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Permit i CITY OF TIGARD MASTER PERMIT " COMMUNITY DEVELOPMENT Permit #: MST2011 -00002 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011 TIGARD 13125 2S104CA06600 Jurisdiction: Tigard Site address: 13350 SW HILLSHIRE DR Subdivision: HILLSHIRE Lot: 66 Project: Murphy Project Description: Convert existing space to ARU(accessory residential unit). 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: 2 Third: 0 sf Right: 0 Detectors: Yes Total: 0 sf Value: $48,500.00 Rear: 0 PLUMBING Sinks: Water Closets: 1 Washing Mach: 1 Laundry Trays: Rain Drain: Urinals: Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Storm Sewer: Tubs /Showers: Garbage Disp: Water Heaters: Water Lines: Drains: Catch Basins: Bckflw Prevntr: Footing Drain: Ice Maker: Hose Bib: Backwater Value: Other Fixtures: Drywell- Trench Drain: Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers: Heat Pump: Y Hoods: 1 Other Units: 1 Furn <100K: Vents: Woodstoves: Gas Outlets: 1 Furn > =100K: ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 -200 amp: 1 0 -200 amp: W/ Svc or Fdr: 6 Ea addl 500 sf: 201 -400 amp: 201 -400 amp: W/O Svc /Fdr: Mfd Home /Feeder /Svc: 401 -600 amp: 401 -600 amp: 601 -1000 amp: 601 +amp- 1000v: 1000 +amp /volt: 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: ALT SF VB R -3 0 Owner: Contractor: MURPHY, PAUL B & JEANINE KHI CONSTRUCTION Required Items and Reports (Conditions) 13350 SW HILLSHIRE DR 3201 NE WYNOOSKI RD Al TIGARD, OR 97223 NEWBERG, OR 97132 PHONE: PHONE: 503- 554 -8601 FAX: 503 -554 -8659 Total Fees: $1,712.10 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 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: Ore. •n law requires you to follow th - �. - •opted by the Oregon Utility Notification Center. or rules are set forth in 0 R 952 - 001 -0010 throu • •AR 952- 001 -00• e. Y•-• ��c• • ■► •e rules o • irect questions to OUNC by calling 503 .800.332.23, Issued By: . - S Permittee Signature: 175 by 7:00 a.m. for the next available inspect date. This permit car• s ept 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. Building Permit Application A g aa r rsoo.2- Residential RECEIVE D FOR OFFICE USE ONLY �y/�� City of Tigard Date /Q� Permit No.: ' � 13125 SW Hall Blvd., Tigard, OR 97223 J 0 11 Plan Review ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: ` Other Permit: Inspection Line: 503.639 Date Rea.. 4: y: Juris: la See Page 2 for I' I Ci A R D Internet: www.tigard-or.gov CITY OFTIGARD • • • . el I /7// Supplemental Information BUILDING DIVISIO � - ,_ . i/Lf ... , i TYPE OF WORK Allpf l'QUIRED DATA: 1- AND 2- FAMILY DWELLING ‘/ ❑ New construction ❑ Demolition / i Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all j $ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION 4 work indicated on this application. � Valuation: $ 1 � 00 !`-' and 2- family dwelling 111 Commercial /industrial 1 .i III Accessory building ❑ Multi- family Number of bedrooms: 1 't 111 Master builder 0 Other: Number of bathrooms: ', f JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: `3' 5O 5,A„, t t`5\ � t P__.. New dwelling area: square feet • • City /State /ZIP: ��t:SC � / (`)it.. Garage /carport area: square feet ' Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet i,' Other structure area: square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: 1 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. D �s \ n bD ,i� Valuation: $ S 1 �� Existing building area: square feet % New building area: square feet ` ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: tA.L ct"3eA 1.)1 f_ D l U I AN Type of construction: Address: 12 2 , 5 5 ? ) - l I 4 i ,... '" . Occupancy groups: City/State/ZIP A-(221 6 2 9.724-5 Existing: I . • Phone: (a7- 571 - 3 96, Fax: ( ) New: q n ❑ APPLICANT ❑ CONTACT PERSON NOTICE — W Business name: All contractors and subcontractors are required to be 2 Contact name: �� (_ licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the © Address: 320 \ 10E 1 . jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: ' Phone: (503) 6Jr — g(e I Fax:: ( ) • E- mail: MAT— 0Of\ . C-0 \ CONTRACTOR Z i Business name: Ma. C ∎ BUILDING PERMIT FEES* Address: (Please refer to fee schedule) O� 1' r Structural plan review fee (or deposit): City /State /ZIP: ' �' K C (Al AC5 Y... ) p FLS plan review fee (if applicable): Phone: ) S/ S1(' Dew ` Fax ( ) CCB lic.: Total fees due upon application: Amount received: 1 .10 . Authorized signature: This permit application expires if a permit is not obtained Print name: V51 11 within 180 days after it has been accepted as complete. Ilo ilo . Date: * Fee methodology set by Tri -County Building Industry Service Board. I:\Building \Permits\BUP -RES PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM /WEB) I I. Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No.: a 13125 SW Hall Blvd., Tigard, OR 97223 Date /By: • C Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: TIGARD 24- Hour Inspection Line: 503.639.4175 El Electrical ❑ Plumbing ID 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. ❑ El ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. El ❑ ❑ 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 El ❑ ❑ 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 ❑ ❑ El 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 a. slicable to the iro under review. JURISDICTIONAL SPECIFICS . 1 . 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. C\ Building \Permits\BUP- RES- PennitApp.doc 03/21/06 440- 4613T(11 /02 /COM/WEB) 1 Electrical Permit Application FOR OFFICE USE ONLY ��jj i City of Tigard Date /B : 1 / Permit No.: ,V7 .. V., III ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C ' Phone: 503.718.2439 Fax: 503.598.1960 JAN 0 6 ? 1 n EDate/B : Other Permit: I" I G A It D Inspection Line: 503.639.4175 Date Ready/By: luris: ® See Page 2 for Internet: www.tigard - or.gov CITY OFTIC'' ,0otified/Method: Supplemental Information TYPE OF WORK BUILDING DIVISION PLAN REVIEW ❑ New constructiont&ddition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder El Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 13 3so sw V‘,- 100HP or more. occupancy. ` � �s ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: ToQ `(�,5� c '. ot 7 13 Z ❑ Health -care facilities. ❑ Supply voltage for more than J d ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: M LUAd\ ❑ Service or feeder 600 amps or more. 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 (with above sq. 75.00 2 DESCRIPTION OF WORK ( 4 ft. ) Limited energy, multi - family 75.00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less % 100.70 i 00110 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or y relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with /^ ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6' 7A2 I J � i 2 each branch circuit Business name: Kk Y Cs -z.c,'(N B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: 1)..X'CN.V branch circuit Each add'l branch circuit 7.42 2 Address: 'Z © 1 ‘1 , E W &705v... Miscellaneous (service or feeder not included) City /State /ZIP: 1,35 Each manufactured or modular -v\� e dwelling, service and/or feeder 67.84 2 Phone: (73) 5' — '(O0 1 L Fax:: - ( Q ) Reconnect only 67.84 2 E -mail: a �Y'* C.c.n.s , C.9("\ . CS��� Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited - energy Business name: K- \ p '�� t-c panel, alteration, or extension. Page 2 2 `t - Each additional inspection over allowable in any of the above Address: Q� d�X S`7 Additional inspection (1 hr min) 66.25/hr City /State /ZIP: 'C4 7 l Z Investigation (1 hr min) 66.25/ hr J r / / Industrial plant (1 hr min) 78.18/ hr Phone: 605 53$ - 33 Fax: (34 _ / . 11t[4 /11,/,3 Inspections for which no fee is specifically listed (A hr min) 90.00 / hr CCB Lic.: f 6 7gyq . *Electrical Lie.: of 3101C„,/ Suprv. Lic.: 52( 2-5 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: _e a IC r Subtotal: 1 j . '2-2., Plan review (25% of permit fee): Print name: �J l�lr l i jippiteN..esf /� - f f Date: ��j /� 1 State surcharge (12% of permit fee): i J i m 7 // ,4- TOTAL PERMIT FEE: t K%L� Y> Authorized signature: ,„,..•-••"------ permit application expires if a permit is not obtained within 180 Print name: (A) ��/ ` ` days after it has been accepted as complete. � Date: � l • Number of inspections allowed per permit. I:\Building\Permits\ELC - PermitApp.doc 07/01/10 440- 4615T(I I /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls n 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 07/01/10 Mechanical Permit Application • FoR orvicr f al•', ()NIA City of Tigard Reacivrt! i>/ 13}25 SW Flail Blvd., Tigard. OR 97223 IENIIIIMMI II Phone: 503.639,4171 Fax: 503.598.1960 Other Permit; 'r III/ Alt O Inspection Line; 503.639.4175 Oatc Read /B Internet; www,tigatd- ot.gnv Ready /By: er See Page 2 for l3oti5ociNctllcd: IN Supplemcntnl Information 11 r 1 1 1 19{ iirnrrlrurrrj p.. P I S �� 1 ,�� rnm�rn�� 1 r I ! ;' Yi111111111111lll ►� i11i ���� ri , %o. '>r I� I>�ri�D', ii RI 111E 1, VERI ilitil � g44, 171,1 Q .r1: m � n. 4 ; 2 , k 7; l,,,f n at11}: , . �r.... u El New construction GI Addition/alteration/replacement Mechanical perm fees" are based de the v alue of the work © Demolition ❑Other: performed..Indicate the value (mundcd to the nearest dollar) of all mechanical materials. e. i.ment, labor, overhead, and . roiil. 1 4!. + ' ' n � ,� to 111} l aigr ° ihS�llt i n e it 4� liEl' i!` � I f: 1a I S M41' l , „, 1 x rnttt n Value: n I n� n�� �a(�j1� , n , '1 a forni 1111 � „'I,, Ii1 ,.1- and 2- fam ily dwelling El Commercial /industrial ❑ .Accessory building ' '}r 1��t�t r�ri . r ('or special t»f prmation use checklist, ❑ Multi - family E Master builder ❑ Other: • / Z t 1,111NiIIII.I4AlIlI l Cni ti P r3 Description . Qt ME Total l � ri 4 llil rjltm. �f IV' "trig R 'm�mir !di' j� :V (11111 tIR ! PR (dentin• cnolin_ Air conditionin Job site address: • 5 t � \ 7� C g rc.uires situ -la>, showin , .laccmenl} 46.75 City /State /ZIP: 1P\Z,C,& >•�,Q• q 7Z� 'urnace 00,1 tt : I acts/vents) 4( Suite/bldg. /apt. nn.: '• Project name: i\A „-�.i ‘irk. Furnace 100.000+ BTU (ducte/vcnra) 54.91 Heat um,. 61.06 NEI Cross stree(/direetions to job site: Duct work 23,32 MO R dronic hot water s stern 0 23 32 NM Residential boiler (radiator or h dronic Ell Unit heaters (fuel -type, not electric), in -wall, in -duct. sus ended, etc. 46.75 Subdivision: Lot no.: Flue /vent for an of above �� Other; 23.32 Tax map/parcel no.: Other fuel a . r Ilanecs I , ; ,. t g� y r .n snr rrnnF r r . gr1�'�r +�. pp � � phi ' ∎I . �. It1tj1��llllY',�11 it il[fi I(�Iti`y�rm�rii' "�rhlhi�lf�n� • , " - f Yt 5 e illl.('h'"ilnii�C �l'i1 1 I, I � l l . .11g t 1 :::�;�, Water heater 23.32 M 1 .. �1,?E :[>~!\ C.kC . j 33.39 —�" S Flue vent for water healer or gas l fire lace 23,32 MI - Lo Ii•htcr(•as) I 23.32 Wood /.clletstove 33.39 Wood fire .lace/insert 1E1E11 v l if llt I(' dlfn U 1 7,,, . n }i�l z lr ir7hnr �1', n g I q r tr J �((���� , �, � �11�. ���'b11� � ., "��lllHll ., I� ���" ,1 �r���l�� i>✓�Vlnit ikili 23.32 Name; Other: 23.32 fi �\ f '.' - Fnvlronmental exhaust and ventilation Address: Range hood /other kitchen e ui.mcnt 33.39 City /State /ZTP: Clothes d Cr exhaust Phone: ( ) Single -duct exhaust (bathrooms, 33.39 ii l'{ 'I Fax: ( toilet com.artments. utilit rooms f�j�. 1� i l��� 'B tl tlllrrl+, fln��e}�a� j�1 �' I� �� a III i r�q��„dIc rim e n , a 23,37 . tttU� I 1 ti' ��.1.0 t , {°- �{ i , 2332 MEM Business name: Other: 23.32 Contact name: „,..2....(.4 514.15 for first four; 54.03 for each additional Address: 1b 20 ` 43 L-2,1 r , . 1`' �a Furnace. etc, • City /State/ZIP: J , 0 qt. 9 7 l-3 Phone: ( 0 Oas heat gum. al L. U `s \ ty Fax:: ( >'� Ss — Water heater UM= E-mail: y 9.,..�. ( Q 1'N � CUy`� K L- ', c . C P ,l I I .� r �llES ?Of1 � � Rl llllR t r 1Tl rt ' }1 10 NOW� 11 Ill 1 r l �ti ea EN Business name: - 6,).y1 /.. Clothes d er as) ) Address: ) � ���� 4 Cloth d � ^7 8� 1 I 1 'lion , � I>,A1n ur. City/State/ZIP: (A t.,n'Cr r 0 / l `/ 49� Z (. 1� n e , n ., r t i �!4 l�fvl(I 'ilr; II{ i)l�l _ Subtotal Phone: ( Z - p -5 Fax: ( p3) ( /-0 C — el ) g'S•- Minimum permit fee ($9().00) CCT3 lie.: 1g Plan review (25% or permit fee) � - Slate surcharge (12% Of p ii f) NEM ,`,./.„---- � — TOTAL PERMIT FEE Authorized signature: / ✓> 7 "hee permit n ppllcatian expire', if permit l not obtained within Ian Prin[ nam C; J day % o'ter it has been incepted nc comrylctc. ✓ti Date; ` 11 j / * Fec ntala set by TN-County y Building Industry 3ervtec Bonrd INgull(Ilu PcrminuNTEC•Pcrnilinu .loc IOMi/ 5 ` 440-46 I 71' (11 /02 /COM/WAA) Plumbing Permit Application Building Fixtures e, TEPID FOR OFFICE USE ONLY 14 City of Tigard Received Date/By: l ��� Permit No.: Gal r n 13125 SW Hall Blvd., Tigard, OR 97223 J N ® ?O 11 p lan Review Phone: 503.639.4171 Fax: 503.598.1960 06 Other Permit No.: DateBy: Inspection Line: 503.639.4175 C ITY OF TIGARD D ate Ready/By: Suds: ® See Pa e 2 for PIGAItp Y Y B Internet: www.tigard- or.gov r Notified/Method: Supplemental Information TYPE OF WORK BUILDING DIVISIO FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I 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 )41- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ 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: \,3350 5t...) 0 ,USL.;‘t__ ... Catch basin or area drain 18.76 City /State /ZIP: 1 �qCA� 0 (k Drywell, leach line, or trench drain 18.76 J J , Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: M 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: 1 Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Do (A) n5 c-5 1 (NU) Pk'�� . Clothes washer ` 25.02 25 OZ Dishwasher 25.02 Move- " ' fi e , \f j c . I 4443` I J J c + s 4 Vl cie.C Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain /floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 *APPLICANT El CONTACT PERSON Interceptor /grease trap 25.02 Business name: h�Z CDr1jbco,C i,p,^ Medical gas (value: $ ) Page 2 i1 lx:c -e- r Primer 12.51 Contact name: o C, Wq��� Roof drain (commercial) 12.51 Address: 3 2v\ )t Wy �p ( S� �a. Sink/basin/lavatory 25.02 City/State /ZIP: 1 J OP c1.7 t '52_ Solar units (potable water) 62.54 t Phone: (50)) 5' -$'( f Fax: : ( ) Tub /shower /shower pan 12.51 E- mail: - pt Is WLCcad'`9 -Ci- C\ . CO vt--k Urinal 25.02 CONTRACTOR • Water closet t 25.02 '-j, 6 Water heater 37.52 Business name: P ` V LLY110 't r• c\ piping/DWV 56.29 Address: vow 5w 0t00.e.,612 �e- , J \ Other: 25.02 City /State /ZIP: ®P €i izcx- • o(. ct7cnoCto Subtotal 456 O Phone: ($ ) C,& '/ 2._ --732 3 Fax: ( ) o��O_1� Pb 74 t Minimum permit fee: $72.50 22,E // Plan review (25% of permit fee) CCB Lic.: I4 `C / /, Plumbing Lic. no ; 2� b,7 �-- State surcharge (12% of permit fee) G Authorized signature: `,� TOTAL PERMIT FEE i5 ( .'Z C) Print name: ? C t■ i-e- Date: 1 /S/ ` t This permit application expires if a permit is not obtained within 180 days 0 Ebb ` after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /O2ICOM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1s' 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 Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: $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 Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to p 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 Review for 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 ❑ 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/Shower i/Whirlpool as defined in OAR918- 780 -0040. Car Wash / irlp ❑ Medical gas and vacuum systems for health care facilities. Drive Thru ❑ 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 that meet the qualifications above. 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: l:\ Building \Permits\PLMF - PermitApp.doc 2 IN _ °' Building Division Development Code Provision Review T (G A R D Commercial Projects with Approved Land Use Building Permit No.: t'T 1 - l-XZ'Y 2,. Land Use Casefile No.: AR- Wa`(O O -- C. 0 2 Routed Plans: Submittal Date: l((.p // Submittal Date: Submittal Date: To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. STAFF: please only mark those items on the left side that are approved. Planning Review (contact /CO 5'I'i -e) P.e.cra`cov.t 503 - 718 - ZtS or Il r6' ♦a @ tigard or.gov) ❑ Land Use Approval ❑ Building Plans Match Approved Plan: , Yes ❑ No ❑ ❑ Maximum Building Height ❑ Conditions Met . . Notes: 0 G(XJiC -' T t t.or}, f- 2d" t ,of" Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) ❑ Actual Slope: 9 ‘14. 10 PFI Permit # '2- - o 00'3 7 ❑ Conditions Met Notes: r1-01- LT 150 g.-1 1 Original Plan: Approved 74, Not Approved ❑ Date: 1 7 6 1 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) ❑ Street Trees ❑ Protected Trees Notes: ,I/M APPu .,r . Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permi oordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) Planning Okay to Issue Permit Arborist Okay to Issue Permit Engineering Okay to Issue Permit Notes: Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes 414 o ■ Date Routed to Building: t 1 ( • • Page 2 of 2 Overview of Changes to Residence s OVE ,fi 13350 SW Hillshire Rd. Tigard, OR JAN ®6 2011 CITY OF TIGARD Plumbing BUILDING DIVISION - Adding stackable Washer/Dryer in Bathroom - Re- locating toilet - Moving Refer to a new location Mechanical - Adding ductless split- system - Capping existing ducts into residence - Adding venting for new Micro -hood Electrical -New Sub -Panel dedicated to the new residence -6 new circuits to feed new appliances and lighting - Dedicating a new meter to separate the two residences Misc. Other Changes - Relocating bedroom door - Relocating bathroom door - Addition of two new fire doors to meet code - Replacing 6'x6'8" French doors with 5'06'8" slider - Replacing existing 6'0x6'8" slider with 6'06'8" French doors w/ fixed panel CITY OF TIGARI) Approved Ti. [ Conditionally Approved [ ] See Letter to: Follow [ ] Attached Permit N , berVt' 7l Addre . • _ - By: r' Date: OFFICE COPY filt - wit ---\ , • . : - A.. , . . . . . : . „ , , . , , . . . . ._ , . .. . i • , - , , , : . . . . . , , ; , , . ; . - : 7 . : , . , . . . . . , , . : . . . . . , , . . . ,....., . . 1 4,. . r---------_ ; . ; • • . _.... : . .. . . . ; '. --E1 ! . .... I . : . , " - ". • ' .' , 1 : ;1' ._ , • • - - i 1 ..L., -- --L---: ! i \:\ - v • •, ' j - ! - , -- • _----, ; , i ' : ; , ! ; ; ! i ; , :; It '.1 _ 1 1 .-1 • ., -,-... - •. •, ' i• extN1 --X - . ' - ., . . . . . . • • . , 1 , , ., ! i ',; I H.. .. l • , ; 1 • , . . . ' ....... , . ( ' , • , . . . . . , .. . . , . . , ..• : ; . : ! . 1 i _ _ 7 - I 1 - • I : • 1 : : . . • ; i • , , : ! : : : , , • ' • 1 --- I , , -1 - , ' • . • 1 1 : i i , .• - ' . ,: . , '...____..• • • , I I • , , , 1 . ' : . . 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J i . • • --- -7 -; ........, . ______ . • • 1 , _ ,. ! . • ,',',,-, ..,;', -;4:::: 1 ....... , • ............. . . , , . . , . . , , . , ----- • •-- , • . , . , i i ‘ ' !, ' ! ! 3-0.. st, ,,,,, ._, ,A\51(\ t. 41)cv , ,.... ,.. . . „... ....: - - t . • 5)2 ' I_ --(,_ 5 - v HS ins., % i S ; GI 4, S )< a ' 120 , 9 (- ci / 12 ' r, i //S , Le, /r GA- 600 -2006 FIRE RESISTANCE DESIGN MANUAL I FLOOR - CEILING SYSTEMS, WOOD FRAMED GA FILE NO. FC 5115 I I PROPRIETARY* I 1 HOUR 50 to 54 STC FIRE SOUND . ' f WOOD JOISTS, GYPSUM WALLBOARD, RESILIENT CHANNELS, ' GLASS FIBER INSULATION One layer 5 /8" proprietary type X gypsum wallboard or gypsum veneer base applied at right iir"1I1 angles to resilient furring channels 24" o.c. with 1" Type S drywall screws 12" o.c. Gypsum board end joints located midway between continuous channels and attached to additional pieces of channel 54" long with screws 12" o.c. Resilient furring channels applied at right angles to 2 x 10 wood joists 16" o.c. with 1 Type W drywall screws. Wood joists supporting 5 /8" interior plywood with exterior glue subfloor and 1 perlite- . sand concrete reinforced with No. 19 SWG galvanized hexagonal wire mesh. 3" glass fiber insulation 0.90 pcf in joist space stapled to subfloor. Approx. Ceiling Weight: 2 psf PROPRIETARY GYPSUM BOARD Fire Test: UL R3453 -7, 5 -1 -70; United States Gypsum Company - 5 /8" SHEETROCK® Brand FIRECODE® C UL Design L516 Core Gypsum Panels Sound Test: KAL L 224- 28 -65, 3 -30 -65 , • c. IIC & Test: (74 C & P) KAL L 224- 27 -65, 3 -30 -65 GA FILE NO. FC 5116 I I PROPRIETARY* I 1 HOUR 50 to 54 STC FIRE SOUND WOOD JOISTS, GYPSUM WALLBOARD, RESILIENT CHANNELS, GLASS FIBER INSULATION , One layer 5 /8" proprietary type X gypsum wallboard or gypsum veneer base applied at right , :.:.:'�':.:� angles to resilient furring channels 24" o.c. with 1" Type S drywall screws 12" o.c. Gypsum board end joints located midway between continuous channels and attached to 1=1i additional pieces of channel 54" long with screws at 12" o.c. Resilient furring channels applied at right angles to 2 x 10 wood joists 16" o.c. with 1 Type W drywall screws. Wood joists supporting 5 /8" interior plywood with exterior glue subfloor and 1 perlite- sand concrete reinforced with No. 19 SWG galvanized hexagonal wire mesh. 3" glass fiber insulation 0.90 pcf in joist space stapled to subfloor. Approx. Ceiling w;' „�,,( Weight: 2 psf PROPRIETARY GYPSUM BOARD Fire Test: UL R3453 -7, 5 -1 -70; American Gypsum Company 5 /8" FireBloc® Type C Based on4iL R3660 -7, -8, BPB America Inc. - 5 /a" ProRoc® Type C Gypsum Panels 11- 12 -87; R2717 -61, 8- 18 -87; BPB Canada Inc. - 5 /8" ProRoc® Type C Gypsum Panels Based on UL R7094, G -P Gypsum - 5 /e" ToughRock® Fireguard® C 90NK10635, 10- 24 -90; Lafarge North America Inc. - 5 /8" Firecheck® Type C Based on UL R8742, National Gypsum Company - 5 /e" G old Bond® Brand FIRE - SHIELD CTM yp p y 88NK22591, 10 -6 -88; Gypsum Wallboard UL Design L516 • PABCO Gypsum - 5 /8" FLAM CURB® Super 'C'TM Sound Test: KAL L 224- 28 -65, 3 -30 -65 Temple- Inland Forest Products Corporation - 5 /e" TG -C IIC & Test: (74 C & P) KAL L 224- 27 -65, 3 -30 -65 GA FILE NO. FC 5120 I I GENERIC I 1 HOUR 50 to 54 STC FIRE SOUND i WOOD JOISTS, GYPSUM WALLBOARD, RESILIENT CHANNELS, i GLASS FIBER INSULATION - - - ° - One layer 1 /2" type X gypsum wallboard or gypsum veneer base applied at right angles to ' resilient furring channels 24" o.c. with 1" Type S drywall screws 8" o.c. at ends and 12" o.c. at intermediate furring channels. Gypsum board end joints located midway between continuous channels and attached to additional pieces of channel 64" long with screws , Aik . A 1 , 1 _ 8" o.c. Resilient furring channels applied at right angles to 2 x 10 wood joists 16" o.c. with 6d coated nails, 1 tong, 0.085" shank, 1 /4" heads, two per joist. Wood joists supporting 5 /8" interior plywood with exterior glue subfloor and 3 /8" particle board, 1.5 psf. 3 glass fiber insulation batts, 0.7 pcf, friction fit in joist cavities supported alternately Approx. Ceiling every 12" by wire rods and resilient furring channels. Weight: 2 psf Sound tested with carpet and pad and with insulation stapled to joists. Fire Test: FM FC -181, 8 -31 -72 Sound Test: G &H OC -3MT, 10 -13 -71 IIC & Test: (73 C & P) Q� -) G &H 0C-3MT, 10 -13 -71 ~'` ; 1:t *Contact the manufacturer for more detailed information on proprietary products. _. i`- , A u.)04 - , — c-,;e.... C 50v-4\ ■ 1 . . . . . _ c ; ce._ f 500-0A ce:,.k■in5 ','•• \ S. ,,„„:, '$.., ; f' , '-; ''' ' '''''' • , , ,- -, / . / \ / • • ,■ .^.4,0 / (El(2.1 4/0 X 5/0 SA. \\ , 'y.‘/// \ \-- (E) 5/0 x 4/0 SL-. r •JQY 7 / (1 ■ 6 '9 CSS t ejd r ( , - .1,• ••• - , , , /1 e-7 SL-. , . < bg 1 , UNDER . . . , , , ., • ' ,.: 1. ; (90 :: , 1 ICE K_Ike SINK i I I 1 ' / 1 Li / I, ‘i . 1 L It. __.,1 •& IC e' P ' NEW / tri .,_,,. 6AS 0 OUJNER TO Sri CIFY FPLC ,..- U 'At IV CABINET SIZES q ,\ 17 ; , • ,.. , .10 1 ,, !I . . e „ I. / 1 -8 1 2 I f 0) ■ l•• 0 • 10 / i - t> , • al k REC. 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