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Permit (79) CITY OF TIGARD MASTER PERMIT . ' COMMUNITY DEVELOPMENT Permit#: MST2016-00414 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2016 t g Parcel: 2S 102 BA02300 Jurisdiction: Tigard Site address: 10005 SW JOHNSON ST A Subdivision: NORTH TIGARDVILLE ADDITION,AMENDE Lot: 15 Project: YOUNG Project Description: Remodeling existing home: Remodeling kitchen and bathroom, and adding (1)office and(1) bathroom. All interior work. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 2 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 24 Bathrooms: 2 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 0 sf Value: $75,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 2 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: 3 Clothes Dryers: 0 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: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 10 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: ALT SF VB R-3 0 Owner: Contractor: YOUNG,BRADLEY RONALD&REBECC/JOSH JONES CONSTRUCTION LLC Required Items and Reports(Conditions) 10005 SW JOHNSON ST PO BOX 5777 TIGARD,OR 97223 ALOHA,OR 97007 PHONE: PHONE: 503-568-3937 FAX: Total Fees: $2,475.27 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 to- r les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throug 952-001-0090. You H. •.tain a co• • the r -s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344 Issued By: %' eL Permittee Signature: tA ,,tole 9.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the proj t 4111 Approved plans are required on the job site at the time of each inspection. 4 s , Building Permit Application t Residential City Of Tigard Received g Date/By: i�~ � j''''` Permit No.: �/ 1111 4 13125 SW Hall Blvd.,Tigard,OR 97223 '� /7 ! �'" f -w` 4l = Plan Review Phone: 503.718.2439 Fax: 503.598.196 ^� // 11 Other Permit: Date/By: ��—a�"1b T I G A R n Inspection Line: 503.639.4175 777 Date Ready/By: ® See Page 2 for Internet: www.tigard-or.govykt 3"" Notified/Method)] �/�r. I Supplemental Information 1 rn 6 . TYPE OF W(�hLB( ,.� -‘ REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction El Demo $ `° �� Permit fees*are based on the value of the work performed. i3` Indicate the value(rounded to the nearest dollar)of all El Addition/alteration/replacement r: ,. it ,�� equipment,materials,labor,overhead,and the profit for the CATEGORY OF C". :� ION work indicated on this application. Valuation: 5 --�Oi VI 1-and 2-family dwelling • Commercial/industrial -IrJ, ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: Z. JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: MOOS oS-, sv. ,...\' ‘A-00 i3 ,...„-k-- -- New dwelling area: Q square feet City/State/ZIP: 1 kCs'1 -t) o 61112,,S Garage/carport area: 0 square feet Suite/bldg./apt.no.: Project name: Covered porch area: 0 square feet Cross street/directions to job site: Deck area: 0 square feet Other structure area: 0 square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: . t p.Z?-.) 0 Z?DO Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. FeAv 6 e_ t41Ai VNDYVkk_, --1-l. j /J TEZ�IOAA- 10 Ott-K4Valuation: $ hh"7r ee pip,�- „ £-fPyy— o fJ EL /41,7–e,0/ , E/Sel, I Existing building area: square feet rlAyStAl 9l/ aL`/( �� ,n j /' tli. fie/ New building area: square feet gi,PROPERTY OWNER 0 TENANT Number of stories: Name: F prii, S g-GL \)(44... )(-1 Type of construction: Address: '\ i4.,30 ck,,,) `ty," ,v (1), ‘4.1( gk. DIC, Occupancy groups: City/State/ZIP: \ b / or.- I °V Existing: Phone:(503 ) ¶SU-1-(o 1553 Fax:( ) New: APPLICANT 0 CONTACT PERSON " BUILDING PERMIT FEES* Business name: Ski l4�tl (Please refer to fee schedule) L Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: City/State/ZIP: Total fees due upon application:15-7 5 Phone: Amount received: ( ) Fax::( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: ti t)s �V-tit Co vac rikc t_-o.ci ��� Submit two(2)sets of roof plan with connection details j l and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( 'i)-3 ) tiA; Ajit 1 Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: ,A;Lcs!3 3v 3//.i/ � 2 Total fee due upon application: $201.60 Authorized signature: 1 ' � This permit application expires if a permit is not obtained < within 180 days after it has been accepted as complete. Print name: \,,,..„4 q©U�...1 ate: 10 I t"1 tip Fee methodology set by Tri-County Building Industry Service Board. I:A Building\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) w 4 a Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE GSE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd.,Tigiih ard,OR 97223 y Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical T I G A P.D Internet: www.tigard-or.gov 0 Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ves No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 i'1 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 0 5 Septic system permit or authorization for remodel. Existing system capacity _ 0 0 0 6 Sewer permit. 0 0 0 7 Water district approval. 0 0 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. . 0 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 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 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 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. I 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 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 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 Oreton and shall be shown to be al.licable to the Iro'ect under review. JURISDICTIONAL SPECIFICS 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 0 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 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 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 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:ABuilding\Permits\BUP-RESPernitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) II A a Mechanical Permit Application FOR OFFICE ISE OM.) 6. . CI of Ti and �'Received _ h�1 25 g Date/By: Permit No. 'I ,7i J . gi2/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review (�0 i 6 Phone: 503.718.2439 Fax: 503.598.1960 0 C T 17Other Permit: 2016 Date/By: TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ld See Page 2 for Internet: www.tigard-or.gov CITY OF-I I G A R II Notified/Method: Supplemental Information TYPE' OF WORRKUICa L�E LJIY�a7 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 0 Master builder 0 Other: Description Qty. Ea. Total Heating/cooling: JOB SITE` INFORMATION AND LOCATION Air conditioning i 46.75 Job site address:4005.7-A SW (rio /_s-.71j, _ 'et T Furnace 100,000 BTU(ducts/vents) 111 i 46.75 City/State/ZIP: -7-7 ,41,„ .4, C2e g72_;_7?? Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: 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 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 1 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 0 PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation: Name: -y`� 'AL 7.- 8-.'G ye.j jt/t-, Range hood/other kitchen equipment I 33.39 Address: /. `� / j 7 !/✓ T'/,„G„,-,4,/ z),€ Clothes dryer exhaust l 33.39 City/State/ZIP: .27‘',4/2_,.... die ,6:A72 2 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 3 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 0 APPLICANT 0 CONTACT PERSON Other: 23.32 Business name: Fuel piping: S �� �� AJE - $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 J Phone:( ) Fax::( ) Fireplace Range i E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business name• �Fen P\4,4:, ir\ A i i.�,,,A A\"2r:,{-L• Other: w " t�`G1 ` MECHANICAL PERMIT FEES* Address: to cai c> ) c7 3F.D .lam ` J Subtotal City/State/ZIP: 'po t--i-ip , o C ; ci -'D.„Acj Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:61)2, ) 2-i - 1- 7(e, Fax: ( ) State surcharge(12%of permit fee) CCB lic.: ( `T�--1 c 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: ( L�, * Fee methodology set by Tri-County Building Industry Service Board Print name: PSE;-k. .j \I G kik/n6 -T Date: k In ' n '\k4 — I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) w 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\Permits\MEC_PermitApp_040113.doc 2 ' Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE CSL. ONE)" City of Tigard ((�� y ^� C Received ,C,j/, / IliRI 13125 SW Hall Blvd.,Tigard,OR 9722P C l ! 9 201 U Date/By: Permit Noir 1.J F,1'Ot �f _ Plan Review Phone: 503.718.2439 Fax: 503.5d9�i icI� ADate/By: Other Permit No.: Inspection Line: 503.639.4175 l I GARD Date Ready/By: Juris: ® See Page 2 for www.tigard-or.govBUILDING DIVISION 4I $ N Notified/Method: Supplemental Information TYPE OF WORK r": FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description Qty. Ea. I Total ❑Addition/alteration/replacement 0 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 0 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: Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: -..\-- y,„( �j c1 } Z2 Footing drain(no.linear ft.:_) Pae 2 g Suite/bldg./apt.no.: 1 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 " Clothes washer ( 25.02 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 fir PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 Name: 1.13:,/ ...42 , .t; V 60,` Vd�4✓ Fixture/sewer cap 25.02 Address: ' T � L Floor drain/floor sink/hub 25.02 � �/�3v �� //�� //A ��/L `C� Garbage disposal 25.02 7/ City/State/ZIP: 6-,it x', e„e 9?? 3 Hose bib ? 25.02 Phone] .) ' '""til) 69�. Fax:( ) Ice maker 12.51 APPLICANT" `, 0 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 Z 12.51 E-mail: Urinal 25.02 Water closet Z 25.02 CONTRACTOR `^ Water heater 37.52 Business name: E_-_1,,,\\).,i. ?\\.L- \[�\10 Luc, Water piping/DWV 0 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:(61 t ) G0(0"--- (2 354 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: C I`1 2 4 t Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: k:,2-- .1- \.1t ' 11 Date: This permit application expires if a permit is not obtained within 180 days ��'L `�i t� I after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Pennits\PLMU-PennitApp.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-15'100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or:Fees Qty. Fee(ea). Total each additional$100.00 or fraction thereof,to pand 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 Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed; Capped Added Relocate Baptistry/Font 0 Any new commercial building with water service 2"and 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 Drive tall as defined in OAR918-780-0040. 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" Isomeltric or Riser Diagram 4„ 0 Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -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 ElectricalPermit Applicat E ' E 1.01R 0111(1: t SI. 0y1.1 City of Tigard RDctBe:d 7/5AM Permit#: i 5r�//J 'CO / 74 in 13125 SW Hall Blvd.,Tigard,OR 97 i cr. Plan Review ■ Phone: 503.718.2439 Fax: 503.598U961 S :I (.016 Date/B : , Related Permit#: Inspection Line: 503.639.4175Ready Date/By: Juris: H See Page 2 for T I G A I:1) Internet: www.tigard-or.gov CITY 1 `ARD Notified/Method: Supplemental Information ❑New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories. where the available fault current 0 Marinas and boatyards. u ,r_ .,i,y,g o k.c TR c z w n _ exceeds 10,000 amps at 150 volts or 0 Floating buildings. El1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or w .ri „„ . ,.. _ # l x i 0 i . x'I. y&!z �!�a. „ , ` ❑Emergency system. larger separately derived . ,. � .s Its_.�r_A —�t` Job#:` Job site address: t 0 UOS ❑Addition of new motor load of system. ryjq S.t) JOhVtStn S IOOHPormore. ❑"A",`B","1-2","1-3", ❑Six or more residential units. occupancy. City/State/ZIP: •T1 ct,v' I 0 . 'I 1223 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 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: ;,$ ,% v 1, i Description Qty. Each Total * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: 5 Ea.add'1500 sq.ft.or portion 33.92 1 �--���' E �;'..�,�� � _, �s. - »� u i�,7WrVi.,t . � ;�� e��s.��s Limited energy,residential 75.00 2 (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) € „.„,,,,,,,,,,,,,,,„.v,,_.,„, ���� � Renewable Energy ❑ See Page 2 '`' n i' . ":r, g , `." r� I�`` � � Services or feeders installation,alteration,and/or relocation Name: /e_4 .rte i /> 011//, 200 amps or less 100.70 2 .S.°0/ A Z� �, 201 amps to 400 amps 133.56 2 Address:/ 401 amps to 600 amps 200.34 2 City/State/ZIP: 77 -',4; 47 ©, 9'2 Z Z2 601 amps to 1,000 amps 301.04 2 Phone:lIa . 9 y,8 a , -' Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: 4z) ` i/A, 7 Q,Q C' fer .e),P(4) 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 Branch circuits—new alteration or extension per panel E.a,.',r.. :»s. . .. v,1' -Ki r.!?'., i-,�r i ...-' s..,.. .v.4';t 7 e- -i.. ...= � -.. r p A.Fee for branch circuits with Business name: ,..kg-- v/vCs2 above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first ' 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 9 7.42 2 Miscellaneous(service or feeder noi included) Phone:( ) Fax::( ) Each manufactured or modular dwelling,service and/or feeder Email: 67.84 2 Reconnect only 67.84 2 '-C NTR CTOR' Pump or irrigation circle 67.84 2 Business name: V A- --tQG. Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: j $O E 06062,„A. panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: �� �� '912t b Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(On\ ) G(iJ ,.bb-13 Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr t'1 3 I Inspections for which no fee is specifically listed(V2 hr min) 90.00/hr CCB Lic.: 6 Electrical Lic.r_ 0 Suprv.Lic.: //S6 0 L i ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: 4-L tw ;/, J S 7psio Date: `4 /:7�/„ ❑Plan Review Required(25%of permit fee): L� T State surcharge(12%of permit fee): Authorized signature '4V TOTAL PERMIT FEE: �[ This permit application expires if a permit is not obtained within 180 Print name: T l) Date: Wit tte days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_Permitppp_ELR_ERE.doe Rev 06/I7/2015 44 615T(I /05/COM/WEB City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10005 SW JOHNSON ST A, TIGARD, OR, 97223 July 11 , 2017 at 3:11 :05 PM Record Type: Record ID: Residential - Master Permit MST2016-00414 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10005 SW JOHNSON ST A, TIGARD, OR, 97223 July 11 , 2017 at 3:10:00 PM Record Type: Record ID: Residential - Master Permit MST2016-00414 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10005 SW JOHNSON ST A, TIGARD, OR, 97223 July 11 , 2017 at 3:12:19 PM Record Type: Record ID: Residential - Master Permit MST2016-00414 Inspection Type: Inspector: 699 Mechanical final David Young Result: FA I L Comments: Locking access port caps. Refrigerant circuits access ports located outdoors shall be fitted with locking-type tamper resistant caps. M1411 .6 Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10005 SW JOHNSON ST A, TIGARD, OR, 97223 August 1 , 2017 at 10:17:51 AM Record Type: Record ID: Residential - Master Permit MST2016-00414 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Corrections complete. Violation Summary: Inspector Contractor