Permit . I
CITY OF TIGARD Mr' jd`, MASTER PERMIT
Ill 2 .• rr COMMUNITY DEVELOPMENT Permit #: MST2012 -00285
Date Issued: 12/03/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S1 3/2012 500
Jurisdiction: Tigard
Site address: 13750 SW 118TH CT
Subdivision: CREEKSIDE PARK Lot: 5
Project: Inman
Project Description: Kitchen, master bath & half bath remodel; vault living room ceiling. 12/10/12: REPRINTED to add
(1) 200 amp service & (10) branch circuits. 12/11/12: REPRINTED to add (1) lay & (2) sinks.
BUILDING
Floor Areas Required Setbacks Required
Stories 1 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 Yes
Dwelling Units 0 Third 0 sf Right. 0 Detectors
Total 0 sf Value $25,000 00 Rear: 0
PLUMBING
Sinks 3 Water Closets' 0 Washing Mach 0 Laundry Trays 0 Rain Drain: 0 Urinals: 0
Lavatories* 1 Dishwashers: 0 Floor Drains 1 Sewer Lines: 0 SF Rain 0 Storm Sewer 0
Tubs /Showers: 0 Garbage Disp: 1 Water Heaters. 0 Water Lines' 0 Drains Catch Basins 0
Bckflw Prevntr 0
Footing Drain 0 Ice Maker 0 Hose Bib 0 Backwater Value' 0 Other Fixtures 0
Drywell- Trench Drain 0
Other Fixture Units.
MECHANICAL
Fuel Types Air Conditioning. N Vent Fans 1 Clothes Dryers 0
Heat Pump' N Hoods 1 Other Units 0
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' 1 0 -200 amp* 0 W/ Svc or Fdr 0
Ea add'I 500 st 0 201 -400 amp 0 201 -400 amp. 0 W/O Svc/Fdr 13
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 Secunty 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:
INMAN, DAVID S & CHERYL F OWNER Required Items and Reports (Conditions)
13750 SW 118TH CT
TIGARD, OR 97223
PHONE 503 - 201 -3683 PHONE
FAX.
Total Fees: $1,357.85
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 Not : -tion Center Those rules are set forth in OAR
952- 001 -0010 through R 952- 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calla' 13 232. 987 or 8 8
,■
Issued By: Permittee Signature: ....•-"'"
Call 603.639.4176 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.
Plumbing Permit Applicatio
Building Fixtures " r FOR OFFICE USE ONLY
C of Tigard DEC 1 1 2012 Received ;. ,_
Date /By A:2////4.2-- P Permit No ST 201 _ 00285 • 00285
a 13125 SW Hall Blvd , Tigard, OR 9722 OFT RD Plan Review
i a Phone: 503.718 2439 Fax: 503 598 I TV I 1 lJr TIG Date /By Other Permit No
T I G A R p; Inspection Line. 503 639.4175 B LDtNG DIVISION Date Ready/By lures l0 See Page 2 for
Internet: www.tigard - gov Notified /Method. Supplemental Information
TYPE OF WORK i FEE* SCHEDULE
❑ New construction El Demolition For special information use checklist.
Description I Qty I Ea Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION ∎ SFR (1) bath 312 70
® I - and 2- family dwelling ❑ Commercial /industnal SFR (2) bath 437 78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13750 SW 118 Ct Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City /State /ZIP. Tigard, OR 97223
Footing drain (no. linear ft . _ ) Page 2
Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03
Cross street /directions to job site: Gaarde Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no linear ft . _ ) Page 2
Storm sewer (no. linear ft _ ) Page 2
Water service (no. linear ft _ ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backtlow preventer 31 27
DESCRIPTION OF WORK Backwater valve 12 51
Clothes washer 25 02
Dishwasher 25 02
Drinking fountain 25 02
Ejectors /sump 25 02
Z PROPERTY OWNER I ❑ TENANT Expansion tank 12 51
Name: David Inman Fixture /sewer cap 25 02
Floor drain/floor sink/hub 25 02
Address: 13750 SW 118 Ct
Garbage disposal 25 02
City/State /ZIP: Tigard, OR 97223 Hose bib 25 02
Phone: (503)201 -3683 Fax: ( ) Ice maker 12 51
Z APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25 02
Business name:
Medical gas (value: S ) Page 2
Primer 12.51
Contact name: David Inman
Roof drain (commercial) 12 51
Address: 13750 SW 118 Ct r tnk/basin/lavator 3 25 02 75.06
City /State /ZIP: Tigard, OR 97223 Solar units (potable water) 62 54
Phone: (503) 201 -3683 Fax: : ( ) Tub /shower /shower pan 12 51
E -mail: inmanfs @aol.com Urinal 25 02
CONTRACTOR Water closet 25 02
Water heater 37 52
Business name: Water piping/DWV 56 29
Address: Other 25 02
City /State /ZIP: Subtotal 75.06
Phone: ( ) Fax: ( ) Minimum permit fee $72 50
CCB Lic.: Plumbing Lic. no.: Plan review (25% of pennit fee) //��
State surcharge (12% of permit fee) ry. C
Authonzed signature: '� TOTAL PERMIT FEE NE , d !•
Print name: .1 vI d rh kvi Date: � Z _ � _ i This permit application expires if a permit is not obtained within 180 days 2
after it has been accepted as complete.
*Fee methodology set by Tn- County Building Industry Service Board
1 \ Budd ingV Permits VPLMU- PermitApp doc 10 440- 4616T(10'02/COM /WEB)
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: : Permit Fee:
Footing drain - 1" 100' 50 03 0 to 2,000 $121.90
Footing dram - each additional 100' 37 52 2,001 to 3,600 $169.69
3,601 to 7,200 $233 20
Sewer - 1st 100' 62 54 7,201 and greater $327.54
Sewer - each additional 100' 37 52
Water Service - 1st 100' 62 54 Medical Gas Systems:
Water Service - each additional 100' 37.52
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 62 54 $1 00 to $5,000.00 Minimum fee $72.50
Stonn & Rain Drain - each additional 100' 37 52 $5,001.00 to $10,000.00 $72 50 for the first $5,000 00 and $1.52 for
Other Inspections or Fees Qty. Fee (ea) Total each additional $100 00 or fraction thereof, to
and including $10,000.00
Inspection of existing plumbing or for $10,001.00 to $25,000 00 $148.50 for the first 510,000.00 and $1 54 for
which no fee is specifically indicated 90 00/hr each additional $100 00 or fraction thereof, to
(minimum charge- 1/2 hour) and Including $25,000.00
Inspections outside of normal business 90 00/hr $25,001.00 to $50,000 00 $379 50 for the first $25.000 00 and $1 45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Remspection Fees 90 00/hr and including S50,000 00
Additional plan review for revisions 90 00/hr 550,001.00 and up S742 00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional $100 00 or fraction thereof
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * .
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Please check all that apply.
y g
Baptistry/Font
Bath Tub /Shower ❑ Any new commercial building with water service 2 and
Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash - Each Stall engineer.
- Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in OAR918- 780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040.
Eye Wash
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above.
-3"
4 Isometric or Riser Diagram
Car Wash Dram ❑ Isometric or riser s
diagram is required for new buildings
Garbage - Domestic- non -food g q g
Disposal - Domestic -food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach. /Refng Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav - Non -food related
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures
http://www.tigard-or.govicity_hall/departments/cd/docs/P LM F -Perm ttApr2doc
I e O
CITY OF TIGARD /a /0 MASTER PERMIT
g''-- COMMUNITY DEVELOPMENT Permit #: MST2012 00285
Date Issued: 12/03/2012
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 2S103CD07500
Jurisdiction: Tigard
Site address: 13750 SW 118TH CT
Subdivision: CREEKSIDE PARK Lot: 5
Project: Inman
Project Description: Remodel kitchen -new cabinets; vault ceiling in living room and new vanities in Master Bath and
1/2 bath. 12/10/12: REPRINTED to add (1) 200 amp service and (10) branch circuits.
BUILDING
Floor Areas Required Setbacks Required
Stories 1 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 $25,000 00 Rear 0
PLUMBING
Sinks 1 Water Closets 0 Washing Mach 0 Laundry Trays 0 Rain Drain 0 Unnals 0
Lavatories 0 Dishwashers 0 Floor Drains 1 Sewer Lines 0 SF Rain Storm Sewer 0
Tubs /Showers 0 Garbage Disp 1 Water Heaters 0 Water Lines 0 Drains 0 Catch Basins 0
Bckfiw 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 1 Clothes Dryers' 0
Heat Pump N Hoods 1 Other Units 0
Fum <100K• 0 Vents 0 Woodstoves 0 Gas Outlets 0
Fum > =100K 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less 0 0 -200 amp 1 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 13
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:
INMAN, DAVID S & CHERYL F OWNER Required Items and Reports (Conditions)
13750 SW 118TH CT
TIGARD, OR 97223
PHONE 503 - 201 -3683 PHONE
FAX
Total Fees: $1,273 79
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 ss nce, or rf work is suspended for more the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notif ation Ce r 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 calla 5 3 2 2 1 or 1 2 2344
Issued By: `Y Permittee Signature: �
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.
Electrical Permit Application RECEIVED FOR OFFICE USE ONLY
71 City of Tigard Received /0 � Permit No.: MST2012 -00285 • 13125 SW Hall Blvd , Tigard, OR 97223 C 1 0 2012 Plan Review
C Phone 503 718 2439 Fax: 503.598.1960 Date /B : Other Permit.
TIGARD Inspection Line: 503.639.4175 Crri OF TIGARD Date Ready /By. Juns ® See Page 2 for
Internet: www.tigard- or.gov BUILDINGDIVIS Notified /Method• Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /hems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Mannas 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 of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately denved system
❑ Addmon of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: 13750 SW 118 th Ct I00HP or more. occupancy.
❑Six or more residential units ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name: Inman Remodel ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Gaarde to 118th 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
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. II.)
Limited energy, multi- family 75.00 2
/-b..6. 1770'V ffL E'LCC7'/� e 9 L 1 residential (with above sq. ft.)
,�," / Services or feeders installation, alteration, and/or relocation
f�
e - ,x/66 op ew f}-CTZJ7 f4 3 /y f/ w� 200 amps or less f 100.70 100 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: David Inman 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 13750 SW 118' Ct Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
h g relocation
Phone: (503)201 - 3683 Fax: ( ) 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
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 ❑ CONTACT PERSON above service or feeder fee, � 7.42 71i, Le 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56 18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Ci /State /ZIP: Each manufactured or modular 67.84 2
h dwelling, 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 limited - energy
Business name: 9Herrh £ L e' I Z i L Lc panel, alteration, or extension. Page 2 2
G am - Ea additional inspection over allowable in any of the above
Address: Poe /3 6S 7 Additional inspection (I hr min) 66.25/ hr
City/State /ZIP: S,qL eve g 730?
Investigation (1 hr min) 66.25/hr
Q Industrial plant (I hr min) 78.18/ hr
Phone: (01 ) g _ 96 Fax: ( .03) 3 75 _9%2.9 %1 9 Inspections for which no fee is 90 00/ hr
J specifically list (%z hr min)
CCB Lic.: 19 2,11 Electrical Lic.: ,L ) 4 ' Suprv. Lie.: 32? - 5 ELECTRICAL PERMIT FEES
Y 'X' 10 I jr: Subtotal /71430 ,/
Suprv. ctr an signature, required: o
/� � Plan review (25% of • permit fee): �+
Print name: RP 6 1-- V `.- Date: IL _t, - i Z State surcharge (12% of permit fee): 2,Q . 7 p
TOTAL PERMIT FEE: /et . 7 te
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Date: • days after it has been accepted as complete.
Number of inspections allowed per permit
I \ Building \ Permits \ELC- PermiApp doe 07/01/10 440- 4615T(I I /05 /COM /WEB
Eltctrical 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:
n 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
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 \Buddmg \Permns \ELC- PermuApp doc 07/01/10
RECEIVED
DEC 10 2012
CITY OF TIGARD
BUILDING DIVISION
TO: CITY OF TIGARD
RE: PERMIT #MST2012-00285
Per your request, attached is the updated electrical permit application. In addition to the work I included
in the original permit application, I hired a sub - contractor (Photo Electric) to upgrade my existing panel
and add 10 branch circuits with it. The attached application was completed and signed by Photo Electric.