Permit c// eto
CITY ®F TIGARD BUILDING PERMIT
r r c . COMMUNITY DEVELOPMENT Permit #: MST2010 00069
1 r Date Issued: 05/11/2010
IT f GARG 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
ti vx^ +ar.S �, ;,
Parcel: 2S112CA08600
Jurisdiction: Tigard
Site address: 7562 SW ASHFORD ST
Subdivision: RENAISSANCE WOODS Lot: 12
Project: Sherk
Project Description: Window addition and remodel. 5/18/10, adding (2) additional branch circuits.
Owner: FEES
SHERK, CHRISTIAN C & TRUDI L Description Date Amount
7562 SW ASHFORD ST Building Permit - Additions, Alterations, 05/11/2010 $225.80
TIGARD, OR 97224 Demolition
PHONE: 503 - 620 -7306 Plan Review 04/20/2010 $146.77
12% State Surcharge - Building 05/11/2010 $27.10
Branch Circuits wo /Purchase Service or 05/11/2010 $56.18
Contractor: Feeder
STALEY CONSTRUCTION LLC 12% State Surcharge - Electrical 05/11/2010 $6.74
16869 SW 65TH AVE, PMB 121 Branch Circuits w /Purchase Service or 05/18/2010 $14.84
LAKE OSWEGO, OR 97035 Feeder
PHONE: 503- 545 -1147 12% State Surcharge - Electrical 05/18/2010 $1.78
FAX:
Specifics:
Type of Use: SF
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $10,000
Floor Areas:
Total Area:
Accessory Struct: 0
Basement:
Carport: 0
Covered Porch: 0
Deck:
Garage:
Mezzanine:
Total $479.21
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 a • - - -- • ' h 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 • ENTION: Oregon I -opt requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through OAR 9521: - ∎ 100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/ /1 L 4
sued By: t / ' �� ' � � ?J'[ Permittee Signature: Gr r/g-tA-Z
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
3A` "A MASTER PERMIT
lh
�f
it "'�e CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: MST2010 -00069
1. Date Issued: 05/11/2010
iT1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 112CA08600
Jurisdiction: Tigard
Site address: 7562 SW ASHFORD ST
Subdivision: RENAISSANCE WOODS Lot: 12
Project: Sherk
Project Description: Window addition and 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:
Total: sf Value: $10,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
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 SrvclFeeders 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 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cir:
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:
Owner: Contractor: Required Items and Reports (Conditions)
SHERK, CHRISTIAN C & TRUDI L STALEY CONSTRUCTION LLC
7562 SW ASHFORD ST 16869 SW 65TH AVE, PMB 121
TIGARD, OR 97224 Lake Oswego, OR 97035
PHONE: 503- 620 -7306 PHONE: 503 -545 -1147
FAX:
Total Fees: $462.59
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and at other applicable law. All work will
b one in accordance with approved plans. This permit wit expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: -• - eon law equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR • 401 -0 0 You may obtain a copy of the rules or direct questions to OUNC by callin. 503.246.6699 or ` :01 / 332. .44.
Is ed By: _ I A /
`_ Permittee S ig na�� j - ��
1 E CEIVED
Building Permit Application �s �O
�
3 - ° ` A gyp, z Pi ton County Phone: 503- 846 -3470, Fax: 503- 846 -3993, Inspection Request: 503- 846 -3699
E CST' VidA /, Suite 350, MS 12, Hillsboro, OR 97124 www.co.washington.or.us
BUILDWEWP OPProval: Project # Permit # MS1 A /l -60 496
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
X Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. KA Y g ❑ Valuation 9 1 Q 000 � 1 -and 2 -famil dwellin Commercial /industrial
❑ Accessory building ❑ Multi- family Number. of bedrooms: , ,`
Number of bathrooms: n _ - !�
JOB SITE INFORMATION AND LOCATION
Total number of floors: 9., i
/
Job site address: 7,5 / '� (,j A s� St
City/State /ZIP: ) , l � U New dwelling area: squar- eet
I 3��� '� Garage /carport area: sq rre feet
Suite/bldg. /apt. no.: Project name: � 2k
Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Plan No. Reissue: Yes [ ] No [ ] 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
DESCRIPTION OF WORK equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
tiny c2 t4J AvIeli+i J in4 e4 Valuation
Existing building area: square feet
A PROPERTY OWNER ❑ TENANT New building area: square feet
Name: G k r.,ts 5 f , it Number of stories:
Address: 7 s 6 '� w A, ),., . ,, s)._ Type of construction:
City/State /ZIP: j ole 04 () r Occupancy groups:
Phone: (5'67'3) G1O — 7 . 1 0 Fax: ( ) Existing:
❑ APPLICANT , , CONTACT PERSON New:
Business name: S7 Le � 1 ` 5 Co,,ts�j e "
vial") 00 LL C NOTICE
All contractors and subcontractors are required to be
�
Contact name: WI -).6 G _c_1.-,,,„ � 1 q
1 k6, S' t (� r A , 1 I L I under with the Oregon Construction Contractors Board
Address: U1 J -� under ORS 701 and d may be e required uirered to be e licensed in the
City /State /ZIP: L. t D ■, (t, (),- 9 7 jac jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
Phone: (sci9 5 s - &i ? Fax:: ( ) apply:
E -mail: 4
CONTRACTOR
Business name: S }..„...v C / ' r f f 9 . r BUILDING PERMIT FEES*
Address: �/ j / s L) 6 s --)� /�` w P\ ) > G I Please refer to fee schedule /r� z 77
City /State /ZIP: L ., V , / 7U !�~' Fees due upon application Sa-- .r''jr
)$ f $ — ) / 6/
Phone: O� Fax ( ) Amount received $
CCB lic.: ) 0 , 7 1 Z7 Tfl�/ 1 Date received:
Engineer: , - ) ,, IT Architect: This permit application expires if a permit is
Address: LJi 2 Casty rb Address: not obtained within 180 days after it has
Phone:( Z7 4 ) s Ck Phone:( ) been accepted as complete.
Email: Email:
* Fee methodology set by Tri- County Building
Authorized / /, Industry Service Board
signature: �"p
� _ 440 -4613T (8 /06 /COM /WEB)
I Print name: l l 1 --)--G l .„ ) `�� t Date: `' ()--• / o
Electrical Permit Application " ° ` " i i � ' i ' ici " ii i i 1 1 I V' 41 10 s �� ii'' II ° "' "4
. P I Ii �l lk va °: 61 - k41 0610 iu b.n.d���r MiC Ii Y � �. id a a � .g
� ( C it y of Tigard DateB f/ Permit No.: r� /O'er✓` ^�
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: Juris. ® See Page 2 for
II I (.;'A , , Ready/By: Internet: www.tigard- or.gov Notified/Method: Supplemental Information
. TYPE OF WORK , • PLAN REVIEW . r
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY ,OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION • ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: 76 (-w Six or or more residential R occupancy.
El Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more"
FEE SCHEDULE '
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'1 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
( ^ I , ^L Li esi energy, mu dential (with abo sq. ft.) 67.84 2
fi l / � f / �t (.liC LJ resi above am
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
• ❑ PROPERTY OWNER . ❑ TENANT . • 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( )
Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT '❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Y dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
Business name: panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr.
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00/ hr
specifically listed (Ys hr min) _
CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES
Subtotal: ' r
Suprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name: Date: State surcharge (12% of permit fee):
TOTAL PERMIT FEE: 1 /6 I y
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: . Number of inspections allowed per permit.
I:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11 /05 /COM/WEB
04/20/2010 13:28 50 " - CITY OF TIGARD PAGE 01/01
)Electrical Permit A r ► '}∎ , .I'�' .:1
Ir112tlr t 1 •l ()%1.1
City of Tiger: d RR 99 (� e g y _ . . ` Pe
r13 rmit NvJYs a7o 0 -0le69
13125 SW Hall Blvd,. Tigat ` Q zoio Plan Review •"
Phone: 501.639.4171 fix 503 598.1960 ,� Da Other Permit:
; r , , , : inspection Une: 503.639IY OF TI f'P Tit. AR a Rudvt0r rem - a See rage 2 for
interrret: www.tigardd.p�,riy1.�NC ikFSIMVJ.Sr Mafi fied/Method: 71- Supplemental iarbrmathn
1')fJlr r `l ll �l'V!111W�(,j K1.71
:Y, .1st 4. ._ . J : . * , a ••.. . - _
� _ -n , �- VA ;: " P�� ^• " . . nVl � .. { b+- .Xl�. • rR • �?'ST•IFr R?' � (- 1 1 v .'.-� a yJ•�o�'4 5 -��•1r1' , .! F �`t
11 New co stn Cti ❑ Addit /alt�f8l o i'rcplacemtnl ^ Plea se chock all Wu apply (submit 2 sets otplana Winans checked betty)
O service or &rile 400 amps or more 0 Building over three nonce.
❑ Demolition ❑ Other: wbe e,A available Dale current- OMariner endboaryardn.
: _ - :' 0:0 r• ,1 c'• ; , ' :: caccccs 10,060 magi et ISO veils oc O Fleeting building.
building Inato e•CeCS1!14,000 ❑ Comm erciat.ase
❑ 1 - and 2-family dwelling QCommercial/industrial 0 Ac
c rY
ward fro all nevi inetailationa. tn,ildierrn
❑ Multi - family 0 Master builder ❑ Other: OFlrc veto. D Insteliatirm of 73 KVA or
,- .. i _ Emergency meter. target stparntcry derived system. •
T
. OAddilion new motor load of ❑ "A ", °x•,"1.2", "t•1 "
Job no.: Job site address: 75 , .ec) if toot.. a mote. Reotr atioy.
f� 1354 v morn tsa denial amts. El FQ eafioonl veT icro p:rkc.
City /State /ZIP: 0 Ireerrh•carc facilities. ❑ Severy voltage Orr more then
Ottawas locations. 600 volts seminal.
5uitcfbldgJapt no: l Project name: ��f /� I O Service or feeder 600 amps or more. , �y a1�,pgylit
Cross street /directions to job site: , Recriphse T otr. 1 Pee 1 reset 1 '
New rraidc,rtial single- or tn alb dwelling uni1.
Includes nftacbed forage.
—
Subdivision: Lot no.: 1.000 sq. ft. or lass 168.54 4
Ea. adds 500 sq. It or portion 33.92 I 1
Tax map/parcel no.: Limited energy, reatdaniar -
. -1iillt ` iRi t .. ' ::':....'',1:..1.-.::::_, _ (with above sq, ft) 67 2
Lirnited enprgy, multi -ramify
id/A/ 4" - A- ) residential with above sq. Ft 67 2
/ 7-/o ���� �
Service or feeders installation andhrr relmetion
200 amps or less 100.70 2
E10 iEti•' : • ...Cp i rvi1 `C. . 201 turps to 400 amps 133.56 2
f 401 amps to 600 amps 200.34 2
Name: 7i� ` ffa S W 60 i amps to 1 ,000 amps 301.04 2
Address: S.¢/`J - . Over 1.000 amps or volts 552.26 2
■ , Temporary aerviees r feeders inrtallative. alteration, sad /or r
City /State/Z)P: relocation
Phone: ( ) I Fax: ( ) 200 amps or 1e19 59.36 ` 1
� Owner 201 amps to 400 amps 125,0P 2
wner installation_ This installation is being made on property that I own which is not 401 amps to 599 amps 166.54 2
intended for soic. lease, rent. or exchange, according to ORS 447.449, 670. and 701,
{ � %rancheireuia- new, idteratina,or extension, per panel
V Owner signature: ure:
�, , A. For for branch circuit with
Q yt i'10011' ' ; ::' ' above service or feeder fee.
A '4 r` sash brand circuit 7,42 2
Business name: O. Fee for branch circuits ,olhonr
service or feeder fee, 0rst
Contact name: branch circuit , 56.18 if 2
N. Address: _ Each edd'1 branch circuit j 7.42 2
q Miscellaneous Joerelce or feeder not Included)
City/State/ZIP:
Each mannfaetttred or modular 67.84 2
1 1 dwelling, service and/or coder
Phone: ( ) I Fax: : ( ) Reconnect only 67.64
E - mail: = Primp tr irrigation circle 67.84 2
:.. - c :• :.... ..):-'..".e.;1'2:::. ,.,,,: ;, Sign or outline lighting 67.84 12
. �.�NlliAii r � . -,:' . '' ' Signed cineait(s) or lithe )•energy L
Bus iness name: 2T L L 5 - G EZ7• i e_ pima Malodor, or extension. Page 2 , Z
Emelt overallnwable In any or the above
Address'
PQ j ed . 7 Additional inspection (1 hr orbs) 1 66.251 hr
City/Statel7.TP; C� r7 / imitsligation (1 Per min) 66.251 hr
Aar" _c — � � Ue OI [ I (e l n d ostriel plant (l h min) 78..81lrr _
Phone: �) �� // I Fax:) 35 _ Inspccrians for which no Ice "s '
‘1•• .} • $ LiC.' J ` specifically listed CA hr min) 90.00f Iv
A , s y0 Elect rical tic.; e .7/ GQ _ , , . ac-• _ _ - 0 •S' t csw ir� "? i' ::4.• .• y.. ti L.
� 4 Suprv. Electrician. signature, required: Subtrt►a1: A.
Pl an review (25% of permit fee):
4 Print nerds: ./ I r *: ! Date: r(. 7-z --- f d State surcharge (I2% of permit fa):
Authorized sign re: TOTAL PERMIT FEE:
` r mi, penal& applle.tisa eaple. • permit te ear e&reined .ialn 180
1 _ I days after a ha, bee. excepted as coople?,.
Print slam : 1 • / / w
( ll ..ir D �� � (( Number criaspecriona allowed Dorpermlt.
I:IRj Dermite M.C- r4,mit , • dee IN el OP 110.46i3r01rosteoev es
I, 'd Z999 - 6Se - s 09 011 0 P1 08 13 S,I1 BE9:90 Ol• 2 Jdy
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORICONLY: -
Fee for all residential systems combined .. $67.84
Check Type of Work Involved:
n Audio and Stereo Systems*
n B • urglar Alarm
n G • arage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
F O ther:
COMMERCIAL WORK ONLY: i
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
[1 Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: \ Building \Permits\ELC- PermitApp.doc 10/01/09
\A r D / • t 006 7
g
kAM
MILLER
CONSULTING
ENGINEERS
FACSIMILE TRANSMITTAL FORM
TO: City of Tigard FIRM: City of Tigard
FROM: Andrew Leichty PROJECT: Residence Shear Wall Design
DATE: Tuesday, May 18, 2010 PROJ. NO.: 100262
FAX NO.: 503- 624 -3681 TIME: 3:13 PM
Copy to follow via ❑ US Mail ❑ Courier Service ❑ Email ❑ Other
Total number of pages: 3 , including this page. Please call (503) 246 -1250 if you do not receive all
pages.
MESSAGE:
Permit No: MST2010 -00069
Per the request of Staley Construction, attached is a revision to the original permit plans.
Please contact us if there are any questions.
Miller Consulting Engineers, Inc:
1cs� t PR O fe j ,
Andrew Leichty. P.E. -r.. 1 182 r
Principal
. � , OREGON
O y i� 4I r
c.c. Mitchell Staley 503-214-8467 4 G. v?,
EXPIRES: 06-30-2010
9570 SW 1. arbur Blvd.. Suite 100 Portland. Oregon 97219 -5412 Phone (503) 246 -1250 Fax 1503) 246 -1395
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