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Permit
• CITY OF TIGARD ' MASTER PERMIT • --- , " COMMUNITY DEVELOPMENT / °?d ....at/ Permit #: MST2012 -00225 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 r Date Issued: 10/08/2012 Parcel: 2S 103CA00601 Jurisdiction: Tigard Site address: 13465 SW HOWARD DR • • Subdivision: WOODCREST Lot: 11 Project: Stockamp Project Description: Garage addition. 11/20/2012: REPRINT permit to change scope of electrical work and add new electrical contractor to permit. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 893 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 0 sf Value: $35,219.92 Rear: 15 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 1 Sewer Lines: 0 SF Rain 0 Storm Sewer: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckfw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 • 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: 0 Other Units: 0 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 8 Ea add 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 BUILDING INFO • Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet: ADD SF VB U - 0 Owner: Contractor: . STOCKAMP, MICHAEL & SUE AMERICAN LEGACY HOMES & CONSTRUCT Required items and Reports (Conditions) 13465 SW HOWARD DR 1600 NE CHEHALEM DR 1 Ersn Cntrl 503 - 639 - 4175 . TIGARD, OR 97223 NEWBERG, OR 97132 PHONE: 503 - 729 -9488 PHONE: 503- 341 -8615 FAX: Total Fees: $1,475.02 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 -00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 /�.,p o1.800.332.2344. / `�O Issued By: / I //174.1 Permittee Signature: // " t\/ , 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. • • /1602 P.001/002 11/19/2012 0324 . . 1 Electrical Permit ADDlicatgetIVLU FOR 01EI(E I'M: ON1,1. ! City of Tiga rd Reeci■ed NOV 19 2012 13125 SW Hall Blvd.. Tigard, OR 97223 - . Phone: 501 718.2439 Fax. 303.59Cny oF TIGARD . Plan Kcv•ew I • • 1 '..)z. ! Othet l'crrns; ----I Inspect lot Line 50 i 639 4175 ! Daract■iB ____ y • : :av:•. ! 0 See Pacte 2 for ; , 1' ''''' r V' BUILDING DIVISION t...`. N . suppknw.lint i _ _ • . _ _ ._ i i PLAN REVIEW ---1 , _ ._ TYPE OF WORK 0 New a.mstruciion XAtiditiolualteration/replacernent F . t-,—, , 1 ir,a".:110 all the! a pp!) (sahmit 2 SeV. aplanx checked bk;10W) I 0 SCZ MC Or reethr ..101) amps ot more 1.: Eta:Yin:lover rh:ce rtotis:: 0 De1110IILiOn 0 Other: ! »hare the itcallahle tau!' .r.n,cto 0 Md1;:t.3 A:Id b01!2..artis CATEGORY OF coNsTatrtioN — 1 i ..vis 15.000 mins al in VO:N V' El Floal.•% uuiienn •----- 1 Jess lo pound. ur exceods 14 OK 0 C.. avituu;:ura: 1 and 2-family dwelling ID Commercial/industrial 0 Accessory- building runpA fro all other ituanlinnum huilclit. 1 0 MUILl•fanniy 0 Moister builder' Or 1 . Fire ru L.1 th: _ . _ I 1.. . m%) ' . 0 ■nnt of 7 5 KVA 0 — 7 — iarer Setneaa!y duive4 .;. sten 1. JOB SITE INFORMATION AND 1.0CMCION ! 0 A:J s a Y 1.7m '' ‘: . ■tor ioul of 1 Job no Job site address: 1 ._,,Ltk , 1 , %HI' te mOR. ocet■Dath.-y I I 0 Sk ea more reildemtittl un:Is 0 Reertnnnal catch: parks City/State/ZIP: 6 4 OA A 0 91 2,23 . I/taint-care lac:anti.. 0 kiteardoua location,: 0 SIIPPl) l'ellne Cal mole than GOO v01■5 nontinal. , Suite/bldg./apt. nu.: Prujem name: ; Q Service 0, li:edel GOO mho or mnec. — _ FEE SCHEDULE Cross street/directions to job silo: --I 1 neSC.1,olieta I Qty. 1 Fet7 reW — j. - ' I' ... _— — _... .----! . New residential single- or mufti-family dwelling unit. 1—,. _ _ _.. .._...„ i c1 win attached garage. i 1 ; .000 i•ir 0 or :Cf,s — T . . — 7 . --,:—.7----.1 Ins.:.4 1 • 4 I ' , i,loolviSiOn: 1 1.0; ;10.: - !:.a. add : i00 se. II or poi I Kin , — 7 .; )9; Tax map/parcel no,: .inuted c;;;:rgy. resit!entia; .---—.-- .— , DESCRIPTION OF WORK i I_ r ),01 alio‘• q. fr. ..___ • . i Lamed energy. McIti-lamily i I _--._h_- . 1.0. ir \li i v ni,.. " , _ . Q.{1b1 C &‘111.-C::1-11f:L riC . :C121/4-1-74— t C— I. i Serv7cdee:06:}f(owl alters i tion.::o ' r relocatioll i "" .3 kW-U- 1 , .D. i \ LW-A ' ' ' '' l amps or teas • 0 I ' PROPERTY OWNER • 0 TENANT . i .! . amps to 400 amps Name: ML . 0 „, ‘\ ,-1 s G 1 7, ---''.°6( . • , U! amps to I ,00o amp, I _ . l Address: t • (sr-, 5V4 kl.)\AICX-cd c)r . ! 0, I .G00 Impl Of volts 171 .. ! Temporary senires or feeders installation, alteration, andior City/Stateft IP: . it A e a* . 12:7 '? i relocation _ 200 amps or less Phonc: (503) 7Z- _ ci c‘s- i Fa.: ( ) . 201 8111PN !Q 4 00 amps 1 b 08 2 Owner installation: This instalhation is being made on prop that I own which is not - i 1 401 amps to 599 amps ; 16a.54 _I intended for salc. Ieaw. rem, or exchange. according to ORS 447. 449. 670. and 701, I i Branch circuit new. alteration, or eatension. per panel .. Owner signature: . , — - _ Dit __. •._ tc: l 1 A l'or :IV branch cirettiN with I • 1 7..12 159 3 i , ' _ . : _....„.._ . 1 1 ;.,:,..,. m:t wee Or feeder fee 0 APPLICANT i 0 CONTACT PERSON , i -41 wench en • - 1 •-■—•!---_L___ • 1 f--..-- : . Fee fur branch circuits without Business name; _ i I i ; service 01 rrcder fde. first _ . . 1 31) rtl I iLl 1 1 branch nntoit I Contact name: .___ 1--_, .- - - 1 ! Etc?: ATI branch circuit — 1, -- i . 74 __ Address: • (Nliscellaneous (service or feeder not included) 1 ._ .. ' --i 1 .; , mal11.1?$C11171Xl Of :r10(k City/Stste/ZIP: servie a r 1 i i:i7.84 I __ ---- Kr:online: only 11:■ ' Phone: ( ) Fax: : ( ) ! ,-- •__ .120:' n'tiyattOrt Citc4.■ - i 67%4 1 21 E-mail: ..—_; ! Si .. oi outline I igj7/74 ------"-- T - 77 4 - 1 --- _ _ CONTRACTOR I • sr nial "inani(•,.• or 'irmod_erc, _ _ _ . ____ I L alter ation, temivn. Page 2 , i I liusiness name M : ollenhauer Enterprises, Inc. DR.\ . Hie' Elect ric itionaI Mi a ction over allowable in any of Ihe above — . — __ • Addrcss: 11070 SW — — I Allen Blvd l F ( ; hr min) hr I LI .._ _... .es mon ( i hr min) 66.25 hr City/State/ZIP: Beaverton. OR 97005 r" 1 : ......_i 1f pram (1 hi nun) 78. lit, hr ; 1 Phone: (503) (49 ‘,. ," .. Fax: (53)641.1 2 I insridtaions for which no fec is i , — — kipecificelly listed ('-': hr mini . 9000 hr CCB Lic.: 191094 ' Electrical I i.. C643 Suprv. I.e.. 4230S ' I ELECTR1CAL I•ERKTI FEES _____ Subtotal. itt,O, ] Suprsr. Electrician signature. re.quired: I ,,• ollr . --------___. ---" 7,) , Plan icyrew (25% of permit fee). Print name: Dogulaa J. Miller `..)- I Date: 1 iq i / state mireherse ( ;2% of penhir t'tErt1 2 / _i _____ i I L 'IO -- TA I PER m n F El : I /7,. 2:4_i Authorized signaler:. _ - •-.../ :/i / "-- -, .-- _.,_ , . , , , . . . , i hit pertna gplibenIKM expieeS it it permit ilt rat Obtained within tau 7 ,,,, _, day% after it has been *vcrpred As compkte. Print name: Darryl Mollenhauer DaLC: I ( i i 2.. : - -,,:r.tx•L. ul ;IIspeCti(m:: ;13(hcal per xi I 'bulldttlOtrau ELL PannitApodoc. c,••o: ':i ;;■...:.t.: ;; t.1)NI Wi • CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit #: MST2012 -00225 Date Issued: 10/08/2012 .TIGARD 13125 SW Hall Blvd Tigard OR 97223 503 718.2439 Parcel: 2S103CA00601 Jurisdiction: Tigard Site address: 13465 SW HOWARD DR Subdivision: WOODCREST Lot: 11 Project: Stockamp Project Description: Garage addition BUILDING Floor Areas Required Setbacks Required Stories 2 Bedrooms 0 First 0 sf Basement 0 sf Left 5 Parking Spaces. 0 Height 0 Bathrooms 0 Second 0 sf Garage 893 sf Front: 20 Smoke Dwelling Units 0 Third 0 sf Right 5 Detectors, No Total 0 sf Value $35,219 92 Rear 15 PLUMBING Sinks 1 Water Closets 0 Washing Mach 0 Laundry Trays 0 Rain Drain 0 Unnals 0 Lavatories. 0 Dishwashers. 0 Floor Drains 1 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 Fum <100K 0 Vents 0 Woodstoves: 0 Gas Outlets 0 Fum > =100K 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders 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. 2 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: ADD SF VB U 0 Owner: Contractor: STOCKAMP, MICHAEL & SUE AMERICAN LEGACY HOMES & CONSTRUCT Required Items and Reports (Conditions) 13465 SW HOWARD DR 1600 NE CHEHALEM DR 1 Ersn Cntrl 503 - 639 -4175 TIGARD, OR 97223 NEWBERG, OR 97132 PHONE 503- 729 -9488 PHONE 503- 341 -8615 FAX, Total Fees: $1,358 67 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 throu OAR 9 - 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 o 1 800 332 2344 Issued By: , r Y� Permittee Signature: mil. . �„ 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 RECE ... }' esidential AH( 28 2012 FOR OFFICE_ USE ONLY Received „ / City of Tigard CITY OF TIGARD Date/By. p � g ,s, , A Permit No..) -(6 12. _00?-_ v 2� IN a • 13125 SW Hall Blvd , Tigard, OR 9741i/ Plan Review t o )) I A r Phone 503 718 2439 Fax: 503.598LDm� DIVISION Date/13y: `+ Other Permit I' I G r\ R D Inspection Line. 503.639 Date ReadyBy. �j �� Lurie ® See Page 2 for Internet www.tigard- or.gov Notified/Method. IV 41 i � �• Supplemental Information • .-CAVC e 4) J 67Z-6 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 worktit>a«ted on this application. ❑ 1- and 2- family dwelling ❑ Commercial/industrial Valuatio•� �I $ --347-0-5-5--- . ? 2 (G'� .� - ❑ Accessory building El Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 3i, 14 5 -5-w H"otiJu.vd b r , `, , a,v( New dwelling area: square feet City /State /ZIP: Garage /carport area: g 9 3 square feet Suite/bldg. /apt. no.: Project name: S"'i--0 C K vii ID 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. A bn G� Kuv Valuation: $ 1\ ✓ Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: yyt t Il.e ST(1(, K a Vbl Type of construction: Address: 13 6 Sco VV v` pit - [u') Occupancy groups: City /State /ZIP: il q VI() 0 l Existing: Phone: (503 ) 72.- C _ Cl' (-1 �[ Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): Address: Total fees due upon application: City /State /ZIP: Phone: ( ) F es:: ( ) Amount received: $ E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Submit two (2) sets of roof plan with connection details Business name: C( �WIP (/ 1 V1 P r /l h am, 5 CoY1Sfifurt and fire department access, along with the 2010 Oregon Address: /6 Go 0 , C. uL,I Ric 0,-, 0 v , - Solar Installation Specialty Code checklist. City /State /ZIP: N 2 2 _ Permit F ee (includes plan revie $180.00 and administrative fees): Phone: (S(j 3c( . - is Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB tic.: Cit 6 c)--- d l ill a 0 I / Total fee due upon application: $201.60 Authorized signature: / This permit application expires if a permit is not obtained / within 180 days after it has been accepted as complete. Print name: a Date: gig -Z-- * Fee methodology set by Tri -County Building Industry � yI � /( � r, L cJISSG 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 Permit No a 13125 SW Hall Blvd, Tigard,OR 97223 Associa Phone Received 503.718.2439 Fax. 503.598 1960 Associated permits 24- Hour Inspection Line. 503.639 4175 ❑ Electrical 0 Plumbing 0 Mechanical I I G A R D 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 ❑ ❑ ❑ architect licensed in Ore Ion and shall be shown to be as plicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans arc 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, El ❑ ❑ 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. 1•\ Building \Permtts\BUP- RESPermitApp.doc 02/24/2011 440 -4613T(I 1/02 /COM/WEB) Electrical Permit Application RECEIVE FOR OFFICE USE ONLY City of Tigard D teBed Permit No. 0 9 '4 13125 SW Hall Blvd., Tigard, O R 97223 A' ! 5 2 8 201 � Plan Review / / ' '� 0 : Phone: 503.718.2439 Fax: 503.598.1960 Date/By. Permit TI G A R D Inspection Line. 503 639.4175 CITY OFTKA'I ),ate Ready/By. r�s ® See Page 2 for Internet: www.tigard -or.gov BUILVI ►"rti6nNIS .. fied/Method Supplemental Information TYPE OF WORK 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 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 - famil ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ' A ❑ Emergency system larger separately denved system ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ", Job no.: 1 Job s I OOHP or more occupancy jte address: I - 51-4.4S S ❑ Recreational vehicle arks �/ W l )0�I},t y ❑ Six H more residential units p City/State /ZIP: - /, q ❑ Health -care facilities ❑ Supply voltage for more than � � ❑ Hazardous locations 600 volts nominal. Suite/bldg. /apt. no.: I Project name: C k a.,vvi p . ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: 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 Ea. add'l 500 sq ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq ft) 75.00 2 (� 1> Limited energy, multi -family 75.00 2 L ( z J- 'O 0 (/ 3- - & - - j - Go residential (with above sq. ft ) /'r - -- Services or feeders installation, alteration, and/or relocation (6 t} -4f tci-e- 200 200 amps or less 100 70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2 c 401 amps to 600 amps 200 34 2 Name: i �'� S � ' 601 amps to 1,000 amps 301 04 2 Address: 9 34 6 C Sw +.- 0 D I • Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or Ci + I ( relocation Phone: (SQ ) 7 Z — oi Li ge 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 125.08 2 intended for sale, lease, rent o exchange . ccording to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 ��// Branch circuits — new, alteration, or extension, per panel .- Owner signature d A _1 ' ♦ �� - ,`%�. Dati0D/ O ki O I �A. Fee for branch circuits with ❑ APPLICANT I • 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, first 56.18 2 Contact name: branch circuit Each add'I branch circuit f 7.42 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67 84 2 ty dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67 84 2 Pump or irrigation circle 67 84 2 E - mail: Sign or outline lighting 67 84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: 060/Je_kt pan el, alteration, or extension Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (I hr mm) 66.25/ hr City/State /ZIP: Investigation (1 hr min) 66 25/ hr Industrial plant (1 hr mm) 78 18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is specifically listed (%2 hr min) 90.00 / hr CCB Lie.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: o Subtotal: Plan review (25% of permit fee). Print name: Date: State surcharge (12% of permit fee). TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: Date: • days after it has been accepted as complete. Number of inspections allowed per permit 1• Building\Permits\ELC- PermitApp doe 07/01 /10 440- 4615T(I1/05 /COM/WEB Electrical Permit Application - City of Tigard • p e Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 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 ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ 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 \Buildmg'Permtts\ELC- PermitApp doc 07/01/10 • Plumbing Permit Application Ramp AUG 2 8 2012 Received Q City of Tigard Date/By �Q 4. Permit No.:' �r� ��/" q 13125 SW Hall Blvd., Tigard,OR 97223 �F GA RD J pla Review t7 Phone: 503.718 2439 Fax: 503.598. ' `i Date/BY Other Permit No • T I G n R u Inspection Line. 503.639 10 ' DING DIVISIOI Dat ea orris Sri See Page 2 for Internet: www.tigard - or.gov Notified/Method Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction 0 Demolition For special information use checklist. Description I 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 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: 1 Catch basin or area drain 18.76 6 S S w \ ac_ +, y a, City /State /ZIP: }.1 /r �� d A _Drywell, leach line, or trench drain 18.76 J Footing drain (no. linear ft • ) Page 2 Suite/bldg. /apt. no.: I Project name: S ?GV _U-wI p Manufactured home utilities 50.03 Cross street/directions to job site: p 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 /� t /J - Clothes washer 25.02 ''CV C' AV i- ` wow 0 f c + oP 4 .� • Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 j� 1 11(.e., i I , _ 5 � (c 0,04 Fixture /sewer cap 25.02 Name: /�6 {7ryltpy�/P t1. �� R v `, ill , ( Floor drain/floor sirllc/hub 25 02 Address: r Li 6 C < W l ` O 6 ( t 1 l 1 y �� J Garbage disposal 25.02 City /State /ZIP: `-1" t 1 -2....6t U, f v Hose bib 25.02 Phone: (50 7 j) -7 -! i-{ “ , 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 ( 25.02 City/State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Far-T:7 ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 CONTRACTOR Water closet 25.02 L Water heater 37.52 Business name: 1 1 1 - 9- t1 pl `; Ai Water piping/DW V 56 29 Address: {O /OQ' 4®x N6 Other: 25 02 City /State /ZIP: /\/E J, 6Z& t O,_ ?7/-7A- Subtotal (5D ) ci 9 `I _ 9 y ( 7 / / / Minimum permit fee. $72.50 - 2..-z,4-b. - 2..-z,4-b. 'Ph I Fax: ( ) CCB Lic.: /? /5 // r /4f, / Plumbing Li . nL�j ei ' Plan review (25% of permit fee) �� State surcharge L P ERMIT fee) Authorized signature: � � � TOTAL PERMIT FEE Print name: / / 1 t U (4,9 P { Date: Z g This permit application expires if a permit is not obtained within 180 days 1 after it has been accepted as complete. 'Fee methodology set by Tn -County Building Industry Service Board I \BuddingTermits\PLMU- PermitApp doe 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 ", Plan Review for Plumbing Installations please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that apply. Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and Fixture Type: Replace greater, except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font Bath -Tub/Shower as New exterior plumbing site utilities for any complex structure as defined in OAR918- 780 -0040. - Jacuzzi/Whiripool Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities. Dave Thru ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric or Riser Diagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. -4" Car Wash Drain Garbage - Domestic Disposal - Commercial Industrial Comments regarding fixture work: Ice Mach./Refng. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial *Note: If the fixture work under this permit results in an - Service increase of sewer EDUs, a sewer permit will be issued and Swimming Pool Filter fees assessed for the sewer increase must be paid before the Washer - Clothes Water Extractor plumbing permit can be issued. Water Closet - Toilet Urinal Other Fixtures: I:\Building\Permits\PLM- PermitApp.doc 2 IN _ Building Division Development Code Provision Review T I G A R D Residential Projects Building Permit No: 'N 5To■0 1- 00 aa CWS Service Provider Letter Received: Yes ❑ No ❑ N/A p 40r /0 4,2 - OG Po T£ A-e_ /HA r Routed Plans: Original Plan Submittal Date: �i. 1st Revision Submittal Date: ❑ Site Plan Only 2 ^d 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 o,, ly if approved. /// Plannin_ Review (contact /v at 503- 718d"` 7�d or @tigard- or.gov) La . Use Case o. Name 15 oning /- ' `! I e S tbacks: r out p s (/ Rear / S Side 5 Street Side Garage aximum Building Height 3 Actual Building Height wT Lsual Clearance 2 �'/ di ' y.sements LLY Sensitive Lands Type: /69 / 1 Notes: Original Plan: Approved Lid" Not Approved ❑ Date: p 4/ / ,9 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) .E( Actual Slope: _f_____% Notes: Original Plan: Approved Not Approved ❑ Date: D 2-6 1 . 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 Applica Revision 2: Date Sent to App • ant Okay to Issue Permit: Yes No ❑ Date Routed to Building: Page 2 of 2 FOR OFFICE USE ONLY — SITE ADDRESS: /3 V45 £ G J /�d7efii2.LS 2, This form is recognized by most building departments in the Tri -County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T I c n It I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: 2 9A DA1 E RECEIVED:: DEPT: BUILDING DIVISION ii 4 0 ' ' \ ( OCT 0 1 2012 FROM: J��/,12 G SS-e- I , co q A E COMPANY: /) y i ,VN CGt, I.-el cc�c- 7 liwm,i =`is'� 'ice .t . PHONE: '7d 3 -• 3E( (-- .Q 41S / By - RE: I -- 1 6 7 Sou 1-FU cticur d Pr, /t7sr a20 /..2 - eo .2as (Site A dress) (Permit Number) 1/14 I`e. $r cKcc. (Project name or subdivision name and 'lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: X Additional set(s) of plans. Revisions: Cross section(s) and details. ) Wall bracing and/or lateral analysis. _ Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: FOR OF USE ONLY Routed to Permit Technici Date: (b ' 12— Initials: Fees Due: ❑ Yes ©'No Fee Description: Amount Due: $ $ $ $ Special Instructions: Reprint Permit (per PE): ['Yes ❑ No - ❑ Done Applicant Notified: Date: Initials: I \Building\ Forms \TransmittalLetter- Revis!ons.doc 05/25/2012 RECEIVED AUG 282012 CITY OFTIGARD BUILDING DIVISION __ 18-1. 34a^ -_ - _ ._ ago d o . F, t 4 N 1� sHOp • •. loa \ Ss -o -4, Ai. Aral6, 1■■A \ 1 (., 1 trw, Z P 416. ■81,4 , LJ 4,----------- \, i 1 s7+uL.,. Q &SICCUGE 27 `Q -0 S 181:170& / S 46 6 L 1o14)424) -• 4:229 3/3A z " Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13465 SW HOWARD DR, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final 02/19/2013 00:00 MST2012-00225 PASS Recept missing and cover plate for stair recpt. Will check at final building. Pass with corrections Violation Summary: Inspector Contractor