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Permit t ti CITY OF TIGARD MASTER PERMIT III 4 COMM UNITY DEVELOPMENT Perm #: MST2009-00095 Date Issued: 05/12/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112BD10200 Jurisdiction: Tigard Site address: 14660 SW 79TH AVE Subdivision: BRITTANY MEADOWS Lot: 38 Project: Brittany Meadows Project Description: New SF - Demo credits from BUP2006 -00427 applied to this permit. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 900 sf Basement: 0 sf Left 5 Parking Spaces: 0 Height: 26 Bathrooms: 03 Second: 730 sf Garage: 463 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $196,000.00 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: Other Fixtures: 0 1 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 . Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add 500 sf: 3 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! 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 Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW Single Family VB R -3 1630 Owner: Contractor: Required Items and Reports (Conditions) WEBBER PROPERTIES LLC 1 MST Engineered Soils 12155 SW WILDWOOD ST 2 MST Ersn Cntrl 503 - 681 -4444 PORTLAND, OR 97224 PHONE: PHONE: FAX: Total Fees: $5,079.55 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 n cordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or ' , .- 1 - - .ended for more the 0 days. ATTENTION: Ore law requires you to follow the rules adopted by the Oregon Utility Notification Center. T ose rules are set forth in OAR 95 001 -0010 through OAR S5 0)Y r r You may obtain a copy of the rules or direct questions to OUNC by calling 503.246 .. ! - . 8x0.332.2344. Iss ed By: I E 0-4/1 t A/ Permittee Signature: .... 1 `__. \-------- \....: • VI M ST a _ 00095 • • wr Engi, In 7312 SW Durham Road Portland, Oregon 97224 Tel. (503) 598 -8445 m Fax (693) 598 -8705 May1 B, 2009 Project No. 05 -9331 Jim Polak Keystone Construction PO Box 476 Lake Oswego, Oregon Joolak3ffacomcasLnet Fax: (503) 699 -7741 Cc: John Webber Webber Properties Jduv870.columbia.edu FOUNDATION. EXCAVATION REVIEW LOTS 38 Brittany Meadows Subdivision Tigard, Oregon GeoPacific Engineering Inc. visited the site on May 14 to review the foundation excavation subgrade on Lot 38. We understand that the proposed residence is a two -story single- family home., The excavation on the lot exposed medium stiff to very stiff fill consisting of silt. The excavation subgrade appeared suitable for support to a maximum allowable bearing pressure of 1,500 psf. The subgrade is very stiff and consistent with the higher allowable bearing pressure. The maximum anticipated total and differential footing movements (generally from soil expansion and/or settlement) are 1 inch and' inch, respectively, over span of 20 feet. At the time of our site .visit, soils exposed in foundation excavations consisted of very stiff fill and native sandy silt soil that could be probed less than about 6 inches with medium pressure using a steel "T" bar probe. These soils are considered adequate to support the planned foundation loads. Footing -to -slope setbacks and foundation embedment depths appeared adequate. General Recommendattiions Due to the dominantly silt soils encountered throughout the site, all foundations should incorporate appropriate drainage measures. The uphill perimeter of footing =should be provided with a drainage system as recommended in our initial report. Also, crawispaces should be provided with a low -point drain and pass through pipes should, be installed through footings which would otherwise restrict water flow to the low -point drain. It may be a good idea to provide a gravel drainage layer in the crawlspace as well. Care should be taken•to avoid saturation or disturbance of footing subgrade soils during and after excavation. If footing bearing soils become saturated or ;disturbed, any softened soil or slough should be removed and replaced with crushed:aggregate -or additional concrete. In general, footing excavations' should be'cteaned such that.no more °than about 1 % inch of loose soils are present prior to pouring concrete. n • GeoPacific ,Engineering, llnc. } ! Our work scope pertains to a geotechnical engineer's foundation excavation review only and the conditions existing and exposed at the time of our site visit No warranty is herein expressed or implied. If you have any questions, please call. Sincerely, GeoPacifc!Engineering', Inc. c.0 PR t - 8 ,s1 ti �5 �GIIV cr- 1 tvripp OREGON 4v 23 'so+` EXPIRES: 06/30/20 Thomas Wayland, James D. tmbrie, P.E. Staff Geologist Geotechnical Engineer Oregon Residential Specialty Code N1107.2 HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No::�� ZQ, -COO- -- Jurisdiction: • Site Address: 7c? n4, Subdivision/Lot #: -( 7 -rkva y Cck tzej S and/or Map and Tax Lot #: 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: I 1D‘ Owne General ontractor /Authorized Agent Print Name: 3N 1A . PO * KEYSTONE DEVELOPMENT INC. P.O. Box 476 Lake Oswego, OR 97034 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. 1:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM JA s rou/' - DE WfsTbo p-v Ei,opM ■ I, , am the general contractor or the owner- builder at the following address: Site Address: / 79: -b--. City: C�-'t Permit #: tL4'T G(cY - Cr() • Subdivision/Lot #: ` l te and/or Map and Tax Lot #: 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: AdMEA L4 . U ' Date: -74161 eneral Co tractor or i Wner- Builder 1: \Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 .1 STREET TREE CER'TIFICA°TI•O1 _ _ I, M M . Po , Owner /Agent for ()P*-ue p Ntr 1 10c (PLEASE PRINT) i (PERMIT HOLDER) Do hereby that the t following location meets City of Tigard Land use and development standards for street tree installation.. A1T'hCH,Ep 51 PLAN_ ADDRESS: ��C� lO - MTh A\I SUBDIVISION: bg- 1TCA 14 { t • co LOT: S2) SIGNATURE: + . ,'�- DATE: 9 I I IN (OWNER/AGENT) RECEIVED BY: DATE: (CITY OF TIGARD) i:\ Building \ Forms \StreetTrecCertificate 01/19/07 I •" i ..: :- 1 12 -0" 6,A 106 • N N 1 °04'17" E 1r0 NOTE z, r 40.00 4 ,. l 0 o Z ENGINEERED FILL ON LOT 38 TOP OF FILL LINE IS 12' SOUTH 2 2 o i OF NORTH PROPERTY LINE TOE N [ _ H N O F BANK - NATURAL GRADE r t5 i "1;0 o , X 1 X - SlLT fENCE 2 STORY .y / RESIDENCE , p R ^ F.F.E.= 173.00' e°' N' K d iv 9 t)F.TS' -6. HIGH, v � - O CO 10 k +' , ` m M 1 3 = 2 CAR co GARAGE ,•< 7 / i' F.F.E. F.F.E.:172.5' F ENO "• 0•• 4 ' CO I 0" 05 - C° DRIVEWAY N ; `�` t a, -13500 P.S.0 I I o t. 6 0 N — S 0°54'50"1W ®1,\� 5' SIDEWALK 40.00' I 'meal '', PLANTER I 1 MAPLE ti. STRIP I 0 T.O.C. = T.O.C.= I WATER 17225' 172.33' laTER R ' P.U.E. SW 79TH AVENUE 16/2009 MRR S C A L E 1 " 2 0 ' - 0 " 4 "' ,,v i";„.ih VffiT ..sc iu-:::Z..x .sx { %. -. a . :',�,_'$ .sum.. Z' -., m_..__r ...-- ..... - t Ls - .., . _ ... ,.. : . r .._ � _ . � 1 '4 V° '!'l "`r �.n '' " ° - - ALAN MASCORO DESIGN ASSOCIATES. INC IS NOT ra ?- 1 s G CITY OF TIGARD GABLE FOR THE I a M s r . ' � j , '' Rr ' 7 ®� RIER TO lFCMA710N 6 riE SOLE OF nE 2 , ?' 3 � 1 , 4 11 MI YEILFY ALL SITE CONDITIONS. IICLOWIS z� , K 11'x a Yl ,i 9T , ` . ANY FILL PLACED ON THE SITE AIM NOTFY THE . LOT 38 '3 - ' 4 - - i ns r 3 Y k, F. "� 2 a . O WNERS OF ANY pommy. F19D MO WICA1I0l�. '• t ,,'^` 'A u C E e T ` I . O N 1 ,+ , ' 1 660 SW 9T AVE. BY: KEYSTONE DEVELOPMENT 4 7 H 1 '�M�'S , ' Won 1. . m1W . . W+- `C"F a9S "w AVE. nnnnno o anon ,. ° �, .. i,r� ,- .., ''�A ,- -P .. , ,-%,V , ". ,, k , 50.1 22 116 FA% /12509)) . , ( : , SQ . fT) .,1.3.< <� "rj ..�..! - � 9r � ..__�" -3 _�-- - : , y� , � „ t5 . ._:� - • : � _-. .,. . ,,. �. -.. .,-'[... . st�4 . s., - . :e:� r _. t .. ,�- .r..- --�3 :...F" ,-,-,..,,As, ...,., ^ ,_ . B iilding Permit Appli CENED ' FOR OFFICE USE ONLY / City of Tigard PR 2 2 7Q�g Received y�$ Q7 , 1 permit No.: ���j/ S I Date/By: 7 i 7 13125 SW Hall Blvd., Tigard, OR 97223 ARD Pi Review ► L' G r ) ' i ther Permit: C GU - .. • Phone: 503.639.4171 Fax: 503.59ttri OF ` tt 10N Date/By: `` eJ��� ��� TIGARD Inspection Line: 503.639 ll�' ► "'D1N('j DIN S DateReady /By: a ' ® See Paget for Internet: www.tigard- or.gov gull Notifi / ethod: •. - -, / / - ! � Supplemental Information i)6- Y.L 1. , 1 44. . - TYPE OF WORK . ,. � =,, „ • . . QUIRED DATA:' 1-AND 2- FAMILY DWELLING' New construction ❑ Demolition Pe it 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. p ,1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ I 1 oco ❑ Accessory building ❑ Multi- family Number of bedrooms: ? ❑ Master builder ❑ Other: Number of bathrooms: •7- S ' ` JOB SITE INFORMATION AND LOCATION Total number of floors: Z Job site address: illobo SVJ -16‘ -h New dwelling area: i( square feet City /State /ZIP: f j4) l OF- c1129-1v Garage /carport area: *49- feet Suite/bldg. /apt. no.: Project name: Covered porch area: iesquare feet Cross street/directions to job site: o , 2 i) Oi` SW 1411, , Deck area: if t square feet I 61--°4- . + 157 (-pT QN UTr Other structure area: square feet REQUIRED DATA COMMERCIAL =USE CHECKLIST Subdivision: E \1. (V'f)0J Lot no.: 38 Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all _Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the ' ' DESCRIPTION' OF WORK , '£° { . work indicated on this application. 6\ F/ �Q sme4 , K _ Valuation: $ �� ��S��I)�� IBC-, n `-i""" Existing building area: square feet New building area: square feet 0. PROPERTY OWNER. . - . ''. ❑ 'TENANT-: " Number of stories: Name: 'I V 1 ,) W e OL Type of construction: Address: Po 1 fosic.. 41(p Occupancy groups: City /State /ZIP: 01/...e., Q6\1,,)e9 1 09- 11 i' Existing: Phone: (5) ) 635 -47-6f2 Fax: (51). / 61 q -" 7ti New: APPLICANT ' ' - ,CONTACT PERSON .a ` - NOTICE' ' - Business name: V_et/( cro t; p e},�'e -L Q (1 14`` I All contractors and subcontractors are required to be Contact name: J/k� i -" f+� I licensed with the Oregon Construction Contractors Board c under ORS 701 and may be required to be licensed in the Address: i 0 r o 4 •)(0 jurisdiction in which work is being performed. If the City/State /ZIP: L 05LO 10� Qi ( � aliant is exempt from licensing the following reasons apply: Phone: ( 5 3) 6$ 5 — 470 Fax:: ( b) 611 - 114 1 E -mail: CONTRACTOR Business name: 140,45-10--e, ke, Lpp Aei l I i�j . BUILDING PERMIT FEES* -. Address: �� 1 ���( G�'16 t " ' . (Please refer to fee schedule) p � ,,,,{�� � — Structural plan review fee (or deposit): !Alto �Cr N 9 1 I - G('Z.0 FLS plan review fee (if applicable): tone: ( ) 635 _ 4.--1 Fax: (�j) 61 �Q 1 -1141 I CCB lic.: '71t36 Total fees due upon application: LL Amount received: 7 75D •Ov Authorized signature: V ►U This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: J AI'n - Pow Date: �'2J2. O * Fee methodology set by Tri - County Building Industry L Service Board. : \Bui lding \Permits\BUP -RES PermitApp.doc 11/6/07 440 4613T(11/02/COM/WEB) 4 Building Permit Application Checklist One- and Two - Family Dwelling 'FOR OFFICE USE ONLY City of Tigard Received g Date/By: Permit No.: n 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 T I GARD 24- Hour Inspection Line: 503.639.4175 1=1 Electrical • ❑Plumbing ❑Mechanical Internet: www.tigard - or.gov ❑ 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 Oregon and shall be shown to be applicable 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 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- 4613T(11/02/COM/VEB) I H! . _. Mechanical Permit Application t FOR OFFICE USE ONLY ,):.- . t Received Permit No.: �,/ O City of Tigard (��� Plan Review : 4/ '� O9 / / yr J 7 — 000 'S�% .Zr 1. 1 tl Plan Re _ : ° 13125 SW Hall Blvd., Tigard, OR , M .. Phone: 503.639.4171 Fax: 503.5' : 960 Date/By: Other Permit: Inspection Line: 503.639.4175 ;GARD R 2 2 2009 Date Ready/By: Ju ris: Internet: www.tigard - or.gov P i % Supplemental See Page for lI Notified /Method: Supplemental Information g F TIGARD { YPE - OF`�B 610,1g0, ,, • COMMERCIAL, FEE * SCHEDULE ' USE CHECKLIST New construction ❑ Addition / /replacement Mechanical permit fees* are based on the value of the work 121 performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: _ mechanical materials, equipment, labor, overhead, and profit. Val CATEGORY OF C ONSTRUCTIO_ N, t - ue. $ ." EQUIPMENT ISYSTEMSFEES* 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE .INF "AND .LOCATION Heating/cooling 1 Air conditioning or heat pump Job site address: 140 b O SW 7ct "(1't ' Mt (requires site plan showing placement) 14.00 City /State /ZIP: 11 > OP- Gj'12 �3 Furnace 100,000 BTU (ducts /vents) ✓ 14.00 M 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: BON 1TA I TUP-0 0/3 5v3 14111 Duct work - —h0 BA --}e— r� Hydronic hot water system 14.00 Pj' L.00.� . 1 £'1 1.-431 0 t Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Flue /vent for an of above ..: t a ,as Subdivision: -ITA N5 Meh{a S Lot no SE J Other: 10.00 Tax map /parcel no.: Other fuel appliances . DESCRII'TION- OF WORK- ' - . Water heater V 10.00 10 yy Gas fireplace ✓ 10.00 (8 coM2 c- 1 }+ - siNCC.. FA (, }des X021 e.. Flue vent for water heater or gas fireplace 10.00 (0 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 . Chimney /liner /flue/vent 10.00 PROPERTY' WNER 0 TENANT 5" Y - Other: 10.00 Name: S t oe)t2 _ I ,C, Environmental exhaust and ventilation Range hood /other kitchen Address: Pa D'a'f-• ' / 4-To V equipment / 10.00 J City /State /ZIP: 1Q � e. , o OR- 410 Clothes dryer exhaust V 10.00 (b (J Single -duct exhaust (bathrooms, Phone: (9)j) 635 117 j(0 Fax: (9)3) 01 — 114 - i toilet compartments, utility rooms) 6.80 27 .2) 'i, APPLICANT z CONTACT PERSON Attic /crawlspace fans 10.00 Business name: V STDhe De,) f � 4C • F piping 10.00 Contact name: \ e w e s f 71-,Pc-- $5.40 for first four; $1.00 for each additional Furnace, etc. ✓ 4d Address: 'p �6X 41(p G as heat pump City /State /ZIP: I/1T"e- c>vJ.o 1 O -- 97031- Wall /suspended/unitheater Phone: ( 50 ((3 5 ....4-73G, ( U/ Fax: : ( SDI) '°t -1141 Water heater k Fireplace •/ E -mail: Range . - . - CONTRACTOR. Barbecue Business name: 12 _ £•oQ N T 60 102.0‘...„ Other dryer (gas) Address: ( 5- c -'Ac.! A AA AS -.1\)'e-R--- F47 M PERMIT FEES!' Subtotal H - 2 gam... 'v /State /ZIP: Q'e t4 6 ' � 1 O 17i 1 Qq- 5 Minimum permit fee ($72.50) ] none: (50`) l j 5-7 -- 222p Fax: (SO ;) 5 9 1 ' OC‘ (et Pleu -r ° 10 . 1 CCB Iic.: ',VA. �j State surcharge (12% of permit fee) 17 .(f TOTAL PERMIT FEE k.7 I This permit application expires if a permit is not obtained within 180 Authorized signature: / Fee methodology set by Tri- County Building Industry Service B days after it has been accepted as complete. J Q ,� f * ce Board Print name: (A , ' , • O � Date: v B I:\ Building \ Permits\MEC- PermitApp.doc 01/19/07 440- 46I7T(11 /02 /COM/WEB) ( (/.'99 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 vYl r , J , rv..0 iv ..ate •• �A VV.,/ .........- .......... . .. ...,....�aaa aaa..- 4Y:, ., v �. Apr 211 09 08:53a Keystone Developoement Inc 503- 699 -7741 pa.2 ; rlui i t v1a reB inn ,A.Dip Ileano Bu1111 lug Fixtures - _. ".., J1 oR il l F F ly4F ()" L1 , • 0 ! Cady of Tigard Received Permit No.: • 13125 SW Hall Blvd., Tigard, OR 97223 Pla II Plan � t " n Review lt 1 Phone: 503.639.4171 Fax: 503.598.1960 - Datrl6y: Oder Permit No.: Inspection Line; 503.639.4175 - f<, -• , , . Da* Ready/By: !arts: ill 6ee Page 2 tIDT l I ' Internet: www.tigerd -or gov Notified/Method: Su �, pplemts06i1 6aformasion rick OF WORK PEE SL79E1tDYJLiE NNew : 7lstruction ❑ Demolition Poe spedal'befri»rraieraarseCM,, checklist. . - Description 1 Qty . f Ea. j Total ❑ Addi i ) t/alter'ationhcplacen ent 0 Other: • New 1- 2-family dwellings (includes 100 ft. for each utility connection) • : CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 �J- an I % •family dwelling 0 Commercial/industrial SFR (2) bath j _ 350.00 i 0 Acce r ry building 0 Multi - family SFR (3) bath 399.00 ❑ Mash : 1 alder Each additional bath/kitchen 45.00 Other: Fire sprinkler ( , sq. ft) Page 2 • . .YOS SITE 8NF'ORMATION AND LOCO ON Site nlllltles • Job site 1 ; d :CSS: 14(0400 4v.J 1 '14Tri ___ A \fe • Catch basin or area drain 16.60 Gity/Swl , "t - ls 1 ( 11 2 Z Drywall, leach line, or trench drain 16.60 Suite/bld ! 1 pt. no.: Project name: Footing drain (no. linear ft: �) Page 2 Manufactured home utilities 110.00 Cross str t directions to job site: } - - g, p 1 TL' i/44 OI& Manholes 16.60 • '"1 a 1 1 f t oc4- Rain drain connector 16.60 I ST - - ©l'-i t.e P'T Sanitary sewer (no. linear ft.: __) Page 2 Storm sewer (no. linear ft.: ) _ Page 2 Subdivisi il•t- t,,pY 1,A3 c 1 Lot no.: ?e. Water service (no. linear ft: ) Page 2 ' Tax map, : r eel no.: ' Fixture or item • - . . Absorption valve 16.60 • - DESCRIiPTION OF WORK' Backllowpreventer Paget I46V GOO STl •Ll C - SpNol.e. ff(fV Li F.6sms z. Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 1 ,PROPERTY OWNER Drinking fountain 16.60 • Name: Xe�Srpa 1 d F ," , _ �- Ejectors/sump Expansion 16.60 IF W - Expansion tank 16.60 Address: _ Po P?oL 7 io Fixture/sower cap 16.60 City/State . :I P: LAY-#2. br_,pAX 0 1 o 3 Floor drain/floorslnk/hub 16.60 Phone: ( i ' a) (t v'65 -413 Fax (313 ) 4 t 11 L}• 1 Garbage disposal 1 6.60 • • 1,�, APPLICANP • qr.CONTACT Fl3RSON • Hose bib 16.60 Business 1 1 r. IC 5ib 0 ( p�-■ie' ore . f oc- „ Ice maker 16.60 Convect m 1 a :: `1,� - tine M I . interceptor /grease trap 16.60 ' 1 o'^r t i-- Medical gas (value: S ) Page 2 Address; • PCP y4- 41.(‘P Primer �* _ 16.60 City/State ■ 1 ?: 1 A 1 (S $ 01?-- o',', 0 34( Roof drain (commercial) 16.60 Phone: (` .: y) b 35 - 49 (, ( Fax:: (5U e ms . ) (it{ -111-1 Sink/basin/lavatory 16.60 E -mail: __ _ Tub /shower /shower pan_ 16.60 Urinal ' CONTRACTOR 61 . Water closet 16.60 Business n 1 t e: �OI��,o C i.0AAPa1N I Water beater 16.60 Address: 4, 16 .5u0 j ( Other: City/State : I ': 51 -1.e.f.- t e)(2_ tri 0 9- Subtotal ----./ hare: (t , !) (025 ( Fax: ( -14'6'1- Minimumperrnitfee: 572.50 5 (0 R esidential baclttlow minimum permit fee: S36.25 CCs Lic.: , is fa l...,A , 9_ Plumbing Lic. no.: 3/.�' 24r'pe, Plan review (25% of permit fee) • Authorized , i mature , 4- 11 State surcharge (12 % of permit fee) TOTAL PERMIT FEE Print name i ° • �J�'' pee (Date 1.43/01‘ Tide permit application exp +teesIfs ' 150 days alter it bas been a we 18 n tvltbi® • accepted as complete. *Fee methodology set by Trl -County Building Industry Service Board. I :1Butldin¢1Pera • \ 'LMF- PermitAyp.d°c 12/27106 446- 4aisroo 12tCOMlw n) ciiiiii . 1 'Electrical Permit Application l t .M. °~ : ° F O USE ONLY City of Tigard RECEIVED d �� Received a y ...9../ elf ll Permit No.: N ,9 5 ° 13 125 SW Hall Blvd., Tigard, OR 97223 Plan Review , IN .. Phone: 503.639.4171 Fax: 503.598.1960 APR 2 .2 2009 Date /By: Other Permit: r 1 G A R D Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for Internet: www.tigard or.gov C nF TIGARD Notified/Method: Supplemental Information Ti�rE;.oF w li.:DIN6r'AIVISION ; .. PLAN REVIEW V 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 CONSTRUCT ION - , , , - ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural g l- 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.: IW 2 i3 Job site address: 1 66 0 5UJ ITN Arise- IOOHP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: 1 cj-.1 fiii ❑ 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 more. ,,. p � nn wA FEE'.. SCHEDULE Cross street/directions to job site: f20( 20(∎3IT,br F .., c0� 1�IV I Q� 3 � Description I Qty. I Fee. 1 Total pD New residential single- or multi- family dwelling unit. 1 bl' - I I SC l'OT 6 N P 1 D€- Includes attached garage. I T(At M c j D_ 1,000 sq. ft. or less Subdivision: � J Lot no.: CJ 000 9� 145.15 ' 4-,,�4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 (06, 1 Limited energy, residential 75.00 2 DESCRIPTION „OF WORK (with above sq. ft.) Limited energy, multi - family Ne.VJ CONS`I'-IMQN — SSW -1-'. 4f' LM P-- , 4\3C -9 -- ) residential (with above sq. ft.) 75.00 2 Services or feeders installation, alters ' n, and/or relocation 200 amps or less 80.30 2 ...PROPERTY ,OWNER • .0 TENANT ,. 201 amps to 400 amps 106.85 2 ��.,,�� /� Name: �et l STI�N 04)-JP.,-)g- L� 401 amps to 600 amps 160.60 2 1 601 amps to 1,000 amps 240.60 2 . tddress: f)0 ( j , Lfi(o Over 1,000 amps or volts 454.65 2 City/State /ZIP: L (751X) tO 1 09- Tip 3t\.- Temporary services or feeders installation, alteration, and /or relocation Phone: ( 6 ) 6`3 G - 113(0 Fax: ( 6b3) Al -114-1 200 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, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ° ` • R APPLICANT .” lg.. CONTACT- PERSON , ' above service or feeder fee, 6.65 2 each branch circuit Business name: Ke(,‘ Qlllt peteLopPlt -. 1 ING, B. Fee for branch circuits ( �^ without service or feeder fee, Contact name: J/ VINe5 pd first branch circuit 46.85 2 Address: Po P2051- Al LQ Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State/ZIP: pp q Each manufactured or modular ty /State /ZIP: 0S 1 f 17� 90.90 2 dwelling, service and /or feeder Phone: ( 503 ) 69 4 Fax: : ( 93 ) bCV —Tit( 'it( Reconnect only 66.85 2 E - mail: J (AAA.. 3 e Pump or irrigation circle 53.40 2 - 1 ., CONTRACTOR - . • Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: I,461t'nM('S'2, euC"r(G L1,( energy panel, alteration, or . 1 - 1So Address: 1,. SVJ (151Ni AlQ, extension. Describe: Page 2 2 City /State /ZIP: W 1 LS o Ovl 1 2, op- Crl 0-1° Each additional inspection over allowable in any of the above I Per inspection 62.50 Phone: ( 503 ) 55Q rho p Fax: ( SO5) 582 - 8N 8 Lk Investigation per hour (1 hr min) 62.50 CCB Lic.: Electrical Lic.: 5 2, , u rv- Lic.;. ', . Industrial plant per hour 73.75 ELECTRICAL P ERMIT FEES Iprlectric EianTgnature --recp. : , rip Subtotal: 2A S, ' Print name: (,/l t.ge. ►AeAk., Date: Li 1�1 I $I Plan review (25% of permit fee): State surcharge (12% of permit fee): CI', 44_ Authorized signature: TOTAL PERMIT FEE: 2 ?A-, •7 �1 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. 1:\ Building \Permits\ELC- PermitApp.doc 05 /23/06 440- 4615T(Il /05 /COM /WEB L-C.Cs..) V -T - 7 ,(O 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: n Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other: I Ql1%INIERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling n 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