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Permit •CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT i Permit#: MST2014-00058 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 - ® Date Issued: 05/19/2014 Parcel: 1S 134DB02000 Jurisdiction: Tigard Site address: 11492 SW 115TH AVE Project: HESS Subdivision: WINTERS ADDITION Lot: 6 Project Description: Family room and master suite addition. 9/8/14:Reprinted permit to include 150 ft.of water service and(1)PRV valve. Contractor: OWNER Owner: HESS,VANESSA R HESS,VANESSA 1550 SW 66TH AVE 11492 SW 115TH AVE PORTLAND,OR 97225 TIGARD, OR 97223 PHONE: 503-702-5472 PHONE. FAX: FEES Quantity Description Date Amount 1 ea Building Permit-Additions, 05/19/2014 $1,407.95 Specifics: Alterations,Demolition 1 Plan Review 04/23/2014 $596.51 Type of Use: SF 1 ea 12%State Surcharge- 05/19/2014 $168.95 Building Class of Work: ADD 1 ea Metro Const.Excise Tax- 05/19/2014 $179.19 Type of Const: VB Residential Use Occupancy Grp: R-2 1 ea Tig-Tual School CET- 05/19/2014 $1,410.18 Stories: 0 Residential 1 ea Erosion Control w/Permit-Eng 05/19/2014 $225.00 1 ea DC Provision Review,SF- 05/19/2014 $70.00 Ping 1 ea DC Provision Review,SF- 05/19/2014 $10.00 LRP 8 ea Info Process/Archiving-Lg 05/19/2014 $16.00 $2.00(over 11x17) 20 ea Info Process/Archiving-Sm 05/19/2014 $10.00 $0.50(up to 11x17) 0 Plan Review 05/19/2014 $318.66 Total $5,284.00 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: . Permittee Signature: 1 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures ,t►li ul II( I i .I (l., VA‘ci< or Tigard CiAN Qaw )13w d II fir t U d0 I GX157•1 1312 5 SW Hall Blvd.,Tigd,OR 9 Plan Reiew ■ Phone: 503.718.2439 Fax: 503.59 L)ate1By Other Permit No Inspection Line: 503.639.4175 T I ti A R L) `n r, . Date Readying luris 0 Sec Page I for Internet: www tigard-or.gov 2 1 NontiediMeibod Supplemental Information TYPE OF WORK 'NW; FEE* SCHEDULE x ❑New construction ❑De$i �� t�1„'4N� For special inJurmalivn use checklist Addition/alteraion/rcplaccment ❑O "'�`!r Description I Qty 1 r a J Total ( �, • New I-2-family dwellings(includes 100 ft.for each utility correction) CATEGORY OF CONSTRUCTION ((1)bath 312.70 1-and 2-family dwelling C'ommer ' �. SFR(2)bath 437.78 Y 8 ❑ �`�1 SFR t 3)bah 500.32 ❑Accessory building ❑Multi-f: • a Each additional bath/kitchen 25.02 ❑Master builder ❑Other. ( ) a Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION L 'ice utilities: Job site address: 1 4 9 t./1 Sit) i IS t ch basin or area drain 1 8.76 Drywell,leach life,or trench drain 18.76 City/State/ZIP: Td (j(i r , b P., q 1199 ark Footing drain(no linear ft.: ) Page 2 sit Suite/bldg./apt.no.: J 1 Project name: • , anufactured home utilities 50.03 Cross street/directions to job site: >(ii1� • anholes 18.76 Nb 4411, l iL_ 3 i_ ez. I-, " Rain drain connector 18.76 0-1--i �A`(.(T��A moo- t el 1 j 5 Sanitary sewer(no.linear ft.: ) Page 2 lv "t Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.`P) Page 2 t OD•a„0 Subdivision: //""��/J2r /l IAA no.: Fixture or item: T OoC_)ax map/parcel no.: i S L,3'4 De) -' D& 4 3-7. Sackflow prcventer _ 3127 DESCRIP'T'ION OF WORK Backwater valve il 12.51 � Clothes washer J 25.02[nll l over Q 0'4 40/c- rch facia U l i' &) /Add Dishwasher 25.02 ��r ��L Porch 46 �-? Drinking fountain - 25.02 Vi/c/1 l //�(e41 C 5-C',.. c � -✓" FC✓Y,•c-e CY^,fecto /sump 25.02 PROPERTY OWNER Cl TENANT om j _ Expansion tank 12.51 `t1 i Fixture/sewer cap Name: 25.02 Address: Floor drain/floor sirlk/Itub 25.02 I 1 L4 /3l _I Ja lv�- Garbage City/State/ZIP: disposal 25.02 y 1 far a � 7 9 Hose bib 25.02 Phone:(C:19)))) '? S i 1 Fax:( ) Ice maker 12.51 APPLICANT ONTACT PERSON Interceptor/grease trap , .- 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: n 1 C,O1 QC ,' e1 a, n Roof drain(commercial) 12.51 Address: • f7+ Sink/basin/lavatory -c Z� ' 25.02 City/Stater/AP: I�� i O�Ua]� aS,3 Solar units(potable water) 62.54 Phone:5b3 0 r II + Fax::( ) Tub/shower/shywer p an Z 12.51 E-mail: c 1i)h I z KitiS 1-+- C- ri''1 Urinal 25.02 CONTRACTOR Water closet i 25.02 Water heater 37.52 Business name: DA./A/Cn- Water piping/DWV 56.29 Address: Other: -pgji 1 25.02 ;)). City/State/ZIP: Subtotal hq5 de Phone:( ) Fax:( ) Minimum permit fee' $72.50 Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: State surcharge(12•4 of permit fee) Authorized signature: V _ TOTAL PERMIT FE 4/71///� O'7 Print(lame: f Y� Date: y This permit application expires if a permit is not obtained wi in Wilily, after it has been accepted as complete. 'Fee methodology set by Fri-Count',limldow hhhodr.Scrvme B.gan1 I'Flu dinearmitsWr.MT-PrmitAppdoe taro1sin 44o-461er(10w024.ost.\s F a) r� CITY OF TIGARD MASTER PERMIT !PI _ COMMUNITY DEVELOPMENT i Permit#: MST2014-00058 T€G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ftelip 1412111,/ Date Issued: 05/19/2014 Parcel: 1S134DB02000 Jurisdiction: Tigard Site address: 11492 SW 115TH AVE Subdivision: WINTERS ADDITION Lot: 6 Project: HESS Project Description: Family room and master suite addition. 9/8/14: Reprinted permit to include 150 ft. of water service and(1)PRV valve. 9/15/14: Revised permit to include gas piping for furnace. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 1 First 1237 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 15 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third 0 sf Right: 0 Detectors: Yes Total: 1237 sf Value: $149,321.41 Rear: 0 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 2 Garbage Disp: 0 Water Heaters: 0 Water Lines: 150 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 1 Other Fixture Units: PRV valve MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 2 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 1 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: 26 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: ADD SF VB R-2 1237 Owner: Contractor: HESS,VANESSA R OWNER Required Items and Reports(Conditions) 1550 SW 66TH AVE HESS,VANESSA PORTLAND,OR 97225 11492 SW 115TH AVE TIGARD,OR 97223 PHONE: PHONE 503-702-5472 FAX: Total Fees: $5,299.85 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. • TION Ore"• I. r=quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-I.1-0010 through OAR 91'-001-s.9•. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.890 332.2344. ticiiiil A�f/Is ed By: ' Permittee Signatur9;�� D�t< / - Call 503.639.4175 by 7:00 a.m.for the next available inipactlairefile. 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. IIIV CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2014-00058 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/19/2014 TIGARD g Parcel: 1S134DB02000 Jurisdiction: Tigard Site address: 11492 SW 115TH AVE Subdivision: WINTERS ADDITION Lot: 6 Project: HESS Project Description: Family room and master suite addition. BUILDING Floor Areas Required Setbacks Required Stories 0 Bedrooms: 1 First 1237 sf Basement 0 sf Left: 0 Parking Spaces 0 Height 15 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 1237 sf Value: $149,321.41 Rear: 0 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 2 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckftw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: Y Vent Fans: 2 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum>=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: 26 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-1 000v: 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: ADD SF VB R-2 1237 Owner: Contractor: HESS,VANESSA R OWNER Required Items and Reports(Conditions) 1550 SW 66TH AVE HESS,VANESSA PORTLAND,OR 97225 11492 SW 115TH AVE TIGARD,OR 97223 PHONE: PHONE: 503-702-5472 FAX: Total Fees: $5,143.91 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 en r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain= •• • =s or direct questions to OUNC by calling 503.2 2.1 7 or 1.800.332.2344. Issued By: ' ,a■__ ter— '•■ ittee Signature: -1111ffellt39.4175 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. f • Building Permit Application Aesitiential FOR OFFICE ',I O\I 1 City of Tigard aCtIN til ciVed „ I,!• ._ , i■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review A Other Permit Phone: 503.718.2439 Fax: 503.598.1960 9,la 2014 Datem : AAA lM T 1 G A R D Inspection Line: 503.639.4175 AP� Date Ready:y: H See Page 2 for Internet: www.tigard-or.gov 1v"� Notified/Method: Supplemental Information � v`1Cnn TYPE OF W % t%C1�iv15�"� REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction 0 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. ® I-and 2-family dwelling ❑Commercial/industrial Valuation:I 4g))06Zt�44 3,...4J-706- -4tic-if1/43 ❑Accessory building ❑Multi-family Number of beQrooms: 1 ❑Master builder ❑Other: Number of bathrooms: I JOB SITE INFORMATION AND LOCATION Total number of floors: 1 Job site address:11492 SW 115'"Ave New dwelling area: 1237 square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: 11e-5- Covered porch ar ,4M0 )7 square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: PGALLP Lot no: Permit fees"are based on the value of the work performed. Tax map/parcel no.:1S134DB02000 „93.. 7 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Addition of family room and new master suite Valuation: S Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:Vanessa Hess Type of construction: Address:11492 SW 115th Ave Occupancy groups: City/State/ZIP:Tigard,OR 97223 Existing: Phone:(503)702-5742 Fax:( ) New: ® APPLICANT AS CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedale Business name: / Structural plan review fee(or deposit): Contact name:Nick or Vanessa Hess la hiss e4J!) Z [i Sfdlr-11M FLS plan review fee(if applicable): Address:11492 SW 115th Ave Total fees due upon application: tyi%i 5/ City/State/ZIP:Tigard,OR 97223 Phone:(503)4062151 Fax: :(503)4062151 Amount received: E-mail:nhess@whizlcidsit.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: 0 /"/.7_,..., Submit two(2)sets of roof plan with connection details 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 lic.: 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. Print name: nit(L(Ai, I Date: / # /11 *Fee methodology set by Tn-County Building Industry 7 Service Board. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613 (11A02/COM/WEB) • Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard ��j. Received �{, Receiv Permit No.: 1 -'r 13125 SW Hall Blvd.,Tigard,OR 97 co p R Review Q 1- �� Phone: 503.718.2439 Fax: 503.598 Date/By: Other Permit No.: Inspection Line: 503.639.4175 T I G A R D Date Ready/By: Juris: ® See Page 2 for Internet: www.ti ard-or. ov Notified/Method: Supplemental Information rmation P9. �� 4 TYPE OF WORK �`GI�V FEE* SCHEDULE ❑New construction ❑De O 1 tNXSAO For special information use checklist VIVO 13 Description I Qty. � Ea. I Total �,Addit ion/alterz[ion/replacement ❑Oifr�V��`` 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 Al building SFR(3)bath 500.32 ❑Accesso ry g ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) I Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: +14 q s)l I5 Catch basin or area drain 18.76 ty TOW& b q 1 a�3 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: J j Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 © DA U � 6 el f) 5 Sanitary sewer(no.linear ft.: ) Page 2 ! Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: 1 S 1 3 4 DP) - Oabob Aral 013-7Y Backflow preventer 31.27 DESCRIPTION OF WORK / Backwater valve 12.51 (� h Clothes washer j 25.02 Jaa eb ver a tr 1�I�c 1�add Qikd i-ion /add_ Dishwasher 25.02 COoq Pbrc +3 Drinking fountain 25.02 Ejectors/sump 25.02 151Vo.._1vu- 5t PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fix ture/sewer cap 25.02 I 51t) I I S`� Floor drain/floor sink/hub 25.02 Address: 1 Garbage disposal 25.02 City/State/ZIP: -II Olt rct p k 1a6 Hose bib 25.02 Phone: ?bcp l g ' Cv Fax:( ) Ice maker 12.51 APPLICANT `1CONTACT PERSON Interceptor/grease trap 25.02 Business name: // Medical gas(value:$ ) Page 2 Contact name: n i chO1 QS Roof 12.51 I� ,�.�}� Roof drain(commercial) 12.51 Address: ' , Q a 3� GJ�H \./ `" `°' Sink/basin/lavatory 6l///j� "-. 25.02 City/State/ZIP: T\a„,-4 0v._ l 7,9.o.3 Solar units(potable water) 62.54 Phone:(5b3 i Div i g" I g Fax::( ) Tub/shower/shower pan 2- 12.51 E-mail: n he 5S E/ LAh I Z K I AS 14- . I'Y'1 Urinal 25.02 CONTRACTOR Water closet 1 25.02 Water heater 37.52 Business name: QitiN 677-' 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: i_f TOTAL PERMIT FEE Print name: �,� Z.� Date: 009 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-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 of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to - Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font El Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: Each Stall CI New exterior plumbing site utilities for any complex structure Drive Stall 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 that meet the qualifications above. Garbage -Domestic non-food 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: -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 Filer - increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal _ Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Mechanical Permit Application `�l� Received 1.0R OI I It I 1 sf t)\I 1 City of Tigard �� Date/By: Permit No.: _, j H_Oc b 5 13125 SW Hall Blvd.,Tigard,OR 9 ,y,. Plan Review Phone: 503.718.2439 Fax: 503.598. s.• �01� Date/By: Other Permit: I I G/\R t) inspection Line: 503.639.4175 �� CO �� Date Ready/By: Saris H See Page 2 for Internet: www.tigard-or.gov r �♦♦ otified/Method: Supplemental Information TYPE OF WO �``° 111 ,S` 1` COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 00 ,�� Mechanical permit fees*are based on the value of the work ❑New construction Addition/alteratio��ment 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* iJ.1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: `�� Air conditioning / 46.75 Job site address: I 14 q SO I I T/' Fumace 100,000 BTU(ducts/vents) f 46.75 City/State/ZIP: TI 1 1 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 1 23.32 Cross street/directions to job site: N1 ,f . / 4- I I Hydronic hot water system 23.32 . �f `► J ^ Residential boiler(radiator or S }gypL(, S `c 6ry, ebY f I /J. �l2 O, ) hydronic) 23.32 1 154 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 _ Subdivision: �/I Lot no.: Other: 23.32 1513LI )f) f1at0 / ir(yJ a3 14' Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 004 n^ 1 , Flue vent for water heater or gas etoe�d ace.a.�,L I /Q ('/]/] I-h y ) fireplace 23.32 04 ebi) ('4 porch ' 3 ba��H11 L"`^^^"""��„"ill Log lighter(gas) 23.32 porch stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 PROPERTY OWNER I 0 TENANT Environmental exhaust and ventilation: Name: t,('��,�ru:lsst Range hood/other kitchen Address: (I 411 d- 1 1 At� equipment _ 33.39 1 n ?9-0 Clothes dryer exhaust / 33.39 City/State/ZIP: i;;9a ro [i Single-duct exhaust(bathrooms, 1 toilet compartments,utility rooms) p,, 23.32 Phone: ) Fax:( ) Attic/crawlspace fans 23.32 lf...litPPLICANT %.CONTACT PERSON Other: 23.32 i Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: p i/'h()l 5 H-e_ ..5 Furn ace,etc. Address: I I+Li q l 0 15` Gas heat pump Wall/suspended/unit heater City/State/ZIP: '—' T (E a( k i Water heater Phone:6 t3 -J O(o \g k g-2-3 Fax::( ) Fireplace Range E-mail: n1 t37Z Mh'1-21._IdsI#• co f-\(l Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: D Al/V672""" 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 lic.: 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: �AC/ /c,f grit Date: 9 a2 I V I:\Building\Permits\MEC_PemutApp_040113.doc -461 (11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I.\Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit Application 1(HZ O I I I( I I .I. O\l.1 City of Tigard Received�t Plan Re: Permit No.: M 5-0.0 pi „�� ill 13125 SW Hall Blvd.,Tigard,OR 972 V Plan Review II Phone: 503.718.2439 Fax: 503.5' 'CEO Date/Ely: Other Permit: I ; b:l Inspection Line: 503.639.4175 + Date Ready/By: turfs' ® See Page 2 for Internet: www.tigard-or.gov 7-°' Notified/Method: Supplemental Information TYPE OF WOR V? PLAN REVIEW ❑New construction Addition/alteration/re E1- Please check all that apply(submit 2 sets of plans w/items checked below): lrT '`'1S0 ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: (\lv where the available fault current ❑Marinas and boatyards. CATEGORY OF C f� exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural '�1-and 2-family dwelling ❑Commercial/industrial El 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. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job#: Job site address: `I l 30 ' t�TIt_ A }� Six or or more residential occupancy. L/ r v�+ ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: 1 l r� 6F, 1 13 ❑Health-care facilities. ❑Supply voltage for more than 1 1 uv�` 1 ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.#: Project name: ❑Service or feeder 600 amps or more. FEE SCHEDULE 'V Cross street/directions to job site: i baKeria Cl Ii5t400 Description I Qty. 1 Each 1 Total I • nc \��.'�,�-�{{'�� 1 New residential single-or multi-family dwelling unit. 3� �e s born chow o'f ,.1 r h Trt6-f>�on f 1 544`4.AUeIncludes attached garage. Subdivision: Lot#: 1,000 sq.ft.or less 168.54 4 Tax map/parcel no.: 1`61 �J4 8 D tt 'Pared ,93-1 Ea.add'1 ner y, es ft.de portion 33.92 1 Limited energy,residential 75.00 2 DESCRI -tioN'OF-WORK - - . ._ (with above sq.ft.) /� , Limited energy,muhi-family aria/[I a outad of n Ab l rki.l NA jod/l /)/�d`44� residential(with above sq.ft.) 75.00 2 (/1'4J C �tJ� T�p�� U �W Renewable Energy ❑ See Page 2 add4ove fed of N , +6 ba Services or feeders installation,alteration,and/or relocation 70PERTY OWNER 1 ❑ TENANT 200 amps or less 7 I 100.70 i(x),-4,2 201 amps to 400 amps 133.56 2 Name: nn%a `1A /� 401 amps to 600 amps 200.34 2 Address: 1 141 a $� loit 15 1 >W J(' 601 amps to 1,000 amps 301.04 2 rd o ta q 7J 13 Over m ora amps services volts 552.26 lte 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or relocation Phone:St?)) 18 1R, Fax:( ) 200 amps or less 59.36 1 Owner Installation:Titis installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature' S Ce" /e d ArS//�ltil 7`-/ , 'ff'ibate: Branch circuits—new,alteration,or extension,per panel *APPLICANT L '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: ;ch bl to 5 service or feeder fee,first 1 / 56.18 2 IA-Q.-SS branch circuit �' Y Address: ` 1 l�i SI ', Each add'l branch circuit 7, ,S" 7.42 145. lo,2 City/State/ZIP: 1 r Miscellaneous(service or feeder not included) iv_ Each manufactured or modular 2) 1 No '% 1 Q dwelling,service and/or feeder 67.84 2 Phone: 'J LL (� Fax: :( ) �U/ J l Reconnect only 67.84 2 E-mail: Y he_ '� 1ih 12-L■d.%4 % CD►'YN Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2• Business name: t I kc/A/6L 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 City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 66.25/hr Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lie.: Suprv-Lie.: specifically listed(%hr min) Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES Subtotal: 7(as.-3,s. Print name: Date: Plan review(25%of permit fee): State surcharge(12%of permit fee): L( t) Authorized signature; TOTAL PERMIT FEE: ir,I"(7 Print name: /V C ate: This permit application expires if a permit is not obtained 180 (�)�Cr� y� / days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Perini ts\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 440-4615T(I1/05/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 Each I Total I • Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 111 Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 ❑ 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 ❑ 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) 66.25/hr 1 Inspections for which no fee is 90.00/hr specifically listed(V2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) • Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n N• urse Calls n O• utdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 Building Permit Number: /f'l.S-i-old fit -G��S$' ;I s ' Building Permit Review Residential Projects TIGARD Site Address: U491 S■n/ <<5-fhb 'Terify site address is valid. • Project Name & Lot #: iCSS AiMrhowl. Clean Water Services-Service Provider Letter: (lot platted prior to 9/10/1995) Required: Yes AST No ❑ Received: Yes No ❑ Site Plan Elements: EiSite plan must be on 8-1/2"x 11"or 11"x 17"paper LI7hree(3)copies of site plan S,� awn to scale(standard architect or engineer scale) Cl�iforth arrow L 2 4./p and tax lot number,site address,project or subdivision • ootpiint of new structure(including decks)with finished name,lot number,and zoning floor elevations IS Applicant information(name and phone number) Ig.. and building setback dimensions Ciifroperty corner elevations(2 foot contour lines if more than t area,building coverage area,percentage of coverage and 4 foot differential) impervious area. ii "' 'ty locations location of wells/septic systems. 2Ex�i ting structures on site face drainage L,�S�eirreet names ,entree size,type and location UE:rosion control(including drainage-way protection,silt fence L�1'Existing trees to be retained with drip line,and tree design,location of catch basin,etc.) protection measures Planning Review Eland Use Case Number: N) Pc Loning R 4,S EKS-etbacks: . i Front 2.0 Rear 15 Side S r Street Side N ! Garage ZQ 5]/I}andscape Requirement: _WA_ N Lot Coverage Maximum: N/Q, % �7'�— El Building Height•. Maximum Height 0 Actual Height G. 2".y.....isual Clearance 2 Easements CU/Sensitive Lands: ❑ Yes Type rban Forestry Plan Ni/(onditions Satisfied r Approved by: Date: Li. 2 3. 14 Notes: Revisions(after Building Submittal only) Reviewer I3ate Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ 1:1Building\Forms\BldgPennitRvw_RES_123013.docx Building Permit Submittal Original Plan Submittal: Date: 4149/[9 By: Site Plans: # _ 3 Building Plans: # Create Case Record#: [ Enter case#�abovvee for Building Permit N ber. �- Workflow Routing: ICJ'Planning ItX�ngineering ermit Coordinator L.I.-.1 lding Workflow Sign-off: ❑ Sign-off 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. ❑ 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: ,.-,..- r, AAc al Slope: L7 Conditions Satisfied Notes: AJ d N pi Al c ,o r A./G !5%3 v 45 Approved by: Date: Ai..X, 3. )lit Revisions (after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved ❑ Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ Permit Coordinator Review nditions Met-Prior to Issuance of Building Permit Notes: Revision Notice 1: Date Sent to Applicant Revision Notice 2: Date Sent to Applic. t Revision Notice 3: Date Sent to A. meant Okay to Issue Permit- • / Date: A.- 3 J 4 1:\Building\Forms\BldgPermitRvw_RES_123013.docx 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 permits. 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 all subcontractors who work on the structure must be licensed with the Construction Contractors Board. 1 or i will be performing work on property I own, a residence that I reside in, or a residence that I will 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. iU ). S9- Print Name of Permit Applicant nature of Permit Applicant Date Permit#: ithErroZit/if 404:411,4 Address: aLtqd ailC r Issued by: d % Date: ,S//gig 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 11492 SW 115TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2014-00058 George Heimos 1. Plumbing post and beam inspection correction not completed. Corrections #1, #2 and (#3 complete correction ﬁnal) on 06/09/14. 2. Recall inspection when corrections have been completed. 103.5.4 3. Work not completed, no inspection made. Recall when ready. 103.5.4 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 11492 SW 115TH AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL MST2014-00058 George Heimos 1. Exhaust fan not working in laundry room. 2. Provide timer on master bath exhaust fan. 3. Insulate supply and return ducts in garage 4. Seal supply duct in garage. 5. Add to existing permit, 1-ea gas outlet in garage for new furnace. Recall 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 11492 SW 115TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2014-00058 George Heimos 1. Hard cap auto washer drain and hot.and cold water pipes in garage. 2. Recall 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 11492 SW 115TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2014-00058 George Heimos NOTE Homeowner installed tub as per provided manufacturers installation instructions. Plumbing Final Approved Violation Summary: Inspector Contractor