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Permit CITY OF TIGARD MASTER PERMIT C COMMUNITY DEVELOPMENT Permit #: MST2010 -00220 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/14/2011 Parcel: 2S102DCO5400 Jurisdiction: Tigard Site address: 13836 SW HALCYON TER Subdivision: GERTZ HOMES AT EDGEWOOD Lot: 4 Project: GERTZ HOMES AT EDGEWOOD LOT 4 Project Description: New SF. BUILDING Floor Areas Required Setback Required Stones: 2 Bedrooms: 3 First: 1408 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1592 sf Garage: 713 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3000 sf Value: 5324,033.01 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 3 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 Drywell -Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL _ Residential Unit Service Feeder Tema Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/ Svc or Fdr: 0 Ea add1500 sf: 6 201 -400 amp: 0 201 - 400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401.800 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 801 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL • RESTRICTED ENERGY SF Residential Audio 8 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 3000 Owner: Contractor: GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions) 19200 SW 46TH AVE 19200 SW 46TH AVE 1 Ersn Cntrl 503 - 681 - 4444 TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: 503 -892 -3390 PHONE: 503-692-3390 FAX: 503.692 -5433 Total Fees: $15,378.63 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Co— : : nd all other . • • icabte law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of iss :nce, or if work i- pended for more the 180 • days. ATTENTION: Oregon law requires you to follow the the Oregon Utility Not�cati•. • Center. Thos- :s are set forth in OAR 952 -001 -0010 throu• • c :52- 001 -0090. You ma obta'• : • • • • a••,• -. - • '• s to OUNC by calling 0..232.1987 or 1.800.. 344. Issued By: "./11 - - ....- -ermittee Signature: - r` Call 503.63'.�Sy�.i:S!ri a.m. for the next available Inspecti. date. This permit card shall be k : - nsplcuous place on the Job site until • pletion of the project Approved plans are required on the Job site at the time of e: Inspection. Buildi'nk Permit Application ` Residential r' 1::,e 1) City of Tigard Received . • 13125 SW Hail Blvd., Tigard, OR 97223 DEC 3 0 2010 DateIB ._ _ �" �` "-' i P lan Review ��' M i, Other Permit: r Phone: 503.639.4171 Fax: 503.598.1960 Date/B : jii��1 - / ao (I - ,6 , it Inspection Line: 503.639.4175 ('ITV/ Pic' °�-r. ri L i D ata Ready ; y: ` kris. ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: [ ' I I � 7 Supplemental Information 1 TYPE OF WORK • dam w ' a°^ REQUIRED DATA: 1- AND 2- FAMILY DWELLING F I . New construction ❑ Addition/alteration / replacement Permit fees* are based on the value of the work performed. ❑ Demolition ❑ Other: Indicate the value (rounded to the nearest dollar) of all CATEGORY OF CONSTRUCTION equipment, materials, labor, overhead, and the profit for the work indicated on this application. l - and 2- family dwelling ❑ Commercial/industrial 0 Accessory building Valuation: $ O ❑ Multi- family ❑ Master builder � ❑ Other: Number of bedrooms: JOB SITE INFORMATION AND LOCATION Number of bathrooms: Job site address: / 3 ir 3 6 5 LJA /,, � / '% -k C ems. . City/State/ZIP: �� , /��� G, 0 Total number of floors: C New dwelling area: � c Zt".J s feet . Suite/bldg. /apt. no.: Project name: Cross street/directions to job site: `S S oN Garage/carport area: 7 ( 3 square feet Covered porch area: ( � quare feet l `lam ©1-r q,c- - E eC / , g.) 0 a a° �— t Deck area: square feet I /05 Other structure area: - 3 7 1 . 7 s square feet 2.3 REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: 5 -e <L 0 b c--0 I Lot no y Permit fees* are based on the value of the work performed. 1 Tax map /parcel no.: z S I O 2 4 C n s [tlCI-- 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. At e L --0 / `'� � � _ Valuation: $ ' Existing building area: square feet New building area: square feet Number of stories: ❑ PROPERTY OWNER y I ❑ TENANT Type of construction: Name: G.</d-2. C ����d1 �, G /4/C. Occupancy groups: Address: I 1 7_0 .5 ( 4/6 - /- Ac, Existing: City/ State/ZIP: `'-er 14 11,,.. ta 2 0 [ Z-- New: Phone: (5 G 9 1. _ 3 3,6 Fax: (Sa 3) 67 'Z -3VPI 5 f33 NOTICE ❑ APPLICANT ❑ CONTACT PERSON All contractors and subcontractors are required to be CAA, with the Oregon Construction Contractors Board Business name: 4--(.z_ L AA, A 1 ,,, L under ORS 701 and may be required to be licensed in the Contact name: /< ' ) Z� .eoLe -ate jurisdiction in which work is being performed. If the / applicant is exempt from licensing, the following reasons Address: j 2-C s (_1_,1- � 4 apply: City/State/ZIP: 7 uc 4 � ,.„, nit 2 e n � Z- Phone: is c (, f _33 76 I Fax:: ( 5 ° 3 ) 6 2 -5 Y3 3 E -mail: /'re"it,. V s 'iz7 ` 2_._Lel , CONTRACTOR I BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: 6 , •,_, ` (\ 4-c- I Structural plan review fee (or deposit): Address: / 7 2._L .,51c_e_Y I FLS plan review fee (if applicable): City / State/ZIP: ��, (et_st‘__ 02 o c `Z I Total fees due upon application: Phone: ( q ) z - 3 3 7 D Fax: (3t) Cp.. - ,S ' 3 Amount received: CCB lie.: 3 y 3 ,r - 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 Authorized signature/ Service Board. Print name: !` e C, f I Date: ` — ?c) ye 5) . , _. Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE: USE ONLY City of Tigard Received 74 Date/By: Permit No.: ® 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: ' Phone: 503.639.4171 Fax: 503.598.1960 ti(iAtt 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑Mechanical Internet: www.tigard- or.gov ❑ Other: l,i - ii FOLLOWING ITEMS EMS ,AR REQUIRED FOR PL REVIEW N No N/A I 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. ❑ 0 ❑ 4 Fire district approval required. Name of district: - ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity 0 ❑ ❑ 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. II 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 0 ❑ ❑ 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 SPECII' 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 - 1/2" x I I" 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 stature 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. I:\Buil ding \Permits\BUP- RES- PamitApp.doc 03/21/06 440.4613T(11/02/COM/WEB) Electrical Permit Applica ��d'U volt (Irrlc II t: 1. IONI.1;' • City Of Tigard C f 2 L. ® �' S Received ' DateB : Permit Nod i - Q .14 / • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.718.2439 Fax: 503 p : Other Permit: / _ • Inspection Line: 503.639.4175 �� �I�� I�� Date Ready/By: r® See Page 22 for 1 ' ; A I: I, g g BUILDING DIVISION . Internet: www.figard-or.gov OV Notified/Method: I MI Supplemental Information ri • •. • .• t . f tf�, / h•.' , V i - ,, �. A: . -'. �., } y ,•- arAliky� , ',.`.. . ➢ , °t , :Y %i•• , : :,'r a- .q 4,, . a. . ,c ! 1 Y t� l 1 r ! .? ' E. 4f r: I'T 'f) K . - . '� • 1" .-� y; ., . - ti'' ew construction ❑ Addition/alteration/replacement Please check all that apply (submit sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three statics. ] Demolition ❑Other: where the a vailable fault current 0 Marinas and boatyards. -" , :tr. ,. p at 1 SO volts or 0 Floating " �; r ', , r : ;t'�r ;',, ' ;,t.. ,;.,�i.� � ��, ;., �:.� :. ; :,,.,K.'.� ..,.' axccedal0,000em a ng buildin s less to for all other a exceeds ons. ❑ buildings. agricultural 4 and 2- family dwelling ❑ Commercial/industrial ❑ A ccessory building snips Cor all other inatalletiona. buildings. ❑ Multi - family ❑ Master builder 1:1 Other: CI Fire pump. ❑ Installation of 75 KVA or A ' p, r. . a `+ , �s - ,.. . ['Emergency system. larger separately derived system. :',I q4 :11 4 ' i , I ' ` • ', r•}7 • il ' `. :�' j '.il xx ��t .!. . • , ,. .. ,1. ` .. , ' .. _ . :. . ■ . •— • ' .. ,.1 L . '. ❑ Addition of new motor load of -❑ °A ^ °I -2". «1 -3" Job no.: I Job site address: /.$'23 c ..c , f,¢L , 7,,� ""HP or more, occupancy. � Y� ❑Six or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: ❑ Health-care facilities. 0 voltage for more than - ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: ` Project name: 6fU 1,-7ES , 17 -- ❑ Service or feede--.:.*'..;',;.) 00 amps or more. Cross street/directions to job site: GE .T•..) .•'. ' ' '' ' ' -" - :'.' ' J � iT � (�GT`(1 1 Description •• w O4• I • F la � •• Total , .. � , -• New residential single- or multi.family dwelling unit.. __ Includes attached garage. • • • . 1 ,0 00 sq. ft. or less / 168.54 , - 4 - Subdivision: � Lot no.: � � � -� -- Ea. add'! 500 sq. ft. or portion • IQ 33.92 ZO S 657...- I Tax map /parcel no.: � ' ; w.Y • - . .- _ Limited energy, residential • d . 0, 7t] .• ;; : (with above ft.) . 75.00 7/.3 2 Limited energy, multi - family �„�� : r 0 46ta ig La- • residential (with above sq. ft.) 75.00 2 )'.6. Services or feeders installation alteration, and/or relocation 200 amps or less - • 100.70 2 `f r2•X.f ; ,,, � t p� l ° ,y y`'. 't b ; •1':', rime' ' i'. ` ‘ ;r ) T: amps to 400 a 201 am s s 133.56 2 t�i1i A is YX!Yf -... 'r'. - a ' : '. ;. ... 401 amps to 600 amps 200.34 2 Name: 601 amps to 1.000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP: relocation • Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 1 1 —125.08 1 2 Owner installation: This installation is being made on property that I own which is not . intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.6 2 Branch circuits - new, alteration, or extension, per panel Owner- signature: Date: A. Fee for branch circuits with ' 4v ! "; e j .,.i tr ; - :,; � abov service or feeder fee, - , , - , �' '7 T!° %` e°!..1., ,, � y a� al 1," ` ' 2 each branch circuit Business name: B. Fee for branch circuits without . - service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 _ _ 2 Address: Miscellaneous (service or feeder not Included) Each manufactured or modular City/State/ZIP: dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only - 67.84 2 Pump or irrigation circle 67.84 2 E r 'P , r „ „ , Sign or outline lighting 67.84 2 ' ": .•.,a < €F , 7,...• ....... c , .., - : . • _ ut < .• : ` . . ., :.. - ,. = Si c or l - energy • Business name: it � /- 6 ,'rt d 6 del panel alteration, or extension. _ Page 2 2 Each additional Inspection over allowable In any of the above Address: Z, Q 2.436 SE cDitzlgeoti 4csielp It:toile Additional inspection (1 hr min) 1 6625/ hr City/StateZIP: f y b".„ 72 $+-f' Industrial Investigation plant I min) 78.18/ hr ) 66.25/ hr /' �j Industrial plant (I hr m Phone: (f3) ;di-- 5 1 — 1 Fax: ( y�3) 6 4 O — Vl'r 6 Inspections for which no fee is 90,00/ hr �/ � specifically Vs min CCB Lie.: / D O - L r- Electrical Lic. 5- C C prv. Lic.. 'i3 ...„, - ,. R .I : i "„1 ! !t ' ,: '• : • p ? Sub 47 t�6 Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: /‘I'1 , 661 , 0.r N 4 K�i rJ Date: _ State surcharge (12% of permit fee): 153, 61 V TOTAL PERMIT FEE: 5 0 0 7 Authorized signature! f _ _" this permit application expires If a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: • Number of inspections allowed per permit. i i :tauildingWamitatiz.0 PmmitApp.doc 07/01/10 440- 4615Tt1 1/O3/COM4NEB • Electrical Permit Application - *City of Tigard Page 2- Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for A ll residential systems combined $75.00 Check Type of Work Involved: rg Audio and Stereo Systems* iN Burglar Alarm ... kr Garage Door Opener* A Heating, Ventilation and Air Conditioning System* q V um Systems* Other: . /cu Fee for lach commercial $75.00 • . system .. • • (SEE OAR 918-309-0000) Check Type of Work Involved: • . [11 Audio and Stereo Systems 0 Boiler Controls El Clock Systems 3 Data Telecommunication Installation El Fire Alarm Installation • El HVAC . Ej Instrumentation 0 Intercom and Paging Systems 0 Landscape Irrigation Control* 1:1 Medical . ; El Nurse Calls ' . • . . . , . . 11 Outdoor Landscape Lighting* Protective Signaling • . - . . . . . 0 Other . - • .. . Total number of commercial systems: • *No licenses are required. Licenses are required for all other installations lAkildirISTaartittELC-ParmilApp.doe 07/01/10 Witelanical Perm04,1 it ADDlica. CEIVED i it , City.of Tigard Received 13125 SW Hell Blvd., Tigard, OR 9722 y ° � ® c r °By: Plan Review grid . . Phone: 503.639.4171 Fax: 503.598.156P • • ., , ; , , Inspection Line: 503.639.4175 Dote/By: Other Pmt; Internet: www.tigard- or.gov CITY OF TIGARD Date Ready/By. = • -,:; Notified/Method: BUILDING DIVISION ,L , ' ?. :+fit „:':-. M New construction 0 Addition/alteration/replacement Mechanical permit f ees• are based on the value of the work ❑ Demolition [] Other. performed. Indicate the value (rounded to the newt doh) of all ' ' r Demolition t ry ` s 1 r mechanical materials, equipment, labor, overhead, and_profit Value: I- and 2-family dwelling Y g ❑ Commercial/industrial ❑Accessory building 0 Multi - family 0 Master builder 0 Other: For spacial information use checklist. Descri on Qty. Total :? ' Heati g nl'/ /cooling 4 J ht e c 'd� r c Air conditioning or heat pump Job site address: /3 1-3 (re site lea showing ptecementr - 14.00 1 I City/State/MP: : ii a � 2 4 ,222_3 Furnace 100,000 BTU (duets/vents) j / ��r Suite/bldg./apt. no.: Project name: Furnace 100,000+ BTU (duetsrvenrel 17.90 Gas heat pump - - 14.00 Cross street/directions to job site: / A if S. f, J e $ . a Duct work 10.00 ,0jk at tid 1 t1 Sd in ea 0i Hydronichot 14.00 Residential boiler (radiator or • hydronic)' v ' 14.00 Unit heaters (fuel -type, not electric), in - wall: in -duct, suspended, etc. 14.00 e' Subdivision: G,A. /loo/loom / a Flue/vent for any of above 6 80 S o/V �`� Lot no.: Tax map /parcel no.: - Other: , 10.00 Other . _:,: ' (i ... n+ ' ' ' -;, ! 'y ,. y .\ e k��;v ,3- it,,,.d< Water h teaepPianees 1 a G saJ OA,� Gas fireplace L _ 3�• 3� w Flue vent for water heater or gas fireplace i 10.00 • Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 t 1 ir[�y : Other: -Chimney/liner/flue/vent 10.00 ' ' - . ... ..- ...LN .. r ' ... ' : • 4 1 .4i§.'i .. er: 10.00 1 Name: 4 e R-Y�2 CO NS '�L4.eet ts,l a /r e._ Environmental exhaust and ventilation Address: / 72 a O S w Y ` -� i! ti r ! Range hood/other kitchen. !T equipment r '33.37 City/State/le: 1.44 a 6 li' dg g 70G. 2- 8 7 76 : Clothes dryer exhaust I '3 G. f Z.- 3 3 _ (bathrooms, Phone: (763) O F a x: ( 3 41 3 Single-duct comp wthe (uality moms) �� toilet comparnneltt9� utility rooms) �� , (i,� i r; e ti , ,', Attic/crawlspace fans 10.00 Business name: 4 d�7_ Cr�f f .,.,s s Z' »4 4 /arc other- 10.00 Contact name: L G eefz Fuel piw^� _ __...-st four, 51.00 for each additional Address: I $ ed.J YL 'di A c.i,* Furnace, etc. I la4r.( 5 Gas heat pump City/State/ZIP: '1 4 (i 4 f ov 0C.� - a ? 70 . ; Wall/suspended/unit heater 1 Phone: ( so3) 4.1 F ;� 7 x :: ( .5 6 pZ- s- W ater.heater j y� l E -mail: Ce Fireplace A( & �Z�-C ® CO Range I Barbecue Business name: oAd .. / 4. Ar 1 14 clothes dryer (gas) Address: 1 p p 3 ARV ! 7 / Other t � ;1 ' ` City/State/ZIP: 4 L Ca to aG 6 7 7 b,2 Z ; ,rx c Subtotal ' ? Phone: (5 4.5'5 a Z Z ( l Fax: ($0,3) 45 2 ?? 3 Minimum penult o f p per(572. Peen review (25% of mit fee) ) CCB lie.: 4 ! / 2 SJ State surcharge (12% of permit fee) r ., TOTAL PERMIT FEE `3 , Authorized signature: This permit application expire, Its permit beet abtdoed.within 180 days after ithas bem.accspted as complete. Print Warne jj 4 ,- � _ 1. Date: IZ 2-�- f if ' • Fee methodology set by Tri -Corny Building lndmtry Smviee Board :um; ` 0 f /ISM 440.4617r (i1/021COMMEB) • � . City ° t: , df Tigard T'age.2 -Supplemental information Commercial F e,S hedtile: $1.00 to ,000.00 Minimum fee $72.50 $2,001.00 to 35,000.00 '$72 :50 forthe first $2,000.00 and $2.30 for .each additional $100.00 or fraction thereof to and incl • $5 000. 00. $5,001.00 to $10,000.00 $141:50 for the fast $5,000.00 _ .$1.80for 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 requir 2 sets of plans. • • 1 : PemtitApp doc 01/19/07 2 Pdumbiane Permit Application Building Fixtures ,i.:: • ; City of Tigard (� . " Received • 13125 SW Hall Blvd., Ti �J Dsre/BY Pt+mit No.: �y, Tigard, OR 9 Q�� Plea Review ! ",Ic // - �� 0i � 3 i::. Phone:' 503.639:4171 Fax: 503.598. i" :11 G Q % DamBy: P am i t-•2!to.: 5S `A'�u[,J -(8 I G .Inspection Line: '503:639.4175 Internet. www based -or goo `' S1, RI Ste P.age1 for NotifedlM od� Jam ..__._.. _...._ .��� s ••,.'• a �E '7::.:- -rat information 1 -'. New construction 0 D „ ..4 For spedal ihijonnmBon use checklist '' - Descnption - I Qty. ( Ea. l :Total ❑ Addition/alteration/replacement ❑ Other New 1- 2-family dwellings (includes 100 ft. for each utility ', 4 , Zt kiiii 7:7 .t 94 `.i 4..4� ! I 4; '.ft41. COIIrIeCtlOn) • .w. rro;:r s sG air° sxT ^xq SFR (1) bath and 2 - family dwelling . ❑ ComrnerciaUiti - ii t ial - . ..:... I SFR (2) b A 24920_. ,.. . , , , 350.00 El Accessory building -_ - • ❑ Multi- family -- SFR (3) bath -:: {.... - - 1: • -.�� ?.? ❑ Master builder ❑Other: Each additional. bath/kitchen"• 45:00 - ' . Fire sprinkler ( sq. R) - Page - -- � 1, ..7/_ _ ..: ,.,. Site utilities -- Job site address: / 3 $ 3 S k J e x d llf 7";Qlde eife Catch basin or area drain 16.60 City/State/ZIP: "7°i' p o 4 , d ( OA 7 7 2 2 3 Drywell, leach line, or trench drain,_ , .. _ 16.60 Suite/bldg./apt. no.: 'r' I Project name: _ . • • ∎ Footing drain (no. J Page y Cross street/directions to job site: ' e: 7` aK 1 Manufactured'home utilities__ _ __. = 1 h'`l Sf Manholes 16.60 in Joe •e A. g4 '7'b Z .y+ - ere e Rain drain connector . 16,60 - r/ �' { Sanitary (no: linear ft.: ,). - Page 2 - - % Storm sewer (no:. linear "ft: >= • --- Page -2 - - Subdivision: Q rQ >f� # . 0. s . Y e.. 4 4 c Lot no.: y Water service (no: linear R: _ Page 2 - Tax map /parcel MK: o 21/0 Z 0 C. p S`�4 FiSture or item ` f ( v r I _ r , , . Absorption valve J a 4.1 _ ._..�C. J N ew i . I.:. . .4 -. a _ ... '., t.:.... _ t . Baekflow enter prey 2 Al a us iip osv e Z. 4.. 4 f--( . _ Backwater valve • . 16.60 • Clothes washer . 16.60 Dishwasher 16.60 ; ,r , t7, Drinking fou ntain • =.: - 1' = = n = -•-• i �.� 1 � �� '� 14 m I n� i`� y { ::� n ' �h � . ' ;I i � :��. 4 g _ t -... I6.6O ' 7: r /a, `� EjeatorsisumP 16.60 Name G c4.2(2_, G.e Ai f" t�/� cs.G Ida d - !ic/ � • Expansion•tank - -- ._ : V _ - - • '- - FS 16:60 - Address: •19 Z, O O $ G.1 .e AD e • I Fixture/sewer cap �._ _ -16.60 _ City/ State/ZIP: 1 j, Z (, 6 - I 2• pi. 2- a 726 1 Floor drain/floorsink/hub • 14.60 Phone (T63) G .. 9O Fax (So3) 2 yry • I Garbage disposal 16.60- - '- ' t . r i' - ♦ 1 t ```: i • , Hose'bib' :( ' _ i - • 166 0 ` ice maker - (� _ 16 • Business name: 4 , i'Cf� A `^,'c. Interceptor/grease trap- - - �-- • - .- . - - -- _ - . 16.60= =,, Contact name: 16e Ai 6 .« f. . . ' Medical $ - )_ • • Page 2 Address: 1 p Z o d ye...) 'le C ^L5 A u r Primer . . . 16.60 City/ State/ZIP: 'Ti 4 L -60,„/ 0 Q at 7604 Z_ g 2 2 0 Roof drain (commercial) - 16,60 Phone: ( 30 G 7 Z . . 3 3 .106 I Fax: : (5‘ 3) G9 2 -,: $ '(J.3 Sink /basinllavatory 16.60 E -mail: (,t ., a e.. ¢ZGt9 , Tub/showeNshower part 16.60 , r , w4�K Urinal i .....:.: - i : : , .:.!' .... I r 1.. ,:�.... i � 1 ?)2. ..: Water C(oSet , 1 l6 60 Business name: o t„... L. "4", lea 0 , Water heater 16.60 Address: A el /3 p 2 2 Y other ty w e s; - L 64 7 70 C. S subto City/State/ZIP: /st � /�( ), - 3L Minimum permit fee: $72.50 Phone: (Y 93 g. A 3 gr./ Fax: ( 5+ 4...f t3 4 gZ. /z' Residential backflow minimum permit fee: $3625 CCB Lit.: / ®3' 7 - 7 - Z• Plumbing Lic. no.: 3- a3'J'�� Plan review (25% of permit fee) State surcharge (12% of permit fee) (tom . 04 Authorized signature: Ar !! ?Z Date• :,Z. f This permit a licadon TOTAL PERMIT FEE ,- Print name: �4ht34a�11 � `s•�tr� ‘81t y� � g- P PP etrpiree if s:perntit:is narobtained:witbio 180 days after. it - has: been accepted as complete. • *Fee methodology set by Tn- County Building.lndustry Service Board. 1: \BullellaperettitAPLAW- PeadhAppdaa 17/17/06 44o.4616711o1001COMtwm) !lumbin ►he rmit Mmlicaaioln -City of Tigard Paget - Suppleame llatfo> on — Fee Schedule E. Residential Fire 'S ■ i j i !cession - Footi drain - { _ 100' .a- 55.00 :: �, . Footing drain - each additional 100' $110.00 46:40 2 001 to 3 600 $160.00 Sewer - 1st 100' 55.00 3.601 to 7 i r 7 01 and r $220.00 Sewer - each additional 100' $309,00 46.40 S� /o Water Service - 1st 100'��� 4150 Water Service - each.additional 100' 46.40 1VJl�dlcal Gas S stems: Storm &Rain Drain - 1st 100' MIN 55.00 . r G ;.. _ Storm &Ram Drain each additional 100 46.40 $ to $5 00000 �1 ... Minimum ' $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 I additional $100.00 or Erection x.52 for each Commercial Back Flow Prevention Device 46.40 includin: $10000,00. to and Residential Backtlow Provention Device $10,001.00 to $25,000.00 $148.50 for the firat410,000:00ynd 31.54 for minimum . it fee 536.25 27.55 each additional $100.00.ar fraction thereof, to •- Rain Drain, single family dwelling 65.25 and includin: $25 000.00. $25,001.00 to S50,000.00 5379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to s • eciall wasted in - •ons - , hour 72.50 Subtotal: _ $50.001.00 and u and includin: $50 000.00. p $742.00 for the first $50,000.00 and $1.20 for each additional S100.00 or fraction thereof. Commercia Fut Work: Are you capping, ' �*�,arat. I y addin or re fixtures? If "yes ", , �: o r ate ..... - _. ' ' ` :- 11 please indicate work performed by fixture. Failure to Please Pl ea review is required for any of the following. accurate re . ' rt fixtures could result to increased sewer fees*, ❑ Any new a c omm e rc al building with water service 2" and greater, except systems designed and stamped by licensed engineer. B • us • /Font ., ❑ New exterior plumbing site utilities for any complex structure Bath -Tub /Shower as defined in OAR918- 780 -0040, lecuui/VVhirlpool ❑ Medical gas and vacuum systems for health care facilities. Car Wash - Each Stall ❑ Any multipurpose fire sprinkler system. - Drive Stall ❑ Any complex structure as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator Dishwasher .Commercial Submit 2 sets of plans with any of the above. - Domestic Drinking Fountain 6 L 3 , , 1...;' . / ?5 1 i I 3 Eye Wash . • Isometric or riser di Floor Drain /sink . 2° diagram is required for new buildings - 3^ that meet the • ualifications above, - a^ Car Wash Drain - Domestic Garbage Disposal Garbage - met,ccia! Comments regarding fixture work: - 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 Swimming Pool Filter fees assessed for the sewer increase must be paid before the Washer - Clothes plumbing permit can be issued. Water Extractor Water Closet - Toilet Urinal Other Fixtures: i oa 112.11- PamilApp,d« 12/27/06 January 6, 2011 RE: NEW SINGLE FAMILY DWELLING Project Information Building Permit: MST2010 -00220 Class of Work: New Res Address: 13836 SW Halcyon Ter Lot Number: 4 Area: 3000 Sq. Ft. Stories: 2 Builders Name: Ken Gertz Subdivision: Edgewood The plan review was performed under the State of Oregon Residential Specialty Code (ORSC) 2008 edition. Please respond to conditions below. 1) West wall of house cannot be built using prescriptive bracing as shown on plans. R301.2.2.2.2 2) IBP's on first floor need to comply with Sec. R602.10.11.2. 3) Provide beam size for planter shelf area next to stairs. When responding, provide an itemized letter stating in what way each numbered issue has been addressed in the revision. When submitting revised drawings or additional information, please attach a copy of the City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Respectfully, Dan Nelson Senior Plans Examiner (503) 718 -2436 dann @tigard - or.gov 57.00 Elev 212 Elev 210 RECEIVED II ., Siltfe ce — Si once " A-.0i 01-:---P.11P---:(1R77)1-77:71, ----1 DEC 30 2010 r 0 • ••.,.. • .,,---.-------_---, CITY OF TIGARD ' - .-.,-:-; Y....r 4://, lq I BUILDING DIVISION : 1 .: " 1 1 " ; ': r-- gl 3 '' .: " .: 0 _ 'el ' :. 11•1 ; I :e.: ! ■5:0001 ! • LO - -....:4 .._._. . ..). i ! .......... . .,...:1 j ; !..:,.,. i..,.. :., - ; • ..6,990' SQFT.--- • A , .• i.,,,,.. i . g -. • • , .. : ; a - .;.„;,- 1 i I i.. • :' ; . , 1.....:, f. • r.... ; .._._. i co 1 ___ _ I - --575e. - r 2 5.25. --- -N411 - I n . • 4 : : I : . I' . ; I! lAt Aril 1 A . 4' LE i ,.. ) ,' s r-W ! 1 , ;,--, , ,....._ •..,,,Z . ,,,,,,,,,,,,, . i 1 ("if :■4 IA ji P. r —.../ 1.) , :i , 7 . i • ' 5.50 i---- — gl Aid i,......___ - , 8 ' VI . 'Jlti 41 CO 11 t: ' ' MU illifillid kr i 2. 1■ 0 ,4 jamilefill . 4> 0 ■-•11-- 4.-- 2dIr_ amp 1 iii i ol • i o i • • la I Ln . ............. _..........i..—.... '',' - 4),111t7) „ Elev 213 ..... .3 ... 1__RG A....ARA q // 4 --,Grovel . Drive • • . :•-i<1•1(1 • ;4. '1 ' Erosion' "• I .-• ' 4 - bl'f 0 I CI 12 1 . i ri ' .. .. : • .:: t ; •7 1 ' i. i 0 I ' ' :4;'' 1 CV •li f., L _-- — - -- -. - -.`><- -; • 't 1 1 ... - -... . . ..,-. 1 ...-- ....„. 1 0 5.00 WARNING: - 4-t. - - ? • .5t.4 g' _.4. 1 ... 0 thow OBTAIN LOCATES PRIOR TO ANY - q VA/ EXCAVATION d " woramm Inv •11111111111111N l> NAI" 2" Caliper Red Maple Elev 216 'Li (1)(b1 t, 20.00 co in • S W - HAL cyoN TERRACE GERTz CONS HOME SQUARE FOOTAGE ' MAIN FLOOR = 1408 SQ.FT. BUILDING 4 r . d z ilk i UPPER FLOOR =1592 SQ. FT. CUSTOM HOMES SINCE 1977 . Pr TOTAL = 3000 SQ. FT. . (503) 692-3390 GARAGE = 437 SQ.FT. _ 13836 SW Halcyon Terrace Lot 4 Gertz Homes at Edgewood SCALE V = 20' GERTZ CONSTRUCTION COMPANY INC. PLOT PLAN 12/21/10 . . . .. . . . . . . . . . . . . . . . . , .. • ' . ' . CITY OF TIGARD - SITE PLAN REVIEW y� B ILDING PERMIT NO.: A Y • PLANNING DIVISION: A roved ❑ Not Approved Required Setbacks: pp Side: _-- Street Side: .22__ ,....____€...' Rear: � s V isual Clearance: (\ � Front. .3212-- Garage: Approved pp`D.ved ❑ Not App t�'� 3 c7 t'�ct Maximum Building k-k &a o CWS Service Provider Letter Required: 0 Re ceived 0 ENGINEERING DEPAK I'Ivi WI' : • Actual . lope:...% I N ot Approved ❑ pr I Site P : n: 21 Approved II No 1 Apposed B L Date: / �, g„...„,_ Notes: CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: M 1-rdo /d —cad eb • Street Trees: Approved 0 Not Approved Protected Trees: +I (A pproved ❑ / Not Approved BY N�cl `N Date: r/ ff Notes: + � � / Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, %2A. ( '_. , am the general contractor or the owner- builder at the following address: Site Address: % G City: cy r7 ZZ3 Permit #: (P//) ©1' 22_47 Subdivision/Lot #: L and /or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture - sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: Date: 7// / `� General Contractor or Owner - Builder I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 tar Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 2 o c o 22_0 Jurisdiction: Site Address: / /-4/4-L ��N r7/ Subdivision/Lot #: fl) ckta 4-7 and /or Map and Tax Lot #: By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) Signature: A l \_..._ Date: l //// Owner /General Contractor /Authorized Agent Print Name: f ' ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. l:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 STREET TREE CERTIFICATION I, / 7 — ,_ agent for CvnitT (PLEASE PRINT) I (PERMIT HOLDER) do hereby certift that the following lo meets City of Tigar 1 jland use ,and development standards for street tree installatio - iznd is consistent zth the approved site plan. PERMIT NO.: SITE ADDRESS: / 3 '3 b st-i/ /4-4z e f d,v SUBDIVISION: 79 J - 7 - 7Z . LOT #: SIGNATURE: / / DATE: 7/////7 • -ER/AGENT) RE CEIVED & VERIFIED BY: DATE: (CITY OF TIGARD) Tree location verified per approved site plan. I: \Building \Forms \StreetTreeCertificate 07/01/2010