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Permit y CITY OF TIGARD a MASTER PERMIT I 2 • COMMUNITY DEVELOPMENT / Permit#: MST2013-00195 T[GARL� 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 420 Date Issued: 09/18/2013 Parcel: 1S136AD01300 Jurisdiction: Tigard Site address: 10470 SW 69TH AVE Subdivision: VILLA RIDGE Lot: 1 Project: MONROE Project Description: Garage and kitchen addition. 10/29/13,adding 79 sq ft addition to master bath. BUILDING Floor Areas R equired Setbacks Required Stories: 1 Bedrooms: 0 First: 614 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 15 Bathrooms: 0 Second: 0 sf Garage: 639 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 614 sf Value: $130,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 0 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 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: 1 Other Units: 2 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 6 Ea add'I 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-3 614 Owner: Contractor: MONROE,ROSS& ZUVER CONSTRUCTION LLC Required Items and Reports(Conditions) MONTERRUBIO,ROSA 20449 SW TV HWY#209 10470 SW 69TH AVE ALOHA,OR 97006 TIGARD,OR 97223 PHONE: PHONE: 503-649-4380 FAX: Total Fees: $3,916.17 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes ••d all other applicable c All work wi be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuan r if work is suspend-• more the 1:4 days. TI : gon law requires you to follow the rules adopted by the Oregon Utility Notification C�. Those rules a •, forth in ••R 952 01-0010 through OAR'952-00 •r90. You may obtain a copy of the rules or direct questions to OUNC by calli = 503. 419: •r 1.800.332.2344dll .1' _ Is ed By: i // ��:�t / Permittee Signature: rr rs• Call 503.639.4175 by 7:00 a.m.for the next available inspecti• d,to / This permit card shall be kept In a conspicuous place on the job site until c•mpl•r•• • •• •role Approved plans are required on the Job site at the time of eac Ins•• tion. FOR OFFICE USE ONLY—SITE ADDRESS: A)4(70 6 .--- 4, 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 Transmittal Letter T I G A R'D Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: _ • DATE RE EJVED; n f r� t� DEPT: -DING DIVISION t?-. r� , t� ,i) OCT 292013 FROM: it ' Nj CITY OF 7 IGA,RD /,'� ,�/�. 9UILDING Ds°�'ISIOIOR COMPANY: "Z LV� W ri 11 17D1 l PHONE: i0 3 -� T2—Cp 3o RE: I V- ` Sb0 & ) P1 O. _C 4"5 (Site Address) 'e 1 `urn.=r (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. VFloor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): ' ARKS: .r_ /%If_ .ii l e // e e 11 to ..i ,.._t (/o/ 9//3 4J/& /? )� F R OFFI E.US ONLY Rout-: to P• it ec ician: Date: .--t O '? ( ( l'''j Initials: Fe; Due: IN es ❑No Fee Description: Amount ue: 2 H ks 1- -3` VI $ 1 PO "() -� ltoc 1 . C CT $ 90• 00 . • -1-;;--1,4-L___ $ a70, e'L Special Instructions: _ Reprint Permit(per PE): es I ❑No n-Do e Applicant Notified: D I144 W/ Ltd Ao akf t 3 Initia s§: J` } 1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 . i Building Division Development ment Code Provision Review TdGARD �r,` ' � Residential Projects OC► 'L l CUi3 Building Permit No.: X21 / 2 _ 00 / 9 cITv f K Project/Subdivision Name: , Site Address: /0470 ,§L,J LPS CWS Service Provider Letter: Required:Yes ❑ No o�m�QQ. c� ( �-` 6t' `�- Received:Yes ❑ No J ��'1 Plans Routed: Original Plan Submittal Date: /49 3 Routed B 1" Revision Submittal Date: ❑ Site Plan Only Routed By: 2nd 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 JoAn I at (503) 718-'12y015 or @tigard- or.gov) / Land Use Cas�To. /t/ Zoning ❑ Setbacksh Front Rear l J ides Street Side Garage (9's° ❑ Maximum Building Height: cJ0 Actual Building Height ❑ Visual Clearance ❑ Easements ❑ Sensitive Lands Type: ❑ Street Trees ❑ Protected Trees Notes: Original Plan: Approved Not Approved ❑ Date: Of/`3 Revision 1: Approved Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RGS.doc_Rev.01/16/13__ Engineering Review(contact Mike White at 503-718-2464 or MikeW @ tigard-or.gov) ems. 4 Actual Slope: S Notes: Original Plan: Approved Not Approved ❑ Date: •d in,/f 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: Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RUS.doc Rev.01/16/13 4? W ,7q :1 _ ocl 9 20�� (E) Garage _�! �; �p�'�-' ? w f 11 �. �, �, �, Verify 48' '�I� ''Oa�,��,�, I' r,,?�� [ ;arage ,�� k 9 �� I 4#4 041 VI *141 _IAA_ (New) I i .( ) A „, (E) Structure o J � ._441 / / 15 I 1 1 NV .... I — � (New) 0 7 -6 I i l ____] . _ Line of setback I in Property Line J . • i n r° _ i. _ n � _ ._ CITY OF TIGARD MASTER PERMIT 1I1 '-- COMMUNITY DEVELOPMENT Permit#: MST2013-00195 Date Issued: 09/18/2013 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439 Parcel: 1S136AD01300 Jurisdiction: Tigard - Site address: 10470 SW 69TH AVE Subdivision: VILLA RIDGE Lot: 1 Project: MONROE Project Description: Garage and kitchen addition. BUILDING Floor Areas Required Setbacks Required Stories 1 Bedrooms. 0 First 462 sf Basement 0 sf Left 0 Parking Spaces 0 Height 15 Bathrooms 0 Second 0 sf Garage: 639 sf Front 0 Smoke Dwelling Units: 1 Third 0 sf Right 0 Detectors Yes Total 462 sf Value $130,000 00 Rear 0 PLUMBING Sinks: 1 Water Closets' 0 Washing Mach 0 Laundry Trays 0 Rain Drain' 0 Urinals 0 Lavatories. 0 Dishwashers- 1 Floor Drains- 0 Sewer Lines 0 SF Rain Storm Sewer 0 Tubs/Showers' 0 Garbage Disp 1 Water Heaters 0 Water Lines. 0 Drains 0 Catch Basins 0 Bckflw Prevntr 0 . Footing Drain. 0 Ice Maker. 1 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 2 Fum<100K: 0 Vents 0 Woodstoves• 0 Gas Outlets 0 Fum>=100K. 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less 0 0-200 amp 1 0-200 amp 0 W/Svc or Fdr. 6 Ea add l 500 sf: 0 201-400 amp 0 201-400 amp- 0 W/O Svc/Fdr 0 Mid 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-3 462 Owner: Contractor: MONROE,ROSS& ZUVER CONSTRUCTION LLC Required Items and Reports(Conditions) MONTERRUBIO,ROSA 20449 SW TV HWY#209 10470 SW 69TH AVE ALOHA,OR 97006 TIGARD,OR 97223 PHONE: PHONE 503-649-4380 FAX Total Fees: $3,646 11 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 don- =cco •-••: with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is . . • . - . ore the 180 days ATTENTION' Or-•on law requires you to follow the rules adopted by the Oregon Utility Notification Center Those ru-s are set f. h in OAR 95 001-0010 through OAR\ -001-0 You may obtain a copy of the rules or direct questions to OUNC by calling 5•.. 32.1987 or 1 800 332.231_ Is ed By: _ Permittee Signature: /` / I_ Call 503.639.4175 by 7:00 a.m.for the next available Inspe on d•te. j' This permit card shall be kept In a conspicuous place on the job site untl com• etion of the • •ect. Approved plans are required on the job site at the time of e•ch I <pec • . Building Permit Application i Ai Residential N ' FOR OFFICE USE ONLY -' . .-� Received mrn Ij�City of Tigard ?1/4 ,... �4 Date/t3• • / " Permit No ,+f , . ' . •" 13125 SW Hall Blvd,Tigard,OR 97223 . , Phone 503.718 2439 Fax 503 598 1960 P\° -;tm Other Permit >T(GARD Inspection Line. 503 639.4175 ..cofro ed/ :By El See Page 2 for Internet: www ugard-or.gov G\�4�,`j,Vo ied/Method y ■ / J11 A Supplemental Information TYPE OF WORK Q� REQUIRED DATA: I-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,mate'tats.labor,overhead.and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ® I-and 2-family dwelling ❑Commercial/industrial Valuation: $1311,0(1(1.00 ❑Accessory building ❑ Multi-family Number of bedrooms: ❑ Master builder ❑Other. Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors. Job site address 10470 sw 691x'ave. New dwelling area: 462 square feet City/State/ZIP:Tigard,OR 97232 Garage/carport area: 639 square feet Suite/bldg/apt.no: Project name: /140 A Covered porch area. 28 square feet Cross streeUdirections to job site: Deck area square feet Other structure area square feet 1 j REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no: Permit fees*are based on the value of the work performed Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Extend Garage and add onto kitchen area, front living room,and front porch Valuation: S Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories' Name: Ross& Rosy Monroe Type of construction. — Address' 10470 sw 69'i'ave. Occupancy groups: City/State/ZIP:Tigard,OR 97232 !Existing: Phone.(503)452-3365 Fax:( ) New: ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedul) Business name:Zover Construction,LLC Structural plan review fee(or deposit): Contact name: Wade Zuver FLS plan review fee(if applicable): Address:20449 SW TV Hwy 5209 ? - City/State/ZIP loha,OR 97006 fees due upon application �}yJ 6,,isS Amount received:IF �. 4,5 Phone-(503)572-6301 Fax :( ) 1 E-mail:w.zuver@zuverconstruction.com zuvcrconstruction.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of' CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: 'Liver Construction LLC Submit two(2)sets of roof plan with connection details and fire department access.along with the 2010 Oregon Address 20449 SW'l'v Hwy#209 Solar Installation Specialty Code checklist City/State/ZIP•Aloha,OR 97006 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)649-4380 , Fax.( ) State surcharge(12%of permit fee): $21.60 CCB lie ) 8 3 -9 40.07 Total fee due upon application: $201.60 1 /Authorized signature: G ` / This permit application expires if a permit is not obtained r within 180 days after it has been accepted as complete. Print name: ��e �_ ' er Date.8/21/13 *Fee methodology set by Tr-County Building Industry ��/// / Service Board I.\Building\Pernuts\BUP-RESPermitApp doe 02/24/2011 440-4613T(I I/02/COM/WE13) 'k r P T>>ing Permit Application �® B 'ding Fixtures %� FOR OFF.ICF. LSE ONLY" , 0 It 1 City of Tigar r,,r. '� Received ( ", 13125 SW Hall Blvd.:,,--,,,.N 223 n 1 1.0� Plan Review • / Phone: 503.718.2439 `:.Fax: 503.59 1a96N �O Datelny. - Other PrnuitNo.: Inspection Line: 503.639.4175 (�v �� `i:}• 1'� \� �� DateReady/By: ,,J Jute: Ed See Page 2 for �1 Internet: www.tigard-or.gov O� �`�-M- Notified/Method.; H Supplemental Information i" t TYPE OF Print name: 1 Dale: h 01 01 ctruction ''emolition - X. •o. Alteration/replacement Other-1 -3 FEE* SCHEDULE CATEGORY OF CONSTRUCTION- For special information use d:ecklist _ Description Qty. Ea. Total 1 ,2 :tmily dwelling a a Commercial/industrial New 1. 2-family dwellings(includes 100 ft.for each utility connection) p. A, y building [1 Multi-family SFR(1)bath _i 312.70 !t ❑; I ilder SFR(2)bath ❑ 437.78 [�Other:j w-1 '`rJ' c CO bath ❑ 500.32 k JOB�SITE 7NFORi'EAtION AND LOCAL, ON ,. ', , -l;, 1 � h additional bath/ititchen , 25.02 lob alt ass:r--7,1,__ I ®41 0 SW (c, Fire sivinkler C7-7.7I sq.fl) EI.i Page 2 Cis■ :/: I P:E-_-_-_-_] Site ut titles: C.wh Y asin or area drain I 18.76 Suit _ pt.nn.: ,1 I roject name:i�i - ,r -Dr}cwe 1,leach line,or trench drain L 18.76 Cr° .e. ltrecions to job site: -i -1--- Footin�drain(no.linear 4::77---) L7 Page 2 ,7-12:-,2-s In Manunctured home utilities Ti 50.03 Manitcles -I 18.76 :=1.-24 Rain d-din connector ❑ 18.76 I Sul- -�I �' Sauiruiy sewer(no.linear ft.: Page 2 i Lot no.: _' `.�- g 1- - -- Stntmsewer(no.linear ft.: 1,,: Page 2 L__„ Tax 0: -cal no.:LT- 1 Water service(no.linear ft:'_ ) ;__ Page 2 [,l 7 `DESCRIPTION OF WORK Flxtur 3 or Item: Backtlowpreventer � I 31.27 e,G cc..@'e, «�I �C. Y1 ',:-.1_. Backwater valve Li 12.51 - --- Clothes washer EI 25.02 Dishwasher I i 1 25.02 I i , Ir PROPERTY OWNER ❑ TENANT • Drinking fountain n 25.02 rl Nan 10 Eject° sump ❑ 25.02 t Adt 1 1 0 4 7 O ��k iA. Expan 'on tack ❑ 12.51 ;L' i ''r"� Fintw sewer cap i 1 25.02 1---_ ' Cit■ ' I':L__1 I C22.;.. Pionr rain/floor sink/huh Ti 25.02 HT] J Pho _ )_ Fax:L Iii i Garba e disposal i- 25.02 Z�1 t __ ❑-APPLICANT ❑'CONTACT PERSON Hose b 25.02 :1 l-._ft Bu: a: le.: J 1 Ice ma.er 1 _] 12.51 , Cot a :-L i Interceptor/grease trap �- 25.02 Medical gas(value:$ -1 t:l Ad, ] 8 ( ) ❑ Page 2 ( �) - -- Primer 7.-17-}~ ] 12.51 � Cii■ /: I':E_`7 -Roof drain(commercial) •_; 12.51 Phe )r-1 Fax::l'._- j Sink/basin/lavatory I �� 25.02 L`_'„ f E-n Solar t,nits(potable water) 62.54 i_ -- _ _'CONTRACTOR :" a ' Tub/shower/shower pan 12.51 -I - Bu. �QL.Vv\ - untia► _ _-25.02 I` . _l- ��L Water:Iosct ❑ 25.02 , Ad, -i 3.e.3 3 Ci.-/ -1 Water neater 37.52 rl�i I Cit. /i i' �� ,`\Sb3•� Q� 9-7173 Water-uping/DWV rj 56.29 ��-' Phe 503)LC9 i-42 5 Z Fax:(` 3i LSO-`13-4.1 Other:l._� Li 25.o2 -i CC: : 1A. -043-7 Plumbing Lic.no.:13 1;_+.1-3,519 fa Subtotal "1 I Minimum permit fee: $72.50 [l- j Au; d ^nature: f � Plan review (25%of permit fcc) [ _'i I:iBuW a :LM!-PcnnitArp doc 10/01/09 404616T(10/02/COM/WEB) Me chanical Permit Application FOR OFFICE usF.ONLY City of Tigard Received�� *' Date/By: PermitNo.: 0— D i T7 q 13125 SW Hall Blvd.,Tigard,OR 97223 �� Plan Review Phone: 503.718.2439 Fax: 503.598.1960 \1 i� Date/By: Other Permit itt.. Inspection Line: 503.639.4175 r1 Date Ready/By Juris ®See Page 2 for Internet www.tigard or.gov r: n0� Notified/Method: Supplemental Information ' 9414 r = "[TEE"of tivoRlr '\ - ',-e. 1r°�_ , . ,COMMERCIAL FEE* SCi1EDBLE. USE CHECKLIST..- t13)Other:�� ®`�� Mechanical permit fees*are based on the value of the work ❑T .v construction Addition/alteration/repl�atett n*,.. j performed.Indicate the value(rounded to the nearest dollar)of all ❑D:molition \\�� mechanical materials,equipment,labor,overhead,and profit. Value:$ :CA 1)CGORY`OE.CONS Ip ON _ _RESIDENTIAL EQU)7PMENTi YSTEMS FEE *. .. r3 I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special Information use checklist. O i ulti-family ❑Master builder ❑Other: Description I Qty. I Ea I Total JOB SITE'INFORMATION AND LOCATION'` - Heating/cooling: Air conditioning 46.75 _ Job::c address: Furnace 100,000 BTU(ducts/vents) 46 75 CityL:tate/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 Suite bldg./apt.no.: Project name: Heat pump 61.06 Duct work 23.32 W.!`-7 Cros: street/directions to job site: 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 Sulu: :tsion: Lot no.: Other: 23.32 Other fuel appliances: Tax 1'ap/parcel no.: Water heater 23.32 ° Gas fireplace/insert 33 39 Y: :.:.ry -DESCRIPTTQN%UF WORK p ,t �� f/ /�� //'� �� 1— /J / Flue vent for water heater or gas i` 0,e.er( OL �✓✓,7( 7 Lt_Ge-e..6.04^r fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER ', 0 TENANT Other: 23.32 - - Environmental exhaust and ventilation: Nan•. Range hood/other kitchen equipment 1 33.39 Add' ,,•;: Clothes dryer exhaust 33 39 _ City; :taterZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phut.-.( ) Fax:( ) Attic/crawlspace fans 23.32 ° - °-0 APPLICANT . 0 CONTACT-PERSON Other: - 23.32 Bust.a s name: Fuel piping: $14.15 for first four.$4.03 for each additional Cont ct name: Fumaco,etc. Ad• s Gas heat pump -- Wall/suspended/unit heater _ Cit',: ..ate:ZIP: Water heater Pha. ( ) Fax::( ) Fireplace Range E-m, I. Barbecue _ GO'1TRACTO Clothes dryer(gas) Buy: _:,s game: Of I /7ec. hQ Other: -i MECHANICAL P E R M I T PEED'',z,-,:-... '- Add. ss: X30_ /J w- 2,3tr 11-A-A2 - - - - -- __ - - ...Subtotal City.,tdtc'ZIP: /€(rL. o 0/7_ 5'?(L7 Minimum permit fee($90.00) 50 Plan review(25%of permit fee) Phi! •(S03 ) 6 yB 1 J-6 l I Fax:(f;3 ) Sc?-0 2 2_5 State surcharge(12%of permit fee) /d, 0. CCI 'c: Y 3''S d- kS i5- . TOTAL PERMIT FEE /(xj. 00 This permit application expires If a permit is not obtained within 180 days after it has been accepted as complete. Au': 'i7i2.1 signature: / - / • Fee methodology set by Tri-County Building Industry Service Board PI_, ...t:: Ske,n.ta,o4-, Ali! I Date: -Y! 2Z/f 3 I:1112 :Pc:nit3UlEC PamitApp 040113 doe 4404617r(I 1/02ICOM/W®) Circtrical Permit Application � Sl°' . 1.O ' E I a' ' City of Tigard (\�� Received Pcmttt No.. g-�13-v d 1'lS VA j� Dait Re l , =,s 13125 SW(fall Blvd,Tigard,01• ,�/ x, Plan Review Other Perak Phone: 5n Lint:2439 F 19•t V rtO OutsBy'. I H See Page x for iiiii Inspection Line: 503.639.4 rn Outs R°a tyNf "Y` �.1". Supplemental Information Internet ww•vv.tigard-0rgov G �'''�1` _ -- -- , y - _ 1rYPtt:Ol<,WORI '-, t _ \ -`. n7 . . - .PLAN REVIEW - - <h.,!" P `A,.Q\ : Please check all that apply(submit 2 sets of plane wfitems checked below) i_! ew construction I�Addihon/alteranon/rCpcla�pr �Av ❑&nit=or feeder 400 amps or more ❑Budding over than vanes. L!t'CmoliUns ❑Other: `_-\\''e.S t\ where the available fault cement ❑Marinas and boatyards .`- '"` '' 'CA7'BGORy-dr.-00 .1.11% l� - exceeds 10,000 amps at ISO snits or ❑Floating buildings - MI/il to pound,or exceeds 14,000 ❑Commercial-use agnculluml and 2-family dwelling ❑CommerciaUinti ❑Accessory building amps fir all other mstalLatmnc buildings J l ❑Fun pump ❑Installation of 150 KVA or Li.lulu-family ❑Master builder ❑OUler. ❑Emergency system larger separately den ved system - -JOLT Sr f E JII4F(�RMATION-AND LOCATION • I,-'`,- ❑Addition of new motor load of ❑"A""L•""1-2""1-S.9,--- -/-y//i IoONP or mere occupancy o Job site address:' 'b4— " / /-'" ❑Sin or more residential units ❑Recreational vehicle parks - -- ❑Health-cvc facilities. ❑Supply voltage for mart than State/ZIP. / ❑Ilamrdous laauons. 600 volts nominal. •i'IdgJac:.no.: ' Prroje Project name: ❑Service or feeder 600 amps or mom. FEE SCHEDULE s street/directions to job site: ortmnttau I otr. I Fre I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. 1,000 sq.II.or less 168 54 4 livisiou: Lot no.: Fn ndd'I 500 sq ft.or portion 33.92 77.92 i map/parcel no.: Limited energy,residential 7500 2 1.'DES C il'J'ION'OF W dtlK.: - , , - (with above sq.ft) `< \ Limited energy,multi-family 7S 00 2 — I, ]•(I�1 - /1�/ l^ restdemin,(with above sq ft-)W 1 y L a [�I O v L Renewable Energy ❑See Page 2 Services or feeders installation,nllejatiott,and/or relocation 200 amen or less JJ 100.70 I 2 ;.'a,PKOl'F.li"fY OtiVi)L`R- _ - []'TENANT' - I 133.56 2 - 201 imps to 400 amps • -,, 401 amps to 600 amps 200.34 2 r,as' 601 amps to 1,000 amps 301 04 2 Over 1.000 amps or volts 552.26 2 /State/ZIP: Temporary services or feeders installation,alteration,and/or relocation ■• •ere.( ) Fax:( ) 200 amps or less I 59.36 1 O•ncr installation:This installation is being made on property that I own which is not 201 amps to 400 amps I !I` 125.08 2 as in tided for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps I 168.54 I 2 0 ter signature: Date: Branch circuits-new,alteration,or extension,per panel COLVTACT PERSON A.Fee for branch circuits with �r• - ❑"AI'I'lr(CrtNT • - - _ d_ - above service or feeder fee, /� 742 2 2 each branch circuit (,(�' •„us name: B Fee for branch circuits wrlhmn -- -.-Cl S ram.• service or feeder fee,first 56.18 2 branch circuit s. Each odd'i branch circuit 7.42 2 Miscellaneous(service or feeder not included) .'Stalt/L.1 P: Each manulbctured or modular 67 S4 I 2 dwelling,service and/or feeder e.( ) Fax.:( ) Reconnect only 67.84 I 2 .tail: , Pump or imgatioo circle 6/84 2 ' " CO,VTRACrOR, • . •' Sign or outline lighting 67.84 2 4 �rl . Signal circuit(s)or limited-energy E ' 'cs name: 4.2. j� �,1(�.�.�jJ 1,(Jf/ /-VC -''C/ panel.alteration,or ceL^(titan. Page 2 2 l 1j' . S ry. Ench additional inspection over allowable in any of the above i•.i;css. �� (J _ AddiliOnal inspection(I hr usia) 66 25/hr t- v:Sta:ealP• (,5r)A1 Q/v g 71/9 66.25/hr : �j cl ( Industrial plum(1 hr min) 78.18/hr ' I (�L77 9 R..5"--- ♦f 7 '� I Fact ) Inspections fur which no fee is 9000/hr l,i / J 3 Electric l Li�� (�Suprv.Lie.: 9f specifically listed(h hr mm) � / '/ t ELEC`CRIf4►f PEAMfr1EES ,v.lilecirician-sf St2d,,'Iquircd: i 1'/f3 Subtotal Pion review(25%ofpermil fie) t name: �� /�� ,/��-. Date: S'�Z 1 State surcharge(12%of permit fee). I .:'.„nzcd signature: �4 I TOTAL PERMIT FEE. This permit application spires if a permit is not obtained within 180 I w.:name Date: days after II has been accepted as complete. -_ • Number of inspections allowed per permit .sEI.0 Per eaAtpi_FLt-PAEda:Ray 05:21r2013 410.46ItT(1 t/05;CORPLB Building Division Development Code Provision Review T i c n ri Residential Projects Building Permit No.: illSra-ot) - ad OS Project/Subdivision Name: VIII A lQ% , Lot #: Site Address: i o'f 7o 54-0 G T 2h-4.-e- CWS Service ProvideLetter: Required:Yes [� No ❑ (co )- n4(- W;it e miA,1 sooty. ei 1r-4ty d6-$ ; 1. rf'-'/r3 1.7) Received:Yes ❑ No ❑ 'Plans Routed: Original Plan Submittal Date: E/i7/'3 Routed By: 1St Revision Submittal Date: ❑ Site Plan Only Routed By: 2nd 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 ly if approved. Planning Review(contact at (503) 718 }''/" or 44( @tigard- or.gov) Land Use Cpf No. Zoning r-, — � [a/Setbacks: Front 7/t.1 Rear (5 Side / Street Side 4k, Garae -g" Maximum Building Height: 3 0 d Actual Building Height / 5 IB"Visual Clearance IltD Easements ' l Sensitive Lands Type: eet Trees Protected Trees � c � G1.21/1/-\ — ei Zs-G/S Z)7 Y Notes: �� Original Plan: Approved Q" Not Approved ❑ Date: 07. 7// Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I•\CURPLN\Masters\Development Code Provision Review\DCPR_RES doe Rev.01/16/13 • Engineering Review(contact Mike White at 503-718-2464 or MikeW @tigard-or.gov) Er Actual Slope: Notes: Original Plan: Approved' Not Approved ❑ Date: 8 / 1/%3_ Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albeit @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: • • • • Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 • ct � 1 Iii 2,S 2013 .,� t�J ► !� 1.�pF116 141D • �v1L�1Clean Water Services File Number AuG 192013 \Li) o z `t li C1eanWater Services 13 0 • By__ � -.�•sitive Area Pre-Screening Site Assessment 1. Jurisdiction:44f41;kfttet*Getfrity T 2. Property.informatIon(example 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Ross Monroe 1s136ad01300 Company: Address: 10470 sw 69th ave Site Address: 10470 sw 69th ave City,State,Zip: tgard,or 97223 !f City,State,Zip: Tigard,or,97223 Phone/Fax: Nearest Cross Street: sw Oak E-Mall: rossmon @hotmall.com II 4. Development Activity(check all that apply) 6. Applicant Information a Addition to Single Family Residence(rooms,deck,garage) Name: Wade Zuver ❑_ Lot Line Adjustment ❑ Minor Land Partition Company: Zuver Construction LLC ❑ Residential Condominium ❑ Commercial Condominium Address: 20449 SW TV Hwy#209 ❑ Residential Subdivision ❑ Commercial Subdivision ID Single Lot Commercial 01 Multi Lot Commercial City,State,Zip: Aloha,OR 97006 Other Phone/Fax: 503-572-6301 'E-Mail: w•zuver @Zuverconstructlon.com 6. Will the project involve any off-site work?, ❑Yes Pri No ❑Unknown • Location and description of off-site work 7. Additional comments or Information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as Issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of Inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name Wade Zuver Print/Type Title ONLINE SUBMITTAL Date 8/19/2013 • FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order - 07-20,Section 3.02.1. All required permits and approvals must be obtelned and completed under applicable local,state and federal law. ❑This Service Provider Letter Is not valid unless CWS approved site plan(s)are attached. ❑The:proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. / Reviewed by Date $/z'Z/( 3 .Tr • 2550 Sw Hillsboro Highway • Hillsboro,Oregon 97123 •• Phone:(503)681-5100 • Fax:(503)681-4439 • www.cleanwaterservices.org • �� VFlGI'iy LIIIG v Line of setback REC EWE" ' 1 F ,, ch AUG 27 2013 "6-0.3.$47;07$47■47$47■010;$47■0*.; (E) garage `PLANNING/ENGINEERING'E Orivewa KV .4# 4*# 0# 0, . °,�,,�,0$4.00$$1.00$14�,� 0 Verify 48'rw■ 1 ► � N Gara e water serice _ _ , � �S� ��# � ∎9 (N) Drvwy 4., # 40 4," . 2 I 00)V4.4V#07#4+4 ' A f.-, - *I#0,#0#‘0#4N t I .■44•0$00$4,4-st.■ 0 . 1..::„., 1.!..,:.._.: :::.-...::.:F ■ ■ ■ ■ .1 r' (New) a 4.)' I •••::'•---i'..• . .;•! ;;1 X ' _ot: 7Y O E Structure ' o i!ice / — • We 4 . — - — , p i I V/ / 15 Ii gas sery y � JI I / ei i I r I - / I Line of•setback _.] 7 / / Property Line _ _ - NO(l 1' . J 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 10470 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal 2014-02-28 00:00:00 MST2013-00195 PASS Range hood on seperate permit to come. 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 10470 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal 2014-03-03 (null) MST2013-00195 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 10470 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal 2014-03-03 (null) MST2013-00195 PASS Violation Summary: Inspector Contractor