Permit CITY OF TIGARD MASTER PERMIT
I . = COMMUNITY DEVELOPMENT Permit #: MST2009 -00073
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639.4171 Date Issued: 03/20/2009
Parcel: 2S1120021200
Jurisdiction: TIG
Site address: 8165 SW LANGTREE ST
Subdivision: Lot:
Project: GAGE FOREST
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories. 2 Bedrooms 3 First 861 sf Basement: sf Left 5 Parking Spaces'
Height 24 Bathrooms: 3 Second. 12 sf Garage: 390
g sf Front: 20 Smoke
Dwelling Units 1 Third. sf Right 5 Detectors: Yes
Total sf Value $0.00 Rear: 15
PLUMBING
Sinks, 1 Water Closets 3 Washing Mach 1 Laundry Trays, 1 Rain Drain Catch Basins'
Lavatories: 4 Dishwashers: 1 Floor Drains: Sewer Lines 100 SF Rain Drains: Other Fixtures'
Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines 100
Bckflw Prevntr
MECHANICAL
Fuel Types Air Conditioning: Vent Fans 5 Clothes Dryers 1
NAT Heat Pump Hoods: 1 Other Units:
Furn <100K Vents: Woodstoves: 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 -200 amp: W/ Svc or Fdr:
Ea add•I 500 sf 3 20 1 -400 amp. 201 -400 amp. 1st W/O Svc/Fdr
Limited Energy. 401 -600 amp 401 -600 amp' Ea add'I Br Cir
601 -1000 amp. 601 +amp -1000v
1000 +amp /volt'
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo HVAC: Security Alarm Vaccuum System: Garage Opener: All Y
Other N Other Description Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW Single Family VB R -3 2130
Owner: Contractor: Required Items and Reports (Conditions)
J T ROTH J T ROTH CONSTRUCTION
TIGARD 12600 SW 72ND AVE #200
TIGARD, OR 97223
PHONE PHONE 503 - 639 -2639
FAX: 503- 624 -0239
Total Fees: $14,460.56 '
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 throu h OAR may 952 -001 -0100. You obtain a co
^ y copy of the rules or direct questions to OUNC by calling . 603246 „ .6699 or 1.800 332.2344.
Issued By: M l Y 1.1 Q aaQ/\> Pe rmittee Signature: 1 • %% - - - 1
�f``
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �'IUypi'�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ' /t ' 5 Zi4 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 4j/�''Y Pour Time: govr4
Code # Inspection Description Confirm # Contact # Message
269 50 6d� D‘oz
Corrections /Comments/ Instructions:
MOB r4Z77 ffii
•
-
PASS I 1 PARTIAL APPROVAL E CANCEL n NO ACCESS
n FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: L, /G ,/ Date: Phone #: (503) 718 -
d Building Permit Application
.giie_work_ RECEIVED FOR OFFICE USE ONLY
C 1 of Tiand F -• .- 3 n n Received Permit No.: yy � ` G `
`J g % ..U9
Date/By: cA ►�l
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re
7
•
� OF TI — Other P erm it ( �I 11 i b
-m.-- Phone: 503.639.4171 Fax: 503.598.19 G ARD Re
Date /By: ��� MMMII // ///
T I G A RD BUILDING Line: 503.639 BU D Ready Juris: ® See Page .for
Internet: www.tigard- or.gov ILDIN DIVISIO Notifie d/Method:3 1 3 , G Supplemental Information
&
C d uacf �cn
TYPE OF WORK REQUIRED DATA: 1- AND 2 -F I LY 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 application.
® .I - and 2-family dwelling Valuatron2z� ZZ. $4.511,040 y g ❑ Commercial/industrial l
❑ Accessory building ❑ Multi- family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION .. Total number of floors: 2
Job site address: 8165 SW Langtree Street New dwelling area: 2130 square feet
City/State /ZIP: Tigard Ore. 97223 Garage /carport area: 390 square feet
Suite/bldg. /apt. no.: Project name: Gage Forest Covered porch area: 32 square feet
Cross street/directions to job site: Hall Blvd. and Langtree Deck area: 0 square feet
Other structure area: 0 square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Gage Forest Lot no.: 19 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.
Construction of New Single Family Resisdnce
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ "TENANT Number of stories:
Name: J.T. Roth Const. Inc. Type of construction:
Address: 12600 SW 72 nd. Occupancy groups:
City /State /ZIP: Tigard Ore. Existing:
Phone: (503)639 -2639 Fax: (503)624 -0239 New:
❑ APPLICANT - ®- CONTACT PERSON NOTICE
Business name: J.T. Roth Const. Inc. All contractors and subcontractors are required to be
Contact name: David Jensen licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12600 SW 72nd jurisdiction in which work is being performed. If the
City/State /ZIP: Tigard Ore. applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 806 -0602 Fax: : (503) 624 -0239
E -mail: davidj @jtrothinc.com
CONTRACTOR
Business name: J.T. Roth Const. Inc. BUILDING PERMIT FEES*
Address: 12600 SW 72nd (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/State /ZIP: Tigard Ore.
•
Phone: (503) 639 -2639 Fax: (503) 624 -0239 FLS plan review fee (if applicable):
CCB lic.: 31700 Total fees due upon application:
=-- Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: David Jensen Date: 1/26/09 * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits \SIT - PermitApp.doc 12 /27/06 440- 4613T(11/02 /COM/WEB)
"Mechanical Permit Application FOR OFFICE USE ONLY
•
City of Tigard Received
Date/By: Permit No.: ,5 , , , . 7
I 41 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
M , -.. Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TIG.A RD Date Ready/By:
Inspection Line: 503.639.4175 Anis: M See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
-'' ' ' ''Y iriiebi4olitc;'"74- -..- "z" , 'I' - 7; -''"':7' - .'7.- ,
Mechanical permit fees* are based on the value of the work
New construction 0 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
• - • ' '-' t . ' t. - 't 't .--:tCATEPORYi0E ::. ....:-.. ',.11.: - 4 ,- - „.,.,,,.:
`. 4Eg .Q. , .-.. 'E ',.` i?
Z 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist
0 Multi-family 0 Master builder 0 Other:
Description I Qty. Ea. Total
t::,:'5 :i, ,41±,03'Stii":,iNF: :0 •:'f,;, •' ,,, Heafing(eeoling
Air conditioning or heat pump
Job site address: 6II..5 511 4 4444rptee
(requires site plan showing placement) 14.00
City/State/ZIP: TIGARD, OREGON Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: GAGE FOREST
Gas heat pump 14.00
Cross street/directions to job site: Hall Blvd & SW Lang Street 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
Subdivision: GAGE FOREST Lot no.: / 9 Flue/vent for any of above 10.00
Other: 10.00
Tax map/parcel no.: Other fuel appliances
';' '1'.. -,„;,• ,, ':,,-.'„ , orwscglpTIorcp .„ WORK ..t,., '-,.,„ ..„, ,,.; ., .. Water heater ( 10.00
Gas fireplace .1 10.00
NEW SINGLE FAMILY DETACHED 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
Chimney/liner/flue/vent 10.00
, 'i ; .•;!-4'W' 4 21 7 '•la i atiitkr , ir oWisitle"47' , ,, 7. `;, ,,- ; ,, -7i ,, ,: , - , :- `,'''.- ' ", ,- .'„,' , , , - - -7.: -
10.00
Name: J.T. ROTH CONSTRUCTION, INC. Environmental exhaust and ventilation
Address: 12600 SW 72 AVENUE, SUITE 200 Range hood/other kitchen
equipment 1 10.00
City/State/ZIP: PORTLAND, OR 97223 Clothes dryer exhaust 1 10.00
Single-duct exhaust (bathrooms,
Phone: (503)639 Fax: (503)624 toilet compartments, utility rooms) ''. 6.80
„ Attic/crawlspace fans 10.00
, ire :.•%':,t'•-: s iiii', p i :,,,-. ,;ErecisiAdt
.:,' 7 '; .'• .". . —• .-1. . •••••• ...•,_,. '.. '. , ..'., Other: 10.00
Business name: J.T. ROTH CONSTRUCTION, INC. Fuel piping
Contact name: DAVID JENSEN $5.40 for first four; $1.00 for each additional
Furnace, etc. (
Address: 12600 SW 72 AVENUE, SUITE 200 Gas heat pump
City/State/ZIP: PORTLAND, OR 97223 Wall/suspended/unit heater
Water heater (
Phone: (503) 639 Fax: : (503) 624
Fireplace I
E DAVIDJ@JTROTHINC.COM Range I
44 -7,7 '''''':*= ", , ,',',' ; , '-7.t . '.;' '."','" " '4<' . '5 ','',. "..• ,!''' •. '•'.' i' . ' w .:' ' ', • 't ''', , I , •'': - :'-': '.. Barbecue
• i• s. ,„ . ..'' , .:41 "'•,4s,.. ' -.7.7 ''c(ripiAcTq#:.0 ;7. 7 ' "': , .:••7.e:"‘ 1 •'„,f , ' ' ''' .
' : '
Clothes dryer (gas)
Business name: THERMAL FLO, INC. Other:
Address: 7236 SW DURHAM ROAD #100 q '' 0 -::',:', ,'-'...:''.,MECHANICAL.PERIVIITEEES!"
City/State/ZIP: TIGARD, OR 97224 Subtotal
Minimum permit fee ($72.50)
Phone: (503) 670 _ Fax: (503)..670,9864 Plan of permit fee)
CCB lie.: 151847 v2Z State surchargepermit fee) il GPI
TOTAL PERMIT FEE 10e .
# This permit application expires if a permit is not obtained within 180
Authorized signature: , „ii , / . j io days after it has been accepted as complete.
9
. IN ■..--, ■ - * Fee methodology set by Tri-County Building Industry Service Board
Print nam f V ino , Date: Ay -,
I: \ BuildineennitAMEC-PermitApp.doc - 64/06/06 441 • .17T (11/02/COM/WEB)
Pluhbi ®g Permit Application
`Building Fixtures FOR OFFICE USE ONLY
•
City of Tigard Date/By: Permit No y n*ve2 q ( JQz)3
_ e 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review `
111
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
T 1 G t\ R D Inspection Line: 503.639.4175 Date Ready/By Juris• J See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK - - FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
El Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
. - CATEGORY OF CONSTRUCTION . SFR (I) bath 249.20
® 1- and 2- family dwelling El Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 1 399.00 399.00
❑ Master builder ❑Other: Each additional bath/kitchen 45.00 1
Fire sprinkler (_ sq. ft.) Page 2
.JOB - SITE INFORMATION AND LOCATION Site utilities
Job site address: 8165 SW Langtree Catch basin or area drain 16.60
City /State /ZIP: Tigard Ore. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Hall Blvd. and Langtree St.
Manholes 16:60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Gage Forest I Lot no.: 19 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Plumbing for new single family residence Backwater valve 16.60
Clothes washer 16.60
Dishwasher - 16.60
• ® PROPERTY OWNER I TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: J :l'. Roth Const. Inc. Expansion tank 16.60
Address: 12600 SW 72nd Fixture /sewer cap 16.60
City/State /ZIP: Tigard Ore. 97223 Floor drain/floor sink/hub 16.60
Phone: (503)639 -2639 Fax: (503)624 -0239 Garbage disposal 16.60
® APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: J.T. Roth Const. Inc.
Interceptor /grease trap 16.60
Contact name: David Jensen Medical gas (value: $ ) Page 2
Address: 12600 SW 72 nd Primer 16.60
City /State /ZIP: Tigard Ore. 97223 Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (503) 806 -0602 I Fax: : (503) 624 -0239
Tub /shower /shower pan 16.60
E -mail: davidj @jtrothinc.com Urinal 16.60
CONTRACTOR - Water closet 16.60
Business name: Malmedal Enterprises Inc. Water heater 16.60
Address: PO Box 207 Other:
City /State /ZIP: Banks Ore. 97106 Subtotal �,co
Minimum permit fee: $72.50
Phone: (503) 324- Fax: (503) 310 -9795 Residential backflow minimum permit fee: $36.25
IV/Ca
CCB Lic.: 102535 Plumbing Lic. no.: 34 -276, QK) Plan review (25% of permit fee)
State surcharge (12% of permi
Authorized signature: t "fee) 4 7 E.6 - TOTAL PERMIT FEE4y .
Print name: /1
4 rS A,1 E!/i?L Date:/Va, 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 \Permits\PLMF- PermitApp.ddc 12/27/06 440- 4616T(t0 /02/COM/WEB)
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Oregon Residential Specialty Code N1107.2
HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: r Jurisdiction: -f p
Site Address:
Subdivision/Lot #: Z/07-/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: � ���� `� Date:
`wner /Genera' o - act • uthorized Agent
Print Name: 47e,r-f, C/ -��i�,
f
1 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.
I: \Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08
� F/7
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
1V , am the general contractor or the owner- builder
at the following address:
Site Address:
City: 4 /4 ./'
Permit #:
Subdivision/Lot #: / l;/ -S r //
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:
General Contractor ar Owner - Builder
Af/R5e/ii A9t /„22 /179.701,46 eayti?&
I: \Buildin Form \RES- MoistureSensitiveWood.doc 09/25/08
./14 5ir70 - 0 7 7j' C.
-4_
STREET TREE CERTIFICATION
I, /V7 L� ;2 - '4/, Owner /A / i ��j' C�v1/ �� Owner/Agent for � g
(PLEASE PRINT) (PERMIT HOLDER)
Do hereby certify that the following location meets
City of Tigard land use and development standards
for street tree installation.
ADDRESS:
SUBDIVISION: � _ gyp_' LOT: 17
SIGNATURE: DATE: 7%7
(1 ER /AGENT)
RECEIVED BY: DATE:
(CITY OF TIGARD)
1: \Building \ Forms \StrectTrecCertificate 01/19/07
•
41 4,1;
MARK STEWART
HOME DESIGN
8137 S.W. SENECA
Cl) Tualatin. Oregon 97062
J ( (503) 885.8377 P
(503) 579.4132 F
5 ® www.marketewart.com
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�� •' 1 1 � IdI :II�IIIIII�III� AI T. I Stock Home Plans
tote _ �/� / Custom Design
` 1 • .� ,�. ; Builder Marketing
C'Zx n. ''-7",... ss --I 11111 Q Q 1 Interior Design
`� ,, d .• • " , r —T -- 0 -- �� - -�•— 8� . J� -------- - -�• -- �p 0 Since 1982
I / � , !(1 / I '
- _ . Ir w.. -. r ..
1,7a,: ° r.e. :I I =
m
Important 01,01011W.
Roam Rank
Under ir y
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- ner .. da Y
�M.is om
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Vt. ..•= W Yw �.... .
1 s M Ni
NYev. Y tr N.t.Y
OslYSlr Y.. ,
amlind r.i �.r�r C.I.. S.
LOT #19 4A-CL-VIS. GAGE E FOEST =BERLAND HOMEY
v J.T. ROTH CON9T7tUG970N
TOUCHSTONE TOWNHOUSES
SCALE: 1" - III -,a" �,.. 110 ;.
,A 22. 2009
in
� ' Pm N. SITE
,
•
.
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.:
r
CITY OF TIGARD - SITE PLAN REVIEW
PLANNING DIVISION:
R 12-
BUILDING PERMIT NO:
Required Setbacks. Er Approved 0 Not Approved '
fv"tc-.72-cnc". cx).02.
Aire XgOld Side ..... Street Sid _ 14 '
IA App Approved roved TIVN
Street Trees:
• Not Approved Fran' iS
G.: ra
Protected Tree
151 ..' • ---
: 0
Date: ak 0 ' Vial& Cf ile.c.-,.. . ,/ - Arrnved 0 -;-,.ot t-oproved
! B
a A
Notes:
ri, i ' ?WS Service Prol..;-' .. ,_ i,.,i I::ulred: n Yes 0 No
.., d
C.,11r /17 0 _ f t , r.
1,_, , i R, eL, ed
, [Jc.,471:, .
ENGINEERING DEPARTMENT:
Actual Slope:.+_% rij Approved 0 Not Approved
Site PI : g Approved 0 No Approved
B : A_ Date: 2 - 4 6?
N otes: a rax......- ee......,
. :
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