Permit CITY OF TIGARD MECHANICAL PERMIT
1111.
COMMUNITY DEVELOPMENT Permit#: MST2013 00015
T f GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/28/2013
Parcel: 1 S136AA10000
Jurisdiction: Tigard
Site address: 10160 SW 70TH PL
Project: Ventura Estates,Lot 22 Subdivision: VENTURA ESTATES Lot: 22
Project Description: New SF. 8/21/2013: REPRINT permit to add(1)additional furnace and(1)gas piping for barbecue
Contractor: DANIEL MACNAUGHTON INC Owner: DANIEL MACNAUGHTON INC
3802 SW MARTINS LN 3802 SW MARTINS LN
PORTLAND, OR 97239 PORTLAND,OR 97239
PHONE: 503-318-3470 PHONE:
FAX: 503-477-4715
FEES
Specifics: Description Date Amount
Building Permit-New Construction 02/28/2013 $1,347.68
Type of Use: SF Plan Review 02/28/2013 $751.34
Class of Work: NEW Type of Const: VB 12%State Surcharge-Building 02/28/2013 $161.72
Occupancy Grp: R-3 Plan Review 02/28/2013 $124.65
Stories: 2 DC Provision Review,SF-Ping 02/28/2013 $67.00
DC Provision Review,SF-LRP 02/28/2013 $10.00
Info Process/Archiving-Lg$2.00(over 02/28/2013 $20.00
11x17)
Info Process/Archiving-Sm$0.50(up to 02/28/2013 $18.00
Fuel 11x17)
Fuel Types: Natural Gas Metro Const.Excise Tax-Residential 02/28/2013 $250.09
Gas Pressure: Use
Tig-Tual School CET-Residential 02/28/2013 $2,045.73
Park-SDC-SF Detached,Duplex 02/28/2013 $4,871.95
TDT-Trans Dev Tax-SF Detached 02/28/2013 $6,665.00
Erosion Control w/Permit-Ping 02/28/2013 $300.00
Permit Fee-Elect(per dwelling unit) 02/28/2013 $270.30
Limited Energy 02/28/2013 $75.00
12%State Surcharge-Electrical 02/28/2013 $41.44
Total $17,974.24
Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
2 Geo tech report required prior to
final inspection
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.gip Issued By: • / mittee Signature:
/4_ .4/
Call 503.639.4175 by 7:00 a.m.for the next available inspe ion 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.
yq CITY OF TIGARD MASTER PERMIT
ip
... .. - COMMUNITY DEVELOPMENT Permit #: MST2013 -00015 .
TIGARD, 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/28/2013
!
Parcel: 1 S136AA10000
Jurisdiction: Tigard
Site address: 10160 SW 70TH PL
Subdivision: VENTURA ESTATES Lot: 22
Project: Ventura Estates, Lot 22
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 777 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25.5 Bathrooms: 3 Second: 1066 sf Garage: 368 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 1843 sf Value: $208,404.88 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 4 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
• Drywell -Trench Drain: 0
Other Fixtures: 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 addl 500 sf: 3 201 -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 +ampNolt: 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 1843
Owner: Contractor:
DANIEL MACNAUGHTON INC DANIEL MACNAUGHTON INC Required Items and Reports (Conditions)
3802 SW MARTINS LN 3802 SW MARTINS LN 1 Ersn Cntrl 503 - 639 -4175 /
PORTLAND, OR 97239 PORTLAND, OR 97239 2 Geo tech report required prior f a 'Ivo/ /N Go
PHONE: PHONE: 503 - 318 -3470
FAX: 503 -477 -4715
Total Fees: $17,917.37
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 i ccordanceapproved 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: Orego la uires you to follow the rules adopted by the Oregon Utility Notification ter. Those rules are et forth in OAR
952 -0 -0010 through OAR 95 01 -0090. ay obtain a copy of the rules or direct questions to OUNC by calling 503 987 •r —800.3 '.2344.
Issu d By: Permittee Signature: _ . i
Call 503.639.4175 by 7:00 a.m. for the next available inspection da ,.
4 111
This permit card shall be kept In a conspicuous place on the job site until comple ion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit A licatioBECEI v D
g PP ED
Residential JAN 2 8 2013 FOR OFFICE USE ONLY
City of Tigard CITY OF TIGARD Date/B ( ' V ' Permit No.: el - )/
° 13125 SW Hall Blvd., Tigard, OR ; ING DIVISION P lan Revie IEr ryr�0 / 3—ere/
Phone: 503.718.2439 Fax: 503.5 .. DateB : A�J�, Other Permit / t
T I G A RD Inspection Line: 503.639.4175 Date Ready Juris: la See Page 2 for
Internet: www.tigard - or.gov Notified/Method: `
No� Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
XNew 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
K 1 - and 2- family dwelling ❑ Commercial /industrial Valuation -,r` `3 1
12 Accessory building 12 Multi-family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: Z
Job site address: /D? (' c psi&) 70- , 4 V - New dwelling area: 1 / $ if .5 square feet
City /State /ZIP: Ti Sa O CZ Garage /carport area: 34, g square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: 62,0 4uare feet (d(oG
Cross street/directions to job site: s(, -7,9+- 'e - st Deck area: square feet 7 `7 '
Other structure area: sZ% ( square feet 26 , `j
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: V 44 (A-K4 zla,`e9 I Lot no.: 22_ Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
l e_ � 5 < (' ` 1 ` � V Valuation: $
11 \ —,l '� 0. Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: V' J, Auk_ v, A (._,ZNL-) Type of construction:
Address: 3% L Std N t/lG 4 u5 , Occupancy groups:
City/State/ZIP: Po1,�F a t? ` 12 ��j 3 yy�� ( q Existing:
Phone: (603) 31 % ` 3'l 7a 50'
Fax: ) 1 477 1 471/ New:
Ct 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:
City/State /ZIP: Total fees due upon application:
Phone: ( ) Fax:: ( ) Amount received: -0 7519 '�
E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: SCUAA.C. 04 . Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
Permit Fee (includes plan review
City /State /ZIP: and administrative fees): $180.00
Phone: ( ) Fax:( ) o
State surcharge (12% of permit fee): $21.60
CCB lic.: 1 1 5z_ 00 Total fee due upon application: $2f "
Authorized signature: 96.4.L. p 2 Ths permit application expires if a permit is not obtait
644_41 — � O ��J within 180 days after it has been accepted as complete.
Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
g Re ceived *' / / L/
City of Tigard ( 1f Permit No.: �7
n 13125 SW Hall Blvd., Tigard,OR 9722 ^ ^t Plan Review
ligi
1l j t 2 8 2013 Plan Review
C 9„ _n „ _
Phone: 503.718.2439 Fax: 503.598. Other Permit No.: Oaf, p
Date/By:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: kris: See Page 2 for
Internet: www.tigard or.gov CITY OFTIGA Notified/Method: kris: ed/Method: Supplemental Information
TYPE OF ILDINU DIVISION FEE* SCHEDULE
R New construction ❑ 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
NI 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: f O // / 0 ih Catch basin or area drain 18.76
r ---- " � 7v v � Drywell, leach line, or trench drain 18.76
`J
City /State /ZIP: I 1 ei f -t 6 k 57 Z z3 Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I 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.: ) Page 2
Subdivision: vei -tv rot. �- �- 54-4,fe 5 Lot no.: ZL Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
I,, Clothes washer 25.02
p ew .w 61i, Qt l Y l Pakk l iy 4 me- Dishwasher 25.02
J / Drinking fountain 25.02
- Ejectors /sump 25.02
PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: D ( Mac $ ?Atoll Fixture /sewer cap 25.02
a I t°' ✓ Floor drain /floor sink/hub 25.02
Address: 380 Z 5QJ ma r'f (Ins LA.
n Garbage disposal 25.02
City /State /ZIP: Po r` � (dK 4 0 R q 7 2-35 Hose bib 25.02
Phone: (5'03) 3/8 3 tl / 7) Fax: (503) y77- /7/5 Ice maker 12.51
II APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Medical gas (value: $ ) Page 2
Business name: e 4 S C be) ue.-
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: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
CONTRACTOR 1 Water closet 25.02
!^ Water heater 37.52 -
Business name: Water piping/DW V 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: C are TOTAL PERMIT FEE r
\ / Date: C� This permit application expires if a permit is not obtained within 180 days
Print name:
< 1 E)`/1, �1t f G�/h.(QQ - La - 13 after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
I:\ Building \Permits\PLMU- PemtitApp.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 - 1" 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
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
Re inspection 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
Bath: Tub /Shower greater, except systems designed and stamped by licensed
- Jacuzzi/Whirlpool engineer.
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 Filer increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be aid before the
Water Extractor p
WaterCloset - Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I: \Building\Permits\PLMF- PermitApp.doc 08/04/2011 2
Feb 2713 04:28p white lightning 5037724008 p.1
Electrical Permit Application •roR orrncr.. -'1: F- -
City of Tigard Date/By: y PevricNo.: VP- 0965..
i 13I25 SW Hall Blvd., Timed OR 97223 Plan Review
II Phone: 503, 718.2439 Fax: 503.598.1960 Dav Other Permit:
t - t : `k J Inspection Line: 503.639.4175 Date Ready/By: lurb: See Page 2 for
Internet wwtv.tigtrd or.gov N�Led ethod: 1 ® Supphmeotnllisfermatia
o New construction 0 Addition /alteration/replacement Please disck all that apply (submit /sets of plans whims checked below
❑ Service or feeder 400 amps or mom CI Building over three stories.
❑ Demolition Q Other:
where the available fault cermet ❑ Matiaas and boatyards.
CAAEUVava v. :,v :.v..w•C:....N 4x-e,-M• 10/$00 mono et 1i0 vettcm ( Flomine h.'i4iinrs
less to ground, or exceeds 14,000 0 Commercial -use agricuttwa
0 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building amps for aft other installations. buildings-
0 Multi- fhmily ❑ Master builder ❑ Other: ❑ Fire pump ❑ ri anatioa of 79 KVA or
.
Jv � `..�..� ... ,,,,:••,.. ` .,. • ..+n ab ❑ Emergency system larger separately derived sr �• r • .....
• Grwtiiuwui ww,uuuxivaiiof
t.j' it', ti .i- 2"`, -3",
cob no.: Job site addfess: /0/ de ) w �Q , ronHP or mare. occupancy.
/ ! 0 Six or mare residential tails. ❑ Recreational vehicle parks.
City/State/ZIP: ❑ Healtb -care 6cilities. ❑ Supply voltage for mare ties
0 Hnrardous [ocatioay. 600 wJs nominal.
Suite/bldg./apt no.: Project same: ❑ Service orfeeder 600 amps or mare
Cross btu:et/dir�ections to job site: Deeetplioo SCHEDULE
1 44• I Yee. 1 Total
New residential single- or multi -fsmBy dwelling unit
l adudes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or Less 16854
Tax map/parcel no.: , tsdtl'I 500 sq. R or portion 33.92 i
Limited energy, residential 75.00
DESCRIPTION OF WORK : ,' (with above sq. R.)
• Limited energy, multi- family
residential (with above sq. ft.)
75.00
• Services or feeders ialtallation,aiteratton, and/or relocation
200 amps or less 100,70
• ❑ PROPERTY OWNER • ❑ TENANT 20I amps to 400 amps 133.56
Name: 401 amps to 600 amps 200
601 amps to 4000 an ! 301.04
Address: Over 1,000 amps or volts . 55226 I
CitylScateJZlp Temporary service: or feeders iastsllatioa, alteration, and/or
Phone: ( ) I Fax: ( ) 200 amps or less 59.36
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08
intended for sale, lease, rent, or exchange, according to ORS 447,449, 670, and 701. 401 turps to 599 amps 168.54
Brtmclt elmnits— new, alteration, or extension. per panel
Owner signature: Dates A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee. lint 56.18
Contact name: trench circuit
Each add'l branch circuit 7.42
Address: Miscellaneous *service or feeder _ notiadaded)
Ci 1State/21P: Each manufactured or modular 67.84
�' dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) °only • 67.84
E Pump or irrigation circle 67.84
•
CONTRACTOR Signor outline lighting 67.84
j Signal circuit(s) or (balked - energy
Business name: 1 r'r'� / /let ie ) Vy
ek 1c) Z ±Th, panel, attention or extension. Page
� � r _ — / • Each additional inspeetioa over allowable inn any of the above
Address: ) ( 1 t� SE { -. a A �/' . M. Additional inspection (l lu min) 66.25/ hr
City /State t'j4f ) r•,,. v • i e Z c , Investigation (1 hr min) 66.25/ hr
industrial plant (] hr min) 78.18/ hr
Phone: 1 VS '7 2.-3 at I Fax: c'a - T 1 'Z- 'S (� inspections for which no fee is 90.00/ hr
: r ✓ ? � + 7 r- 3240 1 , , , S T specifically listed ('/4 E CIRI
CCB L CAL PERMIT FEES
�'� ^+rit�l I.ie.: C,,.e S . Lie t•'l i�L� .
Suprv. Electrician signature, required: -� SQL:
..- `` It— L Plan review (25% of permit foe):
Print name: , ,-i• , Date: State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit applicator' expires if a pencil is not obtained within 18
days
Print name: Date: _ safter it has been accepted as comptr.
Number of inspections allowed per permit.
1: lTuiktaa %PnmitsIELC- PaaitApp.doc 07101110 440.46157(11105 1COMIVWES
Mechanical Permit Application RECEIVE FOR OFFICE USE ONLY
Received
City of Tigard Date/By: : Permit No.: ,.i �( �
IN
1 3125 SW Hall Blvd., Tigard, OR 97223 JAN 2 8 2013 y 5
Plan Review otpot
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: C. tt:�'U/
TI G A R D Inspection Line: 50 CITY OF TIGAR Date Ready/By: Inns: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISIO otifed/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
R New 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"
rg I- 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:
Air conditioning
Job site address: / 01 &0 S w 70"v five - (requires site plan showing placement) 46.75
n q� Furnace 100,000 BTU (ducts/vents) i 46.75
City/State /ZIP:
Ti 5 4r O I\ l 1 '2_ 2-3 Furnace 100,000+ BTU (ducts/vents) 54.91
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
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: ve 1,-C1 U rQ E � Lot no.: 2 Flue /vent for any of above 23.32
5 S Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater I 23.32
l Gas fireplace/insert I 33.39
New k S ill F4vvt 1 ty k A W1 e °, Flue vent for water heater or gas
J / fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
I81 PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
I '_ / Other: 23.32
Name: pG h 116 ( "Mar Ak L Q!` tv h (.1:-/Ac.) Environmental exhaust and ventilation:
��D a J Range hood/other kitchen
Address: O S w / r 'V tQ t,-1- t,-1- tidyls l'l equipment 1 p
33.39
City /State /ZIP: / I A - ) at- d OR Q 72-3 ? Clothes dryer exhaust 1 33.39
b3 2Q C 7 F ax: 2 / 77 _ 1/7 S- toilet compartments, (bathrooms, rooms) ) C
3 I °' 3 y 7 (J�Q / ) l [ toilet corn ments, utili rooms "✓ 23.32
of APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
h Other: 23.32
Business name: _54141 p 4 S Q h 0t/6 Fuel t io
P�P� g:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc. I
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater I
E -mail: Fireplace I
Range 1
CONTRACTOR n 1 Barbecue
Business name: q_ 0� 4-f AT n 9- A Cb1r4 l TDi31 t �p Clothes dryer (gas)
Othe
Address: /?43 /l L _ t � , MECHANICAL PERMIT FEES"
City /State /ZIP: of t ..I,J �1 C.�i , p 02 4f7r3 Subtotal
�j� ) ( ) Minimum permit fee ($90.00)
Phone: (
Ju$ /verb, � 6' 1 Fax: Plan review (25% of permit fee)
CCB lic.: 66 7a, ,�p `5lpr State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: J oh h Coq d 1 I Date: I - Z $3- 1 3 • Fee methodology set by Tri- County Building Industry Service Board
IABuilding\ Permits \MEC- PermitApp.doc 03/07 /12 440 -4617T (I1 /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
$107 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
$ 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
c $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.
1:\Building\Pennits MEC- PermitApp.doc 03/07/12 2
• . t
111 Building Division
Development Code Provision Review
!r i c A rz Residential Projects
Building Permit No.: 1 do 13 - Coo /
Site Address: /Q / Lo0 $‘4, 7p "' 40 t.
Project Name & Lot No.: @.A = ,: a ,
CWS Service Provider Letter
Required: Yes ❑ No
Received: Yes ❑ No F
Routed Plans:
Original Plan Submittal Date: . / /Aflb Cab
1st Revision Submittal Date: ❑ Site Plan Only
2 °d Revision Submittal Date: ❑ Site Plan Only
fr 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 (1) 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 ' -P VcV\i G at 503 -718 2 or arin r1/4s @tigard- or.gov)
Land Use Case No. SulT69B PDRE >b
Z oning • Q
Br/Setbacks:
ront "D Rear _ Side S Street Side � Garage "2
El/Maximum Building Height: �D Actual Building Height ' 4:")"
GVVisual Clearance
E Easements
Cr Sensitive Lands Type: N I
EKS,treet Trees
I -Protected Trees
Notes:
Original Plan: Approved - Not Approved ❑ Date: 0
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov)
e Actual Slope: " 5
Notes:
Original Plan: Approved O Not Approved ❑ Date: / 2 ` / 3
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 N
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes I No ❑
Date Routed to Building:
Page 2 of 2
1:
RED EPA
ED
,, JAN 28 20 13
CITYOFTI
BUIL DIVISIpN
,,> ® r _ N..0 ° 10 . 21" E
— — 89.76'
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P.U.E. ` 5'.' 1 9\ti 25.65•.
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r U �Ir rn I 1 MAI FLOOR
0 I I f EL.d -13.0'
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`5
O
A covtvta� : 1, < lc. 5F S.W. 70TH AVENUE
0 /0 o GOIMAa.y.: Za %
Iwo f. cuw- l 5
18 JAN 2013 MRR SCALE 1" = 2 0 ' - 0
ALAN N FOR THE DESIGN ASSOCIATES, IN IS NOT CIT • TIGARD Z 1136 B
LIABLE FOR THE ACCURACY OF THE TO
El IN IT IS THE SOLE flESPONSIBI OF THY E ° L OT RA TATES
...
BUILDER TO VERIFY ALL SITE CONDITIONS. M LOT 22
ANY F0.L PLACED ON THE SITE AND NOTIF T
OWNERS OF ANY POTENTIAL FIELD MODIFICAT . S.'
C O L L E C T I O N rASOOnn� no BY: DANIEL MACNAUGHTON, INC
Y , L305 NW IBM AVE. PORTLAND OP 07200 ° ( 5,584 SQ. FT.)
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
115 Electrical service
05/22/2013 00:00
MST2013-00015
CNCL
Already approved by Jeff Grove
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
615 Mechanical rough-in
05/22/2013 00:00
MST2013-00015
PART
Utility room fan box not attached to duct, Fan to exhaust to the out doors.
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
115 Electrical service
05/22/2013 00:00
MST2013-00015
CNCL
Already approved by Jeff Grove
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
320 Plumbing rough-in
05/22/2013 00:00
MST2013-00015
PASS
DWV tested
Note: call for shower pan inspection once ready
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
310 Crawl drain
05/31/2013 13:23
MST2013-00015
PASS
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
135 Low voltage
05/22/2013 00:00
MST2013-00015
PASS
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
235 Shear walls/anchors
04/29/2013
MST2013-00015
FAIL
Framing and shear walls not done as to approved plans. 24 on center framing needs to
be approved. R106.4 2011 ORSC
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
615 Mechanical rough-in
05/24/2013 00:00
MST2013-00015
PASS
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
135 Low voltage
05/22/2013 00:00
MST2013-00015
PASS
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
240 Exterior sheathing
05/03/2013 00:00
MST2013-00015
PASS
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
215 Footing drain
03/12/2013 00:00
MST2013-00015
PASS
NOTE footing drain runs along rear of bldg to left rear corner, where outside back water
valve is located
2nd back water valve is in crawl at front center
CRAWL DRAIN PASS
SANITARY SEWER. PASS
STORM SEWER PASS
RAIN DRAIN PASS
WATER SERVICE PART
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
215 Footing drain
03/12/2013 00:00
MST2013-00015
PASS
NOTE footing drain runs along rear of bldg to left rear corner, where outside back water
valve is located
2nd back water valve is in crawl at front center
CRAWL DRAIN PASS
SANITARY SEWER. PASS
STORM SEWER PASS
RAIN DRAIN PASS
WATER SERVICE PART
Violation Summary:
Inspector Contractor
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
10160 SW 70TH PL, TIGARD, OR, 97223
Residential - Master Permit
322 Shower pan
06/25/2013 00:00
MST2013-00015
PASS
Violation Summary:
Inspector Contractor
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, . l /4vtiLl y IL , am the general contractor or the owner-builder
at the following address:
Site Address: 014 D S t.d 7611-, a .e -f y � d(Z T.1 ZZ3
City:
� � J
Permit#:
DUST Wi 7) 000 Ic
Subdivision/Lot#: A-0 LG^Z V Lam& 3141
G I T '
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: / 4 Date: 1 t Z`(I i 3
eneral Contra•;.r Owner-Builder
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: AS(ZUl3 ^C .1!' Jurisdiction:
Site Address: 10(60 I, ail-e_ q21-3
Subdivision/Lot#: l Z z/ I LL' %
and/or U t ul
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)1
Signature: �' ] I ' Date: i/Z?ll3
er/General Co t tor/Authorized Agent
Print Name: 1,44;-e,1 (/it U l rGv-
ORSC Section N 1107.2.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
nermanently inctallerl liohtino fivtnrec are rmmnart nr linear fliinrecrent nr a minimum effiirary of 41) himenc net.
/t�ST 0.20/ -000 r
STREET TREE CERTIFICATION
, Owner/Agent for r� l�l.
(PLEASE P (PERMIT HOLDER)
Do hereby certify that the following location meets
City of Tigard and Washington County
land use and development standards for street tree installation.
ADDRESS: /O/&.(O S CO 7O ?4i/-e "V 6.0 ¶2 z
SUBDIVISION: (41,.fu. S [-es LOT: z Z
SIGNATURE: I _� DATE: /-2,--(//3
06 ER/AGENT)
RECEIVED BY: DATE: /a/7//.3
(CITY i TIGARD) -
I:\Building\Forms\StreetTreeCertificate 01/19/07
,000 t5
0451 A° 13
/5\ J INSl1L.A7'li)N
r " CnmSprnery d F•a me rn &al n
e%011
.5■11 r I9i9'
14255 S.W. Galbreath Dr.,Sherwood,OR
Phone(503)625-9700—Fax(503)625-9730
Certificate of Insulation
Contractor: DAN MAC
Job Name: VENTURA ESTATES LOT 22-E STAR Job Number: JB-29009
Customer ID: MAC102
Job Address: 10160 SW 70TH AVE Contractors Telephone: 503-318-3470
Proposal Number: BD-29009
City: TIGARD State: OR Permit Number:
Product Location
Blown-In Fiberglass • polar blanket 2x6 exterior walls 9'or less
R-38 high density unlaced belts at garage ceiling
R-21 unlaced high density batts at rim Joists WITH FS PAPER
R-38 unlaced batts at flat ceilings WITH R11 TO TOTAL R49
R-38 unlaced baits at overhangs-DONE
2°Rigid at headers
Foam No Expand Window&Door Polycel-PENETRATIONS ONLY
Baffles at save vents
THERMAL PLY 4X8 AT FIREPLACE-FINISH AT TOP
Blown-In Fiberglass R-49 In attic over living space
R-38 unlaced balls at joist after deck 16-19-24°
1E FOLLOWING PRODUCTS HAVE BEEN INSTALLED AS SPECIFIED ABOVE
ELLULOSE R-Value Thickness Bags Footage
NAUF JETSTREAM ATTIC OF HOUSE
•WENS-CORNING PINKPRO ATTIC OF GARAGE
ERTAINTEED INSULSAFE
ithorized Agent V ,_ , ■ Date: q I 1 K, 1
hw Mahar fhw R.VaI II 'ha nrAatAr thA tnelllafInn Pri •• I nnce fill Inca elatInne very In ther,nal nerfnrrnanre rhre to fortnre m.nh ea enInn