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Permit 1 F CITY OF TIGARD MASTER PERMIT 11 : COMMUNITY DEVELOPMENT Permit #: MST2010 00077 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01118!2011 Parcel: 2S 104BB 13600 Jurisdiction: Tigard Site address: 14242 SW WALNUT CREEK CT Subdivision: WALNUT CREEK Lot: 53 Project: Walnut Creek Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 3 First: 942 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 27 Bathrooms: 3 Second: 1262 sf Garage: 435 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 2204 sf Value: $233,680.45 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 TubslShowers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add 500 sf: 4 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2204 Owner: Contractor: MATRIX DEVELOPMENT CORP LEGEND HOMES Required Items and Reports (Conditions) 12755 SW 69TH AVE #100 12755 SW 69TH AVE #100 1 Ersn Cntrl 503 - 681 - 4444 TIGARD, OR 97223 TIGARD, OR 97224 PHONE: 503 - 620 -8080 PHONE: 503 - 620 -8080 FAX: 503 - 598 -8900 Total Fees: $15,068.55 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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 0 952- 001 -0090. You ma obtain a copy oft - - • .'rect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. // i s / J lir Issued B —0 - �� 4 - Permittee Signature: � Ca 5• 75 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. , . �-, AR'' a, /0 0 — y Bl'ldim Permit Application ` ,, // 1' Residential RECE OFFICE USE ONLY City Of Tigard Date/By: Received I D P ermit No.: A / • III 13125 SW Hall Blvd., Tigard, OR f t4 2010 y S 4 7y% a0 /O OdD77 ° Pl an R eview Phone: 503.639.4171 Fax: 503. ' :. 960 • Date /By: ( ( ► / • , `4 0 Other Permit: atu / D s" -- T •IGA•D Inspection Line: 503.639.4175 Date Read /B J/ kills is: 0 See Pa _ e 2 for Internet: www,tigard- or.gov CITY OF TIGARD Notified Method: l9 t' l 1 ' d �� c'ementat -I '''? Nil! f1ING DIVISION . S pact. d � '�-' l�l�1.;7 :: .. , ,, , ,,- , TYPE OF, WORK REQUIRED DA : i • _ • ® 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 ` n '' CATEGORY`QF `CONSTRUCTION `' _ ., the profit for the work indicated on this application. ® 1 -and 2- family dwelling ❑ Commercial /industrial Valuation.2 ,, O 0-2,2c5413.8L. ID Accessory building ❑ Multi- family Number of bedrooms: 3 ® Master builder ❑ Other: Number of bathrooms: 3 ' JOB SITE INFORMATION AND t OCATION Total number of floors: 2 Job site address: 14242 S.W. Walnut Creek Court New dwelling area: 2,204 square feet City /State /ZIP: Tigard, OR 97223 Garage /carport area: 435 square feet Suite /bldg. /apt. no.: Project name: Walnut Creek Covered porch area: 2 square feet W442 2. Cross street/directions to job site: Barrows & Walnut Deck area: 7, square feet 140 1 Other structure area: square feet 27 • ) REQUIRED°DATA: COMMERCIAL- USE'CHEGKLIST Subdivision: Walnut Creek of no.: 053 Permit fees* are based on the value of the work Tax map /parcel no.: 2S104BB 13600 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: $ Existing building area: square feet New building area: square feet . ® PROPERTY OWNER .❑ TENANT o " Number of stories: Name: 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 . NOTICE Business name: Legend Homes All contractors and subcontractors are required to be If' 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 /I D � T-./- 1 QA� (OD !t t ��- l/ E -mail: slucas@legendhomes.com MO C °O, -rr .I1 & f CONTRACTOR , r w l �� �C V Business name;,Lag end - Homes_,, / -4.6 j/EC -0 - 7° •1/T "BUILDING PERMIT. FEES* Address: 12755 SW 69' Avenue, Suite #100 �� End (Please fee schedule ) Structural plan review fee (or deposit): City /State /ZIP: Portland, OR 97223 FLS ( ` Ian review fee (if applicable): Phone: (503) 620 -8080 y a a Fax: (503) 598 -8900 P CCB lie.: 55151 Total fees due upon application: od Amount received: #7,Z 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: 4/30/2010 * Fee methodology set by Tri- County Building Industry Service Board. E+ Ir�ctria,,i1 Permit Application FOR OFFICE USE ONLY . . City of Tigard Ell E 1 ie h Permit aid, OR 97223 w g at J '7 i f9 /G- 7 g � D w P 1- 13125 SW Hall Blvd., Ti Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit: 2 c9cto....61f06.1 TIGARD Inspection Line: 503.639.4175 MAY • - 4 201 Date Ready /By: Juris: 10 See Page 2 for Internet: www.tigard or.gov Notified /Method: Supplemental Information TYPE OF WORK CI I Y OF TIGARD'' '' - r ' , PLAN REVIEW ' '. • . . , . New construction A ddition /alterati MA I- Please check all that apply (submit 2 sets of plans w /items checked below): ® ❑ '• I ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. - exceeds 10,000 amps at 150 volts or Floating buildings. ;� ,, CATEGORY OF CONSTRUCTION •, , p g 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 ® Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. o . JOB. SITE INFORMATION AND LOCATION 1 ❑ Addition of new motor load of ❑ "A ", "E ", "I 2 ", "1 -3 ", Job no.: Job site address: 14242 S.W. Walnut Creek Court 100HP or more. occupancy. ❑ 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 SC HED,ULE . Cross street/directions to job site: Barrows & Walnut Descr 1 Qty. 1 Fee. 1 Total 1 * New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Walnut Creek Lot no.:053 1,000 sq. ft. or less 1 L _I(„8-- 4 Ea. add'I 500 sq. ft. or portion 4 — 73,92 ',35,us 1 Tax map /parcel no.: 2S104BB 13600 Limited energy, residential 1 /t°� ?eA 2 .. DESCRIPTION OF WORK'a: - a 'ar (with above sq. ft.) (CJ e�k- 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: 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, per panel A. Fee for branch circuits with Owner signature: Date: above service or feeder fee, '® APPLICANT'' , ` ❑ CONTACT. PERSON �.. '' each branch circuit 6 .65 2 B. Fee for branch circuits Business name: Legend Homes without service or feeder fee, 46.85 2 first branch circuit Contact name: Steve Lucas Each add'l 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 circuit(s) or limited - energy panel, alteration, or Business name: Garner Electric Page 2 2 extension. Describe: Address: 2920 SE Brookwood Avenue #A Each additional inspection over allowable in any of the above City /State /ZIP: Hillsboro, OR 97123 Per inspection 62.50 Investigation per hour (1 hr min) 62.50 Phone: (503) 648 -4552 Fax: (503) 642 -7925 Industrial plant per hour 73.75 CCB Lic.: 12115 Electrical 1 ' • 1 . -30 C. 1 Suprv. Lic.: 3707 -S ; ELECTRICAL PERMIT FEES I b �I - —7/i I /' Subtotal: `3 'Z - Qk - Suprv. Electrici h si requir-.J: l �l t I D Plan review (25% of permit fee): /> ` p/ ✓ ' State surcharge (12% fee): 44 �� Print name: Chuck Garner ' If pr -'. !- - 0/2010 t � ' I TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: r Number of inspections allowed per permit. • J Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: 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: COMMERCIAL WORK,ONLY: • ,r Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ 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 . Mechanical Permit Application FOR OFFICE USE ONLY City W Tigard Hall Blvd., Tigard, I ECFVE eceived , n_ ' 13125 SW ard, OR 97223 J� Z / Permit No.: H6r9 vo 7 7 ' Phone: 503.639.4171 Fax: 503.598.1960 Illate/By:iew /� a Date /By: Other Pennitd`rwI/ 04/b_ G"' O TIGARD Inspection Line: 503.639.4175 MAY 4 2010 Date Ready /By: Juris: 0 See Page 2 for rl/ J Internet: www.tigard or.goV Notified /Method: Supplemental Information TYPE,, OF WORT{ (tTY OF T GARD ;COMMERCIAL",FEE* SCHEDULE – USE CHECKLIST ® New construction ❑ Addition /alteration/240lMo DIVISION 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: $ ® 1 - and 2 ' dwellin E , ' RESIDENTIAL EQUIPMENT / SYSTEMS FEES* y g Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi family ® Master builder ❑ Other: Description Qty. Ea. Total . 'JOB' OB' INFORMATION AND LOCATION' . • -l• Heating /cooling Job site address: 14242 S.W. Walnut Creek Court Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) ( 46 44 o 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.: 053 Flue(vent for any of above i.80 Other: 1 10.00 Tax map /parcel no.: 2S104BB 13600 • Other fuel appliances , n '' DESCRIPTION, OF WORK - ; " Water heater ( _ 73:32 Gas fireplace I _ ` 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 ® PROPERTY 'OWNER . .1=1, TENANT.; d Chimney/liner/flue/vent 10.00 Other: 10.00 Name: Legend Homes Environmental exhaust and ventilation Address: 12755 SW 69 Avenue, Suite #100 Range hood /other kitchen equipment 1•�� City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust 1 33• Single -duct exhaust (bathrooms, I Phone: (503)620 -8080 Fax: (503)589 -8900 toilet compartments, utility rooms) 5 2.3:&2 (I. LU ® .APPLICANT.. ❑ CONTACT :PERSON __ , , ' Attic /crawlspace fans 10.00 Other: 10.00 Business name: Legend Homes Fuel pinino Contact name: Steve Lucas Address: 12755 SW 69 Avenue, Suite #100 Furnace, etc. 1 A.)6 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 • g — ' � ' ' CONTRACTOR' . . e au ., : ` e Barbecue Business name: Tri County Temp Control Clothe Other dryer (gas) Address: 13150 Clackamas River Drive .MECHANICAL PERMIT FEES'* - City /State /ZIP: Oregon City, OR 97045 Subtotal ' _ -9 Minimum permit fee ($72.50) Phone: (503) 557 -2200 Fax: (503) 557 -0919 • Plan review (25% of permit fee) CCB lic.: 72623 - 11" State surcharge (12% of permit fee) 1.D,1 z // •`^ TOTAL PERMIT FEE 3 67. t Z Authorized signature: i!' This permit application expires if a permit is not obtained within 1 8U days after it has been accepted as complete. Print name: Steve Lucas Date: 4/30/2010 * Fee methodology set by Tri -County Building Industry Service Board 1 • Plumbing Permit Application Building Fixtures L L . V U FOR OFFICE USE ONLY Er City Of Tigard , � M A� _ Received Permit No.: J ' 13125 SW Hall Blvd., Tigard, OR 97223 MA 4 2011 Date /By: �j f/ 2.10 +' (T U /� .� Date/By: Review Other Permit No.: , �- Phone: 503.639.4171 Fax: 503.598.1960 CITY ®F TIGAR �� y Q �,� _��, TIGARD Inspection Line: 503.639.4175 _ ,�•� e ^ 't Date Ready /By: Juris: El See Page 2 for • Internet: www.tigard- or.gov ItC'IP lilotified /Method: Supplemental Information TYP ,O,F WORK , FEE SCHEDULE ® New construction ❑ Demolition For special information use checklist. Description 1 Qty. Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2- family dwellings (includes 100 ft. for each utility connection) CAT OF CONSTRUCTION . SFR (I) bath 249.20 ® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building I=1 Multi-family SFR (3) bath 1 j, j� 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: 14242 S.W. Walnut Creek Court 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.: _) Page 2 Subdivision: Walnut Creek Lot no.: 053 Water service (no. linear ft.: _) Page 2 Fixture or item Tax map /parcel no.: 2S104BB 13600 Absorption valve 16.60 „DESCRIPTION OF WORK Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 ® PROPERTY' OWNER .: , . ,❑ TENANT , Ejectors /sump 16.60 Name: 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 16.60 Hose bib 16.60 '' ®..APPLICANT ❑ CONTACT PERSON Ice maker 16.60 Business name: 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 Phone: (503) 620 - 8080 Fax: : (503) 598 - 8900 Sink /basin/lavatory 16.60 Tub /shower /shower pan 16.60 E - mail: slucas @Iegendhomes.com Urinal 16.60 = C ONTRACTOR Water closet 16.60 Business name: Wolcott Plumbing Water heater 16.60 Address: 1075 W. Historic Columbia River Hwy Other City /State /ZIP: Troutdale, OR 97060 Subtotal �7Lt Minimum permit fee: $72.50 Phone: (503) 667 - 1781 Fax: (503) 667 - 9891 Residential backflow minimum permit fee: $36.25 CCB Lic.: 112220 Plumbing Lic. no.: 26 Plan review (25% of permit fee) G ~1 t State surcharge (12% of permit fee) , Authorized signature: A / I I) TOTAL PERMIT FEE 74:0, l(r,_) Print name: Gloria Hawes Date: 4/30/2010 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. ill Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site, Utilities Qty.. Fee,(ea) Total Square Footage:; Permit Fee: Footing drain - I 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: • Water Service - each additional 100' 46.40 Storm &Rain Drain - 1st 100' 55.00 "'Va1uation: 'Permit'Fee: . $1.00 to $5,000.00 Minimum fee $72.50 . Storm &.Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Qt :Fee, (ea)' Total additional $100.00 or fraction thereof, to and FIXture Or ;I telTl' "� including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Commercial Fixture Work: ° 'Plan Review for Plumling,Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees*. Any new commercial building with water service 2" and Quantity by:(Fixture) Work;Performed greater, except systems designed and stamped by licensed Fixture„Type:' ` „ ' Replace engineer. Previous Capped Added Existing '• ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash - Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Riser O Isometric Drinking Fountain Eye Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. -4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: PI O'T PLAN! , . //rya z a // 4/29/10 ''-- LOT 4 S3 WALNUT CREEK 14242 SW WALNUT CREEK COURT IlECFIVED _ . ,..„:..,,..=....,,...,-,. NE 1/4 SECTION 4, T. 25, R. 1W, W.M. MAY - 4 2010 CITY OF TIGARD / , .2 ../. 2 e / 2 CITY OF TIGARD • 1" . 20 • WASI-IINGTON COUNTY, OREGON ,----- - - • - -- — -`''"-' - 7 - 7= .:7 i w - i t. if C I ' CA . :' 4 i,,A!...0 • 1 4 , • 7 , 4 44.7 1 ' :, CA• 2 i ,.., ! 4 ND -- ---- - . >.' I '1% ( .:., . -,- ,,, , • -,--: _ -, -,_,_., l' l°16.1-4. 4 1 0 M 1 Fi l S ek II lir,: ,e , - .., . ,.• ,h- ,r ( ; ,... , ,v). ,jy..„rA 1 - . r . I , , i. • .. • •4 • - q•-•-_,.,_ .2t.L.13_11. •!--.::•';‘-'4- I siiimai, mpIll 12756 SE 66th AVE. OFFICE (503) eia:.8iial • ', :'.' • ... • • • " • OR. 97223 FAX (�03)698-8900 . ., ., . ..; :. • ' i ! ... j PORTLAND, ...,... . , . . 1 b ,:efligrif '! . :: 1 • CURTE . : 71-1-W— r' — - W — - - — WATER LINE i 244 ,,. .t . V/ ^ ' ' 55 • SANITARY SEWER, • . . • •• ... •.::: - .4'. li-V z , : • I . - - : 1- • /I H SD -- - -• -- STORM DRAN i . , SIDEWAL,K .5 , .....,,,,, . ., o o EROSION FENcE ! STREET TREE: . '2 -4-1 ,..(' - - q q OF STREET „....._. CI-IANTICLEER PEAR - • - . ..., : i S - - 2" Caliper . at PUE • "1. ` I). :13:•'' \ 121 WATER METER i ,.,. ,. /,i-;fH,1") 8 MANHOLE " • • ' , 1 i' "rh t l' / ..• : ••1)1 • • • • • '• - '!• ,e • •• • ; . - .. ,7 ' ■ . , c CATC .(0. _ CI H BASIN PROPOSED 1...,_....,....,.... '... • . .. „...... : .1,...—.....— . rli .1/.-:::...2,...41.;4.1.::..4„„,:— .:1:71i,i,Dil 4 :., Y. 1 -- .. — ...' ..' LOT 52 1 - eta, •...., STREET TREES co 02 . STREET LIGHT ••• . • - • - iv , 8 8 4. ' FRE Y NT q • C% , ...9 lr I HDRA ' \\ ' .. 6•,(C) / ,.\\ \\■, \- ,.:.:-..,,° • ( SP •. ' *i PROvIDE EROSION 24 7,.. CONTROL FENCE ---- ■• k o\\ \\\ \ . \\\ ----■■ \ 1 \\ \\■ \ \ ,,,,\ , , • , PER COMMUNITY / \\ \\\ ,\\ ,, , \ o, \\ \\ k 'y .- \\ \\ EROSION PLAN 'LOT 54 ./.0, D,. 244.6' SETBACKS : 1 ; 4 or \ \ \\\41116cFr‘"\\'`\\\\\\\ ,-,, ..... \ , \ , ,, , . ,■ ;,.:\„,\ \ ‘,,, \ A . -?) \\\\ \\\; \\JUNIPER 5 \\ \•!,\ 0 \ 0 i FRONT YARD = 15 FEET • - , \ \ • • \ \ \ \ \ \ FN. FLR ..2.40 0'\\\ , i \ •,' pc , GARA6E = 20 FEET / \\ \ \\ • \ \ 6AR. FLR..245 \\ \\\\",'•°) LOT 51 REAR YARD = 15 FEET .\\\\\\ \\\\, \ v \\, \\\■ \\\\\\ l ' //I ' SIDE YARD = 4 FEET \\\\\\\\\ l \\ \\\\ \\ \\\•\ \\\\\\ \ \•.\\ kr N STREET SIDE YARD = 10 FEET ! _ .,..,3_ ,i . w 3 , \ tl, ., , ,, \\;:\\ \, : .\\, \\...\‘.\, \ \;\, ... ' ,. - •::: : :: : :::, 7 7: :: : :,,, . i I. / ,.:, t- '- / ----- s /z) 245.5.,,, = .. 40 t -- -0 ,,..,,,, 1-.1.:, .1 , . /‹. • -..:$ 1 •V(.2 i ' t-'0 1 ' 1 ' I' , ' ' ID"' • ...... .,, „,,...t,.., • '</ '' - C:" ' . •I', :.t. InVI CI /4t0 - : . Y.`2 1C:1•'' ...., ii,\ - •..,,,y Ati •,,,,,,,• . ' 4/ -'-•°-..'-''''''''''''.-. l' LOT 50 ik.',•:.---N . . , NNN 246 • '',. • \ -..qW i, s: \ / , l3‘ 246 l'k CITY OF TIGARD • SITE PLAN REVIEW BUILDING PERMIT NO.': \--4e - 004)7 7 PLANNING DIVISION: Required S tbacks: DApproved A 0 Not Approved Side: Street Side: d Front. Ga ��e: d Rear: 15 Visual Clearance: C " Ap oved ❑ Not Approved Maximum Building Height. `f feet CWS Service Provider Letter Required: ❑ Yes 0 No 0 Received By : Date: 67(4 40 ENGINEER( - DEPARTMENT: Actual Slo : ° MApproved ❑ Not Approved Site Plan: RI- Approved of 9C pproved By: Date: 6 / /d Notcs:g s� cam BUILDING PER MIT MID-SITE PLAN ,� NO• v ItE W Street Trees: Protected Tr tv Approved B ? ( APProv Not Approved Notes: 3 4 V M �`sJ Date: _ G I� PProved • CITY OF TIGARD FEE AND PAYMENT HISTORY >1 E 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD - MST2010 -00077 - 14242 SW WALNUT CREEK CT, TIGARD, OR 97223 Revenue Payment • Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due Building Permit - New Construction 2300000 -43104 $1,459.18 $1,459.18 ✓ $1,459.18 V Plan Review 2300000 -43106 $751.34 $751.34 $750.00 5/4/10 Check 177787 ,/ $$171 ci CDC Plan Review, RES 1003100 -43112 $46.00 $46.00 ,/ / $46.00 CDC Plan Review, RES - LRP 1003100 -43117 $6.00 $6.00 I 6.00 V 12% State Surcharge - Building 1003100 -24001 $175.10 $175.10 y0:7 i ;„,, $175.10 ✓ Metro Const. Excise Tax - Residential 2300000 -24010 $280.42 $280.42 ��' ," $280.42 .1/ Use 7L Beaverton School CET - Residential 2300000 -24101 $2,204.00 $2,204.00 1, P V $2,204.00 ✓ Park - Single Family Unit 4250000 -43300 $4,811.00 $4,811.00 1 \ ✓ $4,811.00 '/ Erosion Control 1003100 -22002 $88.00 $88.00 f V 31 0' q .../ $88.00 d Erosion Plan Review CWS 1003100 -22003 $28.60 $28.60 I l 1 $28.60 Erosion Plan Review COT 2300000 -43102 $28.60 $28.60 ✓D ✓ C $28.60 ,',/ Permit Fee - Elect (per dwelling unit) 2200000 -43103 $304.22 $304.22 $304.22 Limited Energy 2200000 -43103 $67.84 $67.84 , & I 0 $67.84 ' 12% State Surcharge - Electrical 1003100 -24001 $44.65 $44.65 G7 i q $44.65 Furnaces < 100K BTU 2300000 -43102 $46.75 $46.75 $46.75 ..--- Water Heater 2300000 -43102 $23.32 $23.32 $23.32 l Gas Fireplace 2300000 -43102 $33.39 $33.39 $33.39 `-, Range Hood /Other Kitchen 2300000 -43102 $33.39 $33.39 $33.39 i-'" Clothes Dryer Exhaust 2300000 -43102 $33.39 $33.39 $33.39 v". ix.. ✓ Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $116.60 $116.60 $116.60 Utility Rooms) Fuel Piping 2300000 -43102 $14.15 - $14.15 0 $14.15 '' 12% State Surcharge - Mechanical 1003100 -24001 $36.12 $36.12 $36.12 SFR - Baths 2300000 -43101 $500.32 $500.32 $500.32 CITY OF TIGARD Building Division TIGARD 13125 SW Hall Blvd.,Tigard, OR 97223 503 - 639 -4171 INVOICE V010 TO: Legend Homes Customer ID: 55151 12755 SW 69 Ave., Ste. 100 Invoice No.: INV2010 -00015 Portland, OR 97223 Invoice Date: 12/28/2010 Attn: Steve Lucas Date Due: Upon Receipt Case No_ � S Add MEL Aiii i R t i vi TaVi ot o Pr N ,,_ A u RI MST2010 -00077 14242 SW Walnut Creek Ct. Walnut Creek, Lot 53 $279.07 Invoice Total: $279.07 ® Please see attached fee schedule for description of fees due. (Detach and return this portion with payment.) Case No.: MST2010 -00077 Customer ID: 55151 Site Address: 14242 SW Walnut Creek Ct. Invoice No.: INV2010 -00015 Project: Walnut Creek, Lot 53 Invoice Date: 12/28/2010 Date Due: Upon Receipt Invoice Total: $279.07 Amount Paid: $ Office Note: Remove parcel tag when paid and route receipt to Accela System Administrator. Please mail payment to: City of Tigard, Building Division 13125 SW Hall Blvd. Tigard, OR 97223 Attn: Dianna Howse I: \Building \Accounting \Invoice.doc 04/06 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due 12% State Surcharge - Plumbing 1003100 -24001 $60.04 $60.04 $60.04 ✓ Plan Review 2300000 -43106 $197.13 $197.13 ( ""` 1i x . $197.13 f� Totals for Fees $11,389.55 $11,389.55 $750.00 $10,639.55 Receipt # Payment Method Check # Payor: Receipt Date Receipt Amount 177787 Check 1954 Estate of Matrix 05/04/2010 $750.00 Development Corp Total Payments: $750.00 Balance Due: $10,639.55 j - i:-1— ,%& Cs 4- c & / 6. - ,/'// E Z 7 i',!T STREET TREE CERTIFICATION ke1//#0 C4Jig?sa ciD , agent fOr - / 7 4 s (PLEASE PRINT) (PERMIT HOLDER) do hereby co/0 that the AllavingTocation meets (io of Tigarctlaqdcore and velome development standards for street tree-installation anchs consistent --- , with the approi)ed plan. vii5 n2 0 10...exb77 SITE ADDRESS: / 4 SUBDIVISION: LOT #: 5g46 SIGNATURE: I • DATE: ■ OWNER/AGENT) RECEIVED & VERIFIED BY. DATE: (CITY OF T7GARD) Tree location verified per approved site plan. I: \Building\ Forms \StreetTreeCertificatc 07/01/2010 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No- 2 b f o _ Qc90..7. Jurisdiction: --� Iq fF� Site Address: -- Subdivision/Lot #: and /or Map and Tax Lot #: 63 te 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: !A ' : ' '. u2 " Date: 5-3) — /1 Owner Genera nt� h r /Authorized Agent Print Name: K(�l r/ j 6u ( E s- 6 0(D jl15 ��olo - 00077 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. C \ Building\ Forms\RES - HighEfficiencyLighting.doc 07/01/08 • Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, Ke , am the general contractor or the owner - builder at the following address: Site Address: I 2.,47_ S w ofiru_4J.- City: _ --- Permit #: a:© tO ®(90'71 Subdivision/Lot #: LA -62 5 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: ; ►! y �� k Date: 5 ---3 ener :contractor or i wner- Builder I: \Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08