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Permit A' CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00169 I I DEVELOPMENT SERVICES DATE ISSUED: 6/3/2004 I '' '= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 10345 SW GREENLEAF TERR PARCEL: 2S111 CC -19100 SUBDIVISION: SUMMERFIELD NO.5 ZONING: R - 12 BLOCK: LOT: 250 JURISDICTION: TIG REMARKS: Addition of 144 square foot sunroom. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 144 sf BASEMENT: sf LEFT: 4 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 4 VALUE: 13 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 144 sf REAR: 8 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: GAS 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 FD R: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: 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: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 398.03 This permit is subject to the regulations contained in the MICHAEL WALTERS PATIO INNOVATIONS, INC. Tigard Munidpal Code, State of OR. Specialty Codes 10345 SW GREENLEAF TERR 5220 NE COLUMBIA BLVD and all other applicable laws. All work will be done in TIGARD, OR 97224 PORTLAND, OR 97218 accordance with approved plans. This permitwillexpire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 684 - 1295 Phone: 503 282 - 0140 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 127345 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing Insp Framing Insp Foundation Insp Electrical Final Post/Beam Structural Final inspection Underfloor insulation Electrical Rough In Iss ed By : k ■■•■•.! i _14 ,, _J.... Permittee Signature :71 --- : 0 * --..7 W 77 Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day 1 Building Permit Application FOR OFFICE USE ONLY City of Tigard Received t 0 41 Permit No.: 1 1 / 4 / h f , • - z /c'9 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 / "j+i: Date/B : Other Permit: Inspection Line: 503.639.4175 _ W Date Ready/By: i :- n El See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: 7 (O' Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction El Demolition Permit fees* are based on the value of the work performed. VI Addition/alteration/replacement ❑ Other. Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the rotfor-the CATEGORY OF CONSTRUCTION work indicated on this application 5 i 5 V ] 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ ❑ 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: ' O34 5 s,\,,), Gree ea...cs ''`_ rte« New dwelling area: square feet City/State /ZIP: M p 1 © p, 9.7aai-4 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Sl.tt`r ,erne r ,� r— Dcz . Deck area: square feet Other structure area: 1 L I square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: a 5O 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. 1� Valua " n: $ C� net,...) `7 Li11 rDoiv-\ eX 4e nSidn C. �J C-C' Existing b " ding area: square feet '' •I`n1 / OM • 'F e. to w ex .- lSk'tn ' -\ Ase. p L I I - i -- e) C�Oo'cv� t� P , I.-IQe1�Yt c- e 1 bw+ died" New building ar • square feet '] PROPERTY OWNER ❑ TENANT Number of stories: Name: r{ I 6,1 4-C',f S Type of construction: Address: 1 0 3 1-45 SN ��I�- � rt ' Occupancy groups: City/State /ZIP: i p Q 7g - Existing: 1 Phone: ('S03) C$ 4 -1 Z9 5 Fax: ( ) New: a APPLICANT ❑ CONTACT PERSON NOTICE Business name: (N( \c,,,i �Ut All contractors and subcontractors are required to be licens• . "th the Oregon Construction Contractors Board Contact name: ' -6k \ V e - under OR - t 1 and may be required to be licensed in the Address: 3 Z26 N ,,E_ . Cp 1 jurisdiction in 1: h work is being performed. If the City/State /ZIP: `" l Oe- q-72-1E applicant is exempt ■ : licensing, the following reasons apply: Phone: 603) ag 2.- O f y d Fax: : (503) 2$ 2- 1 E -mail: c)00 0 r "'(` - V5r1, C. O'N•--_ CONTRACTOR Business name: ' \f- C `7 BUILDING PERMIT FEES* Address: Please refer to fee schedule. City/State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) ' 277 2 Amount received CCB lic.: J Date received: Authorized signature / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: f /� Date: 1" * Fee methodology set by Tri- County Building Industry . . . Electrical Permit Application ,, , , FOR OFFICE USE ONLY - - , • . City ef Tigard Received Date/By: Permit No.: 5 WV —0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Ali% iiiii'\ Date/B : Other Permit: Inspection Line: 503.639.4175 4 , 3 1-,14111w, -' I ' Date Ready/By: Juris: El See Page 2 for Internet: www.ci.tigard.or.us Nonfied/Method: Supplemental Information ;TP:,-*VaiLOT,„ l'AliVittir :!:WRIZW4t:Spitfllkr'VPtiirfW2 MX14MagettrWigliaMVIIVC,..R:':;;:c .: ,. : -: ', liktljr^ :Wrgi.,.,'ZAA':' '..,:.7 '_-•.• lil-%),.k - ,- .;,,,,, '1^.....,:v El New construction "Addition/alteration/replacement Please check all that apply: ['Service over 225 amps, comm'l DHazardous location [1] Demolition E Other: V SO ervice over 320 amps - rating 0Buildng over 10,000 sq. ft., o'W v:'?ewer-PeraiiitriiifbV6ialitrribV4 - !U : Plit t of 1- and 2-family dwellings 4 or more new residential 0 1 and 2 dwelling 0 Commercial/industrial 0 Accessory building 0System over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more 0 Multi D Master builder 0 Other: [' bvr.k,/yt-erWl4V „ .. oo ..,. Occupant load over 99 persons ['Manufactured structures or Ti o. kii-oli NAV: . .4„,,V,i At. ,,, 0 Egress/lighting plan RV. park 5 5 Job no.: Job site address: 3 fees, 1...-r.. tr- 0Health-care facility DOther: 1 b 4 , ‘,..), G it Submit 2 sets of plans with any of the above. City/State/ZIP: Q 7 72.2 The above are not applicable to temporary construction service. , WilfiliManYPSR figfitigKLM:V:e; :.. 7 :7 :I: Suite/bldg./apt. no.: Project name: Description Qty. Fee. Total ** Cross street/directions to job site: i , tr ..4 e,g 7)(-,. New residential single- or multi-family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Z St) Ea. add'l 500 sq. ft. or portion 33.40 I Limited energy, residential 75.00 2 Tax map/parcel no.: . . „ Limited energy, non-residential 75.00 ' 2 EMFeriPPIEVIV40WO1O,9 :tivfilXigYetreNAVINTAV Each manufactured or modular dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 fttnr,ireefdinVVAffej'e4,P1'VPWW::;':'WS:Afg.g''trrr:4 201 amps to 400 amps 106.85 2 Name: MI C-Vae- (dLDI4Cg'S 601 amps to 1,000 amps 240.60 2 Address: I (:) 5 ,),/. G„,,,„....1a,,..p Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: -- T - ve- l c.429 C)e q 7 2Z_'( _ Temporary services or feeders installation, alteration, and/or i relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel Ai.irrArriiiffigRri*OVEki- INWAtCtgfrarNTAttliiiiMekZPV A. Fee for branch circuits with „.. ; ,..:`,-0,,,,,,,,,-0, ..-404M,c1h41 WO004,, • '0.:i:A4. ,..-: smice or feeder fee, each 6.65 2 Business name: Ir 4-1.4 • branch circuit e.... en B. Fee for branch circuits / Contact name: 4------- I 1 ry- without service or feeder fee, i 46.85 4. t' 2 each branch circuit Address: 5 2 -2 t..-1.c._. eo) ‘A ...,1,-, Each add'l branch circuit 6.65 2 City/State/ZIP: --- p rt _, 72--A Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (561) 2$ 2. ..-. 0/g C.) Fax: : ( 5Y3 ) 2g 2 — / Sign or outline lighting 53.40 2 E-mail: vv,--1-1 6,......‘,..,,,,--, @ c-,, . c_crp"--- Signal circuit(s) or limited- etz ;:, ! i',. i lmisgromms, gte„riviwtrst--Egatim energy panel, alteration, or extension. Describe: Page 2 2 Business na : eimprz ‘. , Address: 0 0)( ,. 411), , Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: /K1 1 &2_ ote_ I7e13/ Investigation per hour (1 hr min) 62.50 Phone: 644 5 8 . & - - „ & ( ) Industrial plant per hour 73.75 K Fax: ,.. CCB Lie.: Electrical Lie.: Suprv. Lie.: Subtotal i/ho - Suprv. Electrician signature, required: Plan review (25% of permit fee) State surcharge (8% of permit fee) g" 7( Print name: Date: TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: . Fee methodology set by Tri-County Building Industry Service Board ** Number of inspections per permit allowed. IABuildingTermits \ELC-PerrnitApp doe 12/03 440-4615T( 10/02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: , RES,rDE1 IA7L WAR IWV Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* Fl Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: E0,0„i7, 57 g'„1.1.2111111;11 Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems • n Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i Building \Permits\ELC- PemutApp. doc 04/03 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GORGE ELECTRIC INC PO BOX 806 HOOD RIVER, OR 97031 Electrical Signature Form Permit #: MST2004 -00169 Date Issued: 6/3/2004 Parcel: 2S111 CC -19100 Site Address: 10345 SW GREENLEAF TERR Subdivision: SUMMERFIELD NO.5 Block: Lot: 250 Jurisdiction: TIG Zoning: R -12 Remarks: Addition of 144 square foot sunroom. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MICHAEL WALTERS GORGE ELECTRIC INC 10345 SW GREENLEAF TERR PO BOX 806 TIGARD, OR 97224 HOOD RIVER, OR 97031 Phone #: 503 - 684 -1295 Phone #: 541 - 386 -2468 R #: ELE 14 -20C LIC 111706 SUP 4856S AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervisictrician If you have any questions, please call 503.718.2433. , , , 8IZL6 2i0 `PUeliaod / ;1 PHIS e!gwn1o3 3N OZZS '00 011Vd QNd JNINMV AVKI • : 0_ _., .----......_ - \ ::......te. ,.‘ \ ;r; --------: s 1 _ 3 9 V ' �— O A ao y � N S I r- 6'. 1; Gm . • 0d A 7, . ..X) , m V F", . 1 -. _ _ - _ - - -- -- - " CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: — - _---- © PLANNING DIVISION: R - ra 'P D 9,) Required Setbac ' : X Approved ❑ Not Approved Side: Street Side: 0 Front. Garage: Rear: Visual Clearance: 0 Aoaroved ❑ Not Approved Maximum Building Height feet • CWS Service Provider Letter Required: gif Yes ❑ No n Received ... 1-1Neft,9ew. ca...si, Dat,.,:a- 3 --(:). ENGINEEr.ING DEPA_R'fT MENT: I l Actual Slope: N % lt Approved 0 Not Approved Site Plan: // Approved ❑ Not Approved B 0 • gwi Date: a • Notes: 14.. P c,.P -- 4 5f DI e teh vc�4rllnrn -,S CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 630 -4175 MST a 310 4 - 6C ' '? INSPECTION DIVISION business Line: (503) 639 -4171 BUP Received Date Re•uested -" /3 AM PM BUP Location 16 'y: • 01 ; ��P�Suite MEC Contact Person 0�/�Y. _� Ph ( ) 3TU'7 ?ZZ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear /�y Int /� o Framing Insulation /Shear U� C�� \ 'i'1� Vl_ — v Q �� � �`' G LJ Insulation itor ' -0 Drywall Nailing "'! �"•� Firewall * ' 6 , ■ �'1 1∎L 0 ` V /i O 3 Fire Sprinkler 1 Fire Alarm Susp'd Ceiling • �' Roof Other: 'ASS PART FAIL r�, - • • Pos - Under Slab Rough -In Water Service Sanitary Sewer Rain Drains 16 7 Catch Basin / Manhole Storm Drain Shower Pan Other: KASS,, PART FAIL ME L°H�I; ICAL Post & Beam Rough -In Gas Line Smoke Dampers Final FAIL Service Rough -In UG /Slab Low Voltage Fire Alarm ASSN PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reins•ection RE: El Unable to inspect - no access Fire Supply Line ADA j/k^'%-- � Approach /Sidewalk Date / _ � Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL