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Permit CITY OF TIGARD 1 , - j MASTER PERMIT 1111 I COMMUNITY DEVELOPMENT a0fiffill Permit#: MST2015-00032 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2015 Parcel: 25111 BA06200 Jurisdiction: Tigard Site address: 14030 SW 97TH AVE Subdivision: ARLIE'S PLANTATION Lot: 2 Project: New Century Holdings, LLC Project Description: New SF. 2/8/16: REPRINTED permit to include(1)backflow for irrigation. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 1560 sf Basement: 0 sf Left: 4 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1401 sf Garage: 465 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 4 Detectors: Yes Total: 2961 sf Value: $352,821.33 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2961 Owner: Contractor: NEW CENTURY HOLDINGS LLC VP CUSTOM CONSTRUCTION LLC Required Items and Reports(Conditions) 13815 SW CAROLINA CT 8613 NE 97TH CT 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97224 VANCOUVER,WA 98662 PHONE PHONE: 360-521-6494 FAX: Total Fees: $23,896.58 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 OAR 952-001-0090..�You �maay obtain a copy of the rules or direct questions to OUNC by callin• 2.1987 or 1.800.332.2344. // Issued By: y� Permittee Signatu -: _ tr 4,6 • �1/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until co • •tion of the project. Approved plans are required on the job site at the time of each inspection. IN n CITY OF TIGARD MASTER PERMIT I COMMUNITY DEVELOPMENT Permit#: MST2015-00032 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2015 Parcel: 25111 BA06200 Jurisdiction: Tigard Site address: 14030 SW 97TH AVE Subdivision: ARLIE'S PLANTATION Lot: 2 Project: New Century Holdings, LLC Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 1560 sf Basement: 0 sf Left: 4 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1401 sf Garage: 465 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 4 Detectors: Yes Total: 2961 sf Value: $352,821.33 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Tvoes Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 2961 Owner: Contractor: NEW CENTURY HOLDINGS LLC VP CUSTOM CONSTRUCTION LLC Required Items and Reports(Conditions) 13815 SW CAROLINA CT 8613 NE 97TH CT 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97224 VANCOUVER,WA 98662 PHONE: PHONE: 360-521-6494 FAX: Total Fees: $23,771.56 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. jose rules -,t, set forth in OAR 952 1-0010 thro OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987.r .80' 2.2 • '0 Iss By: Permittee Signature: / / • 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. --.114. I. t t 5- 1`��- uild?n Permit Application G� �/ Residential fikec i G FOR OFFICE USE ONLI City of Tigard 3 '6\5 Received rlTa0/S OQO31. • �; Permit No.: i 13125 SW Hall Blvd.,Tigard,OR 97223 gNit Plan Re�'^ ■ 0 1 q 0 Other Permit: o'�u�, .,k)/ Phone: 503.718.2439 Fax: 503.598.19 -CIGAR De/gy; �`� 6 s ab)� TI G n R p Inspection Line: 503.639.4175 -f� OF V,S,O� Date Ready : : Joni ® See Page 2 for Internet: www.tigard-or.gov vt-N 1 NNotified/Mdh.•: /7 IS'/ - Supplemental Information OA-1.1k c iIr TYPE OF WORK 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 CATEGORY OF CONSTRUCTION work indicated on this application. �--� Valuation: $ - z( ) Oil-and 2-family dwelling ❑Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: `3 / LI ❑Master builder 0 Other: Number of bathrooms: 3 JOB WE_INFORMATION AND WCA• I Total number of floors: `2-� 1 Job site address: / If 0 3 S (� 17 to v New dwelling are Zct�-,l square feet City/State/ZIP: +1" ( (�l_d d Q 7 7 2 2'f Garage/carport area: � G 5 square feet Suite/bldg./apt.no.: Project name: it/C1.4.) CeArit.4 rta r/ 4j Covered porch area ts- 3 square feet KO I Cross street/directions to job site: M c O tttlJcet-0 Deck area: LS- 3 square feet h Other structure area: • square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: f Lot no.: 2, Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. ..K" Valuation: S Existing building area square feet New building area: square feet Q PROPERTY OWNER 0 TENANT Number of stories: )�t Name: e,of a e,f.f-r g efe,L�/IQ g 41.-G Type of construction: Address:, « pis----3u) G g r o L j Nq s Occupancy groups: City/State/ZIP: P b R+ /-' ti e 0 R 47-- 7 7 27- y Existing: Phone:(S b3) ci g( C7 p r Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES' Business name:I j {1 C i.5 .gyp 64 e_ e ) 5+ r J e., t'r 0 N L 1 (Please refer to fee schedule Structural plan review fee(or deposit): Contact name: v � ,E, FLS plan review fee(if applicable): Address: C'3 2� 3 S w C.el ro L., NQ Total fees due upon a nation: City/State/ZIP: Po R+l et tv� c) R 9 7 2-2 c f p� •�' Phone:( ) I Fax::( ) Amount received: 7✓U- E-mail: P L a if ca !t -1 yew) 6,0 . .' o 0 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES' PL b0r °°' t 14'lA rOR Commercial and residential prescriptive installation of roof-top moun -. PhotoVoltaic Solar Panel S - -m. Business name: 6.e_€ 4h4 JQ/ Submit two(2)se. of roof plan with •. ction details and fire department cess,alo : •th the 2010 Oregon Address: Solar Installation Spec . . ode checklist. Permit Fee(' de• .Ian review City/State/ZIP: administr. e fees): $180.00 Phone:( ) ' I Fax:( ) State surch a(12%of perm' e): 521.60 �qq33 �r t 7 CCB lic.: / Total fee due upon applcation: $201.60 Authorized signature: • _f= • Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Date/By. 13125 SW Hall Blvd.,Tigard,OR 97223 I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: TIGARD 24-Hour Inspection Line: 5l)3.639.4175 ❑ Electrical ❑ Plumbing ❑ \!,J!.n.11 Internet www.tigard-nr.gnv ❑ Other. THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A I 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 ❑ ❑ ❑ 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,roofmg,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 analysisprovide 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 applicable to the .ro'ect under review. .11 RISI)I( I IO\AL SPECIFICS 23 Three(3)site plans are required for Item I 1 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"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) r 1 Electrical Permit Application tiT 0�3�- City of Tigard H E�E�V E Q Received 15 �s aois i ' 13125 SW Hall Blvd.,Tigard,OR 97223 C Plan Review I Phone: 503.718.2439 Fax: 503MAR960 3 ZO15 Date/B': °UiarPEtID1t �L`' S" ' i �; RI) Inspection Line: 503.639.4175 Date Ready/By: kris: E See Page 2 for Internet: www.tigard-or.gov .. .I^ARD Notified/Method• - Supplemental Information TRJQJDV'RPF DIVISION PLAN REVIEW El construction [3 Addition/alteration/replacement Please check all that apply(submit j sets of plans whtems checked below): ❑Service or feeder 400 amps or more 0 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 0 Floating buildings. ❑ 1-and 2-family dwelling less to ground,or exceeds 14,000 ❑Commercial-use agricultural ly g ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire Pump. ❑Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ID Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A",`B,"l-2","I-3", Job no.: Job site address:14 o361 S 7 14 v 100HP or more. occupancy. 1 0 Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: -1 a 0 (2 7 7 2._?._ ❑Health-care facilities. ❑Supply voltage for more than 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: LL) ❑Service or feeder 600 saps or more. FEE SCHEDULE Cross street/directions to job site: Deserip en 1 a.,. I Fee. I Tea I • New residential single-or multi-family dwelling unit _Includes attached garage. _ Subdivision: Lot no.: 1,000 Mt.ft.or less 168.54 4 Ea.rdd'l 500 sq.ft.orporticn 33.92 1 Tax map/parcel no.: Limited energy,residential . 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) ____2i i Limited energy,multi-family �/ i J J f - residential(with above sq.ft.) 75.00 2 Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 , 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or 1 City/State/ZIP: relocation Phone:( ) Fax:( ) 200 amps or leas 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,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel Owner signature: Date: _ A.Fee for branch circuits with ❑ APPLICANT I l ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: v P t1 CJ S cc,noff Cxa , •it. � (� B.Fee for branch circuits without i B.service or feeder fee,first Contact name: Poi v 1---- branch circuit 56.18 2 Each add'!branch circuit 7.42 2 Address: - Miscellaneous(service or feeder not included) City/State/ZIP: i Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:( ) I Fax::( ) , Reconnect only 67.84 2 E-mail: Pump or irrigation circk 67.84 2 Signor outline lighting 67.84 2 CONTRACTOR - Signal circuit(s)or limited-energy Business name: /4/,0.,li..- (4z, ;C I-i G panel,alteration,or extension. Page 2 2 -1'�! /i r1 Each additional inspection over allowable in any of the above _ Address: 2 , �. 6' = ----} �] Additional inspection(1 hr min) 6625/hr City/State/ZIP: , /-E—C4/C Investigation(I hr thin) 66.25/hr a'o c o&(V" ti'. " 1 4 ,91v v ! Industrial plant(I hr min) 78.18/hr Phone:(36' 5//f_ �-5'Q9 Fax:g 3a= 9 C o Inspections for which no fee is hr specifically listed(h hr min) 90.00/ CCB Lic.:112 c/9 - Electrical Lie.:-C Z 30 Suprv.Lie.: /7 95 g ELECTRICAL PERMIT FEES Subtotal: Suprv.Electrician signature,required:e/ Plan review(25%of permit feet Print name:CA 6-4,1„,,,, 6 spa, Date: State surcharge(12%of permit fee): ��1 ,�/ TOTAL PERMIT FEE: Authorized signature: ` jam/ yr' trice permit apys after expires bu been Ha permit is asco complete. within 180 days after it Yoe boa accepted as complete Print name: V Date: • Number of inspections allowed per permit. I:13uildinalPermite lEl.C-PermirAPA 440.461 5T(1 I/05/COM/WEB , I --- Mechanical Permit Applic 1 'C E I V E D Received City of Tigard Pemnt•,,, Da(d9y: l Y�l „,,,,,v4, -_e„.. ...4 3 13125 S14 hall Blvd.,'I'igard.OR 97` Plan Review �"' n ,��, Phone: 503.718.2439 Fax: 503.598' k 3 2015 DatelBy. Other Permit: 64,0K fS�eo19 I i i i,1 I:1 t Inspection Line: 5(13.639.4175 //ii�� hate Read 1B - /will Internet: www tigard or.gov 1 Ready/By. QI Sec Page 2 for p� Notified/Method Supplemental Information CITY'OF TIGARD TYPE O OI P `vim' � I.5— COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ( "• -,•A• Mechanical permit fees*are based on the value of the work lia New construction ❑Addition/alter, performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: V mechanical materials,equipment,labor,overhead,and profit. _-- Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. _ ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCAT! N Heating/cooling: -rt 41,• Air conditioning 46.75 Job site address: / y (,, 7 M`00 A.0 Furnace 100,000 BTU(duets/vents) 46.75 City/State/"/.1P: �F-t/ ` . it f p 0 R € 7 2 z•. Furnace 100.000+BTU(ducts/vents) �— 54.91 Suite/bldg./apt.no.: , Project name: `` '' �/ Neat pump 61.06 !x' _ Duct work 23.32 Cross street/directions to job site: Ilydronic hot water system .__ 23.32 Residential boiler(radiator or hvdronic) 23.32 Unit heaters(fuel-type,not electric). in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Other Subdivision: Lot no.: _-- _ Other fuel appliances: Tax map/parcel no.: Water heater FT 23.32 DESCRIPTION OF WORK Gas fireplace/insert i'' 33.39 Flue vent for water heater or gas v.) fireplace 23.32 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: Environmental exhaust and ventilation: 23.32 Name: /V e f c e N 2-r ? K Q L cI� S' 1- 1— e-- Range hood/other kitchen i ,p equipment 1 33.39 Address. 2 Lys- e G� t L 1 151 �-. � ... _--.! ._.— � -__ Clothes dryer erhausY I 33.39 City/State/ZIP: 0 rz Y C t�t�6' Q f 2 1 7 Z Z- Single-duct exhaust(bathrooms, , P , ,_toilet compartments•utility roomsj' 23.32 Phone:( ) Fax:( ) Attie/crawlspace fans —_ 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: V p e © s 4o m c 0A 'f"/y Fuel piping:L l e $14.15 for first four;$4.03 for each additional Coronet name: it a (S C a o L ir ti It, S f Furnace,etc. O /•� f L c i f O /7 7 7 a 'L Cf Gas heat pump Address: /� T N /t / Wall/suspended/unit heater City/State/ZIP: � Q V� Water heater Phone:(36(9 S 2 / C tr c] ci,f Fax::( ) Fireplace - Range I E-mail: Barbecue CONTRACTOR Clothes dryer(gas) , Other. Business name: �/��t ir MIECIIANICAL PERMIT FEES* Address: _ Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:{ } Pax:( ) State surcharge(12%oolpermit fee) CCB lie.: /4' r / / TOTAI.PER311T FEE _ �� This permit application expires if a permit is not obtained within ISO _ i y - .•V days after it has been accepted as complete. Authorized signature: • Fee methodology set by Tn-County Budding Industry Service Board ( Print name: /.3 Q1 v -£ 1—_ _ I Date 1 2 St r Y i I'Vluilditteermi4,MF.0 PernuiApp,,,04011i doe 440-4617T(I Ii02iCOMiw Ea) A r Plumbin2 Permit Application Building Fixtures lute O1 Fl( I' I til. l)\I I City of Tigard V E D Received __AY Permit No. M7r /� i/ 13125 SW Hull Rlvd.Tigard,0 9 Plan Review . 5w E.040/5--•-e906/9 a Phone. 503 718.2439 Fax: 503 598.196n i Date/By. Other Permit Nn I I l;.\Ia) Inspection Lme 503 639.4175 MAR 3 2015 Date ReadylBy. Boris 0 Sec Page 2 for Internet: www tigard-or gov NotifiedRvtethod Supplemental Information TYPE OF ail OF TIGARD FEE* SCHEDULE Il New construction B II;II Ii\IGnIDIVISION For special information use checklist - _ Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 tl for each utility,comection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ( 1-and 2-family dwelling ❑C'onunercialiindustrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25,02 ❑Master builder ❑Other: Fire sprinkler(_sq.ft.) 1 Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: / 1 a �) jA U ,Cs e q N e , _! catch basin or area drain 18.76 -- i Lc/ orywcll,leach line,or trench drain 18.76 City/State//.1P: . t a Q R �.. d (7 7 2 2- Footing drain(no.linear il.. ) Page 2 Suite/bldg./apt.no.: I Project name: Neu) 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: Lot no.: Fixture or item: Tax map/parcel no.: Back flow pm-venter 31.27 DESCRIPTION OF WORK Backwater valve 12.51 d E 5 Clothes washer 25.02 -_- �_-- ......-_.._._ _-._._-....._ ___ -------._ . Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 _ ❑ PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: !t ! e (.0 C 1_ 2 L d/i(J 4 S 4 4 e Fixture/sewer cap 25.02 Floor rain/1 a strivhub 25.02 Address: /3 8/s- S W p YOL f N ei S'3 Garbage disposal 25.02 City/Slate/ZIP: P p et L Ca �() (i 0 e q 7 - Z Ii. Bose bib 25.02 r - , - - - Phone:(j Oj) f g/ 7 g f Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON interceptor/grease trap 25.02 Business name: V Q CDs 4 Q M. C D u S`f"le L L. Q Medical gas(value.S ) Page 2 Contact name: e Primer 1251 P� v �- -- ------- --- Roof drain(commercial) 12.51 Address: -f - ,3 �s a r L N &-f- sink/basin/lavatory 25.02 City/State/ZIP: PO R 1-//L et N 0 ie g 7 2 Z. (/ Solar units(potable water) 62.54 Phone:(3("6) ..S Z iv 1 T q y Fax::( ) l'ub/shower/shower pan 12.51 ... . ...... ` E-mail: L 7 de I et h ©Q, e. t�/C'i Urinal 25.02 Water closet 25.02 CONTRACTOR L‘4.1.14„gprt_ -- - -.._.._..5 - titer heater 37.52 Business name: ' �-s-- �` -+d Water piping/DW V 56 29 Address: Y r t� �/ �!'�i/74-� "- Other: _.._25.02_.____- City/State/ZIP: 2e�,,F-2 f jJ /27' ,Z,.,e3E-eriz.77� 9.7e-r7 - Subtotal Phone:(. 4-4 r1!r - ,P33 Minimum permit fee: 572.50 ! [/ Fax:( ) ._. l Plan review (25%of permit fee) C'C'B Lie.: ?J 7 0 � • /4 / Plumbing Lit:.nq -** ,,j-?/� -- / State surcharge(12%of permit fee) Authorized signature: /.4 �� !7/Z�7 TOTAL PERMIT FEE _ Print name: J c)`'' Y I Date:/Z, P I--/ / (/ This permit application expires if a permit is not obtained within ISO days .._._...... ` ( after a has been accepted as complete. *Fee methodology set by 7n-County Building Industry Service Board. I`Budding.Permits'Pt.MU-PemmnAppdoe I0i0I:09 440-M16T(10U2'('0kJWEB) 1 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT . s T I G A R D Building Permit Review — Residential Building Permit #: N'5 X15 Ood 3 D-- Site Address: I y0 30 SW C11-111 PkV e Project Name: Ar1 i e 3 PI art ro..+on Lot #: 2. (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: new SF WVerify site address/suite #exists and active in permit system. Si)e Plan Elements: i" 'ltree (3)copies of site plan xisting structures on site prawngto plan must bg on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished to scale(standard architect or engineer scale) �°or elevations prawn e catiarrow bdUtility locations(required for new,may apply for additions) te address,project or subdivision name and lot number i on of wells/septic systems pplicant information name and hone number Erosion control(including drainage-way protection,silt fence t dimensions and building setback dimensions esign,location of catch basin,etc.) -Btot area,building coverage area,percentage of coverage and Street names impervious area(applicable if R-7,R-12,R-25&R-40) JEI.9treet tree size,type and location Property corner elevations (2 foot contour lines if more than $Existing trees to be retained with drip line,and tree 11 foot differential) protection measures Clean Wateer,Services-Service Provider Letter (lot platted prior to 9/10/1995): Required: ® Yes,applicant was notified ❑ No Received: MrYes ❑ No VPublic Facilities Improvement(PFI) Pe it: Required: CI Yes,applicant was notified 'No Applied For: ❑ Yes ❑ No,stop intake -Land Use Case#: VAR201 -00Q 11 , VAR201 5 -000 1 2- VZoniR—LI.5 ng: etbacks: t Front Rear 15 (IS'�Side Street Side 1'1 of Garage 201 (WI) 4E1-Landscape Requirement: %1sst(15) y J 7 of Coverage Maximum: wilding Height: Maximum Height a Q1 Actual Height Zia M Visual Clearance ? 00/Easements c ck w l al G I' Sensitive Lands: Yes ❑ No Type Wv, \o,rtc ou,'r 1 k praP,t' ctrw4.../ ...Urban Forestry Plan �l - Conditions Met Notes: ad j s h nexi 40 -roar ark side yard seEbo. s •• •••rov- • • )1i .& L. :.. - . • ' ..\ own- . •. . o. .1 g/ ,, Approved By Planning: Ir H •, t,t__• Date: „ 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\B IdgPermitRvw_RES_020415.docx • . Building Permit Submits l Original Submittal Date: �/ Site Plans: # 1 Building Plans: # Building Permit#: 0 -Enter building permit#above. Workflow Routing: Planning [-Engineering Ehlrermit Coordinator ErBuilding Workflow Sign-off: —ign-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. l]-Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: ,_ 0, , , Date: a 7/Ls--- Engineering Review Z Actual Slope: ' )k1) ( t-gs k12{ ,cam t 0 40 ❑ Conditions Met Easements (encroachments) -- 5> 64-- L-I N1- Fr72 96 S o 62'8'14"A"'7' vr- g14-- 2[ Water Quality/Quantity Facility: P/ �-+� Ham Assess Water Quality Fee: V Yes ❑ No Assess Water Quantity Fee: li Yes ❑ No NOT Approved by Engineering: 41-,74-6 ,14-)_4 Date: 1-1'f 1 J Notes: W I L-C N 1 ? F 1 fr- CO)-) T7 yr 7 5 r i 7' RF,-r im- 96 pro. wIw fri Pr rag- 577L I i-c5V 1h r� s4 , c ci,c y�C f2- 76 ga . Approved by Engineering: Date: Revisions (after Building Submittal only) Reviewer at Revision 1: "Approved El Approved \ 3 16 !S-- Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions Met-Prior to Issuance of Building Permit ❑ Approve NOT Released: Date: Notes: or"APP non b — �`-^aT4/ ` 1#'t, 4.-Y 3 /S /Le 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: K to Issue Permit Date: // /‘,6—'d-24-4.-- ---- 1j �S Approved by Permit Coordinator: 1:\Building\Form s\B I d gPerm i tRvw_RES_020415.docx f r -. . N TIGARD City of Tigard 0 ■ — '-';'' Wednesday, March 04, 2015 .4 '''''ft Pavel VP Custom Construction LLC 13815 SW Carolina St. Portland, OR 97224 Dear Pavel: I tried sending this to your email address but apparently I couldn't read the address correctly because both times I sent it the message came back as not deliverable. The email is attached. Please call if you have any questions. , Albert Shields Permits Coordinator 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov Albert Shields From: Albert Shields Sent: Wednesday, March 04, 2015 3:40 PM To: 'PLG467Q @yahoo.com' Cc: Mike White Subject: MST2015-00032, 14030 SW 97th Ave., Tigard Pavel, on reviewing the site plan for this application Engineering has the following comments and requirements: 1. Sewer line for 9680 SW McDonald may be under the proposed building structure. Please verify location of 9680 building sewer. 2. Will need PFI permit for connection to sanitary sewer. 3. Will need an easement across 14030 for the 9680 sewer. 4. Will need a PFI permit for the storm drain and provision of a storm drain conveyance for 9680. Please address these items and resubmit your application. 1 + ti Albert Shields From: Albert Shields Sent: Wednesday, March 04, 2015 3:43 PM To: 'PL6467Q @yahoo.com' Subject: FW: MST2015-00032, 14030 SW 97th Ave., Tigard From: Albert Shields Sent: Wednesday, March 04, 2015 3:40 PM To: 'PLG467Q @yahoo.com' Cc: Mike White Subject: MST2015-00032, 14030 SW 97th Ave., Tigard Pavel, on reviewing the site plan for this application Engineering has the following comments and requirements: 1. Sewer line for 9680 SW McDonald may be under the proposed building structure. Please verify location of 9680 building sewer. 2. Will need PFI permit for connection to sanitary sewer. 3. Will need an easement across 14030 for the 9680 sewer. 4. Will need a PFI permit for the storm drain and provision of a storm drain conveyance for 9680. Please address these items and resubmit your application. 80atf 59 P4S Y6 Dedication • Approvals A R L I E'S FL A NT A T ION KNOW ALL MEN BY THESE PRESENTS: not Arlie Motehimer and Irene Mo muter do hereby mane, ,..,, y Mts Oy41tdd of 5 e 4e.e.Ih� ,/986 A RE-PLAT OF A PORTION OF LOT 28. TIGARO✓ILL£HEIGHTS establish orn0 declare Me oo,ered plat of ARL/6S PLANTATION:OS portico/ory 44Sehaed,0 Me y IN THE W.GRAHAM OLC N10 39 surveyors cMifKOte hereto attached,0 true mop and plat thereof. All/O/s Sling Of Me dimensions CITY OF T/GARO shown on mid plat and easements being Of Me!taro thereon set forth,and Me do hereby dadicole PLANNING DIRECTOR..BY DOE/,- to Me use of/he public os public ways forever tine easement adjacent to SW McDonald Street os BY VIIPE'Wiffi!1 LOCATED IN THE shorn on mid mop. CITY ENGINEER a NE 1/4,NW.1/4,SECTION 1f, T2.5.,R/W.,W.M., �p CITY OF TIGARD WASHINGTON COUNTY, OREGON e_l S APpro.Yo INi/So don of /Js vtw+6er ,/9Br WASHINGTON COUNTY,OREGON Arlie Morhirler Irene Mowhirlet BOARD OF COUNTY COMMISSIONERS A.K.A. Arlie Less seawall, SUR✓E TED. JULY 1985 BY BURTON ENGINEERING B SURVEY/NG 302 T/GARD BY VJA+' _' 845/5 OF BEARING: TIGARD, OREGON PLAZA 97223 ' CENTERLINE OF (50 31 63 9-61/6 • 8 A/�O.Pos . ' /A %:.---.....,'. SW 97th AVENUE . (Ref PS/8,499.05/ea June/979) No.85-227 Acknowledgement er ..._s STATE OF OREGON I WASHI,NGTON3COUNT IEALTH DEPARTMENT /�1 COUNTY OF L✓ash r JIM-, ) SS. By 4 G td7'L / r/ r re OetSS OSK(vier s-3J61m wgWnMEM 8OX NSevmwq S5 Cem er / GEORGE R/CHA8DSau S C Ha SO ,5.00!5 LINE,LOT 10,01GMpv1LLE 5E105TS TN/S/S TO CERT/Fr That on this 29'a y of �f/W ,198 ,before me,o notary Approved Mis -e day Of C''c x.3 e_il ,/98 S , 1 d.1 WASHINGTON COUNTY SURVEYOR _ __ public in and for said State and Cawny, per-sae//y op Arlie Mo hinter and/rent Mowhirler,+M ---- SG{7''fG'�'E -- 93�C/T— - - --- being first duly sworn, Ale my that they are the iden//e1 persons named and described in Me foregoing h V rnslrosef old mis is ee certificate thereto,and Mot the signatures affixed to said instrument was of By C PAM-....� / ` l S.W MC DONALD 1481 ' STREET *err own free act and deed. '\ / _ W/TN£SS my/058 and officio/sea/ L e mqy LrO.IJ _-__-.095.00'�,/O-/Y-2'JS.CZU•'-/60.0 rU" --- ' Approved lnrsls�-3. of F�T�LaE-TZ ,/982 4.— - /� D/RECTOR OF ASSESSMENT AND TAXATION --c' "• —-'' " 4.J—''e— ;1 FrAparlomm.OBNCIT,p�7�1, �' _ O/.N',EL T.EURTON (CDUMr ASSESSOR)WASH/NGTON CVJ/NTY,OREGON I 9vr".Gb' LYJ' .SGl 00' O WO),i-U9LIC-CRiLC'! R•S EAS AKA? ' Notary PlNic tar SJOIe of 000900 -76.08 By ,..1 1 1 I ,y,:fypl :I Ly Cam:ton Fr has �i(Ccw�Piro J r j 8 My commission expires 7'8'88 - - y Z 8 `k, v / q tv 11)O STATE OF OREGON I 5 W y I y "a"" ass c 0 $ 1 COUNTY OF WASHINGTON) S.S. Q 3,„,„„,,r,,,,.....,/ h I ' a A/hst;This-- -day of N000n� ,/9B,i k sBC'46'ro E' 3 7 4 0 • i• DIRECTOR OF ASSESSMENT AND TAXAr/ON F. .5.6,60' • 7,300 San k 7500 sets O t 3 - 6 O 1i, EX-OFFICIO COUNTY CLERK1 s< Less $� edo0 sefx ODOO Sea O- Sur Surveyors Certificate B, C' -//I C It°+�Deg dy I; I � ,,aw ?'-� % \g • i$ 9QY4G'7"E- -4 . I,THOMAS N.BURTON,being first duly sworn,depose and soy Mat 1 nave comet/y surveyed owl C t5. O 2 8 £iOp61p} ' ' A \ ' reed with paper monuments Me lands shvrm on the onne ed map of'ORGIES PLANTATION"Ond Mal Iw\ h K I .. I e for me lniaio/Point a'so/do/DI/set 0 2 r 36 ga/eO S.ed iron pope w,m on dunmam cap msenbed T. b y �deO3Saf't h\ \ \ ■ \ BURTON,L.S.590,6'below the surface of the ground Sold In/Ito/Point being south 88446'10" STATE OF OREGON ) O j 1\v) e) , y p) Ir/o Cost 934./7 feet and Soon 5/9'00"West 30.00 Net from a Brom Disk in o monument bar SS. m +� , found of Me Southeast comer of Me George Richardson Donation Land Gaim No 38/hence Nam 00rd COUNTY OF WASHINGTON) y.ay V _s, 4od..-rr Melia/Mint rutnir g North(/9'00"Eos/1000 feet to o pan/20.00 feet Southerly of Me Center/Pre °j �f of S.W.McDonald Street;/hence Alarm 88.46'/O-West,parallel a me North line oy Lot 28,"T/GARD- I do hereby certi/rNwl the attached 2=k,• 9_5,00' -SO.LW• .50.027 0. . ViLLE HEIGHTS;a duly recorded plat,o dlslonce of'95.00 feet b o point 2500 feet Cos/er/y plat was received for record on Me�day ofd, �1 Q I i'd6�•RG�O - /9-5-.00; zoos of Me West line of said Lot 28; thence 50,4 r 19 00 West,parallel to sold Lot 28 NW/Me /98 ,of 10 NT .d loco PM,a d recorded on 0a70 /50.00 feet to a point of the Soom/Me of MO/certain frac./of/and 50155706 to Arlie L.Mow/te e, 48 _ in 80.—.4L—_of Records of Pals of sold S 6 I.R h and Irene Mawnilter,husband and wile,recorded/8 August 1963 M Book 565,Mgt 58,WOShinglon County. C m$Y•vnu4A-sac- • ��' '� County Deed Records; thence South 88'46/0 East 5/ono mid South/Me and Me Smith/ine Of/hot N 0•rs'/sbt �✓x'-116,%-E-/GY1•QO' eerie:n tract of/Ono'0/10 Conveyed to Arlie L.end Irene MOwhirter,recorded 29 February/972 in80oe 856,Page 9/,Washington County Deed Records,a distance of 195.00 het to on angle point On JAe DIRECTOR OF ASSESSMENT AND TAXATION 5,..,•,„ South lax of said lost described M0w6irler tract; /hence South/•/9 West along said South EX-OFFICIO COUNTY CLERK COMA,.- �--- QO" Of W 2 3N'/4 line 20.00 feet to on angle point thereon thence South 88.46/0 East continuing along sold �y i u/t/C natr�l LEGEND South/thee/00.00 feel l0 the mast SoulhlHy 50utneos/Caner Meleo/, thence North/•/9.00-East By 9'f'(-('C ,,. �"4� foe, 29" 23 �POf ASSDe -_ Wong the East line of said lost-mentioned Mowhirter tract/60.00 feet/o Me Imhof Mint and polo/ `a �'-"• PKo of Beginning. 2 cert.:/y eh:. cop 's t — T' '' : Y f�,I.-'�,e 3 J=,r 5" Elio r Fowsa as noted on mop. true and exact'copy of the o/9inl/ph** REGISTERED .. .T._... PROFESSIOC.AI� a E-Set initial Point,2",36"Gal- �LA.NO SURYEYC•3• y w vowed Iron Pope wed 4/0m- LAND'J""� COOkTk' = i1!um COpsraroed"5900 sew 70 Narrative 6 e<a+Megmwd f . Regis/erect Oregon Lod Sur vow I e • L.S 590 OR E GN The bouabry of this plat is dosed ono comprehensive •n Set 5B"x 30"/ron Rod!narked 1110MrO05 BJRTON survey of this ponce/done in June/979 by Gory AL a nMa Yellow Mastic Cop in- Bufard ono'Associates,record NO 18,499. SCALE /"-40' scribed-77 BURTON,L S. Subscribed and stun to ems me Monuments as called on said surrey were food,ve.-tired 23 85-527 B3 5907 lnis 19tid0y o/ JULY ,/9B and held per ma survey. / East booday line Heed per Dees 8OOB 565,Page 58, STATE OF OREGON ) /�,vrxe-Or O'rl•^ Washing/an County Deed Records. COUNTY OF WASHINGTON) S.S. Nstory Public for State of Oregon '�� /'1��- JT+� �2 ' °v'^C". 3,1 '°' 1 eta Meetly certify loot/have compared the wilhin plot with the 01,9151 thereof, DAME/T.BURTON Mat Me same is O fu/,true,and correct transcript therefrom Ond Mt who/e there- NelotO PUBLIC-OREGON 0l,as Ine same appears of record et Plat Book_S,Page tit` ,thereof. Sty tow+:..sEW.s 719'8F1 My cammvssIOn expires 7-8-8S DIRECTOR OF ASSESSMENT AND TAXATION EX-OFFICIO COUNTY CLERK BY , C ,.l,41.1., (/ Shee t / of/ Mr. Rooter Plumbing of Portland/Vancouver 2 0 8 9 4 3 PO Box 789, Gladstone OR 97027 hilt v CONTRACT/RETAIL INSTALLMENT CCB#138941 1 MRROOP*992JP RECEIVED Stet 503-223-6447 • 503-653-5301 • 360-604-5540 7 ,r1 1 P L U M B I N G portland.mrrooter.com • vancouver.mrrooter.com START DATE: / /1 D END DATE: / / JOB ADDRESS BILLING ADDRESS IF DIFFERENT SERVICE ORDER Customer Name t - ;ustomer Name h } , �c •- ,1 _CLTY OFTIGARD—__ 1 1 '1 + lddre s '\,6 C (`, t: \ j �`� �, .t �� r � � �" Address PLAN_NINGIENGI NEERING -Alta. Y�1 \J, ) St( X. &I)R1 4 '2V,T5n€"5 1 /'Li`1 L City St Zip Other Phone J Service _Prev Main1 J O Po rtunit Call — cia ( Contact Person J Advantage Plan Member J Estimate Nould you like to receive E-mail T�q1�� '� — - - E-mail offers? Li Yes 'J No Address: J '- is iv) J Owner J Tenant PAYMENT J Cash J Check J Billed LVfSAI Check#or Credit card refral#: Auth Code: 'J Residential 'J Commercial DIAGNOSIS L v. /-1i'f`Ac..4. ,/'Jc'V , ; •'-f f- SERVICE AUTHORIZATION f I. t` / IMPORTANT NOTICE:You and your contractor are resr.nsible for meeting the terms and conditions of this contract.It you sign this contract and you fail to j (-' /�,r �, Y\! r 2'�V - 'i (l_ a-- I ii,i f L, e•-r ' meet the terms and conditions of this contract.you may1:;se.legal ownership nghts to your home.KNOW YOUR RIGHTS AND DUTIES UNDER THE LAW.I agree that initial price quoted prior to start of work doe§n'. include any additional or unforeseen tasks.Nor materials which may be found to be necessary to t roil J r• complete repairs or replacements.I also re to hold . 'doter"or its assigns harmless for parts deemed corroded,unusable or unreliable for completion of j r t,,, I -,' /r 1 fi stated work to be done.I hereby authoriz M Rooter •p,dorm proposed work and agree to all agreement conditions as displayed on the face and reverse sides of this document and further ackno d e that invoice is due upon receipt.A monthly service charge,at maximum allowed,bylaw,will be added after 10 days.Independently owned and oner ec�'rapotli 7„_�y -122 . ...1 Authorized Signature (X j_ t„ TASK# WARRANTY DESCRIPTION OF PRODUCTS AND SERVICES APPRp1AL INITIAL STANDARD RATE MEMBER RAIL YOU SAVE it Ili, C �� - I {�'� f \- ,,:a/1-If ,, ' 41 V 1 .� /, t I �`:I-1 I t f. (_ F2, t..�i c — J l,/ Yr t , --r s Cyr , • ;.l �'/ CH { , /a ,\./() V� t , t, ( c' I — — Cllr _11 <,C I 111-61 IV\ e_o► . C.,1&'1k..A;0tV_7 TiO R .1'1'1 /VT— .c,(-_ , re:0 -- - 1, V . i A- E Frvi 07' A 1--- C CV- Ni k G'T l•_1 �,I ∎5E , L ►/t..A( ft'�,."",y"` - -- - 1)oV N e /=1'`�6i/✓'1 iv (k A�i%; (2 f`; ',:44 j -t L. -F.t e 11) r 0 C Hy t....J4.''.d- '41 - RECOMMENDATIONS SAVE MONEY WITH OUR ADVANTAGE PLAN'"! t — 1_-. 1, 1._�` / 1 t!' I Al - i i s.' -,��ti' .,+ I t ;,!! tn. J Approved U Declined 'j ,. 1 cl c, b. c' ) :�, JA roved J Declined �—— t — �� t, t. . I 1 1 ry y r i t 1't PP 11 r_� 7,0 114 S , ;i J Approved J Declined $ Acceptance of work performed:I find the serf, - . -a1r performed&installed have been completed in accordance with this Advantage a �� agreement.I agree to pay reasonable eft& f-:5,... 4. tees and court costs in the event of legal action pursuant to collection Plan — I $ _ -- (/ Never an overtime charge! of amount due. ! SUB TOTAL $ -- `�'' 24 Hours a Day •7 Days a Week Customer Signature X_-_ . ( - --- ----- --- - ----- 1--- - I n TAX $ MrRooter.com I do hereby state that the above work has been done in a workmanlike manner and to applicable codes. 1 t /-„, I v Independently owned&operated. / �/ --�- --- TOTAL $ Technician Si nature)' �--- ._. _ - Truck#-- L. •a se . . rcli ,; , _IBL..‘4.. iit''t � i4 ., .r, '+. - i. ^ r 13966 1 70 .` .^ # p 31C L.- _ t• - J ,� » : E •1 r •, Cr) llJ - �� I .- �r � — — '�' � � r ,�,��a �. ' lo =� 0086 - �,� -. . - r 2 M ._ , :i -•. t ZR -' S 5 02 0125 ■ Di a:-18" 020090 -- 5 020124 :w � 1160142 11 fir._ .s ,".", C C C N A ,'? 5 T '- —; 1 B o 1'91. . i ,-- (It CI- . I f - 1 : u p ., I ,4----. , -. 11 1 air I _ r 9 tea, $,1 i, D B t1 y0 _ , 1 �' i t l � I ; .. r- 't FO, . _ J , i I. Y s�` t'`�''.4 F 1 wltr O 'kl f H �) „ ,,ft a , tt r •#S• I1.1 - F _� 9520 a 9628 9571 • -� '�. ,. )011111.11.11,. , �— Fr 52 9530 .� r x . 9 • ,. 4:..,/...9 ' L - J. t ' 005 it) t [i+ a ` . iiii , .1. ......--4--. . Ja. . ),.. - 4 ., ,, ',14T q ,,, li.--_."16.401,..,_ 4ittlit , 0..t , LA rf ,,,4 1 TT - M 1r' ±. - r 1 36 r • N p !� '35n:1120 Pell P , _ + .• " • . 1 {Al • ! . 1•1re a n .1 — y�J1 4 1 TAN -",' . .-*Si- ,,- . ...17.11, , . �_ 4 , ; z• i f . . V 1-ir . _ • " 1. �� I. 1 I ri c 95 13 r I /1► 1 • -- 1 evil 7r -. a•• i- _ �'. t 9747 to t ��. � l ■ jr-�� r y 7k JJ gr� •5 *� [w 14U 77 w/ - , an / ',�,. 1 7.7 .L.' �' 7w.-.. f 1 1 Ma r f i- 4e ,,-- Feet f + itok a,r .r 4 .9 7 547 » 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 14030 SW 97TH AVE, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical ﬁnal PASS MST2015-00032 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 14030 SW 97TH AVE, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal FAIL MST2015-00032 David Young Insulate all water lines in crawl space unconditioned space. Calk or seal base of tub in upper level main bath. Provide lawn irrigation back ﬂow permit and ﬁnal inspection with approved test report. 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 14030 SW 97TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2015-00032 David Young Plumbing ﬁnal corrections not done for upper level main bath tub. Permit and inspection not done for lawn irrigation Backﬂow devise. After corrections complete, recall plumbing and building ﬁnal inspections and plumbing ﬁnal for Backﬂow devise after permit is issued. Provide city required documents at ﬁnal inspection including street tree certiﬁcation, moisture content form, high efﬁciency lighting form, duct seal test report for ductwork in crawl space, and insulation certiﬁcation. 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 14030 SW 97TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection FAIL MST2015-00032 David Young Plumbing ﬁnal corrections not done for upper level main bath tub. Permit and inspection not done for lawn irrigation Backﬂow devise. After corrections complete, recall plumbing and building ﬁnal inspections and plumbing ﬁnal for Backﬂow devise after permit is issued. Provide city required documents at ﬁnal inspection including street tree certiﬁcation, moisture content form, high efﬁciency lighting form, duct seal test report for ductwork in crawl space, and insulation certiﬁcation. 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 14030 SW 97TH AVE, TIGARD, OR, 97224 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2015-00032 David Young Plumbing ﬁnal for Backﬂow devise 3/4" Wilkins model 950xltz serial # 3916513 located left front yard. Other corrections complete. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 14030 SW 97TH AVE, TIGARD, OR, 97224 Residential - Master Permit 299 Final inspection PASS - C of O MST2015-00032 David Young Final erosion control approved. No street tree required per planning. Moisture content form received. High efﬁciency lighting form received. Duct seal test report checked. Insulation certiﬁcation checked. C of O left on site with contractor. Violation Summary: Inspector Contractor Electrical Permit Appiicat' FOR OFFICE(SF.O\I1 City of Tigard CEIVED Rec�tf DmcBy �� /� (ij i' /'Jl._.1C-'l '_I C t-�. 4 IIII 13125 SW Hall Blvd.,Tigard,OR 97?73,r, A 2015�� plan Review (liner Permit g. Phone: 503.718.2439 Fax: 503.598 b Dat&By t t t A Ft I) Inspection Line: 503.639.4175 p late Ready:By lens ( $ See Pagel for ' Internet www.tinard-or,gov CITY OF TIGARD Notifiedr:Atethod 1 Supplemental information tt TypAtUitridt3-t Ur/ISiON PLAN REVIEW IrNew construction ❑Addition:alteration replacement Please check all that seer.(submit j sets of plans w naps checked below i. D Service or feeder 400 amps or more ❑Building over three stories ❑ Demolition ❑Other: where the available fault current ❑Manilas and boatyards i CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 wits or ❑Floating buildings. i 7 less to ground,or exceeds 14,000 ❑Commerctal•use agncathural 1 ❑ I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building amps for all other installations buildings I ❑Multi-family ❑Master builder ❑Other: 0 Fire pump ❑installation of 150 K's'A or i 0 Emergency system. larger separately derived system 1 . JOB SITE INFORMATiON AND LOCATION O Addition of new motor load of ❑"A"."E"'."1.2",'t-3", Job no.: Job site address: ‘4030 S> 'C 1 A4 3ix or or more. occupancy. S. D Six or more residential ants 0 Recreational vehicle parks City/State/SIP D Hcalth-care facilities. 0 Supply voltage for more than � � Q� D Hazardous locations 600 volts nom mat. Suite/bldg./apt.no.: 1 Project name: D Service or feeder 600 amps or more FEE SCHEDULE Cross street directions to job site: description I Qes. I Fee. I Total I - ' 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'l 500 sq 0 or portion 33 92 I Tax map parcel no.: Limited energy,residential DESCRIPTION OF WORK (,with above sq ft) 75 00 2 Limited energy,multi-family 1 5\ y` 04f-C residential(with above sq ft) _ 7500 1 _ , 11/� _ /� 1 Renewable Energy D See Page 2 A, V f0J d� ��7-- /en c . L—L'N C/ e'/C i Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 100 70 2 1 201 amps to 400 amps 133 56 1 2 Name: ` 401 amps to 600 amps ! +Op;; � Address: 601 amps to 1.000 amps 30104 Over 1.000 amps or volts 552 26 1 2 2 City /Stater'Zi1': Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:t ) relocation 200)amps or less 59 36 1 1 Owner installation:This installation is being made on property that I own which is not t 201 amps to 400 amps l25 OS 1 2 intended for sale.lease,rent,or exchange,according to ORS 447,449.670,and 701. e R 401 amps to 509 amps 16fi 54 f 2 Owner signature: __Date: Branch circuits-new,alteration,or extension,per panel APPLICANT 1 ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, }` Business name: each branch circuit - B.Fee for branch circuits without Contact name: service or feeder fee,first 56 18 branch circuit - Address: Each add'I branch circuit 742 i 2 - s Miscellaneous(service or feeder not included) City:$talc%ZII: • faeh manufactured or modular dwelling,service and or feeder 67 84 I 2 I Phone:( ) }"ax :( ) Reconnect only j} 67 84 Tt , 1• E-mail: Pump or irrigation circle ! 67 84 2 CONTRACTOR Sign or outline lighting } 67 84 - 2 Business name:pQ ,u .� , c `� Signal ctrcuitts i or limited-energ_i 1 Page 3 t panel,atteranRti,or extension Page 2 1 1 i Address: 4�t\Q ` �c - t Each additional inspection over i sable in any of the above __....._ Additional inspection i 1 hr mini 66 25'hr City/State/ZIP: \oC�C\u. -1+ 1 _.► 2185.,' A t lnvesu uon t t hr mm? 66 hr x Phone ( ) i tax:( t G t 1 industnal plant t 1 lir min) ..- 78 hr gcr1 kAs-37 - t inspections for which no fee is �� CCB t,ic.: Electrical Lic,: Suprv.I.ic.: ' specifically listed(',i hr mint 90 00-hr ' T 2C 1� C , IT p 5 3Q 1 ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: L 1,.x31 "- Subtotal _armor Plan review(25%o£permit fee) Print name:��, C�. �' , a,r,f fit law et. i.te: Z Jr i € .�rtt�s. - State surcharge(12%of permit fee). Authorized signature: TOTAL PERMIT FEE Se,v This permit application expires if a permit is not obtained within ISO Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit I tiltuddrnglPmnits sEi.C..PrnnirApp_Et.R,..ERE doe Rev OS/2 r:a t 3 440.161 ST(I IiewO%twE6