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Permit CITY OF TIGARD MASTER PERMIT s . COMMUNITY DEVELOPMENT Permit #: MST2010 -00040 :xi GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/19/2010 Parcel: 2S114BA01600 Jurisdiction: Tigard Site address: 16180 SW GRIMSON CT Subdivision: PICKS LANDING NO. 2 Lot: 123 Project: Brod Project Description: Install 5' x 6' window in front wall. BUILDING Floor Areas Required Setbacks Required Stories: 1 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: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $798.00 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 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =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 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 addl 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) BROD, STEPHEN D & YVONNE W OWNER 16180 GRIMSON CT TIGARD, OR 97224 PHONE: 503 - 639 -3334 PHONE: FAX: Total Fees: $175.21 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: MO k, vu_ \ k.1Q Permittee Signature: ,>_ Q Q *P Building Permit Application r .b: "( 'y Residential RECEIVED y �� �, , , ,K 0 "41.'. , d,4ia " "i + '.:':1i t . (1l I IC I ` UtiI t)\ 1 : , • „1 : A ,s�t�,T ti �, • 111111 City of Tigard QQ ,. Received ` i g Io Permit No.: s I t � - ,, MA 1 [n DateB ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 t Date/B : �� �e I �� Other Permit I (. A It I) Inspection Line: 503.639.4175 CITY OF TIGARI) Date Ready /By: Juris: ® See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING • ❑ New construction 111 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 0 work indicated on this application. 7?? Cs" � Valuation: $ .D.Z2- and 2- family dwelling Ib I- 11 Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: (to i e. 0 3. , ) , C Y' I y s o v C- , New dwelling area: square feet City /State /ZIP: 1 0 a r O R CI -7 Z 2- 4 --r Garage /carport area: square feet i Suite /bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: l6' ec e VJ ,- L rVs 5 e1 Deck area: square feet Talc, n C_ 1/ k/A VICIVV11 eZA — � `r tA V1 / SZ) . d r1iv Other structure area: square feet 4 e c e 1n a — ) r v e- - 5tro 1 v.11 e&4 t Yirb 6 Irl PLR 1/ REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: t c 1 0. 5 )1o I Lot no.: / ` `3 Permit fees* are based on the value of the work performed. � "+ Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: -, equipment, materials, labor, overhead, and the profit for e /I ,.j the • DESCRIPTION OF WORK work � r work indicated on this application. 1 ' d A c,_ �7 & -et, t tc) , f -or" Valuation: S ( ` �„ s Existing building area: square feet U New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: Si-.CV e— ,- r L) p h r G g rz) e Type of construction: Address: I t 150 4. I(� . �T r 1 v s 0 1 , 1 c j Occupancy groups: City /State /ZIP: 1 T ' 1 q Ckr . o R ei 7 2— el Existing: Phone: (5t ) 6 5 J C / , - 3 3 -3 44 Fax: ( ) New: ❑ APPLICANT • ❑ CONTACT PERSON NOTICE ., ' Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors.Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax::( ) E -mail: CONTRACTOR Business name: BUILDING PERMIT FEES* (Please refer to fee schedule) Address: LL) r Structural plan review fee (or deposit): City /State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: Total fees due upon application: Amount received: .r (f) At Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: St Gu e r ,,, Date: a3 - 1 — id * Fee methodology set by Tri -County Building Industry Service Board. l: \Building\Permits \BUP -RES PermitApp.doc 10/01/09 440- 4613T(I I /02 /COM/WEB) Building Permit Application Checklist , ,,,� Ole � One- and Two- Family Dwelling 1 <1II Icl llk; ' IA A y t --1--:-,:-- .,:' • Received t City of Tigard y Permit No l ig V 13125 SW Hall Blvd., Tigard, OR 97223 D Associiated permits: e . Phone: 503.639.4171 Fax: 503.598.1960 ' 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical sa..: - ;> Internet: www.tigard - or.gov ❑ Other: M FOiritWEIR iCKESI S1 1zr iz70-1 rig "OIZ.di— .RIB IIKA '" RRV- t 5� �% 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ 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 ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ 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. ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ 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. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ 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 ❑ ❑ ❑ architect licensed in Ore. on and shall be shown to be applicable to the .ro'ect under review. . Z . P t -.0 ` - 611'.' 7t] i: Y ,rs . L % It A-1,1, Y�'C J ' • t ;'}l r4- p . u i -?_ ' - ,I 4F �. = I ,_ UD D IC , f S _ I I ,. ,1 CrS1 1 .1: ._. t . 4. 1 . . A' r• �_ ,- ,,T . ,��r :� . l 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. ❑ ❑ ❑ 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. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ 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, ❑ ❑ ❑ 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. 1:\ Building \Permits\BUP- RE$- PermitApp.doc 03/21/06 440- 46I3T( I I /02/COM/WEB) PN RE CEII 9 1L D ` rr; 'r yNtr �2 ( �.,,,,, ( ° j.. I i Sa6, l �h't fi a { + ' rr Electrical Permit Application f`', y���, �p, it f ir �y x3 ^,. 6Nllav y�1E Yt:a �p3ot �kls ^i WPm aeMi , isu . . 1 «r.rtr..> Received Ili City Of Tigard MAR 1 8 2D10 Date /B : igt /Q Permit No.: H5ra60.- 060 O 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598 GI I X OF TiGARD Date/B : Other Permit: I' I c A R 17 Inspection Line: 503.639.4175 Date Ready/By: hris: ® See Page 2 for - Internet: www.tigard - or.gov BUILDING DIVISIOI Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW • ❑ 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 ❑ I- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ", Job no.: Job site address: / [� /` .} IOOHP or more. occupancy. { f/ 71 0 S t /�l f1't 60,, CL ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: Health -care facilities. ❑ Supply voltage for more than Ti 9 u 0 /Z 7 a a `� ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: t7 Project name: r 0 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] 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 Limited energy, multi - family 67.84 2 residential (with above sq. ft.) 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 /J 401 amps to 600 amps 200.34 2 Name: S /O k B. n l /� I . l? It O d 601 amps to 1,000 amps 301.04 2 Address: /6 /11-0 S W 6 et m sQ of G j, Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City /State /ZIP: j t Q4G / 0 le f?a .2 9 relocation Phone: 0`63) f , 3? 3 3 3 4/ 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 ex ange, 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: 3 I! 5/lz0 w A. Fee for branch circuits with above service or feeder fee, ❑ APPLICANT . 1 ❑ CONTACT PERSO each branch circuit 7.42 Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit ��p,�� Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) manufactured Each City /State /ZIP: dwell ng, service d/or feeder or modular 67.84 2 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 (V: hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: . ELECTRICAL PERMIT -FEES Suprv. Electrician signature, required: o Subtotal: r Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): k 74_ TOTAL PERMIT FEE: ij f, • R 2j. Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. N um b er of inspections allowed per permit. 1\Building\Permits\ELC- PermitApp.doc 10/01 /09 440- 4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: • Fee for all residential systems combined .. $67.84 Check Type of Work Involved: n A • udio and Stereo Systems* ❑ Burglar Alarm n G • arage Door Opener* n Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls • • ❑ Clock Systems ❑ Data Telecommunication Installation I - 1 F ire Alarm Installation ❑ HVAC ❑ Instrumentation n I • ntercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling • ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1: \ BuildingWermits \ELC- PermitApp.doc 10/01/09 • i I CITY 4 T IGARD , ... 1 _ : Conditionally APprovgd..;. [ - • ]' ; -- ■ j i See Letter to Follow I ? i ! i i i - Attache f ! { Permit a:• : ti-1 ' , d . 1 . 1 ICt i ; Approyed pI ns' Y ' Ad. i�'Z _ ,'.7 ��,, ; i shall be . I. s • . ' , i B pate on , i f { 1 t I 1 1 t i I 1 : i > H HHH - H j ' _ . 1 , • • 1 I i f i i ; I i Y - -- I r — f i _ I ; J ,. ' l ' 1 K z' I i _ �i 1- ' t f YI 1 , ■ I R ,J�fD V , j i 1 . I i f 1 i f I i i r i i 1 i i } ' y 1 1 ! ? 1 i 1 1 f f ? .. i __ t - , -..-i - . 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