Permit CITY OF TIGARD MASTER PERMIT
I I COMMUNITY DEVELOPMENT Permit #: MST2012 -00054
'HOARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/15/2012
Parcel: 1 S 134C D02900
Jurisdiction: Tigard
Site address: 12010 SW 119TH AVE
Subdivision: LERON HEIGHTS NO.3 Lot: 59
Project: Brimhall
Project Description: Installation of new above - ground 275 gallon heating oil tank. Placement of unit must maintain
minimum 5 side and rear yard setbacks.
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:
Total: 0 sf Value: $2,400.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 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: 0 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: 0 Other Units: 0
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'I 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +amp /volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
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BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF Other R -3 0
Owner: Contractor:
BRIMHALL LIVING TRUST,THE FIRST CALL HEATING & COOLING CO Required Items and Reports (Conditions)
BY BRIMHALL, GEORGE H & 1650 NE LOMBARD ST
DIANA C TRS PORTLAND, OR 97211
PO BOX 230668
TIGARD, OR 97281
PHONE: 503 - 351 -0324 PHONE: 503 - 231 -3311
FAX: 503 - 286 -5194
Total Fees: $223.21
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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 503.232.1987 or 1.800.332.2344 4
Issued By: - Permittee Signature:
Call 50 t;t • 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.
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03/09/2012 FRI 15: 33 FAX 5032865194 FIRST CALL HEATING X002/018
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v . - - Permit Application \, ® FOR o usi ON 1s
City of Tigard Datel6 p) JJ� ./LJ Perot -No.: o 0 4 1 '
� 13125 SW Hell Blvd., Tigard, • ' % 1, Plan R
: . :. Phone: 503.718.2439 Fax: 1 `l, y . ry "
IRD L
Inspection Line: 503.639.4175 r �� ��
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Internet: tier d- g ov www.d or. ` � O r t i , � Q w\ Dace Ready :: 7ur1s: ® Page 2 for
\`c` �\v \ O `" N oa fi ed/M e tho d Supplemental Information
t :J (1. 51,-c f , I I f ;, 7 11 I L. 1C 1 . 1I'I .,.:', v I
E l New construction E Additlon/altera :k . • & ' • Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all • i. ❑ Demolition 0 Other: mechanical materials -. i / .nt labor ov• . -; . and 1 roll F i y : ,S CF I4JIh `' 4 -J a, r LJ r. f Q - ' ° �! ,- I I. .n -, (
.. r_ r - , ..- ✓.'''" ._,.« ....,..e., ..r.. ''''v.,_....'r z-_- G'�..?ti.'3. ' x i1J I I V Y11 ' 7L1 �1F 1 '_ ...J I. ) f �l
E 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special Girormarton tut chedrllrt
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
r . ; 1 : t111J1 `',•;,. ''' H1Vi ' 15 F`('w (71 i IA,� 5 HCad'_COOIln_
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Job site address: 2 0 ti 0 5 W ) .; .1111101,1A
City/State/ZIP: / �.( • ' 22 3 Furnace 1 t 1 000 BTU dtmts/vows —�A
Furnace 100 400+ BTU ducts/vents _ _ _
SultelbldgJapt. no.: Project name: Heat pump .��
sire , ....
Cross street/directions W job site: Duct work /M1
H dronic hot w stem _ ®
Residential boiler - • iator or
h dronic -I 23.32 -
Unit heaters (fuel -typ not electric),
in -Will in-du ..I.. etc. 46.75 -
Subdivision: Lot no.: Flue/vent for an of abov'F- 23.32
Other: MEM 23.32
Tax ap/paroel no.:
rn Other fuel a • .Ilances:
C a . ( ., t1 1 'l '1 7 f 1 ' ;, ur _EE 2332
_c h , ��; �: r :_3 __.....,_ .�. l c2 � I ,:'- , ,;'
. .. ...> .... ; �' j Waterhea ITEMMEMINIIIIILVIIIIIN 33.39
1 ll , 1 I . 1.i11 if • / , , i Flue vent for water heater or gas Alli
fire •lace • 23.32
ET, ._ea _gee 1111►_ 2332
Wood/ .elletstove ai 3339
Wood fire .lace/insert MII■. 23.32
1, , •1 ? , V I ; ; I r ' , , Chimne /liner/flue/vent 23.32
y + �f { ' S m ) Other. 1 '((" a ! dl l�- 23.32
o s /.. G Enviroomenta exhaust and lunation: _
Address: pb 6 0 , 2. 0 1 8 ' Range hood/other kitchen -MI '�
City /Statc/ZIP: 11 0 , , ?• 2J l - 0 , ' g . Clothes M. =111 EMI
Phase 3 let eom Single-duct , : •I „ ms, .��
to
(� ) 3r j 032 4 Fes( ) toilet .I en, utit' roans _ ®
s r f I t �( C i ', _ I �. t . ' I w J `'Q Attic/cia .ace . fns
...5� ...v.ry -.. .:. .��: � ay.. a _1 i l ... .. . s ._ k. I , .. .v, _l.e .F. .� .�.. ,1•
Business name vs C _ .0 / I C 0U1,1 Other. 1111111111=1 23.32 \_
Contact name:
I .r I[. 'e , 1111M four $4.03 for each addtdonal
Address: (0 51 a 61*, • i Furnace etc. —_
Gas heat • —I
City/State/ZIP: a • a , '1 Walsus. , ed/unit - _
Phone (51 j) 2. 1 ' 2 0 ' j 5 1 ) 3 ' _
Water heater — MI
Frmad ( Ea . ,/ . a t Oa e s ,,, Flr •lane
e _
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'� r- k �' 1 -ji ( C7 1.{-;?7,..:, r,� r >� 7 C
Y
. 1 ,,.._. & :. . , Barbecue � �_
Business name: / A tea, h.. t t r, Clothes . :�: —_— ai. other I=
Address: t ' ''P l [
� � � � t � , I�I r
City/StatetZlP: • 1 • L Subtotal ..... ".::__:..:.:
(93) 231 -3311 Fax (�3) 2 Mwmum permit fee ($90.00) 01 I •0
Phone: Plan review (25 %ofpermit fee)
CCB Iic.: i 0 2. 0 / State surcharge (12% of permit fee) 0 .. 0
TOTAL PERMIT FEE I fl
Authorized signature: �,f,� i - This permit application iapires if a permit is not obtained within 1811
� wn-_ ""° days after k has been accepted as complete.
I Print name: /v/gf� L. Ferk.e. Date: 3/q// 2 1 • Fee methodology sat by Td- County Building Mosey Service Board
hl8viidulz6PumiulalfiCf itApp.dx 03/07/12 440•4617T (I 1/02/COM/W110)
5 • ° Building Division
Development Code Provision Review
T I G A R D Residential Projects
Building Permit No: /1' hr &) 1)- —oc) )S1
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: 3 nAL L'/l
1st Revision Submittal Date: ❑ Site Plan Only
2 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 ____ «ui at 718 - 5 or Sh @tigard- or.gov)
�
Land Use Case No. Name �c kt'Fi4tL
❑ Zoning g- S
❑ Setbacks:
/Front Rear t 9 / Side 5 Street Side it Garage DO
[[1 aximum Building Height 130 Actual Building Height
D' Visual Clearance
❑ yasements
C]' Sensitive Lands Type: ii I VI'
Notes:
Original Plan: Approved Not Approved ❑ Date: 3 1 iI y
Revision 1: Approved 1 Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
❑ Actual Slope:
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard- or.gov)
❑ Street Trees
❑ Protected Trees
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes ❑ No ❑
Date Routed to Building: .
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Page 2 of 2
03/28/2012 WED 6:40 FAX 5032865194 FIRST CALL HEATING 0001/002
.First ca F 1650 NE Lombard Street
Portland OR 97211
503/231 -3311 FAX:503/286 -5194
360/693 -3311 Vancouver
Heating CO www.FirstCallHeat.COm
FAX Coversheet ! f
additional pages to follow
Date
Z RECEIVED
� �
MAR 2 8 2012
CITY OF TIGARD
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g rap l rJ - (4 BUIL DIVISION To: (� l 79a
From at direct phone:CSD 3) 2- I" - ZO 1-5
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