Permit (12) 1111111
,� CITY OF TIGARD MASTER PERMIT
`"7 I° - COMMUNITY DEVELOPMENT Permit#: MST2016 00061
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/03/2016
Parcel: 2S104CD10200
Jurisdiction: Tigard
Site address: 13611 SW TRACY PL
Subdivision: HILLSHIRE ESTATES NO.2 Lot: 101
Project: Cerbone
Project Description: Accessibility retrofits,widening doorways, moving door, new platform entry from garage, &new
pantry. Trades under separate permit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $54,000.00 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
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 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 Srvc/Feeders 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: 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:
ALT SF VB R-3 0
Owner: Contractor:
CERBONE,ROBERT REVOCABLE LIVINROBERT J DOMZALSKI Required Items and Reports(Conditions)
13611 SW TRACY PL 8933 SW WOLDS DR
TIGARD,OR 97223 BEAVERTON,OR 97007
PHONE: 503-590-9300 PHONE: 503-349-6332
FAX: 503-746-4459
Total Fees: $1,350.94
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. • NTIO : 4 -.on la equires you to follow the rules adopted by the Oregon Utility Notificatio Center. Those rules are set forth in OAR
95 -001-0010 through OAR • -001-.091 You may obtain a copy of the rules or direct questions to OUNC by calling 50 '32.1987 or 1.800.332.2344.
.sued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspec io 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.
L
Building Permit Application
Residential RECEIVED I Olt (►I I I( I I tii ()NI l
Received 'd9 / ' H /6 erin6/
DaCity of Tigard Rece/Bived
, Permit No.:
4 13125 SW Hall Blvd.,Tigard,OR 972V B 2 9 2016 Plan R '
:1111 I Phone: 503.718.2439 Fax: 503.598.1 Date/B : Other Permit:
1i , .k t\11 Inspection Line: 503.639.4175Cg r, J Date Ready/By: rod ®
+ See Page 2 for
Internet: www.tigard-or.gov i�� (N.--
'y i i�� F� Notified/Method: 0� Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Et Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ $t{ e o 0
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: (3 (o l S14.1 -r i Lip P L Ai.LC New dwelling area: 0 square feet
City/State/ZIP: "In 4 4 ...0, e 1Z t{I vi 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: LER.Q o N C (i;,E7.1 o\/lT1 es 4 Covered porch area: p square feet
Cross street/directions to job site: Deck area: Q square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: R 2 0 91 p(.4( equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
A CSL SS 1 131t-t r y ca..a-fltai.F 11-S : w tv a:-l•l t Al Ea 'aoe(L.S t Valuation: S
/An V t N k p ootZ, w arst�.� AD RY E Z, SO/K t IP I,,,P.-r- (L,p,l Existing building area: square feet
62 e--N"My , N w P ac'-TR..'f t P-e-13 LA c-E i-y ia, w/t(-IoWlg. New building area: square feet
p$PROPERTY OWNER 1----1-3 TENANT Number of stories:
Name: (Z o 6 IT T GE14.60 N-E Type of construction:
Address: i3 6 L( SW -T zAc._%t ?i...44,C-1E Occupancy groups:
City/State/ZIP: '1-1 Cq At27, o 12_`i.7 2 2 3 Existing:
Phone:(433) S'9.O- cc3d0 Fax:( ) _ New:
(,1�t APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedules
Business name: C,o Iok itk•(,t N t Tom'L'rri'R.-E. I.AJ C-- Structural plan review fee(or deposit):
Contact name: -r A-Z Lao M.A Ai S
Address: FLS plan review fee(if applicable):
84o se- , L.pm-R. 5-r.
City/State/ZIP: pp(L-n_46,.p O t o(L 9 121 Total fees due upon application:
Phone:(503) 230- 1 2.C(-S Fax::( )
Amount received: D'zig3,72-
E-mail: t 0.-z. e.. L.,t.uwcv,I.;._¢. -ri ye_, et e.-t" PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel S -m.
Business name: ?„,,o *' Submit two -is of roof plan with cl ection details
and fire departmen • cess,alo . • the 2010 Oregon
Address: --61 33 5 W 1401_05 ,tZ Solar Installation Spec• , "ode checklist. 1
City/State/ZIP: Se/Wig-2-n,Iv, O K T7007 Permit Fee(', review $180.00
administrativ ):
Phone:(5o3) 34/ — 00, 1//332 Fax:( ) State•, charge(12%of permit fee . $21.60
CCB lie.: 7 G( 6 70)/Vii
` //i Total fee due upon application: $201.60
Authorized signature: / This permit application expires if a permit is not ob ed
within 180 days after it has been accepted as complete.
Print name: T i . Lb 6•, - j'u Date: 02.21.U IC *Fee methodology set by Tri-County Building Industry
t Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/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
13611 SW TRACY PL, TIGARD, OR, 97223
Residential - Master Permit
399 Plumbing final
FAIL
July 12, 2016 at 11:32:10 AM
MST2016-00061
David Young
Plumbing final inspection scheduled on wrong permit, no plumbing on this permit.
Plumbing final to be scheduled on permit PLM2016-00279.
All else ok.
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
13611 SW TRACY PL, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
July 12, 2016 at 11:36:19 AM
MST2016-00061
David Young
Final inspections for separate trade permits to be scheduled on correct permits for trade
contractors. This MST permit does not include plumbing and electrical work.
Add bath fan to permit and change venting to 4" hard pipe or 5" flex.
Fix step in garage over 8" in height.
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
13611 SW TRACY PL, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
FAIL
July 12, 2016 at 11:35:11 AM
MST2016-00061
David Young
Electrical final inspection to be scheduled on correct permit, no electrical on this permit.
Electrical final to be scheduled on permit ELC2016-00293.
Outlet by garage sink to GFCI protected in garage.
Laundry outlets ok per rough in approval for moving existing outlets.
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
13611 SW TRACY PL, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00061
Chip Barnett
Previous corrections have been completed.
Violation Summary:
Inspector Contractor