Permit y CITY OF TIGARD MASTER PERMIT
F'1 a COMMUNITY DEVELOPMENT Permit#: MST2014-00211
Tigard OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 12/04/2014
TIGARD 9
Parcel: 1 S 135 DA02603
Jurisdiction: Tigard
Site address: 9095 SW NORTH DAKOTA ST
Subdivision: GRAHAM ACRES Lot: 29
Project: SELENE FINANCE LP
Project Description: Installing a 275 gallon above ground oil tank that is connected to the furnace.
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:
Total: 0 sf Value: $2,300.00 Rear 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0
0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp$rvc/Feeders 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: 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. N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
OTR SF R-3 0
Owner: Contractor:
SELENE FINANCE LP C/O KRISTIN BROtSOIL SOLUTIONS Required Items and Reports(Conditions)
3835 NE HANKCOCK ST SUITE 201 3540 SE 28TH AVE
PORTLAND,OR 97212 PORTLAND,OR 97202
PHONE: 503-381-4315 PHONE: 503-234-2118
FAX: 503-331-7133
Total Fees: $213.21
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 e in accorda ce 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
d s. ATTENTION: Oregbn law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52-001-0010 through OAR• r r 00• You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 7 .800.332.23 .
sued By: _ .� ��.! 1 / Permittee Signature: k
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.
11/26/2014 14:31 Soil Solutions (FAY)5033317133 P.002/006
Building Permit Application
Residential FoR OrrICE usE.ONi,Y
Received
City of Tigard Deter : r i Permit No.: y 1rr,
III 13125 SW Hall Blvd.,Tigard,OR 97223 V 2 2u'14 Plan Review ��
------Ir. Phone: 503.718.2439 Fax: 503.598.1960 ( Date/B : 18,•I� � l Other Permit:
'1t(.AR1) Inspection Line. 503.639.4175 CITY(y.-f A av DataReady/By: r see Pate I(or
Internet: www tigard-or.gov CITY vv�a Notified/Method Supptemenial Information
11mrt. gflI Ifh f4,?
TYPE OF v'ORK°"- k. .RF7 u NfRED DATA`I"la.,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 El Other: L equipment,materials,labor,overhead,and the profit for the
CATEGORY•Of CONSTRUC'?ION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial
Valuation: $2,300
1:1 Accessory building _I=1 Multi-family Number of bedrooms.
12 Master builder l7 Other Number of bathrooms:
JOB SITE INFORMATION AND}•L(•)CATIOti Total number of floors:
Job site address:9095 SW N.Dakota St New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Seim)Finance LP Covered porch area: square feet
Cross street/directions to job site: K A Deck area: square feet
A;•e,oe, ', -' Other structure area: 16.25 square feet
'C,11) p' r3 I. REQUIRED DATAinGOMMERCIAL-USE G'H1 CKI;IST
Tax Subdivision: i L1 I li4 I Lot no. Permit fees*are based on the value of the work performed,
iJ I Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Installing a reinforced concrete pad and a new,UL approved 275 gallon above Valuation, 5
ground heating oil tank.The tank will then be connected to the furnace. Existing building area: square feet
The pad is 39 inches x 5 ft x 6 inches New building area: square feet
X PROPERTY OWNER U CENANT Number of stories:
Name:Selene Finance LP e/o Kristin Brown Type of construction:
Address:3835 NE Hankeock St. Suite 201 Occupancy groups:
City/State/ZIP:Portland,OR 97212 Existing:
Phone. ' Fax:( ) New:
IS A.PPI.ICANT .m Q geplI €I' PERVN BUILDING PERMIT FEW, _
fPleasareJa
Business name: Soil Solutions Environmental Services r:rofeaschedul
Structural plan review fee(or deposit):
Contact name:Aaron Siemers,Project Manager
FLS plan review fee(if applicable):
Address:3540 SE 28t°Ave -
Total fees due upon application
City/State/ZIP: Portland,OR 97202
Phone:(503)234-2118 Fax::(503)331-7133 Amount received: _L- 7----
E-mail: aaron @soilsolutionsenvironmcntaLcom puoT'oVOL•'f,AICsoLALA`A'EL$y5'FIr,M�,FFE,S"
- Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System
Business name:Soil Solutions Environmental Services Submit two I roof plan with connection details
and fire department access, : t ith the 2010 Ore
Address:3540 SE 28th Ave Solar Installation Speclalfy Code thee'
City/State/ZIP:Portland,OR,97202 Permit Fee(includes plan route. . •0.00
and administrativ '.es):
Phone:(503)234-2118 Fax:(503)331-7133 State surcharge(12%of permit fee): $21.60
CCB tic.: 138344 Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: C Date: ///241(y "Fee methodology set by Tri-County Building Industry
A Arot1 Si t~r e S Service Board.
I:\Building1Pcrmits■BUP-RESPcrmitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
1112612014 14:31 Soil Solutions TA'}5033317133 P.0011006
RECEIVED
S SOILSOLUTIONS NOV 26 2914 3540 SE 28th Avenue,Portland,Oregon 97202
ENVIRONMENTAL SERVICES
C�l i � � Office 503.234.2118
t'I IU hIIf II nfhi I P Toll Free 877.234.2118
Fax 503.331.7133
www.sollsolutionsenvironmental.com
To: City of Tigard Building Services
FAX: (503) 598-1960
Pg 1 of 6
RE: Building Permit Application for 9095 SW N. Dakota St.
City of Tigard,
Please find the attached building permit application for the installation of a new
275-gallon above ground heating oil tank at 9095 SW N. Dakota St. I have also
included the engineering plans for the reinforced concrete pad and the tank,as well
as a basic site plan.Please let me know the most convenient method to pay the
permit fees.
Thank you,and if you have any questions please contact me at(503) 234-2118.
Sincerely,
i
A. on Siemers'
Project Manager
Soil Solutions Environmental Services
CITY OP TIGARD
REVIEWED FOR CODE COMPLIANCE
Approved: [l� --
F •rrltit #: M'ST 2O(4 '—ODD
l Ilir`.ss: il'O'l - 0.-biWo Tank Division
_l( 7 .1 l°`A� Soil Testing&Decommissioning
re S +c c I. Soil&Groundwater(leanup
B_: Date: f `I:6114.
Sewer Division
Scopes&Inspections
Line Repair&Replacement
OFFICE COPY Stormwater Division
Dry Well Registration
Radon Division
Measurement&Mitigation
CCI0131344/WA#SOILS"995ttM
•
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
9095 SW NORTH DAKOTA ST, TIGARD, OR,
97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
December 16, 2014 at
11:40:12 AM
MST2014-00211
David Young
Installed per city approved plans.
Violation Summary:
Inspector Contractor