Permit CITY OF TIGARD MASTER PERMIT
al
I • • COMMUNITY DEVELOPMENT Permit #: MST2012 -00194
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/14/2012
Parcel: 2S104CCO2900
Jurisdiction: Tigard
Site address: 13995 SW HILLSHIRE DR
Subdivision: HILLSHIRE ESTATES NO.2 Lot: 135
Project: Ream
Project Description: Permit area previously converted without permit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 0 First: 649 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 514 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 1163 sf Value: $120,858.96 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Tubs /Showers: 0 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: 0 Other Units: 1
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn > =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! 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 2
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 1163
Owner: Contractor:
REAM, STACEY I & SARAH M OWNER Required Items and Reports (Conditions)
13995 SW HILLSHIRE DR
TIGARD, OR 97223
PHONE: PHONE:
FAX:
Total Fees: $3,749.00
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 ' • - +. • - - 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 ' TTENTION: Ore• •n law e•uires you to follow the rules adopted by the Oregon Utility Notification Cent . Those rules are set forth in 0' r
95 - 001 -0010 through OAR 9 r r II 9.. / You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. 87 or 1.800.332.2344.
/ /� / � ./ AP I sued By: i /• t Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available Inspection • -
This permit card shall be kept in a conspicuous place on the Job site until complIw,• of the project.
Approved plans are required on the job site at the time of each Ins • Trion.
Building Permit Application
Residential � roa 01. us; clNI.1
City of Tigard Received Permit No.: .r 00 Date/B :� 5170„, �i
i11 • 13125 SW Hall Blvd., Tigard,OR 98 Plan Review�w�.jlw p
Phone: 503.718.2439 Fax: 503.5 0 �+ 6 20 Date/B A' ��`- // Other Permit:
I' I C. n It Il Inspection Line: 503.639.4175 Date Ready/By: �/ , runs: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF T GARD Notified/Method: y /-/ / , Supplemental Information
ouumwanTioN TYPE OF WORK REQUIRED D • TA: 1- AND 2- FAMILY DWELLING
❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
1:1 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ p gij .:9G
❑ 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: 13Q q 5- S I -( i l t S (,. ` ' tIR a ^D New dwelling area: ‘'t 63 square feet
City /State /ZIP: -1-t- E-i A .O7, E C, tJ t...1 Cl Z2-7 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 'AR L A vv‘ Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
• Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
V aluation: $
IAA 1 At A C( s i ,Z 1 ( -gip... t-t -c � 0
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: St-Ac .c Li -R e orm Type of construction:
Address: t ci n S, �J i 0, S k i R e. ' 1 r. Occupancy groups:
City /State /ZIP: 1 C /11/11-. ' J v A. E E 011/44 01 2,2_3 Existing:
Phone: ( So3) p - &( 4 4 L. Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name:
FLS plan review fee (if applicable):
Address:
City /State /ZIP: Total fees due upon application:
Phone: ( ) I Fax: : ( ) Amount received: ,�ej - —
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted PhotoVoltaic Solar Panel System.
Business name: O (AD M E. Submit tw. 2) sets of roof plan with connection ... ils
and fire dep , • . -nt access, along with th I Oregon
Address: Solar Installation s lty Cod- • list.
City/State /ZIP: Permit Fee (inc '. review $180.00
administrative - :
Phone: ( ) I Fax: ( ) - o
tale surcharge (12% of permit fee): $21.60
CCB lic.:
Total fee due upon appbcation: $201.60
Authorized signature: - / ,e This permit application expires if a permit is not obtained
U (�. within 180 days after it has been accepted as complete.
Print name: �S 1 — Date: 1 .] I Z * Fee methodology set by Tri County Building Industry
'- III I Service Board
I: \Building\Permits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(11 /02 /COM/WEB)
Building Permit Application Checklist
One- and Two - Family Dwelling Fc)R OFFICE USE ()Nix
Received
City of Tigard Date/By: Permit No.:
1 114 n 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
C Phone: 503.718.2439 Fax: 503.598.1960
24- Hour Inspection Line: 503.639.4175 ❑Electrical 0 Plumbing 0 Mechanical
- I - IGAR
Internet: www.tigard -ocgov ❑ Other:
•
TI -IF FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ) es No NIA
1 L: • d use actions completed. See jurisdic • an criteria for concurrent reviews. ❑ i •
2 Zonin : Flood plain, solar balance po' • , seismic soils designation, historic district, etc. ❑ ❑ , ❑
3 Verificati i , of approved plat/l - ❑ ❑ ❑
4 Fire district : 'royal req d. Name of district: . ❑ ❑ ❑
5 Septic system pe -'t I . uthorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water distric 1 proval. ❑ ❑ ❑
8 Soils rep, . Must carry origin. . iplicable stamp and signature on file or with application. ❑ ❑ ❑
9 Eros'. control ❑ plan ❑ permi - o uired. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
b.: n protection, etc.
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state Cg ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site /plot plan drawn to cale. The plan must show lot and bu' setback dimensions; property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. e e • : ' on differential, • 1. r •- . s ow contour lines at 2 -ft. intervals); location of easements
and driveway; footprint of structure 6:. -... g decks); location of wells/septic systems; utility locations; direction
indicator; lot area; buildin: • age area; per - - - !e 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, g ❑ ❑
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 Ore • on and shall be shown to be a . I licable to the . ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services' Sensitive Area Pre Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I: 1Building lPermits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(11 /02 /COM/WEB)
Mechanical Permit Application FOR OFFICE USE ()NIA
III City of Tigard
a E C E i Received Permit No.:
13125 SW Hall Blvd., Tigard, 9722 D a t eB Y . ,g10 / �� /�, - l
g Plan Review
Phone: 503.718.2439 Fax: 503.598.19 0 Date/By: Other Permit:
- r I G A Ii D Inspection Line: 503.639.417 JUL 2 6 2012 Date Ready/By: 3uris: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CITV OF F°GAp0
TYPE OF , :�ltl�i( / 1 1;100 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
_Jr 31 �, Z J' Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 13 q q s 3,,,... a i l S k ; ge-,- 'j.• , (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State /ZIP: ci A & , 0 /LEC 0 N ei 1. 2_1- ? Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
�'� (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 1 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
f Gas fireplace/insert 33.39
JDi (7A- S�.% LtJ gs tvJ CJ• As sd Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Stet e' - (,1 Z c -, Environmental exhaust and ventilation:
Address: Range hood/other kitchen
3 q q S (c S ‘-0 N ; 1 1 S �.i Rc �Jr. equipment 33.39
City /State /ZIP: r i S AA r1 (V 2-i-7 nl Q I1 2-23 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( 503) 30 - y S c{ L Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: _
Business name:
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: O ( n ` k Clothes dryer (gas)
' v Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: "A , . . . . : 1 - 4 - - - - - - - - I Date: 7/13 /2 " ix. • Fee methodology set by Tri- County Building Industry Service Board
I: 1Building\PennitAMEC -Yttmi Wpp.docr03 /07/12 440 -4617T (I 1 /O2ICOM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
•
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
I:\Building\Permits\MEC- PermitApp.doc 03/07/12 2
rirli pi
Electrical Permit ApplicatioC FOI2 OFFICI• USE ONLY
City of Tigard JUL 2 Date/B : `f Pep K � 5 to (s'Z -� !
G 2012 Permit No. ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' C Phone: 503.718.2439 Fax:. 503.598. 'CF T ' Date/By: Other Permit:
In Line: 503.639.4175 fy , 4d !_ , .' + I. � Date Ready/By: ��s ® See Page 2 for
Internet: www.tigard-or.gov J,.,
I I A R D ' !1 Li a 1V �1 Notified/Method: Supplemental Information
{2 �'1i�iS1�PE
TYPE OF WORK PLAN REVIEW
❑ 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 ❑ Building over three stories.
❑ Demolition ❑ Other: 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 all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 1'1 Q GI s S t:� F� ( i 5�
♦ l R� or or more. occupancy. p of ❑ Six Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: , ❑ Health -care facilities. ❑ Supply voltage for more than
C�/AQ r / O (.sO N
. ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name: 12 C ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I 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'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
� I (� C Limited energy, multi- family 75.00 2
A DN- Ni A ._.- 0t�1" (= � C 1� - 3 A kj residential (with above sq. ft.) _
(16 /_ Services or feeders installation, alteration, and/or relocation
V fk�i C�� =) •k 200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: .. 1: — k-;.e ‘ 9 �,1 601 amps to 1,000 amps 301.04 2
Address: 13 Q e c S i i 1 Si„,‘ 1 tic t e t y Over 1,000 amps or volts 552.26 2
Temporary City/State /ZIP: � c) (. �� relocation
services or feeders installation, alteration, and/or
•
%
Phone: ( 503) 30 - S 4443 tax: ( ) 200 amps or less 59.36 1
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, r or exchange, according to ORS 447, 449, 670, and 701.
I / Brandt circuits — new, alteration, or extension, per panel
`}
Owner signature: ( � e� �� Date: i Z? /2o /7 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 'L 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 e d or modular 67.84 2
dweng, 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 Iimitcd -cncrgy
Business name: .n� N t 4- panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (I hr min) 66.25/ hr
City/State /ZIP: Investigation (I hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18 / hr
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00/ hr
specifically listed ('A hr min)
CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: o Subtotal:
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
days after it has been accepted as complete.
Print name: ( St—Ave-1 p ; 01 d rg y ‘ Date: 1 /2_J',/2_z/ Z • Number of inspections allowed per permit.
I:\ Buitding�Permits \ELC- PermitApp.doc 07 440 4615T(II /05 /COM/WEB
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: 1
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
•
❑ Burglar Alarm
❑ Garage Door Opener*
❑ He`ating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
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
❑ Fire Alarm Installation
El HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other _
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Prnnits\ELC- PermitApp.doe 07/01/10
•
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.055 (4))
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
I c S Os ea.■
Print Name of rmit Ap plicant
p — 20 t
Sign ure f Permit Applicant Date
Permit #: 67- AO 0l 9 �
9 C ` �LfLLMistb
Address: l ? J �S dw /Z
tr2b, 02 97
:
Issued b : Date: 2-, .• [.u>
This Copy for Permit Offices
•
_/Z1 5 T2C i a — cry°
135 'M % / / L� e �
City of Tigard Contact:
Y g RE CO VFO
Mark VanDomelen JUL 26 20 12
Planning Department CM/
O , .
F Es9 r. r
503- 718 -2448 �I !1 Q; j� D ' p
City records show 1,279 sf on the main, 957 sf up and 1,339 sf for the garage. No record of any permits
since 1996. Need to submit a drawing of the modified space with measurements, windows, doors, and
venting for HVAC for the building permit. An electrical contractor will submit paperwork for the
electrical permit and an HVAC contractor will for the mechanical.
Permit fee is based upon the valuation of the property after the modification. A quick calculation by
Mark showed that if 700 sf of garage space was converted to living space, then the building permit will
be around $1,200. The electrical and mechanical should be around $100 each and then there is a
$1.07 /sf charge for the school district.
445 2 c- / — cre 9 7
Scope of improvements in upstairs dressing/workout area
Re I Ei VED
$1,800- Sheetrock (done by contractors JG Wallboard), tape and texture
JUL 2 6 2012
$300- Additional electrical plugs and swapping out light fixtures (electrician)
$400- Carpet from original install (price included in total house carpet but guessin SMOY -21.41 i top :
$100- Paint and trim by owners (unsure of price)
Upstairs area already existed, no structural changes were made to this area and electrical was existing.
Room was used previously as a workout area and to store the house's sound, security and other
electronics. Some sheetrock already existed but was beat up so removed and replaced (told would be
cheaper than repair). See upstairs pictures A and B for idea of area
Scope of improvements on main level
$- Door replaced with larger sliding doors (contractor)
$- Electrical expanded to include wall scones and additional outlets (electrician)
$- Additional wall in garage installed to expand area for TV room & closet area (contractor)
$- Sheetrock wall, repair others, tape and texture (contractor)
$- Window added (framed previously), contractor [window provided by us from Lowes)
$- Electrical & breaker added (electrician)
$$ Total 3,280
$ -80 Duct size increased & moved to provide better air flow (HVAC friend, materials only)
$900, Carpet and padding (Lowes)
$300- Painting, trim and closet doors (owners)
Area adjacent to kitchen (see pictures 'Main Level A, B, C & D) was previously finished and being used.
Carpet was changed out, as well as doors and fixtures. Did not realize this sq footage was not included
previously. Hard to believe it was not part of the original footprint & permitted based on the finishes.
Pictures 'Main Level New Area A & B' show work done on new room. No changes were made to
external walls. Wall is constructed of 2x6 and insulated.