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Permit CftY O TIGARD MASTER PERMIT F PERMIT #: MST2003 -00440 1it DEVELOPMENT SERVICES DATE ISSUED: 8/19/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13267 SW WOODSHIRE LN PARCEL: 2S104DC -08600 SUBDIVISION: MORNINGSTAR ZONING: R - 4.5 BLOCK: LOT: 023 JURISDICTION: TIG REMARKS: Addition of chimney for a gas fireplace tied to existing chimney for gas fireplace in story above. New fireplace installed under MEC2003- 00498. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: OTR HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 Two sf RIGHT: VALUE. 2,000 00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 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 < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: W000STOVES: 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• 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 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: $ 158 This permit is subject to the regulations contained in the VORWALLER, DOUGLAS F + MR HANDYMAN WESTSIDE Tigard Municipal Code, State of OR. Specialty Codes and KARYN A 18988 SW SHAW all other applicable laws. All work will be done in 13267 SW WOODSHIRE LN BEAVERTON, OR 97009 accordance with approved plans. This permit will expire if TIGARD, OR 97223 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 - 524 - 3154 Phone: 503 236 - 6000 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg #: LIC 146726 may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. REQUIRED INSPECTIONS Electrical Rough In ' Framing Insp Electrical Final C ' . ±, ' " �/ Permittee Signature • (10.--, ' Call (503) 639 -4175 by 7:00 ' p.m. for an inspection needed/the ne t business day . • Buildin Per n FOR OFFICE USE ONLY <- fd Building 1 DateB Received y ? ® Permit No.: � 5 , 1 003 Date/By No City Tigard Ti and Planning Approval Other ' 13125 SW Hall Blvd. AUG Plan Review Other Tigard, Oregon 97223 DateDate/By: f e\.,-,/ I - / K - G Permit No.. Phone: 503-639-4171 Fax: ` Rp G >,.. ► Post /By. w Land Use E -+, . Date/By. Case No Internet: www.ci.tigard.t c Contact Juns ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Method Supplemental Information x' 05/ @' - 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 4 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. Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation $ 7 0cc) 6 ± X JOB SITE INFORMATION and LOCATION ' No. of bedrooms: No. of baths. ' Job site address: )3 Z 6 7 sw 1,✓0 Jq,ti-e Total number of floors Suite #: Bld /A t. #: New dwelling area (sq. ft.) g p 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.) ......................... REQUIRED DATA : COMMERCIAL - USE CHECKLIST Subdivision: Lot #: Tax map /parcel #: 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, Rt..; kvcQTr, .. ) S overhead and profit for the work indicated on this application. t � � r /in j '� the ev,a r M wi // / I li e. I JP (.9v n /)m Amuse �� , 5+4 // Valuation $ I 1 Existing building area (sq ft.) © , re p C.42 - I , as ,,' e , - evilstisi New building area (sq. ft.) P?re phmee oh i"ta .%ova - D' +e /QC±NC - Fay Number of stories . PItOPERTY,OWNER - ❑ T NANT Type of construction �j Occupancy group(s): Existing. ame: D �lmr Keg Il-� Address: New: City/State /Zip: Phone: 5 53'3j Fax: NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under ❑ APPLICANT' ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: seiVo w h •e t- jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing, the following reason applies - Address: City /State /Zip: Phone: Fax: - E -mail: BUILDING PERMIT FEES* . . Please refer to fee schedule. • CONTRACTOR - - Business Name: fi„ a ,, / o y Fees due upon application.. ... ........ $ J Address: $ q $ ' 514 4 w City/State /Zip: 4 /o 4 a o R q 70"c'7 Amount received........ $ Phone: 5o 9, 6 -2, 5743Fax: 503, 64 2, 530¢ Date received. CCB Lic. #: 4c• 7 2 6 Authorized n 311543 Signature: �[/ Date: Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. D 01 Oi•w / Q 6 1`� *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) / 9J Y. i.\ Dsts \PermitForms\BldgPerrnitApp.doc 01/03 /17 / �� � )� 1 Q b p@ C�C �/1 ?��QI / i 4 a �� ✓ i C oul c o r f / / Y Cc 13 # 665"78- • One- and Two - Family Dwelling 11 Building Permit Application Checklist Reference no Associated perrruts: City of Tigard City of Tigard `J g ❑ Electrical ❑ Plumbing ❑ Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other Phone: (503) 639 -4171 ' Fax: (503) 598 -1960 TIIE 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 ❑ plan O permit required. Include drainage -way protection, silt fence design and location of catch -basin protection, etc. 10 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. 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 A plication , , FOR OFFICE USE ONLY Received Electrical 4,d `Y `/0 A El ' J C Date/By: t / S 0 Perini t No H `7Tj}Q0 J City of T1 (CE V ` Planning Approval Sign Date/By: Permit No : 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 972 NG 15 2003 Date/By. Permit No.: Phone: 503- 639 -41 Fax: 503-568- 1960 Post- Review Land Use Internet: www.ci.ti Q� G11 Date/By: Case No.. 24 -hour InS ec `' Contact Juns. Su See Page 2 for P Name/Method: Supplemental Information. TYPE OF WORK _ - PLAN REVIEW (Please check all that apply) • New construction ❑ Demolition ❑ Service over 225 amps- ❑Health raze facility El Addition/alteration /replacement ❑ Other: commercial ❑ Hazardous location ❑ Service over 320 amps -rating of El Building over er 10 10, ,000 square feet, 'CATEGORY OF CONSTRUCTION , I & 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 stones ❑ Feeders, 400 amps or more El Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park El Master Builder El Other: ❑ Egress/lighting plan ❑ Other: JOB SITE INFORMATION and LOCV ION Submit _ sets of plans with any of the above. 326 7 s 7 The above are not applicable to temporary construction service. Job site address: wOo d . FEE* SCHEDULE - Suite #: Bldg. /Apt. #: Number of inspections per permit allowed Project Name: Description Qty Fee (ea.) Total New residential- single or multi- family per I Cross street/Directions to job site: dwelling unit. Includes attached garage. Service included: 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: I Lot #: Limited energy, residential 75.00 2 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 AA i � Services or feeders - installation, of f` 1 ti o ( P f1 I) /m t Q alteration or relocation: 200 amps or less 80.30 2 fa ti 51A, 8115 +9 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 IS PROPERTY OWNER I ❑ TENANT: , ' . • 601 amps to 1000 amps 240 60 2 D Over 1000 amps or volts 454.65 2 Name: o u 1 V }'. W cio [ (s Reconnect only 66 85 2 Address: Temporary services or feeders - installation, alteration, or relocation: City /State /Zip: 200 amps or less 66 85 1 Phone: 5o3, 524,8154- Fax: 201 amps to 400 amps 100.30 2 ❑ APPLICAN Branch ' ❑ CONTACT PERSON n ch h amps 133.75 2 circuits circuits -new, alteration, or Name: extension per panel: Address: A . Fee for branch circuits with purchase of 6.65 2 service or feeder fee, each branch circuit City /State /Zip: B. Fee for branch circuits without purchase of / 46.85 ic • 6 ( 2 service or feeder fee, first branch circuit Phone: Fax: Each additional branch circuit 6 65 2 E -mail: Misc (Service or feeder not included): CONTRACTOR Each pump or imgation circle 53.40 2 Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, Business Name: c e W --k o w h �� alteration, or extension Page 2 2 Description. Address: City/State/Zip: Each additional inspection over the allowable in any of the above: y p Per inspection per hour (min 1 hour) 62 50 Phone: Fax: Investigation fee CCB Lic. #: Lic. #: Other. ElectricalPermit Fee's* . Supervising electrician Subtotal $ </6, • g ` signature required: Plan Review (25% of Permit Fee) $ Print Name: Lic. #: State Surcharge (8% of Permit Fee) $ S • 7 TOTAL PERMIT FEE $ SO , (,o d Authorized Notice: This permit application expires if a permit is not obtained within Signature. Date. 15 /O 3 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. ) &v. VO1` e -1 k) - (Please pnnt name) 1 \Dsts\Permmit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard ti Page 2 - Supplemental Information • e. �1 d' LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: El Audio and Stereo Systems Burglar Alarm ❑ Garage Door Opener 0 Heating, Ventilation and Air Conditioning System Vacuum Systems ❑ 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 El Clock Systems 0 Data Telecommunication Installation ❑ Fire Alarm Installation HVAC n Instrumentation Intercom and Paging Systems Landscape Irrigation Control * . Medical Nurse Calls ❑ Outdoor Landscape Lighting • Protective Signaling Other Number of Systems * No licenses are required. Licenses are required for all other installations • i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 3 - 00 L.L 2j INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested g' AM PM BUP Location 13 2 —(07 W Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/ ELC Footing g i 5- ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: .n ' SIT Post & Beam W �i t U 14)1 A I WC Shear Anchors Ext Sheath/Shear � 7` ? -/29' '-' ' Mor fw J SINt - Int Sheath/Shear Framing Insulation Drywall Nailing • Firewall Fire Sprinkler .•,' do ' '. Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL • PLUMBING 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 I" Low Voltage Fire Alarm fit - � 44 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. �`�' PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date i • .P-P j 03 Inspector : — Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour , BUILDING Inspection Line: 9-4175 trA Do cfi f INSPECTION DIVISION Business Line: 639 -4171 BUP Received Date Requested ? °?� AM � M BUP Location 3 24 W /I 7 bt- B-e6a— k4)1, k Suite EC – 0 0 q `7 1 Contact Person Ph ( ) GO .3 ' ay � Contractor Ph ( ) SWR BUILDING Tenan • -) S d- 4 — 'f5'f ELC Footing D ELC Foundation Access: �,, Cr l Drain ELR e d 1 I_ �_ Crawl Drain ` 1� Slab Inspection Notes: SIT Post & Beam Shear Anchors Int Ex S Sheath/Shear Sh- l�Zi // Int h -th/Shear AS /3? ing h��/� • - on / e c-" Ole__ Drywall Nailing r Firewall Fire Sprinkler Fire A - ,� larm � �i� ��e Susp'd Ceiling , Roof F,vI,_P&.&z ((Y ,i A ( .r d anal PASS (PART FAIL Ctj �jL / S- / 6 A g" v PLUMBI NG; Post Beam - "` Q Ze -- - -/ Under Slab / Rough -In Water Service ��- Sanitary Sewer Rain Drains \ Catch Basin / Manhole e . iN S _ ,z p, F Storm Drain C Shower Pan ���<., I YI . Final HANIC , L Post & Beam (106 _ �� ��-®v f ...(.4. Rough -In )(L.—LS moke Dampers ii ge V V d ) .\ UUU ASS PART FAIL RICAL Service U ab I V 1 U -In L i Low Voltage (t C Fire Alarm final ,, _ 51 ,,,, Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. M , S ' .E ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 0A7O J Inspector - Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING, Inspection Line: (503) 9 -4175 . IQ 3 OO 4'0 INSPECTION DIVISION Business Line: (50 171 BUP Received Received Date Requested o 2 7 AM PM 3561 BUP Location ( 3 Zce w 0 d Suite _ 3 C d Contact Person Ph ( ) PLM Contractor Ph ( ) SWR UILD Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear �l Framing Insulation , Drywall Nailing r 1 _ /— Firewall / t Fire Sprinkler Fire Alarm , Susp'd Ceiling Roof Ot • • SS PART FAIL • - f BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final 4 ANI FAIL C Post & Beam ✓/� Rough -In Gas Line S Dampers FA PART FAIL 'J RICAL Service Rough -In • UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Date / . Approach/Sidewalk V-Z-7 ` c Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL