Permit CITY OF TIGARD MASTER PERMIT
III ■: COMMUNITY DEVELOPMENT Permit#: MST2013-00200
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2013
Parcel: 2S104AD05100
Jurisdiction: Tigard
Site address: 12860 SW 129TH PL
Subdivision: 2004-003 PARTITION PLAT Lot: 2
Project: Fleskes Partition, Lot 2
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1109 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1370 sf Garage: 754 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2479 sf Value: $300,323.59 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets 4
Fum>=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: 5 201-400 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 2479
Owner: Contractor: _
PARK PLACE INVESTMENTS LLC PARK PLACE INVESTMENTS LLC Required Items and Reports(Conditions)
PO BOX 91069 PO BOX 91069 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97291 PORTLAND,OR 97291
PHONE: 503-574-3111 PHONE: 503-574-3111
FAX: 503-574-3321
Total Fees: $20,740.19
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 0 r-..1-0090. You may obtain a copy of th=,.,u-r.1rarrWift_ s ,. •QU.NC by calli 503.232.1987 or 1.800.332.2344. l /' / /!
Issued By _ " ermittee Signature: ;C c�c!�'/!�" .CSC ,
Call 503.639:12 i a.m.for the next available Inspection date. /D /.2/'•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.
Belildi12 Permit Application
RECEIVEDFOR OFFICE USE ONLY
1 y Received /�,�
City of Tigard Date/B : MI Permit No.:// d/. -iU ZC2C
13125 SW Hall Blvd.,Tigard,OR 972 i( 9. 8 2013 Plan Review/-M �O■i
: 111' Phone: 503.718.2439 Fax: 503.598.14 Date/B : Other Permit:6/.0)2- 9013—ooi go
r l G A R D Inspection Line: 503.639.4175 Date Ready y� �, Suns: ® See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method:CO f.- Supplemental Information
RiUiLDINGDIVISION Usk uJ/ �l/4744-
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING i
'New construction ❑Demolition Permit fees*are based on the value of the work performed. r
Indicate the value(rounded to the nearest dollar)of all '3
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the Y
CATEGORY OF CONSTRUCTION work indicated on this application. O
,� .Valuation: $
g l-and 2-family dwelling ❑Commercial/industrial J�-��i 2 3.�
El Accessory building 12 Multi-family Number of bedrooms: by—
El Master builder ❑Other: Number of bathrooms: 3 O
JOB SITE INFORMATION AND LOCATION Total number of floors: 2- O
Job site address: /Z gj�Q 01'121 la/, New dwelling area: 2_4743 square feet ` '
City/State/ZIP: '77d7F}/ D �__ `,�ZZ 3 Garage/carport area: -jam- square feet V
Suite/bldg./apt.no.: Project name: J et_r-c#/ Z JesE Covered porch area: °0/ square feet (310
Cross street/directions to job site: n/ " " Deck area: square feet(�'(1
S1/0 12 724 )0/ - I ,grit) Oa�/2G( . Other structure area: -j Z�j3 square feet ."4I
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:-Pa,--1-j )Lj ON p Let 4 Lot no.: Z Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 41 ao-E- _t�� Indicate the value(rounded to the nearest dollar)of all
__ equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
y(] n , , /-/�5 n sh,1e Gti D�j Valuation: $
f [�J ( Y v.:u i Existing building area square feet
New building area: square feet
ROPERTY OWNER ❑ TENANT Number of stories:
Name: is n k/ Type of construction:
Address: rt Lp c- nQ e c9--k____, Occupancy groups:
City/State/ZIP: 770- a '. �� 9 '7ze,I Existing:
Phone:)) 5,7Z/. .51/ / Fa 43) 6'i-74/.3.3z_1 New:
L VAPPLICANT {❑0 CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name:
3 allY1)6- �/1 licensed with the Oregon Construction Contractors Board 19-5 d-b 6 Y under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) 2 Fax::( )
E-mail: Ta ny)mot-vet / 3 . # l° e C/fP}'fa//. c
CONTRACTOR ✓ BUILDING PERMIT FEES*
/ (Please refer to fee schedule)
/ Business name: Permit fee:
111/// Address:
3zin, O
State surcharge(12%ofpermit fee):
City/State/ZIP: FLS plan review(40%ofpermit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.: / J L) 56'7 Total permit fees: \4(73----0
i��Ilk o ' e i 1 Amount received: r�
� CCI„ �� � This permit application expires if a permit is not obtained
Print name:T mr /4 9,oef'La� Dater .2_g •Zoi js within 180 days after it has been accepted as complete.
l `9 * Fee methodology set by Tri-County Building Industry
Service Board
p,. I:\BuildingWermits\FPS-PermitApp.doc Rev 01/05/2012 4404613T(t 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
Describe w ork to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1-10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: - Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq.ft.
Fire Protection Permit Fees
Project valuation subtotal(see A,B&C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review(40%of permit fee): $
TOTAL: $
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees are required at submittal.
I:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 2
•Pluth'bing Permit Application
Building Fixtures . Folr OFFICE, usr ONi
Received n
City of Tigard RECEIVED Date/By: b ORg 13 Permit No.:H.67-6 / j
INU 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1,9(Q.. Q DateBy: Other Permit No.:5,,e do15-60/E6
l-I G A R U Inspection Line: 503.639.4175 ff��`U1�I t7 - 13 Date Ready/13y: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF 1 ,' OFTIGARD FEE* SCHEDULE
10.1,4'
II 11NcDIVISION
['New construction • Demo t ton For special information use checklist
Description I Qty. I Ea. L Total j
❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) '
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
911-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(__sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /2 '&' _) /2 C/ 771 Pt®e.,e_. Catch basin or area drain 18.76
City/State/ZIP: 77 6,-7 � (74, '9' Zz 3 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name7ayGe/ 2, I__/ k_Q� Manufactured home utilities 50.03
Cross street/directions to job site: /267-271
6 7 p 6, Manholes 18.76
*° Li)a-/i� ;/ , Rain drain connector 18.76• �fil Sanitary sewer(no.linear ft.: ) Page 2
. Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: h41_fj b n P -i „z,04 - I Lot no.: .z Fixture or item:
Tax map/parcel no.: 005 Backflow preventer 31.27
• DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
y/P. ` 0.4917n- b'-t /(2J� Dishwa sher
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
/ Fixture/sewer cap 25.02
Name: �,- ia. 62 o.�,,u,.. �c' ,7} Floor drain/floor sink/hub 25.02
Address: �/ �(,� /Dea9 Garbage disposal 25.02
City/State/ZIP: 20-L`F la C4.. /?2.9/ Hose bib 25.02
Pho ) . '2� /// Fax '594/352/ Ice maker 12.51
11/XPPLICANT ❑ CONTACT PERSON I Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: „ _Sink/basin/lavatory 25.02
City/State/ZIP: ' Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: /Ai/�-r,�!� �ii ."Pi/I5!./�,/�%i_: Water piping/DWV 56.29
Address: v%a,/ a. r P0/ _. 'C Other: 25.02
City/State/ZIP: Subtotal
Phone:q91) 2.,--y6-. D I -723 Fax:( )
Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signal e: / / ' . TOTAL PERMIT FEE
Print name:t\ I (//3 �-)j!_ `2 . Date6 2� •� This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1°100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
P 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 eyes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
1:1 Car Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive Stall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall _
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
•
Mechanical Permit Application • FoR OFFICE USE:ONLY
City of Tigard 'EIVED Date/By: 0 �/5 4)c 4, Permit No.:M`�T_dol 3-5O
° 13125 SW Hall Blvd.,Tigard,OR
C Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit: 51.0/2_00/3-cogQ
D 1:(:,A It Inspection Line: 503.639.4175 A i '% S 2013
I Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OFTIGARD
TYPE.;1 It DWG DIV ISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
ErNew 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*
2 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special informalion use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
//__ / G� o Air conditioning 46.75
Job site address: I Z v(.E�U /Z L _ ib t�C Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: / / [J /9-7E4 0-4 , 9�25 Furnace 100,000+BTU(ducts/vents) 54.91
' _ Heat pump 61.06
Suite/bldg./apt.no.: Project name:?rC�r 2� }�/e34�� Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
� Ir!—� /� Residential boiler(radiator or
S
7:11 p�, S ) Lba/i2 ' 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
,2y i _r o� Pia4 7 Other: 23.32
Subdivision: 7"] n Lot no.: �i
Other fuel appliances:
Tax map/parcel no.: c/Q/)4-�3 Water heater 23.32
. DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
1 .0"0 (c - /A ft-CCdLirr) fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove _ 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
•__ 70PERTY O NER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: ,,„_„ 1/4„,,,. ,� Range hood/other kitchen
J Clothes dt 33.39
Address:
Clothes dryer exhaust 33.39
City/State/ZIP: ��29/ Single-duct exhaust(bathrooms,
p)( toilet compartments,utility rooms) 23.32
Phgr )%� ?it . / / F� 5'.43.3Z/ Attic/crawlspace fans 23.32
\\.YY - APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: — { -- Furnace,etc.
r w \ Gas heat pump
Address: YviAl)/(j
Wall/suspended/unit heater
City/State/ZIP: • Water heater
Phone:( ) Fax: :( ) Fireplace
/� 2 J � Range
Email: man' rwa i' 23 . -'1"e TY4 I. C 7 v/ becue
CONTRACTOR Clothes dryer(gas)
Business name:
Other:
.MECHANICAL PERMIT FEES*
Address: ZEIW Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.: ' 1 0 7 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized si atu e: ,Thfria.v 7--1(--,,:k. - / tkulw * Fee methodology set by Tri-County Building Industry Service Board
Print name: U f `i ICJ _Lam( r A' Date: . •_ I I
I:\Building\PermitsNEC_PermitApp_040113.doc 440-4617T(I 1/02JCOM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$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.
1:\Building\Permits\MEC_PermitApp_040113.doc 2
Electrical Permit Application QQ /JC' FOR OFFICE USE ONLY
City of Tigard JJCEIVED Date/By: Q P 8 • Permit No.: Si�QJ�-DQ�QQ
Ilq ° 13125 SW Hall Blvd.,Tigard,OR Plan Review c
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Other Permit: dQe.)/3-4t7/
TI Ci A R D Inspection Line: 503.639.4175 A U r 2 8 2013 Date Ready/By: Judo: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
Cj 'IPF TIGARD
TYPE ORF]����,N �i,�'( *� PLAN REVIEW
giNew construction ❑Addition TdltCtdttOtt/[p1�CEM�111ON Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stones.
❑Demolition ❑Other: where the available fault current ❑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
la -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 ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","l-2","l-3",
Job no.: Job site address: �7 C ., // T7� 100HP or more. occupancy.
' / ' ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: ') ,9___,D,) Cr--k„ c /7 22 3 ❑Healthcare facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:TAY(&f 2, j_I es eS ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total i •
New residential single-or multi-family dwelling unit.
�l 1_ Includes attached garage.
Subdivision: ,: ,c-1- t jbyl Plc.�-�- zoo/1-163 Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 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,multi-family
2 Y n C- 3 C17 residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: t c- / _ �LQ (�E �/2 V 1_4_0
� 401 amps to 600 amps 200.34 2
Address: 106 6 oy c-ii 601 amps to 1,000 amps 301.04 - 2
Over volts 552.26 2
Ci ty/State/ZIP: J e / riV'Cn( o7G 9--7„:2 'j Temporary services or feeders installation,alte ration,
and/or
Phort�3) 5/74/.3/// ) 5/,L/33z) 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, er panel
APPLICANT ❑ 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
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:( ) Fax: :( ) dwelling,service and/or feeder _
v� Reconnect only 67.84 2
E-mail:�Q ni r)?CLYa z 3 . �- tc e 5 r 1 I .. �`� yY3 Pump or irrigation circle 67.84 2
CONTRACTOR f Sign or outline lighting 67.84 2
I Signal circuit(s)or limited-energy See
� /�usiness name: 1 / ►h 57 1 � �C panel,alteration,or extension. Page 2 _ 2
Address: vl/ N JJJ Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: Investigation(1 hr min) 66.25/hr
Phot ✓ 9Q/- /i Lj 0 Ft�3) 6 U/ - L&I./3 Industrial plant(1 hr min) . 78.18/hr
(J Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%A hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: Q
8 2 p /3 Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: Date: This permit application expires if a permit is not obtained within 180
�'Zg days after it has been accepted as complete.
" Number of inspections allowed per permit.
1:\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 otv. 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
El 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
El Heating,Ventilation and Air Conditioning OAR 918-309-0040)
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:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min) -
Inspections for which no fee is 90.00/hr
specifically listed eh hr min)
CONIIVIERCIAL 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
•
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building\Permits\ELC_PermitApp ELR_ERE.doc Rev 05/21/2013
1,11 q e Building Division
Development Code Provision Review
TIGARD Residential Projects
Building Permit No.: H`` c9U/ _0Oa0U
Project/Subdivision Name: rl-6-5P4 II e T >i o lv , Lot #: _°
Site Address: ,9`�LoOac.J 1 a 7 ' L -
CWS Service Provider Letter:
Required:Yes ❑ No 11
Received:Yes ❑ No t
Plans Routed:
Original-Plan-Submittal Date: 9la�f /-5 Routed By:����
1St Revision Submittal Date: ❑ Site 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 (1) items are approved. Items not approved and those listed in the notes must be
revised prior to re-submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review(contact 141t (I Cain 2s at (503) 718- f2 4 3/ or Che.fry I c @tigard-
or.gov)
Land Use Case No. MLPaoo 1 -ooOO7
Zoning R- 4.5
70 Setbacks:
Front aZ 0 Rear 15 Side s Street Side 44 IC✓ Garage 02 O
A Maximum Building Height: 30 Actual Building Height 4
Visual Clearance
Easements
Sensitive Lands Type: WA
Street Trees I❑ Protected Trees — no-1- S ha -see, ®t - l 01 2.I (3
Notes: Teo Ak 44-44 1-1-e�S 4. e c-`- 0-1 K b+ S k a-‘..s n . i 'I fi;4'
Trrc e MI 4- P t.-41..,,t Gl l ti -W % -lam be p r-u it c o d.
Original Plan: Approved ❑ Not Approved g Date:
Revision 1: Approved Not Approved Date: J 01 et! i.
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_R13S.doc Rev.01/16/13
•
Engineering Review(contact Mike White at 503-718-2464 or MikeW @tigard-or.gov)
,S Actual Slope: ecb 0/0
Notes:
Original Plan: Approved,Er Not Approved ❑ Date: 5 Vi 3
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albeit @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 J�Q/ No q/�
Date Routed to Building: C
/v9 `3
Page 2 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13
ADDRESS:
SEP 3 2013
CITY OFTIGARD 4.n, ,.OR..
BUILDMG DIVISION V M T r IIE 7 ,
;yea
t.01.777 1131,•171.113 WU NU.4771'GM,tin171777107,
7 13711. 1.1 bULYIN (7/SUM YOH A ROW Of 747 77.7•110
EL=270' 107.67'
tract "A" EL=271.
1" R
0
•
J ... 29.15 �.�.—�'^
/
PARCEL 2 N& DRIVEWAY. ,-
FLESKES GRAVEL DRIVEWA GARAGE , ;;
�j > DURING EONSTUGTI
51 23'•15 '' ,
7,570 SQ.FT. CO _ 20' MP��R_ ;
0, T9.7q.P,
-0 cfe
z i It .
15'
A • PRIVATE STOW
SEWER
EASE-11E10
/o F.
` 205
78
�`�ir .50'
\ k §,_t
o w §Za
.— > wmu
n— \ neR 64.17'
EL=272' 0.
N
W 1 E
S
SCALE = 1"=20
`PLAN NAME:
2479 PC2
E Drafting Corp ,,''r !-1 r1
PLOT: 8/29/13 PLAN Jd �.f
REV: 8/11113 R'8o�70�'POf ° g"'f §
M.cien ..7 0 ra? -Anna D
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: X-fs 72a/3 - 7 2 00 Jurisdiction: (I I Y OF /),17/517e---,6
Site Address: J28 sa) /27 ?CQ e --1/6/9720 97223
Subdivision/Lot#: 0-'- 2 , P/Ese 75 0/V
and/or 2 00 2/— (9Og 7 -fC/V P/cit I LD T Z
Map and Tax Lot#: 2 is-'J04. i)0 100
By my signature below, I certify that a minimum of fifty (50)percent of the permanently
installed lighting fixtures in the above mentioned building have been installed with compact or
linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)1
Signature: CLzL C_a cej v L,L C - Date: 2-6-2u1/
Owner/General Contractor/Authorized Agent
Print Name: .,CkTPCa a Jru' t c
-T' c\/67 ES T/tom°J/t
1 ORSC Section N1107.2.High-efficiency interior lighting systems. A minimum of fifty(50)percent o the
permanently installed lighting_fixtures shall be installed with compact or linear fluorescent,or a lighting source that
has a minimum efficacy of 40 lumens per input watt. Screw-in compact fluorescent lamps comply with this
requirement.
The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
permanently installed lighting fixtures are compact or linear fluorescent,or a minimum efficacy of 40 lumens per
input watt.
I:\Building\Forms\RES-HighEfficiencyLighting.doc 07/01/08
t
,
Oregon Residential Specialty Code 8318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
1, a e.t Coce,.1n-v l-/C - , am the general contractor or the owner-builder
at the following address:
Site Address: j 25&0 3a) /2.9724- 'P1 aC-e
City: 776719-x'p , sot, 9 2223
Permit#: p ST OD2
Subdivision/Lot#: 407 7 T-/ -54.8-5 Q�• �'U�
and/or Z oov/ - oc,3 5: >v T/* ON kali- 1
Map and Tax Lot#: 2 /o2714L 7 5 i OO
To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and
OAR 918-480-0140, I am notifying the building official that I am aware of the moisture content
Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement.
[Section R318.2 is provided for reference].
R318.2 Moisture Content: Prior to the installation of interior finishes, the building
official shall be notified in writing by the general contractor that all moisture-sensitive
wood framing members used in construction have a moisture content of not more than 19
percent by dry weight of dry framing members.
Signature: Fkii[..�1" 62 L« " Date: 2-6-241/
I:\Building\Form1RES-MoistureSensitiveWood.doc 09/25/08
s� X0/3-°0700
HOME Certitied, Inc. Monitoring Report
Customer: Park Place Inv.LLC Street Address: 12860 SW 129th PI. MC Goal % Start Date: 12/3/13 Sales Order#:
Subdivision: Lot/Unit#: City: Tigard Completion date: 12/13/13 PO or WO#:
Cross streets: Site Supervisor: PH#: Cert: Expected Date: Price$:
Date Moisture Content Readings
12'13120138:56 14% 16% 17% 14% 16% 18% 14% 15% 14% 15% 13% 16% 14% 14% 16% 14% 15%
15% 15% 17% 14% 14% 15% 1 1% 14% 16% 14% 15% 19% 15% 17% 12% 15% 14%
11% 12% 11% 10% 9% 14% 18% 18% 15% 16% 15% 14% 14% 14% 11% 12% 12%
16% 13% 10% 1 1% 12% 14% 11% 14% 12% 17% 14% 14% 15% 11% 14% 16% 14%
15% 19% 15% 17% 12% 15% 14% 11% 12% 11% 10% 9% 14% 18%
•
Crawl Space
1,9:1411:45 13% 14% 13% 10% 16% 16% 13% 15% 15% 13% 15% 18% 17% 13% 15% 17% 17%
13% 17% 19%
Livin s ace Equi : Pulled
Equipment
Pre-ism/ario,moisture main(Frame dying): Notes:
Crawl testing:drfirg:
Fbor testing/drying:
Water Damage:
Sheetrockdrying
Stud scrubbing:
Certificate of Moisture Content
Other.
E le;trc heat:
Visitation:
Contractor signature: Date: Customer signature: Date:
Chris Jones
See terms&conditions on back
zor 1
.ntsr �or3 =70e - I .
Energy Trust New Homes ..77."1E,Eriav5r,;, 7e.
Certified Residential Air Dud System 7F
. Co F"`two ma to
Company Name tii,,■ Lr!n t
Technician A ■fr. ■ `
Date
Z'I
fiance Zone CAZ Test ?;
Main Zone Zone 2,if applies
CAZ WRT Outside
Pa Pa
Baseline(WR T Outside,fans off) Pa Pa
NET CAZ Pressure(subtract Pa Pa
baseline from CAZ WRT outside) ____
Duct Leakage .. out one x Pa sticicetper duc - b
Description of Area System Serves / f
Cond.Floor rea System Serves(ft')
0 yes no Air Handler in conditioned space?
0 yes 10110 Air Handler present during test?
If"yes"for either,then axi um CFM is 75 CFM @50 Pa or
floor area x 0.06 q CFM @50 Pa,whichever is greater.
If"no"for both,then maximum CFM is 50 CFM @50 Pa or
floor area x 0.04 = CFM @50 Pa,whichever is greater.
, Test Method: ❑Leakage to Outside or otal Leakage
Test Result �"r FM @50Pa
I )
4 Fan pressure&CL( Pa Gauge type: ❑DG-3 or G-700
2 i Ring(circle one) OP P-1 ��
Q.....
Duct Blaster Location 3-(z, _.
< - {
Pressure Tap Location k i if k k1-61