Permit rt CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit #: MST2013 -00070
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/11/2013
Parcel: 2S102DC06100
Jurisdiction: TIGARD
Site address: 13871 SW 90TH AVE
Subdivision: GERTZ HOMES AT EDGEWOOD NO.2 Lot: 10
Project: Edgewood 2, Lot 10
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1178 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1598 sf Garage: 421 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2776 sf Value: $307,610.32 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker. 1 Hose Bib: 2 Backwater Value: 1
Drywell -Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn > =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 addl 500 sf: 5 201 -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 +amptvolt: 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:
•
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R -3 2776
Owner: Contractor:
GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions)
19200 SW 46TH AVE 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: $20,000.45
This per,.' -. . •'ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be • •ne in accordance wi =pproved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
d • s. ATTENTION: Oregon I: • r-quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
'• 52- 001 -0010 rough OAR • : -01 1• • You may obtain a co.y of the rules or direct questions to OUNC by calling 3.232. or 1.800.332.2344. •
I • ued By: Permittee Signature:
Call 503.839.4175 by 7:00 a.m. for the next available Inspection d
This permit card shall be kept In a conspicuous place on the job site until comp on of the project.
Approved plans are required on the job site at the time of each Inspection.
B Permit Application _ - - - -- •
__ _ _
' Residential RECEIVE r FOR OFFICE USE ONLY
• City of Ti MAR' 20 2 013 Datd9y Received : , 3/0 i , C, M 13.0001
13125 SW Hall Blvd., Tigard, OR 9723
3. Permit No.: �J
p Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 �/ D : / ~ f (3 (3 Other Permit. JO 3 .€00&4. T I GA RD
Inspection Line: 503.639.4175 CI' r D R �� • / t� ® See Page 2 for
Internet: www.tigard- or -gov BUILDING DIVISION Notified/Method: i3 l
Supplemental l n fo rm a tio n
p.:-. • TYPE =OF WORK . = , r
�,.•: �: � •' - • • � • j �- • - REQUIRED DATA:_ 1-' ArFD FA1t�IL'I'D'iRJFJL�I� —
New construction ❑ Demolition i - Permit fees* are based on the value of the work. performed. .
0 Indicate the value (rounded to the nearest dollar) of all
Addition /alts
ration/replacement . ❑ Other: _equipment, materials, labor, overhead, and the profit for the •
; . e{,�g z' '•t. iii 'a" - work indicated on this application,
p lil 1 - and 2- family dwelling ❑ Commercial /industrial Valuation: • $ ` 23�7 i (7( : Z
❑ Accessory building ❑ Multi - family I Number of bedrooms: -
❑ Master builder ❑ Other: - ; . Number of bathrooms: z - - - -(- �
- :'.•.., ` JE) slob ;'i iogne IO F,AN}k -.41iie1lF
t ::: _ • . ; ; x;;t' . Total number of floors: 2. --
Job site address: / 3 8 ?. J (A.\ I'D `t`l' New dwelling area: 2, , G square feet
City/State/ZIP: Tigard OR 97224 - Garage/carport area: y ).. / square feet .
Suite/bldg. /apt. no.: Project name: - 1 0 — Covered porch area: -- - square feet (5(/
Cross street/directions to job site: ‘Q / s.e ea) -*� , Deck area: - -- F - - r — - . square feet l ( 7 .
F- 1
/ - Other structure area: 3 ( q 7 square feet
6 e4 1`41 ,. 4.27 - - - - „REQuiRED .iDA TNydo• ghat- *. #. H I.
Subdivision: �-df,C t ce Z I Lot no.: /Q Permit fees* are based on the value of the work performed.
Tax map /parcel no,: 2 57 L , Q `( O d i- indicate the value (rounded to the nearest dollar) of all -
{; equipment, materials, labor, overhead,. and the profit for the •
'ya7 ,.'i.,:, '. . ,, BE9cEdin ,:Ob 'wpF •`.... , . • -' ”. -- . work on this application, = - -
Af - 0.) . 1 i-- - - Valuation S
j ` , :4 , -:-.Existing building area: - square feet - -
- New building area: • _ _ square•feet;. - -
•y . r" ° s' WOW -'',. ; ., l rT ; .`L .' ; Number of . - -- • ? r I;': , i stories:
Name: ( 7:h f Z- �N� j 1 -u " G e o
I ; , GYP of ,construction: _ _-
G
Address: fZd d ... �i, ca; Occupancy. groups: _ . .
City/ State/ZIP: /-_ •: n / ` q r
/ t,.._ cG Lw �sr �� 6 ��c z— : - - Existing: - - -
Phone: ( )6.q .2- 3 fb V Fax: ("5 3) c yz -S X 3 ..3 i .. _ •
New , ,-
i ""` ;. ... _:h:' CONRt CF P RSON: {.._ , OVIUMIIy.FRAI 'i' -.......-.1:,i
r ' ''=` `'•;4.
*-
Business name: 6 ti ' / r p as- L— : '' fkEl�oea lkasrA�trrrdll�. �: •
_Structural plan review fee (or deposit)::
Contact name: e G 1 • r --
Address: /1 gap - -fj 4a '' i FLS plan review fee (if applicable) •
City/State/ZIP: LL-Q. t 4 LL• w d/ - 9 oe .. I-- Total fees due upon application:
Phone: ( 3) 6.1.2.. -33 96 Fax:: (SC3)G f 2,3- Y3 it Amount • received: -
E -mail: �'�-e.0 CO arsi't- c0 ,Cvioy g31'. ;°
T� ki _ = - , ' Commercial and residential- prescriptive installation of
`. r �t.a '' :.`r. _ . •. ,L, „ ,., :. . _ 't . s,.. roof -top mounted Photo Voltaic Solar Panel System.
�• • �� • �: ,: :. -• op
Business name: 6' ,7 ,c;,,,, >. ,$ i _ Subinit:two (2) sets of.roof plan with connection details
/ y ZUi� and fire department access, along with the 2010 Oregon
Address: s Cc) 4 e ( Solar Installation Specialty Code checklist.
City/ State/ZIP: - /_ 1 -,,,C 7 Permit Fee (includes plan , review.
- - - and administrative fees): $180.00
Phone: (ST43) ‘f2 .3, 3 r6 Fax: (_)733) (T 2 _ j `.1.' 3 3, - State surcharge (12% of permit fee): $21.60
CCB lic.: S Total fee due upon application: $201.60
Authorized signature: /L This permit application expires if a permit is not obtained
jam r ^_� within 180 days after it has been accepted as complete.
Print name: Date: �/Z,•d(/2 `Fee methodology set by Tn -County Building Industry
/ DS O / _ . Service Board.
I:\ Building \Permits\BUP- RESPermitApp,doc 0224 /2011 440- 4613T( I 1 /02/COM/WEB)
Plumbing Permit Application REcE„, '
Building Fixtures I:olz OFFICE ILSE ONLY
City of Tigard . MAR 2 0 2O1i Re e e ve 3 /a, 13 s•t' _ Permit No. Sr do) 3 -00 70
14 V 13125 SW Hall Blvd., Tigard, OR 97223 .lam Review
C ITY OF TIG • • Other Permit No.: i2 3 - 0 00/4
o Phone: 503.718.2439 Fax: 503.598.1960 � �ate/B
Inspection Line: 503.639.4175 p l t is dy/By. kris,: See Page 2 for
f 1 G \ IZ D Internet: www.tigar - or.gov t7u �7 �1 ifiedR R ea vlethod' Tito Supplemental Information
7Wa3 .ic= _ �..rny - It•i - f. _ - y.' '1-''' IE ,.0 _ 13 !,4. /r � .
,-' :} , ^ 'ti
'n For special information use checklist
(ew 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)
SFR (1) bath 312.70 •
;k ::.._.- • -�. SFR (2) bath 437.78
tg 1- and 2- family dwelling ❑ Commercialindustrial - � 500.32
SFR (3) bath
❑ Accessory building ❑ Multi- family Each additional bath/kitchen 2 5. 02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
'• `: am '
• ,,r:x; ,r`,r,''rOB I E- f ON%A3 fk LLQ�CATIDN:, Site utilities:
x;• Catch basin or area drain 18.76
Job site address: / 3 5 Q Drywell, leach line, or trench drain • 18.76
City/State/ZIP: ,l OA- ff 7 2-7
- 2 V Footing drain (no. linear ft.: ) • Page 2
Suite/bldgJapt. no.: V Project name: Manufactured home utilities 50.03
Cross street/directions to job site: ‘GiS c..1 d�� Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear R: ) Page 2
Water service (no: linear ft.: ) Page 2
. Subdivision: Zre J Z I Lot no.: (C Fixture or item: 1
c.- Q G lc-t) Backflow preventer 31.27
Tax map/parcel no.: 2 S� Z /� 12.51
:i.:::1,7.5---1:,-'„-,--,•'..=-.1.'.':."--"...,'.. Backwater valve
f1)�31CPI€fPF.QP ;t
� - • - Clothes washer 25.02
l��� .• 44.6..e. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump • 25.02
E • a rY� e . s r : -,•� yv? . t'-'1 . r , 410 ., k : ' _ 71 Expansion tank 12.51
i). it i6 F r 1 4
j i r... ` L'FIF• � t ' ' ' ' " „ «J.
• Fixnrre/sewer cap 25.02
Name: 6 e f,'(y,_ a At ft- G /4.4., Floor drain /floor sink /hub 25.02
Address: / 7 2. a a 1"44-) (o • 1 p Garbage disposal 25.02
City/State/ZIP: 4( d2 ! 2 ` 2- Hose bib 25.02
Phone: (se 3 )492 - 3 3 96 Fax: ($' ?) G q2- 5 ie 3 3 Ice maker 12.51
':::.:4A''''.... .rr ,,�, 'r} •#' ' wro t . - .. . . . 1 + « ?�: Interceptor /grease trap 25.02
1 '4•4 .144, 't gt 'lj t .�5 f - - i0.4 r _ :7v.:r. . , , • �' ^ ` ' Fi
, , Medical gas (value S ) Pa 2
Business name: e4 _ C:d� (k-e__ Primer 1151
_- Contact name: /(,a.,,j G s,,. . f z ___ Roof drain (commercial) 12.51
Address: [q Z 47 5 5 co ijC 4- Sink/basin/lavatory 25.02
City/ State/ZIP: --! a 4 C4„'L' (3 4 q) 66 2- Solar units (potable water) 62.54
• Phone: (56 3) /, q 3 340 I Fax: : ( 503) G ?2.- $'i{ 33 Tub /shower /shower pan 12.51
_ Urinal 25.02
E - mail: ( L corn , Water closet 25.02
h.��� v,. }; ` 7. , • :;�..,, ::• Water heater 37.52
�: �::��k_^��,.,�:;ir�u �. . .'.�'. •_.,
Business name: ",,,,, F- p t 4.4,14s ‘ ‘lay Water piping/DWV 56.29
t/
Address: P O 13 p x 2 7'{ • Other. 25.02
Subtotal
City/State/ZIP: ( , J es -tc 4 ; ,/n D, /7 • (r8
Fax: ( )L�`82/ 2- Minimum permit fee: $72.50
Phone: (563 ) SS .. r 8 s I 3 Plan review (25% of permit fee)
CCB Lic.: 1 b 3 7/2-. Plumbing Lic. no.: 3.251 P4 State surcharge (12% of permit fee)
Authorized signature: TOTAL PERMIT FEE
This permdt expires if a permit V not obtained within 180 days
I Print name: I Date: /� %� I after it has been accepted as complete.
*Fee methodology act by Tri- County Building Industry Service Board
I: kBuildinglPermitsWLMU •Pmrritepp.doe 10/01/09 440.4616T(10/02/COMIWEB)
Viechanical'Permit Application HIV sa!' I O1.1:IcI: tisi: ()NIA
City of Tigard Da 3IaU / 3 � - -•- PernitNo.: / - 3- a00 . 7v
13125 SW Hall Blvd., Tigard; OR 97223 — 2 Q 't01K P lan Review /�
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit :SW(L sot 3 '- ( e0/p(p
FIG A It i� Ins Line: 503.639.4175 CITY nC TIn . dtuu. - MI See Page 2 for
Internet: www.tigard - or.gov V V f I �,l t . r/ S upplemental Information
BUILDING DAIS : . '
,. ,,‘- !i:, x „, ? .: *i;: %s :'.; - f - , - - coMM I: P
ERErA&1 ., S D1p LiE;
Mechanical permit fees• are based on the value of the work
g New construction ❑ Addition /alteration/replacemeni . I performed. Indicate the value (rounded to the- nearest dollar) of all- _ - - - -
n Demolition -. ❑ Other: - • _ mechanical materials, equipment, labor, overhead, and. profit:: _
- - Value: S -- -
;. ='- ; ,t. - -_,: y , : , ; .�� y �,-,� - - nom: r.` r :• ; _::
^',�1{?•�_:_�1'Ii, J�;I:� j. �i::if.::�T - � 1: �, . :M' :. - _ ..r,.., - � - ;
"FFb- ".5x.�. -. :.t' �.... i,. .- .- IT- ��Tr?. - .. � 3� - ..- .. ^.1= §:`•_ i - I�' ]�Git't1g]�i� •!�. �y .. �• `11 � - '-
1- and 2- family dwelling c , Commercial/industrial ❑ Accessory building - - For sped al tnfornuuton use checklist _ : _
❑ Multi- family :❑ Master builder ❑ Other. i Description _ I Qty. I Ea. • I Total. • -..-
�.. `� k�'.� ;!;�i:� , � N - :.:. ; '1 Heating/cooling :.. .
,. I• It fig," : ' . r ;A � ;.r; _�” , z ';7 1 - _ -
_41.t.:e- +: r -. .,.. .,. - : - A ir conditioning -
Job site address: 1 3 tf l S ( ( (regW�T showing placement) 46.75' - --
FurnaceT00,000 BTU (duets/vents) : t: .46.75 -
City/State/ZIP: 77 & 0.__40 6 /L ? 2 2. L Furnace 100,000+ -BTU (ducts/venta) - - 54:91 - - _'
Suite/bldgJapt. no.: Project name: -:-- _ 1 Heat pump" _:.,. _ _ - —
/ (requires site plan showing placement) -- - -- 61.06
Cross street/directions to job site: CCC C, W • Duct work - - - - 23.32 -- -
'Hydronic'hbt water system '23.32 _
• Residential boiler (radiator,or. . - .
hyionic) t - - - - _ -- 2132 - - -- - - --
- Unit heaters (fuel -type, not electric),
_ _ - , in -wall, in -duct, suspended, etc. 46.75 - ="-----
Subdivision: di eJ pt9- c Z - Lot no.: l Flue/vent for any of above 23.32 -_
. Other: 23.32
Tax map /parcel no.: Z S 12_ ,f) C.1 O C / c3 - Ot her fuel appliances: - - — -- __
,,,- 41 .,.;. w , �lkiti�.-rvy ;i , :;, ,u;, :- - ,. :,' Water heater - -- - ----- -- - - -(- -- 2332 -
' Y1 • :.�� -- - .,
. �7:i: ;i. ��' I� .a�l>.r7.Ca0C!<d��:��'.R�:. . . I . ; - .. : l :`1.? , _` - 1.aryr,..�7�.';: ' �'.;;�
Gas tireplacdtinseh - _ I 33.39- - - -- -- -
Al e «,) Q lb ....e.- - Flue vent for heater or gas , -- S -' -
fireplace- - - -_ - - - 23.32 -
. Log lighter (gas) _- • 23.32 - - - -- -
- - Wood/pellet stove 33.39
• - - - -- _ _ -- -- . - _ - Wood firepiace/insert . _ ' - • 23.32
". ,y Chimn /liner /flue/vent_ - - 23.32 - - -- -
' :�- :tit .� ' �j t 4 k oP.* ., _0 1::17 A- i �- . .�y" t --H - - -
x ,:' {; "3_ uo1 ,` v,r.iridrdai '.'�?i :....3•; =c .: Oth _ 23.32. - _
Name: 6.0 -6 S f- & 1"..c., • Environmental exhaust and ventilation: - - _ _ _ _
Address: I ( - 5 Y L �� . Range hbod/other kitchen- .
L
/ equipment. _ - _ 3339._
City/State/ZIP: �
�d, f „) Olt. q Q fo L Clothes dryer exhaust f 33.39= - 1. _ - _ - -
S� 3 3 - 6 Fax: (S O3) ` Z r ie 3 ,3
Single
-co p : rtment (bathrooms; 7.
Phone: ...
( ) � j — Q toilet utilit�roems) -
.`. ^.i . ate.. k. , . a�:' . .V test rid •�:;::. =. ` „ Attic/crawlspace fans- : - - 23.32
:::' ;'::;'' Other: - 23.32
Business name: / �.:.L 6 �, f- �Cy -Fuel piping: _ - : - -- -
Contxict name: x,.,,r( Geyr'(..z._ • — • mu "St4I5 foklrstfonr, S4:03:for• e=eh additional. , __. -_ --
Address: e Zgro S4cJ tit — Fumace; etc. I'
-as -
- G heat pump _ ..,
CIty/StaWZIP: � 4,.:la,.( C T 2 0 C WaWUsuspended/unit heater - - - - - - .
Phtme: (See) (q 2.r. 3 g C Fax:: (6 )4 f 2 5'33 Water heated - L
•
Fireplace I
E -mail: .‹,e Al Ci � ,..- LC o , C7 Range - - - -
•4.r.�..,,,i,' •_:t.; :. -,.t: •
�. - - - _
.m< Barbecue -
1 111 •.. _�. - •Y•• ..:. .. ., - _ ___
,(, j C�:_ +:•GI, � . �., :.:_•.ni�:lvtii �:.} • �. :': '�;'i.:
:y ',::..., t �C� . ..: /rtLre!9, -.•. rvr �4 �,: �'. ;.�:.. ,- Il `,:: ; +:Y�` - .. -, � • /�p� Clothes dryer () r
Business name: 4. EG CM Chbomis 4.ef I "61 - - J
- other: ;`
Address: Pro . 4,:11,. 8 z IYBy - -. . . ...•,
. . ;, F , a
City/State/ZIP: '/ (� q g'a - (. -g 2 Subtotal- - --
Y 4 N Minimum'permit fee ($90.00)
Phonec (SG3 ) L ss . 6 Z?:. Fax: (J ) G st .- 2147.3. Plan review (25% of puutnit fee) . -
CCB lie.: 4 /2 57 9 - _ - State surcharge (12% of permit fee) - -
TOTAL .PERMIT FEE
This permit apptiestlon•eapiresif • parmlt•ts not obtdaad.wttbtu 180
Authorized signature: / days after it haobeset aeeeptad- aa- eompiafa..
Print name: ,.....e,,j- Date: 3/. o7(3 ' • Fee methodology set by Tri.County Building industry Service Beard
1- ,rbrUi-r■; -- •:ootEC-PeOat.o.doo /12 440.4617T(II /02/COM/WEB)
Electrical' Permit Application RECEIVE r, 1 Olt OPFIC'I•; USE ()NIA
City of Tigard Da�dB 3 �!7 / 3 Permit No. / 3 000 D
• 13125 SW Hall Blvd., Tigard, OR 97223 MAR 2 O 2013 Plan Review
Ill
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: SW (�(j / 3 -0 DO (o p
TI G A R D Inspection Line: g 03.63 84175 CITY OF TIG • Date Ready /By: Juris: See Page 2 for
Internet: www.ti and -or. ov 1 I I Notifi ed/Method: Supplemental I nformation
ILD1NG DIVAS . e 7 . .c- ..s :_, : : 1 - . .
.. "c; . ".�. "•:; •:: •�,: T7�J3E.;01%' ..,... •:: `FL..4IV-SAiis�a?V;'` "' • ?'. = �•.
P lease check all that apply (submit 3 sets of plans w /items checked below):
construction ❑ Addition/alteration/replacement ) :
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
:= %.' '),: ; ; , ` _ , CAB .a® `t ®P: - ` iir .. ,. 1` , i, a , ., exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
.: - ' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
CI 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
:)r; y,, :,:;;" " system.
yi ( ,, A C ; ,- °i: : ; ..,.,: ; ' ;I �Jg ;�SL �: Il �® I t A` f1iIQIiF- •e�F!]r:'I - mer nc system. larger separately
. to derived
. :: : • . � ;. , :•I ..... - , - Addition of new motor load of "A E •• ] -2 Y
Job no.: Job site address: / 3 8 . 7 / S (Ai 86 (' I or more. occupancy.
❑ Six x or or r more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: 1 f i 4 7 2 2 li ❑ 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: SCHEDIIJLE • :. T " ; . : • . ,. s :,r .
Cross street/directions to job site: ‘17. . JJ Description I Qt I Fee. I .. , y Total ` I
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: ‘‘C, faaace Z Lot no.: / 0 1,000 sq. ft. or less 1 1 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: /2 S Z /) C.-e D G l d�
t:
. a - , Limited energy, residential Lr.�, 4: ' � ✓ a `CI:?- .:` +S� '6'lf .'a';:i:: _ ! i :,it`":.t; \�' „" •�7'• ,j. ":}� e;x %pi with above S ft. ( / 75.00 2
a. � � ti Limited energy, multi- family
� �} .� residential (with above sq. R.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
s `:. -;i f;t , PitoRF:Riii 6 R( {1 i y . 1:' ;:; t PiJY�F I :. , 201 amps to 400 amps 133.56 2
Name: G C4.-(Z a Ai t 1 4--- ea 6-e 601 amps to 1. 0 amps amps 30.04 2
601 amps to 1,000 amps 3011.04 2
Address: / 1 S eJ eiC, -
- ' Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: 7,74. ,d 02 q ?Q 6 - relocation
Phone: (5t6) 6 92. -33 C t 6 Fax: (5 4") 6 I1, _ -r33 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
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
l :� { ^°4 { ,_ : 3 ,a. :w �r ^, pip, :
,i.f. i :,. ; ,. i ; :• ���1 •��, \ /t���! /�1 ���Q/��r above service or feeder fee,
i °:'I4 � \ 86• �' eov 14� il::':l .7 ' U., lY/lrl•ALi.Y:� 1.E1001�•i: _ 7.42 2
each branch circuit
Business name: G ,e�.z.z.----Cb-4. s4- ea (41 B. Fee for branch circuits without •
service or feeder fee, first 56.18 2
Contact name: X A j G r in e- -- 2._ branch circuit
f{ Each add'I branch circuit 7.42 2
Address: If 2 I w 41 � 1 Miscellaneous (service or feeder not included)
� Each manufactured or modular
City/State/ZIP: - L 4 6aft A Qg_ 1 706.2_ dwelling, service and/or feeder 67.84 2
Phone: (563 ) 4.'2-3 ' ) Fax: : ( 50 Q q a- s-.1.3 L Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail'
rp4i �• .. Sign or outline lighting 67.84 2
1 1i .1q1: :4 +1`. 7 .. ,�-*: .V rr'9ii.'1 a � .; .. n: . ,J,i1/i ;;g f d c h k: e- ',
.�; ., 2rS., . 'il•?• =� \ "'0R3 tn• t � i ;'�;:. ..�. �' };: ta W'� - ,' �•, .>,• t.,ty ` Kt,:; Si circuits) or limited-energy
Business name:
panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: • Additional inspection (1 hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City / State/ZIP: Industrial plant (I hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is
90.00/ hr
specifically listed (% hr min)
CCB Lic.: Electrical Lic.: Suprv. Lic.: , a Ill eli'n (‘-'..1 . ) ' ':,; ,,
St &tota4:
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Date: State surcharge (12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
I: ■BaildingPermitsE .C- PermitApp.doc 07/01/10 440-461ST(ll/0s /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
Audio and Stereo Systems*
[✓Burglar Alarm
Garage Door Opener*
Er Heating, Ventilation and Air Conditioning System*
Vacuum Systems*
❑ Other:
•
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:\ BuildingWermiu\ELC- permitApp.da 07/01/10
7 Building Division .
Development Code Provision Review
T I G A R D Residential Projects
Q - 4213 - o e o7 d .:-.:.4.f,
Building Permit No.: , -
Site Address: 1 3 Sr 7 1 $) 90-4— .: • - •
Project Name & Lot No.: E(bGW 0 0 6 =2 , L-v % u)
CWS Service Provider Letter •
Required: Yes ❑ No Er"
Received: Yes ❑ No E f
Routed Plans: S4"
Original Plan Submittal Date: 3 /g0 //3
1St Revision Submittal Date: ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
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 • / I _ at 503- 718 -��ZI or i hS tv
— @ti - or.
Land Use Case o. U3-3tt7^ 000/3
Zoning ,/ , 5
tr Setbacks:
/ Front - 0 Rear / 5 _ Side 5 Street Side N Garage a O
E Maximum Building Height: 30 ' Actual Building Height 2.4
0 Visual Clearance Y 4-
O Easements /J 4.111:4 114 r
1110 Lands Type: f VA/ , SG' -� 74, A/ � l( /lM1
L Street Trees
L' P
rotected Trees ' ,'�
Notes: phVe,NJGl J mYlaf-1' IA'. [IA v e1 ? 110Y € h 0.-0 .
Original Plan: Approved GK
Not Approved ❑ Date: 5 (25 I 1 '
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
: 9
Page 1 of 2
I
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov)
JActual Slope: 1 ' 0
Notes:
Original Plan: Approved.-B' Not Approved ❑ Date: 3 Ni 13
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 Appli : nt
Okay to Issue Permit: Yes P No ❑
Date Routed to Building:
3 ?r 13
Page 2 of 2
May 7, 2013
RE: NEW RESIDENTIAL
Project Information
Building Permit: MST2013 -00070 Class of Work: New
Address: 13871 SW 90 Lot Number: 10
Area: 2776 Sq. Ft. Stories: 2
Builders Name: Gertz Homes Subdivision: Edgewood 2
The plan review was performed under the State of Oregon Residential Specialty Code
(ORSC) 2011 edition. Please respond to conditions below.
1) Please show accurate depiction of out of plane exterior walls on wall section
details B from Turner Engineering page L.
2) Show location of holddowns on first and second floor on S3 wall line.
• When responding, provide an itemized letter stating in what way each numbered
issue has been addressed in the revision.
When submitting revised drawings or additional information, please attach a copy of the
City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard
in tracking and processing the documents.
Respectfully,
Dan Nelson
Senior Plans Examiner
(503) 718 -2436
Bann @tigard- or.gov
April 30, 2013
RE: NEW RESIDENTIAL
Project Information
Building Permit: MST2013 -00070 Class of Work: New
Address: 13871 SW 90 Lot Number: 10
Area: 2776 Sq. Ft. Stories: 2
Builders Name: Gertz Homes Subdivision: Edgewood 2
The plan review was performed under the State of Oregon Residential Specialty Code
(ORSC) 2011 edition. Please respond to conditions below.
1) Please show accurate depiction of floor joist layout on wall section details B
and D from Turner Engineering page L.
When responding, provide an itemized letter stating in what way each numbered
issue has been addressed in the revision.
When submitting revised drawings or additional information, please attach a copy of the
City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard
in tracking and processing the documents.
Respectfully,
Dan Nelson
Senior Plans Examiner
(503) 718 -2436
dann @tigard- or.gov
April 15, 2013
RE: NEW RESIDENTIAL
Project Information
Building Permit: MST2013 -00070 Class of Work: New
Address: 13871 SW 90 Lot Number: 10
Area: 2776 Sq. Ft. Stories: 2
Builders Name: Gertz Homes Subdivision: Edgewood 2
The plan review was performed under the State of Oregon Residential Specialty Code
(ORSC) 2011 edition. Please respond to conditions below.
1) Provide type of hold downs to be used in house on foundation page.
2) Plans call for MST27 straps at 2 floor ABP's which will not work between
floors.
3) Exterior wall cantilever and setbacks found at garage, den and great room
shall comply with R301.2.2.2.2 ORSC.
When responding, provide an itemized letter stating in what way each numbered
issue has been addressed in the revision.
When submitting revised drawings or additional information, please attach a copy of the
City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard
in tracking and processing the documents.
Respectfully,
Dan Nelson
Senior Plans Examiner
(503) 718 -2436
dann @tigard - or.gov
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.
lig City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal
Letter
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.7 1 8.2439 • www.tigard- or.gov
TO: / Afic (44y\-- DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM:
/(-cti MAY 09 2013
COMPANY: e // _ CITY OF TIGARD
BUILDING DIVISION
PHONE: — G 92-- 3 ,? F By:
RE: 3' Z- 5cJ ?c 7±./ 14 , 7 l 3» —2ts
( ite Address) (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Co lies: Descri 1 tion: Co lies: Descri • tion:
�= Additional set(s) of plans. 3 Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. / Engineer's calculations.
Other (explain): iqcs
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\ Building\ Forms \TransmittalLetter- Revisions.doc 05/25/2012
N RECEIVED
N
• , 1 MAR
cn • 1.� 207
■ � L CITY OF TIGARD
Elev. 209
BUILDING DIVISION
. W 90TH c -it.
✓� \ .o' c9,
)
,.... „mil - , L7 w Gra d c 8 CO C5 , 0
• N '
0)
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CO �,�����! 207.5 c I 7.
00 1 1 llll klp► h I i
03 ae' I o.o. 1 z
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N Elev. 208 I N -r- t"
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ev. 2 06 _t_. O , j 0 !r ..
J . /0 Elev. 209 _. PATIO i O P1 -H
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.� Elev. -2d8� -'
' l ° -
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9 ''/ 124 Q7 c; ,
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q \‘ , - Elev. 208 . -'�
l _ . i 9 -' _ GERTz CONSTRU' TI �i
C IN s .
HOME SQUARE FOOTAGE BUILDING
At MAIN FLOOR = 1178 SQ.FT.
UPPER FLOOR =1598 SQ. FT. CUSTOM HOMES SINCE 1977 Street trees Tilla
N� (503) 692 -3390 Ameranana 2"
TOTAL = 2776 SQ. FT. 13871 SW 90th
-,
GARAGE = 421 SQ.FT. Lot 10 EDGEWOOD EAST
SCALE 1' = 20'
GERTZ CONSTRUCTION COMPANY INC.
PLOT PLAN 3/19/13
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
13871 SW 90TH AVE, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
2014-01-08 00:00:00
MST2013-00070
PASS
Violation Summary:
Inspector Contractor
. '1
Y ':'k I \
M
•
1 1 '- z9Z 4/ 6
i l
' � i ✓
F 25 6
/ F
ViN
� f >�.
) U.. i ; /. c , ,,
/ //j\f/ 256
, 0� - I i. 2g9
O
`'' 1 O•` 218
<
0
t 'f zoa h o ° ‘,1,3S 3916'03" W 32.16' .
e
( ^ I sm
O / ti e
1
fl, y ,� / / ‘, goo.
. ' 4 / 000
O r o , /
i • ,
O `` (6 �O
� 60 Q \ a VI
° O . .
A, e ti
,4,� Q STAKEOUT
' •
• q% LOT 10 EDGEWOOD 2
r' '
\ ' i / SE 1/4 SEC 2, .T2S, R1 W, W.M.
fLl'• ,. ,
IA - C CITY OF TIGARD
�' n 9 z �� / / r 1 ` WASHINGTON COUNTY, OREGON
'� ‘6\ . I APRIL 29, 2013
' DRAWN: DMR CHECKED: SPF
SCALE 1"=20' ACCOUNT # 188
. 0 / 3 5 7� - t„/ ! Y: \188- 003 \DWG \L10E2
r , � e .. h1 5 - r, � d(3 -00070
EJ,� S SURVEYING CONSULTING
692 32.
il' 2 69 `''s _ .
43 4 ) • 2 5 913' `" ° - NOTE: 9138 SE ST HELENS ST
' s W USED- DRAWING IS NOT INTENDED TO BE USED FOR PO BOX 3251
' CLACKAMAS, OR 97015
THE PURPOSES OF A MORTGAGE LOAN INSPECTION - PHONE (503) 850 -4672 FAX (503) 850 -4590
.
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
13871 SW 90TH AVE, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
2014-01-24 00:00:00
MST2013-00070
PASS - C of O
*Erosion Control approval Passed
*Street Tree Certification, checked for trees. Received
*High-Efficiency Interior Lighting Systems Doc Received
*Moisture Content Acknowledgement Form. Received
*Insulation Certification checked. Checked
*Carbon monoxide Detector checked. Checked
*Garage Vehicle Barrier Installed. Checked
*Final Plumbing, Mechanical, Electrical approval (and Fire Sprinkler if required) Checked
*Lawn Irrigation final with Backflow test results. (if required), Passed/received report.
Checked
*Duct air leakage test documentation, (if ducts installed in crawl) in accordance with
ODOE Stds. and Sec. M1601.4.1. Copy e-mailed
* Provide blower door test documentation (50pascal’s, no more than 5. Checked
Violation Summary:
Inspector Contractor