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Permit
I I i1 P MAST ER x CTY OF TIGAR® q ' f . COMMUNITY DEVELOPMENT Permit #: MST2010 -00063 Awi,...--,41 Date Issued: 06/16/2010 t T f G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S103CB01300 Jurisdiction: Tigard Site address: 12355 SW JAMES ST Subdivision: Lot: 0 Project: Tabor Project Description: Replacement of SF residence that is being completely demolished. Original address to be retained. Sewer service is not available, copy of Washington County septic permit required prior to issuance. t . C+.c af.fru 1 c.- P./2-rt (p - . BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 3 First: 2533 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 15 Bathrooms: 3 Second: 0 sf Garage: 820 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $289,046.05 Rear: 15 PLUMBING Sinks: 2 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Catch Basins: Lavatories: 4 Dishwashers: 1 Floor Drains: Sewer Lines: 100 SF Rain Other Fixtures: Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Bckflw Prevntr: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: Fum <100K: Vents: Woodstoves: 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 -200 amp: W/ Svc or Fdr: Ea add' 500 sf: 5 20 1 -400 amp: 201 -400 amp: 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 401 -600 amp: Ea add' Br Cir: 601 -1000 amp: 601 +amp- 1000v: 1000 +amp /volt: 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) TABOR, KRISTEN E BRENT HILLMAN & ASSOCIATES INC 1 MST Ersn Cntrl 503 681 - 4444 12355 SW JAMES ST PO BOX 3188 TIGARD, OR 97223 Tualatin, OR 97062 PHONE: 503- 807 -8789 PHONE: 503 - 209 -1794 FAX: 503 -590 -8962 Total Fees: $7,512.72 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 do ' accordance 't 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 da . ATTENTION: Oregon • -w e• ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9 2- 001 -0010 'rough OAR 9521 -0 • . You may obtain a copy of the rules or direct questions to OUNC by calling 513.246.6699 or 1 800.332.23.4. .1/ Is ued By: — // ■" - J Permittee Signature:x — ^fir �X%� Building Permit Appli 1.c1 ce I DIED -* �I�IS �r�. t� �tlo /,�uDA°lD ecO75 ...b . . kw e y "';,;;T:,7"!,^1',,+,=.50, ". m>e, .. ,T �,�,.. art r ri, } .'i r k 4,1 .t P 5 Residential �' � 1' , , 'F', 7'," , �I OH2OF I F LSI OyIn�����, l � ,' ∎ ", � , APR 14 2010 " , : !i' �L',x�ai ,' a + #'ta 1'1: r %'t":i .arc- ia,i , d�,a t"?'.' ' -1 r : it ' ;' ‘ 43/S City of Ti and Received 5f l U `.7 g Date/By: 7 � 4 �0 1 Permit No : M p� 0606 5 lir ° 13125 SW Hall Blvd., Tigard, O . s ' y: TiGARD Plan Review e / Phone: 503.639.4171 Fax: 50 . '44li DIVISION DateB : _ i ___. 4a t _, �� � z. 4 Other Permit: 1/' r 7 T 1 G A`R +D' Inspection Line: 503.639.41758 1JJ UUUUU Date Ready t ® See Page 2 for � ka ' + ,tfk'P. ` Internet: www.tigard - or.gov Notified/Method- c ., , lo ‘11 Supplemental Informati n , TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ 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 CATEGORY OF CONSTRUCTION work indicated on this applicati dwelling Valuation: �{{ yl a y g ❑ Commercial/industrial V� I���o�C7�J ® 1 - and 2-family ❑ Accessory building ❑ Multi - family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: _.2.8" JOB SITE INFORMATION AND LOCATION Total number of floors: 1 Job site address: 12355 SW James Street New dwelling area: 2533 square feet City/State /ZIP: Tigard, OR 97223 Garage /carport area: 820 square feet Suite/bldg. /apt. no.: Project name: Covered porch area: 92 square feet Cross street/directions to job site: SW 124th Deck area: 453 square feet Other structure area: `"34.5"' square feet 15 REQUIRED DATA:_ COMMERCIAL -USE CHECKLIST Subdivision: Willamette Plat 2 I Lot no.: 12 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 DESCRIPTION OF WORK work indicated on this application. major remodeUreplacement dwelling Valuation: $ Existing building area: square feet 1. New building area: square feet 1 ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Kristen Tabor Type of construction: .10 Address: 12355 SW James St. Occupancy groups: City/State /ZIP: Tigard, OR 97223 Existing: Phone: (503)807 -8789 Fax: ( ) New: ® APPLICANT ® CONTACT PERSON NOTICE • Business name: Patrick Schmitt, designer Inc. All contractors and subcontractors are required to be sC Contact name: Patrick Schmitt licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the 4 Address: 8695 NW Ryan St. jurisdiction in which work is being performed. If the City /State /ZIP: Portland, OR 97229 applicant is exempt from licensing, the following reasons Oft. Phone: (503) 768 -4573 Fax: : (503) 297 -4290 E -mail: patrick@psdesignerinc.com CONTRACTOR Business name: Brent Hillman & Assoc. BUILDING PERMIT FEES* Address: PO Box 3188 (Please refer to fee schedule) . Structural plan review fee (or deposit): 41 City /State /ZIP: Tualatin, OR 97062 Phone: (503) 209 -179 ,Fax: (503) 590 -8962 FLS plan review fee (if applicable): _- Total fees due upon application: CCB lie.: 159399 1 41511) , ;; /i q o d - • Amount received: JQ Authorized signature: / 7 /// �/ This permit application expires if a permit is not obtained / within 180 days after it has been accepted as complete. Print name: Patrick Scll Date: 4/12/2010 * Fee methodology set by Tri -County Building Industry Service Roard - APR /Q8 /2010 /THU 07:54 AM THERMAL FL FAX No, 5036709064 P. 001 /001 0 CC \\I t M.. , + i`�dsiP `' ^+ `" iIR4'.da.''P� n wn��"` ,.:. ,° t „}�nwcc:^n., ',.� Mechanical Permit Applica v l i �, -'r��" �� ) r�trc)1 I # lc l 1 tit c�ht , ! , x� a a r r1 .., d \d Received Ili 4 Ci ty of Tigard APR 14 Date/By: 7 14- too Amm1l N °.: NSrao /a '7040 oo 6 .., .. • t o ° 13 125 SW Hall Blvd., Tigard, OR 97223 Plan Review :, ® ,,, phone: 503.639.4171 Fax 503.598.196 O F Ti G A RQ Date/By Other Permit: A`, I (� ,t-1T Inspection Line: 303.639.4176 �jl� n ' \lV�`'�0 t lat R 4 hares: 13 See Page 2 for k ;2:u f Internet www.tigard- or.gov BOWING lJ tl v Notified/Method: Supplemental lafornwfion `3 - - u+: .c : tw. r ..:x. re ° al 1 . q , Mechanical permit fees• based th ;'"f • _.:.. , r :,A, h ; � _ � ��' Addition /alteratlotl/teplaceme pexform�, Indicate the value are (rowt dcd to e the value nears s of the t dolla r) of an ■ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit value: 5 T . • �f � . /�k' Y.' a.K r ' �t� +r:.. �y}�/+� -- -- . _ ,,..,. - - , „„ t'�.I:,t, 11 Di 1 r w. : r �i o l g..�.' i�i.a `�r'L"-”' ..,B sF ;max -� '�I- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building • For special inform alion use checklist. ❑ Mufti- family 0 Master builder ❑ Other Description 1 Qty. 1 Ea. Total " µ � 1u : ,. c� i 1 .. ,, q _ [ Uwko -_ t .-r-, 4 Heating/cooling . Air conditioning Job site address: 12' ar't5 SW • S At S 'S re. eat , (roquires site plan showing ptaoement) 1 46.73 4 G. ci / State/ZIP: Furnace 100.000 BTU (ducta/ven s) 1 46.75 4:15.- 4:15.- TtG��D q - 1.2. * Furnace 100,000+ BTU meets/veota) 54.91 Suite/bldgJapt no.: Project name: Ewa \ 1 lA & . 1 .b Heat pump 61.06 • Cross street/directions to job site: Duct work 2332 Rydronic hot water system _ 23.32 Residential boiler (radiator or . , hydronic) 2332 - • Unit heaters (fuel -type, not electric), ' • in -wall, in -ducd, suspended, etc. 46.75 Flue/vent for any of above 23.32 Subdivision: I Lot no.: Other. 23.32 'fax Map/parcel no.: Other fuel appliances _ k r ^ yf r 1 t • t o r - •; t c ,-. - - w :: •---,- ' , ■ Water heater 23.32 ` f � a Gas )fireplace 33.39 :,' ( _ _ _ . _..... ... _. ' Flue vent for water heater or gas ` fireplace _ 23.32 [J5r.) malt- eNt � rA %l�l R. r.k ppp1C- Loglighter(gas) , 2332 Wood/pellet stove 3339 Wood fireplace/insert 23.32 , , , r ._. 1, ". ". ---1f ^, , ^ , 1 . , _ p Chimney/liner/flue/vent 23 :. c a J t r - w t � 3 ^ n t5 1 4 ! ? 1- ,: ` ` t , �4 Outer _ . 23.32 Name: 1/w -0b0 ✓, Environmental exhaust and ventilation iaddrtrss: �' V _ Range hood/other kitchen • 1 Z3S 5 S JGt Vii - P,� .1 • cq pxnent • I 33.39 j -. City /State/ZIP: ll rc/d , 012- 97-2 -i Clothes dryer exhaust t 33.39 Single -duct exhaust (bathrooms. Phone 603) .00 e7901 Fax ( ) toilet compartments, utility rooms) 23.32 `, its _..t .. . - , .r.. , ti-w -1--.i,, ` „ , , , 1 -r'fLt Atticicrawlspace fans 2332 • r ® �u,l "� ^w.. Ste' F 5olt'S' c - i�iN� a ..'�,�JS: ; - � uL' m + ,.( ..sa Olbtr: 2332 _ • Business name: i I »1 l Fuel piping Contact name: (W./ ®� �8 � � " , . Q®� /e ✓`£ ��f v iv-et y 4, w\ 5 ES 514.15 for first four: S4.03 for each additional Address: /Z� ✓v � � i [ frl i'L6�0/ 'e re- I�® Furnace, etc. 1 / k7 Gas heat pump I City / StateIZLP: l®./V id et, Q, r 9/%11.- Wall /suspended/unit heater ' , Phone:6 )b10 .80 Fax: : ) 57g '10� 'Water heater • NA Fireplace E -mail: 4 9 1 (4.1t `' t i ID .- _ wn • • Range ,gy -°a`�' " °„-°'� Business name: _ Clothes dryer (gas) Other. A ddress: iV ' = m' . Iffi1 "m :i _ City/State/VIP: Subtotal ( r � " Minimum permit fee (590.00) Phone: ( ) l Fax ( ) Plan review (25% of permit fee) CCB lie.: /5/� 4-? 0117 i , 0 _ State surcharge (12% of permit fee) ' ..- TOTAL PERMIT FEE 3 z., 1 • This permit application expires If a permit le not obtained within 180 Authorized signa days after It has been accepted as complete. I Print name : y : Date: • Fee methodology set by 7ti•Counly Building Industry Service Board 04/12/2010 19:15 FAX Z001 • 0,4/A ,6VVi 11.06 ••A.11 10V.S0 OV4OV • •••• V. ••ww... 1,1‘ ,1 17' 4 $' I'iel t,a i1 ( �4e a dal �t "i gyp l x a �s� ter+ In ere+ Alk , . 'c4 1 .., no.: AK _._ 0 If' u .1: o-- "a n 420; w r. 2• '` V t t' Address: 13123 $W Bali Blvd. T _.,, I ,- • r : I . omme�.I. cr � +ry 4 171 Berd Per: (503) 639.4191 APR 1 4 2010 ffiY' Pe:: (503) 593.1960 Wee in inset aLs _..�. Land ues v®1: CITY OF 1, 1 comma, "yamat k.. 'k4A ,;..,, '4"., 1 •,,,, t?•,4 y "a'11 xk ?.N ,4,t. A lT'!S r ^ 1 ,, '",i4- 4 141 1j 1 . 4,g 1 1,% f ; �* 4,,y� . ttn r'+ i ! A ' +.;. . ' 1` % Y +• � : a r �l a zr% v .wP4a+rA� � Yl.q .+a�Y".�- tr�,. F,... ��w� ". +�. tuk.'':u rx�. 1:1i k�'���u�,�+� : a�Y `' A a Etrailly dwelling ad =sem 0 CensibeedaYlndsonlid 0 )441 Ibnply A Tenant intereyenuset 0 Now oo9Atntadoo 0 AddWodeltntndav eeealm9 "� jt n'�A,I e✓i'A 4Cn e�' t4'A, ', Tror � "i, rar- � ®leoy4e 0MY•fi �. q ,.z97 .,, irltl rl , 1'i 1 4 : 14 A .2 I�II � ' .x .I Sf rt rwFx •>a r . .e. ��y��� w ax I I I l y t 1 14 I hF ' "11,' 4.q. li t r i 'k I: i I "1 � w . Job 1111 ° 1 .; ti %, � 4 . a! 1 ,'1 by -IIIIIIIIIIIII • 4 on end - wok 'Rta CAM Walesa ®ralo NM r ,+I+ e �'�h , { t . !+. ' .? , +a, 7. _ NMI 1'.,44� , x II C I � m l' ' ' Y ', t ll 4 : 4 k f . 14x - 1 7 ^ ` 'R:, ." Y i t„ i . l `1'Yl'w�(�'i� B adman ff q � . t. f ... . 4 'LL � S l . .r Ri Jixik,�+W Q.I.WI+ I.r. MW �kY _ tunas Ww.' • ..:is � I � - _ � • r Add 8. I •. •. . L•. �„ �T'•�>"'' a Stag — . • 1 , m�ir� t 6 «"9maram e+b. bets, 111 -_ -,., mac! 0 .1■w■r. • - rmpr ens ,... •: 6« r.. d-$. i. _ aP ga . +It. $•f , w ,I;p +nYi :T ,. lire'' - : r Stah ' "L.b Hum Pon Ili : �� r -l�� I n c' + ., ,x en"k 7{ a r: .w �rt '*, as m' *+. w ,, aw ,a. 1 1 2 . Illimiiiiiiiiii' --r'-7" ill MIMI w;..� Ar tan B J C , r�.- - --tH may � . . __. �: __ MU be by me ar die ' ap4 meat ands by MY tegeldr R _ : Tc ,- s. � employee an die pawn, d ow ea par ORS 441. n -r t� �, Y A , e ta < rh'A1 � Vi171 ' kq� e Sa�, :"�^b'.., - per 'r .a+Y rr�� .� .'.1..**., a� � � 'r , �tcc�:+ ° �� r�� •. , 72; • r� &Mau: = -- +rrwhl� MUM an 111111111111tl na Nebo,: non Mhtttanaf t o... $ . - , • CT,7 `� avba 0AtelastOrd p�aedl ��• wait Plan :WI" (At 'NI $ adN aed maw !f o psaultt 1. 9ot obmtged - '.°- - within I !0 cars elb r ft his been S tato mtl ge ,. $ Ka �� C3' Kamp deadyalicr r Awn as est& ease" a =opted et caMplop, TOTAL ...... „ $ .mod t, 4airoorEmma —�. - 151 6 5 111 C (, 1,(wwut 5 I 0 C l 7 v 15- 03/09/2010 14:44 5036489723 JERMOE ELECTRIC INC -- PAGE 01 rill% Electrical Permit Applicat on / 1 � 1 O I& 01 1 I( F : 1 tiF 0" I , _ . v r 2010 - �- .. APR 4 pats : ti i o Permit No.: rip /a— v 3 AN :';';', , City of Tigard Received ev 13125 SW Hal Bl vd., Ti OR 97A F T �GPRD Plan Ravlow Other permit: 9 phone: 503,639.4171 FP; 503.598J 0 NISIG�4 Date R • hair: l8 See Page 2 for ins ection Line-. 503.639.4175 B UILDI NG D Date Rradyl9Y' Supplemental Information T 1 ,. ri_ P Notined/Method: v �' -. a + : internee: www.tigard•ocgov TYPE OF WORK PLAN REVIEW ❑ New construction Addition/alteration/replacement Plt� check all that apply (submit a sale of plans iv/kerns checked below)! 0 gervice or feedet 400 amps or more ❑ Building over three storiec. Other: where the available faun current ❑ Marinas and boatyards. ❑ Demolition Other: 10,000 amps at 150 molts or ❑ Floating buildings. CATEGORY OF CONSTRUCTION less to ground. or exceeds 14.000 ❑ Commetvial•use agricultural 1:4 -1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installation,. buildings. 0 1:3 Fire pump. El Irradiation of 75 KVA or Multi-family ❑Master builder ❑Other: larger separately derived system. ❑ Fire pump. 1CY system. 8 Y JOB SITE INFORMATION AND LOCATION ❑ Addiiioe of new motor Iond of CI " 100HP et more. ounpancy, Job site address: O .0 ,' Recreational vehicle parks. Job no.: ^rte ❑ S ix or moro residential units. O City/3tattNZ1P: W► c1lieanMwre facilities. (a Supply voltage for more than air r, ❑ Hazardous locations. 600 volts nominal. - CI service ar feeder 600 amps or more. Suite/bldgJapt. no.: Project name: FEL SCHEDULE 1-1'1 vocriytMw 1 Qtr. 1 Pee. 1 Ten l Cross street/directions to job site: Z k New residential single- or multi - family dwelling unit. aw Includes attached garages r, 4 I , 000 • . R of less 168.50 l ; Subdivision: i lrq,�„Zi - P Z— Lot no.: \Z 5 33.92 1 VI Jet Ea. add•. 500 le ft. or portion Tax map /parcel no.: Limited energy, residential 67 84 67 2 ON OF WORK with above ..6. DttSCR» Limited energy, multi- family 67,8,6 2 residential jwit above se. 0.) Services or feeders tnstaliattonialterationiand/ar relocation 2 . 200 amps or less 10010 201 amps to 400 amps 133.36 2 VI PROPERTY OWNER 1:1 TENANT 2 401 31773 to 600 00103 200.34 2 Name: l L. b r 601 amps to 1,000 amps 301.04 Over i3O00ampsorvoits 552.26 2 w. Address: 4 S ACC C ✓ Temporary services or feeders installation. alteration, and /or City/Slate/Z1P: O ail 225 relocation l //�� 200 amps or leis 59.36 Phone: (Sns) 7J0� $a Fes: ( ) 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on properly that i own which is not 401 amps to 599 was 11111 168.54 2 intended for sale, lease, rent or exchange, according to ORS 447.449.670, and 701. Branch circuits - new. altered or extension, per panel Date, A. Fee for branch circuits with Owner signature! above service or feeder tee, 7 42 2 Si APPLICANT �� • each branch circuit � C 6,.... t _ L B. Fee for branch circuits Business name: �I +wtT without service or feeder fee, 56,18 2 a" - e7 .v. first branch circuit 2 Contact name: lc - A - h u T ech add'I branch catcall 7.42 Address: j '� Di �' Miscellaneous service or feeder not included Each manufactured or mohair 67.8q 2 City/State/ZIP: DR "17 dwelling dul, service and /ar feeder 2 Phone: (Co ) 7 , e, - Fax :: (5 7 7 ) 17 — n O Reconnect only 67.84 67.84 2 Pump or irrigation circle 2 E 7 ■� " '" • '`'. C.,' O Sign or outline lighting 67.84 _ CONTRACTOR Signal eireuit(s) tm limited- / 'B/ --' r + — energy panel, alteration, or Pie 2 2 Business name: 1 f L - � 1 trj .S ri extension, Describe: Address: F O ": 4 �� I r Eac additional ioapectioa over allowable in an of the above ./ / A. 66.25 y �, Per in spec tion / / / -`, / _ investigation per hour (1 hr We) ��� / � industrial plant per hour 78.18 1123E d:GMI Electrical Lie.: a �ilrl ELECTIIICAL PERMIT FEES w , . , p;� subtotal: • d o ; Suprv. Blcciricii i'1 - : re �I& Plan review ( 25% of p foe): Dater �� State surcharge (12% of permit fee �Fg .72_ Print name: - Ar' 4 / . �4E4� "/f% %M TOTAL PE FEE:. -i-6, Authorized signature: Th is permit Ipplitetioo!apire! if p ptrmlr it 7,01 obtained within 180 dart a It btu been accepted u complete. D ate: I ( i 2 1 � Print rOmC: ■A • Number of inspections allowed per permit. .W.461 silt I NRCO/Amon t: t&dldieR‘Pennitat- C•Pern,sApa.Aoe 10101/09 07/14/2010 06:53 5033240580 MALMEDAL ENTERPRISES PAGE 01/01 ( va4u,oul9+%r -m mint bopaar8w+ad. us.uuu iNt1 •pieoe 60 1Amgkqvivu18utPo71 Ae"aJ-M.E At 710 69nFC+ppytaa+ bd. ` oletuooe is iwdawn lang erq il ,ama %;1) a2zoLluo /, :oJauv9ia Potµ °g1o1� M. kr 7utuk4 EMI ( WO M3aar W i 1 OS :osg F!uuad mum A :$o ( .. —.. ' � . NM • PS) am/OLId r0' SZ of +r . owl IEEE g - Mita ' P:4 lelr(b f 1 ` "P H MINtrai MIN wiz e 11111 DM 11=11111.2111 1.11111.1.111.11111.1=111-3 MINI "I On uea =emogspotda4sm : aceg ( ) zuog4 EEM _ 02. ammo dun MPS MN VI S C NM 'Wp s dI'lJ�03SI+b1� ��� (InValawu+oo) weJp Jnog :...., MEM (— S : 311 1 34 ) nil WW1./ :au= aanu Z(-5Z Fa• � d6tR eeonrdJul *WSW �:'� =�: ^..' • ��� M i1 .. - �. ..:. -. ,... „ ... ' _... .- . . .Q.•b. ,:+ 1 '' >Jy �' •� �; � /Jiliv�/ i.' .:� "t. ;i� ZO 6J: x ra ( ).d Zo'sz ,.. .. . M. ZD Sx l"w w!8 700 EJP l •, •t Jppv 11..11 MIX .11111 dW118133010013 •e DM a : mlUt=a Z°.SZ zn1M►usla f :ua a{. J1= t Ou (... eB, Ze .1:. ;uotegniP4nS (– — ;'u 1dautl 'o(c) AMU WOK ( Mil a woauuoo uialp uI IIMMIMIIIIIIMINIMMIllnill OEN 9"" Pi W :aps gofoj suoi3ajtpnaays s9wj £0'0S 11.11 sam911 auwM POInUtli wEp.4 � � uPAP r : 410 41 'MO u!wp 2ugood !AWLS �9 r uu yda /'J�1914?uS W Ju *III 4 l lluksa dI7Ja3giS/ fhx� ��� 4ieq (E) wFa n B°fP11n4 �s�d d Min 41#4 CO ads Ivi4enpuuJ1$!o . „ . 33 8441Ilap ADF"1 P' - 1 OL'Zt£ 11111 4 (t) ILO ^1': s f;, r�, lluHaO I n aaa ru6.n.rf... •�1P!,' i' - -. :i. : . =toiW Pa 4 /DJ `1001 apniaui • !tPup Huli•e i► J :;;:, . API . w • NoQ � �uOuaaoldaiNo!araViUO SPpt+ ❑ ", ,`• „tom; : '• x �' • .. -.. .... , 4 NM r 'f - 1 '? Aol•JO.PAIiq•MA*A := 1giU1 . f oN� r17 ` Q .. d SL tb'6£9'E9Ji su ioliaadsuF " ` = . u,,,„ u,,,„ OL OZ in '86l'EOS " a 16[Y'6E4'fAS - OAP - al Pe..,1S , '� (1 L6 �o ' 'TAW $ H nns szr s t a.AR'°a Fiat .3n illa XIII aUMUng Ng � 62I 07) MV/9441777C/ ..9o-,97,/,2y - -- t . • l ulo p Eagd ad _ ZH /Z0 39Vd U l E II 4 MID 096IB6Ga6OS ZZ :98 0Z0Z /8Y /L0 Office Use Only: �,GTON PERMIT NUMBER: lC `rX: FEE: - 1 , (, 5 7, 00 DEPARTMENT OF HEALTH & HUMAN SERVICES oREGON Environmental Health Program Onsite Wastewater Treatment System Construction Installation Permit EI NEW CONSTRUCTION ❑ REPAIR ❑ ALTERATION ❑ RENEWAL ❑ OTHER ❑ Major ❑ Major ❑ Minor ❑ Minor PERMIT ISSUED TO: f: t l T E'r.! '1 A�t3C = AA/ 3C-l") 7300 Property Owner's Name Township Range Section Tax Lot/Acct.# j\&/ :SAME: .5 J iC i _ Site Address Nearest City or Community , 1 1 7 /7 -71:7;472 col I U 201 IL !f /? ( Issued by - Signature ' Date Issued Expiration Date Type of Facility Served: © Single Family Res. # Bdrms: 3 ❑ Other - Specify: Max. Peak Design Flow: ` : GaVDay All work must conform with Oregon Administrative Rules, Chapter 340, Divisions 71 & 73. Work must be done by the permittee or by a licensed sewage disposal service business. No changes in system location or specifications may be made without written approval from the Washington County Environmental Health Program. SYSTEM SPECIFICATIONS Type: ❑ Standard ❑ Capping Fill ❑ Seepage Trench ❑ Seepage Bed ❑ Pressurized Distribution ❑ Tile Dewatering ❑ Sand Filter ❑ RGF © ATT: r)FL TA W I-fITEWATER OFS0Fr Manufacturer /System Type /Model # Treatment Level Required: 1 I or ❑ 11 ❑ Disinfection Unit: Manufacturer /System Type /Model # SEPTIC TANK SPECIFICATIONS NEW ❑ EXISTING Min. Septic Tank Volume: 1, S Gal Min. Dosing Tank Volume: -" Gal Special Requirements: Mu'ci" i� 1l11Lt- A 1)E 24.';1I'�/ PumP DRAINFIELD SPECIFICATIONS 2 A NEW ❑ EXISTING Media Type: D Rock /Pipe ©, Other ( Product /Manufacturer): l_; ivELLE HALF- Ph Trench Specifications: 12S Linear Ft. 250 Square Ft. Undisturbed Soil Between Trenches: feet Max. Depth: 1 G inches Min. Depth: 12 inches Total Rock Depth: -- inches Rock Below Pipe:. — in. Rock Above Pipe: — in. Capping Fills - Min. Depth of Fill Material: — in. Special Drainfield Specifications: Distribution Method: ❑ Equal ❑ Loop ® Equal- Hydrosplitter ❑ Serial ,0. Pressurized © Gravelless Half Pipe Special Requirements: ❑ Ground water interceptor: Depth: Distance from Drainfield: ❑ Rake Sidewalls ❑ Filter Fabric On Top of Drain Media ❑ Other: Inspection Requirements: For Pressurized, Sand Filters, RGFs, ATTs and Capping Fill systems, there are several inspections required. See inspection requirements specific to each system. The attached Final Inspection Request And Notice Form must be completed and submitted at time of system completion. For pre -cover inspection information, contact Washington County Environmental Health at (503) 846 -8722. OFFICE USE: rev 5/07 I I }( 0D t 6 t; { L{ q iI 0 Type of System: �� Fee Received: - Date: i { 1 1 Li Payment Type: ► Lk 1 CR# 1 1 - - 1 ( I i 05 NCR: White copy to Environmental Health Program Yellow copy to Land Use & Transportation (LUT) Pink copy to Applicant BE CAREFUL and BE SAFE — CALL FOR UNDERGROUND UTILITY LOCATIONS BEFORE YOU DIG! (503) 232 -1987 or 1- 800 - 332 -2344 Rules, Approved Material Listing, and Database of Licensed Installers can be accessed at: http: / /www.deq. state .or.us /wq /onsite /onsite.htm General Conditions And Requirements For All Permits Onsite Construction - Installation Permits are valid for one year from the date of issuance. The expiration date is noted on this permit. Renewal or reinstatement of a permit may be granted to the original permittee if an application for permit renewal or reinstatement is filed within one year after the original permit expiration date. The renewal or reinstatement will be issued an expiration date one year after the previous date of expiration. Transfer of a permit from the original permittee to another person may be granted if an application for a permit transfer is filed prior to the original permit expiration date and no other changes to the permit are necessary. Note: The fee for renewal, reinstatement, or transfer of a permit is less than that for a new permit. ALL WORK IS TO CONFORM TO OREGON ADMINISTRATIVE RULES, CHAPTER 340, DIVISIONS 71 & 73. WORK MUST BE DONE BY THE PERMITTEE OR BY LICENSED SEWAGE DISPOSAL SERVICE BUSINESS. MAKE NO CHANGES IN SYSTEM LOCATION OR SPECIFICATIONS WITHOUT WRITTEN APPROVAL FROM THE PERMIT ISSUING AGENT. Installation Requirements: The drainfield is to be installed in undisturbed native soil. There are to be no alterations of the natural site conditions such as soil removal or filling, or slope /topography alterations within the approval areas for both the initial and replacement systems unless otherwise authorized by the Agent. System installation is not to occur when soil moisture, high groundwater, adverse weather, or other conditions that could affect the quality of installation or reliability of the system are present. If such conditions are present and there is a need for sewage disposal at the site, the septic tank can be utilized as a temporary holding tank as outlined in 340 - 071 - 0160(9). Inspection Requirements: The system installer and /or the permit holder must notify the permitting Agent when the construction, alteration, or repair of a system for which a permit was issued is completed (except for the backfilling or covering of the installation). For Pressurized, Sand Filters, RGFs, ATTs, and Capping Fill systems several inspections are required during the construction process (see inspection requirements specific to each system installation). The permitting agent has 7 days to perform an inspection of the completed construction after the official notice date, unless the permitting agent elects to waive the inspection and authorizes the system to be backfilled earlier. Receipt and acceptance of a completed Final Inspection Request and Notice form by the permitting agent establishes the official notice date of your request for the pre -cover inspection. Faxed copies are acceptable for inspection request purposes only. Originals must be received before a Certificate of Satisfactory Completion can be issued. Please ?complete all of sections 1 through 4 on the form and return it to the office that issued the permit. Forms determined to be incomplete will be returned. System Backfill Requirements: The system is to be backfilled or covered only after the permitting agent has approved the construction installation, tie inspection has been waived, or the Certificate of Satisfactory Completion (CSC) has been issued "hv operation of aw,ry where the inspection has not been conducted within 7 days of notification of complete: installation. 'Unless cherwisr? required, it is .the system installer's responsibility to backfill the system w;lhita 10 says after inspection and ssu ;nce of the CSC. Backfill must be carefully placed to prevent damage to the system. The b.a kifill must be free of large stones, frozen clumps of earth, masonry, stumps, waste col!strur other materials_ tt; could damage the system Be sure that the untreated building p. filter fabric. or etfer'':material approved by the agent is completely covering all drain media where required 9r Hr The system can : b3 connected to and placed into service once it has been properly backfllle and the has been issued. • Initial and Replacement Areas — Protection: T! r installed subsuri 65sorption field and designated replacement areas must be protected and kept free of development such as road',•vays, covering with asphalt or concrete, filling, cutting, or other soil modifications. Washington County HHS Environmental Health Program, 155 N First Avenue. Suite 160, MS -5, Hillsboro, OR 97124 • Phone: (503) 846 -8722 Fax: (503) 846 -4490 LAND USE COMPATIBILI I Y g I Al L MtI' I (LUw) For Onsite Sewage Disposal System Permits �`xa°^' c ° G 4 , 2-,,-,,.."--. t Washington County Department of Health & Human Services Environmental Health ° RrcO' 155 North First Avenue, MS 5, Suite 160 • Hillsboro, Or on 97124 -3072 Telephone: (503) 846 =8722 T ff r-1--"x ' ' t4 1 A } i f"'Y'r4 t- NM, 'a 17 7* 7. 1 "c T �-- ,�!'�iS:t' N Y., �,�'^ t rt'�" -' �� ; S*+..;P.ar a r'x t+ . "- '���4�c :9; rh t u"a2 ,�.a'+'�:;e - a..�+ -:SL t' �f• F � � .,. � ��l� �s�"�x'�1 -, ':',,'.1,-, � . �� Y � d�. u: . � , , i � 0 " "' ) � � ai " '' ,S ECTIOI 1 i,T, LDyBY A v } , "M L. ..� 4 . .,,4,i. +..,,,,.. :4.,:._ ,,.. -M•i L., Pt-,k' ., ,... ...• * ..__1L, -- �$ pp . _. ..3.. Ste. ,� . r � -wit '4 y - 5 r��. 4 E � v' Ali -0: � ":: �1��� ri'F w : ��. �! Si�i yt`5���.'. �, t n �e� f. � a,ti::+a:r ., 1. Printed Name of Applicant/Property Owner: /C...4 2. . Mailing Address: I A / �` City, State, Zip Code: 0---7.— / 2-2. 7 i Day Phone #: Fax #: E -mail Address: 2. Property Information: County: ! Tax Lot #: / 7eO Township: 2 5 Range: / w Section: e he Physical Address: / 2_ 7 5 5 ' e--(.--- ki efrgee,________._.____Aaea Block: Lot: Subdivision: 3. This proposal is for: ►'2 ' n Individual /Single Family, Dwelling • Other - Describe type of development, business or facility and the provided services: 4. Permit or approval you are requesting 0- Construction /Installation permit for: ❑ New Construction 1 ❑ Repair ❑ Alteration ❑ Non -Water carried facility requests (i.e. pit privies, vault toilets for campgrounds) ❑ Authorization Notices for: ❑ Replacement of Dwelling ❑ Bedroom Addition ❑ Other changes in land use involving potential sewer flow increases .. /27 �..:: s if" 4 ' - . � P' x'' - • k 1h4' 47.;i K. '' ..:. , ^! 1 . 7' t , xCj. H 'r `` R..y,; :I; 3 Cre Y. N l A7.2 l% <.: } ' 'i e _ "A -'077 ` 1=+1' 7 r 4 ` ," f. ' . E T T , ii . L. _ ; f a � '',...4! • • ITY�IOR,C OUNT P ' ,, r t i „H „ � ,fi,;.� , r �sgECTIU 2: taT B E � C OMP LETE D B C N n f x r-{ ; =. > , 64. ; : 4 �;,� _ Dt7 ..,. ....t. „§ }?'�4t c M � � �,. r,.,: ,,.� . 1 :_�S � i , , � �, � ^'2 ,� ax x:, a w t ,�.edYt - �i. {�t�^ �? =- �?:<rrx -iu e. Fri, .� >� _ 5. Property Zoning: ` 7 ' s Zoning Minimum Parcel Size: 7 5 D® sest FT' i 6. The facility proposal is located: rgInelde City Limits ❑ Inside UGB ❑ Outside UGB If inside the UGB, the facility is subject to: ❑ City Jurisdiction ❑ County Jurisdiction ® Shared City /County Jurisdiction 7. The business or facility complies with all applicable local land use requirements: % Yes ❑ No If you answered "Yes" above, was this compliance based on: Compliance with local comprehensive plans and land use requirements (provide a citation to the applicable provisions) ❑ Conditional approval (Provide findings and citation or attach a copy of the applicable land use decision) ❑ Measure 49 waiver (provide Department of Land Conservation and Development approval number) Either provide reasons for affirmative compliance decision or attach finding of fact: 8. Planning Official Signature: Print Name: M t CAA. F-4.. ! trJ N i r f::.. Date: 2.0 za t 0 Title: SP-. a.A. L 624.4 AJG, ` T Telephone: S 7, 8 - , -5 0 : o' ���z t; �> a d1 ---P- • • 85.nI agd 0' E �7 = A T R I C K � • ,1 4y:11•:‘, ` INSTALL MIN. 9llf OF /77:11 'SCHMITT 'STORM -TECH' SC -310 STORM L � H WATER CAMBERS OR EQUIVALENT. INSTALL PER ' W IE designer, Inc. GEO -TECH AND /OR MANU. / ! , SPEC. AND • ■ I • k , Ct�!om Home Design RECOMMENDAITONS. / S \ �\. +Consulting - LENCstH IS BASED ON A • // A PQ \�� \�� COLLECTED IMPERVIOUS // , AREA OF 0 � AREA OF 4,360sf AND AN • / SEPTIC DRAIN • G \ '\k ��C 8695 N.W. Ryan Street INFILTRATION RATE OF I / FIELD (BY 0 8 16 $��5 Portland Oregon 97229 • / T:503- 768 -4573 / // OTHERS) I • � F:503- 297 -4290 o SITE PLAN NOTES °� / • / // N • I LEGAL DESCRIPTION `° '"° ° tea" P ,,....1 N ..... r w...., EYw•lon / T Willamette Plat 7 Wllieme "' '.... • / I A BubdlVlelon In OaCtlon 3 T28 RIW WM. c.°n.ro.n am.4acAt�uac> m' °�0r'" ---.1. / // • .Y tr m.,w .h tr o....0 p.l•e . �. I e. w Lot 11 0, TAICOSamrr.e.a x°wuu.- / r N '''.C. '''p e' / • / // SITE ADDRESS W / !2355 8W Jemae 9trarot U / Tleard)OR ST223 0 CO) •\ • / OUTLINE OF 1 W / EXST'G RES ID. I I +�■ /^ J/ / / . ■ LOT COVERAGE Q C1 • / � TO BE 1 / II � T / � '/ L , I LOT AP. A • 0000 W (• I _ �� REMO VED) G • CWDNGEA S) 0000 a (0 w N BLDG. LINE I TOTAL LOT COVERAGE • 000 /0000 (100) • 0,000 ,, ,0 J .A N �M W , , v / OF NEW 1 Z in N / // RES ID. 1 1 ' EROSION CONTROL NOTES: _ o v W • ()REFER TO THE ITY OF LAND 'EROSION CONTROL MANUAL' Z M W , I 1 c FVRT Q It1t.M L. .. FOR ADDITIONAL DETAILS AND EROSION CONTROL MOS. W • / I 2/ COVER ALL DISTURBED GROUND AREA BETWEEN OCT. I TO F 0 / • APRIL 30. DOVER WITH MULCH, eOP, GRASS, PLASTIC OR CO Et / — — — — — — 1 I OTHER APPROVED MATERIALS AS SPECIFIED IN THE 'EROSION Q m ` ) �Wy // I i 1 I CON IROL MANUAL' M ° II 0 \ \\ LL / EA VE LINE ; 9) SEDIMENT EMOVE ONLY AFTER GROUND ISS ESTABLISHED. B D ~ 0 . LL J ~ TO EARTHWORK. T� - �/ / • // OF NEW r J 1 • 4) NO Soil_ ALLOWED TO ERODE OR BE TRACKED OFF SITE. J `*� t / // RES ID. 1111 ILI LEGEND m 1 in o � • // ' GRAVEL CONSTRUCTION ENTRANCE -SEE IL.I m N / � / ' Q / ■ — jj% DETAIL 4.4% BELOW OR M THE CITY OF 2 O m /„ • PORTLAND 'EROSION CONTROL MANUAL' O �./ d / a) Ie 4 4 • 4���4 COVERED STOCKPILES Z '�' / / • I � �••• • _ ) WORK K STAGING / MATERIAL STOR AREAS O / / ❑ I WOODEN CURB RAMP - SEE DETAIL 4.IA / • IN THE CITY Y OF1 U PORTLAND 'EROSION / r� WRAP AND PROTECT ALL CATCH BANNS PER (I/ ( ❑ L / I DETAIL 41H IN THE CITY OF PORTLAND / � / / L 'EROSION CONTROL MANUAL' % / ,/371L. \ • m • WA❑TER❑LINE 0 • SEDIMENT FILTER FENCING ain Fi r. 2,533 sf3 sf / FUSE I' PVC LINE FROM METER TO HOUSE) I Garage = 820 sf / ❑ 8D • STORM SEWER LINE - (USE 3' PVC LINE FROM LATERAL TO HOUSE) / ■ S AN • SANITARY SEWER LINE - ///// / I!'•0' (USE 4' ABS LINE FROM LATERAL TO HOUSE) ❑ SETBACK r 1 PILE • PUHLIC UTILITY EASEMENT / \ • WATER METER DATE: April 9, 2010 � \ \ LINE / , [ Joe NO.: PS- 1407 -10 ♦ 1 � REVISION: __ J )MATERIAL J ... \ EROS -- ei r STORAGE a »', a' ' Y °ar • L =50451 CONTROL l STAGGING I r ill all } SHEET TITLE: R =251 FENCE �A AREA I ' Site 3 R _ 1 • IJ f <c, °s, l,.:ar;o >.. Z Plan • ■ ❑ ❑ ❑ ❑ • • • • • — — _ . 1 sine VIPti SIQr�aE� + EXISTING GRAVEL /CONC 1 I ro. .mom WATER ENTRANCE 3 CONSTRUC. / a " .`; METER E a — ° — � — — — — — 128.00 1 ti r — v EDGE OF ,,, - - OF uY .:" ��:_�•;�.:5-'� STREET rr - MOON I* sup JAMES s ST. ;: ,:_ :A ,R. e� �1.;;.;`,;,,,,•s,. -. I PAVING 8 ,,, ,, i \ DETAIL DRAWING 41A - TEMPORARY SEDIMENT FENCE © COPYRIGHT 2010 - PATRICK SCHMITT. 5.819301nc, I CITY OF TIGARD - SITE PLAN REVIEYV BUILDING PERMIT NO.: ‘ D/b 'Co/3MM? PLANNING DIVISION: Required Setbaas: 12 — Approved 0 Not Approved Side: 5 ' Street Side: I < Front. Garage: Rear: Visual Clearance: 13 - 7\oproved 0 Not Approved Maximum Building Hei Q. feet CWS Service Provider Lt;tr trj 0 Yes 0 No 71 Received B !Li: ' ALS LEitto ENGINEERING D 'PARTMENT: Actual .lope. .% 0 Approved 0 Not Approved Site P/ : / la-Approved ot • pproved B : Date: 4 t 1:1 /0 Notj: SC60 C.42._ isb A - 1 /01 - /c.A - 3,_,E. Ve 5 c9 15 sr7-tanc- CITY OF TIGARD - SITE PLAN REVIEW BUILDING 1 NO: Approved 0 Not Approved Street Trees: ted Trees: Approved 0 Not Approved Protec n , By: litutr Date: Notes: