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Permit o CITY OF TIGARD MASTER PERMIT m • COMMUNITY DEVELOPMENT Permit #: MST2012 -00097 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012 Parcel: 25 110BA06000 Jurisdiction: Tigard Site address: 14252 SW MCFARLAND BLVD Subdivision: SHADOW HILLS NO.2 Lot: 43 Project: Roth Project Description: Finish crawl space. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 904 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 904 sf Value: $93,943.68 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell- Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 1 Other Units: 1 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 5 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 -3 904 Owner: Contractor: ROTH, DAVID & LESLIE WIN CONSTRUCTION Required Items and Reports (Conditions) 14252 SW MCFARLAND BLVD 14055 SW KENTUCKY PL TIGARD, OR 97224 BEAVERTON, OR 97008 PHONE: PHONE: 503 - 209 -6908 FAX: 503- 524 -6332 Total Fees: $3,165.88 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Code 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 issuanc , 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 C; ter. Those rules are set forth in OAR 952 - 001 -0010 thro OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. • ;7 or 1.800.332.2344. Issued By: Permittee Signature: 1,I diI Call 503.639.4175 by 7:00 a.m. for the next available Inspectio ∎ • =te. 1 This permit card shall be kept in a conspicuous place on the job site until co • etion of e project Approved plans are required on the job site at the time of each I action. Building Permit Application FOR OFFICE USE ONLY Received permit No.: / I City of Tigard M 15 2012 Date/B ,. _ �,/ ST. /� 060 9 7 ° 13125 SW Hall Blvd., Tigard,OR 972 plan Revi T": - Phone: 503.718.2439 Fax: 503.598.1960 Date/By: II �7 • • ther Permit: T (G n (t D Inspection Line: 503.639.4175 CITE OF TIGARD Date Ready : y: ria: to See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: cPA /� ` � , r Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (routded to the nearest dollar) of all • ❑ Addition /alteration/replacement her: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. and 2- family dwelling ❑ Commercial/industrial Valuation: $ (?Z 94. 3.10 ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION (� ) Total number of floors: Job site address: I �a5 - . (,J c r / n A (13 I U o/ . New dwelling area: crof square feet City/State /ZIP: F i (1 q v` d J OR O1 1) , 'I Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: g 7 1-k Covered porch area square feet Cross street/directions to job site: bu 1 I m T N Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Perm fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rowded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. .. I ^ Valuation: $ . 1` - �� Ar Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: 1 ) -)_ 0,0 1 N n Type of construction: Address: I 2 3 �"+ ] $' ` c, -Ga y, tan) I?J I Occupancy groups: City /State /ZIP: .f-) Gbi 141 O 1 j_ a Existing: Phone: (95-.)-a-01—(74-46 Fax: j) v 46532— New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: $ 0 py1 Jy I/ (_,41 0Y\ All contractors and subcontractors are required to be Contact name: ' V ► G U h h Iv 1% 01,-11\ 1 licensed with the Oregon Construction Contractors Board Address: a o 5 5 St / e Y ru C / f y p / under ORS 701 and may be required to be Lensed in the jurisdiction in which work is being performed. If the City /State /ZIP: Fg tc J r 012 cr' d 06 applicant is exempt from licensing, the following reasons Phone: 6d3) 3,96t Fax: : (SG3) 2 t / ) 6 3 3 2 apply: E -mail: �a (I • E I ' ( +1 S / il UGJ)(Y1l 6 ./1 G )J . C awl CONTRACTOR BUILDING PERMIT FEES* Business name: S (' S At (Please refer to fee schedule) Permit fee: Address: State surcharge (12% of permit fee): City /State /ZIP: FLS plan review (40 % ofpermit fee): Phone: ( ) I Fax: ( ) (Due upon application.) CCB lie.: /c I c( , 4)0 Total permit fees: 6 Amount received: S3 •y s Authorized signatu + This permit application expires if a permit is not obtained Print name: ( V V 1 yi 5 h 4 ►O Date:5/f 4,// / within 180 days after it has been accepted as complete. * Fee methodology set by Tri -County Building Industry Service Board 11Buitding\Permiro\FPS- PermitApp.doc 02/01/2011 440-4613T(II /02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: _ Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: I $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ Permit fee based on project valuation (see fee schedule): $ Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ FLS Plan Review (40% of permit fee): $ TOTAL: $ Plan review requires a completed application and three (3) sets of plans at submittal. Plan review fees are required at submittal. I: \Building \Pemvts \FPS - PermitApp.doc 02/01/2011 2 from.' ' 05/15/2012 09:55 #114 P.002/003 Plumbing Permit Application Building Fixtures RECEIVED r(,u c,l l 1c I. l 0.11 g Permit No.: • 1 9 , 1 25 W Hall Tigard Tigard, OR 9 Y 1 5 2 012 Date B *: Received S• 1 S / fJ,O ' ' l �`l /rO /a F7 Plan Review C ' Phone: 503.718.2439 Fax: 503.598.1960 ` Datemy. Other Permit No.: r I Inspection Line: 503.639.4175 C � c TIGARD rmic: ED See Page 2 for Internet: www.figard-or.gov OF bate Ready /By: Q ION Nonfie6Metbod. 9 , • annual Information S '_ , x "s _; _ ; Gt7 i ;),r1:E . > : ., n . ..s J � h .. -2-,-i.---:- . - , .4 1 �� ❑ New construction ❑ Demolition For spedal information use checklist. lacement Other: - Description 1 Qty. I Ea. I Total e • j Addition/alteration/ np ❑ New 1- 2- family dwellings (includes 100 ft. for each utility connection) ,,_, 1 ...: C,?10) 3 _ -52 _{ .1 - . r )- � 1 SFR (1) bath ' [ 312.70 ■ , ® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi- family SFR (3) bath 5 25 0 2 Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler (_ sq. R) I Page 2 , t: - ' , . ` : ` ,4 1 JfF,U6, ! F2)a efulittaa n, t ii ,> 3 f siteutilitles: Job site address: 14252 SW McFarland Catch basin or area drain , 18.76 City/State/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: _) Page 2 Suite/bldg. /apt. no.: I 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 R: _) Page 2 Water service (no. linear ft.: _) Page 2 Subdivision: I Lot no.: Fixture or item: , Tax map/parcel no.: Bacldlow preventer 31.27 f` - - ti. V J, ),1 Baekwater valve 12.51 �._ ._ (7 � '_. _ _ _ ._ Clothes washer 25.02 Bath addition, I WC, I lav,1 bar sink, 1 shower Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 fin S .:2 I t 1rtc 2.i ,°1 c) -.; .`,-, t. }.e 53F. i _ 5 , - ,' , F , ; ,,. - 's Expansion tank 12.51 Name: David Roth Fixture/sewer cap 25.02 Address: 14252 SW McFarland Floor drain/floor sink/hub 25.02 Garbage City/ State/ZIP: Hoose se bib disposal 25.02 IP: Tigard, OR 97224 b 25.02 Phone: ( ) Fax: ( ) 3 ice maker 12.51 1 , ), ,1- (t i' t:l , ,x l e.(e1,; (Cr 1�,1 1.. ' Interceptor/grease trap 25.02 Business name: Five Star Plumbers, Inc L CUb � lloq - 10 3 3 Z if Medical gas (value: S ) Page 2 Contact name: Ed Scbolerman ; t • 12.51 I luIrk orb/et % P e1o$ 9 / / / Roof drain(commen:ial) 12.51 Address: PO Box 28 WAD : 8215 Sink/basin/lavatory 2 25.02 50.04 City/State/ZIP: Banks, OR 97106 Solar units (potable water) 62.54 Phone: (503) 324-0717 Fax:: (503) 324-0883 Tub/shower/shower pan 1 12.51 12.51 ' E -mail: janel@five- star- bullders.comI 25.02 - Water closet 1 25.02 25.02 -,t .. ;. p r c t 1.,5', . '_L f h ...' r. Water heater 37.52 Business Warn . Inn Constru _ n WaterpipingIDWV 56.29 Address: 14055 S • en . • 4 Place Other: 25.02 City/ State/ZIP: Bea , . OR 97008 Subtotal 87.57 Phone: ( 1 3- 2094908 Fax: ( ) Minimum permit fee: 572.50 Plan review (25% of permit fee) CCB Li .148436 �} �/ �'f j����Plumbing Lic. no.: State surcharge (12% of permit fee) 10.51 Authorized signature: g& f Sr , '`4._ TOTAL PERMIT FEE 98.08 Print name: Janet Sohler I Date: May 15, 20 I This permit appl radon expires If a permit is not obtained within 1110 days after It has been accepted as complete. *Fee methodology set by Tai- County Building Industry Service Board. I:. Buildoq \Permiti.PLMll- PermitApp.doe ID/01/09 44O- 4616T(I002+COWWEB) Mechanical Permit Application FOR OFFICE 11, O. t., City of Tigard � ; �= ; " , ��i Permit No • Slob /, �.� p 4 13125 Bvd., d, R 3 RECEIV view Review g Phony 503 Hall ,417 Fa 50 Da OtherPennu: , , • , „• I , Inspection Line: 503.639.4175 MAY 15 2 p 19.10 4.0,93,;• kris: ® See Page 2 for • Internet: www.Iigard- or.gov tifie4/Methed: Supplementallnrormadow CITY OF TIGARD • TYPE OF WORK CODI RCIAL..FEE'. SCHEDULE-, USE ( ECJx J$T BUILDI DIVISIOAI Mechanical permit fees are based on the value of the work 0 New construction [ Addition /alteration /replacement perlbnned. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition 0 Other: mechanical materials, equipment, labor. overhead, and profit. CATEGORY' OF CONSTRUCTION Value: E AESIDENTI&EQUXPMENT / SYSTEMS Fes" e • and 2- family dwelling 0 Cornmereia1/industrial 0 Accessory building For special information use checklist. 0 Multifamily 0 Master builder 0 Other: , Description I Q. I Ea I Total JOB SITE INFORMATION AND LOCATION Meager/cooling • c inc ��n /1 Air conditioning • lob site address: I yasa 5.4U / " FN LAND &IL . Treauirea site plan showing olaamenl) 46.75 City/State/ZIP: 1 OR Y7aa,? Furnace 100,000 BTU (duets/vaua) 46.75 � Furnace 100,000+ DTU (duets/vents) 54.91 Suite/bldg. /apt. no.: Project name: an O / R �i�W Heat pump 61.06 � Cross street/directions to job site: g�.. ��• Duct work 1 1 1 23.32 23. 3 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: J 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 23.32 _ Gas fireplace 33.39 �Q/? toci¢/-X s`u / ; if R,�; t cad J,,� (ie7-tr�0 'k Flue vent for water heater or gas fireplace 23.32 �. NeW fir / ,_ 37%,:p6/, 014_017,617"K Log lighter (gas) 23.32 Ni - /4 _, A 4! , - ' Wood/pelet stove • 33.39 Wood fireplace/insert 23.32 . IZPROPE IY OWNER I • TENANT Ot imney/liner /lludvrnt , 23.32 P 4 ! Other 23.32 Name: r J2� ff Environmental exhaust and ventilation _ Address: Nail - ,, sw mG r OR equ Cher kitchen 33.39 �.3q City /State/ZIP: . 7 � Clothes dryer exhaust 33.39 _ �•'(' �` > / n 9 �� � - - Single-duet exhaust (bathrooms. Phone: ( ) Fax: ( ) toilet compartments, utili y rooms) 23.32 • Of APPLICANT 0 CONTACT PERSON Apio/crawlspace fans 23.32 Other _ 23,32 Business name: ff■ .+ / / Ali iiir i L•_.,L is ! Mr 14f Fuel pipinn Contact name: A - , Val d 514.15 for first four; S4.03 for each additional Address: r2(10 A7�713 - 04Z / AO, ,eav ,9 O h e e at pum ?� City/State /ZIP: J J[/ Mr , ) fl ¢7��3 l f p Wall/suspended/unit heater Phone: (5 ... OD II ) 3e/ I Fax:: (� 357- 0640 raeeeraheater E-mail: ke141.7 g I/Vela 0/X • torn • Range • CONTRACTOR � f y Sail, R' • / Barbecue /! i Ad i ' K as 2Z o O ther dryer (gas) Business name: dT /'w n/ der: Address: ,. y _ � r ‘ J Via • • .. MjrUB r4ige A erawr PEES• . • . City/State/MP: raRNC i 1 W r 4 il AZ V? Subtotal 4./r e p Minimum permit fee ($90.00) t 2 ! Phone: (5 ) 35 - SS'6b3 Fax: (5 35 7' t�d(7p Plan review (25% of permit fee) 4 tic,: /V; 7n3 y/ 2 -S/ / State surcharge (12% of permit fee) •1Q QO /// TOTAL PERMIT FEE it 90 Tbis permit app0eedos expires if a permit is tot obtained witblo 180 4Airt. Authorized sivtature: sp��jl days after it has been accepted as complete. Print name: if enti i (, / �+ I Dater - / y --RO/ - • F ee methodology set by Tri - County Building Industry Service Board t16ui1diegarsiult F,C.Peernuiii4ppp.doe 10/01/00 4 4.617r(I1 /02/COMIW®) May 1512 06:48a Ertell Electric, LLC 5033595652 p.1 Electrical Permit Application F:t-)ll Olt rIt t •: I sr. (1.1., City of Tigard i RECEIVED Reee;vea ® oerma Nn.: ' Vo/ P ' 1)6C) Q 13125 SW Hall Blvd., Tigard, OR 97223 Plan R K C w . II Phone: 503.718.2439 Fax: 503.598.1960 MAY 1 5 2012 DardB : Other Pennic t ; t Inspection Lane: 503.639.4175 Date ReadylBy: 1wis. la See Page 2 for Internet: www.tigard•or.gov CITY OF TIGARD 142ti6ednaethod: SupplementalInrorme:ion tilt ❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three modes. Demolition ❑ ❑ Other: where the available fault current ❑ Marinas and boatyards. - : • : CAI'hOoRY OF; CONSTRUCTION - - ` -' exceeds 10,000 amps at 150 volts or ❑ Floating buildings. ® ] -an 2 dwelling less to ground, or exceeds 14.000 ❑ Commercial-use se agricultural y g ❑ Commercial; industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA o' . . :. . � system. larger separately derived . _ . Emergerrcy separat syst cm. :JOB SITE `114PORMATLON! .. AND LOCATION : - . :. - _ . - ❑ Addition of rrw motor load of ❑ "4 ", "E" "1 -2". '1-3". loOIIP or more. Job no.: I Job site address: 14252 SW McFarland Blvd cum• ❑ Sn Recreational more residential units. ❑ Recreational vehicle parts. City/Stale/ZIP: Tigard OR 97224 ❑ Health -rare facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 wtta nominal. Suite/bldg. /apt. no.: I Project name: Roth ❑Service or feeder 600 auras or inoru Cross street/directions to job site: neatpttea SCBl -. b i . � °-- 10'Iv. 1 Fee. I Tall I • ' New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map/parcel no.: Ea add'1500 sq. ft. or portion 33.92 1 residential energy , ential 75.00 2 : DESCRIIPTIQN: :WORIK - (with above sq. It) • - Limited energy, multi - family 7500 2 New circuits for basement remodel residential (with above sq. R.) Services or feeders Installation, alkrotion, and/or relocation 200 amps or less 100.70 2 ' .. . : • 201 amps to 400 amps 133.56 2 12. PROPiT3RT1'' OW . .. • '1'NNA :' :' :.. P Ps • Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I Owner installation: This installation is bein made on 201 amps to 400 amps amps 1 25.04 2 g property that I own which is not 401 am to 599 s 168 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. - Branch circoits - new, alteration, or extension, r panel Owner signature: Date: A. Fee for branch circuits with . , • ❑.APPLICANT:. • . ;:..: .. , :- [� . COIrTAC T. ER S ON' above service or feeder fee 7.12 2 - each brooch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 1 56.18 56.18 2 Contact name: branch circuit • Each add'l branch circuit 4 7.42 29.68 _ 2 Address: Miscellaneous (service or feeder not Included) Each manufactured or dular City/State/ZIP: dwelling, service aed/orfeeder I 67.84 , 1 Phone: ( ) [ Fax: : ( ) Reconnect only • 67.84 2 Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting . 67.84 2 . . • . :•: • CON'1'RACTO :. : • ' - . - - : Sigrid circuit(s)orlimited • Business name: Ertell Electric, LLC panel, alteration, or extension. I Page 2 2 Each additional inspection over allowable lo any of the above Address: PO Box 279 Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr rnin) 66.25/ hr City/State/ZIP: Forest Grove OR 97116 Industrial plant (I hr min) 78.18/ hr P one: (503)841 I Fax: (503) 35 2 Inspections for which no fee is 90.00/ hr iJ teepfcally listed (f, hr min) - CCB Lic.: 180540 QL 7l4 /tf lectrical Lic.: C 390 / r%t t .: 5420 S /0//// . :::; - • E LE L'[1 At. P OMI T - Es - Suprv. Electrician signature, required: ` - Subtotal; 85.86 •. 6 Plan review (255i. of permit fee): Print name: Dylan Wentworth l Date: 16 May, 2012 State sureharg (12% permit fee): 10.30 '� • (((��� TOTAL PERMIT FEE: 96.16 Authorized signature: _ _ ... This permit application expires if a permit is not obtained w�ittdn li n � . days after it lies beery accepted an complete. Print name: Dylan Wentwort ' / I Date: 16 May, 2012 • Number of inspections allowed per prxmil. L•1Buit&tq'tPermitiELC4'umis. pp.doc 07/01)10 440 - 46 :sr(IU05/COMIWES