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Permit
_ CITY OF TIGARD MASTER PERMIT i ll ?` , ' COMMUNITY DEVELOPMENT Permit #: MST2011 -00198 13125 SW H Bl Tigard OR 97223 503.718.2439 Date Issued: 12/21/2011 - f , , . , Parcel: 2S102DCO3900 Jurisdiction: Tigard Site address: 13895 SW ANDREW TER Subdivision: MCDONALD WOODS Lot: 12 Project: McDonald Woods, lot 12 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First 1664 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 4 Second: 1679 sf Garage: 600 sf Front: 20 Smoke Dwelling Units: 1 Third. 0 sf Right: 5 Detectors Yes Total: 3343 sf Value: $364,114.82 Rear: 15 PLUMBING Sinks: 2 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs /Showers: 4 Garbage Disp • 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add' 500 sf: 6 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 0 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 Other: N Other Description. Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 3343 Owner: Contractor: GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions) 19200 SW 46TH AVE 19200 SW 46TH AVE 1 Ersn Cntrl 503 - 681 - 4444 TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: PHONE: 503 - 692 -3390 FAX: 503- 692 -5433 Total Fees: $20,108.16 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 ' accor.a - 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. TENTION: Ore.• law = .uires ou to follow the rules adopted by the Oregon Utility Notification Ce er. Those rules are set forth in OAR 952 -00 0010 through OAR 9' -0e -0090. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232. .800.33 44. Issued Permittee Signature: ...----- 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. ail(ing PermitApplication 2.7- -,- : . -z 7 . - - - t. , .... ,- ,-: - 2, - =:-,. - . ----- --- . . . . - '-.6itteW --- - -- _ .. ,-,-; - .':%.::.,..„..!,. - ,-. , ,.,: .,, ,',.::- -- sjiitii - .:0 , -,.: i-'' -` "•'''' - 3; '' `,.° :.. •_,`:g=iVa 4 _ . ,...' ,'-.' - ::-, - 11: , / , ' - ' , 1J -, - - =:4 , :... '',',V , F ' r ..7.. r:, City of Tigard / , I Received DateiBv: ta Permit No.:Ai t ie / '' 13125 SW Hall Blvd., Tigard. OR 97223 rkt\NV - Plan Revie .. .."...- 1 4116 0 5 .• ri" P •.-4. • -' 11 .--, 4„4. Phone: 503.639.4171 Fax: 503.598,..i • D -7-- ate/Bv: auFakt Other rerma. it , — 7 _ , _____ _ - ■ ,' :i Inspection Line: 503.639.4175 ,1 4 0 V \. \ Date Rea. 777 0 See Page 2 for Internet. www.tigard-or.gov D.A .___ Notified/meth°. -/„ Ater/ e Ill i ,,,,/ / A Supplemental Information,... .,--. ,,, 11-e-v,- /1// - // _ ._ ' ek. , "1"3. : . • . • - - RE IREDiD • A.- ' " ' - T. • DeCt'leiRr\G . , New construction E . -Permit fees* are based-on-the value of theworicperformed. - V) Indicate the value (rounde to:the nearest d011ar) of all ' • _ . _ . Addition/alteration/replacement E Other: • equipment,.materials, labor, overhead: and the-profit for the CATEGORY OF CONSTRUCTION Work indicated on this - applitation. : . - - • . ,.• : -, . • . IT.. I_ and 2-family dwelling E CommerciaUindustrial Naltiation: - Number of bedrooms: , 475 . Accessory building - ['Multi-famil . - - - Master builder • 0 Other: . • -- Numberof bathrooms: 3 - - - • -'- • • " - - - • — Total - number of floors: --- - '._ - -. -.- ' -, .-- - . ' .JOB SITE ..:- . --, ''.:: •- .: .:' - / i site address: "/ 3- -g. f 5 . c.e..,'i A-Aree,,-,,..) 7 -- New dwelling area: - 33- - square feet - :., y/State/ZIP: Tigard OR 97223 • • 1 . - — Garage/carport area: = --- square feet - - - -. - - - •te/bIdelapt. no.: - . • - Project name: - - Covered-porch area: ---:---( - square feet - 4 : 7791"-:-:----------- )ss street/directions to job site: 92"' off McDonald :' - • - Deck area: • ',--• . feet 1. ' ------- - ----- .- -- - - - - - . . -.. - Other structure area: [ square feet 2 - _ i )division: McDonald Woods . Lot no.42 •P.ermit feesLare_based_onthe_value of the work performed. :Indicate the_valneVonneled:Iol-the.nearest dollar) of all • c map/parcel no.: 2S102DC .. . -. • equipment, materials, labor, overhead, and the profit for the --- l;wCorriicii ,:-i :::'"::',: work indicated on this . . .. . _ . ..._ w Home , Valuation2•'' ‘" '-" - S. - •. . • . • . . : - ' Existing:building area: :,-,. ! i_ .•% - sanare feet • - -... ; _ — - . . New.building-area: square feet : _..._.._ • •: • : PROPERTY OWNER '='',A''i:`„:6:- , Nianber '' • '''.‘-' '• me: Gertz Construction Co INcl ., - : - Type of construction: ,.. dress: 19200 SW 46 Ave . . i . ' --" Occupancy groups: _ . ... y/State/ZIP: Tualatin, OR 97062 • • - - -- - - I !.. Existing:, .- - --,. _ , me: (503)692 Fax:.(503)692-5433 • Pi; ' New: . ._. -. ...: , :a.APITICANir'',':':::" , `,‘:::•to'' , A'.. : ..-. .r ,•-::-:::.. .' - - " - : - "7.''• , - ": ''..' NOTICE ;Mess name: Gertz Construction Co Inc All contractors subcontractors are required to be licensed with the Oregon Board itact name: Ken Gertz ' . under ORS 701 and may be required to be licensed in the 1 iress: 19200 SW 46' Ave jurisdiction in which work is being performed. If the //State/ZIP: Tualatin, OR 97062 • ' applicant is exempt from licensing, the following reasons • 41) ■ne: (503-) 692-3390 Fax: : (503) 692-5433 .. • .., . .. _. . tail: Ken@.Gertzco.conr. ---- .... _ -__ _ . .... „ .. . . . . . ' • • --'•• • - • - CONTRACTOR . . - :. • . - • ._ - • -Mess name: Gertz Construction Co Inc :- . BUILD1NPERJVUti,FJES (PlifaseaViir, tress: 19200 Sw•46 • . Structural plan review fee (or deposit): /State/ZIP: Tualatin. OR 97062. . FLS plan review fee (if applicable): r.: (503) 692-3390 Fax: (503) 692-5433 Total fees due upon application: 3 lic.: 34350 \\\II.),V9 Amount received: horized signature: .. .,....__ This permit application expires if a permit is not obtained within 180 after it has been accepted as complete. name: Kenneth Geretz; 1 Date:/2/1l *.• Fee methodology set by Tri-County Building industry Service Board. .1dineWermits \BUP-RES PermitApp.doc 10/01/09 - 440-413T(11/02/COM/WEB) ' . .: Building Permit Application Checklist One- and Two - Family Dwelling :r�rn r -.� .,t ,¢ . ()ftl( F t tiF 0 `e ':`s s City of Tigard Received n 1312 SW Hall Blvd.. Tleard. OR 97223 Date/By Permit No Phone. 503 639 4171 Fax. 503 598 1960 associated permits: 'TIGAIiD 24- Hour Inspection Line: 503.639.4175 ❑Electrical ❑ Plumbing ❑ Mechanical Internet www.tieard- or. eov • ❑ Other . j � 7 HFi FOLLOWING ITFM5 ARE RF .. UIREU FOR PLAN REVIEW _ N '' I Land use actions completed. See jurisdiction criteria for concurrent reviews. i ® CI El j 2 Zoning. Flood plain, solar balance points. seismic soils designation, historic district. etc. ❑ ❑ CE 3 Verification of approved plat /lot. ❑ I ❑ I _ ❑ 4 Fire district approval required. Name of district:.. ❑ ❑ I El • 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ 6 Sewer permit. I ❑ ❑ I ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. -❑ ❑ El 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, and location. s, vent size ® ❑ II] 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. ® 0 E 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- ® ❑ 0 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 E. ❑ systems, see item 22. "Engineer's calculations." 19 Beam calculations.' Provide two sets of calculations using current code design values for. all beams and multiple joists ® ❑ ❑ over 10 feet long and /or any beam/joist carrying a non-uniform load. 20 Manufactured floor /roof truss design details. ® ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ® ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided. (i.e.. shear wall, roof truss) shall be stamped by an engineer or ® ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the project under review. r`r IURISDIC' 1 tONA1 SP II WS - .. . 3 Three (3) site plans are required for Item 11 above. Site plans must be 8-1/2" x 11" or 11" x 17 ". ® 0 '4 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. E' ❑ I ❑ _ '_6 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ I E "Drawn to scale" indicates standard architect or engineer scale. © ❑ I ❑ ' 8 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard Q ❑ ❑ Street Tree List. 't9 Site plan to include trees and tree protection measures as required by conditions of Tree locations. driplines. ❑ I ❑ I ❑ and protection measures must be drawn to scale and must include the protect arborist's signature of I 1 0 A Clean Water Services Sensitive Area Pre - Screening Site Assessment form is required for all building additions. ❑ ❑ el 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. E \Permits■BUP- RES- PermaApp.00c 03/21/06 440.46 13T(I I /02 /COA1/N'EB/ Electrical Permit Application TOR01.-FiC.--k.'SLON , -- A-. ': - L,,,, -:- -- ----,-, ------ x - .-i::=T•=',7i-:L7,,, .•.-;:-';',. City ottig 7 1: 17 ' 1 ' . - : - -- Da e B Rec t e ; ve y d . . • ,-;.= ■•=- - •-: '-' ' • ':ili .1...: . .-,,•.: .:.X:ti• _ - _.. - . 1 -. SW Ha Blv OR" view Phone: 503639.4171 Fax: 503.5 . 9%-- 1 - 7 -7- - III Plan Re -:- ---- • OtherPiriri •° : ftl it: -ii; .) . :; .98.1 60 41% DateiBv: - - 1 •' . - '' ,,,- I Line 53175 ,:.iijc,:iA1;. I L 0 .639.4 i„,, .0 , &V.V./ ,1 Date Ready/By m . L.: , ,;...,-- ,.„...,,.. 7u• 0 See Page 2 for Internet: www.tigard-or.gov 0.3 0 \()V' Notified/Method. - •f.:. 7 ' - ''' __, „ " Supplemental Information fci (3 {':c0 \- ._. -,.., I • . - ] .TYPE OF ...... . • ..T_LAN,REVIEW ; E New construction 0 AdditionialteratiO061Kement . Please check all that apply (submit 2 sets checked below): 7 ,.L: Service or feeder 400 amps or'more Building overthree stories. r: ----- -- ' 0 Demolition E Othe . - . _ '. - where die available fault current 0 Marinas and boatyards. .. 'CATEGORY-*OF CONSTRUCTION. . • ' . . exceecis!0,009 amps ati50 0 Floating buildings.,...„ less to iround 14.000:: _ AD Commercial-use agricultural Z I- and 2-family dwelling E Commercial/industrial E Accessory building ' amps for all other installations. -.-:' buildings.; ,:),' • s • . -- • ' 0 Multi-family 0 Master builder 0 Other: - . 0 Fire pump --:- ' Elinstaltanori of KVA or :. - -- -• - - 0 Emergency'iVSiem.' . separately deriVedtemi -• • - - .:2:' - ' . - ..„. .JORSITE INFORMATION AND: 'LOCATION: • - . • • .. : ,- : Addition of new. mg load of - la"A", -3" - ...., Job no.: Job siNaddress: -- I.3S q s- - 51-' A.,/ (9,,,,,..j-X-4,e_._ - 1001-LP or more": - occupancy. '''''" •' •' . - 0,Six.ormoreresidential units. 0 Recreational vehicle parks. .,,.,. . City/State/ZIP: Tigard, OR 97223 . - ' 0 Health-care facilities. - . .___ .._______O.Supply-voltage for more than ' 0 Hazardous locationsak 5.7F. .04" ,7li600.,v nommar) - ... oics' 1 . .....; __ Suite/bldg./apt. no.: Project name: - ' - 0 Service or feeder 600 amps or niore. -' -- -7- • - -. . ..,,,.. ' . .' - .. Cross street/directions to job site: 92. off McDonald , , . . Description _ • • - - '" - 7 •[. Qty. F Fee. I Total 1 ^ ' --- - New residential single- or multi-family-dwelling-unit. . - - , . - - • Idehicies.attiched garage. Subdivision: McDonald Woods • - - Lot no.:12. .- 1-,000y ft.jorAess,„ , : , 1i,„ Ft 16 , 8,:,5 i 168.54 4 \ , - 7E 500 sq. ftor-portion h - '2gM•32 1 Tax map/parcel no.:.2S102DC.. ''-. . . - , Limited_energy,,residential_ . _ ' _ - ' .: : •:•,:j--„ -1.:,•:,': :.'- - .- I)EgClii.EFFIONTOF' :: :,,,i (with above sq. ft.) .-1---- Wt - - - -- - :-- - Limited energy; multi-family- _ . - - . • ' New Home -1•-• -7 / ti _ e 67.84 2 _ - • , residential (with above sq. ft.) . Services or-feeders installation, alteration, and/or relocation ' • - 200-amps-or-less- -- --- - - 100.70 _ _1 2 .. . . Cli 20I'aintS'io 400 amps ' 7- ' 2: • 133.56 2 ''.■ -4- - Name: Gertz Construction Co Inc : 401 amps to 600 amps - -.-- __:.• -, 200.34 ., . - 2 , .601_amps to 1:000 amps - - - 30E04' -71 - - 2 -, Address: 19200 SW 46` Ave . . Over 1.000 amps or volts- - - 552.26- - . 2 City/State/ZIP: Tualatin, OR.970624770 - - - • Temporary services or feeders.installation, alteration, and/or ' 1 . - relocation - - - - - ,3 -. ...... Phone: (503)692-3390 Fax: (503)692-5433 . . - 200-amps.or less- _ 59.36 1 c' ": ' ',I Owner installation: This installation is being made on property that I own which is not -- 201 amps to-44Vainps 125.08 ..2 intended for sale,- lease, rent, or exchange,..according to ORS 447, 449, 670, and 70L . • 4 91 amps to 599 amps 168.54 - 2 ---..... , - Branch circuits or per panel --...., Owner signature: • Date: ' • A. Fe for branch circuits with 21'4 : ..;.:;,.. .. 0 :::CONt-ACVPERSC111:..i....' . ; „ above service or feeder fee, : 742 -• 2 ' --each•branch.circuit- . . _ _. . _ - Business name: Gertz-Construction Co Inc - • ! . ' B. Fee for branch circuits - Tvithout serv ice or feeder-fee - - 56.18 .... . -f _ Contact name: Ken Gertz 1 -...,, ,,,, i first branciircircuitk ,--, . . _.. Address: 19200 SW 46 Ave : . , , , Each:add'I branch 7.42 ') ' ' - Miscellaneous (service or • - City/State/ZIP: Tualatin OR 97062 . ! . _ Each or modular • 67.84 dwelling service and/or feeder Phone: (503) 692-3390 - Fax: : (503) 692-5433 , . Reconnect only -- 67.84 -:, , , E-mail: Ken@Gertzco.com • - Pump or irrigation circle 67.84 2 , , . ' "'' ''' "' • ' CONTRACTOR-. • . ' .. • - • - or-outline ooutline lighting 1 67.84. 2 Signal circuit(s) or limited- Business name: ‘,1 giti- - f - - . 4, 4 ! a .........6 c, _ energy panel, alteration. or • . Address: 1. - ',4 0:A 6364,,,A.. , 4-'00 extension. Describe: Page 2 •-, _, City/State/ZIP: !. ._ b :;j4: 41 .2 r i 1 : .' Each additicinahinspection,over allowable in any of the above I . , Per inspection 66.25 Phone: (503) - :.' - 67 . - - - ,40 3-4 2.1 Fax: (503) 6- :Cr:- iq't CI -- -- investigation miro- I - I 6625- CCB Lie.: (..g'8`1,/ iz__ Electrical Lic.: 055% . Suprv. Lic.:' . _ Industrial plant per hour I 1 78.18 ELECTRICAL • PERMIT FEES Suprv. Electrician signature. requirecl. 2.7. ' I subtotal: 447,6t, Print name: Tony Sheridan Date: Itt/2/II H Plan review of permit feet ' I 7f-_-t____4 State-surcharge (12% of permit fee). r Authorized signature: Z/ TOTAL PERMIT FEE: .588 , 7 i 1 . - This permit application-expires if a permit is not obtained.within.180 Print name: Ken Gertz Date: /FM I days after it has been accepted as complete. - Number of inspections allowed per permit. 1:03011dinuTermits \ELC-PermnApp.00c 10/01/09 4 0 I 5T( 1 1 /05/COM/WEB • Electrical Permit Application - City of Tigard Other Page 2 - Supplemental Information Total number of commercial systems: LIMITED ENERGY PERMIT FEES: *No licenses are required. Licenses are requii for all other installations RESIDENTIAL WORK ONLY: Fee for all residential systems $67.84 combined Check Type of Work Involved: x, Audio and Stereo Systems* 7 Burglar Alarm X Garage Door Opener" X Heating, Ventilation and Air Conditioning System' Z Vacuum Systems Other: COMMERCIAL WORK ONLY:: ' Fee for each commercial $67.84 system (SEE OAR 918 - 309 -0000) • Check Type of Work Involved: - Audio and Stereo Systems - Boiler Controls. IT Clock Systems n Data Telecommunication Installation - Fire Alarm Installation HVAC .. Instrumentation - - Intercom and Paging Systems Landscape Irrigation Control Medical Nurse Calls. I Outdoor Landscape Lighting= Protective Signaling \l iuddmd\Permits∎ELC- Perm¢App.doc 10/01/09 Mechanical Permit Application ._. - , , r O.R EICE. SI ONI '''; > hr- `' ' : C1 Of Ti and Received `Ji Permit No ,, ` Date/By: .. 13125 SW Hall Blvd., T OR 9 CE� V PIan.Reveu � 1` � v` � � P r ''"' Phone: 503.639.4171 Fax: 503.598.`10 Date /By • - Other Permit: ;;A l \,. Inspection Line: 503.639.417` : n nil Date ReadwBv: _ -_ luris: RI See Page 2 for J 1 _, " .t. Internet: www.ttgard- or.gov % Notined/Method Supplemental Information TIGARD ' -- . TYPE- OF'N W %SIO COMMERCIAL • FEE * "S(sMP:Dt E -:USE HECKLIST • ,iiil) t �c n Mechanical permit fees* are based on the value of the work ® New construction ❑Ad dition /alteration /replacement performed. indicate the value,(rounded to the nearest dollar) of all - ❑ Demolition ❑Other: __ mechanical materials, equipment, labor, overhead, and profit. -- - : -CATEGORY : O F CONSTRUCTION - - V S - -" • RESIDENTIAL:EQIIIPMEr r / * . ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ • Multi family - ❑ Masterbuilder - ❑ Other: For special information use checklist. Description • Qty, I Ea. I Total • JOB SITE INFORMATION. AND= LOCATION • ' ' - Heating /cooling 15 $ 75- f1 �r n Air conditioning Job site address::; -2 "r ` lOa/eY /4� �6ri (requires site plan' showing placement) 46.75 City /State /ZIP: Tigard OR 97062 Furnace 100.000 BTU (ductsivents) 1 46.75 • Furnace l00:000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: 92 off McDonald Duct work • 23.32 - _ Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric),.. . • . .. - . . .. • in -wall, in -duct. suspended,.etc. 46.75 •• Subdivision: McDonald Woods i Lot no.: 1'2- Flue /vent for any of above 23.32 Other: _ f 23.32 Tax map /parcel.no.: 2S102DC ;`.2'T- - Other fuehappliances • -,', . Water heater I 23.32 " i l . DESCRIETION OFF; WORK ' Gas fireplace 1 33.39 New Home Flue vent for water heater or gas .. fireplace: ' _- 23:32' - : • ______ Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 PROPERT'QWNER: ,±,' ;.': Chimney /liner /flue /vent ' 23.32 ... .... , -.... , - ... .. .. .. - Other:. 1 23.32 Name: _ Environmental. exhaust: and.ventilation Range hood/other kitchen. Address: - • equipment - 1 33.39 - City/State/ZIP: Clothes dryer exhaust 1 33.39 Single -duct exhaust (bathrooms, a � Phone: ( ) Fax: ( ) toilet compartments, utility- rooms) k.' 23.32 '139 q2 ' ` ;*. , ®.APP.i ICAiNT;'. _`:" ; '; :=; . 0 CONTAC I?i PERSON:; ; ` : , `,: crawlspace fans 2 ..3 Amc/ - �3 '2 _ Other: 23.32 - • Business name: Gertz Construction Co. Inc. Fuelipiping- - Contact name: Ken Gertz -- $14.15 for first• four: S4.03.fo_ r _ Address: 19200 SW 46 Ave -- Furnace. etc. Q i �'� Gas heat pump City /State /ZIP: Tualatin,.OR 97062 _ Wall /suspended /unirheater' t � - -_ _ _ -- - -_ - -- _ `�1Vater= heated.. - : -: °�, _ _== _.r, - -._ � Phone: - (503) f,)_- 3390- - - - - -- - _F- ax.� -�(503.)_692.�A'i3 -�, , - - -�! "�T - � - - _ = - - -_ --• - - __:.. .m�__- .a-.•r_..- -W...�__- --._._ Fireplace+ -° E -mail: Kenia/.Gertzco:com Range . • , . CONTRACTOR . . , : . _ . - ' .. Barbecue- - - I Business name: Oregon ComforrHeating Clothes dryer (gas) = -- Other. - -- .. _ • Address: P.O. Box 190 - - •MECHANICA:L'EERMflFEES "' - -.• -. .. . City /State /ZIP: Eaglle Creek, OR 97022 . Subtotal I - Zg: _ I Minimum permit fee ($90.00) `'hone: (503) 655 -0221 I Fax: (503) 650 -2993 I Plan review (25 %.of : :permittee) I - CCBlic.:42519 i -. State-surcharge (12% of permit fee) 1 36,9' TOTAL PERMIT FEE 43, z5 \uthorized signature: �/ this 'permit'application.expit•es if a permit is-not obtained within-I80- i" �. — days-after it has been accepted as complete. ` Fee methodology set by Ti -County Building Industry Service Board Print name: Ken Gertz i. Date:f0%2/11 Ii\ BuildingsPermits \MEC- PermfAup.doc 10/01/09 440 (II /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 I Minimum fee $69.06 $500.01 to $5;000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 S207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $1 0.000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50.000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 foreach additional $100.00 or fraction thereof, to and including $1 00,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. • • I.`\l \Permits \MEC- PermitApp.doc 10/01/09 2 Plum • ing Permit Application _ .__ - - - Aluild- i= ng7F-ixtu =res - -- - 5 -,, :IOt 01 V *51" ( ?fi n Ci of Tigard Received 1 _ A Date /By. • ': . - .. . = Pemtit No.:. sThi�� (� 1 , 13125 SW Hall Blvd., Tigard, OR 97 y p °` — - -- Phone: 503.639.4171 Fax: 503.6 � � `t% � � Plan Revtee + : s� - . Y•> I Other Permit No.: Date/By s Inspection Line 503 4175 T 1 GA O Date Ready /By. uris 0 See Page 2 for Internet: www.ti ard- or.eov Nouned/Method. etal ` Supplemn Information v . . - — rma ' 'TYPE of : woRK: p t p+`� ` � 9 _ `�PrEE *'75C1>17grDIJLE -- ® New construction . ❑ De r l Otef A l For special information use checklist ! i Desdription - Qty. l Ea. � Total ❑ Addition/alteration / replacement ❑ Oth New 1= 2 - family dwellings (includes :100 - fr : foreach utility:connection) CATEGORY OF- CONSTRUCTION- - . .. • I ' SFR (1) bath - .- 312.70 ® I- and 2- family dwelling . _❑ Commercial /industrial SFR (2) bath - 437.78' - ❑ SFR (3) bath_ - - -__ -- ._ - -1— 500.32- %j' 1 ❑ Accessory building _ Multi- family c ?G ❑Master builder = ❑ Other: Each additional bath/kitchen=_• -_ I;, - '_`f° ;':..'_ :02' j.fj r d :�;,;._ - .JOB. STPE:INEORMATION:.AND: LOCATION° I -' Fire — 9 It g 2 - — y Fir sprinkler ( s . ft.) Pa e <_, Site utilities: - - -- Job site address: :'_,' = ti t : , S&3 d f_ -� �st Catch - balm or area dram -- Ig.76 City /State /ZIP: Tigard, OR Drywell;'leach line..or trench drain "18.76 ..,= Footing,drain'(no. • linear ft:: — ..... t' .: Page.2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities - - 50.03' Cross street/directions to job site: 92N off McDonald - . _ Manholes 18.76 — ' • Rain drain connector _ _ . _ _ _18.76_ .. _ _ _. _ . _ . Sanitary sewer (no. linear ft.: ) Page 2 Storrnsewer(no;linear.ft.: ; :..).. Page 2' , WatefserVii;e (no --)- Page 2 Subdivision: McDonald Woods Lot no.: 1:r - Fixture_or item:_.' - 31 Tax map /parcel no.: 2S102DC _ is . Backflow preventer = - -r 27 - -• - < .y : s,, , =," � ;_.. °; ,_ 0.-': DES 'ciiu'I?IO.N-OF-WOIRK: Backwater valve . > ,.ii �,; 12.51 Clothes washer - 25.02 New Home Dishwasher -- - 25.02 - Drinking fountain 25.02. Ejectors /sump 2 5.02 ' : ❑ lIciPFtItr oER'; '';,, r [;,:TENANT ` . Expansion ta .. 12.51... - . _. Name. Fixture /sewer cap - - - — - 25'.02 • . Floor drain/floor sink/hub 25.02 Address: - . . .. . _ , ' Garbage disposal_ _ . 25.02 ' City /State /ZIP: ' ' -: - ' •• Floselbitiit t 25.02 Phone: ( ) Fax: ( ) ' ! Ice -maker 12.51 <... [cAPPLICANT - - - - - - — ;-� ��`'= ❑„ NTA l nterceptorlgrease - trap• - .:_. 25:02 --- .__. . -. - . Business name: .Gertz:Construction Co..Inc , ! Medical gas (value: $-' . ' -- Page - 27 -- Contact-name: Ken Gertz Primer - 12.51 • Roof drain (commercial)4 - " 12.51 Address: 19200 Sw 46` Ave _ Sink/basin/lavatory 25.02 City /State/ZIP: Tualatin, OR 97062 :Solar units (potable water) 62.54 Phone: (503) 692 - Fax:: (503) 692 - 5433 T-ub /shower /shower pan- I - i , 12.51 E- mail:. KeniiuGertzco.com . _... . Urinal _ V - _ 25..U2: _ .' CONTRACTOR:; . Water closet 25.02 Water heater •.__ . 37 Business name: Threefoot Plumbing -Inc. Water pipmg/DWV 56.29 Address: P.O. Box 274 . ; Other: 25.02..1 City /State /ZIP: West Linn OR 97068 Subtotal x`25, 3\ Phone: (503) 557 - 7585 I Fax: (503) 650 - 8212 Minimum permit fee: 572.50 • CCB Lie.: 103792 Plan review (25% of permit feel Plutntiing bic. no.: 3 -259pb / / State surcharee-(12% 01 permit tee) •.authorizedsignature: : / , 4. - ,. TOTAL PERMIT FEE , Print name: Marshall Threefoot i This permit application expires if a permit is not obtained within 180 bays I�ate:11/2 /11 atter it has been accepted as complete: -Fee methodology set by Tn- County Building Industry Service Board. I:\ Building \PermtslPLAMU- PermitApp.uoc 10/01/09 440 4616T( I0 /OJCOM/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: f Permit Fee: Footing drain - 1' 100' 50 03 0 to 2.000 1 $121.90 Footing drain - each additional 100 37.52 2,001 to 3.600 1 5169.69 Sewer - 1st 100' 62 54 3.601 to 7,200 • 5233.20. 7.201 and greater - S327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Water Service - each additional 100' 37.52 Medical Gas Systems: Storm & Rain Drain - 1st 100' 62.54 Valuation:. Permit Fee: $ :1.00 to 55.000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100 37.52 55.001.00 to $10,000.00 572.50 for the first $5.000 00 and 51.52 for ! Other Inspections. or Fees Qty. - Fee (ea) Total each additional $100.00 or fraction thereof to Inspection of existing plumbing or for and including $10.000.00 which no fee is specifically indicated 90.00/hr $10,001.00 to $25,000.00 $148.50 for the first $10.000.00 and $1.54 for (minimum charge - 1/2 hour) each additional $100.00 or fraction thereof, to Inspections outside of normal business 90.00/hr and including $25,000.00. hours (minimum charge - 2 hours) $25.001.00 to $50,000.00 $379.50 for the first $25.000.00 and $1.45 for hours Fees each additional $100.00 or fraction thereof, to 90.00/hr and including 550. 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 5100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to ' -,. ''Plan :Revi for Plumbing itstallations 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 Baptistry/Font engineer. Bath Tub /Shower ❑ New exterior plumbing site utilities for any complex structure -Tub/Shower /Whirlpool as defined in OAR918 -780 -0040. Car Wash Each Stall ❑ 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 Floor Drain/sink - 2 I sometric. or. Riser., Diagram " ❑ Isometric or riser diagram is required for new buildings q" that meet the qualifications above. Car Wash Drain Garbage - Domestic Disposal - Commercial Industrial Comments regarding fixture work: Ice Mach. /Refrig. Drains Lill Separator (Gas Station) Rec: Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley � omimercial *Note: If the fixture work under this permit results in an swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and i 't asher - Clothes fees assessed for the sewer increase must be paid before the ater Extractor plumbing permit can be issued. ,k aier Closet - Toilet ) 'renal I ether Fixtures: 1 I C.\ Ken \KENSFILE \Projects \McDonald Woods \MD 2 \MD2 PLUMB- Pertr?itApp.doc 1,1 s .. Building Division Development Code Provision Review r l c A R° Residential Projects Building Permit No: ()1ST 2-C)(( —00 Gq. CWS Service Provider Letter Received: Yes ❑ No ❑ N/A Routed Plans: fit Original Plan Submittal Date: i / 1 i ' 'T - 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 (V) 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 Ghent Cantu at 503 -718- c2 431 or CJt ! G @tigard- or.gov) Land Use Case No. Su43,2DOS -oQD0S Name HC{7on IJood 91 Zoning R. • 5 Setbacks: -- wNSK Front go Rear 1 Side $ Street Side 5 Garaged Maximum Building Height 30 Actual Building Height "07(0 Visual Clearance Easements Sensitive Lands Type: J/ A Notes: Original Plan: Approved Not Approved ❑ Date: 11" I — l/ 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) )2"7 Slope: 7 Notes: Original Plan: Approved Not Approved ❑ Date: l 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) gyp/ Street Trees LT Protected Trees Notes: Original Plan: Approved d Not Approved ❑ Date: I//&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 MAII No ❑ Date Routed to Building: Page 2 of 2 Elev 230 43.6 2' Mk •J Elev 230 L 0 T 12 RECEIVED NOV 29 2011 _ 5.00 5.00 6,027.16 S F. BUIL DIY OF DIVISION 6.00 — —_, 6.00 �� ; .0 All street trees to be Elev 229.5 Prunis Serrulata Q Amanogawa Flowering 0 cJ. Cherry 2" I ° 1 I e o CO rn rn > Kam , . _° I Mill Elev 228 M 111111 i ■` i • -_ /I m 0 I Ap i i i ,/ \ \\ 1 Z � - WARNING: D OBTAIN LOCATES PRIOR TO ANY L - __ __ a t_ EXCAVATION I otiiIIIII ' e �, cv o Gravel Or��1I ° ` i, 3 o for Eros '• - _____- _� _ 3 °'aoua� }IBS N , Ele 226 5; 00' brAN 1.-4 7 4.5 A \IREW TRACT Mr TERRACE 2,840.40 S.F. o 01 57.00' 15.50' - GER CONSTRUCTION HOME SQUARE FOOTAGE T Z COMPANY INC. MAIN FLOOR = 1664 SQ.FT. \ UPPER FLOOR = 1679 SQ. FT. BUILDING (� CUSTOM HOMES SINCE 1977 �� TOTAL = 3343 SQ. FT. (503) 692 -3390 GARAGE = 600 SQ.FT. 13895 SW Andrew Terrace 1 Lot 12 McDonald Woods SCALE 1' = 20' GERTZ CONSTRUCTION COMPANY INC. PLOT PLAN 11/28/11 STREET TREE TIGARD CERTIFICATION )2(41 5 owner agent a g f or (PLEASE PRINT) (PERMIT HOLDER) do hereby certn that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: / 3 g f C 14/ ,4 brioti 72 Tye SI " E ADDRES. — Q 0 (q r SUBDIVISION: /4/ )Z LOT #: / Z SIGNATURE: /3* DAl E: /07/2// (0 R/AGENT) RE CEIVED d� VERIFIED BY DA "J E: (CITY OF TIGARD) ❑ Tree location verified per approved site plan. I: \Building \Forms \Street 1'reeCertificate 05/30/2012 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 2_ / c' 1 6 Jurisdiction: Site Address: / 3 ill Subdivision/Lot #: 12-- and/or � Map and Tax Lot #: By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) Signature: di14 Date: / 0 72/ Owner /General Contractor /Authorized Agent Print Name: A-I'10 12‘,L\ t_ ' ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the fmal inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. I:\Building\Forms\RES- HighEfficiencyLighting.doc 07/01/08 • Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, gelqz , am the general contractor or the owner- builder at the following address: Site Address: 13 9J l 4/we-4-4v 72( City: 77; Permit #: Z a )' o o I eK Subdivision/Lot #: /))/ and/or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture- sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: Date: Ge ral Contrac I. or Owner -But . er 1:\Building\Form RES- MoistureSensitiveWood.doc 09/25/08