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Permit • #j CITY OF TIGARD MASTER PERMIT ip ` ; pw - COMMUNITY DEVELOPMENT Permit #: MST2011 -00204 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2011 . „,. RD Parcel: 1S133DB06500 Jurisdiction: Tigard Site address: 11103 SW ESCHMAN WAY Subdivision: CASTLES AT BRITTANY Lot: 11 Project: ZIEHNERT Project Description: Kitchen remodel. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third 0 sf Right: 0 Detectors: Yes Total: 0 sf Value: $28,950.00 Rear: 0 PLUMBING Sinks: 2 Water Closets: 0 Washing Mach: 0 Laundry Trays 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 2 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains 0 Tubs /Showers: 0 Garbage Disp: 1 Water Heaters: 0 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: 0 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods. 1 Other Units: 2 Furn <100K: 0 Vents: 0 Woodstoves 0 Gas Outlets: 1 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 3 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB 12-3 0 Owner: Contractor: ZIEHNERT, MICHAEL D & BROOKE A EVAN ADAMS DESIGN & BUILD Required Items and Reports (Conditions) 11103 SW ESCHMAN WAY 1104 NE 28TH AVE #245 TIGARD, OR 97223 PORTLAND, OR 97232 PHONE: PHONE: 503 - 477 -3333 FAX: Total Fees: $1,222.65 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 forth in OAR 952 - 001 -0010 through O • : 2- 001 -0090. You may obtain a copy of . - act questions to OUNC by calling 503.2 .1987 or 1.800.332.2 Issued By /,.!' ✓ .... _ — _ � � _ Perm ittee Signature: 2 _ Call. • +7� : by 7:00 a.m. for the next available inspection date. This permit card s . 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. r Building Permit Application , t, -.,. Residential ,._ 0" FOR OFFICE USE ONLY City of Tigard Received Permit No.: ® DateB �f/ , r 1 ' : ` Phone: 503.718.2439 Fax: 503.598.1 ° 13125 SW Hall Blvd., Tigard, O 972�C A w\ Date /B � Plan Review eview ►'4 © � 1 ®G 'C�, \ eV,* `. / Other Permit: ' - ` ``,, T I GA RD Inspection Line: 503.639.4175 ` \ ` V Date Ready : : El See Page 2 for Internet: www.tigard - or.gov G` \ tC Notified/Method: /, , 1� Supplemental Information a TYPE OF 1 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 0 Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CSONSTRUCTION work indicated on this application. ® I- and 2- family dwelling ❑ Commercial/industrial Valuation: $ /�.g ( CO ❑ Accessory building ❑ Multi- family Number of bedrooms: o r rt,,JA-t, ❑ Master builder ❑ Other: Number of bathrooms: 3 d ,b0, frl 0,0,4 tr JOB SITE INFORMATION AND LOCATION Total number of floors: ,, P. / Fk.12. i Job site address: ,� `.. , New dwelling area: o square feet IIf�� Su+ �SL�t�� `"� City /State /ZIP: f T J el , et O V — 97 2 2, 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: ;elK„..&-r 4 Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:.COMMERCIAL - USE CHECKLIST • Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the•profit for the 1 s DESCRIPTION OF WORK . work indicated on this application. tE 6 ('Gt^10 1 I fc ciao r i— 1„ V; (oa,.... Valuation: $ K ■ ` 1 � Existing building area: square feet � i 's o r any, r t ., Q1‘:e•r r (e - L � cp.ar New building area: square feet 2 PROPERTY OWNER SIC ❑ TENANT Number of stories: Name: lM . k r 2: .d e ,. + Type of construction: Address: `1 10 3 5 ,.) c - 5 CA, tom. e...K VI "1 Occupancy groups: City/State /ZIP: �r : &r. d (5 1 /'7 -2 - 1 - 3 Existing: Phone: ( 5O? 3 ) l 75'i_ 1725 Fax: ( ) New: ❑ APPLICANT 1 ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): Address: City/State /ZIP: Total fees due upon application: 4 3) 7� 3a Amount received: Phone:( ) Fax::( ) PHOTOVOLTAIC SOLAR PA NEL SYSTEM FEES* E -mail: Commercial and residential prescriptive installation of CONTRACTOR , • roof -top mounted PhotoVoltaic Solar Panel System. Business name: r, a Submit two (2) sets of roof plan with connection details tiJ /� � �--- S Q v S S h J t I and fire department access, along with the 2010 Oregon Address: 1101 N e - ,,$ 1 4 4 is -2_,15- Solar installation Specialty Code checklist. City/State/ZIP: Permit Fee (includes plan review $180.00 Ci rO ( f 14 ,...,.4 t, R g 7 2 32. and administrative fees): Phone: (60 ) 17 Z — 33 31 Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: / 7 q S 55 U /11� i 3 dx._ Total fee due upon application: $201.60 /'� This permit application expires if a permit is not obtained Authorized signature: / within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Print name: i/ Date: e(� _ ` / Zi, j 1-/ Service Board. I: \Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440-461 3T(I I /02 /COM/WEB) • Electrical Permit Application ` FOR OFFICE USE ON LY . City of Tigard ' .' ® Permit No.: Sr>f 1 J,,1 Date/13 : 13125 SW Hall Blvd., Tigari . -. 9 L° �Q � Plan Review " "- Phone: 503.718.2439 Fax: 1 ' '. % Date/B : Other Permit • • T IGJi 1 Inspection Line: 503.639.4175 t:1� \G � l w \ Date Ready/By: Ed See Page 2 for Internet: www.tigard-or.gov V s � G�� \ Notified/Method: thod. Supplemental iaformaInformation F S TYKE :'O , ,O Please check all that apply (submit 2 sets of plans wlitems checked below): ❑ New construction ( Additivn/alt ,• „ eptacement 0 service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards. . . exceeds 10,000 am at 150 volts Floating ® 1 . and 2-family d t otnmerctaUin . ... .IO . _.': I ts or g buildings. CATEGQRY:.OF:CON ; • - less to ground, or exceeds 14,000 0 Commercial -use agricultural y g ❑ dustrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: pump. 0 Installation of 75 KVA or c ".. .. ..: - `. IO B :SITE ., I N>:•ORRIAT i ON =AND: LQCATION _ • motor load of l- • Em ergency system. larger separately derived system. ['Addition of new m ❑ `A" `E" ° 1 2" ° 3" r 1005P or more. o�pancy. Job no.: Job site address: (i t 0,3 S'tA, ' Sc k Lu t:,,w WC7 ❑ Six or more residential units. 0 Recreational vehicle parks. City /State /ZIP: -� 0Health -care facilities. ❑ Supply voltage for more than t ; q �i f t 172-1-1 ❑ Hazardous locations. 400 volts nominal. Suitelbldg. /apt. no.: 6J Project name: 2 ;e... ( .4.. O Service or feeder 600 amps or more. :: ".: FEE SCHEDULE. . ::' Cross street/directions to job site: Deseription 1 Qty. I Fee. I Total i . New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'1500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential (with above s ft) 75.00 2 '` _''., :: . ;" -< "; ".;.AESCRIPTJ(ON�:OFt. WOR)f , >. °;'.:'; ;- ; : ` ::;.`: ` ' },`, :. �: ::..; . • .` ( q - Limited energy, multi - family 75.00 2 " residential (with above sq. ft.) VD�w J-C �t tr c. a 9 'i �i Services or feeders installation, alteration, and/or relocation 0 200 amps or less 100.70 2 .: PROPERTY OWNER: : ..: ❑ TENANT :: :. 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 r C.r 7r t e L► ka r 601 amps to 1,000 amps 301.04 2 Address: (1 t 03 S jai , tLen.. ca..., IA) Over 1,000 amps or volts 552.26 2 , e� Temporary services or feeders installation, alteration, and /or _ City/State/ZIP: (, . cr 61`4, f 7 22' relocation Phone: (543 ) Fax: ( ) 200 amps or less 59.36 1 201 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 ,,. . above service or ce o :G : APPLI : • ::: <::.. <,;' . `Q :CONTACT ° 7.42 2 • each branch circuit Business name: t V r r !/ f i ( ,B. Fee for breach circuits without '7 service or feeder fee, first 56.18 l 2 Contact name: E ,c Act e...w branch circuit _.Each add'i branch circuit 7.42 'L, 2 Address: t iQ c,i i d €.., /t 4 2 G f Miscellaneous (service or feeder not included) ' Each manufactured or modular City /State/ZIP: 1 f C j " viz 3 Z dwelling, service and/or feeder 67.84 2 Phone: (5© a 17 - '3 3.3 Fax: : ( ) Reconnect only 67.84 2 E -mail: 8, S F >� r to i' i— / cZ ,a 67.84 2 1 . c., t t (....a•—(....a•--- .- .,_. Sign or outline li circle or e...0.8,4, ,,., . 67.84 2 CQ _ - , Signal circuit(s) or limited- energy Business name: pe, J 6 L. 0 i s (, o ,,J �f �ci-e. r • e panel, alteration or extension. Pag 2 2 .. Each additional inspection over allowable i n any of the above Address: ( 6 -Z 00 5:4 f4 L, t l •(w ,s f~ e. j..•# Additional inspection (I hr min) 66.25/ hr t Investigation (1 hr min) 66.25/ hr City /State /LiP: T • r j Ca Industrial plant (1 hr min) 78.18/ hr Phone: (503) 7 7 . g5 4/ ( Fax: ( ) Inspections for which no fee is 90.00 / hr 111 specifically listediy2 hr min) CCB Lic.: f 11 t 7 Electrical Lic.: C 6 Suprv. Lic.: 5' SD Suprv. Electrician sighattite ELECTRICAL PERMIT;: FEES ' :: � �7 /j, y required: 7�� �� i v Subtotal: o Plan review (25% of permit fee): Print name: / '[ , 4 I ( a t t v WA I k e r'- Date: / 1 I 2 2. State surcharge (12% of permit fee): TOTAL PERMIT FEE: Authorized signature: Veltei This permit application expires if a permit is not obtained within 180 Print dame: (Date: days after it has been accepted as complete. Number of inspections allowed per permit. 1:Viuildiag\Permits\ELC PennitApp.doc 07/01 /10 440•4615TO /05/Ctx t/WBs Mechanical Permit Application • - FOR OFFICE USE ONLY City of Tigard Received `J Date/By: No.: y a a 13125 SW Hall Blvd., Tigard, OR 97223 L • I an Review 2 'e Phone: 503.718.2439 Fax: 503.598.1960 I IF a ate/By: Other Permit: T;1 G A R� Inspection Line: 503.639.4175 RI See Page 2 for Date ReadyBy: Internet: www.tigard or.gov / � O � Notified/Method: ,1 Supplemental Information TYPE OF WORK 'SO.' 11. C �,i COMMERCIAL FEE* SCHEDULE - USE CHECKLIST �'t\ \ S�0 Mechanical permit fees* are based on the value of the work ❑ New construction J ,Addition/alteration/replacemel ®�� performed. Indicate the value (rounded to the nearest dollar) of all El Demolition ❑Other: CI `' ,w,`` mechanical materials, equipment, labor, overhead, and profit. \N`v Value: $ y..50 , ..-v 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 I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating cooling: Air conditioning Job site address: 1 1 10 3 5 '+y 'J' . 5 e.:-1► u w w u (requires site plan showing placement) 46.75 Furnace 100,000 BTU (ducts/vents) 46.75 City /State /ZIP: 1 / 3a.rc OA •7 .2 2-3 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: ? i<_,.4 g,-c, 7 Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 2.„, 23.32 l/ 6 _P 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 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK, . Water heater 23.32 Gas fireplace 33.39 /{ 1 h._t:, yv Ce. bvtd I / r J t Flue vent for water heater or gas fireplace 23.32 I `, / S 4 i ( Vey- few- Log lighter (gas) 23.32 Lk 46 .Z_ 1 Oa ►n. a V d LPG'," W d r (Z) Wood/pellet stove 33.39 ` 1 Wood fireplace /insert 23.32 PROPERTY OWNER i ❑ TENANT Chimney /liner /flue /vent .. 23.32 Other: 23.32 Name: M - tom. 2, g COO 14. Z l t r, Z , f.F Environmental exhaust and ventilation: t % Range hood/other kitchen Address: m a s S W � SL ,F ,A tw.A.M. W 4,1„ equipment i 33.39 33.31 1- Ai City /State /ZIP: .,, © �, i'71-7:5 I Clothes dryer exhaust 33.39 rC 7 � Single -duct exhaust (bathrooms, Phone: �.J S) 'rj .. T z S' Fax: ( ) toilet compartments, utility rooms) 23.32 ,I21 APPLICANT 11 ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other: 23.32 �U,LI K Ac‘ AA.- 5 C-S v1 1.1 Fuel piping: yn S �J �t Contact name: E. v� � AI 6---s a $14.15 for first four; $4.03 for each additional Address: (( N.E. Zg 4-A-1. /j m - 2 [1 S Furnace, etc. r T - t Gas heat pump - . . City/State /ZIP: ! t�o�,. f«,i Wan /suspended/unit heater . . Phone: ( ) Fax:: ( ) Water heater t ' _. �j0� ] 7 ' . 3 3 3 Fireplace J E -mail: Q_c&A,Co 5 • .r J'tAks k t e InA.A,; 1, C. 0 ----- Range ,: 1 lq.,15 CONTRACTOR " . Barbecue Business name: t�v�h f'kr h.‹ o- a - k S By i 0 Clothes dryer (gas) ,, Other: r Address: `1 o '-I 4 A" A 4 - # 2 y5 MECHANICALPERMIT City/State/ZIP: l? I- -( co, d O /L 97 ? Z Subtotal I D , Minimum permit fee ($90.00) I Phone: (sou 477 _ 3 331 Fax: ( ) Plan review (25% of permit fee) 1 1 CCB lit.: / / 5' 5-5--8 State surcharge (12% of permit fee) j (1 ,'j /J TOTAL PERMIT FEE tO 5 � !a )__ y//_ This permi application expires if a permit is not obtained within 180 Authorized signature: �_ L �jC ✓✓ days after it has been accepted as complete. r-.--- Print name: L ,��yA a S Date: a / K ' i' * Fee methodology set by Tri -County Building Industry Service Boa010 1: Building \Permitsl MEC- PermitApp.doc 09/09/10 440 -4 (11 /02/COM/WEB) .0 °, ' Building Fixtures � �� V ti��� .Oil orric:1: LSE ONLY' City of Tigard �' g ' M • 13125 SW Hall Blvd„ Ti d, OR. 97 G Nan Review Permit No.: . , i _ 110k11 Phone: 503,718.2439 Fax: 5g3i5 .19�u c ` S Other'PermitNo.: Inspection Line: 503.639.4175 O ' C3\)\ 1 `� Date/By; .. I' t i� A R P O bate Readv/Hy: tuns: See Page Z for Internet; Www,t'igard - or ov Notified/Method: • S •IcmantaiInformation TYPE OF ,X0 t' : }EE .SC1(i1�DrlXpl: 0 New construction i ❑ Demolition Fars, eclat in ornation use checklist X!4 Addition /alteration /replacement © Other: New N j . tion New II- 2- family dwellings (includes 100 ti. For each utility connection) • CATEGORY AF CONSTRr7CTION • + 3 12.70 MINI 2 - 1 - and 2- family dwelling Q Commercial /industrial SFR (2) bath 437,7$ MEM 11 Accessory building _ SFR (3) bath ❑ Multi- family 500.32 NM ❑ Master builder, Each additional bath/kitchen 25.02 MN ❑ Other: Fire sprinkler ( , sq. ft.) Page 2 JOB SITE >CN.FORMA : A IVb: LOCAT�OIV TIO N, Site utilities: lob site address: , ' t' tn.t x yM Catch basin or area drain M 18.76 City /State /ZIP: ` Drywall, leach lint, or trench drain MONEIMMI 1 11 _ Footing drain (no. linear ft.: _) 1111111EZIMII Suite/bldg. /apt. no.. Project name: G.t.l , . Manufactured home utilities 50.03 MON Cross street/directions to job site: Manholes Rain drain connector Sanitary sewer (no. linear ft.: _, immagmiEliM Storm sewer (no, linear (t,; .. Subdivision: Water service (no. linear IL „) Lot no.: Fixture or item: Tax map /parcel no.: liaokflow preventer 3127 DE$GRL ?TJON OF W(IRR • `, Backwater valve r • r . �t e -h , _ , 25.02 i d"�- .,. Dishwasher ME 25.02 ar Drinking fountain 1111 25.02 1 Ejectors/sump 25,02 Ii..PROPERTy-4WN R ❑ ONANT Expansion tank III 12.51 I ,( K Fixture/sewer cap 25.02 1 Address; Floor drain /floor sink /hub 25.02 b Garage disposal City /Statc/ZIP: , r , . � 2`7.(T� Hose bib Fax: 25.02 Phone: (7c3) 2 - 1 75 ( ) Ice maker III 12.51 MEM . .0 .APPLICANT' • • ' 0 COTAGT PEit:SON , interceptor /grease trap 2502 13ut incss oat en: l Medical (value: S Mill G.t t�:a A11_, .- S az e, s .a f r gas ( ...._. ) Page 2 Contact name: k16,-...• /i ! Roof drain (commercial) 12,51 Primer 12.51 Address: ! t ti Sinklbasiit/lavato : � P n` 25.02 � City /Statc/ZiP : 4) ° - r - fc 2. Solar units (potable water) 1121M Phone: ( 3) - Fax: : ( ) Tub/shower/shower pan II 12,51 E -mail: Urinal 25, CONTRACTOR 12ACT OR Water closet ME 25,02 " Business name: L: . ,,, ., f � `" -. • .C-ic Water piping/OVI/'tr IE. 56.29 Address: .17, Other: 25 02 City /State/ZIP: .r .. . ` ` o Subtotal IMMEI Phon 7n , 5c'1 ESIMIREIMMI Minimum permit fee: 572.50 CCB Lie.: („ 0.6 G 3 Plumbing Lie. no.: ti's` _ r Alan review (25% of permit Pe • 8 -� "" , State surcharge (12% of permit fee) Km Authorized signature: r — ~ TOTAL PERMIT FEE ! . 1 2.4 Print name: / This permit application expires if a permit Is not obtained within .186 days ` after it has Ircen accepted as complete. L 'd 9960 . (1 WV L l l0� l '3,0