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HomeMy WebLinkAboutPermit ,, CITY OF TIGARD MASTER PERMIT 1111 4. :' . - COMMUNITY DEVELOPMENT Permit #: MST2011 -00207 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2012 Parcel: 2S109DA04500 Jurisdiction: Tigard Site address: 15412 SW GREENFIELD DR Subdivision: SUMMIT RIDGE Lot: 22 Project: BUTCHER Project Description: 165 Sq. ft. addition. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 165 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms' 1 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units. 1 Third: 0 sf Right: 5 Detectors Yes Total: 165 sf Value: $40,000.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 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. 2 Clothes Dryers: 0 Heat Pump: N Hoods. 0 Other Units: 1 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: 7 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: ALT SF VB R -3 165 Owner: Contractor: BUTCHER, BILL & JOAN OLSON & JONES CONSTRUCTION INC Required Items and Reports (Conditions) 15412 SW GREENFIELD DR PO BOX 19563 TIGARD, OR 97224 TIGARD, OR 97280 PHONE: PHONE: 503 - 244 -7467 FAX: 503- 244 -6791 Total Fees: $1,662.40 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in - • • - : with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended f• u • e the 180 days. AT ' NTION: Oreg. I- • requires you to follow the rules adopted by the Oregon Utility Notification - • - • e:‘,. r es are set forth in OAR 952-001-1110 t rough OAR 9 • -001-0• • You may obtain a copy of the rules or direct questions to OUN - ing 503. . APi 00.: .2344. . / t ' Issued :y: Permittee Signature: __ Call 503.639.4175 by 7:00 a.m. for the next available inspecti.n date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • Building Permit Application Residential 1 FOR OFFICE USE ONLY Cl of Tigard (` Q' Received . `J g v /J Date /B PermitNo.: a QE l� Q � 1L /� � '—' U'�•z� 1111 13125 SW Hall Blvd., Tigard, OR 97223 Sx® Plan Review �� Phone: 503.718.2439 Fax: 503.598.196 Date /B : ♦ • Other Permit: .� of ,40 00 � _" /L!L TIGARD Inspection Line: 503.639.4175 Cj� n r�o� Date Rea,! � . luris: 0 See Page 2 for Internet: www.tigard - or.gov eU1�o` \� Notified/Method: / Supplemental Information �.%` 'a, w. ��st' , 3. ?-h j .; '.si s x �v.��. �, ',� � k � �w�ar �..-., .;;- :<=- .^�'az � . .�, ;. ,. ., a^..,, <;Vo- .Y'$- � h,. • x. e 4 '. ''' s m are s °;; # " e C` - 4.4• , ., , : , # , fi, x 4 -� ' y y T YPE -t =, O F WO ), , : a r - ¢ — P -,, h p a , . REQUHtED DAT -1 4 , D 2 A MIL - „ 1' *DWEL °'LING ❑ New construction ❑ Demolition Permit fees* are based on the value of the wdrk performed. Indicate the value (rounded to the nearest dollar) of all A Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the -r Ail , -C 6 W' ' � `° work indicated on this application. 'r'' . �-, ” t 4 -, C ATEGORY.OF CONSTRUCTION '. :" �>_ "04 pp k `° i' . - ,.� °gip .� . ss. v�x <_., .�d as, _ ff R,,..' s,' :, %c= _3., .`cu �_ _ ,�. _ v �.;- z _ _:t: .`� Valuation: $ z k 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building 111 Multi-family Number of bedrooms: LI ❑Master builder 0 Other: Number of bathrooms: X t 3 `JOB , SITE IN A' ND LOC i''',117-44 Total number of floors: 3 Job site address: /Sy /Z (.5W GU S G ;rL16 Kra New dwelling area: /45 square feet City /State /ZIP: f c.,, O, 0, 2Z'3 Garage /carport area: 6:, 4 square feet Suite/bldg. /apt. no.: v Project name: boA-- \c or - ' Covered porch area: Z 16 square feet li Cross street/directions to job site: lr V Deck area: 2 15 square feet Other structure area: d square feet O.. '°REQUIRE6 DA TrA USECHECKLIST= 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 ( t .. DESCRIPTION? OF, -WOR : work indicated on this application. N8.8.7\ - 1 �\�C1.�MC Q—\. OV PUS '6 6 Valuation: $ - r - \ iN; , Ck � = Existing building area: square feet tV \ New building area: square feet .•-k) PR'OPERTY OWNER . it TENANT t" a Number of stories: Name: & l � l E jOGv--t 7\ )J�GVt =r Type of construction: Address: 1 9 I2 5 Gv 1 c-. 0 a R D Occupancy groups: City /State /ZIP: 7 ci\av 7 1-2 Existing: Phone: ( 6 (' "' 5/37 Fax: ( ) New: _ . ® , ' 4 , _,- -,. £ CONTACT PERSON ., r , k _,., BL,,IL6[NG$PERIYLIT,FEES . a i' .a & - , O /ee;scberintejTii..t a, f..: , Business name: 0 0, Q,„,d Jd�a..,S Cd,,,,_SSs 1v, Structural plan review fee (or deposit): Contact name: _Sca o\nelr,S / FLS plan review fee (if applicable): Address: C.) , c ltS u f City /State /ZIP: Pip v \ c-v. . C) �4 `7 Total fees due upon application: ��] s f (:-�) 2 / - 7 y6 7 (5 2 y y - � 7 l Amount received: `� ' 5/ Phone: Fax: : Cam` 1 ,� ' ,PHOTOVOL TALC SOLAR PANELSYSTEM F E E S *V E -mail: 0 me O&) Q o l io %,Cl -.�, t-xJwi :AKA <. ...: „aa f.;, .t ,8 ., , t.. S - ..1t : S ts:: - , ' .. . - - 4 ' . T4 , t : " p b A :_ r A . Commercial and residential prescriptive installation of v ° ,n ; 1 � � � C R * . t , ` , 44' -. 0. roof -top mounted Photovoltaic Solar Panel System. Business name: Q 1 � al v-C..l , `� . b C S � Submit two (2) sets of roof plan with connection details �� and fire department access, along with the 2010 Oregon Address: / tU 4-- ' _ t ,.-) X /9.3 S Solar Installation Specialty Code checklist. City /State /ZIP: ` Gjra "gild V 12 C 7 z j Permit Fee (includes plan review $180.00 and administrative fees): Phone: (50S) 22-/L.-/ - ?y6 7 Fax: (563) 24/17/ - 6 71 i t State surcharge (12% of permit fee): $21.60 CCB lie.: (; Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name /212h * Fee methodology set by Tri- County Building Industry C Date: � Service Board. I:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(I 1 /02 /COM /WEB) Electrical Permit Application . . . FOR (ATI CE USE ()NI .1' . . . , . I ,....„(v li _ City of Tigard Receivr.d , DatelB : Penrrit 5 • 13125 SW Hall Blvd., Ti : . .,.,..o (-• ,-; SO C C;ra Plan Review No.: Aa I . Phone: 563_718.2430 zr ,,, .1.d., 9 ...,.', • Dale:0 4: OtherPennit: TIGAR.11) inspection Line: 5(13.63 "k7" \ .---,' ' $1 Dale Ready113y: huts: IZ1 Ste Page 2 for . Internet: www.tigard-or. ■ ' l Notfi ied/Mmhod: Supplemental Enformatfon ..... fi . . _ .._ _ _ . __ . ...., . _. . . v:::... :W;ii?; .- : . •:-_ . --....::::'„:..:.,..:::: - ,-'. - ..-: , .....: , :-.:::.......-:. - :-,- - E:ii , o,itiot;;,:::_ : - :::-.: , ...,-.::::-:'. - -:,: , ..: - . , ::::::-- - ..::::: - ... - ..: , ._ 0 New construction r AdditioriffitcreoilOsthv Please check all that apply (submit 2 sets of plans 1v/items checked below): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition El Other: ‘.)" 00 ' - where the available fault current 13 Marinas and boatyards. •:,...: ........STRUCTION:;.:-::.;",;:1-'.:- : exceeds 10,000 amps at 150 volts or 13 Floating buildings. less to ground, or exceeds 14,000 El commercial agricultural I- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. El Multi 0 Master builder 0 Other: OFite pump, 0 Installation of 75 KVA or 0Emergencysyrtem. larger separately derived sys tem. 1; '7::, ::1: ' a Addition of new motor load of 0 "A", 'S", "1-2", "1-3", Job no.: y .--, ..--... 1 ' lob site address / / ' i 4 - ,--- CV aftZ.V1C1G-i(? P.) 0 S liP or m units. occupancy-. 0 Reereationa/ vehick pads. - - City/Stale/ZIP: I / „ a 0 c q '7 2 2 3 0 Health-cart facilities. 0 Supply voltage kr more than ' I , , r I ), 0 Hazardous locaiions. 600 volts nominal. . Suite/bldg./apt. no.: Project name: A-,,chlr 0 StrVICO or feeder 600 amps Or IrtOre. ...:. : Cross street/directions to job site: --a_c V?..,c Deseripikm I 0U. i fee. 1 To lat / • New residential single- or raid ti-fandly dwelling unit. Includes attached garage, , Subdivision: f Lot no.: t,000 sq. ft. or less 168.59 4 Ea. add'l 500 sq. R. or portion , 3192 I Tax map/parcel no.: Limited mited energy, residential 7.5.00 2 M (with above sq. R) Limited energy, multi-family 75.00 2 A cla A- \o-\,--... AZ...c.4....pfy(-1-1 ( 4,7 1,.. id ja _ : \ , d residential (with above sq. ft.) Services or feeders instaliationolteration, and/or relocation 1 j ! I Vnei, SI:c K- 11;4' q TO lokOv■ i‘i 200 amps °rims 100.70 2 i 4)*0.tA.t,f(:: ik-: P.:: 2 ' amp 4 ' a'11P' 13156 2 40[ amps to 600 amps 200.34 2 Name: >., \ V CAV)A s _ . &1. 6 \V”) F7)) 601 amps to 1,060 amps 301114 2 Address: ),S SCA/ C--, vr:c 6/1c lei ‘c..( )4) Over 1,000 amps or volts 55226 2 Temporary services or feeders installation, alteration, and/or City/State/2IP: 1 6 r) , 41-ili - 7? ?-p i relocation _ Phone: (,11:5) 6 'Y1 - 6 i 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 401 amps io 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - Branch circuits- new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with C - .;.,•-::,--..;.,:,,,:,:-: above service or feeder fee, 400 .:..W.:''.. N i:0.0.4: each branch &on 742 2 Business name: (") 150\/ el /1 d L T-5 4c4„S (c..31-9 SA. B. Fee for branch circuits without service or feeder fee, first y f , 56.18 aid' 2 .----- ' - Contact name: )er ) OV.I0.<"7:'_) branch circuit Each midi branch circuit ip 7.42 9 4 .4 2 A ,.-, Address: ;.>,,,,,,. , (" - A /c)5,-5,::=:-; hliscell an eons (service or feeder not included) , Each manufactured or modular 1 67.84 j 2 City/State/ZIP: P.:,y4 I/)d 0 r - ..-7 ':-;•.' . ? - e` '4- dwelling, service andlor keder ' Phone: 003 )2. V''' 71/7 FEOC : (50 ) 2/19 — .Z 7,1/1 Reconnect only . 67.84 2 Purnp or irrigation circle 67.84 ' 2 E- Ma i l: i a-a:0- 1 d'A',7 ,;/) Via.:S r '7 Sign or outline lighting 67.84 2 -:,:.• :: :: ' S .:'/J : :: .: ::; --, ,,1 -7- ',''.j. : ',A:::g..!. - .:: - .; - .. i .i::!: : ,1"-',::::::.'-',': . 4 : 1' : : :CO.NtRAC.1 . ..0.. : ' : ::: : ::::";-', : :: : :- ‘-i '!: si d ralt(s) or lirrited.erni-gy Business name: ivi e.-/,,,-/„4,‘/,„ panel, alteration, or miens ion. Each additional inspection over allowable in any of the above 2 Address: - 71 1 % .5" iv47y -70 0 1,ette?- ,P1 . Additional inspection (( hr min) 6625/hr ! Investigation (1 hr min) - 6625/ hr City/State/ZIP: (A..eGia. 1 , (c c z Q7� y Industrial plant (I hr min) 78./8/ hr ' Phone: ( q..5 6 , ? li fi.0 -- —7* 't.' r Fa: ( -6 )-) t-//ec7 Inspectioto for which no fee is specifically listed CA hr min) 90_00/hr . - . .... .,.-.. ...- CCB Lie,: /6;1117 Electrical Lfe.: 63 Suprv. Lic.. Z2-6' :::::;::.;], :.: 7 Suprv. Electrician signature, required; ',..04.... ./.,,,e,-_______ Da (. i-;-- ' / -.II Plan review (25% of penn Su i b t t f ol ee l: Print name: j 06 . iv tt -- 1/ (43 ' - - z • , I Date /7 / State surcharge ([2% of permit fee): ) Authorized signature: ,d' }Ze' " . : - .//(......."- i ,t TOTAL PERMIT FEE: 1 II, IT This perrn it a ppl ica lion expires if a peentit is hot obtained within 180 days after it has been accepted as complete. Print name: (1A- (- Ct I Date: i . 71// b / • Number of inspections allowed per permit. EADultdingtPerrnits\ELC-Pensquipp.cloc 07/01110 SE11-46157(1105/COMIWEB • 1, • d 69 9t7 I, C9€09 0 1 i 'oppeo eseqdRinvi . ., . . . . . . Mechanical Permit Application FOR OFFICE USE ONLY IIIII 13125 Ill City of Tigard S) Received Permit No.: yrIs SW Hal I Blvd., Tigard, OR 972 01 0 7 4 r cisi c ii CC 0 \ 44 iparelBY: 2,0 , Planneview Phone: 503.718.2439 Fax: 503,598.1' P 12 (1 kit . \)\` • Date/By : • Other Permit: Inspection Line: 503.639.4175 TIGARD a, • Date Ready/By: aria: PI See Page 2 for Internet www.tigard-or.gov ICr 7 ‘'...?" 1 J Supplemental Information c. \C7 _ - NNSN;=,igdnig•Sattat#tg;*No.itervetz0*t O gf iltl •.' ikrAOx.'1414...„..it't...ft . 0...4 t taf.....,-, oa0 et Mechanical permit fees* are based on the value of the work 0 New construction ZAddition/alteration/ ret t performed. Indicate the value (rounded to the nearest dollar) dal! 0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. ?ig';.'kg:ggy:::::. !' ;!. ... .. , „, ,........, ... :. • . ••••,,,,..::•,:,;,:.:•:•:,.,:..,....„ ...,...,.,.,. ..A,...,■.:r.`,.-.......-,....,............,..........k.AR•aZAQ,.R.40.4tiOaiM:::1:1:,:: 51.,..141tESMENZIA14991K,WROMX14§3151a.a::::::: RI 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For. spedal Infonnafion use checklist 0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. 1 Total 40:'%$t nen linW"Dii": • - Air conditioning Job site address: te-Z-12 OJ G C ; cc. id RD (requires site plan shrnvinapineement) 46.75 I ) 1 Furnace l00,0 00 BTU (ducts/verus) 46.75 City/State/ZIP: r Ptalf A 6.) R, CI 7 7-2- '''' Furnace 100,000+ Bit (duets/cents) 54.91 SuitelbidgJapt. no.: I Project name: -. ,,.;:),'NC1,11- Heat pump (requires siteplart shinvinaplaceineat) 61.06 Cross street/directions to job site: gcr...cf.._0 Bc),,,.. Duct 'mak ( 23.32 - 2:::, 3Z..- 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: I Lot no Flue/vent for any of above 23.32 Other. 23.32 Tax map/parcel no.: Other fuel appliances; 4*4 ggii ingg Vg A tifaigg e k;410 , 1 s - MAteilitidli i bifAiiiiiiri°fk W iji:li Water heater 2132 twsaw.:4.9.t.44-;kaiteklMir:::, • 4 ..& ,,,, ... ,,, .. - ......A.4..- , .. 4 ....4it. , i , ....... , ...:44•44•41:Solilrz*::ii.:IFi.F.g:PSO /Oat \ / RCE eri c iciGuav Alva,/ Gas fireplace Flue vent for water heater or gas 33.39 ... 41/161 InA/5'I-G 1.1 47 L' l'I/ fireplace _ 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/Insert 23.32 ip dilibititt'jj;f6WienZAlliNkl:VS..11-W-i-V .WW,P4g010.694404,1W1 Inine Hier I 1 en 2332 2332 Name: ' Bt( II civ‘ci c \ cA vi F3u4C,h(A.X1 Environmental exhaust mid ventilation: Address: / L i/ 2 S CO r 4-0-1•1 (r. (tic) R 17 Range hood/other kitchen equipment , 33.39 • _... City/State/ZIP: 7 ,,„,„,,,,,,\ 6,, ,1 7 12.- --..-s Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms, Phone: ( 6 . 7'9 - s A37 Pax: ( ) toRet compartments, utility rooms) ' 23.32 tinktallattiMaigigiti L ilitgOkitgai Attic/crawls P ace fans 2332 Other: i 2332 Business name: 6 [ , p d 1 0,,,,,, 57 e- Fuel piping: Contact name; - \- L. /...V . 10-4 ° : 514.I5 for first four; S4.03 for each additional Address: PI b t Bei 1 / . 6 Q Fumaet etc. t Gas heat pump Cit l?'/' ri- hir)d OR (:),: 7 2,W . Wall/suspended/unit heater Phone: (.n) 24-/ 4/ -7 4 1 6 ? Fax: : (661 ,90../ ...671 / Water heater . . .4 A , Fireplace E-mail: 4 ...07 ,,,,,,,-,,,„ e 41 0 . ,. . Range i:qiii:'iltg B a rb ecue _,, 0 ecue I , i Business name: 7790,0,8 frittA7j.n.e.. %.3' G- Clothes dryer (gas) , Other: Address: ty y 7ii s E ,4. 9 vice 4f tagati:Wit:M10 City/State/ZIP: iadri..7/449..-1/4 6/1-1&.‘.../. / 7 2 ez Subtotal Minimum permit fee ($90.00) 16. OA Phone: (.1" 0,3 ) Z. 3 0- 7331 Fax: (503 ) 19 )3 .- 9 24.5.1 Plan review (25% of pennit fee) CCB tic.: / 9 9 / . State surcharge (12% of permit fee) ( 0 . RC) TOTAL PERMIT FEE (00 e Pr.) Th Authorized signature *•___ i permit mildication aspi if a permit Is mit obtained within ISO -- Z.: - days after It has been accepted as complete. .... Print name: ,41.$77 7 Date: /2./3**/// 1 * Fee methodology set by Tri Bonding Industry Service Board . IABoadirsoPermirrafEC.Permirdtoptior 04/09/10 440 (I WOWCOMIWEB) ■ • . . . - . • ,, , PIumbing Permit Application Building Fixtures ® roe .OFFICE USE ONLY City of Ti and RecenYd �J g .. Date/By: Perm i \o t� r �I'�D�� l - d 13 125 SW Hall Blvd., Tigard, OR rte A# D /By: Review Phone: 503.718.2439 Fax: 503.5 :4 N.'C•' �, �r1 ®\\ Date/By: OtherPernutNo.. TIGARD Inspection Line: 503.639.4175 < fiJJ 4 A i Date Ready/By: rnris' Ei See Page 2 for Internet: www.tigard- or.gov ` J` Notified/method: , do q, � [ YPE OF'iYORK: l` V - FEE SCEDULE Supplemental �(' V si`i� ,H In rt-�`` Information n 1 C] New construction ❑ DCmi+Ali ' O\ For special Information use checklist. �� Description I Qty. I Ea. I Total Addition/alteration/replacement [] Ot}l New 1 - 2- family dwellings (includes 100 ft. for each utility connection) ' . CATEGORY OP: CONSTRUCTI ' -: SFR (1) bath 312.70 • ril 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 ❑ Accessory building 0 Multi- family SFR (3) bath 500.32 Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( , sq. ft.) i Page 2 JOB SITE: :INFORMATION AND 'LOCATION Site utilities: /" G f � h Catch basin or area drain 18.76 Job site address: /54//7 � 0... ( r( ?,0-til (/ 16. (�''( ( L✓ �� ( ({� > ' Drywell, leach line, or trench drain 18.76 City/State/ZIP: , �1t , c f L. Footin drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 1 Project name: ? )„ J . I -\,, {/°- Manufactured home utilities 50.03 Cross street/directions to job site: R C.f! ( f co 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 • Backwater ....,:..:DESCRll'TION:OF.aYORIC. ,: '.':, ...: mti 12.51 ` l'� 1 • 1 ti � I Clothes washer 25.02 AAA t "l 7 11��/ Kcf .`/)f)( )dam - l U` C 1_.t1'-kbr f:? -�)r2, 4 Dishwasher 25.02 ll �. I , t. 1 - __ Off 1(�l MCA `, •<1,._t/ i; ;;(<A i k �' () 1,, ac 1Vl d Ul f Drinking fountain 25.02 Ejectors /sump 25.02 ` PPERTY, OIYANER : : [l TEi Expansion tank 12.51 Name: r ) t GStl�C;\ G )�_ Fixture/sewer cap 25.02 4 \ �- (,. u Address: / 7 (73)(,) r ( j {' Floor drain/floor sink/hub 25.02 ! ` /(/ ) Cyr Q!l Y c r.1. 1 4 1-), ! .? Garbage disposal 25.02 City/State/ZIP ? r .. 7 ; j y t`�r "�L'C� �.��... i / :., Hose bib 25.02 • Phone: (: ( T •• %.} 7 ,' -/ Fax: ( ) Ice maker 12.51 APPLICANT i0 CONTACT. PERSON Interceptor /grease trap 25.02 r c Medical gas (value: $ ) Page 2 Business name: QTr y ) ri0c C)) _ ` , ((i✓I;.7- Contact name: - Printer 12.51 1' e)�71�7, > Roof drain (commercial) 12.51 Address: t' f `' t(� r `1 .. ,,,. ) �' i ( ! l t) ) Sink/basin/lavatory 25.02 i- City/State /ZIP: , ,) y kill i l l ('1 (l) 1:,, (7 / r l , - , c ,( 1 Solar units (potable water) 62.54 Phone: ( O -) 2- Fax:: (5o3) > 'V'� `Z 11 / Tub /shower /shower pan 1 12.51 \Z, 1 �� 1: h V c Urinal 25.02 E-mail: S < :.: ,.. - (.1()?-4--1 . Water closet 25.02 25, 0 , OR - .. - • - - Water heater . 37.52 Business name: se.‘", 5 f O W 1AQIA Cs!) Water piping/DWV 56.29 Address: ?, 64 -Alu Other: 25.02 City /State/ZIP: Loi& 06wErto J. 9103S- Subtotal '3'37. 3 ( 5 ) log Z.s� Minimum permit fee: $72.50 Phone: Fax: ( ) 4 y 7 Plan review (25% of permit fee) CCB Lie.: al %(oT. 1 /1s - (.-- Plumbing Lic, no.: TLl Z O'Pg State surcharge (12% of per mit fee) (3 `7O Authorized signature: V- CI 7 ( /l1 TOTAL PERMIT FEE 8 t 2_0 Print name: Teri= A. S Date: 1)... • Q` • 1/ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fce methodology set by Tri- County Building Industry Service Board. i:l Building \PermitstPLAMU -Pe mitApp.doc I0, 01/09 470- 76I6T(1 0 ;02/COM/11'EB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: •Qty.: Fee (ea). Total Fee: . _.. S quare Footage:' ;Permit -Tee: Footing drain - 1" 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater _ $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 • Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Qt}:, :.Fee (ea): Total each additional $100.00 or fraction thereof, to Other Inspections, or fees and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/tr each additional $100.00 or fraction thereof, to (minimum charge -1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge -2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/11r and including $50,000.00. 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 $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees Qua byrixtu ..;.... .p ev P ns ns Quantity Type Fixture Type for .. Replaced ' Pl an R ie�w for. .lumbing taliatiti .Work Performed: - -Capped . Added Relocate. Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub /Shower ❑ Any new commercial building with water service 2" and lacuzzi/'Vltirlpool greater, except systems designed and stamped by licensed Car Wash - Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918 -780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system, Drinking Fountain ❑ Any complex structure as defined in OAR918 780 - 0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" 4„ Isoinetricor- :Riser,:Diagram -, Car Wash Drain II Isometric or riser diagram is required for new buildings - Domestic - non - food l s q g Disposal - Domestic related that meet the qualifications above. - Commercial -food related - Industrial -food related ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang - Stall Sink/Lay -Non -food related - Bradley - Commercial -food related - Service Swimming Pool Filter *Note: If the fixture work tinder this permit results in an Washer - Clothes tiner p Water Extractor increase of sewer EDUs, a sewer permit will be issued and Water Closet - Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\ DOCUME-- 1\ Uones\ LOCALS-1 \Temp\PLMF- PermitApp.doc 2 . 1,1 Building Division Development Code Provision Review T I G AR D Residential Projects Building Permit No: ,") v7 ) ) �} CWS Service Provider Letter Received: Yes ❑ No ❑ N/A EI---- b /1)- •'N Jvd4, Routed Plans: Original Plan Submittal Date: 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 Koh. T L ' i anav■ at 503 -718 - Z Z or i /13 4 @tigard - or.gov) Land Use Case No. $ kb 2005. 'a000 Name I� boning # 4 -7 E Setbacks: Front /' Rear /r Side Street Side / D Garage 2 C"Maximum Building Height .3S Actual Building Height 48 Ea/Visual Clearance Q ❑ Sensitive Lands Type: Notes: Original Plan: Approved/Er Not Approved ❑ Date: 12"16/ , 1 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) Actual Slope: S Notes: Original Plan: Approved Not Approved ❑ Date: I2 ( ` ( 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) Street Trees Uri Protected Trees Notes: Original Plan: Approved E'J Not Approved ❑ Date: / � /r"- 0 /aoGi 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: 7 I Page 2 of 2 • Pg.# INDEX: - RECEiVED Pg.1 COVER PAGEISITE PLAN � 2011 Pg.2 FOUNDATION PLAN /FLOOR PLAN DEC Pg.3 CROSS SECTION PLAN B U 1' C H E R A CITY OF TIGARD Pg.4 ROOF FRAMING PLAN BUILDING DIVISION Pg.5 ELEVATION PLAN Pg.6 ENGINEERING PLAN 41 110' -4" \ L.400 c ::,_ ry EL.38L16/11 �� ^^o�ff, c� �O, [ {�` hHONEI I �1 3 I� -�u//i. u � I _ 2-- A -..., OWE — �._ �._. . I IlI / \\ \ N�! ////////,.///// /' A I i'AS��Ai*.*w I .....•.......... I / / i iiiiiii.iiiiiii 4 ' 4 i • • / \ \ \ \ \ \\ \ // ! ! / ! /, j ! / I ��i�i�i�i�i 'O� M ( W \ \ \ / / ,,, ! 4. ! . .... I � Q . i \ \ \ '. �.: PROPOSED : ❖:•: [� - \ \ \\ .r / / / / / /, i / /� ' ./ / j /i e ���������������������� ������� I 1 I \\ \ \ '�f // /./////// ! / !// // !/ ! f • .�i�i�i�i�i�i °i�i�i� :kV 1 �I \ \ \ \\ \ \\ \ ., / ./ / /� // . !j;� /j /� ! .......... ADDITION .... I / I ENERGY PATH ONE '� l /< // \ \- -I` ..,,,,/,/ , /, ///// / 1 , / / . f f , j a / / I ( I ZONE: R7 // o/ \ ,,..1 \\ \ /! // !// / ,� a // / .// / \ \. / — ! a \ \°\ \ / /j /, / /j /i, /,� / GENERAL NOTES: V Lt) I /' \ \ \rn \\ \ / 1 /./ - 5 L U X/ // / / • ` / Z el \ \ \ /r // /W / / f/ .\\ j \\ / A/W/ f /, ! j z j /// I I Existing Living 2, 594 sq.ft. ~ \ \ \ ! . O 3/4/.//7/ % \ i z \ / / / / / M � fY \ / O \ \ \ \ / / , / / / . /4///;////////. / 0 /.// / \ / I / Existing Garage 662 sq.ft. 0 ui \ \ \ \ \ \ \ \ //� / / /i / /////////;////. / , /, / /; / /( 1 / ( New Living 165 sq.ft. o t Z \ \\\ \ \ /f / / / / / // !/ !j / !/' / c)-1 New Total Living 2,754 sq.ft. (J EXISTING HOME / Deck 215sq.ft. c, / \ \ \ \ / / /� /% / /! /� �� f!j! /1�.:'/.� N / (0 Lot Area 6,621 SOFT. C cr , d � \ \\ ,� /j /,/ /,!� /,� — 1 / / t 41 cn 6 \ \ \ \ � \ \ \, �._ - -.. // / / Existing Lo coverage = % X g \ \\ \ \ \ �� i / / New Total Lot coverage = 43% O O O \ \ \ \ \ \ \ \ \ / / / Tax Lot 2S109DA04500 \\ \ \\ \ \\ X396— — - �� f / V Q ` � ' �,%;; \ \ MI \ \ \ \ i / / / \ / R2132391 Cn O \ • I' I / / / 4 ' ENGINEER: F=] /- , ` 1 4 ': A '$� : • \\ ' i / / / Duane Thompson son 7 ' �� \ \ \ / P (503) 293.3811 H =` � �� \ \ \ �, \ _ -__ -, r ,w No. Revision / Issue DATE: �,.. \ Y / / / / / e� .,, O I I 1 \ \\ �� / � / / / / / /' / / /! / / / / / 0 0 ! \\ \ \\ ! / // /• EXISTING / �/ •/ / / COO G� T2 0 et F-1 \\ / , /// /,/ /• ac�400aoaco \ \\ \ \\ \ / �!/ / D , ;/./ / 1 / / / (503) 244 -7467 • \ \ \ \ \ \ !! / /�i/ ! ECK i /j !! // \\ \\ \\ / , /, �/ // ,f / / /! / / / // PROJECT MANAGER Jeff Jones O \ \ \\ \ ! / / / / .� / // -' / / SCOPE: \ \ � \ \ \ /� / ! _ / \ \ \ � \ � ` -- -- ' -- 7 — _ 165 sq. fi, main level addition. a`� \ \ \\ . 39d' • ' -- —. ,� EL139 — — — — I — .29/J — — rd..388 — — GL � �a • - I ' ' �,.�$� / O 1 EL. \ • PROJECT NAME AND ADDRESS: • BUTCHER ADDITION 15412 S.W. GREENFIELD DR. TIGARD, OREGON 97224 CATaWDEM bilw NOTE • >CALE }• = 1'0 DWG. NO. • U N.O. UNE PG lEgif Gg BUILDING CONTRACTOR AND / OR FRAMING CONTRACTOR ' "'t 11-18-1 1 rRES - 2011/39 RESPONSIBLE TO VERIFY ALL DIMENSIONS. C�OG734WMC�4�OO a C OO o COMPLY TO ALL SHEETS OF PROVIDED CHill. BY OWL.. BY ©08a04 PEns4tow ©@1:3 # 94597 3 COVER PAGE SITE PLAN iii. ENGINEERING FOR CONSTRUCTION OF THIS PROJECTI REF. NU. Sal PROJECT (503)522 -2659 Scaler" = 10' -0" .1. Page 1 1 II