Permit (82) CITY OF TIGARD MASTER PERMIT
INll'.. - COMMUNITY DEVELOPMENT
Permit#: MST2018-00321
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/28/2018
T I C.A I<.D9 Parcel: 2S112CA02300
Jurisdiction: Tigard
Site address: 15210 SW GENTLE WOODS CT
Subdivision: GENTLE WOODS Lot: 15
Project: MCKEE
Project Description: Basement 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. Yes
Total: 0 sf Value: $30,000.00 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 1 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 1 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 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!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 5
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:
MCKEE,KATI FANTZ BME INC Required Items and Reports(Conditions)
15210 SW GENTLE WOODS CT PO BOX 2396
TIGARD,OR 97224 LAKE OSWEGO,OR 97035
PHONE: PHONE: 503-704-2206
FAX: 503-697-7751
Total Fees: $1,288.63
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 througg••A-952-001-0090. You •- •• - • - ••y. - es or.1 - •uestions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _JL.r_g‘,e`t_ _ Permittee Signature:
Call 5'. ..0'75 by 7:00 a.m.for the next available inspection dC)----.2.---‘,/-___ :(5--€.,_r
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR 0l I i( 1: t 0\l.1
CI of Tigard Received _ !, '� p
ipqg a FIN
i'
Date/By: �/ 7 � Permit No.: Ms/ 7rt/7�
13125 SW Hall Blvd.,Tigard,OR �. E plan Review + �J((�
■ Phone: 503.718.2439 Fax: 503 598.1960 Date/By: �l� % G3 Other Permit:
�-i ARD Inspection Line: 503.639.4175 (1 ap p Date Ready/By. //,,,,' Juds: , ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:/1 i f, ,/ J.I Supplemental Information
f,. t r
TYPE O1I( IN(3 DIVISION REQUIRED DATA:I-AND 2-FAMILY DWELLING
El New construction 0 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.
Valuation: $ '3 C9
gj 1-and 2-family dwelling 0 Commercial/industrial
Accesso buildin Number of bedrooms:
0 ry g ❑Multi-family
0 Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ( a. I a c lio 6 ...4-1e '0 der,„ New dwelling area: square feet
City/State/ZIP: 1 n x-1 / h G1.7 2?
1 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: ") G "I- CO 6.12.-",--1-1-e Deck area: square feet
(4•1'
IA) _L-3 I) r Other structure area: square feet
6; / e C sCs if f j--/90i REQUIRED DATA:COMMERCIAL-USE CH, KLIST
Subdivision: Lot no.: Permit fees*are based on the value of the wo performed.
Tax map/parcel no.: Q — Indicate the value(rounded to the nearest•• lar)of all
Vol 7 i I. isc77 equipment,materials,labor,overhead,,. d the profit for the
\ DESt�RIPTION OF WORK work indicated on this application.
Q •- (` Valuation: $ ,
VAS i Existing building area;i square feet
New building are.: square feet
ROPERTY OWNER ❑ TENANT Number of s 'es:
Name: -Tlm C K„, Type of construction:
Address: t 5'a,( v SLA /'?—..f-i, Wi,-0J5 (7_,+._ Occ,.'.ancy groups:
City/State/ZIP: I-. ,� OR. q 1 ?.2'-I Existing:
Phone:(9);) a /.c L Fax:( ) New:
via APPLICANT El CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to jee schedule
Business name:
Structural plan review fee(or deposit):
Contact name: d �J
FLS plan review fee(if applicable):
Address:
Total fees due upon application: �
City/State/ZIP:
Amount received:
Phone:( ) I Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive; stallation of
CONTRACTOR roof-top mounted Photo Voltaic Sol.."anel System.
Business name: f:(1 (42(-
/ --)44— ,O a Submit two(2)sets of roof pl.t-With connection details
' '�,l � r { � f `'C and fire department acces ong with the 2010 Oregon
Address: /(J B T /}3 9V
1 Solar Installation S� 'alty Code checklist.
p� l Permit �.--'includes plan review
City/State/ZIP: t /�j�� -']� ( p $180.00
(4141. o g 0 ✓J 3 : and administrative fees):
Phone:( ) 70-ti �b Fax:(Jl'j�) `"7(7,7 7/7 S% State surcharge(12%of permit fee): $21.60
CCB lic.: . -7(.2o Total fee due upon application: $201.60
Authorized signature: ,� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 4,. tDate: / *Fee methodology set by Tri-County Building Industry
4.2_0ll /a-� /{ Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46f/3T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFl( F FSE Oy►.v
4
Received
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223
I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I G A R D
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW lcs No " '
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 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
4 Fire district approval required. Name of district: • 0 0 1i
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 M
6 Sewer permit. 0 0
7 Water district approval. 0 ❑ 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ;l 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 F2' ❑ ❑
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 .l ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, El ❑
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 ❑ ❑
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. . ] ❑ ❑
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- 12 ❑ 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 .. ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered .23 0 El
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.
0 ❑
20 Manufactured floor/roof truss design details.
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 El
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 ❑
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® 0 ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. •] ❑ , 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ M
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ El
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ 4E1
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ j0
and protection measures must be drawn 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, ❑ ❑
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.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ReceivedDate/By: Permit No.: i `4 —>
111h13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' Phone: 503.718.2439 Fax: 503.598.1 6
,, Date/By: Other Permit:
T 1 c, R D Inspection Line: 503.639.4175 "" Date Read/B Jug
f , , 7„ i Ready/By: la See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
v ,.� .. . 1NQv 2, b, �? 6►ry i�R T
TYPE OF"WORK ". .,CIAL FEE* SCHEDULE =USE CHECU,,
' '''� ^ wn ''' Mechanical permit fees*are based on the value of the work
❑New construction ' Addition/altt 4 c3 { performed.Indicate the value(rounded to the nearest dollar)of all
a t a.-, d rl eO?\
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:
CATEGORY OF CONSTRUCTION
ESPIIIAL Et1JIPMENT/SY'S EMS FE1;S*
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
:TOB SITE INFORMATION AND LOCATIO "" " Heating/cooling:
Lx.)
� � Air conditioning 46.75
Job site address: t`S \C7 <' IN 4. p �cr9 a5 " Furnace 100, 000 BTU(ducts/vents) 46.75
�"� c9,(4... q, a
City/State/ZIP: � Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: 1 'rt• ( Hydronic hot water system 23.32
( � � �7 Residential boiler(radiator or
V` ai d S 4/c 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: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
4
` *�' �' ``" � t Gas fireplace/insert 33.39
ON OF WORK° i'. e1'
'�'tea` Flue vent for water heater or gas
D ? ^_��,� tzif- O.2 fireplace 23.32
Y"� ] ,,� ,��Y� Log lighter(gas) 23.32
1 i C .Q - `�' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
" a. 4x = .. Other: 23.32
" Ak, '$ P 3�p<e' _�� * . ,nr":41'•te .#'
.. ..,r.a .5- .a �: k."t�r'wL
rs"
.
'" 71 •ait t
Environmental exhaust and ventilation:
Name: +i
- Gl ` �� Range hood/other kitchen
L�'-- equipment 33.39
Address: 1., .}t C> S �V`,,, 1 J j v`' �c4.5 e`-f- Clothes dryer exhaust ` 33.39 33 39
City/State/ZIP: ` —r J t Single-duct exhaust(bathrooms,
` +�7' toilet compartments,utility rooms) / 23.32 ;3, .,
Phone:(5-0 V 5 a .Ce S . Fax ( ) Attic/crawlspace fans 23.32 �/
] APPLI = (INTACT PE - ,., Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
TOR dryer(gas)
�� } '' � � e tl`� '�" '' Clothes as
Business name: A� •�p Other:
M� � d V ` 'la,,, MECHANICAL P' S* it t,
Address: .x,
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: _ 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: '.&._ .., Q® * Fee methodology set by Tri-County Building Industry Service Board
Print111110.-
name: , C -,, Date: `
I:\Building\Permits\MEC_PermitApp_040I13.doc 440-,617T(11 I2/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
,Total Valuanpn ; Permit Fiee � '
$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
Electrical Permit Application ro►z 01.1,1( 1 tis►:osl.v
o ! ew
lig13125 SWHallBlvdTigard,OR 97E��,J.. ri,., ' a"
1111Phone: 503.718.2439 Date/B : Related Permit#:
Email: TigardBuildingPermits@Tigard-or. 1G�V a2 7 2Jur
is:Ready Date/By: See Page 2 for
T i G n K D Inspection Line: 503.639.4175 Internet: www.igard-ot.go Notified/Method: Supplemental Information
TYPE OF WAY OF i ICARDPLAN REVIEW
0 New construction 4Addition/alt 's p °E ailS r(,y i\k Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
A.
1-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.
0 Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: i�,� 0 Addition of new motor load of system.
v A 44 e IA) l, j 100HP or more. ❑«A» «E,> ..1.2„ «1 3„
City/State/ZIP: ❑Six or more residential units. occupancy.
(It((}l�d 0 ��� ❑ ❑Recreational vehicle parks.
I Health-care facilities.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. ❑Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: "lot AiyNG.�l��----jo . FEE SCHEDULE
A Description I Qty. I Each I Total I *
V v l� New residential single-or multi-family dwelling unit.
Subdivision: )--Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
W.- C Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
C-3 -2t C''e Renewable Energy 0 See Page 2
PROPERTY OWNER 0 TENANT` Services or feeders installation,alteration,and/or relocation
'/
Name: .�'�n1-, 1. A C ,{1 ,y !1 200 amps or less 100.70 2
Address: t 5?-1 0_\S l o �(- o , t 201 amps to 400 amps 133.56 2
n 401 amps to 600 amps 200.34 2
City/State/ZIP: ( -�C ®R. CA ')2.94 601 amps to 1,000 amps 301.04 2
Phone:(.-D7,) 5 0 z 70 GT t Over 1,000 amps or volts 552.26 2
i f Temporary services or feeders installation,alteration,and/or
Email: y c 1. 0!1g relocation
Owner installation:Thi all n is bel
made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670, d 701 201 amps to 400 amps 125.08 2
Owner signature. Date:!( a2 7 /C3I 401 amps to 599 amps 168.54 2
CANT 0 CONTACT P SOMI Branch Branch circuits-new,alteration,or extension,per panel
0A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7'42 - 2
Contact name: B.Fee for branch circuits wit ut
service or feeder fee,first ®
Address: branch circuit 56.18 Sb'V 2
City/State/ZIP: Each add'I branch circuit 41 7.42 ?Y. 6`Q 2
Miscellaneous(service or feeder not included) 0
Phone:( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 4 is ,. 6yv1 - 1u,O V Sign or outline lighting 67.84 2
Address: W"`� ��CC 11((/! panel,alteration,oor extension.n. ❑ See Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(1/2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
7.,
This permit application expires if a permit is not obtained within 180
Print name: V.eli'sk
► i( C i' _ , Date: i �7days after it has been accepted as complete.
J / Zr••r� `713.• ' Number of inspections allowed per permit.
I:�Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(l1/0M/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE )I7LE
I *
Fee for all residential systems combined: $75.00 Description Qly. Each j Tnta�
3' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ 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)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
VOMMERVI ffi , e ONLY. ELECTRICAL PEI = j3
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Inst lation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging/.ystems
❑ Landscape Irrigatig' Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor,landscape Lighting*
❑ Protec ive Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 10/26/2017
Plumbing Permit Application
Building Fixtures FOR OFFICE I SI: 011.\
City of Tigard Received
` w Permit No.: -,
13125 SW Hall Blvd.,Tigard,OR 9 �„ldt 4�! , n Date/By: ��� � � �
= Plan Review �/
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
I I G A R O Inspection Line: 503.639.4175 NOV
2 " 2016 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WO ()TY
TIG
R FEE* sCHE'),I 4
❑New construction tlitleUNgiIll\/IF;a 0 `.k For special in ormation use checklist
Description Qty. Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY t I CTION SFR(1)bath 312.70
g 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
�
17:',..'k "'4,04107%. it- ,RMATION)1r$) LOATJON Site utilities: _
Job site address: 1 s--a 1 D 5 G I vt)C.n�- A CAL".
Catch basin or area drain 18.76
v Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tc �- ,' v '7) or �
`� ISFooting drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: -7 q'� G�-�)C6,e,......4-1,
- 1 4, Manholes 18.76
A7-1��1 '
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 i\ 31.27 3/17+
,,
DESCRIPTION ?.' Backwater valve 12.51 ``^C 'Z. ^C
'. i^ .` :`''° Clothes washer I 25.02 5 1)�
�Vt'�-p V� W`P�- �-- Dishwasher f 25.02 c2S'a2
r�Srl � M�ie_ - Drinking fountain 25.02
Ejectors/sump 25.02
4 PR ` R 1 TENS'y . Expansion tank 12.51
tx {
Name: ` M G Fixture/sewer cap 25.02
! Vv V A V` �� C__.4--
Garbage
Floor drain/floor
iisposa sink/hub 25.02
Address: � -
C C ✓ Garba a disposal 25.02
City/State/ZIP: a ,fl 0 Ol Z ...„;)_.1.-1 Hose bib / 25.02 ,J,,p.
Phone:(935) � 6,ty-7 Q Fax:( ) Ice maker 12.51
* .,APPLICANT 0 CONFi4 PERSON , Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Contact name: Noo`,gyp Primer 12.51
u�' Roof drain(commercial) 12.51
Address:
Sink/basin/lavatory 25.02 50,di
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan / _ 12.51 I,,
E-mail: Urinal 25.02
CONTRA K Water closet / 25.02 7- p)
Water heater 37.52
Business name: ,_ k toL✓_e' Water piping/DWV .,..,/-. 56.29 5644.
Address: i/ Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.:
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: 6.2::S "_"_ TOTAL PERMIT FEE
Print name: C Date: r� / This permit application expires if a permit is not obtained within 180 days
I t. 7 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 Utiht es Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-151 100' 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 K2 cy 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 V uation: .Permit 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
.Feed o each additional$100.00 or fraction thereof,to
Other Ins►ectio - =r FeeS, 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
accuratelyreport fixtures could result in increased sewer fees*. "bing
i��. �Vie�'Y`.foi' , . 1 6 IIlS ,:. $
P :..
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for > Pl' Please check all that apply.
Work Performed: Capped ; Added Relocate
Baptistry/Font 0 Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator / 0 Medical gas and vacuum systems for health care facilities.
0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash ;'r Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3 Vkt etrie-or Rism`.a alp h:
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain /
Garbage -Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related /
-Commercial food relat
-Industrial food relat-.'
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station %
Shower: -Gang
-Stall
Sink: -Lav/Bar non-ood related
-Bradley /
-Com/S-• /Util food related
-Servi *Note: If the fixture work under this permit results in an
Swimming Por Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clea es fees assessed for the sewer increase must be paid before the
Water Ex i :ctor
Water Cl'set-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:
15210 SW GENTLE WOODS CT, TIGARD, February 25, 2019 at
OR, 97224 2:34:20 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00321
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor