Permit CITY OF TIGARD MASTER PERMIT
IN ,
I ' COMMUNITY DEVELOPMENT Permit#: MST2019-00343
Date Issued: 08/26/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S104CA03400
Jurisdiction: Tigard
Site address: 13648 SW LAUREN LN
Subdivision: HILLSHIRE Lot: 34
Project: MAI
Project Description: Basement bonus room conversion to a bedroom.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Yes
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors:
Total: 0 sf Value: $3,000.00 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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Natural Gas Heat Pump: N Hoods: 0 Other Units: 1
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: 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 N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
-MAI,Mtt.HEtt€L&MATTHEW E - OWNER- = Required Items and Reports(Conditions)
13648 SW LAUREN LN MATTHEW&MICHELLE MAI
TIGARD,OR 97223 13648 SW LAUREN LN
TIGARD,OR 97223
PHONE PHONE: 503-954-7665
FAX:
Total Fees: $312.51
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 952-001-009 btain�rules or direct questions to OUNC by calling 503.232.1987,or 1.800.332.2344.
Issued By: / P'errflittee Signature: (r//
/774....______
03.639.4175 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 I OR 01 1.1( I. 1 SI ()NI I
City of Tigard RECEIVED Received
g Date/B : i 1 ! Art Permit No.: . j ,,10.t"7•
.11111 I • 13125hnSW Hall B.2 39d.,Tigard,OR 97223
8.19 Plan Review �i ice'. `i'l
Phone: 503.718.2439 Fax: 503.598.1960 AUG 2 6 2019 Date/B : C I M Other Permit:
TIC D Inspection Line: 503.639.4175 Date Ready/By ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:0 / .;,t �►� Supplemental Information
BUILDING DIVISION trQ� .
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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $? ("-L_
1-and 2-family dwelling 0 Commercial/industrial /U-fL
ccessoryNumber of bedrooms:
❑ building 0 Multi-family
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13(i q% s(A) L4,4 ft'.vt LI/1 - New dwelling area: square feet
City/State/ZIP: ,q x.11 ) 9-x.4 3 Garage/carport area: square feet
Suite/bldg./apt.no.: J Project name: I-MN (31/44,04„‘ �(�A= Covered porch area: square feet
Cross street/directions tojob site: /_'
Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
&00,-�r'� �� u.S Kdil# Y) /.,rlt/t i �vt/ '71j ei Valuation: $
Ae'llY14 Existing building area: square feet
New building area: square feet
GKPROPERTY OWNER 0 TENANT Number of stories:
Name: pfolti t,,." - VI; d 4; Type of construction:
Address: 13(7 i{ S Ind Lua✓e 0 Lo Occupancy groups:
City/State/ZIP: f` t,�I)0l(, 97,Ea 3 Existing:
Phone:(S'a- ) .Sy_'4(,4 Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: ,eve.-1e+` �
(Please refer to fee schedule.)
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application: 3 j). )C I
City/State/ZIP:
Phone:( ) Fax::( )
Amoun`f receive.,�-. ._..
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specially Code checklist.
City/State/ZIP: Permit Fee(includes plan review
and administrative fees): $180.00
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:
Total fee due upon application: $201.60
Authorized signature: iie
7 -- - 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
Print name: Lt I MQ�' Date: /a(r/�y Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist '
One- and Two-Family Dwelling I O R oil R I. I S l o v l.l
Cl of Tigard Received Permit No.:
g Date/By:
ill • 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
s Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
1It,ARD
Internet: www.tigard-or.gov O Other:
THE FOLLOWING ITENIS ARE REQt !RFD FOR PLAN REVIEW l« v" ` v
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. A ❑ 6
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 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 , ,
6 Sewer permit. 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 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 ❑ ❑
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
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
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 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
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
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ 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
architect licensed in Ore.on and shall be shown to be a•.licable to the s ro'ect under review.
JURISDICTIONAL SPECIFICS
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 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 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, ❑ ❑ ❑
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 ❑
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 CSE Oyl.l
•
City of Tigard Received
Date/By:
13125 SW Hall Blvd.,Tigard,OR 972213 E E V Plan Review
ill Phone: 503.718.2439 Fax: 503.598.19 Other Permit:
Date/By: Permit No.:�p `
T I
GA R U Inspection Line: 503.639.4175 AUG2 6 2019 Date Ready/By: funs: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB STTE INFORMATION AND`LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: ) (,tf r s-6,) 1..4 L.fie...1 l Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: I-1304, L 4.. <l 7 a,a,3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: > L Duct work i 23.32 .52
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
D R1'YFION OF WOGas fireplace/insert 33.39
Flue vent for water heater or gas
C U A J{,1/S l u+1, G 10 i,✓11A s V.() i'D (4,-- - (8t',if u, , fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
UPERTY 41WNER :TENANTY
Other: 23.32
A / `/� Environmental exhaust and ventilation:
Name: kid"e, i. .. p/14,7 t
/i. Range hood/other kitchen
equipment 33.39
Address: i3 6(15, s i.,.i L4,,,,,,-e, Lh
Clothes dryer exhaust 33.39
City/State/ZIP: --r-:#1- G1'�d o'z c,7J 3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(Su 1)ei
iS _-7 ,4S Fax:( ) Attic/crawlspace fans 23.32
Q APPLICANT ri',CONTACT PERSON `:, Other: 23.32
Business name: Fuel piping:
Serb"-' . L5 a,i°4re-- $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
,
ttttetZl
Water heater
Phone:( )
E-mail: Fes::( ) Fireplace
Range
Barbecue
CONTRACTOR Clothes dryer(gas)
r
Business name: 'llOther:
Address: MECHANICAL PERMIT FEES*
F J a v k g-S 1�L Subtotal
City/State/ZIP: SLt'V Ai-...,c �} 97f 1/(, Minimum permit fee($90.00) qtA 434-
{ Plan review(25%of permit fee)
Phone:(9 ]+ ) 3 ) -Si)1 3 Fax:( ) State surcharge(12%of permit fee) `l1. p
CCB Iic.: /6/pAr 1 d I TOTAL PERMIT FEE jam),�j
1( This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: /� �� * Fee methodology set by Tri-County Building Industry Service Board
Print name: n c,,,) F Mgr Date: /) //q
'7
I:\Building\Permits\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
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13648 SW LAUREN LN, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2019-00343
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
All smoke detectors updated to current code.
Final inspection for Basement bedroom ok.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13648 SW LAUREN LN, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2019-00343
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor