Permit 114 -- 111 CITY OF TIGARD MASTER PERMIT
3 COMMUNITY DEVELOPMENT Permit#: MST2016-00037
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2016
Parcel: 2S103BB11700
Jurisdiction: Tigard
Site address: 12160 SW ANN PL
Subdivision: YE-OLDE WINDMILL Lot: 36
Project: Travis
Project Description: Update master bath and convert attic space into habitable loft area. Trade work under separate
permits.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 235 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 235 sf Value: $25,000.00 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
1 ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 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-3 235
Owner: Contractor:
TRAVIS,CRAIG B&TANAE T&R CONSTRUCTION LLC Required Items and Reports(Conditions)
12160 SW ANN PL PO BOX 2356
TIGARD,OR 97223 TUALATIN,OR 97062 -
PHONE 406-544-6750 PHONE: 480-332-8243
FAX:
Total Fees: $1,120.49
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
d . ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52-001-0010 through••R 9 '01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.234.
ssued By: / / Permittee Signature: =/ /23�_%.
Call 503.639.4175 by 7:00 a.m.for the next available inspection.ate.
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.
Residential RECEIVE C
11
ived !
Permit No
City of Tigard 1 D,teiey: z/.2s /0 , /IST�O%4_ --0. 001 2_i
� • 13125 SW Hall Blvd.,Tigard,OR 97223 r-- ��-- —
FEB 2 2 2016 /
Phone: 503 inn: 439 Fax: 503.598.1960 ', Plan Review 3 /# j H Other Permit:
II t ,A t<t) Inspection Line: 503.639.4175 ' Date BY' _- - -----f
interne. www tiaard-nraov CITY OF TIGARI
BUILDING DIVISION- - - ---------
TYPE OF WORK ; Print name!9(....er_ Mesh
_ _ I1
New construction I Demolition REQUIRED DATA:1-AND 2-FAMILY DWELLING
Addition/alteration/replacement Other: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION
_ _-_- _-, equipment,materials,labor,overhead,and the profit for the
1-and 2-family dwelling X j Commercial/industrial work indicated on this application.
Accessory building Multi-family Valuation: S ;
Master builder Other: Number of bedrooms:
JOB SITE INFORMATION AND LOCATION
Number of bathrooms:
Job site address: iTotal
— — — ;�-��.0 SW._-14,J1_. -
--- -- -- Total number of floors:
--77=G New dwelling area: Z 5
square feetSuite/bldg./apt.no.: Project name: tJJ "?%__ l^�cr
•
Cross street/directions to job site: Garage/carport area: square feet
S� r
/ Al�taZ /�V v.T ; - Covered porch area: square feet
lr Deck area: square feet
Subdivision: Lot no.: Other structure area: square feet
Tax map/parcel no.:
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
DESCRIPTION OF WORK
Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all ,
1.As-r€ ?crri-1 .,.At%. cD _._ i,equipment,materials,labor,overhead,and the profit for the
/� ',work indicated on this application.
l..oJJE -f - ;-r-r=L S?i4[-EZ.�-rt- — —_ —
Valuation: S
A Lc) -r
PROPERTY OWNER TENANT Existing building area: square feet •
Name: _ .L M.tAE = CAE-As.0-t It Jz$ .__.---- : New building area: square feet
Address: I Z 1(00 Su.) AJJ---?l . _-- Number of stories:
City/State/ZIP:
TzGAe.Q Oc_ CIL - - — —
F---------- -1 •- Type of construction: i
Phone:('104d 544 - ,1'5O. . Fax_( _
APPLICANT CONTACT PERSON • Occupancy groups:
; Business name: "„ /1 Existing:
Contact name: - "LEE_ New:
Address: ? i BUILDING PERMIT FEES
Sox 540
70.
---__.__.--- 3 .._._._._ _..----- ---------- ------------' (Please refer to fee schedule)
City/State/ZIP:
Phone:(y 'O) 332- 82(f 3 il Fax::( ) Structural plan review fee(or deposit):
E mail: 01 05LEI GL+ G G 2_i,.._. C C yy1 FLS plan review fee(if applicable):
I
CONTRACTOR Total fees due upon application: I .
1 Business name: I
---_--- SAtMEASA1QVE..-- -------- --- 1 Amount received: ; � Q
Address:
— —-__-- -- - PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
City/State/ZIP:
t ---------\----- -- T — — --- -- _' ' Commercial and residential prescriptive installation of
II Phone:( Fax:( ) 4 1 roof-top mounted PhotoVoltaic Solar Panel System.
LCCB1iCLJ_1Jy1.! ��� Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
Authorized signature: -- — —-
_.- --
I:\Building\Permits\BUP-RE rmitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
FOR OFFICE USE ONLY–SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project. ,
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: [Bw� DATE tic >�Cn
DEPT: BUILDING DIVISION Ci.A
JUN 1 2016
CITY OF TIGARD
( FROM: ecAivz /-4crit2C r� BUILDING DIVISION
COMPANY: -7--- 4 ��,S�uGT-io.J
PHONE: 3(0 ?p(._ Li/go11
By.
RE: 9-11aO ��A� kJ /4- H5� X37
(Site Address) (Permit Number
------1-14v/3
(Project name or subdivision name and lot numbe
/
ATTACHED ARE THE FOLLOWING ITE
Copies: Description: / / Copies: Description:
Additional set(s) of dans. Revisions:
Cross section(s) . . details. Wall bracing and/or lateral analysis.
Floor/roof frami,g. Basement and retaining walls.
Beam calculati.ns. Engineer's calculations.
Other(expl.', :
REMARKS: o-ea
b
r A6.-/- \
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: , J ,a.. / ) c Initials:
Fees Due: [a Yes No Fee Description: Amount ue:
/ $
i $
$ _
Special
Instructions:
Reprint Permit(per PE): ❑ Yes 'No ❑ Done
Applicant Notified: Date: Initials:
1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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
12160 SW ANN PL, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00037
Jeff Grove
Violation Summary:
Inspector Contractor