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9425 SW MCDONALD ST
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2005-00769
DATE ISSUED: 11/21/2005
JIM 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171 PARCEL: 2S102CD-02400
SITE ADDRESS: 09425 SW MCDONALD ST ZONING: R-4.5
SUBDIVISION: EDGEWOOD LOT: 018 JURISDICTION: TIG
Project Description: Replace hirnace.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
S-ORIES: BOILERS/COMPRESSORS HOODS:
_ ;ucL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15-30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30-50 HP:
GAS PRESSURE: 50+ HP: WOODSTOVES:
DRYERS:
FURN< 100K BTU: 1 AIR HANDLING UNITS
OTHER UNITS:
FURN>=100K BTU: <= 10000 cfm:
>
GAS OUTLETS:
10000 cfm:
Owner: FEES
MITCH BROWN Description Data Amount
9425 SW MCDONALD ST -- --
TIGARD,OR 97224 IMF("] Permit Fee 11/21/20( $72..50
[TAX]8°i, State Surcha 11/21/20(Y $5.80
Phone: 503-694-8246503-694-8246Total $78.30
Contractor:
OREGON HEATING+A/C INC
PO BOX 397
DUNDEE,OR 97115 REQUIRED ITEMS AND REPORTS
Phone: 503-538-2953
Reg#: LIC 125815
IL
t—
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This permit is issued subject to the re;tulations contained In the Tigard Municipal Code, State of Ore.Specialty Codes and all other
J applicable laws. All work will be done.n acco-dance with approved plans. This permit will expire if work is not started within 180 days of
m issuance,or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rulos are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these
W ruins or direct questions to OUNC by calling 503-246-6699 or 1-800-332-2344.
J
Issued By: ��� Permittee Signature: o A
Call 503-639-4175 by 7:00 a.m.for Inspections that business 118),
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved pians are required on the job site at the time of each Inspection.
Nov 21 05 09: 15a 503-537-2172 p. 2
M� hanical Permit A li(cation ' FOR A
L_ P.eeeived / ' r Permit Vo.
City of Tigard R C G E I V
x31'1.5 SW Hall Blvd..Tigard,OR 972?3 Plan Renew Oyler Permit
Phone. 503.639.4171 Fax: 503.592.1960 Date/By
Inspection Line: 503.639.4175 Dale Randy/By: rtlria' S Sac Pate t for
NntifiedlMetbod: Supplemental Iefornstloa
Internet: www.ci.tigard.or.us
F,
COMMtiRCIAL,I%t•'9CII91100IJLt Y1SE-EI`tEdaA6T
Meehuueal permit tees•are based on elle value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition []Other: tnechauical mexerials,equipmetu labor,ove:besd,and mfit.
UCT[ON
Value $ _
,C.ATICGOA'Y OF CONSTR
- = r: FlB31DEN1'IAL$QUIfiv1ENT/RY.STIILS;1tF:ES'
1-and 2-family dwelling ❑Commereial/industrial []Accessory building For spec tat informflon ure checklist.
❑Multi-family ❑Master builder _.Other: 5;cription Qty. Fx Total
•'1161i 81 CE INPO[tMAT10N LOF.A110�'. . Heattng/coeliag
Air conditioning or hest pump
Job site address. S �- (� _-_ (Mmarea she plan a howlaapkwe:n!j) 14.00
Cary/State/Zip: �r a l► Feunaee 100,000 BTU duets/venta 14.00
_ Furnace 100 000+BTU.L&wWve=L 17.90
Suite/bldg./apt.no.: / Project name: Gas he!!pump 14.00
Cross street/directions to job site: Duct work 1400
--- H drone 1_mt waterasy tem _ 14.00
Residential boil-r(radiator or
h drouic) 14.00
_�. Unit beaten(fuel type,ant electric).
in-wall,in-duct,,auspehded etc. , -_ 10.00
U1_L1 --— Fluriventforany of above 10.00
Subdivision: Lot no.: _ Oth.; + --1000
Tax map/parcel ho.' Other fuel appliances
-- - -— D 4,e lx5 Water beater
10.00
SC1tITION;OF y 10.00
Gas fireplace _
Flue vent for water heater or gas
dace 10.00
-- Lo li or( � 10.00
Wood-' ellet stove 10.00
Wood fimlace/insen 10.00
chi niner/fludvmt 10.00
other. 10.00
Name. �/y/n �()n _ Environmental exhaust and vendlatlo_n
ya v r Range bnod/other kitchen
Address: �- 6 'lk G'� eou?iment ----- --- 10.00
tV/SmteIZLP: - Clothes d cr exhaust 10.00
Ci
_ V� Single-duct exhaust(bathrooms,
Pbone: j Fax:( ) toilet then rtmerlts,utility moms 6.80
Cb1TACY'1?ER$OF
Attic/crawlspace fans _ 10.0000
APPLICANT a
Other. 10.
Business name .r Fuel piping_
Contact name: e) 55.40 for first four;51.00 for each additional
soi
-- Furnace,etc
a Address: _ Gas beat pump
IX City/State/Z1P: I L S� Walllsjn� nded/unitbeater•
H _ -
U) '] ]/ Water heater _
Fireplace -
J E-mail: Range--- -
m Business nam C RA( I'OR Barbecue --
_ 1 clothes et
W e: _ Other.
J M$CHANICAL PLt 1t11i1 .§"
Address: �-
�---- �- --- -- Subtotal Y_
City/State/ZIP: I
r �--- Minimum Pennir fa(572.50 _
Plan review(25%of penrdt foe) -
CCB tic.: State surcharge($%of permit fee)
-- --_- - TOTAL PERMIT FEE
�n This permit applleatlon expires it•permit b not oblate w thin 188
Authorized s' nuc L21 4' 1'17� :/�� `� der ager It has t+rea accepted as complex.
Print nnn+o• ,D , n / I Dat - • Fee methodology set by Tri-Cmuity Building Industry Service Board
_ i L — 1�-�+—' —
I:�1ui7dlaaWermiu'JAHC-P.rmi,Aon Me 17.'77 44",1 TT(I l mvoomrWan1
CITY OF TIGARD
BUILDING DIVISION PERMIT �: MF.-c 7nos OU16y
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111111(kN.,
Phone: (503) 639.4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: ))01000--, TIME: 1 03AM PAGE: Q!,
SITE ADDRESS: Qq2(,;a'W MCDONAI I)SI CLASS OF WORK:
SUBDIVISION: ('LXyf-7Nt�7nf) LOT a: Oyy TYPE OF USE:
PROJECT NAME: I3()WN
DESCRIPTION: R(jA rr:e furnace.
OWNER: I ()VM, MITCH PHONE a: !0 684.0746
CONTRACTOR: OPF-GON IIFATINt3 + All.,INC PHONE 0: 503530-29!,3
Inspection Request Scheduled For: Date: 171170NY, Pour Time:
Code # Inspection Description Confirm # Contact # Message
MPI hopli al filw' 0),1001 0) ;i Y
(- —4;
Corrections/Comments/Instructions: (eaAr oo 6c)
to 6(086
ASS ❑ PARTIAL APPROVAL ❑ CANCEL [] NO ACCESS
❑ FAIL ❑ CALL FOR IN PECTION ❑ ADDITI AL FEES ASSESSED
Inspector: ____4 N
_ _.__ Date: 77/0t-''hone #: (503) 718-
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00531
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/6/03
SITE ADDRESS: 09425 SW MCDONALD ST PARCEL: 2S102CD-02.400
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT: 018 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS.
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 75 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install 75'of water line.
FEES
Owner: --
—' Description Date Amount
BROWN, MITCH
9425 SW MC DONALD IPLIIMB] Permit Fee 10/6/03 $72.50
TIGARD, OR 97224 ITA X]8%)Stntc'rax 1016/03 $5.80
Total $78.30
Phone : 503-624-8246
Contractor:
MR ROOTER OF PORTLAND
PORTLAND SERVICES INC
15033 SE MCLOUGHLIN BLVD#344 RI'QUIRED INSPECTIONS
MILWAUKIE, OR 97267 _
Phone : 503-653-5301 Water Service Insp
Final Inspection
Reg#: LIC 138941
I'L.M 3-434PB
L
C
0 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
U Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
E
IssuedBy: �1cr 44 ) Permittee Signature:
Call(503)639-4175 by 7:00 P.M.for an inspection needed the next bu iness day
P.kilding Fixtures
Plumbing Permit Application Received Plumbing ,
Date/By:1L b 3 � PermitNo.•.I -M" _
1 1
CI of Tigard
E I U Planning A val� sewer
`J g Date/By: Permit No.:
13125 SW hall Blvd. Plen Review Other
Tigard,Oregon 97223 ? Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Datc/BInternet: www.ci.tigard.or.us Contac Cue.
g I Concoct Juris.: See Page 2 for
24-hour Inspection Request: 503-604 " Name/Method: Supplemental Information.
7r
New construction Demolition Dacrl bon Qty. Fee(a.) Total
Addition/alteration/re lacement Other:
I & 2-FamilydwellingCommercial/Industrial SFR 1 bath 249.20
SI'R 2 bath 350.00
-FlAccesses Building Multi-Farnily SFR 3 bath 399.00
Master Builder Other: Each additional bath/kitchen 45.00
Fire sprinkler-sq. ft.: Pae 2
Job site address: "ZS wJ M'-1 LxQ4LD S
Suite#: Bld ./g Apt.#: Catch basin/area drain 16.60
Project Name: D; ell/leach line/trench drain 16.60
Footing drain(no.linear ft.) Pae 2
Cross street/Directions to job site: Manufactured home utilities 110.00
1-11N-t- ?S`VT> _ ---rU -Vc-� ML0,_,QNL j Manholes 16.60
Rain drain connector 16.60
e,ar -TC) Sanitary sewer no.linear ft. Pae 2
Subdivision: Lot#: Storm sewer no.linear ft.) Pae 2
Tax ma /parcel #: -- Water service no.linear ft. Page 2
„ 4 1
Absorption valve _ 16.60
Backflow reventer _Pae 2
t-% Backwater valve _ 16.60
Clothes washer 16.60
-- - - Dishwasher _ 16.60
Drinki,ig fountain 16.60
R_^ - -Ejectors/sump 16.60
Name: V/\ Expansion f Ex ansion tank v 16.60
Address: 'ZS- L Fixture/sewer cap 16.60
City/State/Zip- k lolly __ Z-2 Floor drain/floor sink/hub _ 16.60
Garba a disposal 16.60
Phone: Hose bib 16.60
Ice maker 16.60
Mame: _ _ _ __ Interceptot/grease ap 16.60
Address: Medical as-value: $ Pae 2
Primer 16.60
Cit /State/Zi ---W_�
Roof drain(commercial) 16.60
L Phone: FaX: Sink/basin/lavatory 16.60
C E-mail: Tub/shower/shower pan 16.60
x<' Urinal 16.60
Business Name__ Water closet 16.60
'J Water heater _ 16.60
Address: V\CLta_)C,4L_I0 D� Other:
Cit /State/Zi L-W ��� Other:
9
Phone:5v3- rax: EWA
subtotal E '50CCB I.ic #: (3� Plumb. Lic.#: �S 3 �- Minimum Permit Fee$72.5) $
Authmized Residential Backflow Minimum Fee$36.25_
ature: Qc__ Date: Plan Review 25%of Permit Fee $
State Surcharge 8%of Permit Fee $ r by
(Please print name) TOTAL PERMIT FEE $
Notice: This permit application expires If a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or
IRO days after It has been accepted as complete. riser diagram for plan review.
'Fee methodology set by Tri-County Building Industry Service Board.
i.0sts\Permit Forms\PlmPertnitApp.doc 01/03
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
k
Footing drain- I" 100' 55.00 0 to 2.000 $115.00
Footing drain-each additional 100' 46.40 2,001 to 3,600 S160.00
3,601 to 7,200 $220.00
Sewer-1 st 100' 55.00 7,201 andreg ater $309.00
Sewer-tach additional 100' 46.40
Water Service- Ist 100' 55.00 Medical Gas Systems:
Water Service-each additional 100' 46.40
Storm&Rain train-Ist 100' 55.00 51.00 to$5,000-00 Minimum fee 572.50
Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 51.52 for each
additional$100.00 or fraction thereof,to and
including$10,000,00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to$25,000.00 5148.50 for the first 510,000.00 and 51.54 for
Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to
minimum permit fee S36.25) _27.55 and including$25,000.00.
Rain Drain,single family dwelling 65.25 $25,001.00 to 550,000.00 $379.50 for the first$25,000.00 and Si.45 for
inspection of existing plumbing or each additional 5100.00 or fraction thereof,to
$50,specially requested inspections- r hour 72.50 and.00fri the first
$50,,
Subtotal: $50,00100. and up $742.00 for the first 550,000.00 and$1.2U for
each additional$100.00 or fraction thereof.
Fixture Work:
Are you capping,moving or replacing existing fixtures? If
"yes",please indicate work performed by fixture. Failure to
accurately report fixtures could result In increased sewer fees*.
Comments regarding fixture work:
i
Baptistry/Font
Bath -Tub/Shower
-Jacuzzi/Whirl ool -
Car Wash -Each Stall _
-Drive Thru
Cus idor/WaterAspirator
Dishwasher -Commercial _
-Domestic _
Drinking Fountain _ - - -
E e Wash
Floor Drain/sink -2"
3„ - - - ---4" -
Car Wash Drain _ - - *Mote: If the fixture work under this permit results in an
Garbage -Domestic _
IL Disposal -Commercial increase of sewer EDUs,a sewer permit will be issued and
X -industrial _ fees assessed for the sewer increase must be paid before the
' Ice Mach./Refri .Drains _ plumbing permit can be issued.
N Oil Separator Gas Station
Rec.Vehicle Dump Station
Shower -Gang
m -Stall
Sink -Bar/Lavatory
W -Bradley
-a -Commercial
-Service _
viniming Pool Filter
Washer-Clothes
Water Extractor
Water Closet-Toilet _
Urinal
Other Fixtures:
is\Dsts\Permit Forrns\PlmPermitAppPg2.doc 01/03
- BUILDING PERMIT
CITY OF TIGARD
E
DEVELOPMENT SERVICES DATE ISSUED: 3-Q0613
ED:
13125 SW Hall Blvd.,Tigard,OR 97223 (5031 639-4171 PARCEL: 2S102CD-02400
SITE ADDRESS: 09425 SW MCDONALD ST
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT: 018 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N7 S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 10 ft GARAGE: 216 sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS REQUIRED
FLOOR LOAD: 40 psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: 1 FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 5,590.00
Remarks: Repair to garage
Owner: Contractor:
JOHN BROWN ALL ASPECTS CONSTRUCTION
9425 SW MCDONALD ST 3520 SW 106TH
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: 503-684-8246
Phone:
Reg#: LIC 150694
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[BUILD] Permit Fee 10/10/03 $100.90 Misc. Inspection
I TAX] 8°%State"fax 10/10/03 $8.07 Final Inspection
113UPPLN] Pln Rv 10/10/03 $65.59
Total $174.56
This permit is issued subject to the regulations contained in the Tigard Municivai Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
3 requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
0 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by
u calling (503) 246-6699 or 1-800-332-2344.
Issued By: ti S .Lt i GL- Y L[c tL1/L)
Permittee
Signe'ure:
Call 639-4175 by 7 p.m. for an inspection the next business day
CITY OF TICARD 24-Hour
fOUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
/_ BUP
Received _—_ _Date Requested�/;�, AM. _PM _. BUP
_ a-s c Suite — —_ MEC
Location ----
Contact Person — _ _ — Ph( ) J"? 7 PLM
Contractor Ph(_ ) —_ SWR --
BUILDING Tenant/Owner __— — _— — ELC —_
Footing J ELC _
Foundation Access:
Ftg Drain _ rte ELR _
Crawl Drain
Stab Inspection Notes: SIT
Post b Beam
Shear Anchors —
Ext Sheath/Shear — _—
Int Sheath/Shear
Insu ation a
Drywall Nailing --- —
Firewall
Fire Sprinkler — --------
Fire Alarm
Susp'd Ceiling Tom_
Roof A. /
Other: —
f''' =`� —
'COAUQ IDART FAIL
Q —
Post&Beam
Under Slab -
Rough-In
Water Service
Sanitary Sewer
Rain Drains -- -
Catch Basin/Manhole
Storm Drain —
Shower Pan
Other: -
Final
PASS PART FAIL — — —
MECHANICAL
Post&Beam
Rough-in .�rC I.✓cl� /7p
Gas Line
Smoke Dampers —
Final fC�
PASS PART FAIL -
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final n Reinspection fee of$
PASS PART FAIL _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
SITE Please call for reinspection RE: _ Unable to Inspect-no access
Fire Supply Line _
ADA / L / 3
Approach/Sidewalk Date ._—� Insp moor_____ ___ _ _ Ext
Other:
Final _ DO 140T REMOVE this Inspection record from the Job ske.
PASS PART FAIL
Building_Permit Application Received Building
Date/B 61/D 0 Permit No
City of Tigard Planning Approval Other —
Uatc/B : Permit No.:
13125 SVA' Hall Blvd. Plan Review Other SID
Tigard,Oregon 97223 Datc/e : Permit No,:
Phone: 503-639-4171 Fax: 503-598-1960 PDate/B oelBy:iew .Cy land use
Case No.
Internet: www.ci.tlgard.or.us Contact Juns. 0 See Page 2 for
24-hour Inspection Request: 503-639-4175 Nana/Method: Supplemental Information
F—
TYPE OF WORK REQUIRED DATA:
New construction _ _ emolition 1&2 FAMILY DWELLING
Addition/alteration/re_placement Othe
CATEGORY OF CONSTRUCTION Note Permit tees•are based on the total value of the work performed. Indicate
1 & 2-Fames dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor,
overhead and profit for the work indicated on this application. (l
Access2ry Building __ LJ Multi-Famil
Other: valuation.. ............... ...................................... $
Master Builder P�
JOB SITE INFORMATION and LOCATION No.of bedrooms: No.of baths:
Job site address: 7143 6.J A)"i -4f -r I76.-401) 0A Total number of Floors.....................................
New dwelling area(sq.R.).............................. _ _r. C4,
Suite #: Bldg./Apt.#: Garage/carport area(sq. ft.)............................ _
Project Name: Covered porch area(sq.ft.).............................
Cross street/Directions to job site: jouTN ar- µ,net Deck area(sq. R.)............................................
00, /N a 4oAa t'a Other structure area(sq. ft.)............................
REQUIRED DATA:
_ COMMERCIAL-USE CHECKLIST
Subdivision: Lot#:
Tax map/parcel #: Noir. Permit fees*are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment.materials,labor,
overhead and profit for the work indicated on this applicatirn.
Valuation........................................................ S
—--—
Existing building area ft.
-- New building area(sq.ft.)...............................
Number of stories............................................
PROPERTY ow—N—E—R----T El TENANT Type of construction.......................................
Name: Jolf,rt) M14(t,e,LL f3Qn�nJ _ Occupancy group(s): Existing:
-- New: _
Address: 7u;S 5h j4l rd ,a
City/State/Zip: or� ?2-7s _
�. FaX: NOTICE: All contractors and subcontractors are required to be
Phone: I,t
APPLICANT CONTACT PERSUN licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: _ _ jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing,the following reason applies.
Address:
City/State/Zip:
Phone: Fax: — -
BUILDING PERMIT FEES"
E-mail: Please refer to fee schedule.
CONTRACTOR ----- —
Business Name: 11 AS12F t3 noire is Fees due upon application... ..........................
Address: ?sro Se , 1`041" A,'t3 til itTV,-' d� 00'r .A /_
City/State/Zip: mount received. ........................................... S � 7 �• c7 w
Phone: S jet D I Fax: SPS 61S Z44F 7 Date received:_
CCB Lic. #: a ee 9 Y
Authorized _ Notice: This permit application expires if a permit Is not obtained within
Signature: f,_ Date I00 days ager It has been accepted as complete.
—rw0 L �fiL1 __- "Fee methodology set by Tri-County Building Industry Service Board.
(Please print name) ii n ,q D
i:ADsts\Permit Forms\BldgPcrrmtApp doc 01103
q 07
_e
17
r y
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
Associated permits:
Cit of Tigard City �' ❑Electrical ❑Plumbing O Mechanical
Address: 13125 SW Nall Blvd,Tigard,OR 97223 0Other:
Phone: (503) 639-4171 — -
Fax; (503) 598-1960
I Land use actions completed.See jurisdiction criteria for concurrent reviews.
2 Zoning.Flail plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved plat/lot.
4 Fire district— approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit. �-
7 Water district approval
8 Soils report. Must carry original applicable stamp and signature on rile or with application.
OL eoatr I U plan U permit required.Include drainage-way protection,silt fence design and location of
(F—c eht basinprotec ' ,etc.
3 Complete sets legible plans.Must he drawn to scale,showing conformance to applicable local and state
ilding codes. Later design details and connections must be incorporated into the plans or on a separate full-size
eet attgched collie plans with cross references between plan location and details. Plan review cannot be completed
tf copyright violatpns exift,
I Site/plot pbm wn to scale.The plan must show lot and building setback dimensions;property comer elevations(if
a 4-ft,elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driA�moingtthan
rint of structure(including decks),location of wells/sepuc systems;utility locations;direction indicator;lot
verage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. _
2 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, ,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade.etc.
14 Cross section(s)and details.Show all framing-member sires and spacing such as floor beams,headers,joists,sub-floor,
wall construction,roof construction. More than one cross sec!ion may he 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.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-sine 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-prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/root framing.Provide plans for all Floors/roof assemblies,indicating member sizing,spacing,and hearing
locations.Show attic ventilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered
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
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
21 Energy Code compliance.Identify the prescriptive path or provide calculations.A gas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e..shear wall,roof truss)shall he stamped by an engineer or
architect licensed in Oregon and shall be shown to he applicable to the project under review.
23 Five(5)site plans ma required for Item 1 I above. Site plans must be 8-1/2"x I I"or I I"x 17".
24 Two(2)sets each are required for Items 16. 19.20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted.
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document.
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 4404614(6axvcoM)
CITY OF TIGARD 24-Hour
BUILDING ® Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639.4171 MST
BUP
Received .__ Date Requested_ d 7 _ M PM BUP
1
Location � C _ _Suite MEC
Contact Person / � _ Ph(—) = PLM 13 061—'x31
Contractor_ — Ph( ) _ _— SWR �—
BUILDING Tenant/Owner _ _ ELC
Footing
Foundation Access: ELC —
Ftg Drain ELR _
Crawl Drain - -
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors —
Ext Sheath/Shear
Int Sheath/Shear --
Framing
Insulation
-
Drywall Nailing
Firewall
Fire Sprinkler ----- -- —_ _�
Fire Alarm
Susp'd Ceiling --- -- -- -
Roof
Other:.---------
Final
ther:.--Final
PASS PART _FAIL — --- -
PLUMBING _
Post&Beam --
Under Slab
Rough-In
<VVArer SServic —
Sanitary Sewer
Rain Drains ---- - - - --
Catch Basin/Manhole
Storm Drain - -- ---
Shower Pan
Other:;A� PART FAIL
HANICAL
Post&Beam
Rough-In
d Gas Line
Smoke Dampers
N Final
PASS PART FAIL ------- —
ELECTRICAL
Service -- —'
Rough-In
W UG/Slab
J Low Voltage
Fire Alarm
Final Reins action fee of$ required before next ins
PASS PART FAIL p -- 9 pection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: --__� Unable to inspect-no access
Fire Supply Line
ADA /A-_3
Approach/Sidewalk Date— U _'? Inspector � --Ext-
Other: _ _
Final DO NOT REMOVE thlri Inspection record from th•job sift-
PASS PART FAIL
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