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Permit (39)
CITY OF TIGARD71 MASTER PERMIT " `, '` Permit#: MST2015-00152 2 COMMUNITY DEVELOPMENT t•' '` /2016 _ Date Issued: 08/17 T t GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 /, ?1 /7 9/- Parcel: 2S17/2016 000 Jurisdiction: Tigard Site address: 11215 SW FAIRHAVEN ST Subdivision: EXODUS Lot: 1 Project: Hamilton Project Description: 1,600 sq.ft.two story addition. 4/13/2017: REPRINT permit to change general contractor. 8/17/17, REPRINT to add 80'of sanitary line to connect addition to existing sanitary line for house. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 770 sf Basement: 800 sf Left: 5 Parking Spaces: 0 Height 26 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1570 sf Value: $170,000.00 Rear: 20 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 80 SF Rain Storm Sewer: 0 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 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: Y Vent Fans: 2 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 8 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 HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Ecompasing: Y Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 1570 Owner: Contractor: HAMILTON,BRYCE A&DEBORAH L STEEL CURTAIN CONSTRUCTION CO LLC Required Items and Reports(Conditions) 11215 SW FAIRHAVEN PO BOX 6445 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 ALOHA,OR 97007 PHONE: PHONE: 503-572-7202 FAX: 503-579-8272 Total Fees: $6,065.55 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80 .332.234.---- Issued By:/ � 'C..„' ,TZ-r7,- 2-- 2 Permittee Signature: Call 03.639.4175 by 7:00 a.m.for the next available inspection te. This permit card shall be kept in a conspicuous place on the job site until co pletion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard "`+ Received Permit No.: I c%7i1/�-�0! �., 1 0 Dann J G� r 13125 S W Hall Blvd.,Tig 1.J Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit: AUG 12017 Date/By: T 1 G A R U Inspection Line: 503.639.4175 7 Date Ready/By: Juris: id See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental information CITY OF T IGARD bi0} EAV1SION - COMMERCIAL FEE* SCHEDULE USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION '' - RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist 0 Multi-family 0 Master builder ❑Other: Description Qty. Ea. 1 Total JOB SITE INFORMATION AND LOCATION " -Heating/cooling: //0/5- /Z/5 .. � Z� Air conditioning0, 46.75 Job site address: ( ! 7 Furnace 100,000 BTU(ducts/vents) , 46.75 City/State/ZIP: /� 6�' /7- Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: / Project name: Heat pump / 61.06 �j/„l)( Duct work O 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 rl //� F ' /2�� a� p es` v/�/„ ,C,K_/vN% Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 /)A/� 1A ,4170 /'v 1. Flue/vent for any of above 23.32 Subdivision: t .57, 7- //Lot no.: V O0'er' 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 2 4;,. , 'y ''w-� • s f-.: ,s „DEse vittio I ,. ' Gas fireplace/insert i 33.39 r ”` Flue vent for water heater or gas 1 ( n.4.4,e_R.. le 0 1.4/ fireplace t 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 ��'A r a`, �.arl �.I_ Wood fireplace/insert 1 23.32 , Chimney/liner/flue/vent _23.32 ' ( ' " - 23.32., x r>l * Environmental exhaust and ventilation: Name: Ni-V4-ft-Y/ ATO Range hood/other kitchen A ss: / — equipment 33.39 i Clothes dryer exhaust 3339 t : Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 2332 ;I. ._ le.a... 'Y,L, "< - r'"`0. :* s' 4 r".;`'44, Other: 2332 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: r Barbecue ;� ,1.. � ,, ` Gt .o t. Clothes dryer(gas) Business name: / Other. 2 Z 3 �"'Ail col l►,i?nnl� ^ 'Y4 ,.. NI 10 > . j v Address: / L� Subtotal LOP I. Gtr City/State/ZI: AjC�-�-t'Y ,,i', p 4..3 ry Minimum permit fee($90.00) — Phone:(97t) a( j--..re, Fax:( l ) (J Plan review(25%ofpermit fee) l / State surcharge(12%of permit fee) 7, CCB lic.: / ftg 7( 74. 9 TOTAL PERMIT FEE ( , This permit application expires if a permit is not obtained within 1 0 days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: i'1 L:.l�k . Date: g.1 7—t 7 taBudding\Permas\MEC_Pmn1App_04o113.doc 440-4617T(11/02/COM/WEB) CITY OF TIGARD MASTER PERMIT 1111. il.a COMMUNITY DEVELOPMENT "'. Permit#: MST2015-00152 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439Date Issued: 08/17/2016 TtCaa' .0 9 �� /7 9�' Parcel: 2S103DC06000 Jurisdiction: Tigard Site address: 11215 SW FAIRHAVEN ST Subdivision: EXODUS Lot: 1 Project: Hamilton Project Description: 1,600 sq. ft.two story addition. 4/13/2017: REPRINT permit to change general contractor. 8/17/17, REPRINT to add 80'of sanitary line to connect addition to existing sanitary line for house. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 770 sf Basement: 800 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1570 sf Value: $170,000.00 Rear: 20 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 80 SF Rain Storm Sewer: 0 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 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: Y Vent Fans: 2 Clothes Dryers: 1 Natural Gas Heat Pump: Y Hoods: 1 Other Units: 0 Furn<10OK: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 8 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 HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y Other: N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 1570 Owner: Contractor: HAMILTON,BRYCE A&DEBORAH L STEEL CURTAIN CONSTRUCTION CO LLC Required Items and Reports(Conditions) 11215 SW FAIRHAVEN PO BOX 6445 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 ALOHA,OR 97007 PHONE: PHONE: 503-572-7202 FAX: 503-579-8272 Total Fees: $6,065.55 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 503.232.1987 or 1.80 .332.2344. ---- ,..-----z.7.,. ._ — Issued By: a — / Permittee Signature:Call 03.639.4175 by 7:00 a.m.for the next available inspecThis permit card shall be kept in a conspicuous place on the job site until the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFR(E.USE O\l.l City of Tigard 1Ef IVED EEew PennitNo.:• 13125SWHallBlvdTig91./ Phone: 503.718.2439 Fax: 503.598.19y60 Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 AUG 17 2017 Date Ready/By: runs: Iii See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OF TIGARO IztUlkId111,%1131VISION COMMERCIAL FEE* SCHEDULE USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION - RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: � / a`f"' t9 Air conditioning T 46.75 Job site address: //075.- S �LlT Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 7:4(..:, 6 C g 7' Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump j 61.06 6/.O(,, Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 gyp!9/i/( w �vMu��r,/7�IV in-wall, ll,in-duct, suctesusp not electric), ��y1�� in-wall,in-duct,suspended,etc. 46.75 j et?, L, e.#71- /. " r /'v. V'.x .5J 1 it. Flue/vent for any of above 23.32 1 Subdivision: f!Y / Lot no.: i/ Other: _ 23.32 Other fuel appliances: Tax map/parcel no,: Water heater 23.32 1 ,, ' `"`';\-%s, : 1 l#1' „14 V( I ?V , '. 4_ IN, ?. Gas fireplace/insert i 33.39 1 Flue vent for water heater or gas ��v724. fireplace 123.32 • Log lighter(gas) 23.32 Wood/pellet stovei 33.39 �� Wood fireplace/insert 23.32 0....)1.0._.a. Chimney/liner/flue/vent 23.32 's''1' 40010 � ,�;; ''P'-',* I,,� ; Other: 23.32 ' Environmental exhaust and ventilation: Name: -/l,(/ CIO 13 Range� hood/other kitchen ment i 33.39 A d pss: Clothes dryer exhaust 3339 /ytn4/7I : I Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 _ Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 _ "'e -*' 2332 � `.�.�P �'�� � �'t ' '� other: Fuel piping: Business name: ~ $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 _ Fireplace Phone:( ) Fax::( ) - Range E-mail: Barbecue .. - atgw ._.' .. - - F.. 4f 4'Q�N 60 41„.*: {. ,.. h Clothes dryer(gas) Business name . A /4, Ail C,i.11)l-rzo'"l j1 Other: ' Address: 24S -C5- Subtotal (L)7. O City/State/ZIP: , ]LLL..r%%C // , �/� 2, i Minimum permit fee($90.00) 7� 1V F-(.lfeeM Plan (25%of permit fee) Phone: ) Z( Fax:( ) State surcharge(12%of pemut fee) 7< CCB lir.: ( 'gg 76 r 7.44, TOTAL TOTAL PERMIT FEE &'1, c This permit application expires if a permit is not obtained within 1 0 days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: le " L- Date: g 1 7--i 7 , I:\Building\Permas\MEC_PermitApp_040113.doc 440-4617T(I 1/02/COM/WEB) CITY OF TIGARD MASTER PERMIT ik" - COMMUNITY DEVELOPMENT t -- 4 Permit#: MST2015-00152 �/ Date Issued: 08/17/2016 T[GAReD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 0 �� parcel: 8/17/2 C06000 Jurisdiction: Tigard Site address: 11215 SW FAIRHAVEN ST Subdivision: EXODUS Lot: 1 Project: Hamilton Project Description: 1,600 sq. ft.two story addition. 4/13/2017: REPRINT permit to change general contractor. 8_/17/17, REPRINT to add 80'of sanitary line to connect addition to existing sanitary line for house. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 770 sf Basement: 800 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 1570 sf Value: $170,000.00 Rear: 20 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 1 Floor Drains: 0 ewer Lines: 8II--J SF Rain 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 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: Y Vent Fans: 2 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 Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 8 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 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: ADD SF VB R-3 1570 Owner: Contractor: HAMILTON,BRYCE A&DEBORAH L STEEL CURTAIN CONSTRUCTION CO LLC Required Items and Reports(Conditions) 11215 SW FAIRHAVEN PO BOX 6445 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 ALOHA,OR 97007 PHONE: PHONE: 503-572-7202 FAX: 503-579-8272 Total Fees: $5,997.16 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. ATT N: O gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 010 through OA 9 009/ You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800..2.2344 Issu By: Y Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspectio .'-te. 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. Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONL\ Cityof Tigard Received g pp II''G 1 7 Date/By: Permit No.:14577:945/57.-06/5772, Ill 14 13125 SW Hall Blvd.,Tigard,OR 972F ) 2017 Plan Review Phone: 503.718.2439 Fax: 503(4qqgR��1,9+60 p� 4 Other Permit No.: V l l i OFI i t3 Date/By: TI C A N D Inspection Line: 503.639.4175 11 I T I 4. Date Ready/By: kris: ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description Qty. I Ea. 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 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: cm • j c; /) � � l a �2 Catch basin or area drain 18.76 City/State/ZIP: 4J /% Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 0 Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: Ct./) Page 2 6,42. Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ,! Dissempriohtzo WO ` r: va valve Backwater ac B k 1 12.51 �•.,iy w' Clothes washer 25.02 .i'1761-44' t+ Dishwasher 25.02 C�1I \ ✓` �'-` Drinking fountain 25.02 t D-z� ,_ unt, •.- . ' . itytt,7O Ejectors/sump 25.02 i❑ PROPERTY OWNER, 'TENANT. Expansion tank 12.51 Name: fJ,q / m i l]7 Fixture/sewer cap 25.02 ( lJ Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 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 , -.• Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: A n d l e,/ Jy ju, y..1/4_, Water piping/DWV 56.29 Address: ' ,© brie Other: 25.02 City/State/ZIP: o, 770 Z Subtotal (QA.SII ' Phone:( 3) 357- 3 3'Z Fax:( ) Minimum permit fee: $72.50 ,y� 4' . Plan review (25%of permit fee) CCB Lic.: / Plumbing Lic.no.: 3--31e Pg -fin/ State surcharge(12%of permit fee) Authorized signature: -----------Crti� / TOTAL PERMIT FEE 70, Print name: -.)---,4 r . ,47/ci I I. Dater--`?- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 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-l'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 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $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 't'• 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 fee 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 plumbila stella€of s P 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 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 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 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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: -Lav/Bar 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 Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard CE I Received c(��5�_�! 111 111 11 13125 SW Hall Blvd.,Tig d, 9.7 Date/By: Permit No.: /J r J� • 7 Phone: 503.7182439 Fax: 503.598.1960,, IP)1ate RBeview 1 y Other Permit: TI G A K D Inspection Line: 503.639.4175 AUG 2017 Internet: www.tigard-or.gov Date Ready/By: Juris: See Page 2 for CITY + Notified/Method: Supplemental Information ITYOF iI ARD tikililitIWAIIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all mechanical materials,equipment,labor,overhead,and profit. El Demolition ❑Other: CATEGORY OF CONSTRUCTION Value:$ ❑ 1-and 2-famil RESIDENTIAL EQUIPMENT/SYSTEMS FEES* y dwellin g ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: /075" [-AAA, a Air 1000g 46.75 4Furnaacece 1000,,000 BTU(ducts/vents) I 46.75 City/State/ZIP: { 6 e g 7- Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: / Project name: Heat pump 61.06 Duct work I 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 SLot no.: Taxubdivision: Other: 23.32 map/parcel no.: Other fuel appliances:Water heater 23.32 DESNbll ; '` Gas fireplace/insert 33.39 "L�}?/L(f — ,,r Q / 4' Fluevent for water heater or gas fI Lr fireplace 23.32 Log lighter(gas) 23.32 0Wood/pellet stove 33.39 i��,44 (7,e9-1---17- 62-- [- Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 s sRT (O, `fit ', ' 4''''' .. CSN Other: 23. 32 Environmental exhaust and ventilation: Name: / L7b J Range hood/other kitchen A d ss: equipment 33.39 Clothes dryer exhaust 33.39 t /Z Single-duct exhaust(bathrooms, Phone:( ) Fax ( ) toilet compartments,utility rooms) 23.32 Attic/crawlspace fans 23.32 k..�„, .. ,., .APP4, ,w„ .. � - CONTACT . ® ,. 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 City/State/ZIP: Wall/suspended/unit heater Water heater Phone:( ) Fax::( ) Fireplace E-mail: Range . , „ Barbecue .. .r , z ., _. ,, Clothes dryer(gas) ::: me: ztvl ) Atm Co10)07,0A1 1A. Other: s: �^ ”' MICA PIV E"* r Subtotal City/State/ZIP: e..,(...7,44 0( !�r '43 Minimum permit fee($90.00) Phone:(9?�) T`, f�j Fax:( ) Plan review(25%of permit fee) 66 State surcharge(12%of pennit fee) CCB lic.: / SI 74 r 7/-///e� TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. • * Fee methodology set by Tri-County Building Industry Service Board Print name: i.t‘.r4.: 1:..A/ Date: g` j'7— I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I1/02/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$10,000.00 $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. I:\Building\Pennits\MEC_PernutApp_040113.doc 2 CITY OF TIGARD MASTER PERMIT } Permit#: MST2015 00152 IN 2 ', COMMUNITY DEVELOPMENT .L1 .' 13125 SW Hall Blvd.,Tigard OR 97223 503.718.243*/"A Date Issued: 08/17/2016 TIGARD Parcel: 25103DC06000 Jurisdiction: Tigard Site address: 11215 SW FAIRHAVEN ST Subdivision: EXODUS Lot: 1 Project: Hamilton Project Description: 1,600 sq. ft.two story addition. 4/13/2017: REPRINT permit to change general contractor. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 770 sf Basement: 800 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 15 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors. Total: 1570 sf Value: $170,000.00 Rear: 20 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 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: Y Vent Fans: 2 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 F u rn>=100 K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 8 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 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: ADD SF VB R-3 1570 Owner: Contractor: HAMILTON,BRYCE A&DEBORAH L STEEL CURTAIN CONSTRUCTION CO LLC Required Items and Reports(Conditions) 11215 SW FAIRHAVEN PO BOX 6445 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 ALOHA,OR 97007 PHONE: PHONE: 503-572-7202 FAX: 503-579-8272 Total Fees: $5,882.12 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 wo suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. ? ose r les are set forth in OAR 952-001-0010 throw OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by c- ' . 0 . - .87.r 1 800.33 :344. IF Issued B Permittee Signature: , `:1": / !..411w Call 503.639.4175 by 7:00 a.m.for the next available inspecti.n 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 ApplicationRE CEIVED Residents 3 rO R o r r i c I: i s t:O�y.�/l.)A7 /� City of Tigard P R 2 Dat ived y� �� fiji Permit Nt7S 045 e)O/5-:L 11111 • 13125 SW Hall Blvd.,Tigard,OR 97221-4. *�l �`� Plan Revie II Phone: 503.718.2439 Fax: 503.598.19�f*1 1 OF TIGARD Date/B : Other Permit: l l C,ARD Inspection Line: 503.639.4175 BUILDING DIVISION NDaoteifiReeadye/Byo:d: Juris: la See Page 2 for Internet: www.tigard-or.gov Supplemental Inf ormation TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ 0 1-and 2-family dwelling ❑Commercial/industrial Number of bedrooms: ❑Accessory building ❑Multi-family O Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: //c„2/5- cce,.i j f-/,, /7/4 //E7‘.r ,S-7---- New dwelling area: square feet City/State/ZIP: Garage/carport area: square feet Suite/bldg./apt.no.: Project name: ,]-//L Covered porch area: square feet Cross street/directions to job site: 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. 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. ' C at - 1 Valuation: $ Existing building area: square feet ,/] New building area: square feet � { -Pi1OPERTY OWNER 0 TENANT Number of stories: /,. _C-70,24--/-74. Name: ,9i2y G'�'— /L i i/L Wit, Type of construction: Address: //�2/3-.. 5.e4-) , --,', ,/.9i/L�/ -Sj Occupancy groups: City/State/ZIP: 776,94_6 e 72_ g 7;2-2-3 Existing: Phone:4 ?) _,,of y —j-'7 O 2 Fax:( ) New: APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: _57,-,- -----, C j,,„ e.j f}i hjO.. A4,e k7A/ Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: J3) 6O)C .-y.5- Solar Installation Specialty Code checklist. /9z,, ,,, ,,5= t � Permit Fee(includes plan review $180.00 City/State/ZIP: G �QQ r and administrative fees): Phone:(i,,3)�w2,-20 , Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lie.: /d 9Q(...„ //t✓p/ Total fee due upon application: $201.60 This Authorized signatu Print name: permit expires if a pit is not obtained within 180 daysapplication after it has been acceptedermas complete. *Fee methodology set by Tri-County Building Industry `�� _��,t� L., r���t L�� Date: y3 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling l OR ()HA(ui is t sl: oyl.v INCity of Tigard Received Date/By: Permit No.: _ " 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 1 t G A R D 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es 10 yin 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. • U U 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: . ❑ 0 0 5 Septic system permit or authorization for remodel. Existing system capacity 0 0 0 6 Sewer permit. 0 ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 ❑ 0 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 0 0 0 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 0 ❑ 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0 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- 0 0 ❑ 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. ❑ 0 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ❑ 0 0 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 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0 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 0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0 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 0 0 0 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. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 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, ❑ 0 ❑ 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, 0 0 0 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\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) CITY OF TIGARD MASTER PERMIT 2 ' COMMUNITY DEVELOPMENT Permit#: MST2015 00152 T IGA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016 Parcel: 2S103DC06000 Jurisdiction: Tigard Site address: 11215 SW FAIRHAVEN ST Subdivision: EXODUS Lot: 1 Project: Hamilton Project Description: 1,600 sq.ft.two story addition. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 1 First: 770 sf Basement: 800 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 1570 sf Value: $170,000.00 Rear: 20 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 1 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 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: Y Vent Fans: 2 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 Srvc/Feeder Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 8 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: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 1570 Owner: Contractor: HAMILTON,BRYCE A&DEBORAH L PRESTIGE DESIGN&GENERAL CONTRACT Required Items and Reports(Conditions) 11215 SW FAIRHAVEN 12302 NE MARX ST 1 Ersn Cntrl 503-639-4175 TIGARD,OR 97223 PORTLAND,OR 97230 PHONE: PHONE: 503-477-5550 FAX: Total Fees: $5,882.12 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 issu if work is suspended for more the 180 day TENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi ion Center hose rule are set forth in OAR 9 -001-0010 through 0A' • 001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling .232.1987 or .800.332.2344. sued By: / / , Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspe tion 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. Buildin Permit Auplication Residential City of Tigard FOR OFFICE CSF O\'L]" 13125 SW Hall Blvd., Receive III ■ Tigard,OR 97223 Re eiv . �� 1" Phone: 503.718.2439 Fax: 503.598.19 ib;L 2016 Plan Review. ����� Permit Permit: 5TH 71 G A Ft D Inspection Line: 503.639.417545�Q /5-P Internet: and-or.g i c Date/B : A — J www.tigard-or.gov gg'"� ' )iw � -� _ �KA ►` Date Read/B - ) G Other Permit: EJe l Y Of- w °�,'�r�aa' +1., Ready/By: Qy r Notifi�n/Method: d �� ��� H See Page 2for �t� r a Ds Ili. h...'€ �� Supplemental Information TYPE OF WORK / At W 1 ,�� -77�~ ��/(o ❑New construction REQUIRED DATA:1- ❑Demolition AND 2-FAMILY DWELLING Addition/alteration/replacement Permit fees*are based on the value of the work performed. 0 Other: Indicate the value(rounded to the nearest dollar)of all lar CATEGORY OF CONSTRUCTION Valuation: equipment,materials,labor,overhead,and the profit for the work indicated on this application. al V $ A l-and 2-family dwelling 0 Commercial/industri ❑Master builder Number of bedrooms: ❑Accessory building CI Multi-family ❑Other: JOB SITE INFORMATION AND LOCATION Number of bathrooms: Job site address: -- Total number of floors:, ,St,,, rq i 2146 v Et.) City/State/ZIP: New dwelling area: Suite/bldg./apt.Suite/bldg./apt.no.: 76 - ` square feet Project name: Garage/carport area: Cross street/directions to job site: o square feet Covered porch area:i square feet Deck area: 6 square feet 4. Subdivision: <',t,,-) square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Tax map/parcel no.: Lot no.: Permit fees*are based on the value of the work performed Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORKon oQ AD� — k:--i- work indicated this application. Valuation: $ • V / .• in c„.\ Existing building area: � ,/� � ♦ INsquare feet PROPERTY OWNER New building area: Name: R ❑ TENANT square feet la Number of stories: Address: "L` , 471. _ Aril el I„ WIG* of construction: SW City/State/ZIP: / ii�t =L. `l`] r�- 9'�-L,LQ Occupancy groups: Phone:( ) A Existing: 0 APPLICANT 0 CONTACT PERSON �,�/�. BUILDING PERMIT FEES* Contact name: �� Please re er to ee schedule Address: V""' "L ��� Structural plan review fee(or deposit): City/State/ZIP: FLS plan review fee(if applicable): Phone:( ) Total fees due upon application: E-mail: Amount received: IIIIIIIIIII awt�te '' oe r r ` v ores , -4 'Si 40,c.,,,,t, PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* ' 'CTOR 7 CO Business name: Commercial and residential prescriptive installation ofS i(a roof-top mounted Photo Voltaic Solar Panel System. Address: 1--s� �" +,a , Submit two(2)sets of roof plan with connection details I'Y1/q-�Q .� City/State/ZIP: and fire department access,along with the 2010 Oregon l N �� Solar Installation S ecialt Code checklist. Phone:(-� • Permit Fee(includes plan review • Fax:(57.)5)14-4:7—.�-`�-. �1 1-' CCB lic.: and administrative fees): $180.00 ..,,a:_,.. 's State surcharge(12%of permit fee): Authorized signature: $21.60 .;✓,,,1 �';?„a �i Total fee due upon application: =�� - (Y $ 201.60 ained This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Date — /�� MI *Fee methodology set by Tri-Cour 1:1 Building\Permits\BUP-RESPennitA t Tri-County Building Industry pp.doc 02/24/2011 Service Board. 440-46 I 3T(1I/02/COM/WEB) lication Checklist Buildin Permit A FOR OFFICE USE ONLY One- and Two-Family Dwelling Received Permit No.: Date/By: City of Tigard Associated permits: ❑ Mechanical g OR 97223 ❑ Plumbing + 13125 SW Hall Blvd.,Tigard, ❑ Electrical 11111 II Phone: 503.718.2439 Fax: 503.598.1960 0Other: 24-Hour inspection Line: 503.639.4175It es 10 'S/�� T 16 A R 0 Internet: www.tigard-or.gov 0 REQUIRED FOR PLAN REVIEW' 0 0 THE FOLLOWING ITEMS ARE 0 0 0 ROI 1 Land use Floodons in,solar balance ,oints,se seismic on sols desia for l_nnation,thistoric sdistrict,etc. 0 0 0 2 ifi . ala0 0 0 3 Verification of a roved latllot. 0 0 0 4 Fire district a royal re uired. Name of district: • 0 0 0 5 Se I tic system permit or authorization for remodel. Existin• s stem cal acit0 7 Sewer district 0 0 8 Soils Water district a royal. permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 8 Soils report. Must ca ori•inal a• licable stamp and si_nature on file or with a.�hcatton. 0 plan 0 0 9 Erosion control 0 applicable local and state basin ,rotection,etc. orated into the plans or on a separate full-size - 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to lab incorporated and details.to Plan review cannot be completed if sheet building codes. the Lateral references and ebetween plan n locationica0 0 sheet attached to the planscorner elevations(if 0 co ryp of plan drawn exist. plan must show lot and building setback dimensions;property 11 tShere is than a to scale. The plan must show contour lines at 2-ft.intervals);location of easements there more a footprint of structureelevation differential,ting location of wells/septic systems;utility locations;direction and driveway;area;building coverag(including decks);ntagand0 0 lot coverage area;percentage of coverage;impervious area;existing structures on site; ❑ indicator; connection details,vent size surface draina•e. 0 0 0 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads, and location. 0 0 balconies and decks 30 inches above :rade,etc.beams,headers,joists,sub- 0 Floorplans. Show all dimensions,room identification,window size,location of smoke detectors,water heater,13 such as floor e furnace,ventilation fans,details.iSh_fixtures, be required o clearly etray 14 Cross section(s)and Show all framing-member sizes and spacing floor,c nwall construction,details roofconstruction. walltand More than one cross roofing,roofsection may 0 0 0 ion. Show of all and roof sheathmgulation slope,ceiling height,siding and retrtode]s.gs andsfruct for and foundation,nviw stairs,fide dace construction,thermal is two than elevations four dns and envelope. 15 Elevation eiew • must reflect lecathe actual for new rif the gradechangestruction; in of e e accefootfatton 0 Exterior elevationsshmust the a grade0 0 ate and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0 Full-size sheet addendums showin.foundation elevations with cross references 16 Wall bracing(prescriptive path) acid and bearing �rescr/five rate framing. sis Provide e for all floors/roof calculationscations and ssembles,indicating member sizing,spacing, 0 0 Provide plans0 17 Floor/roof placement of debar. For engineered locations.eShow atticaventilation. 0 0 0 18 Basement and retaining walls. Provide cross sections and details showing s semc,see rm 22,"En.de two sets of c ." 0 0 0 calculations. Provide two cal l calculationstiousing oc ]onadode design values for all beams and multiple joists 19 Beamv0 0 over 10 feet lon.and/or an beam/'fist ca in:a non-uniform as i in schematic is required 0 201 Energy Codeoded omplianc truss tidytn details. prescriptive path or provide calculations. A g --P P g 0 0 0 21 Energy compliance. Identify the ed by an engineer or forn foure or more a''fiances. provided, t e.,shear wall,roof truss)shall be stamp 22 Engineer's calculations. When required or (•. 0 architect licensed in Ore:on and shall be shown to be a 6,licable to the ,ro'ect under review. 0 0 JURISDICTIONAL SPECIFIC 0 0 23 Three(3)site 'tans are re•uired for Item 11 above. Site ,lans must be 8-1/2"x 1 1"or 1 1"x 17". 0 0 0 20220 0 24 Two(2)sets each are resuiredntfor Items f or and M above. 0 0 outlined in the Permit&S stem Develo,ment Fees document. 0 0 25 Buildin• dans shall not contain red lines tase-ons. Mirrored"buildin. dans will not be acce.te0 26 "Reversed"buildin_plans must meet criteria0 of Ti and 0 applicable),and City g type and location per approved project street tree plan(if app 0 0 0 27 "Drawn to scale"indicates standard architect or en_ineer scale. 28 Site plan to include tree size, Street Tree List. approval. Tree locations,driplines, form is required for all building additions, 0 0 0 measures must be drawn to scale and must include the pro act arborist's si_nature of as•roval. 29 Siterplan to include trees and tree protection measures as required by conditions of and prote ate Services' Site Assessment non-impervious surface)and accessory structures to existing residential dwellings 30 A Clean Water ,patio SensitiveoArea Pre-Screening sg including decks,patio covers(over non-imp on a lot of record a6,roved ,rior to Se,tember 9,1995. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) . sommil oit(),I I( 1.t.ss:()Ni. Electrical Permit A licep_dal. WirlfetiNall'iNi r Penh 4: N City of rigardviwit oR 97223 '' - -I -Do r=r2:riimarairi 1111,- 13125 swma B43101.9-. F,x. ,,,,,,,,,,a.,,, phone: 503.7181 ••As)°" ', . . ReertY DatelaY= ''' „.'. ,,*, kmpection line:503.639.4171 Notified/Metbod: hialilltREMMI ''1''' Internet www.likard-onitov nom clink en Stet 4511Y Outbmita sett ofplans Weems abiciern: 0 Service or-1404w 400 amps or mere 0 Ileaciietes'er three nod°. 1:3 DentolNew cZnucti" 210therAddili'milal"clilliViacernen-t . . "ft th'"ailibk tarn cturtut 0 Madam and bommrde ' ' • r rci5 : ' .44110.4,7::* •--,-,,,,-,, `., ': ..•,,,,,i; ago*JOAO ova at ISO rolls or 13 Mom*wawa. ,,,..,„,, „. -. ::••:,:-'•••,'• '•'' ''''IW-'t '''''' - - " : 0 Accessory building fess topmast.or wounds 14,000 CI Commercial-use agricultural arms for all other te•r•e•-•'--. aMulti-family l_and 2-family dwelling •CommercialAndustral 0 Master builder 0 Other 01111tallatiou of 150 KVA or 40,11,,srit,1 ::0 , ,, Orit/A"Nril;,t i ft;no g}Abne,feartital kad or krger separately anima aroma Job it: Job site address: IA 2. • S 12111MMI 100dw HP or more. 13 Six or more residential units. oompuncy. CilyiStateiZIP: C.---` b 0 Fie.,re q "L?C) • OHealtb-cere halides. CI acereationd vehicle pads. 0 fiestardout locations. 0 Supply voltage for more Oro Suite/bldg./apt.ft: Project name: 0&Tyke or ibeder 600 Imps or more. 600"ft 20aling Cross street/directicars to job site: '.'.. ''''.7,..,.':',:'"..' .22:,,',.' ktill'',-,,Alaitle', ''/:,•:.,,"''., ',..- -' . .•!'•!..Tionsimmumeltr,"ft i:ei, --Ilviliciii New nokleattal single-or maktlemny dwealag oak sli . .sian: Lot#: hadudes attached 1,000 90'it•°r les° INIMIEZEIIIIIII.13 Tax map/parcel#: Es-WW1 MO sq-fi or111111111011111111111 i I vflar above ..ft. A Limited enemy,multi-fantilY III 75.00 ma residential with above •.it. MilliraMINIP ' EMt=mnfelomm11111111=11N sisse::Pii,. r::e„ r$wpftie.:':n.„ .2.,-::..' .-,: '": ," 7,2. service.er reed.,wrtaktio ot..., IAMIIIIIIIIIIIIIIIIIIMIIIMIIIIIIIMIIIN Name: le . II,13 ,g.Minin. 2oo*pepriess . 11111.low'Maw 201 amps to 400 amps 111111111133111111111111E1 Address: „.. ..., 40/amps to 600 mops EN 213°34 Mile cityistatemp: 1-1.,t.,4 16.L. 1 cv 601 amps to 1,000 amps all 30144 11111111118 phon=et;E) . ,.,161111aMINIZMINIMinnal over IA*lemls er voil3 11111111113E31.111.1B Temporary services or feeder;hatritation,afterattom and/or Email: relocation Owner Installation:This installation is being made on property that I own v/hich is not 200 an Cr less 11111111112311111111111 , intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 .... to 400 atape 1111 325.08 111111111110 Owner signature: Date: 401 snot to 599 Mime 11111111111=1111111111E1 Business name: Ili, L.vt. Ilk, • above setvice‘tui orkefterke. bt Co n tact name: B.Fee far breath- - •wulaut II Ulla service or Near tea&at Address: VZ, th '-' Pi&A 1°.. wanniniminin breath circuit CitylStatarZTP: lia i CDit.x. Irrrinrirrr-r— ammil1111111112211111111111E1 Phone: ..u) 411 . Fa&:(4351) 4 14 zs-- ii;R1111112:1111111111 Emaik i. .. Vv.+ • 6 li t I' INS$ 1- ,.. ,„. 112= 1111111152a111111111113 ' , , . ' : ' siz:minnurioluiva i_ .., • - Ent:E22:milimill11111137111.11111111E1 mcfress: carisi'•.molintiftiminimmem. signeckmasoornadtod-ceergY ri See Page 2 ma Baal additional • • -; ever aBowable le of the above City/Staten] 4 i , ,. dki i 6_0 _ , ..................______IE:2===.111111111 66-2sar 11111111111 phorie.mirporami Fax: ,,v, ) - - .m.. ... in 90-00ibr 1111110 industrial plant(I broil)) 111111EM0111111111 e , a a A A • ' 24..A 123MMINI Electriiral Lic.;./1_ 1''. ECEIMI111 IFP.—i.;;Ii.51101 9°40/hr 1111111 -..... ". I- i Suprv.Electrician signature,required: ait...4 ,allIllIllm Suburb]: 11.11111111 limifffp,11plimin Data—1 MIMI 13 Plan Review •-..1 .. li (12%of -'Opens:it foe): 111111111111 State surcharge • ... fee): _11111111111111 / ' TOTAL PERMITME: 111111111. Authtnized signature: 411. mob, Tab permit applIcatios ember Ws permit la sot obtainer,MO&IS Date:7- It-. / days alter ftkm bees accepted at complete i Print name.: .111919...ist IllEM.1111111111111111 . • Number°therm:tient allowed per permit. am 06/17201$ 440-misro iaVor:014/wEg OttoictorawmitioncyrrratApp' JILft_Earcrloc Mechanical Permit Application FOR OFF1CL USE ONLY 1 11125 O) all Blvd., Received /�� 1!!/� 13125 SW Hall Blvd.,Tigazd,OR 97223 Dat 7: Permit No.;l/y 6..1 t0!Sa _ Phone: 503.718.2439 Fax: 503.598,1960 Plan Revie J Ins ection Line: 503.539.4175 Date/By: Other Permit: TtGARD P DateReady/By: Juris; Internet: www.tigard-or.govSee for Notified/Method: Supplementent ali Information TYPE OF WORK ;; COM1«RCIAL FEE* SCI EDULE `USE CRECKLIST,`.: 0 New construction ( ,Addition/aiteration/replacement Mechanical permit fees*are based on the value of the work ❑Demolition �" performed.Indicate the value(rounded to the nearest dollar)of all Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION:: Value:$ l-anddwelling RESIDENTIAL'EQUIPMENT/SYSTEMS FEESil * 2-family g 0 Commercial/industrial 0 Accessory building For special information use checklist. Multi-family 0 Master builder 0 Other: Description Qty. I Ea. I Total JOB SITE INFORIIIATIQN AND LOCATION Heating/cooling: Job site address: ' L i� r ` Air •conditioning j 46.75 fliJi Furnace I00,000 BTU(ducts/vents) 46.75 City/State/ZIP: l&Aril) epC(7 Z.z37 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 ��Avi t LTD t` Duct work X 23,32 Cross street/directions to job site: Hydropic 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: I Lot no.: Other: 23 32 Other fuel appliances: Tax map/parcel no.: pp lances: Water heater i 1 23,32 I DESCRIPTION'.OF WORK Gas freers ceiinsert 3339 zsty t� Do k crt b 0 Flue vent for water heater or gas s{ fireplace 23.32 [ Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ROPERTY'OWNER ! Other: .,.. I 0 .;TENANT 23,32 Name (� f7 Environmental exhaust and ventilation C3 e`..6 4--( Egg(C,, 1, 1-,t,10yv Range hood/other kitchen Address: ` r ui ment `k'1"Zt c i(� `lk pLUI t.`, Clothes dryer exhaust 33.39 City/State/ZIP: _` t&ice (.0 tk, y Single-duct exhaust(bathrooms, r ``�,, 33.39 Phone ' (0'%(-ta Fax:( ) toilet compartments,utility rooms 23.32 Attic/crawlspace fans 23.32 (-(tAPPLICANT p CONTACT PERSON Other: 23.32 Business name: ?2:s f i DE c f(.,,,,, � Fuel piping: Contact name: $14.15 for first four;$4,03 for each additional ot k' 1`.kFurnace,etc. 1 Address: 123 OZ. t I<w I'Vt Arl St Gas heat pump City/State/ZIP: ''Y ' icti ,1clt rc��+` 3 t� Si?. o Watheaended/unit heater orc.;!..,- C-` �•.1 Water heater Phone:30 -77-z sc.%(G ' Fax::f9)-I) q:77 t4 Z'j" Fireplace E-mail ? r. Range ����i SiveVIR.ep gE•'l 1 •Ds&t uk)0\IC\ �.O+'h Barbecue CONTRACTOR Clothes dryer(gas) ) Business name: 4�.� DE t'(op TN C Other Address: t2,ZC Z .�fZ. ��w MECHANICAL PERMIT FEES' Subtotal City/State/ZIP: Pb;Lk t 0 f2`-(t�'3O Minimum permit fee($90.00) Phone: 2� C l _s-s- Fax:( O 1...4 -2-7} ZPlan review(25%of permit fee) l t State surcharge(12%of permit fee) CCB tic,: et t TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized Signature days after It has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board I Print name: Syk- F..........__, <,4 I Date: '-'7--t21 t f �•j I?13uildings?erwits,MEC_PermitApp_040113.doc 440-4617r(I 1,02'COM,WEB) Plumbing Permit Applikatioii ' v Building Fixtures . FOR . .FIC.E IS ONLY City of Tigard Received ;wvj. , Date/Br 14 11 • 13125 SW Hall Blvd.,Tigard,OR 97223. �y 6 q /3//6v Permit No.; /�I�, S-oo�S- Phone: 503.718.2439 Fax: 303.598.1950 Plan Review Date/By: Other Permit No,: TI G A R D Inspection Line: 503.639.4$75 Date Ready/By: Juris: - id See Pae 2 for Internet: www.tigard-or.go`y , '% -- Notified/Method: g S Supplemental iem en tel Infarmanon TYPE•OF WORK ' 1 - FEE* SCH1iDULE 0 New construction 0 Demolition For special information use checklist Description J Qty. I Ea. I Total lbAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OFCONSTRUCTION,, SFR(1)bath 312.70 [Al-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 ❑Other: Fire sprinkler( sq.R-) Pae 2 JOB SITE INFORMD•ATION ANLOCATION Slte utilitiesg : r area Job site address: 'r % _ Catch basin odrain t.t 1 I.1^ SLA) r`!-4t - 1'itti.cU 38.76 f City/State/ZIP: �t G p -b Off(,,p� C, 7 Z2? Footing Drywe1,/each line,or trench drain 18.76 "1 ! Footindrain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:__) Page 2 • Water service(no.linear ft.: ) Page 2 Subdivision: j Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK a ater va ve . Bckw 1 ,.: ,. .... , ..,. ..:: 1251 Clothes washer 25.02 .'-tf>t A O I)il-f b i,,`..,,._.. Dishwasher 4.. 25.02 Drinking fountain 25.02 _.' 0 PROPERTY WNER ❑.TENANT ` Expansion tank 25 02 ..,, O ,. „ . � 32.53 Name: Z tL 4' ') I 6 ga S Aq t , -.O� drain/floor cap 25.02 Address: ( Ca J t Floor sink/hub4. 25.02 5 i 2.4 W i,' i ' Garbagep disposal City/State/ZIP: 1 kt W t Q17'�Z3 Hose bib 1 .1' 25.02 Phone L`)�" - 25.02 c6 S ,C)C1 Fax ( ) Ice maker PLICANT 12 5i k.) t'CONTACT PERSON Interceptor/grease trap 25.02 Business name: S`-(c�,,E. D Es>'Csv- z-� Medical gas(value:$ ) Page 2 Contact name: f.0.t4, J Y�` Primer 12.51 1 2, 0. .iii Roof drain(commercial) 12.51 Address: 1 3 ikkiA�tC a �-{ Sink/basin/lavatory 25.02 City/State/ZIP: Pb. bpiti^ Cyl-= D U"' Solar units (potable water) 62.54 Phone: Z�, 4.( /".2..c.�p 4L�_ Fax::�7�) Li?? lTub/shower/shower pan 12.51 E-mall: SC©L `SV Viti t )(L 5 1(s Urinal 25.02 Water closet I `X 25.02 CONTRACTOR T Water heater Business name: V i 5 P t LAN, ' i 1P4( k 37.52 rq (� �1 f�.- _ Water 56.29 Address: g),V, `J / - �n 1 k l-�-- kbt. Gt. Other: ""� 25.02 City/State/ZIP: V' C\ N �' �i� � � Subtotal Phone:( S'']' Fax:( ) Minimum permit fee: $72.50 CCB Lic.: i tt Plumbing Lic.no.:p R [ Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: S c i K}cl-N„,,..- Date`7-1^z, This permit application expires if a permit is not obtained within 180 days 'f t after it has been accepted as complete. `Fee methodology set by 1'ri-County Building Industry Service Board. I.Building Permits,PLMU-PerrnitApp.doc 10`01/09 4404616T(10,02 COM'WEB) City of Tigard 111 w COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review — Residential TIGARD Building Permit #: �`"� off O I 5--co 15 2— Site Address: 11215 semi rve/in Project Name: } fl1 Wd.t. Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: A att-h l — 5111G/C -71Yr). reS1cia.il.CI• ❑ Verify site address/suite# exists and active in permit system. ,1 River Terrace Neighborhood: .X No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: ' Ihree(3) copies of site plan Existing structures on site Site plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished rawn to scale(standard architect or engineer scale) floor elevations orth arrow 5Itility locations(required for new,may apply for additions) 'Site address,project or subdivision name and lot number r ocation of wells/septic systems 1j c,ivE (I�pplicant information(name and phone number) 1 xisting trees to be retained with drip line,and tree ot dimensions and building setback dimensions protection measures NIot area,building coverage area,percentage of coverage and lJtreet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) ylStreet names Property corner elevations(2 foot contour lines if more than 4 foot differential) yClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified ❑ No Received: Af Yes ❑ No (a.Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified ' No Applied For: ❑ Yes ❑ No,stop intake g Land Use Case#: rf /.k la Zoning: R.,3.S , f Setbacks: Front Z0 Rear t rj Side 5 Street Side ►N)//l Garage 'd !�Landscape Requirement: n/ 0,Lot Coverage Maximum: I Building Height: aximum Height a-) Actual Height .,,24 .Visual Clearanceki /4s, Easements p Sensitive Lands: Yes ❑ No Type C��S V e U►( .C (da -WLtt-I LAJ v Urban Forestry Plan N ! iN \- modt ri 4c va Conditions "Met"prior to issuance of building permit knit pr Notes: //�� Approved By Planning: M 0 V1P-0 ►311(O Date: 7 / ( L/ i Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved El Not Approved I:\Building\Forms\BldgPermitRvw_RES_060116.docx Building Permit Submittal Original Submittal Date: g 45— /fa/0 Site Plans: # Building Plans: # Building Permit#: 2-Inter building permit#above. Workflow Routing: ..2 Planning 2'Engineering fr<rmit Coordinator .2 Building Workflow Sign-off: 2i Sign-off for Planning(include notes from planning review) Route Application Documents: 0 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. ,/ .. Building: original permit application,site plans,building plans, engineer and beam calculations and trust details, ifapplicable,etc. / Notes: , B-I� ,a6. ' de,-,(7/77=4„6 L / J 44.14) / O 9I Lr —7,^� By Permit echnician: p ,0,Fti Date: '7//V* Engineering Review Slope at building pad: Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: CIYes ❑ No LIDA Facility on lot: ❑ Yes ❑ No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: oliA,P Date: 70.#4Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: DC Fees Entered: Wash Co Trans Dev Tax: El Yes g..1" /A Tigard Trans SDC: ❑ Yes i /A Parks SDC: ❑ Yes Pp'N/A (bK to Issue Permit j" 1 Approved by Permit Coordinator: Date: 9/1':Y/47 I:\Building\Fonns\B1dgpennitRvw RES 060116.docx 1n ° ,lin Permit A• •lication orF►c� l�s� o �idential , , ' �, , a .�r ` City of Tigard FOR ,�►.I 13125 SW Hall Blvd.,Tigard,OR 97223 ' 2 4 ,h-{ Received Phone: 503.718.2439 Fax: 503.598.1960' I Date/13 Permit No.: I I c;A R I Inspection Line: 503.639.4175 Plan Review 6—'„„. , Date/13 Other Permit; Internet: www.tigazd-or.gov a Date Ready/By: Mill Nati Read ethod; PI See Page 2 for Supplemental Information , 1 �� `-` N TOE OF- /R�,. F a 0 New construction IQIJIRED DATA:I-AND:2-FAMIL 0 DemolitionI DWELLING k Addition/alteration/replacement Permit fees*are based on the value of the work performed. 0 Other: Indicate the value(rounded to the nearest dollar)of all CATtGOItY O CONSTRUTCTIfxv on this equipment,materials,labor,overhead,and the profit for the work indicated 1. -and 2-family dwelling application. 0 Commercial/indu• Valuation: ❑Accessory building $ 0 Multi-family Number of bedrooms: r ❑Master builder 0 Other: Number of bathrooms: JOB SITE INVOTTON AND E©'ATION " Job site address: _ �' Total number of floors: City/State/ZIP: ` area: Garage/carport New dwelling area: t _ square feet Ci2 , Suite/bldg./apt.no.: Project name: _ liiimi, square feet jjsstrejjdnstoiobsite: \ Covered porch area square feet Deck area: square feet 1' lj Other structure area: Subdivision: : square feet �� RECfIItt p DATA:COMMERCIAL-ESE CHECKLIST Tax map/parcel no.: • = .\� Lot no.: Permit fees*are based on the value of the work performed. � e Indicate the value(rounded to the nearest dollar)of all DESC' ' ' ON A 0® , equipment,materials,labor,overhead,and the profit for the —.� work indicated on this ...lication. a/ Valuation: IIIIIIIII Existing building area square feet PROPEI I Y Own New building area: AIIIIIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIN ❑ "TENANT square feet Number of stories: Address: 1DAP 0 C _ Type of construction: City/State/ZIP: Jim Alk " • lig (110,0Occupancy groups: Phone:( ) el,n A;arPLle- , Cl CONTACT 1PE" Business name: • � RSON ar t.G c,..) i c-O* i 1TILDINGPERMFC FEES* Contact name: PIeaser pr,, ee k Address: �R �� 712.1.4-0-• Structural plan review fee(or deposit): City/State/ZIP: 'I RNIr FLS plan review fee(if applicable): '�' 11.111111111111111 Total fees due upon Phone:("►a � P application: �' Amount wiffinf nt received:y, i . C ( on ,- PHOTOVOLTAIC SOL PANEL sysrEM�FECommercial and residential prescriptive installation of, kCC0NTTUR Business name: roof-top mounted Photo Voltaic Solar Panel System. Address: 1� 11.1.‘..) ak ' Submit two 2 y t'7 (2)sets ofroof plan with connection details City/State/ZIP: i r..- Alb _ y kit "_�` �► and fire department access,along with the 2010 Oregon - s — Solar Installation Ssecial Code checklist. Phone:(sr ) U 0" e�©(p Permit Fee(includes plan review CCB lic.: 05 and administrative fees : $180.00 State surcharge(12%of permit fee): Authorized signature: , -711) $21.60 Total fee due upon application: � $201.60 This permit application expires if a permit is not obtained Print name: 0 6 within 180 days after it has been accepted as complete. �� ���. Date: � *Fee methodology set by Tri-County Building Industry I:1Building1Pennits1BUP-RESPermitApp doc 02/24/2011 Service Board 440-46 3T(1l/02/COM/WEB) Buildin Permit A lication Checklist FOR OFFICE hsH• O^ One- and Two-Family Dwelling Received Permit No.: DateBy: City of Tigard Associated permits: Mechanical 131.25 SW Hall Blvd.,Tigard,OR 97223 0 Electrical 0 Plumbing ■ Phone: 503.718.2439 Fax: 503.598.1960 0 ether: 24-Hour Inspection Line: 503.639.4175 }`s No o �/ t<<'\t�a Internet www.tigard-or.gov REQUIRED FOR PLAN REVIEW 0 0 0 THE FOLLOWING ITEMS ARE REQ0 0 1 Land use actions on►o balance ,omts,d. See se seismic soils deson criteria for �nat nation, district,etc. 0 00 0 2 Verification FlFond slain,solar00 • 3 Verification of a roved lat/lot. 0 0 0 54 Fire district a ,royal I ah ri Namen of district: 00 0 0 5 Se i tic s stem I ermit or authorization for remodel. Existin:s stem ca'acit 0 0 0 6 wer d is ermit. 0 0 7 Water district a royal. required. Include drainage-way protection,silt fence design and location of catch- 00 8 Soils re s ort. Must ca ori.final a 6►licable stam• and si.nature on file or with a�� ica ton. 0 9 Erosion control ❑plan 0 permit0 basin protpctten,etc. applicable local and state 10 a Complete sets of legible plans. Must be drawn to scale,showing into the plans on a separate full-size and plan location and details. Plan review acannot bcompleted if 0 0 sheet building a codes. to the plans with details eferencesebetween must t be incorporatedtio shecorner elevations(if 0 coo ri:ht violations exist. 4-ft.elevation differential,plan must show contour lines iet 2-ft. ft.ninseutility lls)l location to ns;de easements 11 Site/plot plan drawn toscale. The plan must show lot and buildingback dimensions;property there is more than a (including decks);location of wells/septic and drtoewot area;tbuildingof structureeepercentage of coverage;impervious area;existing structures on site;and0 0 0 g p indicator;lot coverage area; pads,connection details,vent size surface drains le hold-downs and reinforcing 0 0 0 12 Foundation plan. Show dimensions,anchor bolts,any and location. 0 0 ter, 13 Floor plans. Show all dimensions,room identification, 30 inchesabove smoke detectors,cwater oasts,sub- 0 furnace,ventilation fdan , aiSh_fixtures,alframing-member member sizes and spacing such required u floor bo clearly portray 14 Cross wallions)and details.fShow cti n. More oneheight,siding material,footings floor, Showidoof all wall and More than sheathing, cross roofing, on slope,ceiling may 0 0 0 construction. details, ilace construction thermal insulation,aton,etc. roof two elevations for additions and remodels. and foundation,stairs, if the change in grade is greater than four foot at building envelope. 15 Elevation views. Provide elevations for new construction;minimum of0 0 0 Exterior elevationshmust reflect the actual grade references are acce'table. Full-size nrums path)a undation and/or lateralevations with analysi plans.Must indicate details and locations;for non- 0 16 Wall bracingv (prescriptive path) 0 0 for all floors/roof assemblies,indicating member sizing,spacing,and bearing �rescri�tive path anal cis • Provide ide specifications and calculations to en:ineerin_standards. 0 0 17 Floor/roof framing. plansplacement of rebar. For engineered basemen Show atticaing ventilation. 0 0 0 18 Basement and retaining walls. Provide cross sections and details showing code design ign values for all beams and multiple joists s stems,see itema22,"rov de two calset of calcul 0 0 0 19 Beam calculations. Provide two sets of calcunatiaonon-unf grin load. 0 0 over 10 feet Ion. and/or an beamfoist c. . as- i in schematic is required 0 201 Energy Codeoded floor/roof compliance. Identify the prescriptive path or provide calculations. A g p P g 0 0 21 Energy comp byan engineer or 0 provided,(i.e.,shear wall,roof truss)shall be stamped forn four or more a.'fiances. 22 Engineer's calculations. When required or p architect licensed in Ore•on and shall be shown to be a',licable to the ,ro'ect under review. 0 0 0 JURISDICTIONAL SPECIFIC'S0 0 0 23 Three 3 site dans are rewired for Item 11 above. Site .lans must be 8-1/2"x 11"or 11"x 17". 0 0 0 24 Two(2 sets each are re,uired for Items 16, 19,20 and 22 above. 0 0 0 256 Bu"Reversed" a d"b shall not ns red lines oaoutlined in the Permitirrored" &Snstem Develonment Fees document. 0 0 0 26 "Reversed"Buildin tans must meet criteria applicable),anarchitect or en.ineer scale. d City of Tigard 0 0 0 27 "Drawn to include treesistandard, and location per approved project street tree plan(ifpp 0 0 0 28 Site plan size,typeapproval. Tree locations,driplines, Street Tree List. conditions of 0 29 Site plan to include trees and tree protection measures as required by0itions, 0 enin Site Assessment form is required for all building residential dwellings and •rotection measures must be drawn o scale and must st include the •ro'ect arborist's si.nature of a',rova. non-impervious surface)and accessory structures to existing 30 A Clean Water Services'Sensitive Area including decks,patio covers(over non-imp on a lot of record a',roved ,rior to Se Itember 9,1995. I:\BuildingTermits\BUP-RESPermitApp. dos 02/24/2011 440-4613T(11/02/COM/WEB) E) s >rical Permit Application FOR OFFICE t SF:OyLv City of Tigard t. p Received 111 `' Date/B Permit#: 13125 SW Hall Blvd.,Tigard,OR 9722 ,t , '' R Phone: 503.718.2439 Fax: 503.598.1�'" Plan Review Date/B Related Permit#: Inspection Line: 503.639.4175 ReadyDate/By: TI(.AR1) Y Juris: ® See Pa Internet: www.ti and-or. ov ge 2 for g g s j , Notified Method: �� 4 �.�) Supplementallnformation TYPE OF WORK PLAN REVIEW ❑New construction yr Addition/alteratignttP/a ie �:8 Please check all that apply�^y (submit 2 sets of plans w/items checked): 3g� �95 � � 1j 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition El Other: ]ll - where the available fault current 0 Marinas and boatyards. CATEGORY OF CO TION exceeds 10,000 amps at 150 volts or 0 Floating buildings. I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,orycceeds 14,000 0 Commercial-use agricultural ❑Multi-family0 amps for all otlW installations. buildings. ❑master builderOther: 0 Fire pump. / ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergenc system. larger separately derived Job#: Job site address: ❑Additio of new motor load of system. I(2„,C 50 ' I Fk�,y�,,Y'1 100 or more. ❑"A" "E" "1-2" "1-3„ City/State/ZIP: Til l a ❑Si r more residential units. occupancy. ❑ ealth-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: pHazardous locations. 0 Supply voltage for more than Cross street/directions to job site: ,�� Service or feeder 600 amps or more. 600 volts nominal. ICI f FEE SCHEDULE IC ") I Description I Qty. 1 Each I Total ` New residential single-or multi-family dwelling unit. Subdivision: Lot#: / Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion 33.92 1 Limited energy,residential nE L,.3 Ph_i-e_�/ 11-C- CA / L „1 / (with above sq.ft. 75.00 2 i 1 �t Limited energy,multi-family residential(with above sq.ft.) 75.00 2 PROPERTY OWNER 0 TENANT/ Renewable Energy 0 See Page 2 Name: �Q, i Services or feeders installation,alteration,and/or relocation c-E., ittt/K 1 O 200 amps or less 100.70 2 Address: 11145 .5, ''� 90_, 9_�aucx� �� 201 amps to 400 amps 133.56 2 City/State/ZIP: I1Oc..� s \\� 401 amps to 600 amps 200.34 2 Tir ziR"T�' \ /y 601 amps to 1,000 amps 301.04 2 Phone:( ) 1 Fax:( ) / % ••\ Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on prope'' C't I o n which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to OR 447,4•',670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits-new,alteration,or extension,per panel 0 APPLICANT A CONTACT PERSON A.Fee for branch circuits with Business name: '2. __ 4...f `— , (61-10 above service or feeder fee, each branch circuit 7.42 2 Contact name: 6 Q --TILLB.Fee for branch circuits without Address: t6,2t4 2 ,..,_.$ 6 y I service or feeder fee,first ✓ branch circuit 56.18 2 City/State/ZIP: i € .VE ,O— c,o.,N Each add'I branch circuit 7.42 2 Phone: O �FMiscellaneous(service or feeder not included) (� )) e� 5 9 `V .- Fax: :( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CON 1' 'CTOR Pump or irrigation circle 67.84 2 Business name: D` 11 Ta`c, Sign or outline lighting 67.84 2 Address: 5(48(4, f'J"�6C1� ,.5 t 06.... Signal circuit(s)or limited-energy panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: LE_ �rI�� ^ ©� Each additional inspection over allowable in any of the above Q� ) Additional inspection(1 hr min) 66.25/hr Phone:(So) S8 ( , ...r1 I Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 1(01 91 Electrical Lic.: ty_ 5-'.4 Suprv. Lic.:��/3's specifically listed('/hr min) 90.00/hr Suprv.Electrician signatur• r=wired: i1 ELECTRICAL PERMIT FEES Subtotal: Print name: c28..„.0,) 5c t 0,FaR, I Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: ei,..... This permit application expires if a permit is not obtained within 180 Print name: c2 -�r-� Date: days after it has been accepted as complete. - S// * Number of inspections allowed per permit. I:\Building,Permits\ELC_PennitAppEL ERE.doc Rev 06'17,201 440-4615T(11/05/COM/WEB r z Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: IttfDtIi ������tttttt������...... r F E SC .LE 5 '� i Description I Qty. Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) D Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 >100 kva-no additional charge 0.0 3 111 Vacuum Systems* Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('h hr min) LEc`I'R1CA1.. fER1V11'I' FEES” ,.t COMMERCIW04IwflNL ►'� Subtotal(Enter on Page 1): 1 Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Mechanical Permit Application FOR OFFICE USE ONLI City of Tigard il�I `3 f Received Permit No.: Il Date/By: 13125 SW Hall Blvd.,Tigard,OR 97 d r. UA Plan Review ' `: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for Internet: www.tigard-or.gov A t 1 tJ 2 4 2015 Notified/Method: Supplemental Information TYPE OF *AU OF i HUARD COMMERCIAL FEE* SCHEDULE - USE CHECKLIST g Mechanical permit fees*are based on the value of the work few construction 'Addition/aI x g I ON performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ,Er 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 1 46.75 Job site address: ( t 5 5L I-aR-�h C1 V (ducts/vents) 1 46.75 1 Furnace 100,000 BTU ducts/vents City/State/ZIP: t cia,r > Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: 4(4011/4,1 1 L.: , Duct work 23.32 Cross street/directions to job site: ` Hydronic hot water system 23.32 l� Residential boiler(radiator or hydronic) 23.32 '" Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 V\ \ Flue/vent for any of above 23.32 Subdivision: I ot�• Other: 23.32 Other fuel appliances: Tax map/parcel no.: N ` Water heater j 23.32 , ir DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas f l€ `-l-LASI--,• , A/C, t.)... a`"C' fireplace ' 23.32 T - �0( + Log lightWood/prellet (gas) 23.32 tom- Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: 0...s j c. 1. t�.o in Range hood/other kitchen equipment 33.39 Address: ( 't Z l 5 Sc„_) �1 tQ- �,� .1 Clothes dryer exhaust . 1 33.39 City/State/ZIP: 'Tt �.e� ` Single-duct exhaust(bathrooms, — toilet compartments,utility rooms) 1 23.32 Phone:( ) F..:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: --�-� I K��9"'14,0 Fuel piping: " "� �-!��S' $14.15 for first four;$4.03 for each additional Contact name: 12Cs, �� •�R N, .p Furnace,etc. Address: i(„3 i ifl) , • 4 elt SLA I c Gas heat pump Wall/suspended/unit heater City/State/ZIP: cr0. 0.9...)E-A-�/f p ,, ,' DQ,_. ?oG� Water heater j Phone:(5" 5�-3 t _ s((,�3" Fax::( ) Fireplace Range E-mail: Barbecue CO RACTOR Clothes dryer(gas) Business name: A0550� �EA:ri ✓,i r60p‘.,l" Other: MECHANICAL PERMIT FEES* Address: ILA n , os— t Subtotal City/State/ZIP: ` // ." _ .i& .OA,a C\$(5346S.' Minimum permit fee($90.00) �Y Plan review(25%of permit fee) Phone:( 52„,4 5356" Fax:( ) State surcharge(12%of permit fee) CCB lic.: '24F) 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: 1 '(�`qtr t h p.so,rn I I"Z 'A, * Fee methodology set by Tri-County Building Industry Service Board Print name: fl ,(Z- p y` Raw,'R-E..Z Date: I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(II/02/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$10,000.00 $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. : 3 I:\Building\Permits\MEC_PermitApp_040113.doc 2 I Plunnbinhermit Application Building Fixtures FOR OFFICE: 1st, ON 1.1 City of Tigard 3 `, 1 `f Received `' Date/B Permit No.: 13125 SW Hall Blvd.,Tigard,OR 9722 Y Phone: 503.718.2439 Fax: 503.598.1960 Date/By:lan Review Inspection Line: 503.639.4175 (� Other Permit No.: TIC.,1 IZ U r U15 Date ReadyBy: Juris: ® See Pa Internet: www.tigard-or.gov ;a ,O. 4 gel for '.r } Z:fiedai thod Supplemental Information ❑New construction1 � 0 It (-1 I1J;/1 S1 For special information use checklist G Addition/alteration/replacement 0 Description Qty. Ea. Total New 1-2-family dwellings(includes 100 ft.for each utility connection) 1-an , 4 ' II'S� �.‘ .I ( t,t a _ SFR(1)bath 312.70 d 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each...itional bath/kitchen 25.02 ❑Master builder 0 Other: Fire•.rinkler( sq.ft. Page .. 1'1 � 1� >1 s ,3' Vi Si utilities: ) 2 l'Lt5 S hatch basin or area drain 18.76 Job site address: t City/State/ZIP: Drywell,leach line,or trench drain 18.76 �1 7 1 .-' Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 �(tiJ Rain drain connector 18.76 l '\� Sanitary sewer(no.linear ft.:_� Page 2 Storm sewer(no.linear ft.:_) Page 2 \)1'(\\1 Subdivision: Lot \ Water service(no.linear it.:_) Page 2 Lot'tr• lf Fixture or item: Tax map/parcel no.: \ Backflow preventer 31.27 t ;, t lt i #rj t 1 > � ''. Backwater valve 12.51 F Clothes washer 25.02 1)E``-) ' ''' 1)E`` -I 4 2Oo''`? t X f S Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 r r: .,'' s 1 . .r Expansion tank 12.51 u Name: - r - Fixture/sewer cap 25.02 Address: t 1-2_t 1 � Floor drain/floor sink/hub 25.02 t n-- e� reN Garbage disposal 25.02 City/State/ZIP: rI Ga.' )P--- Hose bib 25.02 Phone:( ) ` Fax ( ) Ice maker . 12.51 aar� ` 1 :. 1 f 94 1 Interceptor/grease trap 25.02 Business name: L /U-I'",p , ii, 5,0.4 Medical gas(value:$ ) Page 2 Contact name: c� -j-�L Primer 12.51 Roof drain(commercial) 12.51 Address: ((€ B ,r,,,) c..4.; L�-t Sink/basin/lavatory 25.02 City/State/ZIP: A ki C,R..,Tvi,N C2- q'o O Solar units(potable water) 62.54 Phone:(SCJ 5-3 i 05(4„'2 Fax::( l ) Tub/shower/shower pan 12.51 E-mail: �f/�, ? �� Urinal 25.02 x. ‘.16y Water closet 3 t. a 25.02" "' Water heater 37.52 Business name: �� Co"�i �n _ r �v ti v A f at('c. ` Water piping/DWV 56.29 e Address: Yk t,2 ,,t',-"C A9r Other: 25.02 • City/State/ZIP: L 4 v t pi' L t 1 , Q ff'7 `� Subtotal • Phone:(r03 ) 3 1 Z - 3 k'7 Fax:( ) Minimum permit fee: $72.50 CCB Lie.: r3 �j Plumbing Lic.no.: (�jVis+ Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: �� TOTAL PERMIT FEE se Print name: j,L� c..( il,^ Date: This permit application expires if a permit is not obtained within 180 days f tafter it has been accepted as complete *Fee methodology set by Tri-County Building Industry Service Board. 440-4t16T(loIo2/COM/WEB) I:\Building\Pennits\PLMU-PemtitApp.doc 10/01/09 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT • r l c A R o Building Permit Review — Residential Building Permit #: Site Address: t 1,115 S i,J lrlct tre Project Name: Y 1{Z,", Lot #: (New dwelling= subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: 41400 051-o-- Qc d-- n c - 5' ;i le --fc r,, / VVerify site address/suite# exists and active in permit system. 'River Terrace Neighborhood: ❑ Yes• No e Plan Elements: ree (3)copies of site plan Existing structures on -to .ite plan must be on 8-1/2"x 11"or 11 x 17"paper 4-Footprint of new st cture ilO ling decks)with finished I Drawn to scale(standard architect or engineer scale) floor elevations -I RNorth arrow 4 /tility locations requi r new,may apply for additions) I�Site address,project or subdivision name and lot number A Location of w: s/s s)stems [VApplicant information(name and phone number) osion con (inclu ing drainage-way protection, silt fence I of dimensions and building setback dimensions design,loc.tion!i?f catch basin,etc.) w V ot area,building(coverappligeblareaifR-7,percentagR-12R-25e of coverage and Street n. es impervious area acae , , &R-40) _q�I.Street • ee si i;,type and location roperty corner elevations (2 foot contour lines if more than�," I. xis w ng t . to be retained with drip line,and tree Qfoot differential) pr. e ti.. measures LJ Clean Water Services-Service Provider Letter (lot platted r ior vi /10/1995): Required: 'Yes,applicant was notified ❑ No ceived: ❑ Yes ❑ No e Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified ,'No Applied For: ❑ Yes ❑ No,stop intake .g Land Use Case#: K/A Zoning: R - 3 .5 Setbacks: Front a o 'ear js Side 5 Street Side Garage a U Landscape Requirement: Lot Coverage Maximum: -- tit Building Height:,_. Maximum Height 3D Actual Height Visual Clearance CDEasements Sensitive Lands: 'Yes ❑ No Type J)r-cL,nc i vel 0)2 C&c Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: Sec s; l ) r-t 10,-,d crl� v-iope«rr +:, b� u . rd Vt e_Q_d S eLdS SPL. L d e--6-r O J/04 /t OW 433- ho11n�:0* Approved By Planning: Date: y/5 Revisions (after Building Submi only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw REs 0701I5.docx Building Permit Submittal Original Submittal Date: -S1)-145 Site Plans: # 3 Building Plans: # Building Permit#: nter building permit# above. Workflow Routing: fanning gtneering ermit Coordinator Ehlrilig Workflow Sign-off: off for Planning(include notes from planning review) Route Application Documents: [—ngineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. uilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: er/j4,7/.5 Engineering Review Slope at building pad: 3 7; �, L s "Met"prior to issuance of building permit E ments (encroachments)per engineering conditions of approval and plat ater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes lil-" �10 Assess Water Quantity Fee in-lieu: ❑ Yes LJ'110 LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: dl_ 27 Date: e6---.2. --j..6" Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ..❑ •Conditions "Met"prior to issuance of building permit NApproved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: IR(OK to Issue Permit Approved by Permit Coordinator: O /2, -, 0 - C.G-z-''Le^J Date: 6 - G7 (v-- 1-s- I:\Building\Forms\BIdgPermitRvw_RES_070115.docx SI:\Building\Forms\B1dgPermitRvw_RES_070115.docx i Electrical Permit Application - �EE 4 ' I OR 011 1( 1 1 OyI 1 City of Tigard Received (JAT� L T'�j�' G� Date/B Q i- Permit#: II J I 13125 SW Hall Blvd.,Tigard,OR 97223 t���G �+ Plan Revie 3 t017 Phone: 503.718.2439 Fax: 503.598.1 � ,�-. y�1114 Related Permit#: Inspection Line: 503.639.4175 C ° 'O9' f1 A 7) ReadyBDate/By: Juris: 0 See Page 2 for 1 l' It Internet: www.tigard-or.gov Notified/Method: ,tILDITG DIVISION Supplemental Information TYPE OF RK PLAN REVIEW 0 New construction !1 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. 41-and 2-familydwellingCommercial/industrialless to ground,or exceeds 14,000 0 Commercial-use agricultural 0 0Accessory building amps for all other installations. buildings. Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: / Z /� 1 ,_ ❑Addition of new motor load of system. / LfJ / , t Aki . s 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: ' 'L (� 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 OBSCRIPTION,OF WORK ,. Limited energy,residential 75.00 2 / with above ..ft. ''cy"`" 3� �n/v v ���,�1 c °n ! - Limited energy,multi-family / � �� /J On/G, residential(with above a..ft.) 75.00 2 ,` ' •.ewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT'; i v Services or feeders installation,alteration,and/or relocation Name: �M NOT-12i L� 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 12 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 1 intended for sale,lease,rent,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 El APPLICANT [] CONTACT PERSON Branch circuits—new,alteration,or extension,per panel / A.Fee for branch circuits with Business name: �� ! C t^' G'� J L above service or feeder fee, 7.42 2 I ` � y v each branch circuit Contact name: DON ` -/- lce B.Fee for branch circuits without Address: E ` !J` service or feeder fee,first 56.18 2 Ft 6 73 L5 ( CD 2/17 S branch circuit City/State/ZIP: A-)0 l-4.k. Q 7 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(5-6' 67-z 72 d L Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: f; rZ 6 [/Li T ,v .4 o/, 66 AA, Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: C_cyn. St- \1(i Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: f ct b I S to 5.Ct g_p Je panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: tir^l/ V t-0A qi 06 2 Each additional inspection over allowable in any of the above �� Additional inspection(1 hr min) 66.25/hr Phone:( (Q ) 1 !i I L�_)�t� Fax;( � / Q � yz Investigation(1 hr min) 90.00/hr V., r L 4/'c--- Fax: Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: / Electrical Lic.: /,O C Suprv.Lic.: Lit, ----015 specifically listed(V5 hr min) 1'� �Q"1 a�-� -fi p Suprv.Electrician signature,required: "�N ELECTRICAL PERMIT FEES "�1/ Subtotal: Print name: C'' LP6(44C-R— — Date: 0 Plan Review Required(25%of permit fee): i, State surcharge(12%of permit fee): Authorized signatu!e: TOTAL PERMIT FEE: ) This permit application expires if a permit is not obtained within 180 Print name: j—� Date: ^ Z Z-�� days after it has been accepted as complete. / * Number of inspections allowed per permit. I:\Building\Permits\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: c� L�7�TT ��1l1 V Mir f „=x: �;� RESI EN IAL;1'O O a ,,,:::k ., . .. .. Description I Qty. I Each I TotalI : Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 55226 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr mm) Inspections for which no fee is 90.00/hr specifically listed(Y hr mm) OM tEROAI,*0 6NLY yK rr. r r"ELE TRI AL PEttiArr FEES 4. AV Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: [II Audio and Stereo Systems El Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* El Medical ❑ Nurse Calls 1] Outdoor Landscape Lighting* 111 Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11215 SW FAIRHAVEN ST, TIGARD, OR, 97223 November 8, 2017 at 2:50:29 PM Record Type: Record ID: Residential - Master Permit MST2015-00152 Inspection Type: Inspector: 399 Plumbing final David Young Result: FA I L Comments: Not ready for plumbing final inspection.kitchen sink not installed. New permits required upon future fixture installation. Unable to test shower, full of debris. Provide approved thread sealant on cleanouts. 316.1 Provide approved fitting at rain drain tie in. Secure outside hose bib. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11215 SW FAIRHAVEN ST, TIGARD, OR, 97223 November 8, 2017 at 2:49:48 PM Record Type: Record ID: Residential - Master Permit MST2015-00152 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: No heat in ARU. Dryer vent not labeled for net aggregate length. Install dryer vent termination. Provide carbon monoxide detectors on each floor. No further inspection done. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11215 SW FAIRHAVEN ST, TIGARD, OR, 97223 November 8, 2017 at 2:49:18 PM Record Type: Record ID: Residential - Master Permit MST2015-00152 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Back deck outlet not gfci protected. OESC 210.8(A)3 Provide gfci protection at washer outlet in bathroom or change duel receptacle to single marked non gfci protected. OESC 210.8 (A)10 Front entry gfci turns off interior lights when tripped. Light switch for habital space doesn't work if gfci is tripped. 210.7(1 ) practical safeguarding 90.1 (A) Provide arc fault protection for bedroom, living, hall and other similar areas not gfci protected. Including lower level habital space. OESC 210.12(A) Violation Summary: Inspector Contractor