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Permit
CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit #: MST2011 -00210 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/25/2012 Parcel: 2S110CB07600 Jurisdiction: Tigard Site address: 14998 SW AUGUSTA TER Subdivision: MOUNTAIN VIEW ESTATES Lot: 1 Project: Mountain View Estates, Lot 1 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 1875 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 21 Bathrooms: 3 Second: 1069 sf Garage: 651 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right. 5 Detectors: Yes Total: 2944 sf Value $340,342.58 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals 0 Lavatories' 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs /Showers. 2 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: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 5 201 -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 2944 Owner: Contractor: RUECKER, DONALD CRAIG & BEVERLY VINCERO REMODELING & CONSTRUCTION Required Items and Reports (Conditions) 13828 SW FANNO CREEK DR, #2 711 N MOLALLA AVE 1 Ersn Cntrl 503 681 - 4444 TIGARD, OR 97223 MOLALLA, OR 97038 2 Provide geo tech report prior to footing inspection PHONE: 503 - 724 -3115 PHONE: 503 -519 -0629 FAX: Total Fees: $19,365.40 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 e in actor 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 d s. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 52- 001 -0010 rough OAR 9 2- -00 ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or .. 32.344. I ued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection date. G� This permit card shall be kept in a conspicuous place on the job site until completi• of the project. Approved plans are required on the job site at the time of each ins.; lion. . 4 - 'Building Permit Application Residential RECE FOR OFFICE USE ONLY City of Tigard Received : /.� AO // ��„ Permit No.:�S��!'/ Jf/�`0 13125 SW Hall Blvd., Tigard,OR 97223 DEC 2 0 2011 (( ll //`�� C Phone: 503.718.2439 Fax: 503.598.1960 Plan Date/B Rev: iew I • er Permit: CA0 Old - 40/7 � I' 1 G n ft D Inspection Line: 503.639 CITY OF TIGAc D w Date Read _ %j� : AA Juris. El See Page 2 for Internet: ww.tigard- or BUILDING DIVISION Notified/Method: i 10 ` /J1 Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING I: 'giew 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 E 1 and 2- family dwelling ❑ Commercial/industrial Valuation: $ ' 7 © e�� ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 C ❑ Master builder ❑Other: Number of bathrooms: ?, S JOB SITE INFORMATION AND LOCATION Total number of floors: "Z Job site address: / 99g W f.G(6, 1467 4 —rig New dwelling area: z�44 square feet City /State /ZIP: l 4 ,,,p Garage /carport area: 6 square feet Suite/bldg. /apt. no.: Project name: Covered porch area ( square feet IOW? Cross street/directions to job site: Deck area: q l7-S (���jQ square feet Other structure area: 1 3 ('J 563 square feet y l 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. r Valuation: $ . - cc ai-o7.• ' 10 .c / ,, Existing building area square feet New building area: square feet ❑4ROPERTY OWNER ❑ TENANT Number of stories: Name: C. rex :0 g N cG G IC e /- Type of construction: '7 Address: Occupancy groups: City /State /ZIP: Existing: Phone: (5 e3) 724 - " //I Fax: ( ) New: [APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* d (Please refer to fee schedule) g � Business name: ' 4 '61 ii hS 1 • _ � i '� see . f (/ ,� G2 P" ' R QN1 �A W T Structural plan review fee (or deposit): Contact name: A / r / l / p 1c Address: /� FLS plan review fee (if applicable): 7/ e4714 ,� "4 IA l! d Total fees due upon application: City/State /ZIP: /yj /41 oft 9 7 0 313 .er) Phone: (.5t4) 5 - a ( 3 Fax:: ( ) Amount received: 7 E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial a • residential prescriptive installation of roof -top mount:. stoVoltaic Solar Pane, System. Business name: 54 C - - A.-.; iL o v Q, Submit two (2) sets of rs :- Om wi .nnection details X77 and fire department access, a with the 2010 Oregon Address: -7 // /1/. /11)1m //mo 617-C. , Solar Installation Spec.' -" Code c - ;. klist. City /State /ZIP: ri 0(4,.(( p` t, Permit Fe eludes plan review $180.00 r an a f ees ) : Phone: (5j ) 5 7 e 0(O01 Fax: ( ) State surcharge (12% of pennit fee): $21.60 CCB lie.: t 7) 3 go) 111)A)- 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: ( .. 1 I'f 0 - L A K Date: f 2 2, —// * Fee methodology set by Tri -County Building Industry 7 Service Board I :\Building\Permits\BUP- RESPermitApp.doc 02/24/2011 440- 4613T(11 /02 /COM/WEB) 1 Building Permit Application Checklist One- and Two- Family Dwelling FOR OFFICE USE ONLY City of Tigard Received g Date /By: Permit No.: n 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: • ® Phon 503.718.2439 Fax: 503.598.1960 P All G A.R.D. 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard - or.gov ❑ Other: . • THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 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 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, 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 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. 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 ' ❑ . ❑ ❑ 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 ariengineer or ❑ , ❑ , ❑ architect licensed in Ore•on and shall be shown to be applicable to the Iro•ect under review. . JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 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 must include 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 - RESPermitApp.doc 02/24/2011 440- 4613T(11/02/COM /WEB) rJJ., iZr Zeiss r17; «rI I nano (t 0001 AL I LU C..LhC I HIC LLC: PAGE 01/02 EAectrietal P e r m i t Appljcati i i FOR, h I I F 1' 1+ f'. i s ()NIA City afT slit n � ' ' Pe/P*1 t157 � ODo r) ,.{ 13115 SW Hitt 3#vd., Tigard, .Oil ' F Pitons; 503.718209 Atli: 303,59839W f f Other P t f: • T l C:, r, ifl8Qea10n Lino: 503.6394175 JAN. 2 5 2012 IAN Rsedyfar NM , Sea Page 1 for internee www.l din .goat , ' Notts Metboa s„p .. too) urroroma4 n �?g •b1F• , i,; „ } y`aAN J1slrw 'New cOXISt 111*01, L7 Addi1ioNal' •: - Ok '- i i Olaa k elf tit r tsubmis 2 seta o p w /item S duelyd below): © S000lae or (i"dor 404 Lope or morn ©nnfidtne avur throe wales Datt01it1on [] Other, stem the available fault amraat fl Marines end baetShit dt- ' " • ' :. , . C4wn s OR'? Or. 'COI im bN ,. , :. ' . • • . : exaaoda 10,000 amps at 159 volts or p ltlaulnp buildings. ID 1. and 24amily dwelling Commercial/Industrial el Aoc�vasory building et. to w Intends l4,oua p buskin oohlu�tas seQrtculturlt $ atilps lbr all ourcr ltlstUAnlona. buitdtrlzo. Q mufti-tautly 0 Master builder Q Other: D1f%pampa ' Q1 1laGam 01 KVp or JOB "STi 'ID14tOAA�+I'!�t AND 1L Qt- �A17CIQ11 ,, DeinaBeaiy inn. tenor 1eoAtsltdlyde0.i.tri ['Addition of tow motor load of Q "A ", 1 13", "1-2 "1,3". Jabno.: labsitead ass: /ii• ge $,w, /4( tr Cas cemal t sld.nelni © tteaealionel vehicle perks. City/State/Z11 ` j1 6 A ( 0 0 l2 3, 2.2 i+ L1 Hach rt t>aalrte. P stvaiv w►taze Dr mum Qua Cltiomrdoo n locations. 499 vote nomktat. Su#tclbld .(apt. no:: I Project nattu: 0 Sucviaa or gene 640 Wit; oc Foote. , Foss street/directions eet/ditecdons to job situ: .�. ' PIE. SCHEDULE New rtsldent.ti sitlgle- or multi fam11y dwt1Iiit$ unit. • Includes attached getup. Subdivision: Lot n 1,000 sq. ft or less I 168,54 - _ 4 °- -- Ea. add'l 300 sq. D. or portion 33.92 l '1'1. tnapJptltoel iii+. +, ,�,,....,� Limited costly, residential 75.00 ' 2 - . 7 t�t?ly' Ul: WO1R3{ (with obeys 50. ft.) NQ rw Limited oud�, mute Cnmily 75,00 2 Af a C:�7N�i Crt 0 A p S� r Ct�-•1', airy residential t with or s above a oe a tcrattan and/0 r relate d -- -- -- • -- 140 emus 1. lea, 100.70 2 ' ti :PROPERTY OWNER ' , • , I, , ❑ , TENANT 201 craps to 400 amps • ` 13156 2 Name: 401 amps to 600 afnys 200.34 2 601 amps to 1,000 amps 301.04 2 Addre t;s= • Over 1,000 amps or volts 55226 2 ` _ , 'Temporary sere es or fowlers invtnila 41., sit tlaP, No eity/Statfaltit relocation Phone: ( ) ? ax: ( ) 200 amps or less 5936 I Owner 1ustellattiwn: This lostetlistion is being ntaade on property that 1 own which is not 201 asltps to 400 amps 135.08 2 401 amps s to 599 amps 16Y.54 2 Intended for sale, least, rent, or exchange, according to P 447, 449, 6'7Q, and 701. Branchelrcults - 'sty t1110r thin Or extensiay . t r r b Owrlar 51gaature: „- Date; A. Pee Mr Mid oirOUite wires .. . D 1.1, ?LiCArrr' . , • , . .1 Q ..t �vi ,+►�-r PERS N ' Eton st rvlcu or Azar fee. raoh brush circuit 7.42 2 B'usiriess Dome; B. Fee for brunch circuits without service 0rfecder first 6616 2 Contact name: circuit ' - Each add'1 branch circuit 7-42 _ 2 Addsesa: Miscellaneous (service ur feeder not lncluded1 C(ty/Stat air: Each mantdacttued or modular dw A4 2 oiling, service and/or f cder Phone: ( ) Fax: _ ( ) R000ts eon Only 67.94 - 1 7 E- retch: _ Putip orirditnion circle 67.64 a - Eia AC'TOR Sigo or outline liahtina 47. 1.4 2 - - sisvlel oircuit(s) or limited-energy $ueinesg name: panel, t:n atttion, 1.r e:tenaiga. Pa u e 2 2 f '�� Q-C t'�l C L[-_� . ,... .... R addlttoost iniloccdori. over aUowaJ fo Itt coy of the abov Address: 9 6 ,ii) /t J / 04frZrA 54• - St71f• iA,A3 Additional inspection (1 hr rain) 66,25(hr w City/State/ZIP: d i fA {2 0 { 44423 toe tl (t trrnIn) 6633/ hr Industrial plant (1 lir min) 7g.181 hr - Plwna: (,50 ) a€ 4. R g g 1 PAX: (b3) Z 4A -SSW Inspections for wtii01) n1. feels 90.00 / hr specifically listed (K hr mien) CCE Lie.; /Sb 7,20 Electrical 14c.; 3 a - . suprv, IJc,: / 9 i3 $ • . , , : • ELEC'TRICAL rgitMIF .FEE8 • • Suptv. 2 1ecl - Lcian signature, required: / / • , Subtotal: Plan review,( 5% of permit tiro), PrinT names: ze. e 6 e 4* Data;: / , C f- 20 a stole sareltarne (1241; of psrnlls tIee): ' Authbriztd signature: TOTAL )'6RMft fa; 441, p ,r , - ' ` i d+s d ysa( ter L Ewe aomptsd oonrpletA •. wklia'> 30 P,rift " 13°1 ' I/ F [bate: f a- "1 " r • Number of inspections allowed per permit • L00 /L00E1 H3UfH9 NNIIIWS E09E1.8909CL XVJ EE :ZZ ZLOZ /tZ/LO ' Mecfia'nical Permit Application FOR - OFFICE — usc oNLI' City of Tigard Received h Q, Permit Jl� 1114 " `J *, �� Date/By: / 90 Ar / ! �6� / /�"�Z) 13125 SW Hall Blvd., Tigard, N •>r 3 Plan Review C Phone: 503.718.2439 Fax: 5 n3.= ` : •- • el Date/By: Other Permit: 50,449U — a9/76 ) T I G A R D DEC Inspection Line: 503.639.4175 p 0 . 2.O'�'� Date Ready/By Juris ® See Page 2 for Internet: www.tigard- or.gov C !� - Notified/Method. Supplemental Information li OF TYPF� p VIS 1,J' UUU1�v� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work Iew construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: / 4/ 9 9 p C > % /4 N ��, ref/ (requires site plan showing placement) 46.75 City /State /ZIP: / f Furnace 100,000 BTU (ducts /vents) 1 46.75 �� 4 / Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: ` 1 Project name: Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: 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: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 1 23.32 Gas fireplace 33.39 /✓ r.J $ :/ti kt. / D /j •, &. //i it r 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 ❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: Gca t ^ A k. 4. G !« / Environmental exhaust and ventilation: Address: / Range hood/other kitchen equipment ( 33.39 City /State /ZIP: Clothes dryer exhaust 1 33.39 Single -duct exhaust (bathrooms, Phone: (c.=3) ?Z 6/ — 7 //f Fax: ( ) toilet compartments, utility rooms) 5 23.32 I ‘ tc,.(eC ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater i Fireplace E -mail: Range CONTRACTOR Barbecue ;—� tt n ^ �� /4.,,,,—; _ l /1 I� , y� Business name: t J K.rT N (,pD L� n� ti2: ^ `` '' // Clothes dryer (gas) Other: Address: a2sr7 4.,7 $ c l J Gtr y a/� `f' MECHANICALPERMIT FEES* City /State /ZIP: V_l N� 0 9v Subtotal 2.(4, ( , Phone: (60 �J ,7 ) eit - 34 2- Fax: ( ) Minimum permit fee ($90.00) fi Plan review (25% of permit fee) CCB lic.: /6 7 ? � State surcharge (12% of permit fee) ? Z �� TOTAL PERMIT FEE �9�, Authorized signature: T his permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: !\ l /¢ / o /( Date: / Z • 1...-4) --e / J * Fee methodology set by Tri- County Building Industry Service Board I:\Building\Permits C- PeermitApp.doc 09/09/10 440 -4617T (1 I/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 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 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $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 for each additional $100.00 or fraction thereof, to and including $100,000.00. $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:\ Buildin \Permits \MEC- PermitApp.doc 09/09/10 2 Y ,nbin permit .Applicatio Wr 7:;.e 1VED ilding Fixtures t. :6:I.. I' OFFICE F ICE ('SE ON1.\ City of Tigard 11%. ` a E Itcveived /a l Permit No.: / I L � O;, al 13125 SW Hall blvd., Tigard OR 9722 - • ' Pla Plan Review Plan Phone: 503.718.2439 Fax; 503.598.1,Q 6 r g.� ;� � , a D bate/19y: Other Permit No.: - 1 . � t i A i j 1 Inspection Line: 503.639.4175 #�`'! 1 j tit � y Date Roady/By; runs; tO See Page 2 for Internet www,tlgard- or. gov EI'• �1! ' D _ IVLION Notified/Method: Su .lementalInformation TYPE OF . T s �' FEE* SCHEDULE ' 1NG DIVISION T For special information use checklist I1 'ew c0zlsttuetion ❑ Demolition Description I. Qty. J Ea. I Total ❑ Addition /alteration/replacement LI Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath - _ 312.70 I and 2- family dwelling ❑ Commercial /industrial SFIt (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bath /kitchen 25.02 ❑ Master builder ❑ Other; Fire sprinkler sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: _ , Job site address: a ": R .1+ _ Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City/State/ZIP: -7-,'-'5. 4 r f f �� / jlr Footing drain (no. linear ft.: ) Page 2 / Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50,03 Cross street/directions to job site: 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; r Lot no.; Fixture or Item: Tax map /parcel no.; Backflow preventer 31.27 Backwater valve 12.51 DESCRXPUON OF WORK /^ Clothes washer 25,02 .4. a 1,-3 %� g )(i 'reiryJ 77 01.- B /. j/ Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 114 OWNER ❑ TENANT Expansion tank 12.51 Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: _ Hose bib 25.02 Phone: (5-4.1) 7 Z t/ - // s Fax: ( ) Ice maker 12.51 0 APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name; Medical gas (value: $) Page 2 Primer 12,51 - - Contact name: Roof drain (commercial) 12.51 Address: - Sink/basin/lavatory 25.02 City /State/ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 12.51 - . Urinal 25.02 E -mail: - Water closet 25.02 CONTRACTOR "- ' Water heater 37.52 • Water piping/DWV 56.29 Address: p t ,r,., 4 G ti dr Other_ 25.02 City /State /ZIP: v ,7t 5. r k 5/ , L ' 1 c'9 Subtotal • Phone; (5 .e - _ / Fax: (`‘ ) k) S 6 1 Minimum perm it tee: $72.50 Plan review (25% of permit fee) CCB Lic.: j '749 g 4/7 /A p - g / zj Plumbing Lie. no.: C r 0 , 7 / IY State surcharge (12% of permit fee) Authorized signature: 1 , , / 4 TOTAL PERMIT FEE _ This permit application expires if a permit is not obtained within 180 days Print name; ,, a r_ o S � Date: \ - \ \ _ t� after it has been accepted as complete. "Fee methodology set by Tri- County Building Industry Service Board. 1:\ Buildipg \PermitaWLMl3- PermitApp.doe 10f01109 440- 4614T(10 /02/COMPWE13.) P19 9g 600 / 4uC015r %-i " Building Division gnu 4-/i Lit Development Code Provision Review T[GARD Residential Projects Building Permit No: �� � (����o . t CWS Service Provider Letter Received: Yes ❑ No ❑ N/A Routed Plans: Original Plan Submittal Date: /2-4' f // 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 SktA. tat at 503 - 718 -0 or 5ki4 @ tigard- or.gov) Land Use Case 540 000 I Name UAL 1110 FST?1-TS Q Zoning K ��( Setbacks: / ,, Front 13 Rear / Side J Street Side l (� Garage 2b Maximum Building Height 3.5" Actual Building Height a( 2 Visual Clearance 172 Easements EV Sensitive Lands Type: 2.0 S Notes: Original Plan: Approved 1;7 Not Approved ❑ Date: 0■./(0 / I Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (c ntact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) .i Actual Slope: +f 20 % Notes: 5 40 0 (c Original Plan: Approved -0' Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City 1�rborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard- or.gov) [� j treet Trees Protected Trees TP ( 4 Notes: . , _ 4 719 Original Plan: Approved / Not Approved Dr Date: i- %v,'2vl/ 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 ►, o ❑ Date Routed to Building: • Page 2 of 2 ' �� P �py9 3 /,`' ./_ ,....., , ,., , PA } � �- -, , RECEI DEC 202011 f- C TY OF TI I- c GAUD ` 1 et J LDING DIVISION — _ - e S e 1O R ! 8 A Ev v' : k 1 i 1 4 1 1\ \ \. \ - ��i,\ - I•I G') 1 i :,.. f . , „,-,-,. , /-..:x\-,- [./( 711 yr _ 1 y . .f.t. il) x ill - 6 .p _ V � , � .. ( - • . .......,........._ L,Pr I —rte e- . RECEIVED JUN 1 2 2013 CITY OFTIGARD BUILDING DIVISION INSULATION DIVISION CERTIFICATE OF COMPLIANCE Date 06/12/12 Builders Name: KOZAK ENTERPRISES Job Address: 14998 SW AGUSTA TERRAC City: TIGARD, OR Job Number 24336 Type of Application Material Type R- Factor Dept. - ATTIC BLOW Fiberglass R38 INSULSAFE 14.5 BAFFLES Fiberglass BAFFLE 1 CAPS Fiberglass R -19UF 6.5 CAPS Fiberglass R -38UF 12 EXT. WALL Fiberglass 1.5" RIGID 1.5 EXT. WALL Fiberglass R -15K 3.5 EXT. WALL Fiberglass R -19K 6.5 EXT. WALL Fiberglass R -19UF 6.5 EXT. WALL Fiberglass R -21 FB 5.5 EXT. WALL Fiberglass R-21K 5.5 EXT. WALL Fiberglass R -21 OF 5.5 KNEE WALLS Fiberglass R -21 FB 5.5 KNEE WALLS Fiberglass R -21 K 5:5 OVER/HEADER Fiberglass R -8UF 2.5 RIM JOIST Fiberglass R -38UF 12 SOUND WALLS Fiberglass R -11 OF 3.5 UNDERFLOOR Fiberglass R -30UF 9.5 VAULTS /SLOPES Fiberglass R -38UF 12 Authorized Signature RECEIVED Oregon Residential Specialty Code 8318.2 JUN 1 2 2013 CITY OF TIGARD BUILDING DIVISION! MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, g-/ le- /eoZi -- k- , am the general contractor or the owner - builder at the following address: Site Address: ly cs� t t ( 5 1 4 31 VUvt- ` .. City: ))/)(1 Permit #: S1. SO 1/ 6 Z10 Subdivision/Lot #: c 1 e and /or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, 1 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: h--1_1 General Con ac . , +I er- Builder 1:\ Building\ Fonn \RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2RECEIVED g p tY JUN 1 2 2013 CITY OF I IGARD BUILDING DIVISION HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: v S7 2,61 - 00 2/0 Jurisdiction: Site Address: ti Subdivision/Lot #: sj '1 -' -- • x`"1 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: Date: 47// L //, Owner /G - ne'r ?!tractor /Authorized Agent Print Name: /<' ( ( G 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 final 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. 1:\ Building\ Fonns \RES- HighEfficiencyLighting.doc 07/01/08 STREET T REE . . ,„ T I G A RD � j2 �� CERTIFICATION �O 6 990 I, K I E KG zP)k , owner/ agent for ()►n ce-rzo Ca 057 rzm Grid (PLEASE PRINT) (PERMIT HOLDER) do hereby certify 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.: b(A 5T 2411- o0 210 511E ADDRESS: pi 9 9 2 ,SG) AU3(4 5-7) - 1 4 E1 RP- - 71 5 1051 - SUBDIVISION: LOT #: SIGNATURE: % DATE: � / //3 frr ER /AG..' ) RECEIVED d."' - VERIFIED BY.• _ DA 1 E: (, _/1 (C OF TIGARD) ❑ Tree location verified per app toed site plan. I:\ Building \Forms \StrcctfrccCcrtificatc 05/30/2012 Arir.e71,7-- f c. /1,/-‘ ,..., __/. . ''r c' _______ , . 1 ,,,,-; ,.- _bf 0 ..' -..." 4` 45 ,A ..- RECEIVED ._. e, . . - '�"' DEC 20.2 0 ,,,,.. ._, C TY OF TIGARD ettJ.LDING DIVISION . W 1, 1 i•,..,. •, .. „. • ; - _ _.: _...i7. ---....,. s 4e44- tli _________....,... ...__...._......._._._ , . 1 \ J : ' . * , ' .41 ■••■ . 1 . r ! . . . iRrIl2rThi.../.r- . %i ei. . .. 4291zoirl . . .,.. •.,, c . .. .,, • i .:,.. • \ • - • .. .b v � ,1. INc VA N -s eg . °SIN l,I,I °" • x Ili . 1 ' - t : L As i h. . I L 001:,11.- RECEIVED { V A; 2013 PTCSTm Duct Sealing Certificate & Sealing Form , J Instructions: All sections must be filled out by a PTCS - certified technician at the time of installation. K c op 013 0 completed form must - be promptly submitted to the utility and homeowner in accordance with utility p® 9GARD enter online at www.ptcsnw.com or fax to Ecos IQ at 877 - 848 -4074. Questions? Call 800- 941- 386� UILIAG DIIII$I I Technidan Certification Nu Instal pang V.,\_ N c Utility Q • f — PTCS - 1 ) _b (1� Name \ (L`:v`c4, 4 — 'e u 1c.14,..... Company L. Customer Name Street Address Site Address 2 City State Zip Code Phone Number (Unit #1 Mailing Address) ( ) ❑ Site Built (Existing) Site Built (New Construction) Manufactured Home ❑ Y ❑ N Year Built: 201a- ❑ Y 021, Energy Star Home? Sections ❑ 1 ❑ 2 ❑ 3 Half Full Energy Star Home? ❑ Y ❑ N Foundation Type: ❑ ❑ ❑ Crawl ❑ Slab Basement Basement Super Good Cents? ❑ Y ❑ N Heated What type of heating system Electric ❑ Heat ❑ Gas Area was installed at this site? Forced Air Pump Furnace. Other (sq ft) Are at least 50% of the t If the majority of the ducts are in conditioned # of supply # of returns ducts in unconditioned space? El N space, the home does not qualify for PTCS. registers: . Duct Sealing. House Pressurization Test - Required for Existing Homes with Existing Ducts and Manufactured Homes j 2Inergy Conservatory Is this a Test -Only? ❑ Y Blower Door House Pressurized to: Equipment Type ❑ RetroTec - ❑ N ❑ +50Pa CFM50 ❑ Other Duct Leakage Test (DB) = Duct Blaster (BD) = Blower Door Leakage to Outside Test ONLY New Construction Existing Home New Ducts Existing Home Existing Manufactured Home Ducts Pre Rin � / Open 1 2 3 Open 1 2 3 (Cirde One) ` A . ;• t f �/ H M L H M L TA Duct Blaster 1 i i CO Fan Pressure A#. i , i , � � P. o. Pre Duct DB CFM @ 0 Pa BD @ +50 Pa DB CFM @ 0 Pa BD @ +50 Pa Blaster CFM / . ; .. * m � tom• .. � . ! CFM CFM -I Post Ring Open 1 2, 3 Open 1 2 3 Open 1 2 3 Open 1 2 3 o (Cirde One) H M L H M L H M L H M L m v co Duct ; t - H 5 M _ n Y Fan Pressure J( _I w _I Pa Pa Pa Pa o m a Post Duct Flow Flow DB CFM @ 0 Pa BD @ +50 Pa DB CFM @ 0 Pa BD @ +50 Pa r Blaster CFM @50Pa ?(• @50Pa • v 1 CFM CFM D Pre- Condition Leakage: Pre - condition (check one) • ❑ >250 CFM or ❑ Single wide > 100 CFM ❑ >15% of floor area ❑ Double wide > 150 CFM ,�6% with AH (Whichever is Less) ❑ Triple wide > 225 CFM Compliance Path l/ " ❑ 10% (Check One) ❑ 4% no AH Reduction 50% Reduction ❑ 50% Reduction Was furnace to plenum ❑ 10% of Sq. Ft connection sealed? • ❑ Yes ❑ No Duct Blaster ,.Return Grille ❑ Return Grille ❑ Return Grille ❑ Return Grille Location (/ ❑ Other ❑ Other ❑ Other ❑ Other Pressure Tap ti 49 C d i /r Location (Supply /� � Register) / 3 Ccd` - t -SC.t. Q r 1 y { Paae 1 of 2 Form continued on next page ■ R ECEIVED m.ay 201 1 2015 PTCSTM Duct Sealing Certificate & Sealing Form JUN 1 2 2013 A CAZ test is required if there are any non - sealed combustion appliances in the home. CITY OF TIG Are there any combustion ❑ Yes Combustion o Fireplace or 0Gas o Gas Water ❑OtJIIDING DIVI ' I appliances in the house? ID No Appliance Type: Woodstove Furnace Heater Baseline Pressure with reference to outside Weather conditions ❑ Calm (all exhaust devices and air handler OFF) Pa on day of test: ❑ Windy m ri With air handler ON, record gauge readings below Internal Doors Open Internal Doors Closed Zone Description Reading Net Reading Net o Zone 1 o Pa Pa Pa Pa 3 ^ c Zone 2 6 - Pa Pa Pa Pa m c co z i s Zone 3 Ti Pa Pa Pa Pa 13 Net Depressurization Example Air Handler OFF I I Air Handler ON 2 "Net" equals how much the pressure goes down when the Baseline Reading 3 pa 2 I 1 I 0 1 7 2 1 3 Pa) 4 Reading ci ci air handler is turned ON (compared to baseline). t N Net Depressurization is -4 Pa C For systems to qualify, the air handler must cause no more than a -3 Pa net depressurization in Yes No m any zone. Does this system qualify? (check one) ❑ ❑ Is there a UL- approved and functioning A Carbon Monoxide (CO) detector installed in the home is required in all cases when a sealed or non - CO detector installed in the home? sealed combustion appliance is located in a conditioned space or attached structure, i.e. garage. ❑ Yes ❑ NO RECOMMENDED CO detector specifications: UL 2034 /CSA 6.19 -01; digital display; peak CO memory and recall. Notes — Attach additional sheets if necessary PTCSTM Certification of Compliance — To be completed by technician at the time of installation As a certified PTCSTM' Duct Sealing Technician, I certify the Duct Sealing at this site and related equipment is in accordance with the standards set for the Performance Tested Comfort Systems (PTCSTM') program. �� \- 0--A.... , - Z . PTCSTM Certified Technician Name (Print) P ST"' Certified Technician Signature (Required) -- _ - s ? -9 Ef9 — 3y 3 . z Completed Date PTCSTM Certified Technician Phone Number Customer Name Customer Signature Ps,nc') nf')