Permit (10) IICITY OF TIGARD MASTER PERMIT
' COMMUNITY DEVELOPMENT Permit#: MST2016-00368
13125SW Hall Blvd.,Tigard OR 97223 503.718.2439 # Date Issued: 10/05/2016
T t GAR.L' i f
9 . Parcel: 2S110BD08100
Jurisdiction: Tigard
Site address: 14822 SW 117TH PL
Subdivision: 1995-015 PARTITION PLAT Lot: 3
Project: Fender
Project Description: Interior remodel to finish crawl space into 2 storage rooms and one wine cellar. Electrical work to
be done under separate permit. 11/2216, REPRINT to correct classification of work to habitable
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 634 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: No
Total: 634 sf Value: $25,000.00 Rear: 0
PLUMBING
Sinks: 1 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: 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-3 634
Owner: Contractor:
FENDER,BYRON W&SHIRLEE NORTHWEST HOME RENOVATION LLC Required Items and Reports(Conditions)
14822 SW 117TH PL 11125 SW 106TH AVE
TIGARD,OR 97224 TIGARD,OR 97223
PHONE: PHONE: 503-267-5552
FAX:
Total Fees: $1,754.26
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. ATTENSION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0016-through OAR\\952-0 ,-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987, or 1.800.332.2344.
C
Cd/a
Issued By: .._ 50
Permittee Signature: �C �--P2_-I d---'/(
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.
CITY OF TIGARD MASTER PERMIT
31 COMMUNITY DEVELOPMENT Permit#: MST2016-00368
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/05/2016
Parcel: 2S110BD08100
Jurisdiction: Tigard
Site address: 14822 SW 117TH PL
Subdivision: 1995-015 PARTITION PLAT Lot: 3
Project: Fender
Project Description: Interior remodel to finish crawl space into 2 storage rooms and one wine cellar. Electrical work to
be done 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: 634 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: No
Total: 0 sf Value: $25,000.00 Rear: 0
PLUMBING
Sinks: 1 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:
FENDER,BYRON W&SHIRLEE NORTHWEST HOME RENOVATION LLC Required Items and Reports(Conditions)
14822 SW 117TH PL 11125 SW 106TH AVE
TIGARD,OR 97224 TIGARD,OR 97223
PHONE: PHONE: 503-267-5552
FAX:
Total Fees: $993.46
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 I - • ' ork is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules ado.ted by the Oregon Utility _.1•1 '._ • en er. ••,,: are set forth in OAR
952-001-0010 through•'R 952-001-0090. You ma obtain a copy o - u es or direct q -stions to OUNC • calling 5087 or 1 sn0 a32�.2344.
I
Issued By: ��'y i- ' c --... ----"0"1"-- - -•••- '•nature:
Call :.c ' 5 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.
I
ti
Building Permit Application
Residential RECEIVED
FOR OFFICE 11SG ONLY
City of TI and Received
4 f g Date/B : 9,S,74, 44 Permit No/4/57-2_0/6--A/3 bye
11 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 1 2016
_ Plan Revie
Phone: 503.718.2439 Fax: 503.598.1960III
Date/B : I—01. Other Permit:
T 1 Ci n R D Inspection Line: 503.639.4175 CITY OF Ti GAR D Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.govNotified/Method:
BUILDING DIVISION, 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
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® m
1-and 2-family dwelling 0 Comercial/industrial Valuation: $25000
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:14822 SW 117th P1 New dwelling area: square feet
City/State/ZIP: Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: f�/v-b&'T` Covered porch area: square feet
Cross street/directions to job site: Deck area. S j„�•e5�,� square feet t� , 1151
•Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
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
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Interior remodel,Illo change to footprint.Build out crawl space into 2 storage Valuation: $
rooms 1 14 l'rk i-- C I(6-4' 67e-c?,----re,-4,...9-4, eutris,972Ja,4,72,476- Existing building area: square feet
/i-GL //46 r;., <f e,e__ / C i 4,37401 17"1) New building area: square feet
® PROPERTY OWNER EI TENANT Number of stories:
Name:Ron and Shirlee Fender Type of construction:
Address:14822 SW 117th PI Occupancy groups: •
City/State/ZIP: Tigard,OR 97224 Existing:
Phone:(503)462-2168 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON
BUILDING PERMIT FEES*
Business name:Northwest Home Renovation (Please refer to fee schedule)
Structural plan review fee(or deposit): y5 07
Contact name:Steve Purves
FLS plan review fee(if applicable):
Address:11125 SW 106m Ave
City/State/ZIP:Tigard,OR 97223
Total fees due upon application:
Phone:(503)380-0008 Fax::( ) Amount received:
E-mail:steve@nwhomerenovation.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:Northwest Home Renovation Submit two(2)sets of roof plan with connection details
and fire department access,alongwith the 2010 Oregon
Address:11125 SW 106th Ave Solar Installation Specialty Codg
checklist.
City/State/ZIP:Tigard,OR 97223 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)380-0008 ---------
__ Fax:( ) State surcharge(12%of permit fee): $21.60
CCB tic.:201587. ,,.
Total fee due upon application: $201.60
Authorized Signa. e. C"" This permit application expires if a permit is not obtained '
A _ _ -- within 180 days after it has been accepted as complete.
Print name:Steve Purves Date:9/21/2016 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
._
Mechanical Permit ApplicatioR ECEIVED FOR OFFICE USE ONE)
City of Tigard Receivedy /1S c/6 --po3(
g y Permit No.:
lig 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 1 2016 ep
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OFi GHR Date Ready/By: 7uris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING 0I\1JS10 ,`Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:14822 SW 117th PI Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Fender Duct work 1 23.32 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
Install heat register and return in storage area 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
In PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name:Ron and Shirlee Fender Range hood/other kitchen
equipment 33.39
Address:14822 SW 117u'PI Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)462-2168 Fax:( ) Attic/crawlspace fans 23.32
APPLICANT (] CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Northwest Home Renovation
$14.15 for first four;$4.03 for each additional
Contact name:Steve Purves Furnace,etc.
Address: 11125 SW 1065h Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Tigard,OR 97223 Water heater
Phone:(503)380-0008 Fax::( ) Fireplace
Range
E-mail:steve@nwhomerenovation.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Northwest Home Renovation Other:
MECHANICAL PERMIT FEES*
Address:11125 SW 106th Ave Subtotal 23.32
City/State/ZIP:Tigard,OR 97223 Minimum permit fee($90.00)
Phone:(503)380-0008 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:201587,- TOTAL PERMIT FEE
� ,,,, This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signa . -- * Fee methodology set by Tri-County Building Industry Service Board
Print name:Steve Purves � Date:9/21/2016
I:\Building\Permits\MEC_PermitApp_040113.doc 440-46I7T(11/02/COM/WEB)
i * k
Plumbing Permit Application
Site UtilitiesRECE .:, FOR OFFICE l'SF ONE)'
City of Tigard SEP 2 1 2016 Received
Date/By: Permit No.: ,51
ligV 13125 SW Hall Blvd.,Tigard,OR 97223 ��� ��
0 Plan Review
• Phone: 503.718.2439 Fax: 503.598.1 Q--y p� p i Other Permit No.:
�F i I OF 1 IG iRD Date/By:
T I G A R D Inspection Line: 503.639.4175 A' n ,/1 [n l� ate ReadyBy: Juris: El See Page 2 for
Internet: www.tigard-or.gov BUILDING DIMS. 10 t\lNjotified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description Qty. Ea. 1 Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500,32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:14822 SW 117th PI Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Fender Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
1
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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
• DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
install utility sink in new storage area in crawl space Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
El PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Ron and Shirlee Fender Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:11125 SW 106th Ave
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224 Hose bib 25.02
Phone:(503)462-2168 Fax:( ) Ice maker 12.51
El APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Northwest Home Renovation Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Steve Purves
Roof drain(commercial) 12.51
Address:11125 SW 106th Ave
igibasin/lavatory ti 7-i z,i7/. 1 25.02 25.02
City/State/ZIP:Tigard,OR 97223 Solar units(potable water) / 62.54
Phone:(503)380-0008 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:steve@nwhomerenovation.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Northwest Home Renovation Water piping/DWV 56.29
Address:11125 SW 106th Ave Other: 25.02
City/State/ZIP:Tigard,OR 97223 Subtotal
Phone:(503)380-0008 Fax:( ) Minimum permit fee: $72.50
.... ..- Plan review (25%of permit fee)
CCB Lie.:201587 ,.........m...„...._, 21tinlb, ing Lic.no.:PB1641
_. --- - State surcharge(12%of permit fee)
Authorized signat
` � TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Steve Purves Date:9/21/2016 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
14822 SW 117TH PL, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
November 21, 2016 at
10:08:28 AM
Record ID:
MST2016-00368
Inspector:
David Young
Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
14822 SW 117TH PL, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
699 Mechanical final
Result:
PASS
Comments:
Tel: 503.718.2439
Inspection Date:
November 21, 2016 at
10:19:40 AM
Record ID:
MST2016-00368
Inspector:
David Young
Note: permit to be changed to reflect habital space for crawl space remodel.
New space includes heat, electrical, plumbing, smoke detectors and egress door.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
14822 SW 117TH PL, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
299 Final inspection
Result:
FA I L
Comments:
Tel: 503.718.2439
Inspection Date:
November 22, 2016 at 7:44:31
AM
Record ID:
MST2016-00368
Inspector:
David Young
Revise crawl space conversion plans, approved site and city plans to reflect habital
space conversion as noted on previous inspections.
Violation Summary:
Inspector Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
14822 SW 117TH PL, TIGARD, OR, 97224
Record Type:
Residential - Master Permit
Inspection Type:
399 Plumbing final
Result:
PASS
Comments:
Tel: 503.718.2439
Inspection Date:
November 22, 2016 at 9:39:19
AM
Record ID:
MST2016-00368
Inspector:
Don Sylvester
Water lines secured by water heater as noted by previous inspection.
Violation Summary:
Inspector Contractor