Permit q CITY OF 1 fir® MASTER PERMIT
PERMIT ED : 9/ 26/200 -00152
COMMUNITY DEVELOPMENT
DATE ISSUED: 9/26/2007
: . 9ARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S135DD -03619
SITE ADDRESS: 11560 SW 90TH AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: OVIST •
Project Description: Addition to garage and 1 bedroom
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 157 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 275 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 157 sf 24,917.67
REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: • TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: . GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 • 200 amp: WISVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
•
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: V
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601.-amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
0
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: �e
HVAC: DATA /TELE COMM: NURSE CALLS: TOTAL 5 SYSTEMS: ` n
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
DAVID OVIST OWNER laws. All work will be done in accordance with approved plans. This
11560 SW 90TH permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97223 if the work is suspended for more than 180 days- ATTENTION:
Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010 .
through 952- 001 -0080. You may obtain copies of these rules or direct
Phone: NA Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
Reg #:
TOTAL FEES: $ 706.09
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681-4444
Issued By Permittee Signature • _ �`_
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
•
111 ,'„ Ir T ®F T e ;AR® MASTER PERMIT
T
COMMUNITY DEVELOPMENT PERMIT #: MST2007 -00152
`DATE ISSUED: 9/26/2007
; IGARO. . 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 135DD -03619
SITE ADDRESS: 11560 SW 90TH AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: OVIST •
Project Description: Addition to garage and 1 bedroom
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 157 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 275 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sr RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 157 sf 24,917.67
REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =10OK: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st WIO SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAL/PANEL: IN PLANT:
p a MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: o
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA /TELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS: lin
`
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
DAVID OVIST OWNER laws. All work will be done in accordance with approved plans. This
11560 SW 90TH permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001-00,10
through 952- 001 -0080. You may obtain copies of these rules or direct
Phone: NA Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #:
TOTAL FEES: $ 706.09
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
•
•
•
Issued By Permittee Signature • r `l _
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
• .. V ��Y ®� �� '��® MASTER PERMIT
N ,... _ PERMIT D : M26/200 -00152 • COMMUNITY DEVELOPMENT
DAT ISSUED: 9/26/2007
,TIGARE 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-03619
SITE ADDRESS: 11560 SW 90TH AVE ZONING: R - 4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: OVIST
•
Project Description: Addition to garage and 1 bedroom
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 157 51 BASEMENT: st LEFT: SMOKE DETECTORS: y
•
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 275 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 51 RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 157 sf 24.917.67
REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: • TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOILICMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > •100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: 3
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR:
Ir
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 • 1000 amp: 601 .-amps- 1000v: MINOR LABEL:
1000. amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL • RESTRICTED ENERGY 64
A. SF RESIDENTIAL B. COMMERCIAL f
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
0
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: Ua®
HVAC: DATA /TELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS: n
`
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
DAVID OVIST OWNER laws. All work will be done in accordance with approved plans. This
11560 SW 90TH permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through 952 - 001.0080. You may obtain copies of these rules or direct
Phone: NA Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #:
TOTAL FEES: $ 706.09
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
•
��
Issued By
0 Permittee Signature _ � _
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
ill 1.� CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2007 -00152
COMMUNITY DEVELOPMENT DATE ISSUED: 9/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-03619
SITE ADDRESS: 11560 SW 90TH AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: OVIST
Project Description: Addition to garage and 1 bedroom
BUILDING
REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 157 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: 275 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 157 sf 24,917.67 REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNALJPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
DAVID OVIST OWNER laws. All work will be done in accordance with approved plans. This
11560 SW 90TH permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97223 if the work is suspended for more than 180 days ATTENTION:
Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952- 001 -0010
through 952 - 001 -0080. You may obtain copies of these rules or direct
Phone: NA Contact #: questions to OUNC by calling 503.246.6699 or 1,800 332.2344.
Reg #:
TOTAL FEES: $ 706.09
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Issued By Permittee Signature • � ��
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
it ,Bail jing Permit Application
Residential .
FOR OFFICE ONLY
of Tigard t � ece - /
City Ol Date /B : 5 / Permit N ' ,��/ 00 . .
13125 SW Hall Blvd., Tigard, OR 97223 lan Revie Q
Phone: 503.639.4171 Fax: 503.598.1960 AUG A U 1 200/ Date /B : I ' '0 ,I Other Permit:
T 1 GA RD Inspection Line: 503.639.4175 CI�i //��± �k pphh Date Ready /By O ® See Page 2 for
Internet: www.tigard- or.gov 611 pgs � ( `�r Sr f LO Notifies /Meh•d: /�(Q D7 �� Supplemental Information
TYPE OF WORK REQ. I' D 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
I g.Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this applSation. p7 "'1 R t, • (p
CATEGORY OF CONSTRUCTION' rr/ii�� ,
Valuation 41 7, j 7 $ -
tq,1 and 2- family dwelling El Commercial /industrial Mar
1=1 Accessory building 111 Multi-family Number of bedrooms:
/
❑ Master builder ❑ Other: Number of bathrooms: 0
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: �5> /6.--- t9 �/� c��NU( New dwelling area: /„..,---7 square feet
[ r 7
City /State /ZIP: , 1 i p . Garage /carport area: - , sq ar f
i eet
Suite/bldg. /apt. no.: , Project name: Covered 'porch area: square feet
Cross street/directions to job site: Deck area: square feet
• Other structure area: square feet
' REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
`l ) y f /(/ 9 Valuation: $
•
/ / � //' ! / � • 6 /iV z //t p ( � i e A i. it�y R4,-- Existing building area: square feet
Gtl Z. ! L New building area: square feet
' ELPItOPERTY OWNER ❑ TENANT Number of stories:
Name: 2/9///) Ai /$ ,L Type of construction:
�{
Address: C � ` / 5 `,v //„.„,.. jai . 1/7) Occupancy groups:
City/State/ZIP: Y ' lei 16 I 1 Cife / 700.8-----
Q ( Existing:
/Phone: (563 Z `-/ ! -/ c7 ci -7 ' Fax: ( ) New:
Cl. APPLICANT . ❑ CONTACT PERSON ' NOTICE
Business name: All contractors and subcontractors are required to be
�" Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
\ CONTRACTOR
Business name: t BUI,DING'PERMIT FEES*
Address: t (Please refer to fee schedule)
City /State /ZIP: Structural plan review fee (or deposit): / yg, 5 1—
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: , Total fees due upon application:
), .
S5/ 7
/ /U7 Amount received: I47 1
5
Authorized signature: 1
W . Thi per t application expires if a permit is not obtained
/y�� ;� T / within 180 days after it has been accepted as complete.
Print nanr. % /� 1, / . d e . / • Date: / 7 07
Fee methodology set by Tri- County Building Industry
r/ Service Board.
l: \Building\Permits \BUP -RES PermitApp.doc 02/23/07 440- 4613T(I 1/02 /COM/WEB)
,.
r S
Building Permit Application Checklist '
One- and Two - Family Dwelling FOR , .O F FI C E USE O NLY
'City of Tigard , Permit No.:
I q 13125 SW Hall Blvd. Tigard, OR 97223 Date /By
Phone: 503.639.4171 Fax: 503.598.1960 Associated permits.
24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
TIGARD
Internet: www.tigard- or. gov ❑ Other:
THE FOLLOWING; ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No . N/A
I 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.
0 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state gli ❑ ❑
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 i:i' ❑ ❑
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.
0 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size r ❑ ❑
and location.
0 Q 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ El
^> furnac ventilation fang, plumbing fixtures, balconies and decks 30 inches above grade, etc.
6 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.
Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- Fr.l ❑ ❑
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."
Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists . .❑ p ❑
over 10 feet long and /or any beam/joist carrying a non- uniform load. ,t.-/ y - ra:.M r2E t?"6. 'd''` 6 f )
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 •
fey Five (5) site plans are required for Item 11 1 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" buildin lans will not be acce ted. ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & Systern 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 tree protection measures as required by conditions 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- PermitApp.doc 03/21/06 440-4613T(I I /02 /COM/WEB)
., . - Electrical Permit Application . ' FO OFFIC U SE O f '
City of Tigard Received Permit N .
SPDnc? Oai5
13125 SW 1-811 Blvd., Tigard, OR 972 Plan Review
illi _ `. Phone: 503.639.4171 Fax: 503.598. 9 '0 4 Date /By: Other Permit:
Inspection Line: 503.639.4175 . „ Date Ready/By: kids ® See Page 2 for
TIGARD
Internet: www.tigard - or.gov AU r, I r Notified/Method: Supplemental Information
. TYPE OF WOI ` Y (:W 1 Itl IMr -e PLAN REVIEW
❑ ' t'
ac t ement r- ' e'"
New construction i Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION . exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
k1- 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 ❑ Addition system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: / o 7 ,g L 9 ' /4 100HP or more. occupancy.
/1 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP' ' c7 - , 7 4 „ ...... 7 ,.., /.3 El Health -care facilities. ❑ Supply voltage for more than
❑ Hazardo locations.
�� w 6 r/ ) v 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE 'SCHEDULE •
Cross street/directions to job site: Description I Qty. I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: ; 10 : 1,000 sq. ft. or less 145.15 4
Ea. add'► 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WO' lk (with above sq. ft.) 75.00 2
,
Limited energy, multi - family 75.00 2
/ r) 1 e. eve i✓ _ residential (with above sq. ft.)
_
4 - 4, C/ Al' : ` M �a 200 amps or less 80.30 2
PROPERTY O j,�,� ! P�.I t' • 201 amps to 400 amps 106.85 2
Name: AA' / �1 1�V 401 amps to 600 amps 160.60 2
`t v �, !� '—`•�I••, 601 amps to 1,000 amps 240.60 2
Address: • . I t =EPA ' 4 Over 1,000 amps or volts 454.65 2
• City/State/ZIP: iv A � � Temporary services or feeders installation, alteration, and/or
/ I .1 U� relocation
Phone: ( `)) 2` / 1 � v ax: ( ) 200 amps or less 66.85 1
Owner installation: This 'nstallar on is being ma ‘" on pro s -rty that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, ren . ore change, accord g.to • '' S 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
ranch circuitsnew, alteration, or extension, per panel
Owner signature: 7 Y Date: A. Fee for�ranch circuits with
❑ A PPLICANT ❑ CO NTACT PERSON ' above service or feeder fee 6.65 2
each branch circuit
Business name: t/ /t B. Fee for branch circuits
Contact name: L without servi or feeder fee, + 46.85 2
first ranch circuit I
,/". ' • '/„ Each add'l branch circuit 6.65 1i • `"S 2
Address:
�� t ' tom - Miscellaneous (service or feed r no Included)
City/State /ZIP: - /
0 Or AY Each manufactured or modular
dwelling, service and /or feeder ,• ., - 90.90 2
Phone: .c03 22 _- f� —' f(' Sr Fax: ( 23) 5 Vg I Reconnect only _ 2
66.85
E -mail: J / Pump or irrigatiotfcircle 53.40 2
- CONTRACTOR • Sign.or'6utiine lighting 53.40 2
- 'Signal circuit(s) or limited -
Business name: _ _/ energy panel, alteration, or
Address: va Al �/ extension. Describe: Page 2 2
V
City/State /ZIP: — �` .,-•"-- Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) p Fax: ( investigation per hour (I hr min) 62.50 'v
CCB Lie.: I E rlc. ■ ic.: Suprv. Lie.: Industrial plant per hour 73.75 •
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: ( . Q
Plan review (25% of permit fee):
Print name: 7) Date:
/ State surcharge (8% of permit fee): - 5.
Authorized signature: M r ' TOTAL PERMIT FEE:
/ \
Print name: / � 7 This permit application expires if a permit is not obtained within 180
Date days after it has been accepted as complete.
/ / * Number of inspections allowed per permit.
1 U3udding\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(I 1 /05 /COM/WEB
Electrical Permit Application - City of Tigard „ '
Page 2.- Supplemental Information
LIMITED ENERGY PERMIT FEES:
I RESIDENTIAL .W■RK ONLY: .
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
• Heating, Ventilation and Air Conditioning System*
Vacuum Systems*
n Other:
.COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
• Audio and Stereo Systems
• Boiler Controls
n Clock Systems
n Data Telecommunication Installation
• Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
• Medical
• Nurse Calls
n Outdoor Landscape Lighting*
• 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
Me(baanical Permit Application y Received
FOR" OFFICE USE ONLY . - ' ti
City of Tigard I „ Receive Permit No. ; ,�" OvI j L
13125 SW Hall Blvd., Tigard, OR d'7 Plan Review
- C Phone: 503.639.4171 Fax: 503.598.1960 /11-i' 1 Date /By Other Permit:
Inspection Line: 503.639.4175 AUG 7 °
T I G A R D Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard or.gov C TY 6F T IGA RD Notified /Method: I Supplemental Information
i A. WI. •4l` ION
TYPE 0 - v -
2K COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New constructions Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition /❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
- IN - and 2- family dwelling ❑ Commercial /industrial ❑ 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: / jd _rev J � /S ,7 'l� , . Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: _ , / p • - - 91_ Z .2--: Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pum ; 14.00
Cross street/directions e 'oh site: Duct work 10.00 —
0 ' Hydroni of water system 14.00
Reside tial boiler (radiator or
`- hydr. ic) 14.00 ,
U ' heaters (fuel -type, not electric),
A l ` _ i -wall, in -duct, suspended, etc. 14.00
lue /vent for any of above 6.80
Subdivision: t Tam Lot no.: Other: PO f 2 1 X 10.00
Tax map /parcei no.: �1/ ` Other fuel appliances
AESERIPTI v mum_ ' tr Water heater 10.00
1 , � ^ r , ir dr Gas fireplace 10.00
-11(' y e''� Flue vent for water heater or gas
M >i 1` �4. ->14 _ �4°' Y , fireplace 1. �� 10.00
Lo_ li , hter (las) t X11 " 10 . 00
Wood /sellet stou�_ 10.00
Wood fireplace /insert 10.00 P ' OPERTY OWNER Bry Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Ai ,I , 7 o ff Ak Environmental exhaust and ventilate r n
Address: Q' `� / A (� Range hood /other kitchen
• U � � 0 equipment �' 10.00
City /State /ZIP: J - , 1111 4 f Dr� IF o e '' Clothes dryer exhaust V i� 10.00
Single -duct exhaust (bathrooms, IIMI
Phone: ( 3) ( ) toilet compartments, utility rooms) 6.
❑ Wrnollprx:
❑ CO ACT" PERSON • ic/crawls 'ace fans • ,�„�,i■ 10.00
Othe . I ME 10.
A
Business name: a (N r E,.R. Fuel pipi _.
Contact name: / $5.• 1 or first four; $1 for each additiona
. _ ■
Address: / • p Furnace, etc.
�' 4,),,,i-Act- ` " `� Gas heat pump
City /State /ZIP: v ` j Wall /suspended/unit
Phone: 2 9 ) f ; / / ( s a Water heater
Fireplace
E -mail: Range
CONTRACT "R, Barbecue
•
Business name:
Clothes dryer (gas)
Other:
Address: ,- , MECHANICAL PERMIT FEES*
City /State /ZIP: - V Iv Subtotal
Phone: ( ) ,.Fax: ( ) Mini mum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 7 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: \ e.:6. This permit application expires if a permit is not obtained within 180
r i days after it has been accepted as complete.
Print name: ; h i f / C Date: ��y� * Fee methodology set by Tri- County Building Industry Service Board
1:\Building\Perm s \MEC- PermitApp doc 01/19/07 440 -4617T (11 /02 /COM/WEB)
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.
l: \Building \Permits \MCC- PermitApp.doc 01/19/07 2
Construction Contractors Board Permit #: 1 a1007 152 n
700 Summer St NE Suite 300 Address: 1157 7 () �� QD - - L) .
PO Box 14140
C _` _''' I. Salem OR 97309 -5052
r Issued by: Date:
Phone: 503 - 378 -4621
\-/�- Web Address: www.ccb.state.or.us
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) 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. 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.
Fill /in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
1. I own, reside in, or will reside in the completed structure.
A #i':I 2. I understand that I must become licensed as a construction contractor if the structure is sold or
offered for sale before or on completion.
❑ 3A. My general contractor is
(Name) (CCB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
11 OR
12 3B. I will be my own general contractor.
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 contract with a contractor who is
licensed with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners abo Col: "r ction Responsibilities on the reverse side of this form.
AO
. ,..--- -; .!--- e W V ' ?" -- ; :- 7 -- P
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file, pink copy to applicant.)
Property_owner.doc 06 -01 -04
•
• kcthi General Contractor?
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the
Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature.
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing
structure, you can prevent many problems by being aware of the following responsibilities and concerns.
E : tyer espo :1; sibilities
You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if
you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the
construction or improvement of a residential structure. As the employer, you must comply with the following:
•
Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time
employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your
employees. For more information, call the Department of Revenue at 503-37.8-4988.
Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes
on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488.
The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and
Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formspay.htmll for the
appropriate forms.
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law,
and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation
insurance, you could be subject to penalties andbe liable for all claim costs if one of your employees is injured on the
job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business
Services at 503-947-7815.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages.
You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal UN number, call the
IRS at 1-800-829-4933 or visit their web site at www.irs.gov.
Other Responsibilities and Areas of Co : cerns
Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code
requirements that may be brought to your attention through inspections.
Liability and Property Damage Insurance: Contact your insurance 'agent to see if you have adequate insurance
coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or
work that must be redone.
Time: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in
and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections.
If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO
Box 14140, Salem, OR 97309
Property owner.doc 06-01-04
ENCLOSE (E) COVERED AREA TO LIVING SPACE
GARAGE ADDITION / EXTENSION 150'
(E) D5 i� o
_ _ ui
20.0 11' Q 24' -a 1 MIN. SIDE SETBACK LINE
r ` (E) COVERED AREA
DRIVEYNAY j / ~ i z
(E) CONG. N GARAG
Nt
•
i, /. i, 12 as
0
• $,,$,i, _;° } .N (E) 1 STORY HOME r < I5.o'
' ._ .. r _ _ - . I � �
:�', 4 MIN.
: t� ; ;,a�€ „� ,• l _� a,� t,t�� ';� = <,t ;:..7 ? ° SIDE SETBACK LINE
! ;3aill.,:,, 5 ., in
'
150
1 ,..,'
_..___ .��. ,_ :IM N
tt� 0 ' • ``: c'. .i t E
f". 1 NEVI STRUCTURE S
O (E) CONCRETE 1NALKYNAY
SITE PLAN
;,
1" = 20' -0"
If
t.
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: ►� 5 +.� –;#0 /
Y
5 PLANNING DIVISION: /A
roved ❑ N Apc�ro�rd
Required Setback- .YJ App, S
Side: 5 Street Side: — t
Front. ;--0 Garage: Rear: —
A
Visual Clearance: 0 Approved 0 Not Approved
Maximum Building Height .L feet ❑ No
CWS Service Provider Letter Required: ❑ Yes
Re
l Jt Date:: (1(0 7
ENGINEERIN DEPARTMENT:
Actual Slope: 5 % ® Approved ❑ Not Approved
Site Plan / Pp
roved ❑ Not pproved
B vw Date: e t ? a
Notes: Giy('c9'tital °
1.