Permit 1 Y M ASTER PERMIT
I
E COMMUNITY DEVELOPMENT ,, Permit #: MST2012 00226
"�`` 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/01/2012
T 9 Parcel: 2 S 102 DB08500
Jurisdiction: Tigard
Site address: 9092 SW HILL ST
Subdivision: CHELSEA HILL NO.2 Lot: 62
Project: Mize
Project Description: Living room and dining room remodel, wall alterations only. 10/22/12, Reprint to add mechanical
to scope of work.
BUILDING
Floor Areas Required Setbacks Required
Stories 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units. 0 Third 0 sf Right: 0
Detectors Yes
Total 0 sf Value $15,000.00 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
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
Heat Pump: N Hoods, 0 Other Units: 1
Furn<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 +a m p /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:
ALT SF VB R -3 0
Owner: Contractor:
MIZE, LOAM & JON M CALLMARK CONSTRUCTION INC Required Items and Reports (Conditions)
9092 SW HILL ST 10543 SW 80TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 639 -2268 PHONE: 503 - 317 -8501
FAX.
Total Fees: $711.80
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 - tig OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by call.. 503.232.1987 or 1.800 332 2344
Issued • Permittee Signat ! _ _ /_, _,� cJ`.--_,
Call 503.639.4175 by 7:00 a.m. for the next available inspecti • - date.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
Oct 22 12 04:03p . Western Heating . 503- 543 -3693: : .'.p.1 , <: • -,., ,.,;, _ ... '
Mechanical Permit Application FOR OFFICE I Sr O\l.1
. •Cl of Tigard - , Received / P ermit N o. : �r ��
ts' g Date/By. r0 / -../ i / i :.
IN ' . q '1 SW Hall Blvd., Tigard, OR 97223 plat Review
® .' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit
T I G J� >:. U Inspection Line: 503.639.4175 Date Ready/By: kris: el See Page 2 for
Internet www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL TEE* SCHEDULE — USE CHECKLIST .
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: S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1 -and 2- family dwelling ❑ CotnmerciaUndustrial ❑Accessory building For special information ass checklist
' ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total ;
JOB SE INFORMATION AND LOCATION Heatiug/coalirrg: SITE ;
Air conditioning
Job site address: 9092 SW Hill St (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ductslvents) 46.75
City/State/ZIP: Tigard, OR .
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. tto.: Project name: Callmark / MST2012 - 00226 Heat pump
(requires site plan showing placement) I 61.06
Cross street/directions to job site: Ductwork I 23.32 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
Gas fireplatx/insert 33.39
Add supply ducting Flue vent for water heater or gas
. fireplace 23.32
Log lighter (gas) 23.32
Please add as Sub Contractor to permit MST2012-00226 R'ood/pellet stove 33.39 ,
Wood fireplace/insert 23.32
® PROPERTY OWNER f ❑ TENANT Chimney/liner/flue/vent 23.32
Other 2332 _
Name: Environmental exhaust and veutilalion:
Address: 9092 Hill St Range hood/other kitchen
equipment 3339
City/ State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 3139
• Single -duct exhaust (bathrooms,
i Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 2332
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 2332
Business name: Western Heating & Cooling Inc Other. 23.32 _
Fuel piping:
Contact name: Darcy $14.15 for first four; 54.03 for each additional
Address: 50618 Columbia River Hwy Furnace, etc.
Gas heat pump
City /State/ZIP: Scappoose, OR 97056 Wall/suspended/unit heater
Phone: (503) 543 -5599 I Fax: : (503) 543 -3693 Water heater . _
Fireplace ,
E -mail: djnelson@westernheating.com Range
CONTRACTOR Barbecue
Business name: Western Heating & Cooling Inc Clothes dryer (gas)
Other:
Address: 50618 Columbia River Hwy MECHANICAL PERMIT FEES"
City /State/ZIP: Scappoose, OR 97056 Subtotal
Phone: (503) 543 -5599 I Fax: (503 -) 543 -3693 Minimum permit fee ( mit fee
Plan review (25% of permit fee)
CCB lie.: 76978 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized si J �twe: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name : / / 4f 7 / I Date: 10 -22 -2012 a Fee methodology set by Tri -Cotmty Building Industry Service Hoard
i Boldina\Pennit EC- P /mitApp.doe 03,07!12 440 -soIrr i1m2/COM/wEB>
•
CITY OF TIGARD MASTER PERMIT
' '1 r -• COMMUNITY DEVELOPMENT Permit #: MST2012 -00226
-T 1 GARD 13125 SW Hall Blvd.. Tigard OR 97223 503.718.2439 Date Issued: 10/01/2012
Parcel: 2S 102 DB08500
Jurisdiction: Tigard •
Site address: 9092 SW HILL ST
• Subdivision: CHELSEA HILL NO.2 Lot: 62
Project: Mize
Project Description: Living room and dining room remodel, wall alterations only.
•
BUILDING
Floor Areas Required Setbacks Required .
Stories: 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces. 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke .
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: Yes
Total: 0 sf Value: $15,000.00 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 •
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
Heat Pump: N Hoods: 0 Other Units: 0
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'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: •
ALT SF VB R -3 0
Owner: Contractor:
MIZE, LOA M & JON M CALLMARK CONSTRUCTION INC Required Items and Reports (Conditions)
9092 SW HILL ST 10543 SW 80TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503- 639 -2268 PHONE: 503- 317 -8501
FAX:
• . Total Fees: $611.00
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 ' - i ith 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
da . ATTENTION: Oregon a .luires you to follow the rules adopted by the Oregon Utility Notification Center: Those rules are set forth in OAR
2- 001 -0010 through OAR 95y 01 -009r ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19 or 1.800.332.2344.
/, /�
I sued By: Perm ittee Sinature:
Signature:
�� � �
Call 503.639.4175 by 7:00 a.m. for the next available inspecti�te r -t'
This permit card shall be kept In a conspicuous place on the job site until completione project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application RECEIVED
Residential FOR OFFICI USE ONLY
City of Tigard 2 9 201Z Date Rece B ived y: ( IA ,I Permit No.: �� 1.. —v v
IN
n 13125 SW Hall Blvd., Tigard, OR 97223 F�
0 P hone: 503.718.2439 Fax: 503.598.1960 Plan Red w TIGA Date/By: ( Q
//1 / Other Permit
Inspection Line: 503.639.4175 ��� ! �/ sate Read /Y ruri9.
TIGARD I BUILDIIIC DNISI ot Y Y. ®SeePage
Internet: www.tigard-or.gov
Supplemental In forma don
'• e / /i
} see- t
TYPE OF WORK / REQ DATA: 1- AND 2 AMIL WELLING
❑ 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.
Z 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $15,000 ,t----t,
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: L'
Job site address: 9092 SW Hill Street New dwelling area: NC square feet -
City/State/ZIP: Tigard /Oregon/97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Omara and Hill Streets 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Living Room and Dining Room Remodel Valuation: $
Existing building area: square feet Q
New building area: square feet ,
Z PROPERTY OWNER ❑ TENANT Number of stories:
Name: Jon and Loa Mize Type of construction:
-I
Address: 9092 Hill Street Occupancy groups:
City/State /ZIP: 97223
Existing:
Phone: (503)639 -2268 Fax: ( ) New:
(r.
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
4
Business name: John A. Stark Architect (Please refer to feeschedul
Structural plan review fee (or deposit):
Contact name: John Stark
FLS plan review fee (if applicable):
Address: PO Box 23215
k ,
Total fees due upon application: 6
City/State /ZIP: Portland/Oregon/97281 ��
Phone: (503) 544 -6840 Fax: : (503) 213 -6181
Amount received:
E -mail: jsbellaopus @msn.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Callmark Construction 1 ll� Submit two (2 • of roof plan with connection de •' s
and fire department . • ess, along with the 21 : I regon
Address: 10543 SW 80 Ave. Solar Installation Specia • ode ch- • st.
City/State/ZIP: Tigard /Oregon/97223 Permit Fee (includes .., = 'ew $180.00
Phone: (503) 3 17- and • strative fees):
( ) $SO'I 6g9 Fa x: (503) 946 -8488
State s - arge (12% of permit fee): $21.60
CCB lic.: / 35 5 /y �/ � A
� � Total fee due upon application: $201.60
Authorized signature: L &j This permit application expires if a permit is not obtained
v within 180 days after it has been accepted as complete.
Print name: John Stark 6 Date: 6 -Z� • 20 2 * Fee methodology set by Tri County Building Industry
Service Board.
I:\ Building \Permits\BUP- RESPermitApp.doc 02/24/2011 440- 4613T(11/02 /COM/WEB)
Electrical Permit Application 111 FOR OFFICE USE ONLY
Ili City of Tigard • � . >ateIB : 1 PermitNo.: �����a 610 d_ ■ •
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
III Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
II G A R D Inspection Line: 503.639.4175 9 2012 Date Ready/By: Inds: RI See Page 2 for
Internet: www.tigard- or.gov all OF Notified/Method: Supplemental Information
TYPE OF WORK t t 1) PLAN REVIEW
❑ New construction / , Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the 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
- 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 ", "l -2 ", "I -3 ",
Job no.: I Job site address: q e/ C I00HP or more. occupancy.
1 1 J f 0 Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: � __ ^^ ,n �f ❑ Health -care facilities. ❑ Supply voltage for more than
Ti t'it(v/ `� �i �/ El Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: tottvat_ �Hr-�r1SM� ❑ Service or feeder 600 amps or more.
1
FEE SCHEDULE
Cross street/directions to job site: k, t f _ i . t �-1.1. L �� /t Description I Qty. I Fee. I Total I •
� +v rv("'T New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family
residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation _
200 amps or less 100.70 2
C4PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: l'\ 0 *4 /% ' (Z L � —
� ` 601 amps to 1,000 amps 301.04 2
Address: LO `'7.■(,_1 , (lit. S - Over 1,000 amps or volts 552.26 2
Ci City/State/ZIP: Temporary services or feeders installation, alteration, and /or
h �L ��� 'D �� 2 Z 7 relocation
Phone: 15'c)3) G - 1 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: ' 0 A , 4 /1 . B. Fee for branch circuits without
`� � service or feeder fee, first 56.18 2
Contact name: (S'� 0 S 1 � branch circuit
i
Each add'! branch circuit 7.42 2
Address: Y D T5 C. x 2 '37 .(› Miscellaneous (service or feeder not included) F Each manufactured or modular
Ci h /State /ZIP: 9a�L.� D ce 2 6 l dwelling, service and/or feeder 67.84 Phone: (563 5 *I.-. g6 f o Fax :: (5-p-3 � � 3. 6 + f� ( Reconnect only 67.84
1111 Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: t C._k/ 1J ` 56 .. CL�772 -1 lam.., panel, alteration, or extension. Page 2 2
%----, • r Each additional inspection over allowable in any of the above
Address: it T q 9 t� �f } (,t/L 4.1,1,42.....„ Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: PoQT rJT 62 9 7 a17 Investigation (I hr min) 66.25/ hr
. _ t " - - Industrial plant (1 hr min) 78.18 / hr
Phone: (r' .6 p.q t b - _ I Fax: (5 ).3) d ....6,04i . ____, Inspections for which no fee is 90.00/ hr
specifically listed (% hr min)
CCB Lic.: 6 55 -5/ f Electrical Lic.: At r C:1 Suprv. Lic.: 3 co j ELECTRICAL PERMIT FEES
Subtotal:
Suprv. Electrician signature, required: Plan review (25% of permit fee): _
Print name Date: /t -- 2, State surcharge (12% of permit fee): _
A A�d�1,■ . �` = TOTAL PERMIT FEE:
Authorized signature: / / This permit application expires if a permit is not obtained within 180
Print name: i a Date: 8 tam . '26 ' Number of inspections •
days after has been accepted as complete.
allowed per permit.
I: \ Building \Permits'ELC- PermitApp.d, 47/01/10 440 4615T(II /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, 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
❑ HVAC
❑ Instrumentation
n 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
1:\ Building \Permits\ELC- PermitApp.doc 07/01/10