Permit I a CITY OF TIGARD MASTER PERMIT
N • 2 COMMUNITY DEVELOPMENT Permit #: MST2011 -00174
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2011
Parcel: 2S102DC01400
Jurisdiction: Tigard
Site address: 8990 SW EDGEWOOD ST
Subdivision: EDGEWOOD Lot: 11
Project: Gertz Homes At Edgewood
Project Description: 400 sq. ft. garage addition.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 13.5 Bathrooms: 0 Second: 0 sf Garage: 400 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: Yes
Total: 0 sf Value: $15,624.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains:r 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs /Showers: 0 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
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, 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 2
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: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ADD SF VB R -3 0
Owner: Contractor:
GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions)
19200 SW 46TH AVE 19200 SW 46TH AVE
TUALATIN, OR 97062 TUALATIN, OR 97062
PHONE: PHONE: 503- 692 -3390
FAX: 503- 692 -5433
Total Fees: $717.43
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 Genie . Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0090. You may obtain a c•„ or direct questions to OUNC by calling 503 232.19: or 1.800.332.2344.
Issued By: � �2 / — .aI' Permittee Signature:
0411-6175 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.
t ,.
Buiidine Permit Application
FOR OFFICE USE ONLY
City of Tigard A Received f
13125 SW Hall Blvd., Tigard, OR 97223 Date1B : Permit No.:
Phone: 503.639.4171 Fax: 503.598.1960 , h i ~ * " -
Inspection Line: 503.639.4175 , 1 I �z n( u t � Other Permit;
L
Internet: Line: gard 39.41 L. ' Date Ready"
Notified/Method: r H See Attached ist for
i/ 1 Supplemental Informatiormatjon
TYPE OF WORK
� REQUIRED DATA: 1- AND
1Vtw construction 2 - I+ AMILY.DWELLING..';
r
�;.
❑ Demolitio �01, Permit fees* are based on the value of the work performed. v.
Addition /alteration/replacement ❑ Other: C\ Indicate the value (rounded to the nearest dollar) of all
f.:: r G0 equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION • : .r\ . ..- work indicated on this application.
N I 1- and 2- family dwelling ❑ Commercial /ins .. 1, Valuation: $ —s
❑ Accessory building ❑ Multi - family By Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: 1
.. .. 408 S INFORMA AND
.. LOCATION ., Total number of floors:
Job site address: (7 0 !� C� f
�J O - New dwelling area: square feet
City/State/ZIP: a 2IP: -`, 4 G � Q� ?
J 7 � ZJ Garage /carport area yOs square feet
Suite/bldg./apt. no.: Project name: V `45 �{ f
Cf'� 2 1aJ,► Covered porch area: square feet
' Cross streetdirections to job site: 0 - " - 741. ( ge - ,� _ n
`� , u Deck area: square feet
Other structure area square feet 1 3 ,
Subdivision: r REQUIRED
DATA COMMERCIAL-USE CHECKLIST
a� t.4. v-r�G( 1- to b Lot no.: ^�
map/parcel no.: J I ` / ! Permit fees* are based on the value of the work performed.
Tax ma �Z �+ _ d lY 00 Indicate the value (rounded to the nearest dollar) of all
DESCRIPTION OF WORK equipment, materials, labor, overhead, and the profit for the
/11 work indicated on this a, .lication.
, L:i . 4 B'Y Y L°w� C /" Valuation: $ �
Existing building area: I square feet
• New building area: i square feet
g PROPERTY' OWNER 1
❑ TENANT Number of stories:
Name: eR �+ fZ C� oAes f e c c. e Cr, 720 O .5 A) �� � C- /ti G Type of construction
Address:
Occupancy groups:
City/State /ZIP: 7 4 f4 tall CA , 706 , 7
Phone: ( ) Fax: ( ) Existing:
New:
❑ APPLICANT
CONTACT PERSON I
Business name: � Co � • NOTICE
�t - C �57�� ea a � Trc�h (.�C M contractors and subcontractors are required to be
Contact name: / V Y� licensed with the Oregon Construction Contractors Board
Address: / / z 0 0 s c..,...) , -f (, under ORS 70I and may be required to be licensed in the
jurisdiction in which work is being performed. If the
City/State/ZIP: a /4.. /1(0 0/< g� � �,
apply:
applicant is exempt from licensing, the following reasons
Phone: (5 3) 9Z _ �
33 9 0 Fax:: (s-o3i G p 2- SY 33
E -mail:
CONTRACTOR ��++
Business name: gt.,t'�L N S Title e74 1,,,, `s 4u L
Address: / 9 Z S YC f C BUILDING PERMIT FEES*
City /State/ZIP: 'rte , (, , ,, OA 7 2 C` Z - 8 ) U Please refer to fee schedule.
Phone: ( 3) .? a_ 3 3 7 O I Fax: ( 503) G 92. - Sy 3 3 Fees due upon application
CCB lie.: 3 y 3 s Cj Amount received
Authorized signature: _ _ Date received:
ire
'This permit application expires p s if a permit Is not obtained
1 Print name: /`,�,�J �`fL Date: // -2- I within 180 days after it has been accepted as complete.
z ` ` Fee methodology set by Tri- County Building Industry
I\ Building \Permits \BUP- PermitApp,doc 12f30/05 Service Board.
440- 4611T( I I /02/COM/W F,a)
• -- Elxctrical Permit Application
FOR OFFICE USE ONLY
City of Tigard Received ( 1
A 13125 SW Hall Blvd., Tigard, OR 97223 Plale(By: , Permit No.: _ , /,--7 Plan Review 41
Phone: 503.718.2439 Fax: 503.598.1960
Date /By: Other Permits
TIGARD Inspection Line: 503.639.4175
Date Ready/By: Metho l
d:
� is I See e 2 www.tigard Notified/Method: �° '{ +�� j ^1 Supplemental Pag Information
Internet
�`', '.'4n,`k ",� ",�,i �6�A'r�';R+?,5s4 l �ta�'re�. -, �'111h'{��l��E� #'O �s. 7ORI�t�'u=w at art 4 j: '•�'.�n,,� ,� ?'!�', ,iA. ;�t�r k,- r • �a;;•;;�..e- .,,..uc, =�.,. oxs
i.t. ,.., r��.,Fkkr,.u„sr.,r, r Yn@,�t C: re ) r ' s ti: + t i , . i � 1 4 '^"t' ga s,.
�,,.0 ,,, .. ,.. _.,._ ...,.� �fi�. r' vi. �,_,., n���tRF1�vIE „��'��itti��?ai.��`;
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: or stories.
❑ Service or feeder 400 amps more o
❑ Building over three stor'
i 3r7 a r u w m a where the available fault c
I, � �a r '� �k , � v El Marinas and boatyards.
Ir v } „I,,,(vr� � , �e,��4 101E OR 1011 1#( . 0 , ,` ', -.5 exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
® 1 -and 2- family dwelling ❑Commercial /industrial Cessorbltti,ltI less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
'1.. amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Ot ❑ Fire pump. ❑ Installation of 75 KVA or
`{ '' � � "16, $ ;t 1NF�ORMA�fION tI,OCATI ” 2 ,” "` k P ❑ F..mergency system. larger separately derived system.
l M ' { ❑ Addition of new motor load of
Job no.: Job site address: 8990 SW Edgewood ` 100FIP or more. I oceupancy.
Q`` V �l ❑ Six or more residential units. 1 ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 P ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Omara to Edgewood Description 1I Qty. i +" + �. : " .s 1 j EE SG i Qt 1I t, iq
I Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Edgewood East I Lot no.: 17 1,000 sq. ft or less I 168.54 4
Tax map /parcel no.: 2S12DC - 01400 Fa. add'( 500 sq. ft. or portion ( 33.92 1
6, Limited energy, residential 2
°v,Ai„wwl ,�� .x i.1� �i L.m a . �. `DLrSCR! IONS 11 t4WORK t 3 I , �`' r +d '� `� . °, .' ��, r ( 75.00
aw A ..�.2,wa � ar.. -.. n i'(t {d�Y��. +, , Yr, I,IA]A,�, �„ �, fir,' +�.f7f,�ilG ( above Sy. ft.)
Garage Addition Limited energy, multi - family
residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
It., ' 1 RO, E0 OWN E R ' I I #', w � ;, ° .
200 amps or less , 100.70 2
. �„ a .:. ,..,ave" ., �,th�,�t� .� -.,,i TVANT 201 amps to 400 amps 133.56 2
Name: Gertz Construction Co. Inc. 401 amps to 600 amps j 200.34 2
Address:
601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 1 552.26 2
City /State /ZIP: Temporary services or feeders 1 alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 168.54 2
Owner Signature Branch circuits — new, alteration, or extension, Rer panel
Date: A. Fee for branch circuits with
"� ° ,, � '��� ° �a� t " A i p�' 4 C 1 CANfT�'� ° � art �a�r � � tr R � � � v � �
� I4 - �' f � "r ® + ON AC110:1305K121 above service or feeder fee,
dx h,�`�gaa+„�f�ii r�`� :��^n "�:a�a`;«�tw a' � .,. �.,m.. k�C + �, 7.42 2
each branch circuit
Business name: Gertz Construction Co Inc. B. Fee for branch circuits without
Contact name: Ken Gertz service or feeder fee, first j
branch circuit 56.18 7
Address: 19200 Sw 46 Ave Each add'( branch circuit I i 7 . 4 2 '7, 42.-- 7
Miscellaneous (service or feeder; not included)
City/State /ZIP: Tualatin, OR 97062 Each manufactured or modular
dwelling, service and/or feeder ' 67.84 2
Phone: (503) 692 - 3390 I Fax:: (503) 692 - 5433 Reconnect only j 67.84 2
E -mail: Ken @Gertzco.com Pump or irrigation circle I 67.84 2
1itra " "q `" CONOrRACfOR' . 1 Sign or outline lighting I 67.84 2
rt .6^a3 'h`}, _ @`n„INai t;e :II:i4h„ ,.,ro...:,.,- ,r'!. 1 z., F �k u., . s
>.' Signal circuits) or limited - energy 'I
Business name: Reliant Electric of Oregon LLC panel, alteration, or extension. I Page 2 2
Each additional inspection over allowable in any of the above
Address: 20200 SE Oldenburg Lane Additional inspection (I hr min) I 66.25/ hr
City /State /ZIP: Sandy, OR 97055
Investigation (I hr min) f 66.25/ hr
Industrial plant (I hr min) ' 78.18/ hr
Phone: (503) 701 -4562 503) 668 - 4190 Inspections for which no fee is
Ele ctrical 1 specifically listed (IA hr min) 1
CCB Lie.: 188492 90.00 / hr
J o� Fax: 71t III I Suprv. Lic 4433S �,t '` : d
{0 3 l 41/0 � ,.{. :. :, ;: �,� ��h�EI: EC "TRICAE�'PE1tMITMZI���,���' ^'
Suprv. Electrician signature, requiredt c ��� A �� Subtotal:
Plan review (25% of permit fee):
Print name: Tony Sheridan Date: 11/2/11 State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
— This permit application expires if a permit is not obtained within 180
Print name: Ken Gertz I Date: 11/2/11
days after it has been accepted as complete.
* Number of inspections allowed per permit.
( .\Building \Permits \ELC- PermitApp.doc 07/01/10 440.4615T(I I
1
Building Division
:71 -
Development Code Provision Review
TIGARD Residential Projects
Building Permit No: ,1r7C)I / Uv I /
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A lid co' 91)1)(
Routed Plans:
Original Plan Submittal Date: it 4
15 Revision Submittal Date: I 7 )J 6 > ❑ Site Plan Only
2 °d 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 at 503 - 718 -061 or ,(/ @tigard- or.gov)
Land Use Case No. 11 CVO/ Name Ge Z--
-17r Zoning .e .
cKsetbacks:
Front r0 Rear / S Side 6 Street Side / j' Garage
❑ Maximum Building Height 3a Actual Building Height
❑ Visual Clearance
❑ Easements �I
❑ Sensitive Lands Type: P-0 S S(n fse_S 'ea& 1,�f'l �'�y'V'l dtY, 6061 Si 5 -
Notes: L( / �(-f , $-(-aC J
Original Plan: Approved — IC Not Approved ❑ Date: / � (
Revision 1: Approved 42 Not Approved ❑ Date: /Ol - ((1
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
,Er Actual Slope: 5
Notes:
Original Plan: Approved ,Er Not Approved ❑ Date: /0/6/1
l
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
Citty / Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
13 ,8"treet Trees
D Protected Trees
Notes:
Original Plan: Approved Not Approved ❑ Date: /"/64 it
Revision 1: Approved 01 Not Approved Date: ll /7/ od
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 App ' ant
Okay to Issue Permit: Yes o ❑ /
Date Routed to Building: „/ _ ,
Page 2 of 2
Elev 233
65.25' Elev 233
RECEIVED
OCT 072011 r
CITY OF TIGARD
PLANNING/ENGINEERING 7,726.45 SF
WARNING:
OBTAIN LOCATES PRIOR TO ANY
�? I EXCAVATION 4 17
it"7 H
CO
O
1 * Proposed future lot lines
and setbacks per
1IIIII (\ SUB2007 -00013
00
Lum Si
e
PROPOSED GARAGE ADDITION
FF Elev 205
Gravel Drive
Elev 205 for Erosion
Elev 205
a
O
a
— �i �� % l
Tilia Americana S.W. 90TH AVENUE
Street Trees
G ER TZ CONSTRUCTION
COMPANY INC.
HOME SQUARE FOOTAGE ' BUILDING
MAIN FLOOR = 0 SQ.FT
UPPER FLOOR = 0 SQ.FT. CUSTOM HOMES SINCE 1977 ll
(503) 692 -3390 , NV
TOTAL = 0 SQ.FT, 8990 SW EDGEWOOD
GARAGE = 400 SQ.FT LOT 17 Edgewood East
SCALE 1" = 20'
GERTZ CONSTRUCTION COMPANY INC.
PLOT PLAN 11/2/11
Map & Tax Lot - 2S12DC -01400