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Permit CITY OF TIGARD MASTER PERMIT II ' • ' COMMUNITY DEVELOPMENT Permit#: MST2013-00216 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2013 Parcel: 2S104CCO2400 Jurisdiction: Tigard Site address: 13951 SW HILLSHIRE DR Subdivision: HILLSHIRE ESTATES NO.2 Lot: 130 Project: Minor Project Description: Remodel(2)bathrooms and add(1)additional bathroom. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 3 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 ' Detectors: Total: 0 sf Value: $150,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 3 Washing Mach: 0 Laundry Trays: 0 Rain Drain 0 Urinals: 0 Lavatories: 4 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs/Showers: 2 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: 2 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 4 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!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 4 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: MINOR FAMILY REVOCABLE TRUST HAMMER AND HAND INC Required Items and Reports(Conditions) 13951 NW HILLSHIRE DR 1020 SE HARRISON STREET TIGARD,OR 97223 PORTLAND,OR 97214 PHONE: PHONE: 503-232-2471 FAX: Total Fees: $3,156.31 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 Centel Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a co questions to OUNC by calling 503.232. -:[i• 80;3 2.2344. Issued = / / _�= Permittee Signature: , ��/,1Y��� . . � ' /- Call 1� -� :00 a.m.for the next available Inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the Job site at the time of each Inspection. • Building Permit Application p Residential RECE ' �kf U FOR OFFICE USE ONLY Received City of Tigard OCT 10 2013 DateBy: /Q 40 t3 I� Permit S7 7/•3' -DG22/,, ° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie l7 IC(1,5 ` , Other Permit: ' Phone: 503.718.2439 Fax: 503.598.196V I T/O"TI VM RD Date/By: i Inspection Line: 503.639.4175 Date Ready y : El See Page 2 for 7 Internet: www.tigard-or.gov BUILDING DIVISION (4,4 j thod: c//el/3 Supplemental Information ormation u)/ & 2 TYPE OF WORK REQUII/D DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ([Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1-and 2-family dwelling Valuation: $ / St0, y g ❑Commercial industrial ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 131,6-7 0'1A/ HI us HI,E pa. _ New dwelling area: square feet City/State/ZIP: -176A--(2,0/ e R 77223 Garage/carport area: square feet Suite/bldg./apt.no.: - Project name: A4`AJO/C. Covered porch area square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rotnded to the nearest dollar)of all . equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. P b de { 2 e—c S f ,its �] // /„a s Valuation: $ �NL c / t _r 1 ►47 (17 u�q/E/ Existing building area square feet �1 c� New building area: square feet PROPERTY OWNER ❑ TENANT Number of stoties: Name: 5:1414 Y itt.1 D Pj AA tkoi2- Type of construction: Address: J 3 q 5/ 5(A) T l/L-5 /i -E, D, , Occupancy groups: City/State/ZIP: /� 76,A .b,,, C g cl7 2%2/3 Existing: Phone: ;�:.-i ) R7 f ' {0tf' 01,06 Fax:( ) New: APPLICANT pi•.CONTACT PERSON BUILDING PERMIT FEES* ,J��Q�—�� t' (Please refer to fee schedule) Business name: t l / -r l /J/m 6 JD �'I�/p( _TN C. Structural plan review fee(or deposit): Contact name: /C 1G�7af'11xf4CO� rAl�Coc74 FLS plan review fee(if applicable): Address: / % l t'A- 44 t SO X 4'7'. City/State/ZIP: I 1)/ ®A g7Z1(� Total fees due upon application: — I / Amount received: Phone:(30 le (,�it�r / Fax: :( ) E-mail: + ry avid f4tOr r co PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. G Submit two(2)sets of roof plan with connection details Business name: p�-��� D 1)' /�C C ( ) P.14 Y and fire department access,along with the 2010 Oregon Address: /D 7/S �J G RN f,l r�N PR 1. Solar Installation Specialty Code checklist. City/State/ZIP: + gyp" e, ak.gw g a-]��('(f Permit Fee(includes plan revie $180.00 1 and administrative fees): Phone:6 3) 23�—2 Fax.( ) - State surcharge(12%of permit fee): $21.60 CCB lic.: 1 65-r t `"1/3'14 Total fee due upon application: $201.60 {�8 P PP Authorized signature: I 1 This permit application expires if a permit is not obtained 1 . ° • within 180 days after it has been accepted as complete. Print name: al if'`( �� ID- . ,/ Date: 1 O: (o A-3 *Fee methodology set by Tri-County Building Industry d co tJtJ ` 4J,/ J Service Board. I:\Building'.Permits\BUP-RESPermitApp.doc 02/24/ III 440-4613T(I I/02/COM/WEB) • Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY ' City of Tigard Received Permit No.: . u 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: C • Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical • Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW - Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: • ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 • Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. . 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, Cl ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- Cl ❑ ❑ floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ ❑ locations. Show attic ventilation. . 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is rcquircd ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore•on and shall be shown to be applicable to the .ro'ect under review. j JURISDICTIONAL SPECIFICS . - . i 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. Cl ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street'Free List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, Cl ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. , • 1:\Building\Permits\BUP-RESPertnitApp.doc 02/24/2011 440-4613T(II/02/COM/WEB) • Plumbing Permit Application I . _ Building Fixtures "', ` FOR OFFICE ici: usi: ONLY City of Tigard Received / /� g OC 1 DateBy: L���Q ��' Permit N ST�Q��!/(/z2/f0 li u 13125 SW Hall Blvd.,Tigard,OR 97223 ® 2013 Plan Review C Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: I DateBy: Inspection Line: 503.639.4175 CITY OF r1GAR 11 Date Ready/By: El See Page 2 for I IGAKp Y Y g Internet: www.tigard-or.gov RI III npr, r ilLey Iotified/Method: / !� Supplemental Information . TYPE OF WORK - 47i YY�� FEE" SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. Ea. Total /.Addition/alteration/replacement CI Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ( CATEGORY OF CONSTRUCTION ' • SFR(1)bath 312.70 X-1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building El 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: l s-1 f4 l(- gh' Catch basin or area drain 18.76 n `�� Drywell,leach line,or trench drain 18.76 City/State/ZIP: j �K f7ZZ r � � I 3 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: /14/N£�1� Manufactured home utilities 50.03 Cross street/directions to job site: - "` Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Po,i/t4 L Clothes washer 25.02 0 t_IL( 2 -exr 5 1 7!/!� lijil` Dishwasher 25.02 LQGt-t c' Qom_a , / (,y, Drinking fountain 25.02 �• �_ tt Ejectors/sump 25.02 . ?PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: 6-- Lei /4, ,.,1 fie-T7-y GI 1 Fixture/sewer cap 25.02 -L wK �/c l 1 / Floor drain floor sink/hub 25.02 Address: .9957 Go �( I C Si� 2G / � � T7 � �' Garbage disposal 25.02 - City/State/ZIP: /Q�P(OE, 17 2-Z 3 Hose bib 25.02 Phone:(q71) !at' D2f 00 Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: /f/f f�Q R c J "//C Medical gas(value:$ ) Page 2 C -l g-cl rr I/'?jn/ , 1ii�Y"� 6"€ Primer 12.51 Contact name: �j / P C Roof drain(commercial) 12.51 Address: / {�FQ�JS�� S 7', Sink/basin/lavatory (-} 25.02 City/State/ZIP: (O /OTT-41U rlit� 7 Z(4 Solar units(potable water) f 62.54 Phone:(L`-j/ 9 790 b v Tub/shower/shower pan ?/ 12.51 �J`"'��jn((//„/J-©/ /% �� Co Urinal 25.02 E-mail: wvJ�(((���'' 1 f r CONTRACTOR Water closet 3 25.02 r Water heater 37.52 Business name: 444d F , l IJ ru h fi2� Water piping/DWV 56.29 /Address: S • D = b A '. L Other: 25.02 1 City/State/ZIP: O� D(-0 1 7 l 7 Subtotal t ( 2 O9? 3 ( ) Minimum permit fee: $72.50 Phone: �,'3) � 7 Fax: CCB Lic.: I/6.5- / Plumbing Lic.no.: .;&P---29 pB Plan review (25%of permit fee) I State surcharge(12%of permit fee) Authorized signature: ji �� TOTAL PERMIT FEE Print name:d��-�� O ^ Datc This permit application expires if a permit is not obtained within 180 days 6 ..c..Q�r- p. O, (3 after it has been accepted as complete. iFee 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. " .Feelea) Total Square Footage: Permit Fee:. Footing drain-1st 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 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: , $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 Ins 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"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan•Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. 'Work Performed: Capped Added Relocate _ _ __ ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall 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 1. ❑ 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: -LavBar 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: l:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Mechanical Permit Application Foil office usE oNLY /�A n City of Tigard` Pi‘j � \I Date/By: p /U / ti:• Permit No ST�/g- /, 71 ° 13125 SW Hall Blvd.,Tigard,0' .' 3,1 w,� 4 Fn Plan Review Phone: 503.718.2439 Fax: 503.598.196 Other Permit: Inspection Line: 503.639.4175 0C I 1 0 2013 Date T I G A R D Date Ready/By:ReadyBy: 7uds: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: 776---- / Supplemental Information CITY OF TRGARD TYPE MEW it A'I V ISIOOI' COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* •and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. . Multi-family ❑Master builder ❑Other: Description Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: / � �( / S WL �h' D� Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 1 . ! OP` �j Furnace 100,000+BTU(ducts/vents) 54.91/ Heat pump 61.06 Suite/bldg./apt.no.: Project name: AV f( AJ Duct work Li 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) - 23:32 --- Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas /2vzocL'/ 2.e.x(S-&. , t /( 4Qa tS fireplace 23.32 f /y Log lighter(gas) 23.32 444 a C C /� `C Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 . yt PROPERTY OWNER I ❑ TENANT , Other: 23.32 Environmental exhaust and ventilation: Name: 5-r- Np (, /14/mi' Range hood/other kitchen ' tG, /y,'Q"`�I j� equipment 33.39 Address: 13 q 5/ w `u f t f G` De_ ' Clothes dryer exhaust 33.39 City/State/ZIP: 776, D/ 04 ' 22 3 Single-duct exhaust(bathrooms, r et 7 toilet compartments,utility rooms) 23.32 Phone:(T7/5 •.IfO/ • 24 6 Fax:( ) Attic/crawlspace fans 23.32 s APPLICANT la CONTACT PERSON Other: 23.32 , Business name: (41j1)0 !L/1,,,�ti TN( Fuel piping:It coop lCt � $14.15 for first four;$4.03 for each additional Contact name: � /�y �f��� Furnace,etc. • l D 2 7f� ,•�J'T I'''-'.7�N Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: ©/7 7 10�/ O� £7 7v(f Water heater Phone:( '7)j 7� — 1(g to( `r I Fax::( ) I ' I Fireplace , Range E-mail: CO O/:-/717/4�• ]b/WD/MA - avii Barbecue CONTRACTOR' A ! : , AG Clothes dryer(gas) E () i�l 6 t t�/�// Amp Other: Business name: I ll�r' [-� �� �O¶7 MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: co_"1 "f .Jp I 1 LI Minimum permit fee($90.00) Phone:6-03 ) 3 - 33i 2 Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lic.: 1 703 7A TOTAL PERMIT FEE / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: I. : . • Fee methodology set by Tri-County Building Industry Service Board Print name: lj4vr4(1'a % 'C.DQ� Date: [ 10- I:\Building\PermitsVMEC_PermitApp_040113.doc 440-4617T(I 1/02/COMM'EB) 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$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Building\Permits\MEC_PermitApp_040113.doc 2 ' • •10`'/10/2013 15:28 5032882231 DEKORTE ELECTRIC PAGE 02/02 Electrical Permit A �' ; -°i4-: I," I FOR OFFICE USE ONLY City of Tigard eserved /0 /0 /' i7!,4. pernitlr si�ZO/3-0• / OCT-.C T: �;:2013 Dat&B I w 13125 SW Hall Blvd.,Tigard,OR 97223 �' / Plan Review ` Phone: 303.7132439 Fax: 503.593.196 t"Duras.: Other Permit. • Inspection Line: 503.639.4175 :Nal i.'k Vii'=:�i4k�� � L4 Date Ready/By: luris: El See Pagel fir -1 ICiAt:li P d n �e fin^" �� I Supplemental information. Internet: wvvw.ligardor.gov " J,ii.y11 16'"',� i!;1 i .J.,,. tificdtMetbod _ ,rrt TYPE OF WORK . M1 ; PI.* REYOW :.:. ttion/altetation/re lar ement Please check a4 that apply(subtnir 3 sets of plena w/iteeos checked below); V❑New construction P ❑service or feeder 400 amps or more ❑Building over three atones. 0 Demolition 0 Other: where the available fault current 17 Marinas Sod boatyards. creeeds 10.000 amps et 130 volts oc ❑Flo liAg buildings. CATEGORY.OF CONSTRUCTION less to ground,or exceeds 14,000 ❑Commercial-use agricultural ...IN:Dand 2-family dwelling ❑Cornmercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: afire pomp. d installation of t50 XVA or ❑Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑Addison of new motor load of ❑"A".-E","1-Z""l-3"• p r I_ !WOtW or more. occupancy. Job no.; Job site address: ( ' � � f I�{r�v .1 ❑sir or more residential units. O gecreational vehicle parks. City/State/ZIP:-7,- ' , *L. • ❑Healh-we facilities. ❑Harerdcus localism.. Supply voltage for MOM rhea 600 volts nominal Suite/bldg./apt.no.: 0 Project name: ❑Service or feeder 600 amps ormare. izfr$ SCHEDULE '!>•�ICE Cross street/directions to job site: New residential New residential single-or mttltl$amily dwelling unIt. • Includes attached garage- Lot no.: 1,000 sq.ft_or less Nii Subdivision: Ea.add'I500 sq.R or portion 33,92 II Tax map/parcel no.: Limited energy.residential 75.00 G r t ©. DESCRIPTION OF WORK /withaboveso.ft) 1`i Limited energy,multi-family 75,00 �® i�I residential with above•..ft, Renewable Energy ❑ See Pa:e 2 Services or feeders installation.alteration.and/or relocation 200 amps or less 100.70 "N1 ❑ PROPERTY OWNER I 0 T T 201 art's m 400 amps 133.56 Q., Name: 401 amps to 600 amps 200.34 Address: 601 amts to 1,000 amps 301.04 Over 1.000 amps or volts 55226 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or relocation Phone:( ) rFac:( ) 200 amps or less 59.36 1 . A Owner installation:This installation is being made on property that I own which is not 201 amps to400 amps 125.08 2 intended for salt,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168,34 J 2 ' Owner signature: Date: — Branch circuits-new,alteration,or extension,per panel ❑ AP. PLICANT f ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder Ice, 7 a2 2 to I each branch circuit Business name: .r B.Fee for branch circuits without y I service or feeder fes,fat 56.18 2 fi,', Contact name: y branch circuit _ I Address! Each add'l branch circuit _3 7.42— 1 2 - Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling,service and/or feeder • Phone ( ) Par::( ) Reconnect only 67.84 2 • E-mail: Pump or irrigation circle 67.84 • CONTRACTOR Signor outline lighting 67.84 ��� Signal circuit(s)or limited energy See 4) Business name: . �� _ _ panel.alteration.or extension. Pa:c2 2 L) Address: • ✓i) y►/1 L,r 1 Each additional lospeefion over allowable In any of the above ! IV ' U Additional inspection(1 hr min) 6625/hr City/State/ZIP: ►6 Ic-�1 �- `'(.>>i% 0 I Z3 Cj v/ Investigation(1 hr min) 66.25/hr Industrial plant(l he min) 78.18!br Phone:(93 .4 a r v Pax: ) Inspections for which no fee is �i CCB Lic.: / T fr Electrical ic.: 07 ' , ciftcall listed emir)n 90.00/hr �/� .ELECTRICAL REMIT REES .' Suprv.Electrician signature,r-- ' -um/ y Subtotal: f r Plan review 0.5%of permit fee Print name: �e l �, r Date: /Q Ito/'3 State surcharge(12%of permit fee): ;� 1�! / M Authorized signature; TOTAL PERMIT FEE: ELM. 1 This permit epplicatioo expires if a permit is not obtained within 180 Print name: Date: v days after it has been accepted as complete. * Number of inspections allowed per permit. I:11Sulleingt.PermitstELCJyutpp_ELR.ELdac Rev 0501/201) 440-46 Intl 1/05/COMPKE$ • 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 13951 SW HILLSHIRE DR, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical final 2014-04-10 14:43:00 MST2013-00216 PASS Violation Summary: Inspector Contractor