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Permit
INCITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2013 00244 T[c A R f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ��� Date Issued: 02/26/2014 tali �� Parcel: 2S110BB04000 Jurisdiction: Tigard Site address: 12165 SW AMES LN Subdivision: ARLINGTON RIDGE Lot: 17 Project: Peterson Project Description: 1,296 sq ft addition.4/15/14: Reprinted permit to change electrical contractor. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 648 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 0 Second: 648 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right 5 Detectors: Yes Total: 1296 sf Value: $138,766.00 Rear 15 PLUMBING Sinks: 2 Water Closets: 0 Washing Mach: 1 Laundry Trays: 1 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 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Heat Pump: N Hoods: 1 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 addl 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 6 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. N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 1296 Owner: Contractor: PETERSON,BRYCE D&KRISTI A RIVER CITY CONTRACTING Required Items and Reports(Conditions) 12165 SW AMES LN 6625 SW 185TH AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97224 BEAVERTON,OR 97007 PHONE: PHONE: 503-828-6600 FAX: Total Fees: $4,771.95 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 OAR 952-001-0090. You may obtain es or direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344 Issued BI --.....------ ._. —��� Permittee Signature: #0,---/-4 .L.- Cal by 7:00 a.m.for the next available inspectio 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. Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received �/ {.s—/I Y /7 7. Permit No.: :// • 13125 SW Hall Blvd.,Tigard,OR 97 ., Plan Review ���13-a�YY Phone: 503.718.2439 Fax: 50 Date/By: Other Permit: 1 1,1 Inspection Line: 503.639.4175 ^ \[� Date Ready/By: Jars: I ® See Page 2 for I Internet: www.tigard-or.gov {O Notified/Method: �- Supplemental Information tpR 1 PLAN REVIEW TYPE OF WORK i�(.ap►� ❑New construction Addition/alteral;�glQl� g�,��``t�e�'1r'\ Please check all that apply(submit 2 sets of plans w/items checked below) El Service or feeder 400 amps or more ❑Building over three stories. El ❑Other: Q����O where the available fault current ❑Marinas and boatyards. CATEGORY OF CON8�11tUCTION N exceeds 10,000 amps at 150 volts or ❑Floating buildings. .! • • less to ground,or exceeds 14,000 0 Commercial-use agricultural 1-and 2-family dwelling ❑Commercial/industrial ❑ -.I,• r,g •• ❑ '+'` amps for all other installations. buildings. Multi-family ❑Master builder l� ❑Fire pump. ❑Installation of 150 KVA or ❑Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCAT ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: /z 6 5 _c,,j,_ A Ai, s 100HP or more. occupancy. ❑ 0 Six or more residential units. Recreational vehicle parks. City/State/ZIP: -77G A p o/Z ❑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. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Tax map/parcel no.: Ea.add'l 500 sq.ft.or portion 33.92 1 Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) • Limited energy,multi-family 75.00 2 4 v/2/17 CA) ry /, 5/,7,CA/ce- residential(with above sq.ft.) J^ , �"� � Renewable Energy ❑ See Page 2 e 1"7LV)�''� �r �,11 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER L ❑ TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:( ) relocation 200 amps or less 59.36 1 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: 1:7/1'!,/f /2L•i(G-r72/c 4,C each branch circuit B.Fee for branch circuits without Contact name: /‘‘ 7 p x yl f /„1�,‘//.T �r- service or feeder fee,first 56.18 2 v� branch circuit Address: ,A ✓ G, c 7,,,...7 Each add'I branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( ) 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: c)//,...7/..)/ �L G I( Signal alteration,or limited-energy See panel,alteration,or extension. Page 2 _ 2 Address: /66 7 V �w 6.I/e, 2j, 7• s�-- Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: �ir...4 v p2 Investigation(1 hr min) 66.25/hr . Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr 1 CCB Lic.:/76 a/..,- Electrical Lic.: (Z9 7 Suprv.Lic.: yZ,7,,,s' specifically listed(Y2 hr min) � � ELECTRICAL PERMIT FEES , Suprv.Electrician signature,required: � A. ,G/� Subtotal: Print name: ------OHS /`LL S G Date: 7/,�//� 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 180 Print name: Date: days after it has been accepted as complete. Number of inspections allowed per permit. I:\Building\Pamits\ELC_PennitApp_ELR_ERE.doe Rev 05/21/2013 440.46151(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined ... $75.00 Description I Qty. I Fee I Total I * Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: I=1 Burglar Alarm 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 El Heating,Ventilation and Air Conditioning OAR 918-309-0040) System* Solar generation systems in excess of 25 kva: Each additional kva over25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 ElOther: additional inspection over allowable in any of the above: Other: Each additional inspection is charged at an hourly(I hr min) 66.25/hr Inspections for which no fee is 90.00/hr specifically listed('/:hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 ❑ Audio and Stereo Systems days after it has been accepted as complete. • Number of inspections allowed per permit. ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC H Instrumentation ❑ Intercom and Paging Systems H 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 L\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 v CITY OF TIGARD MASTER PERMIT 11111 I COMMUNITY DEVELOPMENT Permit#: MST2013 00244 Date Issued: 02/26/2014 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110B604000 Jurisdiction: Tigard Site address: 12165 SW AMES LN Subdivision: ARLINGTON RIDGE Lot: 17 Project: Peterson Project Description: 1,296 sq ft addition BUILDING Floor Areas Required Setbacks Reauired Stories: 2 Bedrooms: 1 First: 648 sf Basement: 0 sf Left 5 Parking Spaces: 0 Height: 25 Bathrooms: 0 Second: 648 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors Yes Total: 1296 sf Value: $138,766.00 Rear: 15 PLUMBING Sinks: 2 Water Closets: 0 Washing Mach: 1 Laundry Trays: 1 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 Tvpes Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Heat Pump: N Hoods: 1 Other Units: 0 Fum<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: 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 6 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 Ecom asin N Other: N Other Description: p g BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 1296 Owner: Contractor: PETERSON,BRYCE D&KRISTI A RIVER CITY CONTRACTING Required Items and Reports(Conditions) 12165 SW AMES LN 6625 SW 185TH AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97224 BEAVERTON,OR 97007 PHONE: PHONE: 503-828-6600 FAX: Total Fees: $4,771.95 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Cod. -er applicable law. All work will be done in ..• •:nce with approved plans. This permit will expire if work is not started within 180 days of issuan•: • is suspended for more the 180 days. ' ENTION: • -eon law requires you to follow the rules adopted by the Oregon Utility Notification C• ••se rules are set forth in OAR 952-:11-0010 through OA',9 -r• -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 2. ' :10.332.2344. lss ed By: a. ——♦ -.4411111-...1'-2 Permittee Signature: ALA r Call 503.639.4175 by 7:00 a.m.for the next available inspection date. IF 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. Building Permit Application firepte„,Residential I I)IZ I I I I I I I I s l ()NI 1 �I Reserved City of Tigard DEC O Dat _ IK• 0/3 I-ln Permit No.: J�f� ,/3 0aI/ 13125 SW Hall Blvd.,Tigard,OR 97223 G 2013 Plan Revie "11111.1.. ' Phone: 503.718.2439 Fax: 503.598.1 � Oc Date/B ���,itt� i1P.�'er Permit: )_ `R n Inspection Line: 503.639.4175 i 'LONG ��C7ARD Date R �: Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method: / M Supplemental Information TYPE OF WORK REQUIRED BATA:1-AND 2-FAMILY DWELLING El New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 51 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. // 91-and 2-family dwelling ❑Commercial/industrial Valuation: $ ( & 77< , El Accessory building ❑Multi-family Number of bedrooms: CI Master builder ID Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: / /GS 5c 4,ilef Lrl , New dwelling area: square feet 1?90' City/State/ZIP: l'y , /f/d Oft f7 _ G{ Garage/carport area: square feet Suite/bldg./apt.no.: J Project name: Pe7/ sor7 Covered porch area square feet Cross street/directions to job site: 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.: 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. /ail fcon Valuation: $ r Existing building area square feet New building area: square feet [t PROPERTY OWNER I ❑ TENANT Number of stories: Name: 3rye`o PL'i6✓S p,1 Type of construction: Address: /2/‘C 5 W ,IM e5 Gr!• Occupancy groups: City/State/ZIP: 779,aytC✓ ./L 4 7r7-y Existing: Phone:(5# ) (r t-///- 3i/j.f/ Fax:( }---- New: ❑ APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: 2/r/C2 e6`� Ls0,,7/4 �,?� (Please refer to schedul f) y Structural plan review fee(or deesit): Contact name: Do q Di y /� FLS plan review fee(if applicable): Address: yet(p ✓5 w �«,2S1Of, W Aty -2631,07c- Total fees due upon application: City/State/ZIP: p,..,„,,,./.,, D/Z. , f7V7 87/ `� Phone:(SQ3 ) g,7 .66'pp Fay{--r Amount received: E-mail: /) f �Sn L Qi.r PH t' OVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercia d residential prescriptive installation P roof-top moun •' PhotoVoltaic Solar Panel Sy . Business name: Submit two(2)se. of roof plan with con : ion details and fire department . ess,along wi ' ' e 2010 Oregon Address: G Solar Installation Spec, ■ C,,• ecklist. Permit Fee(include . review City/State/ZIP: and as istrativ ees): $180.00 Phone:( ) Fax:( ) State Burch. :- (12%of permit fee . $21.60 CCB lie.: /5/(2,0 36-- q\t ,d Total fee due upon appication: $201.60 Authorized signature: `/ This permit application expires if a permit is not obtained L 7 within 180 days after it has been accepted as complete. IPrint name: a ,<.j D/e y Date: /a4a//3 *Fee methodology set by Tri-County Building Industry Service Board. tuilding\Permits�BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling 1t1Iz 014 I( l t Sl: OOMl.' City of Tigard Received Date/By: Permit No III .: • 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: II(.AkD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITI':N1S ARE REQUIRED FOR PLAN REVIEW 1 e y0 •/1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ • • 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. . 10 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ El ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. _ 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore.on and shall be shown to be applicable to the •ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17'. ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ _ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Application 1 FOR OFFICE USE ONLY Received City of Tigard DEC Date/By: %' /5 A - PennitNo.:,t'/ 7/6—a);` 9 13125 SW Hall Blvd.,Tigard,OR 97223 C Z�j Plan Review Phone: 503.718.2439 Fax: 503.598.1 .0, Date/By: Other Permit: I l C i\R U Inspection Line: 503.639.4175 ��1° Q �°! Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.goVf' ( n / A Notified/Method: Supplemental Information �11D 1+.roll tt+, -wtV1Oi _ TYPE OF WORD ,`. . `. PLAN REVIEW ❑New construction Please check all that apply(submit 2 sets of plans w/items checked below): ❑Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. " CATEGORY 0F.C(�)!iSTRiTCTION 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 150 KVA or ❑Emergency system. larger separately derived system. 4013 SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: 421 bc..- j Lei /fares 67 100HP or more. occupancy. ❑ 0 Six or more residential units. Recreational vehicle parks. City/State/ZIP: I;(40z, D� 7zz ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: Pe.71-reyt,_5,ph ❑Service or feeder 600 amps or more. FEE SCHEDULE. Cross street/directions to job site: Description Fee. 1 * I Qty. i � Total New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4 - Ea.add'l 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK: (with above sq.ft.) • 75.00 2 Limited energy,multi-family 75.00 2 4-41 10,_ residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY:OWNER ❑ TENANT 200 amps or less 100.70 2 �r�� � �� �� 201 amps to 400 amps 133.56 2 Name: / e C 401 amps to 600 amps 200.34 2 Address: — 601 amps to 1,000 amps 301.04 2 y /m., - Over 1,000 amps or volts 552.26 2 City/State/ZIP: / Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:( ) relocation 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 intended for sale,leas ,rent,or�ats�lange,according to ORS 447,449,670,and 701. it 401 amps to 599 amps 168.54 2 Owner signature: ( \// u�t�t� Date: 2'2 o- 1 i Branch circuits—new,alteration,or extension,per panel ❑ APPLICANT - ❑ 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: service or feeder fee,first branch circuit 56.18 2 Address: Each add'l branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:( ) Fax::( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: )to 1' 9-) Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Investigation(1 hr min) 66.25/hr • Phone:( ) .Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90,00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: speci9cally listed(4 hr min) - --ELECTRICAL-PERMIT FEES _ --- Suprv.Electrician signature,requi ed: Subtotal: Print name: Date: Plan review(25%of permit fee): F State surcharge(12%of permit fee): Authorized signature: x TOTAL PERMIT FEE: `�, This permit application expires if a permit is not obtained within 180 Print name: J� U_ice{r Date: 2 02/ f 3 days after it has been accepted as complete. 1 * Number of inspections allowed per permit. t:\Building\permitstELC_PermitApp ELR ERE.doc Rev 05/21/2013 44o-4615T(t 1/05/COM/WEB Plumbiri2 Permit Applicati L lD Building Fixtures DEC 2 2013 I "k l ll I Il I I `..1 (0.1 City of Tigard D Received: / �� / Permit No.: /3-�� 13125 SW Hall Blvd.,Tigard,OR 9YOFTIGARD Plan Review • Phone: 503.718.2439 Fax: 503. 1MING DIVISION Date/By: Other Permit No.: T I C i;1 R L) Inspection Line: 503.639.4175 Date Ready/By: runs: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 building SFR(3)bath 500.32 ❑Accesso ry g ❑Multi-family -- - Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: /2/ s(,4/ /¢ors <<!. Drywell,leach line,or trench drain 18.76 City/State/ZIP: 1"y Aye/ o,e f y Footing drain(no.linear ft.: ) Page e 2 Suite/bldg./apt.no.: I Project name: : /LrSOfrR 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.: FV :he Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 /' 1 Clothes washer 1 25.02 Aki ,'T,��� Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: .0/7 e e pC.le r-obi Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: /� yt�r 11 g/_lJe Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker , 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 3 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan _ 12.51 E-mail: Urinal 25.02 CO R Water closet 25.02 c Water heater 37.52 Business name: Water piping/DWV 56.29 Address: lets?2, aLAD - kO Other: 25.02 City/State/ZIP: ct>�4 0Q 1'7067 Subtotal Phone:('j7() 60(t--6'3`5T Fax:( ) Minimum permit fee: $72.50 CCB Lic.: /Q�m4 t Plumbing Lic.no.: P6 ( j(/ Plan review (25%of permit fee) / State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: ID t.,„4_,.9 D/e-Y Date: 407/f This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permita\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 Square Footage: Permit Fee: Footing drain-10 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $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 and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr 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*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font 1:1 Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash:Wash: -Each Stall New exterior plumbing site utilities for any complex structure Drive Stall as defined in OAR918-780-0040. CI Cuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash p y Floor Drain/sink: -2" 3" Isometric or Riser Diagram 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food _ that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filer increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Mechanical Permit Application Folz orFlc'l: tSE ONL\ 114 City of Tigard a 1 �,� Date/B Permit No.: iL/ Received �� / ��_//� • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review CSC fGi 1 II Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: Inspection Line: 503.639.4175 DEC ;• L U I j Date Ready/By: rur s. Vi See Page 2 for TIGARD Y y Internet: www.tigard-or.gov �) Notified/Method: Supplemental Information �p���C�pITYOFTIGARD TYPE OF WHUQ- ()N' 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 ❑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 Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: /42?/6 5 t l/ //C5 `,l, Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: f�pr �� 7 !/ Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: , Pe 02.50 1 Duct work I 23.32 Cross 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 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert I 33.39 Flue vent for water heater or gas l `ph fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: p_yec Pt-1 S©.t Range hood/other kitchen equipment 1 33.39 Address: 5 Clothes dryer exhaust 1 33.39 City/State/ZIP: /T�� �� r/�/�v�— Single-duct exhaust(bathrooms, toilet compartments,utility rooms) I 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name: 1,/� 4,1A �� N f` 0.., Other: 1111 �ttl �( MECHANICAL PERMIT FEES* Address: 4710 , 1-1_k,,,_. U Subtotal City/State/ZIP: A AL. Cj7 a-a-/ Minimum permit fee($90.00) ) a$t{� 2 r Plan review(25%of permit fee) Phone:(5a 3 37�v Fax:( ) State surcharge(12%of permit fee) CCB lic.: 154 Iti3 g 2� (‘ TOTAL PERMIT FEE 1 ( 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 name: t„c✓ b fey Date: /A/ 7i 3 L P \\Building\ ermitsMEC_Perini tApp_040113.doe 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: 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:Building\Permits\MEC_PermitApp_040113.doc 2 Building Division Development Code Provision Review T i n ii Residential Projects Building Permit No.: MQ-1 0LI Y 00a41-/ Project/Subdivision Name: -i£ ‘a C)lT , Lot #: Site Address: I I to E biz F L--13• CWS Service Provider Letter: Required:Yes ❑ No 0 Received:Yes ❑ No I Plans Routed: l Original Plan Submittal Date: 10� .91/ Routed B . 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 (✓) 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 AIM )-OWGICZ at(503) 718-242.1 or _____ _ @tigard- or.gov) Land Use Case No. al 13q3 poc 02- At v Jtw) 12- Zoning P 3.5 Et/Setbacks: � Front 2j Rear 1 E Side S Street Side 20 Garage 26 [ Maximum Building Height: ap' Actual Building Height t 2� Er-Visual Clearance tJlec 'Easements Ca' Sensitive Lands Type: Std S lopes "0 13}/ treet Trees I.f(.pt Protected Trees Oilt PIA E • Pro\/ f _C^r11100 rs -aced i nerul bx i Vl Sleep Slope- ac keol t ( lc'ko fi fr►,° 7d��I li Rao , i Original Plan: Approved 0 Not Approved , Date: `2- L`t Revision 1: Approved IT Not Approved ❑ Date: IL- 19-(3 Revision 2: Approved 0 Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR RES.doc Rev.01/16/13 • • • - Engineering Review(contact Mike"hite-at 503-718-2464 or MikeW @ tigard-or.gov) ❑ Actual Sloe: yo Notes: • *i - -- or, Original Plan: Approved ,kf Not Approved ❑ Date: 42,=-. Al I I> 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: _J Z 7 1/3 (a 7 C:pnar&C Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes IA No ❑ Date Routed to Building: ! Z` l I - Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 I 121'5 AVE. .53' ALI< o ----___ 1, ,; ;,; -r\.. .: g r2:,.\\ :.,. _4 .4:,.. 14.,:', ''. /.. Z N \�•: / "1• ; ,, ♦ ir 1 r , 6 L Q rn , 1 \'''c / r r m I r h' 1 I I, 1 ri . I 1 ,^ I I f ')'.,^^'' . \,<'.. to , ni 77 .ex `< z. (li rn , I < Z 1 I ,r I < /1! 0 (J1 n ., : ; ,r(f�� rn 7 z r ,i A r 0 ....;1. I ' 73 CP rn z ' ' 1 4 : , "4,i/ g .4....--- -L..--.- - -1 '19 . ,./z D . 115.4 ' l s n o Qo �c) N riri Q., t j RIVR CITY ADDITION �5 \ w SITE PLAN t �' P.O.box 8 1) bend,Or.9 O8 Phone:54I-4O8-6212 �i, ,/ Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12165 SW AMES LN, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical final PASS MST2013-00244 Jeff Grove Violation Summary: Inspector Contractor