Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
CITY OF TIGARD MASTER PERMIT rt , Ill C COMMUNITY DEVELOPMENT 44 Permit#: MST2010-00147 TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718 2439 Werittiokli. Date Issued: 11/09/2010 Parcel: 1S134CD01100 Jurisdiction: Tigard Site address: 11665 SW KATHERINE ST Subdivision: LERON HEIGHTS NO.3 Lot: 81 Project: McAdams Project Description: 1.000 SF addition 5/6/11. permit extension granted for 180 days. 3/11/14 permit extension granted for 180 days, no further extensions allowed. 3/11/14, adding (1)service panel. BUILDING Floor Areas Required Setbacks Required Stories- 2 Bedrooms 1 First 0 sf Basement 0 sf Left 5 Parking Spaces 0 Height 20 Bathrooms 1 Second 1058 sf Garage 1000 sf Front- 20 Smoke Dwelling Units 1 Third 0 sf Right 5 Detectors Yes Total 1058 sf Value $166,502.70 Rear 20 PLUMBING Sinks 0 Water Closets 1 Washing Mach 0 Laundry Trays 0 Rain Drain 1 Urinals 0 Lavatories. 2 Dishwashers 0 Floor Drains 0 Sewer Lines 0 SF Rain Storm Sewer 100 Tubs/Showers 2 Garbage Disp 0 Water Heaters 0 Water Lines 0 Drains- 0 Catch Basins 0 Bckflw Prevntr 0 Footing Drain 0 Ice Maker 0 Hose Bib 0 Backwater Value 0 Drywell-Trench Drain 0 Other Fixtures 0 Other Fixture Units MECHANICAL Fuel Types Air Conditioning N Vent Fans 2 Clothes Dryers- 0 Natural Gas Heat Pump: N Hoods 0 Other Units 1 Furn<100K 0 Vents 0 Woodstoves 0 Gas Outlets 0 Furn>=100K 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less 0 0-200 amp 1 0-200 amp 0 W/Svc or Fdr 0 Ea add,500 sf 0 201-400 amp 0 201-400 amp 0 W/O Svc/Fdr 4 Mfd Home/Feeder/Svc 0 401-600 amp 0 401-600 amp 0 601-1000 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 Cortstr: Occupancy Group: Square Feet: ADD SF :!8 R-3 1058 Owner: Contractor: MCADAMS.JACK C F.CAROL A JACK C MCADAMS Required Items and Reports(Conditions) 11665 SW KATHERINE ST 11665 SW KATHERINE ST 1 Ersn Cntrl 503-681-4444 TIGARD.OR 97223 TIGARD.OR 97223 PHONE PHONE 503-590-0200 FAX Total Fees: $4.613.10 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 do 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 day ATTENTION. Oregon law re``ui�uires you to follow the rules adopted by the Oregon Utility Notification Center Those rule are set forth in OAR 95 001-0010 r rough OAR 952-90 '09Q , may obtain a copy of the rules or direct questions to OUNC by calling 503. 2 1987 or 1 90 2.2 4 t is Issued'By:_ i ��'C�.1(. �,L Permittee Signature: �/ � l Call 503.639.4175 by 7:00 a.m.for the next available inspection d This permit card shall be kept in a conspicuous place on the job site until comple on of the project. Approved plans are required on the job site at the time of each inspection. J I. rt CITY OF TIGARD i MASTER PERMIT IIIII 5 ' - COMMUNITY DEVELOPMENT lierika Permit#: MST2010-00147 TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718 2439 Date Issued: 11/09/2010 Parcel: 1 S134CD01100 Jurisdiction: Tigard Site address: 11665 SW KATHERINE ST Subdivision: LERON HEIGHTS NO 3 Lot: 81 Project: McAdams Project Description: 1,000 SF addition. 5/6/11,permit extension granted for 180 days. 3/11/14, permit extension granted for 180 days, no further extensions allowed. -- — - BUILDING Floor Areas Required Setbacks Required Stones 2 Bedrooms. 1 First 0 st Basement. 0 s1 Left 5 Parking Spaces 0 Height 20 Bathrooms. 1 Second: 1058 sf Garage 1000 sI Front 20 Smoke Dwelling Units 1 Third. 0 s1 Right 5 Detectors Yes Total: 1058 sf Value $166 502 70 Rear 20 PLUMBING Sinks 0 Water Closets- 1 Washing Mach 0 Laundry Trays 0 Rain Drain 1 Urinals 0 Lavatories 2 Dishwashers 0 Floor Drains. 0 Sewer Lines 0 SF Rain Storm Sewer 100 Drains 0 Tubs/Showers 2 Garbage Disp 0 Water Heaters: 0 Water Lines. 0 Catch Basins 0 Bckflw Prevntr 0 Footing Drain 0 Ice Maker 0 Hose Bib 0 Backwater Value. 0 Drywall-Trench Drain 0 Other Fixtures 0 Other Fixture Units MECHANICAL Fuel Types Air Conditioning: N Vent Fans 2 Clothes Dryers 0 Natural Gas Heat Pump N Hoods 0 Other Units 1 Furn<100K: 0 Vents: 0 Woodstoves 0 Gas Outlets 0 Furn>=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]500 sf: 0 201-400 amp: 0 201-400 amp 0 W/O Svc/Fdr 4 Mfd Home/Feeder/Svc: 0 401-600 amp 0 401-600 amp 0 601-1000 amp 0 601+amp-1000v 0 1000*amp/volt 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo N HVAC N Secunty 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: ADD SF VE3 R-3 1058 Owner: Contractor: MCADAMS.JACK C&CAROL A JACK C MCADAMS Required Items and Reports(Conditions) 11665 SW KATHERINE ST 11665 SW KATHERINE ST 1 Ersn Cntrl 503-681-4444 TIGARD,OR 97223 TIGARD,OR 97223 PHONE PHONE 503-590-0200 FAX Fees: $4.554.92 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 uaj ce 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. ENTION Oregon low requires you to follow the rules adopted by the Oregon Utility Nntrfirathooi Center Those r es are set forth in OAR 952-0 -0010 through OAR,95 7-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 32 1 0 3 :234,1. Issue\y: i ef-4 r(` `�"' Permittee Signature: Y -.‘re/6-6/1" 4341/(- Call 503.639.4175 by 7.00 a.m.for the next available inspection pate. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application FOR OFFIC'F I ',I 11\I 1 City of Tigard Received Permit No.: ';t /0-40„�7 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Ill e Phone: 503.718.2439 Fax: 503.598.1960 Dateiny: Other Permit. I I c \R I) Inspection Line: 503.639.4175 Date Ready/By turfs 0 See Page 2 for Internet: www.tigard-or.gov Notified/Method Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ❑Addition/alteration/replacement Please check all that apply(submit i<sets of plans w/items checked below) ❑Service or feeder 400 amps or more ❑Building over three stones. ❑ 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 ❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. El A A of of new motor load of ❑"A” "E" "I-2" "1-3" Job no.: Job site address: ii 66,6- 61.4) Kam, 100HP or more. occupancy. ❑six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations 600 volts nominal. Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or snore. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • 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 2 DESCRIPTION OF WORK (with above sq.ft.) 75.00 CJ l 'f Limited energy,multi-family sq. 75.00 2 CL 1/-k f�, residential(with above sq.ft.) Renewable Energy _ ❑ See Page 2 /Lhr• c (10 (0 —C;/(7(7 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER L ❑ TENANT 200 amps or less / 100.70 /zic,-7C' 2 201 amps to 400 amps ' 133.56 2 Name: �t� C zt—L--4 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:( ) relocation 200 amps or less 59.36 I Owner installation:Thi installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease, • t, •r exchan le,acc•rding to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: _ / m � / ,t a Ai. z --Date:3.--// r Branch circuits-new,alteration,or extension, .er panel ❑ A' L ANT • - I ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7 42 -, Business name: each branch circuit i B.Fee for branch circuits without Contact name: service or feeder fee,first 56.18 2 . branch circuit Address: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included)- _ City/State/ZIP: Each manufactured or modular 67.84 2 Phone:( ) Fax: :( ) dwelling,service and/or feeder - •Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr City/State/ZIP: Investigation(1 hr min) 66.25/hr Phone:( ) Fax:( ) Industrial plant(I hr min) 78.18/hr . - - Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lic.: Suprv. Lie.: specifically listed('Y hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: f GG. 7e Print name: Date: Plan review(25%of permit fee): State surcharge(12%of permit fee): (g-O C( Authorized signature: TOTAL PERMIT FEE: 1/a r 7 Ce This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I:/Building\Permits\ELC PermitApp_ELR_ERE doe Rev 05/21/20 13 440.4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined $75.00 Description I Qtr. I Fee I Total I Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 nBurglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 * 50.01 to 100 kva 2 ❑ Garage Door Opener* 552.26. >100 kva(fee in accordance with 552.26 2 ❑ Heating, Ventilation and Air Conditioning OAR9l8.309-0040) System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 1=1 Other: additional inspection over allowable in any of the above: Other: Each additional inspection Is charged at an hourly(1 hr mm) 66.25/hr Inspections for which no fee is 91)00/hr specifically listed('/:hr min) _ COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL.PERMIT FEE: This permit application expires if a permit is not obtained within 180 nAudio and Stereo Systems days after it has been accepted as complete. • Number of inspections allowed per permit. ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC Ti Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* J 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 1.1Building\PermitsTLC PermitApp_ELR,ERE.doe Rev OS121/2013 CITY OF TIGARD MASTER PERMIT a 0 COMMUNITY DEVELOPMENT Permit #: MST2010 -00147 T [G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/09/2010 Parcel: 1 S134CD01100 Jurisdiction: Tigard Site address: 11665 SW KATHERINE ST Subdivision: LERON HEIGHTS NO.3 Lot: 81 Project: McAdams Project Description: 1,000 SF addition. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 20 Bathrooms: 1 Second: 1058 sf Garage: 1000 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1058 sf Value: $166,502.70 Rear: 20 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 100 0 Tubs /Showers: 2 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bcktlw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: / MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Natural Gas 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 add'I 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 4 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -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: ADD SF VB R -3 1058 Owner: Contractor: MCADAMS, JACK C & CAROL A JACK C MCADAMS Required Items and Reports (Conditions) 11665 SW KATHERINE ST 11665 SW KATHERINE ST 1 Ersn Cntrl 503- 681 -4444 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: PHONE: 503 -590 -0200 FAX: Total Fees: $4,554.92 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 1 95 - 01 -0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 .1987 or 1.800.332.2 •4. Iss / ( ' (f .' /f ' t 4_/ ed By: ` _ Permittee Signature: • I �._4Y_&.I / Aft l i Call 503.639.4175 by 7:00 a.m. for the next available inspection: `-- This permit card shall be kept In a conspicuous place on the job site until comp): of the project. Approved plans are required on the job site at the time of each ins . : • ion. Building"Permit Application Residential : ��ii���VE� FOR OFFICE USE ONLY City of Tigard ]J Received Date/B � � ��/ Permit No.: � 1 A , q 13125 SW Hall Blvd., Tigard, OR 97223 t1 At 2410 Plan Review '� L Phone: 503.639.4171 Fax: 503.598.1960 \ ', ` ' c') Da te/B : `a / � Other Permit: , r i c. n it i� Inspection Line: 503.639.4175 G PRD �` Date Ready/By: ® See Page 2 for Internet: www.tigard - or.gov . CIF T1 Cl®`I Notified/Method: 10P• ' l U 1111 // Supplemental Information C ` l ,s- wrr," JZt.ci-r TYPE OF WO W i. ' 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. p1- and 2- family dwelling ❑ Commercial /industrial Valuation: . ,0I :::"Ni Id ) 5 . 7O ❑ Accessory building ❑ Multi - family Number of bedrooms: 1 ZSjj ❑ Master builder ❑ Other: Number of bathrooms: 1 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 �(do5 S.v,/ / ` 1Lt - n 6 New dwelling area: i �, square feet City/State /ZIP: 7j 6 0A q 1 ?? , Garage /carport area: 1OOd a? square feet I , Suite/bldg. /apt. no.: / Project name: M cAdam 5 Covered porch area: N'_ square feet (C r.s Cross street/directions to job site: go j..6e ne 4— I / to T % Deck area: nA square feet I eloC, Other structure area: 2,05E, square feet ZO REQUIRED DATA: COMMERCL4L -USE CHECKLIST Subdivision: L Ms (-\ 3 Lot no.: 8 1 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 15 G _oi 1 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. Valuation: - . $ s dal o cu e Low&- Ie(F,( - -a v0o,r1) lak, ` Ue few,' Existing building area: square feet New building area: square feet jig-PROPERTY OWNER . ❑ TENANT Number of stories: Name: Carol 4 EacK lhC Gm5 Type of construction: Address: 1 I (oho 5 SSW uc I Occupancy groups: City/State /ZIP: T d) ) 0 Is . q `)a ?3 Existing: Phone: (503) 5.p .Y.1 LI???- Fax: ( ) New: (APPLICANT �^+�' `�,,� y�r ❑ 'I, CONTACT PERSON NOTICE Business name: l W ' ` 1 All contractors and subcontractors are required to be Contact name: - 504-4 1 % NWA-i.MS licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 11(2(0. 5- 50/ I'NCi,44 yen h Sf jurisdiction in which work is being performed. If the City /State/ZIP: T(( Cj"]�y3 applicant is exempt from licensing, the following reasons JJ f (�►' apply: Phone: ( i n ) sa,y . -4-f 2 Fax:: ( ) E -mail: /►� CONT . RACTOR Business name: tv c VT1) 9 eo '� BUILDING PERMIT FEES* Address: (Please seer tojee schedule) Structural plan review fee (or deposit): City /State /Z1P: Phone: ( b--( Fax: ( ) FLS plan review fee (if applicable): CCB Tic.: ' O(o r Yf I 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: c airO ( ,,,, I Date: i / iV 1 10 * 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) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard R eceived Permit No.: IN Date/By: q 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical TIGARD Internet: www.tigard - or.gov O Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0 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. ❑ ❑ a 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control 0 plan 0 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 L' ❑ ❑ 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 indic • lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and urface drainage. 12 Foun a ion p an. 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. Z. . 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 ❑ 0 ❑ 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 Lon and shall be shown to be applicable to the . ro'ect unde review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ 0 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 accompanied by the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I : \ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440-4613T(1 I /02/COM/WEB) Electrical 'Permit Application FOR OFFICE USE ONLY City of Tigard ��� Ich Received. No.: mi C7""�„ ,` x � { (� :� 13125 SW Hall Blvd., Tigard, OR 97223 �� e5 Wlan Review C ' I V l Phone: 503.639.4171 Fax: 503.598.1960 '� '`pate/By: Permit: I I G A R [ Inspection Line: 503 C c1,1 Readyy: Juris: B See Page 2 for Internet: www.tigard - or.gov P`'\J � �\ � B egelethod: Supplemental Information • TYPE OF WORK •O � 3 `- PLAN REVIEW ❑ New construction Addition/alteration/replacei i Q\" Please check all that apply (submit 2 sets of plans w /items checked below): V).\- \ CI 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. Tess to ground, or exceeds 14,000 ❑ Commercial -use agricultural K 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 ", "l -2 ", "1 -3 ", Job no.: Job site address: /� 51,41 �� f p,� p C 100HPor more. occupancy. ��IOto J I her 1 5^ ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: ?'�! / t:' - a' ❑ Health -care facilities. ❑ Supply voltage for more than { {,M { ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: MGA,dct.i►45 ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: i,.P(ier o� 4 - j { 711 Description i Qty. 1 Fee. l Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: 61 3 I Lot no/ 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: / 5' 13 co e b 1 L. 00 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) �Q ���� ) Limited energy, multi - family C4C1- C) Cl L. -I — b ec k ao I / 1 ) brA 4-1,\ residential (with above sq. ft.) 75.00 2 J a r Services or feeders installation, alteration, and/or relocation I 200 amps or less 80.30 2 IN PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: Cairo 1 (V \ . %S 401 amps to 600 amps 160.60 2 / ` � 6 S 601 amps to 1,000 amps 240.60 2 Address: etr i Y1 e, Over 1,000 amps or volts 454.65 2 City/State /ZIP: T 1 A/a Oa , a 129-3 Temporary services or feeders installation, alteration, and/or / Phone: ( 50 3) 5 �� ff?' �� _44 -?.�a' I Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, leas: rent, or exchange, . cor7g o ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: GL � i( /� ,r; a a e// f �7 Branch circuits — new, alteration, or extension, per panel re: /�/ A. Fee for branch circuits with •' " ICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: C j jy`er Co»s>1-riAd -.I `1 B. Fee for branch circuits Contact name: r1/1< 1 ��� "" without service or feeder fee, ( 46.85 !k.( 2 `_ / �1� -Ic /t4 first branch circuit Address: 1 Svs. KCV141.6{{ Yl'ed Each add'I branch circuit 3 6.65 kci ,c:i 2 Miscellaneous (service or feeder not included) City/State /ZIP: ( d, v R at 1 a' 3 Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( 3) 54 0 - - -C)>O0 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: JA-e... "' -o— Ott)/10 /� a / "- 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: 60, $O Print name: Date: Plan review (25% of permit fee): ) State surcharge (12% of permit fee): t - 7 ,02_, r © Authorized signature: a nl a da.11�� TOTAL PERMIT FEE: 7 4 . UZ This permit Print name: Date: application expires if a permit is not obtained within 180 axe,' I 1 S $` !J / { 6 days after it has been accepted as complete. • Number of inspections allowed per perrnit. I:\ Building \Permits\ELC- PermitApp.doc 05/23 /06 440- 4615T(111051COMIWEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: PRESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm Garage Door Opener* Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: t COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) ,n A Check Type of Work Involved: r ` ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation O Intercom and Paging Systems O Landscape Irrigation Control* • ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* O 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 03/23/06 Mechanical Permit Application FOR OFFICE USE () EN City of Tigard � Received II 0 �� Date/By: Permit No.: I ° 13125 SW Hall Blvd., Tigard, OR 97223 ("A . `J Phone: 503.639.4171 Fax: 503.598.1 cj \% Plan Review Date/By: Other Permit: i . i t_ ` I , i Inspection Line: 503.639.4175 1J �s 1 ' Date Ready/By: Juris: See Page 2 for Internet: www.tigard or.gov , \'„,, �� t, Notified/Method: Supplemental Information \,` .C S AO TYPE OF WORK ' � Q1. �� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST C V�' Mechanical permit fees* are based on the value of the work ❑ New construction ddition/alteration/r ement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ 1 - and 2-family dwelling C industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES* y g ❑ ❑ 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: ((v fo5 SV1i 1/ � Air conditioning f"!/�- I i 1„v6 s4-- Y4 (reqguires site plan showing placement) 46.75 City /State /ZIP: r , L -d ( c - '.›2/ Fumace 100,000 BTU (ducts/vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Mc„AricM,S Heat pump 61.06 Cross street/directions to job site: 1 1 (0'11' KA,.�ef, I e, Duct work f 23.32 23 .32 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 , Flue /vent for any of above 23.32 Subdivision: `�zm i 4A h .I 3 Lot no.: I Other: 23.32 Tax map /parcel no.: V3 34 C,DP) 11 W Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 `� `pp Gas fireplace 33.39 (� (A an wrtu . 4- ion I b&..4 -h Flue vent for water heater or gas J fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 likPROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32 Other. 23.32 Name: 144, 4_ a V ( (W'f'-icievAS Environmental exhaust and ventilation Range hood/other kitchen Address: 1 1 (p (0 S S Vi KG1, nel(1 I'Ye equipment 33.39 City /State /ZIP: 7 i , /r C - a' 3 Clothes dryer exhaust 33.39 '' t� Single -duct exhaust (bathrooms, Phone: (503) � ,t.{.- t.�a.,)- Fax: ( ) toilet compartments, utility rooms) v 23.32 4( ,(A- K APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 N \`A�) c h^ k Fuel 23.32 Business name: Wt i Fuel piping Contact name: Ire- 04.(.K rW ilnS $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: ow 0 Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal (p`t,c Co Minimum permit fee ($90.00) ' n, OA Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lie.: State surcharge (12% of permit fee) (0 ,e0 _ TOTAL PERMIT FEE 106 6 This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: (.iAiYb ( MC - pr n/\L. I Date: SIN ',O • Fee methodology set by Tri-County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (11 /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 $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:U Building\Permits\MEC- PermitApp.doc 10/01/09 2 Plumbing Permit Application are Building Fixtures ��� FOR OFFICE USE ONLY City of Tigard R eceive a d� Permit No.: a 13125 SW Hall Blvd., Tig 7 223 c1 � Plan Review : 0 Phone: 503.639.4171 F 503.59$.190 � ' Other Permit No.: T I C A R 1) Inspection Line: 503.639.4175 P�\ \\ Date/By: J G �R Date Ready/By: Juris: III See Page 2 for Internet: www.tigard-or.gov `1 1 .\5V3 Notified/Method: Supplemental Information TYPE OF �� fj V FEE* SCHEDULE ❑ New construction �1� emolition 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 249.20 taj- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ 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: 1 1(0(5 S v .• -',er I nPJ � Catch basin or area drain 16.60 City /State /ZIP: - - 4 7 d3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Mc, .MS Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: 6 Manholes 16.60 ,1N'1 ✓1€ r ' 1 1 (a rn Rain drain connector '' 16.60 ( V) Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.:100) ( Page 2 5.5 100 Subdivision: 1_€((W 146 , 1 Water service (no. linear ft.: ) Fixture or item Page 2 Tax map /parcel no.: 151 5 4 0 I Lot no.: y f .d 1100 Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 arAd_ Vn GCI4 I. JC d �� - uM l f,`� Backwater valve 16.60 J _ I Clothes washer 16.60 Dishwasher 16.60 ROPERTY OWNER l ❑ TENANT Drinking fountain 16.60 �� /lli' Ejectors /sump 16.60 Name: L { - .k Mt Expansion tank 16.60 Address: /1 (7(p 5 SN/ ketA er i ?re .N Fixture /sewer cap 16.60 City /State /ZIP: 71 (y, v g" Floor drain/floor sink/hub 16.60 Phone: () 3.9-+ Fax: ( �,{ ) Garbage disposal 16.60 APPLICANT 1�1 CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: MC,1 c #v e.j � ,,-J• n fl Interceptor /grease trap 16.60 Contact name: G JCA.,/_ V J L Medical gas (value: $ ) Page 2 Address: I16(95 St1/ KLi-44Y>�i1'the at Primer 16.60 City /State /ZIP: 7" ici V k 772.2'3 Roof drain (commercial) 16.60 G �i� a Sink/basin/lavatory "Z„, 16.60 16.60j Z_I ( Phone: JV Fax: : ( ) Tub /shower /shower pan "Z 16.60 '33 , E -mail: Urinal 16.60 CONTRACTOR Water closet , 16.60 1 6b Business name: -40fif12, 0013? � i Water heater 16.60 Address: Other: City /State /ZIP: Subtotal (�( ,O Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (12% of permit fee) . 6 7 Authorized signature: ck `) ' -( ,kC � TOTAL PERMIT FEE e 136 4 7 Print name: Caro ( fNy...45 Date: II / j / o This permit application expires if a permit is not obtained within i 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. 1:\ Building \Permits\PLMF- PennitApp.doc 12 /27/06 440- 4616T(10/02/COM/WEB) Plumbing Permit Application - City of Ti Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 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 - Storm &Rain Drain - 1st 100' 55.00 Valuation: Permit Fee: $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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to 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. -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: i:\Building\Permits\PLM- PermitApp.doc 12/27/06 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be 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: 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 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. cyia -' C Print Name of Permit Applicant , /1/9//) Si,n ure of PermitAppli nt Date Permit #: H' t 0 9 . 000 - 67014(-1 Address: /1(166 1 CA Oq ) 1 a l ", DI' . Olt J Issuecc Date: ///9//0 E t This Copy for Permit Offices i 5— Vo -U0/y7 This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. B ILDI DI N\C' k DAB Art- . 3 ! ` a U NG VISION c; 4 s „, , 4 �'! v TIGARD TRANSMITTAL LETTER `� A G � ,,, 5 -1 0 .. 0 `s' TO: _ 1 DATE RECEIVED: e DEPT: BUILDING DIVISION RECEIVED OCT 7 2010 FROM: CITY OF TIGARD BUILDING DIVISION COMPANY: PHONE: r By. RE: 90/0-00 / `1 7 (Site Address) (Permit/Case Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: 1 Description: 1 Copies: 1 Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: f (off) ..) FOR OFFICE USE ONLY Routed to Permit Techn Date: (0/z.6, / i Initial Fees Due: ❑ Yes L 'No Fee Description: Amount Due: $ $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: I:\Building\ Forms \TransmittalLetter - Revisions.doc 4/4/07 0070050281 NOTICE TO BORROWER OF PROPERTY NOT IN A SPECIAL FLOOD HAZARD AREA CERTIFICATE: ISSUE DATE: RECEIVED LENDER: MetLife Home Loans, a Division of MetLife Bank, N.A. �1 BORROWER(S): JACK C McADAMS & CAROL A McADAMS AUG 2 7 2010 PROPERTY: 11665 SW KATHERINE STREET CITY OF TIGARD TIGARD, OR 97223 PLANNING /ENGINEERING The Flood Disaster Protection Act of 1973 and /or the National Flood Insurance Reform Act of 1994 mandate that all federal instrumentalities or lenders that service loans for the Federal National Mortgage Assoc. and Federal Home Loan Mortgage Corp. require borrowers secured by unproved real estate or a mobile home, that are or will be located in an area designated by the Director of the Federal Emergency Management Agency as in a Special Flood Hazard Area, to purchase flood insurance. Special Flood Hazard Areas are areas delineated on the Flood Insurance Rate Map (FIRM) or, if the FIRM is . unavailable, on the Flood Hazard Boundary Map (FHBM) of a given community. These areas have a 1% chance of being flooded within any given year. The risk of exceeding the 1% chance increases with time periods longer than one year. For example, during the life of a 30 -year mortgage, a structure located in a special flood hazard area has a 26 % chance of being flooded. A review of the applicable FIRM or FHBM on which the improved real estate or a mobile home securing the above described address is located shows that on the date printed above, the security for the subject property IS NOT located in a Special Flood Hazard Area and flood insurance IS NOT required at this time. If, during the term of your loan, the subject property is identified as being in a Special Flood Hazard Area, we may, at our option, require that you purchase and maintain flood insurance at your expense. Upon notice, and after failure to comply, this will result in flood insurance being forced placed at your expense. Signature of Lender MetLife Home Loans, Date a Division of MetLife Bank, N.A. �1( 'a ,v -- — Si na a of Borrow JA C Mc ADAMS g Date Signature of Borrower CAROL A McADAMS Date Signature of Borrower Date Signature of Borrower Date • Notice to Borrower not in SFHA 0807 Page 1 of 1 CB6D571 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11665 SW KATHERINE ST, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final PASS MST2010-00147 Jeff Grove Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11665 SW KATHERINE ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2010-00147 David Young Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11665 SW KATHERINE ST, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing final PASS MST2010-00147 David Young Violation Summary: Inspector Contractor