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Permit
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I y CITY OF TIGAR MASTER PERMIT I 2 COMMUNITY DEVELOPMENT Permit #: MST2009 -00183 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/06/2009 Parcel: 1S125DC07100 Jurisdiction: Tigard Site address: 7143 SW ASH CREEK CT Subdivision: ASH CREEK ESTATES Lot: 4 Project: Ash Creek Estates Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 2 First: 1949 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 18 Bathrooms: 2 Second: 461 sf Garage: 594 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $272,307.00 Rear: 15 PLUMBING Sinks. 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Catch Basins: 0 Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 1 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: 5 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc /Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cir: 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: Owner: Contractor: Required Items and Reports (Conditions) ASH CREEK PROPERTIES LLC WINDWOOD CONSTRUCTION INC 1 Pln Gen NOT OK for building permit per Engineerin 12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA 2 Prcl Pln NO BUILDING FINAL UNTIL CONDITION TIGARD, OR 97223 TIGARD, OR 97223 3 Pln Gen TREE PROTECTION FENCING REQUIRE PHONE: PHONE: 503- 625 -6526 4 MST Ersn Cntrl 503- 681 -4444 FAX: 590 -7606 Total Fees: $16,571.86 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: . al l: 1 _ _ -1. .4 1 . , Permittee Signature: } °a Building Pe rmit Application I o OFFICE use oN �i . DIVED r . �.. Cit o f Ti gar d �� D ;B e ' ® .I��� Permit No.: ,"f Q- 'I8 74 v 13125 SW Hall Blvd., Tigard, OR 97223 209 Plan Review L•-'1, • : Phone: 503.639.4171 Fax: 503.598.1960 S EP Da te / By • ,' � , Other Petmit � �. - I � T I G A RD Inspection Line: 503.639.4175 Date Ready/By: El See Attached•Checklist fo - .. Internet: www.tigard - or.gov CITY OF TIGARD NotiSei/Metho t Supplemental Information BUILDING DIVISION r .i ` , ;`y' ? , , i �r, 3 . ,,� : :-. '. ,.w• TYPE; 'F 2 ' a ", ,�;:;•` al"�` E 1- AND, D WELLING` '.: st, -�4•,., , _ .. _ O.< WORK •';.:,:_.,_� -- `t''3r'•;: ?Y.'tst'i� � D DATA: .,. 2- FAMILY ; ;_ J ' ew 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 profit for the ".^ *::; "� :; - ,,,,,;�7, Aa, ' >��tW 6,nr. - _ -', , work indicated on this application. =' ,i 4 "� ;? v�' �` � . t , c �: _ ` � C A TEGORY OF CONSTRLIGTION� ; fi•,,� ,n- :� � PP � � c y®<and 2 -family dwelling ❑ Commercial /industrial Valuation273307 $ ❑ Accessory building ❑ Multi - family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: - , sdx';;n n:i °�'�a:"'�d'f,..i;.:i.:- : -;, �•«ce..r ; .,. } , , a3; /"� ?,t + ; c- JOB SIT INFORMATION " `AND'LOCATION ; k i t y , ;r ; , t Total number of floors: Job site address: '/4 it h G Z4 New dwelling area: :�10 square feet City /State /ZIP: a.5 a � CA( Q")2,---3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: ( `i square feet Cross street /directions to job site: �5 h tied( JQ/ Deck area: square feet Other structure area: square feet -„ - REQUIRED DATA: COMIVIERCIAI USE;C'HECKLIStt Subdivision: / 13, 1s h oz 'i'i ,/. Za Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: i / 2_, O �3d .- Q ,0 y 2 Indicate the value (rounded labor, to the nearest a, an d the profit of all equipment, materials, labor, overhead, and the profit f for the *St ;a r °3, >: ?tt :t�•: ;,,, Y; ..ew.,.:�: IP �.� ^:w,.. .:,,�;,., µ ::n"r,'t�`n', ;:F.:7 �," Ne ;�,},:.,,;;,.: h�.k.. ,- s, - 'z z a , , I' DESCRIPTIOiV OF: R'ORIC gt` , b, q4 r r work indicated on this application, Valuation: $ Existing building area: square feet New building area: square feet : `;S" R ,` - - "-'t+ °" �ki•:i , '�- :,; ',,,, i , �:,un "x - i . :7,, ' .;. d; ,; ,,, ® , PROPER O WNER TEN b �, w Number of stories: .',.. .1 '�",, .t� .. .. . /5,v tV`'`' m:k;:S`. ,1ti- �_,: ,T �m±� .a� _ _ _ ..d = . - ,k 2 �! ,. Name: k/pkezr.0 ( f 7 f Type of construction: Address: t c:c S CI.) �N ,i—k. L3_/,4. Occupancy groups: City /State /ZIP: ""� 7< o t Q' 71 2-3 Existing: Phone: ( ) 7 a —42132c— Fax: ( ) 5 - 7GD` New: p:�a,`'i i ,.: r :- ,�;tT` "'�;'. .4 ?�t: t -�; ^f; ..�; ":Gt; „r.�:,. �t, :�,:: : •,.;�n����r *.. ,�;+ _ ' '''41 ,�. ' 3 4 ❑:.APPLIC ''a" , i;, ; {'t`',yi? tat Fr O'•CONTACT PERSON 4r;. r n , . ,. �, ..;'a tp '` - . -. N OTIC E ' . . ^ ,, , Business name: ,.5' 4414 All contractors and subcontractors are required to be Contact name: / _,h licensed with the Oregon Construction Contractors Board tv under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone:( ) Fax::( ) E -mail: ,,. 1�:^xr.±�• :5 " + "�3� 44,�.•�y . , . ^.rr '. "S�wa'w`"rx,�vk,',i= "..;�,• w7R. + a, ; ^ OM " ' tryt w � s . a� `�. � r� .4\ CONTRACTOR r " i ' � ,,' N ..: t ;, - t� , it . q ' , t'rt ... Business name: 6‹v BH U.DINGPERMIT FEES* • Address: - `' aj : ^ . . `" (Please refer to fee schedule1 . Structural plan review fee (or deposit): City /State /ZIP: Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): Total fees due upon application: CCB lie.: , TJl al, ■ Amount received: Authorized signatur This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: / iewc Date: * Fee methodology set by Tri- County Building Industry �� Service Board. I.\ Building \Permits1BUP- RES- PermitApp.doc 03/21/06 440- 4613T( I I /02/COM/W EB) . , . . 12/4/2006 3:11 PM FROM: Perfect Climate Perfect Climate, Inc. TO: 503-590-7606 PAGE: 002 OF 002 RECEIVED :•,.....„„2.„:„,.,„....„,.,-„.„___„:,.,E :4,1;,;4f'gmt4:-.444151gritel" Metitntic al Permit Al.. licatio t 1 s 2%9 o ; fa City of Tigard PArzli‘1,3 n ja„ .1,..vii3 .,..: y IftrielMr" ram.41.: •f ■ /g3' * ..... ..0.4 .: "- 1?.• 123 SW Ian all ttil„ 7 ic74+.1, C.gt 972g of TIGARD Into AweizAv A . ph ontl 50:619,4171 Pg3-,:: 5 f_13.5 S. iota i r., DIVISION 0.:-..1 ..____ - ,-.., , b 4) .t.,..f .°1°6,, ,,,t.t.f,::: O,Liiii , 1 rispi:ciim 1-ira, 5016 D. 4 .. i 7 5 SOWN , , - Zzat Rax,Y233r, '7!'n!'7'!'....r Intumg, vAirtv.tirozd-or,erri• '6, i SEpplemr.2.1a1.1s4ntIvA4.1.1 _ .. . .. _ .1.-.---r ,. ..---..: ' -:.„-ntt..r...L.:44t,;-,rz..v.„,,,,,,,,,,,,,,-1.-... : ,,K yp • g..7„ . - -i" ,-. ' T - ' 1r' 4' '''''' • .. . 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',"., • r)..k1 • - .- .... _ 41.4461.7-p0 .,•ovotwrwr•-',4 li• .:J1 -.',, (.;•1 p• .? - •:-., • .:;:- ..i . . . . • " - • - - - • • • . . . . .. . . . . . . . . . .. .. . . t.k.:Iti ‘i twill/ _ Plumbing Permit Applic t R on bt? 1S '616 . Building Fixtures , . . FOR OFFICE USE ONLY , • . .''.. ''''''''' ,' '''''' .3.1 'f'■ F 16°14 . '. . ' , - ',.' . ' .- 4 ', . ri ' City of Tigard 9V Ci \\AS\O - Received a 13125 SW Hall Blvd., Tigard, OR ® 503. 639.4171 : . Phone: 5036394171 Fax: 5031 1111 MG P Datc/By ? /.5- ot Permit No: A Plan Review Date/By: Other Permit No 1 • ■ e..1.6- 9 00 ''' ,.■ TI GA RD Inspection Line: 503.639.4175 Date Ready/By: furls: El See Page 2 for Internet: www.tigard Notified/Method: Supplemental Information Ti'ie45V■V 1 1.0 ; 4,-7 ' A :2141 W .,..''' '. '' FEE* SCilEDIJILE ,- 1 - 4K , 1 , .`, , ::I....-.:' , ?-`:. , ''.e-` - -i"-'. :'' - :'.i. ' . ' . , ,,,.::• , I, ' ; •,-,. , .. -. :fti ' r 1 ' ".2 ' 6 " 'i -j .i4.: , i r. :•■ ! '''' 44 '''''' '; ' '-'" '' '''' ' ' "'". ''''' ""' ' • i2-5ew construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection) -,- ii .---. sr.t T j ,*:,- :, ''W"-' 64 , .,,-,400:>114,,, , ,,3 , .:N,,.?; SFR (1) bath 249.20 1<- and 2-family dwelling 0 Commercial/industrial SFR (2) bath ••••"-- 350.00 SFR (3) bath 399.00 0 Accessory building 0 Multi-family Each additional bath/kitchen 45.00 0 Master builder 0 Other: . Fire sprinkler ( sq. ft.) Page 2 *i IValitif■IMUMIVAtgei; y..,:4g .. . , . - • ., ., .- ....,- ...,.., .. - - , ..., - ... ...; ....,,, - i" - 0 - ,, :f. , : ,, ,'“ , ,,, f:: ,),;.;, ; Site utilities Job site address: --- 2-AZ.5Ay___A s i't ,ic Catch basin or area drain 16.60 City/State/ZIP: r(c.,ve--/ ,- 72 2_ Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. no.: I Project name: n A_ liz e A-3AX° Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: 5 Atot3 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: _ ) Page 2 Subdivision: ' ,..- it 6:4 , a . i Lot no.: dift itr Water service (no. linear ft.: _) Page 2 Fixture or item -..- Tax map/parcel no.: _ Absorption valve 16.60 -,= ' , ;`; . 4,,Wtit , N ,. 1:N.1 ,,, 4;t' , ' ,„ :: - .::,:•; . DE§eitiiiiiitiV: r oit4olik,.41W4qat*W,,,,i0114f,,,,,''' :;.1-:, ,S,1 , : .* ,v, ,,„, ,,,,!;',4,,,,„,. „,, c i " , ; , „ , .. ? ;i' l .Z . ': , A. ,, V 7.; ' ,, tW, , '7' ,- ,,I,`' Backflow preventer Page 2 ili 6-t-.) S7 ,. Backwater valve 16.60 Clothes washer 16.60 • Dishwasher 16.60 6Y:14■R 4 ti'ilf.'AIVi.,50Z Drinking fountain 16.60 -., - ' ■ , , .' ''' • ' - ' ,-'''''.'''` '/. 'k'"'" '.' .'''''''''' '" '''''' '''''''''' ' Ejectors/sump 16.60 Name: 6,,t ...// A 6,4-e."Cc./ l i " S 1)1 ( Expansion tank 16.60 Address: / _6 5 5a Ai."-/-" 6d/c.„ Vir--ef Fixture/sewer cap 16.60 City/State/ZIP: 7-3 a/2 619 4/1.-)..2 Floor drain/floor sink/hub 16.60 Phone: ( 011 *00_4/375- Fax: (4 SW," 7606 Garbage disposal 16.60 ,. : ‘,0 /9 L I a'A NT .,,:=1...;--.,,1,,r4.4 t ' Hose bib 16.60 r7... : .., '.. '4::'; -';'t:t'f 1, 74474.z... , 47 1 , .. Ice maker 16.60 Business name: Interceptor/grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State/ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) Fax: : ( ) Tub/shower/shower pan 16.60 E-mail: Urinal 16.60 1 " '' -':- i '. cor■iitAllai .:,'::;',',''..`• „, .,, , , ,,,,-. 4 ..., .:,:',-:,,,,..,,, ,. . - . , . _ .:. , , ,,,.„, , t . ,,,- .:. -,-.,..,;:. Water closet 16.60 Business name: / A a 16 r io .1 7( . 5 Water heater 16.60 Address: 4/ 9 ( /c/e, /3/m Other: City/State/ZIP: , ..-- Subtotal 356 . CO Z , 0 0 Q ? o 5 C Minimum permit fee: $72.50 Phone: (ii2d3) $0,..,.-3■•73 Fax: ( ) Residential backflow minimum permit fee: $36.25 _ CCB Lic.: /C3 ,. 2 (7 Plumbing Lic. no.: 3-4 y: 2 _R-4 Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: o f, ' /./ . TOTAL PERMIT FEE ( - 392 .,, - - Print name: Date: gAVO 7 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. 1:\BuildingWermits\PLMF-PermitApp.doc 04/06/06 440-4616T(t 0/02/COM/WEB) Electrical P ermit Applica l• litil:'ONt,r' Rdeeivud n Ji - l 1 iyi " 13125 SW W Hell Blvd,, Tigard, OR 97223 Pfau Review Other tscnnit: f City of Tigard II . Phone; 503.639.4171 Fax: 503, 598.1960 Date/13 Date/13 ®Sts Page 2 for Inspection Line: 503.639,4(75 Date Ready /By: Supplemental see e 2 forormuliwt T i ii AR L1 Internet: www.tigard -0r.gov :MI TYPE Oct WORK PLAN REVIEW Ylcase cheek all that apply (submit a sets of plans wlitems checked below), '` New construction ❑ Addition /alteration/replacement El Scrviue Of feeder 400 amps or noro El Building over sW,Yes. // — �j Demol itian ❑Other; where the ovailamn fault current O Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground. or exceeds 14.004) ❑ Commercial-use agricultural and 2- family dwelling ❑ Commerc /industrial ❑ Oth essory building imps for all other installations, buildings. Acc ❑Fire pump, ❑ Installation of 75 KVA or Multi-family Q Master builder ❑Other' 0 Emerpney system. Ior4er separately derived system JOB SITE INFORMATION AND LOCATION ❑ Addition of new tooter load of lJ "A", "E ", "1.2 ". "1 -3 ", I OOHP u' more, eCoupancy Job net I Job site address: r � � [ I Reeroatienal vehicle parks, ❑ Six or more rnsid shat units. — alt p � tieallh.care facilities. ❑ supply voltage for more than City /State /ZIP: a as n sup ly v u age n. . ID locations. 0 Service or feeder 600 antes or snore. Suite /bldg, /apt, no.: Project name: FELL SCHEDULE Doren Won ����� • Cross street/directions to job site: New residential single - or multi- family dwelling unit. Includes attached garage. _ 1,000 sy, tt, or less 1 68.54 4 � Lot no.: 63 5 4 1 Subdivision' � N ' / _, � � t/.�/ Ea. add'I 500 sq. ft. or portion Tax map /parcel no,. _ Limited energy, residential 67,84 2 DESCRIPTION OF WORK (with above sq. It) Limited energy, multi- fancily 67.84 2 residential (with above sq, ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ©PROPERTY OWNER 1 ❑ TENAN'C -- 201 steps l4 400 amps 133.56 401 amps to 600 amps 200,34 2 Name: _ 601 imps to 1,000 amps 301,04 2 Over 1,000 amps or volts 552.26 2 Address: ,— —� Temporary services or feeders i nstallation, alteration, and /or City/State/ZIP: --- - relocation Phone ( ) Fax: ( ) 200 amps or less 59.36 _ 125.08 2 amps s to 400 amps Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits— new, al tcration�r extension, per panel Owner signature: Date: . -- A. Fee for branch circuits with 0 CONTACT PERSON above service or feeder fee, 7.42 2 ❑ APPLICANT' eaelt branch circuit Business name: Feb FF for branch circuits without service or feeder fee, 56.18 2 Contact name: first branch circuit Each add') branch circuit 7.42 2 Address: ._., — - Miscellaneous (service or feeder not included City /State /ZIP: Each manufactured or modular 67,84 all dwelling service and/or feeder �-- - Phonee: ; ( 67.84 2 ) J Fax: : ( ) � Reconnect only Pump or irrigation circle E 67.84 2 CgAITRACI0 -mail: Sign or outline lighting 67,84 2 Signal circuit(s) or limited - 1� + i� f energy panel. alteration, Address: I w or 2 extension. Describe: Page 2 'I' 1Nro y0 i t A` Each additional inspection over allowable in any of the above V Per inspection 66.25 Phone: hone: �j��fr1 1 �� �.� Ca ) Investigation per hour (I hr min) 66.25 IMIMMEE A Aiii 78,18 1 Suprv. Lie.: �� Industrial plant per hour J_ ELECTRICAL PERMIT FEES Subtotal: Suprv. Ele titian signature, required: ... ....--- 0 " . ...-41111111°Loarde, plan review (25% of permit foe): i p ate '�— _ 1 . L / l f State surcharge (12% of permit fee): TOTAL PERM FEE: i ChC . This permit application Authorized int rl Slgnatgre: plication expires if n permit is as' obtained within ISO Date; days after it has been accepted se COmplatC. Print name: ■— —....—-' • Number of inspections allowed per permit. 440.4615'rp U a9COM/WEB 1. 1nuilding \PCrmitst21_C.P4rtaiIApp,doc IW01/09 TO 39dd ONI. DI?J13313 alAIN3I' £ZL68179£05 aZ :TT 6002/8T/TT City of Tigard, Oregon • 13125 SW HZl Blvd. • Tigard, OR 97223 - • • • Wednesday, December 16, 2009 .TI GARD Windwood. Construction Inc 12655 SW North Dakota Tigard, OR 97223 RE Transportation Development Tax (TDT) Refund. Permit No. MST2009 -00183 for 7143 SW Ash Creek Ct., Ash Creek Estates At the time the above building permit was issued you paid a Transportation Development Tax (TDT) fee of $4,599.00. Effective December 1, 2009, Washington County approved a Temporary Discount on TDT charges and has made that discount retroactive to July 1, 2009. The enclosed check represents a refund to you of the difference between your original TDT payment for your project and the new Temporary Discount charge. The amount of the credit refund is $920.00. Please call at 503 - 718 -2426 if you have any questions. dr // lbert Shields Permits /Projects Coordinator 503 - 718 -2426 Phone: 503.639.4171 • Fax: 503.684.7297 . • www.tigard - or.gov • TTY Relay: 503.684.2772 City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Accela System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Windwood Construction Inc. DATE: 12/10/09 12655 SW North Dakota Tigard, OR 97223 REQUESTED BY: Dianna Howse AMS TRANSACTION INFORMATION: Receipt #: 175950 Case #: MST2009 -00183 Date: 11/06/09 Address /Parcel: 7143 SW Ash Creek Ct. Pay Method: Check Project Name: Ash Creek Estates EXPLANATION: Refund amount discounted for TDT per Washington County. :.REFUNDINFORl1'IATION:_ . , . "'Refund;':;.:. t''. - - Aiinou `��)xam tJTI;D ::I'eriit_'Fee��:; .. - ,. ,. ..... _. �;B;icairple:: X245 =.0000 .. ..... .n .. TDT - Transportation Development Tax 4050000 - 43320 $920.00 TOTAL REFUND: $920.00 APPROVALS: If under $50011 Professional Staff If under $7,500 Division Manager If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board ' '.FOR ACCELKSYSTEM ADMINISTRATION;:USE'ONI Y_ ; : t<' Refund Request Reviewed: Date: . ", ` f By: • Case Refund Processed: Date: ; � ' .t-./,; ; By % � elfEZi f l0 ac'. 1: \Bwlding \ Refunds \RefundRequest.doc 04/13/09 I IIII CITY OF TIGARD RECEIPT a . _ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD '1 Receipt Number: 176357 - 12/18/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2009 -00183 $ - 920.00 Total: $•920.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 102203 DHOWSE 12/18/2009 $- 920.00 Payor: Windwood Homes Total Payments: $ - 920.00 Balance Due: $920.00 • Page 1 of 1 • 'r'- - Ty- ::.7 , CITY OF TIGARD RECEIPT r 3 _ 13125 SW Hall Blvd., Tigard OR 97223 • , I 503.639.4171 : ."1:1GARD; Receipt Number: 175950 - 11/06/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2009 -00183 CDC Plan Review, RES 1003100 -43112 $46.00 MST2009 -00183 Additional Permit 2300000 -43101 $62.54 MST2009 -00183 Park - Single Family Unit - 4250000 -43300 $5,370.00 MST2009 -00183 TDT - Transportation Development Tax 4050000- 43320 $4,599.00 < — MST2009-00183 Erosion Control 1003100 -22002 $88.00 MST2009 -00183 Erosion Plan Review CWS 1003100 -22003 $28.60 MST2009 -00183 Erosion Plan Review COT 2300000 -43102 $28.60 MST2009 -00183 Permit Fee - Elect (per dwelling unit) 2200000 -43103 $312.15 MST2009 -00183 Limited Energy 2200000 -43103 $75.00 MST2009 -00183 12% State Surcharge - Electrical 1003100 -24001 $46.46 MST2009 -00183 Air Conditioning or Heat Pump 2300000 -43102 $14.00 MST2009 -00183 Furnaces >= 100K BTU 2300000 -43102 $17.90 MST2009 -00183 Water Heater 2300000 -43102 $10.00 MST2009 -00183 Gas Fireplace 2300000 -43102 $10.00 MST2009 -00183 Range Hood /Other Kitchen 2300000 -43102 $10.00 MST2009 -00183 Clothes Dryer Exhaust 2300000 -43102 $10.00 MST2009 -00183 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $27.20 Utility Rooms) MST2009 -00183 Fuel Piping 2300000 -43102 $5.40 MST2009 =00183 SFR - Baths 2300000 -43101 $350.00 MST2009 -00183 Metro Const. Excise Tax - Residential 2300000 -24011 $326.77 Use MST2009 -00183 Tig -Tual School CET - Residential 2300000 -24102 $2,032.40 MST2009 -00183 Building Permit - New Construction 2300000 -43104 $1,540.25 MST2009 -00183 Plan Review 2300000 -43106 $336.79 • MST2009-00183 12% State Surcharge Building 1003100 -24001 $200.64 MST2009 -00183 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $23.32 Utility Rooms) MST2009 -00183 12% State Surcharge - Mechanical 1003100 -24001 $15.34 MST2009 -00183 12% State Surcharge - Plumbing 1003100 -24001 $49.50 MST2009 -00183 Additional Plan Review 2300000 -43106 $180.00 MST2009 -00183 CDC Plan Review, RES - LRP 1003100 -43117 $6.00 Total: $15,821.86 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1344 LSELLERS 11/06/2009 $15,821.86 Payor: Windwood Construction, Inc. Total Payments: $15,821.86 Balance Due: $610.34 Page 1 of 1 ei - RECEIVED iv.pvoktooso c44-st. C. a d •• eb- , As 5 to ii16,KIL /L2,,....e_-9....., OCT 0 8 2009 CITY OF TIGARD Z. 4Li...,y2...1,* BUILDING DIVISION 7i_t3 ‘,...-__., 6e_hz r . I ... '', 1 , ' 1 , ; +.. : ' , ; . ': , , 7 • . 5 / 4.... .1 ....(,) 0 (2 " Yen, 1 i - .. . . . .. .. . , . i f 54162, . • I , 1 . . f . 1^■OCiV11.063 e" f EDC-if- of' I V i t : r 5 i 5 ,--t 1.-At3 1) C.i FREGS - Pc dra.)(d E-E. ■ TO D&ikt MOW IL liCeE A, FE-qa--- . , 624;t2:44.. e;k --ket, _ _ ___ __ , ._ , „a..m...a.t_ski , 1, , 4,,, • '..e.o, . :6.e. . 11 4 •1-4, I 4 0-74, Vitt-- ' 6 1 , I A jelt p t . - .1 ‘-,u_ 7 • Woo - , - 4 , - / 1 a -, -) eS .fAi -01Z0 /11/ I/ 1-,— ... . 05 hiscetzfe i 0 - A - 67 I . , a llot< O „..,.., , ,.. -'-/' .._.... ' . - • . go, . , d.... F ..... ,,,../.,.... '..., " -1 i -----.--- . ' i • ' ..• t 1 .,,!..• : _. ' .!• — 1 _in 410 '11 i'ea Arrovf*e-42 . . red F.Ar i 1- 1 Ak 4 1 • ' 7? A al .X °r� p�'!q � . e2 `a { ,'9 is CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: vn si Zppq _ 00 PLANNING DIVISION: Required Setbacks: IR Approved ❑ Not Approved Side: . Street Side: f S Front. $ Garage: __ . Rear: /- Visual Clearance: 17 Approved ❑ Not Approved Maximum Build* Height. 3.11 feet CWS Service Provider Letter Required: ❑ Yes ❑ No fFal Received 61 Da to / /L/ �d/ ENGINEERIN EPARTMENT: Actual SI pe: % 121 Approved ❑ Not App oved Site Pla [Approved potyoved / / a °( Notes: CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO; V " c q • Street "tees: y� Prote dTi J'� Approved ❑ Not Approved : B : P - Approved • Not Approved No e:: Date:. / /S D y te- 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. u BUILDING DIVISION TIGARD TRANSMITTAL LETTER a TO: 0Q,6 E CEIVED: DEPT: BUILDING DIVISION (`)/, • CEIVED FROM: JANA du-0 c 61-4-• NOV 06 2009 / CITY OF TIGARD COMPANY: " Pr L L - A., s / BUILDING DIVISIO PHONE: • a , . • �► By: RE: - 7 / Li 3 ; A � rze C( ►15 - .20o - 0c�l �2 (Site Address) (Permit/ Case Number (Project name or subdivision ame and lo umber) ATTACHED ARE THE FOLLOWI , TEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and /or lateral analysis. X Floor /roof framing. ( 2) �; pi Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): 11 __ - _ ^1 REMARKS: '�A , l seA -- r u1.s ` -6 ac k), of i / r • — / 4. v-x. IC . f, a y - .4" FOR OFFICE USE ONLY CT' Routed to Permit Technicia f. Date: Initials: O Fees Due: ❑ Yes 'Q 00 Fee Description: Amount Due: $ & $ Special (.o l() ,31 Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: — I — 9 0 4 l:\ Building\ Forms \TransmittalLetter - Revisions.doc 4/4/07 9 ` k D-leAr3 9 v/ S, `ls 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. V BUILDING DIVISION TIGARD TRANSMITTAL LETTER a TO: \ DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED NOV 18 24 FROM: OC Li . CITY OF TIGARD COMPANY: BUILDING DIVISION PHONE: a 0- Lk RE: ( i A h c- Q ddress) 5 ._Q.k LAC (Pe oL -M k e 3 (Protect name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. X, Revisions: + be -Vh 4: 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: � l \ -e. Qf � ■ - -l oan( pla.n - FOR OFFICE USE ONLY Routed to Permit Technician: Date: (I I (g, 16 Initial :d" Fees Due: ❑ Yes co, 00 Fee Description: Amount Due: Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: I:\ Buildin Forms \TransmittalLetter- Revisions.doc 4/4/07 2 7L � ---- . CG cJ :245 c C 4(-:\ • .