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Permit p CITY OF TIGARD MASTER PERMIT 11 ' COMMUNITY DEVELOPMENT Permit#: MST2013-00256 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/06/2014 Parcel: 25111 DC08500 Jurisdiction: Tigard Site address: 15735 SW OAKHILL LN Subdivision: SUMMERFIELD NO.10 Lot: 572 Project: Shultze Project Description: Master bath remodel 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: Yes Total: 0 sf Value: $24,500.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays' 0 Rain Drain: 0 Urinals: 0 Lavatories: 2 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains. 0 Tubs/Showers: 1 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 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders 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: 6 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v. 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N 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: SCHULTZE,CHERYL K TL REMODEL AND CONSTRUCTION INC Required Items and Reports(Conditions) 15735 SW OAKHILL LN PO BOX 1996 TIGARD,OR 97224 LAKE OSWEGO,OR 97035 PHONE: 480-353-7978 PHONE: 503-984-2783 FAX: Total Fees: $1,108.84 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. AP 1TION: • =ron law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0r -0010 through OAR• r= ,-: You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 or 1.800.33 344. 1 Iss ed By: ` • / ��f1 J _/ Permittee Signature: �• Call 503.639.4175 by 7:00 a.m.for the next available inspection.ate. i 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. 33ailding Permit Application Residential FOR oFFlci: US1 ONl;1° Ci of Ti and i Received EcEl01. illED• }�, II `J g t DateB ��� / Permit No.:/1/4/jregaJ7--r,C) 5.--, ° 13125 SW Hall Blvd.,Tigard,OR 97 2 A Plan Re 'l 1♦r�� C Phone: 503.718.2439 Fax: 503.598.19613 E C 19.2013 Date/B : other permit: TI G A R D Inspection Line: 503.639.4175 u Date R .Pr.': ® See Page 2 for Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: I 6 y)� na Supplemental Information TYPE OF WOOING DIVISION REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 2-[I J aO Accessory building Number of bedrooms: ❑ ry ildin g ❑Multi-family ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 15735 S j (7■Ics 4 tji.\1 IC4ht New dwelling area: square feet City/State/ZIP: Garage/carport area: square feet eT►r��ral,� �7�-Z`� Suite/bldg7apt.no.: Project name: 51,1411-z.. Covered porch area: square feet Cross street/directions to job site: Aw ✓ 8il00I Deck arca: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST' Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. /VI of-tl./- bictil, Rte. 64� Valuation: $ Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: 0.4.310.A. (. . Type of construction: Address: 15 735_ S� ©a k ,t 'a``e Occupancy groups: City/State/ZIP: T Ai,� ( '7Z.2N Existing: Phone:( (/ 3 71/.8. Fax:( ) New: ❑ APPLICANT CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: C�a1MG -� Structural plan review fee(or deposit): Contact name: 1 w„ L....ctJ~h FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: l��5O7 Phone:( ) Fax::( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top m. ted Photo Voltaic Solar Panel System. Business name: 1 o�, ,tom,` 46 � O Submit two( ets of roof plan with connection.- .ils "� and fire departm-•t access,along with - t 0 Oregon Address: co Qa k I el ot t Solar Installation .•cialty Code c list. City/State/ZIP: r � ..e5a c�7 ads Permit Fee(incl *es pl. eview $180.00 X03) °lig zit 3 J ( ) and admim. .tive fees): Phone: Fax: State surcharge( o of p•• it fee): $21.60 CCB lie.: Iq(ZI4 _ _ Total f due upon appli ..ion: $201.60 Authorized signature I - This permit application expires if a ,ermit is not obtained within 180 days after it has been ac •.ted as complete. Print name. / Date: I Z•I °t.1 *Fee methodology set by Tri-County Buil ng Industry !-���1^' k j v Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) PlulimBing Permit Application Building Fixtures ill:ECE1VE ; FOR OFFICI ONLY USE OLl 1 l !i Received City of Tigard 9 2013 Date/By: ,-9. 0 A Permit No.: . S� l a62�5� 511 q 13125 SW Hall Blvd.,Tigard,OR 9 DateB : �a • Phone: 503.718.2439 Fax: 503.5 0 plan Review Other Permit No.: p Date/By: .I.I G A It D Inspection Line: 503.639.4175 CITY OC TIGAAD Date Ready/By: luris' ® See Page 2 for Internet: www.tigard-or.gov lI����yy qq r y� p� Notified/Method: Supplemental Information TYPE OF i iNG 1JIUISIOIV FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description Qty. I Ea. Total fg Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 SFR(2)bath 437.78 and 2-family dwellin g ❑Commercial/industrial Uindustrial ❑Accessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 . JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: i S S al( 11 A\ ' Catch basin or area drain 18.76 TI t a`�� Drywell,leach line,or trench drain 18.76 City/State/ZIP:T3q 0 R q�7 7.L1 Page' Footing drain(no.linear ft.: ) P e 2 Suite/bldg./apt.no.: I Project name:S��I1-� Manufactured home utilities 50.03 Cross street/directions to job site: Amckcr'h 'ook Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Ms ' btu t eyv,A[kEs\ Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 .ig PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Ckt.ries 51,,(..' Address: )S'-7;�7 S1 f Oak_ 1 ICt Floor ge disposal sink/hub 25.02 �W `1� Garbage disposal 25.02 City/State/ZIP:• A(4 c Q QN ql Z.. ) Hose bib 25.02 Phone:Igo 2 • ']O,'�8 Fax:( ) Ice maker 12.51 ❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 M,� •� Medical gas(value:$ Business name: . /� tr/�7�/Y g ) Page 2 Tin 8i/`"/ i Primer 12.51 Contact name: / �T Jr' Roof drain(commercial) 12.51 Address: /WV'_(}r) �uv/ V l Sink/basin/lavatory 2 25.02 City/State/ZIP: tvl�'�/, O� 97/1-f Solar units(potable water) 62.54 Phone: L 1,27 cy7 j GC rFax::( 1 ) ar� Tub/shower/shower pan i 12.51 E-mail: if� �_�1 G[/ '��'f'i"ce /��/"" ,C. �7 Urinal 25.02 Water closet 1 25.02 CONTRACTOR Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 7/�-(/q� Plumbing Lic.no.: f/21 / State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: 77-41 ii /-44105(faera/J14', Vie. Date:�f��CS This permit application expires if a permit is not obtained within 180 days "y < after it has been accepted as complete. *Fee methodology set by Tn-County Building Industry Service Board. I:\Building\permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/C0M/WEB) 1Vteclianical Permit Applica • FOR OFFICE USE ONLY City of Tigard ' Date/By: lQ` �� Permit No.:/- , f>/., � 13125 SW Hall Blvd.,Tigard,OR 9 2 Plan Review C " ' Phone: 503.718.2439 Fax: E Date/By: Other Permit: Inspection Line: 503.639.4175 U C 1 9 2 013 T I G AR � Internet: www.tigard-or.gov Notifieed/MeReady/By:od: kris: Supplemental� Information Page 2 for CITY��Ooo�F TIGARD TYPE O1��oo 41:1MG DIUISIC' COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction *'Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*. 115-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: /�_ 1u1 `` Air conditioning 46.75 Job site address: 15-7.35 Su/ �bl 17 i11 14He Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:-II c►r, et7 9 l.I Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: ° 7 Project name: Heat pump 61.06 S`1�I�Z Duct work 23.32 Cross street/directions to job site: A I ol`f. 1:7.t ^ak 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 Two vex 6.-rt, RAIN AE,Tt fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 PROPERTY OWNER I 0 TENANT Environmental exhaust and ventilation: Name: Q,�1 ` Range hood/other kitchen [ \t...1.-1.-1... equipment 33.39 Address: 15735 g4.1 OaK �:11 1 0.1„8 Clothes dryer exhaust 33.39 City/State/ZIP:t—'� R o� J7 ZZ� Single-duct exhaust(bathrooms, n 1 i r' 4f r _ toilet compartments,utility rooms) L- EXT Phone:(9i10) 3t '7 7 O Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT ! -CONTACT PERSON Other: 23.32 --1--.1_, W �Q+1 Fuel piping: Business name: 1Q $14.15 for first four;$4.03 for each additional Contact name: --f- ,vv, La D t4 P O �C( v\s J Furnace,etc. Address: l 1 g ' "r Gas heat pump � 4�,b WalVsuspended/unit heater City/State/ZIP: / „kc t,A_DU / O f Water heater Phone:(5Q ) 9$� .2_753 Fax:::( ) Fireplace v Range E-mail:-ft.,Rev,ro AAA (] L'C TOCi)' Barbecue CONTRACTOR Clothes dryer(gas) Other: Business name: nath wv i MECHANICAL PERMIT FEES* Address: IT 6303 A/K 36 t.. ) Subtotal City/State/ZIP: I/ IV 4 5 et C gZ% Minimum permit fee($90.00) �, ��� Plan review(25%of permit fee) Phone:(s63) 9/r_I ' Rost' Fax:( ) State surcharge(12%of permit fee) CCB lic.: j 1 15 99 TOTAL PERMIT FEE //' /1i This permit application expires if a permit is not obtained within 180 �� days after it has been accepted as complete. Authorized signature: • Fee methodology set by Tri-County Building industry Service Board Print name: nq Pt t,(x h p✓ Date: )2.:n''3 1:\Building\PermitstsEC_PermitApp_040113.doc 440-4617T(I l/02/COM/WEB) • MVb ) Electrical Permit Application DEC 19 2013 FOR OFFICE USE ONLY City of Tigard Date/B Received /7"® i Permit No.: 1-15i—ye, 4 570 ° 13125 SW Flail Blvd.,Tigard,OR 97223 CITY OF TIGARD Plan Review : Ill • Phone: 503.718.2439 Fax: 503.598.1 1ILDfNG DIVISODateB : Other Permit: Inspection Line: 503.639.4175 f Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction Igl,Addition/alteration/replacement 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: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. tir 1-and 2-family dwelling CommerciaUindustrial less to ground,or exceeds 14,000 ❑Commercial-use agricultural y g ❑ ❑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: 1001-1P or more. occupancy. IS�35 S w OaK 41;LI I°.k es ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: q a � O� tail��y ❑Health-care facilities. ❑Supply voltage for more than Jl 1 ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: S,(.1-1 ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: AId�, npc. Description I Qty. i Fee. I Total I V '1 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 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 75.00 2 Mci Thdr .t(„.. 12.9.1(1,041A residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation liA PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: <t_ , _ ,1 sL.. v 401 amps to 600 amps 200.34 2 Address: 15 7 3 5 S Li e)c i� H Ai i��e4 601 amps to 1,000 amps 301.04 2 City/State/ZIP: t�TQI Over 1,000 amps or volts 552.26 �2 � "4- i OK 1 u` Temporary services or feeders installation,alteration,and/or Phone:( ) 3.5?„ `791% 1 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 • 18 CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: `n_ Rcvy,0(/1 kl. , each branch circuit R. B.Fee for branch circuits without Contact name:—T,INN Lcx� 1 service or feeder fee,first i u�c' branch circuit 56.18 2 G Address: PI k I leu Each add'l branch circuit t; 7.42 2 City/State/ZIP: Q �7 Miscellaneous(service or feeder not included) LA k l\ cn C 35 Each manufactured or modular Phone:(503) LD •21 g3 Fax: :(! ) dwelling,service and/or feeder 67.84 2 n Reconnect only 67.84 2 E-mail: .-r'1_, v„�okd Q i qL p6 ��� . Pump or irrigation circle 67.84 2 r� CONTRACTOR Sign or outline lighting 67.84 2 Business name: t-(/ ti, Cl�t;�/- ((C Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: P() 9 O y U- o Each additional inspection over allowable in any of the above (kid n Additional inspection(1 hr min) 66.25/hr City/State/ZIP: "kJ d c Jh✓.� 0 1"' °L r Investigation(I hr min) 66.25/hr Phone:(17( ) 3 3 8-- CI$-A Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: (q 'b$7, Electrical Li :C IQ li Suprv.Lic.: 5-5 specifically listed(V2 hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,requ• ed: 644 Ck,f34- 41 Subtotal: Print name: iQh� ri l''aS,eui Date: Plan review(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: -__! • TOTAL PERMIT FEE: / _ / This permit application expires if a permit is not obtained within 180 Print name: (' 5{#„U /it", C��kc v/[ Date: days after it has been accepted as complete. ' Number of inspections allowed per permit. I:\Building\PermitAELC_PermitApp_EL.R_ERE.doc Rev 05/21/201 440.46151(11/05/COM/WEB