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Permit Th-s/, u Gdol(2- -k all e rvcc o,Ss,w 1 v� vom it t o v CITY OF TIGARD MASTER PERMIT il ffi COMMUNITY DEVELOPMENT Permit #: MST2010 00115 T 1 G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/30/2010 Parcel: 2S101DB00617 Jurisdiction: Tigard Site address: 13360 SW 76TH AVE Subdivision: ROLLING HILLS Lot: 25 Project: Thackery Project Description: Remodel and 464 square foot addition. 8/25/10 added all encompassing low voltage. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 464 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 2 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units:' 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $80,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 4 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 3 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea addl 500 sf: 0 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea addi Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) THACKERY, RUSSELL H III & JOSHUA D CHRONISTER 1 MST Ersn Cntrl 503 - 681 - 4444 AMY E, 13360 SW 76TH AVE PO BOX 1296 TIGARD, OR 97223 North Plains, OR 97133 PHONE: PHONE: 203- 810 -7447 FAX: 503 - 647 -7295 Total Fees: $2,792.12 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or If work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 -001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By / —.— Permittee Signature: -� : CITY OF TIGARD MASTER PERMIT f ,- COMMUNITY DEVELOPMENT Permit #: MST2010 00115 k �a, : Date Issued: 07/30/2010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101DB00617 Jurisdiction: Tigard Site address: 13360 SW 76TH AVE Subdivision: ROLLING HILLS Lot: 25 Project: Thackery Project Description: Remodel and 464 square foot addition. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First 464 sf Basement: 0 sf Left 0 Parking Spaces: 0 Height: 0 Bathrooms: 2 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $80,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 4 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs/Showers: 3 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 0 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir: 601 -1000 amp: 0 601 +amp- 1000v. 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) THACKERY, RUSSELL H III & JOSHUA D CHRONISTER 1 MST Ersn Cntrl 503 - 681 -4444 AMY E, 13360 SW 76TH AVE PO BOX 1296 TIGARD, OR 97223 North Plains, OR 97133 PHONE: PHONE: 203 - 810 -7447 FAX: 503 - 647 -7295 Total Fees: $2,708.12 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 wit be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center- Those rules are set forth in OAR 952 -001 -0010 through OAR 952- 001 -0100. You may obtain : • o e > - • r direct questions to OUNC by calling 03.246.6699 or 1.800.332,2344. Issued B �i �" — — _ 440 PermitteeSignature: __ . nsew lip, Building Permit Application RECEIVED � � . ., . e7D z : f - -��, ----.- - Residential 1..(ilt OFFICE I ICE'. IHSI. O \I.1` JUL 06 201 City of Tigard DateB Received ?. W to Permit No.:. g 10 ....06 /1 13125 SW Hall Blvd., Tigard, OR 9722 CITY OF TIGARD Plan Review 0 � Other Permit: Phone: 503.639.4171 Fax: 503.59 � C DW Date/By: G DIVISION c �1 1 . l G ` it it Inspection Line: 503.639 Date Ready78 briar 1 . See Page 2 for Internet: www.tigard- or.gov Notified/Method: 7 34,c) fdTT— at( Supplemental Information A.S w 71 - SOS IN 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 ❑ Commercial /industrial Valuation: $ e(l,( L'• .� ❑ Accessory building ❑ Multi- family Number of bedrooms: 0 '�� El Master builder ID Q 8 Other: Number of bathrooms: -' 4011• SIIE INFORMATION AND LOCATION . . Total number of floors: Z. Job site address: ( "3 2 0 St.,..) 76 T \-- New dwelling area: GL! square feet City /State /ZIP: .+I\ C.`� C1 7� i Garage /carport area: square feet Suite/bldg. /apt. no.: tJ Project name: -- t - V N C V LV-r ; ,;� t 1 Covered porch area: square feet Cross street/directions to job site: J Deck area: square feet �0 Other structure area: square feet CN • REQUIRED DATA: COMMERCIAL- USE'CHECKLIST • •...), Subdivision: Lot no.: Permit fees* are based on the value of the work performed. ZIN Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all O equipment, materials, labor, overhead, and the profit for the 0 DESCRIPTION 'OF .WORK`. work indicated on this application. M l o∎ .. i?n■ • c )...5 V)..; Ae,.NN- 5 L I (,z-i S, Valuation: $ r Existing building area: square feet 1 New building area: square feet • •❑ PROPERTY 'OWNER . I ❑ TENANT : %'' - Number of stories: Name: tZt.- 5Pts 1 C_kv :-:• lW Type of construction: Address: 1 3 ) .---4)-1 " F -•'‘ Occupancy groups: City/State/ZIP: r `� y : L`tv & L>1 v 5 Existing: Phone: ( -) CT, - -1 b.1. :,6 'A Fax: ( ) New: ❑ APPLICANT ❑ .CONTACT PERSON . NO 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: applicant is exempt from licensing, the following reasons apply: y: Phone: ( ) Fax:: ( ) . E -mail: CONTRACTOR:' Business name: J V). C AN/ 0Y - \. - z.. k' { (" ' 11 ' f.J<- 11 C -'.^ . BUILDING PERMIT.FEES* • : - .(Please refer fee schedule) Address: P.0.. (f• 12w6 Y �. L J �,, • Structural plan review fee (or deposit): M City /State /ZIP: • (4,-,. �‘cr )e t=( ( 7 FLS plan review fee (if applicable): Phone:(` O) (6 iC; 7t-1H I Fax:C1-411 ) 4 7-) -( -72 Total fees due upon application: 4 (I_ 0,20 • Y g CCB Iic.: ( yit coo (p y lY 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: ��A C \^1rCv∎■ ' v' I Date: 6 •- J ^ 1 U * Fee methodology set by Tri -County Building Industry Service Board. 1:\Building\Permits\BUP -RES PermitApp.doc 10/01/09 440 -4613T(11 /02 /COM/WEB) • ` 4 • 4 ii — Building Permit Application Checklist One- and Two - Family Dwelling I OR Ol l lcl 1i'1 ;ONl.Y City of Tigard Received Permit No.: RI 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: IA Phone: 503.639.4171 Fax: 503.598.1960 Associated perrmts: 24- Hour Inspection Line: 503.639.4175 CI Electrical ❑ Plumbing ❑ Mechanical TIGA . Internet: www.tigard- or.gov 0 Other: . 1 . 1 - i t r()u. 1:ci iN(, r i . rMS. � ;Aizr zi.QuI RED. FOR PLAN. Ill. I E.W-. 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. 1 1 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property comer 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 Toad. 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 l on and shall be shown to be a • . licable to the s ro'ect under review. IURISI)IC " I IONAI. Sf'I:C IF: ICS : 23 Three (3) 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 ❑ ❑ ❑ 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- 46I3T(11 /02/COM/WEB) Electrical Permit Application R � ��y " I (!“) I :Ic,l': uSI' ONl City of Tigard V Rece Permit No.: ∎ D ��l 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review TM 7� ' Phone: 503.639.4171 Fax: 503.598.19601 /� 0 ,; DateB 7 r DateB : Other Permit: .1.1.6 A It D 6 Inspection Line: 503.639.4175 / Tit 0 Date Ready/By: luris: ® See Page 2 for Internet: www.tigard - or.gov R C �, I , T ,,� Y OF TI Notified/Method: Supplemental lnformation TYPE OF'� II )I GA PLAN REVIEW New construction Addlti n/alteration/repllac ® I - 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 ", "I -3 ", it 100HP or more. occupancy. Job no.: Job site address: 3 ',L.) 7( ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: J h j ZZ ❑ He facilities. ❑ Supply voltage for more than �� l ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: f ti (J �t ❑ Service or feeder 600 amps or more. 7;ts t�£�i�t I FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 67.84 2 • 'DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 67.84 2 ` t✓ .\-(--) ENv"'S \-- l :.:∎ t r`-tt )( J- .- residential (with above sq. ft.) \ ) Services or feeders installation, alteration, and/or relocation L. 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 ��.,,``..LL .75---' 401 amps to 600 amps 200.34 2 Name: ti7c'C t ca- °' 601 amps to 1,000 amps 301.04 2 Address: 11/1:c 0 : &J -7c t Over 1,000 amps or volts 552.26 2 �' -7 Temporary services or feeders installation, alteration, and /or City/State /ZIP: 1 •t - �N `�� q L 3 relocation Phone: ( 2 •! L 5 66 p/ Fax: ( ) 200 amps or less 59.36 1 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to 447, 449, 670, d 701. Branch circuits — new, alteration, or extension, per panel Owner signature: FuS Q S (. / Date: A. Fee for branch circuits with ❑ APPLICANT . .7 above CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: 13. Fee for branch circuits without service or feeder fee, first i 56.18 2 Contact name: branch circuit Each add'I branch circuit ' 7.42 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: • Each manufactured or modular 67.84 2 tY `"'' dwelling, service and/or feeder Phone: ( ) • • Fax: : ( . ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: • • Sign or outline lighting 67.84 2 'CONTRACTOR` Signal circuit(s) or limited- energy Business name: (a() n panel, alteration, or extension. Page 2 2 ` (� Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: Investigation (1 hr min) - 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (%2 hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL 'PERMIT FEES ' - Subtotal: l; fr Suprv. Electrician signature, required: r Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): Q TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtain4 within 180 days after it has been accepted as complete. Print name: I Date: • Number of inspections allowed per permit. I:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11 /05 /COM/WEB • <a - Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: . Fee for all residential systems combined ... $67.84 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: . Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation • El Intercom and Paging Systems ❑ Landscape Irrigation Control* %, ❑ Medical • . • ❑ Nurse Calls Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building\Permits\ELC- PermitApp. doc 10/01/09 Mechanical Permit Applicatio> E( 'EIVED _,,_; 1 0 :: o1- 1( 1 wsi: :,(ivf., City of Tigard JUL. Received permit No `J g J J o CD (7''' Date/By: / j f , 13125 SW Hall Blvd., Tigard, OR 97223 C Plan Review Phone: 503.639.4171 Fax: 503.598.196 Other Permit: Inspection Line: 503.639.4175 C ITY OF TIGARD D a t eBy: ,-1- 1 i ; A It 1) Date Ready/By: Juris. ® See Page 2 for Internet: www.tigard- or.gov BUILDING DIV'S ION Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling f h� Air conditioning Job site address: 1 33 6 0 ) JJ 7 4 j (requires site plan showing placement) 46.75 City /State /ZIP: • ; ; , 6\ ( cf I M 1 I � Furnace 100,000 BTU ( ducts/vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: 7 A...., j . ,k,� 1 Heat pump 61.06 Cross street/directions to job site: Duct work 1 23.32 z3:52.._ Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances . DESCRIPTION OF WORK Water heater 23.32 { ( , , Gas fireplace �,` 33.39 I, „' '; M 1 e T,4)ro i', ,'X��` �f y G�, i, .i Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER I ❑ TENANT. Chimney /liner /flue /vent 23.32 Other: 23.32 Name: 1Q CSC Ili `1 ckti () i 1\ Environmental exhaust and ventilation Address: Range hood/other kitchen 7 (�)l T' 1 equipment 33.39 G� City /State /ZIP: ` ',, w I � cc_ q.-7 Clothes dryer exhaust 33.39 l Single -duct exhaust (bathrooms, p � Phone: (602-0 -7 b _( 6 9 Fax: ( ) toilet compartments, utility rooms) 23.32 '°ccl ❑ APPLICANT ' ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: Fuel piping Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax :: ( ) Water heater Fireplace E -mail: Range CONTRACTOR • Barbecue • Business name ' Clothes dryer (gas) �{{ �� ( / no,. 5'yt Y c��° -(vCJR Other: Address: 1 , O , tP_ 1. 1216 MECHANICAL PERMIT FEES* City /State /ZIP: '* t� . �� 0 Cf ( � 7) Subtotal 61, w —` M inimum perm fee ($90.00) fQ 04 (`X) ) v 10 -- 19 i f Fax: a � -,7c(, J )ct� J Plan review (25% of permit fee) CCB lic.: j (iboo State surcharge (12% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signatur days after it has been accepted as complete. Print name: c_ t Date - ,2„.9-1 0 • Fee methodology set by Tri -County Building Industry Service Board 1:\Building\Permits\MEC- PermitApp.doc 10/01/09 440.4617T (1 I/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation:. Permit Fee: - $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. — Note: All new commercial buildings require 2 sets of plans. 1:\ Building \Permits\MEC - PermitApp.doc 10/01/09 2 Plumbing Permit Application �i ` Building Fixtures RECEIVED �� 1 OR 1 1 I Ic , I ;; Ilti1 (ill 1; City of Tigard I Received ` J I �� Permit No.: K5 • 13125 SW H Blvd., Tigard, OR 97223 J �' 0 6 (f ` i Date/By: ao�0 ; C ' Plan Review Ph one: 503.639.4171 Fax: 503.598,19,611 , Date O F TIG Date/By: Other Permit No.: Inspection Line: 503.639.4175 i I ti it I ( j Date Ready/By: furls. ® See Page 2 for Internet: www.tigard_or.gov BUILDING DIVISION Notified/Method: Supplemental Information • TYPE OF. WORK • .. • - " FEE*- SCHEDULE • ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION • . SFR (1) bath 312.70 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 building SFR (3) bath 500.32 ❑ Accessory g ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: . Job site address: 1 3c,.. �� h Catch basin or area drain 18.76 ' City /State /ZIP: �- �1k Drywell, leach line, or trench drain 18.76 ^ 0 R �� Footing drain (no. linear ft.: _) Page,2 • Suite/bldg. /apt. no.: I Project name: AC�' -,t' i' ,,t � - 'C A Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: . ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: _) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 .DESCRIPTION. OF WORK Backwater valve 12.51 Clothes washer j 25.02 2_ t Q?� ma t A - t 4 V\ It) C:7 C:7 k /"t--� 4 a:, �� t V 1 46 tI 5 Dishwasher 2 J ` Drinking fountain 25.02 Ejectors /sump 25.02 • ',('PROPERTY. OWNER I ❑ TENANT Expansion tank 12.51 Fixture /sewer cap 25.02 Name: 1\ -I .'Ll 1 li Address: �� C tom �` Floor drain/floor sink/hub 25.02 I Garbage disposal 25.02 City /State /ZIP: 1 �) x OI -. q 1 Z � � Hose bib 25.02 Phone: (4�'L, 97 7 ` 96E\ 9 Fax: ( ) Ice maker 12.51 . U' APPLICANT ❑ CONTACT PERSON, interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin/lavatory 4 1 25.02 'COt(p, City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan S 12.51 S E -mail: Urinal 25.02 - CONTRACTOR Water closet ).--. 25.02 �, (\ Water heater 37.52 _ Business name:" _ _ Water piping/DWV 56.29 Address: Other: 25.02 City /State /ZIP: , Subtotal a Phone: (/� � -) v Fax: ( ) Minimum permit fee: $72.50 �J Z b /y _4,--t _ Plan review ( tee.)- CCB Lic.: ,...... / Plumbing Lic. no.: State surcharge (12% of permit fee) 2,25- �� i. Authorized signature: A f4 Gr�/ TOTAL PERMIT FEE � a lam{ ✓✓ v • L Date: / This permit application expires if a permit is not obtained withi 180 days Print name: U 7 f l� -� ��(�.�1/ I �./ `D after it has been accepted as complete. / 111 *Fee methodology set by Tri- County Building Industry Service Board. 1:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities • Qtr. ; , Fee_ (ea) Total ' ,Square Footage: Permit Fee: ' Footing drain - l'' 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuat Permit Fee: • . Storm &Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for ) Fe (e a Tol • each additional $100.00 or fraction thereof, to Other+ Inspections or Fees •Qt y. - ta and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", • Plan Reviewlor Plumbing Installations, please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees Please check all that apply. 'Quantity by (Fixture) Work Performed t ❑ Any new commercial building with water service 2" and Fixture:Type: Replace greater, except systems designed and stamped by licensed Previous Capped Added 'Existing engineer. Baptistry/Font Bath -Tub/Shower ❑ New exterior plumbing site utilities for any complex structure Tub /S i/W hirlpool as defined in OAR918- 780 -0040. Car Wash -Each St ❑ Medical gas and vacuum systems for health care facilities. Drive Stall ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric..or Riser Diagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings 3 that meet the qualifications above. - 4" Car Wash Drain Garbage - Domestic Disposal - Commercial • - Industrial Comments regarding fixture work: Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial *Note: If the fixture work under this permit results in an - Service increase of sewer EDUs, a sewer permit will be issued and Swimming Pool Filter fees assessed for the sewer increase must be paid before the Washer - Clothes Water Extractor plumbing permit can be issued. Water Closet - Toilet Urinal Other Fixtures: 1:\Building\Petmits\PLMF- PermitApp.doc 2 TRANSMISSION VERIFICATION REPORT TIME : 07/25/2010 22:35 NAME : TIGARD BUILDING DEPT FAX : 5036243681 TEL . SER.# : BROD4J479592 DATE,TIME 07/25 22:35 FAX NO. /NAME 5036477295 DURATION 00:00:23 PAGE(S) 01 RESULT OK MODE STANDARD ECM City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 July 26, 2010 , „ :N RE: RESIDENTIAL ADDITION 1 I G A' 'R D; - Project Information Building Permit MST2010 -00115 Class of Work: Addition Address: 13360 SW 76 Lot Number: NA Area: 464 Sq. Ft. Stories: 1 Builders Name: Josh Chronister Subdivision: NA The plan review was performed under the State of Oregon Residential Specialty Code (ORSC) 2008 edition. Please respond to conditions below. 1) Please show sizes of all expanded footings that carry girder truss Toads, 2) What type of flooring is is being used and readable floor joist detail. 3) Provide engineered truss details. 4) What type of connection is being used at new floor to existing construction. When responding, provide an itemized letter stating in what way each numbered issue has been addressed in the revision. When submitting revised drawings or additional information, please attach a copy of the City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Respectfully, jVi 10)%rj A an Nelson Past -it' Fax Note 7671 I p�es� t Senior Plans Examiner ITo ; j 0a07(./?b � Fre„„�. • , ,,.. ,. 07/25/2010 22:35 5036243681 TIGARD BUILDING DEPT PAGE 01/01 City of Tigard, Oregon • 13125 SW Hall Blvd. * Tigard, OR 97223 July 26, 2010 RE: RESIDENTIAL ADDITION T I (1 A ;R D Project Information Building Permit: MST2010 -00115 Class of Work: Addition Address: 13360 SW 76 Lot Number: NA Area: 464 Sq. Ft. Stories: 1 Builders Name: Josh Chronister Subdivision: NA The plan review was performed under the State of Oregon Residential Specialty Code (ORSC) 2008 edition. Please respond to conditions below. 1) Please show sizes of all expanded footings that carry girder truss Toads. 2) What type of flooring is is being used and readable floor joist detail. 3) Provide engineered truss details. 4) What type of connection is being used at new floor to existing construction. When responding, provide an itemized letter stating in what way each numbered issue has been addressed in the revision. When submitting revised drawings or additional information, please attach a copy of the City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Respectfully, o. 06 5 - 2 Z r.77( 1 ' o an Nelson Post -ir Fax Note 7671 oat [vim l Senior Plans Examiner To -t-,Tfr Fem ai lOrE (503) 718 -2436 s co dann@tigard- or.gov Phone o Pe S7 a Fa C , c dst 7 72 Fax & Phone: 503.639.4171 • Fax: 503.684.7297 . www.tigard- or.gov • TTY Relay: 503.684.2772