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Permit 1 V CITY OF TIGARD P.s® MASTER PERMIT III 4 ��% Permit __ ... --_____ _ #: MST20 00 13-0 COMMUNITY DEVEL TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2013 Parcel: 1 S135BD00500 Jurisdiction: Tigard Site address: 10855 SW 95TH AVE Subdivision: MEADOW VIEW Lot: 8 Project: Gertz Project Description: New duplex, addressed at 10855 & 10875 SW 95th Ave. 5/15/13, demo credits from BUP2013 -00061 applied to this permit. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 6 First: 1676 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 6 Second: 1822 sf Garage: 896 sf Front: 15 Smoke Dwelling Units: 2 Third: 0 sf Right: 5 Detectors: Yes Total: 3498 sf Value: $402,439.44 Rear: 15 PLUMBING Sinks: 2 Water Closets: 6 Washing Mach: 2 Laundry Trays: 2 Rain Drain: 2 Urinals: 0 Lavatories: 8 Dishwashers: 2 Floor Drains: 0 Sewer Lines: 200 SF Rain Storm Sewer: 200 0 Tubs /Showers: 6 Garbage Disp: 2 Water Heaters: 2 Water Lines: 200 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 2 Hose Bib: 4 Backwater Value: 2 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 8 Clothes Dryers: 2 Natural Gas Heat Pump: N Hoods: 2 Other Units: 0 Fum <100K: 2 Vents: 0 Woodstoves: 0 Gas Outlets: 8 Fum > =100K: 0 ELECTRIC Residential Unit Service Feeder ern D Srvc!Feeders 's Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 1) W/ Svc or Fdr: 0 Ea add! 500 sf: 7 201 -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 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 3498 Owner: Contractor: GERTZ FINE HOMES GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions) 19200 SW 46TH 19200 SW 46TH AVE 1 Ersn Cntrl 503 - 639 -4175 TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: PHONE: 503- 692 -3390 FAX: 503- 692 -5433 Total Fees: $18,380.02 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. Th e rules are set forth in OAR o 952 - 001 -0010 throug ' 9 e^- r 40•0. ou may obtain a copy of the rules or direct questions to OUNC by calling 503. 2.198 r 1.8 .332.2344. •"gi., / Issued By: I / /�_JEZ Permittee Signature: Call 503.639.4176 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. CITY OF TIGARD MASTER PERMIT ''1 3 ' . - COMMUNITY DEVELOPMENT Permit #: MST2013 -00048 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2013 Parcel: 1 S135BD00500 Jurisdiction: Tigard Site address: 10855 SW 95TH AVE Subdivision: MEADOW VIEW Lot: 8 Project: Gertz Project Description: New duplex, addressed at 10855 & 10875 SW 95th Ave. 5/15/13, demo credits from BUP2013 -00061 applied to this permit. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 6 First: 1676 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 6 Second: 1822 sf Garage: 896 sf Front: 15 Smoke Dwelling Units: 2 Third: 0 sf Right: 5 Detectors: Yes Total: 3498 sf Value: $402,439.44 Rear: 15 PLUMBING Sinks: 2 Water Closets: 6 Washing Mach: 2 Laundry Trays: 2 Rain Drain: 2 Urinals: 0 Lavatories: 8 Dishwashers: 2 Floor Drains: 0 Sewer Lines: 200 SF Rain Storm Sewer: 200 Drains: 0 Tubs /Showers: 6 Garbage Disp: 2 Water Heaters: 2 Water Lines: 200 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 2 Hose Bib: 4 Backwater Value: 2 Other Fixtures: 0 Drywell -Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 8 Clothes Dryers: 2 Natural Gas Heat Pump: N Hoods: 2 Other Units: 0 Furn <100K: 2 Vents: 0 Woodstoves: 0 Gas Outlets: 8 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc!Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add l 500 sf: 7 201 -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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 3498 Owner: Contractor: GERTZ FINE HOMES GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions) 19200 SW 46TH 19200 SW 46TH AVE 1 Ersn Cntrl 503 - 639 -4175 TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: PHONE: 503 -692 -3390 FAX: 503 -692 -5433 Total Fees: $18,380.02 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. ATTENTI N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001- 0 through 0 952 -r , -009* You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 °' or 1.800.332.2344. Issue f y: I� Alf tr Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection • ate. Thls 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 FOR OFFICE USE ONLY City of Tigard ri . 20 1 : Recei /, 11 14 13125 SW Hall Blvd., Tigard, OR 97223 201 ' Date /B ved e?-42 / Permit No.:�9rat4 j —a) v ( t � Plan Revie Phone: 503.718.2439 Fax: 503.598.1960 � '� .ate/ : 1 Other Permit: i 'O FTI atb. 2G1D/3 —000 -../ / T I GARD Inspection Line: 503.639.4175 B[�lLD1NG D ISl, 1 ' . ` 65 See Page 2 for Internet: www.tigard- or.gov �` l t ( v Supplemental Information • TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ,t] 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 Valuation: $ �1- and 2- family dwelling ❑ Commercial /industrial Z✓ 1 ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Z Job site address: / v ((JS?. f ? S-1-41 New dwelling area: . 3 square feet City/State /ZIP: Tigard OR 97224 Garage /carport area: 9 h square feet Suite/bldg. /apt. no.: Project name: Covered porch area: ! square feet 18'22_ Cross street/directions to job site: Deck area: square feet i(,s7L Other structure area: , .5cpo _ square feet 25 REQUIRED. DATA: COMMERCIAL -USE CHECKI4ST. Subdivision: Lot no.: $ Permit fees* are based on the value of the work performed. Tax map /parcel no.: S I 3 '� ,a DO ,s--� Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the ' - DESCRIPTION OF WORK work indicated on this application. Valuation: $ N- GL) kit Existing building area: square feet New building area: square feet X PROPERTY OWNER 0. TENANT Number of stories: Name: �h �' N�� i_ Type of construction: Address: / z� / �r�J Occupancy groups: City/State /ZIP: / —, �_ w � 0( 7 QO •Z_ Existing: Phone: ( ) (.9 2'2 31 O Fax: (7d 3) 6 ?L.-- 6/ 3 3 New: y� LICANT' . ❑ CONTACT PERSON • •�.' � ''` f-t• � BUILDING PERMIT FEES*''' ; , Business name: 6 A--(2— � e (Please refer ro. /ee schedule Structural plan review fee (or deposit): Contact name: .e ,.. t o -tZ_ FLS plan review fee (if applicable): Address: /1 2 — 51.J `/ Total fees due upon application: City /State/ZIP: - 77,,,,,b,.. e-, 6/1` 9 2 oC L . Phone: (563) 6./2. -33fa J Fax: (5 fL_3- y Amount received: E -mail -e.d✓ Q area cO ,Gvsy •7 PHOTOVOLTAIC SOLAR'PANDL SYSTEIVI:FEES* Commercial and residential prescriptive installation of CONTRACTOR. CFOR roof -top mounted Photovoltaic Solar Panel System. Business name: 6ut� , i e - p .,, y Submit two (2) sets of roof plan with connection details / y Z6� and fire department access, along with the 2010 Oregon Address: S Gci '�!( ' Solar Installation Specialty Code checklist. City/State /ZIP: -1-f---,‘, o2 1 ',7 4C y Permit Fee (includes plan revie $180.00 and administrative fees): Phone: ( 6,1:2 -3s 9lS Fax: (Sp3) (' p 2 - j Y 3 j State surcharge (12% of permit fee): $21.60 CCB lic.: /K 3 Total fee due upon application: $201.60 Authorized signature: — This permit application expires if a permit is not obtained i within 180 days after it has been accepted as complete. J>� �_ * Fee methodology set by Tri -County Building Industry P • rint name: 19(4,s—i6 l,� Date: 2 - Z Z- I 3 Service Board. I:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440 4613T(I I /02 /COM /WEB) Plumbing Permit Application RECEIVE)) Building Fixtures FOR OFFICE USE ONLI• FEB 2 6 2' 13 Received Permit No.: �0 3-0z) o �g City of Tigard Date/By: a- jc3-O / 3 �! • 13125 SW Hall Blvd., Tigard, OR 97223 TIG Plan Review Other Permit No.: C Phone: 503.718.2439 Fax: 503.598.1960 ®F at eBy: Inspection Line: 503.639.4175 BUILDING DWISI9gate ReadyBy: 1t g/ I ®See Page 2 far T I G A R D Internet: www.tigard II Notified/Method: f Supplemental Information - . TYPE OF WORK . ' FEE* SCHEDULE • For special information use checklist Tlew construction ❑Demolition Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) I CATEGORY OF, CONSTRUCTION SFR(I)bath L 312.70 437.78 • SFR (2) bath 1- and 2- family dwelling ❑ Commercial/industrial 500.32 SFR (3) bath ❑ 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: d Catch basin or area drain 18.76 Job site address: 1 , i; S dose ? 5 �y 44) s 4/ Drywell, leach line, or trench drain 18.76 City/State/ZIP: 71 y � O� • 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: 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: S1 p ez Backflow preventer 31.27 . Tax map /parcel no.: �� Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 25.02 / �� r c Dishwasher I 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 Expansion tank 12.51 Fixture /sewer cap • . " !WI, ERO* Y OWNIai' , l' . 0; TENANT 22.51 •� a Name: G ,,r{,_. c., ft- G 49-c, Floor drain /floor sink/hub 25.02 Address: / / . O a 1 k' C Garbage disposal 25.02 City/State/ZIP: t(A OA, ! 2o4 Hose bib 25.02 c D F ax: ( Sal) C 7 5 '(33) I maker 12.51 Phone : (s 3)G - 3d9 - 25.02 „ 1 . __m , , ' TJI�A�N'I'xr . _ -..• (�z � ©I'4TACT RER�QN -. ; i . • Interceptor /grease trap Medical gas (value: $ ) Page 2 Business name: c4-eZN. lsa.e... Primer 12.51 Contact name: K 6 , Roof drain (commercial) 12.51 Address: /9 2. Cr a 5 w �' 4'1 Sink/basin/lavatory i 25.02 City/State /ZIP: C { ,V ) /� 7 ) 06 L Solar units (potable water) 62.54 u- Q st t n 12.51 Phone: 663) 6 qZ ` 3 3 Q(0 I Fax: (5 03) 4 ` / - J 3 3 Tub /shower /shower pan Urinal 25.02 E -mail: /�,e Jt( 1. G CLG d GO on Water closet ( 25.02 ' . - •Ci OR •;` • ' . Water heater 37.52 Business name: x .... '(v E P t.4.4 4 r Address: P. o !� t y Water piping/DWV 56.29 n C ?, 7 ?'( t/ Other: 25.02 � 7 t City/State /ZIP: (,J e s f 4 iH O/Z. subtotal Minimum permit fee: $72.50 Phone: (563)3.'5'7 ' b p 5 -- Fax: ($ G 3 )�. `J6- 8242_ I Plan review (25% of permit fee) CCB Lic.: / 63 7 9 Z t I 2 11 Lk Plumbing Lic. no.: 3.25 pa , State surcharge (12% of permit fee) Authorized signature: - i i ( TOTAL PERMIT FEE Z Z _ /2 'J I This permit application expires if a permit is not obtained within 180 days Print name: ( /�! I Date: after been accepted as complete "Fee methodology y by set by Tri- County nty Building Industry Service Board. 1: 1BuildingtPermits \PLMU- PermitApp.doc 10/01/09 440- 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 . S uare'Footagei { • q R• Peir•,mit Footing drain - 1" 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 . 2,001 to 3,600 $169.69 Sewer - 1st 100' 62.54 3,601 to 7,200 $233.20 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Water Service - each additional 100' 37.52 Medical Gas Systems: Storm & Rain Drain - 1st 100' 62.54 Valuations . Permit.Fee: _ .. . Storm & Rain Drain - each additional 100' 37.52 $1.00 to $5,000.00 Minimum fee $72.50 $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 Inspection of existing plumbing or for and including $10,000.00. which no fee is specifically indicated 90.00/hr $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for (minimum charge - 1/2 hour) each additional $100.00 or fraction thereof, to Inspections outside of normal business 90.00/hr and including $25,000.00. hours (minimum charge - 2 hours) $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hour mini Fees 90.00/hr each additional $100.00 or fraction thereof, to and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 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 f Plumbing Installations ' Fixture.Typefor Replace/ Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. 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 " , • Car Wash Drain : . - . _ • Isonitetric or Diagram, . ' Garbage - Domestic-non -food ❑ Isometric or riser diagram is required for new buildings Disposal - Domestic-food related that meet the qualifications above. - Commercial -food related - Industrial -food related Ice Mach. /Refrig. Drains - Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lay - 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. gov /city_hal I/ departments /cd/docs /PLMF- PetmitApp2doc Mechanical 'Permit Application RECE : 1;012 OFFICE USE ONLY . . City of Tigard P -. eceived Date/By: ermit No.g&T ,50 / 3 - 0004g • 13125 SW Hall Blvd., Tigard, OR 97223 FEB : :-•' 201; Plan Review .1 . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: Inspection Line: 503.639.4175 I i G A R D CITY OF TIGARRESIMIll jurir SS See Page 2 for Internet: www.tigard-or.gov & BUILDING DIVIS Supplemental Information 1 ■ ....'.4-q,•-io :..• - .. . ' • • : COMMERCIAL FEE*. SCIIE1RTLE..-.-tRW,C.EtgROT",..:,t;:-1.. Me6hanical permit fees* are based on the of the work New construction 0 Addition/alteration/replacement • • performed. Indicate the value (rounded to the nearest dollar) of all Demolition . 0 Other: • mechanical materials, equipment, labor, overhead, and profit Value: $ ';d :.::.-..,:-','t::::- .-. ..- : .. -'' - -,. , .- -.-. • -- - -----, .:' -,,.-:.,---, - . -.. -"" -.. RESIDENTiALA*WhiE ix 1- and 2-family dwelling In Commercial/industrial 0 Accessory building For special information use checklist. - El Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total " Heating • 1,r ''S'''-'3 4 :ifOliAiiii:/I4EiiiiikkiliiiIfq: ei.nr,kidekt*) N ::i•.';:-:....:':"'- .. .. . . . . /og'5 - (, - ,r7 ' ' t...,) Job site address: . _ _ - 1 _ 5 _ I' . (requires site plan showing placement) 46.75 - ,„_, Furnace 100,000 BTU (ducts/vents) 2.. 46.75 City/State/ZIP: 7 ; 4 ci ,,,o 64 i Furnace 100,000+ BTU (ducts/vents) 54.91 ' Suite/bidg./apt. no.: Project name: Heat pump (requires site plan showing placement) - - 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system •• . 23.32 Residential boiler (radiator or hydronie) ".. - '' 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.: / 5 / 35- Z exi Sv Other fuel appliances: -- - ''':* -• - - ' . • - ..,',-- •,--:;',, ' ' - DESCRIPTION:•OF WORK'. - -, . - -.,- -•••• - -,,- • ",. ,,...- • ,: ,: • _ Water heater 7 23.32 Gas fireplace/insert 2- 33.39 /Va ei.) AtylOiteqC 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 :41 ';':':,-,ii..-s-,. : g . Chimney/liner/flue/vent - 23.32 2132 _ Name: G „ 2 , c 0 .1 si c- & (.6-•(... Environmental exhaust and ventilation: ,' 1 Address: / dy lab 5 ex-T 4zii... 4 - . Range hood/other kitchen- - equipment '- 7 33.39 City/State/ZIP: ."77,,,,( f, J ()/Z 5 ) d 6 2--- Clothes dryer. exhaust 2- 33.39 Single-duct exhaust (bathrooms, Phone: (Idi ) 4 2-33 -- 6 Fax: (5 )3 ) 49 2-- 5- y 3 3 toilet compartments, utility rooms) 6 23.32 . ,.,.A:. ,a' i...1,-ir,;-.; - ..-;. - i - j,,N-. 1 ' - ,7-15. 1 7.F.ii,k - o14,,,.;;11;,0,1;.ttc:ditT;:.--..:;.:'..'--,..:'i Attic/crawlspace fans. 23.32 ..:i. ,11 -114! ..t-:,.1 ...., --•'-'--- Other: 23.32 Business name: / c.„--( dd...J.1- d 4-4-r. Fuel piping: Contact name: A......c le..- 514.15 for first four; $4.03 for each additional Address: ' 7 xao 5 teC ''') Furnace, etc. Gas heat-pump City/State/ZIP: 77 OA f 7 Z._ Wall/suspended/unit heater- _ Phone: (SC? ) 5q 2.-4 3 Fax: : (c5 ) '1 5 4(?3 Water heater ''- Fireplace . 7.- E-mail: /C, „,,) e.,,,,^t o , cz1,00-t : "7.4! - ..,'::::!:;:;:',.?, - ip, B ar b ecue Business name: 6466 CM Cd sp. -6, ea 1 ;, Clothes dryer (gas) Oth . Address: / 0 , a szi.1681( er: City/State/ZIP: V4 i feesceu4A. I.J4. 1 g 2- ' . Subtotal Minimum permit fee ($90.00) Phone: (S03 ) 4 •s•. 622d Fax: (543 ) 4 56 - Z1f3 Plan review (25% of permit fee) CCB tic.: 4'2 57 1 State-surcharge (12% of permit fee) thorized TOTAL PERMIT FEE Au signature: / This permit application expires if a permit is not obtained within 180 • days after it has been accepted as complete. Print name: i iea- g„„e06,11. Date: 2. .2- 7-4 (3 • Fee methodology set by Tri-County Building Industry Service Board 1.11 4.ilelitymPermiti6r4EC-PermitAm.doe 03/07/12 440-4617T (11/02/COMAVEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information • Commercial & Multi-Family Fee Schedule: ta1ftbj Permit Fee • • . . $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I: \ BuildingTermits NEC-PemlitApp.doc 03/07/12 2 A' Electrical permit Application {� fp FOR OFFICE USE ONLY /L City of Tigard ° 6 20 a teBy: . ,A(0 ((; �( Permit No.: u aC) / 3 - DDUT . 13125 SW Hall Blvd., Tigard, OR 97223 . Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Cl °UPTTG /rat: ":y: Other Permit: T I G A R D Inspection Line: 503.639.4175 BALDING D I' ' eady/By: kris: ® See Page 2 for Internet: www.tigard- or.gov 1VIS: 'r.: fied/Method: VP Supplemental Information TYPE OF WORK • 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 0 Floating buildings. ' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural NI I- 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 ", "1 -2 ", "I -3 ", Job no.: Job site addre f 5S -fc) k7.5 w IOO or more residential R occupancy. � ` sr 0 or more residential units. ❑Recreational vehicle parks. City/State /ZIP: -.KJ ex- g 2 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE. SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 168.54 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion -7 33.92 1 Tax map /parcel no.: / 5 / 3 SJr3 n Uo rfeiv. Limited energy, residential 75.00 2 • DESCRIPTION, OF 'WORK ' • (with above sq. ft.) ' Limited energy, multi - family 75.00 2 H { residential (with above sq. ft.) . , Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 • 201 amps to 400 amps 133.56 2 �� PROPERTY OWNER ❑TENANT P P �� N `� 401 amps to 600 amps 200.34 2 Name: �Z t 601 amps to 1,000 amps 301.04 2 Address: // i g (� �/� ' 'S Over 1,000 amps or volts 552.26 2 � - Temporary services or feeders installation, alteration, and/or City/State /ZIP: / w , i ,[,� -e-, ,J 0/4... q 2 6 6 Z relocation Phone: (st ) 7 -33 C� Fax: (543 ) 6 `f . - 5 1‘33 200 amps or less f 59.36 1 4 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with above service or feeder fee - APPLICANT • •:. ❑. CONTACT PERSON: 7.42 2 each branch circuit Business name: G .. ,.. j ..F (4,,_e_ B. Fee for branch circuits without service or feeder fee, first ci Contact name: ` ` e w..) G L . w L branch circuit 56.18 2 ,( Each add'I branch circuit 7.42 2 Address: (y LrJt � et.) GV 4 Miscellaneous (service or feeder not included) City/State/ZIP: rC.,e L� t 00 0 � q Z 7' a dwelling, service and/or fe 6 eder 67.84 2 Phone: (563 ) C 72_ 3 3 dr b Fax: : (5(13) C Z • X ( 3 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: X side 'e.iiri...GO , 4-00•1 Sign or outline lighting 67.84 2 COt(i"PdR- Signal circuit(s) or limited- energy Business name: 3 k 14. i� �� e'� panel, alteration, or extension. Page 2 2 / Each additional inspection over allowable in any of the above Address: / 0 /O Cs r 22? C Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: 5; Sie.ft S (5X r7 ? v ! 7 Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( 3() ryf ., 72, (O Fax: ( ) Inspections for which no fee is 90.00/ hr specifically list ('/2 hr min) CCB Lic.: 13 2 . 2- - 2— Electrical Lic.: 3 r C Suprv. Lic.: iC `7 r ELECTRICAL. PERMIT, FEES // Subtotal: Suprv. Electrician signature, required: I/ �d� _ Plan review (25% of permit fee): .., - ifirl h Print name: 4.i Date: 2: - Z.,� / .. S tate surcharge (12% of permit fee): TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: �� � � Date: 2,.-2Z -� days after it has been accepted as complete. 00 • Number of inspections allowed per permit. I:\ Building\ Permits\ELC•PermitApp.doc 07/01/10 440- 4615T(Il /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* ET Heating, Ventilation and Air Conditioning System* Vacuum Systems* El 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 ❑ 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 I:\ Building \Permits\ELC- PermitApp.doc 07/01/10 0 " Building Division :1101111 Development Code Provision Review T I G A R D Residential Projects Building Permit No.: C / 3 - 0d d t t Project /Subdivision Name: (`fir I Z , Lot #: Site Address: (DS.S la 7 - 5— qS — CWS Service Provider Letter: Required: Yes ❑ No C3 Received: Yes ❑ No ❑ Plans Routed: Original Plan Submittal Date: c / 4' //. Routed By: 1St Revision Submittal Date: ❑ Site Plan Only Routed By: 2 Revision Submittal Date: ❑ Site Plan Only Routed By: To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (1) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review (contact {Ij1P.0 V O « at (503) 718- 2-42 or A ants P� @tigard- or.gov) J Li Land Use Case No. Zoning 2 ing R I2 S Front It' Rear IS Side S Street Side I Garage 20 Er Maximum Building Height: 35' Actual Building Height 2' E 'visual Clearance 0 Easements CV—Sensitive Lands Type: IDJ4 h((lb 101\l ' D S treet Trees C- Protected Trees Notes: Original Plan: Approved Not Approved ❑ Date: -7 21 - 7 I "/ Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 1: \CURPLN \Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13 IN _u •P, .. + Ir Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov) Actual Slope: 5 Notes: i 5 - fan= )W -4/ S �viN�� v Fdk. ¢� /3�i. L Original Plan: Approved ,0' Not Approved ❑ Date: 3(7/t Revision 1: Approved ❑ Not Approved`, Date: • Revision 2: Approved ❑ Not Approved ❑ Date: - - • ' • Permit Coordinator Review (contact Albert Shields at (503) 718 -2426 or albert @tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes No ❑ Date Routed to Building: _ _ 4 • Page 2 of 2 I: \C URPLN \Masters \Development Code Provision Review \DCPR_RES.doc Rev. 01/16/13 s A I ■ RECEI o:k) REMAIN VF ..,,-.... - .MAR 6 2013 '11111) E lo s Timo n rF E CITY OF TIGAR BUILDNG on/00N Elev. 202 L 10 . -0" L S 10 �� J , Elev. 205 Fr7::".........."."........"'".."74.24 / i= � `s� i Si /fp .IC; 6 L 1 L 1 1 -91 eIIIIIIMIIIIIII LP. � ,_ Elev. �o co 1 ?.1 i t I II 205.5 co i 1 I El E)OSS!NG HOUSE TO BE REM i 1 i� 205.5 i L 1 , , .. I _ 47 I v w I -o N I �w ^' 0 I Elev. 205 L N II 05 I i �° m I ' `, M 1 m 1 a) r..) . • ( : s s' 1 v , ..." ' N.) I A o � 30 �'• vNi f I ( M`' , t e w t 18 , ! •, �� I , , 1 CLUSTER 1 s 22 ( ,i �, g- :•Q `, ; I �_ � • , 20 ► . `r .. . f top, : ; . • `. /r �, • i 103.46' via" evod` 1 `— �� * ' MSTER` ; 20 t Elev. 204 � e< Gravel Drive cu `. Elev. • ;� Qo for Erosion \ `,` L 5' of Road Dedication • SW 95TH AVE 04MAR2013 KG SCALE : 1 ° = 20'� f �■ fl. A/( a4(49-}44.1., ww YASCO ACC UN C Y C F ,ES, we a NOT CIT OF TIGA , INFEalAllEtt IT IS THE SALE REEMNSBIL" a THE 1966 SW 95TH AVENUE no BUM TO VERIFY ALL SIE comma u+aUEOX ANY nU RAGED ON THE stE AND NDTDY THE tJk� - `�� -. ... OTTERS OF ANY PDTamAL fELD Yaa nCAlla+s 7 400 COL t E C T 1 0 N ALAN NASCORD DESIGN ASSOCIATES. INC. BY: KEN GERTZ 17x0 11.10N AK PCi1WD m xrlaP ( o � 007/7x101 PA% 007/1b -OY77 IRS /� 9,062 SO. FT FOR OFFICE USE ONLY — SITE ADDRESS: This form is recognized by most building departments in the Tri -County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City Of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT v Transmittal Letter T I G∎A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: (J�(. DAT d •_,. � ''''D DEPT: BUILDING DI ION MAR 5 2013 FROM: k, , e-r\ Gerh--- CITYOFTIGARD BUILDING DIVISION COMPANY: , PHONE: (09d-33 ° J u By: 2_ = i JAS" "?S RE: leer—to/ 5 0 'is Iku-t gs I ,p0/3— 0 9- 8 (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: I Description: 0 .6 Lr Copies: Description: )C Additional set(s) of plans. - S e..-I Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. • Basement and retaining walls. Beam calculations. Engineer's calculations. X Other (explain): s (-IC pc o v (Li co . e s) REMARKS: FOR O FI� E USE ONLY , :---- 4/k64. Routed to Permit Technician• Date: '3 12 7- 5C3 Initials: Fees Due: ❑ Yes 'No Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: (:\Building\ Forms\ TransmittalLetter- Revisions.doc 05/25/2012 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 10855 SW 95TH AVE, TIGARD, OR, 97223 Residential - Master Permit 335 Rain drain 06/07/2013 00:00 MST2013-00048 PASS Spoke with Mike White about location Of discharge 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 10855 SW 95TH AVE, TIGARD, OR, 97223 Residential - Master Permit 205 Footing 05/30/2013 14:00 MST2013-00048 PASS Site Development Erosion Control City of Tigard, Passed Ufer tag installed, yes Setbacks, front to footing on bldg driveway (25) Min, yes Setback, on side of bldg 11 8" as per plans, yes 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 10855 SW 95TH AVE, TIGARD, OR, 97223 Residential - Master Permit 210 Foundation walls 05/30/2013 14:00 MST2013-00048 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 10855 SW 95TH AVE, TIGARD, OR, 97223 Residential - Master Permit 205 Footing 05/30/2013 14:00 MST2013-00048 PASS Site Development Erosion Control City of Tigard, Passed Ufer tag installed, yes Setbacks, front to footing on bldg driveway (25) Min, yes Setback, on side of bldg 11 8" as per plans, yes 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 10855 SW 95TH AVE, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final 2014-04-07 00:00:00 MST2013-00048 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 10855 SW 95TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing final 2014-04-10 00:00:00 MST2013-00048 PASS Violation Summary: Inspector Contractor