Permit q CITY OF TIGARD MASTER PERMIT
;'�! 3 COMMUNITY DEVELOPMENT Permit#: MST2015 00023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2015
Parcel: 2S103DB03500
Jurisdiction: Tigard
Site address: 11270 SW QUELLE PL
Subdivision: GENESIS NO.2 Lot: 33
Project: Haglund
Project Description: Repair of tree strike damage.
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: $40,000.00 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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel 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 SrvclFeeders 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:
ALT SF VB R-3 0
Owner: Contractor:
HAGLUND,LINN G AND DEBRA M ALPENGLOW CONSTRUCTION CO Required Items and Reports(Conditions)
11270 QUELLE CT 8105 SW 71ST AVE
TIGARD,OR 97223 PORTLAND,OR
PHONE: PHONE 503-793-3866
FAX: 503-245-7765
Total Fees: $1,162.99
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 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_a r direct questions to OUNC by calling 503.232.1967 or 1.800.332.2344.
Issued By: Lr-�` _ _�_sue - Permittee Signature:
-. ' ..39.4175 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.
Building Permit Application
Residential RECEIVED I•OI2()Hi( I. I til t)\I.1
City of Tigard Received
Permit •', �+ , (J )
C� p 2015 DateB : Z 01111 /�5/Oe��� -d v�
13125 SW Hall Blvd.,Tigard,OR 972123-8 2 3 Plan Revs- 'WI �
Ill Phone: 503.718.2439 Fax: 503.598.1960 Date/B . Other Permit:
F I G AR ll Inspection Line: 503.639.4175 CITY OF TIGARD Date Rely: Juni.: la See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
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
%k ❑Other: equipment,materials,labor,overhea., . d the rofit for the
CATEGORY OF CONSTRUCTION work indicated on this application. / & .,1
l-
and 2-family dwelling Valuation: $ , ;/ 1f 0
y g ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I 1 Z 7 a `)W atA e 1(i► P/J New dwelling area: square feet
City/State/ZIP: IN 1, 14 01 01 7 z z- 3 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: 1u, Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
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 all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: S
ottli.)CL.4..11.‘
c ___ �✓t J o...w.D-t�Q_ .
Existing building area square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: L,j'I• n 4- (S?1�„7 H05 !0 n el Type of construction:
Address: �� 4*C Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
[APPLICANT L CONTACT PERSON BUILDING PERMIT FEES*
Business name: ( (Please refer to fee schedst&)
11 t 05 ii0�' CO V144- Structural plan review fee(or deposit):
Contact name: L. k� L.L H f.t/�
FLS plan review fee(if applicable):
Address: 0 1 0C. S 1, A,-•C
Total fees due upon application:
City/State/ZIP: /y
Phone:(� -7 G Fa ( ) vJ 7 Z Z Amount received: 4'j.2�,, n 7
E-mail: b 0 L IJk,t l l 0,1 e v_11 vt ® tAAS yl- c o 1-1^ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installat't of
CONTRACTOR roof-to. ounted Photo Voltaic Solar Panel •stem.
Business name: Submit two sets of roof plan with c.• ection details
�� r� �� 5 and fire departm 't access,along .•t the 2010 Oregon
Address: Solar Installation Sp• 'ally C.•e checklist.
City/State/ZIP: Permit Fee(inclum•• 'Ian review $180.00
and ad' nistr.: e fees):
Phone:( ) Fax:( )
State surch. :, .- (12%of permit - $21.60
z
CCB lic.: «t 93 104!1
otat fee due upon application: $201.60
Authorized • `� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print n ' Date: *Fee methodology set by Tri-County Building Industry
Service Board
1:\Buil ding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
Received
II City of Tigard Permit r,,
13125 SW Hall Blvd.,Ti ard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
1IGARD
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE RFOl IRFI) FOR PLAN REVIEW les No N/A
1 Land use actions completed. Sec 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 .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 Ion and shall be shown to be applicable to the rro'ect under review.
.Il RItiI)I('TIO\AI. 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"building_plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
vt
Electrical Permit Application C �` I tliz (H 1 i( I. t SI 0.N1.1
City of Tigard �� Received
hr tip 3 DateB : 2 -Z 3 -I ' e Permit No.
IPII :
13125 SW Hall Blvd.,Tigard,OR 97223 16
a Phone: 503.718.2439 Fax: 503.598.1960 MPR i OWer Permit•
T 1( A R I) Inspection Line: 503.639.4175 V l` 11V n I ,- 'eady/By: hurt: El See Page 2 for
Internet: www.tigard or,gov i��1 V� `,1 A�_ d/Metbod: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ®Addition/alteration/r acement Please check all that apply(submit2 sets of plans Wheats checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ®Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of
hOOliP or more.
Job no.: Job site address: 11270 SW Quelle PI. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 0 Health-care facilities. ❑Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: Net Sl a rid ❑Service or feeder 600 amps or more.
Cross street/directions to job site: J FEE SCHEDULE
) Description I Qty. I Fa. 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'l 500 sq.ft.or portion 33.92
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
Single circuit for new garage door opener. residential(with above sq.ft.)
Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
0 PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:Linn&Debby Haglund 401 amps to 600 amps 200.34 2
Address: 11270 SW Quelle Pl. 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:Tigard,OR 97223 Temporary services or feeders Installation,alteration,and/or
Phone:( ) I 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,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
0 APPLICANT I ❑ CONTACT PERSON A.Fce for branch circuits with
above service or feeder fee,
7.42 2
Business name:Red's Electric each branch circuit
B.Fee for branch circuits without
Contact name:Rhonda Durham . service or feeder fee,first
branch circuit 56.18 2
Address:6336 SE 107th Ave. Each add'!branch circuit 7.42 2
City/State/ZIP:Portland,OR 97266 Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Phone:(503)233-6467 Fax::(503)233-1281 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:rhonda@redselectric.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business Red's Electric name:R ' E1 rI Signal circuit(s)or limited-energy See
panel,alteration,or extension. _ Page 2 2
Address:6336 SE 107th Ave. Each additional Inspection over allowable in any of the above
City/State/ZIP:Portland,OR 97266 Additional inspection(I hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(503)233-6467 I Fax:(503)233-1281 Industrial plant(1 hr min) . 78.18/hr
Inspections for which no fee is 40.00/hr
CCB Lic.: 4443 I Electrical Lie.: 26-152C I Suprv.Lie.: 5010S specifically listed(V:hr min)
ELECTRICAL PER
Suprv.Electrician signature,required; PERMIT FEES
Subtotal:
Print name: Jim Ferris Date: 02/26/15 Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: Jim Ferris I Date 02/26/15 This permit application expires If a permit Is not obtained uithln 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I'Buitdmeermits'ELC_PermilApp ELR ERE.doe Rev 0521/2013 440-615T(1t.05■COat'WEB
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
11270 SW QUELLE PL, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00023
Jeff Grove
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
11270 SW QUELLE PL, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
PASS
MST2015-00023
Jeff Grove
Violation Summary:
Inspector Contractor