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Permit
Il q l CITY OF TIGARD MASTER PERMIT 2 • COMMUNITY DEVELOPMENT Permit #: MST2011 00214 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012 Parcel: 2S111AD05600 J urisdiction: Tigard Site address: 8730 SW PINEBROOK ST Subdivision: PINEBROOK TERRACE Lot: 79 Project: THOMPSON Project Description: 427 sq. ft. addition with deck. 6/21/12 add (1) 200 amp panel, change ELC contractor. 6/25/12, adding (1) additional rain drain connector. BUILDING Floor Areas Required Setbacks Required Stones: 1 Bedrooms: 0 First: 427 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 427 sf Value: $75,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 2 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker. 1 Hose Bib: 0 Backwater Value: 0 Drywell -Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 1 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: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 1 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 R -3 427 Owner: Contractor: THOMPSON, WM R MILA A THOMPSON CONSTRUCTION, MARK Required Items and Reports (Conditions) 8730 SW PINEBROOK ST 11505 SW TWIN PARK PL TIGARD, OR 97224 TIGARD, OR 97223 PHONE: PHONE: 503- 312 -5715 FAX: Total Fees: $2,656.81 This permit i- • - ubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done • accordance • 'th approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. • TENTION: Orego - r quires you to follow the rules adopted by the Oregon Utility Notificati• • Center. Those rules are set forth in OAR 952 -00. -0010 through OAR • ' • -001 • • • 0. You may obtain a copy of the rules or direct questions to OUNC b •0.232.1987 or 1.800.332.2344. . / / 4 . • l /� Issue• = y: /� ! Permittee Si _iii is r - — Call 503.639.4175 by 7:00 a.m. for the next available Inspection da T 7 his permit card shall be kept Ina conspicuous place on the Job site until co • • etion of the proj = t. Approved plans are required on the Job site at the time of each Inspection. vr ept -t.w} - CITY OF TIGARD MASTER PERMIT I • - COMMUNITY DEVELOPMENT Permit #: MST2011 -00214 T [ GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012 Parcel: 2S 111 AD05600 Jurisdiction: Tigard Site address: 8730 SW PINEBROOK ST Subdivision: PINEBROOK TERRACE Lot: 79 Project: THOMPSON Project Description: 427 sq. ft. addition with deck. 6/21/12 add (1) 200 amp panel, change ELC contractor BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 427 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 427 sf Value: $75,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 0 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 Heat Pump: N Hoods: 1 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: 0 Ea add! 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 1 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 R -3 427 Owner: Contractor: THOMPSON, WM R MILA A THOMPSON CONSTRUCTION, MARK Required Items and Reports (Conditions) 8730 SW PINEBROOK ST 11505 SW TWIN PARK PL TIGARD, OR 97224 TIGARD, OR 97223 PHONE: PHONE: 503- 312 -5715 FAX: Total Fees: $2,635.80 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 copy of the rules or direct questions to OUNC by calling G 5003..2 ' 32.1 ,9 9887 or 1.800.332.2344. Issued By: � � a� a Permittee Signature: f?i PPu ekf f OM Call 603.639.4175 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 of the project Approved plans are required on the job site at the time of each inspection. Jun 21 12 10:31a Leeann Greason 503 -359 -1981 p.2 Electrical Permit Application 1 t ) It n i l l( 1, I tile 11\11 City of Tigard Received .N i • 13125 SW Hall Blvd., Tigard, OR 97223 Permit No.:///16r, — a J'f ii. ' Phone: 503.639.4171 Fax: 503.598.1960 Plan Rewew Inspection ' Other Permit r 1 ;, r•. o Line: g rd - or. ov75 Nate Ready/BY: ®Seep 2 for Interne www tt and - OI N ufi /M a T+n 's ; � r�- K y 1 d elhOd S�Pkrme tai Information Addition/alteration/ ❑ New construction [R f - : n ' r CplBeemtnt P lease check all that apply (oabmit 2 sets o. plans w/rtems dxeked below): elow): ❑ Demolition � ❑Service or feeder 400 amps ormore ❑Building over tbmostories. y. Y = ,� _. f:�t ' , where tau available fatdt currc n ❑ Marinas and boatyards. �.,i :%'a ,ef ` ''. . - -i ,: - _.. ' -'',., s:e s ` . :� ' =cats !moo em at 150 wits or ❑ FhnLLmgbu�algc. amps ® I - and 2- family dwelling c] Commerc ndustrial ❑ Accessory building less to ground, or exceeds 14,060 ❑ Canmercial -use agricultural r Ohre (oral other installations. In ❑ Multi family ❑ Master builder Installation ,. � ,,,.F,.�. i''s� ., � ❑Other ❑ Pua pump. ❑ rastallation of 75 KVA or �`ow> — ' '~ . '' . ° _.�.. 4 Pc. Z ❑�erltm�7 system larger separately derived system. Job no.: r ` ❑AddiuonofnewmotorIe dof ❑`A °F' "1 -2" "1-3 ]obsitcaddress :8730 SW Pine Brook St looHPormorc. occupancy. ❑Sa or Moro residential units. ❑ Recreational vehicle parks City; Slate /ZIP: Tigard , OR 97223 ❑ Healtb.eare facilities. ❑ Supply voltage for more than Suite/bldg./apt. 1 no.: l ❑H�ardous locations. 600 vults nominal. Project name: CI Service or feeds 600 amps or more. • Cross street/directions to job site: -� Ye v New residential single- or multi- family dwelling unit Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 1 map/parcel no.: Ea. add'1500 sq. R. or portion 33.92 1 �� '`-' r:: Limited energy, residential eS�'. —F i T :f a above sq. R) 67.84 2 ,o- (with Change electrical contractor on permit #IMST2011 -00214 U d�e l(with u7y 67.84 residential (wilb above s sq. ft.) 2 Services or feeders installation, alteration, and/or relocation Add Par.el change to permit t S e r ' 7 .�� s -j .t- ; t, ', , ',' y -' 2DD amps or less I 1 100.74 100.70 2 r, _ -;- __. 20l turps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City /State/ZIP: Temporary services or feeders installation, alterations, and/or Phone: ( relocation Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps L 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 I 2 Owner signature Date: Branch circuits —new, alteration, or ex tension, per panel ° ` d °' � Y A. Fee for branch circuits w/Nt above service or feeder fee, ...._ - r. _ i +� , ...,c. b 7.42 2 Business name: each branch circuit B. Fee for branch circuits Contact name: without savice or feeder fee, first branch circuit 56.18 2 Address: Each add9 branch circuit 7.42, I 2 City/State/ZIP: Miscellaneous (service or feeder not included) Ear.11 manufactured or modular !'hone: ( ) I Fax :: ( ) dwelling, service and/or feeder 67.84 2 I_ E-mail: ct only 2 It 67.84 '''''''!*'7-0'-''' a g. Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 Business name: A&J Electric, lac Signal circuit(s) or limited- Address Pp Box 330 - energy panel, alteration, or extension. Deccribc: Page 2 2 CityiState/ZIP: Forest Grove, OR 97116 Each additional inspection over allowable in any of the above Phone: (503) 359 -5691 i Fax: (S03)3139-1981 (t5 Per inspection l 66.25 CCBLie.: 959 Investigetionper hour (l hr min) 66.25 Electrical Lic.: 34-le Suprv, Lic.: Industrial plant per hour 78.18 Suprv. Electrician signature, required i-? _ - . . L2 %J _ r3 ; .�.. •£ a •:yea. -. =. ! • . Print ranee: Anthony Wilson Subtotal: 100. Date: 6/21/12 Man review (25% of permit fee): _ Authorized signature: State surcharge (12% of permit fee): TOTAL PERMIT FEE: '1M �� Print name: Date: This permit application expires if a permit is not obtained within 180 'yJ�f days after It bas been accepted as Camplote. I t Oding PrTm�z\E.C- PamitApp.doc 10/01/C9 • Number of inspections allowed per permit, 440- td15T(11105/COM/WF9 �t�S .... \ \ ....i)--C1.5\ '.a \ \� OICIP1 R I 111 CITY OF TIGARD MASTER PERMIT • I • '' COMMUNITY DEVELOPMENT Permit #: MST2011 -00214 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012 Parcel: 2S111AD05600 Jurisdiction: Tigard Site address: 8730 SW PINEBROOK ST Subdivision: PINEBROOK TERRACE Lot: 79 Project: THOMPSON Project Description: 427 sq. ft. addition with deck. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 427 sf Basement 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 427 sf Value: $75,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 0 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 Heat Pump: N Hoods: 1 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: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 1 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 Ecom asin N 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 -3 427 Owner: Contractor: THOMPSON, WM R MILA A THOMPSON CONSTRUCTION, MARK Required Items and Reports (Conditions) 8730 SW PINEBROOK ST 11505 SW TWIN PARK PL TIGARD, OR 97224 TIGARD, OR 97223 PHONE: PHONE: 503 - 312 -5715 FAX: Total Fees: $2,433.01 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 a ... • e 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. AT • NTION: Ore•.n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-'010 through OAR • 2 •1 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 .1987 or 1.8 .332.2344. - -- Issued - e .__ l / / 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 of the project. Approved plans are required on the job site at the time of each inspection. ' Building Permit Application • ' Residential FOR oFFlcE USE ONLY • City of Tigard Q�'\ RDeacteived: 42. Permit No.: j ,� /(� ° 13125 SW Hall Blvd., Tigard, OR ' � ' plan Review C Phone: 503.718.2439 Fax: 503.59::9'. `�� t,` .. Other Permit: rr D ateBy. T I G A R D Inspection Line: 503.639.4175 0 ` '`�V Date Ready : p /' Juris: El See Page 2 for Internet: www.tigard- or.gov O ff( ®w Notified/Method: 1 1 A 1)- 7 1 " Supplemental Information O TYPE OF WORK �� REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application P] 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ P7� � O 30 ❑ Accessory building ❑ Multi - family Number of bedrooms: Ar ❑ Master builder ❑ Other: Number of bathrooms: P' JOB SITE INFORMATION AND LOCATION Total number of floors: i Job site address: g7 sij 0j� j3iZ j____ c--7-, New dwelling area: 11:Z!7 square feet City /State /ZIP: '7i 4e.D 0 2 9 72 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: ( i-uPS,,,rJ 40i210„ / ,/ Covered porch area square feet Cross street/directions to job site: /4, 3 Deck area: 2_00 square feet Other structure area: square feet 1 - 2 , REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: I 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 DESCRIPTION OF WORK work indicated on this application. iii" ' k , r j /l Valuation: $ /'7 tTU Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: er j g Type of construction: Address: Po sLJ -g ice. S'i , Occupancy groups: City/State /ZIP: '7'6 c2L- 7722_1 / Existing: Phone: (g.)3 ) (j ?.9 /� / Fax: ( ) New: ❑ APPLICANT © CONTACT PERSON BUILDING PERMIT FEES* —i-u0 <' - t _ (Pteaserejertojeeschedute) Business name: `� 1� �� Z Zt �/� S r, L `l Structural plan review fee (or deposit): �f Contact name: L, 77- j < 0,- -f " �-�� FLS plan review fee (if applicable): ._� Address: //57),S .- 5-',..,,, �.,11� . I L eL City /State /ZIP: / ,� ©� 7 �3 - Total fees due upon application: 516 , 5 r- Amount received: 54( SI Phone: (S 3(Z S -7 iS //JJ Fax: : ( ) (( ` E - mail: . , - (2 i*Ltr,SCW 6?" 2 - : C f,W` PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted Photovoltaic Solar Panel System. and fire department access, along with the 2010 Oregon Submit two (2) sets of roof plan with connection details Business name: 3/01,44,6 lJ�� DNS/ • • !!VG- r n / Address: /6724 / sb4 5 77,6j P4._ I" C Solar Installation Specialty Code checklist. City/State /ZIP: 71.04,CD O CC 7.7 22-3 Permit Fee (includes plan review $180.00 Phone: 3 ) and administrative fees): ��L 7� Fax: ( ) State surcharge (12% of permit fee): $21.60 GCB lie:: /IL/( --- 1 //5/J� Total fee due upon application: $201.60 Authorized signature: v 7 T his 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 Print name: lit + _ 77/ Z yt/ Date: i .Z ZZ' i1 Service Board. I:\Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(11/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received ' g Date/By: Permit No.: 'I 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 P _TI GARD 24- Hour Inspection Line: 503.639.4175 0 Electrical ❑Plumbing 0 Mechanical Internet: www.tigard- or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes 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. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and /or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore:on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\ Building \Permits\BUP - RESPermitApp.doc 02/24/2011 440- 4613T(I 1 /02 /COM /WEB) Plumbing Permit Application ; _X Building Fixtures `'�:° f`° FOR OFFICE USE ONLY City of Tigard _y, Received . 445r .G /f- O•o 219 t. ! Permit No.: 't 13125 SW Hall Blvd., Tigard, OR 97223 ,, r;, ,,- Da 4:•G C , r Plan R Other Permit No.: P hone: 503.718.2439 Fax: 503.598.1960 �) :. - -:- , Plan Review e Inspection Line: 503.639.4175 4 '< y e d•,,':-.,)' , Date Read /By: Juris. El See Page 2 for TIGARD Internet: www.tigard- or.gov ,:•••:,', z `. ` ` -� " _ " Notified/Method: Supplemental Information TYPE OF WORK ° M.` FEE* SCHEDULE ❑ New construction 0 Demolition For special information use checklist. Description 1_ 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 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 p 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 LOCATION Site utilities: _ Catch basin or area drain 18.76 Job site address: (.5-(73D �j G�,� jjl� fZ / Drywell, leach line, or trench drain 18.76 City /State /ZIP: 764‘2J) 0 Z-. 7 2244' t J Footing drain (no. linear ft.: _) Page 2 Suite/bldg. /apt. no.: Project name: . 770 t"i, pc4,,.,/ A-m m.0 Manufactured home utilities 50.03 Cross street/directions to job site: 1 „ 7 tl g Manholes 18.76 ' Rain drain connector 18.76 Sanitary sewer (no. linear ft.. ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 J Clothes washer 25.02 Pil X 7 ? o /- Oi. ) J Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ki PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Address: ] �j' _ r} _ Floor drain/floor sink/hub 25.02 j �/ - k- 6iwi . s 1 ` Garbage disposal 25.02 City /State /ZIP: --/76-D Lam- l t72t_Lli Hose bib 25.02 Phone: (,S733) 6 ' 2 77 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 1 25.02 )-5"; CA- City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet 25.02 CONTRACTOR f Z 4 t,`t� q Water heater 37.52 / Business name: 4:Cf f Water piping/DWV Address: 3 0 3 ?„D co c.,,,z4B 'p . Other: 25.02 City /State /ZIP: H r u-S 1%,cJ� 02- 5 7/ 2-3 Subtotal / Phone: Fax: Minimum permit fee: $72.50 CCB Lie.: /y 7 J / Plumbing Lie. no.: 31-1 -1%593 Plan review (25 %of permit fee)' State surcharge (12% of permit fee) Authorized signature: `,9(G" TOTAL PERMIT FEE Print name: 41,41.-1/4L 77,(0 1)"..) Date: 2/Z_2 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. I'\Building\Permits\PLMU- PermitApp doc I0 /01/09 440.4616T( 1 0/02 /COM/WEB) Mechanical Permit Application ,. FOR OFFICE USE ONLY - k % '` Rece City of Tigard 4z , -,t, , ' Permit No 57 - ao / 1_ e vii y ;` �:. � ' Date /By: " 13125 SW Hall Blvd., Tigard, OR 97223 1-5. ;`°, 4. -i, !` C + ; Pl Review Phone. 503.718.2439 Fax: 503.598.19,60 E. R „ Othel Permit r. ,.. Date /By' Inspection Line: 503.639.4175 °" "v ` ! `'' ' T 1 G A R L7 p _ , t` Date Ready /By Saris' ® See Page 2 for Internet: www.tigard -or gov t t ''' :' �d;, 4` ,7 ' .,� PP Notified/Method Supplemental Information i TYPE OF WORK_,., -4 k.3 ( SN" COMMERCIAL FEE* SCHEDULE - USE CHECKLIST kit - 7'N' :' -- Mechanical permit fees* are based on the value of the work ['New construction ® Addition /alteration/repla_eement performed. Indicate the value (rounded to the nearest dollar) of all El 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. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: 8 73) S ,,,) m - , u l ` S / (requires site plan showing placement) 46.75 Furnace 100,000 BTU (ducts /vents) 46.75 City /State /ZIP: _ (� 0I' 722 7 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: 77.6 5$,-,/ 4 9 - s j Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: /....e4-(,(,__ ' f Duct work / 23.32 ;-? . Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 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 �//�� n/ � l Gas fireplace 33.39 / (t 0 k. 30 / J,0 -f rU 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 10 Other: 23.32 Name: ;314,,c 04264 7.7Ot t o, J Environmental exhaust and ventilation: Address: j 7 �� �_ '-o� S , equipment other kitchen L ' equipment 33.39 City /State /ZIP: 7/6.417-0 ©2 7 72-Z21 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (s 3 ) 09 -2_,'7? Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range .1 CONTRACTOR 0e Barbecue � ,_.� ` � . pp T Clothes dryer (gas) Business name: C�'U4(., j R '1' 1(5 4 4 1 (oot,I °um 1 PrI rl 3 (l ! 1 r Other: � Address: J ��,= 3 � � � jZ ll �� __ MECHANICAL PERMIT FEES* City /State /ZIP: P00-71:41 ) .1.11...._ .1.11...._ I? 1-I 1 - - - Subtotal • Minimum-permit-fee-($90:00)- - - Phone: ( S03 ) 33c- 1 1 1 1 Fes ( ) Plan review (25% of permit fee) CCB lie.: 6( � 2:Sc State surcharge (12% of permit fee) TOTAL PERMIT FEE T his permit application expires if a permit is not obtained within 180 Authorized signature: 2 days after it has been accepted as complete. Print name: ONthL,� / I'l o U 'K Q t J Date: 2./Z.,./ 'l * Fee methodology set by Tn- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440- 46117T (l l //02 /COM/WEB) Electrical Permit Application FOR OFFICE uSF: ONLY City of Tigard - - : `t i. ' c_:. ; Received eceve ` t . ' Date/By: Permit No.: �/J � 7 - '�f / / t— ° 13125 SW Hall Blvd., Tigard, OR 97.22- -i3 ' .. C `� ,. T Plan Review ' C Phone: 503.718.2439 Fax: 503.598K19f0 .r • ' j' DateBy: Other Permit • I' I C A Ii D Inspection Line: 503 w .639 ` C , ``I Date Ready /By' turis• ® See Page 2 for Internet: ww.tigard- or. gov ,J' 'Z Notified/Method: Supplemental Information TYPE OF WORKS °' V. r«:c, Fit PLAN REVIEW ❑ New construction Addition /alteration /re'p Please check all that apply (submit 2 sets of plans w /items checked below)' r s,.. ` "" Service or feeder 400 amps or more ,� p 0 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 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ 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 ❑ "A ", "E ", "1.2 ", "1 -3 ", f �'J 1 �:(�J�L 100HP or more. occupancy. Job no.: Job site address C✓ / .6 SG ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: - 71 4 -i-A r a t:- ❑ Health -care facilities ❑Supply voltage for more than / ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: I / • fits , t A f� t/ . y ❑ Service or feeder 600 amps or more. +J •�� ' rte"" FEE SCHEDULE Cross street/directions to job site: /41-1,L, i3�0 . Description I 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 Tax map /parcel no.: Ea. add'I 500 sq ft. or portion 33.92 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) n Limited energy, multi- family 75.00 2 11 x 30 , 4 - J iTC A. i residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation _ 200 amps or less 100.70 2 El PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 fjy�ty 401 amps to 600 amps 200.34 2 Name: ✓ ^ 4 1,j41 ,D ✓t i $ r 601 amps to 1,000 amps 301.04 2 Address: )"730 5'i,,.J civrt':3 /Zoog_ c • , Over 1,000 amps or volts 552.26 2 City/State /ZIP: 6,41 , ,, , ) (1k- 'ii7Z2' Temporary services or feeders installation, alteration, and /or relocation �' 200 amps or less 59.36 1 Phone: (03 Fax: �� ( ) 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, le. e, int or excha ■e, a .rding to ORS 47, 449, 670, and 701. 401 amps to 599 amps 168.54 2 g ./ ‘ = ` 2 , / ' Z Branch circuits - new, alteration, or extension, per panel Owner signature/ , - lids Date: fJ a A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, lint 56 18 2 Contact name: branch circuit Each add'l branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67 84 2 Pump or irrigation circle 67 84 2 E - mail: Sign or outline lighting 67 84 2 CONT ' • - OR ! Signal circuit(s) or limited-energy Business name: f 1_ ,. L% ' �' panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr � � t Investigation (1 hr min) 66.25/ hr City/State /ZIP: rC - a 1 .. � 0 � d Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (%z hr min) CCB Lie.: Electrical Lie.: Suprv. Lie.: ELECTRICAL PERMIT FEES Subtotal: Suprv.. Electrician signature, required: Plan review (25% of ii fee): Print name: Date: State surcharge (12% of permit fee): TOTAL PERMIT FEE. Authorized signature: 5/te This permit application expires if a permit is not obtained within 180 � ', days after it has been accepted as complete. , ''^ Print name: ''_ -t`-- - P-to f ,PS Date: 2/2-4 L * Number of inspections allowed per permit. I' \Building\Permits\ELC- Permi[Apo doe 07/01/10 440- 46t5T(11/05 /COM/WEB .74 7 - 2 / / - v v y RECEIVED FEB - 2 2012 `S �.a G A vL v, iaYJ (� M xif , v T /fCf t ie Number I} I� �1 Bb1ea>W�re U 12-- I l JAN 2 5 L012 CleanWaker Services � _ - ensitive Area Pre - Screening Site Assessment Ir.K ---- T" -7 (CAA- Rio 2. Property Information (example 1S230801400) 3. Owner information Tax lot 1D(e): Name: wTur.AitA. bkA i v-i . Company: Address: 8 7?O S't.I fra.mokootc (7. Site Address: .11A v . r 'q- Ixtc— 'ri. City, State, Zip: 74 ` O�- 9 9ml CRY, State, Zip: •"1 .a' 49 i' Phone/Fax: SW &3 724' Nearest Cross Street: 14, •1 44 0. E - Mall: 4. Development Activity (check all that apply) S. Applicant Information ��� A) Addition to Single Family Residence (rooms, deck, garage) Name: (Ml� 714 144 o a ❑ Lot Line Adjustment ❑ Minor Land Partition Company: 7{Oi'4,'(41' a/ 04Z7r', C DN$ ' ❑ Residential Condominium O Commercial Condominium Address: / /cOr SW TU i "- pc. ❑ Residential Subdivision Q Commercial Subdivision Q Single Lot Commercial C3 Multi Lot Commercial City, State, Zip: 7Z44/2- d /� 9 Other Phone/Fax:��2. �I� E -Ma il: W1 7 1form 1J elt'Jit`y" y. coat 8. Will the project Involve any offeite work? ❑ Yes to No Q Unknown Location and description of off -site work 7. Additional comments or Information that ma be needed to understand your project 711 $ A.) Zr TOLTPI tom- /I.rowt C t - /6Rea•lrf4dt CAs ./ PR.vtovs PWs: This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEC 1200 -C Pernik or other permits as Issued by the Department of Environmental Quality, Department of State Lands andlor Department of the Any COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, admowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site i certify that I am familiar with the adormation contained in this document and to the best of my knowledge and betaf, this Information is true, complete, and accurate. Print/Type Nave ,.., . /. t• 1 041 Print/Pipe Title ______44/1 Signature i ...IMPAIR. Date it �z FOR DISTRICT USE ONLY ji Sensitive areas potentially exist on site or within 200' of the site. TNB APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. ❑ Based on review of the subritted- materials and best available information Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas If they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order07-20, Section 3.02.1. All required permits and `approvals must be obtained and completed under applicable local, State, and federal law. t` l l Based on review of the submitted materials and best available Information the above referenced project will not significantly impact the existing or potentially sensitive areas) found near the ski. This Sensitive Area SiteAesessrnent does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered. This document wIll serve as your Service Provider letter as required by Resolution and Order 7 - 20. Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state and federal law. 0 This Service Provider Litter is not valid unless (, GINS approved site plen(s) ere attached. ❑ The proposed activity does not meet the delnition of development or the lot was platted after 9/9195 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PRO , R LETTER IS REQUI' E.D. Reviewed by—.Air, �.1�.► r Date I to TO 39tid NOO AlI'ldfl NOSdWOHl 061.0896E0G TO:00 t00Z /tO /TO _ Building Division Development Code Provision Review T f GA RD Residential Projects Building Permit No: MS i ( — (1 ))4 `1 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A ❑ Or/fprr -.../ G SITA-^e y) Routed Plans: Original Plan Submittal Date: I @t( 8 Pt Revision Submittal Date: ❑ Site Plan Only 2nd 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 3 p at 50 - 718 - ..{ or @tigard- or.gov) Land Use Case No. 1 Name f tflL IR Zoning it ^ `l/• 5 CEl Setbacks: Front 2 Rear (s Side .5 Street Side I s Gara e 1� lg.—Maximum Building Height 30 Actual Building Height f 2 I3/Visual Clearance ("Easements BIV Sensitive Lands Type: C fi) 5 I/ 7 . �.��e�'." ►' 7.4.6 Notes: Original Plan: Approved ®.'" Not Approved ❑ Date: /1Z/Z 0/ 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) pr Actual Slope: Notes: Original Plan: Approved Not Approved ❑ Date: Z Z Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City7borist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) 13 greet Trees Protected Trees Notes: Original Plan: Approved I!d' Not Approved ❑ Date: lY ") ?,, N 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 No 0 Date Routed to Building: / • Page 2 of 2 , a ,:., � rAx)s ctle t3o. (2.- bOor}s�k mo o ° Approved .q` moo Clean Water Services -mew eKt'W v `3 EXISTING By Lvvt N+ Date t / z (O DRIVEWAY , SPt. A +fi g- 1 nc DOSING \ 4 e' DRIVEWAY EXISTING HOUSE . \ \ at EL 185' \ 1 creele- a %` II 180' b '0 ms's / A. • . EXISTING ! GARAGE SITE PLAN SCAL 1- = 30'_0 \ SITE INFORMATION: ADDRESS: 8730 SW PINEBROOK ..\ TIGARD. OREGON. 97224 OWNER VA LAM AND MILA THOMPSON / / EL ,90' yam/ r 69.;0' l l •