Permit CF f YOFT!GARD MASTER PERMIT
PERMIT #: MST2002 -00230
Y� DEVELOPMENT SERVICES DATE ISSUED: 5/17/02
''�-- ---'-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06885 SW VENTURA DR PARCEL: 1S125DD -02600
SUBDIVISION: WASHINGTON SQUARE ESTATES ZONING: R -4.5
BLOCK: LOT: 017 JURISDICTION: TIG
REMARKS: Enclose existing front porch and relocate front door.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: 84 sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 7,610 40
OCCUPANCY GRP: R3 BDRM: BATH: - TOTAL: 84 00 sf REAR:
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 c 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 WIO SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: 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 AREAISPC 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: $ 258.38
This permit is subject to the regulations contained in the
ATTIA, FARAG A + PEGGY C BRUCE TOMBLESON
ATTIA, F YENT + PEGGY BRUCE E OM ST Tigard Municipal Code, State of OR. Specialty Codes and
6885 TIGARD, OR 97223 TIGARD, OR 98223 -6002 all other applicable laws. All work will be done i
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:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rea #: LIC 42695 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 Insulation Insp
Electrical Service Electrical Final
Electrical Rough In Final inspection
Framing Insp
Low Volta
I/
Issue By : _ ! _ /i ! ✓ /�_�. Permittee Signature : ce d v 0 A -- Call (503) 6 • -4175 by 7:00 p.m. for an inspection needed the next business y
1 ds�S -4 -4 .r
.
Y x B uil d i ng P e r m i t App •
Datereceived: 5/ 4, Permit no.: If f, i -Dda i
Vi City of Tigard
Project/appl.no.: date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 /
Phone: (503) 639-4171 Date issued: (EMI Receipt no.:
Fax: (503) 598 -1960 ` "' 1 - Case file no.: Payment type:
Land use approval:
1 &2 family: Simple Complex:
TYPE OF PERMIT
libli 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
S tAddition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION ` -`
Job address: 8'8 t 5(n )_ c 1`0- 't - T C. a -,r el 3 Bldg. no.: Suite no.:
Lot: 'Block: (Subdivision: ' . Tax map /tax lot/account no.:
Project name: �
LL
Description and location of work on premises/special conditions: C„JCLOSiIJ'o EX /677/J6 CieoNT �
POf{ / R T/ J�o•
ao,J r 2-
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: + raC 9, A . / L q (Floodplain, septic capacity, solar, etc.) '
Mailing address: 6 $1 . ,v1.1-u -v T'r. 1 & 2 family dwelling:
City: 'r, 3 .... 4 moo( 'State: O k ' ZIP: q 7a a 3 Valuation of work $ 7 C(e)
Phone: ,2(44. —774? (Fax: 1E-mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) ry
APPLICANT.- Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: YS • Deck area (sq. ft.)
City: 'State: 'ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
�� Existing bldg. area (sq. ft.)
Business name:
�'"rU c G b4/10 1-e 'A New bldg. area (sq. ft.)
Address: -n S .S LA- d ril Q' y4 St • Number of stories
City: V v a- tp_,y ci I State:0/QI ZIP: C 7.3
Type of construction
Phone: ‘ 3 qk 6 I Fax: 1E-mail:
CCB no.: 40- �� �� Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT" /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is, being performed. If the applicant is
City: State: 'ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $
Phone: I Fax: 1E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this o Visa t] MasterCard
work will be complied with, whether specified herein or not. Credit card number.
Ex
1 \ 4,.
A signature: e-f r� CC eg Date: r 7_ Zaa Name of cardholder as shown on credit card
$
Print name: •-r !! L' C! Cardholder signature Amount
Notice: This permit application ekprres if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/COM)
ter" , \•: :,, ,
•
One- and Two - Family Dwelling y,
::: __. Building Permit Application Checklist Reference no.:
°' Associated permits:
City of Tigard City of Tigard l] Electrical O Plumbing Cl Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 CI 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, histonc 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.
q &Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
0 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
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 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.
C Fl 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 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 Buildingplans shall not contain red lines or tape -ons.
26 No rolled, reversed or mirrored building plans will be accepted.
27
28
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 (6100 /COM)
• ' 'ElectricalPermitApplication
Date received: §ih. t- Permit no.: r/ 5 TH...eog •
�li�,.�_I`' City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
•
Land use approval: .
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ,Addition /alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: d g' it a� $(n/ . vt'O Ta 1:::••t- Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision: •
Project name: • I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEL SCliFl)IiI.E
Job no: Fee Max
Business name: Description Qty. (en.) Total no. insp
New residential - single or multi - family per
Address:
thseilingunit Includes attached garage.
City: I State: I ZIP: Service included:
Phone: I Fax: I E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: I Elec. bus. lic. no: Limited energy, residential 2
City /metro lic. no.: Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders — installation,
alteration or relocation:
_ 1'ROPER'TY O��'NER _ __ __ __ - _ 200 amps or less 2
Name (print): Fa �u ai, fAt y( A f ' t q 201 amps to 400 amps 2
y 401 amps to 600 amps 2
Mailing address: 6..).. �q-P. 601 amps to 1000 amps 2
City: 7 c 4 1 , 0 { I State:O,* I ZIP: 9 3 Over 1000 amps or volts 2
Phone: 24 7 7 90 Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, V.O.,701. 20 amps to or less 2
201 amps to 400 amps 2
Owner's signature: vl'r C. ( Date: 'J 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIE1V (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps -rating of 18a ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension' - 2
❑ Building over three stories ❑ Feeders, 400 amps or more •Descnption: -
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other. Per inspection I I I 1
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6i00/COM)
Electrical Permit Fees: Limited Energy Fees: - .- "_,
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems , ,, .
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits I � I
with purchase of service or I I Clock Systems
feeder fee.
Each branch circuit $6 65 2 ❑ Data Telecommunication Installation
-
b) The fee for branch circuits .
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 ❑ HVAC .
Each additional branch circuit $6.65 ,
•
Miscellaneous ,- ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 I I Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy .
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above ❑ Nurse Calls
Per inspection $62 50
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees:
•
❑ Protective Signaling
Enter total of above fees $ El Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $ ,
i:\dsts\forms \elc- fees.doc 10/09/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST aava - b Oa3D
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested ! _ a AM PM BUP
//
Location (D ggs V U2/11 Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes i . SIT
Post &Beam � � � • ,r • ' do ,e49-2.--
//
Shear Anchors
Ext Sheath/Shear . J �-�i4 E - QX.
(/
6x'1
Int Sheath/Shear •
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
final
PART FAIL
PL rMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers •
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire A,: rm
404 -§1 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date °2 D7 Inspecto �° ` Ext
Other:
Final - DO NOT REMOVE this Inspection record f om the ' � J Job site.
PASS PART FAIL