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Permit CITY OF T � ���® r MASTER PERMIT ' l - PERMIT #: MST2008 - 00006 COMMUNITY DEVELOPMENT DATE ISSUED: 2/20/2008 TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 103AC -01300 SITE ADDRESS: 11245 SW FONNER ST ZONING: R -4.5 SUBDIVISION: LOT: JURISDICTION: T1G PROJECT: OAK Project Description: 569sf addition. . BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 569 sf BASEMENT. sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sr FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 5f RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: 1 BATH: 1 TOTAL: 569 sr 54.049.31 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER: ELE FURN > =1006: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: . 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 0 - 200 amp: W /SVC OR FOR: 0 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FOR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: 3 SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: P 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY 00 A. SF RESIDENTIAL B. COMMERCIAL i AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: 0 BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 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 e RICK /BARBAR OAK EASTERLING CONSTRUCTION laws. All work will be done in accordance with approved plans. This 11245 SW FONNER ST 9007 SE 39TH STREET ST. permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 MILWAUKIE, OR 97222 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: 503 -887 -1252 Contact #: PRI 503- 744 -0268 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 744 -0268 Reg #: LIC 179394 TOTAL FEES: $ 1,354.36 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 i Iss ed By :.L f MAL! _4LL_I ..�. • Permittee Signature : 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. CITY OF TIGARD BUILDING DIVISION N• PERMIT #: MST2008- 00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21'201200U Phone: (503) 639 -4171 ���,. Inspection Requests (24 Hrs.): (503) 639 - 4175 . ': , 'I�.. INSPECTION WORKSHEET FOR DATE: 3/19/2008 TIME: 7:01AN1 PAGE: 10 SITE ADDRESS: 11245 SW FONNEF ST CLASS OF WORK: SUBDIVISION: • LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 589sf d taon. • OWNER: OAK, RICK /13ARFiAR PHONE #: 503. 887-1252 CONTRACTOR:. EAST E1-ZLING CONSTRUCTION PHONE #: 503 -744 -0268 Inspection Request Scheduled For: Date:' 3/19/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 3 : PPM/beam plumbing 068868 -01 503 -367 -2152 Y Corrections /Comments / Instructions: j-c (,A1 4✓ �'► TV' i p Al.° 1-., S Lo. i \ lV c -- j' 70 c A-. cc -Tb • (A r o I,"J a-6✓ SeJ.,s u.• °•" 46-x, � p� S z : n , -CL e- e n Lit' At cep , � Pr,�..��»„ Cza �,., � J;LJciocc. "bow 4 1 \ ma c✓ ;.,o; n P ,r6.1.- , A -CD cii•* n PASS [PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CY \f_ui 1 V Date: 3 L9 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 00:;06 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2J20/2008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ...Va _. INSPECTION WORKSHEET FOR DATE: 5/15/2008 TIME: 7:00AIYI PAGE: 33 SITE ADDRESS: 11245 SW FONNER ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 6694 addition. Adding and bath, relocating kitchen, structural dhang s, and decommissioning septic system. OWNER: OAK, RICK PHONE #: 503.887 -1252 CONTRACTOR: EASTERLING CONSTRUCTION PHONE #: 503 T44 - 0268 6.5 A1 / 7 i 1V /5 Cp PP' 09/1/S , • co/J Insp •ction 'eq est scheduled For: ate: 5/1512 , 8 Pour Time: / Code # Inspection Description 1 ,10, A onfi # . Contact # Message 275 Framing / 9 X 90 , 950-01 2 Y o 503 -887 -1 F �'GiFcgo e7 PLe % � "cA-L.- UNpLE - " C /Com nstruc ons: ' 1- c' �,c. vfrb / N6- ', 4EC'7r U - /A cieD1/ A/ i____Ag:160_(2= �g s / = c N -- EX 7 Ai 7Z & iii i)-re ��, X3 , z) 77 I v F-- /�fs— Pkov D &,D . Uss u- W49.1.i7 4 e24 /HPseA/./ ✓G�� az LS 77,4�r a c;•7 Ara.-- •. - 0 / af 2 ° 'I • [1 --_ L0 LA- , 1)N. e • 3-/------ ,/ • '7!;6--- V .7 - , 0 a:, - /16-- .--e57r , -.1_, 6 ' - -7t71 / � LocA-Doss /oo - Mvz - ./. /l/l5 ^-. '< JC- -e- .� o C/ P7&N �o �/e " -tee (��� , � kbi / e e& 4 oil; e 497''/1/6 --f f -; _ P, S RTIAL AP RO A CANCE - _ NO ACCESS k ' - :IL LL FOR IN , ION _ ADDITIONAL FEES ASSESSED Inspector: ' Date: / - Phone #: (503) 71$:2 CITY OF TIGARD - BUILDING DIVISION PERMIT #: MS1 06 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/20013 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 - 'f AI INSPECTION WORKSHEET FOR DATE: 4/21/2008 TIME: 7:00AM PAGE: 19 SITE ADDRESS: 11245 SW FONNIER ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 5694 addition. OWNER: OAK, RICK PHONE #: 603 CONTRACTOR: EASIERLING CONSTRUCTION PHONE #: 603 744 - 0268 Inspection Request Scheduled For: Date: 4/21/2008 Pour Time: Code # Inspection Description Confirm # Contact # . Message 2 Extelior sheathing 068657 -01 503- 367 -2 °152 N Corrections /Comments/ Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS _ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: �- 2-/ —a & Phone #: (503) 718- Z4-- / CITY OF TIGARD BUILDING DIVISION PERMIT #: MS1200 00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2120/2008 Phone: (503) 639 -4171 i � l Inspection Requests (24 Hrs.): (503) 639 -4175 „.. .. '`:_.. INSPECTION WORKSHEET FOR DATE: 4/17/2008 TIME: 7:02AM PAGE: 25 SITE ADDRESS: 11245 SW FONNER ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 569sf addition. OWNER: ()AK, RICK PHONE #: 503 887 - 1252 CONTRACTOR: EASTERLING CONSTRUCTION PHONE #: 603 -744 -0268 Inspection Request Scheduled For: Date: 4/17/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior sheathing 068534 -01 503-367-2152 S` Corrections /Comments/ Instructions: ® A a-t 4 .. 1 L o • :Y c5 d $O _ lire C c /c.sfrz. i n P , ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: ¢- -Y7- - Phone #: (503) 718 - J CITY OF TIGARD BUILDING DIVISION #: MST2008-00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2008 . Phone: (503) 639 -4171 p Inspection Requests (24 Hrs.): (503) 639 -4175 .�': ":_.. INSPECTION WORKSHEET FOR DATE: 3120/2008 TIME: 7 :O2AM PAGE: 5 SITE ADDRESS: 11246 SW FONNER ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 56Osf addition. OWNER: OAK, RICK PHONE #: 503 - 887 -1252 CONTRACTOR: EASTERLING CONSTRUCTION PHONE #: 503-744-0268 Inspection Request Scheduled For: Date: 3/2012008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/beam structural 067052 -01 511 367 -2152 Y Corrections /Comments /Instructions: S PARTIAL APPROVAL CA PASS ❑ ❑ ❑ NO ACCESS ❑ FAIL 7 CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 3 – 2 —v & Phone #: (503) 71 7A--Q CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/ Phone: (503) 639 -4171 � Inspection Requests (24 Hrs.): (503) 639 -4175 J . � '`' INSPECTION WORKSHEET FOR DATE: 3/19/2008 TIME: 7 :01AM PAGE: 8 SITE ADDRESS: 11745 SW FONNER ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 669E:1 addition. OWNER: OAK, RICK /E3ARBAR PHONE #: 503 -881 -1252 CONTRACTOR: I: ASTERLING CONS1 RUCTION PHONE #: 503.74 <1 -0268 Inspection Request Scheduled For: Date: 3/19/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Post/bnam structural 066968 -02 503.367 -2152 N Corrections /Comments /Instructions:. �7 / ell , •L: _ J 7�i/W -4-e C��c'' .. �lti� -7- ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ L ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: g J a Phon #: (503) 718 - P 2 ■ • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008- 00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2008 Phone: (503) 639 -4171 q� it Inspection Requests (24 Hrs.): (503) 639 =4175 .J. . -_.. INSPECTION WORKSHEET FOR DATE: 3/11 /2008 TIME: 7 :00AM PAGE: 54 SITE ADDRESS: 11245 SW FONNER ST - CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 569sf. addition. OWNER: OAK, RICK /SARF3AR PHONE #: 508387 -1252 CONTRACTOR: EASTERLING CONSTRUCTION PHONE #: 603144.0268 Inspection Request Scheduled For: Date: 3/11/2008 Pour Time: 9:00 Code # Inspection Description Confirm # ontact # Message 210 Fy walls 066436.01 5 503 367 -2152 N .205- OFSec- Correcfions /Commentstinstructi ns: D&/.S3 I al 4, r 4„ u-2,-, 3 10 C'ovw 4 , • $ / ddel < f Oct ' A-te "~ I, ' ,.... ,i �ifriA n. t , -(dsr e-t 9 t4,k t e414 01,1 [ A , /, i . . - - - _ffAINIZZI: , ,e I) i r PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL i ALL F INS CTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: // 0 r-----Phone #: (503) 711 ■ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 _-_ L INSPECTION WORKSHEET FOR DATE: 3/10/2008 TIME: 7:00AM PAGE: 67 SITE ADDRESS: 11245 SW FONNER ST CLASS OF WORK: SUBDIVISION: • LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: 569s€ addition. OWNER: OAK, RICK /E3AR8AR PHONE #: 503 -887 -1252 CONTRACTOR: EASTERLING CONSTRUCTION PHONE #: 503-744 -0268 Inspection Request Scheduled For: Date: 311012008 Pour Time: 10:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 066315-01 503.367 -21552 N Corrections /Comments/ Instructions: iD aai -e.. 2 /a _c. ,,, .7: ti. " TL °Cart PT 5 =i'r 0- T'1 - LG'. �3) oi —r1ect/ .�rG�rb s - ,- -- >4.-e.,------7- �V moo' .ter- v r \ T - 4 /11 (A) i ) 1 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • IL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: 73— JO —G 0 Phone #: (503) 718- . ?i i Albert Shields From: Albert Shields Sent: Tuesday, March 11, 2008 1 1 :19 AM To: Jamie Greenberg Cc: Hap Watkins; Mike White Subject: 1 1 245 SW Fonner Attachments: Albert Shields.vcf; image001.jpg FYI, this house has now been connected to sewer and an SWR permit should be forthcoming. MST2008 -00006 covers an addition and ENG2008 -00014 covers a tap of the city main on 113th Ct. with a 6" lateral splitting to two 4 "s at the propertyline in anticipation of a future land partition. Mike White inspected the lateral work. I've directed the contractor to add the building sewer and septic decommissioning to the MST and to take out an SWR for the connection. We have a receipt for the septic pumping and I've verified the gravel fill. We'II see a test on the building sewer after the plumbing is added to the MST and the SWR is added. Albert Shields City of Tigard I �a P z . t Housing Inspector, Building Codes Enforcement Officer albert bgard- or.gov (503) 718-2426' Vol k (503) 624 -3681 Fay 13125 SW Hall Blvd. Tigard, OR 97223 1 CITY OF TIGARD t� BUILDING DIVISION PER IF` le 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171.411, ,,�G,��� Inspection Requests (24 Hrs.): (503) 639 -4175 .� .,,, r ',_.. INSPECTION WORKSHEET FOR DATE: $ / S E: PAGE: SITE ADDRESS: 1 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: . DESCRIPTION: OWNER: 19 PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: . Code # Inspection Description Confirm # Contact Message 3 Z� % 3 -1/if — 0064 041-0 o 3 ° Z /J Alit Corrections /Comments /Instructions: 7 alc- •=7 V Aref =____ Plag Rei"4 y i-d-r effL f/E__Li I--- ,ql l ∎ ©/ _ ' - c...1 < / 1 /A/4M as d Ei11eAcJ Q9A Dcc OP /e._ ,i AK5-- eQu . r ks, -- A.t et Ism O 4/ i s &= �J r e,/, E&Y /-____, 4? ie„ ' • ❑ P'' S ❑ PART ' L APPROV ' ❑ CANCEL ❑ NO ACCESS IL C. / F• - I► •' •N ONAL FEES ASSESSED A Inspector: �, Date A Phone #: (503) 71 AALLPUMP S TATI N SERVICES - ,; `Da3 conp. • -. . • M .11 13023 - NE Haar.: 99 #7 an Va�i: auver, WA 9 686 �' �// (360) 887-2969 - Port. ( 285 -5�r b , .,;., PS I '7-,•-•.,.. . CUSTOMER'S ORDER NO. - PHONE. DATE - C �-- NAME f�'��/. r/1�} (76.4.1,l2•44 t tUO {j �j / 37 1�'� • .._ . _ ...----- i —.. _ . _-_ - - ADDRESS r -f � d Y rG SOLD BY CASH C.Cfp. CHAR, GE ON,ACCT. MDSE. RETD. PAID OUT ' Y • . t QTY. DESCRIPTION PRICE / AMOUNT ..• ', : . ":,-. ..- __ it,/ I• /1L1/4*' 11 , 1 * . 4-. 1--m #.41p_ v .... _ ..__...- e Y 40 / T fraYbffittrs invoice. ' NET 30 days. A finance charge of 11% per month (1.84b pet annum} -Wilt iiiiFatd alances. " TA - —. _. -- - -_. Co4feon fees will be assessed if necessary. RECEIVED BY ' - TOTAL • / • All claims and returned goods MUST be accompanied by this bill. 3 2 9 2 or rrebs.com `Thank`You �, �r��i°'t� +:� � �F Y nT i "�L- c„)��' . w � ; • F , ^ � !' S Y�'�' fi r, �• F �'_4.. F�j y J ICI n, '7 �f it h ° !te 7;4, dr yA ( r ^^�.k• a� �'a5!. e L, r ! i4 �i� � e':" .ta. t d' ik ..s'rac'' ! :'+�'.��a.' ,, �3i z ?. �!Y '` . M I . 3.:f �? ail . .�rf4s_ . ��� ®0�� DIVISION #: MST200130000€ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20;2( }t) Phone: (503) 639 -4171 ; 11� J i llii , � Inspection Requests (24 Hrs.): (503) 639 -4175 46 =— INSPECTION WORKSHEET FOR DATE: 311112.0018 TIME: 7 00A PAGE: °'y' SITE ADDRESS: 11i/15 SW F1')NNt R ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OAK DESCRIPTION: Li69St Pddit OWNER: OAK, RICK /IBARBAR PHONE #: 60 CONTRACTOR: EAS1 El GON'S1'RUCTION PHONE #: t•03 741-0268 Inspection Request Scheduled For: Date: 3111120Ya Pour Time: 9:00 Code # Inspection Description Confirm # ontact # Message 210 F la x. „.,ti ",n viAis 066436 - 01 503•:3(:+7 -21x 2 N Corrections /Comment structi ns: �401,S 0/ 0 )1/- '` r !— h ' U - 14 , ` . 3 /0 ec, Q--c , / - ,..:_ - i-tA , li ff," ‹ . --- - i Z,, /... .61 i _ Annw ® .. / Ii / r PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS ( � FAIL ALL•Fe' INS CTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: �� o � P hone #: (503) 7 _t4',___ ', CITY OF TIGAPF) ELECTRICAL PERMIT a , COMMUNITY DEVELOeMENT Permit #: MST2008-00006 13 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/20/2008 T [ U a� R 9 Parcel: 2S 103AC01300 • Jurisdiction: TIG Site address: 11245 SW FONNER ST Subdivision: ' Lot: Project: OAK Project Description: 569sf addition. Adding room and bath, relocating kitchen, structural changes, and decommissioning septic system. Owner: FEES RICK OAK Quantity Description Date Amount 11245 SW FONNER ST TIGARD, OR 97223 1 [BUPPLN] Pln Rv Deposit 01/29/2008 $348.10 PHONE: 503-887-1252 1 [CDCPLN] CDC Pin Rev 02/20/2006 $46.00 1 [LRPF] LR Planning 02/20/2008 $6.00 Surcharge Contractor: 1 b I (( r( c..4 1 [BUPPLN] Pln Rv Balance 02/20/2008 $7.67 PLUMBERS INC. • 1 [BUILD] Bldg Permit 02/20/2008 $547.34 90 NW 150TH AVE � �N1 1 -6 1 [TAX] Build 12% State 02/20/2008 $65.68 BEAVERTON, OR 9700; 1 Surchrge 1 [MECH] MEC Permit 02/20/2008 $72.50 p\ i PHONE: 503- 519 -6644 1 [TAX] MEC 12% State 02/20/2008 $8.70 FAX: Surcharge 1 [PLUMB] PLM Permit 02/20/2008 $99.60 Q 1 [TAX] PLM 12% State 02/20/2008 $11.95 Surcharge Type of Use: SF 1 [ERPRMT] Erosion Control 02/20/2008 $40.00 Class of Work: ADD Type of Const: 5N 1 [ERPLN] Erosn Pln Rv CWS 02/20/2008 $13.00 Occupancy Grp: R3 1 [EROSN] Erosn Pln Rv COT 02/20/2008 $13.00 W%5 • 1D .-.— [ELPRMT] ELC Permit 02/20/2008 $66.80 • J Surcharge 1 [TAX] ELC 12 %State 02/20/2008 $8.02 • p0 ® t{, i-E F -1 Sj Q R&.tc a `�f Q 125 da Additional Plan Review 06/04/2009 $125.00 --1 — r - b , p P N (L. ce wwa, Total $1,479.36 c�PNgE 0 C CZ $ IV fAI`k\^ Required Items and Reports (Conditions) e c E 3 () AO CA\ c 464"CA4 Ro \)0•:,N •• _ ■_S G--. NO3 S — b• °g This permit is issued subject • • . regulations •.. -d 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: Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. 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. • r ��;-' r P:IJE: JI FrJ0314 , tJrir ii mfr_V =T1 `5 r`�`1 J1 I' � ° I https:;, ay. accela .comijetspeed,`portallmedia type /html; user /TlGARD.GNOBLE; page ' default.psml /js a- +,� 4- 3 P -: File Edit View Favorites Tools Help { j Home - 1=: i i:;: t Print L Page ■ '.t : Tools ■ 0 Help ■ a Research 3 Messenger TEMPORARY SERVICE FEEDER 3 ' o:`��j 0 - 200 amp: _ 201 - ?00 amp: _ I 401 - 600 amp: _ 601 - 1000 amp: _ BRANCH CIRCUITS = - A With Service cr Feeder: Without Service and Feeder: 4131 _.-- .., RESTRICTED ELECT RESIDENTIAL Audio /Stereo: Security Alarm: Garage Dcor Opener; _ HVAC Vacuum System: Other: _ Other Description: .==—_,' _ }i ' All Encompassing: 1i i ASI TIDEMARK Master Number: 2 _ u € Issued: i _ __ ?�.,_ M ST `` [ ,.J: (3 ;< ) t Internet .>� ` +1100°•c - - - yJ 1 , Inbox - Microsoft o. 4 �� 7:16 HM _ ._.. , Iss•-,?I' .-2).1-1- • , . ,.,...0 ,. _ ... ,. . , :4,.... ,,,, „• _ ' ' ■ '16 https:ilay.accela.com/jetspeed/portailmedia-typelhtmlluser/TIGARD.GNOBLE/page/default.psm1;j4 - 2] „ • - ' - - -- __ _ _ _ _ .. _ ____ _ _____________ File Edit View Favorites Tools Help c? d'i ql Home - fri :'-- ( ciiil Print - ',,'-?' Page ,, Tools ■ 0 Help ■ 'A Research .3 Messenger Case # Number Street Name Suffix Unit # Case Status Active Task Opened Description :.--_--. - =7--: 0 1,1 5T2CCa-C1:1006 11245 FONNER ST Issued Inspections 01129/2008 569.4 addition. Adz ' - - , = a.- -.----. -- 7 0. :L..' ;Ili 7 - 11 17, : g li CAP ID: MST2008-00006 -a. v 1 ,----• . _.... I Menu -- L . j j New tj j Delete %1/4.--4 I Look Up '../ 1 Help . '...1 jii = 1 1.! Go To .... 113r - r (16) Calendar Classic Reports Comments (0) Conditions (0) Contacts (1) Documents (0) Fee (16) GIS (1) 2 E li 11 , , 0 Number Primar First Name Last Narne Role Type Preferred Channel Email Phone 1 Phone 2 F—: ..---- , i - i 1 ,_, m Al Li 2... No OWNER Electrician i [T. . ,i , . fi E -7 1 :, . . A T , — 41 Reports ' )-My Reports ---- 1 Ir-Case Specific Permits ›-Cashier .....=.—=. ........1 g p -,.. 1; Yr-Export - IFS Payment , _. i l ;! D'Export - Permit Activity ' ■ Ir-Inspections 1 Yr-Miscellaneous Yr Reports *1 1: 1 ...,-.._...--......, :I ,...=..; 1, =-. ---, 7 =---- =-°--.=:- ■ .=-- ' •-•=--- - ; : --------- ,.' , I ) 0 Internet 4 ‘,100c:fa - 7:10 AM Li il,,,,,, Inbox Microsoft ... IL-ku,Iir-,2„ . -.... ____, /SS cc& 2 /2, ZOOS EX/° //Z E � / / /z/ // EXPIRED Community Development RE CEIVED TIGARD Request for Permit Action SEP282011 TO: CITY OF TIGARD CITY OF TIGARD Building Division Services Coordinator BUILDING DIVISION 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov FROM: n Owner ❑ Applicant ❑ Contractor City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) K CAIN. O /1 1,4N, Mailing Address: ij i 1 c-1S (-.4D FOLINi L T' City /State /Zip: -'11 62 9 7 A9 - 3 Phone No.: 503 g 7 - (2+S9 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): • CANCEL PERMIT APPLICATION. n REFUND PERMIT FEES (attach receipt, if available). h e INVOICE FOR FEES DUE (attach case fee schedule and explain below). REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit #: h l 1`a,00S 'COOoCo Site Address or Parcel #: 1 1 A4 S .1.k.) ron7tJf /L 6-1- Project Name: O Pt Subdivision Name: Lot #: EXPLANATION: f.Ji'. `aKP,.-i,T4.b 5/a9 /6/. 01,,,Jf2 lJa-r, es,..) G 1;101 LI4/ /if 1 q-r Mx)/ Po n.14-1. ,dies 'Du D 'o,Jet ,e_tFuSES T Q.¢y. Lsr 1,-.1 Ecl1, . 3 // / /,,, ,, pJo Aar/ J,Ty Goy 1 I I 0 r.) tic p,2t PP #N, P€.e H9/4k /. Signature: _ �� _ aJ . Date: ( 119:01/ • Print Name: 1JtMM61 2, l(l-6- 1-4 SKI Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to S s Admin: Date ' ®e' B ` _A• Rte to Bld: Admin: Date // /A, B ,-1!/211 Refund Processed: Date AVIIPI B - vA1 Invoice Processed: Date " `�Q' B v� Permit Canceled: Date // /j By,r j irAl Parcel Tag Added: Date By Receipt # Date Method Amount $ I: \Building \Forms \RegPemutAction.doc Rev 07/26/07 IN CITY OF TIGARD • , .. ° . Community Development TIGARD 13125 SW Hall Blvd.,Tigard, OR 97223 503.718.2439 INVOICE TO: Rick Oak Customer ID: C11 -0002 11245 SW Fonner St. Invoice No.: INV2011 -00014 Tigard, OR 97223 Invoice Date: 11/10/2011 Date Due: Upon Receipt C ase No . ' . ;; 7 Site,Address , ; 1 - ~- � --� � `'� r,� '� : - Siibiiivision� L'of #korWPtd ect Name i;RAmoun' ;, MST2008 -00006 11245 SW Fonner St. Oak $125.00 Plan review fees for revisions submitted after permit issuance. Permit expired by limitation per building official. Invoice Total: $125.00 ® Please see attached fee schedule for description of fees due. (Detach and return this portion with payment.) Case No.: MST2008 -00006 Customer ID: C11 -00002 Site Address: 11245 SW Fonner St. Invoice No.: INV2011 -00014 Project: Oak Invoice Date: 11/10/2011 Date Due: Upon Receipt Invoice Total: $125.00 Amount Paid: $ Office Note: Route copy of receipt to Dianna Howse when fees are paid. Please mail payment to: City of Tigard, Building Division 13125 SW Hall Blvd. Tigard, OR 97223 Attn: Dianna Howse I: \ Building \Accounting \lnvoicc.doc 04/06 Debbie Adamski Subject: Pull MST2008- 00006, expire permit, refer to Mark for enforcement. Start Date: Wednesday, September 14, 2011 Due Date: Wednesday, September 14, 2011 Status: Not Started Percent Complete: 0% Total Work: 0 hours Actual Work: 0 hours Owner: Debbie Adamski Address: 11245 SW Fonner St Owner: Rick Oak Refused to pay additional plan review fees. Per Mark if no further action after 3/11/11, we will expire permit and it will be forwarded for enforcement. 1 ((..1z1(� This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. 1 . 1 1 1 q BUILDING DIVISION T I G A R D TRANSMITTAL LETTER a TO: Da Ir 11/41 QJ`so n DATE RECEIVED: DEPT: BUILDING DIVISION RECP MAY 2 9 2009 FROM: K ‘ ______ 0 p (L1 CITY OF TIGARD COMPANY: --.. 6lJI�DIi�JG DIVISION kPHO E: _ 9 3-` 3` - Loma_ R�,l_0 ' D � ii RE: C ' ■ - (Permit/Case T. - 0 um eg • 00)( - ) '1(r, rte •s.ress (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: - q 'Go es d`Descri tion. R Additional set(s) of plans. Revisions: ? Cross section(s) and details. Wall bracing and /or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. SC Other (explain): 0_.V\CLt\ ,a -- p 't `i'S l a rAct n. REMARKS: • _, °FOR O FI, E USE; ONLY : : s - , , , 9, '.env ■iriilgiiI hnician: Date: ,-• I 6 4111 Initials: Fees Due: E Yes L No Fee Description: �;; -r.1 :. _ ;: 44 *rte - l , -, II - 2---5 oo .' ; '. $ 3 A 1 $ fY ^ % 1, ._- , ,..4,t,„; "v $ Special Instructions: Reprint Permit (per PE): ❑ Yesio ❑ Don Applicant Notified: Da e: f, Initials , • • ,VA//// •61)644-t- il:Rti_je)-Po— 'AR-6-4,c344 97r 1: \Building\ Forms \TransmittalLetter- Revisions .doc 4/4/07 ss (:Q 10 9 c_,,, �.0 eLe0c �,,:. CITY OF - � - I AR® MASTER PERMIT -*' & • - COMMUNITY DEVELOPMENT Permit #: MST2008 -00006 ._- Date Issued: 02/20/2008 :rid ARE:i ' 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171 Parcel: 2S103AC01300 Jurisdiction• TIG Site address: 11245 SW FONNER ST Subdivision: Lot: Project: OAK Project Description: 569sf addition Adding room and bath, relocating kitchen, structural changes, and decommissioning septic system. 8/6/09 adding electrical service & (20) branch circuits to scope of work BUILDING Floor Areas Required Setbacks Required Stories 1 Bedrooms 1 First 569 sf Basement sf Left. 5 Parking Spaces Height Bathrooms 1 Second sf Garage sf Front 20 Smoke Dwelling Units 1 Third. sf Right 5 Detectors Yes Total sf Value. $54,049 31 Rear 15 PLUMBING Sinks 1 Water Closets 1 Washing Mach Laundry Trays Rain Drain Catch Basins Lavatories 1 Dishwashers 1 Floor Drains Sewer Lines SF Rain Other Fixtures Tubs /Showers 1 Garbage Disp 1 Water Heaters Water Lines Drains Bckflw Prevntr MECHANICAL Fuel Types Air Conditioning N Vent Fans 1 Clothes Dryers ELE Heat Pump N Hoods 1 Other Units Furn <100K Vents Woodstoves Gas Outlets Furn > =100K . ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less 0 -200 amp 1 0 -200 amp W/ Svc or Fdr. 20 Ea add 500 sf 20 1 -400 amp 201 -400 amp 1st W/O Svc /Fdr Limited Energy 401 -600 amp 401 -600 amp Ea add'I Br Cir 601 -1000 amp 601 +amp -1000v 1000 +amp /volt ELECTRICAL - RESTRICTED ENERGY SF Residential Audio 8 Stereo N HVAC N Security Alarm N Vaccuum System N Garage Opener N At 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) RICK OAK OWNER 11245 SW FONNER ST TIGARD, OR 97223 PHONE 503 - 887 -1252 PHONE FAX Total Fees: $1,479.36 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 d..- • - ccordance 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 • =ys ATTENTI• Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR •52- 001 -0010 through 0AR : 2 -01 -1100 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246 6699 0 1 800 2 4 sued By. I J � � Perm ittee Signature: J( i ,,, ,, � T rr CITY OF TIGARD MASTER PERMIT PERMIT #: MST2008 - 00006 COMMUNITY DEVELOPMENT DATE ISSUED: 2/20/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 103AC - 01300 SITE ADDRESS: 11245 SW FONNER ST ZONING: R -4.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: OAK Project Description: 569sf addition BUILDING REISSUE CUSTOM STORIES 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK ADD HEIGHT FIRST. 569 sf BASEMENT sf LEFT: 5 SMOKE DETECTORS Y TYPE OF USE SF FLOOR LOAD 50 SECOND sf GARAGE sf FRONT 20 PARKING SPACES TYPE OF CONST 5N DWELLING UNITS 1 THIRD sf RIGHT 5 VALUE 5 4,049 31 OCCUPANCY GRP R3 BORM 1 BATH 1 TOTAL 569 of REAR 15 PLUMBING SINKS 1 WATER CLOSETS 1 WASHING MACH LAUNDRY TRAYS• RAIN DRAIN TRAPS LAVATORIES 1 DISHWASHERS 1 FLOOR DRAINS SEWER LINES• SF RAIN DRAINS CATCH BASINS TUB /SHOWERS 1 GARBAGE DISP 1 WATER HEATERS WATER LINES BCKFLW PREVNTR GREASE TRAPS OTHER FIXTURES MECHANICAL FUEL TYPES FURN < 100K BOIUCMP < 3HP VENT FANS 1 CLOTHES DRYER. ELE FURN > =100K UNIT HEATERS HOODS. 1 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 0 - 200 amp W /SVC OR FOR 0 PUMP /IRRIGATION: PER INSPECTION EA ADD'L 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• 3 SIGNAUPANEL. IN PLANT MANU HM /SVC /FDR 601 - 1000 amp 601 +amps -1000v MINOR LABEL. 1000+ amp /volt • PLAN REVIEW SECTION Reconnect only > =4 RES UNITS SVC /FDR> =225 A. > 600 V NOMINAL: CLS AREA/SPC OCC ELECTRICAL - RESTRICTED ENERGY A SF RESIDENTIAL B COMMERCIAL AUDIO & STEREO. VACUUM SYSTEM AUDIO & 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 RICK /BARBAR OAK EASTERLING CONSTRUCTION laws All work will be done in accordance with approved plans This 11245 SW FONNER ST 9007 SE 39TH STREET ST permit will expire if work Is not started within 180 days of issuance, or TIGARD. OR 97223 MILWAUKIE, OR 97222 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: 503.887 - 1252 Contact #: PRI 503 744 - 0268 questions to OUNC by calling 503 246 6699 or 1 800 332 2344 FAX 503- 744 -0268 Reg #: LIC 179394 TOTAL FEES: $ 1,354.36 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Iss ed By : LDITfi Permittee Signature : ■•----- 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. Building Permit Application 1 �0�� � � './ Juno') :x Residential t, ` t r FORO FFICE;US E ONLY Cit of Tigard ._ ' %�... v ¢ _ S." Received �, ' Date /B � , Pennrt No ,(� `�,. /O L q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revr ' Y L li C Phone 503 639 4171 Fax. 55N , l9�0(� ` R DateBy Date Ready/By ' Other Pen_ TIGARD Inspection Line 503 639.4175 .. 1 A 1�mt® See Page 2 for - Internet www ttgard -oy1 1 Li /� Notified Metho�Q D � _ J Su pplemental Information h1 - - C! 'a PV II I PO�iK- y � REQUIRED DATA:1-AND 2 - AMILY DWELL I G ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all S I, Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION , - , work indicated on this application. v g,l- and 2- family dwelling ❑ Commercial /industrial Valuation: $'4a5a' ❑ Accessory building ❑ Multi- family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address- I j) A 5 5(4) i Sr New dwelling area: 5 square feet City /State /ZIP: l z,„,„,i1 p F .. q 7 123 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: ZZ 4:9Alcl.. Covered porch area: square feet Cross street/directions to job site: C.02Na e S r e-A N i ,atNO Deck area: square feet il h cov -St.T Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: 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 the DESCRIPTION OF WORK . work indicated on this application. ,I 44-cm �t a c Valuation: $ e; 1 Existing building area: square feet )4:4-4101 New building area: square feet NI R. PROPERTY OWNER ❑ TENANT . Number of stories: In Name: 12 v* 4x Type of construction: '� 4 Address: i k 2445 6'( f_• S-, Occupancy groups: City /State /ZIP: T m1_ / OR 9 a2.3 Existing: y Phone: (CO3) gsS7._ (' a Fax: ( ) New: ®:APPLICANT ❑ CONTACT PERSON NOTICE Business name: E-44 F 1ef_.t) c /0 S rzAc All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: C MI5 F f sri. : 2e. .F.. e..v under ORS 701 and may be required to be licensed in the Address. '(j SE 3c t a- Sr jurisdiction in which work is being performed. If the City /State /ZIP: (wu h lC ( applicant is exempt from licensing, the following reasons P t apply: .,... Phone: (S03) ?YY Fax: :(52 3) Jq `i —oZ& E -mail: CONTRACTOR Business name: F cc, „ r2u 4 r-DN BUILDING PERMIT FEES* Address: q 001 S gq 7 - 0 i` 5;} (Please refer to fee schedule Cit /State /ZIP: �� ^ �w Structural plan review fee (or deposit): _7�-z}' Z / d / g �` l�uw < <, P I /' FLS plan review fee (if applicable): / g p Phone: ($7i l) 7 Ley_ c yzi o x Fax: ( ) Total fees due upon application: CCB lie.: I 93 qt.( ti 1V 0 Amount received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Cliiik3 for z,T�st. Date: F/7ei1ei * Fee methodology set by Tn- County Building Industry Service Board I• \Building \Permits \BUP -RES PermitApp doc 11/6/07 440- 4613T(l1/02 /COM/WEB) A P a Building Permit Application Checklist One- and Two - Family Dwelling • ' ' FOR OFFICE USE ONLY City of Tigard Received Permit No q 1 3125 SW Hall Blvd ,Tigard, OR 97223 Date /By. Phone. 503 639 4171 Fax: 503 598 1960 Associated permits 24 - Hour Inspection Line 503 639 4175 ❑ Electrical ❑ Plumbing ❑ Mechanical T t GA - Internet www.tigard -or gov ❑ Other ''THE 'FOLLOWING ARE REQUIRED'�FOR: ; Yes REVIEW N o N /A. l 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 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 ❑ ❑ ❑ architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS ,` ... ._ - • • , - 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. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ Cl 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 as •roved •rior to Se•tember 9. 1995. • I \Bwldmg\Permns\BUP- RES- Perm¢App doc 03/21/06 440- 4613T( 1 1/02 /COM/WEB) Plumbing Permit A .lcati �. 1 r Building Fixtures pA1 t (, `t008 FOR OFFICE . .USE O N1% • City of Tigard �`'t� Received III 131 SW Hall Blvd , Tigard OR 97223 � Date/By 1 Permit No �O���0 Phone 503.639 4171 4. t x.i 503.598 Q DIVAS ION Ph Review Other Permit No Inspection Line 503 6 DateBy 3 4d 7 5 - ra T I GAR`D Internet www t1 ardpiV Date Ready/By ions 10 See Page 2 for g ` Notified/Method• Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. Ea I Total Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath / 249.20 2d t z 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350 00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45 00 0 Fire sprinkler ( sq ft) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address. I I2 / Su) Foe . Catch basin or area drain 16.60 City/State /ZIP. --C-L&Arto o R.. 1 Z 3 Drywell, leach line, or trench drain 16 60 Suite/bldg. /apt. no j Project name: Footing drain (no linear ft ,) Page 2 f_ �,u Manufactured home utilities 110 00 Cross street/directions to job site. CDR (2 (, so.) Foagtt Manholes 16 60 A.ND Sit) (i Y" C.i t, -g Rain drain connector 1 16 60 Sanitary sewer (no linear ft _) Page 2 Storm sewer (no. linear ft . ) Page 2 Subdivision Lot no : Water service (no linear ft ) Page 2 Fixture or item Tax map /parcel no.. Absorption valve 16 60 DESCRIPTION OF WORK Backflow preventer Page 2 -t � `` tz l p, 11. i ouNit P �, ; 1,4 04) Backwater valve 16 60 jZA, j 0 . 0GGL4 (i 0-c (, ( I e4t1 Clothes washer 16.60 I[, r vV Dishwasher ' 16 60 /1 la PROPERTY OWNER I ❑ TENANT Drinking fountain 16 60 Ejectors /sump 16.60 Name: R, alt Da`[ Expansion tank 16 60 Address: I 1'b t4 5 Lo ) 4 Fixture /sewer cap 16 60 City /State /ZIP: i-s(,4(I,1) l el Z. cry z z 3 Floor drain/floor sink/hub 16 60 Phone ( 6)3 ) gTS7 .- 1 Z S2 Fax: ( ) Garbage disposal 16 60 4 Hose bib 16 60 APPLICANT 0 CONTACT PERSON Ice maker 16 60 Business name E4fN✓l7L.tN CiDA)9T12Ji 7t1 Interceptor /grease trap 16.60 Contact name: C i +IZL E!t'67_4y6, Medical gas (value $ ) Page 2 Address: 9Q0 5 - e 39 ,n 5 Primer 16 60 Roof drain (commercial) 16 60 City /State /ZIP: AA ,I �0- ti,le A V 7Zz? ( ) / Lr Sink/basin/lavatory 2 16 60 33, , 2.0 Phone- ( 7 y� -0 id, 11 Fax: . ( 503 ) -y UZlo .:0) E -mail: Tub /shower /shower pan •(( 16 60 v (p(7 Urinal 16 60 CONTRACTOR Water closet / 16.60 4,,e,, O Business name: 1lµ br. /AA, Water heater 16 60 Address. `j0 O I o +N Othe -- s ✓e Subtotal City /State /ZIP: -3 t, a le 97�� / Minimum permit fee $72 50 Phone: (50 g'11 4,6 y y Fax: ( ) 1 • i , O Residential backflow minimum permit fee. $36.25 CCB Lic : 1 7 ' 1 zit/ q .A i Plumbing Lic. no - P6 y y 7 Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name. Date: 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 Service Board i \Buddmg\Permits \PLMF- PermrtApp doe 12/27/06 440- 4616T(10 /02 /COM/WEB) V Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55 00 55,66 7,201 and greater $309.00 Sewer - each additional 100' 46 40 Water Service - 1st 100' 55 00 Medical Gas Systems: Water Service - each additional 100' 46 40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46 40 $5,001.00 to $10,000.00 $72 50 for the first $5,000.00 and $1 52 for each Fixture or Item Qty. Fee (ea) Total additional $100 00 or fraction thereof, to and including $10,000 00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000 00 $148 50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100 00 or fraction thereof, to (minimum permit fee $36.25) / 27.55 2 and including $25,000 00. Rain Drain, single family dwelling 65.25 $25,001 00 to $50,000.00 $379.50 for the first $25,000 00 and $1.45 for each additional $100 00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00 specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000 00 and $1.20 for Subtotal: g2• each additional $100 00 or fraction thereof. Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure _ Baptistry/Font as defined OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical.gas and vacuum systems for health care facilities. - 1acu77i/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. -3" - 4" Car Wash Drain Garbage - Domestic . Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures - \3w ldmg\Permns\PLM- PermtApp doc 12/27/06 Electrical Permit Applicati , `�° Eiv ' FOR OFFICE, ONLY i '. , cerved City of Tigard Date/By No �[y —0V0/24 I II 13125 SW Hall Blvd , Tigard, OR 97223�� Plan Rewew 'vim w`' �v wa I N 9 2008 Other Permit - ' Phone • 503.639.4171 Fax: 503.598 1 iU rv� 2008 DateBy TI GARD Inspection Line• 503.639.4175 Date Ready /By: Juns H See Page 2 for Internet. www.tigard - gov J y /� 3 Noufied/Meth Supplemental Information T P E l OO .VirO - flT I tTirs T T PLAN REVIEW — e V .. LI'2. '1/4j1" N Pl check Please cec all that apply (submit 2 sets of plans w /items checked below ❑ New construction L! Addition/alteration/replacement " 400 y ( p below) ❑ Service or feeder 400 amps or more ❑ Building over three stones 0 Demolition ❑ Other: where the available fault current ❑ Mannas 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 ill 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately denved system ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", 10OHP or more occupancy Job no.: Job site address: I + 2 /5" Si rO %or 51 ❑ Six or more residential units ❑ Recreational vehicle parks ❑ Health -care facilities ❑ Supply voltage for more than City /State /ZIP: '( ri (ag j r� / I) R 1 (722,3 0 Hazardous locations 600 volts nominal Suite/bldg. /apt. no.: Project name: R i dt line ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: C' apt c Su F0r10e0 ale k o b Description I Qty. I Fee. I Total I " • New residential single- or multi - family dwelling unit. 11 - p L Includes attached garage. Subdivision. Lot no.: 1,000 sq. ft. or less / 145 15 / '!j ,T 4 Ea. add'I 500 sq ft or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75 00 2 DESCRIPTION OF WORK (with above sq ft ) et t; Limited energy, multi - family Lee A d I ,-foe 1 tA p � / t ylo residential (with above sq ft ) 75 00 2 ii f) I - 0 - Services or feeders installation, alteration, and/or relocation " RelbGtT.tY t h D D- 1 k 4 /I 200 amps or less / 80.30 10.34 2 r& PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: cg. Ottttc 601 amps to 1,000 amps 240.60 2 Address: 1 %2y S 5w I oNnLsa 51- Over 1,000 amps or volts 454.65 2 City/State/ZIP: TZG/4(L Temporary services or feeders installation, alteration, and /or l a , O. 7 Z relocation Phone: (563 ) K' 1 .. I A Fax• ( ) 200 amps or less 66.85 •/ .' , „'a 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 21 CONTACT PERSON above service or feeder fee, 1+ 6.65 2 n each branch circuit Business name: 1�.6T�12l.rA96, Cc94j8T72t, -riO'f) B. Fee for branch circuits without service or feeder fee, Ci ,rte 46.85 ei� j 2 Contact name: C04.12_, S E_ A57;e4u 2,oc, first branch circuit Address: q00 '7 s' 3q r'# Sr Each add'l branch circuit A 6 65 gg,q5 2 Miscellaneous (service or feeder not included) City/State /ZIP: /YCEwgtaci © e el 7222 Each manufactured or modular dwelling, service and /or feeder 90.90 2 Phone: (503 ) ) /y 454 Fax: : (57./3 ) 7 /y_ $. Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53 40 2 Business name: d p a ` ZG ' �A /1 - i Signal circuit(s) or limited- r pp. i , _ _ .. , L / � , energy panel, alteration, or Address: ,f) 11.0v 30 7 ( 1 W _, - extension. Describe Page 2 2 City/State /ZIPI A- -C1/01 ( ,t 2 ? '7 Each additional inspection over allowable in any of the above V Per inspection 62 50 Phone: " " "" Fax: ( ) Investigation per hour (I hr min) 62 50 CCB Lic.: / 26 A, ` Electrical Lic. A79...-G Suprv. Lic.: 5-05f5 Industrial plant per hour 73 75 ELECTRICAL PERMIT FEES 1 • /r Suprv. Electrician signature, required: /0 // h Subtotal: 2-52 Plan review (25% of permit fee) a Print name: Date: State surcharge (12% of permit fee). I Authorized signature: TOTAL PERMIT FEE This permit application expires if a permit is not obtained wit in Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit � � I \Building\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(i 1 /05 /COM/WEB -ILA! 1 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* n Other: 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 ❑ D ata Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ P rotective Signaling n O ther Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I \Bwldmg\Permits \ELC- PermitApp doc 03/23/06 Mechanical Permit Application •�. - , li'OR. USE ONLY . City of Tigar E C I E V ED R eceived Permi Date/By T� J'� l v 13125 SW Hall Blvd , Tig .' ,3 Plan Review UDO : Z _ Phone: 503 639 4171 Fax 503 598 1960 DateBy Other Permit 9 T 1'GARD Inspection Line. 503.639.4175 JAN 2 9 200 , Date Ready/By Juris ® See Page 2 for Internet www tigard- or.gov Notified/Method Supplemental Information CITY OF TIGARD • it iii: LEI N'S 'VISION COMMERCIAL FEE* SCHEDULE _: USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction El Addition /alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ E 1- and 2- family dwelling ❑ Commercial /industrial E] Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES* - For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total . JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: )(2,45" 30 �o042 Sr Air conditioning fires S t plan or heat P pump ) re uues site plan showing placement) 14 00 City /State /ZIP: - A ©e.- 9 72 z 3 Furnace 100,000 BTU (ducts /vents) 14 00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no. Project name: Erciz C'1 Gas heat pump 14.00 Cross street/directions to job site: Duct work 10 00 Hydronic hot water system 14 00 c.k9 /"'OA9AJE(L Art9 b 1/ 3 F''' PZ_ Residential boiler (radiator or hydronic) 14 00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc 14 00 Subdivision: Lot no.: Flue /vent for any of above 6 80 Other. 10 00 Tax map /parcel no.: Other fuel appliances -- DESCRIPTION OF WORK Water heater 10.00 2 Gas fireplace 10.00 1'f~ t 1l i ?/a-r kit W svi / K( tc4ein Flue vent for water heater or gas (�-e D - - 0 _ C,Vi fireplace 10 00 C�—t Log lighter (gas) 10 00 Wood /pellet stove 10.00 Wood fireplace /insert 10 00 4 ❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10 00 Other 10.00 Name: 12,` G k_ o `c Environmental exhaust and ventilation Range hood /other kitchen Address. /(z cf 664) 494.1/0.45/e_ equipment 4' 10 00 City /State /ZIP: ( ..i./aArt © /® 2 ` E r 72? 3 Clothes dryer exhaust 10 00 Single -duct exhaust (bathrooms, Phone: ( ) Fax ( ) toilet compartments, utility rooms) \ 6.80 ,a APPLICANT c®-- CONTACT PERSON Attic /crawlspace fans 10 00 //�I Other. 10 00 Business name: SC f�G.ji t Lt�.t' .Qt-tJ Fuel ue piping P Contact name: Clfie 5 F a4sr , e., $5.40 for first four; $1.00 for each additional Address. 9007 Se 317' 7'64 .5 Furnace, etc MI' Gas heat pump City /State /ZIP: /, L I't le t (/Z Cf 7Z 2 2 Wall /suspended/unit heater Phone: ( )3) 7 cy c 6 Fax: : ( ) Water heater E -mail: Fireplace Range CONTRACTOR Barbecue Business name '� r +' Clothes dryer (gas) Other. Address. qQ 9 7 s. 3 4 7# S r MECHANICAL PERMIT FEES* City/State /ZIP AA. :1 47 0.-w<<t c I 6,K q7 Z. 2 Z Subtotal Phone: (So3) 7YC/— O Fax: ( ) Minimum permit fee ($72.50) S Plan review (25% of permit fee) CCBlic.• )793 9cy ✓ State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: �w This permit application expires if a permit is not obtained within 180 /� -....r" ----- " T days after it has been accepted as complete. Print name 6Ft2r5 Tomas rF e z' 6 Date: l/2 I/ x , i * Fee methodology set by Tn- County Building Industry Service Board I \Building\Permits\MEC- Permit.kpp doc 01/19/07 440 -4617T (11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2.- Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00, $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I \Building\Permits\MEC- PermaApp doc 01/19/07 2 Jan. 30. 2008 11:34AM CASE No, 452b P. 1/1 r ip TTOTM111 /215 o 2(?O6 — O (2c9°6' JAN 2 9 2+i 11 RECEIVE* CleanWater S•rvices FEB 1 LUU8 By (JnY - ncc r• ,.r Ira! rig. du/ . r 8FlteNumber Sensitive Area Pre -Scr Vi 1'iir f � - oo Site Assessment NOON'S! � ' �? `� Jurtsdlogon: Property information: (example 15234A601400) Owner Information: Taxlot ID(s): @ ;3A=! L 3 ([7 Name; J' C i4 ()AK Company: Address: 11 ( II fi t,;.'? /'r. "44.,0 V: AL d s Site Address: i I AL'S' aei Fat:Wil t' 5 r Tie .r,k , C'r 2 GI Y;? Z TxbAgnp( '17c 3 Phone /Fax •-• 7 I — Nearest Cross Street: ,J /A Puac.6 E -mail: Development AaUvlty: Check all that apply Applicant information: Addition to Single Family Residence (moms, deck, garage) 911 Name: jiLareLs 6 «.s t r 6 Lot Line Adjustment ❑ Minor Land Partition ❑ Company: , rl rte fv 5∎14 a 7 Residential Condominium ❑ Commercial Condominium ❑ Address: (rt .. c,/ 1•!/ 1 7 Residential Subdivision ❑ Commercial Subdivision ❑ single Lot Commercial ❑ Multi Lot Commercial ❑ phone/Fax..$0i <r 076 15" / 303. 70-09 • 0,2. Other E -mail: Will the prajeo4 Involve any off -site work: YES ❑ NO [- Unknown ❑ Location and de.oriptlon of oft-eite work: Additional comments or information that may be needed to understand your project: his opplloetion does NoT replace tin need for Grading and Eio !on Control Permitrc, Connection Penults Building permits, bite Development Perrnft, DEP 1200.0 Permit or outer permits as issued by the Department of Environmental Quality, Depa►9ment of State Lends anaror Pepartment of the Army co E. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or repreaentalive, ecknowledgee and agrees that employees or Clean water Services have authority to enter the project site at all reeronable times for the purpose of sweating projeot site oondillone and gathering Information related to the project Site. I certify that 1 am familial with the information Contained In this document, and to the best of my knowledge end belief, this Information is We, complete, and accurate. PrinVrype Name; , 3 Printfrype Title: �. / rrJTYZI4c S�'i nature:' �-. !' =" ---- —, _ Date: /.4 tic' r FOR DISTRICT USE V Li Sensitive areas potentially exlat on Oita or within 200' of the mite. THE APPLICANT MUST PERFORM A SITE ASSESSMENT • • , : ; _ - .41 l • _ p • a ■ - : Iui, c if Sensitive Areas exist on the site or within 200 feet on element propetllee, a Natural R e sources Assessment Report may also be required. ," Based on review of the submitted materials and beet available information Sensitive areas do not appear to exlet on site or within 200' of the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas If they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution end Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, Stale, and federal law. ,] Based on review of the submitted materials and best available information the above referenced project will not significantly Impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre.Sareening Site Aussesement does 3 eliminate the need to evaluate and protect additional water quality sensitive areas If they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02,1. All required permits end approvals must be obtained and completed under applicable local, state, and federal law. ❑ This Service Provider Letter Is not valid unless CW8 approved alto plan(e) are attached. ❑ The proposed activity does not meet the definition of development or the lot wee platted after 919188 ORO 92,040(2). NO SITE ASSESSMENT O' S RVICE PRO : DER LETTER iS REQUIRED. Reviewed 8y: ../' _. may. • Date: 9/T 2860 SW Hillsboro Highway + HlllebOfo. Oregon 07123 fi„ g- nom (803) 001.8100 a FM ( 609) 501-4430 + www rieamwr■mrrvso.e vtg nawor Mriii,2007 T�G1H -t T1 AtiA1:4S'AC M147 - 1) , 1a I QHA ANH -1.IT l AP :2121 RRRP -AP- TA 01 -29 -2008 23:33 TIFFANY EASTERLING 5036101071 PAGE1 Information Notice to Property Owners About Construction Responsibilities Statement Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. [ORS 701.055 (4)] This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. 'umi ";:- ., "'sr} •-'� ;'t'�'"a" - `:w'z. t.. -- ' „x,.a ,�,' , °;:'' t ,r^': '. .� r,• `urt':.:;F'; ='��.. �a' ^ y ` " " a - ° _'at i�, .,,*, ".. >x.� �th _ _ ;, Please 'check °th"eF-a o riate;`box ands c,o m}lete pee :.foll:ow-ing state ent:,:. ti n, ,. tricx �g pr ,� � sa`aa r ° V - - - a�ib. .t � ,. n<� ° s oik x +4 : .r vex,- , °�:•, .t.°- I . -own xt ` =:,or :�viil:' "reside, coin'° leted=. structu °reland=Y�; � m�eneral contractor rx fit° ": t^ - ^ar k Ftetr- Uu ;y • ` -;` - , , rd ^ - � - ; 1; ; iv° ':.r - xN "^`^4e ° A'" c . E} =✓e-,. x^ �. - d-' ' t4 ▪ `" 3• - N' - _. r -., �a - - : ,� .,> � ='y�'z�"``' � � i`✓ ", u:.,�; , _ �;�;s ", :mow,.- ' -arc fax "y "• `da ., ,Yhc, _ - u�,tr,r - - h Yt 1 i i$ x „" • 4ti;y f” a , - .ruc _ . r ' F = X. ^., «SE.n :.� : - " -' 'A `: '" (P ,' : -:' : =m � will ` eneral ' cont t h a t ; all` sub c ontractors* w h o - work one =t - st ructure °.mus t: De': licensed witYi tle -: Gonstruction� Contractors Board :`��' s =,w � °� =F�`� "�'`�,.� ",- .��w °��w +tF. .,^ i , ".;, >' . - ' "s„ u _ -_ , e -,'. -; ` ' s - ' , v t` ,�., ; :i �" _ • tr. ;te <�`a"� *: w,� ` ' - , s �� YCi * :�f "..' e aj' �' � :rv ' ^a'E' ,$` +• , re, s - « �, fi° • .a - fir-, - ° ,.:-_'�' '' �,, s'Sa "'• �' `x* _ w - n1"w, ,si " ence fi a � Y,,.. 4 < residenc - 'bp•.ais'x' _ - wil°l.kber. erforming -.work on;= ro° e , :`I ow =`as red'that;I`rr eside°'in orra' `eahat Twill ^ � x, ,y . � ��" r + _ %a „ x7, ° „x�e1'4g� «Sb`�."`.. ,. %P' ' ”, ,.... �4 ","w �,,��,' "'z. s -�' " : , ~. , rai r , .. .-.y: "� z 'r ” - .` - r 1n. If - I - hire:.sub'contractors' I. will hire subcontracor -= l =icenedh.the Cuction's :. ▪ Contractors °° -,Board if I chap eim" mind'a'ndFh'ire.a general contractor :I will contract -with AX : =- -40 b � � � �. +a: '' < : "C3 °��''� "_, se �. i ,.. ', �., 7 , ', -,:;.' , �.� i , Y e ':��,Y ✓.= contractor whogiis'licend withetthe= CCB, -and.,wrl1- immediatel y -Ahe :offic 'issuing tl is bui=ldirig rrrii nthe m ` f ` h °c ` n r.rs ` � . _ �^ e t;,of a e,o . t e eon _ �,., � ^^'"''�:" ;,x, x` _ - " :«n ,�.�,, .. xs, �., - �k ,�:s" ' °� .,§ - _Y.�ii �� �; � � = "= �`'.i_ =' ''•; i e E x " �P �r �16a i s � :. y -i' =' a- A ar ?'ek, r� iF , S, +mod- =- x - < ry f yr - ,_ , '%9 ,x -}""= �`f. - `�H, ^P.w +& _ e. � '' "'�`,`'�"- ' `s • M:`: ry zit h 5<' , w ' �"�n� � ya °r r • .; ir. - �"'. . . 4u3""" ` {� _ r�ES s "" iQN ,x � � rider 'ha = = >read and u stanilaNe Iriformatiori� °e : I op rty- Owners "aboutCons tru ctio'n :'Res onsibilities 'contai'nedon;these- -two` pages ,and'IY :he-r-"eb�.certi •`that°the., checked - - �«#' " .; € 1 - � a ' e'is�correct"arida - � , , - �com� et d . , - °�:., "- `<'Y"'`'.' - ; - ' "'3':, ,' , . , ; : � . - # ° „ , . 3 : > - A. , „, .. :�'<"', `::r : =`a ,..`ta;•z.�.'- � °•s ",.' __ - .,�a, r„>' -?T� ,>.w ; :; -... _ <E;�r, ..F, - -- .,, �. - , - „'.. ::' -Yw,. ._ °r'A„<:::- =ix , - ;' - � ; fix +,,,�, - - s ,�x, -. +r - fit - ”- t;:'.`� r-e,., .;a §"a ;,; "�'�;i >"'; k � y`. ' x * r 'P �. 's"kt``d .' >.S,s, nom -:;k , °,+T,&'t, de`53".y_.' + -; ". t °fii x - ; ,.:, .' "r•"i ':t'"'^; ▪ .� " r . = av .s 'r�` .y� - a °'ra "� ?'� . ';'v�t�;s} r �`xi` ,, we - - : t a��, -- - ' ;; "wv s?ii ,xc - - . -,w, P::wu;. - - � '" ` '� ��, r /' 't`;•� '``; ;' . . ► - 6 ",�` , 'Print of :': ' ermnitia > cant , ;w , {` ; - Si n at - 3 ` r re; • • f P r �:K:� "•- � u ` : erni't applicant W- S,t�°r -iies s 'is x,, - - - . ,G1,m - ,a'i'r,« _ '�'K'>�':K" _ - te a - ::F .4 . aJP'i - " Permit # : " � This form is supplied to building o o Address: permit offices by the Oregon Address: L " 2't' /-614,1%../-- Construction Contractors Board, 'N� =1 ., , - / as required by ORS 701.055 (6) ,v / g� Issued by: �• ' Date: ' ' v This copy to issuing permit office CITY OF TIGARD '. COMMUNITY DEVELOPMENT .TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Plumbing Signature Form IMPORTANT PERMIT NOTICE PLUMBERS INC. 90 NW 150TH AVE BEAVERTON, OR 97006 Permit #: MST2008 -00006 Date Issued: 2/20/2008 Parcel: 2S 103AC -01300 Site Address: 11245 SW FONNER ST Subdivision: Lot: Jurisdiction: R - 4.5 Zoning: TIG Project Name: OAK . , . • Description: 569sf addition. Your company has been indicated as the plumbing contractor for the permit referenced above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing 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 plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: RICK /BARB OAK PLUMBERS INC. A' A 11245 SW FONNER ST 90 NW 150TH AVE TIGARD, OR 97223 BEAVERTON, OR 97006 V Phone #. 503 -887 -1252 Phone #: 503 - 519 -6644 Reg #: LIC 179394 LLIC 177214\ LIC 179394 LIC 170294 AN INK SIGNATURE IS REQUIRED ON THIS FORM X _ / .. / I (TAI Prn5$ Sign.. 'ure of Auth•rized Plumber Name (printed) CITY OF TIGARD _. COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Electrical Signature Form IMPORTANT PERMIT NOTICE OWNER • Permit #: MST2008 -00006 Date Issued: 2/20/2008 Parcel: 2S103AC -01300 Site Address: 11245 SW FONNER ST Subdivision: Lot: Jurisdiction: TIG Zoning: R -4.5 Project Name: OAK Description: 569sf addition. 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: RICK OAK OWNER 11245 SW FONNER ST TIGARD, OR 97223 Phone #: 503 - 887 -1252 Phone #: • Reg #: AN INK SIGNATURE IS REQUIRED ON THIS FORM X k 'G PNG ,_ D a Signature • ' upervising Electrician Name (pri ed) SUP LIC # . p r, 7 e El \i I r" . .,t ' .- : .! : ' , : , .. . s ' .. ,, �A'� ro t, n n . y '' ' - • ..,6,,--,-1-- ,,, ,, , . ..„ ; , .,,,,,,,, .-..„ :_, ...), - , --, \,,,,, .., i.-..--: ; .._ ; ...,•,,. __ . _-,........!, - - ' 54`- g „ - .. _M ..... _- .. 30, 9„ 14' 6„ 0 45' -0" o x ADDITION N Ls_ N N N ®� N f N r 45 0" _ ® 14'- 6 " # , 0 0 0 N N \ \ 100.00 Ai " � op lrVllll� d� 11 ��'Ibi1 1[ 1 1 1 1 11 NORTH I pLc6IN. I.. 201_0" TAX ID: 2S103AG01300 r BUILDING 2 FOOTPRINT = 11S SQ. FT_ 1% COVERAGE ` )1.P/S■ AREA OF LOT = 24200 SQ. FT. 1 Seueli Pillars ®OO ICTJDO' DC XDR, Oa& E—mail : pionseseventpalarodostn.com el.". s (871) 278 -7780 a/ •, CITY OF TIGARD . A _` .._ BUILDING PERMIT NO.: IA & _ 000e) Affr3 PLANNING DIVISION: Required Setbacks: ❑ Approved Side: `� Street Side: CS ❑ Not Approved Front. _ Garage: Visual Clearance: ❑ A � .Reap' kb ❑ Not Approved Maximum Building Height* feet CWS Service Provider Letter Required: ❑ Yes ❑ No B : �� ❑ Received ENGINEERIN DEPARTMENT Date: / 31 4.0k Actual SI /se: - V a Approved Site Pla ,( / ❑ of • pproved S Approved ❑ o Approved 'Notes: � Date: 3 va /o — net SSoC iS i 3 y o f