Permit CITY OF TIGARD MASTER PERMIT
111
m COMMUNITY DEVELOPMENT Permit #: MST2010 00144
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/08/2010
Parcel: 2S104DB01400
Jurisdiction: Tigard
Site address: 13036 SW BROADMOOR PL
Subdivision: AMESBURY HEIGHTS Lot: 14
Project: Young
Project Description: Removing wall in lower level.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front 0 Smoke
Dwelling Units: 0 Third: 0 sf Right 0 Detectors: Yes
Total: sf Value: $4,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
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 add'I 500 sf: 0 20 1-400 amp: 0 201 -400 amp: 0 1st W/0 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)
YOUNG, THOMAS R & ANITA A CUSTOM BUILT INC.
PO BOX 4017 22865 NW YOUGEN RD.
BEAVERTON, OR 97076 Hillsboro, OR 97124
PHONE: PHONE: 503- 648 -4411
FAX:
Total Fees: $238.13
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 i - ,— • , -= . VI 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. ENTION: Oregon • • ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -•01 -0010 rough OAR 952 -I • ' -01, 0 You may obtain a copy of the rules or direct questions to OUNC by calling 503. 6699 or 1 i
Iss ed By: 1/ h /"` Yo a..� Permittee Signature: —i` 1/ ..l.%"
Building Permit Application ��� , . ' .�"�
-- E'Oflhiflere P - S i s k l i cA C V i N1 1 6 1 ) ro R O I- F i c i.: U S ► : o N I. I
City of Tigard tl Received
R Y
i Permit No.: k J
rk
Date/B : / ,
13125 SW Hall Blvd., Tigard, OR 97223 9 ' L ' ��'7,
' Phone: 503.639.4171 Fax: 503.598.1960 At\Cj � ew `y r • 23 O Other Permit:
. i r, A it 10 Inspection Line: 503.639.4175 ,, PRII Date Ready/By: Juris: _ ® See Page 2 for
Internet: www.tigard - or.gov CI • (AF -` -' L. fied/Method: 3 r v ,] Supplemental Information
TYPE OF WORK B'�}1LDLN�� J REQUIRED ATA•: 1- 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 applicatitnr.
El 1- and 2- family dwelling ❑ Commercial/industrial Valuation: g f kX)
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 73 01 4 S L.) P iO 0.aft ' 1 1 New dwelling area: square feet
City /State /ZIP: ` f ,A .0 / 9) z. Z,� Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: y o VK y Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
Re l( � N t OW e./ 1-12_, - o Valuation: $
tl -ems Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER J ❑ TENANT Number of stories:
Name: a l •k y Type of construction:
Address: S .j2... Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) 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: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR
Business name: c.„..}-p, / U /1) LO (* I 1 �� BUILDING PERMIT FEES*
Address: Z Z S , S W Y f;J L� �j�� (Please refer to fee schedule)
City/State /ZIP: ) 4, C S ? I � Structural plan review fee (or deposit):
Phone: ( 0.3) Z 6 d o Z 2 Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: L" 75-� Total fees due upon application: t�i "�, L.-15— Amount received: $ 8-7 & S
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ! E e ., l 4w Date: IR.., r 9r Gv * Fee methodology set by Tri -County Building Industry
J Service Board.
1: \Building\Permits\BUP -COM PerrnitApp.doc 10/01/09 440- 4613T(11 /02/COM/WEB)
,
i e Building Division
Accessibility: Barrier Removal Improvement Plan
TIGAILD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building \Permits \BUP -COM PermitApp.doc 06/25/08