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Permit (47)
CITY OF TIGARD MASTER PERMIT ' '' COMMUNITY DEVELOPMENT: Permit#: MST2018 00114 rDate Issued: 05/14/2018 TfG.ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 - WMParcel: 2S 1108607200 Jurisdiction: Site address: 14079 SW 119TH PL Subdivision: 2018-011 PARTITION PLAT Lot: 2 Project: VESA Project Description: New SF. 6/13/2018: REPRINT permit to correct basement square footage and add 4th bathroom. 1/17/19: REPRINTED permit to include backflow preventer. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 2768 sf Basement: 1362 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 4 Second: 0 sf Garage: 637 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors. Yes Total: 4130 sf Value: $504,605.43 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 WDrains: 0 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 1 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Wbodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 7 201-400 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: V BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 4130 Owner: Contractor: CIPRIAN VESA SMART DEVELOPMENT&CONSTRUCTION Required Items and Reports(Conditions) 4616 SW42ND PLACE 4616 SW42ND PL 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97221 PORTLAND,OR 97221 2 Geo Tech Required Prior To Pour PHONE: 503-209-0544 PHONE: 503-209-0544 FAX: Total Fees: $35,248.13 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fol.• •- - - adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through•a'952-001-0090. You may obta -copy of the rul>-or direct questions to OUNC by calling 503.232.19877orr11.88000.33332.2344. Issued By: ,dpr�- -- Permittee • e: l .4 ArkIlik 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the prof- t. Approved plans are required on the job site at the time of each inspection. i. iumbina Permit Application Auiiding FixturesEI FOR OFFI( F l SF ON L.\ Received _ City of Tigard Date/By: Permit No.:/9.751- /a''d u I l it 11413125 SW Hall Blvd.,Tigard,OR 97223 JA N1 1 7 2019 plan Review ether Permit No.: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Inspection Line: 503 639 4175 1e, Y t- f x= Date Read B funs ® See Pae 2 for Ready/By: g ' i) Internet: www.tigard-or.gov .�� . Notified/Method Supplemental Information _ ,,,, `,' .1 %kaa r t x..e.,°4_r.„t` ,` 0, ,.k 9A,,...,-,„.4...,,,,,",-} .c,'i,-y`�' ,,-,;,r�r 4 2‘f,,q: ;1; t �a„.,.,,.. `+.,Fn:f # x}+ 3 ,, ,a A','4.1'+4.,,,.�'-a' �. ' ,::: ,;;,;:r:1;,;14;;'S'� 04,1 ..,A% it:i.' a rt'"+e s`L s'2$+s.'S.d ,ih3a.%e: ,.t.,�,� . ."1,..`. '',''-,,, ,« ,...3,e,s„ F.S:1 Al.i.,.,- , ter ". .tea u, ',,'.=,a7e*s�s �� � ®New construction ❑Demolition For special information use checklist Description I Qty. 1 Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) c .,s r.1aa P' , a ,�� 'b .. SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath500.32 57J ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Othert Fire sprinkler( sq,ft.) Page 2 aye I: 4 s-*tv '^'.t1V :,6 z ,'.' x- , a €e ,y. ! gr : a el'''''''''''''''*'; x� a € ''�' ' '4,,, r ' x �' Site h basinies: �f, E n,; ,F. n. ,fa�:Y!r irt� °ts''Yy vim. ."ri: ., �-�n�SPdr'-a,.:,r' ,� wF.e.�B .�....Y.. Job site address:14079 SW 119TH PLACE Catch or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:TIGARD OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site:SW GAARDE 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: f Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer // ?/i, er / 31.27 3/,�7 aye,,r,r,,,.al t. ".k" ,tr /t ` ` " ;,74g Backwater valve 6o4r -F '' to'"h'a)Era,.g ,� ,� � , .*,,, a "` Clothewasher 12.51 25.02 NEW SINGLE FAMILY RESIDENCE WITH 3 BATHROOMS Dishwasher 25.02 i/i 7/1'1 .%Kl,7 0 1176.1e.../ (/) �`vc' "Zi. p' "P -t' Drinking fountain 25.02 (( Ejectors/sump 25.02 I'`d s {z _, ,� z l Expansion tank 12.51 .n,s.,:,,'ii. .,.a' .;a4Pxt.fr +.€ 5�... 1i.se 4.-*.fro .rk:J`.sy.,,; ;- „f0" e .i.,A.r. Fixture/sewer cap 25.02 Name:CIPRIAN VESA - Floor drain/floor sink/hub 25.02 Address:4616 SW 42ND PLACE Garbage disposal 25.02 City/State/ZIP:PORTLAND OR 97221 Hose bib 25.02 - Phone:(503)2090544 Fax:(503)2066204 Ice maker 12.51 � ra a-s� n�" `��v'_ Wms€ 4 3s.�3'Lh" p f r¢ r^i +a "W� , ky*:. IterceY}or/ r easetraP 25.02 ,'r''F''' '' ''' ''t < 4' i -t4_ ,',,,1'f- . . 'k'v*4. $do..CR. C,, - Business name:SMART DEVELOPMENT&CONSTRCUTION INC Medical gas Page 2 - Primer 12.51 Contact name:CIPRIAN VESA Roof dram(commercial) 12.51 Address:4616 SW 42ND PLACE Sink/basin/lavatory ti 6H`f>/ / 25.02 City/State/ZIP:PORTLAND OR 97221 Solar units(potable water) 62.54 Phone:(503)2090544 Fax::(503)2066204 Tub/shower/shower pan 12.51 E-mail:CIPRIAN VESA@YAHOO.COM Urinal 25.02 m u , t,„' "i s�" -t � 4f4:& Water closet 25.02 'g„;x-, ,, .6 .,1:K to r�" ,� .�z ����H t�,1��� &�v� 3�:�� :,t�.�: �� . ��, � ?�.,k��:, Water heater 37.52 Business name:DELTA PLUMBING INC Water piping/DWV 56.29 Address:12205 SE 108TH AVENUE Other: 25.02 City/State/ZIP:HAPPY VALLEY OR 97086 Subtotal Minimum permit fee: $72.50 -- Phone:(503)9980683 F ( ) 1,� B Lic.:182846 Plumbing Lic.no.:PB 562 Plan review (25%of permit fee) ))))))"""""" State surcharge(12%of permit fee) Authorized signature: j2--t,s-- - TOTAL PERMIT FEE Print name:GABRIEL BOGDAN Date:04/22/2018 This permh.application empires if a permit isnot obtained within 180 days after h has been accepted as complete. "Fee methodology set by Tri-County Building Indust . :•ard. I:\Building\Pentriha\PLMU-PemritApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 35 . 1)3 CITY OF TIGARD MASTER PERMIT i3 /f iV 4 11,1"''''' ■ . COMMUNITY DEVELOPMENT Permit#: MST2018-00114 Date Issued: 05/14/2018 T i G A R T7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110BB07200 Jurisdiction: Site address: 14079 SW 119TH PL Subdivision: 2018-011 PARTITION PLAT Lot: 2 Project: VESA Project Description: New SF. 6/13/2018: REPRINT permit to correct basement square footage and add 4th bathroom. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 2768 sf Basement 1362 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 4 Second: 0 sf Garage: 637 sf Front: 20 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Total: 4130 sf Value: $504,605.43 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 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: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 7 201-400 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: NEW SF VB R-3 4130 Owner: Contractor: CIPRIAN VESA SMART DEVELOPMENT&CONSTRUCTION I Required Items and Reports(Conditions) 4616 SW 42ND PLACE 4616 SW 42ND PL 1 Ersn Cntrl 503-639-4175 PORTLAND,OR 97221 PORTLAND,OR 97221 2 Geo Tech Required Prior To Pour PHONE: 503-209-0544 PHONE: 503-209-0544 FAX: Total Fees: $35,168.10 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through• 95 '�90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. i Issued By: r Permittee Signature: /� Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the t. Approved plans are required on the job site at the time of each inspection. i Mechanical Permit Applic,;� i CEIVEPfi CEIVE1 , FOR OFFICE USE ONLY ipgCity of Tigard Received Permit No.//j ` y 13125 SW Hall Blvd.,Tigard,OR 97223] Date/By: Plan Review = Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit: Inspection Line: 503.639.4175 y' ' 1 ' � i Date Ready/By: Juris: ® See Page 2 for T 1 C A R ll CITY Supplemental Information Internet: www.tigard-or.gov Notified Method: BUILDING DIVISION -, -- :COMMERCIAL FLE* S 1;*LE'= £USE CHE 4ST I LOPE GAF ?,' .;. - Mechanical permit fees*are based on the value of the work ':i New construction .µ 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all D Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ ' CATEGORIC OF CONSTRUCTION ;m „' ,; ',- � ItESfDE13TIAL;1EYQi11��ME1�'!'S'YST I * .. t.; � rM; �:: EMS FE � , ❑ 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 tea„ ice, •; Heating/cooling: w. JOB SITE INFORMAjib N'''AND LOCATI)N ' . _.' Air conditioning 46.75 Job site address: k t\so ��� I, ' .4`s-,. �� Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: -- `' C \ )j LLI Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: S J (, �,l,j kI,,,kh'' 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 Other: 23.32 Subdivision: Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 FA RI?T . Gas fireplace/insert 33.39 Flue vent for water heater or gas c - J ��� �N..._-71,...0y.:3,..,r fireplace 23.32 ` 23.32 Log lighter(gas) b 'C -y Wood/pellet stove 33.39 ,}� tR ` c-I-o.c,, w1, Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 P' 6 a '..1.1(-9**--,..--,---;:'L ' a f ! •-_, •P 7_A... Environmental exhaust and ventilation: Name: C�, ,s-1 ks ( k . c f' Range hood/other kitchen equipment 33.39 Address: V'lb\ Ll 2� Clothes dryer exhaust z 33.39 City/State/ZIP: � . q-Ln- \ Single-duct exhaust(bathrooms, toilet compartments,utility rooms) / 23.32 Phone:( -3/4- Z.,0-S.\ pSV-tk Fax ( ) Attic/crawlspace fans 23.32 T£4 Other:12 23.32 .. n.. .. IC -ti vim Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: Water heater : Fireplace Fax: Phone:( ) ( ) Range E-mail: Barbecue " ' Clothes dryer(gas) s Other: Business name: � � N .Val-ti�� (�`-. 2.-C . . kk '. I. ^.� mE L ER . ". 7 A:`t ` 1 s c Address: 1 {j+kSt -t_ \ Subtotal City/State/ZIP: o OC'L . c )--Z--\ Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(' }� ©). Co ,-0..N. Fax:( ) State surcharge(12%of permit fee) CCB lic.: Z‘' - 001' - 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: * Fee methodology set by Tri-County Building Industry Service Board Print name: L Pc) ,_t t`k. L i� Date: 0 b_0A.--"1, 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 Valu tion <4. $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 ApplicatioillECEIVEI) Building Fixtures FOR OFFICE USE ONEI' City of Tigard U 7201g Received Date/By: Permit NoJyJ f wyf 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _ Phone: 503.718.2439 Fax: 503.598Date/By: Other Permit No.:TOIGARD T I G A R D inspection Line: 503.639.4175 BUILDING !��ggINDIVISION runs: See Page 2 for Internet: www.tigard-or.gov Notefied/Method: Supplemental Information TYPE OF WORK : FEE* SCHEDULE I 1 New construction 0 Demolition For special information use checklist. Description I Qty. Ea. Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) -V= x}� 'CONSTRU �'IQI�i 312.70 SFR(1)bath ... X31'I'E�OR�`t`OF 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen (// 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 . SOB SITE INFORMATION'AND LpATI®N', Site utilities: Catch basin or area drain 18.76 Job site address: ‘.`�c- c--)4) `\� %L ,�j� C�\*CDrywell,leach line,or trench drain 18.76 City/State/ZIP: .-Vcc- an_ 'ZZ� 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 C \10.-1 C.- 4\4\k( -- ,..\:Z_ a_ -6.),_p k4� 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 :. .4 DESCRIPTIO-,;N O _ Backwater valve 12.51 25.02 (..\ . C* '-- "Lk LA___ 2 r � N Dishwasher 25.02 `1 `1��- "k`K Drinking fountain 25.02 Ejectors/sump 25.02 -oft. Ift OP RT 'O R tv Expansion tank 12.51 Fixture/sewer cap 25.02 Name: C�I=. �f -(s- C JFloor drain/floor sink/hub 25.02 Address: '`L\(o S ( tZ�JS' Garbage disposal 25.02 City/State/ZIP: CI> cJ;L`�. �,' -Z`Z 1 Hose bib 25.02 Phone:( �),, `Z,c\ c ' i Fax ( ) Ice maker 12.51 sOInterceptor/grease trap 25.02 K- M ; - V:: '4? .,.. - ky 2 Medical gas(value:$ ) Page Business name: 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 Urinal 25.02 E-mail: Water closet 25.02 : =.. w ONT tACT=011 -,-Ii �.. R . *4.: Water heater 37.52 Business name: �`''. -i _._k_k K fes:\t'l..G Water piping/DWV 56.29 Address: rZ p j Sci . kO , KZ Other: 25.02 City/State/ZIP: \E-\ s.Q(>'- b. 1 k q_--k. c.A Subtotal p Minimum permit fee: $72.50 ( �e 8 � ' Fax: Phone: � ( Plan review (25%of permit fee) CCB Lie.: \,2, Li fp Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE /�/� Date: This permit application expires if a permit is not obtained within 180 days Print name: Cil t��(� �G Q TS 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 t") Total , ,Square outage. Jr it Fie Footing drain-1"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' 37.52x... storm&Rain Drain-1st 100' 62.54 dlilatl0n:" Pel'1T11 Feed $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 Qty•''" Pee(e7 tah " each additional$100.00 or fraction thereof,to Other yin ec$ons,ar eeand 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*. w Plan R ' a , or 'Iulmiiig staCia t►s .: Qwinti y by FixtureeType{' Plan review is required for any of the following. Fixture Type for; '"' '� • ''RePlaee/ Please check all that apply. 'Work Performed: CaPPes1, .Added . Rei to Baptistry/Font ❑ Any new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. 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" 4>, 9 44 .4.54:7 44444 Itio 11 , rsP Car Wash Drain 0 Isometric or riser diagram is required for new buildings 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 Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 FOR OFFICE USE ONLY—SITE ADDRESS: /VQ 79 Se<} 7/9 /L— This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT i II rIII Transmittal Letter T i 6 A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: / D/yDATE ' tEJVEP DEPT: BUILDING DIVISION JUN 7 2_018 CITY OF TIGARD FROM: C'(i°X//9—"4 BUILDING DIVISION COMPANY: 4 PHONE: cQ 0 — 2° g — 0_5-/-/VOA By: RE: /qO 77 S /7 9 _ "L— rtr7-P0/, Do//j/ (Site Address) (Permit Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: /9 /4— /304 Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: .��� 4/ ' ev` 20o/7 f.1s,/ZS t /9/9-;67. 7-s r- 75e0,-/ -7%7 70 /3 1 (/Ez-r-e•y) bet"7 a FOR OFFICE USE ONLY Routed to ' - • it Technician: Date: Initials: 04' Fees Due: g Yes ❑No _ Fee Description: Amount Due: $ tii-- ` 6 Special //Vl/Q, 70 7-19Z— /6/s. i Ins '• • • Reprint Permit •er ' : Yes 1:j No ❑ Done ..- '• i ied: C , -4 Dat : /p //ZA / Initials: -- I:\Building\Forms\TransmittalLetter-Revisions_061316.doc . CITY OF TIGARD MASTER PERMIT 1 . COMMUNITY DEVELOPMENT Permit#: MST2018-00114 T t .ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2018 Parcel: 2S110BB07200 Jurisdiction: Site address: 14079 SW 119TH PL Subdivision: 2018-011 PARTITION PLAT Lot: 2 Project: VESA Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 2768 sf Basement: 747 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 0 sf Garage: 637 sf Front: 20 Smoke DwellingUnits: 1 Detectors: Yes Third: 0 sf Right: 5 Total: 3515 sf Value: $434,587.68 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 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: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 7 201-400 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: NEW SF VB R-3 3515 Owner: Contractor: CIPRIAN VESA SMART DEVELOPMENT&CONSTRUCTION I Required Items and Reports(Conditions) 4616 SW 42ND PLACE 4616 SW 42ND PL 1 Geo Tech Required Prior To PORTLAND,OR 97221 PORTLAND,OR 97221 Pour 2 Ersn Cntrl 503-639-4175 PHONE: 503-209-0544 PHONE: 503-209-0544 FAX: Total Fees: $33,552.25 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 foll.. . -_ -dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00•. . .ay obt-n a copy of the rules ,r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: g �✓� A/�� /��it Permittee Signature: / 1503.639.4175 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 proj-- Approved plans are required on the job site at the time of each inspection. Building Permit Application Refidential ,.,. x,z t ��: FOR OFFICF 1SF O\LI `_x i a k> City of Tigard Received ' p Date/B /K y I fj Pemvt No.: 11) - 13125 SW Hall Blvd,Tigard,OR 97223 C, f I`i Plan Review /�,� Other Pemvt: t l j ' L Phone: 503.718.2439 Fax: 503.598.1960 1-- Date/By: 3 i cu i�N ,564. (1 r�(..)J1l j InspectionLine: 503.639.4175.gov ; Date ed/Mety: �J ��)�/ I Page 2 for � ��� '����� •, `" 'Al ,Notified/Method:Sif, Supplemental Information Internet: www tigazd or gov ®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 f. , , 4 U- work indicated on this application. Valuation: 00 _ Lf 3tr i—) ® 1-and 2-family dwelling ❑Commercial industrial Number of bedrooms: 4 0 Accessory building 0 Multi-family ❑Master builder t- 0 Number of bathrooms: 3 4,t Sa— ❑Other ,, -,fes g -�'''Si-,. ' Total number of floors: 1 .rila;1;5*----- !ti Job site address:14079 SW 119TH PLACE New dwelling area: +$2j square feet City/State/ZIP:TIGARD OR 97224 Garage/carport area: 637 square feet 210, Suite/bldg./apt.no.: Project name: ` (Jc I-‘ Covered porch area: square feet —747 Cross street/directions to job site:SW 119TH PLACE Deck area: 2 square feet Other structure area: square feet Subdivision: Lot no.: Permit fees*are based on the value of the work performed. l9► Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the a _ t work indicated on this application. BUILD A NEW SINGLE FAMILY HOME. Valuation: $ Existing building area: square feet New building area: square feet t IrA " � • Number of stories: w . A„: .,_ gte . $._� 4' .k'>a-`4,_• Name:CIPRIAN VESA Type of construction: Address:4616 SW 42ND PLACE Occupancy groups: City/State/ZIP:PORTLAND OR 97221 Existing: Phone:(503)2090544 Fax:(503)2066204 New: a'" Z . ` fir' ''.. 'In $ ' a '�' s -----t . Business name:SMART DEVELOPMENT&CONSTRUCTION INC. Structural plan review fee(or deposit): Contact name:CIPRIAN VESA FLS plan review fee(if applicable): Address:4616 SW 42ND PLACE Total fees due upon application: City/State/ZIP:PORTLAND OR 97221 Amount received: Phone:(50310 2090544 Fax: :(503)2066204 3 E-mail:CIPRIAN_VESA@YAHOO.COM ig,,,,-Ag,--U e', Commercial and residential prescriptive installation of 12 :' 7 •- ffi1' ry ,4 , roof-top mounted Photo Voltaic Solar Panel System. Business name:SMART DEVELOPMENT&CONSTRUCTION INC. Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address:4616 SW 42ND PLACE Solar Installation Specialty Code checklist. City/State/ZIP:PORTLAND Permit Fee(includes plan review $180.00 and administrative fees): Phone:(503)2090544 Fax:(503)2066204 State surcharge(12%of permit fee): $21.60 CCB lic.:217092 Total fee due upon application: $201.60 This permit application expires if a permit is not obtained Authorized signature: within 180 days after it has been accepted as complete. Date:04/22/2018 *Fee methodology set by Tri-County Building Industry Print name:CIPRIAN VESA Service Board. I:\Building\Permits\BUP-RESPermit'. oc 02/24/2011 440-4613T(11/02/COM/WEB) I I Mechanical Permit Application FOR OFFICE 1 SE ON Ll City of Tigard Received Date/By: Permit No.: } • q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: OtherPennit: K n Inspection Line: 503.639.4175 Date Read B Iuris: Internet: www.tigard-or.gov Ready/By: See Page 2 for Notified/Method: Supplemental Information __ ��4- :- = ,114°.1(1;t 7' s ,� get ®New construction 0 Addition/alteration/replacement Mechanical Indicatepermt the'are based do to theue of the work 0 DemolitionPeed. value(rounded to nearest dollar)of all 0 Other: mechanical materials,equipment,labor,overhead,and profit c c s Value $$4,000 00 ® 1-and 2-family dwelling 0 Commercial/industrial ,. ��. � -�� r� ''�,� �'�� „,,T.:..4; _,”; �� �'°``�`���, ��� 'k� 0 Accessory building For special information use checklist 0 Multi-family 0 Master builder 0 Other Description Qty. Ea. 1 Total s .; g i .' Vb ; _ t : Head/cooling: , . Air conditioning 1 46.75 Job site address:14079 SW 119th PLACE Furnace 100,000 BTU(ducts/vents) 1 46.75 City/State/ZIP:TIGARD OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: I Project name: Heat pump 61.06 Duct work 1 23.32 Cross street/directions to job site:SW GAARDE 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 Other fuel appliances: Tax map/parcel no.: Water heater t 23.32 � _ � 1-'' a - � Gas fireplace/insert 33.39 - -`"� � " , 4 -: - '-, �< _ �= Flue vent for water heater or gas INSTALLATION OF A COMPLETE MECHANICAL SYSTEM,FURNACE WITH fireplace AC,DUCTWORK2332 ,/� Log lighter(gas) 23.32 f • BATHROOM FANS,DRYER AND RANGE HOOD EXHAUST C4„i ,5,;:,7, Wood/pellet stove 33.39 VENTING FOR WATER HEATER AND FURNACE. Wood fireplace/insert 23.32 GAS LINE FOR WATER HEATER,FURNACE,RANGE,FIREPLACE,BARBECUE Chimney/liner/flue/vent 23.32 other 23.32 - .,- _` - Environmental exhaust and ventilation: Name:CIPRIAN VESA Range hood/other kitchen equipment 1 33.39 Address:4616 SW 42ND PLACE Clothes dryer exhaust 1 33.39 City/State/ZIP:PORTLAND OR 97221 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 4 23.32 Phone:(503)2090544 Fax:(503)2066204 Attic/crawlspace fans 23.32 Other: 23.32 *" erg' .,� .i 3: ..- -. -, ; z 6 4. ,, t r'<`'„'�� Fuel piping: Business name:SMART DEVELOPMENT&CONSTRUCTION INC $14.15 for first four;$4.03 for each additional Contact name:CIPRIAN VESA Furnace,etc. 1 Gas heat pump Address:4616 SW 42ND PLACE Wall/suspended/unit heater City/State/ZIP:PORTLAND OR 97221 Water heater 1 Phone:(503)2090544Fireplace 1 Fax::(503)2066204 Range 1 E-mail:CIPRIAN_VESA@YAHOO.COM Barbecue I , - ':--q.11402.1 Clothes dryer(gas) , *. _ � � , : „ . te. i.�-r�; >T z _�a , .�.e5 .., Other: Business name:SMART DEVELOPMENT&CONSTRUCTION INC. : S'-` r . ,;; Address:4616 SW 42ND PLACE Subtotal City/State/ZIP:PORTLAND OR 97221 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)2090544 Fax:(503)2066204 State surcharge(12%of permit fee) CCB lic.:217092 TOTAL PERMIT FEE . This penult application expires if a permit is not obtained within 180 days atter it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name:CIPRIAN VESA Date:04/22/2018 I:\Budding\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Electrical Permit Application FOR OFFICE USE ONE)' Cl ofTigard Received `J g Date/B Permit#: tl 4( * 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439PA" Date/B : Related Permit#: Email: TigardBuildingPennits@Tigard-or.gov ''` Ready Date/By: .naris. H See Page 2 for T I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information ''" TYPE O RKC .; ," PLAN-IVEVIEW New construction ❑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. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. O'' exceeds 10,000 amps at 150 volts or �`` CATEGORY"Al''CONSTRUCT!** '"- 0 Floating buildings. p 1-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 D Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND.LOCATION k " 0 Emergency system. larger separately derived 0 Addition of new motor load of system. Job# "� Job site address: 4 ti 041 5 tki a4r FL 100HP or more. ❑"A","E","l 2","1-3", S ❑Six or more residential units. occupancy. City/State/ZIP: 2.2 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: 5 u G,ti\-f2,pl2,- i#;, ', FEE SCHEDULE Description I Qty. I Each I Total I * 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#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCI1PON OF WQt(, ,,, Limited energy,residential 75.00 2 o sr�� (with above sq.ft.) /� r 7 Rw 81)4 6 t l Z of S( t1Ef 0 r C Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 nes PROPERTY OWNER k�„ 0 ANT :,..: � 71/' Services or feeders installation,alteration,and/or relocation Name: c.,..c:• k, c.-- 200 amps or less I 100.70 2 r e Sir Lk c�� 201 amps to 400 amps 133.56 2 Address: l 401 amps to 600 amps 200.34 2 City/State/ZIP:. cJ( (....#04--k.... 0j L Ck`k Li. ( 601 amps to 1,000 amps 301.04 2 Phone:( Z... c7�1 Over 1,000 amps or volts 552.26 2 ` Temporary services or feeders installation,alteration,and/or Email: �1���-k _V c ' .4to p, c,,z S•/\ 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: /17—2...0/ 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel LICANT" t (31CTEUI A.Fee for branch circuits with Business name: SI ba."ApilT-8 ozy4 a-. f),,Lc_ above service or feeder fee, 1 D7.42 2 each branch circuit �J Contact name: C(dc,(e_ekty (_ J -- B.Fee for branch circuits without Address: I7(pI 2. "' ._ service or branch circuit 56.18 fee,first 56.18 2 City/State/ZIP: Po/ L i/,,4 of 97-2.2 r Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 5 S Q''LI Each manufactured or modular 67.84 2 ^^ dwelling,service and/or feeder Email: ��W t . _ 0 ta.5 ,,�{?-1 of Reconnect only 67.84 2 !' %4 ONTRA R . Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: Electrical .Sc.: Suprv.Lic.: specifically listed(/i hr min) ELE `I'RICAL PI T" I :, ,!:;:.4- Suprv. Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PemiltApp_ELR ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard e 2 Su lemeutal Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORI+ ONLY: .s, SCHEQULEDes4 u 7 :. Fee for all residential systems combined: $75.00 °° Qty. Eeeh RenewableTotal electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 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) 552.26 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 charged at an hourly(1 hr min) 66.25/hr 1 Inspections for which no fee is 90.00/hr specifically listed('A hr min) COMMERCIAX 'VORK ONLY: ELE . °1 CAL fix FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * 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 I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 lumbing Permit Application wilding Fixtures FOR OFFICE ISF O\L\ Cl Of TI Received `J and ll Date/By: Permit No.:i.n,5 y`C✓C1/1 11 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 DateBOther Permit No.: y: Inspection Line: 503.639.4175 Date ReadyBy: inns: ® See Page 2 for Internet: www-tigard-or.gov Notified/Method: Supplementallnformation s. s.t ®New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) r• €- € , -41ti rri SFR(1)bath 312.70 CO 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath / 500.32 S-Z:,1.Z ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 ' ,s.. --'au°a a ' 4r, ,,� i site hbsin.utilities: t'- -pg sa sem , s, A.-.n ;.--:---"g.- .-_ ,y,,,.„, s u. o, Job site address:14079 SW 119TH PLACE Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:TIGARD OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site:SW GAARDE 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 Backwater valve 12.51 - Clothes washer 25.02 NEW SINGLE FAMILY RESIDENCE WITH 3 BATHROOMS Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 x t Expansion tank 12.51 # Name:CIPRIAN VESA Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:4616 SW 42ND PLACE Garbage disposal 25.02 City/State/ZIP:PORTLAND OR 97221 Hose bib 25.02 Phone:(503)2090544 Fax:(503)2066204 Ice maker 12.51 t . -' '` - 'te e , ' Interceptor/grease trap 25.02 Business name:SMART DEVELOPMENT&CONSTRCUTION INC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:CIPRIAN VESA Roof drain(commercial) 12.51 Address:4616 SW 42ND PLACE Sink/basin/lavatory l-if I I 25.02 City/State/ZIP:PORTLAND OR 97221 Solar units(potable water) 62.54 Phone:(503)2090544 Fax::(503)2066204 Tub/shower/shower pan 12.51 E-mail:CIPRIAN_VESA@YAHOO.COM Urinal 25.02 � 4 --5--e-41.,,,-,4*- .,-,_-- Water closet 25.02 'Nefil •�z" .:;„:1;-8,7:.g_t e _ Water heater 37.52 Business name:DELTA PLUMBING INC Water piping/DWV 56.29 Address:12205 SE 108TH AVENUE Other: 25.02 City/State/ZIP:HAPPY VALLEY OR 97086 Subtotal Phone:(503)9980683 Fa -( ) Minimum permit fee: $72.50 r CB Lic.:182846 Plumbing Lic.no.:PB 562 Plan review (25%of permit fee) i State surcharge(12%of permit fee) Authorized signature: y-� - TOTAL PERMIT FEE Print name:GABRIEL BOGDAN Date:04/22/2018 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\Pemtits\PLMU-PernutApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2- Supplemental Information • Fee Schedule: Residential Fire Su• •ression S stems: � ' ,, ,a=';. 5 t 3esz� $ .: r� xR ^, .'- z?z' Footing drain-14 100' 1 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 7,200 $233.20 agreater Sewer-1st 100' 1 62.54 7,201 and greater $3277.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 1 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 1 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 iywiw- ;, each additional$100.00 or fraction thereof,to �' 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 char:e-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*. 1 `c lbc1t_ Plan review is required for any of the following. Please check all that apply. Baptistry/Font Bath Tub/Shower 0 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 Thty 0 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 0 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. Car Wash Drain Garbage Domestic-non-food C] 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 *Note: If the fixture work under this permit results in an Washer-Clothes 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: C:\Users\Ciprian\Documents\Smart Development&Construction INC\14 79 SW 119th Place\PLUMBING PennitApp.docx City of Tigard 71 i a COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Review — Residential TIGARD Building Permit #: ,n/f T't,20/e - DO/12-72 Site Address: /2./O - c /i ) /, t No cc_ Project Name: /t Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: /.i3 X51 L/J Verifysite address suite# exists and activ inpermit system. / � Y ❑ River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached Sit/Plan Elements: itree(3)copies of site plan ,v sting structures on site e plan must be on 8-1/2"x 11"or 11 x 17"paper 1'a ootprint of new structure(including decks)with finished V>orawn to scale(standard architect or engineer scale) or elevations rth arrow VJ .•"ty locations&easements (required for new and additions) lIS a address,project or subdivision name and lot number %Sidewalk/driveway approach b. pplicant information(name and phone number) J /.cation of wells/septic systems +.t dimensions and building setback dimensions w Existing trees to be retained with drip line,and tree tn .0 uare footage of buildings to be demolished .rotection measures t area,building coverage area,percentage of coverage and S l eet tree size,type and location iimpervious area(applicable if R-7,R-12,R-25&R-40) a Street names Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? Yys ❑No 4 foot differential) If yes,is a storm water quality facility shown? s ❑No Clean Water rvices—Service Provider Letter(lot platted prior to 9/10/1995): Pequired: voi Yes,applicant was notified ❑ No Received: Yes ❑ No ublic Facili,�ti�Improvement(PFI)Permit: o/ -C�cx7g, equired: L1� Yes,applicant was notified ❑ No Applied For: /Yes ❑ No,stop intake VI jand Use Case#: 441--P-20//V-6660 Ur-k0-6/C?) - 0)66'5 /Roning: equired Setbacks: Front Rear Side Street Side Garage�� �� � � � g �20 OKandscape Requirement: % W' of Coverage Maximum: cyo IA Building Height: Maximum Height Actual Height a1 N'/ isual Clearance '9ensitive Lands: Yes CI No Type � ted'!1 h-r Crban Forestry Plan 1J onditions "Met"prior to issuance of building permit Notes: Approved By Planning: - -- _ _ — �— Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw RES_061417.docx Building Permit Submittal Original Submittal Date: �a3/I r Site Plans: # / 3 Building Plans: # 3 Building Permit#: 1�1.-- t--e� L- _ r building�permmit-#above. Workflow Routing: L,�"�Planning ngineering /rmit Coordinator 1 --Biuilding Workflow Sign-off: r LSlgn-off for Planning(include notes from planning review) Route Application Documents: engineering: (1) copy of permit application, (1) site plan, (1) building plan and ,� on al plan review routing form. L4�Suilding: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: �"'_„ -41111101111. Date: y i .•- , -_ :(glineering Review 40-oa pe at building pad: Conditions "Met"prior to issuance of building permit asements (encroachments)per engineering conditions of ap royal d plat Water Quality/Quantity Facility: � V h�b1f p� 20����OC S Assess Water Quality Fee in-lieu: 1:(Ye ❑ No Assess Water Quantity Fee in-lieu: ErYe ❑ No LIDA Facility on lot: ❑ Yes C'No ❑ Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: A Approved by Engineering: la L Date: 5/--`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 * r 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: SDC Fees Entered: Wash Co Trans Dev Tax: ...Si Yes E N/A Tigard Trans SDC: X Yes ❑ N/A Parks SDC: Yes ❑ N/A LIDA ❑ Yes X N/A 0 OK to Issue Permit Approved by Permit Coordinator: Date:'�j l� 11\11)\il)v I:\Building\Forms\BldgPermitRvw RES_010118.docx Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. CG c P12-4- C-- %/A— Print Print Name of Permit Applicant /4!: 65 --1(t - 2,91.3 Signature of Permit A./icant Date Permit#: /7757- j 7-s- /11 Address: 1170 7/ P-v /4°,2 .�u %• Issued by: / ' Date: ..74///y' This Copy for Permit Offices Electrical Permit Application -, f� FOR OFFICE USE:o\Lr City of Tigard Received s DateB : /� i� 13125 SW Hall Blvd.,Tigard,OR 97223 AUG1 �• 1 n' Plan Review IIMPAII 2 Phone: 503.718.2439 Date/B : Related Permit#: Email: TigardBuildingPermits@Tigard-or.gov ("', . eady Date/By: Juris: IO See Page 2 for TI G A R(7 Inspection Line: 503.639.4175 Internet: w t}4,aed-or gov ,, Tiolified/Method: Supplemental Information TYPE OFWORK PLAN REVIEW �New construction Addition/alteration/rep lacement 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. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural a❑Multi-family 0 Master builder 0 Other: Firebuildings. 0 for all other installations.pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: `[ie)7, SCJ //9 72-, 100111'or more. ❑"A">"E","1-2","1-3", l 0 Six or more residentialunits. occupancy. City/State/ZIP: ❑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: FEE SCHEDULE DescriptionI Qty. I Each I Total 1 * 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#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential ��) 75.00 2 (with above sq.ft.) N" NS O!" `f\sex .kcx... kV elk Unk ' Limited energy,multi-family 75.00 2 Z��� k^ t W residential(with above sq.ft.) �+C 1A� ` �S c_.� Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 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:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 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 APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name:k.O K L--E C`e c L p5 C_e 1`A 5-'1/41-2-li C1 0 j above service or feeder fee, 7.42 2 each branch circuit Contact name: ` tt L v L t ft B.rT-1 B.Fee for branch circuits without servAddress: , 5 7 d1 1 '� C '7 0'` �- ''' branche it feederitfee,first 56.18 2 I branch circuit City/State/ZIP: v({N\Co.i a(Z U p. 8 k, .' Z Each add'l branch circuit 7.42 2 1 l Miscellaneous(service or feeder not included) Phone:( '5 3) '7(b-- 3 131 Each manufactured or modular 67.84 2 f(Z. N _E C 16-\i- C R dwelling,service and/or feeder Email: `� ' �=M Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Aj?._.,0 NI g JCc R—'I CA-L c 4..1.. 0 co 0 H Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: ( 5 t 0 N r= 7 0 ( r\-- S'—‘ panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: V s Ni c k j`.["L(2 1/,l ct E 6SS , Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(5Z 9 '5 ( Ip -31 3 CI Investigation(1 hr min) 90.00/hr Email: 20 _a Cl'( _...."11,1\(--`J 0 . CZ*-' Industrial plant(1 hr min) 78.18/hr I Inspections for which no fee is specifically listed 'A hr min 90.00/hr CCB Lic.: I cl 2./4 g Electrical Lic.:C. 13 Suprv.Lic.: 5 7� . p y (' ) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: L5)`.5. `Z_ A.J O7..r Date: a-(L - (( 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: k. rJ t>.SLP T fl ti\ Date: g - (Li ^- I S days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY .; i.; FEE SCIIti,E * Description I Qty. I Each I Total I * Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 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) ❑ 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 min) Inspections for which no fee is 90.00/hr specifically listed('A hr min) E : CAI..PERMIT FEES; `; t tot r. CO' , ERC WORK O rt £. moi= $ t �. jam:'; .. .... SubtotalEnteron Page 1): Fee for each commercial system: $75.00 3' * 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 I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: V`N. DATE RECEIVED: DEPT: BUILDING DIVISION RECEP/Fs FROM: C_`Pit , � - _ AUG 6 21 ; CITY OF COMPANY: `S i\--KIT: -\-\Zit-k AQ Naf`-k r BUILD! 1. .Dr,;i3 O0 PHONE: -1C;: 7,&'1 .z=S 4i-t I By: RE: VA 0A-C\ 1Qq Ask _- \ ZO \$ 'r'oc k l4 (Site Address) P-rmit Number) (Project name or subdivision name and lot number) OL. ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: op'-s: Description: Additional set(s) of plans. "L__. Revisions: ' h7:1-(t SSL aNU_ Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. r 1 l Basement and retaining walls. Beam calculations. l(I r ' Engineer's calculations. Other(explain): REMARKS: C(>41. ,-C • � " L�,31:1. t.o FO TICE USE ONLY Routed to Pe chn.'Ian: Date: % 1j Initials: itit- Fees Due: es M No Fee DescriptAmount Due: $ 6 y $ IIS IFZ Oi v f)(.sr\ $ $ Special Instruc 'ons: Re r nt Permit (per PE): ❑ Yes N ❑ Done • pplicant Notified: yoo--- Date: 717/ Initials/AC- I:\ nitialsI:\Building\Fonus\TransmittalLetter-Revisions_061316.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14079 SW 119TH PL, TIGARD, OR, 97224 January 31 , 2019 at 11 :59:27 AM Record Type: Record ID: Residential - Master Permit MST2018-00114 Inspection Type: Inspector: 199 Electrical final Jeremy Burrows Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14079 SW 119TH PL, TIGARD, OR, 97224 February 1 , 2019 at 12:00:50 PM Record Type: Record ID: Residential - Master Permit MST2018-00114 Inspection Type: Inspector: 699 Mechanical final Jeremy Burrows Result: PASS Comments: Corrections completed. A/C install complete Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14079 SW 119TH PL, TIGARD, OR, 97224 January 31 , 2019 at 11 :59:23 AM Record Type: Record ID: Residential - Master Permit MST2018-00114 Inspection Type: Inspector: 399 Plumbing final Jeremy Burrows Result: PASS Comments: Note: water pressure 74 psi Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14079 SW 119TH PL, TIGARD, OR, 97224 February 4, 2019 at 11 :15:30 AM Record Type: Record ID: Residential - Master Permit MST2018-00114 Inspection Type: Inspector: 299 Final inspection Jeremy Burrows Result: PASS - CofO Comments: Final erosion control passed Moisture content form received Moisture barrier acknowledgement form received High efficiency lighting form received Insulation certification verified C of 0 left on counter. Violation Summary: Inspector Contractor