Permit 1 MASTER PERMIT
, �� CITY OF TIGARD Co rs �� .
'- � .2 -> COMMUNITY DEVELOPMENT Permit #: MST2011 -00071
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/31/2011
Parcel: 2S104CD10100
Jurisdiction: Tigard
Site address: 13620 SW TRACY PL
Subdivision: HILLSHIRE ESTATES NO. 2 Lot: 100
Project: McKinney
Project Description: Finish crawl space, 1157 sq ft, and replace existing deck. 6/1/11, reprinted permit to include
hydronic piping and gas piping for water heater. 6/15/11, adding sanitary, storm, water service,
•
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 1 First: 0 sf Basement: 1157 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right. 0
Detectors: Yes
Total: 1157 sf Value: $126,393.85 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr. 0
Footing Drain: 200 Ice Maker: 1 Hose Bib: 0 Backwater Value: 1
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units: Hydronic piping for radiant floor
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0
Natural Gas Heat Pump: N Hoods: 0 Other Units: 1
Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvcfFeeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 8
Ea add'I 500 sf: 0 201 -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:
ALT SF VB R -3 1157
Owner: Contractor:
MCKINNEY, FRANK D & LISA M LORDS CONSTRUCTION LLC Required Items and Reports (Conditions)
13620 SW TRACY PL PO BOX 969
TIGARD, OR 97223 TUALATIN, OR 97062
PHONE: PHONE: 503 - 638 -5777
FAX: 503- 638 -5770
Total Fees: $4,597.62
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 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. ATTE Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -• 5 10 through . • R 95 '001 -009 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 0��344. 31 )— Issued : • ,4__ . Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion o he project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application 9 ,
Building Fixtures w :-.„.,„ i ,;,...„.„.,.. ,, FOR OFFICE USE ONLY
City of Tigard Received /,,, ! /` // P No.: �i /� 7/
II 13125 SW Hall Blvd., Tigard, OR 97223 JUN 1 5 2011 Date/ ( - Si S r
Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit No.:
Inspection Line: 503.639.4175 CITY OF i , I i
T IG A R D 6394175 1� { t �s• t 6 Date Ready/By: Iuris. 0 See Page 2 for
. Internet: www.tigard - or.gov 1'3i lit ripArZ r Ini, Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I 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 312.70
❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LO ATION Site utilities:
Job site address: 1 w ( 9 0 I . „ .5 - 7 - r , e t / L Catch basin or area drain 18.76
City /State /ZIP: 7 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.a00) Page 2 ff 7.5 '
Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
ain drain connector' it) ` OMe 18.76
Sanitary sewer (no. linear ft.• .2 , • Page 2 6,, ,Sy
- Storm sewer (no. linear ft.:Sdryeo Page 2 40A,51
Water service (no. linear ft.:atchep Page 2 Zea•Sef
Subdivision: Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve / 12.51 /2. s/
Clothes washer 25.02
U ✓h Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: Fixtur sewer ca" .ONQ" 25.02
Floor drat oor sink/hub 25.02
Address:
Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:
. Water piping/DWV 56.29
Address: Other: 25.02
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic. no.: 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.
1:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02 /COM/WEB)
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' 50.03 50, 03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 11 Z 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54 6 2, SY 7,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 62,5y Medical Gas Systems:
Water Service - each additional 100' 37.52
Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee:
G ` Y $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other ec
Ins tions or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
Inspections and including $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof.
, Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry /Font Please check all that apply.
Bath Tub /Shower ❑ Any new commercial building with water service 2" and
- Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918- 780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
-3"
4 Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings - Domestic-non -food s
g q g
Disposal - Domestic -food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav - Non -food related
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer - Clothes
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
I:\Building\Permits\PLMF- PermitApp.doc 02/24/2011 2
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CITY OF TIGARD MASTER PERMIT
•
COMMUNITY DEVELOPMENT Permit #: MST2011 00071
TIG D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/31/2011
Parcel: 2S104CD10100
Jurisdiction: Tigard
Site address: 13620 SW TRACY PL
Subdivision: HILLSHIRE ESTATES NO. 2 Lot: 100
Project: McKinney
Project Description: Finish crawl space, 1157 sq ft, and replace existing deck. 6/1/11, reprinted permit to include
hydronic piping and gas piping for water heater.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 1 First: 0 sf Basement: 1157 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 1157 sf Value: $126,393.85 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 2 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0
Natural Gas Heat Pump: N Hoods: 0 Other Units: 1
Furn <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: 1 0 -200 amp: 0 W/ Svc or Fdr: 8
Ea add! 500 sf: 0 201 -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
Ecompasing: Y
Other: N Other Description: p g
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R -3 1157
Owner: Contractor:
MCKINNEY, FRANK D & LISA M LORDS CONSTRUCTION LLC Required Items and Reports (Conditions)
13620 SW TRACY PL PO BOX 969
TIGARD, OR 97223 TUALATIN, OR 97062
PHONE: PHONE: 503 - 638 -5777
FAX: 503 - 638 -5770
Total Fees: $4,275.42
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 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 -0090. You may obtain a cop •t the rule& e direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344.
Issued By: Permittee Signature: C
C X1.4175 by 7:00 a.m. for the next available inspection date. (/
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.