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Permit y y CITY OF TIGARD MASTER PERMIT ' g - COMMUNITY DEVELOPMENT Permit #: MST2013 -00069 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/02/2013 Parcel: 2S102DC06600 Jurisdiction: TIGARD Site address: 13838 SW 90TH AVE Subdivision: GERTZ HOMES AT EDGEWOOD NO.2 Lot: 15 Project: Edgewood 2, Lot 15 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 1437 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 25 Bathrooms: 3 Second: 1650 sf Garage: 510 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3087 sf Value: $341,704.24 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 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: 0 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 add'I 500 sf: 6 201 -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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 3087 Owner: Contractor: GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions) 19200 SW 46TH AVE 19200 SW 46TH AVE 1 Ersn Cntrl 503 - 639 - 4175 TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: PHONE: 503- 692 -3390 FAX: 503 - 692 -5433 Total Fees: $20,502.42 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 acc. • _nce 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. • NTION: Or-!on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 -0010 t rough OAR •5 X01 -* • • 4. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 87 or 1.800.332.2344. / ,p Issued = : /�j X .41 Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available Inspection te. 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 - - • - - - Residential ��I �� FOR OFFICE USE O`LV - - II City of Tigard MAR 2 0 2013 Received -_ z c Date/By: ( Permit No.: S r -ODO�O p • 13125 SW Hall Blvd., Tigard, OR 9723 C TIGARD Plan Review � � ^!- Phone: 503.718.2439 Fax: 503.598.19 ®I� O 1 IG�lf 1�J Date/By: F � '1 _ O Permit: Q w/ o o S Inspection Line: 503.639.4175 Date Read B _ 2 Jur;s: TIGARD BUILDI DIVISION y y' t 5 S See Page 2 for Internet: www.tigard- or.gov Notified/Me > , Supplemental Information spy- _ -- i REQUIRED 1 AND° 2= FAMIL' 1}WJLLINe:: 1; . t 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 fop the ' - }' ;-s ,r + :: 4 " : work indicated on this a ,vim `j?: ; r:..:iti - e;,, f -.!. -.L`U " N ;:':, - . application., 151; �'� l, - ? " : � +r ='Y :'r �'z� ��` ., " r�11,]�F _ ,.. -� � IN : •,7 "" . „ ,. � X1- and 2- family dwelling ❑ Commercial /industrial = Valuation: ( ) (— ❑ Accessory building ❑ Multi - family Numb o f bedrooms: 3 - P ❑ Master builder ❑ Other: - . .. Number of bathrooms: -_ z - 2 – ."" - : +i' • fi�rr;; = Tip1i ;'I;d.6AT1i:fw'' t., Total number of floors Z Job site address: .. 5•g 5 w ?Q - New dwelling area: 3a g. 7 square feet City/State/ZIP: Tigard OR 97224 Garage/carport area: 43' i O square f e e t - Suite/bldg. /apt. no.: Project name: _, . -. Covered.porch area: .4C _ square fe. I Cross street/directions to job site: ‘d , G} '-' Deck area: - square-feet (�� 'J - Other structure area: 35417 square feet '2.."" ' REQURIEDRATAi:ciE=2:11SigdYtiEMISVi Subdivision: 6 r7 C -� z Lot no.: - - Permit fees* are based on the value of the work performed. Tax no.: ,� s Z DC, – O ( � - .., equipment, materials, - -- indicate the value (rounded to the nearest dollar).of all _- Tax ma/ ;x �._, p • r map/parcel n . , , ; . equ ipm , ma als, labor, overhead,,and.the profit for the , Z t4,7 .. '' i i_ of °H K � OF <,; ,,, work indicated on this a Al-C. lication. -- - e-C_) f7 ... r i. . hill a _ . Valuation:_: $ _ - _ .- - _ Existing.building area: _ _ square feet — ` New building area:: _ _ square feet _. 7:.R, 's k ?',r' , 5},,t.::•,;;.- .• "' Number of stories Name: lam" efi • N�7- - 4"",. . J - . - -_ -- - , • i. . _.Type of construction: • Address: l 1ze'D <' �(;,_ Occupancy groups: - ; City/State/ZIP: `` t„• �� L�/ Q/( ` 06 z-., ? _- _- .. Existing: - - _ _ / 2 - j Fax: (a 3) 6 y Z- ,5' 3 3 ,; "n, ya• q ., r; , New: - - - ; s ", ' ;x'- ,•.t CO1VS' F..BHRSO - tit:. s;!'? :.,.:.. >' ;t; Business name: ' - „ _ .. _ ra*Iee'sdldttiatek :.: , U 0/..."(2.- �r 0C ' " 7 "Y Structural plan review fee-(o r.deposit): Contact name: .4..., G.ei( - - - — — - L - -- FLS.plan review fee (if applicable): Address: J/e 7_41Z) - 1"G4..) g a le. - : " -77,..( City/State/ZIP: t, N , 62 9204 2— Total fees due upon application: • — 4 ) Z Amount received: Phone: ( 5 � G4 - 3,�.ga. Fax:: (,Saj)t:g -g S - - - E - mail: /C-coo C ark 0 iCG•�i► . _ . .. �, 4` : , ` ti ' r:x e ; _ r` ,� n:;:4.::; Commercial and residential prescriptive installation of q i '. +( - .+ C`x: I U a ry ! 1 . ; : ,. ,, , r+-; y . +.� .?`. a u. , �, , : � . �, i ; .::14 , „E: =, ' roof -top mounted Photovoltaic Solar Panel System. Business name: G urZ c i J��O y — - "Submit-two- (2) sets_ofroofplan with.connection details_ / y z6i� l- and fire department access, along with the 2010 Oregon Address: 6 ) �C Solar Specialty Code checklist. ' City/State/ZIP: pC J ty � /N � 2 �� Permit Fee (includes plan review $180:00 and administrative fees): Phone: (t3) ( j, 3,t, Fax: ( ))3 ) ( ? 2 – j c• 3 j State surcharge (I 2% of permit fee): $21.60 CCB lie.: 3 i 3 , 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: ' Date: - Zd – * .Fee methodology set Tri- County Building Industry �i�So ""' �- Service Board. I: 1BuildingTerrnits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(I I /02/COM/WEB) • Electrical Permit Application RECEIVE I FOR OFFICE USE ONLY City of Tigard Received Pe No.: • 13125 SW Hall Blvd., Tigard Date/B : , OR 97223 MAR 2 0 2013 3 N Sr Sri/ 3 4900 ■ Plan Review : Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit �i ig.„91)/ J 2 --00-06 1" I G A R Inspection Line: 503.639.4175 CITY OF TIG .. Date Ready /By: Pi See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISI I ►''otified/Method: Supplemental Information 64 New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Other: Nei : where the available fault current ❑ Marinas and boa .GATE . ,, . boatyards. > > +` , ' i:' - -', , ��' �� F _ . exceeds 1 0,000 amps 150 volts or ❑ Floating building �,.: �.,' ;S•',' - °r -,,' � �R . -�� ... �. �N,- �:.�:�':,��:��,: ;::��; �� ^� �P Floa s. 1711- and 2-family dwellin less to ground, or exceeds 14,000 ❑ Commercial -use agricultural Y g ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA or i ❑ Emer enc s stem. • ' JOB 81 :.1LFOOMAq'1QN . ;1 'OCA.I71ONk',. . ' anger separate) derived system. • Y Y ❑ Addition of new motor load of ❑ "A" '•E•• '•1_2••• ••I -3" Job no.: Job site address: / 3 g 3 8 $ j O - 4 100HP or more. occupancy. '7;t7 L ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: , off, ? 7 2 2 it ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. Cross street/directions to job site: 6 `1?EE= SCHED1314E ,`,' A ?-, ";:; -• < z. ^:;; - Description I Qty. I Fee. I Total I • • . New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: r_ w '1 Z Lot no.: / S 1,000 sq. ft. or less _ I I 168.54 14 fax map /parcel no.: 2 .57 Z Pe - D6, C �t Ea. add') 500 sq. ft. or portion ( 33.92 1 > 1 r� k ^;;,: �':_" t �,a r,,.`y. • • Limited energy, residential ;4 `.d'.i;f;' ;''fir, :ka, ;. f i:; -,` OP l: . ...''. `, i ,o (with above q. L 75.00 2 ter-- I " r "' s ft. ) ,f -e / Limited energy, multi - family �`'L ` residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation c` *' , 200 amps or less 100.70 2 ;� i='S k�PRQ1►1$RrL .: :ORDi r c :, ' ` . [ 1hTF, AN:p. _ 201 amps to 400 a ' r i': stops 133.56 2 \lame: G v2�Z �Nt t---- �6- / 401 amps to 600 amps 200.34 2 c_.� ( 601 amps to 1,000 amps 301.04 2 kddress: /el Z.erb S L4.S / 4 C ` b Over 1,000 amps or volts 552.26 2 :Ay /State /ZIP: / , ,`[,� f� O e q ,Q 6 Z Temporary services or feeders installation, alteration, and/or / ' ` relocation 'hone: (5) 7 ...3'3 el Fax: (543.) 6 v.. ,_ 5l3J 200 amps or less 59.36 1 )wner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 ntended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 )wner signature: Branch circuits - new, alteration, or extension, per panel t Date: A. Fee for branch circuits with �. � _ ;':< _ki» . ' ,. '' % i° I ` [,E015T 11Ey�1'i ;bt$f71�: above service or feeder fee, a ` �. L ' ' 1 :z Rl each branch circuit 7.42 2 lusiness name: G eo z` — Ca-4, A /_ B. Fee for branch circuits without service or feeder fee. first ;ontact name: Kt.A.1 t! G p L branch circuit 56.18 2 > ddress: if Lv a L,` -‘c Miscellaneous add') branch circuit 7.42 2 , !� Miscellaneous (service or feeder not included) - ity /State/ZIP: ie C.,. Z L- A o �f Q 7 0G Z Each manufactured or modular ' ` ( dwelling, service and/or feeder 67.84 2 'hone: (5 ) 4/2_3 era Fax: : (5d3) C./ Z, 3—t/ Reconnect only 67.84 2 mail: �A/-�� • 4.47 Pump or irrigation circle 67.84 2 i7p1 .C� Eta 4,�l�.�t ti p.,, yy I Sign l circuit(s) lighting 67.84 2 1 / - ^ It, Efd €� tit +e `til: to `1 �. >: ?: .... a.a ..r , �f' gnat t(s) or limited- energy ;usiness name: A a I_ 1 _ �(Q�r y el, alteration, or extension. Page 2 2 " " t L ( - , . . ach additional inspection over allowable in any of the abov .ddress: po 0 x 22- ity/State/ZIP: �j Investigation t 5^�P r'S D 2 q —7 MAY 6 2 Additional inspection (I hr min) 66.25/ hr 3 ation 1 hr min ) 66.25/ hr B ( IGA ©® Industrial plant (I hr min) 78.18/ hr hone: (6 Sffet_77 D Fax: (S ) 9/480E1 t o rt In s e' In spections for which no fee is CB LiC.. f ?j2 ZZZ- Electrical LiC. ®t t l IOK s. 'Beall listed %, hr min 90.00/ hr 1 3y_ y83 G S uprv. Lic.. y't7 31 ;,,• ;;;;''tr_. a az ' : uprv. Electrician signature, required: Subtotal: Plan review (25% of permit fee): rint name: � yo Date: 5 / 4 /!y State surcharge.(12% of permit fee): uthorized signature: / TOTAL PERMIT FEE: This permit application expires if a permit is not obtained wf int name: days after it his been accepted as complete. eit Date • Number of inspections allowed per permit. / ilding\PanrusApp� .doc /01 /t0 440- 4615T(11 /OS /COM/WEB rdectrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 • Check Type of Work Involved: Audio and Stereo Systems* Burglar Alarm • at Door Opener* ET Ventilation and Air Conditioning System* [Vacuum Systems* ❑ Other: 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 I:\ Building \Permita\ELC- PermitApp.doe 07/01/10 Plumbing Permit Application Building Fixtures RECEIVED IOIZ OFFICE USE ONLY CI of Tigard Received • 131 SW SW Hall Blvd., Tigard, OR 97223 MAR 2 0 2013 Date/By: Vce /3 g-r" Permit NO 1451- o?p/ 3_600‘9 314 Plan Review I �;,,'` / Phone: 503.718.2439 Fax: 503.598•fy Date/By: Other Permit N st (/2�/ 3° � Inspection Line: 503.639.4175 "� a ' OF �G�D Date Read B ethod: kris ®See Page 2 for ^ � "r I G n RD Internet: www.tigard or.gov BUILDING DIVISION Notifie �� Supplemental Information '/+ ;'1.mot" +` ��t.p v1, auy,` _ u� � _�, *.;• __ . i c "'�: rc:Nr ' t 4. ; .. ,�.. '�Pr ����.��)(Z'T{`: ' � .il - . - .. _ : lei' � ' S ' �ik}r: ;� : ' °t:. 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) " , ^;r LIC`L?r0 ; < .A ii ' ,. SFR (I) bath 312.70 ! :' : i i ... *t; . :01•gq- tr;,�?a*Is, SFR (2) bath 437.78 , I- and 2- family dwelling ❑ Commercial/industrial Y - SFR (3) bath ( 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft) Page 2 '� , . r - ".c- JOB ''SFik. NUO `LONi A AND I OCA iON - Site utilities: Job site addre a SC l � ' � Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City/State /ZIP: 7,11..,•P CD/C._ 9 72- 2 r F ooting drain (no. linear ft.: Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Ccd Manholes 18.76 d 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: S e u j' -� Z I Lot no.: /3 Fixture or item: Tax map /parcel no.: r / 5/ Z pc- O c Backflow preventer 31.27 y /� WORK/ Backwater valve 12.51 '''''' '' i'''" _ . ! "'.:DEJC1r[]Fi:1ION': Vp `FORK/ ± , , :'. ' ., , , . : \ /4e4,1 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 le +3f r,. i , � -; , �. :yK, r0, .;;a i .. _.... �, ,, " , Expansion tank 12.51 rt ` r�prVp�ia�.►. �}J' ytC h 1 !1 ..� '' '' .�ti� ... Is .: %1�. /..� �. ^. :.IqR •, C1.�' • . . • �`:isk..T. n iPr'''• . n.,. Name: • G t�f�- a „,f- G / Fixture/sewer cap 2 5.02 Address: / / z O b iw !r`6 '� 1 Floor draiNfloorsink /hub 25.02 Garbage disposal 25.02 City/State/ZIP: 4142(4:2 a2 .72a 4 Z Hose bib 25.02 Phone: (Si 3 )69 2- 339a Fax: (50,')6 ?2 - 5 4 (33 Ice maker j 12.51 xg n,. f7 1 i r •; ' #r.:' ?: t 41.e. 3, J.;.1,,,, v, ! Ir .. , . .f ..i. Interceptor/grease 25.02 d. P r , r N I .i ' : ; to i lia : $ , trap �a 4t „m iius.waTam. 4 ri It. j '3 ; e`. "- ' -�-- h J ,. � i . , ,. Business name: e4'tZ C f - t 6.-c._ Medical gas (value: $ ) Page 2 Primer 12.51 , Contact name: /4 Gvt _ Roof drain (commercial) 12.51 Address: // Lc- a 5 co xj` 4- 5 Sink/basin/lavatory 1 25.02 City /State/ZIP: / "" 4 ( 4,-6 43 o iZ g ? GG L Solar units (potable water) 62.54 Phone: (s 3) 4 .72 3 3 gQ Fax: : (5O3) ( ?,Z- ,51 3 Tub /shower /shower pan 12.51 E -mail: / < eGe ri i&G Q Ca Urinal 25.02 :r. 4 1. ,,,,:: 1'•.- t�... ,_ Water closet j 25.02 �0 .3 " �i � . . ' ; r �p� 'r. . { ry.;i:.�: �� ` . ; ., I j . i , F `; u'= ; H i;i ° ! ` ;,.5 "i �. ' � : . ! a ,1%;,i; 1 i,=i. 2lva i1 1 w r.wpa -: , , gk; i .' .. �'.. . , • ' ' - ��� ""� '�� , Water heater 37.52 Business name: --- g".w 66 d o` y ,p, ,(j, Is Water P•tP in � DWV 56.29 V Address: Ps. O /3 C K Z 7 Other. 25.02 City/State/ZIP: (,J e s f C ;NA, B,( 17 068 Subtotal Phone: (563 )3-5'7_ 7 r g S Fax: ($3)4/ Z Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lic.: it b 3 212._ Plumbing Lic. no.: 3.2s1 /off State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE Printname: A g Date: 5 7? 6 f r Thy applicadon expires if s permit is not obtained within 180 days after it has been accepted as complete. *Fee-methodology set by Tri- Comity Building Industry Service Board. I: 11uildingWermiu \PLMU- PermeApp.doe 10/01/09 440.4616T(10/07/COM/WEB) riumuing rermit Application - City of Tigard • Page 2 - Supplemental Information Fee Schedule• Residential Fire Suppression Systems: Schedule: ,� L Vfa�!:' �f ., - : ,� - f: ", v' ;u ' - it _ tY ". ^ 7 + fi 7 �;,rirc._ 3 „z i Slue .Ut111tles Qty (. ) S uaTe;T 0 $a. a , r . .^ `s 4 s .r" : ", . �i�!t''.D�"?I!�!t.,.:,,,; ,:_ �i�:... . rd's ?� �'", Footing drain - l 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' 37.52 114 = .:,.; . +:•s . : • :t1 <'.�T 4'�' "�� �x4:"= < F= ... {' .� Storm &Rain Drain - 1st 100' 62.54 itlfl - r "'�' �I ''� Ta F ' $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 <. F ee'. ea _' Phta each additional $100.00 or fraction thereof, to r Qthe> ''I?pSpel bons: or`l eew ; 'Q�` . (. ). 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 *. Quantity by: FixtureType . Fixture' Iy!pe for Replace/ ' €orthi � air - Work Performed: Capped: ;. Added: Relocate: Plan review is required for any of the following. Baptistry/Font Please check all that apply. . Bath Tub /Shower ❑ Any new commercial building with water service 2" and - Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash - Each Stall engineer. - Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in 0AR918- 780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. - 3 „ Car Wash Drain .... !ligP M } fi° 2:!i+ .:: "..; V ._ ,1,7. h ❑ I Garbage - Domestic-non -food Isometric or riser diagram is required for new building • Disposal - Domestic-food related that meet the qualifications above. - Commercial -food related - Industrial -food related Ice MachiRefrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lav - Non -food related - Bradley - Commercial -food related - Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer - Clothes increase of sewer EDUs, a sewer permit will be issued and Water Extractor p Water Closet - Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: ' http: / /www.tigard- or.gov/ city_ halUdepartments /cd/docs/PLMF- PermitApl doc vlechan,ical Permit Applicati ECEIVED rolz or• clef: IISE ON1,1 City of.Tigard - _ - - • : • Received - _ - Permit No.: S 3- - — -- - 013 — ' = u aoio �-v� . • 13 125 SW Hall Blvd., Tigard; O 97 2 2 3 - l� v i+ �' Plan Review - �/ I NI Phone: 503.718.2439 Fax: 503.598.1960 D a t e / B y , : O t h e r P ermi Q 0 1 9 1 3 ?, - ODU(Q� I' I G A It D Inspection Line: 503.639.41 75 CITY OF TIG�IIZD Daze Ready/By: __ — - Iath: " la See Page 2 for Internet: www.tigard or.gov BUILDING DIVISION Notified/Method: _ - - Supplemental Inform ation 1 , ..... „ .::.:• -:,._•,:.:.i� _:. - _ .. ,.::;�. ;,,.- - - _ - - - - - CUNISPIERCIAL F'EL*"b - - Ar • - Mechanical permit fees' are based on the value of the work New construction ❑ Addition /alteration/replacernent - 'performed. Indicate the value (rounded to the nearest'dollar) of_all_ _ -. _ __ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, Fin rofit. - -' - - - _-=._' - _l . . -- Valur$ ,b . .....:.: - !, . '��', - . - , ..,... a ; e' t ic• tai, _ � r X 1- and 2- family dwelling in Commercial/industrial ❑ Accessory building ; For spedd informwfon use checklist - . - -- ' -- D Multi- family ❑ Master builder ❑ Other: - � Description... - _...:.,, Qty. I Ea Total. j _._ i.' , �r, :Yr.. r. �� . • Heatin . t k, '�„,�,:r:,, �,: ,..:.�, .. ..,. ' - 1 � . , ,.. � "� .A on ir conditioning ... .: •: _,.- .._ --- -- - _- -_- - fob site addres0 ` e� Coo 9( ..f--41 I (inquires site plan showing placement) 46 „75 - -7.------ , - } Furnace 100,000 BTU (ducts/vmts1 I - 46 :75 - 2ity/State/ZIP: -77 : .. 40/C 40/C G p 2 � Y L Furnace 1.00,000* BTU(ducts/ rs)- - 54.91 -- - - 3 uite/bldgJapt. no.: Project name:- 1 Heat. pump <-:.-r - (requires site plan showing placement) - - 61 - .06 - — _ — --- — Cross street/directions to job site: L'CCC • dy f/ . .' Duct work _ 23.32 _ _ _ . ,r// 1 Hydronic -v hot-water system r '-''• 3.32 • - Residential boiler (radiator or ' - - _. _ - . .. _ .., ._ .,. . .. -' j hydronic) -- . .- 23.32 _ _ - -' Unit heaters (fuel -type, not electric), . - -in -wall, in -duct, suspended, etc: • - - 46 :75- - - -- - Subdivision: I Z - 7 - Lot no.: Flue/vent for any of above 23.32 _ - ,[F -�,. Other: • 23.32 - - - Tax map /parcel no.: / /3_ C - - G C 6.C6 - - Other fu - el appliances: — - fj;1 � , : , r ,: ;;. W e ,;� ..,�, ;:; - - - stet • h aer t 1 '.mf1J .. � /r � "��, �� -• i �l•� ry: ' . �` • Gas frepl'ace/insert - -33.39 - . Al - e . 4 1.7 / - - - Flue vent for water heater or gas,..:-: : . _ -. , - . -- - fireplace -- - L. - - -- - • - 23:32 --..- - ... - -' • Log lighter (gas) 23.32 .- . - _ -- - . Wood/pellet stove 33.39 - _ Wood fireplace/insert -- ' - _ - - `;,,, • Chimney /liner /fludvent -- 23 • - -, .. J t ., r•-:;o, : iK �� ' (;yj�ntyry � ll a2„ s: h7'. — - - i . i � ni l , i a . s r - '''''' ,. : a te( - -. tit: r. : nh ,�;,.. nwm3l a Other. 2332 -- Name: (, ,fyCa M S -r- -de (4"L. Environmental exhaust and ventilation: F( Range hood/otherkitchen L -` - Address: f �� V,4.-T- YG equipment - -�� 33 :39 __ • - City/State/ZIP: !µ.6..f . O/` q ,c4 L - Clothes drye•exhaust 1 33.39 . l ` - - Single—duct—exhaust—(bathrooms Phone: (leg ) ( - 3 3 - 6 Fax: (S o3 )GQ 2.- rY . 3 toilet compartments, utility rooms) 5 23.32 - - . -- _ - - T d•.;:..'' .rawls ace fens - 23.32' � • AtticicOther.- - 23.32 Business name: / ti► �L .�. s d e!� ' ' Eitel_dipingf ::: ._ _ - _ = Contact name: A45.0S ac r"{•z_ • • • • • 514.15 for first tour,, S4:03 :tor each. additional Address: el , 2..( 7 0 S •J Y G Fumace „etc. Er • - - -- - _. Gas pump - City/State/ZIP: - 0 4 . . . T 7eC Z Wall /suspended/unitheater_ _-_- - _- _ - .- - - - F a x : 4,, 2:- g 0 wear heater . I Fireplace E -mail: / 4 , C N (i ‘,” fLC o , mi• Range - - I - - - -- - -- .�y�p i Y4 ' : r 9 • •+i” Barbecue' Business name. G 01c( ��o+-{ �,. Clnthes_aryer (gag) • t ' other: _ Address: — ,3, ,.„V::...v. ti. • a.. City/StatrJZIP: V 4 ie e v w i t w . 4.14 - z - - 'z- - -- - - - - - - . __Subtotal.__ _- -- - -• - Minimum permit fee ($90.00) I Phone: (SO3.) G SS . e zzr Fax: ( ) - 4: Sa -- 29f3 Plan review (2596 of pemrit fee) .. .. . CCB lie.: (/Z, 57 ! - - State-sur r(I2%ofpemitt - - - - -' - • TOTAL PERMIT FEE This permit application- a:pineda.parmit• s not obtained within 180 Authorized signature: /4...,..../et . - days after it has beim-mieephd-u eomplate. Print name: Date:. % • Fee methodology set by Tri- County Building Industry Service Board i• m.auin.tr+a,nestMEC- PumsAno.dco 07/07/12 440- 4617T(I1 /07/COMMWEB) zmpiniuduVu - of 1 igard Page 2 - Supplemental Information • Commercial & Multi- Family Fee Schedule: :. $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. I: \ BuildingTermits1MEC- PermitApp.doc 03/07/12 2 71 : Building Division Development Code Provision Review T I G AR D Residential Projects Building Permit No.: /4's - ( ,20;13-000i Site Address: 1 33 8' ad 90-4-4'' o Project Name & Lot No.: Eb ceuVIL D o ?. 1 L.e►T /.5 CWS Service Provider Letter Required: Yes ❑ No� Received: Yes ❑ No O" Routed Plans: Original Plan Submittal Date: � 3v// 3 Sr " 3 1st Revision Submittal Date: it/3// 3 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 only if approved. Planning Review (contact ' / tt° • GL ( at 503 - 7182'1 2-1 or _ ' 1 @tigard- or.gov) Land Use Case No. 5 kP,7_0D — I' 000I3 Zoning O-S I Setbacks: 1 1 Front 2D Rear I S -Side S Street Side I`- Or Garage OW Building Height: 2,d Actual Building Height 2S' I7rVisual Clearance N I N" D 'Easements C"Sensitive Lands Type: IQtIer \J vei ht10I tU'k o Street Trees M P rotected Trees , - ("Ll Notes: �l l �n I , . ar GorT1s�► 't0 D1 PpYG & P (rit rig. ctA. „ ' �Q b _„,;(0„,--, r l ..- 1.-. 0 . Ai L-4 • . i it J .. L 1 -.1'4! i A v • Original Plan: Approved — Not Approved i Date: a 2-s 13 Revision 1: Approved Not Approved ❑ Date: 9 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) Actual Slope: S Notes: Original Plan: Approved ,Er Not Approved ❑ Date: 3 S 1 3 Revision 1: Approved .& Not Approved ❑ Date: 4. /4- 13 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 Applican Revision 2: Date Sent to App • • . nt Okay to Issue Permit: Ye 2 o 2 --4//-yp i7 4/ Date Routed to Building: lAVALTIM Page 2 of 2 1 Elev. 200 Elev. 200 — 53. 7 4' ° - -- 60.00' -- 50.13 - n �� Siltfence Siltfe a _ u. P" 0 3 2013 I I PATIO 4 'I; . CITY OF TIGARD 1 I a o BUILDING DIVISION 1d d i NOOK Elev. I + ++� +0 2 04.5 � ' GREAT RM. 1.._ IMMIIII I f MARTIN y LOT 16 W '► 0 � ►-�-m LOT 1 4 il S QFT 1 1 S 15-3---G RAGE 8 SQFT 7 ,146 IiI 6 ,13 E 204 • d v r r r CO FOYER a ' PRIVATE +°°E,. o 5.00' bo � 1 _A_ STORM SEWER v) 0v T .ti i :• co), o G •` C � i EASEMENT FOR TH t�ao� ,, FIT OF LOT 1 � , `\ ' -I 0 \ -1°— — t j 5.91 ' --' --. __ --- __. , , -- i ° Z26 )--\ 0 _.------"------ 60.00 k ev. 20 50 rn lev. 2 5 =39. -1 ' , Ilk- .. 16.00' ' • N �•I �I G E R T Z CONSTRUC COMPAONSTNY IN C. HOME SQUARE FOOTAGE BUILDING MAIN FLOOR = 1437 SQ.FT. CUSTOM HOMES SINCE 1977 0 Street trees Tilia UPPER FLOOR =1650 SQ. FT. (503) 692 -3390 Ameranana 2" TOTAL = 3087 SQ. FT. 13838 SW 90th GARAGE = 421 SQ.F . Lot 15 EDGEWOOD EAST SCALE 1" = 20' GERTZ CONSTRUCTION COMPANY 2 INC. i PLOT PLAN 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 505 Sanitary sewer 05/20/2013 00:00 MST2013-00069 PASS 4" tested 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 205 Footing 05/10/2013 12:00 MST2013-00069 FAIL Need erosion approval 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 605 Post/beam mechanical 05/23/2013 00:00 MST2013-00069 PASS Note provide underfloor duct air leakage test at final 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 340 Storm drain 05/17/2013 00:00 MST2013-00069 FAIL Not Ready for Inspection OSSC 110.5 and ORSC R109.3 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 340 Storm drain 05/20/2013 00:00 MST2013-00069 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 330 Water service 05/17/2013 11:29 MST2013-00069 FAIL Not Ready for Inspection OSSC 110.5 and ORSC R109.3 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 330 Water service 05/17/2013 11:29 MST2013-00069 FAIL Not Ready for Inspection OSSC 110.5 and ORSC R109.3 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 315 Post/beam plumbing 05/28/2013 00:00 MST2013-00069 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 335 Rain drain 05/17/2013 11:29 MST2013-00069 Scheduled Not Ready for Inspection OSSC 110.5 and ORSC R109.3 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 505 Sanitary sewer 05/17/2013 00:00 MST2013-00069 FAIL Not Ready for Inspection OSSC 110.5 and ORSC R109.3 test for sanitary sewer required 723.0 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 335 Rain drain 05/20/2013 00:00 MST2013-00069 PASS 4" Violation Summary: Inspector Contractor 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 13838 SW 90TH AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection 2013-10-22 00:00:00 MST2013-00069 PASS - C of O Violation Summary: Inspector Contractor