Permit CITY OF TIGARD MASTER PERMIT
NI C COMMUNITY DEVELOPMENT Permit #: MST2013 -00113
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2013
Parcel: 2S102BC01807
Jurisdiction: Tigard
Site address: 10360 SW WALNUT ST
Subdivision: NORTH TIGARDVILLE ADDITION Lot: 26
Project: Thomas
Project Description: Convert existing attached garage to habitable space. Approximately 420 square feet.
BUILDING
Floor Areas Required Setbacks Required
Stones: 0 Bedrooms: 0 First: 420 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:
Total: 420 sf Value: $36,443.40 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
Other Fixtures: 0
Drywell- Trench Drain: 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
Fum > =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: 1
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 -3 420
Owner: Contractor:
THOMAS, MARC C & CAROL A OWNER Required Items and Reports (Conditions)
10360 SW WALNUT ST
TIGARD, OR 97223
PHONE: 503- 639 -9022 PHONE:
FAX:
Total Fees: $1,474.92
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 -0010 through : • - - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344.
Issued By: 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.
`-' vI v IUIVry
Building Permit Application
Residential RECEIV FOR OFFICE USE ONLY
Cit of Tigard Received Permit No.:
y g Date : 5 e ii. t T - .„
13125 SW Hall Blvd., Tigard, OR 97223 MAY 0 8 2013 Plan RevietG
C ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T 1 G A Ii D Inspection Line: 503.639 CITY Date Ready / fan ® s: See Page 2 for
Internet: www.tigard- or.gov TIGARD Noti� d: �� �� "y Supplemental Information
BUILDING
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 (rounded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, 1. - ' . . bor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work tcated on this app i s , .
V. uation:3 1 ' ,
® I- and 2- family dwelling ❑ Commercial/industrial I 4 'La
ID Accessory building ❑ Multi- family umber of sedrooms:
❑ Master builder ❑ Other: Nu .: • .. , s' .
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10360 SW Walnut St New dwelling area: 4 2 5 square feet
City /State /ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Thomas Garage Conversion Covered porch area: square feet
Cross street/directions to job site: Corner of Walnut & Pathfinder Ct. 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.: 2S102BC 01807 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.
Convert existing 2 -car garage into habital living space for Bonus Rm/Family Room Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I El TENANT Number of stories:
Name: Marc & Carol Thomas Type of construction:
Address: 10360 SW Walnut St. Occupancy groups:
City /State/ZIP: Tigard, OR 97223 Existing:
Phone: (503)639 -9022 Fax:( ) New:
® APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
I_PrIJ S '10 RPtW 14 $ Y (Please refer to fee schedule)
Business name: Structural plan review fee (or deposit):
Contact name: Marc & Carol LE 1:>A1-1 t
FLS plan review fee (if applicable):
Address: 10360 SW Walnut St.
City /State /ZIP: Tigard, OR 97223 up 3ct 3 3 p • Cc 4 Total fees due upon application:
Phone: (503) 639 - 9022 Fear : (603) 2.0c1- 88 6q Amount received: / _ AO ,
E -mail: ktglirrkeertSNIOrtir. PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: by Homeowner Submit two (2) sets of roof plan withection details
and fire departmes access, alo • ith the 2010 Oregon
Address: Solar Installation Spec!, • .' ode checklist.
Permit Fee (in ..es plan ev
City /State /Z1P: a • .dministrative fees): $180.00
Phone: ( ) I Fax:( )
States • arge (12% of permit fee): ''.., $21.60
CCB lic.: Total fee due upon application: $201.60
Authorized signatureyr La,,,,,E.---eiL - .g„_ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
r , , hom _ 1 * Fee methodology set by Tri- County Building Industry
Print nam �� �tJ Date: 5/8/13 Service Board.
l:\ Building \Permits\BUP -R ESPermitApp.doc 02/ 24/2011 440- 4613T( I 1 /02 /COM/WEB)
Mechanical Permit Ap 1 ' u ,,, FOR OFFICE USE ONLY
4di City of Tigard F DateBy I 3 t� Permit No.: tSr0 6 l t
li p l 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 Phone: 503.718.2439 Fax: 503.51006°0 8 2013 Date/By: Other Permit:
T I G n R D Inspection Line: 503.639 Date Ready/By: tans:
Internet: www.ti and -or. ov TIGARD S upplemental Information
See Page 2 for
g g CITY n Notified/Method: Supplemental
OF W O RK 11`f�SIV� 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
El 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 I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
Air conditioning 46.75
Job site address: 10360 SW Walnut St. Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 61.06
Suite/bldg. /apt. no.: Project name: Duct work 23.32
Cross street/directions to job site: Corner of Walnut & Pathfinder Ct. 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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map /parcel no.: 2S102BC 01807 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Add heating duct vent for conversion of existing 2 -car garage into habitable fireplace 23.32
living space.
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney /liner /flue/vent 23.32
® PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Marc & Carol Thomas Range hood/other kitchen
equipment 33.39
Address: 10360 SW Walnut St. Clothes dryer exhaust 33.39
City /State/ZIP: Tigard, OR 97223 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: (503)639 -9022 Fax: ( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: - 23.32
Fuel piping:
Business name:
$14.15 for first four; $4.03 for each additional
Contact name: Marc & Carol Thomas Furnace, etc.
Address: 10360 SW Walnut St. Gas heat pump
Wall/suspended/unit heater
City /State/ZIP: Tigard, OR 97223 Water heater
Phone: (503) 639 -9022 Fax: : ( ) Fireplace
Range
E -mail: Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: Owner Installation Other:
MECHANICAL PERMIT FEES*
Address: c�
Subtotal ! � .00
City /State/ZIP: Minimum permit fee ($90.00)
Plan review (25% of permit fee) (Q. TO
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee)
CCB lic.: TOTAL PERMIT FEE /DO .0
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature - • Fee methodology set by Tri- County Building Industry Service Board
Print na Lrc 1J �- C r I Date: 518 /13
I:\Building\Permits MEC_PermitApp_040113.doc 440 -4617[ (I 1/02 /COM/WEB)
Electrical Permit Applicatio ECEIVED FOR OFFICE USE ONLY
0 8 2013 Received
City of Tigard MAY IATl
- Permit No.: n ,, 2
DateB � �' I r S T " o�� 3 �' o0
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.59 DateB : Other Permit:
Inspection Line: 503.639.4175 ` �� TIGARD Date Ready /By: Juris: El See Page 2 for
T I G A R D RUILDMI" �'rt'D ^r ^° ° N otified/Method: Su lemental Information
Internet: www.tigard- or.gov PP
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 ❑ 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 of 75 KVA or
JOB SITE INFORMATION AND LOCATION
El Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 "I -3 ",
Job no.: Job site address: 10360 SW Walnut St. IOOHP or more. occupancy.
['Six or more residential units. ❑ Recreational vehicle parks.
City /State/Z1P: Tigard, OR 97223 ❑ 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: Corner of Walnut St & Pathfinder Ct. Description I Qtv. I Fee. 1 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
Ea. add'I 500 sq. ft. or portion 33.92 l
Tax map /parcel no.: 2S102BC 01807 Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75'00 2
Limited energy, multi - family
75.00 2
Add plugs for conversion of existing 2 -car garage into habitable living space residential (with above sq. ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
IS PROPERTY OWNER 1 ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: Marc & Carol Thomas 401 amps to 600 amps 200.34 2
Address: 10360 SW Walnut St. 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
Phone: (503)639 -9022 Fax: ( ) relocation
200 amps or less 59.36 l
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
Owner signature:)( Date: Branch circuits — new, alteration, or extension, per panel
® APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
B. Fee for branch circuits without
Contact name: Marc & Carol Thomas service or feeder fee, first / 56.18 2
branch circuit r
Address: 10360 SW Walnut St. Each add'l branch circuit 7.42 2
City /State /ZIP: Tigard, OR 97223 Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: (503) 639 -9022 Fax: : ( ) dwelling, service and/or feeder
Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Owner Installation Signal circuit(s) or limited- energy
panel. alteration, or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
Additional inspection (I hr min) 66.25/ hr
City /State /ZIP:
Investigation (I hr min) 66.25/ hr
Phone: ( ) Fax: ( ) Industrial plant (l hr min) 78.18/ hr
Inspections for which no fee is 90.00/ hr
CCB Lic.: Electrical Lic.: Suprv. Lic.: specifically listed (% hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print name: M - � �A --TnIJ Date: SIB 13 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building\ Permits \ELC_PermitApp_040913.doc 440- 4615T(I 1/05 /COM/WEB
,
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325 (2))
This statement is required for residential building, electrical, mechanical, and plumbing per mits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that a II subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
,-- I will be performing work on property I own, a residence that I reside in, or a residence that I w ill
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
� 1 Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
ilf.'e- who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
MARX T I, vni01 S
Print Name of Permit Applicant
' &Y11.< -- 13
Signature of Permit Applicant Date
Permit #: H.51 c9,C 1 3 - 0 1
Address: I C tOO iLO U L S JL . ~;-'0: ; .
�6 A-2_, v2 Q-169.3 -i .
Issued by: � % ' Dater / ` ...
This Copy for Permit Offices
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
10360 SW WALNUT ST, TIGARD, OR, 97223
Residential - Master Permit
280 Insulation
05/30/2013 00:00
MST2013-00113
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
10360 SW WALNUT ST, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
06/04/2013 00:00
MST2013-00113
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
10360 SW WALNUT ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
06/04/2013 00:00
MST2013-00113
PASS - No C of O
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
10360 SW WALNUT ST, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
06/04/2013 00:00
MST2013-00113
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
10360 SW WALNUT ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
06/04/2013 00:00
MST2013-00113
PASS - No C of O
Violation Summary:
Inspector Contractor