Permit ...../6. 9 ,
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.t, 4,,,a,/,,, 1-&.,' <_ ° �� / MASTER PERMIT
, , ITY OF TIGARD
II 2 :° • COMMUNITY DEVELOPMENT Permit #: MST2009 -00103
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2009
TIGARD 13125 Parcel: 2S104CD03200
Jurisdiction: Tigard
Site address: 13530 SW HILLSHIRE DR
Subdivision: Lot: 0
Project: Smith
Project Description: Adding 550 sq ft of non - conditioned storage area. 6/15/09, adding (1) branch circuit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage' 0 sf Front: 0 Smoke
Dwelling Units: 0 Third' 0 sf Right: 0 Detectors:
Total: sf Value: $12,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach. 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Drains
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
0
Bckflw Prevntr: 0
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
Furn > =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 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 0 401 -600 amp' 0 Ea addl Br Cir:
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
asin N
Other: N Other Description: Ecom p g
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
SMITH, ROBERT R & ADURA C A & H BUILDERS INC
13530 SW HILLSHIRE DR 6077 NE ALDER ST
TIGARD, OR 97223 Hillsboro, OR 97124
PHONE: PHONE: 503 - 830 -2817
FAX:
Total Fees: $354.79
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 i suspended for more the 180
days. ATT ■ o Oregon law requires you to follow the rules adopted by the Oregon Utility Notification • • - ru s are set rth in OAR
952 -00 .1110 through • • R 95 a +1 -0100. You may obtain a copy of the rules or direct questions to OUNC by callin• e:10. � 344.
O
Issu By: ' - i Permittee Signature:
Electrical Permit Application F OR OFFICE USE ONLY '
1. ? ; 4 City of Tigard Received Permit No.:
Date /By:
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TICARD Inspection Line: 503.639.4175 Date Ready/By: Juris: 65 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF. WORK . . - PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plan w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building r three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas ancf boatyards.
CATEGORY' OF CONSTRUCTION' . ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder R Other: `Mal -i" 6 171 ❑ Fire pump. ❑ Installation of 75 KVA or
1.4____Lailt. 0 Emergency system. larger separately derived system.
JOB SITE INFORMATION AND 'LOCATION - 0 Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
10OHP or more. occupancy.
Job no.: Job site address: 1 3 530 5 ii,,, H I (4,s t+1 0 f i)12t\ E
0 Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP: l Health -care facilities. ❑ Supply voltage for more than
I IG� (fir c ' �" 223 CI ❑Hazardouslocations. 600 volts nominal.
Suite /bldg. /apt. no.: — Project ❑ Service or feeder 600 amps or more.
5 tM I T Fi FEE. SCHEDULE
Cross street/directions to job site: 1,J K1(.NU 1 l4ifr l3s 1 sl Ave /101_• Description I Q. I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRII'T ION OF WORK , (with above sq. ft.)
Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
' ,'t2t PROPERTY OWNER ' ❑ ' TENANT `.. ' , , ' ' 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
R t7t nob A ub121� ra I'ft-1 601 amps to 1,000 amps 240.60 2
Address: 1 3 530 , , i_k I LLS l tit2.' - D12mV c Over 1,000 amps or volts 454.65 2
City /State /ZIP: f Temporary services or feeders installation, alteration, and/or
5'31
1(?l IA(2 -) I) Let Do tj 1 2 �3 relocation
Phone: ( I i , y r1 G') 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: _ Date: A. Fee for branch circuits with
..®. APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 / 2
•-� each branch circuit
Business name: 14 cold H act tlde .Y/► • B. Fee for branch circuits ��/�
Contact name: /l/) tee A bret✓h4-
without service or feeder fee, 46.85 �1u �� 2
J first branch circuit
Address: to t r l . /q. A) e 4 /d e4- 5'/Y-CG Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
Ci ty /State /ZIP: N; )is bol -o / Di S0n 9 '� I 2 � Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ( 5b3) �S D - ,2 8 /�- Fax: : ( ) Reconnect only 66.85 2
E -mail: 177 >c ti q e / G- 03, -ec h-1- - j. 0 h o-hmwi 1. e rry, Pump or irrigation circle 53.40 2
' " CONTRACTOR ,. . : Sign or outline lighting 53.40 2
Business name: C �cC r Signal circuit(s) or limited -
�`� I � t � / (I / J - energy panel, alteration, or
Address: � 0 1, 7 - - - ) c ' / a _ extension. Describe: Page 2 2
City /State /ZIP: ..- r —, aet tQ ' CO Q_ 7 7 1 _ Each additional inspection over allowable in any of the above
I l �y Per inspection 62.50
Phone: (rte' 5 y� - --76-5 - I ax: (joy) ' _ �-I -g g 76 Investigation per hour (1 hr min) 62.50
CCB Lie.: i Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: `/ �f
�
Print name: Date: Plan review (25% of permit fee): 7` lS
State surcharge (12% of permit fee): r
Authorized TOTAL PERMIT FEE: ;.
i �� N/6/ Date: This permit application expires if a permit is not o plain -. wi m 180
Print name: days s after r it has been n accepted as complete. Li 7
* Number of inspections allowed per permit. 52--
I1Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(I1 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
R
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
. COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
n Data Telecommunication Installation
7 Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ 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
, CITY OF TIGARD MASTER PERMIT
-- COMMUNITY DEVELOPMENT Permit #: MST2009-00103
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2009
Parcel: 2S104CD03200
Jurisdiction: Tigard
Site address: 13530 SW HILLSHIRE DR
Subdivision: Lot: 0
Project: Smith
Project Description: Adding 550 sq ft of non - conditioned storage area.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units. 0 Third: 0 sf Right: 0 Detectors:
Total: sf Value: $12,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Other Fixtures. 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines' 0
Bckflw Prevntr: 0
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
Furn > =100K. 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 0 0 -200 amp 0 W/ Svc or Fdr: 0
Ea add! 500 sf: 0 20 1 -400 amp. 0 201 -400 amp: 0 1st W/O Svc /Fdr:
Limited Energy: 401 -600 amp: 0 401 -600 amp• 0 Ea add' Br Cir:
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 N
Other: N Other Description' Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
SMITH, ROBERT R & ADURA C A & H BUILDERS INC
13530 SW HILLSHIRE DR 6077 NE ALDER ST
TIGARD, OR 97223 Hillsboro, OR 97124
PHONE PHONE: 503 -830 -2817
FAX:
Total Fees: $302.32
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 .i• - ' . cordance 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 1:0 days. ATTEN •N:__OFegT law requires you to follow the rules adopted by the Oregon Utility Notification Center. ' ose rules are set forth in• R
952 - 001 -0010 through OA X52 -001 1 O. You may obtain a / c o opy of the rules or direct questions to OUNC by calling 503.246. +•'9 j /��
Issu By: \ JJ /t�i�yinl V PermitteSignature: K - / //7 / �
Building Permit Application
residential RECEIVED F
/ /; R OFFICE' USE ONLY '
ail d �J Received
City of Tigard DateB C 141 (/"I Pennit No.: .1-0 3
q 13125 SW Hall Blvd., Tigard ' OR 9722 Ay 1 4 2009 Plan Review
1: . Phone: 503.639.4171 Fax: 503.598.1 4' Date/By: Other Permit:
Ti G A RD Inspection Line: 503.639.4175 Date Ready /By: Juria ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: /(�. Supplemental Information
BUILDING DIVISION
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.
Valuation: $ 12 a oa
❑ 1- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
Number of bathrooms:
❑ Master builder � Other: V.�1`t'tY SvgCCs 1N G/Lnt�L
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: (353b rJ W M ( LA_ . 4024, brtw New dwelling area: square feet
City /State /ZIP: l lAL,r 0 r 43 b ri X1 722-3 Garage /carport area: square feet
Suite/bldg. /apt. no.: ..— Project name: .Bvb u,nd Anciya Shat Covered porch area: square feet
Cross street/directions to job site: knin I) + / 5 TM A ye . Deck area: square feet
Other structure area: square feet
REQUIRED DATA:. COMMERCIAL -USE CHECKLIST
Subdivision: 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.
PI-124n 4. only , new S -foreje Piper a- wails' Valuation: $
U h de ✓ 01�+q`4 ,. . S 1,49- �, yAI s-r qi.c, p NS!!) Existing building area: square feet
049 /J9�P.P.re,d S -f -G L, Bey-) • 572 .g 7' ^ wry Spc. New building area: square feet
a PROPERTY OWNER ❑ TENANT Number of stories:
Name: 13o p 4 A V d p 6 ' 1 ;443 Type of construction:
Address: l 3 Sao 5 w b'J ILLS 14121. D . Occupancy groups:
City /State /Z1P: 176a/rd x(
n Ori K ,, I '722 J Existing:
Phone: ( 503 S 1 el 2,4 7 LjL2 `� Fax: ( ) New:
tk APPLICANT ❑ CONTACT PERSON NOTICE
Business name: A and it $wc rg?S , All contractors and subcontractors are required to be
Contact name: A4 �K /q �b 1^ec 1.71--- licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4 09 d) /v _ A LDele_ / � c - v J jurisdiction in which work is being performed. If the
City /State /ZIP: N ;z s /3 6AD D�167b1 of 1 /Z app
applicant is exempt from licensing, the following reasons
Phone: ( 503) (Q 29 17 Fax :: ( )
E -mail: v i 1c lis r j l o►-1 breGh--1e bo - fr,aA / • C.-cm
CONTRACTOR
Business name: ,y and I/ B t&belz,S //✓C . BUILDING PERMIT FEES* .
Address: ( 77 /lie /I L,0 S -Tie view ere (or d schedule)
J Structural plan review fee (or deposit):
City /State /ZIP: NiGLS aode° Q2 67nn1 9"7/Z-
Phone: (5D2,) g3 2 g i — Fax: ( ) FLS plan review fee (if applicable):
Total fees due upon application:
CCB Tic.: '7Z078
it, 9 //o
Amount 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: / I Date: / 2 q r( 0 1 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(1 I /02 /COM /WEB)
Building Permit Application Checklist ` F >t.
One- and Two - Family Dwelling FOR OFFI US ONL , .
City of Tigard Received Permit No.:
' 13125 SW Hall Blvd., Tigard, OR 97223 Associ t
C Phone: 503.639.4171 Fax: 503.598.1960 Associated permits:
24 Hour Inspection Line: 503.639.4175 ❑ Electrical 13 Plumbing ❑ Mechanical
TIGARD
Internet: www.tigard- or.gov ❑ Other:
TH 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.
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to 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. , • • - ' , e. t •: . , •• •
I I Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements
and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction
indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site and
surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑
floor, wall construction, roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling. height, siding material, footings •
and foundation, stairs, fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ' ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- . ❑ ' ❑ ❑
. prescriptive path analysis provide specifications and calculations to engineering standards.
1.7 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."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ ❑
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. •
JURISDICTI.ONAL •
SPECIFICS '
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or'l 1" x 1'7 ". • ' " • '❑ • ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ .
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale" indicates standard architect or engineer scale. • . • ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑.... ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and accompanied by the project arborist's signature of approval. •
30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions; ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings'
on a lot of record approved prior to September 9, 1995.
I:\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(11 /02/COM/WEB)