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Permit idah -c3o---42t-9(et---CZ_ illil CITY OF TI A R D MASTER PERMIT PERMIT #: MST2003 -00114 j �! t DEVELOPMENT SERVICES DATE ISSUED: 4/22/2003 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13088 SW ST. JAMES LN PARCEL: 2S109AB -10900 SUBDIVISION: RAVEN RIDGE ZONING: R - BLOCK: LOT: 038 JURISDICTION: TIG REMARKS: Addition of 240 s.f. at rear of house. 5/13/03, addition to fire sprinkler system. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 240 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 15 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 27 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 240 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: ■ MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 2.00 SIGNAUPANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +ams6.1000v. MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 870.22 BOB & RUTH HORVAT VINTAGE HOMES NW This permit is subject to the regulations contained in the 13088 SW ST. JAMES 13000 SW WILMINGTON LN Tigard Muniapal Code, State of OR. Specialty Codes TIGARD, OR 97224 TIGARD, OR 97223 and all other applicable laws. 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 the work is suspended for more than 180 days. Phone: 503 - 590 - 0645 Phone: 503 312 - 0759 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 16766 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing Insp Framing Insp Sprinkler Rough -In Foundation lnsp Shear Wall Insp Sprinkler Final Post/Beam Structural Exterior Sheathing Insr Electrical Final Crawl Drain /Backwater Insulation lnsp Building Final Electrical Rough In Rain drain Insp ��ll Issued = : �_1 _ i. _L Permittee Signature • / .,..,e,,_ .,..,e,,_ % * / Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day 5/1,516S cLAzi ',. ta," , _t: i,,,,_,_ , • , ..._,L.,,,,,,,k, „a--, , _ MASTER PERMIT '''" A CI Y OF tIGARD PERMIT #: MST2003 -00114 ��� DEVELOPMENT SERVICES DATE ISSUED: 4/22/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13088 SW ST. JAMES LN PARCEL: 2S109AB -10900 SUBDIVISION: RAVEN RIDGE ZONING: R - BLOCK: LOT: 038 JURISDICTION: TIG REMARKS: Addition of 240 s.f. at rear of house. 5/13/03, addition to fire sprinkler system. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 240 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 15 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 Troy: sf RIGHT: 5 VALUE: 27 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 240 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: 2.00 SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps - 1000x. MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 745.22 This permit is subject to the regulations contained in the BOB & RUTH HORVAT VINTAGE HOMES NW Tigard Municipal Code, State of OR. Specialty Codes and 13088 SW ST. JAMES 13000 SW WILMINGTON LN all other applicable laws. All work will be done in TIGARD, OR 97224 TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the • Phone: 503 - 590 - 0645 phone: 503 312 - 0759 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Rea #' LIC 16766 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing Insp Electrical Rough In Rain drain Insp Foundation Insp Framing Insp Sprinkler Rough -In Post/Beam Structural Shear Wall Insp Sprinkler Final Underfloor insulation Exterior Sheathing Insr Electrical Final Crawl Drain /Backwater Insulation Insp Final inspection Issued B : K. • , 1 "` 1 Perm S ignature : 4 I Y Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Oaf 4* A CITY OF TIGARD MASTER PERMIT PERMIT #: MST2003 -00114 ��� DEVELOPMENT SERVICES DATE ISSUED: 4/22/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 _ SITE ADDRESS: 13088 SW ST. JAMES LN - -- PARCEL: 2S109AB -10900 — SUBDIVISION: RAVEN RIDGE �_ ZONING: R -7 BLOCK: LOT: 038 JURISDICTION: TIG REMARKS: Addition of 240 s.f. at rear of house. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 240 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 15 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 27 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 240 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: 2.00 SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps -1000v MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 621.02 This permit is subject to the regulations contained in the BOB & RUTH HORVAT VINTAGE HOMES NW Tigard Municipal Code, State of OR. Specialty Codes and 13088 SW ST. JAMES 13000 SW WILMINGTON LN all other applicable laws. All work will be done in TIGARD, OR 97224 TIGARD, OR 97223 accordance with approved plans. This permit will expire ti work is not started within 180 days of issuance, or if the • work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 - 590 - 0645 Phone: 503 312 - 0759 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You Reg a: LIC 16766 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Footing Insp Electrical Rough In Rain drain Insp Foundation Insp Framing Insp Electrical Final Post/Beam Structural Shear Wall Insp Final inspection Underfloor insulation Exterior Sheathing Ins Crawl Drain /Backwater Insulation Insp Issued By : ,t -4-t 4 �A,.I/U Permittee Signature : ., & I/. f 1,,,,t.. Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day / Building Permit Application FOR OFFICE USE ONLY Received r� Building _ T ,1 Date/By:3�`)`D`3 66 Permit No.( /�O3 —00 // i City of 1 Igil rd Planning Approval Other Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 � " tip lj1l Date/By: Case No. ,' \ Post - Review Land Use � Internet: www.ci.tigard.or.us * ^ ^^ � Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: ❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING Addition/alteration /replacement ❑ Other: CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate ® 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. �I El Accessory Building ❑ Multi- Family cio ❑ Master Builder ❑ Other: Valuation $ .27 JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths: Job site address: 13 0R$ S ,St' Tagp Total number of floors ' lI New dwelling area (sq. ft.) Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) Project Name: Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) Other structure area (sq. ft.) 't5T /n4G� V.10.a.' / � 1 a , 13 REQUIRED DATA: • . . / ' i • COMMERCIAL - USE CHECKLIST Subdivision: i fiffliMMIXIMI Lot #: : ..‘k Tax map /parcel #: 0 2` S / ' rj fr/2.) - /b 90c) Note: Permit fees* are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor, // . . overhead and profit for the work indicated on this application. /r_e r (D ••Ii •O. •►. I r Valuation $ Ph �I _'!_ ` I rill_ •� - Existing building area (sq. ft.) FXLS inq _ _ °LIM -� a New building area (sq. ft.) .••� Number of stories IN PROPERTY OWNEIZ I ❑ ENANT Type of construction Name: SO 4- R O �/ Occupancy group(s): Existing: New: Address: 13OR S t (flLPS City /State /Zip: `j'�qaY "OYe on . 37).1 Phone: S3 -.5'76-06q6 F , 579- 6585 • NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under DZI APPLICANT ❑CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: V yi 1z NW jurisdiction where work is being performed. If the applicant is exempt Contact Name: 1 yn. < Jett from licensing, the following reason applies: Address: 53 (") I r 1 / , City /State /Zip: 13 ronks O rego N 97305 Phone: .6'03 -A17 - ?57.5 I F : 56/ -3 ny -17Iq BUILDING PERMIT FEES* E -mail: Please refer to fee schedule. CONTRACTOR Business Name: � g •. • it ' k i Fees due upon application $ Address: G o ry r f , City/State/Zip: j y i 97,223 - 9/ 2. Amount received $ Phone: 563 -3/7-%.7S I Fax -36q-171i1 1� Date received: CCB Lic. #: '6 6 Authorized • / • , / / Notice: This permit application expires if a permit is not obtained within Signature: . . ii iii f.. . Al i.1. Date:3l2 / ( 180 days after it has been accepted as complete. nt Ok' db e.rr / ( *Fee methodology set by Tri- County Building Industry Service Board. (please print n. • e) RA) 1 n n (/ z n m is \Dsts\Permit Fors\BldgPermitApp.doc 01/03 `'� `� One- and Two - Family Dwelling j Building Permit Application Checklist Reference no.: Associated permits: City of Tigard City of Tigard ❑ Electrical U Plumbing O Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 l7 Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 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. 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 0 plan ❑ permit required. Include drainage -way protection, silt fence design and location of c ch -basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ing 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 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 an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS 23 Five (5) 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 & 22 above. 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not 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 & location per approved project street tree plan (if applicable), and COT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614 (6/00/COM) Electrical Permit Application • FOR OFFICE USE ONLY Received Electrical Date/By: Permit No.: / — O> // City of Tl and Planning Approval Sign g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 ho Post - Review Land Use , Y" � +1 Date/By: Case No.: Internet: www.ci.tigard.or.us e J Contact Juris.: ® See Page 2 for • 24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information. TYPE OF WORK - PLAN REVIEW (Please check all that apply) . • ' , - ❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location ® Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in • 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more 1=1 Accessory Building ❑ Multi-Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other: • JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above. The above are not applicable to temporary construction service. Job site address: 13ogg S S mes - FEE* SCHEDULE , ' Suite #: Bld /Apt. : Number of inspections per permit allowed Project Name: 6c>1) 4-. Rii ` f O( va .r Description Qty Fee (ea.) Total i New Cross street/Directions to job Ste: . • dwelling i t.a ncl n d e or multi-family per site: dwelling unit. Includes attached garage. Service included: r 1000 sq. ft. or less 145.15 4 RV y� Each additional 500 sq. ft. portion thereof 33.40 1 R `o Z+ Limited energy, residential 75.00 2 Subdivision: Wyy�y/p �Q LOt #: .3e Limited energy, non residential 75.00 2 Tax map /parcel #. •'] Each manufactured home or modular dwelling - DESCRIPTION OF WORK service and/or feeder 90.90 2 Services or feeders - installation, 1.11r14iii o nnl C.ircaits alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 , 2 f PROPERTY OWNER I ❑ TENANT 601 amps to 1000 amps 240.60 2 gob � ��� _ H 1 � r � Over amps or volts 454.65 2 Name: b Reconnect only 66.85 2 Address: 13 0 8$ S I/ t', (Tnm P S Temporary services or feeders - installation, r alteration, or relocation: City /State /Zip: j t py Qr(o 7 722 200 amps or less 66.85 1 Phone: Fax: 201 amps to 400 amps 100.30 2 �7I APPLICANT ❑ a r n h c ircuits - new, alteration, or me: amps 133.75 2 Ilse- CONTACT PERSON Branch c V Epe �C Na q{� Q �, � � extension per panel: Address' nf 1 8 710 S, w ` vin „ A. Fee for branch circuits with purchase of � service or feeder fee, each branch circuit 6.65 2 City /State /Zip: Ate,/ ( � rP ) yi 77007 B. Fee for branch circuits without purchase of X03 -� 7 7 - �3' y �•J service or feeder fee, first branch circuit 46.85 2 Phone: Fax. Each additional branch circuit 6.65 2 E -mail: Misc.(Service or feeder not included): CONTRACTOR Each pump or irrigation circle 53.40 2 Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, Business Name: Advgi } alteration, or extension Description: Page 2 2 �� r ic. * Address: 18 710 SW i ric_N //�� City /State /Zip: Aloh Clew!. 77007 in Each additional inspection over the allowable in any of the above: Per inspection per hour (m. 1 hour) 62.50 Phone: ),3 -S 77- y.1 e ax: Investigation fee: CCB Lic. #: Lic. #: Other: Electrical Permit Fees* ' Supervising electrician _ Subtotal $ signature required: Plan Review (25% of Permit Fee) $ Print Name: ppr,.1,1 W0/1 Lic. #: State Surcharge (8% of Permit Fee) $ TOTAL PERMIT FEE $ Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after it has been accepted as complete. *Fee methodology set.by Tri -County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: 1 Fee for all systems $75.00 • • Check Type of Work Involved: 0 Audio and Stereo Systems Ei Burglar Alarm • 0 Garage Door Opener • 0 Heating, Ventilation and Air Conditioning System 0 Vacuum Systems rij Other • COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: Audio and Stereo Systems • Boiler Controls Clock Systems Data Telecommunication Installation El Fire Alarm Installation HVAC El Instrumentation E . Intercom and Paging Systems Landscape Irrigation Control Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting El Protective Signaling n Other Number of Systems * No licenses are required. Licenses are required for all other installations i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03 Building Fixtures PlumbitiZ Permit Application , FOR OFFICE USE ONLY Received Plumbing 1 / � ` Date/By: Permit No ' u s i tio5 -Tr)0fig- City of Tigard Date/ y Approval Sewer Date/y: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 UA Post - Review Land Use Internet: www.ci.tigard.or.us . a• Date/By: Case No.: Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 _" Name/Method: Supplemental Information. TYPE OF WORK FEE* SCHEDULE (for special information use checklist) . El New construction ❑ Demolition Description I Qty. I Fee(ea.) I Total l' Addition/alteration /replacement ❑ Other: New 1- & 2- family dwellings CATEGORY OF C (includes 100 ft. for each utility connection) SFR (1) bath 249.20 F1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath 350.00 ['Accessory Building ❑ Multi- Family SFR (3) bath 399.00 ❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION Fire sprinkler - sq. ft.: .2 y0 , J Page 2 _ /13. Job site address: 1'a .o$$ 1..0 o -3f-1-1'"L Site Utilities Suite #: I Bldg. /Apt. #: Catch basin/area drain 16.60 Project Name: Drywell/leach line/trench drain 16.60 1 Footing drain (no. linear ft.) • Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 • Sanitary sewer (no. linear ft.) Page 2 Subdivision: I Lot #: Storm sewer (no. linear ft.) Page 2 Tax map /parcel #: Water service (no. linear ft.) • Page 2 Fixture or Item DESCRIPTION OF WORK Absorption valve 16.60 /9-L6/ 7 /€ A/ 7D S/A2,,J /< L EIC. SYS Backflow preventer Page 2 /' AEI /b A71177/4 L. fJ - .6Z.V 77O' r Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 ® PROPERTY OWNER I ❑ TENANT Ejectors/sump 16.60 Name: /2 4Se ✓t '1-4A-& 1-‘or '``t Expansion tank 16.60 Address: 1 3 081 Si.) 5 s lc„ c_ Fixture /sewer cap 16.60 City/State/Zip: T.' c, ,-c- t 0 c"( zti t. Floor drain/floor sink/hub 16.60 Y p Garbage disposal 16.60 Phone:5b2-5 o- o o•f5 Fax: Sa3-51 ct- 6 5VS --- Hose bib 16.60 ❑ APPLICANT ❑ CONTACT PERSON Ice maker 16.60 Name: Interceptor /grease trap 16.60 Address: Medical gas - value: $ Page 2 Primer 16.60 City /State /Zip: Roof drain (commercial) 16.60 Phone: Fax: Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower, pan 16.60 CONTRACTOR Urinal 16.60 Business Name:? 0 Ll____ Water closet 16.60 Water heater 16.60 Address: Other: City /State /Zip: Other: Phone: Fax: Plumbing Permit Fees* Subtotal $ //.5, 0 - CCB Lic. #: Plumb. Lic.#: Minimum Permit Fee $72.50 $ Authorized Residential Backflow Minimum Fee $36.25 Signature: 4 &. , ^-J Dates 4 2 - k3...7 Plan Review (25% of Permit Fee) $ - X i.. 4 t,c,-I- State Surchar:e 8% of Permit Fee $ ' (Please print name) TOTAL PERMIT FEE $ ==: Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans wi jme� tric or A go 180 days after It has been accepted as complete. riser diagram for plan review. gel *Fee methodology set by Tri -County Building Industry er6ice Board. i:\Dsts\Permit Forms \PlmPermitApp.doc 01/03 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - l 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and Fixture or Item Qty. Fee (ea) Total including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees *. Quantity by (Fixture) Work Performed Comments regarding fixture work: Fixture Type: Replace New Moved Existing Capped Baptistry/Font • Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" • - 3" 4 .. Car Wash Drain *Note: If the fixture work under this permit results in an Garbage - Domestic Disposal - Commercial increase of sewer EDUs, a sewer permit will be issued and - Industrial fees assessed for the sewer increase must be paid before the Ice Mach./Refrig. Drains plumbing permit can be issued. Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\Dsts\Permit Forms\PlmPermitAppPg2.doc 01/03 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 RECEIVED IMPORTANT PERMIT NOTICE ADVENT CONSTRUCTION LLC APR 25 2003 18710 SW VINCENT ST CITY OF TIGARD ALOHA, OR 97007 BUILDING DIVISION Electrical Signature Form • Permit #: MST2003 -00114 Date Issued: 4/22/03 Parcel: 2S109AB -10900 Site Address: 13088 SW ST. JAMES LN Subdivision: RAVEN RIDGE Block: Lot: 038 Jurisdiction: TIG Zoning: R -7 Remarks: Addition of 240 s.f. at rear of house. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: BOB & RUTH HORVAT ADVENT CONSTRUCTION LLC 13088 SW ST. JAMES 18710 SW VINCENT ST TIGARD, OR 97224 ALOHA, OR 97007 Phone #: 503 - 590 -0645 Phone #: 503 - 259 -2548 Reg #: ELE 34 -612C LIC 153338 SUP 2335S AN INK SIGNATURE IS REQUIRED ON THIS FORM x J- a (,),,,, Signature of Supervising Electrician If you have any questions, please call 503.718.2433. • fr1 Permit #: j p(t ofo 3 1 ( Address: Issued : t -� ! Date: 5715/C 3 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: © 1. I own, reside in, or will reside in the completed structure. ■ 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale © before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR X 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. �,. j/ S— r 2 - r3 (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) • Information Notice to Property Owners About Construction Responsibilities Note: This lrfornmation Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement ofa residential structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax law: As an employer. you must withhold income taxes from employee wages at the ti me employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 378 -3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law. and must obtain workers' compensation insurance for your employees. Ifyou fail to obtain workers` compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information. call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. U.S. Internal Revenue Service: As an employer. you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1- 800 - 829 -1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any fai lure to meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see ifyou have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, tire, or work that must be re -done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052, 503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own.pm4 1/94 CITY OF TIGARD 24 -Hour BUILDING Inspection Li • - : (503) 639 -4175 MST 6 63 — /I / INSPECTION DIVISION Business Li - : (503) 639 -4171 BUP i Received 3 p Date Requested e -L / ' AM PM BUP Location /' . J v o g ' / Suite MEC Contact Person t Ph ( ) Xb3 - q39? PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: e , �/L�..Zt�Afo�Al 15(sT ELC Ftg Drain ) 7 ELR Crawl Drain Slab Inspection Notes: c / , SIT Post & Beam �J Shear Anchors Ext Sheath/Shear Ina Sheath/Shear ,� �, 4 c � Framing N Insulation &- SPX l� H -� j 5 Drywall Nailing �� Fire ire S rinkler h Fire Alarm 1 (•••••••••00100.1k Susp'd Ceiling Roof Other: •ASS - ART FAIL • 1 MBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole ( 111 1 0.0. 2 Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL 0 Service Rough -In UG/Slab Low Voltage m 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE 0 Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA / e - D , Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this Inspection re from the Job site. PASS PART FAIL