Permit CITY OF TIGARD MASTER PERMIT
111 I.. " COMMUNITY DEVELOPMENT Permit#: MST2020-00150
T t Gr A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2S/18/2020
Parcel: 2S 108 DB04200
Jurisdiction: Tigard
Site address: 15277 SW THAMES LN
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 40
Project: McIntosh
Project Description: Cap plumbing fixtures in existing half bath to convert into closet space. Close off original entrance
and open wall to extend space into existing master bedroom closet.
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: $2,500.00 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 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 2
Drywell-Trench Drain: 0
Other Fixture Units: capping fixture/sewer
MECHANICAL
Fuel Tvees Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum<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: 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:
MCINTOSH,RONALD PATRICK&BRITT 360 HOUSES REDO Required Items and Reports(Conditions)
15277 SW THAMES LN 3155 SW 199TH TER
TIGARD,OR 97224 ALOHA,OR 97003
PHONE: PHONE: 503-863-9709
FAX:
Total Fees: $293.41
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 9521-0090 You m obtain a copy f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / /lit mittee Signature: fl VZ (:: :: � a
Call 603.639.4175 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—
. I ECEIV C.D FOR OFFICE I SE(PS LI
. Received <•• ,s.--• .i),...t.
City of Tigard MAY 4 2020 ,,,,,,,.. --- = ,. ,
4,. ( :
,c SW Rail Blvd..Tigard.OR 97223 ^ Neu Reim
-7 , ifo- Other Pane•
1 a. l'11)11c 54)1'7112439 F4x: "3.998-1rITY OF TIGARD '''''''
inspectiort Lee 503 6:19.4175 Due Ritat,S,F
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irtkrriet Imr.v.W,,ard-or gov BIR_DINGD!VISON '''' ' '''' ' - ' ..4-/A s.pplerientikt leacrestlee
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',,L1 Nev*etItts11111:11041 0 Demolition Permit fees'are limed on the value of the work pertbrmed,
- Indicate the value(rounded to the nearest dollar)of all
7 AddaidivalteradoWreplaceracrii elpther: equipment,materials,labor,overhead.and the profit for the
Indicated ou this application,
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end"-•,..,,,t,-1;.. relining 0 Comintecndindustrial I
0 Multi-family Nutuber of bedrooms:
' El other NtInthcr of bathrooms:
T. „Pt:'+• , sam( 1.41; Total rIlkfilba•of Rowe
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,.,:-. ,ad 4i.iiir,:.•,-; is2-7 7 SA,..ir, 77/i9/4t7S I New dwelling area; square feet
‘ditiet/IP: •---* A O. 22cir, Ciaragecamors anea: Name fix(
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suiteibitivapt„no,: isiONC1 NUM: ctSa Arts ...% ( at.1 I 4 Covered porch mem Nuare feet
,' Cross suer to job site: ei Deck area; square feet
Other Amelia-it arca: square find
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Subdivision: Lot no.: Permit fees*are based on the value of the work performed,
Indicate the value(rounded to the maresi&Mall of all
I as reteeparce i: equip-net*mataials,labor.overhead,aid the profit for the
DI ( Rt pTiryit, OF wo;. ":„Ii.5.4•;!g-f•i•---"7:---i-l-z,„„i7,ii ..Itiitiiiql. welt ineicatcd on thisieati041-
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(7 • A..V OkotS I a,.46(01M Pt tit a oco IN,- 0 4 'Pr vaivation: s
I) AV,r4 i)sv, ' Existing building Mt: square fect
IA,0 4 ar›, sit el - s
f 0 .
, MQICYq (17 1CAii1 P . . Kew building atea: $q4.414 tiet
PU01'1.61} trisMtit .- r7 1 1.N -ri;;,:icit6itttei" s"-igi.-ii Number of stoner.
e
: Name, Type of construction:
€ Address:
Occupancy grOldpa;
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.. Existin2.-
Plidrar.t
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Inatioces name: 360 #40.05t,„7-5 12-E700 )14-4„,...
s,n,,,,,,,--,:p1.4...4 I t'''iew fee tor deposit):
Contact name: Al ikas19.0s_ * .1... FLS plan review fee of applicable):
Address:
Total fees due:upon application:
CityNatti/IP:
Phone:‘5(.3 1 „3 .97b5 Fax::( j Amount received,:
----`ral s,,,xo-.-arJ7Ak:nr,„+prait,vwxuis-os(:sr(:zoreta(--smstniita
r 4tiait 1 3€0 iloulfs tt-CIAD OIN ail. CP4A--
- Commercial and residential preacriptive installation of
CONTRAfIfilt 1.. roof-top mounted l'hotoVoltaic Solar Pare'System.
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. B148,03Ct6 ilan1C, h 34-c. bttwoseN, f ,--to kit
1 ' - submit,two 12)sets of roof plan with oonnection details .
, and the diatiannent amen,along with the 2010 ategoil
i Address,: 31g5- ,S* Figitt, Ttt, 4 i sok..tesiallation Specialty Code checklist
! -
CityiState/ZIP: oi't (Cji Ok.. 9?t).03 Permit fee(includes plan review
SISPO0
and administrative fees):
1i Phone:(5;b3 ) Ng.; 4-jog t..:(s93) 7040 State mucilage i 12%apennit Re): S2(.60
(-en fic.: 11{0.3g 664)/24 , -
Teal fee doe Ullne application: _
$201 60
Authorized signature ei=4=4.--0 /I Tins permit amplitatioat expires ifs penult is not()limited
..,,,,,1 P _t Prin"ancrr),H15EZ_A -, Dilte=5/5629te 0 whist*180 daps after it bas been accepted as complete
*Fee Methaniney set by Tri-Couray Building Memos
, Service Board.
I itsuldintiPeraritiOBLT-RESPenetAppitoc 0.2124/011 440-4613T4 11 61)2X'factirailift)
'Plumbing Permit Application
.-4tc s FOR OFFICE INSE ONLY
eived
City of Tigard Rec Rece,iv Permit No.:
DatIt.' at 13125 SW Hall Blvd.,Tigard,OR■ 972E �"` VE plan Review
an Rev i Phone: 503.718.2439 Fax: 503.598 1 L^ P Other Permit No
Inspection Line: 503.639.4175 Date Ready/By: Iuris: h3 See Page 2 for
IIGP,k:L) Internet: www.tigard-or.gov ���:tf t -Tn.... Notified/Method: Supplemental Information
TYPE OF WORK PEE" SCHEDULE
❑New construction ❑1)em,d ppi�pp,, -` For special information use checklist
1-� -J��Jti DIVISION Description I. Qty. I Ea. I Total
El Addition as-1
/alteration replacement Other: New 1-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CON r t SFR(1)bath 312.70
Ec1-and 2-farnily dwelling ❑Commercial/industrial SFR(2)bath 437.78
SIR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other Fire sprinkler(_sq.ft.) Page 2
30Tt Tf, )NV01ay1 4 a. - °. ainflati Site utilities:
/ T/� CS Catch basin or area dram 18.76
Job site address !S� 77 / t'l / V-3
--T- / � Drywell,leach line,or trench drain 18.76
City/State/ZIP: / �^^^f(9d� �j k, tij?pro Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: �/ I Project name: veficero 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: I Lot no.: Fixture or item:
Tax map/parcel no.: l3ackflow preventer 31.27
DESCRIPTION OF WOR( ' Backwater valve 12.51
f Clothes vrasher 25.02
r ,�,. r1 C�"�.L r'"�/ ova Q Dishwasher 25.02
t/ A 1. 111 co ou 'CZ.i I iJ.'-0. 4 > Drinking fountain 25.02
7 ✓ E f `: ' Ejectors/sump 25.02
0 ,-,,,, 0, v " Z Expansion tank 12.51
Fixture/sewer cap 7 25.02 , L1
Name:
�l i
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/Z1P: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
�i .APPLICANT,_ / t r ; , Interceptor/grease trap 25.02
Business name: rr�� ace - ; Medical gas(value:$_) Page 2
l>LT O- / �C� Primer 12.51
Contact name: //�,� �jJ�
l l4 ka `� A.A re.t. Roof drain(commercial) 12.51
Address. Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:(sa3 66 3 9 70. Fax: :( ) Tub/shower/shower pan 12.51
F � _ Urinal 25.02
E-mail: ... 'f r r �_0, _
Water closet 25.02
CONT 1 r
Water heater 37 52
Business name: , . " ��-99,, /�Ao (. Water piping/,DnWV) 56,29
Address: 3 ft jc t$� /JCJ Other j(t b I% a I a, 25.02
City/State/ZIP: A co4A ' or 70� Subtotal C1j.1
Phone:(&'31 jr 7 Fax:(X 3')6 Z1'`-,7l)Jo imam permit fee: $7250 '"7 -�
ti 111 Plan review (25%of permit fee)
CCB Lie.:t /�®, Plumbing Lic.no.:
State surcharge(12%of permit fee) `a.7i)
Authorized signature: �1 J TOTAL PERMIT FEE g1-
Print name. C�ui p L.�T) (./tPe Dale. �{^ /�,�, This Permit application expires if a permit is not obtained within 150 days
t after it has been accepted as complete.
°Fee methodology set by Tri-County Building Industry Service Board.
I:IBuriding`Permits\PLMU-PemtitApp don 10/01/09 440-4616T(10/02/COM/WEB)