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Permit
'ii ' .: CITY OF TIGARD MASTER PERMIT ` COMMUNITY DEVELOPMENT ,}., . '., i' Permit#: MST2013 00205 Date Issued: 10/07/2013 T•I(JARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 // / Parcel: 1S125DA01100 Jurisdiction: Tigard Site address: 9035 SW 66TH AVE Subdivision: 2006-073 PARTITION PLAT Lot: B Project: Courtnier Project Description: Remove shop and carport and replace with garage, approx. 1,020 sq ft. 11/12/13: Reprinted permit to include change of electrical contractor to North Lake Contractors. 11/18/13: Reprinted 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. $41,432.00 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 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 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 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 19 Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF - 0 Owner: Contractor: COURTNIER,FRANK E&KATHLEEN C ELLIOT DENNIS WALTER Required Items and Reports(Conditions) 9035 SW 66TH AVE 2545 NE 23RD AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PORTLAND,OR 97212 PHONE: PHONE: 503-819-9538 FAX: Total Fees: $1,597.26 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 sus'ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thoj. •es are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a co y of the rules or direct questions to OUNC by calling 503.232.1987 o -.•.332.2344. Issued Byt• -----P—e –ii s–T Permi be Signature: . fSe} - - 175 by 7:00 a.m.for the next available inspection date / This permit card shall be kept in a conspicuous place on the Job site until compl- on o.'•- project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Applicatio-ECE1V�j 1 i►It(►l rlcl: usi (:) I.1 City of Tigard Received Permit No.: pi 5T-An 13._00A03" lig ° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C ' Phone: 503.718.2439 Fax: 503.598.I9(t,QOV 12 2013 Date/By: Other Permit: i'r Ic a Inspection Line: 503.639.4175 �`t Date Ready/By: lurid', ® See Page 2 for Internet: www.tigard-or.gov {�Y O�,r`GARD Notified/Method: Supplemental Information • TYPE OF WO G DIVISION • PLAN REVIEW ' ❑New construction All Add ition/altettI acement Al Please check all that apply(submit a sets of plans w/items checked below): '... ?.,_, ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: Q where the available fault current ❑Marinas and boatyards. ,l;: 4 CATEGORY OF CONSTRUCTION t� ,` exceeds 10,000 amps at 150 volts or ❑Floating buildings, '�/w less to ground,or exceeds 14,000 ❑Commercial-use agricultural ! and 2-family dwelling ❑Commercial/industrial ❑Accesso *11)- i L J amps for all other installations. buildings, I` Multi-family ❑Master builder ❑Other: a .1" ❑Fire pump. ❑Installation of 150 KVA or JOB SITE.INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Ads ,;,i,of new motor load of ❑"A","E", 'I-2","I-3", Job no.: Job site address: 9035 Pi/ 6ify�11/ , /) ri Dm occupancy. ��! 4;,�t•y ' residential units ❑Recreational vehicle parks.• tr cilitics. ❑Supply voltage for more than City/State/ZIP: 7-1-644;:p Q� 97l�1/> �' 11 ',/ ocalions. 600 volts nominal. Suite/bldg./apt.no.: Project name: t��■: ice or feeder 600 amps or more. . FEE SCHEDULE. Cross street/directions to job site: A. -17--. 7": 4„.Di?p S F�� Dererlptron I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.R.or less 168.54 4 Ea.add'I 500 sq.R.or portion 33.92 I Tax map/parcel no.: Limited energy,residential 75.00 2 _ _ DESCRIPTION■∎OF•'WORK' • ' (with above sq.R.) /� Limited energy,multi-family 7500 2 eLTG�G4L ,,j7 6if X.88-Z-7-Z��✓ residential(with above sq.R.) - Renewable Energy ❑ See Page 2 !r/�/i 3 o� /7 �r fIJ� r rGt7�, 87= Services or feeders installation,alteration,and/or relocation !!J ❑'PROPERTY OWNER ❑ TENANT, 200 amps or less 100 70 2 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 90 35- $i / er/?'`/Xye' 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: 7T " Mi i �� 977-2,3 Temporary services or feeders installation,alteration,and/or Phone:( ) I Fax:( ) relocation 200 amps or less 59.36 I Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125,08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel 0 APPLICANT ', • I '• ,❑'CONTACT:PERSON. .• A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: each branch circuit B.Fee for branch circuits without Contact name: service or feeder fee,first 56.18 2 branch circuit Address: Each add'I branch circuit J'7 7.42 (26 ILI 2 City/State/ZIP: Miscellaneous(service or feeder riot included) Each manufactured or modular Phone: dwelling,service and/or feeder 67.84 2 ( ) I Fax: ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: 11� / // // Signal circuit(s)or limited-energy I See G/Tf'1 L-�Z K E Con,*f Q c.T6 rJ panel,alteration,or extension. Page 2 2 Address: /,2-?PC 4/,v /4 j /, �jil- Each additional inspection over allowable in any of the above V% (((�j///� p Additional inspection(I hr min) 66.25/hr City/State/ZIP: '�or-E-4....s.L1 dig / 7z 2 Investigation(1 hr min) 66.25/hr Phone:(<,3) 7e'9- cc;9k5--$-- I Fax:( ) Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB.Lic.: /� /729' I Electrical Lic.: G - /3 I Suprv.Lic.: Al g 9�s specifically listed('G hr min) t 'ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: ,#72-....k. `�/G 4- Subtotal: /2-6.f� Print name: Cf(e Gp� �, GI'J2fn j Date. J' L /� Plan review(25%of permit fee): / / State surcharge(12%of permit fee): I -- // Authorized signature: j9 7 t/1 e v;e e. ,y. TOTAL PERMIT FEE: h i I.4 Print name: Date: ? This permit application expires if a permit is not obtained within 180 C-r/e r f 1 �, i/�drys ///Z�) days after it bas been accepted as complete. • Number of inspections allowed per permit. I 1:1Building‘PermitstEt.0 PermirApp R_EL RE.doc Rev 0521/2013 4404615T(I I/05/COM/WEB t' 4 rj-r C ' 0(1387. CITY OF TIGARD MASTER PERMIT iii 2:� COMMUNITY DEVELOPMENT Permit#: MST2013 00205 11111- TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ' ( Date Issued: 10/07/2013 Parcel: 151 25DA01100 WHIMJurisdiction: Tigard Site address: 9035 SW 66TH AVE Subdivision: 2006-073 PARTITION PLAT Lot: B Project: Courtnier Project Description: Remove shop and carport and replace with garage,approx. 1,020 sq ft. 11/12/13: Reprinted permit to include change of electrical contractor to North Lake Contractors. 11/18/13: Reprinted 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: $41,432.00 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: 1 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: 2 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF 0 Owner: Contractor: COURTNIER,FRANK E&KATHLEEN C ELLIOT DENNIS WALTER Required Items and Reports(Conditions) 9035 SW 66TH AVE 2545 NE 23RD AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PORTLAND,OR 97212 PHONE: PHONE: 503-819-9538 FAX: Total Fees: $1,455.98 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. Tho, .- are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy_, ,.,_ direct questions to OUNC by calling 503.232.1•: or 1 : 32.2344. Issued By: Perms- :_ •,•. ure: .- �75 by 7:00 a.m.for the next available inspectiojt' � 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. Electrical Permit Application R OH ,1CL uSF ONL City of Tigard 11 N�`' Date/By: f ! / Permit No.: /�,r��o I 13125 SW Hall Blvd.,Tigard,OR 97.- ' _ w "�� /" 3 �� '� C ' . Phone: 503.718.2439 Fax: 503.598.'.;tk. Date/By:Review Other Permit: Inspection Line: 503.639.4175 rO\' Date Ready/By: Juris: ® See Page 2 for I I C,A 1.DJ Notified/Method: Supplemental Information Internet: www.tigard-or.gov sw 1 D ` ��, PP ' TYPE OF WORK\v • • C�1...,•.O� PLAN REVIEW • ' ❑New construction ❑Addition/alteration/ ar `tlt ,�1�" Please check all that apply(submit 2 sets of plans w/items checked below): v.. ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition El Other: �\�`o, where the available fault current ❑Marinas and boatyards. CATEGORY OF.CONSTRaI PION exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION JOB system. larger separately derived system. __ ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: e(03 s— t,.) 7hj- I Six or or more residential R occupancy.r __ _ S f!p�p ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:i ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: CaLtetni i■ec ❑Service or feeder 600 amps or more. FEE SCHEDULE .. • Cross street/directions to job site: . Descriptioo I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: ____ Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 I Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK • (with above sq.ft.) . ' Limited energy,multi-family 75.00 2 cA dd'KJ 5 Ct) g7- `i V c` v "�_✓.1 e, residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation , ''❑ PROPERTY OWNER ., I ' ❑ TENANT 200 amps or less 100.70 ,oaf 712 2 201 amps to 400 amps 133.56 2 Name: • 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or Phone:( ) 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 intcndcd 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 A.Fee for branch circuits with . APPLICANT • ❑ 'CONTACT PERSON above service or feeder fee, 7.42 2 Business name: 2/S'p, L!/,, 717 ,t �, ‘• each branch circuit B.Fee for branch circuits without Contact name: -77e-! � ,ti✓ service or feeder fee,first 56.18 2 branch circuit Address: 7S9f 5h7 7'2,t� 4Ve"- Each add'I branch circuit 7.42 2 City/State/ZIP: /76 L4?A/ 2 97�r j Miscellaneous(service or feeder not included) v\ Each manufactured or modular 67.84 2 Phone:(5-03) �—/-!V Fax: :( ) dwelling,service and/or feeder Reconnect only • 67.84 2 E-mail: Pump or irrigation circle 67.84 2 'CONTRACTOR. Sign or outline lighting 67.84 2 Business name: A/� ) /__,r Signal circuit(s)or limited energy See 1V �� L-Q W+‘ / 0. i f panel,alteration,or extension. Page 2 2 Address: /agda �J/� �Xy Cr Each additional inspection over allowable in any of the above I �rV Additional inspection(l hr min) 66.25/hr City/State/ZIP: P0� oe- 47)-01-q�+ Investigation(I hr min) 66.25/hr Phone:(5 63) 7( q..O �S Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(/2 hr min) !ELECTRICAL'PERMIT,FEES ' Suprv.Electrician signature,required: Subtotal: f(iLt.-7n . Print name: Date: Plan review(25%of permit fee): _ State surcharge(12%of permit fee): I) .08' Authorized signature: TOTAL PERMIT FEE: f()._-fig 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:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB • Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined $75.00 Description I Qty. I Fee I Total I Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ❑ Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 ❑ Heating,Ventilation and Air Conditioning oAx91s-3o9-ooao) System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: CIOther: Each additional inspection is charged at an hourly(1 hr min) 66.25/hr 1 Inspections for which no fee is 90.00/hr specifically listed(%z hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 ❑ Audio and Stereo Systems days after it has been accepted as complete. Number of inspections allowed per permit. ❑ 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\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 CITY OF TIGARD MASTER PERMIT 1., COMMUNITY DEVELOPMENT i ` Permit#: MST2013-00205 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 rim Date Issued: 10/07/2013 Parcel: 1 S 125DA01100 Jurisdiction: Tigard Site address: 9035 SW 66TH AVE Subdivision: 2006-073 PARTITION PLAT Lot: B Project: Courtnier Project Description: Remove shop and carport and replace with garage,approx. 1,020 sq ft. 11/12/131 Reorinted permit to include change of electrical contractor to North Lake Contractors. 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: $41,432.00 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'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 2 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF 0 Owner: Contractor: COURTNIER,FRANK E&KATHLEEN C ELLIOT DENNIS WALTER Required Items and Reports(Conditions) 9035 SW 66TH AVE 2545 NE 23RD AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PORTLAND,OR 97212 PHONE: PHONE: 503-819-9538 FAX: Total Fees: $1,397.81 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. ri•=- rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You •• •• - •• or direct questions to OUNC by calling 503.232.19: /:00.332.2344. • Issued By: — — _ y=s- Permittee Signature: C11 .4175 by 7:00 a.m.for the next available Inspection d• .� This permit card shall be kept In a conspicuous place on the Job site until• lion of th- • oject. Approved plans are required on the job site at the time of ea inspection. Electrical Permit ApplicatioJ C'IV D Received FOR OFFICE USE ONLY' - III City of Tigard V Date/By: Permit No.: ST�1�13 oo;. q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ' C Phone: 503.718.2439 Fax: 503.598.19b0ov 12 2013 Date/Ely: Other Permit: I I ci K t� Inspection Line: 503.639.4175 �V Date Ready/By: Juris: HI See Page 2 for Internet: www.tigard-or.gov Y �E TIGI RD Notified/Method: Supplemental Information TYPE OF W���t�� 7� G ®IVES►ON PLAN REVIEW El New construction / ddition/altelitx4r acement I'.%f Please check all that apply(submit 2 sets of plans w/items checked below): �. ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: ,y 'r 'r B t where the available fault current ❑Marinas and boatyards. A.. CATEGORY OF CONSTRUCTION, , ! i.)- t� 17 exceeds 10,000 amps at 150 volts or ❑Floating buildings. ( less to ground,or exceeds 14,000 ❑Commercial-use agricultural if and 2-family dwelling ❑Commercial/industrial ❑Access° s i g amps for all other installations. buildings. r Multi-family ❑Master builder ❑Other: . ❑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","E","I-2","l-3", Job no.: 1 Job site address: 9435 5' ' 6 =71( /6- 100HP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: ' 6� �/ '' 97�1i� ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: I Project name: ❑Service or feeder 600 amps or more. FEE SCHEDULE. • . - . " Cross street/directions to job site: A'—},--- „Q fia4 s " , 2"' Description I Qty. I Fee. I Total I " Ncw 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 (with above sq.ft.) 75.00 2 DESCRIPTION OF'WORK. ( 4 /� r _ Limited energy,multi-family 75.00 2 G(mac C7 4j ,,4q 51,1e166- ,qV j]Z9- �D ' residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ❑'PROPERTY OWNER I ., ❑ TENANT' 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: / 401 amps to 600 amps 200.34 2 Address: 90 3J Sr'/I/ O ?y(X// 601 amps to 1,000 amps 301.04 2 ty '7 A �� �77.� Tem1,000yseriesos 5,alte 2 City/State/ZIP: � �a Temporary services or feeders installation,alteration,and/or Phone:( ) I 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 I ' • .❑•CONTACT:PERSON- A.Fee for branch circuits with • above service or feeder fee, 7.42 2 Business name: each branch circuit B.Fee for branch circuits without Contact name: service or feeder fee,first 56.18 2 branch circuit _ Address: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:( ) Fax: :( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: 6 ,rTf1 Za KE C� f ac-,-4e,r- Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: /2_%l)p /14V c '-of car- Each additional inspection over allowable in any of the above City/State/ZIP: 7)„,-1-/4,c1 d� wvV/ U9 72 Z 9 Additional inspection(I hr min) 66.25/hr investigation(I hr min) 66.25/hr Phone:(c.3) 7c'9- e,9 iS ." I Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB.Lic.: /511/7 Electrical Lie.: G - /3 I Suprv.Lie.: $97s specifically listed(%:hr min) / /� 'ELECTRICAL PERMIT,FEES Suprv.Electrician signature,required: `�/G/may Subtotal: Print name: Cre4 G r C Lj/ t d.40/r Date: 7/ /Z /I Plan review(25%of permit fee): . / State surcharge(12/o of permit fee): Authorized signature: `� `L�� y, TOTAL PERMIT FEE: �—� �, , This permit application expires if a permit is not obtained within 180 Print name: are l r L�, , 4 i ///�0/S Date: ///Z /3 days after it has been accepted as complete. �//L/j,� , • Number of inspections allowed per permit. 1:1BuildingTermits\ELC_PermitApp_ELR L.doc Rev 05/21/2013 440-4615T(11/05/COM/wEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined ... $75.00., Description I Qty. I Fee I Total I * Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ❑ Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with OAR 918-309-0040) 55226 2 ❑ Heating,Ventilation and Air Conditioning - System* Solar generation systems in excess of 25 kva: Each additional kva over25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is charged at an hourly(I hr min) 6625/hr Inspections for which no fee is 90.00/hr specifically listed(1/2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 ❑ Audio and Stereo Systems days after it has been accepted as complete. Number of inspections allowed per permit. ❑ 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\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 • 14 CITY OF TIGARD MASTER PERMIT It.. COMMUNITY DEVELOPMENT Permit#: MST2013-00205 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2013 Parcel: 1 S 125DA01100 Jurisdiction: Tigard Site address: 9035 SW 66TH AVE Subdivision: 2006-073 PARTITION PLAT Lot: B Project: Courtnier Project Description: Remove shop and carport and replace with garage, approx. 1,020 sq ft BUILDING Floor Areas Required Setbacks Required Stones: 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: $41,432.00 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 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 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 Furn<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: 2 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener. N All Other N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF 0 Owner: Contractor: COURTNIER,FRANK E&KATHLEEN C ELLIOT DENNIS WALTER Required Items and Reports(Conditions) 9035 SW 66TH AVE 2545 NE 23RD AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PORTLAND,OR 97212 PHONE: PHONE: 503-819-9538 FAX: Total Fees: $1,397.81 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 folio • les 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 • -e.•uestions to OUNC by calling 503.232.1987 or 1.800.332.2344. c // I s s u e d B .Lc — ��- Permittee Signature: /c-- a .4175 by 7:00 a.m.for the next available inspectio ate. This permit card shall be kept in a conspicuous place on the job site until ompletion of the project. Approved plans are required on the job site at the time of each inspection. It tiilding Permit Application Residential 1.ECEIVED Irt,it t,rflrl,: t"15h;Qrl>Y City of Tigard p Received lf. , g S f 9 2013 Date/A : ` ,D PenuitNo.: fri f,.0 —.06 Y . 13125 SW Nall Blvd.,Tigard,OR 97223 p“12, ; 9@ITY OF A A: 0 0, Otter Permit: ' � Phone: 503.778,2439 Fax: 503,598.1 Date/B , ,• 1"i C A R f) Inspection Line: 503.639.4175 BUILDING Ir DING DIVISION Date Ready:+ ( / Ste Page 2 for Internet: www.tigard-or.gov UlL DIVISION l N. :ed/Method: o ` Supplemental information•1JJ I,DA17A:l'-',AND 2-4041-DWELLING ;. ew construction 0 Demolition 'Permit fees*are based on the value of the work performed. Indicate the value(rounded to tho nearest dollar)of all Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the ' ',` : CATEGORY-`O0'CON&TR;CJCIION work indicated on this application,/ A.and 2-family dwelling Valuation: s �' y 5 y g ❑CommerciaVindustrial E3 Accessory building C]Multi-family Number of bedrooms; . ❑Master builder ❑Other: Number of bathrooms: - ,.OR sin 11147P I44TION:4ND LOCATION Total number of floors: Job site address: r _ . --�6 , j New dwelling area: square feet fbet City/State/ZIP: ".7• p4��ff��G��'� 7 z• =3 Garage/carport area: l�4 () square r Suite/bldg./apt,no,: Project name: disn �-" C Covered porch area: square feet Cross street/directions t o job site: i d -"-,may S 4J Deck area: square feet Other structure area: square feet ti QJl1RlDDAt'rA::C.b1V1�RCIAL-USE OfteCICL tit''' . Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Taxmap/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DFFCRJPTION;or-NYORY �+ _ - work indicated on this application. rl pe ,.5-4s'fi Yi f d c i-loil ""l- Valuation: $ e Existing building area: square feet Q New building area: square feet - ,, "PROPt11T' tfOtrA4- _.[] ''F i • Number of stories: Name: n; � g if tz� Type of construction: 1 Address: '.1� 0 ,(,c) ( e Occupancy groups: City/State/ZIP: i �bL�( 722 3 Existing: Phone:(6�) *ts 7 7 7 ' Fax: l ,C 4P1140ANT': .f: ,• ., {]�COI!17'At;T:1C1<N - BiTII,D1,riG.1,433.4--1'"mB* - Business name: , � yt, - l> er""e(oth feposiie elej Contact name: Structural plan review fee(or deposit): f-�� FLS plan review fee(if applicable): Address: /7 fa , fL rAd i)j)e• Total fees due upon application: City/State/ZIP: .0 l , / 70/6.-- �!f $� Phone: L "J '.• 'd' Fax::( ) di{.)-✓ Amount received: LP 1 . o c vv T.ti :sot ii4i sYS'r t ks< E-mail: i -•,, L //^� 17'I/ _ ! C`� Commercial and residential prescriptive installation of , •. _ roof-top ruck .tad Photovoltaic Solar Panel System. Business name: I �� i r.f i�� t t / I Submit two(2)s > oof plan with commotion a,- : , and fire department a ong with the .t r Oregon Address: Z - f 2jq' _ Solar Installation Specialty Co••: 1, -4 tst, • up_/' Lit i1 Permit Fes(includes r relit-City/State/ZIP: I r � U L and ,i tstradvefeas : $180.00 Phone:(�q J ) j i i,Q Fax:( ) State sure urge(12%of permit fee): _$21.60 CCB lic.:`t q �i �(ri/o-1 y Total fee due upon application: $20 .60 Authorized signature: -- / ,. This permit application expires if a permit Is not obtained . w — within 180 days after it has Was accepted as complete. Print name: -' j 4.` .�f Date: r�C:— *Fee methodology sot by Tri-County Building Industry Service Board. I:BBuilding\Pemuts\BUP-RLSPetmitApp.doc 02/24/2011 440-4613 T(11/02/COM/WEB) ' Electrical Permit A lice ' NED IO.,t:OI FICI1 us,,.ONl.,v City of Tigard Received /3 •! Permit •No,: •- r/5_‘949 jrJ— 13125 SW Hall Blvd„Tigard,OR 97� Plan Review -II r'• Phone: 503.718.2439 Fax: 503.598 8 2013 Dete/By: Other Permit: • r I• A 1,n Inspection Line: 503.639.4175 .�+��± Date Ready/By: Jerla. El See Page 2 for Internet: www.d -or. ov CITY O Notified/Method; ga►'d g 11V Supplemental Information ,"r' ' ; . dGDIVISI0AI . . ;OAS:AiS/Ew ❑New construction SAddition/alteration/replacement Please check all that apply(submit/seta of plans wlitems checked below): ❑Demolition Other: where Service or feeder 400 amps or more ❑Building over three stories. where the available fault entreat ❑Marinas and boatyards. -',:','':';;.,:',:• ;!",':;•':•:,;,..: CA'TICG:i} if OF:CONglittl itl(ON exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural Via:and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. . 0 Multi-family 0 Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or - ❑Emergency system. larger separately derived system. 'J)B gi'i ia!0**rlOiv= IO'CATION` `,;:2:.;,1. `�, •. ,..... .. . . 0 Addition of new motor load of (]"A","$","1-2","1-3", 5,f p/ /_f j �j', , Six o P or more. occupancy. Job no.: Job site address: W �iiF / v ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: per,,7e-tr„i„,03, q 7 3 ❑Health-care facilities. ❑Supply voltage for more than / / ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt .: Project name: ' ❑Service or feeder 600 amps or more. g Pt- J ��� � � Cross stretx/directions to job site: �� �j�� `n®r,.luaon ,- ' '•' ° " I air.7 nee. I 'rot■i' I ��'�'� 77 New residential single-or multi-family dwelling unit. Includes attached garage. • Subdivision: I Lot no.: 1,000 sq.ft or less 168.54 4 — Ea.add'1500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential ' 75.00 2 -r: -. :: 1�` , 1' ,,DJES A,I_BT.1GO4rOPAi/00,i (with above sq.ft.) dddl /�r�?Ot� i , Limited energy,multi-family /� �,� residential(with above sq.R) 75.00 2 j Renewable Energy ❑ See Page 2 Services or feeders installatlonialteration,and/or relocation 4 C :Ll:?1!1 OO I Y:001 1,..: 0 amps class 10070 2 p-, 1 201 amps to 400 amps 133.56 2 Name: F�' N 4 K-G C e' rc� 401 amps to 600 amps 200.34 2 • Address: ��p3 ✓: U/, b . ..7-t& r 601 amps to 1,000 amps 301.04 2 rte-' �, 1 Over 1,000 amps or volts 552.26 2 City/State/ZIP: 7/. � > 11,,, - 6/7 3 Temporary services or feeders Installation,alteration,and/or Phone:( ) . ^777, Fax:( ) 666 relocation I° 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 cps to 599 amps 168.54 2 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel ',tits- - A Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: 4,_) each branch circuit H.Fee for brmtch circuits without Contact name: ' � �� .6(....,4(+),._) service or feeder fee,first , brunch circuit 56.18 2 Address: 17(q tu,)R(}�;Q s 1� Each add'I branch circuit i 7.42 2 ^►I�° Miscellaneous(service or feeder not Included) City/State/ZIP: 15 ep 04-6,,f, 63- q/, j- Each manufactured or modular /�� dwelling,service and/or feeder 67.84 2 Phone:(707) r7 Z'�' D�I I Fax::( ) �� , E-mail: �,, / ��„ ,, r yy� R�rmect only 67.84 2 1:7�'! �'l " t ,�, l+{ 2 0 Pump or irrigation circle '�, `: 67.84 2 .. i° ,• .-. .. :, _'% . „_ . Sign or outline lighting 67,84 2 Business name: S�kl /.yt'4 R �fI iv 7. /N C Signal circuit(s)or limited-energy See L' �t panel,alteration,or extension. Page 2 2 Address: .2 3$'3 3 NE h S/f Ar S7^, Each additional inspection over allowable in any of the above • C� Additional inspection(1 hr min) 66.25/hr City/State/ZIP: 0 etc,el v/y/ f', 49,q , 9 O o Investigation(l hr min) 6625/hr • Phone:(Se3)7g29 3/S P. ax:(SZ33) t719^ 39'78" Industrial plant(1 hr min) 78.18/hr CCl3 Lie,: Electrical LiC. -�I Su — Inspections for which no fees �7©y g- prv,Lic.. j j?6 S s.ecificall listed K hr. miin� 90.00/hr Suprv.J;lCCtrlcl8n t I i ) ' ,required: ii' O ^ li)Ill t`x'i: .._.. r (*ryiAl f�+i.'g Fi'1114�5 1' _>`i"r.:i+i ?: _ Subtotal: Print name: SR tit U e' P, 'lc,R(74 2 Date: /0,, ,/3 Plan review(25%of permit fie): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEB: . / n This permit application expires if a permit is not obtained within 180 Print name: s�Al V P (... e JUs,,,c/ov" Date: /D ,.,>_ / . days after it has been accepted as complete. I:\au0diaglPermita�BLC Pe[m r ' [mac L * Number of inspections allowed per permit. tApp BLR_BRE:dco Rev 05/21/2013 440-4615T(11/05/COM/WEB Building Division Development Code Provision Review TLC; ° Residential Projects Building Permit No.: H‘31 /�J —CCIaOS Project/Subdivision ame: JcTi E-12- Lot #: Site Address: 035 aLO Lo(o÷`" OL CWS Service Provider Letter: Required:Yes 13, No ❑ 041P-(� nnp 1� 0 Ple-c)('Xe4 Received:Yes ❑ No 1 1�' :,J,0 LA0/ C�5 J�eQ Plans Routed: Original Plan-Submittal-Date: 9-/?//3 Routed - --1St Revision Submittal Date: d E 5ite Plan Only Routed By: 2nd Revision Submittal Date: ❑ Site Plan Only Routed By: 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.n Planning Review(contact 61e ti I l./`:"nei at(503) 718- .14'4 37 or GI'te.Yt j c @tigard- or.gov) Land Use Can No. Zoning `1 .5 Lt Setbacks: Front , O Rear 15 Side 5 Street Side 15 Garage a 0 - Maximum Building Height: 30 Actual Building Height A- 15 -04.e s-61 Visual Clearance P' Easements Sensitive Lands Type: •/Pr cif Street Trees Niik Jo Protected Trees N/f Notes: 1 c&va1e 5-ctioac.IC nuk- wle�h., _JSt-lC plah Skovds 1B F1 . Re U i5e <i LA) a✓Me I osac `�" pI aLQ-rr1 a✓1 t' t i e e4-n c se RiCIc r-ef i�w.,pn4.5. Original Plan: Approved ❑ Not Approved Date: 9 ' i i - i 3 Revision 1: Approved* Not Approved (0 Date: /O/2' l Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 1 a Engineering Review(contact Mike White at 503-718-2464 or MikeW @tigard-or.gov) )' Actual Slope: 5 % Notes: Original Plan: Approved Not Approved ❑ Date: I/211 3 Revision 1: Approved X' Not Approved ❑ Date: 11 IA 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 Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes\X7No J'Z �3 Date Routed to Building: g /-e=727;3 Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 • I t �`_n r5 `.rn - - Clean Water Services File Number �, J C1eanWater .Services I Prop./el-till SCf' () G 2013 ensitive Area Pre-Screening Site Assessment Bit Juisdiction: ngard=-- 2. Property Information(example 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Fred K.hahn Company: hahn Design Address: 18190 S.Sltverwood Drive Site Address: 9035 S.W.66th Avenue Avenue City,State,Zip: Oregon city,Oregon 97045 City,State,Zip: Portland,Oregon 97223 phone/Fax: 707-479-3091 Nearest Cross Street: Taylors Ferry E-Melt; hahndesign @gmx.com 4. Development Activity(check all that apply) 6. Applicant Information Addition to Single Family Residence(rooms,deck,garage) Name: Fred K.Hahn ❑ Lot Line Adjustment ❑ Minor Land Partition Company: Hahn Design ❑ Residential Condominium ❑ Commercial Condominium Address: 18190 S.Silverwood Drive, ❑ Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial City,State,Zip: Oregon City,Oregon 97045 Other Phone/Fax: 707-479-3091 • E-Mail: hahndesign @gmx.com 6. Will the project Involve any off-site work? ❑Yes ,:1 No ❑Unknown Location and descrtptlon of off-site work • 7. Additional comments or information that may be needed to understand your project Removing existing shop and carport and Installing new garage per site plan This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as Issued by the Department of Environmental Quality,Department of State Lends and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,end federal law. By signing this form,the Owner or Owner's authorized agent or representative,acimowiedges and tees that employees of Clean Water Services have authority to enter the project site at all reasonable limes for the purpose of Inspecting project slle conditions and gathering information related to the project site. I certify that I am familiar with the information=tallied In this document,and to the best of my knowledge and belief,this Information Is true,complete,and accurate. Print/rype Name Fred K.Hahn Print/lype Title Owner ONLINE SUBMITTAL Date 9/5/2013 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 201y of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ,❑ Based on review of the submitted materials end best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available Information the above referenced project will not sign ilcanlly impact the exlslirg or potentially sensitive area(e)found near the silo This Sensitive Area Pre-Screening Ste Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas If they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3.02.1. AU required permits and approvals must be obtained and completed under applicable local,slate and federal law. ❑This Service Provider Letter Is not valid unless CWS approved site plans)are attached. ❑The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR i[ SERVICE PROVIDE-,LETTER IS REQ I E0. Reviewed by - �! �J' Date 4 /041/1..3 2550 SIN Hillsboro Highway • Hillsboro.Oregon 97123 • Phone:(503)681-5100 • Fax:(503)681.4439 • w: ..•/.cleanwaterservices.org r fIEVSE D 9 035 S.W. toroth Avenue RECVED OCT 2 2013 oud" MY OFT GARD 6.0' Elev.I I I I I - - - - - - - - - - - - - - - - - - - - -'- - - - - - - - - - - - - - - - - - - / ' I I I 5.5' EI v.100.0' — — liii . • 93•6'4• 1.4'-214" 13'-10• Y-6• 1'-t 16•94N' EW PARKING SLAB Ia-4"Goncele over 4•crushed rock. 76•616• / I 4 2 1'-1115• j E 1/4 SE 1/4 SECTION 6 25 115 RIW W.M. TAX LOT 1100 , , rte'-< >�� �sa' ■ °P ud . v '.-- pd" �c'.sd 013 I 5 0 I I jj . I I T 0 b rq IL A ? EXISTING HOUSE NEW GARAGE j P I I 4 'v 0 I I p L I I 0 T to I I I- I -. I B I j ti) � I I I I I 4.-I15" 1'-6• 20. I I 47.3•• 16•1015• / / / 10 971" J 1.V-21e V-0" / I I I I I I I I 0.0' Elev.----------------------------------------•---------- 100.0--------------------------------------•------ 0.0' Elev. SITE PLAN SCALE:)AP"l i'-0" 4 -5/3A = (Lot' 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 9035 SW 66TH AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection 2014-01-17 00:00:00 MST2013-00205 PASS - No C of O Violation Summary: Inspector Contractor 14 CITY OF TIGARD MASTER PERMIT It.. COMMUNITY DEVELOPMENT Permit#: MST2013-00205 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2013 Parcel: 1 S 125DA01100 Jurisdiction: Tigard Site address: 9035 SW 66TH AVE Subdivision: 2006-073 PARTITION PLAT Lot: B Project: Courtnier Project Description: Remove shop and carport and replace with garage, approx. 1,020 sq ft BUILDING Floor Areas Required Setbacks Required Stones: 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: $41,432.00 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 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 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 Furn<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: 2 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener. N All Other N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF 0 Owner: Contractor: COURTNIER,FRANK E&KATHLEEN C ELLIOT DENNIS WALTER Required Items and Reports(Conditions) 9035 SW 66TH AVE 2545 NE 23RD AVE 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PORTLAND,OR 97212 PHONE: PHONE: 503-819-9538 FAX: Total Fees: $1,397.81 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 folio • les 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 • -e.•uestions to OUNC by calling 503.232.1987 or 1.800.332.2344. c // I s s u e d B .Lc — ��- Permittee Signature: /c-- a .4175 by 7:00 a.m.for the next available inspectio ate. This permit card shall be kept in a conspicuous place on the job site until ompletion of the project. Approved plans are required on the job site at the time of each inspection. It tiilding Permit Application Residential 1.ECEIVED Irt,it t,rflrl,: t"15h;Qrl>Y City of Tigard p Received lf. , g S f 9 2013 Date/A : ` ,D PenuitNo.: fri f,.0 —.06 Y . 13125 SW Nall Blvd.,Tigard,OR 97223 p“12, ; 9@ITY OF A A: 0 0, Otter Permit: ' � Phone: 503.778,2439 Fax: 503,598.1 Date/B , ,• 1"i C A R f) Inspection Line: 503.639.4175 BUILDING Ir DING DIVISION Date Ready:+ ( / Ste Page 2 for Internet: www.tigard-or.gov UlL DIVISION l N. :ed/Method: o ` Supplemental information•1JJ I,DA17A:l'-',AND 2-4041-DWELLING ;. ew construction 0 Demolition 'Permit fees*are based on the value of the work performed. Indicate the value(rounded to tho nearest dollar)of all Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the ' ',` : CATEGORY-`O0'CON&TR;CJCIION work indicated on this application,/ A.and 2-family dwelling Valuation: s �' y 5 y g ❑CommerciaVindustrial E3 Accessory building C]Multi-family Number of bedrooms; . ❑Master builder ❑Other: Number of bathrooms: - ,.OR sin 11147P I44TION:4ND LOCATION Total number of floors: Job site address: r _ . --�6 , j New dwelling area: square feet fbet City/State/ZIP: ".7• p4��ff��G��'� 7 z• =3 Garage/carport area: l�4 () square r Suite/bldg./apt,no,: Project name: disn �-" C Covered porch area: square feet Cross street/directions t o job site: i d -"-,may S 4J Deck area: square feet Other structure area: square feet ti QJl1RlDDAt'rA::C.b1V1�RCIAL-USE OfteCICL tit''' . Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Taxmap/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DFFCRJPTION;or-NYORY �+ _ - work indicated on this application. rl pe ,.5-4s'fi Yi f d c i-loil ""l- Valuation: $ e Existing building area: square feet Q New building area: square feet - ,, "PROPt11T' tfOtrA4- _.[] ''F i • Number of stories: Name: n; � g if tz� Type of construction: 1 Address: '.1� 0 ,(,c) ( e Occupancy groups: City/State/ZIP: i �bL�( 722 3 Existing: Phone:(6�) *ts 7 7 7 ' Fax: l ,C 4P1140ANT': .f: ,• ., {]�COI!17'At;T:1C1<N - BiTII,D1,riG.1,433.4--1'"mB* - Business name: , � yt, - l> er""e(oth feposiie elej Contact name: Structural plan review fee(or deposit): f-�� FLS plan review fee(if applicable): Address: /7 fa , fL rAd i)j)e• Total fees due upon application: City/State/ZIP: .0 l , / 70/6.-- �!f $� Phone: L "J '.• 'd' Fax::( ) di{.)-✓ Amount received: LP 1 . o c vv T.ti :sot ii4i sYS'r t ks< E-mail: i -•,, L //^� 17'I/ _ ! C`� Commercial and residential prescriptive installation of , •. _ roof-top ruck .tad Photovoltaic Solar Panel System. Business name: I �� i r.f i�� t t / I Submit two(2)s > oof plan with commotion a,- : , and fire department a ong with the .t r Oregon Address: Z - f 2jq' _ Solar Installation Specialty Co••: 1, -4 tst, • up_/' Lit i1 Permit Fes(includes r relit-City/State/ZIP: I r � U L and ,i tstradvefeas : $180.00 Phone:(�q J ) j i i,Q Fax:( ) State sure urge(12%of permit fee): _$21.60 CCB lic.:`t q �i �(ri/o-1 y Total fee due upon application: $20 .60 Authorized signature: -- / ,. This permit application expires if a permit Is not obtained . w — within 180 days after it has Was accepted as complete. Print name: -' j 4.` .�f Date: r�C:— *Fee methodology sot by Tri-County Building Industry Service Board. I:BBuilding\Pemuts\BUP-RLSPetmitApp.doc 02/24/2011 440-4613 T(11/02/COM/WEB) ' Electrical Permit A lice ' NED IO.,t:OI FICI1 us,,.ONl.,v City of Tigard Received /3 •! Permit •No,: •- r/5_‘949 jrJ— 13125 SW Hall Blvd„Tigard,OR 97� Plan Review -II r'• Phone: 503.718.2439 Fax: 503.598 8 2013 Dete/By: Other Permit: • r I• A 1,n Inspection Line: 503.639.4175 .�+��± Date Ready/By: Jerla. El See Page 2 for Internet: www.d -or. ov CITY O Notified/Method; ga►'d g 11V Supplemental Information ,"r' ' ; . dGDIVISI0AI . . ;OAS:AiS/Ew ❑New construction SAddition/alteration/replacement Please check all that apply(submit/seta of plans wlitems checked below): ❑Demolition Other: where Service or feeder 400 amps or more ❑Building over three stories. where the available fault entreat ❑Marinas and boatyards. -',:','':';;.,:',:• ;!",':;•':•:,;,..: CA'TICG:i} if OF:CONglittl itl(ON exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural Via:and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. . 0 Multi-family 0 Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or - ❑Emergency system. larger separately derived system. 'J)B gi'i ia!0**rlOiv= IO'CATION` `,;:2:.;,1. `�, •. ,..... .. . . 0 Addition of new motor load of (]"A","$","1-2","1-3", 5,f p/ /_f j �j', , Six o P or more. occupancy. Job no.: Job site address: W �iiF / v ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: per,,7e-tr„i„,03, q 7 3 ❑Health-care facilities. ❑Supply voltage for more than / / ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt .: Project name: ' ❑Service or feeder 600 amps or more. g Pt- J ��� � � Cross stretx/directions to job site: �� �j�� `n®r,.luaon ,- ' '•' ° " I air.7 nee. I 'rot■i' I ��'�'� 77 New residential single-or multi-family dwelling unit. Includes attached garage. • Subdivision: I Lot no.: 1,000 sq.ft or less 168.54 4 — Ea.add'1500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential ' 75.00 2 -r: -. :: 1�` , 1' ,,DJES A,I_BT.1GO4rOPAi/00,i (with above sq.ft.) dddl /�r�?Ot� i , Limited energy,multi-family /� �,� residential(with above sq.R) 75.00 2 j Renewable Energy ❑ See Page 2 Services or feeders installatlonialteration,and/or relocation 4 C :Ll:?1!1 OO I Y:001 1,..: 0 amps class 10070 2 p-, 1 201 amps to 400 amps 133.56 2 Name: F�' N 4 K-G C e' rc� 401 amps to 600 amps 200.34 2 • Address: ��p3 ✓: U/, b . ..7-t& r 601 amps to 1,000 amps 301.04 2 rte-' �, 1 Over 1,000 amps or volts 552.26 2 City/State/ZIP: 7/. � > 11,,, - 6/7 3 Temporary services or feeders Installation,alteration,and/or Phone:( ) . ^777, Fax:( ) 666 relocation I° 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 cps to 599 amps 168.54 2 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel ',tits- - A Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: 4,_) each branch circuit H.Fee for brmtch circuits without Contact name: ' � �� .6(....,4(+),._) service or feeder fee,first , brunch circuit 56.18 2 Address: 17(q tu,)R(}�;Q s 1� Each add'I branch circuit i 7.42 2 ^►I�° Miscellaneous(service or feeder not Included) City/State/ZIP: 15 ep 04-6,,f, 63- q/, j- Each manufactured or modular /�� dwelling,service and/or feeder 67.84 2 Phone:(707) r7 Z'�' D�I I Fax::( ) �� , E-mail: �,, / ��„ ,, r yy� R�rmect only 67.84 2 1:7�'! �'l " t ,�, l+{ 2 0 Pump or irrigation circle '�, `: 67.84 2 .. i° ,• .-. .. :, _'% . „_ . Sign or outline lighting 67,84 2 Business name: S�kl /.yt'4 R �fI iv 7. /N C Signal circuit(s)or limited-energy See L' �t panel,alteration,or extension. Page 2 2 Address: .2 3$'3 3 NE h S/f Ar S7^, Each additional inspection over allowable in any of the above • C� Additional inspection(1 hr min) 66.25/hr City/State/ZIP: 0 etc,el v/y/ f', 49,q , 9 O o Investigation(l hr min) 6625/hr • Phone:(Se3)7g29 3/S P. ax:(SZ33) t719^ 39'78" Industrial plant(1 hr min) 78.18/hr CCl3 Lie,: Electrical LiC. -�I Su — Inspections for which no fees �7©y g- prv,Lic.. j j?6 S s.ecificall listed K hr. miin� 90.00/hr Suprv.J;lCCtrlcl8n t I i ) ' ,required: ii' O ^ li)Ill t`x'i: .._.. r (*ryiAl f�+i.'g Fi'1114�5 1' _>`i"r.:i+i ?: _ Subtotal: Print name: SR tit U e' P, 'lc,R(74 2 Date: /0,, ,/3 Plan review(25%of permit fie): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEB: . / n This permit application expires if a permit is not obtained within 180 Print name: s�Al V P (... e JUs,,,c/ov" Date: /D ,.,>_ / . days after it has been accepted as complete. I:\au0diaglPermita�BLC Pe[m r ' [mac L * Number of inspections allowed per permit. tApp BLR_BRE:dco Rev 05/21/2013 440-4615T(11/05/COM/WEB Building Division Development Code Provision Review TLC; ° Residential Projects Building Permit No.: H‘31 /�J —CCIaOS Project/Subdivision ame: JcTi E-12- Lot #: Site Address: 035 aLO Lo(o÷`" OL CWS Service Provider Letter: Required:Yes 13, No ❑ 041P-(� nnp 1� 0 Ple-c)('Xe4 Received:Yes ❑ No 1 1�' :,J,0 LA0/ C�5 J�eQ Plans Routed: Original Plan-Submittal-Date: 9-/?//3 Routed - --1St Revision Submittal Date: d E 5ite Plan Only Routed By: 2nd Revision Submittal Date: ❑ Site Plan Only Routed By: 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.n Planning Review(contact 61e ti I l./`:"nei at(503) 718- .14'4 37 or GI'te.Yt j c @tigard- or.gov) Land Use Can No. Zoning `1 .5 Lt Setbacks: Front , O Rear 15 Side 5 Street Side 15 Garage a 0 - Maximum Building Height: 30 Actual Building Height A- 15 -04.e s-61 Visual Clearance P' Easements Sensitive Lands Type: •/Pr cif Street Trees Niik Jo Protected Trees N/f Notes: 1 c&va1e 5-ctioac.IC nuk- wle�h., _JSt-lC plah Skovds 1B F1 . Re U i5e <i LA) a✓Me I osac `�" pI aLQ-rr1 a✓1 t' t i e e4-n c se RiCIc r-ef i�w.,pn4.5. Original Plan: Approved ❑ Not Approved Date: 9 ' i i - i 3 Revision 1: Approved* Not Approved (0 Date: /O/2' l Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 1 a Engineering Review(contact Mike White at 503-718-2464 or MikeW @tigard-or.gov) )' Actual Slope: 5 % Notes: Original Plan: Approved Not Approved ❑ Date: I/211 3 Revision 1: Approved X' Not Approved ❑ Date: 11 IA 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 Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes\X7No J'Z �3 Date Routed to Building: g /-e=727;3 Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 • I t �`_n r5 `.rn - - Clean Water Services File Number �, J C1eanWater .Services I Prop./el-till SCf' () G 2013 ensitive Area Pre-Screening Site Assessment Bit Juisdiction: ngard=-- 2. Property Information(example 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Fred K.hahn Company: hahn Design Address: 18190 S.Sltverwood Drive Site Address: 9035 S.W.66th Avenue Avenue City,State,Zip: Oregon city,Oregon 97045 City,State,Zip: Portland,Oregon 97223 phone/Fax: 707-479-3091 Nearest Cross Street: Taylors Ferry E-Melt; hahndesign @gmx.com 4. Development Activity(check all that apply) 6. Applicant Information Addition to Single Family Residence(rooms,deck,garage) Name: Fred K.Hahn ❑ Lot Line Adjustment ❑ Minor Land Partition Company: Hahn Design ❑ Residential Condominium ❑ Commercial Condominium Address: 18190 S.Silverwood Drive, ❑ Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial City,State,Zip: Oregon City,Oregon 97045 Other Phone/Fax: 707-479-3091 • E-Mail: hahndesign @gmx.com 6. Will the project Involve any off-site work? ❑Yes ,:1 No ❑Unknown Location and descrtptlon of off-site work • 7. Additional comments or information that may be needed to understand your project Removing existing shop and carport and Installing new garage per site plan This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as Issued by the Department of Environmental Quality,Department of State Lends and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,end federal law. By signing this form,the Owner or Owner's authorized agent or representative,acimowiedges and tees that employees of Clean Water Services have authority to enter the project site at all reasonable limes for the purpose of Inspecting project slle conditions and gathering information related to the project site. I certify that I am familiar with the information=tallied In this document,and to the best of my knowledge and belief,this Information Is true,complete,and accurate. Print/rype Name Fred K.Hahn Print/lype Title Owner ONLINE SUBMITTAL Date 9/5/2013 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 201y of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ,❑ Based on review of the submitted materials end best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available Information the above referenced project will not sign ilcanlly impact the exlslirg or potentially sensitive area(e)found near the silo This Sensitive Area Pre-Screening Ste Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas If they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3.02.1. AU required permits and approvals must be obtained and completed under applicable local,slate and federal law. ❑This Service Provider Letter Is not valid unless CWS approved site plans)are attached. ❑The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR i[ SERVICE PROVIDE-,LETTER IS REQ I E0. Reviewed by - �! �J' Date 4 /041/1..3 2550 SIN Hillsboro Highway • Hillsboro.Oregon 97123 • Phone:(503)681-5100 • Fax:(503)681.4439 • w: ..•/.cleanwaterservices.org r fIEVSE D 9 035 S.W. toroth Avenue RECVED OCT 2 2013 oud" MY OFT GARD 6.0' Elev.I I I I I - - - - - - - - - - - - - - - - - - - - -'- - - - - - - - - - - - - - - - - - - / ' I I I 5.5' EI v.100.0' — — liii . • 93•6'4• 1.4'-214" 13'-10• Y-6• 1'-t 16•94N' EW PARKING SLAB Ia-4"Goncele over 4•crushed rock. 76•616• / I 4 2 1'-1115• j E 1/4 SE 1/4 SECTION 6 25 115 RIW W.M. TAX LOT 1100 , , rte'-< >�� �sa' ■ °P ud . v '.-- pd" �c'.sd 013 I 5 0 I I jj . I I T 0 b rq IL A ? EXISTING HOUSE NEW GARAGE j P I I 4 'v 0 I I p L I I 0 T to I I I- I -. I B I j ti) � I I I I I 4.-I15" 1'-6• 20. I I 47.3•• 16•1015• / / / 10 971" J 1.V-21e V-0" / I I I I I I I I 0.0' Elev.----------------------------------------•---------- 100.0--------------------------------------•------ 0.0' Elev. SITE PLAN SCALE:)AP"l i'-0" 4 -5/3A = (Lot'