Permit ° ' .' CITY OF TIGARD MASTER PERMIT
��
° A' COMMUNITY DEVELOPMENT Permit #: MST2009 -00165
Date Issued: 09/24/2009
1..G P:A D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 109AC04900
Jurisdiction: Tigard
Site address: 14612 SW 133RD AVE
Subdivision: WILSON RIDGE NO. 2 Lot: 17
Project: Wilson Ridge 2
Project Description: New SFR
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First 1290 sf Basement: 0 sf Left: 5 Parking Spaces: 2
Height: 24 Bathrooms: 3 Second: 1360 sf Garage: 629 sf Front: 15 Smoke
Dwelling Units: 1 Third. 0 sf Right: 5 Detectors: Yes
Total: sf Value: $297,757.00 Rear. 15
PLUMBING
Sinks. 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 4 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. 1
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 0 Vents: 1 Woodstoves: 0 Gas Outlets: 4
Furn > =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'I 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
Ecom asin N
Other: N Other Description. P 9
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
STONE BRIDGE HOMES NW LLC STONE BRIDGE HOMES NW LLC 1 MST Ersn Cntrl 503 - 681 - 4444
BY VENTURE PROPERTIES INC, 16869 SW 65TH AVE # 505
4230 SW GALEWOOD ST #100 LAKE OSWEGO, OR 97035
LAKE OSWEGO. OR 97035
PHONE' PHONE: 503 - 387 -7577
FAX: 503 - 387 -7615
Total Fees: $17,471.06
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 . - 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. • ENTION. Orego law •uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 #01 -0010 through OAR 95 : ' 1 -0 • ou may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Is- ed By: Permittee Signature: 'S
V - . • . Building Permit Applicati E FOR OFFICE USE :ONLY •
•
City of Tigard NNN X11 V EIVED Received
��++ �� Q / /� P ermit No.://5 20O 00 //4
13125 SW Hall Blvd., Tigard, OR 9722S P 0 9 � 209 Date/B : Plan Revie
Phone: 503 Line: 03 Fax: 503.598. IT Date/B : ,. „�” R• 2, , 09 Other Permi t:SA/R.2009 —# #
T1 GAltD Ins Line: 503 CI TY OF TIGARD Date Ready /By: ip a G Q Juris: ® See Attached Checklist for
Internet: www.tigard or.gov BUILDING DIVISION Notified/Method: 7C� Supplemental Information
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® 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 profit for the
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® 1- and 2- family dwelling 0 Commercial/industrial -
❑ Accessory building ❑ Multi- family Number of bedrooms: 4„
'❑, Master builder ❑ Other: Number of bathrooms: 2 • J5
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Job site address: 461 . E ` A. � 1s &I� New dwelling area: z6, 50 square feet
City/State /ZIP: Tigard, OR 97223 V Garage/carport area: C z9 square feet
Suite/bldg. /apt. no.: Project name: Wilson Ridge II Covered porch area: 1 35 square feet
Cross street/directions to job site: SW Bull Mountain Rd. & SW 133' Ave. Deck area: co square feet
•
Other structure area: [ }(�, square feet
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Subdivision: Wilson Ridge II Lot no.: 11 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all .
equipment, materials, labor, overhead; and the profit for the
., , t wig. W( ,n .« work indicated on this application.
•
Valuation: $
Existing building area: square feet
• New building area: square feet
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Name: Stone Bridge Homes NW, LLC Type of construction:
Address: 16869 SW 65 Ave., #505 Occupancy groups:
•
City/State/ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7577 Fax: (503)387 -7615 New:
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Business name: Stone Bridge Honies NW, LLC All contractors and subcontractors are required to be
p ���,. licensed with the Oregon Construction Contractors Board ,
Contact name:
C 0(LAz S? ► under ORS 701 and may be required to be licensed in the
Address: 16869 SW 65 Ave., #505 jurisdiction in which work is being performed. If the
City/ State/ZIP: Lake Oswego, OR 97035 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 387 -7577 i I Fax: : (503) 387 -7615
E-mail: lewy_le C. h
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Business name: Stone Bridge Homes NW, LLC .4 °tix > M IIILDIlU G PER117Ti'.: P3BS"� ' ` a; ` �*'` -':
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Address: 16869 SW 65 Ave., #505 :' -,
City/State /ZIP: Lake Oswego, OR 97035 Structural plan review fee (or deposit):
Phone: (503) 387 -7577 Fax: (503) 387 - 7615 FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received:
Authorized signature: ��`1 e G 1 This p ermit a ex if a permit is not obtained
C � ( within 180 days after it has been accepted as complete.
Print name: ' C L 4 I 8ffr r1 . . Date: 9 1 4 1 * Fee methodology set by Tri- County Building Industry
1 Service Board.
I:\ Building \Permits\BUP- PertnitApp.doc 03/21/06 440- 4613T(I1/02/COM /WEB)
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CEIVE
Plumbing I
Permit Applicat, I)JI . FOR OFFICE - USE O NLY ' I
Received G }
City of Tigard P 0 9 2009 Date /By: /y� r iZ - Permit No. /iff `���� I
I n 13125 SW Hall Blvd., Tigard, OR 97 3 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit No. 0067
Date /By: CIJ/��OQ -
TI GARD Inspection Line: 503.639.4175 CITY OF TIGAR Date Ready /By: kris: H See Page 2 for
Internet: www.tigard - or.gov BUILDIN( -� �I V E$IQtL. Notified /Method: Supplemental Information
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® New construction ❑ Demolition For special information use checklist.
Description f Qty. i Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
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® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
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Job site address: 1461 Z '' `a5177, Avei.ids Catch basin or area drain 16.60
City / State/ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain • 16.60 _
Suite/bldg. /apt. no.: I Project name: Wilson Ridge II Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Bull Mountain Rd. & SW 133' Ave.
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Wilson Ridge II I Lot no.: 1" Water service (no. linear ft.: _) Page 2
1 Fixture or item
Tax map /parcel no
�, <_ Y Absorption valve • 16.60 •
a .' w . _. t4J & of 4 B''i t} 0 0 ()' B
.;'. c Backflow preventer Page 2
•
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Backwater valve 16.60
Clothes washer 16.60 •
Dishwasher 16.60
€" : rs� ES-. : a :aa .x�i ra :. ., ::::r- v- 1 pa p, 6 -m'' - t ,,^�, c . . 1 Drinking fOUntain 16.60 •
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Name: Stone Bridge Homes NW, LLC Expansion tank 16.60
Address: 16869 SW 65 Ave., #505 Fixture/sewer cap 16.60
City / State/ZIP: Lake Oswego, OR 97035 Floor drain/floor sink/hub 16.60
Phone: (503) 387 -7577 Fax: (503) 387 -7615 Garbage disposal 16.60
• „,a, , .._::..,<;_: Hose bib 16.60
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- Ice maker 16.
Business name: Stone Bridg home NW, LLC Interceptor /grease trap 16.60 • Contact name: ,--74:21 � 4 � '7Cr Medical gas (value: $ ) Page 2
Address: 16869 SW 65th ve., #505 J Primer 16.60
City / State/ZIP: Lake•Oswego, OR 97035 Roof drain (commercial) ■ 16.60
Phone: (503) 387 -7577 f Fair: : (503) 387 -7615 Sink/basin / lavatory 16.60
E-mail: CS .10.coY1� Urinal
LI - u lower /shower an 16.60
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16 60
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Business name: Legacy Plumbing Water heater 16.60
Address: 8985 SW Hazelwern Way Other:
City /State/ZIP: Portland, OR 97223 Subtotal
Minimum permit fee: $72.50
Phone: (503) 816 -8887 Fax: (503) 297 -4587 Residential backflow minimum permit fee: $3625
CCB Lie.: 159281 I Plumbing Lic. no.: 26 -517PB Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signature: 7 , >��� �� TOTAL PERMIT FEE
Print name: Matt Nelson Date: 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 \Pemuts \PLM- PennitApp.doc 06/26/06 440 -46I 6T( I 0/02/COM/WEB)
Electrical Permit ApplicatioREC E ` Y E ® Fo O use ONLY,
Ci ty of Tigard Re ceived
`J g Date /By: ti 1i� P ermit No. si
- 9' 9 oy - s7��. i, �6s
13125 SW Hall Blvd., Tigard, OR 97223 E P 0 9 2009 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit: i
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: Juris: EZ See Page 2 for I
Internet: www.tigard- or.gov Notified /Method: Supplemental Information
BUILDING ING DIVIso
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® New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /ite ns checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
0 Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
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n ^ exceeds amps at volts e
• less to ground, or exceeds 14,000 ❑Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. '
0 Multi - family ❑ Master builder ❑ Other: pup. a 75 em
❑ Fire pump. Installation of KVA or
s; :; ^ - ,...:.:.::.,:.- a- ,- r:::;: : ,, ..: ^:.:..,- :a::_:.;,:.._ .w .t;: ;c „ Emergency y larger separately Y •
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m
A lar er se aratel derived system.
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100HP or more. occupancy.
Job no.: 1!3 Job site address: 14612 51 ,4 ( Avq ,
0 Six or more residential units. ID Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ` ^�v ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Wilson Ridge II ❑ Service or feeder 600 amps or more.
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Cross street/directions to job site: SW Bull Mountain Rd. & SW 133 Ave. Description I Qty. I Fee. 1 Total I
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Wilson Ridge II Lot no.: I.1 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: • Limited energy, residential
u» q ;,: • - ^:, x „^ .,.:_... :. . „. ,. F ,. n ,..x,:. ,.;..:.: ,. 75.00
� rc< rte: r a' i :.. s- with above sq R
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x .. , .._ LW multi-family
rte,. «::. «a.._:. -:
tad energy, m ti- family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
_ .:,, -. 13 . .ti �2'....1%, „ PI sa"6 ] 1,`s '', r , 201 amps to 400 amps 106.85 2
Name: Stone Bridge Homes NW, LLC 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 16869 SW 65 Ave., #505 Over 1,000 amps or volts 454.65 2
City/State/ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)387 -7577 Fax: (503)387 -7615 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
,�_, ='ri !: `S , •S •,, :.'.,:«. aibea .�.- (x •: g N.xx S .ffir<, Fxr � °41110i.:;. ii i' ° ..._ 1m , ._,,,.:, -._, ;� ':-:. a 'Y:: �: :::•u:. i u y � i •,,,., ,..', '
�P� i ��� i p al...: ( 1® ., � ` ,v i above service or.feeder fee 6.65 2
.K;',las' ,,k7N'�. riv . �.dt e,a's. S s... a ;= :.:.„v, x"w x.<,. :».r.sr�xeTklt - ' x - a4�:.
' each branch circuit
Business name: Stone Bridge Homes NW, LLC B. Fee for branch circuits
without service or feeder fee,
Contact name: '
��� ,12 :) TZ` . �, .. 9 first branch circuit 46.85 2
Address: 16869 SW 65th Ave., #505 Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included) •
City/State/ZIP: Lake Oswego, OR 97035 Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: (503) 387 - 777 f Fax: : 503) 387 -7615 , Reconnect only 66.85 2
E • & nn , ayy y) i,,7. C,oyyi Pump or irrigation
53.40 • 2
e
Pu
ion circl
r
53
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a.�4t.:.:... u�,x, >. x:..., .. :. E,..„.::..•::,.,,:�.,.,t�:..A ONTR�ICT _;�c�,:. ._„„ t. .:u�'.xr % ""' °..a.'�''��.:;
c o x . v. x ... r„ u:e.
a. i.,:itm:rw•...<f.:::x:.• .?:,i . .. ..:::� �. � ..... .... ... ..... ttt, r.,.r. ..: a.. _`.i: �_ '._r...:. ...+. .
Business name: ity Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: 8900 SW Burnham St. F -27 extension. Describe: Page 2 2
City/State /ZIP: Tigard, OR 97223 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 443 - 1092 Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lic.: 42422 Electrical Lic.: 26 -289C Suprv. Lic.: 35925 Industrial plant per hour 73.75
x . a;: .. ; ..
. k , � .:... 1:4z 'PITucAl;:TXRivuTOP.M.PNV.......... ,
Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: �� ... TOTAL PERMIT FEE:
Print name: c This permit application expires if a permit is not obtained within 180
r
C'` l\ - I � I ` ,,C 1-- � i (� � �' ,`� • Dat e: days after it has been accepted as complete.
* Number of inspections allowed per permit.
i:\ Building \Permits\ELC- PermitApp.doc 12/03 440.451 ST(10 /02 /COM/WEB
Mechanical Permit Application . FOR OFFICE USE_ONLV --
' Cl of Tigard ReE'Eiew d/
'J g Da: ei ' Permit No/ 7 Z -on/65- " 13125 SW Hall Blvd., Tigard, OR 972 E
� - :: Phone: 503.639,4171 Fax: 503.598.1960 Date/By: Other Permit: 1
ea
e a
S EP 0 9 2009 D t Rd /B Page 2 for
Inspection Line: 503.639.4175 lures: See Pa e or
Ready /By: 1
. Internet: www.tigard - or.gov Notified /Method: Supplemental Information
CITY OF TIGARD
•
x,... - _........:a.:,:i: -.- -� �..IAI:'. SEE:::, SCIiET ).f3LE'��b51�CAECT{L 35'I``?
.: : <,,,..:,.::::.....�.:,.n��.x:: ,.. ..,_. :,,.._:_�:::: - -t. QF„ _ :..� COIVIIVIERC
New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (round to the nearest dollar) of all
❑ Demolition to Other: mechanical materials, equipment, labor, overhead, and profit.
:.::.. n :.:. _..., ......f,.. # ,.x .............. ... -.:. ... ONS TIONas'� `�.iu -:� :,
�. e.:.:..::x...., ._. _:. _, < .... ... .........�CAO:EGCQR�'..OF.,C TrRUC� . .., •.....s +� ''.x.. ,: � , :..: ;,,,.,,:,:. ,
x
`REU tliL' { J\ E • ll1Z��!L"�'I' <S
N YS1aJ•'�1r1SYl�i�L
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building °•.::° <,.....'
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
.< >.:, ``r:':s.�;u.:.f.:; -;'F Heating/cooling
�: ....: .:..::. .::�.: ,. �;< ..,�,." 3`4B ST�E� IL�TB'O 4ND ��. ; �� F� g
Job site address: 'w1 Air conditioning or heat pump
1 12 SW ' �� �� A C �F i j�.�(„(,� (requires site plan showing placement) 14.00
City/State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Wilson Ridge II Gas heat pump 14.00
Cross street /directions to job site: SW Bull Mountain Rd. & SW 133 Ave. Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. _ 10.00
II Lot no.: y Flue/vent for any of above 10.00
Subdivision: Wilson Ridge
l� Other:
•
10.00
Tax map /parcel no.: Other fuel appliances
xs, #` _ . - } , , . �� «k u, r-Ra€aux a .ter o., i =ate i Water heater 10.00
it , 1 SG ..x ,. n .. i f 10.00 4. AIM .>xi
Gas fireplace •
•
•
Flue vent for water heater or gas
• •
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
..._ ,..; '< �m.:s. ,' himne /liner /flue/vent
► OM .� ...x „; y as "._.. :s. � '�1` Other- 10.00 .
<
Name: Stone Bridge Home NW, LLC Environmental exhaust and ventilation
• . Address: 16869 SW 65 Ave., #505 Range hood /other kitchen
equipment 10.00
City/State/ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust - 10.00
Single -duct exhaust (bathrooms,
Phone: (503)387 -7577 Fax: (503)387 -7615 toilet compartments, utility moms) 6.80
;. : ; xt.u..-, r ,i,„ . =,t ? , ;€ > �;; ; Attio /crawls ace fans 10.00
`r'x'•x
.., a tv.�v�. R .
:�.�:::a... �:•. _F���';4P�1"III��: ���y :;. :.�; , ,:� QpNIP�GO',,.- R .(9N::u, -
-” , Other. ,
Business name: Stone Bridge Home NW, LLC
Fuel piping
Contact name: C�f` �� $5.40 for first four; $1.00 for each additional _
Address: 16869 SW 65th Ave., #505 Furnace, etc.
' Gas heat pump
City/State/ZIP: Lake Oswego, OR 97035 Wall /suspended/unit heater
Phone: (503) 387 -7577 I :x:: (503) 387 -7615 Water heater
1 Fireplace
E -mail: I a_ 0. • , i �' J C S e i .. a 1 ft 04 � - ,4 • ..ti Ra nge
r,
s. :.::� *.n :... ;h:." ..,. .•`v:. " ... ...................t. -... _ ._. .. _.,.. , ....,. .a.....5......v. ...e. .. .. ....... ... ..... ....c. : .,..
Barbecue
�._:.:w...:.:..., W...:.:.:....._. a. ..o_...,... ....._.........._..
Business name: Comfort Zone Clothes dryer (gas)
Other:
•
dress: 1032 NW Cor orate Dr. i `F"<<: < � ': r ";, " x ='° : 3
: iii ti.":. r n�ME. �lA�CAL:4'�R1�I� x ,
a
City /State /ZIP: Troutdale, OR 97060 Subtotal
Phone: (503) 667 -5595 Fax: (503) 491 -8253 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 110091 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: T his pennit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: David Heldstab Date: * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \l'ermns \MEC- PermitApp.doc 12/03 440- 4617T(II/02 /COM/WEB)
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, /411.1 ( 71,o --.-a- S , am the general contractor or the owner- builder
at the following address:
Site Address: /46/ S- /7 3 /4e__
City: 4
Permit #:
" 57— zcbq — dp / ��'
Subdivision/Lot #: / - (7
and /or
Map and Tax Lot #:
To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and
• OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content
Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement.
[Section R318.2 is provided for reference].
R318.2 Moisture Content: Prior to the installation of interior finishes, the building
official shall be notified in writing by the general contractor that all moisture - sensitive
wood framing members used in construction have a moisture content of not more than 19
percent by dry weight of dry framing members.
Signature: Date: .//,2¢f o q
General Contractor or Owner- Builder
•
I \BuildingTorm\RES-MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
•
HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: c,5-7--2001 - 6 a C Jurisdiction: C q,"
Site Address: fitI I Z S,U / 3 3'
Subdivision/Lot #: C J Sn� .,74f l / 7
and/or
Map and Tax Lot #:
By my signature below, I certify that a minimum of fifty (50) percent of the permanently
installed lighting fixtures in the above mentioned building have been installed with compact or
linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)
Signature: �(2---------- Date: //7 ilo
Owner /General Contractor /Authorized Agent
Print Name: y ( tv.
ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the
permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that
has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this
requirement.
The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per
input watt.
1:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08
•
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I, ,4"-e1 Y om h.. 5 Owner /Agent for S - - 5, •,4f e_ ( >—, 5
(PLEASE PRINT) (PERMIT I-IOLDER)
Do hereby certify that the 'following location meets
City of Tigard land use and development standards
for street tree installation.
ADDRESS: 46 1 Z S L- / 3 3 re(
SUBDIVISION: , 1 st R,-et 77 LOT: ( 7
SIGNATURE: ` z_____— DATE: / Z s 0 7
(OW \TER /A GENT) I
RECEIVED BY: DATE:
(CITY OF TIGARD)
L rt , .a4iZ.rr',2'M2+.ralvie r:7+Kaa 1111~rsr lilL:rvaz SMAMii40t.rr:vws 4ia;IlWarWat;llit6W41. } .i. .1,4S,_s..y, AI+v e. -:0/kt +ItSA .a , z.tm :; s5:-wsrsu%ai YC 'ten e.'q-+z2a.^11t4AS : a P - a11M - 14t p.: Z.S eM2,4•0- i.,..z.-sU.Wt
I:\ Building \Forrns \Street l rccCcmficate 01 / 19/07
. City of Tigard, Oregon 13125 SW Hall Blvd. • Tigard, OR 97223
Wednesday, December 16, 2009
TIGARD
Stone Bridge Homes, NW
16869 SW 65th Ave., # 505
Lake Oswego, OR 97035
RE Transportation Development Tax (TDT) Refund.
Permit No. MST2009 -00165 for 14612 SW 133th Ave., Wilson Ridge 2.
At the time the above building permit was issued you paid a Transportation Development
Tax (TDT) fee of $4,999.00.
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 $1,320.00.
Please call me .t 503- 718 -2426 if you have any questions.
. e Shields
Permits /Projects Coordinator
503 - 718 -2426
Phone: 503.639.4171 • Fax: 503.684.7297 • • www.tigard - or.gov • TTY Relay: 503.684.2772
111
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, engineering and building application fees.
Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be
attached to this form. Refund requests are due to Accela System Administrator by Friday at
5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela
System Administrator for distribution. Please allow 1 -2 weeks for processing.
PAYABLE TO: Stone Bridge Homes DATE: 12/10/09
16869 SW 65 Ave., #505
Lake Oswego, OR 97035 REQUESTED BY: Dianna Howse
AMS
TRANSACTION INFORMATION:
Receipt #: 175318 Case #: MST2009 -00165
Date: 09/24/2009 Address /Parcel: 14612 SW 133'd Ave.
Pay Method: Check Project Name: Wilson Ridge 2
EXPLANATION: Refund amount discounted for TDT per Washington County.
: REFUND`INFORMATION ..
`..,::.• ' :Reveriie: Account�No: �::' _ . .: � �.
Fee: -� :. _ � _
;`E xam le
:� "2450000 . 432000 ..':$� ...........�
..... P
TDT - Transportation Development Tax 4050000 - 43320 $1,320.00
TOTAL REFUND: $1,320.00
APPROVALS:
If under $500t 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
;`:...: �<= :- ::��:_� •'� �' =. EOR ACCELA: SYSTEMADMINISTRAT .ION�US.E.ONLY.:. :�:�`� �::�.;.'. "
Refund Request Reviewed: Date: /? -. "rr ' :; B et?
Case Refund Processed: Date: ��2�i,+` =�� �, By. ,,i1.97-t.
eff /e- - i /OoZ /?
I: \ Building \ Refunds \RefundRequest.doc 04/13/09
CITY OF TIGARD RECEIPT
_ q
C . 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
.��.. /• i� ._1
Receipt Number: 176346 - 12/18/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2009 - 00165 $ 1,320.00
Total: S- 1,320.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 102189 DHOWSE 12/18/2009 $- 1,320.00
Payor: Stone Bridge Homes NW LLC
Total Payments: $ - 1,320.00
Balance Due: $1,320.00
Page 1 of 1
f
';:'4 CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
;IIG .iw:
Receipt Number: 175318 - 09/24/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2009 -00165 Building Permit 2300000 -43104 $1,644.50
MST2009 -00165 SFR - Baths 2300000 -43101 $399.00
MST2009 -00165 Plan Review 2300000 -43106 $135.58
MST2009 -00165 CDC Plan Review, RES 1003100 -43112 $46.00
MST2009 -00165 CDC Plan Review, RES - LRP 1003100 -43117 $6.00
MST2009 -00165 Additional Plan Review 2300000 -43106 $62.50
MST2009 -00165 12% State Surcharge - Building 1003100 -24001 $197.34
MST2009 -00165 Metro Const. Excise Tax - Residential 2300000 -24011 $357.31
Use
MST2009 -00165 Tig -Tual School CET - Residential 2300000 -24102 $2,650.00
MST2009 -00165 Park - Single Family Unit 4250000 -43300 $5,370.00
MST2009 -00165 TDT - Transportation Development Tax 4050000 -43320 $4,999.00
MST2009 -00165 Erosion Control 1003100 -22002 $88.00
• MST2009 -00165 Erosion Plan Review CWS 1003100 -22003 $28.60
MST2009 -00165 Erosion Plan Review COT 2300000 -43102 $28.60
MST2009 -00165 Permit Fee - Elect (per dwelling unit) 2200000 -43103 $312.15
MST2009 -00165 12% State Surcharge - Electrical 1003100 -24001 $37.46
MST2009 -00165 Furnaces >= 100K BTU 2300000 -43102 $17.90
MST2009- 0'0165 Duct Work 2300000 -43102 $10.00
MST2009 -00165 FlueNent For Any of Above • 2300000 -43102 $6.80
MST2009 -00165 Water Heater 2300000 -43102 $10.00
MST2009 -00165 Gas Fireplace 2300000 -43102 $10.00
MST2009 -00165 Range Hood /Other Kitchen 2300000 -43102 $10.00
MST2009 -00165 Clothes Dryer Exhaust 2300000 -43102 $10.00
MST2009 -00165 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $34.00
Utility Rooms)
MST2009 -00165 Fuel Piping 2300000 -43102 $5.40
MST2009 -00165 12% State Surcharge - Mechanical 1003100 -24001 $13.69
MST2009 -00165 12% State Surcharge - Plumbing 1003100 -24001 $47.88
MST2009 -00165 Plan Review 2300000 -43106 $183.35
Total: $16,721.06
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 30484 DADAMSKI 09/24/2009 $16,721.06
Payor: Stone Bridge Homes NW LLC
Total Payments: $16,721.06
Balance Due: $0.00
Page 1 of 1
, . .
STONE BRIDGE, EIVED OBE: 1385
1-3 CP 1%4 EC SI 1■1 I...I.., C - Lon 17
1.8869 SW et 15 t.im. AVM . , 4 5 O8 DATE: 09/01/2009
L • K 1 OSWEGO, OREGON •70E5 SEP 0 9 2009
(503)387-7577 PROPERTY: WILSON—RIDGE—II
s 4
1 si 1 CITY OF TIGARD CITY: TIGARD
SCALE: 1"=20'
IIIVAOSFAI 598 OgrjG DIVISION PLAN No.: 198A
OPTION-1 ELEVATION
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STREET TREE LEGEND k i q i ...
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LOT COVERAGE
LOT AREA: 6,952 5Q. FT.
BUILDING AREA: 2,054 SQ. FT.
PERCENTAGE: 25.8%
NOTES:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS. LOT MI
ALL D IMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING WALL HE !GI-ITS AND LOCATIONS ARE ESTIMATES. 6,982 6ci. ft.
THEY MAY VARY AND BE SUBJECT TO CHANGE.
T
I 1
fl 2=
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: /'!57.16 a 9— Dll/4 5 -
PLANNING DIVISION:
Required Setba ell Approved ❑ Not Approved
g'7 Side: 5 Street Side: ...(L__
Front. (; age: �J Rear: �S
Visual Clearance: DAppr ved 0 Not Approved
Maximum Building Height ..1. feet Yes ❑ No
• Service Provider Letter Required: ❑
//� � � y ❑ Reti'.:ivcd
B :' clot t-a Date: W4 IV
ENGINEE )EPART NT:
Actual Slope:.../_% ' pproved ❑ Not Approved
Site Pip: v d.. Ia'Approved ❑ Not A proved
sy:4L ,n i.e`L.e, Date: ? ' .
Notes: Qyiy /"
• • ..... `CITY OF TIGARD - STYE PLAN REVIEW
....
• BUILDING PERMIT NO: /1S .2 n0 9 — 40 /4 _
:0:06 • -
••• Street T
Trees: A pp roved ❑ Not Approved
• • Protected T_ reps: A pproved ❑ Not App roved
• • •• •• • - • • .•- iOL ( I Date: �_/0,oy
00 00 • • • • • Notes:
• .• .
•
• • •
•- •-
• • •
• • 0005 • •
••••
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0000