The URL can be used to link to this page

Permit TIGARD City of Tigard October 13, 2014 J C Parker Company Attn: Jennie Hasson 12245 SW Walnut St Tigard, OR 97223 Re: Permit No. MST2014-00059 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 12245 SW Walnut St Project Name: Parker Job No.: N/A Refund: ® Check#215190 in the amount of$150.00. ❑ Credit card"return" receipt in the amount of$ ❑ Trust account"deposit" receipt in the amount of$ Notes: Refund of erosion control fees collected in error. I f you have any questions please contact me at 503.718.2430. Sincerely, „ee 41P Dianna Howse Building Division Services Coordinator Enc. I:\Building\Refu rliAlanii,WitgKiiohltm`L' gd,✓ ¢gon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request far Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: J C Parker Construction DATE: 10/2/2014 Attn: Jennie Hasson 12245 SW Walnut St REQUESTED BY: Dianna Howse Tigard, OR 97223 TRANSACTION INFORMATION: Receipt#: 196120 Case#: MST2014-00059 Date: 5/20/2014 Address/Parcel: 12245 SW Walnut St. Pay Method: CreditCard Project Name: Parker EXPLANATION: Refund only of erosion control fees collected in error. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Erosion Control 100-0000-43134 $150.00 TOTAL REFUND: $150.00 APPROVALS: SIGNATU• DATE: If under$5,000 Professional Staff �/ If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ON,. Case Refund Processed: I Date: /0,i3//y By I I:\Building\Refunds\RefundRequest.doc x 09/01/2010 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 71 . " R 1 e e Request Permit Action T I G A IL I , 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov RECEIVED -1,0: CITY OF TIGARD Building Division Services Supervisor S E P 2 9 2014 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov CITY OFTIGARD lyING DIVISION FROM: ❑ Owner El Applicant Contractor ❑ City B k to (check one) REFUND OR Name: INVOICE TO: (Business or Individual) }enn\ -\61 ))1 ci o/1% e ( Em % Mailing Address: L Q s 6-(--. City/State/Zip: l I r� , q9() ) 3 Phone No.: �J_ '✓ c () PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (• ): • - : • _._ VOID PERMIT APPLICATION. _RI REFUND ' RMIT FEES (attach copy of original receipt and provide explanation below). 1 " ' • FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: MST -0 `4 00059 Site Address or Parcel#: ' OV V L 6 -- - ( Sn ( ,�nf �rn� I Project Name: V NOS 621 �►1 '40 ())'4-- Subdivision Name: L4i.ICQ — 'fl j: . Lot#: EXPLANATION: flPX )5DY) NOV) ) (I N-0Yel ( Signa ' / D . . . 2-` Print Name: V ,. RS S5(3Y) 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 JJSE ONLY Rte to Sys Admin: Date 114 jy By',) Rte to Bldg Atinun: Date /d /3 /V I ":ff Refund Processed: Date /4/,J/f/ By Invoice Processed: Date By Permit Canceled: Date ',, j9- ByM o / Parcel Tag Added: Date By Receipt# Date Mefh Amount$ I:\Building\Forms\RegPermitAction_062614.doe City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT = r Request Permit Action i , i , 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • wwwlJ�� Jt4) TO: CITY OF TIGARD , SEp 2 4 2014 Building Division Services Supervisor (-ITS 13125 SW Hall Blvd.,Tigard,OR 97223 84JJLDI NI�I G,ARD Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov I VISION FROM: p Owner ❑ Applicant ❑ Contractor City Staff (check one) REFUND OR Name: CO INVOICE TO: (Business or Individual) f,J lz t. f `c)I., / 3L' PPt 2✓44-, CO n1".,rrL.t.LeflO Mailing Address: 1A,Z4 6,0 (ADAw(,t r r City/State/Zip: --1-704 in) oQ 97a2.3 Phone No.: 503— 547-`I590 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#: 1l -rA0) 4-00057 Site Address or Parcel#: ( 9...4 5 �(j L)P Li...)CL1 �7'. Project Name: P4 CIA,E a- Subdivision Name: c � !'n Lot#: EXPLANATION: Gu 6,5b /D� I DO oFF I'D Eilc. i i O a N-r (.... e E 46 Ea.4751 tIQ Con.r2ot.- 4ift4, 1,-)or Qu0 u,2ca °�6H-61.A_La n/or /MA_ 73Ef Cµf}/Lafb, ("go-y. lJvnisF 73/cuaHr77:tis T My e4/72"177/)/J Signature: _ i p , ' Date: Q/off 4'/el Print Name: .,5 6,q L 47D 4M 5/1....4 ' �� r / 5 0� ' Refund Policy �p, y III 1. The Community Development Director or Building Official may authorize the refund of: I ( 1 a) any fee which was erroneously paid or collected. I Dr b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any iew 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. Rte to Sys Admin: Date 9 alt/ /f By 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\Req PermitAction_062614.doc n CITY OF TIGARD MASTER PERMIT t ! COMMUNITY DEVELOPMENT ip I Permit#: MST2014 00059 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/20/2014 , ESE Parcel: 2S103BB09001 Jurisdiction: Tigard Site address: 12245 SW WALNUT ST Subdivision: LAKE TERRACE Lot: 17 Project: Parker Project Description: 670 sq ft addition over existing garage. Adding(1)bedroom,(1)office&(1)bathroom.6/19/14, reprinted to add(1)service and(19)aditional branch circuits. 9/22/14: Reprinted permit to include BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 0 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 1 Second: 670 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right 5 Detectors: Yes Total: 670 sf Value: $73,894.30 Rear: 15 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 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 Fu @I Types Air Conditioning: Y Vent Fans: 1 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 1 Ea addl 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 22 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-3 670 Owner: Contractor: PARKER,CRAIG R&CHERYL J C PARKER CONSTRUCTION INC Required Items and Reports(Conditions) 12245 SW WALNUT ST 12245 SW WALNUT ST 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 TIGARD,OR 97223 PHONE: 503-969-5298 PHONE: 503-547-9590 FAX: Total Fees: $3,355.24 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State • •-. •.. ty Cods and a •oth r 4pplicable w. All work will be done in accordance with approved plans This permit will expire if work is not started wit,n 180 d-•s'of issuan•-, or if wor 0 suspende for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Ore••n Utility Notification I-• - r T ost rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy•ma& direct questions •OUNC by•-ling 503 .826332 44. Issued Byk„...," Permittee ''gnature: ,�T C=.r'" 175 by 7:00 a.m.for the next ay.'lable inspection•alai I ;,, This permit card shall be kept in a conspicuous place on the jo• -ite until completion bf the project. Approved plans are required on the job site at the time of each inspection. - q CITY OF TIGARD MASTER PERMIT " 1/ COMMUNITY DEVELOPMENT �� Permit#: MST2014 00059 13125 SW Hail Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/20/2014 TtGA.RD 9 ��/ ' Parcel: 2S103BB09001 Jurisdiction: Tigard Site address: 12245 SW WALNUT ST Subdivision: LAKE TERRACE Lot: 17 Project: Parker Project Description: 670 sq ft addition over existing garage. Adding(1)bedroom,(1)office 8r(1)bathroom. 6/19/14,_ reprinted to add(1)service and(19)aditional branch circuits. BUILDING Floor Areas Reaulred Setbacks Required Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 28 Bathrooms: 1 Second: 670 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 670 sf Value: $73,894.30 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 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: 1 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less. 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr 1 Ea add/500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr 22 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-3 670 Owner: Contractor: PARKER,CRAIG R&CHERYL J C PARKER CONSTRUCTION INC Required Items and Reports(Conditions) 12245 SW WALNUT ST 12245 SW WALNUT ST 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 TIGARD,OR 97223 PHONE: 503-969-5298 PHONE: 503-547-9590 FAX: Total Fees: $3,100.21 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. AT ON: Or e•• law • • ires you to follow the rules adopted by the Oregon Utility -- These rules are set forth in OAR 952-00 0010 through OAR 952-••"-00-r. •u may obtain a copy of the rules or direct questions to OU•• • _ `-- or 1.800.332.234,4. . _ �/ ary Issu By: �- . J Permittee Sign: . J 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 Application FOR OFFICE USE ONLY ��yyy/�� -p Received �� Permit#: M • IIJ Goi / . City of Tigard Date/B III • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: luris 0 See Page 2 for TI t :\R 1) Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address: /;-‘9,1/(, 6-10 I vw ❑100H Addition of new motor load of system. CC 100HP or more. ❑"A" "E" "1-2" "1-3" Cit /State/ZIP: ❑Six or more residential units. occupancy. y ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: - . Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential - /', /24.e 7! /-16��///_6�0 ,�1Q, (with above sq.ft.) 75 00 2 ( (�(y p f [ `r / Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less / 100.70 (CY','74)2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ❑ APPLICANT I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: branch circuit Each add'l branch circuit 7.42 Alb,q¢2 City/State/ZIP: - Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 _ 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 TT Address: Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr _ Phone:( ) Fax:( ) Investigation(1 hr min) 66.25/hr Email: Industrial plant(1 hr min) 78.18/hr • Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(V2 hr min) ELECTRICAL PERMIT FEES_ Suprv.Electrician signature,r- uired: Subtotal: 4,27 /.074C Print name:i Date: ❑Plan Review Required(25%of permit fee): 1 State surcharge(12%of permit fee): p.9-00 Authorized ••_nat 1 TOTAL PERMIT FEE: A?Q.(p$ .�A r This permit application expires if a permit is not obtained within 180 Print name: MTh ( - of .,j Date: tf I days after it has been accepted as complete. uu Number of inspections allowed per permit. 1:\Building\Permits\ELC_ermitApp_E r P _ERR doe Rev 04/21/2014 440-4615T(ll/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 y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance • with OAR 918-309-0040) 552.26 2 ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr l charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(A hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal I Fee for each commercial system: $75.00 • Number of inspections allowed peEremrton Page 1):t. (SEE OAR 918-309-0000) 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 ❑ Nurse Calls ❑ Outdoor 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 IN CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2014-00059 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/20/2014 T C,��li D 9 Parcel: 251038809001 Jurisdiction: Tigard Site address: 12245 SW WALNUT ST Subdivision: LAKE TERRACE Lot: 17 Project: Parker Project Description: 670 sq ft addition over existing garage. Adding(1)bedroom,(1)office&(1)bathroom. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces 0 Height: 28 Bathrooms: 1 Second: 670 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors. Yes Total: 670 sf Value: $73,894.30 Rear 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0 Tubs/Showers: 1 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 Tvpes — Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 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: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr 3 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-3 670 Owner: Contractor: PARKER,CRAIG R&CHERYL J C PARKER CONSTRUCTION INC Required Items and Reports(Conditions) 12245 SW WALNUT ST 12245 SW WALNUT ST 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 TIGARD,OR 97223 PHONE: 503-969-5298 PHONE: 503-547-9590 FAX: Total Fees: $2,884.14 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Code= and . other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within - •, s of issuance or •rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Or Utility No`cati• •y ' T•ose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a : _• es or direct question o OUNC by calling r : :00.33'.2344. r Issued By: �' �— — _ _ Permitte: Signature: �_ '-'1.--- -, �'� - 175 by 7:00 a.m.for the next.vallable inspectio • This permit card shall be kept in a conspicuous place on the •• '. •- ompletion of :. •roject. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential RECEIVE . FOR OFFICE USE ONL1 City of Tigard RDaetceea ��/y Permit No.: �jr��lr-Qdd '✓rot iii 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i i Phone: 503.718.2439 Fax: 503.598.1960 APR 2 3 2014 DateB : AY, •her Permit: I I . \R I, Inspection Line: 503.639.4175 Date Ready': - / tuns ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: S�/1 t•( /37 Supplemental Information dit)ILBII�G BiVISfi01V b�`` w. Orrntt,� TYPE OF W REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑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 X CATEGORY OF CONSTRUCTION work indicated on this application. :"? �4 !� 1-and 2-family dwelling ❑Commercial/industrial Valuation -� ❑Accessory building ❑Multi-family Number of bedrooms: 1... 4.- 1 Ode& ❑Master builder ❑Other: Number of bathrooms: 1 JOB SITE INFORMATION AND LOCATION Total number of floors: I_ Job site address: I2 5 W 0.W✓t o-F St. New dwelling area: Ca 70 square feet City/State/ZIP: -7.1 9 a r'ci / O g- £1223] Garage/carport area: square feet Suite/bldg./apt.no.: 1 Project name: PCL(Lr Q fetC. , Covered porch area square feet Cross street/directions to job site: l �at Q6- wean 0 l-. Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: La et. fiefrat -e Lot no.: j 7 Permit fees*are based on the value of the work performed. Tax map/parcel no.: Zrjl D.'tj ( Indicate the value(rounded to the nearest dollar)of all �O equipment,materials,labor,overhead,and the profit for the MDESCRIPTION OF WORK work indicated on this application. d ti-(.f)y ) / 2 , (site kr 4-ii a 1nr e- Valuation: S 63 a.ro ,� n_rooms rr"`r► Existing building area square feet vu��' New building area: square feet At PROPERTY OWNER I 0 TENANT Number of stories: Name: rX Z tc r Ltr. d- 01,6 it I Pa(ri)(• Type of construction: Address: S O et* to rp-tit Oct, &t& Occupancy groups: City/State/ZIP: % and , eV- t I?i Existing: Phone:() OW •S 2Ci Fax:( ) New: E6 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Pq(r.,2_r C oyi%iIU( +-(C , ....1.4t, Structural plan review fee(or deposit): Contact name: J21\0 te5V00-12-4/W-1-'S� FLS plan review fee(if applicable): Address: 122415 4SVJ City/State/ZIP: 1—i,1 o( , (Jg 91 223 Total fees due upon application: (5 ),5-1-‘7 .1 D ( ) 2...S-C1 Amount received: 339.�� Phone: Fax:: � ,("I 13-1 E-mail: Je s ' I r_hoz) . coley) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* " CONTRACTOR Co l ercial and residential prescriptive installation of roof-to. ••unted Photo Voltaic Solar Panel System. Business name: 'J )a C Viii CS✓► c—of f � I G Submit two( • of roof plan with connecti.• .etails ' and fire department .- -ss,along with • 110 Oregon Address: I2Vf c 'MA) W'q Qp n Ut ( . Solar Installation Specia '1 .••' ecklist. City/State/ZIP: Torre{ 1 (J� Q'7 2�3 Permit Fee(incl plan re ) $180.00 q/59 an. ..ministrative fees): Phone:(�) .91, �0 Fax:(5 ),2..5 1. State s - arge(12%of permit fee): $21.60 CCB lic.: 18 • to Col f I Total fee due upon appication: $2 .60 Authorized sign ture: ' .1 Milk / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: c:)2fln(-� ! - co O-yi Date: 9 I '4_ 16 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Date/By Permit No. 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: • Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 It Electrical it/Plumbing ,Mechanical T I G A R n Internet: www.tigard-or.gov ❑ Other III I . i.()I.LOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. _ ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑ V/ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations.exlst. 5 11 Site/plot pla drawn to scale. - r lan must show lot and buildin:set..ck dimensions;property corner elevations(if ❑ ❑ ❑ there is more than a,--.e evation di e •, •lan u : r w contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(inc •' : •ecks; 6 • •;• r f wells/septic systems;utility locations;direction indicator;lot area-build' c. :ge area; ercen ,g of overage; ■ :-rvious area;existin structures on site;and /J- �4 �% ff, surface drainage.PLC . IQ,Stt�� ,1�tQCe�.A40tE.It.41--•�. � i eo. r/44mA s fr/� ''(( ,-("4.1 'V 2 Foundation plan. Show dimr3nsi ns anchor bolts,any hold-downs and>nforcing pads,connection d'etai size D ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. i Full-size sheet addendums showing foundation elevations with cross references are acceptable. 2l 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. (-)/' I Manufactured floor/roof truss design details. ❑ ❑ ❑ 1 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ for four or more appliances. 1 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore.on and shall be shown to be ;•.licable to the iro-ect under review. .11 RISl)IC'fIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ , ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:1Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , 'Plumbing Permit Appr�__ L wtp 'r - Building Fixtures City of Tigard PR 2 3 2-Vt Received U �� IIII DateBy: / t9'3 �� Permit No.: t6J� /l • 13125 SW Hall Blvd.,Tigard,OR 97223 ` $ °f 1GAR� Plan Review Phone: 503.718.2439 Fax Q Date/By: Other Permit No.: I I c i A R(� Inspection Line: 503.639.41 1 1 1 DIVISION Date Ready/By: Juris See Page 2 for Internet: www.tigard-or.g UILDING 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 al-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building Multi-family SFR(3)bath 500.32 ❑Multi-famil 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: 1 IL, 5 1L.t.(JIC.Yt.-.,k- Catch basin or area drain 18.76 City/State/ZIP: ''r)cia(ck r 0L C 9 22-3 Footing 1.leach line,or trench drain Page 2 Footin drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: t't Z(6( (C,E3 Manufactured home utilities 50.03 Cross street/directions to job site: 1 2, rid y- L.f t , 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: Lake. -t-e,rit, I Lot no.: / Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 �w�� Clothes washer 25.02 POci 2 r�tsrns / (i'/� ' Dishwasher 25.02 OW( ()(j r a c;Q� Drinking fountain 25.02 (� Ejectors/sump 25.02 ..('PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: C`j}l rti. Pa( t ( t#- G r(Q' �( r r` Fixture/sewer cap 25.02 ��` IN D o Garbage drain/floor e disposal sink/hub 25.02 Address: 'n � /� C Garbage disposal 25.02 City/State/ZIP: ¶ 3. vI.� I g /9,...2., - Hose bib 25.02 Phone:( ) -(09 t 3-9__C? ; Fax:( ) Ice maker 12.51 lb APPLICANT /�,, ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: �C Pa( (a r/ Cc 1S1 f,�o l o1 / ¢-(illy Medical gas(value:$ ) Page 2 n Primer 12.51 Contact name: j•,G n vl 11° v„? 5 5f54 f Roof drain(commercial) 12.51 Address: f 2-7.-q 6- r1,0 4.0)-t -- Sink/basin/lavatory / 25.02 City/State/ZIP: 1- aft rJ 1 7 2y Solar units(potable water) 62.54 4" A Phone:(5) 5q..(/ .95---. 6 Fax: :( ) 259 c,/, Tub/shower/shower pan 1 12.51 E-mail: J e n Via s yl It�k c-eD.�"v r r l Urinal 25.02 J'r 1 Water closet 25.02 CONTRACTOR `` Water heater 37.52 Business name: • '► , ; • _. Water piping/DWV 56.29 Address: �_' A • ti. 1 a Other: 25.02 City/State/ZIP: 2 , I O I c11 S Subtotal Phone: LJ i, )Q O(.-b" Fax:60 ) te g--6 eli6 Minimum permit fee: $72.50 CCB Lic.: 16 i 16• t)P 14 Plumbing Lic.no.: .' : . 7 t [NI Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: �� TOTAL PERMIT FEE ek I. 7_sa r/L' Date: -� -13 This permit application expires if a permit is not obtained within 180 days A. after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. I:\BuildingTermits\PLMU-PermitApp.doc 10/01/09 440-46I6T(l0/02/COM/WEB) r • 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- 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer- 1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to 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 -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram El 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 Filler 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 Ap licationR ECEIv E I I t O OI n ',EON tl. l I.1 P City of Tigard Received � ! 13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 3 2014 Date/By: Permit No.: �Osy Plan Review = Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit: T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris H See Page 2 for Internet: www.tigard-or.gov otified/Method: Supplemental Information BUILDING DIVISI TYPE OF WORK 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* .g.j-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. Multi-family ❑Master builder ❑Other: Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: 1 n-c-- ilk) � �1J+ Furnace 100,000 BTU(ducts/vents) ` 46.75 City/State/ZIP: •I tqa I`k f , v `!-1'2,2 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: a(1 r Office._.:S Duct work i 23.32 Cross street/directions to job site: 1 2 CI- U.{ Hydronic hot water system 23.32•I � 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: Lab, --re(ea c-e Lot no.: l - Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 r. Flue vent for water heater or gas Ak t 4u& 2 rams fireplace 23.32 Ot 19a41/1004 t2 1n�`Q qt, e Log dghtee(gas) 23.32 Cic.'✓L Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 14 PROPERTY OWNER I ❑ TENANT Other: 23.32 n� Environmental exhaust and ventilation: Name: a, l_,Lt ir 01...) )I (( (' Range hood/other kitchen `7,1/0° equipment 33.39 Address: I �Q t( Clothes dryer exhaust 33.39 City/State/ZIP: T23rca(,Id O� J 97 -2-S— Single-duct exhaust(bathrooms, I toilet compartments,utility rooms) 23.32 Phone:(5j) aro- sip 7(6 Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: L�Ctr r ) �I f t! CM-- Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: 4 ' '�j)1 e S Furnace,etc. Address: ) 2-)+S- SW IV ttelltif 51—. Gas heat pump Wall/suspended/unit heater City/State/ZIP: 11 oarri ) �� q�223 Water heater Phone:(spa) c1-7..J cis--qo Fax: :(953) ac-- 91311 Fireplace Range E-mail: .e h lia �SS h� Barbecue �J CO TRACTOR Clothes dryer(gas) Business name: d a r2' (ns five Other: �'`i MECHANICAL PERMIT FEES* Address: 1 224 S 5544) I,t)(Val,I t- Subtotal City/State/ZIP: -Nova (JY 1'7 22-3 Minimum permit fee($90.00) �1�a/�v q1 Plan review(25%of permit fee) Phone:(J5)`S-4-t`f - c)0-/0 .. •( )2..S - (3c) State surcharge(12%of permit fee) CCB lic.: 14, 19 W . TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. e Authorized si•,attire: fir =� '� * Fee methodology set by Tri-County Building Industry Service Board Print name: ( 17 s ' 1% J r + , Date: .f 2 0 1.\Building\Pennits\EC_PermitApp_0401 I -oc 440-4617T(t 1/02/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. 1:\Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit ApplicatioRECEIVEl) I OIZ ()I I It I l �I O\I City of Tigard Received 7 a3 /4/ Permit No.: MT��(f 13125 SW Hall Blvd.,Tigard,OR 9722 2014 7 P Plan Review O Phone: 503.718.2439 Fax: 503.598.10 R Date/By: Other Permit: •I E,I Inspection Line: 503.639.4175 Date Rea /B 7uris: ® See Page 2 for I Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information TYPE 0'i3!► l l: I a PLAN REVIEW ❑New construction Addition/alteration/replacement Please check all that apply(submit j,sets of plans w/items checked below): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural '.01 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: - 100HP or more. occupancy. III 1 . AL.// 1 s ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: i ,, ard ( 0—(2-- 0 Health-care facilities. ❑Supply voltage for more than ` ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: 1, ( / • •MEM ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: d I- . a ` Description I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: ce -firs -.6 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 7500 2 DESCRIPTION OF WORK (with above sq.ft.) IIMMEN ,ten / Limited energy,multi-family 7500 2 i'4-V/, 2 rows • / ••v-& residential(with above sq.ft.) /�,,pp Renewable Energy ❑ See Page 2 V ,I / are- / # Services or feeders installation,alteration,and/or relocation a I!' PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: g&& A sa,1 J P, ' l e nea tr N I 0 401 amps to 600 amps 200.34 2 Address: 57 N 0• f Do., • i.l ! ke. 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: 7g �( l �a ' q Temporary services or feeders installation,alteration,and/or 'hone:( S ) / Fax:( ) relocation 200 amps or less 59.36 l Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 _ 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits—new,alteration,or extension, .er panel i'4 APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, Business name: ( C 'a • , C "(jam . ��t , each branch circuit 7.42 2 B.Fee for branch circuits without .y+ Contact name: 1 , • milt S .R' service or feeder fee,first / 56.18 .Z./$ 2 - branch circuit Address: 1 C 4' _ •. /, Of- Each add'I branch circuit 2 7.42 /f; Si" 2 Miscellaneous(service or feeder not included) City/State/ZIP: • O.l/ O 2- 2 Each manufactured or modular 67.84 2 Phone:( 1' ) 9)-17. qs--iv Fax: :('5 ) 2-5-q.qf 3`) dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: ? a • 501 =MTh" dirli Pump or irrigation circle 67.84 2 CO _ OR Signor outline lighting 67.84 2 Signal circuit(s)or limited-energy See Business name: . panel,alteration,or extension. Page 2 2 Address: Po • I a / Each additional inspection over allowable in any of the above City/State/ZIP: �` Q ir.0 / _ Additional inspection(1 hr min) 66.25/hr �^7�� v h-- lQ Investigation(1 hr min) 66.25/hr Phone:( OC) `'t5 3 2_093 Fax:( 923) 92(0 .9 r Industrial plant(1 hr min) 78.18/hr - Inspections for which no fee is CCB Lic.: I; ,j'• • Electrical Lie.: C5-2, Suprv.Lic.: ,�'f 5 specifically listed(/s hr min) 90.00/hr i ELECTRICAL PERMIT FEES Suprv.Electrician si: . 1, equired: ` / -�%Jim Subtotal: 7/ .OZ. Print name: CAT)I 15 a • d 01 C , illes1111311= Plan review(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: `/i j r ---- TOTAL PERMIT FEE: Print name: �— Date: This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. • Number of inspections allowed per permit. I:t BuildingTermits\ELC_PennitApp_ELR_ERE.doe Rev 05/21/2013 440-4615T(II/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 1 Qty. I Fee I Total I • Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ElAlarm 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 El Heating, Ventilation and Air Conditioning OAR 918-309-0040) 552.26 2 System* Solar generation systems in excess of 25 kva: Each additional kva over25 7.42 3 El Vacuum Systems* >100 kva—no additional charge 0.0 3 ElOther: additional inspection over allowable in any of the above: Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%:hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 ElAudio and Stereo Systems days after it has been accepted as complete. • Number of inspections allowed per permit. El Boiler Controls ❑ Clock Systems El Data Telecommunication Installation El Fire Alarm Installation El HVAC n Instrumentation El Intercom and Paging Systems El Landscape Irrigation Control* El Medical El Nurse Calls El Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 05/21/2013 . . Building Permit Number: fr/457.-(96 j 606 5.21 IPIII " Building Permit Review Residential Projects I IC,;\Rll Site Address: 12244 SW WAliiupt- s . ,lierify site address is valid. Project Name & Lot #: PAYv.�r- tho- .. Clean Water Services—Service Provider Letter: (lot platted prior to 9/10/1995) Required: Yes .0- No ❑ Received: Yes ❑ No ❑ Site Plan Elements: &Site plan must be on 8-1/2"x 11"or 11"x 17"paper ET'h-ree(3)copies of site plan L76rawn to scale(standard architect or engineer scale) [ th arrow L 0rap and tax lot number,site address,project or subdivision ootprint of new structure(including decks)with finished ,.,_,�name,lot number,and zoning floor levations L�'Ap licant information(name and phone number) L n:t at and building setback dimensions Ld'Property corner elevations(2 foot contour lines if more than Pnarea,building coverage area,percentage of coverage and 4 ff of differential) impervious area. ['Utility locations El<cation of wells/septic systems. Neriisting structures on site giSiirface drainage l,�1 �eet names E�S/et tree size,type and location L'�J'Erosion control(including drainage-way protection,silt fence L>d'Existing trees to be retained with drip line,and tree design,location of catch basin,etc.) protection measures Planning Review Gland Use Case Number: laVe " 'rr .c G ( l ii"114 ) I oning: R 4.S wetbacks: I 201 Front 2_01 Rear is Sider) Street Side �S Garage [ i andscape Requirement: N p, I '1 o 1- f Coverage Maximum: (� E Building Height: M�mum Height 30 Actual Height ±' �,�Visual Clearance L_T r:asements i Seensitive Lands: 2"-Yes Type (,WS Vel.CArYtaar'I �,VA1u. - Vvtk -b'*. -INDtr- R1 rban Forestry Plan y - propp•1so1 l� AY1y 6lrlS l�Me tet i .S, Conditions Satisfied f_ Approved by: 1111.6 c0/44-- Date: y. 2-?, NI Notes: Revisions (after Building Submittal only) Reviewer Date Revision 1 Approved ❑ Not Approved El Revision 2 Approved ❑ Not Approved ❑ Revision 3 Approved ❑ Not Approved ❑ (:\Build ing\Forms\BldgPermitRvw_RES_123013.docx , . . Building Permit Submittal Original Plan Submittal: Date: 4 5//t/ By:C/) Site Plans: # Building Plans: # ) Create Case Record#: Enter case#above for Building Permit Number. Workflow Routing: 1241 nu g ❑.gineering 2rmit Coordinator . wilding Workflow Sign-off: S' noff for Planning staff,including notes from planning review(page 1) Route Application Documents: Z Engineering: (1) copy of permit application, (1) site plan, (1)building plan and oal plan review routing form. 1."-Building. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Reviewed By �. Date: f/P-54/ Notes: Engineering Review—reviewed by: Ac9r. Slope: Conditions Satisfied Notes: X) c. a N G/ .Ai4,Ly a i.n/C-7 /A:SO1 ES _ --------- Approved by: _ ^ Date: /I ,�.j , 1 ii 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 onditions Met-Prior to Issuance of Building Permit Notes: Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applic. . ' / Revision Notice 3: Date Sent to A..i I _ Okay to Issue Permit- / • Date: 9 Z 3 I:1 Building\Forms\BldgPermitRvw_RES_123013.docx FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. 11411 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT = Transmittal Letter 1 1 c,A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION FROM: ()Om COMPANY: OC.A9a P1 ( Co-y ( PHONE: 7 5-6- �`1 _ --9 O By_ RE: /W(' `61N [4kb&V,Ith n151 -9,0111 - DUOS (Site Address) (Permit umber) (Project name or subdivision name ma tot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): ;� �r ,,I REMARKS: r2-ev /C4 CQ�GY,(,J1n °J e ( ■ lTJ dry erier FOR pFFrE USE ONLY Routed to Permit Techn�i-c,�i Date: 4-51 ( (4- Initials: Fees Due: ❑ Yes L1 No Fee Description: Amount Due: $ $ $ , $ Special Instructions: _ Reprint Permit(per PE): ❑ Yes El No El Done Applicant Notified: Date: Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 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 12245 SW WALNUT ST, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2014-00059 David Young Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12245 SW WALNUT ST, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal PASS MST2014-00059 David Young Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12245 SW WALNUT ST, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal PASS MST2014-00059 David Young Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12245 SW WALNUT ST, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2014-00059 David Young Note: future sink not completed at this time. Provide permit and approved inspections at time of installation. Violation Summary: Inspector Contractor