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Permit IN ,';, : CITY ®� y� �® _ MASTER PERMIT COMMUNITY DEVELOPMENT • . PERMIT #: MST2008 -00032 DATE ISSUED: 4/4/2008 T;f G'A R n 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134DD-01200 SITE ADDRESS: 11675 SW TIEDEMAN AVE ZONING: R - 4.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: PENA Project Description: Altering existing garage. Installing (2) branch circuits. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT • HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: s1 GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: 2 ,000 0 0 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sr REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS; CLOTHES DRYER: FURN > •100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ' ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 • 200 amp: W /SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/0 SVCIFDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT: � nn MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: v 1000• amp /volt : PLAN REVIEW SECTION Reconnect only > =4 RES UNITS: SVCIFDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: 8 ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL . B. COMMERCIAL C9 AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: Y BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: 0 GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS: 0 This permit is subject to the regulations contained in the Tigard l3 Owner: Contractor: Municipal Code, State of OR Specialty Codes and all other applicable ® e JOEL PENA BATEMAN CONSTRUCTION INC laws. All work will be done in accordance with approved plans. This �+ 11675 SW TIEDEMAN 4991 SW NEVADA CT. permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 PORTLAND, OR 97219 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952-001-0080. You may obtain copies of these rules or direct Phone: Contact #: PRI 503 452 - 2380 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 768 -4986 Reg #: LIC 1 1 1019 TOTAL FEES: $ 170.55 REQUIRED ITEMS AND REPORTS i d' .. �` ,��' �- - �'- ' Permittee Signature � � P �' ,• , . Issued By . -; C -l ,' �.� � � � 3 _ _ Call 503.639.4175 by 7:00 a.m. for an inspection thM 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. q ;. 1 I Y •T 1 fq COMMUNITY DEVELOPMENT MASTER PERMIT PERMIT #: 8 - 00032 DATE ISSUED: 4/4/200/4/200 8 !TIGAR6 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134DD-01200 SITE ADDRESS: 11675 SW TIEDEMAN AVE ZONING: R - 4.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: PENA Project Description: Altering existing garage. Installing (2) branch circuits. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 2,000.00 REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADDL 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp: 601+amps- 1000v: MINOR LABEL: 1000+ amp/vol : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVCIFDR> =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable JOEL PENA BATEMAN CONSTRUCTION INC laws. All work will be done in accordance with approved plans. This 11675 SW TIEDEMAN 4991 SW NEVADA CT. permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 PORTLAND, OR 97219 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: Contact #: PRI 503 452 - 2380 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 768 -4986 Reg #: LIC 1 1 1019 TOTAL FEES: $ 170.55 REQUIRED ITEMS AND REPORTS _...- -....amon..- ' 1 ,....„ .. Issued By . ----- �// Permittee Signature : ���� �� , - Call 503.639.4175 by 7:00 a.m. for an inspection t siness ay. 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. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00032 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639-4171 14/1 Inspection Requests (24 Hrs.): (503) 639 -4175 s_' ' ._.. INSPECTION WORKSHEET FOR DATE: 6/5/2008 TIME: 7:00AM PAGE: 37 SITE ADDRESS: 11675 SW TI EDf MAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: Altering existing garage. Installing (2) branch circuits. OWNER: PENA, JOEL PHONE #: CONTRACTOR: f3A - I EMAN CONSTRUCTION INC PHONE #: 503 -452 -2300 Inspection Request Scheduled For: Date: 6/5/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 070920 -01 503 -516 -5710 Y Corrections /Comments /Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 6- S Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -0002 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639 -4171 4 111111' Inspection Requests (24 Hrs.): (503) 639 -4175 _.. INSPECTION WORKSHEET FOR DATE: 5/21/2008 TIME: 7:OOAM PAGE: 8 SITE ADDRESS: 11675 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: Altering existing garage. Installing (2) branch circuits. OWNER: PENA, JOEL PHONE #: CONTRACTOR: EBATEMAN CONSTRUCTION INC PHONE #: 5034152 -2380 Inspection Request Scheduled For: Date: 5/21 /2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 070226-01 503-516-5770 Y Corrections /Comments/ Instructions: G Z. (b v (A ❑ PASS /PARTIAL AL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date:/ e5 Phone #: (503) 718- "2--9--(> CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200B -00032 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/412008 Phone: (503) 639 -4171 +� Inspection Requests (24 Hrs.): (503) 639 -4175 ,''f�,. INSPECTION WORKSHEET FOR DATE: - 5/13/2008 TIME: 7:02AM PAGE: 23 SITE ADDRESS: 11675 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: A9.. ring c�.xir.ting garage. Installing (2) branch circuits. OWNER: PENA, JOEL PHONE #: CONTRACTOR: BATEMAN CONSTRUCTION INC PHONE #: 503 -452-2380 Inspection Request Scheduled For: Date: 5/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 06979501 503- 516.5770 N Corrections /Comments/ Instructions: 6 }/ 6cr7Zi G9 L A2/ i ,4o ggizi � 9 Cc e , 7Ti^� 4 L'r , ; - /e.<11rU 9"4-4 /4M - - vS'r� � � Gs�L::,. 1. � rA-cy,\ ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: S —/ —e.e Phone #: (503) 718 �51--`F I . CITY OF TIGARD BUILDING DIVISION PERMIT #: MST20t)0 -00032 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4M/20i08 Phone: (503) 639 -4171 A l..l�ltib, Inspection Requests (24 Hrs.): (503) 639 -4175 __' INSPECTION WORKSHEET FOR DATE: 5/9/2008 TIME: 7:00AM PAGE: 14 SITE ADDRESS: 11675 SWTIEIDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: Altering g existing garage. Installing (2) branch circuits. OWNER: PENA, JOEL PHONE #: CONTRACTOR: E3ATEMAN CONSTRUCTION INC PHONE #: 503. 452 -2380 Inspection Request Scheduled For: Date: 5/9/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 230 Underfloor insulation 069667 -01 503 - 516-5770 Y Corrections /Comments/ Instructions: 7. n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 3 9 - Phone #: (503) 718- Z`SJ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00032 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/8/2008 TIME: 7:01AM PAGE: 14 SITE ADDRESS: 11675 SWTIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: Altering existing garage. Installing (2) branch circuits. OWNER: PENA, JOEL. PHONE #: CONTRACTOR: BATEMAN CONSTRUCTION INC PHONE #: 503- 452 -23€30 Inspection Request Scheduled For: Date: 5/812008 Pour Time: Code # Inspection Description Confirm # Contact # Message 730 Underfloor insulation 059598 -01 503516.5770 N Corrections /Comments /Instructions: 214! ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 3 `gi b Phone #: (503) 718- 4z5- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200t3- 00032 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/20(38 Phone: (503) 639- 4171�e Inspection Requests (24 Hrs.): (503) 639 -4175 ..:_..� INSPECTION WORKSHEET FOR DATE: 5/6/2008 TIME: 7:00AM PAGE: 24 SITE ADDRESS: 11675 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: Altering existing garage. Installing (2) branch circuits, OWNER: PENA, JOEL PHONE #: CONTRACTOR: BATEMAN CONSTRUCTION INC PHONE #: 603 - 452 - 2380 Inspection Request Scheduled For: Date: 5/6/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post /beam structural 069432 -01 603-516-5770 Y Corrections/Comments/Instructions: ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: S F, Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: IviST2008- 00032 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5!2/2008 TIME: 7:00AM PAGE: 23 SITE ADDRESS: 11676 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: Altering existing garage. Installing (2) branch circuits. OWNER: PENA, JOEL PHONE #: CONTRACTOR: BATEMAN CONSTRUCTION INC PHONE #: 503.452 -2380 Inspection Request Scheduled For: Date: 5/2/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/bearn structural 069261 -01 503- 516 -5770 Y • Corrections/Comments/Instructions: 1 /�%cf77L ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS AIL It ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- ? CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008.00O32 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4141:0013 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR • DATE: 4/18/20013 TIME: 7:01AM PAGE: 16 SITE ADDRESS: 11675 S,'STIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PENA DESCRIPTION: Altoring existing garage. Installing (2) branch circuits. OWNER: PENA, JOEL PHONE #: CONTRACTOR: t3A l EMAN CONSTRUCTION INC PHONE #: 503-452-23130 Inspection Request Scheduled For: Date: 4/18/2003 Pour Time: 100:0 Code # Inspection Description • Confirm # Contact # Message 205 Footing 068586 -01 503-516-5770 Y 2/c co AA Corrections /Comments /Instructions: PASS ❑PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: a Phone #: (503) 718 - .Z,t_a�.• Electrical Permit Application ' ` '4' ' O FFICE USE O K `.. ; ; s a,, City of Tigard Receiv / � . - p `J g 1�� DateBy: // (>Yj Permit No.. S7 - 10 1 (1 ` °co. k. o r. q 13125 SW Hall Blvd., Tigard, OR 97223 �Y Plan Review ( / J N--.:- ® Phone: 503.639.4171 Fax: 503.598.1961 •i' �46 Date/By: Other Permit: 1.* y"^ Inspection Line: 503.639.4175 C . 'r .- Date Ready /By: turis: ® See Page 2 for T I G'A R Ui Y r t otifi e d/Method: Su lemental Information '�aAta gra Internet: www.tigard- or.gov � \ ` pp TYPE OF..WORI � ... 1 ���.: ;,-, ji ' . . . PLAN' REVIEW ❑ New construction Addition /alteration / v p�acq �i� ` j Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Other: 210 r ,� 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION • . exceeds 10,000 amps at 150 volts or ❑ Floating buildings. Al - less to ground, or exceeds 14,000 ❑ Commercial -use agricultural {J 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 JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: / ,, ) 100HP or more. occupancy. 1 6 7 — Jl ",) 2 - 4 ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: , ❑ Health -care facilities. ❑ Supply voltage for more than 0t 0 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 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTIO OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 4 roe, ,06,_ & �r -to /,5»,_)� residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation ` j 7/iL& 200 amps or less 80.30 2 ROPERTY .OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: /70EZ ip2j /-_ 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: /'/ /7$- �� 77G Z Over 1,000 amps or volts 454.65 2 City/State /ZIP: 77 M Temporary services or feeders installation, alteration, and/or relocation Phone: l �l (77/ Z Z - 7/ 3) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 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, 6.65 2 each branch circuit Business name: /2 /CJ ( /iv B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 �(� 2 J ,(� j% :;i9� first branch circuit i Address: 999/ / S� /0 PVfZ2' C-/ M s llan branch (service circuit t 6.65 C (D5 2 Miscellaneous (service or feeder not included) City/State /ZIP: d Q Each manufactured or modular �7� / 90.90 2 dwelling, service and/or feeder Phone: (.3,3) y 238 z7 I Fax: : ( 7 66 — 996 ,6 Reconnect only 66.85 2 E -mail: j . ,��r r..) ak415 77ZuC?? 2A c2 C0 '1C-1,5 Pump or irrigation circle 53.40 2 CONTRACTOR' Sign or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: 4e4 -.-— "296— , Z Z7 Krii energy panel, alteration, or Address: extension. Describe: Page 2 2 City/State /ZIP: �rAr Ue 9'- l Each additional inspection over allowable in any of the above I Per inspection 62.50 Phone: (<43 ) C / 2 / — t/ 87 7 Fax: ( ) Investigation per hour (l hr min) 62.50 CCB Lic.: l 33 09 Electrical Lic.: _ f c '-- Suprv. Lic.: II() / 3S Industrial plant per hour 73.75 V ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Print name: Date: Plan review (25% of permit fee): - State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I: \Building\Permits\ELC- PermitApp.doc 05/23/06 440- 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 .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: 1 COMMERCIAL WORK ONLY: —' Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ID Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: 03/23/06 ' -" B> Permit Application y . • Residential � � �74,A 444,;c y 5't,.'+i rFi .'�F Ct'7" ty t ax n et s +r'y'd . ! � 'Y _ . z ' k - �. OFFICE ( ONLY rr ' � %,,4 �t ,,x '?„ i yi r +3 dlic : :µ a , USE ..'�'R , , '7 , : ro .1 P1`....:,- , iw, C Of T igard „ A Date/B : �d 6 p Permit No.: 3461, ...5 jj 6 ` /Ce . V 13125 SW Hall Blvd., Tigard, OR 97 v �v Q ,. �O Phone: 5 03.639.4171 Fax: 503.598 6� , n DatePlan B C}Q Other Permit: F Revy: ie '' I'G AR D Inspection Line: 503.639.4175 � t � , 1 . � d `T 1a ® ate Ready /By: luris: See Page 2 for .:ups' Internet: www.tigard or.gov CPC �'• 1 A : 10 r otified/Method: Supplemental Information Oki �� 0:; . TYPE OF' WOlf r� 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 gl Additi a terati - replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 000 Q . 00 ❑ Accessory building ❑ Multi - family Number of bedrooms: � ❑ Master builder ❑ Other: Number of bathrooms: . JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 t (07 5 S W T .1 CC Av.Q New dwelling area: square feet City /State /ZIP: 1 C\Ct V C1 1 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: TPt,Q Covered porch area: square feet Cross street/directions to job 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. `, Q [� Valuation: $ lJ Existing building area: square feet New building area: square feet a PROPERTY OWNER ❑ TENANT • , Number of stories: Name: V 0 p ` � �� Type of construction: Address: l l � c C e l.k.) T 2 Q cxr /Q Occupancy groups: City /State /ZIP: ( J �+ J- C\ Existing: Phone: ( ) Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE . .. Business name: All contractors and subcontractors are required to be Contact name: kO C`f ,, licensed with the Oregon Construction Contractors Board _ J� 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: n ,y✓ L_DitJ STIZJGT7Dit1 /Az, r BUILDING PERMIT FEES* Ad Address: ! 91 `,.� eu x)�h Grp (Pleaserejerrtojeeschedrrte) dress: /State /ZIP: Structural plan review fee (or deposit): City/State/ZIP: �� ©� 'J7 2 / / FLS plan review fee (if applicable): Phone: ( ) (../ _ 3Y, v Fax: (5/3S) 7 6 8 — c o S 6 CCB lic.: /// 9 Total fees due upon application: Amount received: • Authorized signature: I : � This permit application expires if a permit is not obtained z 09-7----e7-74-1.4,-/L9 y- Q we m n 180 days after it has been nt Building as complete. �%7 Print name: !` Date: U- � J * Fee methodoll by set by Tri -County Building Industust ry Service Board. I: \Building \Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02 /COM/WEB) Building Permit Application Checklist S, w ,w ^ Fo 'd`1.44¢ �'�''�.Y ;. a't'e„ ,;9- if R0, r �I K', One- and Two- Family Dwelling < . OFFI E , U oNL �' y „ R eceived. City of Tigard y ;' Permit No.: � 0 13 125 SW Hall Blvd., Tigard, OR 97223 AAssociated 'permits: ' _2 Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 ❑Electrical ❑Plumbing ❑Mechanical -T, I G' R D ,, , , Internet: www.tigard- or.gov . ❑ Other: 7 ' THE FO afoWIN E RE ( O I gti A ttf V IE"We R ~ ,V es `No N A'' • 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 Oregon and shall be shown to be applicable to the .roject under review. '` -- 9..01SDIC� N L %PTC ICSl ,m vw , �i Y,1 7 . - ,, , . a _. IO S. ._ ... rl h ,. .... , . t� 3,w. `ai! �d` worm., ; , .V _ ,�,a 4- ` ` r t ,. • 23 Five (5) 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. r 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 accompanied by 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- RES- PermitApp.doc 03/21/06 440 -4613T(1l /02 /COM/WEB) CITY OF TIGARD COMMUNITY DEVELOPMENT TiGfR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Electrical Signature Form REC ;. ,41 IMPORTANT PERMIT NOTICE MAY 2 0 2008 THREE DOG ELECTRIC BUI JGD G� 5250 SW CAMERON RD !VISION PORTLAND, OR 97221 Permit #: MST2008 -00032 Date Issued: 4/4/2008 Parcel: 1 S134DD -01200 Site Address: 11675 SW TIEDEMAN AVE Subdivision: Lot: Jurisdiction: TIG Zoning: R-4.5 Project Name: PENA Description: Altering existing garage. Installing (2) branch circuits. Your company has been indicated as the electrical contractor for the permit referenced above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work. Please mail the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681. If you have any questions please call 503.718.2433. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: JOEL PENA THREE DOG ELECTRIC 11675 SW TIEDEMAN 5250 SW CAMERON RD TIGARD, OR 97223 PORTLAND, OR 97221 Phone #: Phone #: 503- 246 -4726 Reg #: ELE C188 LIC 138509 SUP 4613S AN INK SIGNATURE IS REQUIRED ON THIS FORM X E v„ r 1 1 - ‘1S S Signature of Supervising Electrician Name (printed) SUP LIC #