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Permit 111 __ CITY OF TIGARD MASTER PERMIT Pe u 11 _ COMMUNITY DEVELOPMENT I Permit#: MST2014-00019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� fYia Date Issued: 03/20/2014 Parcel: 1S134DA01800 Jurisdiction: Tigard Site address: 10757 SW NORTH DAKOTA ST Subdivision: NORTHERN PINE Lot: 6 Project: TASTO Project Description: New SF. DEMO CREDITS FROM BUP2014-00024 APPLIED TO THIS PERMIT. 10/20/14, reprinted to change GC to Run of the Mill LLC and ELC contractor to Carton Electric Inc. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First 2031 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1941 sf Garage: 576 sf Front: 20 Smoke Dwelling Units 1 Third: 800 sf Right: 5 Detectors: Yes Total: 4772 sf Value: $580,886.66 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 6 Furn>=100K: 1 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 add'I 500 at 9 201-400 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 4772 Owner: Contractor: TASTO,RUSSELL J&NICOLE K RUN OF THE MILL LLC Required Items and Reports(Conditions) 1401 E 8TH ST 10875 SW NORTH DAKOTA ST 1 Ersn Cntrl 503-639-4175 NEWBERG,OR 97132 TIGARD,OR 97223 PHONE: PHONE: 503-317-3652 FAX: Total Fees: $13,749.84 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 •• -«r. .: _ ith 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 day . ATTENTION: Orego law re•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR •.2-001-0010 through OAR 952 r r -109.. Y. may obtain a copy of the rules or direct questions to OUNC . - 'It. -• .232.1987spr 1.800.332.2344. % ∎ �Ls Issued By: ! // Permittee Signet �� c'�� Call 503.639.4175 by 7:00 a.m.for the next available inspectio i .ate. This permit card shall be kept in a conspicuous place on the job site unt• completion of the project Approved plans are required on the job site at the time of each inspection. 1. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT II = r Request Permit Action F I G A R O 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov 'I'0: CITY OF TIGARD Building Division Services Supervisor 13125 SW Hall Blvd.,Tigard OlL)7223 Phone: 503.718.2430 ax: 503.598.1 www.tigard-or.gov FROM: Owner ❑ Applicant ❑ Contractor ❑ City Staff (check one) REFUND OR Name: (� \ INVOICE TO: (Business or Individual) Mailing Address: ( a7 t S� N V a Y d City/State/Zip: T, �`-� . 7 Zu Phone No.: Q b5 3`1 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ❑ CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). la REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: H6]—a4(`/- (,Q '/9 Site Address or Parcel#: Project Name: Subdivision Name: Lot#: )(EXPLANATION: P,�O t\ C.CQ i ' .YNkrc,\ c0rnac C; \)%e a� ,,Q '\ A\ L � c C> ‘1' ZQ-1 b Signature: "K Date: l y C Print Name: X Fti V SSt`1 a�, r Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80%of the land use application fee for issued permits. d) not more than 80%of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80%of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds. FOR OFFICE USE ONLY Rte to S s Admin: Date 0,0272/EIM1J Rte to Bid! Admin: Date !e®®Q,S Refund Processed: Date By Invoice Processed: Date By Permit Canceled: Date By Parcel Tag Added: Date By Receipt# Date Method Amount$ I:\Building\Forms\ReqPermitAction.doc Rev 05/25/2012 Building Permit Application Residential IECEIVED FOR OFFICE USE ONLY Received /l�L City of Tigard Date/By. /4/ /, Permit No.: / l7/-aol -000/9 2 y: 13125 SW Hall Blvd.,Tigard,OR 972230 C T 2 O 2014 Plan Review Other Permit: Phone: 5n Line: 39 Fax: 503.598.19.1 Date/By.Ready/By:, \It t) Inspection Line: 503.639.4175 to Date ReadyBy: Jung ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information a7 TIMM 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(rotnded 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 ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /97 5 7 Scd N- —0/9-g6Ti`7.- New dwelling area: square feet City/State/ZIP: Garage/carport area: square feet Suite/bldg./apt.no.: Project name: 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. Indicate the value(romded 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. CA-1-141-10 ,i .O CJ Z-/4Cre) - Valuation: $ Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: City/State/ZIP: Total fees due upon application: one:( ) Fax: :( ) Amount received: C2E!.dail: r u 5 S 01 ,oncP F w;\\,V S PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: V 0 �1,g M ;\1 1 _LC Submit two(2)sets of roof plan with connection details 0 �`__ S� ✓ and fire department access,along with the 2010 Oregon Address: J a z Solar Installation Specialty Code checklist. City/State/ZIP: 'r- . d.t� Q Q ` � 3 Permit Fee(includes plan review $180.00 ( 02) 31 1 ( ) and administrative fees): Phone: Fax: State surcharge(12%of permit fee): $21.60 CCB lic.: Z Q Q SA/4 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained ` within 180 days after it has been accepted as complete. V3 Print name: , it\\ TQsL Date: 10/ t 0/my *Fee methodology set by Tri-County Building Industry �/� {{{ Service Board - I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received 1114 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Phone: 503.718.2439 Fax: 503.598.1960 Associated permit TI c;A Ii t� 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet www.tigard-or.gov ❑ Other THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1t.'. No `/ _I 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 3 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, ❑ ❑ ❑ 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 ;..licable to the .ro'ect under review. .II RISUI( 'I IO\AI, SI'1•:( IFI( S 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"buildingplans 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:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB) I Electrical Permit Applicati , FOR OFFICE USE ONLY City of Tigard � � Received /10 O Permit 4: / 1.--6.,,,:__< e, • 13125 SW Hall Blvd.,Tigard, 972 t Plan Review ! �` g i Plan Review III Phone: 503.718.2439 Fax: 503.598.1980-T L L U I"� Date/By: Related Permit k: Inspection Line:8503.639..4175 CITY �-J._ y`, Ready Date/By: kris: 65 See Page 2 for I I l'•\I:I\ Internet: www.tl ardor. ov 16AHU Notified/Method: Supplemental Information- TYPE OFI' Mt PLAN REVIEW ❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 1 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATIO ❑Emergency system. larger separately derived Job#: Job site address: /0757 g -1.-- ❑Addition of new motor load of system. I00HP or more. ❑"A" "E" `9-r' "l-3" Ci /State/ZIP: 0 Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. _ Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential �1 -- (with above sq.ft.) l I I'G�-f Limited energy,multi-family 75.00 2 U residential(with above sq.ft.) 75.00 2 ----• Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 _ 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ❑ APPLICANT I 0 CONTACT PERSON Branch circuits–new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 Each add'I branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 n \ CONTRACTOR Pump or irrigation circle 67.84 2 Business name: l'4Q��) _ r72--/ /rJ C Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: PO /3p y gl ❑ See Page 2 2 panel,alteration,or extension. g City/State/ZIP: a T�/ D2 /O r' Each additional inspection over allowable in any of the above T/M Additional inspection(1 hr min) 66.25/hr Phone:( ■3) I/36--/4,pa Fax:(2'3) V 3 5--63 S 3 7 Investigation(1 hr min) 66.25/hr Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: 15�'j( 3 Electrical Lic.:3 L-Iao( Suprv.Lic.: 3.675S specifically listed(/z hr min) ELECTRICAL PERMIT FEES YA"Suprv.Electrician signature,required: Cal2, ek— Subtotal: Print name: 0 CAr--6 r-N Date:IQ-AO -- 1 t.-1, ❑Plan Review Required(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. L\Building\Permits\ELC_PermitApp_ELR_ERE.docx Rev 04/21/2014 440-4615T(I 1/05/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 Description i Qty. [ Each I Total I * Fee for all residential systems combined: $75.00 Renewable electrical energy systems: S kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ 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 OAR 918-309-0040) 552.26 2 ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0 0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed(%hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: El Audio and Stereo Systems El Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems El Landscape Irrigation Control* El Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations C\Building\Permits\ELC_PermitApp_ELR_ERE.docx Rev 04/21/2014 1 W CITY OF TIGARD .�, t MASTER PERMIT i 1111111 "3 . COMMUNITY DEVELOPMENT �' Permit#: MST2014-00019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/20/2014 Parcel: 1 S134DA01800 Jurisdiction: Tigard Site address: 10757 SW NORTH DAKOTA ST Subdivision: NORTHERN PINE Lot: 6 Project: TASTO Project Description: New SF. DEMO CREDITS FROM BUP2014-00024 APPLIED TO THIS PERMIT. 10/20/14, '/„,,,,(0.44.4„(3 reprinted to change�G/C to Run of the Mill LLC and ELC contractor to Carton Electric Inc. /o/'' t 4 14/r? Lei A p LG aL ,..,�BUILDING ctroor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 Fi : 2031 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 3 Second: 1941 sf Garage: 576 sf Front: 20 Smoke Dwelling Units: 1 Third: 800 sf Right: 5 Detectors: Yes Total: 4772 sf Value: $580,686.66 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 6 Furn>=100K: 1 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add?500 sf: 9 201-400 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 4772 Owner: Contractor: TASTO,RUSSELL J&NICOLE K RUN OF THE MILL LLC Required Items and Reports(Conditions) 1401 E 8TH ST 10875 SW NORTH DAKOTA ST 1 Ersn Cntrl 503-639-4175 NEWBERG,OR 97132 TIGARD,OR 97223 PHONE: PHONE: 503-317-3652 FAX: Total Fees: $13,749.84 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATT • . •egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0'10 through OA” 952-0e -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 0 Issued c I/ Permittee Signature: 4111PP � � i _ - ' / , / Call 503.639.4175 by 7:00 a.m.for the next available inspection date. / This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the job site at the time of each inspection. Mechanical City of Tigard l l lic.__^ DaeB ��3 FOR OFFICE USE ONLY { l � ' ■ 13125 SW Hall Blvd.,Tigard,OR '7 :_ y 10. / VI J_ . `, Plan Review Phone: 503.718.2439 Fax: 503.598.196pc G 3 Other Permit: UU Date/By: T I G A R D Inspection Line: 503.639.4175 Date ReadyBy: Juris. 0 See Page 2 for Internet: www.tigard-or.gov C1��iV�}{� Notified/Method: Supplemental Information 1IVV��'� F TYPE O>1?"1� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling El Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑ Master builder ❑Other: Description I Qty. l Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: Furnace 100,000 BTU(ducts/vents) _ ! 46.75 City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: 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 33.39 n Flue vent for water heater or gas fJ'� 12_1/ K. 't .2Q Ted s fireplace 23.32 4- lh rit / c �1 / , Log lighter(gas) 23.32 // p�' •�J� 0 rG Wood/pellet stove 33.39 tet-re.-t Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: Or_.4- Range hood/other kitchen equipment 33.39 Address: Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 . Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: 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) Other: Business name: - MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: TOTAL PERMIT FEE _ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: L JQ` • Fee methodology set by Tri-County Building Industry Service Board Print name: 1'v v,S S t\\ "I T ots,U Date: \OR Z 3 l Z 014 I:\Building1Permits\MEC PermitApp_040113.doc 440-461 17T(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_0401 I3.doc 2 111 n CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2014-00019 Date Issued: 03/20/2014 TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 1S134DA01800 Jurisdiction: Tigard Site address: 10757 SW NORTH DAKOTA ST Subdivision: NORTHERN PINE Lot: 6 Project: TASTO Project Description: New SF DEMO CREDITS FROM BUP2014-00024 APPLIED TO THIS PERMIT BUILDING Floor Areas Required Setbacks Required Stories 3 Bedrooms 3 First 2031 sf Basement 0 sf Left 5 Parking Spaces- 0 Height 28 Bathrooms: 3 Second 1941 sf Garage: 576 sf Front 20 Smoke Dwelling Units 1 Third 800 sf Right 5 Detectors Yes Total 4772 sf Value 8580.886 66 Rear: 15 PLUMBING Sinks: 1 Water Closets 3 Washing Mach 1 Laundry Trays I Rain Drain. 1 Urinals 0 Lavatories: 4 Dishwashers 1 Floor Drains 0 Sewer Lines 100 SF Rain Storm Sewer 100 Drains: 0 Tubs/Showers: 3 Garbage Disp 1 Water Heaters 1 Water Lines 100 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. Y Vent Fans 5 Clothes Dryers 1 Natural Gas Heat Pump: N Hoods 1 Other Units: 0 Fume100K 0 Vents 0 Woodstoves. 0 Gas Outlets 6 r Furn>=100K 1 I ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 100D sf or less 1 0-200 amp 0 0-200 amp: 0 V.4 Svc or Fdr 0 Ea add'500 sf: 9 201-400 amp 0 201-400 amp: 0 W%O SvcrFdr 0 Mid Home/Feeder/Svc 0 401-600 amp 0 401-600 amp: 0 601-1000 amp 0 601+amp-1000v: 0 1000+amprvolt 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 Y BUILDING INFO Class of Work: Type of Use: Type of Constr Occupancy Group: Square Feet: NEW SF VB R-3 4772 Owner: Contractor: TASTO,RUSSELL J&NICOLE K OWNER Required Items and Reports(Conditions) 1401 E 8TH ST RUSSELL TASTO 1 Ersn Cntrl 503-639-4175 NEWBERG,OR 97132 10875 SW NORTH DAKOTA ST TIGARD.OR 97223 PHONE PHONE 503-317-3652 FAX: Total Fees: $13.749.84 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 952-001-0090. You may obtain a copy of[h or3lreet.guestions to OUNC by calling 50 2.1987 or 1.800 332 2344 3 Issued By: —_` - Permittee Signature: /Zit CaOF 5D3_tt .41755)y 7:00 a.m.for the next available inspection 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. - ir , Building Permit Application ft PCiel e Crcei rf-j -67-aM sikeoq()til— . Residential FOR OF F1( F. 1 tiF: O\I.1 City of Tigard RECEIVE I1 Received k Permit No..„9.2 f , a — . II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re Ii l� I Phone: 503.718.2439 Fax: 503.598.1960 Date/ : ' g in.r- Other Permit: TIGARD ^ Inspection Line: 503.639.4175 FEB 19 2014 Date Ready/tty: hills ® See Page 2 for Internet: www.tigard-or.gov Notitied/Method. 3 /l ill 'J _ 7 7T Supplemental Information CITY OF TIGARD t `4ap:) w��f7. R.,i,i-.-f% TYPE OFaALt®Nf�IING/ENGINEEl�1NG REQUIRED DATA:1-AND 2-FAMILY DWELLING 14 New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dolls)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this appli lion. ❑1-and 2-family dwelling ❑Commercial/industrial Valuation:— 50 ea,4 s ❑Accessory building El Multi-family Number of bedrooms: 3 ❑Master builder ❑Other: Number of bathrooms:K, 3 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 07 5 SW �LJr^ a�C 34 New dwelling area: -, ' square t 4�7'� City/State/ZIP: - r Q . 97 Z Z 3 Garage/carport area: 51 b square t eG�, Suite/bldg./apt.no.: ) Project name: KA s-fb Covered porch area f)9 a square. (1 k f Cross street/directions to job site: N 4 I. �` 6‘k 4y, ly 4t 1, L c \?o Deck area: square feet 20 Other structure area f.?,tic square feet ) REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:ti 0 v. Q,e�D; Lot no.: 17 Permit fees*are based on the value of the work performed. `3 L� A�' QQ Indicate the value(rowded to the nearest dolls)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. \� S \tr t\ Valuation: $ Existing building area square feet \ New building area: square feet Di PROPERTY OWNER ❑ TENANT Number of stories: Name: V S SQ.\L To,S Type of construction: Address: ' O $'7 LJ 3V1 Nor V a\•-t,'w` S_-6 Occupancy groups: City/State/ZIP: T; v , Q m z_z1 Existing: Phone:(5011 2‘-'7 b5 z Fax.( ) New: APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: ,/Le�'t� (Please refer to fee schedule) . Structural plan review fee(or deposit): Contact name: Address: FLS plan review fee(if applicable): City/State/ZIP: Total fees due upon application: Amount received: Phone:( ) Fax::( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: Submit two(2)sets of roof plan with connection details a4/fie✓ and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: Total fee due upon appication: $201.60 Authorized signature: �r\ This permit application expires if a permit is not obtained �J��JJJ J vv �` ��rr within 180 days after it has been accepted as complete. n *Fee methodology set by Tri-County Building Industry Print name: �,1� ��Q\� T� Date: z! 1 2 « Service Board I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4f613T(11/02/COM/W EB) Ili . Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE I ,st (l\1 ' City of Tigard Received III Date/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 Tic/kilt) 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other 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 3 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, ❑ ❑ ❑ 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 ❑ El ❑ 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 he shown to be a•r licable to the s ro'ect under review. JURISDICTIONAL SPECIFIC'S 23 fhrec(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"buildingplans will not be accepted. ❑ ❑ ❑ 26 "Reversed"buildingplans 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. L\Building1Permits\BUP-RESPermitApp.doc 02/24/2011 440-46I3T(I 1/02/COM/WEB) Plumbing Permit Application 'Building Fixtures FOR OFFICE USE ON 1 Received City of Tigard r(��j Date/B : PermitNo.:�OW/it- )L`I i r+ 13125 SW Hall Blvd.,Tigard,OR: 503.598.972 CI1 Plan Review Phone: 503.718.2439 Fax: 503.598. DateBy Other Permit No.: TI G A RD Inspection Line: 503.639.4175 '4 Date Ready/By: Juris ® See Page 2 for Internet: www.tigard-or gov 1(�1_� Notified/Method: Supplemental Information TYPE OF WORK `�� n$� FEE* SCHEDULE 4 New construction ❑Demo1i 0w�‘G u∎' For s r ecia/in ormmion use checklist C `` CS�,v 5 Desert.Lion OE Ea. Total ❑Addition/alteration/replacement ❑Other:, v.DX New 1-2-family dwellings(includes 1.00 ft.for each utility correction) CATEGORY OF CONSTRUC � it SFR(I)bath 312.70 cii 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath ( 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 107►5 7 S _f ri LL �Qko Catch basin or area drain 18.76 City/State/ZIP: ( t Q� q-7 z z 1 Footing l•leach line,or trench drain Page 2 ` Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: N(1:2,1.- \0 uti, 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: N Co% f✓hte r Q 1 H t I Lot no.: & Fixture or item: Tax map/parcel no.: 1 ,S 1 ? , D 1_` e\8 p p Backflow preventer J 31.27 J DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 girl PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: `�,S st\\ Td►S- Fixture/sewer cap 25.02 I 08-75 - \,,,i QC X1'1 1_,�],,� Floor drain/floor sink/hub 25.02 Address: N + �7(�K`A,l, ,sk Garbage disposal 25.02 City/State/ZIP:Tr Ctira r Q K g Z Z I Hose bib 25.02 Phone:('5()3) 3\ 3 b Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name:c-AA.Arty" Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: ,(7),%'rr-e Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 2/1 ^ / TOTAL PERMIT FEE Print name: t1\ 'CJ� Date:. L/ `-7/z,Q�1.� This permit application expires if a permit is not obtained within 180 days V S S .� after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. I\Building\Permits\PLMU•PermnApp doe 10/01/09 440-4616T(I0/02/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-1"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 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $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 p and including$10,000.00. Inspection ol'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 ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -7'ub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. 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 Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" -3" Isometric or Riser Diagram ❑ 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 -Stal Sink: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter 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 p Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: 1:113uilding1Permits\PLMF_PermitApp.doc 08/04/2011 2 MechanicIF al Permit Application FOR OFFICE USE ON I.1 City of Tigard Received �t� : Permit Na.: M 13125 SW Hall Blvd.,Tigard,OR y �° �_C)'�`'I Phone: 503.718.2439 Fax: 503.5ViScrt‘l 960 �Q,t Plan Review ew Other Permit: I'I GARU Inspection Line: 503.639.4175 `n 1 Date Ready/By: Juris ® see Page 2 for Internet: www.tigard-or.gov �(GV y,v a `, CC Notified/Method. Supplemental Information TYPE OF W T ui�1 ,,lc COMMERCIAL FEE* SCHEDULE – USE CHECKLIST O,t� Mechanical permit fees•are based on the value of the work New construction ❑Addition/alter placement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 2 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family ❑Master builder ❑Other: Description I Qty. J Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling:I Q7 5 ry , ` �� 1 V.O�A S Air conditioning 1 46.75 Job site address: 7 S W U Furnace 100,000 BTU(ductslvents) 46.75 City/State/ZIP: i i A Q 1k. 97 -z 3 Furnace 100,000+BTU(ducts/vents) , 1 54.91 Heat pump 61.06 Suite/bldg./apt_no.: 1 Project name: Duel work 23.32 Cross street/directions to job site: 6Q at, 10 v _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 G « C ► (1., Other fuel appliances: Tax map/parcel no.: 1 J i 4 D/"]4)1 V i Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 liti PROPERTY OWNER f ❑ TENANT Other: 2332 -- Environmental exhaust and ventilation: Name: .Vss�A\ �a� Range hood/other kitchen n` equipment 33.39 Address: 1 0 a7 5`rJ 1`1 u r D o,Vtk, , 6 Clothes dryer exhaust 33.39 City/State/ZIP: t\ O R b-77 zz 3 VV Single-duct exhaust(bathrooms, h . £�►r toilet compartments,utility rooms) ✓ 23.32 Phone:( Q' 11 2 bt-i Fax:( ) Altic/crawlspace fans _ . 23.32 _ ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: t ti Alter $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. t Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater I Phone:( ) Fax: :( ) Fireplace '7 Range i E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Other: i Business name: MECHANICAL PERMIT FEES* Address: Sabtotal _ City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%ofpermit fee) CCB lie.: _ TOTAL PERMIT FEE 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: i/`.V , 1 Date: Z i c,1 ... - I`nuilding\Permiis "I C_PamitApp_040113.doe 440.4617r(I1/o2/COMAVEB) 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:1Building\Permits\MEC_PermitApp_040113.doc 2 Eiectrical Permit Application ,` FOR OFFI('E USE OBI 1 City of Tigard ' i)1 Received Permit No. Date/13 : J — 1 C • 13125 SW Hall Blvd.,Tigard,OR 97223 Ci) Pl an Review 1 11 ' Phone: 503.718.2439 Fax: 503.59 �� Date/By: Other Permit: I I t,A K I inspection Line: 503.639.4175 �O Date Ready/By: Juns ® See Page 2 for Internet: www.tigard-or.gov C 1 .rONotified/Method: Supplemental Information TYPE OF WORK `� y(fl� `�� ** PLAN REVIEW New construction ❑Addition/alteration/replgil!tl G� , Please check all that apply(submit/sets of plans w/items checked below): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: � where the available fault current ❑Marinas and boatyards CATEGORY OF CONSTRU exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural J 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 JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system \,..1 �+ ❑Addition of new motor load of ❑"A","E","I-2","1-3", Job no.: Job site address: ( 7 5/ 5 'Ra• cx _� 1 Six or or o more residential occupancy. �� K 0 or more residential units. ❑Recreational vehicle parks. City/State/ZIP: 1 G c ' �� 2 j ❑Health-care facilities. 0 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: "s tc i.i \0 6i A... Description I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: N co,e k�,r 4 ,a v‘C Lot no.: b 1,000 sq.ft.or less I 168.54 4 Tax map/parcel no.: ` C y Ea.add'l 500 sq.ft.or portion 3392 1 1 S\ 7_ 1 it.j 0 V G Q Limited energy,residential r 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) l Limited energy,multi-family 75.00 residential(with above sq.fl) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation (i4 PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: V 5 5 e, ,u �(>$ n, 1� \, 401 amps to 600 amps 200.34 2 Address: ' 0 Si J S W 1 YCIr U ►/c x it �i 601 amps to 1,000 amps 301.04 2 T Over 1,000 amps or volts 552.26 2 City/State/ZIP: l l QA K)vs ?-1 t.Zi Temporary services or feeders installation,alteration,and/or Phone:( 0_' "1,` LL�Z Fax:( ) relocation D 200 amps or less 59.36 I 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 exchanrding to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: _' Date: 3(t 7I z Q(1-1, 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 Business name: ept.,,y-- each branch circuit B.Fee for branch circuits without Contact name: service or feeder fee,first 56.18 2 branch circuit Address: 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 Arc—f 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(I hr min) 66.25/hr City/State/ZIP: Investigation(I hr min) 66.25/hr Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/CCB Lic.: Electrical Lie.: Suprv.Lie.: specifically listed(%x hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: Plan review(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:\Building\Permits\ELC_PennitApp_ELR_ERE.doe Rev 05/21/2013 440.4615T(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: 5kvaorless 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 El Garage Door Opener* 50.01 to 100 kva 552.26 >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 over 25 7.42 3 I I Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: Other: Each additional inspection is charged at an hourly(1 hr min) 66.251 hr 1 Inspections for which no fee is 90.00/hr specifically listed 1%z hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within I80 nAudio and Stereo Systems days after it has been accepted as complete. • Number of inspections allowed per permit. ❑ Boiler Controls El Clock Systems El Data Telecommunication Installation ElFire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls Ti Outdoor Landscape Lighting* I I Protective Signaling Ti Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 ,. • Building Permit Number: 7)-).5r-,z)/4., _ C1 k ;L ci. 71 " Building Permit Review T 1 G A R D Residential Projects Site Address: 16/15'7 w ■ . Da-k0+,1 Verify site address is valid. Project Name & Lot #: T Spa Res ;de r c e Clean Water Services –Service Provider Letter: (lot platted prior to 9/10/1995) Required: Yes ❑ No ❑ Received: Yes ❑ No ❑ Site Plan Elements: 14Site plan must be on 8-1/2"x 11"or 11"x 17"paper 6Three(3)copies of site plan _ S. a .um to scale(standard architect or engineer scale) ceiNorth arrow V Map and tax lot number,site address,project or subdivision J''Footprint of new structure(including decks)with finished name,lot number,and zoning floor elevations Applicant information(name and phone number) tot and building setback dimensions f Property corner elevations(2 foot contour lines if more than , tot area,building coverage area,percentage of coverage and 4 foot differential) impervious area. pJ/R l Ctility locations faf ocation of wells/septic systems. N/J- lgxisting structures on site POurface drainage lgtreet names 2Street tree size,type and location N/0 'y$rosion control(including drainage-way protection,silt fence .0txisting trees to be retained with drip line,and tree design,location of catch basin,etc.) protection measures Nj,4- Planning Review Land Use Case Number: 1j/A - 0 G 1 p „(i u-J -k3."Zoning. R - Li ,5 I 'Setbacks: Front ,a 0 Rear i S Side 5 Street Side IS Garage o C . Landscape Requirement: %- i$ Lot Coverage Maximum: ❑ Building Height: Maximum Height 30 Actual Height - _,?67 I' Visual Clearance R Easements Sensitive Lands: ❑ Yes Type 1J IA Urban Forestry Plan N 1 A 1 Conditions Satisfied N/Pt Approved by: C — d-�, ti(�i-A.i� Date: ._;? - 1 c/ - 1 5 Notes: o Revisions (after Building Submittal only) Reviewer Date Revision 1 Approved 4ir Not Approved Cl thiviric_a C4{ass 3-11-1± Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ I:1Building1Fonns\BldgPcrmitRvw_RES_123013.docx • a Building Permit Submittal Original Plan Submittal: Date: /// f By: 627, Site Plans: # _3_____ Building Plans: # Create Case Record#: nter case#above for Building Permit Number. Workflow Routing: ggineering CHI e t Coordinator Q--Building Workflow Sign-off: i n s ff for Planning staff,including notes from planning review(page 1) Route Application Documents: engineering. (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Reviewed By: Date: Notes: Engineering Review—reviewed by-, di p,G":"..„.„:„...c.s Actual Slope: .0g ❑ Conditions Satisfied Notes: r Approved y: � %. Date: Revisions (after Building ub 'ttal only) Reviewer Date Revision 1 Approved C Not Approved ❑ /L �1' 42 3-119--it/Revision 2 Approved L�fi Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ Permit Coordinator Review 9<onditions Met-Prior to Issuance of Building Permit Notes: Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant Revision Noticc 3: Date Sent to Applic. Okay to Issue Permit- / L, Date: 5/1 /s i *1— 3/It 74 I:\Building\Forms\Bl dgPermitRvw_RES_123013.docx r Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing per mits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that a II subcontractors who work on the structure must be licensed with the Construction Contractors Board. 9r I will be performing work on property I own, a residence that I reside in, or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. R c se.I\ Tca S ks� Print Name of Permit Applicant 3/) 7 011'1 Signature of Permit Applicant Date Permit#: "57420/11-06t.11? Address: /d 757 /v �` .s�` t1� Issued by: /�-/- Date: yviy This Copy for Permit Offices 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 10757 SW NORTH DAKOTA ST, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal PASS MST2014-00019 David Young Owner changing receptacle by laundry to Gfci protected. Both bonus rooms unﬁnished at this time. Permits needed at time of ﬁnish. Violation Summary: Inspector Contractor 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 10757 SW NORTH DAKOTA ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O MST2014-00019 David Young All ﬁre, life safety conditions ok. Final inspection approved. Final erosion control approved. Street tree certiﬁcation received. High efﬁciency lighting form received. Moisture content form received. Insulation checked. C of O left on site. Violation Summary: Inspector Contractor 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 10757 SW NORTH DAKOTA ST, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2014-00019 David Young Violation Summary: Inspector Contractor 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 10757 SW NORTH DAKOTA ST, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal PASS July 7, 2015 at 1:52:56 PM MST2014-00019 David Young No ac installed at time of ﬁnal inspection, permit and inspection required at time of installation. Violation Summary: Inspector Contractor 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 10757 SW NORTH DAKOTA ST, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL MST2014-00019 David Young Not ready for inspection. Drafts topping needed in mechanical room, no power in 1/2 bath main level. No inspection done. Violation Summary: Inspector Contractor