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Permit IN a CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2013-00143 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ; ) Date Issued: 05/05/2014 1 Parcel: 1 S 126DB03100 W,5_B•./ Jurisdiction: Tigard Site address: 9347 SW 92ND AVE Subdivision: MONTAGE Lot: 2 Project: Montage, Lot 2 Project Description: Building 1 -New SFA. 3/31/15: Reprinted permit to include air conditioner. Placement of A/C must comply with manufacturer's clearance requirements. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 312 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height 34 Bathrooms: 3 Second: 700 sf Garage: 280 sf Front: 4 Smoke Dwelling Units: 1 Third: 700 sf Right 5 Detectors: Yes Total: 1712 sf Value: $200,015.78 Rear: 4 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: Rain Drain: 1 Urinals: Lavatories: 4 Dishwashers: 1 Floor Drains: Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: Bckflw Prevntr: Footing Drain: Ice Maker: 1 Hose Bib: 2 Backwater Value: Drywell-Trench Drain: Other Fixtures: Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: Furn<100K: 1 Vents: Woodstoves: Gas Outlets: 4 Furn>=100K: ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0-200 amp: W/Svc or Fdr: Ea add'I 500 sf: 2 201-400 amp: 201-400 amp: W/O Svc/Fdr: Mfd Home/Feeder/Svc: 401-600 amp: 401-600 amp: 601-1000 amp: 601+amp-1000v: 1000+amp/volt: 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 SFA VB R-3 1712 Owner: Contractor: NW AREA INVESTMENTS LLC AAA PROPERTIES INC Required Items and Reports(Conditions) 11150 SW RIVERWOOD RD 16501 NE 65TH CIRCLE 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97219 VANCOUVER,WA 98682 PHONE: PHONE: 360-609-3465 FAX: 360-718-9701 Total Fees: $14,962.99 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a co o the rules or• = t questions to OUNC by calling 503.232.198 'r.332.2344. i Issued By: �- — ...��i�, Permittee Signature: , Call .y 7:00 a.m.for the next available ins,' on date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard R"/By. III - `J g Plan Review 1 5. iJj Permit No.:At , / s -do y 1 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 RECE��E�. Date Read /e Juris: - - Internet: www.ti ard-or. ov Ready/By: Supplemental See Page 2 for g g Notified/Method: (-%� Supplemental Information R 31 2015 TYPE OF W COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑Addition/alti t/ T s QN Mechanical permit fees*are based on the value of the work New construction 1 lll�� performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: BUILD mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES" TV 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION ` Heating/cooling: Job site address: 93(I 7 S C1 2 V\� Air conditioning 46.75 5'�7s 7 l /�;t/ /R Furnace 100,000 BTU(ducts/vents) , 46.75 City/State/ZIP: j`r,G r C OR. 0 15 Furnace 100,000+BTU(ducts/vents) , 54.91 "v� 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 I A I Flue vent for water heater or gas \vrC akcI`\ A\f Ca 'CJ 1 t Or -ti fireplace 23.32 Log lighter(gas) 23.32 "� �` Wood/pellet stove 33.39 �c.iµrrle k' t°�t,3�r/p ��yy�1� MsTv�)(�-00/i(3 Wood fireplace/insert 23.32 ✓ l' Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER I ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: 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 Business name: j, P �_ __ _�"I Fuel piping: �' $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: DaNN t 5 Flea_t 0k g,C c 0(14 5 l h C. MECHANICAL PERMIT FEES" Address: &30 3 N 36 `` Subtotal 116, .'75-- City/State/ZIP: C.Gv, C,p v .1L C W � q 5/6 , Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(5"Q)) i/cf $6s V Fax:( ) State surcharge(12%of permit fee) 5`, (p CCB lic.: / / 75 (-/9' TOTAL PERMIT FEE _ 59, 3V 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: &)h i'S 709 cy to p Date: 3 f ! J 15- I:\Building\PermitsVMEC_PermitApp_040113.doc 440-4617T(I 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\P ermits\MEC_PermitApp_040113.doc 2 g CITY OF TIGARD MASTER PERMIT III _ •� COMMUNITY DEVELOPMENT Permit#: MST2013 00143 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/05/2014 TIGARD Parcel: 1S126DB03100 Jurisdiction: Tigard Site address: 9347 SW 92ND AVE Subdivision: MONTAGE Lot: 2 Project: Montage, Lot 2 Project Description: Building 1 - New SFA BUILDING Floor Areas Required Setbacks Required Stones: 3 Bedrooms: 3 First: 312 sf Basement. 0 sf Left 5 Parking Spaces: 0 Height: 34 Bathrooms: 3 Second: 700 sf Garage: 280 sf Front: 4 Smoke Dwelling Units: 1 Third: 700 sf Right: 5 Detectors. Yes Total: 1712 sf Value: $200,015.78 Rear: 4 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: Rain Drain: 1 Urinals: Lavatories: 4 Dishwashers: 1 Floor Drains: Sewer Lines: 100 SF Rain Storm Sewer 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: Bckflw Prevntr: Footing Drain: Ice Maker: 1 Hose Bib: 2 Backwater Value: Other Fixtures: Drywell-Trench Drain: Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: Furn<100K: 1 Vents: Woodstoves: Gas Outlets: 4 Furn>=100K: ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0-200 amp: W/Svc or Fdr: Ea add'I 500 sf: 2 201-400 amp 201-400 amp: W/O Svc/Fdr: Mfd Home/Feeder/Svc: 401-600 amp: 401-600 amp: 601-1000 amp: 601+amp-1000v: 1000+amp/volt: ELECTRICAL-RESTRICTED ENERGY SF Residential Audio 8,Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SFA VB R-3 1712 Owner: Contractor: NW AREA INVESTMENTS LLC AAA PROPERTIES INC Required Items and Reports(Conditions) 11150 SW RIVERWOOD RD 16501 NE 65TH CIRCLE 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97219 VANCOUVER,WA 98682 PHONE: PHONE: 360-609-3465 FAX: 360-718-9701 Total Fees: $14,910.63 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-Q01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By: .3—e-__ Permittee Signature: �A / _ e,(-/e }"T/O/�/ 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. S . Building Permit Application Residential FOR OFFICE USE ONLY of Tigard �� Received /4 / �- /� �/� u Date/By: :� Permit No.:�� I3 VV�/ Ph • 13125 S50 Hall Blvd.,Tigard,OR 97223III Plan Revie /� Other Perm Phone: 503.718.2439 Fax: 503.598.198f4�N 19 2 013 Date/By: /0(16 I +brWie a0/.3 OG/s/ I i,, \R n Inspection Line: 503.639.4175 Date Ready/fly: J H See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: AO% /3 / Supplemental Information �x�,,1iOiN1 oIv1 ° Al ,4.D,. i;41-J 4 q d,[` ,-• ;ts *-z '�r ;.4�;,4' 4it'iti fh` ORI ` 6 �' .r REQUIRED DATA:/1 A11IILYDWELLING 1- :14,4--:4! 4,1--:-4 ._„R , -,4-, er-, ': '� < r_. ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ '��Q o(�j, ❑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: 9'3'77 902 ' -/G/e- New dwelling area: )/ 71 •2_ square feet City/State/ZIP: Garage/carport area: ,? p square feet Suite/bldg./apt.no.:6146 / Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: `udP--u- square feet L `_ ff 1lrl .�j Other structure area: d square feet /jr�2:�filp';rte' /`ice'/ / / /� REQUIRED DATA:COMMERCIAL-USE CHECKLIST S 'division: i Lot no.: 02, Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the .r7DEESSCRIPATIION O,FF WORK,/I,/ 7 work indicated on this application. L�2� p ��g .. // !//4t (24'A ` / . v l Valuation: $ '7�•r. �-- :�`J y�,�-,�7� � Existing building. -a /©J lA�quare --.tG�J New building area:./f. 2-7 • are feet PROPERTY OWNER ❑ TENANT Number of stories: ' 'c Name: h/tti r L Ii A JJJ ENJ / S _ Type of construction: f`� — Address: /J/ �/ r A/ A� Occupancy groups: City/State/ZIP: 772>17t9 / 72 J Existing: Phone: Fax: c% 7 ---377S:? New: Q 2 APPLICANT :1 CONTACT PERSON BUILD G PERMIT FEES* Business name: �� At,s ! //` (Please refer to fee schedule) �� Structural plan review fee(or deposit): Contact name: f1� ti // - ."-- /�/] FLS plan review fee(if applicable): Address: trffi !`ff`ji Total fees due upon application: City/State/ZIP: /�� , -- – Phone:( '7)/ "7 7®� ��jj ax:: )71.)v Amount received: ,/ f 6�'v / r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: °� / 'V.Y I�C�e v L>' /,(iii l Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: ,n I !,--f i /�'1` Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: L 0 l / . le I ti t Solar Installation Specialty Code checklist. �+•s+7 Permit Fee(includes planreview City/State/ZIP: � �l �'�2 and administrative fees): $180.00 Phone: ax J �le.-��9/ State surcharge(12%of permit fee): $21.60 CCB lic.: ls]'e% 1 Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained ,`�/� L� within 180 days after it has been accepted as complete. Print name: - � '�� r f fa m�.Jm/-�• / �1 I *Service e methodology oard set by Tri-County Building Industry I:\Building\Permits\B '-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) r Plumbin Permit A lic • Building Fixtures CE1VED FOR OFFICE FSE ()NIA City of Tigard Received _Permit Nosh��? (�ar/3 jig '1 13125 SW Hall Blvd.,Tigard,OR 9 19 2013 Date/By: Review Phone: 503.718.2439 Far: 503.598.1960 Date/By: Other Permit No.: TI G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: funs: la See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 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: 93 9? SA) 9.2-- Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: /#1-X,111 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 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.: Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: /,,l i Al l -2 s� -ms .- Fixture/sewer cap 25.02 -'° ",/�� Floor drain/floor siric/hub 25.02 Address: NEW ti7p__)7....„4/4.0 .„/ W / J AV' Garbage disposal 25.02 City/State/ZIP: ` fj �7 - Hose bib 25.02 Phone: 4 - A ax: v.-fr.': �� _ 14/4ii Ice maker 12.51 • APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: Water closet 25.02 CONTRACTOR � ��, J'Jyo Water heater 37.52 Business name: / l�rE //c-1 Water piping/DWV 56.29 Address: ,19 l r" -7 d Other: 25.02 City/State/ZIPI// �'. /L / _ Subtotal Phone:) 77?� ti li �J fax: '� ` / / Minimum permit fee: $72.50 �2 Plan review (25%of permit fee) CCB Lic.: ( 1 )7 / Plumbing Lic.no.: T-e-::::. J State surcharge(12%of permit fee) Authorized signature: o// ;/� TOTAL PERMIT FEE L /r /tom / 7�_ This permit application expires if a permit is not obtained within 180 days Print name: Ali ,jr ,,y� �P I, Date: .9/ G i Gam! after it has been accepted as complete. E7, *Fee methodology set by Tri-County Building Industry Service Board. t:\Building■Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Mechanical Permit Application 00) FOR OFFICE USE ONLY Received jig City of Tigard R Date/By: Permit No,/7S7�o,3�c/g3 " 13125 SW Hall Blvd.,Tigard,OR ' . :4 41J Plan Review Phone: 503.718.2439 Fax: 503.598. • I 0, Date/By: Other Permit: I I t.i A K u Inspection Line: 503.639.4175 OC\ P�Q Date Ready/By: Suits: See Page 2 for Internet: www.tigard-or.gov -`\G "AT Notified/Method: Supplemental Information TYPE OF WOR it Ol`a� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commerciallindustrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description 1 Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: 61 '1 3�-1- Stk-- erg- Ave, Furnace 100,000 BTU(ducts/vents) 46.75 (d City/State/ZIP: '�; /1�t f j OQ. Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: V Project name: Imoart. e- 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.: d Other: 23.32 L Other fuel appliances: Tax map/parcel no.: 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 0 PROPERTY OWNER ❑ TENANT Other: 23.32 p Environmental exhaust and ventilation: Name: l �. Nu�(i 111 0' Range hood/other kitchen mpL1�5 -��'` equ pment 33.39 Address: t\T (� ` {mil iQwvolod I .(1'1 Clothes dryer exhaust 33.39 City/State/ZIP: 0.VA vkdk 0 P-. q T 0 t el Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( I Fax:(�.7l)')3 ?- 9 Attic/crawlspace fans 23.32 �� 3'�a -311`1 �� -3-1^l �.� p ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name: $14.15 for first four;S4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name: I Other: ��`�v� 5 �'�f�`�11� (o&ec � { MECHANICAL PERMIT FEES* Address: '�;' 2, l�,t'.. 3c,-id J+ ; Subtotal City/State/ZIP: \rakikeN J()if' A- Cr 368 �C Minimum permit fee($90.00) Phone: l ( ) Plan review(25%of permit fee) ((' 3) q 113c_ g(,7b{i Fax: State surcharge(12%of permit fee) CCB lie.: 14 4 c. 4 Ct 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: �f cart./ * Fee methodology set by Tri-County Building Industry Service Board Print name: \---:: _c,_,‘. 2v.■,,- G w^o,Y Date: tO- 3-(3 I:\Building'Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) 1 Electrical Permit Application FOR OFFICE USE()NIA. City of Tigard Received `, Date/By: Permit No.,// /3 1/5 14 13125 SW Hall Blvd.,Tigard,OR 3 - i Plan Review Phone: 503.718.2439 Fax: 503. 0 DateBy: Other Permit: Inspection Line: 503.639.4175 '- FilifFD Date Ready/By: orris 1 [(AARO Y Y ® SeePage2for Internet: www.tigard-or.gov ,,, 1n�3 Notified/Method: Supplemental Information TYPE OF WORK tU PLAN REVIEW ❑New construction ❑Addition/alieria�i�i> p� r".t Please check all that apply(submit 2 sets of plans w/items checked below): ❑Demolition ❑Other: 9UILDRIri, RI q/� ❑Service or feeder 400 amps or more ❑Building over three stories. ��;��Il/ where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION . exceeds 10,000 amps at 150 volts or ❑Floating buildings. 1\ less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory uildlR amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: v`' t ik>t'tre pump ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION '(�O� \ ergency system. larger separately derived system. \� r r+I�`� Addition of new motor load of ❑"A","E","1-2","I-3", Job no.: Job site address: �G,7 G IOW. IOOHP or more. occupancy. 9 .W 94 ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: 1 ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 - Services or feeders installation,alteration,and/or relocation PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2 Name: t 201 amps to 400 amps 133.56 2 ,-///1„1// ^ /,4/i' )2 / s'�/ ��111 401 amps to 600 amps 200.34 2 Address: ///S lam, / 7 L/ ...< 7P //1)/ 601 amps to 1,000 amps 301.04 2 � Over 1,000 amps or volts 552.26 2 City/State/ZIP: �"`�Z �/� .477 2i" Temporary services or feeders installation,alteration,and/or Phone: p cr 7 Fax: j � �s;� relocation ( �` ( , 7 22' 200 amps or less 5936 1 Owner installation:This installation is being made on property own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel ❑ APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: each branch circuit B.Fee for branch circuits without Contact name: service or feeder fee,first 56.18 2 branch circuit Address: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular Phone:( ) Fax: :( ) dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: l /# � �� Signal circuit(s)or limited energy See / / -� ` [[ panel,alteration,or extension. Page 2 2 Address: IV /6 a '� Jam; Each additional inspection over allowable in any of the above S /Y 4J , Additional inspection(1 hr min) 66.25/hr City/State/ZIP: �/ ��%'�F�tA �T/�-ti--2 Investigation(1 hr min) 66.25/hr Phone:( ' _>7��J Fax:( ) Industrial plant(1 hr min) 78.18/hr ` Inspections for which no fee is CCB Lic.:ret L x.-'74. Electrical Li . .S Suprv.Lic 4-4-16-4/ specifically listed('/2 hr min) 90.00/hr 1 ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: /f/ • Date: Plan review(25%of permit fee): Of 4. State surcharge(12%of permit fee): Authorized signature: 3'�" ' TOTAL PERMIT FEE: Print name: ,��aliffi 1�' ) ��This permit application expires if a accepted is not obtained within 180 p days after it has been acce ted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB 1111 _ Building Division Development Code Provision Review 1 I`A R D Residential Projects Building Permit No.: /4C-7-0.2n/_3 - CO/X-3 Project/Subdivision Name: ,904/7 /3 46 6- / , Lot #: .2--- Site Address: 939? s4-) 9a-`-- '"1/c CWS Service Provider Letter: Required:Yes ❑ No ja Received:Yes ❑ No ❑ Plans Routed: Original Plan Submittal Date: 4A9,/-3 Routed By: -t° 1St Revision Submittal Date: G.27 /3 ,� Site Plan Only Routed By: . 2nd Revision Submittal Date: 2/f 43 ,g Site Plan Only Routed By: 4/ To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re-submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review(contact el:o at (503) 718-2-4/3Y or %47P @tigard- or.gov) / Land Use Case No. ' ' 2'G c"7`12 Zoning Wax- O Setbacks: Front Rear Side _ Street Side Garage O Maximum Building Height: Actual Building Height O Visual Clearance O Easements O Sensitive Lands Type: O Street Trees -Et Protected Trees Notes: r r2a-' G ku-.15 64 1 Original Plan: Approved ❑ Not Approved E• Date: 6 -46 - /3 Revision 1: Approved ❑ Not Approved jic— Date: 7-10 "/3 Revision 2: Approved.0' Not Approved ❑ Date: 7`7-"( - '3 (Review Continues on Page 2) Page 1 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 1 • Engineering Review(contact Mike White at 503-718-2464 or MikeW @ tigard-or.gov) ❑ Actual Sl pe: % Notes: 4- s II .( r-Af,.17 The + k ,21- S Original Plan: Approved ❑ Not Approved ®" Date: 4- Z 7 /3 Revision 1: Approved;D Not Approved ❑ Date: 7 e) 13 Revision 2: Approved�0r- Not Approved ❑ Date: h03 Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albert@tigard-or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant - Okay to Issue Permit: Yes , tkNo ' 6/_v_?,/7.3 Date Routed to Building: 7 � �3 \II Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal PASS March 2, 2015 at 12:55:55 PM MST2013-00143 Chip Barnett 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 2, 2015 at 12:47:44 PM MST2013-00143 David Young Cap and label dryer vent per code for developed length and for future use. M1502.4.5, .6 Seal ceiling penetration around gas line in garage ceiling. All else ok. Note: no AC installed at this time. 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL March 2, 2015 at 12:39:11 PM MST2013-00143 David Young T&P drain to be secured per manufacturers installation instructions and table 3-2 at 3' OC. All else ok. 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL March 2, 2015 at 12:18:43 PM MST2013-00143 David Young Provide approved planning and engineering sign offs for project prior to building ﬁnals. No inspection made. 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 18, 2015 at 1:31:04 PM MST2013-00143 David Young Correction for sealing around gas line in garage not done as per previous inspection. Dryer vent developed length not labeled as noted on previous failed inspection. 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS March 18, 2015 at 1:33:57 PM MST2013-00143 David Young Correction from previous inspection complete. 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL March 18, 2015 at 10:58:33 AM MST2013-00143 David Young Provide approved planning sign off prior to building ﬁnal. 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL March 2, 2015 at 12:39:11 PM MST2013-00143 David Young T&P drain to be secured per manufacturers installation instructions and table 3-2 at 3' OC. All else ok. 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 9347 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 2, 2015 at 12:47:44 PM MST2013-00143 David Young Cap and label dryer vent per code for developed length and for future use. M1502.4.5, .6 Seal ceiling penetration around gas line in garage ceiling. All else ok. Note: no AC installed at this time. Violation Summary: Inspector Contractor