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Permit ,, CITY OF TIGARD ` MASTER PERMIT 1 *-a - COMMUNITY DEVELOPMENT 1, • Permit#: MST2015-00141 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t A� Date Issued: 10/06/2015 Parcel: 1 S 136 DD07601 Jurisdiction: Tigard Site address: 11905 SW 69TH AVE Subdivision: WEST PORTLAND HEIGHTS Lot: 36 Project: Parsa LLC Project Description: Remodel 1st floor, add 623 sq ft 2nd story master suite,enclose existing garage and add 200 sq ft, and add new 384 sq ft attached garage. Enclosed garage for residential use only per planning BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 3 Second: 623 sf Garage: 584 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 623 sf Value: $95,485.67 Rear: 0 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 0 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 3 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 1 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: 1 0-200 amp: 0 W/Svc or Fdr: 16 Ea add'I 500 sf: 0 201-400 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+a mp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Ecom asin N Other: N Other Description: P 9 BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 623 Owner: Contractor: PARSA LLC WESTERN OREGON BUILDERS Required Items and Reports(Conditions) 1510 6TH ST PO BOX 90220 1 Ersn Cntrl 503-639-4175 WEST LINN,OR 97068 PORTLAND,OR 97290 PHONE: PHONE: 503-381-5708 FAX: Total Fees: $3,974.25 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 Cen r. Those rules are et forth in OAR 952-001-0010 thro R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 32 87 or 1.800.332.2.44. ` Issued By: 'ttee Signature: C 9.4175 by 7:00 a.m.for the next available inspectio 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. MASTER PERMIT II n CITY OF TIGARD ° COMMUNITY DEVELOPMENT f Permit#: MST2015-00141 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ErM� Date Issued: 10/06/2015 / Parcel: 1S136DD07601 Jurisdiction: Tigard Site address: 11905 SW 69TH AVE Subdivision: WEST PORTLAND HEIGHTS Lot: 36 Project: Parsa LLC Project Description: Remodel 1st floor, add 623 sq ft 2nd story master suite, enclose existing garage and add 200 sq ft, and add new 384 sq ft attached garage. Enclosed garage for residential use only per planning BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 3 Second: 623 sf Garage: 584 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 623 sf Value: $95,485.67 Rear: 0 PLUMBING Sinks: 0 Water Closets: 3 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 3 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: Y Vent Fans: 3 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 1 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: 1 0-200 amp: 0 W/Svc or Fdr: 8 Ea add9 500 sf: 0 201-400 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. N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 623 Owner: Contractor: PARSA LLC WESTERN OREGON BUILDERS Required Items and Reports(Conditions) 1510 6TH ST PO BOX 90220 1 Ersn Cntrl 503-639-4175 WEST LINN,OR 97068 PORTLAND,OR 97290 PHONE: PHONE: 503-381-5708 FAX: Total Fees: $3,655.58 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 through OAR 952-001-0090. You may obtain a co y of the r or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 7 L�_ –—,■�_ _ �� Permittee Signature: — �/`,-____ / Call 503. 411"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. CITY OF TIGARD MASTER PERMIT 11111 - . COMMUNITY DEVELOPMENT Permit#: MST2015 00141 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/06/2015 Parcel: 1S136DD07601 Jurisdiction: Tigard Site address: 11905 SW 69TH AVE Subdivision: WEST PORTLAND HEIGHTS Lot: 36 Project: Parsa LLC Project Description: Remodel 1st floor, add 623 sq ft 2nd story master suite,enclose existing garage and add 200 sq ft, and add new 384 sq ft attached garage. Enclosed garage for residential use only per planning BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 3 Second: 623 sf Garage: 584 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total, 623 sf Value: $95,485.67 Rear: 0 PLUMBING Sinks: 0 Water Closets: 3 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 3 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: Y Vent Fans: 3 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 1 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: 1 0-200 amp: 0 W/Svc or Fdr: 8 Ea adds 500 sf: 0 201-400 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+a m p/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-3 623 Owner: Contractor: PARSA LLC WESTERN OREGON BUILDERS Required Items and Reports(Conditions) 1510 6TH ST PO BOX 90220 WEST LINN,OR 97068 PORTLAND,OR 97290 PHONE: PHONE: 503-381-5708 FAX: Total Fees: $3,655.58 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 Ce r. Those rules are t forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtai a copy of the rules or••ect questions to OUNC by calling 503.232 987 or 1.800.332.2344 Issued Bys is.a+ ( q Permittee Signature: a 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. 6 Build�:n2 Permit Application i iti I tdential 1 t1�11)1 11( I. I "I O\I.1 t City of Tigard RDeacetemived: O y(©mom Permit No.:H) ,c o/%' Ili---- 13125 SW Hall Blvd.,Tigard,OR 9722 I I r 3 2015 Plan Review r Phone: 503.718.2439 Fax: 503.598.10 a Date/By: ,. ' 1 d 2/5 (" Other Permit: Inspection Line: 503.639.4175 Date Ready/By: Qb.41(3-6-7- Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIC�ARD Notified/Method: I Supplemental Information BUILDING; DIVISION ❑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,overh- and - profit for the work indicated on this applicatio ' "'' 4' Valuatir. . $ -�� 7 ® 1-and 2-family dwelling ❑Commercial/industrial • r s . / ' _ n� ❑Accessory building q��''f•m. r. r@(droo ` •' ❑Multi-family ❑Master builder ❑Other: Number of bathrooms: V ai 5...r------ - - JOB SITE IN TION AND LOCATION . Total number of floors: S•a 3 Job site address: J yU W 41' V s' ling area: square fe � / City/State/ZIP: AkJ a( 97 3 /4• arage/carport area: sy square feet ist.g.pA+• Suite/bldg./apt.no.: Project name: A D R t 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. 1 Valuation: $ ' / • • of 6T R y ii Nob / --c�x,2 `� ►4D� N �.�� . �F • ANt. 4 A SG, FOt 1(i'� Existing building area square feet C0/4//16-72.7- '/,6,w 9 7_ c //249-/3/779-494e j-Je ft 6New building area: square feet :0 PROPERTY OWNER I 1;1 TEN `l re 'umber of stories: Name: FARsA LL c -0KA26nk t< 144 Nu- --t}-Mpe2t c 5AIA2i t=\ Type of construction: Address:/5/c) 6) 112 S.-free 7 Occupancy groups: City/State/ZIP: (A)LS L/ NM, V t lI0 0 Existing: hone:(cup 79 y_ 3ti5 I Fax:( ) New: "a, ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* 1 Business name: SG,_, ?,_ ,z _ ti'_a Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): 4 Address: City/State/ZIP: Total fees due upon application: ' Phone:( ) Fax: :( ) Amount received: /63 L.9 S E-mail: Commercial and residential prescriptive installation of CONTRACTOR coo op mounted Photovoltaic Solar Panel System. '' Business namb: .W��f�� 6/2_,E-60/6 • (L b c-iej Submi o(2)sets of roof plan with connection details and fire de. ent access,along with the 2010 Oregon Address: PO 'Poo oo x 90 8,..9-0 Solar Installatr.•Specialty Code checkli Permit Fee i udes plan rev' City/State/ZIP: P02fGW IJ� ne. 97 a9U $180.00 3 and adm - • fees): Phone:(6j4'�j) -?j$I—570$ .: Fax:( ) State o of pe ••t fee): $21.60 CCB licZo �'�3 / 4 Total fee due upon applicatio` $201.60 Authorized signature / This permit application expires if a permit is ,t obtained within 180 days after it has been accepted as co I . ete. Print name: Date: •Fee methodology set by Tri-County Building Industry L Service Board I:Building lPermitslBUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) , Building Permit Application Checklist '` One- and Two-Family Dwelling FOR 01.4 Iti: 1 s1: o\l.l '' ` ` City of Tigard Received Permit No.: Ipt13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ■ Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical I Ike A I'D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1 e No v.* 1 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,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore.on and shall be shown to be a.p licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 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. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB) A Oct 06 15 04:34p LD Electric LLC 503-658-1681 p.2 CITY CF TIGARD PAGE 01/01 '0/0/06/2015 03:11 5035981960 r r A . •Electirical Permit Applicatt L EIVEP {.� /� ) Received PnrnitIt: /5i I5-00/9) City ofTi�ard ALA D,,,s,•• 7j I, ,l. y I d 125 SW Hall Blvil..Tigard,OR 97tiW G 3 20 15 I'Int1 Review kcinted Permit n: Phone: 503.710,2439 Fax: 503.598.1960 De e/By• h re: ®See rage 2(M S Rtady Oalc/By: rage 2 tafntwalloa inspection Line: 501-639.417. C'�'�/0��',�JA� Notifief/Method: j Supplemental Interact: www tipord•or.gnv rr L . r r:✓ rrsv - -% .r.- '• Phrcheckn71trIavP1Y( .-t.e6ofelrna+.litemichocked): 0 New construction ei Additicmielterannnlrcpltaeomcnt ❑Service or feeder 400 amp%or more ❑Bailain>ever three e+mim. Demolition Q Other: where the avallibk NOV.corral []Marina•and bollyards. `.-:_ ._ -.h.•.,_,: : .• ,'.-• emceed%1r.090 am1+%a1150 volt.%or ❑Floating tw iltliape.• Its%ur ground,rw c%ttula 1 1_100 ❑('nnxserc',skew agriculture! gl I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building n,rps tor or other inFm.,t%liO n• tui11inro- ❑Other: OEM orm r, O rnrtmimion n-F 10 K VA or ❑M ulti-family ❑Minter builder 71 - iL:�. ,• ' 'a n i t ° ❑Emergenc eyMetn. {r e r sco mretNy d*vcd ❑Adii:ionorncs•mem load<4 rytmem, TOT- 5.0 60 '1�f 1 f0HP or wort. ..A. _r- ••1.7.. ..t l.. Job p Job site address: 7 nec�q.rtcr. � ❑Slx or mare rc<idcmtrinl rata. ❑Rtt��rl vclick parks. City/StatelzlP:�/ Ale ❑rkaldm•crc E,ciliriex. ❑Hnrmnlous lecrtitnx. ❑StMPn'reap for more t'unR SviLdbId$.rapt #: Project name: ,11 J 600 vnitr iromiivml. ❑rrnwvi o feeder mm9 RtrrpF�mn atorc. Crass strc+Vdirl:ctions to job •'f5 Fits": ^�'_','<;. :- ::'2r. site: �` 14 ( t Tee y. ItIrlLYfp 11M Now rtsldentioi hurls-or multi-family dwclliug nail. { LM k: Includesattnehcd totratc. Subdivision: 1.000 Rt.1t.nT Ic%s 168.54 4 Tax mop/parcel#: For 3dd•1500 W.R.or portion 33.92 i r^• •:n,r-.-r:' •"': :i V -`yw RA c - . :?':'c',',.,".:'.' ;."-;;:: i.imitcx1 en rAv.rct 4o it l 75.00 1 2 1 ► d.� rQ /`!'d�f L ��%^ 1�W02 A'3. Limited energy.multi-remily 7540 2 'n iesidcntiol,with above sq.ii.) _ R'r1rr4C14-'Ev) ea �' . :,. . _ Renewable Enerp�v CI Sec rage 2 ::. `) V1r=: "'"`r;-''-• Service%arfeeders InetallatiognIreratlow�ansfor relocatiow aine.`� ze'M fVAD QI k 0,4122,'C SAIAez ig 2(0%tars 01.1m4 ` 100.70 NameA fti5 A. 133.56 or r, r :rS 231 amps to 400 mama Address;/ JO W S-i 7+ 4111 salsa In(i0amps 2)0. 2 r . ' r7 601 amps to 1.000 amps 3QL.04 ' 2 City/State/DP: L(l 6,5T Lo rfnl IP 1 7o 10 Over I,OW tarp%cr volts I i 552.26 2 Phone:L(j3)?q,r 3Lf , i Fax: ) Temporary services or ftkden installation.alteration.and/or Email: XQ^/A/q�!'/"(.,:e. e tJ✓►'t relecation or IG%s 1 59.36 I I Owner installation:This installation is being made on property that I own which is not r 200 amps 125.08 '' intended for sale,lease.rent.or exchange.according to ORS 447,449.670.and 701. 201 amps io 400 amp } 125.0R il 2 Owner signature: Date; 401 crepe to 599 amp% 1 {_ ,•q I Branch circuits-new.alleratio or extension,ecr pond -.•'.r:.y.:.. . •�yt��.atr� ..r,+.<+r:•- .:r•• • ., ' 1 „ ;• :•:�_.,;;,..: ., �-:.:.•:?c...... .. . .� I A.I�KfWbrancheileullatrllb 7 2 BMW novice or fewer tee, 4 2 Business name: ��,� � T catch branch vacua Contact name' B.Fee for hands circuits wiihmu service or focdm fee,fire 56.1R 2 Address: t,rondt Nrcuil e 1 Each add')branch circuit 1 3 7.42 1 , 2, City/Stitt/ZIP: Miicellnneous(service or feeder not included) Phone:( ) Fax:.( ) Each=nurscturcd or Itn(lulpr 67.44 2 dwelling,Ircrvweand/or feeder Email Rcoonoct only 67.84 2 ::4 r.:_ - :. - .. . .._ _-- - . .. .-. - Pump to in igatinn Nrc<L 07.114 2 y Y':-i-;= 67.84 2 Business name: //^! ^' 4x_ outline lighting 4 �- r[ Si nsI circuit(%)or limited-mercy I I Q . Mi7 x / �� panel,alteration,or extension. 0 Sco?saez i. JJ Address: x 6 �� O/� Each adrRUoaa[inspection over allowable In Ray of the above City/StateiZlP: Mdllmonolinspection(Ihrmin) 66-75!In - ! 9(1-t10!hr /hone:(503) d— J jc S'> ' Fax:( 3 ) ratr- rb9I lnvtslitalinn(1 hr min) LL �tndustriul plant(1 hr min) 78.15/hr j Email: 'Inspections fbr which no fce it 90.OW hr CC) Lie.: /65V/7 I Electrical Lie.:,26,-/b7gcf Suprv.Lie.: etfiffy5 slfoeificellY limed tA.hvmin) •" Su7rv.Electrician signature.required: , ./, +�� SubloLnl: Print name: Q Date:#lc_ CI Pica Review Required(I5%c+f pant fcc): l`�� y l� .1 -/ Sgtcsltrrharge(1Z6/nQ:-ptrmitfee): V TOTAL PERMIT LEE: Author-1=d signature: 1 Mb peralH agptltslisn raplm If s permh is notnbtnincY wSlhin ten Print name: I Date: ` rbpw O W It Dm l>ren aeteyttd in rnmpkr•• I ' Number fi mom irmsnllowedccr remit . I,^.RplAlinorpmiu'•CLC Purni+nrn_F:4a ER Enrt Ra•nc:17-:011 4.151,151(1 RIltgY)Mewrn mechaicannitAliciaEcEIVED FOR OFFICE USE ONLY it 'Cl of Tigard nn Received (j I Permit No.: / 1": „..)// `/ '� ■ 13125 SW Hal Blvd.,Tigard,OR 9721?3UG 3 2015 Date/By: 0 . 2 174 a/Y -. - Plan Review Other Permit: • Phone: 503.718.2439 Fax: 503.5 6 Date/By:TIGARD Inspection Line: 503.639.4175 p 1 OF TIGARD Date Ready/By: Juris ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information 111,111.111.11.1k 1111=111111111111MMINEIN Mechanical permit fees'are based on the value of the work ❑New construction gi.Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ .1-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 Heating/cooling: Air con d Job site address: L190_5 5 . 6 9 7 A V E itioning / 46.75 (ducts/vents)) Furnace 100,000 BTU 46.75 City/State/ZIP A/ea, V 2 1`7 2-3 Furnace 100,000+BTU(ducts/vents) 54.91 ,� j Heat pump 61.06 Suite/bldg./apt.no.: I Project name: l A D ieT 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 Other: 23.32 Subdivision: I Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORKAMMIE Gas fireplace/insert 33.39 �7 c., / Flue vent for water heater or gas �-D a A`�o2ra 2.y NOS`.L_ 1:1 r-e_.00 C `'L. �b� fireplace , 23.32 Log lighter(gas) 23.32 4-�� 4rr4e ti CDC Wood/pellet stove 33.39 Wood fireplace/insert , 23.32 Chimney/liner/flue/vent . 23.32 ❑ PROPE•'d Other: 23.32 Environmental exhaust and ventilation: Name:''j�2S A L L C.�WA Zt :M V A 9 eJ-t MA2 2.4 S,q(Are ir= Range hood/other kitchen Address:/+c/0 k'th 54-reht ()WIW/f equipment Clothes dryer exhaust 33.39 City/State/ZIP: W Eicc ).i NA', Oe / 70 6? Single-duct exhaust(bathrooms, 2 toilet compartments,utility rooms) . J 23.32 Phone:j)3 ) 71 9.-3J../5- ( Fax:( ) Attic/crawlspace fans 23.32 i Other: 23.32 Fuel piping: Business name: 4 v aS c L $14.15 for first four;$4.03 for each additional Contact name: �J11'� Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) I Fax::( ) Fireplace Range E-mail: Barbecue Clothes dryer(gas) 'Business name: Other: GL"--ktrdi .,t.. __Cc c Address: / ..X n ,� Subtotal City/State/ZIP: / Minimum permit fee($90.00) fir-/ `�',4 C aje q—id-go o Plan review(25%of permit fee) Phone:(V3 ) 35 i _ 5---7,0 Q Fax:( ) State surcharge(12%of permit fee) CCB lie.: faia / TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: Thi• Fee methodology set by Tri-County Building Industry Service Board Print name: Date: I1Building\PermitAMEC_PennitApp_040113.doc 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information • Commercial& Multi-Famil Fee Schedule: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 Plu.nbing Permit Application Euilding Fixtures Il RECEi\!f E FOR OFFICE USE ONLY City of Tigard Received c 2 Date/By: O J �5 • ° Permit No.: G�i l.5-1.1 / / N 13125 SW Hall Blvd.,Tigard,OR 97 {3i C 3 2015 Plan Review . Phone: 503.718.2439 Fax: 503.59 g��to Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 n Date Ready/By: ]aria: WI See Page 2 for Internet: www.tigard-or.gov CITY OF TIG �rD Notified/Method: Supplemental Information ❑ Ncxc construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total cl Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGOR SFR(1)bath 312.70 ® 1-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 Site utilities: Job site address: /LD S, i I I Catch basin or area drain 18.76 y ,�// , got/ ^,,p 3 Drywell,leach line,or trench drain 18.76 City/State/ZIP: V!� V 4` - Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: ,c}1)2r Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 / Clothes washer 25.02 AbD a- TV2 / kfv D€ /� LC eZ *'T A D _ Dishwasher 25.02 ‘1- I A-Q40,E . Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I•/' aA❑ TENANT Expansion tank 12.51 Name: -FAK5R )--Lc- 0(426//0.46 Aoaa.t AAe2I sRM421 a Fixture/sewer cap 25.02 Address/5/0 6 fh 5.1-reef 0 W Al erf Floor drain/floor sink/hub 25.02 I , Garbage disposal 25.02 U City/State/ZIP: e 5)- J- i/A) O- 9 70 6,8 Hose bib 25.02 Phone:(-57.3 ) P7l77€7 /-f '-, ) Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Sat,,>z J. 4 tcnJ"L Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory "Ai/ 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 CONTRACTOR Water heater 00 37.52 Business name: /1 �L U�)lJr/n, . L� Water piping/DWV it 56.29 Address: / Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: h r-7;0 Plu in ic.no.: - Plan review (25%of permit fee) ir-U State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE t Print name: 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. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbin>s 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-1st 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 _ Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for •>ther n i eC 4115 O t each additional$100.00 or fraction thereof,to 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 char_e-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 char_e-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 chaz_e 1/2 hour each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall 12 New exterior plumbing site utilities for any complex structure Drive Stall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Sery/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 I a City of Tigard r COMMUNITY DEVELOPMENT DEPARTMENT ■ T 1 G A R D Building Permit Review — Residential Building Permit #: \�jT" 5=60 lL1 Site Address: li105 (.5('3 (o 61-r"`- P' - Project Name: airir; )60-10,6e- Lot #: (New dwelling— subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: I1,-ci i-42%o,O — 1 cLrot_e c V ■ f' rs+ •l o o r o.' cj V/v■r19 o rc 0-' o e Se co-a s.4-1, r , .'Verify site address/suite#exists and active in permit system. )River Terrace Neighborhood: ❑ Yes A'No Site Plan Elements: Three(3) copies of site plan 34Existing structures on site [$site plan must ht on 8-1/2"x 11"or 11 x 17"paper ktFootprint of new structure(including decks)with finished ,'brawn to scale(standard architect or engineer scale) floor elevations .North arrow I'tJtility locations(required for new,may apply for additions) Fite address,project or subdivision name and lot number Location of wells/septic systems ❑Applicant information(name and phone number) Xrosion control(including drainage-way protection,silt fence tot dimensions and building setback dimensions design,location of catch basin,etc.) ,ii Lot area,building coverage area,percentage of coverage and Street names impervious area(applicable if R-7,R-12,R-25&R-40) 0'►5 treet tree size,type and location CI Property corner elevations(2 foot contour lines if more than xisting trees to be retained with drip line,and tree 4 foot differential) protection measures Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: .&Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No K. Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified AtI No Applied For: ❑ Yes ❑ No,stop intake AT Land Use Case#: N I R LV- Zoning: 4u..E l Setbacks: Front — Rear Side Street Side Garage Landscape Requirement: % t Lot Coverage Maximum: X Building Height: Maximum Height 445 Actual Height X54-0 'Visual Clearance .x-Easements gr Sensitive Lands: ❑ Yes ir-No Type Nlt) 'Urban Forestry Plan Conditions "Met"prior to issuance of building permit I/ Notes: Approved By Planning: e """4,. a - eC`v'... Date: e -3- 15 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Building\Fonns\B1dgPennitRvw_RES_070915.docx Building Permit Submittals g 22 Original Submittal Date: e // Site Plans: # Building Plans: # _ Building Permit#: , Enter building permit#above. Workflow Routing: .r Planning Engineering Permit Coordinator ilding Workflow Sign-off: EI S' -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. Building: original permit application, site plans, building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technicia : reWe Date: � / Engineering Review / [2.'..-lope r S at building pad: l 2"Conditions "Met"prior to(issuance of building permit .Easements (encroachments) per engineering conditions of approval and plat [;?"\x'ater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ErNo Assess Water Quantity Fee in-lieu: ❑ Yes Q�No LIDA Facility on lot: ❑ Yes CYi\lo ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: Date: 13-5'- i r 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 ❑ Conditions "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: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A Led by Permit Coordinator: + Date: 0.../S- 1:\Bui l ding\Fonns\B1dgPennitRvw_RES_070915.docx 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 11905 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 120 Electrical rough-in FAIL MST2015-00141 Herb Stabenow Add outlets at:upstairs hallway, left of ﬁre place(ﬂoor plug) add nail plates forSE cable in future shop Violation Summary: Inspector Contractor CITY OF TIGARD MASTER PERMIT 1 • COMMUNITY DEVELOPMENT ` I.111 Permit#: MST2015-00141 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 r j Date Issued: 10/06/2015 TIGARD 9 a Ito3 Parcel: 1 S136DD07601 Jurisdiction: Tigard Site address: 11905 SW 69TH AVE Subdivision: WEST PORTLAND HEIGHTS Lot: 36 Project: Parsa LLC Project Description: Remodel 1st floor, add 623 sq ft 2nd story master suite,enclose existing garage and add 200 sq ft, and add new 384 sq ft attached garage. Enclosed garage for residential use only per planning BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 3 Second: 623 sf Garage: 584 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 623 sf Value: $95,485.67 Rear: 0 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 3 Garbage Disp: 0 Water Heaters: 0 Water Lines: 100 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: Y Vent Fans: 3 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 1 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: 1 0-200 amp: 0 W/Svc or Fdr: 16 Ea add9 500 sf: 0 201-400 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 623 Owner: Contractor: PARSA LLC WESTERN OREGON BUILDERS Required Items and Reports(Conditions) 1510 6TH ST PO BOX 90220 1 Ersn Cntrl 503-639-4175 WEST LINN,OR 97068 PORTLAND,OR 97290 PHONE: PHONE: 503-381-5708 FAX: Total Fees: $3,848.15 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••R 952-001-0090. Y•• - =- '••••'•• ••y o - .es or direct questions to OUNC by calling 503.2 2. .:7 or 1.800.332.2344. 1.011°F Issued By: _ `liL �� Per - ignature: / _ C.'4'''�9.4175 by 7:00 a.m.for the next available inspecti• date. r 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. 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 11905 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS MST2015-00141 Chip Barnett Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11905 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - No C of O MST2015-00141 Chip Barnett Previous corrections completed 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 11905 SW 69TH AVE, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal FAIL MST2015-00141 Herb Stabenow Locked no access. Violation Summary: Inspector Contractor Plumbing Permit Application • Building Fixtures RE EI ED FOR 011.1(.1, 1_1:1,i_ O\l.l City of Tigard ticcived Permit No.: M �I �Ql7I Dat:iyeMY: /G� ii, v 13125 SW Ball 131vd.,Tigard,OR MA 1 92016 Plan Review ' Phone: 503.718.2439 Fax: 503.598 1960 Other Permit No.; ' Date/13 Inspection Line: 503-639-417C1_'�! I F TI. ARD Date Read By': 6A See:Pa e 2 for TiGARID et' w��vtl ardoC Y S Internet: g g. , Notifred/Metliod: Su kmental information r a., ;rInter e Rr,`Y,:,?�d-orr,l;.,, .,,.,-,.-,,.97.-,-;-,-,,,,7,.;, ,•ally? ., r ,,.'. ,rr57 .+.y-.i r^^rr�^,.mow ,, . ,,,. r °.'C x ,,, ,,.;77 7PC ,. 2,: ` ?W wi.,T; If .:?.c,�..�.., r ?..,..G,,, r . 1?,- .r.S,,i ,,�,.+ , . i J [;;,,f,{ :4 'I, hilt, y ;!: '7 I,'' 1""`{t r N :( , 1 t t..4. VV!,tis.li {,.tly,tr;f rc�7:::.i .*,y rl r Y,. �y,,. ti ,f ]...1:if• t 1,,.::_•G,rf ..1.1�::, ,fm ir G 1 i- J11� rt .N R s}-,-..::.!--...;.:,..,,,,,,;',-1,..;.i.,4„.. . .- f.°�+-- �: ,I,:,,1 r" ?.:.:.1 a F 1 t t •1 td `p. .,,.} !•{Tw 1;� :,,z..,? P{ {.b,lid. } '1 :rrwq�t:rf_i,l:.�,. ;'.:la i�{h:..:s�}:,-,.:,,,,,11..,,,,,,i .m r:Z.aa;",,rr. :..,,-. . �: .. ,o>(]., ❑New construction LI Detnoli on For special information use checklist �D ption -1 Qty. I Ea, f Total ❑Addition/alteration/replacement `1 Other: {New 1-2-family dwellings(includes 100 ft.for each utility connection) �""}}1 r Y7"CM r rv "L"'9Tf,4 fir `-{' , "lf 1P k'f{r1[}j rA 1 4i):1:,,'tl l a r X11 9 � N001 ?``�71, 11 a�(Q�M(I ��1 11 t{ll/ k 1i''ffV.dr� fi.,�lllr+....r,.{q • �.SF (1)bath 312.70 ' .,,: ',.+1„ l 1...! ,.,r Z.,:il...wt?.,01 Fd, 1•lt....;2.e C- L,i 1,.G; .,:''°t P ., .r.'.tf,?a.,J +L fd:,G...... .},, 1111-and 2-family dwelling Q Comm tial/industrial SFR(2)bath 437.78 _LSFR(3)bath 500.32 ❑Accessory building [l Multi-f,, .ly additional NM 25.02 1 ❑Master builder ❑Other !Fire sinkler( bat�sq°ft) I= Page 2 "t'rs ° �}., mr r i1 ,+ y(d ur'{Nrf? 2'},g 1 aK F`�`'f' iii' , ,11 "''',','"I''' w {�$tI l `'iii!'{ 1 ,I 11,{�y Y1 � 4� . ti'vrvri: �li: r' n�9 =,,, }1..511,.:r,'++(}rl ,{' {t{t,,+,H{.}{tr(r3 ]: eutilities: Et;l1'.1:::1s'a.;1.{. ntr.i;, t il;� ,1; s-- ,,,,,,r ...,,...... , .l,.Mr,,a:l..}.I l„1,.Y uc Catch basin or area drain 18.76 1 Job site address; _J 'q0 5(J (,q i Drywell,leach line,or trench drain ? 18.76 City/State/ZIP: 'i c-a,,,o ©R 7p'.3 Footing drain(no.linear ft.:___) Page 2 1 Suite/bldg./apt.no.: Project name: L. L.. 1 Manufactured home utilities 50.03 _ { Cross street/directions to job site: Manholes _ 18.76 j j Rain drain connector 18.76 7 Sanitary sewer(no,linear ft.: ) Page 2 'I `� Storm sewer(no.linear ft.:__) Page 2 _ f ;Water service(no.linear ft.:.y.._) ] Page 2 U .;571 Subdivision: L Lot Po.: ?Fixture or item: Tax map/parcel ne.: ;Backflow preventer - 31.27 _ 7rt ` c 7 t: � �' Backwater w .` " rP 'cwl4 :':3rF} } 1f ; 'r.$ 1 4!y r+1s } F} ' : r1fr .l 1 1 ;. i Clothes washer 25.02 A DP TC) /3e trri i+.Ai - / !Dishwasher 25.02 /l1 s T,)/S"_ O 019 / / j Drinking fountain 25.02 1 Ejectors/sump 25.02 I yil 1 i Expansion tank 12.51 Name: , Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/Z1P: i Hose bib 25.02 i{1 • :.. ,. .. J ' Ice maker 12.51Phone:( ) Fax ¢) 25.02F , 4,, e".41,11CC4i yTr ►1' ntor/greae trap rr 'd( ?Y .! ,,,,tTT$M> J lltrr Ct1 ;'f} f7}1Fi :A. NK { V.1r,il11s'''.t+ ` p1 sur 4,11Ste} 'li f"kal{ !1i (71tf r{ fLL�Ill�T"Vit? d4 (.,i,^ rtrJ! , 11 Business name: d n1 G Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: *A A Fe * $ rRoofdrain(commercial) 12.51 Address: C � 150 34. Sire S . , I ( y PP ^ Sink/basin/lavatory 25.02 "� I,ra City/State/.ZIP: A C I1 . C A, 1 D P" 7D J Solar units(potable water) 62.54 Phone:603) (,57-5375 Fidx..6-.m ) p-•78'31 Tub/shower/shower pan 12.51 + ( Urinal • E-mail: 25.02 5,,l 1 • la• AA' I C ....1 ... ft � .�.,,„..„,,,,F.,,,,,,;,:,dt+ . Water closet _ 2 5.02 , a t {l L7 lit{f+'iix F''nfqv I?,f I; e { ;i ' it!r tnl I T ' 1',al � tIr+{ri?n ),i1 t -, -!'.' ',',, ,.,� re,•!-!::'::.14,17.„.:, , IY1 .t. u i" ,w` r., :.i 1._,..1:� .;,...1.;‘Lr,J;ni,i[ ...:,.,i. . ,.,,.,4, Water heater 37.52 Business name: i n Water piping/DWV 56.29 il Address: Other: 25.02 City/State/Z1P: I Subtota Phone:( ) Pax:( ) Minimum permit fee: $72.50l ! / , CC13 Lie_: p i g 79 Illumbing Lic.no-d/b-Ll7 05 -� Plan review (25%of permit fee) State surcharge(12%of permit fee . 7-1 �. Authorized signature: cY�'v TOTAL PERMIT FEE' This permit application expires if a permit is not able,ed wi In 180 days Print name: T'i'm FGt pater_S...1 _ - after it has bees accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. ~ I t1Suitding\Perrnits1PLrvtU•PermilA.pp.roe 10/01/09 1 440.46167(10/02/COhiV0n) j 1 i Plumbing Permit Application]- Ci of Tigard I Page 2 - Supplemental Informatioa 1 f Fee Schedule: Residential Fire Su t e ression S stems: '" R.772 r t r7Ohl 1' EIS{ 7 1,ry�[1 1 ' ' i 1 fi rlt:7 1 r1 {,•fr Y' ' -, . d rt'1 rrrtr"ir'. f �I�,f f/"'.: rt r f` ;,rT'�n7:.'4. f',0 �f h t , rF .'il, € r �� i t l l;r:�r 1 i I r r Pr 1EL{; ,.,.,t. ,:.,, .....,� ,..� + _,._,w.a,,. .,.,,. t '......,,� i ....,nail„r. JI ._.l.n...,a. 7 � Footing drain-1"100' 50.03 0 to 2.00t $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer 1st 100' 62.54 3,601 to 7.200 $233.20 7 2�Tg�reater _ $327.54 _ Sewer-each additional 100' 37.52 ��''if Water Service-1st 100' / 62.54 j Medial Gas S stems: Water Service-each additional 100' .� 37.52 j ! ''t 1 } " 1 )1r i f "�f "`c rf 1' 7 gipl S,N 1 1r1� J [ tr ,nIEI IPy . Qa �r ' -,". IlV! } pit Storm&Rain Drain-1st 100' 62.5.1 �., .. ,. „n {.. l... ... n. t_.,.,. L tri, ,a . . . ,,. w.... $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain additional adonal 100 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for f4" ,t'Xlrtlf I^ •'re�4E ,7,77,!=c r r' ,"f,ri F � :: r 1 i r�'1 illi r w 1TI1 Y i;�. 1 each additional$100.00 Or fraction thereof,to _ti>Irl 11 r r w1tl Nt. ?1. 1., ._ ' .r„ It. .. t;C1.,,,,tCc,.._ytln,.r, •tl,, ,l.,r ,({. ' and including$10,000.00. Inspection of-existing plumbing or for I $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 90.001hr 1 each additional$100.00 or fraction thereof,to {minimum charge-1/2 hour) I and including$25,000.00. Inspections outside of normal business j 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) I each additional$100.00 or fraction thereof,to Reinspection Fees 90.00ihr j and including$50,000.00. Additional plan review fbr revisions 90.00(hr $50,0040 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) I f each additional$100.00 or fraction thereof; Subtotal: I 1 AmP � � Commercial Fixture Work: j Are you capping,adding or replacing fixtures? If`yes", I please indicate work performed by fxtut,a Failure ailure to . ' * acuratelyreport fixtnre9 could result inincreased sewer fees . - , .�. G,'A'n44 ! ^rl1 AYi Q 3i:i nliYV1 27 � EV' r : i 'f .. r} 7'i•}yvIt TEl �� ^ , x, rr-v•r1.,uim ,..r�c�^.+rte� �.r ' ;^ , ,TY01 ',1,4� 14.', 1,E - rgct $Ti r }: «i';,,_.,Si!:,0) r'.,ti + ._ _cif: . Ir ._ . ,,.! , }r,.,,, .r .:, .:: , ^,1P::I , T :.ara l , r 'ry innrl4 l''r{ c., plan eview is required for anyof the following. ,i3, m- 7 ,,, ti f ,,i l ,L71g riNi �k Baptistry/Font Pleascheck all that apply. '}t{ ElBath Tub/Shower Any new commercial building with water service 2"and -Jacuzzi/Whirlpool I greater,except systems designed and stamped by licensed Car Wash -Each Stall Igineer. Drive Thru J CI New exterior plumbing site utilities for any complex structure Cuspidor/Water Airator 4s defined in OAR918-780-0040. Dishwasher -Commercial I .. CIMedical gas and vacuum systems for health care facilities. -Domestic I' CI Any multipurpose fire sprinkler system. Drinking Fountain - 0 .any complex structure as defined in OAR918-780-0040. Eye Wash - I Floor Drain/sink -2" y Submit 2 sets of plans with any of the above. r ..n"1 ,rv� 7777 r i t i rmw7 rr7:9,77^P-m 1 fi�, r r + >, 4>, E N :: ,1 '� �. E 1 I IE i1, 9 t r i, � ` ,_.�l E!,r �, .E + s E r^ il 1,.2 `, �1.1,.M i_...:�wG'..:,f. f1 1 ll „l Car Wash Drain T Garbage Domestic-non-food food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related ; that meet the .ualifications above. -Commercial-food related , _ -Industrial-food related _ Ice Mach,/Refrig.Drains oil Separator(Gas Station) - _ T Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang I,J e-�?�� -Stall Sink/Lav -Non-food related -Bradley MSTCSQ/c- LN 1t.'/ / -Commercial-food related f ! -Service , Swimming Fool Filter k Washer Clothes Note: If the fixture work under this permit results in an Water Extractor _ 1 w increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet i fees assessed for the sewer increase must be paid before the Urinalplumbing permit can be issued. Other Fixtures: i C:\Users\OwnerlDocuznents\Tigard Plmb_PerMitApp.doc 2