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Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT UPI Request Permit Action T I Ci A It f) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: CITY OF TIGARD Building Division Services Supervisor 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: ® Owner ❑ Applicant ❑ Contractor El City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) Mailing Address: City/State /Zip: Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): El CANCEL /VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ® REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit #: MST2012 -00116 Site Address or Parcel #: Project Name: Subdivision Name: Lot #: EXPLANATION: Change Electrical contractors Signature: C Date: 12/6/ 12 Gertz Print Name: Refund Policy 1. The Director or Building Official may authorize the refund of. a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2 Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2 -4 weeks for processing refunds. FOR OFFICE USE ONLY Rte to Sys Admin: Date Ar t y — - Rte to Bldg Admin: Date / N / 0 7.— By ' Refund Processed: Date By Invoice Processed: Date By Permit Canceled: Date By Parcel Tag Added: Date By Receipt # Date Method _ Amount $ 1:\ Building \Forms \RegPermitAction.doc Rev 05/25/2012 RECEIV NOV 0 7 2012 city of Tigard ' COMMUNITY Y L1l V15LUrMGN 1 ur,YA.K 1 Mret� � T'^ . Dn .1. Si RC1.113 :st r- cr1 11 I i A cf; r,11 BUILDING DIVISION T l c; A ii I 13125 SW Hall Blvd. • 'Tigard, Oregon 97223 • 503.718.2439 • www.tigard - or. gov TO: CITY OF TIGARD Building Division-Services Supervisor 13125 SW Hall Blvd., Tigard, OR 9722' Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov ritalr=. l] v w,.... D AFF1 Wc 1..a..A:.l.,. El C:h- ger.cr (chuck one) REFUND OR Name: INVOICE TO: (Ausiness or Individual) Mailing lddreoot _� J City/State/Zip: ,- Phone No.: PLEASE TAKE ACTION FOR THE ITEMS) CHECKED ( ✓); 1 CANCEL /VOID PERMIT APPLICATION. El 1 Ni t l P K.IY'V FF.F.R (t .1 n11 . 11 ...l .y 1 1r 1 1. i6i..:.1 1,1..e-11.1 :....1 1.1 V i.$c c.l1 bchw). / Q INVOTCVJ FOR I EES 17Uh (attach case fee schedule and provide explanation below). K 1*.MC•)V FIR F!1>T.A Cr, CONTRACTOR ON PERMIT Ou IAA. t;atwc:l na.itul . Pc:unit 4: t 2L 1 . -- 0 0 1 t 17 )..e Ker( Ve-A Site Address or Farce' 4: \ 0 ? - 33 1 < < ( Y O C1k_. Project Name: t Subdivision Name: _ K/ ` I +C-•“ Lot #: 3 __� EXPLANATION: W .e l�(t ' ` -[ M &k ca Y�1 Ll) th7 £ v 8 r o -e.ok Iwpa. �w 71. 40kK -- P,.Q. llet .1,1„ --A-vit-H,-) c forf- i'..4-ce0,--,-N._ F ....0 . 7 4:an ..r,..o. ? 1 I` � � _ l/t�i�li1(j.WI - l l „rp• I ( - ) - . I Print Name: :' I I I /a /51 1 a , - t1 6 Refund Policy r � -be,, ;•-� 601.0- �J �_ /�, 1. The Director or Building Official may attthnti.e the refund of: • e ePril; � -1 Iic�1 -d fi q �'^' �1 e v' .--- . ” .) . ,. 1y fen vobil-l■ von. C....1,1,,,.,iy raid V/ ,,,,u,,,.1.d. 1, &Af-R, tNf 'fie • � G not rn•..0 th.., or14. :. f ILL Unit •:.... :i.1.. :.:ati:.:. f : .1.:.... ayyliaatior..r 1.. .. 1631 C .::. 1:... r. ,.1 l::h l,hhi, ii:ry c) riot more than 80% of the land use application fee for issued permits. d) net men than MUYra at the otmarng plan rev,ew tee who* an apl, 1.1 raneeltn niter any plan .evlew effort has been expended. o) not mare than 80% of th• building peemit fee foe iaaued pemtito prinr to any in. p•-∎ -w,n *..1,wa14. — ^.. Refizs.l.. mill be ===:d w the c:%r.d Parer in th m _• _.t}u,.d in s.t.itiCit w m was rvcch'cd P e,r alma. 7_4 , 1 , 1•01 , 4 for r rew .m refunds. FOR (MACE iCI USr ONLY . �AIjII . Rte to B1dLAdmin: . B • _ iit' Refund Drococeod: ' `�•7 Tnvnirn u• Prrruer•rl- l)str• B Permit Canceled: Date ` g' 7 Parcel Ta_- Added: Date �� Ti • A......i .1. If rinre M nrhnrl A mremnt it — I:\ Building \lrorns \l egPcrnitAction,doe Rev (15/25/2012 _.. - FLT 'aQV3 • OCit -0294.70C2 '-`9`.'"r0—.7." ..TT-,-...Ta n"' r - =s 0 F' 31a 3T123'. O• ..•••ri Dec 04 :12, 03:33p BRIGHTEN • ELECTRIC 5415497213. p.1 ` 24I2_ _. ®011b ,drat Permit Applica ' , > f Hilt OFFICE LSE ON1a II City of Tigard I I Received �� Permit No.: 0 12 -00116 r P Review 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi Other Permit Phone: 503.718.2439 Fax: 503.5981160 0 4 2012. Daie,B . TI GA R D Inspection Line: 503.6394175 Date Ready/By: lure 61 See Page 2 for Internet: wsnv.tigard or.gov CITY TI�� Notified/Method: Supplemental Information ® � qy t� f r TYPE VUIZYII J G D PLAN REVIEW ❑ New construction N 17 Please check all that apply (submit 2 sets of plans w. items checked below): ❑ Addition/alteratio rep acemen Other: ❑ Service or feeder 400 amps or more 0 Building over three stories. ❑ D emolition ❑ where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for alt other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of75KVAor JOB SITE [�i IFOR3fAT[ON AND LOCATION ❑ Emer system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", `E^, "1 -2 ", "1 -3 ", Job no.: I Job site address: 10233 SW Murdock St. - 1001-IP or more occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: Tigard, OR 97224 ❑ Health facilities. ❑ Supply voltage for more than ❑ Hazardous locations • 600 volts nominal. Suite/bldg. /apt. no.: I Project name: Gertz Construction Co. ['Service or feeder 600 amps or more. Cross street/directions to job site: SW 103 Ave. �L I Or FEE SCFIED I E t ' sr' v• - or multi-family Fee. I Total I ly dwelling unit . . t1 : : t arage - • Subdivision: Lot no.: I,0. t sq. ft. or 1 168.54 a Tax map /parcel no.: Ea. 500 sq. it or portion 33.92 1 Limited energy, residential 75.00 • 2 DESCRIPTION OF WORK (tivith above sq. ft.) Limited energy, multi- family 75.00 2 Change electrical contractor on existing permit / I residential (with above sq. IL) , l 71 Services or feeders installation, alteration, and/or relocation ,, (j a". 200 amps or less 100.70 2 0 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 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: ( ) Fax: ( ) 200 amps or less 59.36 1 • Owner installation: This installation is being made on property that I own which is not, 201 amps to 400 amps 125.08 2 • intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: B. Fee.for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'l branch circuit 7 42 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67 81. 2 dwelling, service and/or feeder _ Phone:,( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67,84 2 E -mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or lunited-energy Business name: Brighten Electric LLC panel, alteration, or extension. Page 2. 2 Each additional inspection over allowable in any of the abov ' Address: PO Box 2236 Additional inspection (I hr min) 66.25/ hr City/State /ZIP: Sisters, OR 9'7759 Investigation (1 hr min) 66 hr Industrial plant (1 hr min) 78.18/ hr Phone: (541) 549 - 7210 Fax: (541) 549 -7213 Inspections for which no fee is specifically listed ('h hr min) 90.001 hr CCB Lic.: 132222 1t /9olir Electrical Lic.: 34 - 483C Suprv. Lic.: 4667S ELECTRICAL PERMIT FEES y Subtotal: Suprv. Electrician signature, required: 0\-1/3/4.t,e..y. Plan review (25% of permit fee): Print name: Larry Young Date: 7/17/12 State surcharge (12% of permit fee): TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within Igo Print name: Date: I days after it has been accepted as complete. I • Number of inspections allowed per permit. 1: 5Buitdmg \Pennitsl4,GPermitApp.doc 07101/10 440- 4619T(tt /05/COMRYEB CITY OF TIGARD MASTER PERMIT IN I COMMUNITY DEVELOPMENT Permit #: MST2012 00116 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2012 Parcel: 25111 BCO5100 Jurisdiction: Tigard Site address: 10233 SW MURDOCK ST Subdivision: 2006 -044 PARTITION PLAT Lot: 3 Project: Mitchell Partition, Lot 3 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 1824 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 3 Second: 0 sf Garage: 458 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1824 sf Value: $210,966.00 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell- Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: I Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =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'l 500 sf: 3 201 -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 1824 Owner: Contractor: GERTZ CONSTRUCTION GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions) 9200 SW 46TH 19200 SW 46TH AVE 1 Ersn Cntrl 503 - 681 -4444 TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: 503 - 692 -3390 PHONE: 503- 692 -3390 FAX: 503 - 692 -5433 Total Fees: $16,752.10 This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTE • : Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -01 0 throug OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 .1987 or 1.600.332.2344. Issued B ` 4 Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available Inspectio ate. This permit card shall be kept In a conspicuous place on the job site until co pletion of the project Approved plans are required on the job site at the time of each Inspection. - Building Permit Application Residential RECEIVED FOR OFFICE USE ON1.\ Tigard City of Ti d Aa Received `J Permit No.: yyf2l��'- DO��{p l m • 13125 SW Hall Blvd., Tigard, OR 9723 1 eaen Phone: 503.718.2439 Fax: 503 8.1960 MAY 2012 Pl Date/g Revi ; e / Other Permit: 1042C�� --009 Inspection Line: 503.639.4175 Date Ready ��� T I CA R D p Y Y• /� f ( / See Page 2 for Internet: www.tigard or.gov CITY OF 11Vt1B' D No ed (o run Supplemental upplementnt al Information BUILDING DIVISION C e • Y�t ,cv` / . Gam.,, TYPE OE WORK REQUIRED DATA: 1 AND 2-FAMILY DWELLING A zi - New 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 }� ., :CA1TECOR] -. OE ..CONSiii*.c ION � : , <'' work indicated on this application. 1 Valuation: $ 0 0 q / ap El 1- and 2- family dwelling ❑ Commercial/industrial f L 110 r CI Accessory building ❑ Multi - family Number of bedrooms: 3 g El Master builder ❑ Other: Number of bathrooms: 2.. _ . ..,: µ "`_ _ , `JO -SITE ;I1YEU T O • . $ )t , Y . 1�;AN1D `I; ., Job site address: C) 2 3 tal number of floors: / Tb / 'J' - - New dwelling area: Q square feet / 3 .S co Gt ! "r: uRdOGI� g /vZ q vl City/State/ZIP: Tigard OR 97224 Garage/carport area: /j 55 square feet Suite/bldg. /apt. no.: Project name: Covered porch area: C•7o square feet Cross street/directions to job site: Deck area: square feet Other structure area: 2262_ square feet 1,6 RE UIRED :DATA: COMMER' Q CIA1sUSE;G1C1K1W" Subdivision: Is1i F, (s s U Lot no.:.' 3 Permit fees' are based on the value of the work performed. Tax map/parcel no.: zoo G . �/t f �0 q` ` 3 Indicate the value (rounded to the nearest dollar) of all . . . f r vt+ /46.4 • equipment, materials, labor, overhead, and the profit for the .?..A.,,,,+y,. •.DEScRIFTION`,:OT' WORK: • ' work indicated on this application. ` /�_ Valuation: $ - N q k -6.6(..) v� Existing building area: square feet New building area: square feet. ' . PRQPERu1` ;Q ` ; .. h , " : - : - a ' Number of stories: • Name: 7�& N � 1 4._ 4 4. Type of construction: Address: 6 qZ� <'a) a "K7 Occupancy groups: N City/State/ZIP: i tlw ,; �� '72 O 2- - Existing: D Phone: ( 51>3 60 2 c3 V F a x : ( � 3) 6 7 -s--q 3 . 3 New: , ] : �AFPYiICAP17"' ; ❑- CONTACT PERSON ' . BUILDING. PERM1Ir; FEES*' - 7 ,§ y 4 _ ` _ 7 (Pleasere1 arta ferseRl +lee • i Business name: �� ,, ,, y J Structural plan review fee (or deposit): Contact name: e ,v c e f Address: /124 -(w t 1% FLS plan review fee (if applicable): 2_ G . City /State/ZIP: 174421te.f w 62 9'7 64 Total fees due upon ap ($ )G L_ Amount received: / 76) Phone: ( 5'0?) �Z -3.3fa Fax :: o g 3- Y3 E -mail: l'Cco✓ (p p � A,� PR�OTlaVOLTAIC`SOLAR RMJEL S3V5=' E' FEESI'-• , >5 .. • . Commercial and residential prescriptive installation of ., w •. _. G -, . °41 °. _.. , ,f.. , l' , ".:' .. roof -top mounted Photo Voltaic Solar Panel System. Submit two (2) sets of roof plan with connection details Business tee; 6A'; ' ` ~` and fire department access, along with the 2010 Oregon Address: / 9 2 fan S Ct) 4 t /C ' Solar Installation Specialty Code checklist. City/State/ZIP: �'c,..,_ 6 4 / ,,,, 0 4._ 9 7 ©G L- Permit Fee (includes plan review $180.00 and administrative fees): Phone: (703) 6 '2 -3$ r6 Fax: (.37.5) 6 Q 2 - j Cl? 3 State surcharge (12% of permit fee): $21.60 CCB lic.: c? Total fee due upon application: $201.60 • Authorized signature: G/ / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: * Fee methodology set by Tri -County Building Industry �iC �So /� Date: Sig(( Service Board. 1:\ Building \Permits\BUP- RESPermitApp.doc 02/24/2011 440 -4613T(I 1 /02/COM/WEB) Plumbing Permit Application Building Fixtures REcEivEl y l OP. „.....I: IISI: ONLY n r Received 4 l ( /' Permit No.: n6 fPoIl -- 0O 1 I tY City SW Tigard MAY 3 1 Date/By: I I r a 13125 SW Hall Blvd., Tigard, OR 97223 2� �Z Plan Review Other Permit No.: C Phone: 503.718.2439 Fax: 503.598.196 Date/By: Inspection Line: 503.639.4175 Or'' T1GARD Date Ready/By: runs: ►a See Page 2 for T 1 G n R D Internet. www.tigard- or.gov &i uu DIN(; Notified/Method Supplemental Information T."y:'' : l :,;:y r: . , Forspectalinjormationuseeheekllst New construction ❑Demolition Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) SFR (l) bath 312.70 ❑ 1 -and 2- family dwelling ❑ -�C z,:, -• CATEGORY ;QFr ONSTRi1CTION ,' . = :' tC .::: ••; :.�• :::,.v -• :. - .,•- ..,.t.. __- 1 437.78 , Commercial/industrial SFR (2) bath SFR (3) bath 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 i;,. ''';',':''''"I'.'. w . t. INF6RMATION A ND;LQCATIO)V ; " ::,•, Site utilities: • �, ; ,��� Sl i . .�. • _ - / Catch basin or area drain 18.76 Job site address: / O 2.. j 3 'Jr"' ��z (� Drywell, leach line, or trench drain • 18.76 City/State/ZIP: 770, d�A 0/_ Q 77-2-Y Footing drain (no. linear ft.: _) Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities l I Manholes 50.03 18.76 Cross street/directions to job site: 18.76 Rain drain connector Sanitary sewer (no. linear ft.: Page 2 Storm sewer (no. linear ft.: _J Page 2 / Water service (no. linear ft.: ) Page 2 Subdivision: / . t_ C/ .- J Lot no.: 3 Fixture or item: Backflow preventer 31.27 Tax map /parcel no.: ,. Backwater valve : ;' t ( DESCRIP`I'ION;OF.WORK , • .t 25.02 ``wi; a ;; i' ,:'...".'%•;r::: Clothes washer ae t41 14,. Dishwasher 25.02 • • Drinking fountain 25.02 Ejectors /sump • 25.02 ;;;',....''..i. , > °. ; -. i +< :' iii ANA` .. rli Expansion tank 12.51 t , ."' Intl' .,,� a :�• ; . ' ;�. .I w _.. _. _ .,.-. 25.02 „� v�'�r'. � • � � t ' ' Fixture/sewer cap Name: G t�fv- LAZ A) grt G ( Floor drain/floor sink/hub 25.02 Address: / 7 Z d a t"44.) t"44.) ¥ / e 1441 _Garbage disposal 25.02 City/State/ZIP: .... L z 62 9`2o G 2 Hose bib 25.02 D • Fax ( 6J) G z_ S Y 3 3 Ice maker 12.51 Phone: (Se a)G42'3a 9 � q ,, 25.02 * ' ; " :'' NTA 1 'E S, QN * "'' ' F• Interceptor /grease trap °� � . , .;. , . • " Medical gas (value: $ ) Page Business name: 6r -e r aNS -- er ! Primer 12.51 Contact name: /6 i G tB�.Y - Roof drain (commercial) 12.51 Address: [9 Z a 6 co itG , Sink/basin/lavatory 25.02 City/State/ZIP: l " a, (g., A) 04 q ) ot: L Solar units (potable water) 62.54 2 �,/� (5 03 (s63) l0 92 _ 3 3 `�� I Fax:. ( 7j 0,;) 4 Q 5 3 Tub /shower /shower pan 12.51 Urinal 25.02 E -mail: /(e K @G CLG o ,Godi, , Water closet 25.02 F : . �• f:° 1, NCF � :.f7 ; : :r_2w :''' Wi t; •h1- i t , . � :.i' ,:..•,`:,f,-, , 'r y ;e`. .r. s O V :; . f -.: 37.52 sh��aCJaw�'�." ..��� C• , .. . � �� c .�_r,�� -r . ;. :� - - Water heater Business name: --ILL..," - f (PL /'LNs / 1", Water piping/DWV 56.29 t/ 25.02 Address: P .. cos Z 7 Other: y Q /� Subtotal S$ City/State/ZIP: (,f,) e S 'f 4 ;Not B ` 7 0 � Minimum perm fee: $72.50 tal Phone: (563 ) 2- 73 D S Fax: ( S a �' � 3 ) - 8 i/ Z Plan review (25% of permit fee) CCB Lic.: I b 3 7 9 L 1\ 141'k I Plumbing Lic. no.: 3.25" 7 pa State surcharge (12% of permit fee) Authorized. signature: TOTAL PERMIT FEE This permit application expires if a permit b not obtained within 180 drys I Print name' I Date: � / 1.-- I after it has been accepted as ora ' /6..... /// *Fee methodology set by Tri-County ty BBuilding ng industry Service Board. IABuilding2ermiu \PLMU•PermitApp•dm 10/01/09 440.4616T(10/02/COMIWEB) Dec 04 12 03:33p BRIGHTEN ELECTRIC 5415497213 p.1 2011 00116, 1 Ica/ Permit A LP lice • _ CEI v �'D Received FOR OFFICE l. ONLY City of Tigard 7/ 13125 SW Hall Blvd, Tigard, OR 97223 Date/By: AR 4/ / Permit No.: r>ls92012 -00116 p - Plan Review Phone: 503.718.2439 Fax: 503.5981 C U 4 2012 Dale/By: Other Permit T I G A R D Inspection Line: 503.639.4175 Date Ready/By: tads: la See Page 2 for Internet: www.tigard - or.gov ow OF TI CARD Notified/Method: - Supplemental Information TYPE a�p r G { ,l p 1 y/ �f/�J�l�t S PLAN REVIEW ID New construction ❑ Addition/ do replace men, Please check all that apply (submit 2 sets of plans w. %items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ©Other: where the mailable fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. ❑ 1 and 2 family dwelling ❑ Commercial/industrial 0 Accessory building less to ground, or exceeds 14,000 [3 Commercial - use agricultural amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire PUMP. ❑ installation of 75 KV A or JOB SITE INFORMATION AND LOCATION ❑ Emergency system, larger separately derived system. ❑ Addition of new motor load of ❑ "A', "E , "I -2 ^, "1 -3 ", Job no.: Job site address: 10233 SW Murdock St. - 100HP or more occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City / State/ZIP: Tigard, OR 97224 ❑ Health-care facilities. ❑ Supply voltage for more than ' ❑ Haardoos locations. 600 volts nominal. Suite/bldg. /apt no.: I Project name: Gertz Construction Co. ❑ Service or feeder 600 amps or more. Cross street/directions to job site: SW 103" Ave. FEE SCHEDU i E Description I OW. I Fee. l Total I New residential single - or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family ( Change electrical contractor on existing permit ) / I (r residential (with above sq. ft.) ' 75.00 2 r► t OP Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 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: ( ) F ax: ( ) 200 amps or less 59.36 -- 1 made on property 201 amps to 400 amps 125.08 2 Owner installation: This installation is being p party that I own which is not 401 amps to 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 ❑ APPLICANT I 0 CONTACT PERSON above service or feeder fee, each branch circuit 7.42 2 Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: //Miscellaneous (service or feeder not included) City / State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone:I ) Fax: : ( ) Reconnect only 67.84 2 E - mail: Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited-energy Business name: Brighten Electric LLC panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: PO Box 2236 Additional inspection (I hr min) 66.25/ hr City /State/ZIP: Sisters, OR 97759 tnvestigatian(t hr min) 66.25 / hr Industrial plant (1 hr min) 78.18 / hr Phone: (541) 549 - 7210 Fax: (541)5 Inspections for which no fee is _/ specifically listed (V2 hr min) 90.00 / hr Lic.: 132222 l` / /Electrical Lic.: 34 -483C Suprv. Lic.: 4667S ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: � ��oLL Su fee) (/1 lj Plan review (25% of permit fee): v Print name: Larry Young Date: 7/17/12 State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete • Number of inspections allowed per permit. 1:l Building \Permits\ELO- PemirApp.doc 07/01/10 440-4615f(r 1 /Ot(COM/WEB Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utihtle4 _ , .; Qty. l ee is titAt• +• t , • :.... S i<t. ee. :, -.` w F ootingdrain - 1 100' Qiare ,�)'iE'ii t�.' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 . 2,001 to 3,600 $169.69 Sewer - 1st 100' 1 62.54 3,601 to 7,200 $233.20 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Water Service - each additional 100' 37.52 Medical Gas Systems: Storm & Rain Drain - 1st 100' ( 62.54 aluation .,` C)rnu Pee ` 7 •: , . ; '' v '' Storm & Rain Drain - each additional 100' 37.52 $1.00 to $5,000.00 Minimum fee $72.50 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for O.therInspecti ar Fees . Q0'•,` , Pee (en), To tal each additional $100.00 or fraction thereof, to Inspection of existing plumbing or for and including $10,000.00. which no fee is specifically indicated 90.00/hr $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for (minimum charge - 1/2 hour) each additional $100.00 or fraction thereof, to Inspections outside of normal business 90.00/hr and including $25,000.00. hour hours (minimum charge - 2 hours) $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for s (minimum Fees 90.00/hr each additional $100.00 or fraction thereof to 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 *. Quantity by Fixture Type . Plan, Review. for. Plumbiiminstallaaio1�s' Fixture Type for Replace/ .- , 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 - Jacuzzi/Whirlpool 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" Car Wash Drain �; m et o-Ar is i m _ '- Garbage - Domestic - food ❑ Isometric or riser diagram is required for new buildings • Disposal - Domestic-food 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/Lav - Non -food related - Bradley - Commercial -food related - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an 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: http: / /www.tigard -or. gov /city_hal Udepartments /cd/docs/PLMF- PermitApecloc Mechanical Permit ApPhicati 1,01z OF I Ict I SII OM.\ C • ,' Received ; , ( - O ( 0 City of Tigard R la � � Permit / r 114 . 13125 SW Hall Blvd., Tigard, OR 97223 MAY 1 pion Review ether Permit: V C Phone: 503.718.2439 Fax: 503.598.1960 2012 Da 50 �� '' D Inspection Line: 503.639.4175 � vg CITY � �.p Date ReadReady/By: surfs: El See Page 2 for I' 1 1. A It D Internet: www.tigard- or.gov OF i IGARD Notified/Method: Supplemental Information • BUILDING DIVISION , w2 - .: wk. `OF WORK,. _, :.- . COMMERCIAL FEE" SCftEDULE. �c: YJS *14.5'I'k: y • : -r ; ` Mechanical permit fees' are based on the value of the work New construction 12 Addition/alteration / replacement performed. Indicate the value (rounded to the nearest dollar) of all Demolition 12 Other: mechanical materials, equipment, labor, overhead, and profit Value: $ . . CATEGOR\ ; OFi. C• . . - • Uf I OIL-• • _ , RESIDENTIAL EQIJkP TENT f Sl'S'PENj,1?EFS "; ' -'� • El 1- and 2- family dwelling [j Commercial /industrial ❑ Accessory building For special information use checklist. 12 Descri tion � Qty. I Ea. � Total Multi- family ❑ Master builder ❑ Other: p A r._u_ : :. _ , . Heating/cooling: .JOB,.S10: M *01,f. IYD'� LOCATION ( ' .. Air conditioning Job site address: V aJ /D 2 . 1 3 5 A /', ' t.aG� / 0eF _ G (requires site plan showing placement) 46.75 Furnace 100,000 BTU ( ducts/vents) I 46.75 City/State/ZIP: 7 y, ova 0/1- F 2 22- 1 1 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Y 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: t / L no.: 3 Flue/vent for any of above 23.32 .. (/ Other: 23.32 Tax map /parcel no.: Other fuel appliances: ..4 i -" i ::': ' '=:?: " ''' ': -. DESCRIPTION OF: WORK . :'" _Water heater 1 23.32 -:; i Gas fireplace/insert 1 33.39 /V W /1(a /"e, - 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 ,. . , r.. .. : :. r . w� �;.� •� Chimney/liner/flue/vent 23 .,'' N- •'4% 'r (i' Q;TtN • . ;. :. ::; , .'fit 23.32 r � ,')i'pil>R'1?1'OWI!1H&;; '�`r . `C ' ... Other: Name: ,a.►•fz G / Ca N s -e- C ' li✓( , Environmental exhaust and ventilation: _ Range hood/other kitchen Address: 1? 7.01) as Yr+ 'e4. Range 33.39 City/State/ZIP: -17", ` ( g , IC a C„ Z ) ci 6 L. Clothes dryer exhaust t 33.39 Single -duct exhaust (bathrooms, Phone: (s ) i6' L -3 3 Q 6 Fax: (S 6 3 ) `Q 2.- 5 V 3 ,� toilet compartments, utility rooms) 23.32 932a A v • t� ' ; : , r . ,,rr _ � ,•. , ;, f ; ° Attic/crawlspace fans 23.32 23.32 _�• .. Other: Business name: ~•{� ,s. 4 . , r Fuel piping: Contact name: 7`A.4nj ‘gistL $14.15 for first four, $4.03 for each addItional rr _ / Furnace, etc. I f4, 1� Address: `� zap Sc tJ YG Gas heat pump City/State/ZIP: k,./..•E.,.) o T 70t Wall/suspended/unit heater Phone: (SO? )14 L 3 3 9 d I Fax:: (tS 3) CY2 5'`33 Water heater i Fireplace E -mail: /. e A ) @ 60,1 o , dP/o.7 Range 1 y.,', ,+ '74'. , „r. .• ;fi f . �.. °./�r�{ • -, '.4 -i, - ''A: .'•. ..�, i- Barbecue _ F'+1S' u �� 9 ' µ :�'i f�{�1•.1': ,:: � � a\ ' ?` {�; � � .,, •' E 6 O� c A ( egL i , � ,� Clothes dryer (gas) Business name: G [ C(' 7 V Other: ,,,.,: Address: P 0 , g c & 8 z ` YBL{ : : ' M EG&etwA)f . - t'°� °, City/State/ZIP: J 4'8 s 2 Subtotal ty /State/ZIP: V4 K G Gaat� Ail. Minimum permit fee ($90.00) Phone: (S03 ) L SS - 6 22( Fax: (6) G 50 .- 21 3 Plan review (25 %of permit fee) CCB o lic.: y?, 57 State surcharge (12% of permit fee) _ / TOTAL PERMIT FEE / This permit application expires if a permit is not obtained within 180 Authorized signature: t // // days after it has been accepted as complete. Print name: I Date: 0 . Fee methodology set by Tri-County Building Industry Service Board \ B \ P l:uildinge mits%MEC•PermitApp.doc 03/07/12 aa0.46 17T(i1 /02/COM/WEB) Mechanical Permit Application - City of Tigard - - - Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: 4.Otalltidikationir" T: 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. • 1:\BuildingTermits\MEC-PermitApp.doc 03/07/12 2 Electrical Permit Application RECE D FOR OFFICE (ISE ONLY City of Tigard MAY 31 2012 Rizyea ; mm hf, 6l Permit No.: 00 IIIII I N q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 0 ter Permit: qj,+ + Phone: 503.718.2439 Fax: 503.598.19ti11 OFTIGARD Date/B : l��OVlAO Inspection Line: 503.639.4175 Juris: P i.. BUILDING DIVISION Dat Ready/By: Oh 55 See Page 2 for "I'1GAitD p Internet: www.tigard- or.gov BU1 Notified/Method: Supplemental Information TOE, OF'WO _ } .''..- . •.,,'. 1 New construction ❑ Addition/alteration/replacement Please check all that apply (submit a sets of plans w /items checked below): ❑ Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. s' !.j4 : : : , - , exceeds 10,000 amps at 150 volts or .; �' . , ' � ....: ; ., ;.;. CATEG[1]tY + �pF: �O1VS�'f1�'I?IOIY.' � . 'o- : ' . _ . P Floating buildings: less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercialindustrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or I,) ,-- _ ❑ Emergency system. larger separately derived system. • ' :SI' TE :I CV F O RMATI N LO CAT70N,'_•: ,. Q ..: D ❑ Addition of new motor load of ❑ separately ately derived Job no.: Job site address: 1. o Z3 3 Su.) P( 664414 // 100HP or more. occupancy. G K 57( ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: 1; 4 6 A.- ? ? 2 2 di ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. . . ' 1 EE'. SCHEDULE ' "' Cross street/directions to job site: Description I Qtr. I Fee. I Total ( • . New residential single- or multi- family dwelling unit. Includes attached garage. 1 ,000 sq. ft. or less 1 168.54 4 Subdivision: ht {- Lot no.: 3 q' Ea. add'I 500 sq. ft. or portion � j 33.92 (01 '710 1 Tax map /parcel no.: Limited energy, residential _ r ,.. ' • " *:r,': . �, : , { a : 1: y . , ):. ititsc P.if tii+i, ,O?r`.=.8?ORti - .. � i. (with above sq. it) l 75.00 2 / 3(.e � " /11C)61- Limited energy, multi - family 75.00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ;', ' v ; PR OWNER; ='' '' _ 201 amps to 400 amps 133.56 2 ^ 401 amps to 600 amps 200.34 2 £ �4� Name: etr,v4 e, 1--e 601 amps to 1,000 amps 301.04 2 Address: lg 7b s cz c/C„ c Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP: T , , ,d o2 q ? Q (' Z relocation S� / 7 2 `3,3 � ,\ I C 2 200 amps or less 59.36 l Phone: ( ) ( p V Fax: (543 > 6 qL - f3,3 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 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 . ; I yRO above service or feeder fee, 7 42 2 I'll'' ° APPLIICAIW [ , ; (] . �ONfACT; each branch circuit Business name: 6 te.,;.r.,_____Ca-.., 4 4_ 4, 4.,_,_ B. Fee for branch circuits without l/ �,J service or feeder fee, first 56.18 2 K Contact name: e , G roof-- - branch circuit iii "` r Each add'I branch circuit 7.42 2 Address: /CLe70 I et) 1 16 .4 s Miscellaneous (service or feeder not included) p p Each manufactured or modular Ci tY / State/ZIP: - ` mat Lss..� io i� [ 7 � � dwelling, service and/or feeder 67.84 2 Phone: (563 ) G f2 _ 3 dr b I Fax: : (543) G q z- s (3 3 Reconnect only 67.84 2 ,,,,� Pump or irrigation circle 67.84 2 E -mail PN fZCO , 4-0,8-1 4-0,8-1 , ' < Sign or outline lighting 67.84 2 , 4,1..x,..r+ .; .. ,, :.it. ,1 , ,., •T' `' i } ,) •: , ` ; ; 11 :1,v'r' , ; `r^ �" ,, ; Si circuits) or limited- energy . Business name: panel, alteration, or extension. _ Page 2 2 • Each additional inspection over allowable in any of the above Address: • Additional inspection (1 hr min) 66.25/ hr City/ State/ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (I hr min) 78.18/ hr Phone: ) Fax: Insp ections for which no fee is ( ( ) f hi f i 90.00/ hr _ specifically listed (A hr min) CCB Lic,: Electrical Lic,: Suprv. Lic.: ELEC AIL,,AB Ifl PE1 /;, -,. . Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): • Print name: Date: State surcharge (12% of permit fee): TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit Is not obtained within 180 ( e4 D a t e: " "0( dope bons allowed has d per accepted as complete. Print name: Y/y1. _ ! ( ` �2� • N um b er of inspections allowed per permit. L• IBui ldinglPermit\ELC-PermiiApp.doc 07/01 /10 440.4615T(t1/05 /COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information { ' - LIMITED ENERGY PERMIT FEES: F SII IT A4 0 ONLY: • . Fee for a residential systems combined $75.00 Check Type of Work Involved: Audio and Stereo Systems* Burglar Alarm Garage Door Opener* Er Heating, Ventilation and Air Conditioning System* Vacuum Systems* ❑ Other: to[ni1IVIEII CIA)€ gl ff'4NLYr Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation p Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling p Other Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations I:\Building\Pmniti ELC- PennitApp.doc 07/01/10 Jun.20.2012 02:26 PM Reliant Electric of Orego 5036684190 PAGE. 1/ 1 eemegagett Dump. tan= 11 limill1111.-- I II MINN Elalll 3 111111 el Le WV a Pri9 11111EIP...... OMMI111.11U... .. El ELLUZ;...Th ILLE:ZRZL-11 MEM _ MI II " II I MN Gad 0 lalliewsup mos vi ap 84.•• .w. 0 limit flebel alo Want II semi mot swot * IPS Wean es 80114 was mks SIP AWN 011.140.1 Ina 1 4 1 140 MOW M I I I I I I I I MI MN I IN Ira; aigrA ti= =0Am 6% 221=f4.61/0=1 -TAWRiMaZiMim' IM ma Kum kaiore qpy ima IIIIIIBIMF;MBUMVikaMiiM_7..7aT:,:::.; ', • 1111111111111Mr==== lame Dumps isossnoy aip011114111111 illainPvWfaesnlaO • 114 4 11tirtn P'. • "'"'" 1 -y • r.- • ---s —Atka 9 rw ial .1. Min :1R11.1) ssaisfig IIIIIW:L- tiMigtak: ...:-.... . Mgagelcei :sac • asusda mac '10L PUe O9» 'OP 330 0 1 °WPM vegmloa a ml lisul Ifn ag Mum mil kiss* **a pap Sisad0A4 ipo ipsui 00911 0 10 010 ' ' ! ONL ! ' .' Imolai now we =roue AMP% Wileaasa MINIMMIS aft Sag n air 4141, 'pow emu eee of eai leseelle oftmariAregatIo "P# ay wadi° Ise doom: mos lunune1 Ina[c6a;1=1=11MinneE NE; aolo 10/10 399cl 1-d 66frS 269 60S riOmmuDNKrling at !yaw MOLL i0 NC 114 :TX= guo vo mum t on p Li fl mraw UogimIlaaY Miami lisPINIT (164111130% )N01118 896 666E" Cl/i1 dO AJJD Zi 0 Z 9 g NflC (1 3/1 4r) NOS same* smrstrftemempianan 29 :60 Z10E/61/913 IdJO zim3p WIJET:OI 210e se unr Ili o ° Building Division Development Code Provision Review T i c n K Residential Projects Building Permit No: "/-- -- v�O /, 2 i 7/ 4 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A Routed Plans: L /' - Original Plan Submittal Date: S3/ .2— ,� ite Pt Revision Submittal Date: / - Er Plan Only 2 Revision Submittal Date: , 17 .Zi Ei Site Plan Only i 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 on if approved. Planning Review (contact ( at 50 -718,- or / b., @tigard- or.gov) 1 Lad Use Case o./v) t , A I ■ / Name / ,../j MIA . Zoning o�i / IA Setbacks: �. Front Rear /`J Side 5 Street Side . 19 Garage a D • Maximum Building Height '0 Pr Actual Building Height ❑ Visual Clearance ❑ Easements ❑ Sensitive Lands Type: atf4.0 Notes: n Original Plan: Approved ❑ Not Approved (E' Date: �/7 /Z Revision 1: Approved � Not Approved ❑ Date: �J 2-. Revision 2: Approved L7 -►/C Not Approved ❑ Date: G Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov) 4' Actual Slope: 7 c Notes: Na r Th L 111 Original Plan: Approved ❑ Not Approved , r Date: 6 i4/iZ Revision 1: Approved.B Not Approved ❑ Date: C 7 1 Revision 2: Approved Not Approved ❑ Date: ( E 9 /a- (Review Continues on Page 2) Page 1 of 2 • City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) Ef/Street Trees gr Protected Trees Notes: • IsD < S' k,^ I q C /6p- •' J`� s . 11 f /y t Sc r c,cn. F ftvyt GjL 5 , 7A„ Original Plan: Approved ❑ Not Approved [ 3 , , Date: G _ y -Jon- Revision 1: Approved Not Approved 12' Date: 6 -6 Revision 2: Approved Not Approved ❑ Date: C 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 A.plicant � / 7 2/— Okay to Issue Permit: Yes 7 No b. y/ Date Routed to Building: • P ■Oift 4 I 't ' 1 • . • • r t t • . Page 2.of 2 CO Tree Protection Verification -10233 SW Murdock Tieard. OR C n • Trees 4, 5, & 6 shall be removed due to hazardous and unsustainable condition. �! • Trees 12 and 14 have protection zones as shown on this site plan. As speafled on the Tree Protection Plan dated ‘To ei. p C p Q v 3/28/05, a tempor 6 ft. high metal fence shall be Installed prior to excavation or other site work, subject to s ...... Ii ��� 0 C 5 7 y A Z Inspection a verification by the project arborist. I. -n o m x t v — v , _, T . • Site work within the protection area, if necessary, shall be under the direct technical supervision of the project ,; g Se a N m arborlst Pr . E ° 3 ° .-.. o 33 c m c ° i � ■ ■ II a Walter H. Knapp I J' 3 a 4 1 9. i _.„ > i+ P g p Certified Forester, SAF 406 i 3 •E 4 ; - Certified Arborist, ISA PN-0497A a m o - P ro m Certified Tree Risk Assessor, ISA PN-450 ° c c o in VISI CLEARANCE f"� (Co l i t l s EASEMENT, SEE DETAIL "B" ; ` 2.4 3 72 . \ 138.03 o ; V --- - TA P Iiiiii\:.• ilrirr • P �_ . cn r` = — 1 -� ~ ° 50.98 c _ w k _.. N (.1 ▪ N UI V < ` 1 w I -i ` i t A u� IV (� W y o it `�%` �0 { _ i � � TC c 7. a cn t F N z -0 . , w — Zul R • 41 I 1 kka 1 PARC Er § - a „ 0 ° ' a w co Z n n 5Fli jIT.r --0- 0 ; g l co z o o ,) mi . 10, 00 c!) � D — I �/ `� j N ar I 15 t I �, Z CO , 1 �, I� `,• � ll � Z C I — ��� � � /116:7% , II . ...p. • Z =/ a 57 ( 1 • eAlir cl 111 (P‘Llikkr!Aitk. lelP N . < :�anwi I� \�%1.I A\�i/ ' ` , �, ° 2 3 0 2.00' P N 245.08' (245.08'(P1)) (245.00'(S2)) SIDEWA I vs Tree Protection Verification —10233 SW Murdod'. Tigard. OI 1 • Trees 4, 5, & 6 shall be removed due to hazardous and unsustainable condition. C C • Trees 12 and 14 have protection zones as shown on this site plan. As spedfled on the Tree Protection Plan dated I fi �v► O G •• 3/28105, a temporary 6 ft. high metal fence shall be installed prior to excavation or other site work, subject to i ' ire ��� O ' lbw m z inspection and verification by the project arborist i - Q �"* m • Site work within the p rotection area, if necessa ry, shall be under the direct technical supervision of the project . m -9 C 1-••, � s � s r '� i— Q o _ C P, r 8 p arborlst. ► x •••" 6 ry J It 72 rn xi > 72 2 Walter H. Kn 7... . . . -n DP � 19.1 i, ar► $ 28 Certified Forester, SAF 406 1 • 1 3 co Certified Arborist, ISA PN -0497A ~ a n o -. 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N \NI 2.00' • 245.08' (245.08'(P1)) (245.00'(S2)) SIDEWA Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: / / Z ^ O D f 1 4 Jurisdiction: 7 , 1 Site Address: 6-3 c 0.11 • Subdivision/Lot #: 3 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: / y/ / wner /General Contractor /Authorized Agent Print Name: E\-j9 k2. r° 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\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 • Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, J , am the general contractor or the owner- builder at the following address: Site Address: feag13 stA) 1 , a a _,,, l._ City: >411-14 614 • Permit #: 2,0/2- _ 00 //6 Subdivision/Lot #: 3 and/or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I 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. g 1 L/Z1 -- Signature: Date: General Contractor or 0 • er I:\BuiidingWorm\RES- MoistureSensitiveWood.doc 09/25/08 . ................ STREET TREE TIGARD A TION CERTIFIC I /2.,i,- owner/ a ent o �� TZ C': z �' , r agent (PLEASE PRINT) (PERMIT HOLDER) do hereby certi 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.: ZD/Z - 0011C STl E ADDRESS: /6233 C ' % /4 SUBDIVISION: LOT #: II e� ARE DA E: Z Z Z SIGNATURE: �' / y ap,_N ' Y AGENT RECEIVED & VERIFIED BY: DA 11✓: / Z / ZY ( OF TIGARD) ❑ Tree location verified per approved site plan. i I:\ Building \forms \StreetFreeCertificate 05/30/2012