S5` 11 J tL T ��p.. „T .D Qy 6cotr po- 3 p, M 4. ,. x0.5 �a 1 0 c � p � �( � .2 1 5 �1 PoFZ -ANv1 Old- q1)--2-7 CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: 0 200`t' cDCCNI1NMINIIIII PLANNING DIVISION: roved ❑Not Approved Required Setbacks: App__ Side: Street Side: Rear: Front. ...;&._ Garage: Approved Qf Approved ❑ Not App P �, �/ i. .�t:a! Clearance: f eet ;::ximum Building Height . _ Yes ❑ No 01S Service Provider Letter Required: ❑ ❑Received ' , 1 dAtAl Da ENGINEERING , EPARTMENT: Not Approved Actual Slope: % Approved ❑ of Ap roved G Approved ❑ Z t d Y Site P1: Date: Notes: 4 vu"`--- SITE PLAN REVIEW CITY OF TIGARD - r 2 •� . �� BUILDING PERMIT NO: V ❑ Not Approved pproved N Approved Street Trees: Approved ❑ Protected Trees f Date: Notes: No 0 Ac i3 ,,y Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 1451 27. 600 S Z Jurisdiction: Site Address: t nv© S (CO P\ Subdivision/Lot #: and /or Map and Tax Lot #: 1.S/ 3 y0G -05 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: 7 g Owner/ eneral Contracto' /Authorized Agent Print Name: W. Ce Orr WOO pia- 1 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. . I:\Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 • Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, S<_oi`Y fop , am the general contractor or the owner - builder at the following address: Site Address: \ -700 SiA) L3 F 0( City: ()-i2-1) Permit #: 2_00 -000Y Z Subdivision/Lot #: and /or Map and Tax Lot #: j 513,,„ 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: fN e Date: to •Q General Contractor or Owne - guilder I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08