Permit (172) CITY OF TIGARD MASTER PERMIT
III . COMMUNITY DEVELOPMENT / Permit#: MST2017-00433
�' /f/� Date Issued: 11/13/2017
T GAR LD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �''
' ' �p� Parcel: 2S103DC00821
Jurisdiction: Tigard
Site address: 11290 SW FAIRHAVEN ST
Subdivision: VIRGINIA ACRES NO.2 Lot: 14
Project: KIRKHAM
Project Description: Replace load bearing wall with structural beam for basement remodel. Electrical permit
application will be submitted at a later time. 1/29/18: REPRINT to add(1)gas line for range and
BUILDING
Floor Areas Required Setbacks Required
Stones: 0 Bedrooms: 0 First: 0 sf Basement 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $15,224.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain
(Storm Sewer 0
0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Drains: Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB
R-3 0
Owner: Contractor:
KIRKHAM,TIMOTHY AKOS CONSTRUCTION LLC Required Items and Reports(Conditions)
11290 SW FAIRHAVEN ST 3444 NE 17TH AVE
TIGARD,OR 97223 PORTLAND,OR 97212
PHONE: PHONE: 503-438-8817
FAX:
Total Fees: $911.16
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 90p,1-0090. You obtain a py of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ��
i �� Permittee Signature: `o' , /j/t/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatio i
aEc FOR OFFICE USE ON LI
City of Tigard Received I� DV
13125 SW Hall Blvd.,Tigard,OR 97223 , N Date/By: it N �� D
iC Phone: 503.718.2439 Fax: 503.598.1960 a 71" Plan Review
(` Other Permit:
Inspection Line: 503.639.4175 Date/By:
TICARD p
Internet: www.tigard-or.gov / { Date Ready/By: Juris:
(lit
1 , 1 4 A w S See Page 2l nr
��" .t Notified/Method: InformationSupplemental
13
TYPE OF WORK: 1 COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
.
❑New construction Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
and 2-family dwelling ❑Commercial/industrialRESIDENTIAL EQUIPMENT/SYSTEMS FEES* ,
0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: \ '� G -14 5 Li r j► C Air conditioning 46.75
T 1M �W Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: j/)Ay-(A 4-.?-).-Z Furnace 100,000+BTU(ducts/vents) 54.91
% 0 l
Suite/bldg./apt.no.: I Project name: Heat pump 61.06
Duct work 23.32
Cross street/directions to job site:
Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater
23.32
DESCRIPTION,OF Vi> : 4' t
, Qlt{ Gas fireplace/insert 33.39
` Flue vent for water heater or gas
�I0,v•,� 6:.) �ltJ+ty. fireplace
23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
OWNER ` Other:
, .;I 0'TENANT: 23.32
PROPERIY
Name: � '" Environmental exhaust and ventilation:
�( �� r f" 1,40,14_ Range hood/other kitchen
Address: P2-1wC. equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: •'r� c)6 1 6 fl-- 4 7 2,),3 Single-duct exhaust(bathrooms,
Phone: t toilet compartments,utility rooms) 23.32
( 4 �) S 3 )-(, Fax ( ) Attic/crawlspace fans 23.32
PIICANT Q NTACT PI✓RSQ1V Other: 23.32
Business name: Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Furnace,etc.
Address: Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Water heater
Phone:( ) I Fax::( ) Fireplace
E-mail: Range
Barbecue
`, ' j 4. CONTRACTOR Clothes d
_ dryer(gas)
Business name: t Other.
Address: I 5 7 5 5 1 �l� r� 14 MECHANICAL PERMIT FEES*
r'i I �\/t _-�'I Q Subtotal #
City/State/ZIP: C} ,r.\C �S / 0 c el 7 0 1`5 Minimum permit fee($90.00)
Phone:(5 ���2� Plan review(25%of permit fee)
�- 6iC 2, . Fax:(SQ 3) 2,5-2, -- 3 If,
CCB lic.: \ 7 Q j� State surcharge(12%of permit fee)
TOTAL PERMIT FEE i C/eS.
(....----ThThis 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
,C__,I Print name: //nt 4 Imi k,l,-k4,, I Date: / —2 1 13 I
I:\Building\Permits\MEC_PermitApp_040113.doc
440-4617T(11/02/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\Permits\MEC_PermitApp_040113.doc 2
CITY OF TIGARD MASTER PERMIT
Permit#: MST2017-00433
1 . . COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2017
T[GARD Parcel: 2S103DC00821
Jurisdiction: Tigard
Site address: 11290 SW FAIRHAVEN ST
Subdivision: VIRGINIA ACRES NO.2 Lot: 14
Project: KIRKHAM
Project Description: Replace load bearing wall with structural beam for basement remodel. Electrical permit
application will be submitted at a later time.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $15,224.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain0 Storm Sewer: 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 1
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
KIRKHAM,TIMOTHY AKOS CONSTRUCTION LLC Required Items and Reports(Conditions)
11290 SW FAIRHAVEN ST 3444 NE 17TH AVE
TIGARD,OR 97223 PORTLAND,OR 97212
PHONE: PHONE: 503-438-8817
FAX:
Total Fees: $895.31
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 throug •' 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Vr I
Issued By:A, . r r l ,7 _- Permittee Signature: vi 7
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1
f
Building Permit Application
Residential a 11--v-
.t s' FOR OFFICE USE ONLY
Received / / 7
City Of Tigard bateBy: l•( rel��L PermitNoa/�ci/7 y 13
13125 SW Hall Blvd.,Tigard,OR 97223
gNov VE,------11- Plan Review — �i Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ) � T
11(,A r,i, Inspection Line: 503.639.4175 /�1,�g g Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov �, r d ➢i�1 aA Notified/Method: /....
//� Supplemental Information
Ts
P r i L/, I
E lttt�a tl tC.11 i a 4 t G J . , ,+ I� t t I ni. €
HIMISO ��0I -�� ._O. t' �. A. ,' i I . ti �� �� a
❑New construction ❑Demolition Permit fees*are based on the value of the work performed. -
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
j.E, l il i,a€L R Oli �r t work indicated on this application.
® 1-and 2-family dwelling 0 Commercial/industrial
Valuation: $15,224
0 Accessory building 0 Multi-family Number of bedrooms: 4
0 Master builder 0 Other: Number of bathrooms: 2
=•:: s� Total number of floors: 2
. , _ � E n, Mf ,.• .,.� � , , ,�.
Job site address:11290 SW Fairhaven Ct. New dwelling area: 0 square feet
City/State/ZIP:Tigard/OR/97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
®° d` #il 418, %°1 1f
i�•s.1 8► iu. � . .��i . Ste ��O
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
�: t ' fi1_` steraurszoommADESCRIPTIONo.s work indicated on this application.
Replacement of load bearingwall with structural beam. /r /� Valuation: $
P ✓ /I 04 t..7` 1
re '6%/. Existing building area: square feet
New building area: square feet
iii!jillatafal,./.,,,EgitntIMILWEIRMI,11,1411110.0smilmiimailNumber of stories:
Name:Timothy Kirkham Type of construction:
Address:11290 SW Fairhaven CT. Occupancy groups:
City/State/ZIP:Tigard/OR/97223 Existing:
Phone:(971)533-6320 Fax:( ) New:
} llys
, . _ ,:: .140 �i4 t ;3 1 :'.,.�•• sr �,.•�.. - •.e PE .,.------
... t ( �` .. ,,'F-P i N ` .a a i;�fid( Y 33�•r I
li
Business name:
Structural plan review fee(or deposit):
Contact name:Same as above
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:( ) Fax::( ) Amount received:
E-mail: PHOTOS :.�'j.k :,i.... , _ A—A _,
imilinnisMOMMEMllonliwimikioiorkFmminuelowittiilqiiintb-,:riimomilliermioCommercial and residential prescriptive installation of
• _- •. ., :``i . .t,r , ,g n.._,f. ,..,MI.,e..l,. roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Akos Construction,LLC Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:5746 NE Wygant St. Solar Installation Specialty Code checklist.
City/State/ZIP:Portland/OR/97218 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)438-8817 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:197751
/` Total fee due upon application: $201.60
Authorized signature: x /� /`/� This permit application expires if a permit is not obtained
/f.� within 180 days after it has been accepted as complete.
11–i_t1 *Fee methodology set by Tri-County Building Industry
Print name:TimothyKirkham Date: Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1
r '
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard
Date/By:I Permit No.:
13125 SW Hall Blvd.,Ti ard,OR 97223 Associated Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
c'`\ Internet: www.tigard-or.gov 0 other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0
El
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0
3 Verification of approved plat/lot. 0 0
4 Fire district approval required. Name of district: ❑ 0
El
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 ii
6 Sewer permit. 0 ® 0
7 Water district approval. 0 D 0
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
El
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
El
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
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
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 El
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
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0
LEI
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 ►i
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
architect licensed in Ore.on and shall be shown to be a1 slicable to the sro'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
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 El
27 "Drawn to scale"indicates standard architect or engineer scale. A 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 El
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑
El
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
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)
Mechanical Permit Application _rf iR Orl I(C. U'l Oy Lv
City of TigardReceived
IV s �� � I V Permit N �/ /�-
13125 SW Hall Blvd.,Tigard,O k a y' Qe,Y3
INI
Phone: 503.718 2439 Fax: 503. ';t i~ Plan Review
i i,i ,is 1 t Inspection Line: 503.639.4175
Date/By: Other Permit:
Internet: Line:g 03 39.41 7 \f Date Ready/By: Juris. El See Page 2 for
rgov
t.1`N Notifted/Method: Supplemental Information
TwitOF, i,:i,i(zk '
, �) rs� COMMERCIAL FSE`' SCHEDULE--t CURCIain
❑New construction ®Addition/{1� .M. ent Mechanical permit fees are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORYOF C (1�i1 Value:S
RESIDENTIAL E(2UIPMEIIWT/SYST'EMS raw
® 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For:pedal information use d[eckltsf.
o Multi-family 0 Master builder
0 Other: DescriptionQ[Y• Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling: ti
Job site address:11290 SW Fairhaven Ct. Air conditioning 46.75
Furnace 100,000 BTU(ducts/vents) i 46.75 lc
City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF"WORK Gas fireplace/insert 33.39
Replace bath fan,relocate furnace,new dryer vent and mechanical room fan flup vent for water heater or gas
fireplace 23.32
/9--�i\ 7?) /5 7,J& J E �/ T Log lighter(gas) 23.32
/ Wood/pellet stove 33.39
-60 47_3 Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
14.1 E TY�:OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Timothy Kirkham Range hood/other kitchen
Address: 11290 SW Fairhaven CT. equipment 33.39
Clothes dryer exhaust 1 33.39 i3,3q
City/State/ZIP:Tigard/OR/97223 Single-duct exhaust(bathrooms, j[/(O
toilet compartments,utility rooms) 2. 23.32 T •
Phone:(971)533-6320 Fax:( ) Attic/crawlspace fans 23.32
APPLIC:INI 0 CONTACT PERSON Other:
23.32
Business name: Fuel piping:
514.15 for first four;54.03 for each additional
Contact name:Same as above Furnace,etc.
Address: Gas heat pump
City/State/ZIP:
Wall/suspended/unit heater
Water heater
Phone:( ) Fax::( ) Fireplace
E-mail: Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: lit Other:
//��pp -1 MECHANICAL PERMIT FEES•
Address: /5% t 5 Je //� ' `it _ .
Subtotal i 2(F7g
City/State/ZIP: Cd r1! �n ry�f1 +� Minimum permit fee($90.00)
Phone: r ) -Z -f/i'�W Fax:K($.3)�z53.32.(0/. 2 / Plan review(25%of permit fee)
J State surcharge(12%of permit fee)
CCB lic.: p 5-7 �/
TOTAL PERMIT FEE r �"j
J ' This permit application expires if a permit is not obtained thin 180
i,' days after it has been accepted as complete.
�j
Authorized signature: -.y am,✓�,�-
* Fee methodology set by Tri-County Building Industry Service Board
Print name:_Timothy Kirkham l Date: 11...lk i ) 1
I:BuildinglPermils\MGt_PermitApp_040113.doc 440-46171(1 I/02/COM/WEi3)
b
'Plumbing Permit Applicati .
Building Fixtures FOR OFFICE USE ONLY
NOV 6 ?IV V Recevea I
City of Tigard Permit No.: /7 U
u 13125 SW Hall Blvd.,Tigard,OR �J pa Review ,A v//_� /3
Phone: 503.718.2439 Fax: 503A8 OF 1 I GA RI) Dateaty: Other Permit No.:
Inspection Line: 503.639.4175in nil nivr, nnlycl ri it, Date Ready/By: .orris: la See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK
❑New construction ❑Demolition FEE* SCHEDULE
®Addition/alteration/replacement For special information use checklist
❑Other: Description I Qty. I Ea. I Total
CATEGORY OF CONSTRUCTION New 1-2-family dwellings(includes 100 ft for each utility connection)
IZI 1-and 2-family dwelling ❑Commercial/industrial SFR(1)bath 312.70
SFR(2)bath 437.78
❑Accessory building ❑Multi-family
SFR(3)bath 500.32
❑Master builder ❑Other: Each additional bath/kitchen 25.02
JOB SITE INFORMATION AND LOCATION Fire sprinkler(_sq.ft) Page 2
Job site address:11290 SW Fairhaven CL Site utilities:
Catch basin or area drain 18.76
City/State/ZIP:Tigard/OR/97223 Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: Project name: Footing drain(no.linear ft.:_) Page 2
Cross street/directions to job site: Manufactured home utilities 50.03
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: Lot no.: Water service(no.linear ft.:_) Page 2
Tax map/parcel no.: Fixture or item:
Backflow preventer 1 31.27 31.27
DESCRIPTION OF WORK
Backwater valve 12.51
Re -p/lrni4 Ad vst 110v vhfer /.-4er Clothes washer 1 25.02 25.02
Dishwasher 25.02
Drinking fountain 25.02
ri PROPERTY OWNER ❑ qNT Ejectors/sump 25.02
Name:Timothy KirkhamExpansion tank 12.51
Fixture/sewer cap i C t dr 25.02
Address:11290 SW Fairhaven C
L
Floor drain/floor sink/hub a'r't e ,1,...t.-4''''''1.-tf 25.02 25.02
City/State/ZIP:Tigard/OR/97223 Garbage disposal (Itd1,,, 25.02
Phone:(971)533-6320 Fax:( ) Hose bib CM 11 25.02
131 ❑ I
APPLICANT CONTACT PERSON Ice maker it 13� 12.51
Business name: Interceptor/grease trap 25.02
Medical gas(value:$ ) nPage 2
Contact name:Same as above
Primer 1 t 12.51 12.51
Address: Roof drain ommercial) 12.51
City/State/ZIP: Sink/ba i avatory 1 25.02 25.02
Phone:( ) Fax::( ) Solar units(potable water) 62.54
Tub/shower/shower pan 1 12.51 12.51
E-mail:
Urinal 25.02
CONTRACTOR Water closet 1 25.02 25.02
Business name:EcoPlumber, LLC Water heater 1 37.52 37.52
Address:7039 N Maryland Ave Water piping/DWV 56.29
City/State/ZIP: Portland, OR 97217 Other: 25.02
Subtotal 193.89
Phone:(503}342-8244 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 190566 ____Pltmbing Lic.no.:PB858
. //
' / Plan review (25%of permit fee)
Authorized signature:j V1��jr-y 5 b n �/l l A 1'0 State surcharge(12%of permit fee)
Print name:Timoth Kir q (TJ
Date: TOTAL PERMIT FEE
y �Ifb/ �7
t:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616Ti10ro2/COM/WEBl
Pluifibing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities �`. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-19100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
Storm&Rain Drain-each additional 100' 37.52 $1.00 to$5,000.00 Minimum fee$72.50
Qty. Fee ea Total `: $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees _ each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00.
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
Inspections outside of normal business 90.00/hr and including$25,000.00.
hours(minimum charge-2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
Reinspection Fees 90.00/hr each additional$100.00 or fraction thereof,to
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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type
Replace/
Work CaPPed Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
-4" Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food LJ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11290 SW FAIRHAVEN ST, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2017-00433
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11290 SW FAIRHAVEN ST, TIGARD, OR, 97223 April 10, 2018 at 10:35:43 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00433
Inspection Type: Inspector:
399 Plumbing final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11290 SW FAIRHAVEN ST, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2017-00433
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor