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Permit CITY OF TIGARD MASTER PERMIT 2 COMMUNITY DEVELOPMENT Permit #: MST201000130 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/25/2010 T [ C, A R D 13125 2S110BD00801 Jurisdiction: Tigard Site address: 11910 SW WILDWOOD ST Subdivision: SHADOW HILLS Lot: 6 Project: Hauke Project Description: Convert 244 sq ft crawl space to habitable space. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 0 First: 244 sf Basement: 0 sf Left 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $23,899.80. Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 0 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) EDWARDS, CAROLYN M 1994 WIN CONSTRUCTION LIVING T 14055 SW KENTUCKY PL BY EDWARDS, CAROLYN M TR, BEAVERTON, OR 97008 11910 SW WILDWOOD ST PHONE: PHONE: 503 - 209 -6908 FAX: Total Fees: $1,083.49 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accon, ce 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. A - 1 TION: 0 - 'on law requires you to follow the rules adopted by the Oregon Utility Notification %-nter. Those rules are set forth in OAR 952 -00 0010 through OAR : -0•1-0 :0. You may obtain a copy of the rules or direct questions to OUNC by calling 03. 'rf/ 699 or 1.800.332.2344. � , 1 • 01/ Issu -d By: . / '4 / /J . / _. Permittee Signature: 1 Building Permit Application Residential RECEIVED �j ,• O lt O l l ti of q City of Tigard REE) DateBed 0 Cr �� I{i� ✓J PertmtNo.' Jr-i,,�0 e� . Ili! Y 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review' ° , p li Phone: 503.639.4171 Fax: 503.598.1960 All 0 1 0 [U10 i 2T r Other Permit: DateB . 6 R la Inspection Line: 503.639.4175 Date Ready/By: L . ® See Page 2 for Internet: www.tigard-or.gov II22II OF TIGARD Notified/Method: I > ��� Supplemental Information TYPE OF WOI ING DIVISION ''I7' LWV le J-rh, REQUIRED DATA: 4 -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 C Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the 'CATEGORY OF CONSTRUCTION work indicated on this application. (Al and 2- family dwelling ❑ Commercial/industrial Valuation y .8O $ S S Q d ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION . AND l7 LOCATION (4 ATILOCATION Total number of floors: Job site address: I / 1 f 4 5 IA) IA/ I q 1 0 d 4 S New dwelling area: ZLly square feet City /State /ZIP: I�'j o y . ti 0 rK 7 2 J 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Mg q r J("to Covered porch area: square feet Cross street/directions to job site: ,{� Deck area: square feet e u 11 n o Y n 4 i t 1 1 IIC, A 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. L I V r be s ecc Q' Cgs, KJ ( se 4 c 4 Valuation: $ Existing building area: square feet New building area: square feet • ' , ,, :❑ PROPERTY OWNER . . ❑ TENANT.' . Number of stories: f) N Name: 5 t ?U V l GP Type of construction: Address: /1 4 /0 S kJ i Ipf 6 J , Occupancy groups: City /State /ZIP: s'- f G ei y ( 0 oz. 9 i ® ,6 4 Existing: Phone: ( SO) y 1 3 /a '2_ Fax: ( ) New: APPLICANT ' • ❑ CONTACT PERSON . - - .. NOTICE. • ' Business name: (AI VIl Can S 0 V) All contractors and subcontractors are required to be Contact name: S') yb- licensed with the Oregon Construction Contractors Board 1,1Y1 h j ;Jill under ORS 701 and may be required to be licensed in the Address: ( VCS j C.• kJ__ Iei ,/ � c ) 1 jurisdiction in which work is being performed. If the City /State /ZIIP: 6 pc/kJ (' � T- K / ('/ n o / L G./ -700V applicant is exempt from licensing, the following reasons 60 ) JA (,10 S 6 0 3 ) 5_a U 6 3 3 apply: Phone: '� F ax: : E -mail: • CONTRACTOR Q 1 . ' . • Business name: (�/ y 1 c ri S 7tu 7G 7 71 BUILDING PERMIT FEES* . , Address: / S!© _s- S bk ,t en 40c1C ) l Pl (pfeoserejertojeeschedu(e) ' Structural plan review fee (or deposit): City/State /ZIP: 6 3 Pq U pt/"1'0 U R 9 700 O Phone: (5 ) , o q il Q g Fax: (5 S) y - ‘ 3 3 FLS plan review fee (if applicable): CCB lic.: [� Y �� /b Total fees due upon application: n Amount received: / 7. 4 3 Authorized signature: j� This permit applicati expires if a pe rmit is not obtained �v /� )n within 180 days after it has been accepted as complete. Print name: m n N ^ 4 j� Date: Q / fJ * Fee methodology set by Tri -County Building Industry "/ Service Board. I:\Building\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(11 /02 /COM/WEB) Building Permit Application Checklist , . One- and Two - Family Dwelling --: OR Ol (.lei USI ONl 1. ti City of Tigard Received Permit No.: IN Dat V 13125 SW Hall Blvd., Tigard, OR 97223 2 Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: `P1 C : A & 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑Mechanical . Internet: www.tigard- or.gov ❑ Other: ` 4:'I 11+ ; FOLLAW'INC ITT MSf RF•RE'QUIRFD;FOR;PLA,N REUI \V 1e ; No L=N /'.`- 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ r ❑ ❑ 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 comer elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore l on and shall be shown to be a 1' licable to the s ro'ect under review. IU RISDIC:1IONAI SPLCIIiICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(11 /02/COM/WEB) • 68/25/2010 15:10 5035991958 CITY OF TIGARD PAGE 01/01 Electrical Permit AeplicatilkiCr H g yf E 1 1 I1 1 1, I , • City of Tigard ;pia /a Ja r lrN4.: H , a,-ah� � 13125 SW Hall Blvd„ Tigard. OR 972.1.V. 1 - , 1. r . Phoac 503.639.4171 Far: 503.598.1960 . VrlAerpbrmit: In Line Sf13 639.41T5 ' (`,F � P.16) D■u Rove r/Sy: B Sea Pa=ne t for wane: www.ti or.g v �,�� ` NoritiedMtettad Sngpte®ead Iat'ernAaoe. ,,a■�.�r����. � " �k.^ 'DIVISION o N ew s a ❑ Addition/alteralionlrrplaeement Plow ehedc ■>t tar apply (submit lows of elrmr Winos decked 1relawZ ❑ Demolition Other CI Semis* er feeder 400 maps et mete l7 9olhl a over dots MOM. wdeec ow available fault aware ❑ Mariner and haaty■rda. -.. CA,'I t1Oltlf: at CI • • , • • .: , ; easecda report amps a1150 "Om m ❑ Reeling teeldirgt• less 1e around, or exceeds 14,000 ❑ Cormnaroial -star eµcisuMural El 1 - and 2 fmnily dwelling ■ Commaciallindustrial ❑ Memory building amps far all other i■amfktion. 6nitdiaat. ❑ Multi-family ] Other: ❑Pro CI ingaliatfon of /5 14.V A er y ❑ Master builder p • • ' •' dam: MM � 'riled :- 1 . TION•' • ' ❑ Em gHtlee ry new r , "A-, E", -1 lel7 derived ryttem. I- ❑ addition anew motor lend 6f O "A`. E", "t -2" »1 -3 ", Job no.: 1 lob site address :1 T� ) 6 sits./ k) J f � kydd (, : i oa>frp or mere. 1, 99a or mods nyidenlial uvitr. 0 Recreational vehicle parka. City /State/ZIP: Oltealrh-tarr fiea'tirita. 0 Supply volume formon, tree ❑14grardmtr 100Ai0115, 600 .oftr nominal. Suite/bldg./apt. no.: Project name: °Sendaa or balm 600 amwA stream. lS Cross street/directions to job site: rAtrtir �LRrE• rse ill' • I . row NM New residential single- or nitti- family dwelling omit. includes attached garage. Subdivision: Lot no.: 1.000 aq. ft or less I 16854 4 Ea. add1 S00 sq. it to Potosi 33.92 1 Tax mapIpareal no.: Limited etwgy, reledadiel ',(! r[( OP• • • . °. • with above •.iL 7$.00 2 • Lofted energy, nntllLfemily ill 75.00 2 residential vaithstxm ••,R Services or feeders honing . . antralao. androrrat. tine 200 amps or Iuv _ 100.70 IMM© Q'lartnartt'b . . :.. • 0- • d-'lFemert . . 201 ampato40Damps ■ 133,56 � � Nalne: 1 -Qv -f 5 eL 401 amps to SOD amps 20 0.36 601 amps to 1,000 amps 301.04 II Address: Over 1.000 amps at volts 552.20 City/Slide/ZIP: Temporary service, or faders loatallatbon, alteration. and /or relocation Phone: ( ) Fax: ( ) 200 snaps or less I 59.36 1 Owner installation: This installation is being made on propeny that 1 own which is mat 201 p0 °00 limps 125.01 2 intottded for sale; (case, rent, or exchange, according to ORS 447, 449, 470, and 701. 401 worn m 599 ernes 161.34 2 !trash circuits - new, pMSratirnl, Or csleesdon _panel Owner signature: Date: A Fee foe bunch clrculta riAA rli>Pi'ICANT ~ .. . 0 :PJ ISt] q .' :_ • ' above service or feeder 11x, 7.41 2 each Enoch circuit 0110118SE name: 13. Fce 6or breath cfmdu without ! !Mkt of !ceder fee, first 56. 11 2 Contact name: brooch eitr.oiI Etch add"! branch circuit 7.42 2 Address: Miaotpaecons tservite or feeder not included) Cry /StatclZSP: Each maautiarsted or modular 67.84 2 dwcllin:. nitrite Indict • -r r Phone: ( ) Fax, . ( ) malt' 67.84 � � Pump or i E-mail pump or rrigation t3utic 67,84 _ Sign or outline 1igJttl 67.34 h(a or Ilmltedtnergr MEM tdusintss na>mo. LC Eh' 11 it 1 QG 1j' ) G Signal circu a teateenfOn � © Each additional li ' • n OW' allowable is o • of the above Address: - r • • City/Stec/ZIP: itional inspection (1 hr min 66,25/ hr � � 1atci'ZIP: fevestigation (! Errata) 66.25/ hr � �' /S 62E4 [ J C. a 9 7 I 1 rrrduactal plant (1 >a rain 71,ts, hr ■ Phan Cam) .41 — t 5 I Fac % ) �' S(o'S rtavpeet;mra for wrier no 181 u ■ _ { r . ICAO listed Mir min 9D.D0lhr CCB Lie : C3 5 V �� ,., `, Suprv. Lic.:SKZh 1 � • oprv. Electrician signature, required: ~ - •��••� SuMatal: Plea review r 5% of permit fee State surcharge (12%of fee): lit r►alnc ) e2s�� / � 44 Authorised _ ' TOTAL PPAMtr FEE: • This portals application oapiros Ira penult to not sataiaed within tan Print name: / I- J7atC AnyraRerit tan beep acagrSad 4 :, — , :7...,:_:.! [t _ e,.. • Nonbor of inspection allowed pot permit, manuraatPemhoinzmvartho of WMlif Afad6IST(llra5/009teerpa 1• Z999 011 0 !JPe13 9 ,1Iev d0£ :170 01. 9Z fitly