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Permit CITY OF TIGARD MASTER PERMIT 2 ' COMMUNITY DEVELOPMENT Permit#: MST2018-00227 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2018 T l�_ A R C� 9 Parcel: 1S134ACO2624 Jurisdiction: Tigard Site address: 11175 SW BOXWOOD CT Subdivision: ENGLEWOOD NO.3 Lot: 181 Project: NEWMAN Project Description: Garage conversion of 274 sf to living space. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 274 sf Basement 0 sf Left 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 274 sf Value: $32,455.30 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 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: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0-200 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: 2 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-3 274 Owner: Contractor: NEWMAN,NICHOLAS&ANNE OWNER Required Items and Reports(Conditions) 11175 SW BOXWOOD CT NICK NEWMAN TIGARD,OR 97223 11175 SW BOXWOOD CT TIGARD,OR 97128 PHONE: 503-391-6274 PHONE: 503-763-9641 FAX: Total Fees: $1,552.36 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.-yvork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cente Tho - rules are set forth in OAR 952-001-0010 through OAR 9 -001-0094 You y obtain a -•py of the es or direct questions to OUNC by calling 503.232.19: • .804.332.2344. Issued By: i�/i, A d �,/ ._"_ _ _' �/, i / ermittee Signature: il�,�w� 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 . the project. Approved plans are required on the job site at the time of each inspectio _-:-,r Building Permit Application Residential 4 FOR OFFICEUSE ONLY '° City of Tigard ReceivedDateB '- Permit N III '1 13125 SW Hall Blvd.,Tigard,OR 97223 pp i i i-• 1 4 Plan R view a Phone: 503.718.2439 Fax: 503.598.19600'1 �� - Date/By: i 7 / (../ Other Permit: TI C A R D Inspection Line: 503.639.4175 ; , _ Date Ready/By: /y� • Jur 65 See Page 2 for Internet: www.tigard-or.gov (._,,i_ i Y y i,.. + otified/Metho, 7 / I Supplemental Information -- i2. � :EiEE vL'Siic4r'caii .. �y ^�y .:{, .. . f. .............MDillNilE;2: ;y( . ;I R1t1..D TA , ry ��{... F i I # ::...:....a.„....._...,.. ..... ....,..: .. .......... �13”. �....:::.:::: ........illi �..:.....: .... ........................................._:~�;..k��.dF., :,��,,..h ........._........,._.................� :'::::: .: :a:•'.:: :::-::x:;:: ... ....... ............. ...::..... ::::;:::::�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 ❑Other: equipment,materials,labor,overhead,and the r fit e work indicated on this application. Valuation: $ `- ® 1-and 2-family dwelling ❑Commercial/industrial 1 0 Accessory building 0 Multi-family Number of bedrooms: 0 Master builder ❑Other: Number of bathrooms: � 1 O fQ iaiiini7OCA fits Total number of floors: Job site address:11175 SW BoxwoodCt New dwelling area: 7 711 square feet City/State/ZIP:Tigard,OR 97128 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Newman Residence Covered porch area: square feet Cross street/directions to job site:SW Cottonwood Ln. Deck area: square feet Other structure area: square feet ill :;s l ' ATCe"ti4) t � 1fAe.. f}11t1i + ' C CKLI'.T Subdivision:Englewood No.3 Lot no.: 181 Permit fees*are based on the value of the work performed. Tax map/parcel no.: 1S134AC 2624 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the EiiiniiiiiigiliiiiiiiiiiiiiiiMiginnintilliNWEWIWWW-7105MEMENiiiiiiiiniiniiiiiiiRiiiiiiiiiEliiiTEwork indicated on this application. Conversion of s.s to living space from portion of exsisting garage Valuation: $ ;19 Existing building area: square feet New building area: square feet tgggig ¢s::s Number of stories: Name:Nick Newman Type of construction: Address: 11175 SW Boxwood Ct Occupancy groups: City/State/ZIP:Tigard,OR 97128 Existing: Phone:4- 9t 1 503_3,/, 6,A)y Fax:( ) :::::::::::::::::::::::aa::::::::::::::::s:a-st.sys;::_==_:=s;tlar;:�:;;.;.;•..::::::::::gym::::::::::::::m::::::_::: New: ..,....._.........,..__................. ... .........._,.... ..._,..,...,.._...._........,... . .... Ai. . ...n.e .ilii., ':iii ...:;, ss Business name:PURE architecture,AIA Structural plan review fee(or deposit): Contact name:Peter L.Strauhal FLS plan review fee(if applicable): Address:658 Church Street NE,STE.100 Total fees due upon application: City/State/ZIP:Salem,OR 97301 Amount received: Phone:(503)-763-9641 Fax: :(267)-392-7157 `� s AN� l E-mail:peter@purearch.com ;:.,ri:::: .: � n..ry _,rz_:.::.:::...,_<::...::...:::.._,,.,..._.:..._..:::-:. .....:... ::._,. ...:.:,::: _._ .:,-,:....::_...._::.:..:.: ..:...:�:.....:.::::,..._.:;.: :_,: ., __r.,..,,:.:_.:_.:...:,....-..,__::.:..0._,�.:...:.:.........,.. Commercial and residential prescriptive installation o f € ff's= n:= r : =s e: €€-;€€@<'`t; ris2SWr . ; : :::, : m::: - m : :...............:: .ili..... _ _ • _q:_ ::::: :::: ::::::::: _ ,:mo............_...,... _.. ,:,..pi........:: :, m :::.-...i ,._ .:,..: roof to mounted Photovoltaic Solar Panel System. Business name:By Owner �� _ / Submit two(2)sets of roof plan with connection details .— and fire department access,along with the 2010 Oregon Address: ,-geoe �� x.3/L! / 721' lSolar Installation Specialty Code checklist. City/State/ZIP: crf6 i/ /90 7 i��'eros Permit Fee(includes plan review $180.00 v � and administrative fees): Phone:( ) G141fEN 7Z1 Fa'�7°iGfe. 'T- eIe State surcharge(12%of permit fee): $21.60 CCB lic.: t Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained `, within 180 days after it has been accepted as complete. e � yt Date: 8 �/ 1 *Fee methodology set by Tri-County Building Industry Print nam KAL\_. •�m,v-e)— i Service Board. I:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No.: . 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: g 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 R D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑ 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 ❑ ❑ ❑ 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 ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ 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- ❑ ❑ ❑ 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. ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ 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 ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑ ❑ 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 ❑ ❑ ❑ architect licensed in Oreton and shall be shown to be a.•licable to the •ro'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". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ 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, ❑ ❑ ❑ 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-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application —. FOR OFFICE USE ONLY - -i - ruyd City of Tigard Date/By: Permit No.: I 9 13125 SW Hall Blvd.,Tigard,OR 97223 \l l(" 3 f l�1 lan Review Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 ate/By: T I GARD Inspection Line: 503.639.4175 Ll�te,Ready/By: tris: 0 See Page 2 for Internet: www.tigard-or.gov l i I .r Ndtitied/Method: Supplemental Information lii:; I - CO•lT#I1rN K .L',.L'>Ft Y a I.: w i l..._:. 1 �" `... Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all mechanical materials,equipment,labor,overhead,and profit. ❑Demolition 1=1 Other: Value:$ ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist ❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total iiiiita:,wall milli .=ii::;:'. i `lll Heating/cooling: E 1 Al+fil ,f . 1 (J1 : Air conditioning 46.75 Job site address: 11175 SW BoxwoodCt Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97128 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name:Newman Residence Duct work 23.32 Cross street/directions to job site:SW Cottonwood Ln. 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:Englewood No.3 Lot no.: 181 Other: 23.32 Other fuel appliances: Tax map/parcel no.: 1S134AC 2624 Water heater 23.32 €)g Ii1 1# '4 i 33.39 Gas fireplace/insert Flue vent for water heater or gas Conversion of 256s.s to living space from portion of exsisting garage fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ::...;..........................._....._....::::::: 23.32 111fiI„Rt __..... Environmental exhaust and ventilation: Name:Nick Newman Range hood/other kitchen equipment 33.39 Address:11175 SW BoxwoodCt Clothes dryer exhaust 33.39 City/State/ZIP:Tigard,OR 97128 Single-duct exhaust(bathrooms, f toilet compartments,utility rooms) 1 23.32 Phone:(503)763-9641 Fax:( ) Attic/crawlspace fans 23.32 a:i .........._.T._..„„„.„ .....T..:x:,,^<sisasi<ei,.vii:::::ra::; ::::::::-:zi: ,;-;i”ryii.ii sil ilEi :hili :-.,..ra's:-::;;:;:::::;aiiiiiivi::ii:iiv-:”-"i:::::gnr;i;ii iii;'s"s's-`€ line iiiki<":::;:•pip; . ::. ::;:::::::-ms s::::::.::::ii ::: ,a ::,::::.. . ._•:...._::: :::::::::::: :- Other: 23.32 Business name:PURE architecture,AIA Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Peter L.Strauhal Furnace,etc. Address:658 Church Street NE,STE.100 Gas heat pump Wall/suspended/unit heater City/State/ZIP:Salem,OR 97301 Water heater Phone:(503)763-9641 Fax: :(267)-392-7157 Fireplace Range E-mail:peter@purearch.com Barbecue stt_' ' : m::::^::::iauaxu:v::vik::Eu.e-ars�_a.i=.,.::E...i.s:..¢.it.tt.;.i...:.:..v.:T....::.:...�.:...:..�.:•:.;;� _n:•::::::;.„_u.�,.w-..:::a:<-.s::>.s>:li.v•::i::.:.Ti:.z:..hilia:::;;.i.+s:-*;Erirrii:i::::aTi::-m r_.:Bia...a.:..ic.---til,1ia:ii: . ii:..it_: allii..^ i.:i.iiiii.it.t ..: ii:::iiiiii:::::::ig:::::•::- t1aifia..2i ..c.:r.:_.::::: ::: ::..xrra::- flliii:_ . . Clothes d e r(gas) ............................. Other: Business name:byowner �; iiiis<ii<iii:i;i. i:::::;:::«:::<,:a:ai ;:i <:: i== i;:::, -:w ::::-- viii:lis:i;€ =iii:::iii. :::::::::::::a::::: .. Mi:afWI L=`;' ti t��J i i iii<-ii ;ia;igBsii iiii§i ii lie - ::::: :::::::::: ..............::.:v.._:: �: : :::::..:::_...:...u.::,._..._:..._: rte::.................... Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lie.: 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 •s-v------ Print name D„t^r r Stra.hat i.«kt1 c e Dat /to a l:ABuilding\Permits\MEC PermitApp_040113.doc 440-4617T(i 1/021COM/WEB) i Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi Family Fee Schedule: Total: * ttoni Permit Feel: LL $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. 1:\Building\Permits\MEC PermitApp_040113.doc 2 RECEIVED Electrical Permit Application FOR OFFICE USE ONLY City of Tigard A U G 14 2018 Received Permit#: III Date/ • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review II Phone: 503.718.2439 Fax: 503. 4 ` .{ { {� Related Permit#: �.��"k �1� T�'lifil'e� Date/B Inspection Line: 503.639.4175 Ready Date/By: furls: ® See Page 2 for TIGARD Internet: www.tigard-or.gov >31JILDIN(i! !Vic YII Notified/Method: Supplemental Information i.. '` . y V „ t jc' RI .' °. . J i iJTi'i'1,n».,+.a. ;:a.,,. ,,,OP 4'4 q i(kr 0 New construction ❑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 ❑Marinas and boatyards. :_ % tt ' -,Olt CO. e _. exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1—and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or '" ,Y _> „ 17 iTIO1 x• i N L 0 Emergency system. larger separately derived Job#: Job site address: 11175 SW BoxwoodCt ❑A o of oew motor load of system. 100HPHP or more. ❑"A","E","1-2","1-3", City/State/ZIP:Tigard,OR 97128 ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name:Newman Residence ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:SW Cottonwood Ln. 4x i ly'1 (. Description Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:Englewood No.3 I Lot#:181 Includes attached garage. Tax map/parcel#:1S134AC 2624 1,000 sq.R.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 r t , ?I s - ESC 01:05371171 1:'. rF,l A Limited energy,residential 75.00 2 Conversion of 6s.s to living space from portion of exsisting garage (with above sq.ft.) Limited energy,multi-family 75.00 2 4 residential(with Renewable Energy above sq.ft.) 0 See Page 2 t1'. '.OPER"•- , la,' 1• •1,..t.,?-20: 0 ii la - Services or feeders installation,alteration,and/or relocation Name:Nick Newman 200 amps or less 100.70 2 Address: 11175 SW BoxwoodCt 201 amps to 400 amps 133.56 2 S-03 3 9/ 4 .2 7 S " \ 401 amps to 600 amps200.34 2 _ City/State/ZIP:Tigard,OR 97128 y C jJ 1,000amps amps to amps 3011.04 2 Phime.:4593)763-9644—+ I Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 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: /��// /(4(41-M42,1., Date: 08-14-18 401 amps to 599 amps 168.54 2 ,aiiiIIM- t O vk Branch circuits—new,alteration,or extension,per panel " ` A.Fee for branch circuits with Business name:PURE architecture,AIA above service or feeder fee, 7.42 2 each branch circuit Contact name:Peter L.Strauhal B.Fee for branch circuits without service or feeder fee,first Address:658 Church Street NE,STE.100 branch circuit 1 56.18 2 City/State/ZIP:Salem,OR 97301 Each add''branch circuit 1 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)-763-9641 Fax::(276)-392-715 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:peter@purearch.com Reconnect only 67.84 2 .. .,-,_ V� Pump or irrigation circle 67.84 2 Business name:By owner Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy ❑ See Page 2 2 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:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lie.: Suprv.Lic.: s ecifically listed('/I hr min Suprv.Electrician signature,required: Subtotal: Print name: I 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: Peter L.Strauhal Date: 7124118 08-14-18 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL11 Off :l' w -` Description Qty. Each 1 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 El 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(I hr min) Inspections for which no fee is 90.00/hr specifically listed(V2 hr min) rSubtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 t Plumbing Permit Application ' p-/ Tit/sc.-3F FOR OFFICE USE ONLY Received City of Tigard Permit No.: n 13125 SW Hall Blvd.,Tigard,OR 97223 }1 r,-) 1 = ;?018 pan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 1 `"• .: Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov I , -Nq�-Nptified/Method: Supplemental Information ....:;:.a::::::,_.;..,. .•........:.......:::: ::::::::�:..........::............. , mx_4.e:9:a�a�Ea �?y:++dxaflis74a aa?*.Al:.....:,. a=;.:._:::-:s:::.:::::::::::::::•:::•::::;; *' * Dom ...:::. :_' � ....:....:...,:.' �:..,:.........,,.:...... .......,. •.. ....... .,......_,. :: � ,.. ..........: -. ......_. :.._ ,.,a,,;... ..... ...•,,,. .... ................._..•.............................. ., .,....., . ...............,.. 111 New construction ❑Demolition For special information use checklist Description Qty. Ea. Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ,:: C E Off-?A g: L11GI'IO SFR(1)bath 312.70 ® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 s; Jam-�' TIO' ND L A' s' Site utilities: _.. ...:._ .illi ..,......::... . Job site address: 11175 SW BoxwoodCt Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97128 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name:Newman Residence Manufactured home utilities 50.03 Cross street/directions to job site:SW Cottonwood Ln. 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:Englewood No.3 1 Lot no.:181 Fixture or item: Tax map/parcel no.: 1S134AC 2624 Backflow preventer 31.27 .:- Backwater valve12.51 ,. .,.,.., „„..„...17.„„.„...„„.„............,,•.. ,., ---- .,.,.r - Clothes washer 25.02 Conversion of 256s.s to living space from portion of exsisting garage Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PR* t Expansion tank 12.51 Name:Nick Newman Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 11175 SW Boxwood Ct Garbage disposal 25.02 City/State/ZIP:Tigard,OR 97128 Hose bib 25.02 Phone:(503)763-9641 Fax:( ) Ice maker 12.51 ,•lli_.....,..._.._l:: EL l ... 1..... �... ti l Interceptor/grease trap 25.02 ...mitnii ili: , :; . .... �......._ Medical gas(value:$ ) Page 2 Business name:PURE architecture,AIA Primer 12.51 Contact name:Peter L.Strauhal Roof drain(commercial) 12.51 Address:658 Church Street NE,STE.100 Sink/basin/lavatory ( 25.02 City/State/ZIP:Salem,OR 97301 Solar units(potable water) 62.54 Phone:(503)-763-9641 Fax: :(267)-392-7157 Tub/shower/shower pan 1 12.51 E-mail:peter@purearch.com Urinal 25.02 Water closet 25.02 EijigiiiinrilmomilEiniiffiii_ ..v 1 ;_:::: :::<s::rr... .. ,;::: :: ::::::;:... ..............v.. _: Water heater 37.52 Business name:by owner Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signatu - , 441‘ 1 ‘No.,----- TOTAL PERMIT FEE Date / 8 This permit application expires if a permit is not obtained within 180 days Print name:•ftit>aIIhal ;� � _LQ C1C��.y ��) IQ� after it has been accepted as complete. 1 uu *Fee methodology set by Tri-County Building Industry Service Board. I:A Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WIB) iii I Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: NIOKIE 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' 37.52 >tlll101n� Pr :P� Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for a_ i Fee':est TC*1 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 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: Other Fixtures: 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*. Quantii by Facture`T`yp�e ": #klr l»l 111 : ala..:......wail.:..........::. 1�ork Pcrfarmg� Capped "..- r�adext.; .. .t2�luca� _........:............._.,........_....,.....f•.,.n ..:•:... ...,....._........................�............. _,..�............v..., ..... , Baptistry/Font Plan review is required for any of the following. Bath Tub/Shower Please check all that apply. Jacuzzi/Whirlpool 111 Any new commercial building with water service 2"and Car Wash Each Stall greater,except systems designed and stamped by licensed -Drive Thru engineer. Cuspidor/Water Aspirator ElNew exterior plumbing site utilities for any complex structure Dishwasher Commercial as defined in OAR918-780-0040. -Domestic ❑ Medical gas and vacuum systems for health care facilities. Drinking Fountain ❑ Any multipurpose fire sprinkler system. Eye Wash ❑ Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" 3" Submit 2 sets of plans with any of the above. -4" Car Wash Drain Garbage -Domestic-non-food Disposal Domestic-food related ❑ Isometric or riser diagram is required for new buildings -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: 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 Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the C:\Users\Owner\Dropbox(PURE architecture)\PureArch All-Team Folder'lick Newman Residence\Plumbing Site Utilities_PermitApp-City of Tigard_Newman.doc Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the 'r 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: Ilown, 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. or X 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. Nick Newman Print Name of Permit Applicant /124 .A 4202, 08-14-18 Signature of Permit Applicant Date Permit#: .� Address: —•r ,fr' Knri�r.,r, Issued by: Date: This Copy for Permit Offices / # ;�. '. Information Notice to Owners About .w.��i Construction Responsibilities \...,,.,.?„/ ,..or (ORS 701.325 (3)) Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure,can prevent many problems by being aware of the following responsibilities: • Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and theworkers who provide the labor may be considered employees.As an employer,you must comply with the following: • Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. • Unemployment Insurance Tax: Employers are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. • Oregon's Business Identification Number(BIN): is a combined number for both Oregon Withholding and Unemployment Insurance Tax.To file for a BIN, call 503-945-8091 or go to http://www.oregon,gov/DOR/BUS/docs/211-055.pdf for the appropriate forms. • Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation Insurance for their employees. If you fail to obtain Workers Compensation Insurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division at the Department of Consumer and Business Services at 503-947-7815. • Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from employee wages.You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their website at www.irs.gov. Other Responsibilities of Homeowners: • Code Compliance:As the permit holder for a construction project,the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. • Property Damage and Liability Insurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray,water damage from pipe punctures,fire, or work that must be redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation Insurance. • Expertise: Homeowners should make sure they have the skills to act as their own general contractor,and the expertise required to coordinate the work of both rough-in and finish trades. CONSTRUCTION CONTRACTORS BOARD PO Box 14140,Salem,OR 97309-5052 Telephone:503-378-4621—Fax:503-373-2007 Website Address:www.oreaongov/c+ f/property_owner adopted 9-23-08 This Copy for Permit Applicant 9 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. III City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T 1 c;1 Et n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: L)11l DATE RECEIVED: DEPT: BUILDING DIVISION k 3' FROM: at /(114/1-frigi SEP 13 2018 COMPANY: / K fc 44,/ e16 c; //e-- EU.,x , PHONE: 711S^0WF^ci.C7 By/ RE: (Sits Address S L(/ /40.-r°CeJ00 ( (pvermul;� mber�lF ‘12 )- (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: 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: XC& - ( Pice,y %is FO OFF CE USE ONLY Routed to Permit Technici :/Date: li I Ab Initials: ' Fees Due: El Yes it Fee De ption• Amount ue: $ $ C� t $ Special Instructions: Reprint Permit(perE)• El Yes ❑ Done Applicant Notified: / Date: _ o7/7 i)l f Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11175 SW BOXWOOD CT, TIGARD, OR, 97223 December 20, 2018 at 8:45:54 AM Record Type: Record ID: Residential - Master Permit MST2018-00227 Inspection Type: Inspector: 299 Final inspection Jeremy Burrows 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: 11175 SW BOXWOOD CT, TIGARD, OR, 97223 December 20, 2018 at 8:45:51 AM Record Type: Record ID: Residential - Master Permit MST2018-00227 Inspection Type: Inspector: 399 Plumbing 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: 11175 SW BOXWOOD CT, TIGARD, OR, 97223 December 20, 2018 at 8:45:44 AM Record Type: Record ID: Residential - Master Permit MST2018-00227 Inspection Type: Inspector: 699 Mechanical 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: 11175 SW BOXWOOD CT, TIGARD, OR, 97223 December 20, 2018 at 8:45:47 AM Record Type: Record ID: Residential - Master Permit MST2018-00227 Inspection Type: Inspector: 199 Electrical final Jeremy Burrows Result: PASS Comments: Violation Summary: Inspector Contractor