Permit p CITY OF TIGARD MASTER PERMIT
'`7 M ' • COMMUNITY DEVELOPMENT Permit#: MST201600048
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/07/2016
Parcel: 2S112BD07600
Jurisdiction: Tigard
Site address: 7832 SW HANSEN LN
Subdivision: BRITTANY MEADOWS Lot: 12
Project: PLASTER
Project Description: Converting existing crawlspace to a bedroom and storage room.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 1 First 0 sf Basement: 312 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 310 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 312 sf Value: $20,000.00 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
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes 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 SrvcfFeeders 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: 3
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-3 312
Owner: Contractor:
PLASTER,KURT K&ALLISON R OWNER Required Items and Reports(Conditions)
7832 SW HANSEN LN KURT&ALLISON PLASTER
TIGARD,OR 97224 7832 SW HANSEN LN
TIGARD,OR 97224
PHONE: PHONE: 503-867-0278
FAX:
Total Fees: $1,577.64
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. Alt 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. ATT . Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001- 10 through OAR 001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503..232.1987�or11.800.332.2344.
Issue By: Permittee Signature: x'a 2f2A-Y , li14-'1(
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This pormit 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.
w
Building Permit Application
Residentialvic1/4)
City of Tigard Received 1
Date/By: 42 ilti A. — Permit No.:*„11S T",]-r',/6P"(ailyk
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ) j vw
11111 t; Phone: 503.718.2439 Fax: 503.598.1960 p /�16 Date/By: �( Other Permit:
T I G A R t7 Inspection Line: 503.639.4175 p ate Ready/By:
Internet www.tigard-or.gov F G� ` y%% .4 I S See Page 2Inr
V otified/Metho lyCi Supplemental Information
TYPE OF WORK LAI N�,,AV�S� /5-fieiL/<LG1L
`` Cj REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demov� Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
'Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
A.1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 201000
ElAccessory building ❑Multi-family Number of bedrooms: t
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ;Z S 'H.a 0 ley, Ln New dwelling area: 12, square feet
City/State/ZIP: 1'1c d i Git_ 9422., Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ice,-- Covered porch area: square feet
JJ q
Cross street/directions to job site: Deck area: square feet
Other structure area: 3I 0 square feet(51br eiee)
REQUI$ED DATA:COMMERCIAL-USE CIIECKLISI
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 1
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
_l. )el I Sj)l l e C ' C71111�s a ace i`' ht' bed epd yl1 Valuation: $
(1,t.iG t-J�j rim 1 Existing building area: square feet
New building area: square feet
Igi PROPERTY OWNER 0 TENANT Number of stories:
Ntune. t , ii i
4 -, Type of construction:
Address: J 3 L V h-Gi 4M
S Li'l Occupancy groups:
City/State/ZIP:T A,�q) a g 9}224- Existing:
Phone:(643)e 6/3-02,i.V Fax:( )
New:
0 APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name: C4___ �- QI (Please refertofeesch4duk�
CjT/-� Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address: `,
City/State/Z1P: Total fees due upon application: t ' 4,1,/
Phone:( ) Fes: :( ) Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
% � CONTRACTOR Commercial and residential prescriptive installation of 1
♦ .�! roof-top mounted PhotoVoltaic Solar Panel System.
Business name: /3 E-ri Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone'( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:
/� Total fee due upon application: $201.60
Authori .ed signature: ,((, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Lru t p tA,cf1t Date: 1 — (4—�`b *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)
a
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE 1 SE O\L'
City of Tigard Received
III13125 SW Hall Blvd.,Tigard,OR 97223
DateB Permit No.:
= Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
l'1 .A It D 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW )t,, No y/.
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 • U
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: 0 0 0
•
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. 0 0
0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 ❑
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 0 0 0
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 ❑ 0 0
_ and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
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- 0 0 0
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. 0 0 0
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- 0 0 0
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 0 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
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 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
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 ❑ 0 0
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑ 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ l 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0
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, 0 0 ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 1/02/COM/WEB)
K
r •
Mechanical Permit Application FOR 014 ICI:. ISE ONI.l
City of Tigard N[1 Received
Permit No.:
41 13125 Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' Phone: 503.718.2439 Fax: 503.598.196 i Other Permit:
A Date/By:
i 1 e .\p I) Inspection Line: 503.639.4175 j Date Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov 11�` �O'�6 Notified/Method: Supplemental Information
t :"1,'",5,-:7-''''
f x 1''1'P OF WORK - �tt1 •�'w SOHEDUI.I� TSECI ►'`F
�� Mechanical permit fees*are based on the value of the work
❑New construction K Addition/alteration/KIN tri performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: �" mechanical materials,equipment,labor,overhead,and profit.
!t "1".....140 - Value $E
Cil°TIEY OF COIVSTRON
..�+ , .,' e - ‘ , ,., -RESID�i!)1TI!l,t,EQ NT/SYSTEMS i1?F�*..
($,I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
'-''''-'7, ', `�� 1� �t'ION AND LOCATION Heating/cooling:
` ' Air conditioning 46.75
Job site address: -9;L S YY H G,,✓l se-✓1 L N Furnace 100,000 BTU(ducts vents) 46.75
City/State/ZIP: Til 24 O q1-22- L Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work f 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: Lot no.:
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
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
' /R RTYO ER 0 TENANT Environmental exhaust and ventilation:
Name: L ..0 Y t 4 Al f i SC,Y.I Pff •u S�. Range hood/other kitchen
t.1 equipment 33.39
Address: 3� r 1 1�5�✓1 L vi Clothes dryer exhaust 33.39
City/State/ZIP: 1 1 ,,4 el- q 12-24-.
Single-duct exhaust(bathrooms,
I ._1 toilet compartments,utility rooms) 23.32
Phone:(9f3) Ei }—(;)� Fax:( ) Attic/crawlspace fans 23.32
D s( ),1,17" 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
- Gt,S4 $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Barbecue
s-ir,&; 77..147,.,."±s,-.1,,,'4,--, .,CONTRACTOR Clothes dryer(gas)
Other:
Business name: ec Lt,,.M /j/,,. ii,fpn A a, a" Cooc.l 1►ECHAN)<CAL ERMITF$ES* . .
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax: Plan review(25%of permit fee)
( ) State surcharge(12%of permit fee)
CCB lie.: `7(8 351 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: * Fee methodology set by Tri-County Building Industry Service Board
Print name: PlaiI Date: a-act_c)016
„Building Permits MEC_PermitApp_040113.doc 440-4617T(I 102 COM WEB)
a
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: ,J'exmit Fee: a,
$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
l - -
•
Electrical Permit Application R 01 1 1( I 1 SI. O\I.l
City of Tigard cii161A-10
Date/ByReceived: Permit#:
'PI13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
': 1 Phone: 503.718.2439 Fax: 503.598.1 Date/By: Related Permit#:
• Inspection Line: 503.639.4175 �'�01� Ready Date/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov <t1 1Notified/Method: Supplemental Information
. , TYPE OF WORK 811itivip� wt
,` PLAN REVIEW
❑New construction igAddition/alteration/l i0\S O Please check all that apply(submit 2 sets of plans w/items checked):
V 0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition 0 Other: �`� where the available fault current 0 Marinas and boatyards.
,. CAT] 1V OF CONSTR ON exceeds 10.000 amps at 150 volts or 0 Floating buildings.
jia 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground.or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITEMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: .-E,3 2._ S V'J fielim-e...vw I h 100HP or more. ❑"A "E","l 2",°`1-3",
71'144. ❑Six or more residential units. occupancy.
City/State/ZIP:
,..4 3 i..2_24-
—10 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sqft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.II.)
Renewable Energy 0 See Page 2
PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: kurf L AN,ie.-, ()I 200 amps or less 100.70 2
Address: Q 201 amps to 400 amps 133.56 2
��`3 L S vd f I ctrl f a✓f Lei 401 amps to 600 amps 200.34 2
City/State/ZIP: 6:),,,,,,L1 t a R 9 !ZZ� 601 amps to 1,000 amps 301.04 2
Phone:(5o ) Fax:( ) Over 1,000 amps or volts 552.26 2
3 2�/�j Temporary services or feeders installation,alteration,and/or
Email: 1Gui,,�rroiUSf 6D YYt S✓I . CrAWI relocation
Owner installation:This installation is being made on property that I own which is not 200 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
Owner signature:
401 amps to 599 amps 168.54 2
(.TQ0 l-+i�: /�iDate: -2,1211(
4'LICAN f 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
�� A.Fee for branch circuits with
Business name: scieiv t . V,e___ above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first I 56.18 2
branch circuit
City/State/ZIP: Each add-1 branch circuit 1..-- 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
Email: dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Qir‘A LJ -e-'L L'</Z-A C (I-'C Sign or outline lighting 67.84 2
Address: 2��— Signal circuits)or limited-energy 0 See Page 2 2
1• panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: ij-'A-t4.4f ei/L__
i Additional inspection(1 hr min) 66.25/hr
Phone:(.9i)) A--c") -"tit. l t7 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: f107400,10 Electrical Lie.: (- ca G Suprv. Lie.:5(3 el 5 specifically listed('/z hr min)
ELECTRICAL PERMIT tErs
Suprv. Electrician signature,requir : (r Subtotal:
Print name: 1.„.....--t--- r Date: 24.13j ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: )I e.� fsCt I IGS Date: Z1 2,3"
'�11 • Number of inspections allowed per permit.
1:Building;Permits•ELC_PermitApp_ELR_ERE.doc Rev 06 17 2015 440-4615T(11 05 COM WEB
•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: I. FEE scDULE
Description I Qty. I Each I Total *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
S stem*
y Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 ka-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:Building Permits tic_PennitApp FLR ERE doe Ret 06 17 2015
Plumbing Permit Application
Building Fixtures l� Folz 01 I It l: l sSE0\1.1
Cit of Ti and Receivedyg �tliNlii
Date/By: Permit No.:
• :4 • Ill 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.598.1 6 G Date/By: Other Permit No.:
U Supplemental
Inspection Line: 503.639.4175 Q A & ��
I I t n It I> Internet: www.tigard-or.gov v I+ Date Ready/By: orris: See Page 2 for
1 Notified/Method: SInformation
�y �,. 4:;:i
v ,.y fit,
'1a .,,. x f. TYpEi:'F wORx .( -,r,‘• ; i' J i [ � x a*4 I
0 New construction 0 Der49I0 IV`�{N For special information use checklist
El Addition/alteration/replacement 0 Ot
1L�1� ' Descnptron Qty. I Ea. I Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)_
SFR 1 bath
``� :(#"-' 7,-.*'-','
.�3�.T ,� �' AIS�'RtIC7�N. ,. ., ( ) 312.70
RI_and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
0 Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑ Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
• JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: C3 3 c1/‘i Reuv 5P-v1 L-vi
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1-15A4(4 0 g 61 4-2_21 4 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 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
Subdivision:
Fixture or item:
Tax
- , Backflow preventer 31.27
DESCRIPTION OP WORK
Backwater valve 12.51
Clothes washer 25.02
' Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
t R Expansion tank 12.51
Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
Tilcurd Hose bib 25.02
Phone: + : . Ice maker 12.51
❑ (INTACT pER ON: " Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
rS - 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
Water heater
37.52
Business name: Crc> ( _a„-J Pi t..&fl IA 149 Water piping/DWV I 56.29 .)1
Address: �-93 �ct,tj r r� Dr �J Other: 25.02
City/State/ZIP: Se&, -g-p1) U g G' 3-06 Subtotal
Phone:(6031 (v9- -- c,q Fax:( ) Minimum permit fee: $72.50
v Plan review (25%of permit fee)
CCB Lie.: 1.01 0(o Plumbing Lic.no.:00--/i "S
/ State surcharge(12%of permit fee)
Authorized signature: . i TOTAL PERMIT FEE)4/54)c)
Print name: 144- 7 Date: 6. l'�.Ul` This permit application expires if a permit is not obtained within 180 days
l after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
Ir Building Permits PLMU-PermitApp.doc 1001 09 440-4616T(1002 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
'N'abisiont 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
Other Inspections or Fees FCe;1i ) Total 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 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 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
Ba tilt /Font
ID Any new commercial building with water service 2"and
P rY greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall D New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
I:Cuspidor/Wattr Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
Domestic 1:1 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
-Corn/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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
l:ABuilding\Pennits\PLMF_PermitApp.doc 08/04/2011 2
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325(2))
This statement is required for residential building, electrical, mechanical,and plumbing permits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not
submit this statement.This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
- p I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
Att( ftsor, 12/aster
—Print Name of Permit Applicant
atzuhic.aaak-if v/7/4,
Signature of Permit Applicant Date
Permit#: tki 0/ 4, —CO b ctg
7$3� aw tf&AJ I-00 '4„
Address: ..�,,,,,,,,�.;
:.
Issued IC:—& ? Date: e/77-1jG t-i"i.
This Copy for Permit Offices
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
7832 SW HANSEN LN, TIGARD, OR, 97224
Residential - Master Permit
699 Mechanical final
PASS
MST2016-00048
Jeff Grove
Violation Summary:
Inspector Contractor
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.
is City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
141 -' Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigar=-or.gov_
TO: ((1—w•_.. DATE 3 "3,
DEPT: BUILDING DIVISION
JUN 2 0 2016
FROM: Al fisa-y3 P(Aste.,,,,E.
' ( .
COMPANY: (6wrJ C.P-- ll��: DIVISION
PHONE: Goa- 869- -02.3--8 t
By:
11
`
RE: 4'8;z w kta.-►I S-�. Ln `� �i ��l -0 o O
(Site Address) �rmit Number)
roject name or subdivision name an' • I,'� ,-r)
P
ATTACHED ARE THE FOLLOW ,G illi. S:
Additional set(s) of plans. V Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: L ,4iLt9 _A
L,c.L�(,- ') c- 7Gf-----/ALt—e- 6-A/2-42
A6-1 ---r- , ' -.� o, .nom : �<< .
Routed to Permit -chnician: Date: -.a3 - J C Initials:
Fees Due: ❑ Y s N No Fee Description: Amount Due:
$
$
1 $
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No ❑ Done
Applicant Notified:AA;r44/ Date: 649w Initials: h'-7
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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
I I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
g ov g g g
TO: • DATE RECEIVED:
DEPT: BUILDING DIVISION liCEAf
MAR 16 ?n16
)FROM: An[ 1.16ARD
COMPANY: BUILDING DIVIS
Bd
PHONE: �v3' E 02,,- y:
RE: 5w fin_ - ifs 1`'i fv- coot/g
1 e • a a ress (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other 1
(explain):
a �
REMARKS: ►I ►� l CXA. d-v\y0 6-v� c ,� 'S . Io-�- e,
1 ,
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: .3/3 / ) 4 Initials: —fir
Fees Due: ❑ Yes No Fee Description: Amount Due:
$
Special
Instructions:
Reprint Permit(per PE): El Yes ❑No El Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doe 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7832 SW HANSEN LN, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2016-00048
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7832 SW HANSEN LN, TIGARD, OR, 97224 March 6, 2017 at 1 :22:24 PM
Record Type: Record ID:
Residential - Master Permit MST2016-00048
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor