Loading...
Permit CITY OF TIGARD MASTER PERMIT s ,, COMMUNITY DEVELOPMENT Permit #: MST2011 00110 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/15/2011 Parcel: 1S133DCO2400 Jurisdiction: Tigard Site address: 11910 SW MORNING HILL DR Subdivision: Lot: Project: GODFREY Project Description: 12 sf. master bathroom addition. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 12 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 12 sf Value: $5,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 1 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Ecom asin N Other: N Other Description: p g BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R -3 12 Owner: Contractor: GODFREY, MARYALICE OWNER Required Items and Reports (Conditions) 11910 SW MORNING HILL DR TIGARD, OR 97223 •1111ft PHONE: PHONE: /, FAX: Total Fees: $474.18 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throu h OA 2 -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: — Perm ittee Signature: • eN /7h/ Z /619'���� Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. Building Permit Application �e - .%'3'11.% ez Residential FOR OFFICE LSE ONLY City of Tigard ` Received `J g 0 'J DateB 41 �� Permit No.: Art I. U G7 q 13125 SW Hall Blvd., Tigard, OR 97 3o ������ Plan Review Phone: 503.718.2439 Fax: 503.598.1960 , ' �,� 1,? � d Date : `�ln Other Petmit: TI G AR D Inspection Line: 503.639.4175 K4 6 �i�i Date ReadyBy: 41� /J , Supplemental See Page 2 for Internet: www.tigard or.gov 0‘ ' v Notified/Method:� upplemental Information 6�' tP **4116∎ i t ^ cki TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® I- and 2- family dwelling 11 Commercial/industrial Valuation: $5000 ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 11910 Sw Morning Hill Dr. New dwelling area: 12 square feet City/ State/ZIP: 97223 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: Master Bath Remodel Covered porch area: square feet Cross street/directions to job site: SW 135th Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Morning Hill Lot no.: 52 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 1S133DC 02400 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. Add 12 square feet to existing master bath by bumping out 1 wall Valuation: $ Existing building area: square feet New building area: square feet 0 PROPERTY OWNER ❑ TENANT Number of stories: Name: Maryalice Godfrey Type of construction: Address: 11910 SW morning Hill Dr. Occupancy groups: City/State/ZIP: 97223 Existing: Phone: (503)590 -4441 Fax: ( ) New: ® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee scheduled Structural plan review fee (or deposit): Contact name: Rich Umphress FLS plan review fee (if applicable): Address: 11910 SW Morning Hill Dr. c � City/State /ZIP: 97223 Total fees due upon application: 1 — 7 . 3 I Phone: (503) 590 -4441 I Fax: : ( ) Amount received: Girl_ if E -mail: richump @gmail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof -top mounted PhotoVoltaic Solar Panel System. Submit two (2) sets of roof plan with connection details Business name: and fire department access, along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee (includes plan review $180.00 and administrative fees): Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: -'- n Total fee due upon application: $201.60 Authorized signature: } } 1-L! .. ) ri This permit application expires if a permit is not obtained ((// (/ within 180 days after it has been accepted as complete. I Print name: Maryalice Godfrey I Date: 7-05 -2011 I * Fee methodology set by Tri -County Building Industry plumbing Permit Application Building Fixtures Received City of Tigard 1 Date/By: Permit No.: UPI 0 13125 SW Hall Blvd., Tigard, OR 97223 ' ` Phone: 503.718.2439 Fax: 503.598.1961 'J t' Plan Review .. telBy: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 \\� r P '. eadyBy: Juris: ® See Page 2 for Internet: www.tigard -or.gov J „ , , mod: Supplemental Information TYPE OF WORK 'k 01; \� \ FEE* SCHEDULE ❑ New construction ❑ Demolitiot . ' For special information use checklist ® \y 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 (I) bath 312.70 ® 1- and 2- family dwelling ❑ Commerciallindustrial 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: 11910 SW Morning Hill Dr. Catch basin or area drain 18.76 City/State /ZIP: Drywell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: Master Bath Remodel Manufactured home utilities 50.03 Cross street/directions to job site: SW 135th 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: Morning Hill I Lot no.: 52 Fixture or item: Tax map /parcel no.: 1S133DC 02400 Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Add 12 square feet to existing master bath by bumping out 1 wall Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Maryalice Godfrey Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 11910 SW Morning Hill Dr. Garbage disposal 25.02 City/State/ZIP: 97223 Hose bib 25.02 Phone: (503)590 -4441 Fax: ( ) Ice maker 12.51 ® APPLICANT ® CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Rich Umphress Roof drain (commercial) 12.51 Address: 11910 SW Morning Hill Dr. Sink/basi avatory) 1 25.02 Zi , OZ-- City/State/ZIP: 97223 Solar units (potable water) 62.54 Phone: (503) 590 -4441 Fax: : ( ) Tub /shower /shower pan 1 12.51 12.51 E -mail: richump@ gmail.com Urinal 25.02 Water closet - 25.02 CONTRACTOR Water heater 37.52 Business name: oWNr,c- Water i in p p g/DWV 56.29 Address: Other: 25.02 City/State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 7 ). CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) � State surcharge (12% of permit fee) sss999 `7 0 Authorized signature: )41, 4 . a , . ,�,� ,.� 5 ' , TOTAL PERMIT FEE , � Q Print name: Maryalice Godfrey I •�� Date: 7/05/2011 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee. mntivvinlnm, ePt h., Tril'n,mt , Fillilsiinor Indnchry CPr.rirn Rnnxi Electrical Permit Application , FOB OFFICE ('SE ONLY City of Tigard \ Received Er 13125 SW Hall Blvd., Tigard, tl 2�6 G, � Plan R Other Permit: Phone: 503.718.2439 Fax: 50 ' :.196A Q DateB : Permit No.: TI G A D Inspection Line: 503.639.4175 J xclx: . Date Ready/By: Juris: El See Page 2 for Internet: www.tigard-or.gov 0� \��S \ Notified/Method: Supplemental Information TYPE OF W450‘1 ' PLAN REVIEW ID New construction ®Addition /altereplacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more 0 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 ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", °E ", "1 - ", "1 - ", Job no.: Job site address: 11910 SW morning Hill Dr. Six 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: Tigard,Or 97223 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Master Bath Remodel ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: SW 135th Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Morning Hill Lot no.: 52 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: 1S133DC 02400 Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family 75.00 2 Add 12 square feet to existing master bath by bumping out 1 wall residential (with above sq. ft.) . Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: Maryalice Godfrey 601 amps to 1,000 amps 301.04 2 Address: 11910 SW Morning Hill Dr. Over 1,000 amps or volts 552.26 2 City/State/ZIP: Tigard, Or 97223 Temporary services or feeders installation, alteration, and/or ty g relocation Phone: (503)590 -4441 Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 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: 7/ j— /// 1 / A. Fee for branch circuits with ® APPLI ANT ® CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 1 56.18 `� 2 Contact name: Rich Umphress branch circuit Each add'I branch circuit 7.42 2 Address: 11910 SW Morning Hill Dr. Miscellaneous (service or feeder not included) City/State/ZIP: Tigard, Or 97223 Each manufactured or modular 67.84 2 ty g + dwelling, service and/or feeder Phone: (503) 590 - 4441 Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Richump @gmail.com Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited -energy Business name: panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr Clty/State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed ('A hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: o Subtotal: , 1$' Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): , , '"7 Authorized signature: TOTAL PERMIT FEE: P Z. , t -2.-- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Mravalice Godfrey I Date: 7-05 -2011 I 11111 Building Division Development Code Provision Review TIGARD Residential Projects Building Permit No: 745T2 /1— C 1 I v CWS Service Provider Letter Received: Yes ❑ No ® /A 0 c r cu..hv - ("btu W,lni Routed Plans: / Original Plan Submittal Date: 7�4 // e./. 1st Revision Submittal Date: ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only 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 check items along left only if approved. Planning Review (contact /<([ 5 f/ 2..) ! .eA, r !Incur) at 503 - 718 - 2 y S or /4 'L, z. @tigard - or.gov) Land Use Case N Name /A in r I Ni 11 11 Ain . C Zoning r Y. 5 PD B"--Setbacks: Front i 0 Rear 15 Side S Street Side 1 S Garage 2— ❑ Maximum Building Height 3 O Actual Building Height t✓/h GYVisual Clearance Q.-Easements la/Sensitive Lands Type: M QN'---' Notes: Original Plan: Approved lV Not Approved ❑ Date: 7 4, /i,i 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) ig Actual Slope: l Notes: Original Plan: Approved Not Approved ❑ Date: 4 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) I // Street Trees le Protected Trees Notes: Original Plan: Approved 13 Not Approved ❑ Date: 7 /ccb(I Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 -718 -2426 or albert @ tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building 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 P. No ❑ Date Routed to Building: ; 4 Page 2 of 2 N I N A RECEIVED ' ' JUL 05 2011 it I I i - - I CITY OF TIGARD - I BUILDING DIVISION • , Master Bath t I P � o ,._ i H 3 j j % .-- H II 00 l Proposed 1 _... ._.... addition 1 . 8 I I ; i1 1 12� -0" I Property line I 0 i l i I . Garage I 1 ` I in Co Name: Maryalice Godfrey L ___________________________ Address: 11910 SW Morning Hill Dr. Phone: 503- 590 -4441 Date: 7 -05 -2011 Description: Site plan 5 - - - - - - � � -- 4 - - - 3 - - - —2 - -- -- 1 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the i formation on this homeowner statement is true and accurate. 6 Print N. it Applicant / �f ��4' �...c:_ // Si • nature of Permit Applicant Date Permit #: 1 s ,/ a0 // " C�I1 c) Add Address: / I qi0 J i y, 1 61/ Q 47-.--});.:f-.7'.>,,, ress: ..-,---„.. Issued by: .3. l . Date: 7 /s7 /I r" /1.5"// This Copy for Permit Offices C f),S7A0 --cn /fin I Clean Water Services File Number JUL 0 6 MI CleanWateer Services i d_ 0 U 3 0 ect B - sitive Area Pre - Screening Site Assessment 1. Jurisdiction: 444 OtiCA El Y j�J ED 2. Property Information (example 1S234AB01400) 3. Owner Information JUL 1 3 2011 Tax lot ID(s): 1 5 1 3 1 C. 0 2-1 027 Name: Maryalice Godfrey Company: CITY OFTIGARD Address: 11910 SW Morning Hill' ILDING DIVISION Site Address: 11910 SW Morning Hill Dr. City, State, Zip: Tigard, OR 97223 City, State, Zip: Tigard, Or 97223 Phone /Fax: 503 - 590 -4441 Nearest Cross Street: SW 135th E -Mail: maryallcegodfrey @gmall.com 4. Development Activity (check all that apply) 5. Applicant Information I� Addition to Single Family Residence (rooms, deck, garage) Name: Rich Umphress ❑ Lot Line Adjustment ❑ Minor Land Partition Company: ❑ Residential Condominium ❑ Commercial Condominium Address: ❑ Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial City, State, Zip: Other Phone /Fax: 503 - 590 -4441 E - Mail: richump @gmall.com 6. Will the project Involve any off -site work? ❑ Yes XI No ❑ Unknown Location and description of off -site work 7. Additional comments or information that may be needed to understand your project Minor bump out to enlarge mater bath. This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEQ 1200 -C Permit or other permits as Issued by the Department of Environmental Quality, Department of State Lands and /or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document, and to the best of my knowledge and belief, this information is true, complete, and accurate. Print/Type Name Rich Umphress Print/Type Title ONLINE SUBMITTAL Date 7/6/2011 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report p ay also be required. B ased on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, State, and federal law. ❑ Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s) are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQ 1' D. °� Reviewed by /' r` Date f 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • Phone: (503) 681 -5100 • Fax: (503) 681 -4439 • www.cleanwaterservices.org