Permit (39) CITY OF TIGARD MASTER PERMIT
111 I' . COMMUNITY DEVELOPMENT Permit#: MST2016-00152
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/25/2016
T f '" 9 Parcel: 2S 110 BA05600
Jurisdiction: Tigard
Site address: 11865 SW WILDWOOD ST
Subdivision: SHADOW HILLS Lot: 9
Project: ANDERSON
Project Description: Basement remodel: Converting(1)large room into(2)bedrooms and (1)bonus room.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 2 First: 0 of Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0
Detectors: Yes
Total: 0 sf Value: $25,000.00 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 addl 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 3
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 COM VB R-3 0
Owner: Contractor:
ANDERSON,KELCIE L FRAME TO FINISH BUILDERS Required Items and Reports(Conditions)
11865 SW WILDWOOD ST 34260 SW OLD PARRETT MOUNTAIN
TIGARD,OR 97224 RD
SHERWOOD,OR 97140
PHONE: PHONE: 503-758-0991
FAX:
Total Fees: $885.03
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 0 952-001-0090. You may obtains co y. r direct questions to OUNC by callin 2.1987 or 1.800.332.2344.
Issued By: Permittee Signature: /It`'-/ eGt 4-
all 5'01f 75 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.
1
,Building Permit Application
Re 'dential I OR OI I I( I t SI. ONI.1
City of TigardRE( FivEp sus./ Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan ReviewG ,•
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : % d' Other Permit:
i },t.1 Inspection Line: 503.639.4175 APR 2 0 2016 Date Ready/By: //Zip= ® See Page 2 for
`J Internet: www.tigard-or.gov Notified/Method: a�_, Supplemental Information
\ TY 01' tGAIW r
TYPE OF ' we I1r� -� Y '`
tiN ❑New construction i "o t on 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 constwCTION work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial Valuation: $25,000
0 Accessory building 0 Multi-family Number of bedrooms: 2
*4.
0 Master builder 0 Other: Number of bathrooms: 0
* JOB SITEINFORMATION ANDLOCATION Total number of floors: 1
Job site address:11865 SW Wildwood Street New dwelling area: 675 square feet
City/State/ZIP:Tigard,Or 97224 Garage/carport area: 0 square feet
\Suite/bldg./apt.no.: Project name:Basement Remodel Covered porch area: 0 square feet
I
Cross street/directions to job site:Bull Mountain to McFarland Deck area: 0 square feet
to Wildwood Street Other structure area: 0 square feet
iEQEMEED DSEM COMMERCIAL-USEom
Subdivision:Shadow Hills Lot no.:9 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.:R1005290 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION or woo(= work indicated on this application.
Basement remodel,turning a large craft room into two bedrooms and an extra room -
Valuation: $
Existing building area: square feet
New building area: square feet
►_� PROPERTY�( Q` f Number of stories:
Name:Tom and Kelcie Anderson Type of construction:
x)
Address:11865 SW Wildwood Street Occupancy groups:
City/State/ZIP:97224 Existing:
.i, Phone:(503)702-9047 Fax:( ) New:
152 APPLICANT 0 CONTACT PERSON BUILDING PERMTT FEES*
Business name:
(Plearc Mier 10fee scitadul0
Structural plan review fee(or deposit):
(,) Contact name:Tom Anderson
FLS plan review fee(if applicable):
Address:11865 Sw Wildwood Street ��
Total fees due upon application:
City/State/ZIP:Tigard,OR 97224
Amount received:
Phone:(503)702-9047 Fax::( )
E-mail:tapdx@yahoo.com PHOTOVOLTAIC SOLAR PANEL SYSTEM *
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Frame to Finish Builders Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:34260 SW Old Parrett Mt.Rd. Solar Installation Specialty Code checklist.
City/State/ZIP:Sherwood,OR 97140 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)758-0991 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:204801 /a.1S /(O
Total fee due upon application: $201.60
Authorized signature: j`� A.A. This permit application expires if a permit is not obtained
/ 41__________
within 180 days after it has been accepted as complete.
Print name:Tom M Anderson Date:4/20/2016 *Fee methodology set by Tri County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Electrical Permit Application t(11,Z 01 I l( I I sl ON I 1
City of Tigard ` Permit#: S , •l ..-OV t S�
,_ 4 13125 SW Hall Blvd.,Tigard,OR 97223Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 DateB : Related Permit#:
Inspection Line: 503.639.4175 A P? 2 0 7016 116 Ready Date/By: Juris ® See Page 2 for
I I 1"\R Il Internet: www.tigard-or.gov Notified/Method: Supplemental Information
7.-' TYPE OF why OF 1'1WWRD . . >t> w .
❑New construction ® �Addition/alt�j'>Ittf�1@/(gp G t j I S1O Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition 0 Other: R° L JJ``5 '4 �1 0 Service or feeder 400 amps or more 0 Building over three stories.
CATEGORY OF CON >(iCTION where the available fault current 0 Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1 and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family 0 Master builder 0 Other: amps for all other installations. buildings.
JOB SITE INFORMATION AND LOCATION' Fire pump. 0 Installation of 150 KVA or
Emergency system. laargerrgerseparately derived
Job#: Job site address: 11865 SW Wildwood Street Addition of new motor load of system.
100HP or more. ❑"A" "E" 'l-2""I-3„
City/State/ZIP:Tigard OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Basement Remodel ❑Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site:Bull Mountain to McFarland to Wildwood ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description 1 Qty. 1 Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision:Shadow Hills Lot#:9 Includes attached garage.
Tax map/parcel#:R1005290 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion 33.92 1
Basement Remodel. Turninglarge craft room into two bedrooms and a small Limited energy,residential 75.00 2
g (with above sq.ft.)
room. Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
C4 PROPERTY OWNER 0
TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name:Tom and Kelcie Anderson 200 amps or less 100.70 2
Address:11865 SW Wildwood Street 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,Or 97224 601 amps to 1,000 amps 301.04 2
Phone:(503)702-9047 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease...xent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: _ Date: 401 amps to 599 amps 168.54 2
IS APPLICANT ❑ CONTA'`PERS�OIIF Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name:Tom Anderson B.Fee for branch circuits without
Address: 11865 SW Wildwood Street service or feeder fee,first branch
56.18 �,1 2
branch circuit
City/State/ZIP:Tigard,Or 97224 Each add'I branch circuit ..t, 7.42 /it` i 2
Miscellaneous(service or feeder not included)
Phone:(503)702-9047 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:tapdx@yahoo.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Frame to Finish Builders Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address:34260 SW Old Parrett Mt.Rd. panel,alteration,or extension.
City/State/ZIP:Sherwood,OR 97140 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)758-0991 Fax:( ) Investigation(I hr min) 90.00/hr
Email:bob@frametofinshpdx.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 204801 Electrical Lic.: Suprv.Lic.: specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: 0 Plan Review Required(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: Date: days after it has been accepted as complete.
L\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
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
11865 SW WILDWOOD ST, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00152
Jeff Grove
Violation Summary:
Inspector Contractor