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Permit (180) IN CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2018-00056 and OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 02/26/2018 Tf i;;AI<.1_� 9 Parcel: 2S104AD02000 Jurisdiction: Tigard Site address: 12605 SW 128TH AVE Subdivision: BELLWOOD Lot: 47 Project: Lu Project Description: Interior remodel of 2nd story to reconfigure(2)bedrooms into master suite and laundry/sewing room. 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: $20,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 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 Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 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: 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 0 Owner: Contractor: LU,RANDY S&LORNA K SQUARE DEAL REMODELING CO INC Required Items and Reports(Conditions) 12605 SW 128TH AVE 8603 SE STARK ST TIGARD,OR 97223 PORTLAND,OR 97216 PHONE: PHONE: 503-254-4156 FAX: 503-254-4206 Total Fees: $981.33 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 Center. Those rules are set forth in OAR 952-001-0010 through OA 52-001-0090. Yi,may obtain a c'py of the rules or direct questions to OUNC by calling 5p3..42.19$7 or 1 800 332.-344. �/�/� 411 Issued By: 04 I Permittee Signature: ti ' 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. fnitdiug Permit ApplicatiionResidential . 1 0. -� r-P/ V R4 FOR OFFICE 11SE ONL1 City of Tigard Received 14.... . 13125 SW Hall Blvd.,Tigard,OR 9722318 DateBy: a 5` /,¢ Permit No,/�r--te.is e70s/ Phone: 503.718.2439 Fax: 503.598.1960 Plan lay : J�rSE S� Inspection Line: 503.639.4175 Date Re 01 - �� Other Permit: TIGARD p ���� �� �gp� DateReadB Internet: www.tigard-or.gov ,I 1 (;; ,t t y y ail .Tuns I El See Page 2 for k = Notifies Method: Supplemental Information '�I , ilw OF WORK EQF EnF3ATA.-1-AND 2 'A1 ,YT1WW.ING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Addition/alteration/replacementIndicate the value(rounded to the nearest dollar)of all 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. J-and 2-family dwelling ❑Commercial/industrial Valuation: $ f t� Oc o 0 Accessory building 0 Multi-family Number of bedrooms: + `"� 0 Master builder 0 Other: � Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 1'7 Job site address: I a OS— !(A ( 7 t\--- 4 _e New dwelling area: 0 square feet City/State/ZIP: T('i av ! 0 R- z- Garage —/carport-1 T 7 3 g /carport area: square feet Suite/bldg./apt.no.: Project name: L V Covered porch area: square feet Cross street/directions to job site: Deck area: square feet j/r 7y 1. Gall se5I V!-r — .Sle rij/CaCV' S Sl t?cc / Other structurearea: stluare feet AKS C° 1-ileed�j� l� vk 4.yl�h a " /�Ptt 6`Gtr REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:e„,,, AcmG `'fi_/1 �W I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: try. 6���� 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. t 1—e lr� C - re M 0�1 e I b a✓ciorn , j G r to /t((.Lt try Valuation: $ (Wfr/F—A i ,„2. :"?, tv7,4-2-("0/1.4. //L`;'Z) /1-777--fruit— / i Existingbuilding area: square feet - ft/re-: L4' ii,',4 4-j/ r,'i" 6:- -147i)i'j r,' New building area: square feet /"1 PROPERTY OWNER I 0 TENANT Number of stories: Name: gavid y f Lov.vv4 L...�f / Type of construction: Address: l Z G 0 S ,--t, 9„,/ �7,0 Ave Occupancy groups: City/State/ZIP: T 11 4 v i" c)-12,. q - -?---7-3 T1/ p1� Existing: Phone:( ) Fax:( ) _,,._ New: APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: S 6,ee D� . �erno je .el — (Please refer to fee schedule) `G I l CO ` Structural plan review fee(or deposit): Contact name: Cr14.Yt`s t/ e`I' ' Address: 660 3 f F 5ta, _/ �^f FLS plan review fee(if applicable): City/State/ZIP: e6 .-(c v1 0Q 0 V_2Cz_eTotal fees due upon application: Phone:(503)1-S—Li ' Lf I.5 b I Fax:_:( ) Amount received: E-mail a v';S k S ucky-e d ea (,i-c4 N 00(61 : C 0,,,, G QL tlJtw 501 A PANEL SYSTEM PEE _ ONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: S et g-.., Submit two(2)sets of roof plan with connection details Address: and fire department access,along with the 2010 Oregon Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review Phone:( ) Fax:( ) and administrative fees): $180.00 CU tic.: ' 88 i Tr, /� State surcharge(12%of permit fee): $21.60 I/ Total fee due upon application: $201.60 Authorized signature: 0 K This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 'nt name: ckY l's. K,fCI` e ( Date: 1 -3 1• _ 74,0f51 *Fee methodology set by Tri-County Building Industry Service Board. yg\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) flaktia Permit Al u ptzc;tiara ckecitlist One- and Two-Family Dwelling FOR OFFICE F SE oNLv 114City of Tigard Received 'e 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By Permit No. Phone: 503.718.2439 Fax: 503.598.1960 Associated permits 1 I G AR I) 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THF U1') i Otis l i; iTL ' IN 1ili'' RFQ1114-1-1` FOR Pi _A'' PFN'i N Vo, No NI e 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0 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 6 Sewer permit. ❑ ❑ 0 7 Water district approval. 0 0 0 g Soils report. Must carry original applicable stamp and signature on file or with application. Q : 0 ❑ 9 erosion contra ❑plan 0 permit required. tnctude drainage-way protection,silt fence design and focation of catch- basin protection,etc. 0 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 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 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 0 architect licensed in Ore on and shall be shown to be a p licable to theproject under review. 23 Three(3)site plans are required for Item I I above. Site plans must be 8-1/2" I7". 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. 0 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 andproteetion measures must be dram 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 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.doe 02/24/2011 440-4613T(11/02/COM/WEB) . . Mechanical Permit Applicate i;1;P: I tli.c, Received FOR OFFICE USE ONE\ II , ,4 tit, f te City of Tigard Da te/By: Permit 13125 SW Hall Blvd.,Tigard,OR 9722;----4 -**.' ' j . ' ' 4 11 Plan Review 11 Phone: 503.718.2439 Fax: 503.598.1960,il R 5 2O 1 Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris. 0 See Page 2 for Internet: www.tigard-or.gov ."'' -T.; ',1=, '?,.. '/4, ,''.•.i.,,i Notified/Method: Supplemental Information 3 ,'"YIftlt, E 0$VIIRIANG`Di V iSION COMMERCIAL FEE* SCHEDULE- USE CHECKLIST U ,___, Mechanical permit fees*are based on the value of the work New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total 1 JOE SITE INFORMATKIS,,AND' ,LOCATION Heating/cooling: ''' ' Job site address: - ..(v.- 16 0(-5- (-4 (-7- 74VC Air conditioning 46.75 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: r k*) a*•C*1 0 fr i i-.7- -?___ Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: 1 Project name: t.....i..., Duct work 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: I Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION,OF-WOW' **I ''''''''''''' 7: ''4. ''''- ' '''',, Gas fireplace/insert 33.39 , „•=. - ,,. -. ' ''' '''' --1 I • 1 , If Flue vent for water heater or gas ....--- ... .....1--vt•tev- k C/Y— \re-0"e„,or e 19 cPz-, +f-c,c,14.1 , , C:,,.. Vt-k fireplace 23.32 1 Log lighter(gas) 23.32 0.-vv.of - Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 23.32 0-PROPERTY OWNER '-` 4, v f" '''''' 1' 'ri fNl t iVr' :: 4 '„t -4, Other: i ' " 73-- .." - Environmental exhaust and ventilation: Name: t-(61,14eV y 1- LOV 0 e- 1— 4-1 Range hood/other kitchen equipment 33.39 Address: ( Z6 0 S 5 Gs/ (7.-&'' Ale Clothes dryer exhaust t 33.39 City/State/ZIP: Vt0-125-10 1-‘, i e' et di 0 r( ci 7- --z-___..3 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 1 23.32 Phone:( ) Fax ( ) Attic/crawlspace fans 23.32 APPLICANT '' ''` - " , .:' :0 CONTA&;PERSON4-, ' '' Other: Fuel piping: 23.32 Business name: iwc...4.(1.: 0 cft i .,..av,ad,,,...! $14.15 for first four;$4.03 for each additional Contact name: CIA,-‘'S le---nzliC Furnace,etc. Address: :)(, 0 s---, 5iS Srd,v-k 1-- • Gas heat pump Wall/suspended/unit heater City/State/ZIP: 190\14't Co-li 0 ' ._. ef i-—a- t 6 Water heater Phone:(505) Z,5-1-/ - Li 1 56 I Fax::(5,40' ) Z (....i - L( L 0 6 Fireplace Range E-mail: C.-Aktr t S k 0 ..c 66)e;re t'- gai revi-,c)dCf • c C441 Barbecue CONTACTOR',-, ', '''' 4, ' '' f''' 4 '''' Clothes dryer(gas) Business name: 412(0 ( (1-Q14^0e (1,1t,---.) Other: MECHANICAL PERMIT FEES* Address: )60 3 c F C f-- e--14— S v . Subtotal City/State/ZIP: ?ci\i, , 0(Z-- ei 7i-?_I ( Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(5,}3) —Lc-9 .. 1-1 ( 5 6 I Fax:(Si,"A,,) CS-t1 • Li zi76 State surcharge(12%of permit fee) CCB lic.: . .1 i g , Ei - 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: tc 6C\ / C * Fee methodology set by Tri-County Building Industry Service Board Print name: C.Lv•s'S I.< • fi I Date: •z _ —/...t In I NrCiru I:\13uildingTermits\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 lectrica l elrm�it A►pplic o RECEIVE FOR c l r"ICI'!'s1:ONLY .. City ofTigard Tigard FEB 2 6 2018Received Hermit 13125 SW Hail Blvd..Tigard.OR 97223 i `'' IN Plan Review I . Phone: 503.718.2439 Dai By Related Permit rr: I CITY OF TIGARD Email: TigardBuildingPamits(a fig 4 v Ready Date'By: Ririe 2 ` t1CAKI) V i `J } $1 See lnspixtiott Line: 503.639.4175 1 tTii :` #� ERI jautled Atethod: i Supplemental Information I I - TYPE OF WORK - f j1 PLAN REVIEW 0 New construction Addi#iomatterationIreplacerrtercrt I Please check all that apply(submit 2 sets of plans w=/trios checked/: ii 1 0 Service or feeder 400 amps or more Q Building over three stories, f I 0 Demolition 0 Other: where the available fault current 0 Marinas and boar}ards CATEGORY OF CONesTRIJCTION t exeeed.10.000 amps at 140 volts or Q Floating buildings. less to ground.or exceeds 14.000 0 Commercial-use agricultural 12E1 and 2-family dwelling Commercial/industrial 0 Accessory building I amps for all other installations, buildings_ Q Multi family 0 Master builder Other; i 00 Fire pump. Q Installation of 150 KVA or , JOB SITE INFORMATION AND LOCATION _ l 0 Emergency system, larger separately derived I r ; -., 0 Addition of new motor load of system. Job#: I Job site address: 7 p c: ` w t .} t,.,,L ...P �,:'- r 1. „,, ,"'J i t9owormore. Q l 2 ,.•13^, , l City/State/ZIP: i I Q Six or more residential units. occupancy. 1 ;�y isi `"' l t 'i `-- --''' _ 0 Health-care facilities, 0 Recreational vehicle parks i 1 Suite/bldg/apt.#: 1 Project name: i 0 Hazardous locations_ 0 Supply voltage for more than + 0 Service or feeder 600 amps or more. 600 salts nominal. Cross street/directions to job site: _ (I FEE SCHEDULE 1 I itescription ( Qts. I +Each ( Total New residential single-or multi-famiiv dwelling unit, Subdivision: Lot#: 1 1 includes attached garage. = Tax map/parcel#; 1 i t 000 so.fl orless 168.54 4 �I o add'i II 51;0 tt or fraction ) 33.92 i DESCRIPTION OF WORK • 1 Limit energy residential -' 1 a (with above sq.I$) �S.flO l :w Vv VI F Y ter(.--1: t &_,,,4'.; €,r.°l1N' 4f). r'-`y,. {i c.rs Vfri Limited energy,muht-familyt---174t i -_ residential(with above sq.ft.) 75.002 Renewable Energy PROPERTY OWNER ! 0 TENANT Q See Page 2 Services or feeders installation,alteration,and/or relocation I Name: / , , 200 amps or less 100.70 12 Address: s t r % 201 amps to 400 amps 133.562 r t"4 -- 1 401 amps to 600 amps _ { i ity,iStatetZlP: / 200. 4 __ -i" -. 601 amp to 1,000 amps 301."4 2 i Phone: ( 1 Over 1,000 amps or volts 1 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation I Owner installation:This installation is being made on property that I own which is not 200 snips or less 59.36 1 f 1 , Intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. I 201 amps to 400 amps 125.08 I Owner signature: _ Date: 4 _ 401 amps to 599 amps 168.54 12 :Pe-APPLICANT ANT CONTACT PERSON # Branch circuits—new,alteration,or extension,per panel E e.-..-.,,-- , s"� A.Fee for branch circuits with !1 Business name: C.X' ,/,'' I- .r tit _ r, rr t t q,, ;J`, above service or ftvdcr fee, v each branch circuit 1 1 7.42 } i Contact name: / t 1,, 11 1 .1,-,„,/t C sq � ' B.Fee for branch circuits without Address: `: j, F "' .: C 1 , vservice or feeder fee.first 56.18 12 R branch circuit 1 Cit hitter - - y ZIP. -y --; 1 , Each add'1 branch circuit 1 ,.42 1 ' .4., f._. ( it Miscellaneous(service or feeder not included) Phone:(C ,; ) ' r i t = Electrical Permit Application `V '.41 Y114: FOR OFFICE USE ONLY - City of Tigard Received cr w 13125 SW Hall Blvd.,Tigard,OR 97223 t-LE Date/Bn Phone: 503.718.2439 Plan Review 111 Date/B : Related Permit#: Email: TigardBuildingPermits@Tigard-ogi�v J ``(, 4 ''A rA ReadyDate/By: TIC ARD s F l(Y)a r ,a i,VI ate/B : J Inspection Line: 503.639.4175 Internet: www.ti ardor. ov Notified/Method: �� VISION mental Information *ALII��.T Supplemental Page for E OF.W � PLAN REVIEW 0 New construction Al Addition/alteration/replacement Please check all that apply . , 0 DemolitionPP Y(submit 2 sets ofplans w/items checked): 0 Other: 0 Service or feeder 400 amps or more ❑Building over three stories. where the available fault current 0 Marinas and boatyards. '' '} `CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or El Floating buildings. X1-and 2-family dwelling 0 Commercial/industrial 0 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. 0 Installation of 150 KVA or JOB'SITE"°INFQRMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site ad eSS: � �� �� �r���h ❑Addition of new motor load of system. Ve ]OOHP or more. ❑"A","E","l-2","1-3", City/State/ZIP: t ��� T 1<l Lti rC 0 q 77 Z----3 ❑Six or more residential units. occupancy. `/ /...._ El Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: (� l./ 0 Hazardous locations. ❑Supply voltage for more than Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 s, F': " ,DESCRIPTIO iOF,WORK Ea.Limitedadd00 sq.ft.or portion 33.92 1 `�'"' � energy,residential t �c Wl Uc)C 1 t 60'f�'t'Wv "x b C-.1-� 1 G�..v i,, q•ft.) 75.00 2 lil e� V (with above s c Limited energy,multi-family residential(with above sq.ft.) 75.00 2 PROP RII Y O R _ i [�`TI;I ANT „, - Renewable Energy 0 See Page 2 Name: Services or feeders installation,alteration,and/or relocation R Q i d Y l- `---v V'Y\G 1_,.., 200 amps or less 100.70 2 Address: I i C� S C t 7---0 1—t. 1�/'!.V. 201 amps to 400 amps 133.56 2 City/State/ZIP: j� 7 � 401 amps to 600 amps 200.34 2 1 C,V-t�C4 K C `( � [p 601 amps to 1,000 amps 301.04 2 Phone:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or Owner installation:This installation is beingmade on propertyrelocations , notapor intended for sale,lease,rent,or exchange,according to RS 449,670,and 701. 2001 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 , -n, '.. : p16A'P ,IOA!TI';; ' y. x1., ,, ", 12>coCT` ERSON ,a ", A., BranchFeefor circuitsbranch circuits-new,alteration,with or extension,per panel js�/; 6',if e )p�` ` ( `2�„:`� C above service or feeder fee, v `�/ vl(^ Business name: t^ t f 7.42 2 Contact name: I each branch circuit CLy t S N e, f C. B.Fee for branch circuits without Address: 6 6 0 3 L` �� service or feeder fee,first (/ v r r branch circuit 56.18 2 City/State/ZIP: or r-I,, © c �z F / Each add'l branch circuit 7.42 Z 2 Phone:(So 3) --•Z s----Ly Lit r 6 1\ ( C� Miscellaneous(service or feeder not included) /' ( 1 Each manufactured or modular Email: clAv ke 5-C /Lic_�-cA c, '� dwelling,service and/or feeder 67.84 2 �� C ( y� Reconnect only 67.84 2 , y t -,.tt, ;' ONTRACTOR or irrigation circle �. s ,:: _ t Pump67.84 2 Business name: Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above Phone:( ) Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: I Electrical Lic.: I Suprv.Lic.: specifically listed(''/z hr min 90.00/hr ) Suprv.Electrician signature,required: x -ELECT C .'-PERMIT FEES Subtotal: Print name: I Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee):,:/ Authorized signature: \,‘,„.16:7 g,„, 1 TOTAL PERMIT FEE: Print name: I This permit application expires if a permit is not obtained within 180 C,C,V't.5 , 'C�1 e�, Date: .-cs - �,, days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 10/26/2017 440-4615TO 1/05/COM/WEB EPage lectr2ical Permit Application–Information City of Tigard –Supplemental Limited Energy Permit Fees: Renewable Energy Permit Fees: C FEE SCHEDULE " r. RESIDENTIAL ©77��ONLY: Description I Qty. I Each I Total I * Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ 15.01 to 25 kva 200.34 2 Audio and Stereo Systems* Wind generation systems in excess of 25 kva: n 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 552.26 2 with OAR 918-309-0040) n Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 >100 kva-no additional charge 0.0 3 ❑ Vacuum Systems* Each additional inspection over allowable in any of the above: Each additional inspection is 66.25/hr 1 ❑ Other: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/z hr min) ELECTRICAL^PERMIT FEES' k COMMERCIAL- '©RK ONLY: m' Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * 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* n Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: — *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp ELR ERE.doc Rev 10/26/2017 • Plumbing Permit Application RECEIVED Building Fixtures FEB 2 6 2018 1OR OFF I( L t SF ONL, City of Tigard Received p�� Permit No.:ki KTED _CO ,.* 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD DatuBy: r^'- t ! Phone: 503.718.2439 Fax: 503.59p�{ Plan Review Other Permit No. �@S IVNHNG/ENGINEERUN4 Bti. TI G A R LJ Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for Internet w'a'w.tigard-Ocgov Notified/Method: , Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description _ _ Qty. Ea. 1 Total 54.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 I-and 2-family dwelling ( 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: r)5au , V �, I Catch basin or area drain 18.76 C t I Dryw'ell,leach line,or trench drain 18.76 City/State/ZIP: r3�CrC-�1 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18 18.7676 ., 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: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer �i {� }'?� � �� \,.� 25.02 ,- ). y o/ 1=t�_` "�'I t _.--a-(A.r(f..`.rt; Dishwasher 25.02 v Drinking fountain 25.02 titofe (LS. ltc vLf)i ."-- /J`C .7,,fkilj Effectors/sump 25.02 0 PROPERTY OWNER a'TENANT Expansion tank 12.51 Name: t/ Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 `❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: ! i/ 1 ;/ { i ', Medical gas(value:S ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/StatelZlP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: _Urinal 25.02 CONTRACTOR Water closet 25.02 �� Water heater 37.52 Business name: f ,,,cm, ,�Ki L Water piping/DWV 56.29 Address: r1 / / f(71 , A, Other: 25.02 City/Statc/LIP: a� '(/ ��) _ 9 � Subtotal Phone:6 ) 5/`? t-, '1 Fax:( ) Minimum permit fee: $72.50 I CCB Lie.: / 7 l_ /../ j Plumbing Lie.no.: l Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 71 kf,ef(11 -- i TOTAL PERMIT FEE Print name: I 5/C( ,- /J { , Date: Z/1,--5-/ / This permit application expires if a permit is not obtained within 180 days vvv ! l ?1 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I.l-.BuildinglPermitsiPLMli-PermitApp doe 10/01/09 440-4016x(10/02/COM/WEB) , • Plumbing Permit Applicata r,.i.--1-L.,-i,Ari p-re, Li ,.0'41 7 A.,..4 V Building Fixtures FOR OFFICE USE ()NIA City of Tigard 1185 2 Oit Received Permit U 13125 SW Hall BlvdNot7S rc,20.6f_00 413- ...„ .,Tigard,OR 9722.5 : Ill Phone: 503.718.2439 Fax: 503.5p.ii6ili c.., -0-.44,..v, i "i 1111Date/By: Plan Review Date/By: Other Permit No.: Inspection Line: 503.639.4175 '-..•i 1 1:- -1 I 4' /A t"1-1 1 T IGARD Date Ready/By: turis: 0 See Page 2 for Internet: www.tigard-or.gov ifi DiN6 :1,-1,.?,v1,c10,,, Notified/Method: Supplemental Information TYPE OF WORK ' '",,,, , FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist. Addition/alteration/replacement 0 Other: Description I Qty. Ea. Total X New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEIVRY O CONSTRUCTION ,., SFR(1)bath 312.70 K_and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 El Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 El Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: t 70 S-- C iAl i -z_6 rl- ,4.1", Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: er % t 5 co-d 0(Z-. ci ?- ?---c., 3 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: L...L.) 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: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 OF wo EscmPTIoBackwater valve 12.51ilk .cf- :,..., '''''i';';'- ':;., I- / Clothes washer i 25.02 -CNC\cv-- v-coAoof et , be/J-1 r cic4,-A it.-okC, tit Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 itOPERTY OWPIKR '' `,,,, 111 TENANr,-, itE, Expansion tank 12.51 '..t Name: Fixture/sewer cap 25.02 -e'L.VIJ y 4- L 1...-Ci Floor drain/floor sink/hub 25.02 Address: (70 5 S C...../ 1 1.,...02 41^ 4.if Garbage disposal 25.02 City/State/ZIP: ---,,! 4...„.ci C)F.-- / 7)f.7 ---z-3 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 4:APP, ,, , Interceptor/grease trap 6Cr.,,', , :4 0 63.1fr , PEW& :, 25.02 Business name: e-;- ,e,..-,r e peo:i Lz..„/,.)' iiOdtd, .A.7 r Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: (../ti.ii t S K.Nre.i tC Roof drain(commercial) 12.51 Address: v 603 E 49 C t Sink/basin/lavatory 'Z. 25.02 City/State/ZIP: ()CV-r.ay' 09- Ci' -f--2''3 Solar units(potable water) 62.54 Phone:($(..r* ) .75 Li - Li I 5 t, Fax::(407.>) Z-c LI- 1-1 Tub/shower/shower pan i 12.51 Urinal 25.02 E-mail: C.....L.v.t I s 15.. @ ---iilx, 5 (1‘,TC, dec./ ire yr4c i 25.02 7- w y,„,.,4, aof ,th,oRcc,,,,:y ,ccc,,,, lc , c7 Water closet . .." Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Minimum permit fee: $72.50 Phone:( ) Fax:( ) Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: ! e State surcharge(12%of permit fee) Authorized signature: C 1,,i,i.5 1Z....lf Q i'?ti TOTAL PERMIT FEE Print name: CL e lc //' ti fi r----V`e I C, Date: Z ,C- ael t 0 0 This permit application expires if a permit is not obtained within 180 days 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) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea� ) Total SquareFootage• ; 'ermit 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 Valuation: Term t 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 Total each additional$100.00 or fraction thereof,to Other Inspections or Fees QtYt Fee(ea) p h�. 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 P�Y accurately report fixtures could result in increased sewer fees*. Plan Review f*Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type forReplace/ ' Please check all that apply. Work Performed: CapP d' Added "Relocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. CW C ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercialirator Domestic 0 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" IsOSetj k or Riser` iagr itn 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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 -Com/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 fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12605 SW 128TH AVE, TIGARD, OR, 97223 May 21 , 2018 at 11 :42:02 AM Record Type: Record ID: Residential - Master Permit MST2018-00056 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - NoCofO Comments: Final ok per approved plans. Windows existing to structure. Smoke detectors updated. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12605 SW 128TH AVE, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00056 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12605 SW 128TH AVE, TIGARD, OR, 97223 May 21 , 2018 at 11 :38:04 AM Record Type: Record ID: Residential - Master Permit MST2018-00056 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12605 SW 128TH AVE, TIGARD, OR, 97223 May 21 , 2018 at 11 :33:14 AM Record Type: Record ID: Residential - Master Permit MST2018-00056 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor