Permit q CITY OF TIGARD MASTER PERMIT
; � 1 2 COMM DEVELOPMENT Permi #: MST2013 00052
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/07/2013
Parcel: 1 S 133DA05900
Jurisdiction: Tigard
Site address: 12940 SW GLACIER LILY CIR
Subdivision: AMART SUMMER LAKE Lot: 81
Project: Shanks
Project Description: Move patio door and vent microwave hood.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 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: $2,500.00 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: 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: 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: 0
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:
SHANKS, MARKS & MARY M GARDEN HOME INTERIORS Required Items and Reports (Conditions)
12940 SW GLACIER LILY CIRCLE 8409 SW 57TH AVE
TIGARD, OR 97223 PORTLAND, OR 97219
PHONE: PHONE: 503 - 780 -4010
FAX:
Total Fees: $313.01
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 ' • = •• • - . - 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. ' TTENTION: Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95. 001 -0010 through OAR 952 00•'•u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I sued By: L Aihres.a.sia4.A Permittee Signature: di i/ / / / . / /
.--------r Call 503.639.4175 by 7:00 a.m. for the next available inspection da =.
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.
Building Permit Application
Residential HECE FOR OFFICE USE ONLY
City of Tigard Received i 9 Per No.: ��
1114 . ° 13125 SW Hall Blvd., Tigard, OR 97223 Pl Review I 7 � I
Phone: 503.718.2439 Fax: 503.598. l9t E B 2 8 2013 DateBy: (ilk :.i 7 1 Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: / ` luris ®See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: 3( L, L �f Supplemental Information
BUILDING D VISIOr " °oICe__ c.) ( /-149-LNA
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction . • ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rowded 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.
® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $2,500.00
❑ Accessory building ❑ Multi - family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: 2
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 12940 SW Glacier Lilly Circle New dwelling area: square feet
City /State /ZIP: Tigard, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Mary Shanks • Covered porch area square feet
Cross street/directions to job site: Off Scholls Ferry Rd. Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
. - DESCRIPTION-9F, WORK work indicated on this application.
Move patio door Valuation: S
Existing building area square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Mary Shankds Type of construction:
Address: 12940 SW Glacier Lilly Circle Occupancy groups:
City /State /ZIP: Tigard, Oregon 97223 Existing:
Phone: (503)590 -8298 Fax: ( ) New:
® APPLICANT , • ❑ CONTACT PERSON BUILDING PERMIT FEES*
- (Please refer to fee schedulee)
Business name: Garden Home Interiors
Structural plan review fee (or deposit):
Contact name: Morris Fletcher
FLS plan review fee (if applicable):
Address: 8409 SW 57' Ave.
City /State /ZIP: Portland, Oregon 97219 Total fees due upon application: (/
Phone: (503 -7) Fax:: ( ) Amount received: f 7 7. 5-"
E -mail: billtletcher860 @gmail.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR;_ roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Garden Home Interiors Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 8409 SW 57' Ave. Solar Installation Specialty Code checklist.
City /State /ZIP: Portland, Oregon 97219 Permit Fee (includes p lan review $180.00
and administrative fees):
Phone: (503) 780 -4010 Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: 162912 is la-S 114
Total fee due upon application: $201.60
Authorized signature: N A , , F /1 •
This permit application expires if a permit is not obtained
�WKl �iJ within 180 days after it has been accepted as complete.
Print name: ii , t - L G. Date:
* Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(1 I /02 /COM /WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
CI of Ti and ' . Received Q e
` g � 201
Date/By: �}�� Permit N o.: M /r� i 3 - a , „� M
11111 - 4 1 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 MAR H� 7 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard- or.gov ary (F T1G � 1RD Notifted/Method: Supplemental Information
TYPE OF i] ,DING DW1 / COMMERCIAL FEE* 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: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 12940 SW Glacier Lily Circle (requires site plan showing placement) 46.75
City /State /ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Shanks Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Scholls Ferry Rd. Duct work 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
Vent microwave hood Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
® PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Mary and Mark Shanks Environmental exhaust and ventilation:
Address: 12940 SW Glacier Lily Circle Range hood/other kitchen �(
equipment ,` 33.39
City /State /ZIP: Tigard, Oregon 97223 Clothes dryer exhaust 33.39
Phone: Single -duct exhaust (bathrooms,
hone: (503 - )590 -8298 Fax: ( )
toilet compartments, utility rooms) 23.32
Z APPLICANT ❑ , CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Garden Home Interiors Other: 23.32
Fuel piping:
Contact name: Morris Fletcher $14.15 for first four; $4.03 for each additional
Address: 8409 SW 57 Ave. Furnace, etc.
Gas heat pump
City /State /ZIP: Portland, Oregon 97219 Wall /suspended/unit heater
Phone: (503) 780 -4010 Fax: : (503) 292 -6660 Water heater
Fireplace
E -mail: bill @gardcnhomeinteriors.com Range
CONTRACTOR Barbecue
Business name: Garden Home Inteiors Clothes dryer (gas)
Other:
Address: 8409 SW 57 Ave. MECHANICAL PERMIT FEES*
City /State /ZIP: Portland, Oregon 97219 Subtotal d
Phone: (503) 780 -4010 Fax: (503) 292 -6660 Minimum permit fee ($90.00) nit, C
Plan review (25% of permit fee)
CCB lie.: 162912 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
/14(„ 9 t F...1( days after it has been accepted as complete.
Print name: Morris Fle cher Date: 3/7/2013 * Fee methodology set by Tri- County Building Industry Service Board
1.\Building\Permits\MIOC- PermitApp.doc 03/07/12 440 -4617T (11 /02/COM/WEB)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12940 SW GLACIER LILY CIR, TIGARD, OR,
97223
Residential - Master Permit
699 Mechanical final
05/01/2013 00:00
MST2013-00052
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12940 SW GLACIER LILY CIR, TIGARD, OR,
97223
Residential - Master Permit
699 Mechanical final
05/01/2013 00:00
MST2013-00052
PASS
Violation Summary:
Inspector Contractor