Permit Pr ,
CITY OF T t R D MASTER PERMIT PERMIT #: MST2006 -00321
COMMUNITY DEVELOPMENT DATE ISSUED: 2/1/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 CB - 02800
SITE ADDRESS: 10023 SW LADY MARION DR ZONING: R -3.5
SUBDIVISION: MARION ESTATES LOT: 001 JURISDICTION: TIG
Project Description: Install 2nd floor in existing garage. 450 sq. ft.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: 0 of BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 450 sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT:
VALUE: 41,580.00
OCCUPANCY GRP: R3 BDRM: BATH: 0 TOTAL: 450 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: 0 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 0 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 0 GARBAGE DISP: WATER HEATERS: 0 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: 0 VENT FANS: CLOTHES DRYER:
OTH FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: 0 WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 0 - 200 amp: W /SVC OR FDR: 0 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 0 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
• Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
JOHN & DENISE GARDNER RYAN KERNER CONSTRUCTIONS laws. All work will be done in accordance with approved plans. This
10023 SW LADY MARION DR 20140 SW YORK ST. permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97224 ALOHA, OR 97 if the work is suspended for more than 180 days. ATTENTION
Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through 952- 001 -0080. You may obtain copies of these rules or direct
Phone: Contact #: PRI 503 - 539 - 8191 questions to OUNC by calling 503.246.6699 or 1 800.332.2344
FAX 971- 223 -3734
Reg #: LIC 143282
TOTAL FEES: $ 846.76
REQUIRED ITEMS AND REPORTS
Issued By : Permittee Signature
Call 503.639.4175 by 7:00 a.m. for an inspection that business ■ ay.
This permit card shall be kept in a conspicuous place on the job site until comp ion of the project.
Approved plans are required on the job site at the time of each inspection.
e
/
Building Permit Application,: FOR OFFICE USE ONLY
City of Tigard 'RECEIVED D Br �. g � , � Perm No V\ • i DO /
1 114 13125 SW Hall Blvd., Tigard, OR 97223 2 8 Plan Review
' Phone: 503.639.4171 Fax: 503.598.1960 N O V 2006 Date/B . • d li Other Permit:
2 8
• T i G AR D Inspection Line: 503.639.4175 Date Ready/By: EN ® See Attached Checklist for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK - REQUIRED DATA I- 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. L4 [ 1 rj$Q
(gi and 2- family dwelling ❑ Commercial /industrial • Valuation: $
El Accessory building ❑ Multi- family Number of bedrooms: -.^
❑ Master builder CI Other: Number of bathrooms: /�
- ' '..JOB SITE ,INFORMATION ,AND LOCATION Total number of floors:
Job site address: j 00 Z 3 Le,..ei i PICAAr P'o- New dwelling area: - .8"4uare feet
City /State /ZIP: Tr, vw✓4. t," c"7 ill Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: g yi 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
• . ' ''' DESCRIPTION OF WORK ' ' , ' _ ' . . work indicated on this application.
4 2^ /4, 0 r �k(3 9 Q- Valuation: $
Existing building area: square feet
New building area: square feet
• PROPERTY OWNER' -❑ TENANT Number of stories:
Name: - 0 - 1A- AonT7.,e 40-v - d-.r^ --v Type of construction:
Address: 14.....e.__ Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
•
❑ APPLICANT e ", , ,„. CI CONTACT_ PERSON - NOTICE
Business name: R r All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
., . - , ' CONTRACTOR .
Business name: r-yAll il.eit -IN-ei _ C 4- r 0G4) -0-7 BUILDING PERMIT FEES *.
Address : - 70 14 0 4v- Y� �i , " ' \ (Please refer to fee schedule)
Structural plan review fee (or deposit): / C, /s
City /State /ZIP:
Al i t , q 04.
(- j) _? C l a I. Fax: FLS plan review fee (if applicable): - —
Phone:
�j �f Z'�3 373/
Total fees due upon application:
- -- CCB lic.: f � 30, - — - -- --
Amount received:
Authorized signatur . This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: , • i Date: / = * Fee methodology set by Tri- County Building Industry
Service Board.
I: Building \Permits \BUP- RES- PennitApp.doc 03/21/06 440-4613T(I1 /02/COM/WEB)
•
s k'
One- and Two- Family Dwelling
_
Building Permit Application Checklist FOR OFFICE USE ONONLY L
City of Tigard Received Permit No.:
Date /By:
to 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
a Phone: 503.639.4171 Fax: 503.598.1960
24- Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical
TIGARd7
Internet: www.tigard- or.gov ❑ Other.
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 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 El El El
architect licensed in Ore•on and shall be shown to be . • •livable to the •ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Five (5) 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. Cl ❑ ❑
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 tree protection measures as required by conditions 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- RES- PennitApp.doc 03/21/06
/, . Electr ?cal Permit Application F012 OFFICE USE ONLY
Permit �o�
City of Tigard Date/By _ �r , ' t,. N - i z / ap.
" 13125 SW Hall Blvd., Tigard, OR 9 9
Plan Review '
. ' .' ®' . Phone: 503.639.4171 Fax: 503.598.1.
IVUV D e � QQ 2006 Date/By: Other Permit
Inspection Line: 503.639.4175 Date Ready/By: H See Page 2 for
TIGARD
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: 1E11 Supplemental Information
. . - ,' , TYPE OF 4ING DIVISION - , . ' PLAN REVIEW ,
❑ 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 stones.
❑ 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
❑ Emergency system. larger separately derived system.
` -, - _ . , -JOB SITE; INFORMATIO AND LOC ,r ' ' ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", "l -3 ",
• Job no.: Job site address: 10(:).23 1,d y /Iat)'c�Yl /�, ' ❑ Six or s. occupancy.
/ v Six o or r moo re a residential units. ❑ R ecre
ational vehicle parks.
City/State/ZIP: ❑ Health-care facilities. ❑ Supply voltage for more than
1 I �'f Q rC t /i� ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. LL I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DES OI WORK (with above sq. ft.)
J Limited energy, multi - family 75.00 2
3 }ei f ( rJ A 4 zi Co /- -71k A) L) residential (with above sq. ft.)
Pk 1 Services or feeders installation, alteration, and /or relocation
• 1 Y 200 amps or less 80.30 2
PROPERT , OWNER 0 TENANT 4 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: ,� � k yL s;r i > Ay o u p ro , -- 601 amps to 1,000 amps 240.60 2
Address: � Over 1,000 amps or volts 454.65 2
. City /State/ZIP: _�0.t i ' / � "� -- Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits rcuits with I
' ❑ APPLICANT' - ' - El CONTACT PERSON .. : , above service or feeder fee, '
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, I 46.85 40 „$ er 2
first branch circuit
Address: Each add') branch circuit I 6.65 440 2
Miscellaneous (service or feeder not included) a,6b.-
City/ State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
, - , . - ' ' 'CONTRACTOR , • . - Sign or outline lighting 53.40 2
Business name: C t x Signal circuit(s) or limited -
E� TILL energy panel, alteration, or
. Address: poi) IN Mi ll- / 1 e„ , ,�U! , •(/I . � � ! extension. Describe: Page 2 2
City /State /ZIP: YY l/" `�^ 972/7 «(JJJ E ach additional inspection over allowable in any of the above
inspection 62.50
Phone: (�Daj )' 3 . '�.1 Fax: ( )
Per Pr P m
Investigation per hour (1 hr min) 62.50
. CCB Lic.: ,gtl Electrical Lica1� — 5 .1q CSuprv. Lic.: 5440_5 Industrial plant per hour 73.75
`l - ELECTRIC AL PERMIT FEES i '
. Suprv. Electrician signature, required: Subtotal: 53,
Print name: Date: �
--P- Ian- review-(25 %_ofpermitfee) :-
State surcharge (8% of permit fee): t4 • o'b
Authorized signature: • TOTAL PERMIT FEE:
This permit applicaon expirs if a permit is not obtained withim 180
Print name: — ,- Date: (zs/?ac
days after it has been accepted as complete.
' Number of inspections allowed per permit.
. 1:\ Building \Permits\ELC- PennitApp.doc 05/23/06 440- 4615T(1 /COM/WEB
. Electrical Permit Application - City of Tigard • r
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
1 RESIDENTIAL.'WORK ONLY;,
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK:ONLI':'��
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
0 Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
•
❑ Nurse Calls
• ❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Permits\ELC- PermitApp.doc 03/23/06
:Mechanical Permit Applicatima. I�-ll VV ECEIVE® FOR OFFICE USE ONLY
City of Tigard Received Date/By. Permit NN _ - ! 41A 1) 3
a 13125 SW Hall Blvd., Tigard, OR 97223 N O V 2 8 2006 Plan Review _ �i!
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R t7 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: ® See Page 2 for
• Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction GrAddition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Al-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
p� jj�� Air conditioning or heat pump
Job site address:
I 0 0 2 3 y P /ci.r o Dr (requires site plan showing placement) 14.00
City /State /ZIP: ---;erg O - e_ - 2 2 9 Furnace 100,000 BTU (ducts /vents) 14.00
' d Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 6 relAsArc, Gas heat pump 14.00
Cross street /directions to job site: Duct work v�. 14.00 yeNcC
Hydronic hot water system 14.00
. Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
^^ p Gas fireplace 10.00
4dIr l l-N51N a � /� 0 G Flue vent for water heater or gas
V fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
• Wood fireplace /insert 10.00
. PROPERTY OWNER ❑ TENANT
Chimney/liner/flue/vent 10.00
Other: 10.00
Name: ` T o k" 4 Elefroaie 4 vo—r-- Environmental exhaust and ventilation _
Address: Range hood other kitchen
. /� equipment 10.00
City /State /ZIP: y Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT = ❑ CONTACT PERSON ° Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each a dditional
• Address:
Furnace, etc.
Gas heat pump
. City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
• CONTRACTOR Barbecue
Business name: 53 4 5 blo I Clothes dryer (gas)
J Other:
Address: 3 n o\ / / 6,..25 MECHANICAL PERMIT FEES*
City /State /ZIP: e, d � Subtotal
Phone.'') )7 — 5 6 ax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
L <
CCB lic.: V-51? > r State surcharge (8% of permit fee)
TOTAL PERMIT FEE
F-- This permit application expires if a permit is not obtained within 180
Authorized signatu
days after it has been accepted as complete.
Print name: c• A „ I - J Date: 1 • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PennitApp.doc 04 /06/06 440 -4617T (11 /07JCOM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC- PermitApp.doc 12/30/05 2
02/07/2007 19:20 FAX 2001/001
CITY OF'TIGARD
COMMUNITY DEVELOPMENT
TIGARP 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
IMPORTANT PERMIT NOTICE
RECEIVED
r 1=6 0,4, 2001
L i rY OF TIGARD
Electrical Signature Form g U1 � di N G DIVISION
Permit #: fv 3 T ZooG - o o 3.P- I
Date Issued: _ o''y
Parcel: p S t 1 1 C$ ~
Site Address: /Qp;A 3 Ja i D / Ph AA.10
Subdivision:
Block: Lot: -3=1
Jurisdiction: - 1 - 1 GAD
Zoning:
Remarks:
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical
permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from
your company sign below and return this Electrical Signature Form prior to the start of the work to the address above,
ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: Z °tNISE 4412 ELECTRICAL CONTRACTOR:
C' viw - F_ LE1'T P_le_
�0 60X (9g _ - 1
Pt2-D . 4'e 9 7M . • I
Phone #: NS A - Phone #: 5D ' A73 Al Pt/
Reg #: ' _ 6? 06r 7,/ /05?
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X _
Sign:t of S pervising Electrician
If you have any questions, please call 503.718.2433.
Please return this form by mail, or you may fax it to 503.624,3681.
.. .
CITY OF TI
BUILDING DIVISION I.
PERMIT #: MST2006-00321
13125 SW Hall Blvd., Tigard, OR 97223
a*IOVIII\ DATE ISSUED: 2/1/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 .71 11.,
INSPECTION WORKSHEET FOR DATE: 6/18/2007 TIME: 7:04AM PAGE: 16
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: Install 2nd floor in existing garage. 450 sq. ft,
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503-539-8191
Inspection Request Scheduled For: Date: 6/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 050399-01 503-539-8191 Y
Corrections/Comments/Instructions:
,--D --- a - ....-- r e_. C .., i. 6 A
1.11 PASS n PARTIAL APPROVAL ri CANCEL n NO ACCESS
I FAIL I CALL FOR INSPECTION
41 ) 0 ADDITIONAL FEES ASSESSED
Inspector: , Date: o-4 Phone #: (503) 718-
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MST2006 -00321
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2007
Phone: (503) 639 -4171 /A
Inspection Requests (24 Hrs.): (503) 639 -4175 L�'tw IL.
INSPECTION WORKSHEET FOR DATE: 3126/2007 TIME: 7:00AM PAGE: 9
SITE ADDRE S: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: install 2nd floor in existing garage. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503 -539 -8191
Inspection Request Scheduled For: Date: 3/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa• -
299 Final inspection 045403 -01 503. 539.8191
Corrections/Comments/Instructions:
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❑_ N_O_ACCES_S_
It: FAIL P4 ALL OR INSPECTION ❑ ADDITIO ' L FEES ASSESSED
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Inspector ` '� / ' Date ,r ► - Phone #: (503) 718 -
_
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CITY OF TIGAR"D .k ..
BUILDING DIVISION , I.
PERMIT #: MS1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 211/2007
Phone: (503) 639-4171 /A it
Inspection Requests (24 Hrs.): (503) 639-4175 _.
INSPECTION WORKSHEET FOR DATE: 3/23/2007 TIME: 7:03AM PAGE: 53
SITE ADDRESS: 10023 SW LADY MARION OR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: Install 2nd floor in existing garage. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503-539-6191
Inspection Request Scheduled For: Date: 3123/2007 Pour Time:
Code # Inspection Description Confirm # Contact • Message
299 Final inspection 045272-02 :503-539-6191 Y
Corrections/Comments/Instructions:
CD (15/Aieezz, ..c• 3-y -2
n PASS ri PARTIAL APPROVAL fl CANCEL NO ACCESS
pi FAIL Ft CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: /
,// Date: ? -- --c '7 Phone #: (503) 718- zm-4•5""
CITY OF TIGARD . • .„
BUILDING DIVISION -
PERMIT #: MST2006-00321
13125 SW Hall Blvd., Tigard, OR 97223
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DATE ISSUED: 2/1/7007
Phone: (503) 639-4171 • 4.00,0
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/26/2007 TIME: 7:00AM PAGE: 76
SITE ADDRESS: 10023 SW LADY MARION DR . CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE: .
PROJECT NAME: GARDNER
DESCRIPTION: Install 2nd floor in isting garage. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503-539.13191
Inspection Request Scheduled For: Date: 2/2612007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 043820-02 503-539-8191 Y
Corrections/Comments/Instructions:
K PASS
r7 PARTIAL APPROVAL El CANCEL I NO ACCESS
FAIL I I CAL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: b /hone #: (503) 718d
CITY OF TIGARD `
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BUILDING DIVISION . ,.
PERMIT #: MET2006-00321
13125SVV Hall 8hd, Tigard, ORA7223 DATE ISSUED: 2/112007
Phone: (503) 639-4171
Inspection Requests �4Hmj:(503)G30��17S ,_.....".•• *�
INSPECTION WORKSHEET FOR DATE: 2/26/2007 TIME: 7:00A&0 PAGE: 77
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: lnstII 2nd floor n exisfing grga. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #: •
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 509'5394m1
Inspection Request Scheduled For: Date: 2826/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing ' 043820-01 503-539-8191 Y 1=1
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Corrections/Comments/Instructions:
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� ' FAss _ \ ) RART|ALAPPRCVAL El CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED co.,/
Inspector: «�� uc-�� u' J�hone #� 8�O3\ 718- --
,`�— ]�' / / /� ` (503)
CITY OF -. ��nn m n=pn TIGARD -
BUILDING DIVISION . ~
PERMIT #: MST2006-00321
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/112007
Phone: (503) 639-4171
Inspection Requests �4Hmj: (503) 639-4175 ~ �hN~ *IL.
|N8PECT|ONVVORKSHEETFOR
DATE: 2/2{��DD7 T|�E� 7�OO�kA PAGE: 75 '
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: lnstlI 2nd floor in existing garage. 450uq. ft.
OWNER: GAgDNER. JOHN &DENISE PHONE #:
CONTRACTOR: RYAN KERNER'C0NSTRUCT|0NG PHONE #: 503-538'5191
Inspection Request Scheduled For: Date: 2y25/3O07 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 hvimcha/`ice|rouoh'/n 043820`09 503-539-8191 V .
Corrections/Comments/Instructions:
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.
Q( PASS El PARTIAL | I CANCEL |
I I FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
/�� � � ^ '� �� ^/ u�~�� �'�^
Inspector: � ` Date: ^~ �~ / P hone #� (5O3\ 718'
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MS12006 -00321
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2007
Phone: (503) 639 -4171 //AiI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/20/2007 TIME: 7 :09AM PAGE: t3A
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: Install 2nd floor in existing garage. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503 - 539 -8191
Inspection Request Scheduled For: Date: 2/20 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 043553 -03 503-539 -8191 ht
Corrections /Comments /Instructions: � Y� HS /Q
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dim/ AdtiA
n PASS PARTIAL APPROVAL ❑_ CAN.CEL NO ACCESS
❑ FAIL `CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
1 Inspector: �/ 1 Date: 2 7.194 7 ! Phone #: (503) 718) WO-
CITY OF TIGARD
BUILDING DIVISION . ,.
PERMIT #: IAST2006-00371
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 211/2007
Phone: (503) 639-4171
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Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/20/2007 TIME: 7:09AM PAGE: 85
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE: .
PROJECT NAME: GARDNER
DESCRIPTION: Install 2nd floor in existing garage. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #: '
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503
Inspection Request Scheduled For: Date: 2/2012007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 tvlechar4a1 rough-in 043553-02 503-539-8191 N
Corrections /Comments/ Instructions:
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1 , V it ite 1 ajei'd A - e , C 1 ( 01 0 P,ve,4 4 ittki p
11-
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I I PASS U PARTIAL APPROVAL fl CANCEL 0 NO ACCESS
I FAIL gli ' ALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
? Inspector: • at.6:1 Date: ` ? 0 Phone #: (503) 718 VVO
CITY OF TIGARD • ,.
BUILDING DIVISION . - PERMIT #: MS
13125 SW Hall Blvd., Tigard, OR 97223
A ..
DATE ISSUED: 211/2007
Phone: (503) 639-4171 ,_zollitilf
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/26/2007 TIME: 7:00AM PAGE: 10
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: Install 2nd floor in existing garage. 460 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503-539-8191
Inspection Request Scheduled For: Date: 3/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 045400-01 503-639-8191 Y
Corrections/Comments/Instructions: A 41
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Writ." ' - ..-
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i)itArl
°Y cl
I - -L PASS 0 PARTIAL APPROVAL D_CANCEL ri NO ACCESS
n FAIL 0 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: Cr"- M Oa 1..- Date: 3. 2-t '(S Phone #: (503) 718-1-4
CITY OF TIGA"RD
BUILDING DIVISION PERMIT #: MST2006-00321
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 211/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 :01
INSPECTION WORKSHEET FOR DATE: 3/23/2007 TIME: 7:03AM PAGE: f4
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: Install 2nd floor in existing garage. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503-539-8191
Inspection Request Scheduled For: Date: 3/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 045272-01 503-53%8191
Corrections /Comments/ Instructions:
[K PASS 1 CANCEL n NO ACCESS
I I FAIL fl CALL FOR INSPECTION I] ADDITIONAL FEES ASSESSED
Inspector: .,4( Date? #: (503) 718-
. • .
CITY OF TIGARD - . -
BUILDING DIVISION • , --
PERMIT #: MST2006-00321
13125 SW Hall Blvd., Tigard, OR 97223
h* DATE ISSUED: 2/1/2007
Phone: (503) 639-4171 . ..f/pctilii.
Inspection Requests (24 Hrs.): (503) 639-4175 ...._-__14- -.I—
NSPECTION WORKSHEET FOR DATE: 2/20/2007 TIME: 7: 09A1v1 PAGE: 66
SITE ADDRESS: 10023 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: MARION ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: Instali 2nd floor in existing gaiage. 450 sq. ft.
OWNER: GARDNER, JOHN & DENISE PHONE #:
CONTRACTOR: RYAN KERNER CONSTRUCTIONS PHONE #: 503
Inspection Request Scheduled For: Date: 2/2012007 Pour Time:
Code # Inspection Description ‘ Confirm # Contact # Message
120 Electrical rough-in 043553-01 503-539-6191 N
CorrectionS/Comments/Instructions:
iri PASS PARTIAL APPROVAI CANCEL I I NO ACCESS
I I FAIL n CAL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector:
Air Dat e: `-1 Phone #: (503) 718-L. ‘ 1 /1 70
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