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Permit CITY OF TIGARD MASTER PERMIT ill Permit#: MST2013 00142 3 COMMUNITY DEVELOPMENT Date Issued: 05/05/2014 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S126D603000 Jurisdiction: Tigard Site address: 9351 SW 92ND AVE Subdivision: MONTAGE Lot: 1 Project: Montage, Lot 1 Project Description: Building 1 -New SFA BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 312 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 34 Bathrooms: 3 Second: 700 sf Garage: 280 sf Front: 4 Smoke Yes Dwelling Units: 1 Third: 700 sf Right: 5 Detectors: Total: 1712 sf Value: $200,015.78 Rear: 4 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib 2 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 2 201-400 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 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 SFA VB R-3 1712 Owner: Contractor: NW AREA INVESTMENTS LLC AAA PROPERTIES INC Required Items and Reports(Conditions) 11150 SW RIVERWOOD RD 16501 NE 65TH CIRCLE 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97219 VANCOUVER,WA 98682 PHONE: PHONE: 360-609-3465 FAX: 360-718-9701 Total Fees: $15,189.63 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 OAR 9 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: C9AT . 'P[1/C/ t77OA/ 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 Application 6/20//s s W -6-, ,Q c r / c Residential ty RECEIVED FOR OFFICE USE ONL\ -DO/ Z Received City of Tigard DateBy: /} /3 Permit N f 7�3 y • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review it t // '� Phone: 503.718.2439 Fax: 503.598.1960 JUN 19 2013 ate/By: /ö tar(�j Other PeniJ J, ' //3 —00/30 T I I l;ll Inspection Line: 503.639.4175 Date Ready/By: /O /�// ruri ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: 3 / �!T Supplemental Information TULDING MASON E-n-t 2 �"a' v '4 TYPE OF WO REQUIRED DATA:1- ND 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 ❑Commercial/industrial Valuation: $ ) d 5; ❑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: 93 $/ 9�? 4-f- New dwelling area: '/ 7/ Z square feet City/State/ZIP: / Garage/carport area: ...-2_13e› square feet Suite/bldg./apt.no.:B I 6= / Project name: Covered porch area: p square feet Cross street/directions to job site: , �� Deck area: `�� square feet L�^�� `A_ Wks`ee/A may%`�j Other structure area: square feet �'�� i� � / / / REQUIRED DATA:COMMERCIAL-USE CHECKLIST S division: 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/WO/RRK,/',/ work indicated on this applicattiio7n. �l a w)7& ' 7n ,1'4 C�zW/7 —SJ 9 Valuation: $ / a , Existing building . a /quare t New building area:1; z:-.7 • are feet k)s PROPERTY OWNER //� ❑ TENANT Number of stories: ' �. h� //72 .:4------ //�l/ � �.� Type of construction: fr' illosPr Name: /- 1 Address: f l/ � �f( / r t — , A� Occupancy groups: Atil (\ City/State/ZI/P:`� 1.1 / / G,1j Existing: Phone: , 77 Fax: 7 377 L? New: , i_ APPLICANT CONTACT PERSON BUILD G PERMIT FEES* (Please refer to fee schedule) Business name: e/ L �/ /` � �17M�r Structural plan review fee(or deposit): Contact name: ,l�.a , '1/f /1 J//G� v FLS plan review fee(if applicable): Address: '��/ !/�`j�/ - Total fees due upon application: City/State/ZIP: f/J' / - , , , Phone:( ?� vv'�'7 l- 416;1/Fax:f� : ) Amount received: E-mail: 1. /3 7J,g c� � if PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* '" t G l Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: hl—nn i F /07. 7�—_ �/ Submit two(2)sets of roof plan with connection details '� // and fire department access,along with the 2010 Oregon Address: ft - I . WI G - - 1� - Solar Installation Specialty Code checklist. lty/State/LIP: r� �7��i Permit Fee(includes plan review $180.00 and administrative fees): ,ne: le i/ W "Ar // g— 1 ° State surcharge(12/o of permit fee): $21.60 lie.: i� • 41 97a0 V Total fee due upon application: $201.60 `'zed signature: f�j, / This permit application expires if a permit is not obtained // within 180 days after it has been accepted as complete. r t 'f' P *Fee methodology set by Tri County Building Industry fe. �� ili�1 ///�i� � . r ` �! I Service Board. \rmits\BU•-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) • Building Permit Application Checklist ' One- and Two-Family Dwelling FOR OFFICE USE ONL1 City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: III Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: T 1 G A R D 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other THE FOLLOWING I I'1':AIS ARE REQUIRED FOR PLAN REVIEW 1 e No N/.-1 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. ❑ ❑ Cl 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. 11 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, ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 showingfoundation 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 required ❑ ❑ ❑ 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 a licable to the ro'ect under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11-x 17". 0 ' 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Buildingplans shall not contain red lines or tape-ons. "Mirrored"buildingplans 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 Tree 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, ❑ ❑ ❑ 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. I:\Building\PermitslBUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) Plumbing Permit Application Building Fixtures RECEIVED Received It)Il Ol l It I I til 1)\I l City of Tigard Permit No S 1111 I ■ 13125 SW Hall Blvd.,Tigard,OR 3 9 2013 Plan Re. T�6/3 Qd y,2 Phone: 503.718.2439 Fax: 503.5 Plan Review Other Permit No.: Date/By: Inspection Line: 503.639.4175'IT�OF TI Date Ready/By: orris RI See Page 2 for l I G A I:l) Internet: www.tigard-or.gov 11 OF n TIGARD Notified/Method: Supplemental Information TYPE II�/�.7IU1°I FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-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: -- Catch basin or area drain 18.76 Job site address: 3'S`/ �'c� i4z/C Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: NO/01 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: 1 Lot no.: / Fixture or item: Tax map/parcel no.: ! Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: / y ' i `/ , i `"J ' r Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: , �� ,i%f� /' Garbage disposal 25.02 City/State/ZIP: I'l / f�� 4/� I Al...-_,, Hose bib 25.02 Phone: ,,,4,1.• 4. - AM ? Ice maker 12.51 • APPLICANT ❑ CONTACT PERSON 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 CONTRACTOR Water closet 25.02 _ Water heater 37.52 Business name: j��, i.I. j A. 4.-Water piping/DWV 56.29 Address: ii,/47 1 ipjX 7 Other: 25.02 City/State/ZIP: / 0pA2 Subtotal Phone:) 77 L ti of ax:�� / j Minimum permit fee: $72.50 CCB Lic.: (' 17 / Plumbing Lic.no.: 501- 4e7.) Plan review (25%of permit fee) 7 State surcharge(12%of permit fee) Authorized signature: ///'�� - "� _ TOTAL PERMIT FEE Print name: f,/'//� This permit application expires if a permit is not obtained within 180 days �� `i>� Date: ,� yj after it has been accepted as complete. - `ply- "Fee methodology set by Tri-County Building industry Service Board. I:\Building\Permits\PLMU-PennitApp.doe 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 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 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 fce 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. El 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 4„ ❑ 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 p Water Closet-Toilet l plumbing permit can be issued. Urinal Other Fixtures: I:\BuildingWermits\PLMF_PermitApp.doc 08/04/2011 2 Mechanical Permit Application l t I11 ul I.ICE ESE ON l,l Received JAr" q/3 I9_.City of Tigard \ #\) DateBey Permit No / V 7 w 13125 SW Hall Blvd.,Tigard,OR i Plan Review Phone: 503.718.2439 Fax: 503.5':.M " Date/By: Other Permit: Inspection Line: 503.639.4175 9 �- Re l I C.A K t) p G� Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov Q Q Notified/Method: Supplemental Information QF1VGP �p14 TYPE OF WO SOW' \S COMMERCIAL FEE* SCHEDULE - USE CHECKLIST p� Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteratid 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* ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: q?,� I 3(A3 q 9- kite. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: \/] a('CI `p Furnace 100,000+BTU(ducts/vents) 54.91 " Heat pump 61.06 Suite/bldg./apt.no.: L..)\ Project name: MOM-ilk/2- Duct work 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.: 1 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 fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Pi PROPERTY OWNER ❑ TENANT Other: 23.32 _ Environmental exhaust and ventilation: Name: 1Vw Kim �.-V1v pc mpiA.*s LL_C„ Range hood/other kitchen _ iht �� -` equipment 33.39 Address: `' T sU e '7 '-1 JO(`VJOOd R.C-1 Clothes dryer exhaust 33.39 City/State/ZIP: l-1�(.1A��CA �} P g l o t (4 Single-duct exhaust(bathrooms, ` f toilet compartments,utility rooms) 23.32 Phone:(61)3 3 a _"3-1 1 1 Fax:( [,`jl; S ,'7 1 I `��'; Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: Fuel piping: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax: :( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) - Other: Business name: INt_ 1 S -1\emit C00ll Ir\��{ ii. MECHANICAL PERMIT FEES* Address: �" y / j J{ b ?).1?� jai t: `:��,' t1 i; Subtotal City/State/ZIP: ' t< S C' . Minimum permit fee($90.00) Phone:(903) L�(l}_ �jQ j{�j Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) I CCB lic.: 1 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 .....z________--- ' Fee methodology set by Tri-County Building Industry Service Board Print name: D�`�S 2t CVAi / Date: �i- i, 1:\Building\Permits\MEC PermitApp_040113.doc 440-4617T(11/02!COM/WEB) l Electrical Permit Applicati IOR OFFICE ISIl Om.) Cl of Tigard Received ///� i 2 _I Permit No � ��'3�O/y� City b ��nn 3CEVE' Re (P Iv �� 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review Phone: 503.718.2439 Fax: 503.598.1 Date/By: Other Permit: `N192013 l c `i<l Inspection Line: 503.639.4175 Date Ready/By: orris: ® See Page 2 for I Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY or TIGARD TYPE Ol 1 t PLAN REVIEW 1` ( 111ci�?h' New construction Please check all that apply(submit�,sets of plans w/items checked below): ❑ ❑Addition/alteration/replacement , 0 Service or feeder 400 amps or more 0 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: ❑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", Job no.: Job site address: pS"7 Set} 9:g_ c"' I Six or more e more. occupancy. / ❑Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: )111/70,11 ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. ] Fee. I Total I " 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'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.) Limited energy,multi-family 7500 2 residential(with above sq.ft.) 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 AP Name: P/ /I/ /�y'��;{� �- 401 amps to 600 amps 200.34 2 Address: iitcp 4, Ai 1/e94/1.5 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: / f.Z)7��-�! � .' ''7�i Temporary services or feeders installation,alteration,and/or Phone:( /j' f`??7 7 Fax:( '7 1-- 71 relocation ,t 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 ❑ 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'l branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:( ) I Fax: :( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: /,/3 �j�� :/ Signal circuit(s)or limited-energy See ,' V panel,alteration,or extension. Page 2 2 Address: q---? , /6- t �� / " Each additional inspection over allowable in any of the above ��/f Additional inspection(1 hr min) 66.25/hr City/State/ZIP: 4f71, /- A 1' 7 ) Investigation(1 hr min) 66.25/hr Phone:( 1-07�7� Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr A CCB Lic.:L q c I Electrical Li .. 44 _rv.Lic '�hd/ specifically listed(%:hr min) J ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: �� Subtotal: Print name: ��-/`- ; Date: Plan review(25%of permit fee): r' State surcharge(12%of permit fee): Authorized signature: Ili g„ird TOTAL PERMIT FEE: nom/ / / This permit application expires if a permit is not obtained within 180 Print name: Wan /�� ✓ / ) r - days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Penniu\ELC_PennitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(1 t/05/COM/wEB I Building Division Development Code Provision Review r l c,n P. Residential Projects Building Permit No.: /`'i-f X0/3 Project/Subdivision Name: ' i1,Vr4G-E, /s z_a 6- / , Lot #: Site Address: j-35/ 4i z/t CWS Service Provider Letter: Required:Yes ❑ No Received:Yes ❑ No ❑ Plans Routed: �,,/ Original Plan Submittal Date: �//Q/-3 Routed By: K5523— 1St Revision Submittal Date: a 7 Site Plan Only Routed By: 2nd Revision Submittal Date: 7 //i3 ja' Site Plan Only Routed By: 4A. 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 (✓) 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 p� at(503) 718-Z4vi or 1� @tigard- or.gov) r ' Land Use Case No. 3 iero ci -03 Zoning 11)U2 "l a Setbacks: o Front V Rear Side 5 Street Side o G age /8 a Maximum Building Height: Actual Building Height 3 7 a Visual Clearance 0 Easements 1 Sensitive Lands Type: ❑ Street Trees .2 Protected Trees Notes: /i2 u: G a/ /T/cc&Lo Original Plan: Approved ❑ Not Approved Date: b—L d —/3 Revision 1: Approved ❑ Not Approved.r Date: 7 ---/e) i3 Revision 2: Approved,Fl Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 Engineering Review(contact Mike White at 503-718-2464 or MikcW @tigard-or.gov) ❑ Actual Slope: 4- Notes: ti j> 1t--i..,' f,F It A2-4-4,2 5,41-/-4 _ j to= 1 4. Original Plan: Approved ❑ Not Approved Jr7 Date: Revision 1: Approved Not Approved ❑ Date: • /2//3 Revision 2: Approved 4' Not Approved ❑ Date: Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albert@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 Ap.licant Okay to Issue Permit: Yes b. No y 1-1-?//Date Routed to Building: lS 7 )//3 Page 2 of 2 I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 2, 2015 at 1:08:46 PM MST2013-00142 David Young Cap and label dryer duct developed length and for future use per code. M1502.4.5, .6 Seal gas line penetration in garage ceiling. All else ok. Note: no AC installed on this permit. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal PASS March 2, 2015 at 1:04:16 PM MST2013-00142 Chip Barnett Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL March 2, 2015 at 1:04:12 PM MST2013-00142 David Young Zip tie on T&P not an approved fastener. Replace and secure @ 3' OC max per table 3-2. All else ok. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL March 2, 2015 at 12:23:04 PM MST2013-00142 David Young Provide approved planning and engineering sign offs for project prior to building ﬁnals. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal PASS March 18, 2015 at 1:36:27 PM MST2013-00142 David Young Correction from previous inspection complete. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 18, 2015 at 1:41:27 PM MST2013-00142 David Young Corrections from previous inspection for sealing around gas line penetration in garage and labeling developed length of dryer vent not done. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection FAIL March 2, 2015 at 12:23:04 PM MST2013-00142 David Young Provide approved planning and engineering sign offs for project prior to building ﬁnals. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 399 Plumbing ﬁnal FAIL March 2, 2015 at 1:04:12 PM MST2013-00142 David Young Zip tie on T&P not an approved fastener. Replace and secure @ 3' OC max per table 3-2. All else ok. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 199 Electrical ﬁnal PASS March 2, 2015 at 1:04:16 PM MST2013-00142 Chip Barnett Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 699 Mechanical ﬁnal FAIL March 2, 2015 at 1:08:46 PM MST2013-00142 David Young Cap and label dryer duct developed length and for future use per code. M1502.4.5, .6 Seal gas line penetration in garage ceiling. All else ok. Note: no AC installed on this permit. Violation Summary: Inspector Contractor 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 9351 SW 92ND AVE, TIGARD, OR, 97223 Residential - Master Permit 299 Final inspection PASS - C of O MST2013-00142 David Young Final erosion control approved. Street tree certiﬁcation received. Moisture content form received. High efﬁciency lighting form received. Insulation certiﬁcation checked. No ac installed at ﬁnal, permit and inspection required at time of installation. Note: builder to ﬁnish raking bark dust on entry side to provide slope to drainage Swail away from slab on grade. Violation Summary: Inspector Contractor