Permit A p
CITY OF TIGARD MASTER PERMIT
. r
'-. .- COM MUNITY DEVELOPMENT Permit #: MST2010 00175
13 125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2010
'..TIGARD. Parcel: 1S135CA09600
Jurisdiction: Tigard
Site address: 11448 SW 96TH AVE
Subdivision: SOLERA Lot: 5
Project: Solera, Lot 5
Project Description: New SF. 12/2/10, reprinted for 3rd story revision.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 670 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height 23 Bathrooms: 3 Second: 891 sf Garage: 209 sf Front: 20 Smoke
Dwelling Units: 1 Third: 300 sf Right: 5
Detectors: Yes
Total: 1861 sf Value: $190,509.72 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100
Drains: 0
Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 3 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add9 500 sf: 3 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
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: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R -3 1861
Owner: Contractor:
EVERETT CUSTOM HOMES EVERETT CUSTOM HOMES INC Required Items and Reports (Conditions)
735 SW 158TH AVE 735 SW 158TH #180 1 Ersn Cntrl 503 - 681 - 4444
BEAVERTON, OR 97006 BEAVERTON, OR 97006
PHONE: 503 - 750 -6268 PHONE: 503 - 348 -5602
FAX: 503 - 726 -7106
Total Fees: $15,888.97
This per..' - ' -- - d subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and at other applicable law. All work will
be : •ne in accordance 'th 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. ATTENTION: Oregon - r- quire you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR • 2 -301 -6190 Yo may obtain a cop of the rules or direct questions to OUNC by c- ' • 1 :232.1987 or 1.800.332.2344.
/ l
•
Issued By: �' t ' 0 Lor Permittee Sig ,.� i ,fit O p.."-.—___,
Call 503.639.4 75 by 7:00 a.m. for the next available inspection . te.
i
This permit card shall be kept in a conspicuous place on the job site until , pletion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGAR®
G MASTER PERMIT
I�' 1 COMMUNITY DEVELOPMENT Permit #: MST2010 00175
T.1 ,ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2010
Parcel: 1 S 135CA09600
Jurisdiction: Tigard
Site address: 11448 SW 96TH AVE
Subdivision: SOLERA Lot: 5
Project: Solera, Lot 5
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 670 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 891 sf Garage: 209 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 1561 sf Value: $161,124.72 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 3 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add! 500 sf: 2 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
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 At
Other: N Other Description:
Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R -3 1561
Owner: Contractor:
EVERETT CUSTOM HOMES EVERETT CUSTOM HOMES INC Required Items and Reports (Conditions)
735 SW 158TH AVE 735 SW 158TH #180 1 Ersn Cntrl 503 - 681 - 4444
BEAVERTON, OR 97006 BEAVERTON, OR 97006
PHONE: 503- 750 -6268 PHONE: 503 -348 -5602
FAX: 503 - 726 -7106
Total Fees: $15,286.79
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. At work wit
be done in - •r•ance 'th approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. • ENTION: Oregon I- . requires you to follow the rules adopted by the Oregon Utility Notification Center. os rules are set fol; in OAR
952 -0B, -0010 through OAR r •
2 -10 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 1 987 or .8i 42.2344. /
Issu -. By: �__.., �` L/ � Permittee Signature: .r4111'
CaII 503.639.4175 by 7:00 a.m. for the next available inspection d. e.
This permit card shall be kept in a conspicuous place on the job site until comple ion of the project.
Approved plans are required on the job site at the time of each inspec ion.
Build Permit Application
Residential FOR OFFICE USE ONLY
III City of Tigard RECEIVED Dateiv / (� Received Q to L ✓�j Permit No.: 670 — /7 t i
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1965) C D 3 0 2010 Date/B : A LE�� Other Permit: deed /�j/p -[rj
I" I C. A R D Inspection Line: 503.639.4175 Date Ready /: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
E 1- and 2-family dwelling ❑ Commercial /industrial Valuation: $ 1� - 12¢ :7
❑ Accessory building ❑ Multi- family Number of bedrooms: `�
El Master builder El Other:
Number of bathrooms: 2_ C 2_
JOB SITE INFORMATION AND L
Total number of floors: 2.
Job site address: Lcy s so tAS12.4. Std 9 c New dwelling area: 1 t S (p ( square feet
City /State /ZIP: - 1. U 0 PIS- J722 Garage /carport area: 2 o 9 square feet
Suite/bldg. /apt. no.:..S Project name: , OL- A • Covered porch area: 2. 1 square feet
Cross street/directions to job site: 112.4■ (jL - Deck area: 0 square feet 6`10
Other structure area: t7 7( square feet 2
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: SiOlt J Lot no.: . j, 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.
it..,.1‘ ..% tr1 41/4....7� s /t t) Valuation: $
Existing building area: square feet
New building area: square feet
Q PROPERTY OWNER ❑ TENANT Number of stories:
Name: IF T c--5---k- 4 7tNA€ Type of construction:
Address: 7 3 S 5 h S 8 14-9 -Ve-- Occupancy groups:
City /State /ZIP: ejS,4`.6 1- 'tZ`rC 7 4■ 3 Qg- 9'700 b Existing:
Phone: (9 33) "7 SQ ( Z 08 Fax: (SQ3 7 2 G. 70 3 4- New:
El<iPPLICANT ❑ CONTACT PERSON NOTICE
Business name: te _Q 0 v1�- �k.� k_IL-C-- All contractors and subcontractors are required to be
Contact name: 2k,_.- a ` -Aes-- .C50 licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 0 (0 7 S ,,,, ‘ J1,. .t k4_7 jurisdiction in which work is being performed. If the
City /State /ZIP: . ,t,...., !' „■,() •=7'■8.--t O(a___ G7 GD aj applicant is exempt from licensing, the following reasons
apply:
Phone: (5 �Q S S52,8 1 Fax: : (O3, &is 9 9 SS 2-
E -mail:
CONTRACTOR
Business name: tO te e / 4,tie: //)C- BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP:
FLS plan review fee (if applicable):
Phone: ( G ) Fax: ( )
CCB lic.: / p `� �� 7 Total fees due upon application:
/ Amount received: 750 Gt!
Authorized signature: V I t ' - This permit application expires if a permit is not obtained
8 within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -RES PermitApp.doc 10/01/09 440- 4613T(l I /02 /COM/WEB)
Building Permit Application Checklist
One- and Two - Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received Permit No.:
11 114 Y 131 SW Hall Blvd., Tigard, OR 97223 Date /By:
C Phone: 503.639.4171 Fax: 503.598.1960 Associated permits:
I' I C. A It D 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑Mechanical
Internet: www.tigard - or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes 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.
1 I Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements
and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction
indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and
surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑
floor, wall construction, roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings
and foundation, stairs, fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and /or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Ore:on and shall be shown to be applicable to the •ro'ect under review.
JURISDICTIONAL SPECIFICS
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)
Mecha Permit ApplicatO II II FOR OFFICE USE ONLY
City Tigard Received / 7 5i� �/1
-✓ of Tiard
b ® 2010 Date /By: 9/t>�O . / Permit No.: �yD
q 13125 SW Hall Blvd., Tigard, OR 97223 SF Plan Review 'Vr
C • Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: aLegde:) 135
h I G A R D C� Inspection Line: 503.639.4175 O 1 ' D % \I R O Date/By.
A` Date Ready /By: Juris: VI See Page 2 for
Internet: www.tigard-or.gov lr Notified /Method: Supplemental Information
BUILDING DivIS
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
ew construction Mechanical permit fees* are based on the value of the work
I�t ❑ 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION f /g-iY Heating/cooling
Job site address: t....40,1- . S O cfi -_L., (44.4.3.6 S v 9 6 719 Air
(re conditioning site plan showin placement) 46.75
City /State /ZIP: €, D . S 0 l � 02 2-3 Fumace 100,000 BTU (ducts /vents) ( 46.75 , k(0765
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: 0 St EA) G Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: ^1Q�&, Lot no.: ,j
Other: _ 23.32
Tax map /parcel no.: Other fuel appliances +7 �
DESCRIPTION OF WORK Water heater t 23.32 v ,
Gas fireplace '1 33.39 ,'% /
PA '. Q/J _ Q• .1 ki& S 'Ifs t& C1 rks(--- Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
1ROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: .---) I. - � -� • ' C-(4 S tj'1 , ikik Environmental exhaust and ventilation
Address: - 73.5 ...s 6/ ' Q .5'� .,J � Range hood/other kitchen
equipment 33.39
City /State /ZIP: v , 4;;42_51-
r4 O 0 a S� 0
'0 ( Clothes dryer exhaust 1 33.39 3'.•a9
0 ) 2- & 8 F (� t)'�1 ? 6 7 o3 4_
Single-duct compartments, exhaust (bathrooms, rooms) ) 3 01 q
��) ' // S toilet corn artments, unlit rooms 23.32 1. 1 �o
We PPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
h� t ,r1 Other: 23.32
Business name: �� ® Fuel t in
P�P� g
Contact name: IN--.1 I t�.--- / - � - r.t lhi D Q $14.15 for first four; $4.03 for each additional _
/ Furnace, etc. I'
Address: wC/ P _&,,A .4-1c__ ' 4_ Gas heat pump
City /State /ZIP: 12,& - - Aki tr05 062 ._ '7C'0 8 Wall/suspended/unit heater
Phone: (503 54 5, 5 �' Fax: : (9:73, 03 9 9s_S` Water heater 1
Fireplace 1
E -mail: Range
CONTRACTOR Barbecue
Business name: etc T 9 - -� £ Clothes dryer (gas)
- �
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal 2.54
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
415 �� Plan review (25% of permit fee)
CCB lic.: - State surcharge (12% of permit fee) v
- 0 TOTAL PERMIT FEE �f j `(
This permit application expires if a permit is not obtained within 180
Authorized signature:, 1 days after it has been accepted as complete.
t` I
Print name: Date:
* Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 10/01/09 440- 4617T(11 /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\ Building \Permits\MEC - PermitApp.doc 10/01/09 2
• Electrical Permit Application ,, , , tY )It c�1 r« H 4.1SE ONI i `
ii' - '6 ." f City of Tigard
13125 SW Hall Blvd., Tigard, OR 97223 i;i '
, I :...1.., ' ' -„•
Plat Review / / �^ � ,/ t
t Phone: 503.639.4171 Fax: 503.598.1r6Q '' D ate /Bv: Other Permit: , j / 0 - cc , 33
", inspection Li 503 Date Ready /13 lads:
rl Itrt A lth ®ScePagc2fnr
c. " .,-- 'W,, Internet: www.tigard- or.gov - •• Notified/Method: Supplemental Information
TYPE OF WORE .11f,1% ` PLAN REVIEW
("New construction ❑ Addition/altcralio'e / iacorfieiit0 `' Please check all that apply (submit l sets of plans wiitems checked below):
? ' `.! Service or feeder 400 amps or more
Demolition c-v � �" ' P ❑Building over three stories.
❑ ❑ Other: y, I
w the available fault current ❑ Marinas and boatyards. I
I
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial -use agricultural
21- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder El Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE 1NFOR.MATION AND LOCATION / /4/ T =mergency system. larger separately derived system.
❑ Addition of new motor load of 0 "A ", - 'E ", "1 -2 ", "1 -3 ",
5 &
Job no.: Job site address: ,s•(v't ' r,W ,b>✓d Six HP or more. Recreational 'r ❑Six or more residen units. ❑ Reacational vehicle parks.
City/State /ZIP: [,1, _ '_, P�' )Q- 97 2_2-- 3 ❑ Hcnith -c re facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to ob site: I' tt--- ' -'` t ",�� r i FEE SCHEDULE
J � ti�� J� L� -``� - DneriPtion 1 Qtr. J Fee. i Total i •
1 New residential single- or multi- family dwelling unit -
Includes attached garage.
Subdivision: Sty k_.- l Lot no.: ,, 1,000 sq. ft. or less ( 1 168.54 ( L. '3¼ q
Ea. add'I 500 sq. R. or portion Z. 33.92 L 7, 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above so. ft) t 75.00 75 00 2
Limited energy, multi - family
75.00 2
1 '-I 'JS < �i &I L., r'i r ° , e S `t l'`��� 3i 1. L--' residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
_ 200 amps or less 100.70 1 12
G rROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
.- - t 401 amps to 600 amps 200.34
Name: t J . r r� C�J r Ivi t - ki. .S
_ 601 amps to 1,000 amps 301.04 2
Address: 73 j SirJ F.. ` % �- Over !,000 amps or volts 1 1 552.26 2
City /State /ZIP: St.-- ,�'.l'ar - T{J` - •a 'P j 'l. + 7f7(
Temporary services or feeders installation, alteration, and/or
relocation
Phone: 50'74) — 7_� (92_ 8 Fax: (, (Ja 72-1 ' 70 -3 4 200 amps or less F 1 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, er panel
Owner signature: Date: _ A. Fec for branch circuits with 1
above service or feeder fee,
O''1i PPLICANT ❑ CONTACT. PERSON each branch circuit 7.42 2
Business name: y A.rJ (��-., LI,„� r - v B. Fee tar branch circuits
- service or feeder fee, first 56.1 B
Contact name: SG - ... t „ .e. ----i .7::) branch circuit 2
�� Each add'I branch circuit 7.42 2
Address: 417 •t,4 t�1�'w(.C+L, ,(z' e:•-:`•-.. l 4- / Miscellaneous (service or feeder not included)
City /State /ZIP: ' • + - -5:A/2.--`T . Q d 0 � 6 Each manufactured or modular 67 84
2
dwelling„ service and/or feeder
(5 1 Reconnect 67.84 2 y
Phone: (.� � F.: .5 C� 5'2t:� Fax: : (S0 �3 5 � � 2. )
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 1 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
1 2
• Business name: 1 i l ' V } 1 1 c ( 0___ panel, alteration, or extension. Page 2
L_0��� t C - �\x� � Y� L Each additional inspection over allowable in anv of the above
Address: z 7'&2o. ( Additional inspection (1 hr min) I 66.25/ hr
City /Statc/ZIP: hY A. \ & c..,\--Q21,,,, Industr p l ( mini 66.25/ hr
J Indastriatplunt(1 hr min) 78.18/ hr
Phone: ( '•' _( Fax: (.B °- „ ,, lc7 Q. Inspections for which no fee is 90.00 / lit
soecifieally listed (V.: hr min)
CCB Lic.: 1 (e.atot ) Electrical Lic.: ?�- J- Suprv. Lic.: g ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 0- .: �1 Subtotal: %� ( ,..F
Plan review (25% of permit fee).
Print name: •� „\`,�‘.,,-N W ,\ C \r\ Date: State surcharge (12% of permit fee): ;7, '- �-
TOTAL PERMIT FEE: 4p, 7 A-
Authorized signature: This permit application expires if a permit is not obtained within ISO
Print namC: Dale: • days after it has been accepted as complete.
• Number of inspections allowed per permit.
1 \ Onildinenmiu \ttLC- PcrmitApp.doc 07 101 /10 .140- 4615T(11,051COM1v0a
Plumbing Permit Application
Building Fixtures i•:oi OFFI( E 1 ili F. ONLY
Received f�
City of Tigard Date/By: 1' 4 :9, No.: /�/ /'-;„1:9//Y �*� J 7S
i 13125 SW Hall Blvd -, Tigard, OR 97223 Plan Review r.LA
_ • Phone: 503.639.4171 Fax: 503.598.1960 ,, . .. D Other Permit No., i6O-- 133
t I t;A t Inspection Line: 503.639.4175 Date Ready/By: runs • I ® See Page 2 for
Internet: www.tigard- or.gov )) r ; tE, I$ J. Aft r (J ., Notified /Method: Supplemental Information
TYPE OF WORI8Im DING; Div's ON FEE* SCHEDULE
[;:rew construction ❑ Demolition ___ For special infornwrion use checklist
Description I Qty. I Ea. ( Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 1
Ell- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
l
SFR (3) bath 500.32 45 C"'i,%j a
❑ Accessory building ❑ Multi - family 0
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( _ sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION / it-�
/ Site utilities:
Job site address: L- SV1 9 (27 -11 .eerie Catch basin or area drain 18.76
Drywell, (each line, or trench drain 18.76
Cit / State/ZIP: --- R. (. - 'e -IL c:72__ ---Too Footing drain (no. linear ft.: �) Page 2
Suite/bldgdapt. no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
tit4t. ) `-t . Rain drain connector 1 5.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _) Page 2
_ Water service (no. linear ft.: `) Page 2 1
Subdivision: \ J $1/c� -i Lot no.: , Fixture or Item: I
Tax map /parcel no.: Backflow preventer 31.27 + 1
• Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
N L 51 1•S t 5 r - i/ - - 1 D.GST I --Dishwasher 25.02
Drinking fountain - _ I 25.02
Ejectors/sump 25.02
ROPERTY OWNER I ❑ TENANT Expansion tank 12.51
-
Fixture/sewer cap 25,02
Name: �U (AilS`Zio tAA L k
Floor drain/floor sink/hub 25.02
Address: - 73 5Vv i sa C a 'TYr _/..r-x•!.
Garbage disposal 25.02
City /State/ZIP: ( _.) `T ?N cDt2-- )0 Hose bib 25.02 I
Phone: (5O a 75 0 G rZ: C p Fax: ( ) Ice maker i 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: E4 _I C) C:),�S t1/4. C--vr-...S Medical gas (value: $ ) Page 2
`_ ' � r Primer 12.51
Contact name: N h^ � t DO
�,,�" Roof drain (commercial) 1 12.51
Address: 6... 107 SVJ .-_ t ' - if ( 4 7 Sinkfbasinflavatory { 25.02
City /State/ZIP: ;�.3 lC:t''' Q'2._ .`7D& Solar units (potable water) 62.54
Phone: (S 5 4S , c> n Fax:: (.9 6,39 J-9 Tub /shower /shower pan 12.51
Urinal 25.02
E -mail:
Water closet 25.02
CONTRACTOR
Vv Water heater 37.52
Business name: � i11 /r,-ff t!' PL_ BIN L7 Water piping DWV 56.29
Address: 107< (f t . l r ' f v r e- C ( .,34112. ia.. R.J /G✓ w Other: 25.02
City / State/ZIP: lir°ateka O2j g Subtotal Yj 7
Phone:
(50)) (06,7 -�/ 7� Fax: (G(/ 0
( / ( /� 7 -1 G ( Minimum permit fee: 572.50
CCB Lic.: (/ 2,.2.2-0 Plumbing Lic. no.: 2( - 02..."-1 p73 Plan review (25% of permit fee)
GGGG State surcharge (12% of permit fee) ([rj, (,ai
Authorized signature: /1; LG 4i.. �i'�T TOTAL PERMIT FEE /TA() , J
Print Dame:
0 f U If 111)11 D te: / /7 /51/ This permit application expires if a permit is not obtained within 180 days
after it bas been accepted as complete.
"Fee methodology set by Tri- County Building industry Service Board.
118uiIdingT errnits1PLMU- PermicApp. doe 10/01109 440a6)6T(1o/02KCOM AVEE)
11/10/2010 03:11 5036243681 TIGARD BUILDING DEPT PAGE 01102
•
® .R
;TIGARD
City of 'Tigard •
•
October 5, 2010
®7 C7:)
Neil. Fernando
6107 SW Murray Blvd. # 147 •
Beaverton, OR 97008
RE: Tree Review for MST2010 -00175
Dear Mr, Fernando:
I have reviewed you site plan for MST2010.00175 for tree related requirements, and will need the
following revision prior to my approval:
1. Please show the species, size and location of street tree (2" caliper Raywood Ash? consistent with
your approved street tree plan for the Solcra Subdivision on the site plan.
Please do not hesitate to contact me at 503.7182700 or toddc igard- or.gov if you have any
questions regarding this correspondence.
•
Sincerely,
Todd Prager
City of Tigard
Associate Planner /A.rborist
•
•
Post -W Fax Note 7671 nam 11 � / pa � � r� $►
To 0 f
Ca. /Dept. L. Co,
Phone M _ Phone
Fax # 015'53 '53 Z— Fax 0 •
•
13125 SW Hall Blvd. • Tigard, Oregon 97223 503.639.4171
TTY Relay: 503.684.2772 • www.tigard- or.gov
11/10/2010 03:11 5036243E81 TIGARD BUILDING DEPT PAGE 62/02
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