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Permit CITY OF TIGARD a MASTER PERMIT IN ...- rt • COMMUNITY DEVELOPMENT MO= Permit #: MST2012 -00063 Date Issued: 05/03/2012 ?MAR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112BD09400 Jurisdiction: Tigard Site address: 14682 SW 78TH AVE Subdivision: BRITTANY MEADOWS Lot: 30 Project: Brittany Meadows Lot 30 Project Description: New SF 9/25/12 REPRINT Added (1) backflow preventer BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 568 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 32.5 Bathrooms: 3 Second: 804 sf Garage: 428 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 1073 sf Right: 5 Detectors: Total: 2445 sf Value: $272,502.88 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc!Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'l 500 sf: 4 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601-1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY ' SF Residential Audio & Stereo: N HVAC: N Security Alarm: N • Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2445 Owner: Contractor: BRITCLIFFE, MARK & DARLA M & D DEVELOPMENT INC Required Items and Reports (Conditions) 27485 SW XANTHUS CT 27485 SW XANTHUS CT 1 geo tech report required prior SHERWOOD, OR 97140 SHERWOOD, OR 97140 to footing inspection 2 Ersn Cntrl 503 - 681 -4444 PHONE: PHONE: 503 - 516 -7700 FAX: 503- 925 -8387 Total Fees: $18,464.90 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 1 952- 001 -0010 through 0 R 952- 01 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: p4 APPUGAli Call 603.639.4176 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. Plumbing Permit Application Building Fixtures FOR OFFICE: USE ONLY City of Tigard R eceived Permit No.: 111 0 a 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Review 503.718.2439 Fax: 503.598.1960 Date/By: Reate/By: view Other Permit No.: D T I G A R u Inspection Line: 503.639 Date Ready/By: kris: El See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ta . New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 312.70 Al- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 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: Job site address: / C,l S--7 S G., 7 g -f-L, Catch basin or area drain 18.76 City/State/ZIP: -�- � Drywell, leach line, or trench drain 18.76 ∎) Footing drain (no. linear ft.: _) Page 2 Suite/bldg. /apt. no.: 1 Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 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.: _) l Page 2 Subdivision: R d , e ..,,, 7 „, I/yt t � Lot no.: Fixture or item: Tax map /parcel no.: - . 3a I , , Backflow preventer DESCRIPTION OF WORK Backwater valve f2. Clothes washer 25.02 rrWL / ./. 2c, v7 e:-.)co 6 3 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 11 PROPERTY tank 12.51 PROPERTY OWNER ❑TENANT Expansion Fixture /sewer cap I 25.02 Name: �y(r4i r•� -r• D elp is f . ! •t : ! Floor drain/floor sinlc/hub 25.02 Address2 2 7 af S 1. %c..' �r Garbage disposal 25.02 City /State /ZIP: S L,. 1,./ V ., •'? Hose bib 25.02 Phone: (7 Sl U 77U O Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 k_b sO r • c....., Medical gas (value: $ ) Page 2 Business name: � J G v Primer 12.51 Contact name: /f Roof drain (commercial) 12.51 Address: S � ' .f ,�L� 4 o t/ Sink/basin/lavatory 25.02 City/ State/ZIP: 6 ' Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: /3 --/- Sow f pky„ l - `1 S Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: I Date: 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•PerrnitApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - I' 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to P and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge- 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: , • Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2" and greater, except systems designed and stamped by licensed Bath: - Tub /Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive Stall as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher. Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918 -780 -0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: - 2" 3" Isometric or Riser Diagram 4 " ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non -food that meet the qualifications above. . Disposal: - Domestic food related - Commercial food related - Industrial food related Ice Mach/Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang -Stall - Sink: - Lav/Bar non -food related - Bradley - Com/Serv/Util food related - Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and Washer - Clothes fees assessed for the sewer increase must be paid before the Water Extractor WaterCloset - Toilet plumbing permit can be issued. Urinal Other Fixtures: I: \ Building \Permits\PLMF- PermitApp.doc 08/04/2011 2 r , CITY OF TIGARD MASTER PERMIT I NI il , : - COMMUNITY DEVELOPMENT Permit #: MST2012 -00063 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2012 Parcel: 2S112BD09400 Jurisdiction: Tigard Site address: 14682 SW 78TH AVE Subdivision: BRITTANY MEADOWS Lot: 30 Project: Brittany Meadows Lot 30 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 568 sf Basement 0 sf Left: 5 Parking Spaces: 0 Height: 32 5 Bathrooms: 3 Second: 804 sf Garage: 428 sf Front: 15 Smoke Dwelling Units. 1 Third: 1073 sf Right 5 Detectors: Yes Total: 2445 sf Value: $272,502.88 Rear. 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach' 1 Laundry Trays' 0 Rain Drain. 1 Urinals. 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer 100 Drains: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib. 2 Backwater Value: 1 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K. 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add 500 sf: 4 201 -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 asin Y Other. N Other Description: Ecom P g BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2445 Owner: Contractor: BRITCLIFFE, MARK & DARLA M & D DEVELOPMENT INC Required Items and Reports (Conditions) 27485 SW XANTHUS CT 27485 SW XANTHUS CT 1 geo tech report required prior SHERWOOD, OR 97140 SHERWOOD, OR 97140 to footing inspection 2 Ersn Cntrl 503 - 681 -4444 PHONE: PHONE: 503 -516 -7700 FAX: 503 - 925 -8387 Total Fees: $18,429.88 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 - - -: - - ce 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. : TENTION: 0 = eon la, equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 ,, 1 -0010 through OAR . - 001 -'0•.. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1,800.332.2344 Issue By: r.` , � �� Perm ittee 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 Applicatio FOR OFFICE USE ONLY City of Tigard • MAR 2 8 2012 Re i t Permit No.: 114 - v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �, ' � / • Phone: 503.718.2439 Fax: 503.598 y OF TIGARD DateB : l id' Min Other Permit:�(,t)4.4 _QQp 57 TI G A R D Inspection Line: 503.639 Date Read B: p funs: El See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: 'f a 4� � / Supplemental Information /I / 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 El Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. - 2 4 50Z, . ee-.., - and 2- family dwelling ❑ Commercial /industrial Valuation: $ Z-7 ❑'Accessory building ❑ Multi- family Number of bedrooms: . ❑ Master builder ❑ Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOC TION Total number of floors: Job site address: t l (t? b d 7 -rt. v�_ '� ( L squ New dwelling area: are feet City /State /ZIP: —1 -. 5, ,---„A Garage /carport area: 4 Z square feet ' 0 Suite/bldg. /apt. no.: Project name: Covered porch area: 76 square feet gOk Cross street/directions to job site: Deck area: square feet f 4 ..,./ 4 -- r - r -- Other structure area: X73 square feet 3Z,' j 1,411 n REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: ' ( - - , c„ . K P4 I 1 ,/' v lAj S' Lot no.: 3 0 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. All E A /C) J S - .e Valuation: $ Existing building area square feet • New building area: square feet ❑ PROPERTY OWNER ❑ T A� Number of stories: ` Name: WI .4, j� C . ` Type of construction: Address: 22 // S .S Y4 - '' fii ✓ S` CI Occupancy groups: City /State /ZIP: S'�.... /,' UC t f. / q 7 / 7 v Existing: Phone: (1—,:,71 S'/ 6 .77 Fax: ( ) 72 S --g New: fa " ❑ CONTACT PERSON NOTICE Business name: V/ `• -.k ' D.. I D r t. ,,, te ,1— All contractors and subcontractors are required to be Contact name: tn/► �r �C licensed with the Oregon Construction Contractors Board r� t ` under ORS 701 and may be required to be ]tensed in the pit Address: Pk / jurisdiction in which work is being performed. If the City /State /ZIP: ��t-_ v V applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Y lf 4 p p e k i l m /J Permit fee: Address: �� � 1 _ lid -1. 0 U e-- /' fry State surcharge (12% of permit fee): City /State /ZIP: FLS plan review (40% of permit fee): Phone: ( ) Fax: ( ) (Due upon application.) CCB lic.: / / l h Total permit fees: 2 Authorized signature: v �/ Amount received: c,0 I f This permit application expires if a permit is not obtained Print name: (/f•J4�'�L � � c Date: 3 7//2._ within 180 days after it has been accepted as complete. * Fee methodology set by Tri County Building Industry . Service Board. C\Building \Permits \FPS - PermitApp.doc 02/01/2011 440- 4613T(11/02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ Permit fee based on project valuation (see fee schedule): $ Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ FLS Plan Review (40% of permit fee): $ TOTAL: $ Plan review requires a completed application and three (3) sets of plans at submittal. Plan review fees are required at submittal. L \ Building \ Permits \FPS- PermitApp.doc 02/01/2011 2 Electrical Permit Application, FOR OFFICE USE ONLY City of Tigard I Received ? 4 / , �1d Permit/ o.: / /a l.L 111111 - N 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' Phone: 503.718.2439 Fax' 503.598.1960 DateBy: Other Permit: Inspection Line: 503.639.4175 Date ReadyBy: ions: el Sec Page 2 for TIGARD Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK ! PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items caccked below): 12 constructor. ❑ Addition /alteration /replacement ❑ Service or feeder 400 amps or more p Building over three stories. • ❑ Demolition ❑ Other: where the available fault currant ❑ 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 agticultaral 0 - and 2- family dwel°ing ❑ Commerciahrindustrial ❑ Accessory building amps for all otherinstallI:ions buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ['Addition of new minor load of ❑ "A ". "E ", "1 2 ",' 1 -3 ", �p 100HP cr mere occupancy. Job no.: Job site address: ( � f C/ G 7 S f ? ((-v ❑Six or more residential units ❑ Recreational vehicle parks. \ / / r ❑ Health -care facilities. ❑ Supply voltage for more than City/State/ZIP: [7 ( ['Hazardous locations. 600 volts nominal. V Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps cr mere. FEE SCHEDULE Cross street/directions to job site: - _ vrssripIion I pry- 1 Fee. I rn.I I New residential single- or multi- family dwelling unit. II ) e ri,,,, includes attached garage. v C Lot no.: 3 0 1,000 sq. R. or less 168.54 4 Subdivision: l , -t - l , . + / t' � Ea. add* 1 500 sq. ft_ or portion 33 I Tax map /parcel no.. Limited energy, residential 75.00 2 DESCRIPTION OF WORK {with above sq 4.) , Limited energy, multi fun:ly 75.00 - IA L`/ J , r residential (with above sq. ft.) ``� L l y -- /,) , !S ■ Servv ices or feeders installation, alteration, and/or relocation 1 200 amps or less 100.70 2 ❑ PROPERTY OWNER "' ❑TENANT 201 amps :o 4C0 amps 133.56 2 r 401 amps to 600 amps 20C.34 2 1Vame. ll. {L�� k r � I t 501 amps to LOCO amps - -2 301.04 2 Address: 7 v • — ......C.......C.41,/ _ . +1 ✓ a_ Over 1,000 amps or volts 552.2:: 1 2 , ! � ` � / + Temporary services or feeders installation, alteration, and/or City/StateiZlP: S'/,, - , w f ; , e /V 6 relocation _ Phone: ( ) j— -770 a Fat: ( ) 200 amps or less 59.36 1 m 201 amps 400 amps 125.03 Owner installation: his in is being made on property that I own which is not 401 amps ro 599 amps 168 54 2 intended for sale, lease_ rent, or exchange, according to ORS 447, 449, 670. and 701. Branch circuits- new, alteration, or extension, per panel Owner signature: Date: - A. Fee for branch circuits with above service or feeder fee, 7A2 2 ❑ APPLICANT I ❑ CONTACT PERSON each branch circuit Business name: y +3:) / ` }.__ (,,.v ,,,r 13. Fee for branch circuits without l Y "' �� ` � "�` ra `C service or feeder fee, fiswt 56.18 2 Contact name: i°4. /.1( branch circuit Each add'I branch c ircuit. 7.42 Address: air Miscellaneous (service or feeder not included) I Each manufactured or modular 67.84 2 City/State/ZIP: dwelling. service antler fender . Reconnect only 67.84 2 • Phone: ( ) Fax: ( ) - Pump or i>ligmion circle 67.34 E -mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited - energy z° Business name: panel- alteration. or extension. Page 2 ! �1 •� l t n r Each additional inspection over allowable in any of the above Address: . Additional inspection (1 ht min) 66.25/ hr P , D 1 1 � �� investigation f F hr rnin) 66.25 / hr City/State/ZIP: r ! �� ( (� I -�} I Industrial plant (l hr min) 78.18/ hr . Phone: ( 50a ) 04 Li S • Fax: ( ) 51.01 inspec:ticns for which no fee is WOO/ hr specifically listed (V. hr min) CCB Lic.: 1 lq ( 1 Electrical Lic.:)4 -311 (l Suprv. Lid.: 1 ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: ; �. yzr6, plan review (25 °/ of permit fee) Print name: �C Tt' or' L�L Li 1 I oil tm Date: Stale surcharge (12 %ofpeit fee): I �,1 Authorized signature: ,/ �" "' T his permit application expires it a permit is not obtained within IRO L ot J J days after it has been accepted as complete. rPtintname: 110,/)45 Lot L„..; rija i bate: 1 1 = Number of mspecbons allowed per permit. :tBvildingPl ermits \ELC- PerrricApp.doc 07 /0I110 -J 4.1 46I 5T(11i05 /COtst'WEB .d Apr30 1209:45a G &B Plumbing & Sons Inc 503925/707 p.1 RECE Plumbing Permit Application APR 3 0 2012 Building Fixtures fYOFTIGARD FOR rFFI(E. 1F. OM.1 City w � d �i.ta.oR 9 DING DIVISIO : P - • S 4 �'° No.: W. Ji n&t l Plume! %l i7 !. 2439 Fat: 5/3,59R.1960 p t7dtu P writ tVa,. t (;. 1 .1.r inspection Liao: 57}3 :9 - 6.4175 Mi. R rem <anyisIy: I m Svc Te I Tor (nterie(. cww.II afd-or.rov Sven net/me/hot 7 x.(31 Seppkmenbl saitrAarsn _. -- TYPE OF WORK FEE' SCUFF-RI . Naa• eonsnue iea El Demolition Far s)orriaJ iirfnrwrrdinn al, rLerlrlitl Dwrription I Qty. 1 Ea- [ Thal ❑ Additiar >;alteratiodlrcptacemerl ❑Other: New J- 7- familY dwellings (ineNef ? ft. fareach utility cc ection) CATEGORY OF CONSTRUCTION SFR (1) bath 31170 21- and 2-Wilily dwelling 0 Coiralaciai!industrial R (2) = 437.72 SEE i3) both 500.17 ❑ Accessory b.ii fins ❑ Mt:lti.- family Each additional bsthlicildttn 25.02 1:1 Master builder fl Other; Fire cprinklrr (__ sq ft.) r Pape 2 JOB SITE INFORMATION AND LOCATION . ' Site utilities: _ Job silt addresi: ! C./ 7 Id sd Catch It in or area drain 1 C)IyIStalcd1 P r U r ` ^ t]rwcel), leach ]ire, or trrnrfi'drain 18..'5 rooting drain (no. linear II.:) Page Suit ibidgJcpt. no.: Piujeetname: Manuf iuccdhonscutilities 50.03 Cross s;renridireaions to job sir: Manholes 1176 . ..-z 4 , L- ; Rain drain coancctor 18.76 �/ / Sanitary sc c (no Iiaear Ii.:_____) Prze 2 Stern sevr-r(u . linear it: I Patsy .2 Waler service f :A. knew It.: ) Page I Subdivisict: tj; -r Ra Lot no. 3� Fi.rrareoritem: Tax Inaptpareel no.: "`666444 Bad: IOW prevenIer s 1 .27 DESCRIPTION OP WORD Bodwrtavlive 17.51 CI other washer 25.112 A .Xt ' Dishwasl'er 25.02 Drinii ing fountain 25.02 Ej ctorsiswrp 25.02 0 PROPERTY OWNER ❑ I TEN. Expansion lank 1251 Manic: ifY► lq- r "� ep e s �; .' ?' S t �_ Fixture/sewer c 25.0: sy s 1 lloordrairdlloor sirkdtwb 25.02 ad4resS : .7 "4 f . 7< fir Garbage distxifll 25"12 C)ty /Stale/2iP: tr . ,,1 C..1,...- !! `` � J 1 ) Host bib r Phonc: (553 ) $ I1, - 770 {� Pan ( ! ) Icc make: 1115 ❑ APPLICANT ❑ CONTACT PERSON loterccprarfgreasetrap 25.672 Sus s name: -� ^ r r J Medical gas (valor.: 5 P:c2 "1 � � u�Pr ''fi�� ' ' Primer 1251 Contact name: - Roo F d. - ain (comma:tiat ) 12.51 Adam rc ss: Sinkibasinfl avatory 15.02 C1ty /StaaeinP: ...- A A i.r-c.--` Solar units (potable'Paler) I 6254 Phan: ( ) Far: - ( ) Tubfshawcdshowwer pan 12.51 E -mr.i. I Urinal p 25.02 - CONTRACTOR VI etc: closet 1i -t12 Water heater _ 0-i si nes narrrc: c— ÷ 6 Pt./A, 4 -. S • Water pipiryDW V 56.29 Address: 0 s 0y. 0-Z other 25.02 CitvffLUC(ZJP; 4 l — - P- i 6. 2-- a `T t. 7 sum atal Phene: (5 e c e - - ' H w Fati_(.,'C ©3 w ! - ' ' . i _ ` - / 3 7 1 5 0 y/ Nen review (23% aperitif Cell t CCH Lic.: 4 0 7 Boasting Lic, re 6 -- jf Stan sur charge (t n. of fee) Authorxcdsignalurt : .�F TOTAL PERMIT Fly L I Print nalne < f �� ±. re, Uatc: ►— . Tti SpeYMi, op[riirstiw o lira fr. Rr.vr a.at .btansd withitt 100 d Yr 4 - r3J,.„ ..--- - ,. 0_ ..,i after it kn lees accepted .r cornea l& 'Fee m: d odaiogysai be Tri•County Duildiuc lnJem.my Service 8carck I.w.acenflleereu I AP LV" 41 p.,ae iarc+aa 410-46 .tQ 1LW6Q) - - d • Mechanical. Permit Application FOR OFFICE USE ONLY J City of Tigard Date/By: jm�`,. Pe rmit No.: ` ie4 ^40 0,406 , lall 11 1 111 . ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review - v - t Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: ; 0 _e2005 . TI G A R D Inspection Line: 503.639 Date Ready/By: Juris. El See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK. COMMERCIAL FEE* SCHEDULE - USE CHECKLIST • Mechanical permit fees* are based on the value of the work U"N construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* • I/J I- and 2- family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total • JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: /� // c-7 S 17 -c-L, A (requires site plan showing placement) 46.75 — 1 \7 / 1 Furnace 100,000 BTU (ducts /vents) 't • - 46.75 City /State /ZIP: '`4.` �,. CJ Furnace 100,000+ BTU (ducts /vents) 54.91 f'c Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 1 ', / Hydronic hot water system 23.32 r t ''t r Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), 9 in -wall, in -duct, suspended, etc. 46.75 Subdivision: A r 1 �� A �) 0 , , ,, � Lot no.: 3 0 Flue /vent for any of above 23.32 1 / •, Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater _ I 23.32 Gas fireplace/insert ( 33.39 Flue vent for water heater or gas k ) C-i-✓ 7 $. fireplace 23.32 l Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER - ❑ TEN T Chimney /liner /flue /vent 23.32 Other: 23.32 Name: 0., A P + r L.-;- ci + e Environmental exhaust and ventilation: Address: 2 ? (l (� sc.,/ X _ 1 4 , 1 1-.4,1 c r` Range hood /other kitchen equipment 33.39 City /State /ZIP: S L, ,..._a UC.C>[ d q' j Clothes dryer exhaust f 33.39 Single -duct exhaust (bathrooms, Phone: (..S"63 s16, -7700 Fax: ( ) toilet compartments, utility rooms) I D 23.32 1(64 .8, APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: YY inn.4.-� J A� of Vvi, ' i - � + Fuel p i p ing: Contact name: •• �� $14.15 for first four; $4.03 for each additional Address: f J Furnace, etc. I /4+ I' S �"� ' S Y � J� Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater 1 Fireplace P E -mail: Range 1, CONTRACTOR Barbecue Business name: Clothes dryer (gas) �� G OL (�P �� �S Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal r ,C( Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: ,q State surcharge (12% of permit fee) -;6,.,12- TOTAL PERMIT FEE '2, .1I Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board I.\ Buildin gPermits\MEC- PermitApp.doc 09/09/10 440 -4617T (11/02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total 'Valuation: _ Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. l: Building \Permits \MEC- PermitApp.doc 09/09/10 2 P -r (ate /, 4,,, B i, L6-?L 111 q Building Division (ilk) $a a‘‹) ?$ 4-1 Development Code Provision Review TIGARD Residential Projects Building Permit No: �I so. /9 -ocao 5. CWS Service Provider Letter Received: Yes ❑ No ❑ N /A 1 Routed Plans: 2 Original Plan Submittal Date: d a; 1st Revision Submittal Date: ,ci S ite 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 310 1 t le-L at 503 - 718 -a,(51 or S y @ tigard- or.gov) L d Use Case o. P 2�■45 = uuoisName 8E4 (L/....t g44 2 .r? Zoning I r (3r% T ra...( M-t 6. (1—$.54.J.5 Setbacks: 0 Front ( Rear de 6 Street Side � Garage Maximum Building Height 36 Actual Building Height 3A ..45' Ur Visual Clearance C, Easements °'' ❑' Sensitive Lands Type: AU . Notes: e.,,3 ,.....c...4-- , ./0- 424_e,..v3A, W v Lt . ra . sr C.—. r a..,J t A. .. w cal. ' Original Plan: Approved Not Approved ❑ Date: 3ia` / I a-- Revision 1: Approved CK Not Approved ❑ Date: 3 ( 3J f 1 2 1C4o Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) Actual Slope: a Notes: Original Plan: Approved,2r Not Approved ❑ Date: IZ Revision 1: Approved ,l' Not Approved ❑ Date: 3 / Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City �rborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) 1 ,, . _di // treet Trees �/ Protected Trees Notes: ST-t,e, 1 l- a'i (,..I, f,v 5 4 T C.o,,. i 44 L, 'h,_ a Sv,. h . Original Plan: Approved -❑ ' Not Approved E Date: `j 'a`(- /a Revision 1: Approved L� Not Approved ❑ Date: /- 3 -Pots 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 Applic t / Okay to Issue Permit: Yes ►i o � 3 /724 1 Date Routed to Building: _ , • • Page 2 of 2 RECE1V ED 17 „, 1q __ y x MAR '2 2.012 CaT ' OF TiCARp 3 a `'\ yy b.r a t n 1/P .4v11 arm,,., *,v. c <— c - ,5-- „ )4 ,..,c,-- / oPe.., ') ,---- :. 1 . t, f-4-b • - - . ?r; J ,."r -,.. . SA r1h. c M eici 5' 0, _ ; 3 s, — i Lot 30 i3Ct't- c, 1,1ed0wS I'-1 bq ski r78 cli t ?cfm‘.r sw rns -000(3 91 r n - D eve to? to -e+ 2745 sue► Xc�,rkrs cT I 5 1 Sh��wil�� ��rya 1P11s}rk �� •Tcl� S o3 SJI 77 ' a ' . Sd rfir 1 All 7 C cs- crJ` I . A 1 1 1• GJ 1 0 I tslY s—tT — �r�(7,, ,..07P t . — L� �te r ,yam ' e✓ 34 / 7 --1-1 / 61-V "C- 1 STREET TREE TIGARD CER TIFICA TI ON I, m - 1( C� �' ; ( t , owner / agent for Vr4-b . 1 z (ic op rn (PLEASE PRINT) (PERMIT HOLDS do hereby certift that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: ri23 20 12 — 100c 6 T SITE ADDRESS: / 6 Z (.4./ 7F SUBDIVISION: , - ,, LOT #: 30 SIGNATURE: /2 DA E: 2 /7 (OWNER/AGENT) RECEIVED & 4 1 7 VERIFIED BY /� DA'1 E: (CITY OF TIGARD) ❑ Tree location verified p'r approved site plan. I:\ Building \Forms \StreetTreeCertificate 04/01/2011 Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, v A - C . , am the general contractor or the owner- builder at the following address: Site Address: / (/6 Z S �/ G 4-L i, -c___ 7 � �a City: j �-t/ /� . • vl / Permit #: 5 f `) D / ? — t�00 C3 Subdivision/Lot #: 2 C) and/or Map and Tax Lot #: - To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I- am notifying the building official that I. am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture - sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: / ��S Date: / �Z� General Contractor or Owner- uilder l:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: MST moo (Z -0 00 6 3 C L+7 G7V Site Address: Subdivision/Lot #: in l • r r and/or Map and Tax Lot #: By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) Signature: f �� Date: 26 Owner /General Contractor / authorized Agent 1210 Print Name: / 34/ / ri: / ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the;final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or „linear fluorescent, or a minimum efficacy of 40 lumens per . input watt. S L\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 • /� ,