Permit CITY OF TIGARD MASTER PERMIT
' COMMUNITY DEVELOPMENT Permit#: MST2014-00005
Date Issued: 01/23/2014
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503 718.2439 Parcel: 1S134DB12600
Jurisdiction: TIGARD
Site address: 11285 SW FOREST LN
Subdivision: 2008-038 PARTITION PLAT Lot: 1
Project: Home Investment Services
Project Description: Repairs due to water damage
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 sr Garage 0 sf Front 0 Smoke
Dwelling Units. 0 Third 0 s° Right 0 Detectors
Total 0 s' Value $800 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
Furn<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 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 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&Stereo N HVA • N Security Alarm N Vaccuum System N Garage Opener N All
Other N Other Descnption Ecompasing N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF JB tt 3 0
Owner: Contractor:
HOME INVESTMENT SERVICES LLC HOME RESOURCES UNLIMITED INC Required Items and Reports(Conditions)
BY BRADEN.JOHN N 294 NW 2ND AVE#412
1102 N SPRINGBROOK RD,STE CANBY OR 97013
113
NEWBERG.OR 97132
PHONE 503-816-8352 PHONE 503-310-7952
FAX 503-263-0067
Total Fees: $115.79
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and :II 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. o/f wor is suspended for more the 180
days. A TION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification C-• 7 r T e rules are set forth in OAR
952-0 1-0010 through OAR 952-1=•-1090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 2 • 1• pf 0 332 2344
Iss d By: t' .0 ;� Permittee Signature: A
Call 503.639.4175 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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit A lice
pp�,E1VE
FOR OFFICF USE ONLY
City of Tigard JAN 21 2014 Received Pernut Na: r o�/y/ 1i
13125 SW Hall Blvd.,Tigard,OR 97223 DateB ,_6 _C c ;
Phone: 503.718.2439 Fax: Spa$9g,196a. Plan y Review ,� i z / er Permit
Inspection Line: 503.639.4174-i 1 Y VC fICi,�}�� Date Ready :y: Suns ® See Page 2 for
Internet: www.tigard-0r.gov(3t I I DING DIVISION Notified/Method: Supplemental information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dolls)of all
Addition/alteration/replacement ❑Other: equipment,materials,labor,overh-•s .•• • .c•fit for the
CATEGORY OF CONSTRUCTION work indicated on this :•: • on.
s I-and 2-family dwelling ❑Commercial/industrial Valuation: S $� '
❑Accessory building ❑Multi-family Number of bedroo
❑Master builder ❑Other: Number of bathrooms: o f
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: \l-5,S 5v,, o GLie_Sic• LAN New dwelling area: I square feet
City/State/ZIP: 17/,4,0 G Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: ({pap.5+ (__iv Covered porch area 1 square feet
Cross street/directions to job siteSW Ivol2k'• -0 A kv-t-A- Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar • all
equipment, ..terials,labor,overhead,and • profit for the
DESCRIPTION OF WORK work indicate, : this application.
Valuation: $
1gi.,?I -ICf_. takkrt — c-kh✓hA cut._ woos
Existing building area square feet
New building . • . square feet
` ] PROPERTY OWNER I ❑ TENANT Number o ones:
Name: V\b ,i 3s 0 S ( M 61 I k SviAl I C Type o •• coon:
Address: \\oZ ts, S�iZ■Iv o (• •fQook R,4 (j Occupancy groups:
1 Existing:
Phone:(513)4(c, EZS L Fax:( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: r t ) V
�ah- z_ ��Ot.,li�L'�.S YtN�l ram ��� � All contractors and subcontractors are required to be
Contact name: s licensed with the Oregon Construction Contractors Board
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:( ) —I Fax::( )
E-mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: k C'i h€ 4._,s oL,\{Z c i S ury 1 i r4,kilt., i C (Please refer urger schedule)
1� Permit fee:
Address: 2 94, 2:-.1 _-_ 412 C(h'- V 7
City/State/ZIP: i C 5)Q4.-- ( State surcharge(12%of permit fee):
,"1vti3.t, 0+` FI.S plan review(40%ofpermit fee):
Phone:(3o3 ) 3(D — 7)_5 Z Fax:( ) (Due upon application.)
CCB tic.: f c6_,5- 4\is ,. Total permit fees:
Amount received: ---4 ;;"----- -
Authorized signature:
This permit application expires if a permit is not obtained
Print name: , 5/14 0 v Date: ( �y� within 180 days after it has been accepted as complete.
7tl I 1 * Fee methodology set by Tri-County Building Industry
Service Board.
I.\BuildinglPermitslFPSpermitApp doc Rev 01/05/2012 440-4613T(11/O2ICOM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work 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 0 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-PevmitApp.doe Rev 01/05/2012 2
CITY OF TIGARD �.. _
BUILDING DIVISION PERMIT#:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 /�a,0141 � � -,� L/
Inspection Requests (24 Hrs.): (503) 639-4175 !i ''L.
INSPECTION WORKSHEET FOR DATE:itc,, f TIME: - PAGE:
SITE ADDRESS: ! ' f l CLASS OF WORK:
SUBDIVISION: E ! '� `1 e f � E J `� LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
�! i 4 L-
Corrections/Comments/Instructions:
1`' / •' 4 d ,i4111:7*. /-7 1 k r. A 4,1 C'i(/ _. '711,M2 L
l o d t ,& / /;. �f p'`7 , E . Ay f.p i`_.i 77,::„: /7 ..���.
/
PASS PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
,,AI-FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
r
I spector: �'�- ��i�'� ....,M-�- Date: /0 t) 12 I(Erb Phone #: (503) 718- e 4'- 47
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11285 SW FOREST LN, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2014-00005
George Heimos
1. No one home, please provide access for inspection, no inspection made. Recall when
ready. 103.5.4
Left paper report1. No one home, please provide access for inspection, no inspection
made. Recall when ready.
Left paper report
Violation Summary:
Inspector Contractor