Permit CITY OF TIGARD MASTER PERMIT
1 COMMUNITY DEVELOPMENT Permit#: MST2016-00271
Date Issued: 07/14/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104CD10200
Jurisdiction: Tigard
Site address: 13611 SW TRACY PL
Subdivision: HILLSHIRE ESTATES NO.2 Lot: 101
Project: Cerbone
Project Description: 775 sf addition of master suite on second floor,60 sf of covered porch, construct elevator shaft,
pouring slab in crawl space for additional living space. Mechanical,electrical and plumbing work
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 2111 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 775 sf Garage: 0 sf Front: 0 Smoke Yes
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 2111 sf Value: $100,000.00 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 Rain0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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 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
Branch Circuits
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders
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:
ADD SF VB R-3 2111
Owner: Contractor:
CERBONE,ROBERT REVOCABLE LIVINi Required Items and Reports(Conditions)
13611 SW TRACY PL 1 Special inspection
TIGARD,OR 97223 required...Bolts in concrete
PHONE: PHONE:
FAX:
Total Fees: $4,573.23
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 enter. Those rules are set forth in OAR
952-001-0010 through•- 952-011-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 .1987 or 1.800.332.2344.
Issued By:
Permittee Signature:
Call 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.
Building Permit Application
Residential 1-012 UI 1 1( 1 1 Si.OV'i.l
Cityof Tigard ` i ,'4 Received /111:111111111111111Permit No.:M���O'� 1
g Raters :
13125 SW Hall Blvd.,Tigard,Oft 91223 Plan Review
v Phone: 503.718.2439 Fax: 503.598.1960 Date/B : -
Mill ARM Other Permit:
I I t,\f1) Inspection Line: 503.639.4175 Date Ready/By 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method:7 , ,o1,'lli Supplemental Information
t L P n. 1,k.‘a:
TYPEPNew 1„,1„,,,,, REQUIRED DATA:1-AND 2-FAMILY DWELLING
fiT"❑New construction `('Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
IX Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ %00 0003K1 1-and 2-family dwelling 0 Commercial/industrial /
❑Accessory building ❑Multi-family Number of bedrooms: 1
❑Master builder 0 Other: Number of bathrooms: (
JOB SITE INFORMATION AND LOCATION Total number of floors: .3
Job site address: W New dwellingarea: 6- square feet,'1%X3611 S Na.cY Pt �lg��-°.5
City/State/ZIP: -1--,,,r,0.d i o fk, 917 2 3g Garage/carport area: 0 square feet
Suite/bldg./apt.no.: Project name: ce.e OOtnO A44;"44 fog5+es4441. Covered porch area: 6 0 square feet
Cross street/directions to job site: Deck area: b 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 p 1 1C)14 l equipment,materials,labor,overhead,and the profit for the
]�
t- ((11 eDESCRIPTION OF WORK work indicated on this application.
A a i,•44p Y. aT c. roc..." keAck 9+c, Sc/1{'t to t, s ( Valuation: $
i Existing building area: square feet
tECW' ok art e-xfs-ti eta howkei Grokir•}-. O f elwa 4Chr
c , {-. ?.a�rrw� a. Stci,6 tr. Gtrctwt5ra.c�.. .
New building area: square feet
i PROPERTY OWNER 0 TENANT Number of stories:
QName: �db e...4”4" 4. a-t, eJ.!a. `e.4"ba,v4... Type of construction:
AU U Address: t 3 6 t t St,,, —r 0.c1 p .acs— Occupancy groups:
City/State/ZIP: —r-- �,,d I 0 4 1 17 2.SI Existing:
Phone:( ) 3 Fax:( ) New:
P lit APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
2 Business name: (Plea refer to fee schedule)
14 N*"� 45 t I I tf`C ' Structural plan review fee(or deposit):
Contact name: l r.•z...bt1;oti sow.0.aNS
FLS plan review fee(if applicable):
Address: sy V Sx— A(ct�t �r-e.� "
City/State/ZIP: (,,� y Total fees due upon application:
� ` �a�"d• D 9 7 1 Amount received: 1/7/3. g.
Phone:(� 'L•�p ill'� Fax: ( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* 1
E-mail: p.f-.-t c4.c2,, CO(4044WK;4-44:4-V.G..ine-f
v.l Commercial and residential prescriptive installation of
P CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Submi o(2)sets of roof plan with connection•• :Hs
Business name. _•
, _ . . and fire d-. ent access,along with th- 1 I Oregon
�' Address: C6 q 33 SW t,ljokcis, De-i Solar Installat.,Specialty Code c. ist.
City/State/ZIP: � sPermit Fee •eludes review $180.00
/ -d""�e�t � — �7d�? and a• ; trative fees):
Phone:(�3) 39j 6;3 z Fax:( ) State surcha : 12%o - it fee): $21.60
CCB lie.: -ICI 6 17atal fee due upon applica $201.60
yyy
Authorized signature: - This permit application expires if a per 's not obtained
within 180 days after it has been accepted :s complete.
�`' *Fee methodology set by Tri-County Building Industry
l
Print name: IP-�Y'vvvvvx) Date:0‘.7,e 7pr(, Service Board.
I:\Building\Perrnits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13611 SW TRACY PL, TIGARD, OR, 97223 May 18, 2017 at 9:38:50 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00271
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Elevator ok per state sign off.
Upper and lower level remodel done.
Re model of main level bath on separate permit.
Violation Summary:
Inspector Contractor