Permit CITY OF TIGARD MASTER PERMIT
1,41 IIII
II • COMMUNITY DEVELOPMENT Permit#: MST2015-00010
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/29/2015
Parcel: 2S114BD03600
Jurisdiction: Tigard
Site address: 9525 SW RIVERWOOD LN
Subdivision: COPPER CREEK STAGE 3 Lot: 76
Project: Baker
Project Description: Permit for bonus room and storage above existing garage completed by previous owner without
permit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors.
Total: 0 sf Value: $25,346.62 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals' 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes 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
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 add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 1
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 0
Owner: Contractor:
BAKER,ADAM T TOM ROGERS CONSTRUCTION LLC Required Items and Reports(Conditions)
9525 SW RIVER WOOD LN PO BOX 231296
TIGARD,OR 97224 TIGARD,OR 97281
PHONE: 503-201-8785 PHONE: 503-704-0000
FAX:
Total Fees: $888.92
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 -= rules adopted by the Oregon Utility Notification Cent hose rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtainain aV�r10=._les or direct questions to OUNC by calling 503. . 987 or 1.800.332.2344.
Issued By: �,..,..,,, - Permittee Signature:
. ' 639.4175 by 7:00 a.m.for the next available inspection dat .
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.
Building Permit Applicati E-S/0,/ T -
Residential DECEIVED FOR OFFICE USE ONL1
City of Tigard JAN 2 6 2015 Received y / / C
IC /ID
Date/B : �(O II%/' Permit N. J ,_r/s...--// //'a
• 13125 SW Hall Blvd.,Tigard,OR 93Z21 Date/B -111111 (��MIN
Phone: 503.718.2439 Fax: 503.5�g;1�1d OF TIGARD ,� Other Permit:
Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready"Z y�/e ;��7/ r��g ® See Page 2 for
116,11:1) ! r/T! J
Internet: www.tigard-or.gov Notified/Method i/ Supplemental Information
It) Tecf
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction , 12 Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
[ ddition/alteration/replacement . ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuatiorf53At,. �;f o
l-and 2-family dwelling ❑Commercial/industrial /
❑Accessory building ❑Multi-family Number of�edrooms:
1:1 Master builder 1:1 Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ct 5e.S $> /24vcZ�dbb t___.L1/4.3 New dwelling area: ( — square feet
City/State/ZIP: 71 /gA Z1) d `L. Garage&varpon'area: square feet Z..`
Suite/bldg./apt.no.: Project name: Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
i DpFtt ,-. 7 AL e %/� Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: 3600 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: a S,i`� p o3 L 0 U Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
rerL..A�1.'1- E,(t S T l CD R o IJ t.)- Valuation: $
1:3_60 vv..- A- lam. STo?.-_oar 6E P Ov i. Existing building area square feet
4EZZ-1 STI I•3 C c,%72*; ' . New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: Al>/tiAA ?.E 2 Type of construction:
Address: ei 515 j ... ,) Zi J�-')pow t--,1/4) Occupancy groups:
City/State/ZIP: 71 tE,ft—■ G Z Existing:
Phone:( .) a 0 k - S'i 8 5 Fax:( )
New:
14 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedale)
Business name: Owl Z.D .,E-12 5 DONS(-
U'- __ Structural plan review fee(or deposit): /4•6 ,s c/
Contact name: 7p r /2-06E S //
FLS plan review fee(if applicable):
Address: p. v_ 13o X a 3 ( a-9
City/State/ZIP: 7-k 14 J O1_ �'1 a $ ` Total fees due upon application:
Phone:(53 •7 oak_be 0 Fax: :( )
Amount received:
E-mail: w114 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
To.�-wit o G eta C.-ON s rat c ioN Commercial and residential prescriptive installation of
CONTRACTOR C-0.^-N. roof-top mounted PhotoVoltaic Solar Panel System.
Business name: c�< ekt.00 Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP: and administrative fees): $180.00
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: CA.5 Cto d /A/(c�� / re Total fee due upon appication: $201.60
Authorized signature: ( This permit application expires if a permit is not obtained
lwithin 180 days after it has been accepted as complete.
Print name: [24`. Z S Date: t la q/ f 5 *Fee methodology set by Tri-County Building Industry
OTC CCC ((( Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
r
Building Permit Application Checklist
One- and Two-Family Dwelling IOR OF1 ICE USE ONLY
Receives
City of Tigard Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
= Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T 1 G A R D 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. III ❑ ❑
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 .Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
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 exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area existing structures on site;and
surface drainage.
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 :••licable to the •ro'ect under review.
.iTRISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item I I above. Siteplans 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"buildingplans 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:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Electrical Permit Application 1,0R oFI-I( 1: l si.:()NI.)
City of Tigard o RECEIVE I Received
DateB Permit#Ill 02 of/51....00 0/•
:. •• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 JAN 2 6 2015 Date/f3 : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: kris See Page 2 for
"`' " " Internet: www.tigard-or.gov CITY OF TIGAR Notified/Method: Supplemental Information
TYPE OF williIILDING DIVISION PLAN REVIEW
❑New construction (Addition/alteration/replacement Please check all that apply(submit T 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.
LM-1-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 El Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 914.5 %‘.1-) de/ilk:2444:40 IOOHP or more. ❑"A","E", `1-2",°I-3",
-776,4./..p ❑Six or more residential units. occupancy.
City/State/ZIP: D12- '" ❑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 I "
6P/71°t/z— L'f g v/2- New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot#: g g
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: aL 5// y/13 v O? dQ Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
b?ON us Az"a w.. I/Z I /../ 6 Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
XPROPERTY OWNER 1 ❑ TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: A- i114/t 84-g-65-et 200 amps or less 100.70 2
Address: ((Q//!i 5- C 201 amps to 400 amps 133.56 2
[ ��l J /e-/1/ Z-4/-10416 �N 401 amps to 600 amps 200.34 2
City/State/ZIP: 7/G4",4) OZZ 601 amps to 1,000 amps 301.04 2
Phone:( ) a,vi — g 7vs- I 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
a APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: �t /�6��5 ��S L IC above service or feeder fee,
7.42 2
/ C ! each branch circuit _
Contact name: �� Q__�GeR B.Fee for branch circuits without
Address: p /° ,f�DX 6�'!� g service or feeder fee,first 1 56.18 2
�_ [J branch circuit
City/State/ZIP: G 4-R-A e7/L 4 ?',�/ Each Miscellaneous 7.42 2
7-7 Miscellaneous(service or feeder not included)
Phone:(5 c 3 744( ,ej I Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: 7A47-0 G��5 ea0Iil. /!t-t4e 774>N) t7 '° Ir r L , Reconnect only 67.84 2
/CONTRACTOR CO &S Pump or irrigation circle 67.84 2
Business name: 0/'Z. ?f If flec, Sign or outline lighting 67.84 _ 2
Address: """""""�� `c Signal circuit(s)or limited-energy ❑ See Page 2 2
�0 G/ panel,alteration,or extension.
City/State/ZIP: p eu ,{/t[ G�`70?( Each additional inspection over allowable in any of the above
/ V ` Additional inspection(1 hr min) 66.25/hr
Phone:(503 ) !'J '- 2.4.5-y l I Fax:(fog ) t.3f{-561_3 Investigation(1 hr min) 66.25/hr
Email: •t ME{9/! c Cf 771'L�f fG,O/C� Industrial plant(1 hr min) 78.18/hr
r� Inspections for which no fee is 90.00/hr
CCB Lic.:l 2 7G/ Electrical Lic.: ` ^ Suprv.Lic.: y''0 specifically Iisted(%,hr min)
//C//(c 1 i `0n/4 ELECTRICAL PERMIT FEES
Suprv.Electrici signature,required: %y�GV k cJ Subtotal: _
Print name: 20ft e r 41a!t." Date: ❑Plan Review Required(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: V � 7, �/ Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC_PennitApp_ELR_ERE.doe Rev r. 014 440-4615T(I1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. I Each � Total
Fee for all residential systems combined: $75.00 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
Gara a Door O ener* 50.01 to 100 kva 552.26 . 2
g p >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over25 7.42 3
•
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
inspections for which no fee is 90.00/hr
specifically listed(%2 hr min)
COMMERCIAL WORK ONLY:
ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): I
y • Number of inspections allowed per permit.
(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
L\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014
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
9525 SW RIVERWOOD LN, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00010
Chip Barnett
Fire, life and safety inspection only
Work done without inspections/permits
Visual inspection only
Violation Summary:
Inspector Contractor