Permit ��... CITY OF TIGARD MASTER PERMIT
,,'- '':�- -- COMMUNITY DEVELOPMENT Permit#: MST2013 00221
T L(;'ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/23/2013
Parcel: 2S109DA13900
Jurisdiction: Tigard
Site address: 12685 SW MOUNT VISTA CT
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 58
Project: Armstrong
Project Description: New 9'x5'elevated deck at daylight basement.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First. 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $800.00 Rear: 0
PLUMBING
Sinks. 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals. 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
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
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets. 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders 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: 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
Ecompasing: N
Other N Other Description: P 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
ARMSTRONG,BRIAN P COPASETIC CONSTRUCTION INC Required Items and Reports(Conditions)
12685 SW MOUNT VISTA COURT 3958 SE WAKE ST
TIGARD,OR 97224 MILWAUKIE,OR 97222
i
PHONE: 503-915-3777 PHONE: 503-780-7329
FAX:
Total Fees: $113.29
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty C••-s an. -II of - -•..licable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within ;. .ays o = ce, or if is sus.-nded for more the 180
days, ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification -•ter: .se rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .2 = or 1.:Pr.332,234 .•Issued B ! ---. 1111111. Permittee Signature: !��
Call -r by 7:00 a.m.
+ for the next available inspec or. . e.
This permit card sha •= ept 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
[ l n',_I 0--1))r FOR OFFICE USE ONLY
City of Tigard Received Permit No.: /7
`J g � T 20 i3 DateB : �0� r l ��Q 3�f�
° 13125 SW Hall Blvd.,Tigard,OR 972 Plan Revie
1 17: Phone: 503.718.2439 Fax: 503.59t.4960,*.- ,q-,- Date/By: 2 Other Permit:
p ��I'V Ui I db�h Ready/By: �� (� 65 See Page 2 for
T I G A R D
Inspection Line: 503.639.4175 Date i curs:
Internet: www.tigard-or.gov r3I I nr�Ir°"r�i01t1; Notified/Method: /Q �/ (3 Supplemental Information
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,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1-and 2-family dwelling ❑Commercial/industrial Valuation: $
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
ob site address: `7 c _ , )\ (3 New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
4 Suite bldg./apt.no.: Project name: Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
ec) {\\\ O� C �t.�V�) Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Se Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 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.
.j Valuation: $
v���►"`���"' Existing building area square feet
New building area: square feet
ROPE TY OWNER ❑ TENANT Number of stories:
Name: / 63, N 4.,\ Type of construction:
■
Address: ? 0 i 11Pi Cr Occupancy groups:
City/State/ZIP: �1 ��� Existing:
\� 2 g
Sone: S 6-31 fl Fax:( )
New:
❑ APPLICANT CONTACT PERSON NOTICE
Business name: • C ( \� � \ All contractors and subcontractors are required to be
Contact name: )\� V \ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be lensed in the
Address: `` ,, j jurisdiction in which work is being performed.If the
ity/State/ZIP: \�W �Z applicant is exempt from licensing,the following reasons
apply:
Phone: \10 ---.73n 3n I Fax::( )
3 E-mail: a �‘
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Permit fee:
4
Address:
-- ---)A.I . State surcharge(12%of permit fee):
City/State/ZIP:
FLS plan review(40%of permit fee):
Phone:( ) ax:( ) (Due upon application.)
CCB lie.: l� `�� � + Total permit fees:
Authorized 'a ature: `�_ Amount received: � -
`r► This permit application expires if a permit is not obtained
Print name:�� Date: r within 180 days after it has been accepted as complete.
r-
.. ... -` -' \ \ ��^ * Fee methodology set by Tri-County Building Industry
., Service Board.
I:Building\Permits\FPS-PerrnitApp.doc Rev 01/05/2012 440-46131(11/02/C0M/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration El 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
•
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq.ft.
Fire Protection Permit Fees
Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
1:\Building\Permits\FPS-PemritApp.doc Rev 01/05/2012 2