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Permit a CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit #: MST2009-00008 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171 Date Issued: 03/24/2009 Parcel: 2S104BB13000 Jurisdiction: TIG Site address: 14146 SW WALNUT CREEK WAY Subdivision: Lot: Project: WALNUT CREEK SUBDIVISION Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories 2 Bedrooms 3 First 843 sf Basement sf Left 4 Parking Spaces Height 24 Bathrooms 3 Second 1 12 4 sf Garage 395 sf Front 15 Smoke Dwelling Units 1 Third sf Right 4 Detectors Yes Total sf Value $0 00 Rear. 15 PLUMBING Sinks. 1 Water Closets 3 Washing Mach 1 Laundry Trays Rain Drain 100 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 1 Gas Outlets 4 Furn > =100K 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 add9 500 sf 3 20 1 -400 amp' 201 -400 amp 1st W/O Svc/Fdr Limited Energy' 401 -600 amp' 401 -600 amp Ea addl Br Or 601 -1000 amp' 601 +amp -1000v 1000 +amp /volt. ELECTRICAL - RESTRICTED ENERGY SF Residential Audio 8 Stereo HVAC Security Alarm Vaccuum System Garage Opener All Other N Other Description Ecompasing BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) MATRIX DEVELOPMENT DBA MATRIX DEVELOPMENT CORPORATION LEGEND HOMES 12755 SW 69TH AVE #100 12755 SW 69TH AVENUE SUITE 100 TIGARD, OR 97224 PHONE 503 - 620 -8080 PHONE 503 - 620 -8080 FAX 503 -598 -8900 Total Fees: $10,555 55 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 rf work is suspended for more the 180 d- NTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952 -00 -0010 through 0 • ' +0 0100 You may obtain a copy of the rules or direct questions to OUNC by - ling 503 246 6699 or 1 800 332.2344 Issue. By: _ , �- ' ►�JLL�'�L _ Permittee Signatu _.' • % VVi / Jiw /t��_) CITY OF TIGARD X1,5 i - Z,Ob6) - coo o g BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171NauN�piq�l��l Inspection Requests (24 Hrs.): (503) 639 -4175 =�� INSPECTION WORKSHEET FOR DATE: 4/ jj /o i TIME: PAGE: SITE ADDRESS: 1 4 �l \, 1 i , i - t' CLASS OF WORK: SUBDIVISION: 1 `I (O �f I'% �" LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: 5 J _-2,0q - X25'.0 PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: / 1'Q 0 Code # Inspection Description onfirm # Contact # Message . VC 6 (Ate—Je (C J'‘ / le Corrections /Comments /Instructions. J.J _i ,,, Lir lr,,.,_,,,,,,,,i A PASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: &nr g1/64 Date: 6 — Phone #: (503) 718- Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: Site Address: L Z /�2 Subdivision/Lot #: it ) G � �. / /��� " ! and/or L - 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) i / Signature: _ Date: ��7 `7�CliiJ . Owner/General ' ontracto /Au nthoz .T Agent Print Name: 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 \ 1- STREET TREE CERTIFICATION 0 k I, _ � 1�� / , Owner /Agent for 7 / 7ei/% 5 (PLEASE PRINT) C HOLDER) Do hereby certify that the following location meets City of Tigard land use and development standards for street tree installation. ADDRESS: //4 6 kj W1��� 1 /t, f`"l\ 9.- SUBDIVISION: (jtC `;y%[z/L � �� LOT: 4/7 SIGNATURE: f:17_1(_,c,,-, ' /i� _ / DATE: j/7 7z-r WATER AGENT) RECEIVED BY: DATE: (CTTY OF 77GARD) 1:\ Budding \ Forms \Streetl'rceCertifieate 01/19/07 Building Permit Application Residential RECEIVED . FOR OFFICE USE ONLY City of Tigard Rec eived an 28.09 _� . Permit No rna -�� Q - woo ._ . � v ` ° 13125 SW Hall Blvd., Tigard, OR 97223 JAN 2 8 2009 P lan Date R /By eview" Phone: 503.639 4171 Fax: 503 598.1960 Date/B z 0 Z I Other Permit its (�,2o04 -OQ 64 Inspection Line: 503.639 D ate Ready B q Suns ® See Page 2 for T I GA RD Internet: www.tigard -or gov OF �G " -- A � Not' d / Method of ��j f) �,. T ` Supplemental Information BUILDING DIVISION E (` TYPE OF WORK REQ IRED 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 ❑ Addition/alteration/replacement ❑ Other: dollar) of all equipment, materials, labor, overhead, and CATEGORY OF CONSTRUCTION the profit for the work i scated on this application. Valuation: ' ' Z d scent 4 4-7 ® 1- and 2- family dwelling 1:1 Commercial /industrial —'?" ❑ Accessory building ❑ Multi - family Number of bedrooms 3 ® Master builder ❑ Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: 14146 Sw Walnut Creek Way New dwelling area: 1,967 square feet City /State /ZIP: Tigard, OR 97223 Garage /carport area: 395 square feet Suite/bldg. /apt. no.: Project name: Walnut Creek Covered porch area: square feet Cross street/directions to job site: Barrows & Walnut Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Walnut Creek Lot no.: 047 � Permit fees* are based on the value of the work Tax map /parcel no.: 2S104BB13000 performed Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and DESCRIPTION OF WORK the profit for the work indicated on this application. Valuation: S Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Matrix Development dba Legend Homes Type of construction: Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups: City /State /ZIP: Portland, OR 97223 Existing: Phone: (503) 620 -8080 Fax: (503) 598 -8900 New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: Matrix Development dba Legend Homes All contractors and subcontractors are required to be Contact name: Steve Lucas �� licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 12755 SW 69 Avenue, Suite #100 jurisdiction in which work is being performed. If the City /State /ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons apply: Phone: (503) 620 -8080 Fax: : (503) 598-8900 E -mail: slucas @legendhomes.com CONTRACTOR Business name: Matrix Development dba Legend Homes BUILDING PERMIT FEES* Address: 12755 SW 69' Avenue, Suite #100 (Please refer lofee schedule) Structural plan review fee (or deposit): City /State /ZIP: Portland, OR 97223 Phone: (503) 620 -8080 Fax: (503) 598 -8900 FLS plan review fee (if applicable): CCB Sic.: 55151 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: Steve Lucas Date: 1/29/2009 * Fee methodology set by Tri- County Building Industry Service Board. Hsraov9 -dam 3 Electrical Permit Application FOR OFFICE USE ONLY RECEIVE City of Tigard • +/ , Date/By Permit No III - v 13125 SW Hall Blvd., Tigard, OR 97223 y g Plan Review Other Permit Phone. 503 639 4171 Fax: 503.598.1960 JAN 2 8 2009 Date/By TI GARD Inspection Line: 503.639 4175 Date Ready /By lures ® See Page 2 for Internet: www tigard- or.gov Notified/Method Supplemental Information CITY OF TIGARD TYPE OF WB4SILDING DIVISION PLAN REVIEW ® New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings 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. ❑ Multi - family E Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system A ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "I -3 ", 100HP or more occupancy Job no.: Job site address: 14146 Sw Walnut Creek Way ❑ Six or more residential units ❑ Recreational vehicle parks City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal Suite /bldg. /apt. no.: Project name: Walnut Creek ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: Barrows & Walnut Description I Qty. I Fee. I Total New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Walnut Creek Lot no.:047 1,000 sq ft or less 1 145 15 145 15 4 Ea. add'I 500 sq ft or portion � �., 33 40 - 66.84+ 1 Tax map /parcel no.: 2S104BB13000 1CO = 26 Limited energy, residential 1 75 00 75.00 2 DESCRIPTION OF WORK (with above sq ft ) Limited energy, multi - family 75.00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80 30 2 ® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: Matrix Development dba Legend Homes 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240 60 2 Address: 12755 SW 69 Avenue, Suite #100 Over 1,000 amps or volts 454 65 2 City /State /ZIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and /or relocation Phone: (503)620 -8080 Fax: (503)598 -8900 200 amps or less 66 85 I Owner installation: This installation is being made on property that I own which is 201 amps to 400 amps 100.30 2 not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 401 amps to 599 amps 133.75 2 701. Branch circuits— new, alteration, or extension, Lrer panel A Fee for branch circuits with Owner signature: Date: above service or feeder fee, ® APPLICANT I ❑ CONTACT PERSON each branch circuit 6 65 2 B. Fee for branch circuits Business name: Matrix Development dba Legend Homes without service or feeder fee, 46 85 2 first branch circuit Contact name: Steve Lucas Each add'I branch circuit 6.65 2 Address: 12755 SW 69 Avenue, Suite #100 Miscellaneous (service or feeder not included) Each manufactured or modular 90 90 2 City/State /ZIP: Portland, OR 97223 dwelling, service and /or feeder Reconnect only 66 85 2 Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Pump or irrigation circle 53.40 2 E -mail: slucas @legendhomes.com Sign or outline lighting 53 40 2 CONTRACTOR Signal circutt(s) or limited - Business name: Garner Electric energy panel, alteration, or Page 2 2 extension Describe. Address: 2920 SE Brookwood Avenue #A Each additional inspection over allowable in any of the above Per inspection 62 50 City /State /ZIP: Hillsboro, OR 97123 Investigation per hour (I hr mm) 62 50 Phone: (503) 648 -4552 Fax: (503) 642 -7925 Industrial plant per hour 73 75 ELECTRICAL PERMIT FEES CCB Lic.: 121159 Electrical -305C Suprv. Lic.: 3707 -S Subtotal $286,96 24.5 Suprv. Electrician signature, requir Plan review (25% of permit fee) $71.74 • State surcharge (12% of permit fee) S3d-4,3' 1, i 4' Print name: Chuck Garner / /l' .. a - 29/2009 TOTAL PERMIT FEE. g39971 Authorized signature: This permit application expires if a permit is not obtained within 180 g days after it has been accepted as complete. " Number of inspections allowed per permit Print name: Date: COW vo 7 7 .5 ' izz ei 84,06 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: rRESI•DENTIAL VORK:ONLY:-',', , ?, .i' Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ® Audio and Stereo Systems* ® Burglar Alarm ® Garage Door Opener* ® Heating, Ventilation and Air Conditioning System* • Vacuum Systems* ❑ Other: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are.required. Licenses are required for all other installations A4 S i acral — avzro 8' Mechanical Permit Application ��) ��j FOR OFFICE USE ONLY City of Tigard RECEH . ED Received li . Date/By Permit No a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 JAN 2 8 2009 Date/By Other Permit T I GA RD Inspection Line: 503 4175 .�.�� p��y Date Ready/By him El See Page 2 for Internet. www tigard- or.gov � OF IGAlIL Notified/Method. Supplemental Information TYPE OF WO SING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ® New construction ❑ Addition /alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit CATEGORY OF CONSTRUCTION Value $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist ❑ Multi- family ® Master builder ❑ Other: Description Qty I Ea I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 14146 Sw Walnut Creek Way Air conditioning or heat pump (requires site plan showing placement) 14 00 City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 1 14 00 14.00 Suite/bldg. /apt. no.: Project name: Walnut Creek Furnace 100,000+ BTU (ducts /vents) 17 90 Gas heat pump 14 00 Cross street/directions to job site: Barrows & Walnut Duct work 10 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 14 00 Subdivision: Walnut Creek Lot no.: 047 Flue /vent for any of above I 6.80 6 80 Other: 10 00 Tax map /parcel no.: 2S104BB13000 Other fuel appliances DESCRIPTION OF WORK Water heater 1 10 00 10 00 Gas fireplace 1 moo woo Flue vent for water heater or gas fireplace 2 10.00 20.00 Log lighter (gas) 10 00 Wood/pellet stove 10 00 Wood fireplace /insert 10 00 ® PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 10 00 Other. 10.00 Name: Matrix Development dba Legend Homes Environmental exhaust and ventilation Address: 12755 SW 69 Avenue, Suite #100 Range hood/other kitchen equipment I 10.00 10.00 City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust I 10 00 10 00 Single -duct exhaust (bathrooms, Phone: (503)620 -8080 Fax: (503)589 -8900 toilet compartments, utility rooms) 5 6 80 34 00 ® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans , 10 00 Other. 10 00 Business name: Matrix Development dba Legend Homes Fuel piping Contact name: Steve Lucas $5.40 for first four; $1.00 for each additional Address: 12755 SW 69 Avenue, Suite #100 Furnace, etc. 1 Gas heat pump City /State /ZIP: Portland, OR 97223 Wall /suspended/unit heater Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Water heater 1 Fireplace 1 E -mail: slucas @legendhomes.com Range 1 5 40 CONTRACTOR Barbecue Business name: Tri County Temp Control Clothes dryer (gas) Other Address: 13150 Clackamas River Drive MECHANICAL PERMIT FEES* City /State /ZIP: Oregon City, OR 97045 Subtotal $120 20 Minimum permit fee ($72 50) Phone: (503) 557 -2200 Fax: (503) 557 -0919 Plan review (25% of permit fee) -- 30.95 -- CCB lie.: 72623 State surcharge (12% of permit fee) M. , -- 3-6-1-- TOTAL PERMIT FEE $ 153 86 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.' 4 b'Z Print name: Steve Lucas Date: 1/29/2009 • Fee methodology set by Tn- County Building Industry Service Board Plumbing Permit Application /14s U7JrJe1 Building Fixtures RECEIVED FOR OFFICE USE ONLY ■ City of Tigard R eceived Permit No JAN 2 8 2009 Date/By 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone. 503 639.4171 Fax 503.598„). �Y , OF �G DateBy Other Permit No T 1 GARD Inspection Line: 503.639 4175 ��;;jj jj M Date Ready /By' funs ® See Page 2 for Internet: www tigard -or gov BUILDING DIVISION Notified/Method Supplemental Information TYPE OF WORK FEE* SCHEDULE ® New construction ❑ Demolition For special information use checklist Description Qty I Ea I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (Includes 100 ft for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 1�4 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350 00 ❑ Accessory building ❑ Multi - family SFR (3) bath l 399 00 399 00 Each additional bath/kitchen 45 00 ® Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 14146 Sw Walnut Creek Way 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.: Project name: Walnut Creek Footing drain (no linear ft. ) Page 2 Manufactured home utilities 110 00 Cross street/directions to job site: Barrows & Walnut Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) ( Page 2 Storm sewer (no linear ft.. ) 1 Page 2 Subdivision: Walnut Creek Lot no.: 047 Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: 2S104BB13000 Absorption valve 16 60 DESCRIPTION OF WORK Backflow preventer Page 2 Backwater valve 16 60 Clothes washer i 16 60 Dishwasher i 16 60 ® PROPERTY OWNER ❑ TENANT Drinking fountain 16 60 Ejectors /sump 16 60 Name: Matrix Development dba Legend Homes Expansion tank 16 60 Address: 12755 SW 69' Avenue, Suite #100 Fixture /sewer cap 16.60 City /State /ZIP: Portland, OR 97223 Floor drain/floor sink/hub 16.60 Phone: (503)620 -8080 Fax: (503)598 - 8900 Garbage disposal I 16 60 ® APPLICANT ❑ CONTACT PERSON Hose bib 2 16 60 Ice maker 1 16 60 Business name: Matrix Development dba Legend Homes Interceptor /grease trap 16 60 Contact name: Steve Lucas Medical gas (value $ ) Page 2 Address: 12755 SW 69' Avenue, Suite #100 Primer 16 60 City /State /ZIP: Portland, OR 97223 Roof drain (commercial) 16 60 Sink/basin/lavatory 1/0/11/4 5 16 60 Phone: (503) 620 -8080 Fax: : (503) 598-8900 Tub /shower /shower pan - 3 16 60 E -mail: slucas @legendhomes.com Urinal 16 60 CONTRACTOR Water closet 16 60 Business name: Wolcott Plumbing Water heater I 16 60 Address: 1075 W. Historic Columbia River Hwy Other. City /State /ZIP: Troutdale, OR 97060 Subtotal 399 00 Minimum permit fee: $72 50 Phone: (503) 667 -1781 Fax: (503) 667 -9891 Residential backflow minimum permit fee. $36 25 CCB Lie.: 112220 Plumbing Lic. no.: 26 -824PB Plan review (25% of permit fee) - 99 75 State surcharge (12% of permit fee) 47 88 Authorized signature: 4s. � ! TOTAL PERMIT FEE .6 6 43 U ura�Ct>cA Print name: Gloria Hawes Date: 1/29/2009 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4c *Fee methodology set by Tri- County Building Industry Service Board J ° Building Division One & Two - Family Dwelling TIGARD Fees Checklist PERMIT INFORMATION: (' n Permit #: _ - Plan #: Date: (, I Site Address: ( ' CO 0T C? P LK Parcel #: Subdivision: J- L 3t7(- C Lot #: 4,47 Zoning: Jurisdiction: Tl& Setbacks: Front: Rear: Left: Right: Class of Work: 000 Stories: First Floor:, pA r Type of Use: Height: 2 Second Floor: f I 2A Construction: Floor Load: G Third Floor: Occupancy Group: J Dwelling Units: Bonus Room: Valuation: Bedrooms: Total Floors: (9 W-1 d� Bathrooms: ` j Basement: Decks: Garage: u' Porches: 5 I Other: FEES: Description: Fee Amount: Amount Paid: Balance Due: Plan Check: Building: '2(, ( j 75U CC.) Extra Set: Permit: Building: ` Tax: Metro CET: School CET: G( c , Mechanical Tax: Plumbing: Tax: Electrical: Tax: Low Voltage: Tax: CDC: CDC Ping. Rev.: CDC LRP Fee: SDC: Parks: TIF Res.: TIF MT: Erosion Permit: Erosion CWS: Erosion COT: Water Quality: Water Quantity: SUB - TOTAL: Sewer: Permit: Inspection: SUB - TOTAL: TOTAL MST & SWR: I \Building \Forms \ResPlanCheckFces doc 01/19/07 Page 1 PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems) 4 1 Description I Qty. I Fee(ea.) I Total Description Qty I Fee(ea.) I Total New 1- & 2- family dwellings . Heating/Cooling (includes 100 ft. for each utility connection) Air conditioning or heat pump* 14.00 SFR (1) bath 249.20 Furnace 100,000 BTU (ducts /vents) 14 -00 SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts /vents) 17.90 SFR (3) bath 399.00 Gas heat pump 14.00 Each additional bath /kitchen 45.00 Duct work 10.00 Rain Drain, single family dwelling 65.25 Hydronic hot water system 14.00 Fire sprinkler - sq ft. 0 to 2,000 115.00 Residential boiler Fire sprinkler - sq. ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14 00 Fire sprinkler - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric) Fire sprinkler - sq. ft. 7,200 and greater 309.00 (in wall, in -duct, suspended, etc.) 14.00 . . Site Utilities Flue /vent (for any of above) 6.80 Catch basin/area drain 16.60 Repair units 12.15 Drywell /leach line /trench drain 16.60 Other Fuel Appliances Footing drain - P 100' 55.00 Water heater 10.00 Footing drain - each additional 100' 46.40 Gas fireplace 10.00 Manufactured home utilities 110.00 Flue vent (water heater /gas fireplace) 10.00 Manholes 16.60 Log lighter (gas) 10.00 Rain drain connector 16.60 Wood/Pellet stove 10.00 st Wood fireplace /insert 10.00 Sanitary sewer - 1 100' 55 00 Chimney /liner /flue /vent 10.00 Sanitary sewer - each additional 100' 46.40 Other: 10.00 Storm sewer - 1" 100' 55.00 Environmental Exhaust & Ventilation Storm sewer - each additional 100' 46.40 Range hood /other kitchen equipment 10.00 g eq P Water service 1 100' 55.00 Clothes dryer exhaust 10.00 Water service - each additional 100' 46.40 Fixture or Item Single duct exhaust Absorption valve 16.60 (bathrooms, toilet compartments, Backflow preventer 27.55 utility rooms) 6.80 Backwater valve 16.60 Attic /crawl space fans 10.00 Clothes washer 16.60 Other: 10 00 Fuel Piping Dishwasher 16.60 * *($5.40 for first 4, $1.00 each additional) Drinking fountain 16.60 Furnace, etc. ** Ejectors /sump 16 60 ** Wall/suspended/unit pump Expansion tank 16.60 Gas heat heater ** Fixture /sewer cap 16 60 Water heater ** Floor drain/floor sink/hub 16 60 Fireplace ** Garbage disposal 16.60 Range ** Hose bib 16.60 BBQ ** Ice maker 16 60 Clothes dryer (gas) ** Interceptor /grease trap 16.60 Other: ** Primer 16.60 Total: Roof drain (commercial) 16.60 Mechanical Permit Fees Sink/basin/lavatory 16.60 Subtotal: $ Tub /shower /shower pan 16.60 Minimum Permit Fee $72.50 $ Urinal 16.60 Plan Review Fee (25% of Permit Fee) $ Water closet 16.60 State Surcharge (12% of Permit Fee) $ Water heater 16.60 TOTAL PERMIT FEE $ Other: Other Plumbing Permit Fees ELECTRICAL FEES (residential single- or multi- family) Subtotal $ Description Qty. Fee Total Insp Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less 145.15 4 Plan Review (25% of Permit Fee) $ Ea. add'l 500 sq. ft. or portion 33.40 1 State Surcharge (12% of Permit Fee) $ Limited energy, residential 75.00 2 TOTAL PERMIT FEE $ Each manufactured or modular dwelling, service and/or feeder 90.90 2 Electrical Permit Fees - Subtotal: $ Plan review (25% of permit fee) $ State surcharge (12% of permit fee) $ TOTAL PERMIT FEE $ I - \ Building \ Forms \ResPlanCheckFees doc 01/19/07 Page 2 ti FIXTURE UNIT WORKSHEET - WATER METER Contractor Name Matrix Development dba Legend Homes Billing Address 12755 SW 69 Avenue #100, Portland, OR 97223 Address of New Meter 14146 Sw Walnut Creek Way Lot # 047 Subdivision Walnut Creek Please fill in the number of each fixture as detailed on the plans, then multiply quantity by the point value given to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total Bar Sink 0 X 1 = 0 Bidet 0 X 1 = 0 Closewasher 1 X 4 = 4 Dishwasher 1 X 1.5 = 1.5 Hose Bibb 1 X 2.5 = 2.5 Hose Bibb, ea. Adt'l 1 X 1 = 1 Kitchen Sink 1 X 1.5 = 1.5 , Laundry Sink 0 X 1.5 = 0.0 Lavatories 5 X 1 = 5 Water Closet, 1.6 gpf 3 X 2.5 = 7.5 Bathtub /Whirlpool 1 X 4 = 4 Shower Stalls 1 X 2 = 2 Bath/Shower Combo 1 X 4 = 4 Under 34 ='/4" Over 34 = 1" Total Fixture Points 33 Meter Size 3/4" Meter Cost ****************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** FOR OFFICE USE ONLY Fixture Count Verified with Plumbing Permit Meter # Receipt # Emp. Name 'PLOT PLAN v22,m9 As LOT *047 WALNUT CREEK C' r 14146 SW WALNUT CREEK WAY " NE :SECTION 4, T.25, R.1W, W.M. J b I•• 20'-0" CITY OF TIGARD +v�l ,, ::; , _ C , , � ' 8 . , - -�' WASH INC=TON COUNTY, ORECxON _ BU � FC C + _. _ LEGEND G D C • ___W" 111111 18766 SB 691h cos. OFFI8 6 (03) 93o -6080 � 0 ,•.. u BORE 100 FAX (603) 699 -9900 4 PORTLND. 08. 97223 CCB/ 65181 - ' • . ' SW WALNUT CREEK;W4 ' ID , 234 1 e�r -, . 234 STREET TREE.: : _ 74 a • • r k I , r CHANTICLEER PEAR I �_. DE WALK 2" Caliper //"/' 0 0 1 ` .. • 236.0 . \ • . 0 i ' 1 8 PUE -- 7 - \4- - ---4— T" — : — \ , — - - -- �� I s tifl 1 � I' ' 236.8 . • a 6 6.00' 5.99' I . ' 7- 235.2' / � / I �� �� 1 1 231.2 /� I W 1 / , l LOT LOT �- 7 ,,i_ 46 48 'Ar , 3 ,369QFT' j \ 235 a r WILLOW V I °° 238 z 1 FR ••238.5 01 \ 1 Foe. •231.0'/ , Z W — \I SANITARY SEWER ' I 5.94 \ / \ 1 STORM DRAIN ■ 4' I \ o EROSION FENCE N 231.8 236' / \ L — cE OF STREET s \ \ _ e 10 WATER METER 239 --1. _ — 1 236 I — 231 O MANHOLE 240 1 —' — — — — 1 — 238 ® CATCH BASIN 241 68 13'26 "E 43.00' _ -239 � 5 88 19'26" E" E 53.50'• • ' - 240 ( PROPOSED •• STREET TREES ' LOT 39'' . .. .. ES STREET LIGHT N FIRE HYDRANT y,• . ( 4 PROVIDE EROSION r _ ._ ._- .... _...,. .. _ _.._., - ` • CONTROL FENCE "r PER COMMUNITY EROSION PLAN SETBACKS : FRONT YARD • 15 FEET GARAGE • 20 FEET REAR YARD • 15 FEET SIDE YARD • 4 FEET STREET SIDE YARD • 10 FEET CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: AA • i' • •' ftga o PLANNING DIVISION: ' /''• roved ❑Not Approved Required Setbacks: Y� "APP Side: 4 Street Side: i0 ,- Rear: Z...___ Front. G age: Not Approved Visual Clearance: [ Appr ved ❑ pP , .-o-, Maximum Building Hei feet Yes ❑ No IL' CWS Service Provider Letter Required: 0 Received B a -I - Date: Vg-00 ENGINEERIN DEPARTMENT: Actual ' ope: % Approved ❑ Not Approved -A roved Site PI , , : Approved 0 • • of • , proved Date: a p Y • Notes: qe ri kw`"" CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: Irytgr2s,a4. Og9nyci Street Trees: Approvi d ❑ Not Approved Protected rees: �T T BY ' O 1 (?0/p • Notes: