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Permit II . CITY OF TIGARD MASTER PERMIT g • COMMUNITY DEVELOPMENT Permit#: MST2014-00039 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 rag Date Issued: 04/21/2014 Parcel: 1 S 136AA01600 Jurisdiction: Tigard Site address: 10345 SW 69TH AVE Subdivision: FUR VALLEY Lot: 5 Project: Thatcher Project Description: 418 sq.ft. addition. 7/7/14, Reprinted, changed plumbing contractor to All Scope Plumbing. 9/3/14, reprinted to change electrical contractor to Young Electric LLC. 3/9/15, reprinted permit to BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 2 First: 418 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 418 sf Value: $50,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvpes Air Conditioning: N Vent Fans: 3 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 Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 3 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 418 Owner: Contractor: THATCHER,CARL NW SURFACES LLC Required Items and Reports(Conditions) 1407 SE 130TH 7123 SW 54TH AVE PORTLAND,OR 97223 PORTLAND,OR 97219 PHONE: PHONE: 503-545-7852 FAX: Total Fees: $2,570.90 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 rules or direct questions to OUNC by calling 503.232.1987 0 Issued By: -Permittee Signature: .639.4175 by 7:00 a.m.for the next available inspection•. e. 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. 13lumbing Permit Application ((""� Building Fixtures .►"' �4 1(11( t)Fal( I 1 'F 0\I City of Tigard �6 48 13125 SW flail Blvd.,Tigard,OR 97223 A� �/ y �� ■ Phone: 503.718.2439 Fax: 503.598 1960 ,! �� A` 4',' Review . Other Permit No.. Inspection Line: 503.639.4175 1*+ q y` rye Re Ions 0 Sec Pa I I r t.AND `- eady/By Page 2 for InterneC www.tigard-or.gov `+y Notified/Method /!Qj Supplemental Information TYPE OF WORK ,vi."' FEE*FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description 1 Qty. I Ea. I Total }Addition/alteration/replacement ❑Other: e ; A New 1-2-family dwellings(includes 100 R.for each utility connection) CATEGORY OF CONSTRUCTION 1741V. j1 F+-- - - --t-- 312.70 '2�t 2_74 . Wil 1-and 2-family dwelling ❑Commercial tiff• f7 j SFR(2)bath 437.78 ❑Accessory building y SFR(3)bath 500.32 ❑Multi-family Each additional Nub/kitchen 25,02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: s L► .j t (k1 6(7'1- ti•. r1�F„s Catch basin or area drain 18.76 Z rt Drywell,leach line,or trench drain 18.76 City/State/ZIP: e- ; Lt!) '/ r� .� - P f Footing drain(no.linear It.:_) Page 2 Suite/bldg./apt.no.: Project name: __ Manufactured home utilities 50.03 Cross street/diredions to job sine: 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.: Fixture or item: Tax map/parcel no.: r .�q S-6. Hackflow preventer 31.27 DESCRIPTION OF WORK Backwater valve III 12.51 Clothes washer 25.02 ME t) , • : 't t-t eF 8''4.-' Dishwasher =11111 25.02 '25,0- A. _ _.. ,� i♦ ► Drinking fountain 25.02 • ti) t ItspDT `I- 0 J I1N Ejectors/sump 25.02 ❑ PROPERTYtIWNER i ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: - Garbage disposal 25.02 .245,01" City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap INI 25.02 Business name: / i1/41130 A--t-AU t� -- NA-f#• Medical gas(value S ) Page 2 t Primer VA Contact name: i„_3-c,(2_, Y y„cC,(,,t..-3' w" Roof drain(commercial) st 12.51 Address: . `� � ,/. CL S' Sink/basin/lavatory' �r' 25.02 I00,6g City/State/ZiP: Lii ri ) t` E. es - A.t 1 Solar units(potable water) 62.54 - Phone:(51)."S) 9t4 t) -ti c I Fax::( ) Tub/shower/shower pan a 12.51 2j.b" E-mail: . 4- , • r 2 -r --, e' Urinal 25.02 CONTRACTOR Water closet ip..mi 25-02 Os•1 Water heater 37.52 Business name:j anti L �L VLA.t 6I�� ►� } �C-� Water piping/DW V 56.29 Address: Other: 25.02 City/State/ZlP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: S72.-° CCI3 Lie.: 87 3 J PI bing Lk.no ��p- V4'5-41,6 Plan review (25%of permit fee) �-'"� State surcharge(12%ofpermit fee' Authorized signature: ,,„-k-••"'" 1 L,..•• . TOTAI.PERMIT Fl Print name: V/4 l / I t Date��5. S. / This permit application expires if rt permit is not obtained thin 180 days �f after it has been accepted as complete. 'Fee methodology set by Tri-County Building Ind - I`suildingTermiU;PI.MU-PermitApp doe Iotn,os 447-4615T(10u02/COM/WE0) 57,.0`1 IIy CITY OF TIGARD MASTER PERMIT 1 COMMUNITY DEVELOPMENT g Permit#: MST2014-00039 T i G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ktp 4 / Date Issued: 04/21/2014 Parcel: 1 S 136AA01600 ��o Jurisdiction: Tigard Site address: 10345 SW 69TH AVE Subdivision: FUR VALLEY Lot: 5 Project: Thatcher Project Description: 418 sq. ft. addition. 7/7/14, Reprinted,changed plumbing contractor to All Scope Plumbing. 9/3/14, reprinted to change electrical contractor to Young Electric LLC. BUILDING Floor Areas Reauired Setbacks Required Stories: 0 Bedrooms: 2 First: 418 sf Basement: 0 sf Left 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 418 sf Value: $50,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 3 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 Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 3 Ea add/500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 801+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All Other: N Other Description: Ecompasing N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 418 Owner: Contractor: THATCHER,CARL NW SURFACES LLC Required Items and Reports(Conditions) 1407 SE 130TH 7123 SW 54TH AVE PORTLAND,OR 97223 PORTLAND,OR 97219 PHONE: PHONE: 503-545-7852 FAX: Total Fees: $2,514.86 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. ATTEN : Oregon aw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 through OAR 952-111-0090. You may obtain a copy of the rules or direct questions to OUNC by call1p -5e5 .1987 or 1.800.3.2344. Issued y: A. 1_ -1/ / Permittee Signat : __1 r(4 . �� _ / 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. Electrical Permit ApplicRECEIVED FOR OFFICE USE ONL‘' .., . City of Tigard Received 1 Hate'Hy Peioti N o ti5r02,0 i ' 3? I __ 13125 SW Hall Blvd..Tigard.OR qq.pp 3 2014 I Plan Review T 1 Other Perinn Phone. 503.718.2439 Fax 503.5,t1t,16!-! 1 Dateilly Inspection Line: 501639.4175 cm of wimp Date Readylly, 1 Jul vs = 13 See Page 2 for Internet: www.tigard-or go v , NotiliedLActInxi 1, Supplemental information 1 • i . ._............... ----- PLAN REVIEW , I-- Please check all that apple(submit 2 yeti at pli;is,,,s-nein,cbeck iiii.6t.ti ,,, 0 NON,construction IXAdditionialtcration;replacement 0 Service or feeder 400 amps or more 0 Budding over three stories 0 Demolition El Other: where the available fault current 0 Manna:,and boatyards CATF.GORV OF CONSTREC-TION exceeds 10,000 amps at 150 volts or 0 Floating buildings rje less to 1,10411d-01 exceeds 14,000 0 Commercial-use amicultiiral _ • , and 2-famil,y dwelling 0 Commercial/industrial 0 Accessory building amps for all other instatlations buildings 1 1 12 Multi-family 0 Master builder 0 Other: 0 Firr pump. 0 installation of 15014VA or 0 Emergency system larger separate!).derived system I ..,' JOB SITE'INFORMATION AND LOCATION El Addition of nevi motor load of i ,,,,4 A. 10011P or more. OCVA11:4113Cy. ' Job no.: Job site address: 03y5 ft.) &,..-/ pvt. 0 Six or more residential units, 0 Recreational vehicle parks. ; - 0 Health-care a Mntes 0 Supply voltage for more titan C'ily(StateSZIP: A,..4-4,,,,i Dr.-- 4? 7 vt7 0 Hazardous locations. 600 volts nornmal -k.ti SU ite.ibldglapt.no.: 1 Project name: 0 Service s>1'feeder 600 snips A,T sore. FEE SCHEDULE Cross street/directions to job site: Description Ectty7 FeT--, '—.-- -'--.T.T.Otg I :— New residential single-or multi-family dwelling unit. .5& 0.,i ii, ,c1. 4- 5(4 I',*IAA tre, Includes attached garage. LOGO sq Ii or less 168 54 II Subdivision: I Lot no.: 1 Ea.add'1500 sq.ft or portion 33.92 Tax map/parcel no.: /..11 3('?AA014 44) Limited energy.residential , -.- 7 .r, ,, , 4, DESC.RIPT/ON OF WORK..i, .. .. - (with above sq-ft.) 5.00. 2 Ii Limited energy,multi-tamily 2 1 (4g.1.1.c1,/4 ,.-AL, -fp iz-efrhipt t-/,4410) residential(with above sq.ft.) I. 7 (Xi L ,.., 1 Renewable Energy I 0 See Page 2 _ 1,0,19?-41 is„„i. -4, .544,44) #04,..*0 (161-440.1 C,11.11 fr 4 C la 1,-- Services or feeders installation,alteration,and/or relocation PROPERTY OWNER " , :1 ''''' El TENANT 200 amps or less 100.70 1 1 2 201 amps to 400 amps i 133 56 ' : 2 - 4 Name: Coe.r./ Tit i 4-e,jue r 401 amps to 600 amps I 200 ,.34 1 i _ —. 4, 1 : Address: /yg 7- $-4.. /jz, 601 amps to 1.000 amps I 1. 301.04 I-- --4 Over 1,000 amps or volts i 552.26 i 2 1 Ste/ZIP: pir/-114 4,it / Opt_ 232-2,1 Temporary services or feeders installation.alteration.,and/or -1 relocation Phone: ••;,.) ) pi? —ô m i Fax:t ) 200 ttmrk or lass { 59.36 1 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps I 125 08 1 El intended for sale.lease,rent,or exchange.according to ORS 447,449.670.and 701. l l 401 amps to 599 amps ; 16854 1 1 . - Owner signature: Date: Branch....._......._ .. circuits-new.alteration or extension.per panel T,._, A( I ! A Fee for branch circuits with I 0 APP u LICAN7' Fa CONT2 MRSON 1 il above service or feeder tee, Business name: 4 i fy,0 IA) /441,0 Li-4-,, c.,-_-_A-4/fZ/11 each branch circuit 1 7 42 - 1 , B Fee fir branch circuits walung r I Contact name: /2,/4.4,'" );1.. 1 service or feeder fee,first 1 i 1 56 18 : ! , I i — ; , 1 ... branch circuit . Address: 7/ 24 5.L ) 52/1t4t A‘i4-' Each addl branch circuit 1 i 7 42 ...t._2.... _Miscellaneous(service or feeder not included) City/State/ZIP: jegroit 14..p.A.4 P4— 4 2,-/7, . , . -Each manufactared or modular , . .,,,,,--r 67.84 _ Phone:50, ) .51/„5"- 1 r,Z--- Fax::( ) dwelling,service and-or feeder --i E-mail: (-It,-•S re 411C) IlA 414 4'4 (4117 Reconntsa only Pump or wngation circle 67 84 67.84 , 1 ve()NTRACTOR •• ,,,, „,4 . Sign or outline lighting 67.84 27 Business name: /9 42,r- -7-._(. .ilInr e.; (//..0 Signal circuit(s)ar limited-energy ,nel.alteration,or extension. Set Page 2 ; l 2 Address: 411 el - 14 :•...---;ThZ ..-4 2, Each additional inspection over allow ble in any of the above -- Additional inspemon(.1 hr min) 66.25i hr City/State/ZIP: ef,in 4 r/eeibu,, 11,-- itnvestigation it hr min) 66 25/hr ...... .. , Phone)rei?) .-1 : Fax:("-- 1 1 06 I %... ..__.. .. v.....,... --iit 1 Industrial plant(1 hr mini ! , 78.18f hr __......_.....A ..............er..___ .... _.... ....._ l -., inspections for which no fee is 174? tk 1 CCI3 Lic.:i)37-s-si Electrical i i.. ......1,_,"„...,,,+ouprv.I...ie..:3-7 8 35 I s N:ificalis.listed t'A hr mini , 40 00f hr - ..a- ..:. i41%. ' 1 , ,. . ELECTRICAL PERMIT FEES Suprv.Electrician sign. re.required: I Subtotal Print name p 1 r,... Plan review(25%of permit feel: : ....0e .ret. i —te-iep /9, 1 i i State surcharge(12%of permit fee): IT i - _ Authorized signature: I I TOTAL PE.RMIT FEE.: - — I ..... - - .--e, ,, 'nit permit A ppAti(i7 expires if a permit is not obtained nithin I bto Print name: _ .4...., t I Date,L...29./ days after it ha+hten accepted a■complete, ____ ,..... t • Number■•■#uisped tams allowed per penult I liuMbreeralm:E.I.C..Parma Am 'L5...1510 Re,:'..?!.21 2,..11 44a-4515111 IMS:COMPATII ___. III CITY OF TIGARD 1 MASTER PERMIT S. COMMUNITY DEVELOPMENT I Permit#: MST2014-00039 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/21/2014 Parcel: 1 S 136AA01600 Jurisdiction: Tigard Site address: 10345 SW 69TH AVE Subdivision: FUR VALLEY Lot: 5 Project: Thatcher Project Description: 418 sq. ft. addition. 7/7/14, Reprinted, changed plumbing contractor to All Scope Plumbing. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 2 First: 418 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 418 sf Value: $50,000.00 Rear 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 3 Clothes Dryers: 1 Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feedere Branch Circuits_ 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 3 Ea add!500 sf 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 418 Owner: Contractor: THATCHER,CARL NW SURFACES LLC Required Items and Reports(Conditions) 1407 SE 130TH 7123 SW 54TH AVE PORTLAND,OR 97223 PORTLAND,OR 97219 PHONE: PHONE: 503-545-7852 FAX: Total Fees: $2,514.86 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-Op1'6through•=R 95 •'1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5 32.1987 or 1.800.332.2344. �' Issued E �L I - Permittee Signature: r�e ri---iAi \ 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. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 11111 Request Permit Action q gErp TIGhRI) 13125 SW Hall Blvd. • Tigard, Ore g on 9722 3 503.718.2439 www. 0/4 TO: CITY OF TIGARD 3/j/in( �-J Building Division Services Supervisor Mfg; v 13125 SW Hall Blvd.,Tigard,OR 97223 �rr(.10^/ Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: ❑ Owner 'Applicant ❑ Contractor ❑ City Staff ,' REFUND OR Name: INVOICE TO: (Business or Individual) Mailing Address: City/State/Zip: Phone No.: 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). REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: H6Ta0/ - COO 3 9 Site Address or Parcel#: /a795 $W Wee- Project Name: Subdivision Name: Lot#: EXPLANATION: Q� ^star t" at-) 6u/`iqe.1— ` Ci4 �� of 6.0 ^ t tic Signature: j( Date: 1— 7- /fr/ Print Name: i /:: —/ V‘=c). .-/stic) 64 4., Refund Policy 1. The Community Development Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80%of the land use application fee for issued permits. d) not more than 80%of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80%of the building permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ONLY Rte to Sys Admin: Date '7 7 / ,� .r Rte to Bldg Admin: Date By Refund Processed: Date By Invoice Processed: Date By Permit Canceled: Date By Parcel Tag Added: Date By Receipt# Date Method _ Amount$ I:\Building\Forms\RegPermitAction 062614.doc y CITY OF TIGARD MASTER PERMIT 1114 Ilt ' COMMUNITY DEVELOPMENT Permit#: MST2014-00039 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/21/2014 Parcel: 1 S 136AA01600 Jurisdiction: Tigard Site address: 10345 SW 69TH AVE Subdivision: FUR VALLEY Lot: 5 Project: Thatcher Project Description: 418 sq.ft.addition. BUILDING Floor Areas Required Setback% Required Stories: 0 Bedrooms: 2 First: 418 sf Basement 0 sf Left 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 418 sf Value: $50,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr 0 Footing Drain: 0 Ice Maker 0 Hose Bib: 0 Backwater Value: 0 Drywall-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 3 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 Srvc!Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 3 Ea addl 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 418 Owner: Contractor: THATCHER.CARL NW SURFACES LLC Required Items and Reports(Conditions) 1407 SE 130TH 7123 SW 54TH AVE PORTLAND,OR 97223 PORTLAND,OR 97219 PHONE: PHONE: 503-545-7852 FAX: Total Fees: $2,514.86 This per 0 -d subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be •- e in accordan = 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 d..s. ATTENTION: Oreg• I, equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9.2-001-0010 through OAR • -001 r r`S. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.3 2.234 / f 1 Is-ued By: /4 !/ Permittee Signature: Call 503.639.4175 by 7:00 a.m,for the next available inspection da . 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. ,, Minding Permit Application Residential �V I OR OFFI( 1: I SE ON1.1 . Received City of Tigard Date/B : s / sir Permit No.: , ..J",(9/15.—OVA ' - Phone:SW Hall Blvd.,Tigard,• .1 Plan Revi_'�� Phone: 503.718.2439 Fax: 503. ..1960 �01 Date B : Other Permit: TIGARD Inspection Line: 503.639.4175 �� Date Ready :y: / 121 See Page 2 for Internet: www.tigard-or.gov \O" A�O a NotifiedfMethod: /V / 'yf ja Supplemental Information !) 47'7,1. , i e A 1/1(1.71," TYPE OF WOI R =. REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(roll-Died 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 Valuation: $50,000 ❑Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: 3 ❑Master builder I=1 Other: Number of bathrooms: 2 JOB SITE INFORMATION AND LOCATION Total number of floors: 1 Job site address: 10345 SW 69th Ave New dwelling area: 418 square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: 412 square feet Suite/bldg./apt.no.: Project name: ri71f Covered porch area: 55 square feet Cross street/directions to job site:From SW Barbur Blvd Right-On SW 65th Deck area: square feet Left on oak,Right at 69th. Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:Metzger Lot no.:6 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(romded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Addition on 418 SqFt to existing SFR and 1 full bathroom Valuation: $ Existing building area square feet New building area: square feet ® PROPERTY OWNER 13 TENANT Number of stories: Name:Carl E Thatcher Type of construction: Address:1407 SE 130th Occupancy groups: City/State/ZIP:Portland OR 97223 Existing: Phone:(503)317.0197 Fax:( ) New: ® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name:Innovative Spaces (Please refer ro fee schedut) Structural plan review fee(or deposit): Contact name:Victor valle FLS plan review fee(if applicable): Address:PO Box 13045 City/State/ZIP:Portland OR 97213 Total fees due upon application' if0`7 / //U Phone:(503)960.7150 Fax: :(484)918.1627 Amount received: E-mail:INNOVAS.VALLE @GMAIL.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name:NW Surfaces LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:7123 SW 54th Ave Solar Installation Specially Code checklist. City/State/ZIP:Portland OR 97219 Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)545.7852 Fa/ jj State surcharge(12%of permit fee): $21.60 CCB lie.: 196136 iffi 7 .' Total fee due upon application: $201.60 WOWAuthorized signature: � /i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: VI _I-.0 e_ v vt_ Y Date:03.25.14 Service Board ■ I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) From Faxlero,co., To 15035981960 Thu Apr 10 23:50 2014 2 of 3 Mechanical Permit Annlic N\IFOR OFFICE LSE ONL1 Received City of Tigard Z��Q Dwil3 gililLIZATII }e�tNo., / _D . v 9 ` 13125 SW Hall Blvd.,Tigard,OR l O y PR plot Review i Phone: 503.718.2439 Pax: 503.598.1960 p Date/By,Re other Pe®ie: l 1G It 1, Inspection Line: 503.639.4175 ^��('.�El� See Page 2 for Internet: www.trgard-or.gov w`1{7C Alvii 1O rjaill !` Sopptemental rnformatw0 . : r:: r:r:r:r:r:r:r::. :a:;.i.U.(fwiefPYf. FAgt KifRr TA. ; E G;af-cfPr P:ri r ................................................................................. Mechanical permit fees'are based on the value of the work ❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit. Value:$ • •'••••••••'•••••••••••i':'::'::•:•• •••••:•••i'i.•••CA' 7°a .' OF CO 15,. iT1C O 1':,r: '::::::::::.:.:::::'::•::':•:•i' •r ® 1-and 2-family dwelling ❑Commerciallmdustrial ❑Accessory building For special information use checklist ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Lea. I Total 1 He a ting/troo g : . 301SM ZSMMAI7g1'1 aiXan ON:::::::::::::::::::::::::::::::::::::::::\ : Air conditioning 46.75 V Job site address:10345 SW 69th Ave Furnace 100,000 BTU(ducts/vents) 46.73 City/State/ZIP:Tigard,OR 97223 Ptlrnace 100,000+BTU(duets/vents) 54.91 •1- Heat pump 61.06 Suite/bldg./apt.no.: I Project name: Duct work I 23.32 23.32 XCross street/directions to job site:From SW Barbur Blvd,right on sw 65th, Hydronic hot water system 23.32 Residential boiler(radiator or left on Oak,right at 69ts. 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 Other. 23.32 Subdivision:Metzger Lot no.:6 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 Gas fireplace/insert 1 33.39 33.39 Pine vent for water heater or gas Addition of 418 SgFt to exisitng SFR,one full bathroom fireplace 13.32 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 3 Wood fireplace/insert 23.32 Chimney/lineriflue/vent 23.32 ........_....... :::::::::::::::::,........................._..._.. Other: 2332 PRrPrSITy p :g :i' ii ..:...:.. ........ AAST.: :.::.::.::.::.::.::::::::: Environmental exhaust and ventilation: Name:Carl E.Thatcher Range hood/other kitchen equipment 1 33.39 33.39 Address:1407 SE 130th Clothes dryer exhaust 1 33.39 33.39 City/State/ZIP:Portland OR 97223 Single-duct exhaust(bathrooms, toilet comparmlenta,utility rooms) 3 23.32 69.96 Phone:(503)317.0197 Pax:( ) Attic/crawlspace fans 1 , 23.32 23.32•� __®'.;i01Ph:$C',i>iMr'° _,' °,';.'.;`.'' .:.,",",',.';":.. !Cf}1nAC'7!'! ISCEt tit:::::.::.::.:::.::.:: Other: 23.32 Business name:Innovative Spaces Piping $14.15 for first four;$4,03 for each additional Contact name:Victor Valle Furnace,etc. 3 Address:PO Box 13045 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland OR 97213 Water heater Phone:(503)960.7150 Pax::(484)918.1627 Fireplace t eJ Range \h E-mail:innovas.valle @gmail.eom Barbecue Other: 111 �+� Business name:Jacobs Heating ._-._.............1►>Y ilyfnsr vR�n err;gi ft..::.::.::.::.::.::.::::.:. ......................................................................... Address:1421 SE Holgate blvd Subtotal 240.09 City/State/ZIP:Portland OR 97202 Minimum permit fee($90.00) 90.00 Plan review(25%of permit fee) ' 60.02 Phone:(503)234-7331 I Fax:( ) State surcharge(12%of permit fee) 28.81 CCB lic.:1441 TOTAL PERMIT FEE 418.92 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 t duury Service Board Print name:V' Date:04.10.14 r:\PmldupPetruite1M5C PrvadtApp_040113.dec 440.4,5177(1 UOI/COM/WPP) �tV . ' Frtumbin2 Permit Application Building Fixtures *C°C)%) c ti�1� FOR OFFICE USE ONE) City of Tigard 6 Recened ? Permit No.: • 13125 SW Hall Blvd.,Tigard,OR 97223 MPS r�i�� BY J��(�//y /'��7vey= �.�f liq v t1C`Review / ■ Phone: 503.718.2439 Fax: 503.598.1960 �`` ` lit te/By Other Permit No.: Inspection Line: 503.639.4175 ,`,S rO�`1` Date Read /B Juris: ® See Page 2 for I II�ARD Ready/By: g Internet: www.tigard-or.gov ` A�� Notified/Method: i Supplemental Information TYPE OF WORK t�� 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 8.1FD-4 )-bath- -f--. 312.70--- 12.340 pi 1-and 2-family dwelling ❑CommerciaUindustrial 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: Catch basin or area drain 18.76 ` �y S~ f' �7 ��' A Drywell,leach line,or trench drain 18.76 City/State/ZIP: iC A C)� Cl � s 9121. Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: 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.: Fixture or item: Tax map/parcel no.: V 9 q s Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer l 25.02 Ze5,O•41 b(}1 Q J D FJ 4 lt L 1" Neco l� Dishwasher 25.02 -"2:55,02.--- Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: . Garbage disposal 1 25.02 25,02- City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 "APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: i�L_ -0 �_00 a4�-m) e C pvcce 3 tV Primer I 12.51 Contact name: V vcU..Lr Roof drain(commercial) I 4 12.51 Address: / P. b K R ot1 r Sink/basin/lavatory 25.02 `t00, City/State/ZIP: Pti Q,�„b ale, V _9,/a 13 Solar units(potable water) 62.54 - Phone:( b 96 0 i Fax::( ) Tub/shower/shower pan 2... 12.51 '24b2.. Urinal 25.02 E-mail: / k O U-1-'.104-LL[-� , C luat-�.• -�M CONTRACTOR Water closet .., 25.02 5"o,Cat- (� Water heater 37.52 Business name: AllA.0!.a_ Y L.i l41/4-i 12)1 1..jCp Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.` CCB Lic.: e t 0 .j`7 Pll�mbing Lic.no.: r26•-9 ,5-PA Plan review (25%of permit fee) ��- / State surcharge(12%ofpermit fee' Authorized signature: / 1� r TOTAL PERMIT Fl Print name: Vi _ This permit application expires if a permit is not obtained w{thin 1811 days � I f Date:05 a !Cj after it has been accepted as complete. V / *Fee methodology set by Tri-County Building Indus*•'c- ^ I:\Building\Pennits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) i 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-l'100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-1st 100' 62.54 3,601 to 7,200 $233.20 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 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 ❑ Any new commercial building with water service 2"and Baptistry/Font ■ greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool -Each ❑ New exterior plumbing site utilities for any complex structure Car Wash: - ch Stall Ea as defined in OAR918-780-0040. -Drive Stall 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 , -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 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 Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 Electrical l'ernut Applicata ill_staillitimmilill_IIIIII IcEmp City of Tigard IGN,6,..,..1 nit • ilk ., z,i I'S S'i't Itall itltd.. tigard.UK S72:2.1 i>xie-Wi PLir.Re;icy, 1 iiiiii:r Portri,I. I ; a. ph,„.. so;71,.24 to Fa.:: in i;(n<ow: !kacil, 1,:n.. 1 63 Set PA$Z.C.2 Go. T ;\R 0 in'Pc%mot Loa. '510f39 4I .3 APR 2 1 2014 ..„,k,...,,,•., i Vv..017s.liNtclh.u: 1 i Supplemental Iriliirmiiiin I Intcree• wa,.....ngArd-or goy , — . i _---- -- !--------- — --- .. ,...., • TYPE " ....._............._..............____..._ .R1),...._ I PLAN REVIEW :- --1 i l'i,...c.c dii.i..if i‘A flu vit.,suhchi is..1,.ic#4,:ri*fi 11;.11*“.11,,L,i 1 LJ NCO;1.:;411,triit.litifl IS Adtltrk;I iiiirA41110A1Vi§oN ' 1 1-1,, i , r..tco,.1.1.,•::iia lie,.e,IV,.i.,1 t114,,, 0 Ruild1,1„.,;., 1 0 Den-million 0 OthcrOUILIIIIII5 U II , I .,...:0,.:,,,,,i,bi,7::■nii‘,.:,,,,i 0 m ,,,..• I 1 CATEGORY (W CONSTRUCE1()% 1 ,....,..,,,i,19.,0f1,.,: ,4.1...U,,.i 0 rilia:EIE`f.: E.,DI:111b1,1,!.,:,,E,ECCEIE:4 Ofit• 0‘,.'Nurnocial-tm:A:4.ilcol.i,:1 i i 1 E I-and 2-famil> delitng 0 Ctsturturrel.t1 intitbiti.:: 0 A.c.4;c:-.4t4trty ItatIclin; -MI,1”? ail:1!ix.1 na,...4:i,:iy., ‘404.11:1V., 7 NI-11,,-hil=13: 0 Nlam,..4 buildo. C()tiler I ri Fn.:(itic,r, 0 Iiim.iirm,4,:viii I 50 kV I0 i.no.',.,..•K` ••,:t"nl. .1011 srl-F. INFORNIATION AND LOCATI()N 0:\mi.:.:11,,,i 00,0,...1.,.■10,41,,!. 0•A". 1-,•.•1-r'.-1-4- , !:grI}P,We.; OCI.,1p..01::', Jt.411..-,: I 10h Silt'inidre,s: 10345 SW 69"'Ave : , t 0 Nt, 0 fli:cr,...clain.:3 Vi:bla it';,:l k• t — I. I i 9.i..,:fii....:..14,!:.,1...,.■ 9`..:appl? •:ii,..ii.:::i'r■Mo..::::lif (‘M:YE■tiE.PP:Tigard.()R 9i22..% , , _ - iu ii....„,1,..,.;14k.st..,,, kkAk.,,,if..ft-sraleval "■,;.1:te NOP AP! tig .. I Preig.:Ct!law: 1 0:rs,ss<ste<s::srts:Ecr i,1,•,....1,ii: I.--.-- FEE SCHEDULE 1 i (..to.,stfcei diretitIgniN Igg;Oh site.From SW Barbur Right om SW 65th.left nn —7-71 New residential illtii;or intilti-litutil•duelling unit. Oak.Right at tak A,c. : InchnIcs Attached trArAuc_ ! 1 1,00i•.i.g I; ;■:1::,,:, tefi.54 it3.i4 I 4 i S,.1hiiiricf:in'Mein:tee I I ill 110. h ! i ! — ---; u„,..,,,i,y1 viio-,i I i or ri,i1A,rt I rf.1-.,;•:. I t I : I 0:.S Map IlfirCi.:i no, I , _____ I 7:4.tnt DESCRIPTION OF WORK 1 ,,t1Ft:ilhi.,+.:'4.i.U.i LEciced.eili:rin,twiathlh. , • . 1 f ,3 tri 1 I Addition of 41/1 StiFt to siNting SFR,and addition of it one full bathroom ;c-.1<1;:!117:11 C..ith 311,111;i‘i fl • C _ i Renewable F7ner • :. Sec Pa.::2 • 1 Scrviccv or leer v inktallation,Alteration,Anti:or relocation ...1.0pS or V . ; i 'NJ 71 I Cg PROPERTY OWNER I 0 TENANT i — --------i, .o.L.ily,to..tott:one. t 1 i Nmile.Carl F.Tahatcher _ I 46;.ssurs.t<,eon arons. ......._........................ ............__..................................................................._......... ....... Ntititess: 1497 sr 130th - 1....ti!ii..iiir...1.1. ii rnii.., ' WI'of 4 ... . , ,.....•::,.,OM,131111,..,:;v-,11: i ..'' ss.f, 1 i ' 1 i (..11%•Sidri.!Ili'. Piirtlatid OR 9722A I i_________ -, , 1 i TermotrAn sers tees or teetkrs instailation.alteration.,And,nr h- ... i - 1 1 relocation ! Plaint:I 913)317.0197 . I tlwtier iniamIllitionz Thoii iiiit:111■1:16■11 gs heing nxidc,,n rr,,Illy:!fy that I own . .,2.,1.1,11 I r'._. , . --.--+ i —.71 ! intentits.;Kn.sate.lease reiii,or et change.,ii.:0 II i • : .. .,. •'1,K.7(1.and 701, ! ., 7-7-7-f---------1-7 1' - i rikoh.sr il,*:1:111iTi: Dai::: ----- ; I ... , , 1 , nranco circuits....new,Alter:idiot,or clot:ovum. wr.artel .-... C ,lPPI It ANT I 0 t(INTACT PERSON i : A i't::-tot hca:scts t•:::_,:t.,..,i: • : : i -- --.4 i ....Se4:;..:!gOd..1 ii,... 2 -. :, BO..11c.,■?tl:Iills: Innovative.Spaces , I •-a•4 brial-i` •i ,‘• a-- -..: r-- • I i 1 Vielfir Vane 1 , ..:,:;•;<.',.:10 tk,tie,■■;,...■,,SI I 36 I I 1 NiIiire ■•illig ROS ilt1.15 i 12...,..ah a:ki'l tuvldi c!“:! 1 __.. . 7 41 i .2...1 - - —1 lailiftiiingtOUti!ten ivy or fretler not inclutirdi_ _ i C. SLIP/Ai': Portland OR 97213 1 i...idi ioaiiiituluro.1:,,1.,,,ifitlai tiWcIi hie:.sers I:c:hii.I or feeeci al, i Paoli: i 5031 4/60.715i 1 Pj‘::t-18-1)913.1627 -12 i- 1 1 it,:ceaowt,wit: ______ ____247 io. _ = I ■ f i 1..4rfai E innfIVIIMV3lit.:irgirt3ILCOM ! I ..■ E: --- _____4 i 1 Vii..1,al:.1,1;11101,310s: t."' 67 X4 r ........,.........._, coN-nt ACTOR < i ' f.tiu■el:.!,01.,11:1”:1,00t,16 )11isc,r;name Connercn Electrie I :.,<<<i..<11::1,in.ititf,i,ir iiino.,ii-oli.re I I • i i I ',h. # 0:411Ci.ettili,it.I.:9.1,i OthliNKW.1. I_Pai..,:,2 : : < !tr .6342 A SE 57" eve 1 i Larkadditional inspizt-iinn over allowable in am,of tlw above i 1 ..kii-Eil:Et.r.311111117,4,1,17■:El:ilEEEE) 1..2; hr i CU: i0tC lIP Portland.OR 9720h Li::..,....:sti:Tifi, .........._...._ Pil,,TI::.g5t1.11 M-5064 i I-,t'.:( 1 I I 1,:tt:cc:::::1,1•11W.11 il:.I,it! 7'.,I I:: i :- - - 1 i 4.1.13 Lk 1824g ;.1:k:or:cal 3.:,,,,C,Al/C1 Stir's'.! is. a 13;143 1 ; c.k.aas.L.:...j .L.L.±.11` in;:::::‘, 1 41.91.:sr 1 : s f I I I ncian Agliature, i — ELECTR/C Si PERMIT FEES 1 Stipry Lka : ictitured: ! / f --i ft .S2S._ 4;4i' I i ciihiorah : 29: :=ii - _,_/../..., 1 tirxti-.0..kw(2v•-;..ir permit fr.cr :: 72 N? Print name V 1 k 4 i I V 4i ... /‹. 1 Dau.'. inf-il . /4/ 1 h- --- ,f = Nuo,cd-i. ti:,is?ms we' i• TO r M.PERMIT l'E1.7 I 04 + —4 —6 ----- I r I 1 . . NI,t1c,:::.:ILII•gt:i I 2""-::oll;X:IM:?1.....: I —.! Ito,a,ricii 411#141i-tfiaff ripirti if 3#ivriiiit ei nor eidlcifees1 within 1311 - 1y I do,,an,,hici ftevs aa-Carrti,1N COISIflICIV ' ." \:;:i1;,N,••!.}:,,,,--.i.,11..1}i•,,,I.:,1!:.1 i,...:01,1 .i.i“....•1•E e,:.“.1.0.1.:ii i, https://mail.g oog I e.c om/mai I/u/0/?tab=wrri#i nbox/1 45850a1 c c48a2b4?pr oj ector=1 Building Permit Number: ,7S „;Cy/7/___ `3Y ;I Building Permit Review Residential Projects I Rc,;\RD Site Address: 1034S SW (sg tin Aver)i e. Verify site address is valid. Project Name & Lot #: Toffo11eI2 1 ri{d.tfic . Clean Water Services—Service Provider Letter: (lot platted prior to 9/10/1995) / Required: Yes CNo ❑ Received: Yes El No E/ Site Plan Elements: -- CtY3it' L� plan must be on 8-1/2"x 11"or 11"x 17"paper 'Three(3)copies of site plan &b rawn to scale(standard architect or engineer scale) l i orth arrow Ric b/ap and tax lot number,site address,project or subdivision L Footprint of new structure (including decks)with finished 4me,lot number,and zoning floor elevations licant information(name and phone number) [ 1 t and building setback dimensions hdProperty corner elevations(2 foot contour lines if more than [t area,building coverage area,percentage of coverage and 4 foot differential) impervious area. 1l Utility locations [cation of wells/septic systems. [B fisting structures on site lE.Sface drainage L►31et names [ St eet tree size,type and location L i-Erosion control(including drainage-way protection,silt fence g'Ex�isting trees to be retained with drip line,and tree design,location of catch basin,etc.) protection measures Planing Review Land Use Case Number: 0 Ifr g'ioning: R IA-S L'Setbacks: Front 2d Rear I S Side \S Street Side S Garage 20 D--Landscape Requirement: 1�1 [ - 1'ot Coverage Maximum: N t__ alluilding Height: Maximum Height 30 Actual Height ±-1G-- D'Visual Clearance LV'Easements Censitive Lands: ❑ Yes Type Ell,lrban Forestry Plan L7 Conditions Satisfied Approved by: k ck.,l Date: 3 f 2(e( i i4 Notes: (� _ Revisions (after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ I:\Building\Fortes\BldgPermitRvw_RES_123013.docx S Building Permit Submittal Original Plan Submittal: Date: _ -�/`'?/y By: o5:77 Site Plans: # 3 Building Plans: # 3 Create Case Record#: nter case#above for Building Permit Number. Workflow Routing: �� ?l' g ❑ igineering [ -Pi Coordinator L-- ui ding Workflow Sign-off: ign-off for Planning staff,including notes from planning review(page 1) Route Application Documents: V1-- tgig-ineering: (1) copy of permit application, (1) site plan,(1) building plan and oal plan review routing form. L'7 Building 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: Pay ide l/-C Actual Slope: 3 °7.p ❑ Conditions Satisfied Notes: Approved by: /4,/ 49/ , Date: 3 /2 -1/i k' Revisions(after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ ``cP it Coordinator Review onditions Met-Prior to Issuance of Building Permit Notes: Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant Revision Notice 3: Date Sent to . .lic. Okay to Issue Permit- / / l ,11"'-- Date: 31/4-7 7/i1 I:\Building\Forms\BldgPermitRvw_RES_123013.docx l 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 10345 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 3, 2015 at 11:56:04 AM MST2014-00039 David Young Provide btu rating and installation instructions for clearance in front of unit for determining combustion air requirements as per code. G2407.5 Flue vent material to be approved for use as installed per installation instructions. 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 10345 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL March 3, 2015 at 11:33:06 AM MST2014-00039 David Young Add ﬁxtures to permit that were not existing to the original structure. Second lav in master bath, laundry sink ect. 103.4.1 Calk base of master tub/shower to ﬂoor, both baths. 310.4, 407.2 Secure sink vanity to wall, both baths. 407 Fix leak under laundry sink. 310.0 Calk kitchen sink top to backsplash.310.4, 407.2 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 10345 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 3, 2015 at 11:56:04 AM MST2014-00039 David Young Provide btu rating and installation instructions for clearance in front of unit for determining combustion air requirements as per code. G2407.5 Flue vent material to be approved for use as installed per installation instructions. 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 10345 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL March 3, 2015 at 11:33:06 AM MST2014-00039 David Young Add ﬁxtures to permit that were not existing to the original structure. Second lav in master bath, laundry sink ect. 103.4.1 Calk base of master tub/shower to ﬂoor, both baths. 310.4, 407.2 Secure sink vanity to wall, both baths. 407 Fix leak under laundry sink. 310.0 Calk kitchen sink top to backsplash.310.4, 407.2 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 10345 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal PASS April 10, 2015 at 8:50:42 AM MST2014-00039 David Young Corrections done. 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 10345 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O April 10, 2015 at 8:52:12 AM MST2014-00039 David Young Violation Summary: Inspector Contractor