Permit (139) III CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2018-00337
Date Issued: 12/19/2018
T r G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S133AD11700
Jurisdiction: Tigard
Site address: 10732 SW 127TH CT
Subdivision: AMART SUMMER LAKE NO.3 Lot: 173
Project: Jenkins
Project Description: Interior remodel including replacement of staircase railing and tub/shower.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $5,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 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: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<10OK: 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: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
JENKINS,ANDREA L&JAMES N WIDE RIVER GROUP Required Items and Reports(Conditions)
10732 SW 127TH CT 6312 SW CAPITAL HWY#122
TIGARD,OR 97223 PORLAND,OR 97239
PHONE: PHONE: 503-358-3156
FAX:
Total Fees: $348.76
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 OAR 952-001-0090. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.22332.1987 or 1.800.332.2344.4.
Issued B �� //� Permittee Si nature: /`!
/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential RECEIVED FOR of i icF: CSI,0y1.1
City of Ti and Received '^ �/
g Date/By: �2 ,l/AF .... PermitN ?/�?V���(J33
13125 SW Hall Blvd.,Tigard,OR 97223 f E C I 0 2018 Plan Review y,
s Phone: 503.718.2439 Fax: 503.598.1960 Date/By: I n v �S /Jn Other Permit:
Tic;n K D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / i Juris: I ® See Page 2 for
Internet: www.tigard-or.gov •.tified/Me • : / 4 Supplemental Information
DIVISION -
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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
Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
1-and 2-family dwelling 0 Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: 2 171._
JOB SITE INFORMATION AND LOCATION Total number of floors: 2-_
Job site address: /07 ?2 S L,/ / .7 r �*- New dwelling area: square feet
City/State/ZIP: 77(,* ()/ on-- / G,7 Z 2 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Si,i Se,A4itit3 Deck area: square feet
51.,—) AI ,<4 r, Yr. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
lam/ 7 -f0A- /�' 5/1.dOLLC /X
- //✓ L. 4.1.. Valuation: $
(2-cCl'L.4-C-0 n 6,-JT �r;cl/c�. ge,74,aExisting building area: square feet
-rag./��d�o� New building area: square feet
,l.I'ROPERTY OWNER 0 TENANT Number of stories:
Name: /l..� j
t 1��, NS 1g Type of construction:
Address:l /1:Y-732_ 0 d../ /.2 -7..4, C_r. Occupancy groups:
City/State/ZIP:77 )e 0 , Ar__ ,-72,2- Existing:
Phone:(296) 77'3_ s--(4,62 2 Fax:( ) New:
APPLICANT- 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: WI b ., ( r✓6t Ct S-7;evc7/ ' ,�j
�1 Structural plan review fee(or deposit):
Contact name: `,D sF( l.-;,:i'4 t.2'
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received: 917, 3
Phone:( )
E-mail: LJ D pi `st dFax::( jQ„L)� 1 co PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
�O F 4'
Business name: //V1/67...(z_ y_i c r cr.-JO-1,JSubmit two(2)sets of roof plan with connection details
(�7� and fire department access,along with the 2010 Oregon
Address: (03 i 2 c lJ Cnf/re,L. h!L✓7 -4/7 Z._ Solar Installation Specialty Code checklist.
City/State/ZIP: Pm,.rL t OW- 872'3 Permit Fee(includes plan review $180.00
and administrative fees :
Phone:(1'33)'S 6-6 - "gf 5-g— Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 'L 2_2_et Total fee due upon application: $201.60
Authorized signature: c, This permit application expires if a permit is not obtained
1 /21/0lL^D((� within 180 days after it has been accepted as complete.
Print name: 1„PH Date: / *Fee methodology set by Tri-County Building Industry
V V' Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling rolz orrice: t si. o'l.I
City of Tigard Received
Permit No.:
4 13125 SW Hall Blvd.,Tigard,OR 97223 Associat
_ Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
TIGARD
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No ' k
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 a a
2 Zoning. Floodplain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 ❑ 0
4 Fire district approval required. Name of district: • ❑ ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0
6 Sewer permit. 0 0 0
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ 0
9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size 1
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
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 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ 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- ❑ ❑ ❑
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
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 ❑
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
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 0 0 ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manutactured floor/roof truss desigii eTails. - -0 Cl - 0 -
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ 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 ❑
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". ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 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
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ 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
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, 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.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Plumbin Permit A licati CEIV
Building Fixtures FOR OFFICE 1 SE ON1.1
City of Tigard �`{{`^ Q� Received
G l 1Date/By: Permit No.:
U 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
= Phone: 503.718.2439 Fax: 503.5 tern Other Permit No.:
Inspection Line: 503.639.4175
�� yy 1 T I G A� Date/By:
l I G A R D j g �{��f Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov T ��1�11�I� Notified Method: Supplemental Information
_ I'DING
ri
TYPE OF O FEE*SCHEDULE
I=1 New construction 0 Demolition For special information use checklist
Description Qty. I Ea. Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CON$TRUCT!ON SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
ElAccessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
?401.3 SITE 1NFoRMATIO1' AND'LOCA'PION Site utilities:
Job site address: /D7 32 S 1-1 /2_7 ' c_4_.
Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: -7-76,,,LZ2 3
7 7 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 0 I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: S c./,/ S e /,/c V-?a....,k-s:11 (J _ Manholes 18.76
GL-..) A9dr,L(� L 'KC-.- Sae- !�'�"J Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Stone sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
I SC1W TION Off.WORK C 7 Backwater valve 12.51
,'., s-,. _ x, "'' t `t" Clothes washer 25.02
2-0/1'w A�- ,�Pr C�00L 6.t.e.-,/��T 6) Dishwasher 25.02
TU 03/2P /.--1Z Sc - f�ph O Drinking fountain 25.02
Ejectors/sump 25.02
501tOPtRTY OWNER ] 0 TENANT `; Expansion tank 12.51
Name: .Q.,,,/�.r j 0'K-'ALS' Fixture/sewer cap 25.02
Address: /J,_ Floor drain/floor sink/hub 25.02
�7 SW �7 - Garbage disposal 25.02
City/State/ZIP: / ii � /l 9 7 ZZ 3 Hose bib 25.02
Phone:(r 41 s- 7 Fax:( ) Ice maker 12.51
4� zz
APPL _ 0 ,c..,,,, ,,A,,
PERSON Interceptor/grease trap 25.02
Business name: V,,l d IPS(✓ -'Ie_ 7.��Gn�„f Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: ci OffT?
L� Roof drain(commercial) 12.51
Address: /2 S 4.-.__) Cif PJ TO 1-.- 1-6--,7 *I./2 2 Sink/basin/lavatory 25.02
City/State/ZIP: 1f27Lq� aye_ Solar units(potable water) 62.54
Phone:( 3)35-5 - 3/s c„. i Fax: :( ) Tub/shower/shower pan ( 12.51 (1-14-1
E-mail: �s kQ Urinal 25.02
i'".,,_+ 'f - �� �� Water closet 25.02
CONTRACTOR
-4-(._
n ' Water heater 37.52
Business name: 4L( S' Ct7P4 _ Water piping/DWV 56.29
Address: f r 3
UQ e7 s f,..l B, �..ei2/j/ur T
S ,' Other: 25.02
City/State/ZIP: */�2� .� -7v�' , GA!O(97 Subtotal
� Minimum permit fee: $72.50
Phone:(5b3) CyZ-7 _of i,3 Fax:( )
Plan review (25%of permit fee)
CCB Lic.: /97-7 Zg Plumbing Lic.no.: State surcharge(12%of permit fee)
Authorized signature: v -----_.. TOTAL PERMIT FEE
Print name: U M -1% Date: 2.//62This 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. poi( ) Total Square Footage: Permit°Fee:
Footing drain-1st 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
Storm&Rain Drain-1st 100' 62.54 Valuation; Permit Fee:
``"
$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
Gt 'inspections or Fees"> ) Total each additional$100.00 or fraction thereof,to
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
accurately report fixtures could result in increased sewer fees*. Plan 'ew forfoi*mbhi:Olsallations
Quantatby Fixture
� Type.�,. Plan review is required for any of the following.
Fixture Typ'e'for It Please check all that apply.
Work Performed: Capped ARd,ed 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
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
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"
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/Serv/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:
10732 SW 127TH CT, TIGARD, OR, 97223 February 1 , 2019 at
10:52:01 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00337
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor