Permit CITY OF TIGARD MASTER PERMIT
2 COMMUNITY DEVELOPMENT Permit#: MST2013 00190
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2013
Parcel: 2S 111 DB08600
Jurisdiction: Tigard
Site address: 15410 SW OAKTREE LN
Subdivision: SUMMERFIELD NO.10 Lot: 547
Project: Owen
Project Description: Interior remodel to master bath and kitchen areas.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 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: Yes
Total: 0 sf Value: $5,400.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 2 Dishwashers:, 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 2 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 0
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves' 0 Gas Outlets: 0
Furn>=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: 6
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 l-IVAC: 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:
ALT SF VB R-3 0
Owner: Contractor:
OWEN,SCOTT W&LORI A TL REMODEL AND CONSTRUCTION INC Required Items and Reports(Conditions)
15410 SW OAKTREE LN PO BOX 1996
TIGARD,OR 97224 LAKE OSWEGO,OR 97035
PHONE: 30.3-808-2798 PHONE: 503-984-2783
FAX:
Total Fees: $953.47
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 Ce r. se rules are set forth in OAR
952-001-0010 through-OAR.952-001-0090. You may obtain a r of the rules or direct questions to OUNC by calling 503.2 .19 or 1.800.332.2344.
Issued By: "�. _ ._• . Permittee-Signature:
. Cal by 7:00 a.m.for the next available inspection ate. 61
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 RECEIVED FOR OFFICE 1 SE c)Nl..Y
City of Tigard DR7te/Bived: (� (^3 Permit No.:
Ill q 13125 SW Hall Blvd.,Tigard,OR 9M.4'.., 1 2 23{3 Plan Review r> IS a
e .. Phone: 503.718.2439 Fax: 503.59 . 460 DateB : 4 ►S�1
Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Jung: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
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 work indicated on this application.
1 and 2-family dwelling ❑Commercial/industrial Valuation: $S 7
❑Accessory building ❑Multi-family
Number of bedrooms:
—
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: F$flo .St..► 04 k - y& iewv3 New dwelling area: square feet
City/State/ZIP:T 9 , 9722 q Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 04✓0,.` Covered porch area: square feet
Cross street/directions to job site: Al otak t,rot)A 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.
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.
�vrt. 142.1•Acki / /tiq.54$2., 8 Ti, it e0"f b 4,vy A:al Valuation: $
P Existing building area: square feet
v New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: S'eo if 4 1,Orl O ,,,, Type of construction:
Address: /5 VI 0 3 u 1 Cie-t . iA 1,\g Occupancy groups:
City/State/ZIP: --r-i_.\,„..,4 9 7 Z Vi Existing:
Phone:(303) gd -Z,--J q�� Fax:( )
New:
❑ APPLICANT 44 CONTACT PERSON BUILDING PERMIT FEES*
n _ (Please refer to fee schedule)
Business name: C�R..1v,,C01.4+1
Structural plan review fee(or deposit):
Contactname:�1 LabLh ,
Address: r 0 6k (�9 FLS plan review fee(if applicable):
T Total fees due upon application:
City/State/ZIP: ' AM. Os
Phone:(t13) qt y • VI g, Fax::( )
Amount received:
E-mail: �� n�� +�� �a 00 �� _ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
K !� Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:er-L R t.`___ d 4 4 �S+- ,. Submit two(2)sets of roof plan with connection details
n ^�1 and fire department access,along with the 2010 Oregon
Address: T d ek melt Solar Installation Specialty Code checklist.
City/State/ZIP: a//�� Q3 Permit Fee(includes plan review
L.a�t e. v�^'�+� `�� and administrative fees): $180.00
Phone:(963 ) q t y • 2.7 S� ' Fax:( )
State surcharge(12%of permit fee): $21.60
CCB tic.: 19l v y Total fee due upon application: $201.60
Authorized signature: 4:4 This permit application expires if a permit is not obtained
'7^ `� within 180 days after it has been accepted as complete.
Print name: ! e v, L e►tsky Date: 8. l Z,.13 *Fee methodology set by Tri-County Building Industry
a' ' 1 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
u
Plumbing Permit Application
Building Fixtures RECEIVED Foil oFFICt: „sr. OM.)
City of Tigard
Received
Permit No.: r
1111 •
13125 SW Hall Blvd.,Tigard,OR 972A)(; 1 2 `0!3 Plan Rev �y /3 `` - T�hl s�oo�yd
fj Plan Review
Phone: 503.718.2439 Fax: 503.598.1 6 Date/By: Other Permit No.:
1 G , D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: luris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF M ING DIVISION FEE* SCHEDULE
❑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
I J-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: k
1 1 St 041<. r Drywell,leach line,or trench drain 18.76
City/State/ZIP: T;�r:�rA ((� q/22_4
.l Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: +1 Project name: Owl Manufactured home utilities 50.03
Cross street/directions to job site: 41 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
Clothes washer 1 25.02�vti1. r�v sc4.k.I / M r 6441, rf`o4 a / Move Dishwasher 1 25.02-,
I-,erc,� !i¢Lta.-_
Drinking fountain 25.02
Ejectors/sump . 25.02
SI PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Sc -*a A Lar; Ok..z.,,,
Address: L Floor drain/floor sink/hub 25.02
�� 1 l0 S w (5 c (e 1 u:hf, Garbage disposal 25.02
City/State/ZIP: T rd. Or\ 9777 vI Hose bib 25.02
Phone:(3 D 6% •Li Dtsi , Fax:( ) Ice maker i 12.51
❑ APPLICANT --i71 CONTACT PERSON Interceptor/grease trap 25.02
Business name: L Medical gas(value:$ ) Page 2
0 .22 Primer 12.51
Contact name: --Ti m La 6�h5 K
/ Roof drain(commercial) 12.51
Address: 4 0 go,, fie; Sink/basin/lavatory 2„ 25.02
City/State/ZIP: j KG �� 01' 97 O35- Solar units(potable water) 62.54
Phone:(503) 11 y• z,17 Fax::( ) Tub/shower/shower pan 2, 12.51
E-mail: 7'L Pe:vb(AO Q$ o,, c vt"'\ Urinal 25.02
Water closet 2. 25.02
CONTRACTOR
Water heater I 37.52
Business name: Sco PE Pl.Urn el►.t cl Water piping/DWV 56.29
Address: 'c S t) R u1T1 J41 Lir ,$-• Other. 25.02
City/State/ZIP: per OP erg, Subtotal
Phone:( ) `A` Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: i 9 - i 2t Plumbing Lic.no.: F' 9 I State surcharge(12%of permit fee)
Authorized signature j_ TOTAL PERMIT FEE
Print name: l l hvt A-- i-lok 1 f3AY H-Tn Date: �' h 9_I IS This permit application expires if a permit is not obtained within 180 days
l" after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
u
Mechanical Permit Application FoR OFFICE USE ONLY (y
IN City of Tigard EIVED Date/By: cs �M PermitNo.: l5r96/? OI �7-O
13125 SW Hall Blvd.,Tigard,a'' ■ O`v
_ Phone: 503.718.2439 Fax: 503.598.1 60 Plan Review
Other Permit:
Inspection Line: 503.639.4175 A U l] 1 2 DateRy
TI G n'R D Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
pLC�
CITY OFTIGARD
TUJIDIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1-and 2-family dwelling ❑Conunercial/industrial ❑Accessory building For special information use checklist
Multi-family 0 Master builder ❑Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 15(4 to 'iv Oak 6 I4' t • Furnace 100,000 BTU(ducts/vents) ` 46.75
City/Sta e/ZIP: L `3A4' (j O" q'Zcty Furnace 100,000+BTU(ducts/vents) 54.91
J Heat pump 61.06
Suite/bldgiapt.no.: Project name: ¢" Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
A Imo' +�,yt. -
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
' Other fuel appliances:
Tax map/parcel no.: Water heater I 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
r / '1-y Flue vent for water heater or gas
lVew kvAnc ..4 f NQyV 4kI� �'�'o► 1-6 fireplace 23.32
X W /� '�-�q/� Log lighter(gas) 23.32
i Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
1.PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: Sos if .. I __4 O fit" Range hood/other kitchen
Address: 10 LGry LL equipment I 33.39
'sli W S Li Cdl *€ J O %' , Clothes dryer exhaust * 33.39
eCity/State/ZIP: I ' AM 0 1 U Single-duct exhaust(bathrooms,
� ���1111 1 toilet compartments,utility rooms) 23.32
Phone:(3b3) S V v •Z' .Gl$ • Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT 't' CONTACT PERSON Other: 23.32
�1 /� �\D I Fuel piping:
Business name: I,` `(Ay $14.15 for first four,$4.03 for each additional
Contact name:7 1,,,1 LQb y e Furnace,etc.
Address: �x 1 Tit f Gas heat pump
,v 1 +v• Wall/suspended/unit heater
City/State/ZIP: 1AIA,e Os,_ - a OR,, (170.35-. Water heater
Phone:($ ) 011 t1 • Zen) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: DAB kf i A Other:
� � / S � ��t 1�t MECHANICAL PERMIT FEES*
Address: I 63,01 /j 3tf ?l.• Subtotal
City/State/ZIP: vAh I,,,�r / 8b g 2 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(50N) q y • 305- Fax:( ) State surcharge(12%of permit fee)
CCB lic.: ( 017591 • TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signs * Fee methodology set by Tri-County Building Industry Service Board
Print name: Datg
I:ouildiwermits _ • p_040113.doa 440-4617['(11/07/
5.
Electrical Permit A licatio `FOR OFF ICEl S ONLY ■
1 Tigard ����� �Received � Permit No.:
City of Tlga Date/B : S��� ti r >!;--6o/?6,
° 13125 SW Hall Blvd.,Tigard,OR 97223. ,. n.
C . .. I (-D 13 Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.19610' Date/B :
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE oF}MukPINGDNISION PLAN REVIEW
. ❑New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
El Demolition 12 Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current El 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
t,
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
Multi-family 0 Master builder ❑Other:
0 Fire pump. ❑Installation of 150 KVA or
JOB SITE.INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑«A «En <`1-2°,"1-3>
Job no.: Job site address: l_ lOOHP or more. occupancy.
0 5 Yl0 . oa K tree W Mt4 ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:
+ ��' ❑Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: Owe" ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: P)j14Qj K Description I Qty. I Fee. l 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
75.00 2
DESCRIPTION OF WORK . (with above sq.ft.)
Limited energy,mui v ily kit'4—kN� `' t b4 r w\D.ke1 / residential(with above sq.ft.)
75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
r PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
II ` 201 amps to 400 amps 133.56 2
Name:
SC a f•d(''1 ^<.h 401 amps to 600 amps 200.34 2
Address: Is y l0 sta \J('gym u 'c°ptG (,„ie, 601 amps to 1,000 amps 301.04 2
°r� Over 1,000 amps or volts 552.26 2
City/State/ZIP: T CT�)® glZLM Temporary services or feeders installation,alteration,and/or
Phone:( 3,) $� • 27 q 9 Fax:( ) relocation
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,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
❑ APPLICANT I7f CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: TL 12R�N t)��. ) each branch circuit
B.Fee for branch circuits without
Contact name: I 1 yh L k L.hs1A-j service or feeder fee,first 6 56.18 2
p branch circuit
Address: PQ go !( 1 904 Each add'l branch circuit 5 7.42 2
City/State/ZIP: Lcikc 6, cy I' 05 Miscellaneous(service or feeder not included)
Each manufactured or modular
(�N $4 � Fax: :( dwelling,service and/or feeder 67.84 2
Phone: l. Reconnect only 67.84 2
E-mail: tie vr'lO(,\ g 7,4%00. CAM • Pump or irrigation circle 67.84 2
. CONTRACTOR Sign or outline lighting 67.84 2
Business name: C t 3 C lel 1P t C • L�/ Signal circuit(s)or limited-energy See
L. T(' ` ` panel,alteration,or extension. Page 2 2
Address: p Each additional inspection over allowable in any of the above
&#r 1 v\ 6� Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: ) Investigation(1 hr min) 66.25/hr
Phone:(5 3) 99 •p3 ae kg w I Fax:( ) Industrial plant(1 hr min) 78.18/hr
Q Inspections for which no fee is
CCB Lie.: h`$6 D Z I Electrical Lie.:C cm L V2 hr min) 90.00/hr
• ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
elfir
Print name: ...)1,,‘v\ Cl,r.;› h Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: Kos47/z L0`_r/`11( TOTAL PERMIT FEE:
aJ`+ ° 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.
I:\Buildng\Permits\ELC_PermitApp_ELR ERE.doc Rev 05/21/2013 440-4615T(l1/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15410 SW OAKTREE LN, TIGARD, OR, 97224 2013 -12 -04 (null)
Record Type: Record ID:
Residential - Master Permit MST2013 -00190
Inspection Type: Result:
199 Electrical final PASS
Comments:
Violation Summary:
Inspector Contractor