Permit 'A t,.
, CITY OF TIGARD MASTER PERMIT
` ''- COMMUNITY DEVELOPMENT Permit #: MST2009 -00140
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/01/2009
:,., .,w Parcel: 2S114BA05100
Jurisdiction: Tigard
Site address: 9850 SW KENT CT
Subdivision: Lot: 0
Project: Cummins
Project Description: Replace patio cover.
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: $5,000.00 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 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
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
CUMMINS, EUGENE A TRUST TROUT CREEK GROUP /ROGER
9850 SW KENT CT STAINES
TIGARD, OR 97224 4053 BRIAN CT
Lake Oswego, OR 97035
PHONE: PHONE: 503 -638 -7918
•
FAX:
Total Fees: $168.13
This permi bject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty r •• and all other applicable law. All work will
be d• - - in accordance with, approved plans. This permit will expire if work is not started within 180 days of is- ` if w•rk is suspended for more the 180
da ATTENTION: Oregon -• ires , ou to follow the rules adopted by the Oregon Utility Notificati. I - Th• rules are set forth in OAR
9 °•2- 001 -0010 through OAR • - - 001 -010 ou may obtain a copy of the rules or direct questions to OUNC by calling 50 •. •r 1.800. 32.2344.
Is sued By: I. 1110 L Ay i ILiatak J Permittee Signature: I i ■ I. . I - 111.
Building Permit Application Rr EIU - .
R FOR OFFICE USE.OrNLv
City of Tigard JUL 0 1 2009 Received 7 I pi, q DateB y Permit No.: ` De, `a ' (fa A 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi A. rwm,
I
Phone: 503.639.4171 Fax: 503.598.19600 I T OF T DateB : �a � Other Permit:
T Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Juni /► ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: /CO, Supplemental Information
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❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
K Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
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'�� � � " ` �:� � „� � ����� ' � work indicated on this application.
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Valuation: S 600. 06
NJ and 2- family dwelling ❑ Commercial /industrial r
El Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
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0 x „ r J OB IT E JNFORMA M D L /T , y >4 0 ION" k F y Total number of floors:
Job site address: 985o 51&) .KENIT C.T New dwelling area: square feet
City /State /ZIP: ' l6PcP0 t U� Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 6,1MHINS Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
EQIJ DATrA COMMERG'IAL -USE CHEGKLIST:?
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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
>» ...,, :..:» ,.;;:m <a ~.:';:.:,$; >> .n,Mn::_,; ::. =::'w, >::.: W. a , and the profit for the
equipment, materials, labor, overh d a e r
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, �: DE$ > �GRTRTION OE °kWOR, f r 9, ? work indicated on this application.
R O 7 P r e. S V� �-rs) L . e . D r _ Valuation: $
• Existing building area: square feet
New building area: square feet
Number of stories:
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Name: L 1) e■IC CO H M i1 S Type of construction: •
Address: 650' SrU) KENT C Occupancy groups:
City /State /ZIP: --n -" ` ic: , oR--- Existing: '
Phone: (503) 6w.023 - Fax: ( ) New:
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Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
Y . - k : t- GONTRAOWE g P . _ -i t?- £ - 0 ` f"
Business name: l 1zw1 �1a k , } �� �o , M.,>
[ R � � �„�' UIT. Pl�TiIVI]f - -�� � °�.
Address: 4os� v 5-- '' M CT `'�' � i(I'leaseeje 'r fofeeschediile' ": ANN" N
City /State /ZIP: (� e oe .,;1-1634- Structural plan review fee (or deposit):
Phone: V v Ut 05)
r / 2 J 1 ( - p � Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: 143(0' At 5 /t 31 If Total fees due upon application:
-- — - Amount received:
Authorized signature: ilt•
This permit application expires if a permit is not obtained
within 180 da after it has been accepted as complete.
Print name: Date: 3 I * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02/COM /WEB)
Building Permit Application Checklist
One- and Two - Family Dwelling FOR OFFICE USE ONLY
City of Tigard Re ceived
g D Permit No,:
a 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
_ Phone: 503.639.4171 Fax: 503.598.1960
TIGARD 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
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. p p ❑
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- El ❑ ❑
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 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.
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 El ❑ ❑
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 0.. ❑ ❑
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 .roject 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:\ Budding \Permits\BUP- RES- PermitApp doc 03/21/06 440- 4613T(11/02 /COM/WEB)
1 I ..1 Building Division
One & Two - Family Dwelling
TicnuD Fees Checklist
:PERMIT INFORMATION: ' ' .. ' ::: . . ;
Permit #: Plan #: Date:
Site Address: c=j C) 4e) -E- J— ( Parcel #:
Subdivision: Lot #: Zoning:
Jurisdiction: Setbacks: Front: Rear: Left: Right:
Class of Work: Stories: First Floor:,
Type of Use: Height: Second Floor:
Construction: Floor Load: Third Floor:
Occupancy Group: • Dwelling Units: Bonus Room:
Valuation: Bedrooms: Total Floors:
Bathrooms: Basement:
Decks: Garage:
Porches:
z 1� Other:
FEES::. Description : - :.,':`Fee.Amount: ;.:. , ::. `Amount Paid::: ; Balance D.ue:
Plan Check: Building: ( , 7 4 c -
Extra Set:
Permit: Building: -. (N , 99 .
Tax: I 1 AO
Metro CET:
School CET:
Mechanical
Tax:
Plumbing: •
Tax:
Electrical: '
Tax:
Low Voltage:
Tax:
CDC: CDC Ping. Rev.:
CDC LRP Fee: •
SDC: Parks:
TIF Res.:
TIF MT:
Erosion Permit:
Erosion CWS:
Erosion COT:
Water Quality:
Water. Quantity:
SUB - TOTAL:
Sewer: Permit:
Inspection:
SUB - TOTAL: — - --
TOTAL MST & SWR:
h \ Building \ Forms \ResPlanCheckFces.doc 01/19/07 Page 1
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems)
Description Qty. I Fee(ea.) I Total Description Qty Fee(ea.) Total
. . . New 1- & 2 family dwellings • . : Heating/Cooling
' (includes 100 ft. for each utility connection) Air conditioning or heat pump* 14.00
SFR (1) bath 249.20 Furnace 100,000 BTU (ducts /vents) 14.00
SFR (2) bath 350.00 Furnace'100,000+ BTU (ducts /vents) 17.90
SFR (3) bath 399.00 Gas heat pump 14.00
Each additional bath /kitchen 45.00 Duct work 10.00
Rain Drain, single family dwelling 65.25 Hydronic hot water system 14.00
Fire sprinkler - sq. ft. 0 to 2,000 115.00 Residential boiler
Fire sprinkler - sq. ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00
Fire sprinkler - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric)
Fire sprinkler - sq. ft. 7,200 and greater 309.00 (in wall, in -duct, suspended, etc.) 14.00
• Site Utilities • • .. " . Flue /vent (for any of above) 6.80
Catch basin/area drain • 16.60 Repair units • 12.15
Drywell /leach line /trench drain 16.60 Other Fuel Appliances
Footing drain - l 100' 55.00 Water heater 10.00
Footing drain - each additional 100' 46.40 Gas fireplace 10.00
Manufactured home utilities 110.00 Flue vent (water heater /gas fireplace) 10.00
Manholes 16.60 Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Rain drain connector 16.60 Wood fireplace /insert 10.00
Sanitary sewer - 1 100' 55.00 Chimney /liner /flue /vent 10.00
Sanitary sewer - each additional 100' 46.40 Other: 10.00
Storm sewer - 1st 100' 55.00 Environmental Exhaust & Ventilation
Storm sewer - each additional 100' 46.40 Range hood /other kitchen equipment 10.00
Water service - 1 S ` 100' 55.00 Clothes dryer exhaust 10.00
Water service - each additional 100' 46.40
-- . Fixture or Item Single duct exhaust
Absorption valve 16.60 (bathrooms, toilet compartments,
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve 16.60 Attic /crawl space fans 10.00
Clothes washer 16.60 Other: 10.00
Dishwasher 16.60 Fuel Piping
Drinking fountain • 16.60 * *($5.40 for first 4, $1.00 each additional)
Furnace, etc. **
Ejectors /sump 16.60 Gas heat pump • **
Expansion tank 16.60 Wall /suspended /unit heater **
Fixture /sewer cap 16.60 Water heater **
Floor drain /floor sink/hub 16.60 Fireplace **
Garbage disposal 16.60 Range **
Hose bib 16.60 BBQ **
Ice maker 16.60 Clothes dryer (gas) **
Interceptor /grease trap 16.60 Other: **
Primer 16.60 Total:
Roof drain (commercial) 16.60 Mechanical Permit Fees •
Sink/basin/lavatory 16.60 Subtotal: $
Tub /shower /shower pan 16.60 Minimum Permit Fee $72.50 $
Urinal 16.60 Plan Review Fee (25% of Permit Fee) $
Water closet 16.60 State Surcharge (12% of Permit Fee) $
Water heater 16.60 TOTAL PERMIT FEE $
Other:
Other:
Plumbing Permit Fees ELECTRICAL FEES (residential single- or multi - family)
Subtotal $ Description Qty. Fee Total lnsp
Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less 145.15 4
Plan Review (25% of Permit Fee) $ Ea. add'l 500 sq. ft. or portion 33.40 1
State Surcharge (12% of Permit Fee) $ Limited energy, residential 75.00 2
TOTAL PERMIT FEE $ Each manufactured or modular
dwelling, service and/or feeder 90.90 •
Electrical Permit Fees. • .
Subtotal: $
Plan review (25% of permit fee) $
State surcharge (12% of permit fee) $
TOTAL PERMIT FEE $
I: \ Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 2 •