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Permit 7////( A/k- ( kevkn i 7 •7 Gtr 6c/141„) / _ „ CITY OF TIGARD MASTER PERMIT 111 `- COMMUNITY DEVELOPMENT Permit #: MST2011 -00167 13125 SW Hall Blvd Tigard OR 97223 503 Date Issued: 10/20/2011 �� Parcel: 2S112BD09300 Jurisdiction: Tigard Site address: 14694 SW 78TH AVE Subdivision: BRITTANY MEADOWS Lot: 29 Project: Brittany Meadows, Lot 29 Project Description: New SF. 11/29/11, reprinted to add backflow preventer. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 802 sf Basement: 0 sf Left: 5 Parking Spaces 0 Height: 24.5 Bathrooms: 3 Second' 1073 sf Garage: 432 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right. 5 Detectors: Yes Total: 1875 sf Value: $208,424.67 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 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: 1 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: 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 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'I 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 1875 Owner: Contractor: BRITCLIFFE, MARK & DARLA M & D DEVELOPMENT INC Required Items and Reports (Conditions) 27485 SW XANTHUS CT 27485 SW XANTHUS CT 1 Geo tech report prior to SHERWOOD, OR 97140 SHERWOOD, OR 97140 footing inspection 2 Ersn Cntrl 503 - 681 -4444 PHONE: 503 - 516 -7700 PHONE: 503 - 516 -7700 FAX: 503- 925 -8387 Total Fees: $17,171.02 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 • r - rules o • - , uestions to OUNC by calling 503.232.1987 or 1.800.332.2 Issued By: _ �l ��J _ _�� Permittee Signature: Call 503. . `=a �� 0 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. - y r, CITY OF TIGARD MASTER PERMIT . - ! 4 - COMMUNITY DEVELOPMENT Permit #: MST2011 -00167 1 3125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 10/20/2011 TIGARD 13125 2S112BD09300 Jurisdiction: Tigard Site address: 14694 SW 78TH AVE Subdivision: BRITTANY MEADOWS Lot: 29 Project: Brittany Meadows, Lot 29 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories 2 Bedrooms 4 First 802 sf Basement 0 sf Left 5 Parking Spaces 0 Height 24 5 Bathrooms 3 Second 1073 sf Garage 432 sf Front 20 Smoke Dwelling Units 1 Third 0 sf Right 5 Detectors. Yes Total 1875 sf Value $208,424 67 Rear' 15 PLUMBING Sinks 1 Water Closets* 3 Washing Mach 1 Laundry Trays 0 Rain Drain 1 Urinals 0 Lavatories 5 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 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 Temp Srvc /Feeders Branch Circuits 1000 sf or less 1 0 -200 amp 0 0 -200 amp 0 W/ Svc or Fdr 0 Ea addl 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 1875 Owner: Contractor: BRITCLIFFE, MARK & DARLA M & D DEVELOPMENT INC Required Items and Reports (Conditions) 27485 SW XANTHUS CT 27485 SWXANTHUS CT 1 Geo tech report prior to SHERWOOD, OR 97140 SHERWOOD, OR 97140 footing inspection 2 Ersn Cntrl 503 - 681 - 4444 PHONE 503 -516 -7700 PHONE 503- 516 -7700 FAX 503- 925 -8387 Total Fees: $17,136.00 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 ATT ION Orego law res you to follow the rules adopted by the Oregon Utility Notification Center Those rules t forth in OAR 952 -001- 10 through OAR 952 r1 -009 •u may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 8 344 I Issued By: ■ _ . / _. - d Perm ittee Signature: K Call 503.639.4175 by 7:00 a.m. for the next available inspection date. T his 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. . I Building Permit Application RECEIVE System F OFFICE USE ONLY , City of Tigard SEP 2 8 2011 Rece i r Permit No aQI/�0I� ` SEP f B 8 DateB ived 9 Ot t ii - I Plan Review ` Other Permit : 13125 SW Hall Blvd , Tigard, OR 97223 a • v /0 I `� ...1.,2,67/0/ /l Phone: 503.718 2439 Fax: 503.598 1960 TIGARD DateBy I 1 �V CITY OF T I GA R D Inspection Line 503 639 4175 ate Ready/By 1 Juris See Page 2 for Internet: www tigard- or.gov BUILDING D IVISI ohfi,, ethod Y Supplemental Information X 1 w )7)1M 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 (rouided 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. 1- and 2- family dwelling El Commercial /industrial Valuation: $ `�� ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2_ Job site address: /4/, 1 4 ✓ New dwelling area: / it 7 5" square feet City /State /ZIP:1'' � U /, Garage /carport area: 4/31 square feet Suite/bldg. /apt. no.: Project name: Covered porch area: 2 f square feet 1673 Cross street/directions to job site: Deck area: square feet C 1Z / C /c 44 + LUJ tA0 b -r, Other structure area: :1.0 square feet W_ REQUIRED DATA: COMMERCIAL - USE CHECKLIST 4 Subdivision: Lot no.: a9 Permit fees* are based on the value of the work performed. Tax map /parcel no.: / Indicate the value (romded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. l v C ! � - p � Valuation: $ )1./ Existing building area square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: yh Ilr D ,,,, C i_ C k--t-c Type of construction: Address' 27 - . (, v4,./... f C Occupancy groups: City /State /ZIP: L T l Iv 0, A 7 v r. 7/ v. 0 Existing: Phone: (S S 3) 4 776 Ca / Fax: (s - ) , 7 2x' '3 t / l New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: ,8- Qv 4 v - m ,° e All contractors and subcontractors are required to be Contact name: in„ licensed with the Oregon Construction Contractors Board 1 r under ORS 701 and may be required to be licensed in the Address: 2'7 k. 5 (v/ X f�,.` -T.) CA---- jurisdiction in which work is being performed. If the City /State /ZIP: s T K .1 4 ,-00d 01. c 71 7 � / applicant is exempt from licensing, the following reasons / ! apply: Phone: )s-// / 7 U q Fax:: ; 3 ) q 2 X � l E -mail: YA,r'` °� r- 1 Q i u(e, C G S CONTRACTARR BUILDING PERMIT FEES* Business name (Please refer to fee schedule) 1 i , C d /,� Permit fee: Address: V' `-� h, State surcharge (12% of permit fee): City /State /ZIP: FLS plan review (40 %ofpetmit fee): Phone: ( ) Fax: ( ) (Due upon application ) CCB lie.: 9 J I ( je /y 4 3 Total permit fees: [ (/ Amount received: 7 0 ' Co i Authorized signature: / - � — �? This permit application expires if a permit is not obtained I Print name: /4 ML &• / — e1 :4 Date: '7 Zfi / / * within 180 days after it has been accepted as complete. Fee methodology set by Tr1- County Building Industry Service Board I \Buildmg\Permits\FPS- PermttApp doe 02/01 /2011 440- 4613T(I I /02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: El Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ Permit fee based on project valuation (see fee schedule): $ Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ FLS Plan Review (40% of permit fee): $ TOTAL: $ Plan review requires a completed application and three (3) sets of plans at submittal. Plan review fees are required at submittal. I \Building \ Permits \FPS- PermmtApp doc 02 /01/2011 2 Electrical Permit Applicatio CEIVED FOR ol` FiCE 1SE'ONLY . '" t' .. Received p�� City W of Tigard SE P 2 8 2011 Date /B p r Permit No • Q/( /, 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review ^ n Phone. 503.718 2439 Fax. 503.598 DateBy. Other Permit OJ/GapI I - / 4( T I GA R D, Inspection Line 503 639.4175 �i Y OF TIGARD Date Ready/By Sufis ® See Page 2 for O Internet: www.ttgard -or gov BUILDING DIVISION Notified/Method Supplemental information TYPE OF WORK PLAN REVIEW r2. New construction ❑ Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings less to ground, or exceeds 14,000 ❑ Commercial -use agricultural g 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building m for all other installations buildings ❑ ulti- family 0 Master builder 0 Other: ❑Fire pump. ❑ installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system ❑ Addition of new motor load of ❑ "q", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: /4G S 7 S .7 4' t' Ale_ 1 00HP or more occupancy ❑Six or more re sidential units ❑ Recreational vehicle parks l ❑ Health -care facilities ❑ Supply voltage for more than City /State /ZIP: C �y / /.! c ❑ Hazardous locations 600 volts nominal. Suite /bldg. /apt. no.: J Project name: ❑ Service or feeder 600 amps or more FEE SCHEDULE n Cross street/directions to job site: / 14 t- 4/c hi c Description I Qty. I Fee. I Total I New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision i) ' ,^ „ 1,000 sq ft. or less I 168 54 lL.?f� 4 rk r t �� ,' t o ieteS Lot no. ..2.1 Ea add'I 500 sq ft or portion _ -3 33 92 1611,77c, 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq ft) ( 75.00 CrD, 2 Limited energy, multi - family 75 00 2 I, (vf ` /�►� f� /1,, � residential (with above sq ft ) ,/6 Services or feeders installation, alteration, and /or relocation 200 amps or less 100 70 2 [7ROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 /9(..e.... 401 amps to 600 amps 200 34 2 Name: nit lf\-/� 4- Da1� tr r 1., G � P P 601 am s to 1,000 am s 301 04 2 Address: 27 (s_ s iy t , ,, e ,f� Over 1,000 amps or volts 552 26 2 I ll / Temporary services or feeders installation, alteration, and /or City/State /ZIP: S4 4 /ic,C1u4 77f (C) relocation Fax: / [ 200 amps or less 59 36 1 Phone: 5C7 ) S/ �7 / �700 `� ) 2 r per s.--? 201 amps to 400 amps 125 08 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 54 2 Branch circuits - new, alteration, or extension, per panel Owner signature. Date: A Fee for branch circuits with j�APPLICANT ❑ CONTACT PERSON above service or feeder fee 7 42 2 each branch circuit t/� 1 {� B Fee for branch circuits without Business name: �/ inn ` I 6 ro -I--'' service or feeder fee, first Contact name: Wk. L 1'( - ( branch circuit 56 18 2 Each add'I branch circuit 7 42 2 Address: 2 S C....-- d�- ' Miscellaneous (service or feeder not included) 1 Ci /State /ZIP: Each manufactured or modular 67 84 2 lt/(yJ� O dwelling, service and/or feeder Phone: (s; .3) C _770 I Fax: : (CO3) - 2 d �- S-3 %'7 Reconnect only 67.84 2 a Pump or irrigation circle 67.84 2 E - mail: IA '.a - _ — _ . - • CO Sign or outline lighting 67 84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: U �� - panel, alteration, or extension Page 2 2 Each additional inspection over allowable in any of the above Address: / 6° - d - e K , 5A Additional inspection (1 hr min) 66 25/ hr City/State /ZIP: 6(11 60 1 -.5C, r �AJ /� ( P e - C 71 Indust p n (t (1 mm) 66 25/ hr (� / Industrial plant (1 hr mm) 78 18/ hr Phone: � ) ^� 379 (5U - 2� ) / Fax: 3 Inspections for which no fee is 90 00/ hr ( ` d specifically listed (' /z hr min) CCB Lie.: o__` 76 Electrical Lie.: Apt.. 3iatL Supry Lie.: / � - 7C ELECTRICAL PERMIT FEES ✓ Subtotal .Q 1 : - . 4 2 ��2 Suprv. Electrician signatu required: Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): A t •)1-A-- TOTAL PERMIT FEE' ' 5 n6:1 A-- Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: Date: * days after it has been accepted as complete. Number of inspections allowed per permit I \Building\Permits\ELC- PermitApp doe 07/01/10 440- 4615T( 1 1/05 /COM/WEB . A Electrical Permit Application - City of Tigard .Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I \Buddmg\Permds\ELC- PermitApp doc 07/01/10 Mechanical Permit Applicatio FO OFFICE USG ONLY RE CEIVED Received City of Tigard Date /By 9/i ' / � Permit No • /�) , % 40 , '' 13125 SW Hall Blvd., Tigard, OR 97223 Phone' 503 718.2439 Fax: 503.598.1960 S E P 2 8 2011 Plan Review DDate/By. Other Permit i9 /2 / - A l , TIGARD' Inspection Line: 503 639.4175 Date ReadyBy _funs ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method Supplemental Information DIVISION OF WORK BUILDING DIVISIO COMMERCIAL FEE* SCHEDULE — USECIECKLIST Mechanical permit fees* are based on the value of the work New construction ❑ Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ CATEGORY OF CONSTRUCTION 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. I Ea I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: ?$90. / ' Air conditioning Job site address: / ) 7 �' '& ye_ (requires site plan showing placement) 46 75 I Furnace 100,000 BTU (ducts /vents) 1 46 75 il li ; , .7-`j City /State /ZiP: 5 tir711 / Furnace 100,000+ BTU (ducts /vents) 54 91 • Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 l -44 ' I / Hydronic hot water system 23.32 ` w Y Residential boiler (radiator or hydrontc) 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: Z `, ��/ I ► 1 us /� Lot no.: 29 Other: 23 32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 1 23 32 `23.3"z A^ Gas fireplace . 1, 33.39 '37,31 �°L� 1V V \ 0 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 PROPERTY OWNER TENANT Chimney /liner /flue /vent 23.32 Other. 23.32 Name: ` \L �— • '- cl 76 c- 1m 1 v �t Environmental exhaust and ventilation: Address: �j it/ te -�� Range hood /other kitchen / /j L/ �� _c Jt�n ✓S C. J equipment I 33 39 �( City /State / "LIP: S -Pl /.t-/ ✓dd c) ( (J,?/IO Clothes dryer exhaust I 3339 - 3371" r Single -duct exhaust (bathrooms, Phone: ( - ci3) . /6 "7700 Fax: ps ) 5 Z - L c b - 7 toilet compartments, utility rooms) 23.32 I t G -few 01, APPLICANT ❑ CONTACT PERSONN Attic /crawlspace fans 23.32 Business name: Other 23.32 �(Y� �cp j „ 0? ✓VL Pivei' �r1 L Fuel piping: Contact name: i/ p $14.15 for first four; $4.03 for each additional Furnace, etc. I 14. [7:7 Address: 2.7 0._ S S w X -t- T Q -1--- Gas heat pump City /State /ZIP: S'k t, it, UU)s c9/ Wall /suspended/unit heater Phone: v7 ) s-16 720 o Fax: : (S ) C Z� 03 �� Water heater l �/ `_ - 1.� I Fireplace I E -mail: 01 � ,<1.,60 ,<1.,60 , eOY Range 1 CONTACTOR Barbecue Business name: s u i.‘._ � 1 (a� �C �� Clothes dryer (gas) Other. Address: '2L 2 c r 105 -1-11 MECHANICAL PERMIT FEES* City /State /ZIP: ()O i -,1_ oi 9- 1 I 6 Subtotal ,/1 Phone: (S05 ) Z3 `77 � Fax: ( ) / Minimum permit fee ($90 ) � ' v " 0) 1 Plan review (25% of permit feeee) CCB lie.: l State surcharge (12% of permit fee) `T( ,,, 1 2 TOTAL PERMIT FEE '?'37, 1 `� This permit application expires if a permit is not obtained within 180 Authorized signature: AL LC c , 1� days after it has been accepted as complete. Print name: T CGS Date.C / * Fee methodology set by Tn- County Building Industry Service Board \B udding\Permrts\MEC- PermitApp doe 09/09 0 I/02/COM/W EB) 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. 1 \Building \Permits \MEC- PermitApp doc 09/09/10 2 Plumbing Permit Application Building Fixtures CEWED FOR O FFICE USE ONLY Received 9. City of Tigard Date/By. 1 ° it , ) Permit No.. r /� o! / 7 n 13125 SW Hall Blvd., Tigard,OR 9722 E 2 8 2011 Plan Review v`'' 9 Phone 503.718.2439 Fax 503.598.1960 Date/By: Other Permit No.ijea !o Inspection Line: 503.639.4175 T � c n R O CITY OF TIGARD Date Ready/By funs la See Page 2 for I n t erne t www hgard -ocgov BUILDING DIVISION Notified/Method Supplemental Information TYPE. OF WORK FEE* SCHEDULE ew 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 (l) bath 312 70 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437 78 building SFR (3) bath ! 500 32): Z� ❑ Accessory g ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( , sq ft) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: �J (6-11, Catch basin or area drain 18 76 L _ J " �� Drywell, leach line, or trench drain 18 76 City /State /ZIP: �t ". � U c- Footing drain (no linear ft ) Page 2 61 Suite/bldg. /apt. no.• Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18 76 7 k -f-' -k— yC r n) e h 6 / Rain drain connector 1 18 76 ✓ Sanitary sewer (no. linear ft . /J ) Page 2 Storm sewer (no. linear ft . ,51 Page 2 Water service (no. linear ft : ,O) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer I 31.27 DESCRIPTION OF WORK Backwater valve 1 12 51 1 Clothes washer I 25 02 V t-W 0 0 Dishwasher I 25 02 Drinking fountain 25 02 Ejectors/sump 25 p(pROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: yv, 1C .k.. � \Jl \ t____ `1 ` 'ci � Fixture/sewer cap 25.02 Floor drain /floor sink/hub 25.02 Address: 2, 7 4 g- S W x A n - . CV' Garbage disposal I 25.02 City /State /ZIP: 5't 1, tic al or C7 / 10 Hose bib 2 25.02 Phone: (s �3 ) ,.5 - 2 ? () () / Fax: (,b3 ) S Z C' g-3 c __,-7 Ice maker 12 51 '(PPLICANT ❑ CONTACT PERSON` interceptor /grease trap 25 02 Business name: m- . t, �V iP u f m f ,.� Medical gas (value. $ ) Page 2 1 Primer 12.51 Contact name: m l(. Roof dram (commercial) 12 51 Address: 27 C./g- S ,c (�/ xG v'1 - f {DVS 0-r- Sink/basin/lavatory 5" 25 02 City /State /ZIP: 5L — [,,/v a t. U,- 9' '7 /V D Solar units (potable water) 62 54 Phone: (ru ? ) . - 0 U Fax: : (ciR) Gi •ZS' _ cc3 % 7 Tub /shower /shower pan 2 12 51 E -mail: rn vv Lt. b r t i— (---- / R 4 0 o , Co {vim Urinal 25 02 CONTRA TO Water closet 25.02 Water heater 1 37 52 Business name: - -_ F, ?1,0,.. I n S Water pipmg/DWV ! 56.29 Address: P.p. / ,/ ei� Q Other. 25.02 City /State /ZIP: �A.a, C, 2 ` 7 / 3 7 Subtotal CC),'32 Phone: ( -) Fax:( ) Minimum permit fee. $72.50 CCB Lie.: G egq J 7 Plumbing Lic. no.: /j3 ( 3 Plan review (25% of permit fee) State surcharge (12% of permit fee) (.r,Q'\ r Authorized signature: TOTAL PERMIT FEE � r O , 3 1, - Print name: /1119,-)e._ )r , r C) Date:C/ 2 0 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tr -County Building Industry Service Board I\Bmlding\Permits\PLMU- PermitApp doe 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 - l 100' 50.03 0 to 2,000 $121 90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169 69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62 54 7,201 and greater $327 54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62 54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm &Ram Drain - 1st 100' 62 54 $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 Remspection 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 Garbage Domestic—non-food ❑ Isometric or riser diagram is required for new buildings Disposal - Domestic —food related that meet the qualifications above. - Commercial —food related - Industrial -food related Ice Mach /Refng Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec Vehicle Dump Station Shower -Gang -Stall Sink/Lay - Non -food related - Bradley - Commercial -food related - Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer - Clothes p Water Extractor increase of sewer EDU 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 - T .� K 6S. � ' q r1 5-1-o c w. Lo 4. 1o K12 OL Sfi v — o 01 s L'ov.Cc-..cc Co h e.-- \ 1 �/ ��fi • - t RECEIVED -2.4- SEP 2 8 2011 1-/-c___ p/„ CITY OF TIGARD BUILDING DIVISION 141684( v -4 /Ue____ to u S i° —9 - 1 1 FF `19.0' 3 1/ 1 i ' 6 6‘. t rl 1 1/ 0 N taiA /' ------> It. X 2 0 Z < sew CO . 1::)r; u c k, 4 y SAA-t t Sew 4 ,` G <v D Stti �o Vr II Aj \ ' kli A- ------ . Li A . - - I 11 11111111111W":= ytreer cuccrel Piaci 3 Y c. 4s* 1 51` U'AkU r RC.-I0C.CA 11Ncq box 8-1 9- 7'10_,_,/ suu 7 55 Eto u,,f lig Building Division Development Code Provision Review TIGARD Residential Projects Buildin g Permit No: H 5r 6! ( _o `" 7 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A NI Routed Plans: Q Original Plan Submittal Date: ` Af? It 1st Revision Submittal Date: ❑ Site Plan Only 2 °d Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review (contact . i S 1 1 4 RerWArt at 503 -718- 2`/ S 2 or � f►s 4 s.c @tigard-or.gov) Land Use Case No. -t R o. S t toes -0.)0 t3 Name Bo r, T T 4.,4 y M E 4- u)5 l Zoning /G - /2- g/ Setbacks: Front I Rear ,5 Side S Street Side A Gara [ .Maximum Building Height 3 S Actual Building Height Z y 7 Z-- GA Visual Clearance ae asements .1 L� Sensitive Lands Type: WO N Notes: Original Plan: Approved E Not Approved ❑ Date: sr 7! Z-5 /i/ Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW@tigard-or.gov) A Actual Slope: Notes: Original Plan: Approved,l2K Not Approved ❑ Date: / Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) 0 8"treet Trees 0 Protected Trees Notes: Original Plan: Approved ❑ Not Approved ❑ Date: / Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes AP , . II Date Routed to Building: • Page 2 of 2 Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, Ork r K... . f1' l i , am the general contractor or the owner - builder at the following address: Site Address: / / V 6 l ci 7 g * s City: ^ c,vrok Permit #: is /— 2 a 1 i6'7 Subdivision/Lot #: R s 7 „ nn `` /� t" 2 9 and /or ion el 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: 2 J� General Contractor or Owner- Builder I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 44 tai / ICo Oregon Residential Specialty Code N1107.2 HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: s - r 2a Site Address: „ / r Subdivision/Lot #: q - t,_ VI'v-,C___4et V w S and /or t 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: Date: Z (r rz__ Owner /General Contractor /Authorized Agent Print Name: 1 /41 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. I:\ Building\ Forms \RES- HighEfticiencyLighting.doc 07/01/08 • i I STREET TREE TIGARD CER TIFICA TIO N I, 7i1-%/< /3d- -tc l� / e , owner/ agent for IIY\-\-- D eve ( ( � vr ,c,A - v kc (PLEASE PRINT) (PERMIT HOLDER) do hereby certift that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: 4St 20 J/ — o /67 SITE ADDRESS: / q y 14- SUBDIVISION. . LOT #: 2 7 SIGNATURE: DA1 E: 2 /S` / (OWNER /AGENT) RE CEIVED & VERIFIED BY DATE: (CITY OF TIGARD) Tree location verified per approved site plan. I:\ Building \Forms \StreetTreeCertificate 04/01/2011 - -- /14 `>% oZri /- Cso/ 7 INSULATION DIVISION CERTIFICATE OF COMPLIANCE Date 12/23/11 Builders Name: M &D DEVELOPMENT Job Address: 14694 SW 78TH AVENUE City: TIGARD, OR Job Number 23973 Type of Application Material Type R- Factor Dept. ATTIC BLOW Fiberglass R38 INSULSAFE 14.5 EXT. WALL Fiberglass R -21 FB 5.5 GARAGE CEILING Fiberglass R -30UF 9.5 KNEE WALLS Fiberglass R-21K 5.5 OVER /HEADER Fiberglass R -8UF 2.5 RIM JOIST Fiberglass R -21 DR 5.5 UNDERFLOOR Fiberglass R -30 OF 9.5 VAULTS /SLOPES Fiberglass R -38UF 12 <�1 . . //1n'I �r Au'orized Signature