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Permit
CITY OF TIGARD MASTER PERMIT II RI It COMMUNITY DEVELOPMENT Permit#: MST2014-00079 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 • Date Issued: 06/03/2014 t f'A 8 trii Parcel: 1S133DC08800 Jurisdiction: Tigard Site address: 13235 SW SHORE DR Subdivision: WINTER LAKE Lot: 18 Project: Perry Project Description: 985 sq ft great room/studio addition. 8/27/14, reprinted to add(1)bar sink, (1)water closet, &(1) shower stall. 8/17/15: Reprinted permit to include(1)ductless split system. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 985 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 985 sf Value: $108,635.65 Rear: 15 PLUMBING Sinks: 2 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvcfFeeders 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: 4 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-3 985 Owner: Contractor: PERRY,CHRISTOPHER R OWNER Required Items and Reports(Conditions) 13235 SW SHORE DR PERRY,CHRISTOPHER 1 Special Inspection(see TIGARD,OR 97223 13235 SW SHORE DR plans) TIGARD,OR 97223 2 Ersn Cntrl 503-639-4175 PHONE: 503-590-6950 PHONE: 503-590-6950 FAX: Total Fees: $3,696.26 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules - - forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or '00.332. Issued By:"` _ - Permittee Signature: ■IICNIIIIIKIIII 41111111 �603.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONI.1 City of Tigard t���Q Received _ [� ! Date/By: Permit No.: Gj • 13125 SW Hall Blvd.,Tigard,OR �72�Y �'� 7 f����� = Plan Review Phone: 503.718.2439 Fax: 503.598.1960 r 1►� 2015 Date/By: Other Permit: I I G A R[� Inspection Line: 503.639.4175 AUG D Date Ready/By: Luri a: ® See Page 2 for Internet: www.tigard-or.gov T��PR Notified/Method: Supplemental Information cs .° .. IV►s,o� Mechanical permit fees"are based on the value of the work ❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ 1 ❑ 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 Heating/cooling: _ Air conditioning / 46.75 "14- a Job site address: / 33 a 3 5 5 Shr>o� ©,-/, Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: / l G Gy,.0/ 6f t Gf"7-Ujs— Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump. L �i .96-- Suite/bldg./apt.no.: I Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. _ 46.75 Flue/vent for any of above 23.32 Subdivision: I Lot no.: Other: _ 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 bESCRIPTION OF WORK Gas fireplace/insert 33.39 L Flue vent for water heater or gas 6 te){i -1 /�'l,.'j )/-t—cX)o 75i� fireplace 23.32 C1 JLLv t_ r r l/� Log Wood/pellet t stove 23.32 1 ^'f1-�'f+'� � `� Wood/pellet stove 3339 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 Environmental exhaust and ventilation: Name: .% r S X r Range hood/other kitchen (� equipment 33.39 Address: /3 t� 3S— Sk} `5- ,c-re �r! J---e Clothes dryer exhaust 33.39 , City/State/ZIP: %/5�y 0/ C Of�dds Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( 3) o- Fax:( ) Attic/crawlspace fans _ 23.32 Other: 23.32 _ Fuel piping: Business name: Vc 1ry G 514.15 for first four;$4.03 for each additional Contact name: Furnace,etc. _ Address: Gas heat pump Wall/suspended/unit heater _ City/State/ZIP: Water heater Phone:( ) I Fax::( ) Fireplace Range E-mail: Barbecue Clothes dryer(gas) Business name: Q�)N.Y� Other: Address: Subtotal *1+G_ -A City/State/ZIP: " ,.5c- , ) S'•44- Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: TOTAL PERMIT FEE 9 7 3 f„,,, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: Nilo • Fee methodology set by Tri-County Building Industry Service Board Print name: A 0 • O I /'/L/ [Date: /7, /J— I:\Building\Permiat 1 C_PermitApp_040113.doc ✓/ ±ar(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Famil Fee Schedule: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and • $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\P ermits\MEC_PermitApp_040113.doc 2 CITY OF TIGARD ; MASTER PERMIT III y n s COMMUNITY DEVELOPMENT I Permit#: MST2014-00079 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 / Date Issued: 06/03/2014 Parcel: 1S133DC08800 Jurisdiction: Tigard Site address: 13235 SW SHORE DR Subdivision: WINTER LAKE Lot: 18 Project: Perry Project Description: 985 sq ft great room/studio addition. 8/27/14, reprinted to add(1)bar sink, (1)water closet, &(1) shower stall. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First 985 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 16 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 985 sf Value: $108,635.65 Rear: 15 PLUMBING Sinks: 2 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea addt 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 4 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 8,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-3 985 Owner: Contractor: PERRY,CHRISTOPHER R OWNER Required Items and Reports(Conditions) ' 13235 SW SHORE DR PERRY,CHRISTOPHER 1 Special Inspection(see TIGARD,OR 97223 13235 SW SHORE DR plans) TIGARD,OR 97223 2 Ersn Cntrl 503-639-4175 PHONE: 503-590-6950 PHONE: 503-590-6950 FAX: Total Fees: $3,598.90 This perm. . u-• ..ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be don- in accordance wiI 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 'w ires you to follow the rules adopted by the Oregon Utility Notifi tion Center. Those rules are set forth in OAR 952 601-0010 t rough OAR 95 ,.01-009'. 'ou may obtain a copy of the rules or direct questions to OUNC b ing 5 3. 32.1987 or 1.800.332.2344. // / Iss ed By: _� ` //i I Permittee Sig : ure• / t- — . �'• Cal 503.539.4175 by 7:00 a.m.for the next available inspection da .. / This permit card shall be kept In a conspicuous place on the job site until c• •etion of the project. Approved plans are required on the job site at the time of each inspection. 940F SWTIa. —._�_ • �, - 30��T J + TaJoR —`_ ' ►,2.c L 1 • �II L.yTA.,2 Slit' Fig.sn q, . !!—f� , w ben. TOP it ,i.11A11.. ( ,, _ . c,TZ ,.)}x A:N 1 - ' '1 -----1 I 1 v, SNt.row Era+-�_. � 1 1 ----Tht`N) -+-I V- • I. *,.,_ ■ ' _, n, Est z - `q Cr of Tigard city g d -. •roved Plans 4.<0 c,, °� PR°,ce Bya ►i►c- Date { -- N 6,. OR . REVISION riFRT rvi Mcc�� OFFICE COPY lr- t1 4---- , Pcit project T�DP STRUCTURAL, Client: 'E%L. Proj.No.: 14-t4 ENGINEERS Date: 6/14. By: RtMM Sheet No.: 2700 SE HARRISON STRUT,MIEWAUKIE OR.07222,101.407-043,FAR 503407-O 6.vuk*Oks puhnmm MIIIMIIIIEM 2 I 3 Std taneo L . � .. 4 x r ].se" SWs8lsxt� rl' �. :' No A 9999.,' _____ i A . . PROPOSED NORTH ELEVATION SOUTH ELEVATION ;. SGALE 1/1".10' le ��''``��..11(` p SCALE lir.1'd' S i $rf ° 8 OpiVS$iU�(13 i .1, l 1 1 p i LAP ` ._. VI ‘ 31.0 WALL - ._ t t t i 1 t� 0 0 0® ® t cdevaal Him..ORARI WMkUI.$1rPT(a sHDI�I.C? y>c{�> , bJa 8 .E'SDLIZ ‘..)toot,_ y 2 s �- SCIAWI. 7-4-111►r�� flu rN„� E Cpl 1L. g " � F �_ s �. PRO'OSEII-VPEST ttEVATiiON Z O =.1.,8 ii o B CONDUCTOR IICAO 1 DRAIN ©®0 0 0 5g N g; and ",ii- W-- III T ' i 1 r PROPOSED EAST ELEVATION N 1 I SCALE 1/$"=t'0' 2 I 3 jp`-,,,grz_y A-Do 1T7DN Xc S S - v D� P -6-rizY ADJT/ dAJ 1 . (2- -- sue,, st-iG r2. -4 3/8" 2'6X 6'6 BBL HUNG TYP ( 1:3 00 ° BATH 3'OX 8' OOR ` FAIN/LIc Hr/ FULL IGF4T • N 2'-$" I 0 72X 84" DOOR OPEN'G 1 I \ DBL STUDS D8L STUDS 14.1:0R 4X8DFL#1 DBL STUDS N W 3'0 X5'0 11 -5 •� 7 1) L HNG SILL( M• . • • /1-bp i nek-) er2D 23 C ,ce., ) S rid SIMPSON$WSII r IOC 0 HOA SOUS SIMPSON SWIN IS*14 vr W deenk 14.4. r TY, 3.-0- r r -0- Mr MUMS SOLIS 104 0,4, volli . -0. ,---0- -0- i. .0- 0. - 41.60 "l .............- ........mem. 1 1...............r.,,i- Ill:- f• * i I 1•4 1 44 KIR *XS Ott*2 AI H re CO 4XS ife WI 4006 TIPP 6'ox ro DOOR SUM WITH I * I; 110e 11111"---...re •ICIHN. HUNG TY P GO-(*)04010iiat LAMPATRO 2 4X2.4 Fl XED AllIOVE Aink WIT N1'6 10100 6LASS NDII DPL*2 0 AK) LISKSTORY) /VP 0 , IVO 1' . ...i. .17 .41 li. = * o 0 1 1 •,... W ID WS 46.6 roc los, MINI rri, ill i,- 6 I ! * 6, .BATH . i I [ ,,..4 Nvirinr,r1 • -4 A }4 0 tf L*2 C.11,Mal, MIS'L4 f, i i lalt tiu , 4 I ., i — II CIL 51Nal +0 4ufstai Mt WM : . I: '. tiltV . - • . . . ___ • J CITY OF TIGARD MASTER PERMIT 114 s. • COMMUNITY DEVELOPMENT Permit#: MST2014-00079 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/03/2014 Parcel: 1 S133DC08800 Jurisdiction: Tigard Site address: 13235 SW SHORE DR Subdivision: WINTER LAKE Lot: 18 Project: Perry Project Description: 985 sq ft great room/studio addition BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First 985 sf Basement: 0 sf Left 5 Parking Spaces: 0 Height: 16 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 985 sf Value: $108,635.65 Rear: 15 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum<100K: 0 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 FM- 0 Ea add'l 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 4 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-3 985 Owner: Contractor: PERRY,CHRISTOPHER R OWNER Required Items and Reports(Conditions) 13235 SW SHORE DR PERRY,CHRISTOPHER 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 13235 SW SHORE DR 2 Special Inspection(see TIGARD,OR 97223 plans) PHONE: 503-590-6950 PHONE: 503-590-6950 FAX: Total Fees: $3,554.00 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_1yl s 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-copy of the rules• •rect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By:, C Permittee Signature: C,p11 5 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. -Built ln2 Permit Application Residential FOR OFFICE USE ON I.) City t of Tigard ��� Received miim Permit No.:l L 9g0/ —Ott) 4. II • 13125 SW Hall Blvd.,Tigard,OR 972 01 Plan Revie• i. � � Phone: 503.718.2439 Fax: 503.598.1 + rt �t DateB : �11k ' Other Permit: I I i, \I;I Inspection Line: 503.639.4175 y l• Date Ready/B : runs 0 See Page 2 for Internet: www.tigard-or.gov �p r� Notified/Method: Supplemental Information TYPE OF WORK , .'14 . E,1,‘. ?C REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑ w construction ❑Demolition Permit fees*are based on the value of the work performed. Ef Indicate the value(rounded to the nearest dollar)of all Addition/alteration/replacement ❑Other. equipment,materials,labor,overhead,and the profit fof the- CATEGORY OF CONSTRUCTION work indicated on this application. ..- _ �y� Mill-and 2-family dwelling ❑Commercial/industrial Valuation: $ /D O ?� ..❑Accessory building ❑Multi-family Number of bedrooms: 6 ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: q Job site address: / Z 3.5- 5'6,/ $4. re. 0ripe New dwelling area square feet City/State/ZIP: ...‘55z, / Tare/ e g72- 3 area: square feet Suite/bldg./apt.no.: Project name: l Covered porch area square feet Cross street/directions to job site: ho' /3 v41 Deck area: square feet 5 Y I�� Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of. ' Tax map/parcel no.: equipment,materials,labor,overhead,and the pro for the G� DESCRIPTION OF WORK wo ' dicated on this application. //i4- j ,1-C 5 4'f Cr B //vl�'I- ' 7IW Valuation. $ (f 119-- QC!,H �`5rab 1O ( Existing buil a ; area . are feet New building area: square feet g PROPERTY OWNER ❑ TENANT Number of stones: Name: r/S%4y�- [P Tfy Type of construction. Address: —/ 2 3 C 5-Gt' J4erer 4p/iV Occupancy _,...ps: City/State/ZIP: � Air vd a5 7 d,23 Exi ling: Phone:(50) 5 v— ‘ fr5e Fax:( ) New: LE/APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: C (Please refer to fee schedule Jt'„- aI,,1f`� Structural plan review -- or deposit): Contact name: FLS plan review fee(if app'c': • . Address: CitylState/ZIP: Total fees due_ • *flea o on: Amount received: i`' Phone:( ) Fax::( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel Syste Business name: /.\ j,�j,/ Submit two sets of roof plan with connec'.n details v Y and fire depart •a t access,along with 010 Oregon Address: Solar Installation 'ally Code ch-••i ist. _ City/State/ZIP: Permit Fee(incline iew $180.00 and administr:; e . Phone:( ) Fax:( ) State surcharge(1 °,of permit fee): $21.60 CCB lit.: Total ee due upon appication: $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: L✓ �' t• rI S ke��4 e.f4. Date: —A' —,po/y *Fee methodology set by Tri-County Building Industry Service Board L\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONL1 City of Tigard Received Permit No 11 13125 SW Hall Blvd.,Tigard,OR 97223 Date/BY' Assoc I Phone: 503.718.2439 Fax: 503.598.1960iated permits 24-Hour Inspection Line: 5113.639.4175 ❑ Electrical ❑ Plumbing CI Mechanical I IGARD ` Internet www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1 es No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 ' . m a , seismic soils designation,historic district,etc. CI—Ja__ 3 Verification of approved plat/lot. ❑ ❑ 4 Fire district approval required. Name ofjistrFiet� ❑ ❑ ❑ 5 Septic system permit or au ' nttl5n• or remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permi ❑ ,`❑ ❑ 7 Wa strict approval. ❑ ❑ ❑ oils report. M t original applicable stamp and signature on file or with application. El 1=1 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 CI codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ti ❑ ❑ . . • ..• . - . • . .-_ : - , . .. . .•. . .. • . • . . );location of easements and driveway;footprint of structure(including decks);! •utility-Feentiens;direction indicator;deraa; ;ietpewie -e ' ;and- sinegcl 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore on and shall be shown to be a licable to the project under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0/ CI ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"buildingplans will not be accepted. Et' ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ , ❑❑ C 27 "Drawn to scale"indicates standard architect or engineer scale. Er Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ CI Tree List. 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 !Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, [�/ ❑ ❑ includink 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. 1:\Buil ding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) 'Plum'bing Permit Application Building Fixtures RECEIVEP s. EIVE FOR OFFICE USE ONLI City of Tigard Received D di �/it rdOl�- 79 •,1 g Permit No.. I�� ---.-- 13125 SW Hall Blvd.,Tigard,OR a(Q• 21 2014 Plan Review Phone: 503.718.2439 Fax: 503. '8. 960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 Date Read B ruris: El See Page 2 for TI GA RD g g CITY OF Ready/By: g Internet: www.tl ard-or. ov Notified/Method: Supplemental Information TYPE CM4bli4NC DIVISION FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. Total VAddition/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 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: / 2 3 Sc t.' 5 'Lave 6 y Catch basin or area drain 18.76 City/State/ZIP: 7! d 0/2 '7 7 2� Doting leach line,or trench drain Page 2 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: ✓ I Project name: pvy-� Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 1 t Clothes washer 25.02 i/ CZi✓Q'I L .. �lei'�'Y Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 � r1 i L r Fixture/sewer cap 25.02 Name: ��-a� 3 5- Floor drain/floor sink/hub 25.02 Address: / �,. ��� �!/{.,[/I'P r��' Garbage disposal 25.02 City/State/ZIP: /�I�r� 'D °I-7 22-3 Hose bib / 25.02 Phone:( ) / Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory / 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) ax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Water nirn^.mWV 56.29 Address: Other: r 25.02 City/State/ZIP: - Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plum. o.: Plan review (25%of permit fee) -` j State surcharge(12%of permit fee) Authorized signature: ■ TOTAL PERMIT FEE Print n• AMIIMPIMMINIPM Date: 4j 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(l0/02/COM/WEB) a 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-15t 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 I� and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace! Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall ❑ 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 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: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Electrical Permit Application FOR OFFICE USE O!SI 1 City of Tigard ���� Received Sion �t Permit No.: Ml�6/�X79 14 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review = Phone: 503.718.2439 Fax: 503.598.1 ��� Date/By: Other Permit: 1 C;A K U Inspection Line: 503.639.4175 1 SO Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov `, P l�- Notified/Method: a Supplemental Information TYPE OF WORK �`P ,rCyP��rtwZ PLAN REVIEW ❑New construction ❑Addition/alteration/rl � �1��5,V Please check all that apply(submit I sets of plans w/items checked below): ('S ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: `�,VN where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRION 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 ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 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: 7_" S 50 51-16ei 0 2 100HP or more. occupancy. ❑ 0 Six or more residential units. Recreational vehicle parks. City/State/ZIP: 1` (y NAIL (Tll. Q/7 Z Z'2� ❑Health-care facilities. ❑Supply voltage for more than _(! ( / 5 ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: L Qa,,,z 14 OR/N ❑Service or feeder 600 amps or more. 1 FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I * New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'1 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: _ Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 /� • Limited energy,multi-family AD D( 1 4,3-V - t3 Ace—tC d \ 4O y,...t_ efg59 residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation K.PROPERTY OWNER ❑ TENANT 200 amps or less . 100.70 2 201 amps to 400 amps 133.56 2 Name: (4j-t p 4.L,/e___ 9(t(2 2 401 amps to 600 amps 200.34 2 Address: l f( ISZ 601 amps to 1,000 amps 301.04 2 S n��� Over 1,000 amps or volts 552.26 2 City/State/ZIP: 1- t (,4_'2.- ' e>_a__- G17 2.'L 3 Temporary services or feeders installation,alteration,and/or Phone:(60 51 O -(p q. -c Fax:( ) relocation 200 amps or less 59.36 1 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,leas- ren s exchange, .. o r ing to ORS 447,449,670,and 701. f 401 amps to 599 amps 168.54 2 Owner signatur - —.. _ `� _ _ Date: ' ‘.--,1-..j-1 r Branch circuits-new,alteration,or extension,peer panel ❑ APPLICANT 6 CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: each branch circuit B.Fee for branch circuits without Contact name: service or feeder fee,first branch circuit l 56.18 2 Address: Each add'I branch circuit 3 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) __ Each manufactured or modular 67.84 2 Phone:( ) Fax: :( ) dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: W h-5.E,14_, Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 _ 2 Address: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: 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 Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: Plan review(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: - This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. ' Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(I1/05/COM/WEB L Electrical Permit Application—City of Tigard • Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined $75.00 Description I Qty. I Fee I Total I Renewable electrical energy systems: Check Type of Work Involved: 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 ❑ 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 OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning 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 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed(Yz 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 ❑ Audio and Stereo Systems days after it has been accepted as complete. Number of inspections allowed per permit. ❑ Boiler Controls El Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls El Outdoor Landscape Lighting* El 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 City of Tigard IIII COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 c R Building Permit Review — Residential Building Permit #: M Si-(9-G i q- OO6 7 9 • Site Address: l 32 35 SW Shoes Drive. Project Name: P e i 1 r n j - e{ .1 -e ( W. - Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 1 020 Addris., -ip S i v-t Le '�7t ert a v VYS t c L -i A.Verify site address/suite #exists and active in permit system. Site Plan Elements: $Three(3)copies of site plan .EhExisting structures on site _te plan must he on 8-1/2"x 11"or 11 x 17"paper ,El Footprint of new structure(including decks)with finished )rawn to scale(standard architect or engineer scale) floor elevations 4E1North arrow „2-Utility locations(required for new,may apply for additions) ..25ite address,project or subdivision name and lot number -T.ocation of wells/septic systems .1E-Applicant information(name and phone number) ❑Erosion control(including drainage-way protection,silt fence '.ot dimensions and building setback dimensions design,location of catch basin,etc.) ,Frot area,building coverage area,percentage of coverage and •street names impervious area(applicable if R-7,R-12,R-25&R-40) $Street tree size,type and location .12rProperty corner elevations(2 foot contour lines if more than j2Existing trees to be retained with drip line,and tree 4 foot differential) protection measures Clean Water Services—Service Provider Letter: (lot platted prior to 9/10/1995): Required: 7 Yes ❑ No Received: ❑ Yes ❑ No Ja Land Use Case#: NIA" -?r Zoning. 7 .. Setbacks: Front IS Rear i C, Side 5 t Street Side N/A. Garage 2.0' ,21- Landscape Requirement: so 2'Lot Coverage Maximum: so 1 'Building Height: Maximum Height 35 Actual Height }-1 CQ 2' Visual Clearance ❑ Easements j2‘' Sensitive Lands: ❑ Yes ,21No Type .® Urban Forestry Plan 'n- Conditions Met Notes: 4-04.4t oil cod (to', 2.510 S# (gypplox) -1.060-s tat CGveN rr7 . 3.514 Approved By Planning: AVI-M 464447" Date: '„, f2..1111-1 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved . Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_RES_042914.docx L 4 4 . ■ Building Permit Submittal Original Submittal Date: S/� /f/ Site Plans: # Building Plans: # 3 Building Permit#: ErEnter building permit#above. Workflow Routing: e'Planning ErEngineering Permit Coordinator ''Building Workflow Sign-off: (Sign-off for Planning(include notes from planning review) Route Application Documents: engineering. (1) copy of permit application,(1) site plan, (1) building plan and original plan review routing form. .21-3uilding. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: <;/,-,/f! Engineering Review Actual Slope: _27 • ❑ Conditions Met Notes: /f/A. 60:e_,7V,G16. Approved by Engineering: Ae / Date: .6—.er:� / Revisions (after Building Submittal only) Reviewer Date s Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions Met-Prior to Issuance of Building Permit Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: • Revision Notice 3: Date Sent to Applicant: OK to Issue Permit Approved by Permit Coordinator: IF Date:S A--I--/ 1:\Building\Fonns\BldgPertnitRvw_RES 042914.docx Mechanical Permit Application FOR OFFICE IISE ONLY Received City of Tigard ���� Date/By: . �I Permit No.: �I _ Ilr 13125 SW Hall Blvd.,Tigard,OR 9722 �C Phone: 503.718.2439 Fax: 503.598.19 Plan Review + Date/By: Other Permit: T I G A R t7 Inspection line: 503.639.4175 ^O,Q Date Ready/By: luris: ® See Page 2 for Internet: www.tigard-or.gov �`+ % 1� Notified/Method: j Supplemental Information TYPE OF WORK ��Q1�,�`�S,— COMMERCIAL FEE* SCHEDULE — USE CHECKLIST L� i_01 Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteratio 4��� Y performed.Indicate the value(rounded to the nearest dollar)of all `l� mechanical materials,equipment,labor,overhead,and profit. ❑Demolition ❑Other: P Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑ Master builder ❑Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: - Air conditioning 46.75 Job site address: 3 J�u � 7 f/t ° Furnace 100,000 BTU(ducts/vents) . 46.75 City/State/ZIP: l�/ jy a q 7 y2 3 Furnace 100,000+BTU(ducts/vents) . 54.91 Heat pump _ 61.06 Suite/bldg./apt.no.: Project name: ccry Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 • Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: — Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 . Flue vent for water heater or gas t, C 6 - Ct Sy✓/'+,sic fireplace 23.32 f7 r Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ❑ PROPERTY OWNER I ❑ TENANT Other: 23.32 IC �p Environmental exhaust and ventilation: Name: ��S " - 7� ` Range hood/other kitchen v I , r equipment 33.39 Address: / 3,p ?� SV`� 6-I �-e Clothes dryer exhaust 33.39 City/State/ZIP: - CV /'/tp q 7c-2-j Single-duct exhaust(bathrooms, C/ll toilet compartments,utility rooms) 23.32 _ Phone:( j) 7 —6 Cj s--c) Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: _ S14.15 for first four;$4.03 for each additional Contact name: �� Furnace,etc. _ Gas heat pump Address: - Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( Fax: :( ) Fireplace Range _ E-mail: r- Barbecue _ CONTRACTOR Clothes dryer(gas) , ' I Other: * Business name: MECHANICAL PERMIT FEES* Subtotal City/State/ZIP: Minimum permit fee($90.00) — Phone:( ) Fax:( ) Plan review(25%of permit fee) _ 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 signatur • Fee methodology set by Tri-County Building Industry Service Board Print name• 2 1? S�4...c,.---et� Date: 6 __ • / /J ' 1:\Building\Permits\MEC_PermitApp_040113.doc 440.4617T(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. 1:\Building\Permits\MEC_PermitApp_040113.doc 2 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing per mits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: rI own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that a II subcontractors who work on the structure must be licensed with the Construction Contractors Board. !- I will be performing work on property I own, a residence that I reside in, or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this hom eowner statement is true and accurate. Cd■I Print Name of Permit pplicant 5 - �s i Signature of Permit Applicant Date Permit#: )1/4-151-00 14-apO7 I 000-77'!".". L,i T Address: 13935 �W orl� `�2 ms '. *rti I C(2- 57;29-3 Issued by: ,Q• / _ Date: 6/3/I` 1'1 4;7,7 This Copy for Permit Offices FIND'F...0 Clean Water Services File Number MAY 2 12014 CleanWater\\ Services 14-000479 WNW*P�ensitive Area Pre-Screening Site Assessment 1. Jurisdi �ibhn ash,ftgton County City of Tigard 2. Property Information (example 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Christopher Perry 1S133DC 08800 Company: Address: 13235 SW Shore Drive Site Address: 13235 SW Shore Drive City, State,Zip: Tigard OR 97223 City, State, Zip: Tigard Oregon 97223 Phone/Fax: 503-590-6950 Nearest Cross Street: 134th Terrace&SW Shore Drive E-Mail: bvisualinc@gmail.com 4. Development Activity (check all that apply) 5. Applicant Information • Addition to Single Family Residence(rooms,deck,garage) Name: Christopher Perry ,] Lot Line Adjustment ❑ Minor Land Partition Company: ❑ Residential Condominium ❑ Commercial Condominium Address: ❑ Residential Subdivision ❑ Commercial Subdivision Single Lot Commercial ❑ Multi Lot Commercial City, State,Zip:_ - Other Phone/Fax: 503-590-6950 E-Mail: bvisualinc@gmail.com 6. Will the project involve any off-site work? Li Yes ra No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands andlor Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name Christopher Perry Print/Type Title ONLINE SUBMITTAL Date 2/24/2014 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. aa Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed bye"�ti:� ffdLY Date 03/03/14 2550 Sw Hillsboro Highway • Hillsboro. Oregon 97123 • Phone: (503)681-5100 • Fax: (503)681-4439 • www.cleanwaterservices org 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 13235 SW SHORE DR, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final PASS - No C of O MST2014-00079 Chip Barnett Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 13235 SW SHORE DR, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2014-00079 Chip Barnett Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 13235 SW SHORE DR, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing final PASS - No C of O MST2014-00079 Chip Barnett Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 13235 SW SHORE DR, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical final PASS - No C of O MST2014-00079 Chip Barnett Violation Summary: Inspector Contractor