Permit (14) ,, CITY OF TIGARDMASTER PERMIT
COMMUNITY DEVELOPMENT t Permit#: MST2016 00341
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 /� �� Date Issued: 08/25/2016
Tf 9 Parcel: 2S111DB01100
Jurisdiction: Tigard
Site address: 15400 SW ALDERBROOK CIR
Subdivision: SUMMERFIELD NO.8 Lot: 439
Project: WILLIAMSON
Project Description: Removing wall for kitchen remodel. 10/26/2016: REPRINT permit to add range hood and duct
work for hood.
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: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $5,900.00 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
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 Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 1 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:
WILLIAMSON,BETSY B HOMEFRONT REMODELING Required Items and Reports(Conditions)
15400 SW ALDERBROOK CIR 3585 LAKE GROVE AVE
TIGARD,OR 97224 LAKE OSWEGO,OR 97055
PHONE: PHONE: 203-706-4183
FAX:
Total Fees: $394.78
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification .enter. Those les are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 .1987 or 1.:,t•.3 . c44.
Issued By: °5� r�" I'Z,C,11''--' Permittee Signature: .. 4 i,
Call 503.639.4175 by 7:00 a.m.for the next available inspe, on date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicati.. E 1 FOR OFFICE ISE()NEN
City of Tigard Y Received/� Z Y
IIIIII 111 le 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Cv i( Permit Nt ��� �
Phone: 503.718.2439 Fax: 503.598.1960 l�C r 2 �' 2.016 Plan Review
Other Permit:
TI G A R D Inspection Line: 503.639.4175 vhe �3 7{"� Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov r� j 'afully,LF Notified/Method: Supplemental Information
aaiDING DIV ISI
TYPE OF COMMERCIAL FEE* SCHLDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
r 1-and 2-family dwelling
0 Commercial/industrial 0Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND, LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: /$y' 5 .) 19—t.46 E -004:- (7// Ct.&--- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Heat pump 61.06
Duct work lilt; 2971/6C-- / 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
Subdivision: Lot no.:
Other: 23.32
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
A/Ele1 /4-,V�" iA-;--6,a E {C7'-' 4C)41--'Z - fireplace 23.32
Log lighter(gas) 23.32
/�-� Wood/pellet stove 33.39
4 'TV I) " /7----
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
ROPERTY OWNER 0 TENANT ", Environmental exhaust and ventilation:
Name: orgg/47�.1.f, UA' Range hood/other kitchen
equipment 33.39
Address: Q ,...cilik2304f270 tL/� Clothes dryer exhaust 33.39
City/State/ZIP: .07,60-1.9,11) '�Q 7L� ��C', Single-duct exhaust(bathrooms,
/ f �Y�' toilet compartments,utility rooms) 23.32
Phone: ,4 Fax:( ) Attic/crawlspace fans 23.32
0 L.�. U, E.";. : Other: 23.32
APPLICANT : ❑:CONTACT I�.SON
Business name: Fuel piping:
$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
E-mail: Range
Barbecue
CONTRACTOR Clothes dryer(gas)
OthBusiness name: �� � &jL1�� z`�� �
h / MECHANICAL PERMIT FEES*
Address:`j ,- , tT 6.7—CZE Subtotal
City/State/ZIP: --/41--/e--e- )S>) -C-76-6C"7�- 74 Minimum permit fee($90.00)
i Plan review(25%of permit fee)
Phone03) Z)6,-y`� Fax:( ) State surcharge(12%of permit fee)
CCB lic.: Jy/yf 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-"ter 0r ,ot * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,' 4�►1 Date:
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$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
�,� CITY OF TIGARD MASTER PERMIT
' 11
'- 8 ' . COMMUNITY DEVELOPMENT Permit#: MST2016-00341
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/25/2016
Parcel: 25111 DB01100
Jurisdiction: Tigard
Site address: 15400 SW ALDERBROOK CIR
Subdivision: SUMMERFIELD NO.8 Lot: 439
Project: WILLIAMSON
Project Description: Removing wall for kitchen remodel.
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: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $5,900.00 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 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 0
Owner: Contractor:
WILLIAMSON,BETSY B HOMEFRONT REMODELING Required Items and Reports(Conditions)
15400 SW ALDERBROOK CIR 3585 LAKE GROVE AVE
TIGARD,OR 97224 LAKE OSWEGO,OR 97055
PHONE: PHONE: 203-706-4183
FAX:
Total Fees: $293.98
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-irr-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
dE
ys. ATTENTION: Oregon la requires you to follow the rules adopted by the Oregon Utility Notification C nter. Those rules are set f9�th in OAR
952-001-0010 through OA -00 ii_.,•0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 .1987 or 1.8/0043 , 44. (\ \
Issued By: k 4 /ivy fr 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
Residentialck
FOR OFFICE USE ONLY
City of Tigard Received �
r,..; Date/B i iL Permit No.: / _ �/, A
R 13125 SW Hall Blvd.,Tigard,OR 97221, ' '"
1 0 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 2�o�� Plan fr Other Permit: ' tl a�
ry, J
TI G A R D Inspection Line: 503.639.4175 P��' �+ Date Ready/By: * ® page 2 for
Internet: www.tigard-or.gov g., y,4:' '' Notified/Method , Th !m Supplemental Information
eA *. r" k Y t. et- J 4 ,
TYPE OF W , REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑ I `'' o'Ilion Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
El- ddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
12'‹d 2-family dwelling ❑Commercial/industrial
Valuation: $ ►,2(
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
15-1/06 JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / fie442 �.;:/j /��:, Vk New dwelling area: square feet
City/State/ZIP: V !/A-J) Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:f 4a/l6iit/ 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.
.t?P-A - yAiC �t Valuation: $
li�/ / /�!�"T�'f/l`4 j / 27.-20''
+ _'/"i` 6
' � Existing building area: square feet
New building area: square feet
%PROPERTY OWNER 0 TENANT Number of stories:
Name: ti f �1� Type of construction:
Address: . f '� *7.....70.,., r
"� L/- �I - Occupancy groups:
City/State/ZIP:ida Existing:
Phone: ) Fax:( )
New:
0 APPLICANTONTACT PERSON BUILDING PERMIT FEES*
Business name:
� �""� (Please refer to fee schedzde)
Structural plan review fee(or deposit):
Contact name: Ej t,.S-
j "/y FLS plan review fee(if applicable):
Address: /0? J� f-7 7-2--
Total fees due upon application:
�
City/State/ZIP: / / '.... ij U)
Phone:(5&3 ) 6 Li &7�� Fax: :( )
Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
� 5 �4�So� z,Ac.,0 �
� Commercial and residential prescriptive installation of
CONtRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: /Op— " ; Submit two(2)sets of roof plan with connection details
j and fire department access,along with the 2010 Oregon
Address: .:� r ecs i Solar Installation Specialty Code checklist.
City/State/ZIP: ,„1 "�/h�C d j 77, Permit Fee(includes plan review
and administrative fees): $180.00
Phone:(_ )� ',/e).6
Fax:( )
��l l State surcharge(12%of permit fee): $21.60
CCB lic.: ! / /.0-
........,
Total fee due upon application: $201.60
Authorized signatur:. ` � / This permit application expires if a permit is not obtained
� / within 180 days after it has been accepted as complete.
Print name' Date: ),,V J a Fee methodology set by Tri-County Building Industry
f/ Service Board.
I:\Building\Permits\BUP-RESPennitApp.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
15400 SW ALDERBROOK CIR, TIGARD, OR,
97224
Residential - Master Permit
699 Mechanical final
PASS
MST2016-00341
Jeff Grove
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
15400 SW ALDERBROOK CIR, TIGARD, OR,
97224
Residential - Master Permit
199 Electrical final
PASS
November 9, 2016 at 9:53:41
AM
MST2016-00341
Jeff Grove
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
15400 SW ALDERBROOK CIR, TIGARD, OR,
97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
November 14, 2016 at 8:18:06
AM
MST2016-00341
Jeff Grove
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
15400 SW ALDERBROOK CIR, TIGARD, OR,
97224
Residential - Master Permit
299 Final inspection
FAIL
MST2016-00341
David Young
Work not complete, not ready for final inspection.
Violation Summary:
Inspector Contractor