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Permit q CITY OF TIGARD MASTER PERMIT III s - COMMUNITY DEVELOPMENT Permit#: MST2015-00029 T {�A R E 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ' Date Issued: 03/16/2015 f 1 Parcel: 1 S125DB08700 wagsJurisdiction: Tigard Site address: 7167 SW LOLA LN Subdivision: RAZBERRY PATCH,THE Lot: 7 Project: Sorenson Project Description: Addition to rear of house for master bedroom/bath expansion. 6/8/15: Reprinted permit to show change of plumbing contractor from MP Plumbing to Artisan Plumbing. BUILDING Floor Areas R equired Setbacks Required Stories: 0 Bedrooms: 0 First 300 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Yes Total: 300 sf Value: $50,000.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 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 add'500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 4 Mid 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-3 300 Owner: Contractor: SORENSEN,RONALD B&BARBARA A ROSE CITY MAINTENANCE&REMODELING Required Items and Reports(Conditions) 7167 SW LOLA LN 1104 SE 148TH TIGARD,OR 97223 PORTLAND,OR 97280 PHONE: 503-475-2430 PHONE: 503-519-8193 FAX: Total Fees: $2,009.35 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 da . • ' suance, or if wo is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati• C-n -r. h e rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obt ' opy of questions to OUNC by •fling 503 0 1 98 or 1.8( 332.2344. Issued By: — .— Permittee Signature: il' Call 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. Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY 114 City of Tigard ; ,Ni . i Received Permit No.. 13125 SW Hall Blvd.,'1'igazd,OR ' +� �1►-�� Date/By: c�l 'Z�f S l9tSC7 Plan Review Phone: 503.718.2439 Fax: 503.5' '.I Date/By: Other Permit Na.: TI G A R U Inspection Line: 503.639.4175 F1 151 Date Ready/By: Juris: See Page 2 for Internet: www.tigard-or.gov 'D Notified/Method: Supplemental Information TYPE OF WO' FFE* SCHEDULE j ecial in For special information use checklist ❑New construction Iii Demolition - W p Description I Qty- I Ea. I Total• �Addition/alteration/replacement [1]Othet�V'• New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTI SFR(1)bath 312.70 -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: L 67 $ coo. t, Catch basin or area drain 18.76 City/State/ZIP: 6� 1 Drywell,leach line,or trench drain 18.76 S`� Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: 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 1 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: 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:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 •ONTRACTOR Water heater 37.52 Business name: A R ` T I S'tt^ p L,1,,w L i r Waterpiping/DWV 56.29 Address: i 223 S Se 19 R., Other: 25.02 City/State/ZIP: J•C�( , e ' Subtotal Phone:( Su3) 4:3- Fax:( ) Minimum permit fee: $72.50 CCB Lie.: i SCra 6 Plumbing Lic.no.: 3bec; P3 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: i q?1,5 TOTAL PERMIT FEE Print name c J'� CI p(a.:_y� Date: 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 4404616T(I0/02/COM/WEB) 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-1°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:. kermlt Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum Ice 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 aOther Inspections or Fees Qty. 'Tile ea) Total each additional$100.00 or fraction thereof,to Inspections 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 Plumbin 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 -Jacuzzi/Whirlpool engineer. -Each Stall ❑ New exterior plumbing site utilities for any complex structure Car Wash: 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" (1; 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the .ualifications 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 EDU5,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:\BuildingWermits\PLMF_PermitApp.doc 08/04/2011 2 ri CITY OF TIGARD MASTER PERMIT II I • COMMUNITY DEVELOPMENT Permit#: MST2015-00029 T I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2015 Parcel: 1 S125DB08700 Jurisdiction: Tigard Site address: 7167 SW LOLA LN Subdivision: RAZBERRY PATCH,THE Lot: 7 Project: Sorenson Project Description: Addition to rear of house for master bedroom/bath expansion. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 300 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Yes Total: 300 sf Value: $50,000.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 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'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-3 300 Owner: Contractor: SORENSEN,RONALD B&BARBARA A ROSE CITY MAINTENANCE&REMODELING Required Items and Reports(Conditions) 7167 SW LOLA LN 1104 SE 148TH TIGARD,OR 97223 PORTLAND,OR 97280 PHONE: 503-475-2430 PHONE: 503-332-3796 FAX: 503-675-5281 I Total Fees: $1,964.35 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 through OAR 952-001-0090. You ma obtain a copy of t direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Qt�...� :is...— - Permittee Signature: — - Call 51 y5 by 7:00 a.m.for the next available inspection d. e. 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. , Baildint Permit Application}ECEIVEP Residential /� I (I I. ( I 11( I ( .I 11\I 1 Iii City of Tigard FEB 2 4 2015 DRea eeBed ;�it7�� 1)i oho!5' aq _ . 13125 SW Hall Blvd.,Tigard,OR 972z3.- Plan Re .*k ,� Phone: 503.718.2439 Fax: 503.598.19W Of I r, Date/B : e� G �.' z�l Other Permit: i i( K I� Inspection Line: 503.639.4175 Li V� 1 l�Alt� Date R kris ® See Page 2 for Internet: www.tigard-or.gov ��1iLDiNG DIVISION' Notified/Method: 3 57IY Supplemental Information 1gReA 1 '0 -+II-v.i 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. ® 1-and 2-family dwelling ❑Commercial/industrial Valuation: #50 1G ❑Accessory building ❑Multi-family Number of bedrooms: 3 ❑Master builder ❑Other: Number of bathrooms: 2 JOB SITE INFORMATION AND LOCATION Total number of floors: 1 Job site address: 7167 SW Lola Lane New dwelling area: 300 square feet City/State/ZIP:97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: O p..\ o.c p3 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. 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. Addition to rear of house for master bedroom/master bath expansion Valuation: $ Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:Ron&Barbara Sorensen Type of construction: Address:7167 SW Lola Lane Occupancy groups: City/State/ZIP:97223 Existing: Phone:(503)475 2430 Fax:( ) New: ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* Business name:The Design Department Inc. (Please refer fo fee scAredrrte) Structural plan review fee(or deposit): Contact name:Pat Sauer FLS plan review fee(if applicable): Address:PO Box 80065 Total fees due upon application: City/State/ZIP:Portland Or 97280I/74 1d . Phone:(503)332 3796 Fax: :(503)675 5281 Amount received: E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel Syste Business name:Rose City Maintenance&Remodeling Submit two 2)sets of roof plan with col., 'in details and fire dep: •I ent access, o abs I • I the 2010 Oregon Address: 1/tLl f_. /i18tZ1- Solar Installatio •ec • ode checklist. City/State/ZIP: 2 �.�j Permit F-> c I:• plan review $180.00 /T'�-t 7,4'Cii 7431 and administr. a fees): Phone:(56,3) cm- N 13 _ Fax:( ) S surcharge(12%of permit e • $21.60 CCB lic.: 7f 7 /7 IN 9 1 7(v Total fee due upon application: $201.60 Authorized signature: k/' , _. _ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1,4,-1— !t*c V4FL.R-- Date:0 2 - 1—5—' , �/ *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) t r Electrical Permit Application FOR OFFICE USE ON I ) City of Tigard RECEIVE l�cowed Date/By: Permit No.. _ " 13125 SW Hall Blvd..Tigard.OR 97223 y' M�o�191�-tj:1U�J 2015 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 MAR 16 Date/BY: Other Permit: TiGARD Inspection line: 503.639.4175 Date Ready/By: Innis: ® See Paget for Internet: www.ligard-or.gov CITY OF GAR®til- ed/Meilexl SuppknenlalInformation PLAN REVIEW_ TYPE OF woi$UILWING DIVISION ❑New construction ddilion/alleration/replacement Please check all that apply(submit 2 sets of plans w/itenn checked below): ❑Service or feeder 400 amps or more ❑Budding over three stories. ❑ I)enxllili(a1 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at ISO volts or ❑Floating buildings. -and 2-family dwelling In less to ground.or exceeds 14.000 ❑Commercial-use agricultural g ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑installation of ISO KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived system. ❑Addition of new motor load of ❑"A" "F"'I "I-3" Job no.: Job site address: L f I 1 ' 1 I(x1HP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:""'' -- 0 R 9 ) A ❑Heahh-care facilities. 0 Supply voltage for more than (`r-- S ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: 1 Project name: ❑service or feeder 600 amps or tool r• Cross street/directions to job site: FEE SCHEDULE Description I Qt,. I Fee I Taal I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1.000 sq.B.or less 168.54 4 Tax map/parcel no.: Ea.add.'5(1(1 sq.ft.or portion 33.92 I Limited energy.residential 75 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) I-Renewable Energy 0 See Page 2 -- Services or feeders installation,alteration,and/or relocation PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2 Name: 201 amps to 400 amps 133.56 2 r it, Sir e_k.) Stv■__ 401 amps to 600 amps 200.34 2 Address: 601 amps to 1.000 amps 301.04 2 City/State/ZIP: — Over 1.000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Phone:( ) i Fax:( ) relocation 200 Owner installation:This installation is being made on property that I own which is not 201 amps or less 59.36 I intended for sale,lease,rent,or exchange,according to ORS 447,449.670.and 701. 201 amps to 400 amps 125.08 _2 401 amps to 599 amps 168.54 2 Owner signature: _ Date: Branch circuits-new,alteration,or extension,per panel 0 APPLICANT J ❑ CONTACT PERSON A.Fee for branch circuits will, above service or feeder fee. Business name: each branch circuit 7.42 2 B.Fee for branch circuits wit/tout Costae Contact name: service or feeder fee.first t 56.18 branch circuit Address: Each addl 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 E-mail: Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name:C)r:Zes34—L E Pint, C Signal circuit(s)or limited-energy See _ panel.alteration.or extension. Page 2 _ 2 Address: 2 S �1 11(^ 3 Each additional inspection over allowable in any of the above City/State/ZIP: Q l ins Q 170E-0 Additional gati inspection(1 (I hr min) 66.25/hr L Yl�Y1 .IC`' Investigation(1 hr min) 66.25/hr Phone:(4.0 ) .- 3 , p,Jy p (t�p� •.�g"'$"'� Fax:(SI)3) 6 ! Industrial plant(1 hr min) 78.1 8/hr CCB Lic.: Inspections for which no fee is 9'732 i Electrical Lic.:�$ , rv.Lic,: s 90.00/hr S 7- l specifically listed(h hr min) Sups.Electrician signature,required: — / 1 ELECTRICAL PERMIT FEES R �/. ____._ Subtotal: Print name: —=�1e: 3^ I a�� Plan review(25%of permit fee): • • l —7 -� State surcharge(12%2 of permit fee): Authorized signature: -- TOTAL PERMIT FEE: Print Wattle; a This permit application expires if a permit is not obtained within 180 _ r A y Date: '3^T'2_,I S days after it has been accepted as complete. nuddmeUlrmgdla C'_I4TmNA1�1_I?Lk t tit:.tit Re,oV21TR1'"1J1} 1 Number of inspections allowed per permit. 441146 IST(1151e/((IM/WI:n Mechanical Permit Applical L l IV I P I ., („ , ,1 i I `I ()'l , City of Tigard Received Permit No" �( ys---n�a 9 ill 13125 SW Hall Blvd.,Tigard,OR 9727,3--- 111111 Plan Review Phone: 503.718.2439 Fax: 503.598.1460 �+ Date/By: Other Permit: I I t I A I,11 Inspection Line: 503.639.4175 Date Ready/By: turis: 0 See Page 2 for Internet: www.tigard-or.gov Cl'i''OF l'1VARL Notified/Method: Supplemental Information U . DTVIS�,DIVISION TYPE OF WORK RK COMMERCIAL FEE* SCHEDULE-USE CHECKLIST Mechanical permit fees*are based on the value of the work New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* JJ l-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling: _ Air conditioning 46.75 Job site address: 2-f La '(/v 1....0 L A. L ANA Furnace 100,000 BTU(ducts/vents) 46.75 . City/State/ZIP: —r ( D Q/7 q-y—Z z 3 Furnace 100,000+BTU(ducts/vents) 54.91 . Heat pump 61.06 Suite/bldg./apt.no.: 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: 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 1 "t- 3 c) ( , R r (Leo ut-, (14- 4c7`Dri—r j Q C7 fireplace 23.32 T Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 PROPERTY OWNER I ❑ TENANT Environmental exhaust and ventilation: Name: (7 c 6„�rl,,,,,-c ( ' ( Q 05 P„i Range hood/other kitchen equipment 33.39 Address: ..-- �- c c,.,, Lc -A-- L/--iv->t Clothes dryer exhaust 33.39 City/State/ZIP: —r—1 6l1 19 �� ( �Z Z 3 Single-duct exhaust(bathrooms, _ toilet compartments,utility rooms) / 23.32 Phone:($U 3 4- 4-5 2 4 3 U Fax:( ) Attic/crawlspace fans 23.32 � ] APPLICANT ❑ CONTACT PERSON Other: 23.32 r Fuel piping: / Business name: ,-----1,(0 p Q C( G Q/t C� 1 I 514.15 for first four;$4.03 for each additional Contact name: (F7' .-` Furnace,etc. Address: f7 L 2(">•<- e.1 Gas heat pump / Wall/suspended/unit heater • City/State/ZIP: f7o a 4/L_. C( d Water heater Phone:(l U 3 3 - 3 '6 Fax::( ) Fireplace • Range . E-mail: p 5 (1-4 Gi r__Qv-f 1 1,,tC Q ,Ac, f - 3 t(i ,CCti- Barbecue . CONTRACTOR Clothes dryer(gas) _ . Business name: /(/rta '-� /. Other: uA�- V /!. .S� u 0``L//L MECHANICAL PERMIT FEES* Address: //C 4j la /La Subtotal City/State/ZIP: A+„c>�� die Q ,3l Minimum permit fee($90.00) .A--;,-.4. Phone: Q ) /✓/, ' / I Fax:( ) Plan review(25%of permit fee) 3 5' - f/T 3 State surcharge(12%of permit fee) CCB lic.: /a--2, TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.'KJ- Authorized signature: GQ,t-L.A-^ * Fee methodology set by Tri-County Building Industry Service Board Print name: ?76,----1 Date: 61.` Z I./ / c I.l\Building\Pennits\MEC_PermitApp_0401 13 doe 440-4617T(1 I/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 Plumbing Permit Application \IV Building Fixtures !G�\ 0,�� FOR OFF I( I t �l ()N 1 , City of Tigard �i Rene"ea fi h' g 16�' Date/By: Permit No: o�U!S 13125 SW Ball Blvd.,'Tigard.OR 972uQ� j Plan Review Phone 503.718.2439 Fax: 503.598. !'��GP �� Other Permit No.: Inspection Line: 503.639.4175 Q ��s DateBy: G`� �� Date Ready/By. turfs B See Page 2 for Internet' www.tigard-or.gov A� Ncnified Method Supplemental Information TYPE OF W ` FEE* SCHEDULE ❑New construction ❑Demolition For special information use check list. Description 1 Qty. 1 Ea. I Total (I Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 1-and 2-family dwelling SFR(2)bath 437.78 g ❑Commercial/industrial ❑Accessory building SFR(3)bath 500.32 ry � ❑Multi-f'amay. Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: -1 , LD ,v, Catch basin or area drain 18.76 t�t -- City/State/ZIP: \ \ a X&. O� ct 1,c Dry ting rain(line,lior near trench drain Page 2 vl ex Footing drain(no.linear ft.: 1 Page 2 Suite/bldg./apt.no.: 1 Project name: k-f CM-1 ?Umr C.-u 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.: Backllow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 -7 i,.rf\W 0 KecCeCila. Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I Q TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: 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 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory a 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:1 ) Fax::( ) Tub/shower/shower pan t 12.51 E-mail: O`v,��+r�/i `C�{'` 7?tAl'yl∎i1(,}kt � Urinal 25.02 v` 1 CWIRACTOR •-.../ Water closet j 25.02 � Water heater 37.52 Business name: 1'� 1�>J\C(1 l Cr, Water piping/DW V 56.29 Address: ?ci ?TA. Other: 25.02 City/State/ZIP: c, CAP,._ `1 1 \c Subtotal Phone:(S,?)11I,Z_ (Lo` Fax:(S.::) (s�S-- 17 Z(i Minimum permit fee: $72.50 CCB Lie.: Seo� it PI bi, Lic.no.: .3 1- J�b Plan review (25/.of'permit fee) / +' State surcharge(12%of permit fee) Authorized signature: ' A A TOTAL PERMIT FEE Print name: t ,W r -c Date: r 1 f This permit application expires if a permit is not obtained within I80 days 1 after it has been accepted as complete. *Fee methodology set by To-County Building Industry Service Board I\Buildin gTermilsuPLMtU-PermitAppdue 10/01/09 440.4616T(I042/COM/WEB) . . 114 City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 G A R D Building Permit Review — Residential Building Permit #: M 'Tcv 15 - Coo a 9 Site Address: -71 (e 7 ii,o L, LA LIV. Project Name: -`7b n a c Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 302 . S Sy,k,Are 60+- ktor+t. old c&A tic n ❑ Verify site address/suite #exists and active in permit system. Site Plan Elements: EE three(3)copies of site plan l xisting structures on site r Site plan must be on 8-1/2"x 11"or 11 x 17"paper L ootprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations 0lorth arrow -BtJ lity locations(required for new,may apply for additions) G,�7'Site address,project or subdivision name and lot number ,`Location of wells/septic systems [ Applicant information(name and phone number) -Brrosion control(including drainage-way protection,silt fence of dimensions and building setback dimensions ��,,d��esign,location of catch basin,etc.) t area,building coverage area,percentage of coverage and treet names impervious area(applicable if R-7,R-12,R-25&R-40) --BSfreet tree size,type and location —IQ-Property corner elevations(2 foot contour lines if more than -BE usttng trees to be retained with drip line,and tree 4 foot differential) protection measures $Clean Water Services-Service Provider�Leper(lot platted prior to 9/10/1995): Required: El Yes,applicant was notified L� No Received: ❑ Yes ❑ No Q.1Ci i'vu.0 Nr.oUJ-2 ❑ Public Facilities Improvement(PFI)Permit: Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake ❑ Land Use Case#: Zoning: P-* 4.S / 7,500 0 Setbacks: Front 2....,0 a-Rear ( 5 Side S Street Side IS Garage V) C.41- • Landscape Requirement: —, Tot Coverage Maximum: Building Height: Maximum Height 3 0 G Actual Height ▪ Visual Clearance $Easements Sensitive Lands: ❑ Yes 2 No Type -2-Urban Forestry Plan -2-Conditions Met Notes: Approved By Planning: I/V7Ovl,i C-Fn_ (31 Go d_ _CA-L,.. Date: 2/2 c/ I S 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\BldgPemtitRvw_RES_020415.docx • Building Permit Submits Original Submittal Date: dt 5 S Site Plans: # 3 Building Plans: #E E� Building Permit#: nter building permit#above. Workflow Routing: -Er Planning laTngineering Et-Permit Coordinator Building Workflow Sign-off: Er-Sign-off for Planning(include notes from planning review) Route Application Documents: D'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Er-Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: s//5- Engineering Review El Actual Slope: ❑ Conditions Met ❑ Easements (encroachments) ❑ Water Quality/Quantity Facility: Assess Water Quality Fee: ❑ Yes ❑ No Assess Water Quantity Fee: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: Z •j,5 /c Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review JConditions Met-Prior to Issuance of Building Permit ❑ Approved,NOT Released: Date: 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: I ] OK to Issue Permit �1 Approved by Permit Coordinator: C)t.�'"Y" a. (mow Date: ?'d(o — (.5 L\Building\Forms\BI dgPerm itRvw_RES_020415.docx THE DEsiuN 1 F,CEtVEE DEPARTMENT (= :R 2 5 ?i`,`! PO Box 80065 Portland,Oregon 97280 CIP(01, 1 i( M4 ) O. (503) 332-3796 BUILDING niv1S O 13'-6" 54'-0" 12'-6" V 23'-9" 30'3" DOWNSPOUTS CONNECT TO EXISTING DRAINAGE DISPOSAL i - 80.00' - N- .4? RETAINING WALL(E) - O LINE OF 15 SETBACK _ ` - Q` I DECK �,/ �I ' Q o (E) i IL T PROPOSED 302.50 I I I SQUARE FOOT ADDITION 1 I EXISTING 1 S ORY HOGSE 11 DAYLIGHT GARAGE I I - (-.. _hs-'' . r ,_____ d _ h_. _ 1 - - - - = 1 DECK I (E) II I ` I = i DRIVEWAY (E) I - • z 4.) el cli, cl e SW LOLA LANE Ct : SITE PLAN fNN =i c t SCALE: 1"=30'my Ci/ i� COD 0 N CCS O � Eill Ci/ IIII City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7167 SW LOLA LN, TIGARD, OR, 97223 May 24, 2017 at 7:23:36 AM Record Type: Record ID: Residential - Master Permit MST2015-00029 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide approved plumbing, mechanical and electrical final inspections prior to building final inspection. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7167 SW LOLA LN, TIGARD, OR, 97223 May 25, 2017 at 10:20:06 AM Record Type: Record ID: Residential - Master Permit MST2015-00029 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7167 SW LOLA LN, TIGARD, OR, 97223 May 25, 2017 at 10:13:48 AM Record Type: Record ID: Residential - Master Permit MST2015-00029 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7167 SW LOLA LN, TIGARD, OR, 97223 May 26, 2017 at 7:18:50 AM Record Type: Record ID: Residential - Master Permit MST2015-00029 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - NoCofO Comments: Permanent step installed in master bedroom at egress window. Step to remain in place to meet egress requirements for sill height greater than 44". R310.1 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7167 SW LOLA LN, TIGARD, OR, 97223 May 25, 2017 at 10:15:30 AM Record Type: Record ID: Residential - Master Permit MST2015-00029 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor