Permit CITY OF TIGARD MASTER PERMIT
•
COMMUNITY DEVELOPMENT Permit #: MST2012 -00261
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/13/2012
Parcel: 1 S 135CD00600
Jurisdiction: Tigard
Site address: 11435 SW GREENBURG RD
Subdivision: GREENBERG HEIGHTS Lot: 5
Project: Reed
Project Description: Installation of concrete slab and anchorage for above ground oil tank. Placement of concrete pad
must maintain 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: $800.00 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
• Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum > =100K: 0
ELECTRICAL •
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add! 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 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 8 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:
OTR SF VB R -3 0
Owner: Contractor:
REED. KATHLEEN M SOIL SOLUTIONS Required Items and Reports (Conditions)
11435 SW GREENBURG RD 3540 SE 28TH AVE
TIGARD, OR 97223 PORTLAND, OR 97202
PHONE: 503 -639 -3795 PHONE:, 503 - 234 -2118
FAX: 503- 331 -7133
Total Fees: $116.79
This pe I. - . - • ubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
b=
•one in accordance wi. 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
:ays. ATTENTION: Oregon I: , - -s 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 -1 s - -009r. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19r 1.800.332.2344.
Issued By: 1/ ' / /e...44441 / Permittee Signature: — -�
Call 503.639.4175 by 7:00 a.m. for the next available Inspection dal /
\ \\ This permit card shall be kept in a conspicuous place on the Job site until completion of the -act
Approved plans are required on the Job site at the time of each Inspection.
•
From:Soil Solutions 503 331 7133 10/11/2012 16:13 11332 P.001/001
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rmit APPlicRECEIVED -_4 o 'MCI'', I I.til::. bNE) •:.. :: . ; : ..r.:: .
. .. . , . :
' . . City of Tigard . Received
I . 13125 SW Hall Blvd., Tigard, OR 972 CT PennitN°':
1 1 2012 Dates : , irarriPM
N fris ie3/4./-11,:26
. • Phone: 503.7113.2439 Fax 503.598.1960 Z „mum Other Permit
Inspection Line: 503.639A175
CITY OF T /
Date Ready : y: brie: lif See Page 2 tor
Internet: www.tigard-orgov .
NolifiedfMethod: / / V f ... .1 . q..2 Supplemental Information
BUILDINGDIVISION '5/Ott- 1 " 4 - 2 -- - „-
gefallatanaVititgeAttgicTiNgmitliMNIMEAPiNg kri7x0 i ' ' . -11 T -E KS CIM P UL WASICCHECIalkigg
Mechanical .- •• fees* are based on the value of the work
0 New construction T.83 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: S $809.00
ENIEVINEMERWijainifircitr,,d147ffirenr-AFONSTESTRIESE ii r-)
e 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special beformation use checklist — C4
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
laNkl=itgra_Fiffirifin73:17INEOIFIAWORWILWCAWINtiar A li ea
Job site address: 11435 SW Greenburg Road ( - ices site plan skewing placement) 46.75
F -. ce 100,000 BTU (ducts/vents) 46.75
City/State/ZIP: Tigard, OR 97223
F • • . • 100,000+ BTU (ducts/vents) 54.94
Suite/bIdgJapt. no.: I Project name: Reed Heat • •••• •
(requires .• plan &mina placement) 61.4 •
Cross street/directions to job site:
Duct work 2
Hydronic ho water system 3.32
Residential ho !er (radiator or
hvdronic) 23.32
' Unit heaters (file , - • not electric),
in-wall, in-duct, . ...• • • - • etc. 46.75
tz.,
Subdivision: I Lot no.: Fluthent for any of . • • ve 23.32
Other: oil tank stand 23.32 23.32
Tax map/parcel no.:
Other Nei a . . . . eta:
irlf2 : cA T:;:l7iNifirepal Water heater Immunli 2332
Gas fireplace/insert
Installation of one 275 gallon above ground oil tank (and associated stand)
Flue vent tbr water heater or .2: r 3339
fireplace 23.32
Lo l Ii: ter 14.. A 23.32
Wood/pellet stove
1 33.39
Wood fireplace/insert 23.32
iigrird'elja'clag'2"1171WWOU7,1,EgilIZAWfaiii- Chian /liner/flue/vent k 2332
Other:
Name: Kathy Reed
Environmental exhaust an 01111411=
Address: 11435 SW Greenburg Road , Range hood/other kitchen
equipment
3
City/State/ZIP: Tigard, OR 97223
Clothes dryer exhaust
Single-duct exhaust • .•■ moms,
Phone: (503)639-3795 Fax: ( )
toilet corn • .• ..• ents ., ' rooms 1 23.32
ifhWAT:03 -_retarata WZREPIr..7 Attiricr ' ' '' ' ' ' PEI
in
Business name: Soil Solutions Other:
Fuel piping:
Contact name: Derek Salida A /4"6 %•1' I( Loppr .crk SA $14.15 , . r first four S4.03 for each ad • ...,
Address: 3540 SE 28 Avenue Furnace, etc.
Gas heat puns ,
City/State/ZIP: Portland OR 97202
Wall/. • edhmit heater
Phone: marzwznisr jj si I_ FOX: . (503) 331-7133 MAIO I=
E-mail: derekitsaffsatntionsenvironmentilree Firepl .
Ram
.,17.4*--MTSESPIIRMIL7.7:7cor#.707cffflitatiflatnISMINV E,
Business name: As above Cl • • es dryer (gas)
a .
Address:
City/State/ZIP: 4'-i-iVIRS.-ilgir..NICAL—..717...74—POliftrAttPZIWZdtgvri
Subtotal
Minimum permit fee ($90.00)
Phone: ( ) I Fax: ( )
Plan review (25% of permit fee)
CCB lie.: f 3 1-ief
State surcharge (12% of permit fee)
TOTAL PERMIT FEE I
Authorized signature: A,...
sip
foil& This permit application expires if a permit ls not obtained within ISO
days after it has been accepted as complete. .
i
Print name: Derek oz I Date: 0/1 /2012 I ' Fee methodology set by Tri-County Building Industry Service Board
1:ailldIng \PermitAMEC-PermitApp dm 03/07/12 440-4617T (11/02/COMMEB)
1
-
From :Soil Solutions , 503 331 7133 10/11/2012 15 :30 #329 P.001/012
I
•
SOILSOUTIONS
EgV,IRONMENTLAI SERVICES
ni 3540 SE 28th Avenue. Portland, Oregon 97202
0 Office 503.234.2118
OCT 11 20/2 Fax Free 503.331.7133
fir,. ,.
'' " I •,,I www .sollsolutiansenvironmental.co
1icuni1e ti; 1fi. CAI
To: C ; 1,3 o f i 4 to rd From: Derek Sandoz / Soil Solutions
attn: Co ker
Fax: (503) 5q $ -- %9 C O: Pages: 12_ including cover sheet
Phone: (503) Date: , October 11, 2012, '
Re: above ground heating oil tank 54'o v (cc •
installation w PAYMENT Fax:
0 Urgent ❑ For Review 0 Please Comment 0 Please Reply CI Please Recycle
• Comments r1 1. i %%4 35 5 >, G c eR-K b...r C
' Please find our mechanical permit application with credit card authorization form and plans
attached. Please fax or email our permit back ASAP. Please call me if there are any
questions (503) 234 = 2118 — Derek Sandoz.
Please contact us if we can be of further assistance.
Sincerely,
• erek Sandoz
Tank Division
Soil Solutions Environmental Services Inc. Soil Testing & Decommissioning
erek �' �, k Soil &Groundwater Cleanup
50I ) e v; r 0'i+*Aeh -.t • Cb
Sewer Division •
Scopes & Inspections
line Repair & Replacement •
Stormwater Division
Dry Well Reg6tration
Radon Division
Measurement & Mitigation
•1
CC00138344 /WAOSOILS,••995NM
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9200 SW EDGEWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
06/20/2013 00:00
MST2012-00260
PASS
Violation Summary:
Inspector Contractor