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Permit
F EPRI — CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit #: MST2012 -00197 T [ G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/14/2012 Parcel: 2S114BD01500 Jurisdiction: Tigard Site address: 9800 SW RIVERWOOD LN Subdivision: COPPER CREEK STAGE 2 Lot: 44 Project: Church Project Description: 440 sq ft bonus room above garage - no change to existing footprint. 8/30/12 REPRINT adding 1 branch circuit BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 21 Bathrooms: 0 Second: 440 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 440 sf Value: $43,000.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 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 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 3 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 -3 440 Owner: Contractor: CHURCH, LARRY & NANCY SLS CUSTOM HOMES INC Required Items and Reports (Conditions) 9800 SW RIVERWOOD LN PO BOX 1093 TIGARD, OR 97224 TUALATIN, OR 97062 PHONE: PHONE: 503 -691 -9878 FAX: Total Fees: $1,972.43 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Jittitt Permittee Signature: old APPu e4 i ?o4 Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. This permit card shall be kept In a conspicuous place on the Job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Aug. 30. 2012 11:25AM RECEVE1 /t437- go/oZ i97No. P. 1 Electrical Permit Application FOR OFFICE I ISE'. ONLY AUG 3 0 2012 Rtxeived City of Tigard Date/B ; Permit No.: 4 13125 SW Hall Blvd., Tigard, OR 97223 fry Of TIGARD Plan Review Other Permit: II I b Phone: 503.718.2439 Fax: 503.598,1 DatelB • `i � tG � ± D�y1 bale Rea /D lark: 13 See Page 2 for TIt;AR4 Inspection tense: ww w 503.639.4175 IL DtIQ!' 1}IVi V Notified/Method: Supplemental Information lnlenlel: www- r- or.gov • TYPE of WORK pLAN REVIEW • P lease check all that apply (submit 2 sets of plans wfitems checked below): ❑ New construction : � Addition/ alteration /replacement []Service or feeder 400 awp5 or more 0 Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marloas and boatyards. CA'IE00R Y OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings. less to pound, or exceeds 14,000 ❑ Commercial -use agricultural Vri 1 and 2- family dwelling ❑ Commercial/industrial El Accessory building amps for all other insiallations, buildings. _ IF — Onto pump ❑ Installation of 75 KVA or • Multi-family [� MasTer 1yUlldet 6 ❑ Emergency system. larger ocparptel9'ilenVed — JOB SITE INFORMATION • AND LOCATION . ., • ❑ Addition of new motor load of ❑ "A". "E ", "1- 2"."I.3 ", • / IOOBP or more. occupancy. Job no.: Job site address: �� J Q ( vert,Un -• ❑ Six or more residential units. ❑Recreational vehicle parks. (] Health-care facilities CI Supply voltage for more than City /$1810 /ZIP: _ ❑Hazardouslocations, 600 vol1S nominal. Project name: • / ❑ Service or feeder 600 amps or more. ' Suitc/bldg, /apt no.: J V 'FEE SCHEDULE :.. Cross street/directions to job site: Ouc,l' lion 10111INNZMMEW • New residential single- or multi - family dwelling unit. . Includes attached garage, Subdivision: Lot no.: 1,000 sq. fl. or less 168.54 4 Ea. add' 1 500 sq. ft. or ponion 33.92 0 Tax map /parcel no.: Limited energy, residential 75.00 — DESCRIPTION OF .WORK .. ' • . '. . . (with shoves .• A. - Limited energy, multi family 75.00 Pe - , S tr * X1 .1 residential with above s..11-) ( J Services or feeders Installation alteration, and/or relocation 200 amps or less r 100.70 — 2 20l amps l0 400 amps 133 56 Q PROPERTY OWNER. TENANT 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps r 361.04 2 Address: Over 1,000 amps or volts 552.26 Temporary services or feeders installation, alteration, and/or City/State/ZIP: relocation 200 amps or less 59.36 Phone: ( ) ( ) 201 amps to 400 amps 125.08 � I © Owner installation: 'Phis installation is being made on properly that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, (cast, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits- new, alteration or extension, v er panel Owner signature: Dale: A. Fee for branch circuits with CONTACT PERSON above service or feeder fee, ' / 1.42 2 • ❑APPLICANT ... ❑' each branch circuit • B. Fee for blanch circuits without a Business name: service or feeder fee, first 56.18 2 branch circuit Contact name: Each add'I branch circuit 7.42 2 Address: Miscellaneous service or feeder not included Each manufactured or modular . 67.84 2 City /State/ZIP: dwellin: service and/or feeder i� Reconnect Doty — . .67. • Phone: ( ) I ( ) Pump or irrigation circle 67,84 64 2 E-mail: Sign or outline lighting 67.84 2. s or . • CONTRACTOR Signal circuit v II • , and! altemtio or extension, • - L la? r Business Each additional ins • eclion over allowable in env or lie above Reds Electric Company/elaina@redselectric.com Additional inspection (1 hr min) ' f 65.25% hr ll i 06.25 /hr � I nvestigation (1 hr min) U 6336 SE 107th Ave — � City /Slat Portland, OR 97266 Industrial plant (I hr min) 78.111/ hr M - _ P:503-2334467 F:503- _ - Inspections for which no (8e is 90.00 / hr 11 Phone: ( E. LIC# 26 -152C / CCB #4443 /PA 7.: • 1695 wi,,:- r 1 ;. call imma • • - - • CCB Lit .... - . ELECTRICAL PERM1T'.FEF.S. � � - .T Subtotal: - -.. r � _ Suprv. Electrician signature, required: Is Plan review (25 % of , anal% lee):' __ win ` D ate: -' State surcharge (12%ofp;nnit 1 }i:) Print name: t b'‘-'l_ 4_.-1./ S t TOTAL PERMIT FEE: • , ( - r, 1 Authorized signature: - This permit application expires if a permii is not olll,ineJ Within 180 , days after it hos been accepted at complete. Print name: I Date: • Number of inspections allowed per permit: • - • - • TAP. MA :n.Aa..mi KWI.f.PennilAoe.dxC 07/01110 440461ST(111051COWWEB • . ; ,.t CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit #: MST2012 -00197 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/14/2012 Parcel: 2S114BD01500 Jurisdiction: Tigard Site address: 9800 SW RIVERWOOD LN • Subdivision: COPPER CREEK STAGE 2 Lot: 44 Project: Church Project Description: 440 sq ft bonus room above garage - no change to existing footprint. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 21 Bathrooms: 0 Second: 440 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 440 sf Value: $43,000.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywall -Trench Drain: 0 Other Fixture Units: • MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Furn <100K: 1 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'I 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 - 3 440 Owner: Contractor: CHURCH, LARRY & NANCY SLS CUSTOM HOMES INC Required Items and Reports (Conditions) • 9800 SW RIVERWOOD LN PO BOX 1093 TIGARD. OR 97224 TUALATIN, OR 97062 PHONE: PHONE: 503 -691 -9878 FAX: Total Fees: $1,964.12 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No ' cation Center. Those rules are set forth in OAR 952- 001 -0010 throug AR 952 - 001 - 00900. /Y You may oo tain a copy of the rules or direct questions to OUNC by calli 503.232.1 87 or 1.800.332.2344. Issued By: JAI L(/1 Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspe tion date. This permit card shall be kept In a conspicuous place on the Job site until completion of the projec Approved plans are required on the job site at the time of each inspection. Building Permit Application • Residential Drift FOR OFFICE USE ONLY City of Tigard 1 DateB 7 1 %�� Permit No /f a p0/97 13125 SW Hall Blvd., Tigard, OR 97223 JUL 3 1 2012 Plan Review �� C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : AR Other Permit: T I G A I: D Inspection Line: 503.639 ` � , o D R ea. • : y : - , ® El See Page 2 for Internet: www.tigard or.gov �7 CITY e !@r i�Y y yt ethod: i rj s �[� Supplemental Information B! j!a i'h t Gy� i - " ` 1 1 of -iw �.! . , TYPE OF WORK / RE d IRE A ATA: 1- AND 2- FAMILY DWELLING ❑ New construction El 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. dwelling Valuation: $ q 3 1 00 / I - and 2-family g ❑ C ommercial /industrial ❑ Accessory building ❑ Multi - family �{, Number of bedrooms: 3 ❑ Master builder ❑ Other: PI Number of bathrooms: .. JOB SITE INFORMATION AND LOCATION 9'h Total number of floors: Job site address: 9 Bop 2t; t,.,kwc 4..., New dwelling area: t.4(.{0 square feet City /State /ZIP: 7"' Qi°1.2.l( Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: G'ico. oica Covered porch area: square feet Cross street/directions to job site: r - Deck area: square feet . � -I { . DvA.ka fact i� 103 � 'JD g Ivet uat, 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. ACD t.'IIA P Pc1Pc." Valuation: $ �� Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: L.M/xt 4. ,,,,,v' 00,,,„ Type of construction: Address: �,q�'� Occupancy groups: City /State /ZIP: �-'' Existing: Phone: ( ) Fax: ( ) New: APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: SI..S CtAI1e' 440/r443 I 4ta•e lie h,. J a` (Please refer 10 fee schedule) C � Structural plan review fee (or deposit): c# Contact name: v- SAot 2 L FLS plan review fee (if applicable): Address: r p q City /State /ZIP: - ,� I` C6u.- c 593 - s/9 -ga3s Total fees due upon application: Phone: (5 ) 1- can I Fax: : (2)3) tAtl 19 T3 Amount received: V y 00 E -mail: S } © SI-.S �(t ts , cop.- PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof -top mounted Photo Voltaic Solar Panel System. Business name: Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: �� PI ^' Solar Installation Specialty Code checklist. City /State /ZIP: Pfd Permit Fee (includes plan review $180.00 and administrative fees): Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: 1 V S 1 1 qs,4 V Total fee due upon application: $201.60 Authorized s' ature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print nam Sh Lieg L. i Date: 1 J 3 t 1 )-L * Fee methodology set by Tri -County Building Industry Service Board. I:\BuildingTerrnits - RESPermitApp.doc 02/24/2011 440- 613T(11 /02 /COM/WEB) 07/26/2012 14:00 50323504 SKY HEATING AND AC PAGE 01/01 U'1 Mechanical Permit A, licati k..,....,-; Mechanical ED Ffllt I?I I It'1', 1 .tit: ll \1,5 City of Tigard JUL 31 2012 amcived 13125 SW Hell Rlvd., Tigard, OR 97223 CITY Dam/13y; PermitNo,• _ d /off — "OP' Plan r �: i , Inspecttcal Line: 5039N3 4175 3.598.1960 CITY OF r AR J Date/BY' Review Other Permit; Internet; www.ti or. ov �S 1 E /� 1 t • ; i �p� D R See Page 2 for g �I `1� z �? i tS 3N Notifc mo hub Supplemental Information TYP)� OP hY(y1iK ... .. t�GIMM81�liCd�i41 f3`:5 £D[JLIi'.':.�JS$' HECYQ�15'1 ❑ New construction [i ddition /alteration /replacement Mechanit�il permit fees• arc based on the value of the work Q Demolition performed, Indicate the value (rounded to the nearest dollar) of all ❑ O ther mechanical materials, equipment, labor, overhead, and profit. $ CATi5 RY' OF WSTI OenerV . . Va t li'M 193'S •• and 2 - family dwelling ❑ Commercial/industrial ❑ Accessory building For spedatWersniwton sae checklist ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. E. i Total FOB SrIt• ATiON AND.:IsOCATION: • Hestinlr/coolinpi Air conditioning Job site address: qgQ, .S6.0 Z tJ fR woad / ) (mites Eire plan showing placement) 46.75 City/Stntc/7,1P: 6 440 � Furnace 100,0(10 BTU (duc1W ants) ' 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: C b6,4.LC4 a Heat pump Out/aims site plan showing placement) 61.06 Cross street/directions to job site: Duct work L 23.32 _ Hydmnic hot water system 23.32 . _ Residential boiler (radiator or • ydronic) 2.332 --- Unit heaters (fuel -type, not electric), in -wall, in- duct, suspended. etc. 46.75 Subdivision: -- Lot Flue/vent for any of above 23.32 Tax map/parcel no.: — Other: _ 23.32 Other fuel appliances: "RIP'FIO3ti OF WORK: . Water heater 23.32 10- L IB ,j) u u:f.J I e»I (rFk t n-m4. ,,.yr.�- Gas fireplace anfor 33.39 Flue van for water heater or gin fireplace 23.32 Loa lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23,32 . Q • 1PRROPFift"i' OWNER t] .TENANT . • Chimne /liner /tl 23.32 Name: Other; 2332 Environmental exhaust and ventilation: Address: Range hood/other kitchen City /State/ZIP: e 3339 _Clothes dryer exhaust 33.39 Phone: ( ) 1 Fes: ( ) Single -duct exhaust (bathrooms, _ . L toilet cnmpartmentq, utility rooms) 23.32 G • •A'PPLtCAPIT.. • • • :.I [] .CO'l'P[/kCT, PERBON• • � Attie/crawls rLaoc fans 23.32 Business name: SKY HEATING & AC, INC. Other 23.32 Contact name: TAMI .HAGEMAN Fuel piping: 514.15 for finat flair; $4.03 for each additional Address: 1635 SE NEHALEM ST Primate, etc. City /State/ZiP: PORTLAND, OR 97202 Gas heat pump wall /su mdcd/unit heater Phone: (503) 235 -9083 I Fax:: (503) 235.0454 Water heater E-mail.: TAMI @SKYRFATING.COM Firc lace Ra — Barbecue Business name: SKY HEATING & AC, INC- Clothes dryer (gasJ Address; I635 SF, NEHALEM ST Other. City /Statu/LIP: PORTLAND, OR 97202 r 1�tB:RRffILPlitt!•Q'[`>i">> — _ Subtotal Phone: (503) 235-9083 I Fax: (503) 2354454 Minimum pcnntt fee (590.00) 1 ► e CCB tic.: 50244 Plan review (25 %ofpermit fee) A. State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature; 111fr i f ill /' • f / This rmit application as Pe PP pirtis if a permit is not obtained within 180 Print name: TAMI HAGEMAN l days after it has been accepted as complete. Date; I Fcc methodology set by TA•County Building I ndn.ny Service Accord l:lnuildinglneniutAMEC.- nennitA qA osionto 440461 rr 111/O2/C.OMAVE8) Plumbing Permit Annlicatio r f r 'Cr) uilding Fixtures Ci iCi City of Tigard JUL 31 2012 rived Permit No Plan R v: /O /S7. 2 o�a oC i 97 13125 SW flail Blvd., Tigard OR 97223 Plan Rcvicw Phone: 503.718.2439 fax 503.54R.tp t Oilier Perm) Nu.: '/Y� r° T.� �dlirt i "ate! )Y. In4 5113 ) cc 1 �(',, Dale lan El see e 2 for rr r I; Internet: www.tigard- nr.gnv el III f iC \ (y { V:f., Jr Nutified/Method: Soppkmenul Information TYPE OF WORK FEE* SCHEDULE - ❑ New umstnaction ❑ Demolition - •_..__..__ - For pedal information use cherkMLu —�— • —... •— •...••.. . ••....•...— Descri tion t _— .. P.a. Total Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 (L for each utility connection) CATEGORY OF CONSTRUCTION SCR (1) bath 312.70 J21 1- and 2-Family dwelling ❑ Conuttercial/ittdu..trial SFR (7) bath -- 437_78 ❑ Accessory building ❑ Multi family s1-3( (3) bath $(NI 37 — - Filch additional bah/kitchen 25.02 ❑ Master builder ❑ Other: giro sprinkler ( sq. fl.) Page JOB SITE INFORMATION AND LOCATION Site utilities: Joh site address: 950) SW Riverwund Lane Catch hagin or Weer drain 1 K.76 •• • •,.:. _ . • . - - • _..... ..... ..... _........:.. _.. _ . Drywell, leach line, or trench drain I R.76 City/State /L1P: Tigard. OR 97224 Footing drain (oil. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project nuwe: Church Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (nu. linear R.: _) Page 2 Storm sewer (no. linear Il.: _). Pate 2 Water service (no. linear ft.: _) Puge 2 Subdivision: IAA no,: Fi>.lure Of item: fax map /parcel no.: Dackflaw premier 31.27 - _ —__ . DESCRIPTION OF WORK Backwater valve 12.51 ('�( (, j � l �/1 {� {- Clothes washer 25.02 ?h 0 Z '�G�G�J� �`^tr! S.Y�lll � ..._ 1d13~'_ �11�. !J�/` ..... Dishwasher 25.02 Drinking tOuntain 25.02 Ejectors /sump 25.02 P ROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Larry Church Fixture /sewer cup 25.02 — .. ..._._. Floor drai &lloursink/hub 25.02 Address: 9800 SW l4iverwood Lane Garbage disposal 25.02 City /Stine/7.1P: Tigard, OR 97224 Hose bib 25.02 Phone: ( ) 1-•ax: ( ) lcc maker 1151 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease Trap 7.5.07 Business name: Medical gas (value: $ ) Page 2 — - - Primer 12,51 Contact name: Roof drum (commercial) 12,51 Address: _ ........ .. .. Sink/basin/lavatory 2.5.02 City /State/7.1P; Sulu units (potable water) 62.54 I'hone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 T?- mail: Urinal 25.02 Water closet 25.02 CONTRACTOR - - ...... —._ ._._ . .... . ...... ...... ,...:....,---- ---'- Water heater 37.57. Business name: Venne Plumbing, LLC — _...- Water pipings )W V 56.29 Addreay: 17675 SW Calewoud 1lrive l )Iftcr: 23,117 City /State /LIP: Sherwood, OR Subtotal Phone: (503) 6249309 Fax: (503) 6840940 - _. —��___ Minimum permit fee: $72.50 a - CC'B Lie.: 192$47 qs/ 12442_ Plumbing 1.14:. no.: ph956 '7/4 f Plan review (25Yooflx.nnit fee) �'j. 70 State surcharge (12% of permit fee) , Authorized slgrtat _ -- TOTAL PERMIT FEE Print name: Lindsay Venne ------ - - - - -_ — T Uate: 7!24/12 mix permit application expire, if u permit in not nhtalnerl within 1511 IC after it hun been nccepted an complete. 'Pee methodology art by 'In-County Building industry Service Board. ^,►� I'\xuitdinf IH rni immm MU- ecrmiIApp.de: 10/111 N9 4411.4611, I'(1 ux1v :i /W KM 47 G �� '•— • I. I. el CRAJPAQCnC « n47AnwQCnC FIN TAWf1di aNNaA 7n: H. b7- Jn -7IMP Jul. 24. 2012 9:31AM No. 1731 P. 1 . Electrical Permit Applica ti` q • • - s , FOR OFFICE USE ONLY Ci}}.�r of Tigard Date /By: / f.$7 I,a D 9 7 •J Permit No.: 1 � " 3125 SW Ilnll Blvd., Tigard, OR 977JWf L 3 1 2012 Plan Review Phone: 503.718,2839 Fax: 503.593.1960 UotdBy: Other Permit: TIGA RD Inspection Line: 503.639A 175 AMU C t bate Ready/By mite: 6J Set Page 2 for Internet: www.tigard- or.gov v�' C ! G: � :J Notified/Method: Supplemental Information B lot; 4'"9e ortt 7ttt�'�p t TYPE OF ltfar— t.ao V r R v PLAN REVIEW ' ❑ New construction ❑ Addition /alteration/replacement Please chock all that apply (submit a sets of pions /items checked below): ❑ DeIn0lilton ❑ Other: ❑ Servieo or feeder 400 amps or more ❑ Building over three stories. whoro she available fault current ❑ Morino/ and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps of 150 volts or ❑ Floating buildings. loss to ground, or CNCCOds 14,000 ❑ Commercial -rue agricultural ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other instal/attune. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ rite Dump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergencysystem. larger separalely derived system. 0 Addition of new motor load of ❑ ' '7,", "1 -2 ", "I -3 ", Job no.: 1 Job site addiesst I or mom, occupancy. Q '.1(� IZ1�/P Y trio ), ❑ S i x or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: n r ❑ llealth• care facilities. ❑ Supply voltage for more than 'MTV- `T ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: • Project name: V 1 U r ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross streel/direclions to job site: Detrrtptlo I Qty. I fee. I 'rowan I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq, 0. or loss 168.54 4 Ea. add'I 500 sq. R. or portion 33.92 Tax map /pareel no.; Limited energy. residential DESCRII''I'IU,Y OF WORK (with aboveSCI. rt.) 75.00 Limited energy. multi - family 75.00 2 residential (with obovo sq. f .) Services or feeders insInllation,alleratiort, and/or relocation 200 amps or less 100.70 2 a ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 snips 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; Temporal' services or feeders - Installation, alteration, and /or relocation _ Phonc: ( ) F ax: ( ) 200 amps or loss 'I 59.36 I 201 amps to 400 maps 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, 'I49, 670, and 701. firmnch circuits -- new, nller ntion, or extenslon, per pa nel Owner signature: Date; A. Fee for branch circuits trlrh ❑ APPLICANT I ❑ CONTACT PERSON above service orlccdcr 7.12 2• each branch circuit BuSinCSS name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit -- Each add'I branch circuit 1 7,42 _ 2 Address: ,lliseell:tne0us (service or feeder_ not included) City/State/ZIP: Each manufactured or modula 67.84 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect onty 67.84 2 E-mail: Pump or irrigation circle 67.84 2 Sign Or outline lighting 67.84 -! " CONTRACTOR Signal circuits) or limited - energy 3 Business name: IZ P f- {� I a r- _ 1� t C � — panel, nhcmtion or extension. page 2 _ - "-' E ach a Inspection over allown • / [ _ ble In any of the above Address: tt. 3 4 , Cy ' 0 - 1 ..h.- ,(I v-e Additional inspection (I hr min) 66.25/ hr City /State /ZIP: '• .1._ I � �. q 7 7 - 6'.� Investigation (I hr min) 66.25/ hr - / Industrial plant (I hr min) 78.18/ hr Phone: 6°3) 3 _ l `7 7 . I rax: 5-' ) Inspections for which no fee is �^' 3 ` I� � specifically listed (A hr min) 90.00 / hr CB Lie.: 6 L - Electrical Lic.:� Sups'. Lie.: 5n10,- ELEC'rft1CAl. PERMIT' FEES Subtotal; Suprv. Electrician n lit o required: d — Plan review (25 %ol'permit fee): Print name: 3 I gip v I S I Date: - 1 2q 1 1 2_ State surcharge (12% of permit fee): V TOTAl, PERMIT FEE: Authorized signature: This permir nppttcmtion mires ir permit is not obteihed within 180 Print name: Dale: • trays after it hoe been necepted oa complete. ' Nwnber of inspections allowed per permit. I:W uitding1PermlIs 'lil.C•PermiLApp.doc 07/01/10 440-46157( 1 I/OS/COM/WED .gyp / /1 .,- 7 , - a it e ° Building Division Development Code Provision Review T I G A R D Residential Projects Building Permit No: �S/ a 0/ — 00/97 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A $ Routed Plans: Original Plan Submittal Date: 7/3/X 1st Revision Submittal Date: ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only 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 only if approved. I f Planning Review (contact / at 503 -718- � 1 O or @tigard- or.gov) Lad Use Case No. Name _ # A4 L ' hff Zoning /‘ - i- /'4 (PD) ❑ Setbacks: �� ront 9-0 Rear / Side Street Side tic ..4, Garage 2 annum Building Height & rr Actual Building Height -- 2- I FT LI Visual Clearance Er Easements CSensitive Lands Type: Notes: r .4 1 P% � a . : / i" ` is /Id A L - -r te Original Plan: Approved Not Approved ❑ Date: 9 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov) ❑ Actual Slope: Notes: Az 1 0 Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503- 718 -2700 or todd @tigard- or.gov) ❑ Street Trees ❑ Protected Trees Notes: I/0 Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard- or.gov) ❑ Conditions of Approval Prior to Iss nce of Building Permit Notes : ) Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes ❑ No ❑ Date Routed to Building: • Page 2 of 2 j+iortlgem I - fbr P.O. BOX 1093 L NAtUj sLs TUALATIN OR 97062 �1° 0 S.14. 'Zi t/et-wood Lam. i s `LUCI U i or. Al s 'JUL 31 2012 CITY CF IMMO BI t!Lf2i G Biti:siON 7 1 6 I _ t 1 Q E)(151", 1. E.S I D kl G E.. a- o / ;4-- 1 3 I I I , EXI67 + ca 10.31 � � - - , W , -IUE W D L E i i \)4 r.. F-1,..,,A\ . ..;:,....f ( sc e , i ... E .... I) z w1-0. loy__..T\A