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Permit „ CITY OF TIGARD MASTER PERMIT ' 11 COMMUNITY DEVELOPMENT Permittt: MST2014-00004 TIGARD 13125 SVV Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2014 Parcel: 25111 DC05600 Jurisdiction: Tigard Site address: 9415 SW BRENTWOOD PL Subdivision: WEST PARK ADDITION TO FOREST GROV Lot: 538 Project: Eischen Project Description: Full interior remodel BUILDING Floor Areas Required Setbacks Required Stones. 2 Bedrooms 0 First 0 st Basement 0 sl Left 0 Parking Spaces 0 Height 0 Bathrooms 0 Second 0 sl Garage 0 sf Front 0 Smoke Dwelling Units 0 Third 0 sf Right 0 Detectors Yes Total 0 sf Value $55.000 00 Rear 0 PLUMBING Sinks: 0 Water Closets 3 Washing Mach 0 Laundry Trays 0 Rain Drain 0 Urinals 0 Lavatories 5 Dishwashers: 1 Floor Drains 0 Sewer Lines 0 SF Rain Storm Sewer 0 Drains 0 Tubs/Showers 3 Garbage Disp: 0 Water Heaters 0 Water Lines 0 Catch Basins 0 Bckflw Prevntr 0 Footing Drain 0 Ice Maker: 1 Hose Bib 0 Backwater Value 0 Drywell-Trench Drain: 0 Other Fixtures 0 Other Fixture Units MECHANICAL Fuel Types Air Conditioning: Y Vent Fans. 4 Clothes Dryers 0 Natural Gas Heat Pump N Hoods 1 Other Units 0 Furn-.100k 1 Vents. 0 Woodstoves' 0 Gas Outlets 1 ruin>=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 WI Svc or Fdr 0 Ea add9 500 sf 0 201-400 amp 0 201-400 amp 0 W/O Svc'Fdr 13 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�.arm 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 V B H-3 Owner: Contractor: EISCHEN.STANLEY M TL REMODEL AND CONSTRUCTION INC Required Items and Reports(Conditions) 15755 SW OAKHILL LN PO BOX 1996 TIGARD.OR 97244 LAKE OSWEGO.OR 97035 PHONE 503-440-2095 PHONE 503-984-2783 FAX. Total Fees: $2.182.74 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 i suspended for more the 180 days ATTENTION' Oregon law requires you to follow the loc-adoptedby the Oregon Utility Notification Center Those ru-- are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a co of the rules or direc uestions to OUNC by calling 503 . or 1 800 332 2344 Issuedp-r. - ._--- Perm ittee Signature: - . 'r 3.6 -4175 by 7:00 a.m.for the next available inspection date. 116/ This permit card sha e i ept 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. 4 . 4 Building Permit Application , q: Fire Protection System Ci ,jE -} FOR OFFICE IISE ONLY City of Tigard , , ..i A. DatelBReceived y: / A /4/ Pcnntt Nu_ i/`.,l Y Q/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review a Phone: 503.718.2439 Fax: 503.598.1960 Date/By frX,Z3/./;Y DiN Other Permit: T I G A R D Inspection Line: 500.639.4175 Date Ready/By: 02402 June B see rage 2 for Internet: www.tigard-or.gov Notified/Method: /9 Sepplementel Information —uL Ttlr+ 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 dollar)of all ,0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: S I-and 2-family dwelling ❑Commercial/industrial 55 ❑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: 44 c lc New dwelling area: square feet City/State/ZIP: 11r rd, ()Q,., CrtZ , 1 Garage/carport area: square feet Suite/bldg./apt.no.: I Project name: 11 f Q..nC lam,C� Covered porch area square feet Cross street/directions to job site: AI der b � 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)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. +4.41 i✓1�'c,r;0r CBw"E c.� Valuation: S Existing building area square feet New building area: square feet Ia.PROPERTY OWNER ❑ TENANT Number of stories: Name: 94Gn k i t E i S el Type of construction: Address: 15755 5u CdrK..ii;II 1 .t.6 Occupancy groups: City/State/ZIP: T‘,..r rA) ( R Civic/ Existing: Phone:(541) Y90- X015 Fax:( ) New: la APPLICANT ❑ CONTACT PERSON NOTICE Business name: TL Rt'rt—pd aI ..d Gs,t^5i c_. All contractors and subcontractors are required to be r / licensed with the Oregon Construction Contractors Board Contact name: f t 1 �*OL,n S ky under ORS 701 and may be required to be licensed in the Address: 90 $ox 1 176 jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP:/ cd4c f _ ,r(� O{�` 97003 S apply: Phone:(5(2) y.z1:751, ` 0 Ij Fax: :( ) E-mail: L/QP.w,o ottJ t &,e4 '- r-0 r+n. CONTRACTOR BUILDING PERMIT FEES* Business name: `7--L (Please refer to fee schedule) ,moo[c.1 J �n . ^L-in e . Permit fee: Address: b y 1 Ch i 1 Slate surcharge(12%of permit fee): City/State/ZIP: 0 cr?C8_4- FLS plan review(40%ofpermit fee): Phone:( ) ley.Z7s3,-1 Fax:( ) (Due upon application.) . CCB lie.: /,/21 y Total permit fees: /, ,7 , Authorized signature:. `Y ..- Amount received: jjj 0P-- This permit application expires if a permit is not obtained Print name: 7 l! y" L IA I Date: / ./3 -,/q within 180 days after it has been accepted as complete. • Fee methodology set by Tri-County Building Industry Service Board. IVBuildingl PermitzVFPS-PermitApp.doc Rev 01/05/2012 440-4613T(I I/02/COM/WI B) City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: (:1 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. T j. 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: aq.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\Perauts\FPS-PetmitApp.doc Rev 01/05/2012 2 . . . Plumbing Permit Application,\JED Building Fixtures {�lll......v FOR OFFICE USE ONLY City of Tigard , * 2014 Received Permit No . II/ ... • 13125 SW Hall Blvd.,Tigard,OR 97223n 11OD DateB /175 _ t i A'la Plan Review Phone: 503.718.2439 Fax- 503.598.196( r• Date By. Other Permit No.: 'HOARD Inspection Line: 503.639.4175 �IQN Date Ready/By luris 65 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK - FEE' SCHEDULE ❑New construction ❑Demolition For special information use checklist • Description I Qty. I Ea. I Total 5a Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) _ CATEGORY OF CONSTRUCTION ' SFR(1)bath 312.70 I-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78 ❑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: `rIS Su) Catch basin or area drain 18.76 rent wot7.� ��SCC. Drywell,leach line.or trench drain 18.76 city/State/ZIP:T• ti„prr`�, Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: R I trI l 1-,/d*t Manufactured home utilities 50.03 Cross street/directions to job site: A lAtr.. 6 r ao, 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: J I.ot no.: Fixture or item: 'Fax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 I iRS>t Cr / P d.,,e'k ' / /1'14 4. J t.Ir( 6•v4L--ib=,-, Dishwasher I 25.02 ✓I[3v11 ,1 Drinking fountain '25.02 Ejectors/sump 25.02 fiEl PROPERTY OWNER l ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 °+e't l e y E s4"6"s Floor drain/floor sink/hub 25.02 Address: 157$6 SI.,i Oc--tK i{,I! iqt.,� Garbage disposal City/5tate2 �lP: - P 25.02 I l` r�J b�i ZZ y Hose bib 25.02 Phone:(505 ) Yyv.20 qr Fax:( ) Ice maker I 12.51 1:1 APPLICANT pi CONTACT PERSON Interceptor/grease trap 1 25.02 Business name: Medical gas(value:$ ) Page 2 T�L' Rs''�,^(E Primer 12.51 Contact name: 1 f (J _ i o" La u'h y Roof drain(commercial) 12.51 Address: fn 66K /14,4 Sink/basin/lavatory S 25.02 City/State/ZIP: L c.ill . 0.5 y J Solar units(potable water) 62.54 Phone:( ) 'fill. L$ Q3 I Fax::( ) Tub/shower/shower pan 3 12.51 E-mail: �j Urinal NJ 25.02 7L�,,.k,dc,� vC . . DO . C-(O►-L • Water closet 3 25.02 CONTRACTOR ,, Water heater 37.52 Business name: ��/ ,Wlr/el/C"9 Water piping/DWV 56.29 Address: l(,6 sc, crk) ,63G.77- jAt1n-(J�'� Other: 25.02 - City/State/ZIP: ; C� " ( 7 Subtotal Phone:ear )527 te5n ax:( ) /A^ Minimum permit fee: $72.50 CCB Lie.: 7x0 Plumbing Lic.no.: Pei Plan review (25%of permit fee) O . ��/ State surcharge(12%of permit fee) Authorized signature: A. TOTAL PERMIT FEE Print name: -d f y p` , • Date; 7p This permit application expires if a permit is not obtained within 180 days 1 11r_ / after it has been accepted as complete. "Fee methodology set by Tn-County Building Industry Service Board. 1-\Building\Pcrmits\PI.Mtl-PermilAppdoc 10/01/09 440-46I6T(10/02/COM/WEB) Mechanical Permit Wictit1Hilcr) FOR OFFICE:USE ONLY V.City of Tigarf teltvBed Permit No. 11 s=" 13123 SW Hall Blvd.,Tig ,OR 9723 y- 1 "� - ' '� Phone: 503.718.2439 Fax: 54.1 6a U li Plan Review Date/By Other Permit: I T I G A RD Inspection Line: 503.639.4 5 Date Ready/By: lung la See Page 2 for Internet: www.tigard-or.ggyN OF 1IGARD Notified/Method. Supplemental Information TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construct ion ,®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES" R I-and 2-family dwelling El Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family ❑Master builder ❑Other: Description I Qty. 1 Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning I 46.75 Job site address: 911 1 Cj S u Er„,,, e A pi • Furnace 100,000 BTU(ducts/vents) 1 . 46.75 City/State/ZIP: T 15otr4) � 17 Z { 9 L Furnace 100,000+BTU(ducts/vents) , 54.91 F_ ` Suite/bldg./apt.no.: Project name: (p�� Heat pump 61.06 LJrer.E w a.dl • Duct work I _ 23.32 Cross street/directions to job site: A I d e../L h Hydronic hot water system , 23.32 Lr 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 i 33.39 Flue vent for water heater or gas ve,,, - 4-,-,.cc Jyy c / IJLre-Fr f 4.40l CRS 0 +;r(, -, , fireplace . I - 23.32 V- 1 Log lighter(gas) , 23.32 Wood/pellet stove , 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER ❑ TENANT Other: 23.32 Environmental exhaust and ventilation: Name: z Range hood/other kitchen + 1< 3 equipment I 33.39 Address: is7ss 5l-✓ QaK .11;11 /c,kt Clothes dryer exhaust 33.39 City/State/ZIP:T rd D R 17Zi Single-duct exhaust(bathrooms, �! 23.32 J toilet compartments,utility rooms) Phone:(yam ) 9 c ,zo 95 Fax:( ) Attic/crawlspace fans 23.32 , ❑ APPLICANT 1.05.CONTACT PERSON Other: 23.32 Business name: Fuel piping: TL (J f �CC� $14.15 for first four;$4.03 for each additional Contact name:1 i Lsq b tM rtftt Furnace,etc. gS-4 VLA Address: Po tc pk (cl9i y Gas heat pump Wall/suspended/unit heater City/State/7AP: L9/._ (L_�o k 1039 Water heater Phone:(515 ) 9 -- gy z7R 3 Fax: :( ) Fireplace , Range , E-mail: i" Qv Y t 1 0 y,t l n o .Ca lw•N Barbecue ONTRACTOR Clothes dryer(gas) Business name: n Other: - - +�`}'tnyJ +t � Gv j 1,/O - MECHANICAL PERMIT FEES" Address: l 6303 ),E 36 ST Subtotal . City/State/ZIP:V0.v.c D(J vex Loa- q t O` Minimum permit fee($90.00) p,� Plan review(25%of permit fee) Phone:(50. 7 G�fe•805 5s. I Fax:( ) State surcharge(12%of permit fee) CCB tic.: /925-146, 6 x7541 4) 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: • Fee methodology set by Tri-County Building Industry Service Board Print name: deo„,",Pd"�zv ok y,0 ve Date: -iii ft' ' I'Huildi ng1'ei mite\MEC PermilA 01 I3.doc 440-4617T(11702/COM/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$1 0,000.00 $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. :113uilding\Permits1MEC_PermiIApp_040I 13.doc 2 II I Electrical Permit Application ', ED FOR OF FICF. t•SE ONLY City of Tigard ,t Zpti4 Received Permit so.: - 13125 SW Hall Blvd.,Tigard,OR 97223 plan R � "• • Phone: 503.718.2439 Fax: 503.598.1960 ()that Permit T 1 G A R D Inspection Line: 503.639.4175 i 4, : - Date Ready/By: Juts B See Page 2 for Internet: www.tigard-or.gov mutt`rtnIl ikir) Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction '�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. 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: 0 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","1-2 "1-3 p� IOOHP or more. occupancy. Job no.: Job site address: 11.05 S W Li(errt•r.cm( f l4(� ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: Tie e „A cfl"L2`� ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: 6 re,i4 ti t ❑Service or feeder 600 amps or more Cross street/directions to job site: Deser,ntioo FEE SCHEDULE A ur brti01� I Qty. I Fee, I Total j v 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'l 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.) (}_ ,t Limited energy,multi-family At ei i I r `—4-� I ,ps' �E., residential(with above sq.R) 75.00 2 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: ...7C-0,,t tt E l.,/G��c11t^1s 401 amps to 600 amps 200.34 2 Address: / '"f.S Sv O,rdL t4 .11 i q►hL 601 amps to 1,000 amps 301.04 2 City/State/ZIP ' Over 1,000 amps or volts 552.26 2 /5e rte(J `17'LZ Temporary services or feeders installation,alteration,and/or relocation Phone:(Sa ) y 40 .2.D. Fax:( ) 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 `44 CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: --'r'_ ��'�4■ each branch circuit R.Fee for branch circuits without Contact name: "r_k name* service or feeder fee,first branch circuit 56.18 2 Address: Po An), I ! 1.1 Each add'I branch circuit i�, 7.42 - 2 Miscellaneous(service or feeder not included) City/State/ZIP: Lq Each manufactured or modular dwelling,service and/or feeder 67.84 2 Phone:(� ) 7Q 1�' iii I Fax::( ) - Reconnect only 67.84 2 E-mail: ' w ti,^ij A r• 1.-.• l,Qi,�j,--• Pump or irrigation circle 67.84 - 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Lr 6 r ,4_,C e(C Signal circuits)or limited-energy • See ' panel,alteration,or extension. Page 2 2 Address: �(� U� Q4:2 panel,additional inspection over allowable in any of the above // p r,,7 Additional inspection(I hr min) 66.25/hr City/State/ZIP: pi[3 DCI Jl�� G f- [7 G� Investigation(I hr min) 66.25/hr Phone:(' .4) 33 v•s-'f7 Fax:( ) Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: ( 6�/� Electrical Li .: Suprv.LIC.: 3 S--5 specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: 6 LA, e 5(L � Subtotal: Print name: �v�h l i J it 5-01 DFat`e;'i Plan review(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: Print name: r/ 5 1,66-sr Date: This permit application expires if a permit is not obtained within 180 �t days after it has been accepted as complete. • Number of inspections allowed per permit. I.1BuildinglPennits\ELC_PerntitApp_ELR_ERE.doc Rev 05/21/2013 440-46151(1I/05/COM/WEB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 9415 SW BRENTWOOD PL, TIGARD, OR, 97224 Residential - Master Permit 199 Electrical final PASS MST2014-00004 Jeff Grove Violation Summary: Inspector Contractor