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Permit CITY OF TIGARD MASTER PERMIT " Permit #: M ST2011 -00066 2 - COMMUNITY DEVELOPMENT Date Issued: 05/25/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S 133CA08000 Jurisdiction: Tigard Site address: 13580 SW ROSEMARY LN Subdivision: VILLAGE AT SUMMER CREEK Lot: 3 Project: Village at Summer Creek, Lot 3 Project Description: Building 1 - New SFA. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 2 First: 38 sf Basement: 0 sf Left 3.5 Parking Spaces: 0 Height: 31 Bathrooms: 3 Second: 573 sf Garage: 480 sf Front: 12 Smoke Yes Dwelling Units: 1 Third: 573 sf Right: 3.5 Detectors: Total: 1184 sf Value: $142,453.58 Rear: 10 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: Catch Basins: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add9 500 sf: 2 201 -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 Y Other. N Other Description: Ecompasing: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SFA VB R -3 1184 Owner: Contractor: CENTEX HOMES GARNER ELECTRIC Required Items and Reports (Conditions) ATTN: OCHSNER, JOHN 2920 SE BROOKWOOD AVE A 1 Ersn Cntrl 503 - 681 - 4444 11241 SLATER AVE NE, STE 100 HILLSBORO, OR 97123 KIRKLAND, WA 98033 PHONE: 503 - 608 -3060 PHONE: 503 - 648 -4552 FAX: 503 - 642 -7925 Total Fees: $12,626.80 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 952 -0 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B . Permittee Signature: ,,1 ffj / ° �4_/ C�i / e Call 503.639.4175 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. Building Permit Application R sident><al >1 r _:. - l . W t FOR OFFICE USE ,, ,, „ . , t , ,tea o� Received � City of Tigard Date/B : ' 4 4a te Permit N it �r,/ �l _ _ : . e, n 13125 SW Hall Blvd., Tigard, OR 97223 [[[��� Tigard, .1) ` 1 • .., + Plan Review Phone: 503.639.4171 Fax: 503.5 - ? Date /By: , ��kt 5 in Other Permit: 5( Li - ., Inspection Line: 503.639.4175 + , TIG p ^ , , r�Q�\ Date Ready/By: Sec Page 2 for ' p Internet: www.tigard - or.gov ', ', (�0. �� 1. Notified/Method: � II 1y , Supplemental Information v r u '' -' .y ,,.:.- , r: „ ire C `` CZ Cl`!r`Ztt tdl 1!A _ .� ar � ��L � YP U� F �y ©RK^ r � " _��,� - ��L `' ` � " ' �,�" �' � ' � r EQ re D DA <TA• APiD WAi WI, IIVC� � ;��,�#" :.� �" -,� `� ;zs�rs�,� � �- � � � '�''?.�'s�"�`��s &4:4 �:v�,�*'. �:? �srid :.•��'r.�„�.�d,-':.x.:- a.ac.. E . .. -.-,, ® New construction ❑ D ti o�li� N Permit fees* are based on the value of the work performed. „` +\ Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Obd equipment, materials, labor, overhead, and the profit for the . °'"l -=` C.A 1sE6 `O ` eON S TRUC *TziON I ' } IK ,, �a "IM work indicated on this application. ® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: % /4 Z -53 ; ❑ Accessory building ❑ Multi - family Number of bedrooms: 2 ❑ Master builder ❑ Other: Number of bathrooms: 3 d BS` jiNORl1 P Q ( � N ,i o j A 0 v - Total number of floors: 3 Job site address: /3 c( r > /w7 ,1 et CA/ New dwelling area: 1186 square feet City /State /ZIP: TIGARD OR, 97223 Y Garage /carport area: 480 square feet ;573 Suite/bldg. /apt. no.: Project name: VILLAGE AT SUMMER CREEK Covered porch area: 18 square feet 'J7 J Cross street/directions to job site: CORNER OF SW BARROWS RD, Deck area: 128 square feet 3 SW 135 AVE, AND SW SCHOLLS FERRY RD Other structure area: 1 tj square feet ✓ ( REQUIRED # Ae: CO b1ER 1AL OS1tWeiCI.IIST ', Subdivision: VILLAGE AT SUMMER CREEK Lot no.: . 3 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 5 equipment, materials, labor, overhead, and the profit for the '4 - ' ; � ,,c : D SC . ; , 1 ON . ,�� 0 R . �- i z tiI r "' work indicated on thus application. NEW SFR TOWNHOUSES Valuation: $ UNIT C 1186 SQ. FT. Existing building area: square feet New building area: square feet 3 lPi t0 FrR OWNE g - . � z � � �; Number of stories: ,ii .: ,r. _. �� as 7 � -.. .... ft;�.r,.�Yu � , _.....€ rr.:a >,t'�:.� `,. Name: CENTEX HOMES Type of construction: Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Occupancy groups: City /State /ZIP: PORTLAND OR, 97224 Existing: Phone: (503)608 -3060 Fax: (503)608 -3061 New: AVI , , t . . � ® CO NT�+ t µ81 RS© a' - �;..1.��,.�ar<� �,�,€uuut: ' � � , ' � � r.,.. _.. �.. ;�„ ;r *`. .�. , ' „u Business name: CENTEX HOMES All contractors and subcontractors are required to be Contact name: GARY CULP licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 16520 SW UPPER BOONES FERRY RD, STE 200 jurisdiction in which work is being performed. If the City /State /ZIP: PORTLAND OR 97224 applicant is exempt from licensing, the following reasons apply: Phone: (503) 608 -3060 Fax: : (503) 608 -3061 E -mail: gary.culp @pultegroup.com IOW T _ s s •s I- sMISZI �-.� ',�' <t p si- Via : Ward, - " . =t , g,C NrT ez .«�_ iv'. a - ,- Business name: CENTEX HOMES _, ° BEII, D 7NGWPER'1IT EES =' '`. , '„"`fin ; " ' - '.'k',?vMbir i iiik e l hr Address: 16520 SW UPPER BOONES FERRY RD, STE 200 �tRleus ejerrot/eetschertnle wu �. Structural plan review fee (or deposit): City /State /ZIP: PORTLAND OR, 97224 FLS plan review fee (if applicable): Phone: (503) 608 -3060 Fax: (503) 608 -3061 CCB lie.: 182591 Total fees due upon application: Amount received: Lt Authorized signature: -.AA. This permit application expires if a permit is not obtained � within 180 days after it has been accepted as complete. Print name: GARY CULP j Date: Z�'y * Fee methodology set by Tri- County Building Industry Service Board. 1: \Building \Permits \BIJP -RES PermitApp.doc 10/01/09 440- 4613T(1 I /02 /COM /WEB) ;iltt.;ca1 Permit Application ° 1� oR O ie uSE orrice xi�.��:�n: I Iii , City of `f'igard �� Received /y� '� r10 Pcnnil No.: DatclBy: J rS I I Zl(f(}CDCo 13125 SW Hall Blvd., Tigard, igard OR V,' t Plan Review , � Elli I r is Phone: 503.639.4171 Fax: 503.598:+" 4 \! f Plan cJBy: Other Permit: Inspection Line: 503.639.4175 Q� '(�\)� C�,Pl t c Ready /By: leis 0 See Page 2 for t r_ °•A Internet: www.tigard- or.gov oQ `�`�� Notified/Method: Supplen,entallnrormutiun do ma ` :-: , ..,1SY ^<� :` Tl'P • P'.1�' Rh , rte`^ %SPY >"�. hL' "r.CN``I2E� -1)✓�Y s'ti ® New construction ' ❑ Addition /alteration /rep � t nt Please check all that apply (submit A 2 sets of plans w /items checked below): �/ ❑ Service or taeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where lie available Paull current ❑ Marinas and boatyards. D00 a volts tin buildings. exceeds 10 m )s at I �0 0l s or P loy s : rm, . .. °: L(;0 ,1'.A CONS %1';i2UC . , , :.. ,., . _ ,. _ I ' less to ground, ur exceeds I 4,000 ❑ Commeicial-use agricultural ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ installation 0175 KVA or r.- ;,,,. =or. r +,: •;,;i x Emergency system. larger separately derived system. ' ` xa "'� "" � JO 5 )1 OIi1T[ON ='IOCATIOV , ;; :x -A s. , ., . ,, ' ... .. :.:.- ,. , .. >,. � .- ,. ..,, ❑Addition of new motor load of ,. ,. „ ... "1-3-, Job no.: Job site address:) � Ulf PooP or more. occr ❑ o Sia or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: TIGARD OR 97223 ❑ Health -care llicilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. • Suite /bldg, /apt, no.: Project name: VILLAGE AT SUMMER CREEK ❑ Service or feeder 600 amps or more. ? e ;et _ :is;I LL SCI-iED.OLL _ ;;' °'" Cross street/directions to job site: CORNER OF SW BARROWS RD, Desninden ( Qn., j Fee. i T,at j •:, SW 135 "' AVE AND SW SCROLLS FERRY RD New residential singk or multi - fancily dwelling unit. Includes attached garage. 1 Subdivision: VILLAGE AT SUMMER CREEK Lot no.: 1,000 sq. R. or less 1 168.54 168.54 4 Ea. add'I 500 sq. ft. or portion 2 33.92 67.84 1 'fax map /parcel no.: Limited energy, residential I 75.00 75.00 ;I. - rre,7 2 '`nr �� :, :o ^'-' Vlllt above 5 4;tss; ( ) if. Limited energy, multi - family NEW SFR TOWNHOUSES residential (with above sq. fi.) 75.00 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 1 „�, k''l� - pry. ", >'.�:�.' '`y'ff'4" :+tik;;i;r "1 .�: :.fyi - 7 7 -J ,�. ,t . =��' � _OI amps t 400 amps 13 3.56 _ i`1?ROPLRTIF °OJ \ \Ctil= 1 - >1 � Ti; NANT�'�. "'`�� :��`- < :'� . ^ : :': p P , Y: 'n iii :.:,gi: `�' Name: CENTEX HOMES - . ....,;4 : :. _,;: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 16520 SW UPPER BOONES FERRY ROAD, STE 200 Over 1,000 amps or volts 552.26 2 : City /State /ZIP: PORTLAND OR, 97224 Temporary services or feeders installation, alteration, and /or relocation Phone: (503)608 -3060 Fax: (503 - 503 - 6031 200 amps or less 59.36 I 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 1e8.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 1 I Branch circuits—new, alteration, or extension, per panel Owner signature: Date: A. Fee fur brunch circuits with ©a &I?P11CA ' as a weserviceor ec erlee T VAt _. 0 , _,. �,,,. Gt7N l 1 CIibON ' '''t' , 7.42 2 . , ,; _ � _. , . - ,. .. each branch circuit Business name: CENTEX HOMES B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: GARY CULP branch circuit Each add'I branch circuit 7.42 2 Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Miscellaneous (service or feeder not included) City /State /ZIP: PORTLAND OR, 97224 Each manufactured or modular 67.84 dwelling, service and /or feeder Phone: (503) 608 -3060 Fax: : (503) 608 -3061 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: gary.culp@pultegroup.com _ Signor outline lighting 67.84 CCINTRAC T.OR ' . '.._; Signal circuit(s) or limited- energy Business name: GARNER ELECTRIC panel, alteration, orextension. Page? 2 Each additional inspection over allowable in any of the above Address: 2920 SE BROOKWOOD AVE, STE A Additional inspection (I hr min) 66.25/ hr City /State /ZiP: H ILLSBORO OR 97123 Investigation (1 hr min) 66.25/ hr industrial plant (I hr min) 78.18/ hr Phone: (503) 648 - 4552 Fax: (503) 642 -7925 Inspections for which no fee is 90.00 / hr specifically listed ('A hr min) CCB Lic.: 182591 Electrical Lic.: 34 -305C Suprv. Lic.: " n , *e E N `<LLEC4TRICAI PGRNI JOKES > :; :;( :' ;' - P : Subtotal: Suprv. Electrician signature, require. / 6 Plan review (25% of permit lee): �' „` Print name: CHUCK GA /ER / , / Date: State surcharge (12% of permit fee): ' ` A /,/ / /r” TOTAL PERMIT FEE: uthorized signature: g ' F . �: ._ _ This permit application expires if a permit is not obtained within 180 ° Print name: " Datc: �Z�/ days after it has been accepted as complete. / !!(/// Number of inspections allowed per permit. 1- \auilding \ Permits \Oi.C- PcrmiiApp.doc 07/01/10 44t1- 4615T( I I /05 /COM / \VGI7 • Mechanical Permit Application ,v ,, 4,0 ; FOR OFFICE USE •ONLY i'i ._ t, , ,�.,.- , City of Tigard ; Received '.. Date/By: Permit No.. 5iin I v0 r' 13125 SW Hall Blvd., Tigard, OR 97 , Phone: 503.639.4171 Fax: 503.1a1 • l \) .% Plan Date/By: Rev iew Other Pet n tt: TIGARD Inspection Line: 503.639.4175 \"-' 1% Date Ready/By: )arms: H See Page 2 for � Internet: www.tigard- or.gov Q Notified/Method: Supplemental information _ .� ` .rr, \� S �0 . ; ms s , E�RC' .:A • y' TaFYP. ®FAT { . `. 4&:( ECIS VfIakt.,S * " ( CHE f dreATSE GHECIa:IS Mechanical permit fees* are based on the value of the work ® New construction ❑ AdditionJalteratioP It s Cement • • performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. '^ . . :1 s a ' ''" s CA � G OF CO O V = - ` '' ,. Value: $ ® 1 - and 2 dwelling ❑Commercial /industrial V _ RESID °NTI` L Q PME T/S,JY,3 TEMS F *: y g ❑Accessory building For special information use checklist. ❑ Multi -family ❑ Master builder ❑ Other: Description Qty. Ea. I Total lt gt JOB: SIkIi ;INEO • 4. ON a� ,,MI ATIO1 I ' r o ,, ..... t, r T Heating/coolin Job site address: 1,--119 w ��t� '^ 1 Air conditioning (requires site plan showing placement) 46.75 City /State /ZIP: TIGARD OR, 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: VILLAGE AT SUMMER CREEK Heat pump 61.06 Cross street/directions to job site: CORNER OF SW BARROWS RD, Duct work 23.32 Hydronic hot water system 23.32 SW 135TH AVE, AND SW SCHOLLS FERRY RD Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Flue /vent for any of above 23.32 Subdivision: VILLAGE AT SUMMER CREEK Lot no.: ` 1, Other: 23.32 Tax map /parcel no.: Other fuel appliances • o "' a� �L, g� :.,° �� :.�,� - CRI�IO OF : i .. ��� 1 �' . F ` Water heater 1 23.32 23.32 `�°� �� Gas fireplace 33.39 NEW SFR TOWNHOUSES ' Flue vent for water heater or gas UNIT C 1186 SQ. FT. fireplace 23.32 Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 m,�,,,_.�x n r .„ „ Chimney /liner /flue /vent 23.32 ®«ROkE O s''. _ s : - -4TTr Other: 23.32 Name: CENTEX HOMES Environmental exhaust and ventilation Range hood /other kitchen Address: 16520 SW UPPER BOONES FERRY RD, STE 200 equipment t 33.39 33.39 City /State /ZIP: PORTLAND OR, 97224 Clothes dryer exhaust 1 33.39 33.39 Single -duct exhaust (bathrooms, Phone: (503)608 -3060 Fax: (503)608 -3061 toilet compartments, utility rooms) 4 23.32 93.28 &r < ® NLIC E A�� v � �. , El.' _ riyo A CT RSOI i, i 4 Attic /crawispace fans 23.32 Other: 23.32 Business name: CENTEX HOMES Fuel o t t p Contact name: GARY CULP $14.15 for first four; $4.03 for each additional Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Furnace, etc. I 14.15 Gas heat pomp City /State /ZIP: PORTLAND OR, 97224 Wall /suspended /unit heater Phone: (503) 608 -3060 Fax: : (503) 608 -3061 Water heater 1 Fireplace E -mail: gary.culp @pultegroup.com Range 1 ':' .m `' *�a =' r m xac ire a ny .,.. 'Yj �!+ f , i s _ 7 ' '? �.' .. ' - t e ',141 li ,,NTRACTORa r• A I r te. Barbecue Business name: MUEHE QUALITY HEATING INC. Clothes dryer (gas) Other: Address: 7301 SW KABLE LANE, STE 500'' *k' ' ,s l.ECHANTCALgPERMIEEE''- • City /State /ZIP: PORTLAND OR, 97224 Subtotal Phone: (503) 598 -0966 Fax: (503) 598 -8498 Minimum permit fee (590.00) Plan review (25% of permit fee) CCB lie.: 50096 State surcharge (12% of permit fee) TOTAL PERMIT FEE / This permit application expires if a permit is not obtained within 180 Authorized signature: / - days after it has been accepted as complete. Print name: KYLE e R N Date: i * Fee methodology set by Tri- County Building Industry Service Board I: \Building \Permits \M EC- Permit App.doc 10/01/09 440 .4617r Ii 1/02 /COM /WEB) Plumbing Permit Application Building Fixtures FOR OFFICE 'USE ONLY . City of Tigard EEiew Permit NoV 13125 SW Hall Blvd., Tigard, OR 97223 to II • v . Phone: 503.639.4171 Fax: 503.5 .J "• Date /B • Other Permit No.: r r Y Inspection Line: 503.639.4175 't° O \\ Date Ready /By: lu is: 0 See Page 2 for Internet: wtwv.ti g and -or. T, g ov V, ' e� Notified /Method: Supplemental Information ;TYPE:.OF0 $RK QF� "•-ram _ ., sy : c. , FEE* SCHEDULE' [2] New construction ❑ Dem � t�� n For special information use checklist. `` ` Description I Qty. 1 Ea. 1 Total ❑ Addition /alteration/replacement ❑ 0Q. *# New I- 2- family dwellings (includes 100 ft for each utility connection) •A TE �� -• U�I .. .• .:, G GORY�OF, GONSTR Y• s4. '� 5 5 � t` :: , � SFR (1) bath 312.70 • ( ® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 SFR (3) bath I 500.32 500.32 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) I'agc 2 ; ' "t, • ` : JOB,;SITE:,, INTORMATION``AND"T;O A ' % ,'' t • • ': ri-- :.H.... <. �.�,. CtTION " �r.<m: Site utilities: Job site address: /566 4 � / -q L� Catch basin leach line drain 18.76 Drywell, (each line, or trench drain 18.76 City /State/ZIP: TIGARD OR, 97223 Footing drain (no. linear ft.: 100) I Page 2 Suite/bldg. /apt. no.: i Project name: VILLAGE AT SUMMER CREEK Manufactured home utilities 50.03 Cross street/directions to job site: CORNER OF SW BARROWS RD, Manholes 18.76 SW 135 AVE, AND SW SCHOLLS FERRY RD Rain drain connector I 18.76 Sanitary sewer (no. linear ft.: 100) 1 Page 2 Storm sewer (no. linear ft.: 100) I Page 2 Water service (no. linear ft.: 100) I Page 2 Subdivision: VILLAGE AT SUMMER CREEK I Lot no.: 5 Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 , Backwater valve fi -. ,.. � . � . 4. --,� ,.�:_,:- ..•�4F RM1.� " x;_ "��� y a n,�,ca. .5 ^ DE , , u r :' `; u'. Clothes washer 1 25.02 NEW SFR TOWNHOUSES Dishwasher 1 25.02 UNIT C 1 186 SQ. FT. Drinking fountain 25.02 Ejectors /sump 25.02 an;. ,,,,..,.113].' r.�. �=, , ,'9-.,.: ..- ., ,;. ., �,� ' : • Expansion tank 12.51 .. " PROPERTY= �,O� }'NER;��, " '� ^� �,;�s . ®�`rENANT� aty:A °':ti?� Ex , P Name: CENTER HOMES Fixture/sewer cap 25.02 Floor drain /floor sink/hub 25.02 Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Garbage disposal 1 2 5.02 City /State /ZIP: PORTLAND OR, 97224 Hose bib 2 25.02 Ice maker I 12.51 ® 'A['PL[CAN , i CONT. -i: : _ Interceptor /grease crap 25.02 ; Business name: CENTEX HOMES Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: GARY CULP Roof drain (commercial) 1 2.51 Address: 16520 SW UPPER BOONES FERRY RD, STE 200 Sink/basin/lavatory 5 25.02 City /State /"LIP: PORTLAND OR, 97224 Solar units (potable water) 62.54 • Fax: : (503) 608 -3061 Tub /shower /shower pan • 2 12.51 E -mail: gary.culp @pultegroup.com Urinal 25.02 3 25.02 CONT " CIiOR ' ` .a x F A �s. >arY;Y; •q;: ; ti ^' 7� . � N ... - . . .. .;e:a - .�. _..9 i,',° : r .,._.. ; 44:1,, r w. � '� Water heater 1 37.52 Business name: CRAFTWORK PLUMBING INC. Water piping/DWV 56.29 Address: 7737 SW CIRRUS DR Other: 25.02 City /State /ZIP: BEAVERTON OR, 97008 Subtotal Minimum permit fee: $72.50 Plan review (25% of permit fee) CCI3 Lie.: 79666 Plumbing Lic. no.: 20 -148P6 State surcharge (12% of permit tee) 1 A Authorized signature: 7, TOTAL PERMIT FEE 1 This permit application expires if a permit is not obtained within 180 days Print name: PETER POLLARD Date: . 9° /?!../0 after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I: \ Building \Permits \I'I.AMU- Permil App .doe 10/01 /09 440- I016T(10 /O2/COSUwtB) Revenue Payment • Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due '4 Fuel Piping 2300000 -43102 $14.15 $14.15 $14.15 12% State Surcharge - Mechanical 1003100 -24001 $29.31 $29.31 $29.31 SFR - Baths 2300000 -43101 $500.32 $500.32 $500.32 12% State Surcharge - Plumbing 1003100 -24001 $60.04 $60.04 $60.04 Totals for Fees $12,560.12 $12,560.12 $750.00 $11,810.12 Receipt # Payment Method Check # Payor: Receipt Date Receipt Amount 182276 Credit Card Gary Culp / Pulte 04/26/2011 $750.00 Homes Total Payments: $750.00 Balance Due: $11,810.12 try , ‘35-, 01:1 CITY OF TIGARD FEE AND PAYMENT HISTORY •14 �- n 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD MST2011 -00066 - 13580 SW ROSEMARY LN, TIGARD, OR 97223 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due Building Permit- New Construction 2300000 -43104 $1,053.32 $1,053.32 $1,053.32 Plan Review 2300000 -43106 $751.34 $751.34 $750.00 4/26/11 Credit Card 182276 $1.34 12% State Surcharge - Building 1003100 -24001 $126.40 $126.40 $126.40 Plan Review $ -66.68 $ -66.68 $ -66.68 DC Provision Review, SF - Ping 1003100 -43112 $64.00 $64.00 $64.00 DC Provision Review, SF - LRP 1003100 -43117 $9.00 $9.00 $9.00 Info Process /Archiving - Sm Sheet (up to 2300000 -43135 $62.50 $62.50 $62.50 11x17) Metro Const. Excise Tax - Residential 2300000 -24010 $170.94 $170.94 $170.94 Use Beaverton School CET - Residential 2300000 -24101 $1,184.00 $1,184.00 $1,184.00 Park - Single Family Unit 4250000 -43300 $4,811.00 $4,811.00 $4,811.00 TDT - Transportation Development Tax 4050000 -43320 $3,106.00 $3,106.00 $3,106.00 Erosion Control 1003100 -22002 $64.00 $64.00 $64.00 Erosion Plan Review CWS 1003100 -22003 $20.80 $20.80 $20.80 Erosion Plan Review COT 2300000 -43107 $20.80 $20.80 $20.80 Permit Fee - Elect (per dwelling unit) 2200000 -43103 $236.38 $236.38 $236.38 Limited Energy 2200000 -43103 $75.00 $75.00 $75.00 12% State Surcharge - Electrical 1003100 -24001 $37.37 $37.37 $37.37 Furnaces < 100K BTU 2300000 -43102 $46.75 $46.75 $46.75 Water Heater 2300000 -43102 $23.32 $23.32 $23.32 Range Hood /Other Kitchen 2300000 -43102 $33.39 $33.39 $33.39 Clothes Dryer Exhaust 2300000 -43102 $33.39 $33.39 $33.39 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $93.28 $93.28 $93.28 Utility Rooms) Building Division Development Code Provision Review . T i c n ii Residential Projects Building Permit No: ! ''- ")11-1L (O(D CWS Service Provider Letter Received: Yes ❑ No ❑ N/A L� Routed Plans: Original Plan Submittal Date: i t /1 int 1st Revision Submittal Date: / hj/ ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only • To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review (contact J at 503 - 718 - - - or @tigard- or.gov) Land Use Case No. D1TP1P / 017 t Name Sr;IOt -LS Zoning Q a S PJ Setbacks: OD Er Front 16. Rear I S Side Street Side l l Garage OD lr Maximum Building Height `-F5 Actual Building Height 3E) 1X Visual Clearance EJ Easements Sensitive Lands Type: Notes: Original Plan: Approved Er Not Approved ❑ Date: (-11( ;4 1/ Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) Actual Slope: Notes: Original Plan: Approved ( Not Approved ❑ Date: 4 Revision 1: Approved fr Not Approved ❑ Date: Mr/ Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) L Street Trees ❑ Protected T es / Notes: n � u ] S �+._ ��1f vii Jae r Srt ei � 16C o. Am P 4 /1/1 .� �, � G a, Original Plan: Approved Cy Not Approved C Date: l ao Revision 1: Approved Not Approved ❑ Date: y fl Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes 17/ No ❑ Date Routed to Building: Page 2 of 2 V illage a _ _ __ __ __ _ I x- -x�x -x x x x- x x x x x x 6.6' 9.0' 1 9.0' 1 9 "0' Summer ree x I 17.0' 1 17.0' I I 17.0' 14.1 @ O O , _I \ 5" 0' I I I , 3.5 1 1 2 ' I 1 �I A I FF /TOW 186.09 FF /TOW 187.09 FF/ 6 •' 187.09 � Building Plan: 1 I GS 185.39 GS 185.89 GS 186.39 FF /TOW 187.09 Lots 1, 2, 3 & 4 X TOP 185.55 1 TOP 186.55 TOP 186.55 I GS 186.39 Units A -B -C -A 1 I TOP 186.55 I Hui0N • I •I SITE PLAN I Scale: 1"-10' -s rErd 1 RECEIVE . x 0/ y I 5 ' 0 Z ' r I H 3.5' • MAY 11 ?Olt _. I r I CITY OF TIGARD . ......... .. • .... I I ____ • BUILDING DIVISION . I . x o — • . .25:0' ' .• �n� 20.5' � e� 20 • .0' . : ........ , III 23:0' .... © © • ��� _ _ L 18_5 . 21.0 , . .. � - 61 © .. I - - — :� :.' .. ..... . . ... ....'.:'..P. wilio. i �T 4 . F— pp H :::::::.... . Q — Q _ Q W Q - - -rte T �.RI� ............. _ b - :AS I I v- E B : i 1 : : : ::::: :i!: ::r :: .'i:' : : ::r: :: :�, ✓i::: :::::::1'i!r :`.::r,::::F II r :r • ENGINEERING ASSOCIATES CORPORATION S W R O S E M A R LANE 17757 Kelok Road Lake Oswego, OR 97034 12" SD Tel. (503) 636 -4005 Fax (503) 636 -4015 gh — City of Tigard June 7, 2011 Pulte Homes Inc. Attn: Gary Culp 16520 SW Upper Boones Ferry Rd., Ste. 200 Portland, OR 97224 Re: Permit No. MST2011 -00066 Dear Mr. Culp: The City of Tigard has processed a refund for Traffic Impact Fees (TIF) paid on the above referenced permit and processed a new payment by TIF credit voucher for the following: Site Address: 13580 SW Rosemary Ln. Project Name: Village at Summer Creek - Lot 3 Job No.: Refund: ❑ Check # in the amount of $ ® Credit card "return" receipt in the amount of $3,106.00. Notes: New receipt for payment by TIF credit voucher is attached for your records. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. I:\ Building\ Refunds16. 1 -2 5;tR {it3aldfuRIVui:va,c Wagon 97223 0 503.639.4171 TTY Relay: 503.684.2772 0 www.tigard or.gov I City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineering and building application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request. Refund requests are due to Accela System Administrator by Wednesday at 5:00 PM for processing by the following Wednesday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing. PAYABLE TO: Pulte Homes Inc. DATE: 6/7/2011 16520 SW Upper Boones Ferry Rd. Ste. #200 REQUESTED BY: Dianna Howse Portland, OR 97224 • Attn: Gary Culp TRANSACTION INFORMATION: Receipt #: 182610 Case #: MST2011 -00066 Date: 5/25/2011 Address /Parcel: 13580 SW Rosemary Ln. Pay Method: CreditCard Project Name: Village at Summer Creek EXPLANATION: Refund Transportation Development Tax (TDT) paid by credit card. Applicant presented credit voucher to pay TDT fees from trust account. REFUND INFORMATION: . • Fee Description. From Receipt - . Revenue Account.No. Refund , Example: • Building Permit Fee - Example: '2300000-43104 $ Amount • TDT - Transportation Development Tax 4050000 -43320 $3,106.00 TOTAL REFUND: APPROVALS: If under $5,000 Professional Staff If under $12,500 Division Manager !' \A) a„k_ 6.- i -11 1 If under $25,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY • Case Refund Processed: I Date: I 4 I By: I I:\ Building \Refunds \Rcfundltcyucst.doc x 09 /01/2010 , CITY OF TIGARD RECEIPT IIII II C 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 182746 - 06/07/2011 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID • MST2011 - 00066 TDT - Transportation Development Tax 4050000 - 43320 $3,106.00 Total: $3,106.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Trust Account 08 -0002 .DROWSE 06/07/2011 $3,106.00 Payor: Centex Homes - Village at Summer Creek, Lot 3 Total Payments: $3,106.00 Balance Due: $0.00 / 6 , ' Accela Ihi a " System Administration • "" Finance Department Request Date: 4 77A, . To: ✓ . Liz Lutz Kathy Gende From: Dianna Howse/ • Re: Receipt #: // ,2 A o / YYs /AZ 2Y4 Please process this request as follows: • Journal Entry (route copy of JE to Dianna Howse). • Reversal (fees have been reversed on Revenue Account Report). Credit Card Return (fees have been reversed on Revenue Account Report). Other /Explanation: 7e eXV/Vi - A9y/r /167770,4) 774 7Zeisi !g 7 Thank you! I: \ Building \ Forms \RteSlip- FinanceReq.doc • Page 1 of 1 IIIII CITY OF TIGARD RECEIPT C . _ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 • TIGARD Receipt Number: 182745 - 06/07/2011 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID M ST2011 - 00066 $ 3,106.00 Total: $- 3,106.00 • PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 025073 DHOWSE 06/07/2011 $- 3,106.00 Payor: Gary Culp, Pulte Homes Inc. Total Payments: $ - 3,106.00 Balance Due: $3,106.00 • • • • Page 1 of 1 III CITY OF TIGARD RECEIPT II C 13 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD die /G /ni1_ Receipt Number: 182610 - 05/25/2011 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2011 - 00066 Building Permit - New Construction 2300000 -43104 $1,053.32 MST2011 -00066 Plan Review 2300000 -43106 $1.34 MST2011 -00066 12% State Surcharge - Building 1003100 -24001 $126.40 MST2011 -00066 Plan Review $ -66.68 • MST2011 -00066 DC Provision Review, SF - Ping 1003100 -43112 $64.00 MST2011 -00066 DC Provision Review, SF - LRP 1003100 -43117 $9.00 MST2011 -00066 Info Process /Archiving - Sm Sheet (up to 2300000 -43135 $62.50 • 11x17) MST2011 -00066 Metro Const. Excise Tax - Residential 2300000 -24010 $170.94 Use MST2011 -00066 Beaverton School CET - Residential 2300000 -24101 $1,184.00 MST2011 -00066 Park - Single Family Unit 4250000 -43300 • $4,811.00 • MST2011 -00066 TDT - Transportation Development Tax 4050000 -43320 $3,106.00 ✓ MST2011 -00066 Erosion Control 1003100 -22002 $64.00 MST2011 -00066 Erosion Plan Review CWS 1003100 -22003 $20.80 MST2011 -00066 Erosion Plan Review COT 2300000 -43107 $20.80 MST2011 -00066 Permit Fee - Elect (per dwelling unit) 2200000 -43103 $236.38 MST2011 -00066 Limited Energy 2200000 -43103 $75.00 MST2011, -00066 12% State Surcharge - Electrical 1003100 -24001 $37.37 MST2011 -00066 Furnaces < 100K BTU 2300000 -43102 $46.75 MST2011 -00066 Water Heater 2300000 -43102 $23.32 MST2011 -00066 Range Hood /Other Kitchen 2300000 -43102 $33.39 MST2011 -00066 Clothes Dryer Exhaust 2300000 -43102 $33.39 MST2011 -00066 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $93.28 Utility Rooms) MST2011 -00066 Fuel Piping 2300000 -43102 $14.15 MST2011 -00066 12% State Surcharge - Mechanical 1003100 -24001 $29.31 MST2011 -00066 SFR - Baths 2300000 -43101 $500.32 MST2011 -00066 12% State Surcharge - Plumbing 1003100 -24001 $60.04 Total: $11,810.12 • PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 0215073 DHOWSE 05/25/2011 $11,810.12 Payor: Gary Culp, Pulte Homes Inc. Total Payments: $11,810.12 • Balance Due: $0.00 Page 1 of 1 • 711 MI Community Development . 4; o ; '' ' : -.''1 TIGARD Request for Permit Action I • TO CITY OF TIGARD .4. Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard- or.gov • FROM: ® Owner ❑ Applicant ❑ Contractor El City Staff (check one) REFUND OR Name: Pulte Homes Inc. (Centex Homes) INVOICE TO: (Business or Individual) Mailing Address: 16520 S.W. Upper Boones Ferry Rd, Ste 200 City /State /Zip: Portland, OR 97224 Phone No.: 503 - 608 -3060 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED ( El CANCEL PERMIT APPLICATION. ® REFUND PERMIT FEES (attach receipt, if available). ❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). El REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit #: / —me 6 6 Site Address or Parcel #: 13580 SW ROSEMARY LN Project Name: Village at Summer Creek • Subdivision Name: Village at Summer Creek Lot #: 03 EXPLANATION: Tiff Credits transferred from JLS, Signature: Date: 47j -3 -11 Gary Culp �, Print Name:6 Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the budding plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. Sx� ; n r ��'.� �' - n lviif" - _ 3 1 .S �:i + t r' �� � ��. � � ; "� 3 - C L�.iN7 _. _ . iai .tR;. ,, O _M IADFF I CE_ US,E P ,os Y x , A . 'h',: �„' - 7,A- � x . r . Rte to S rs Admin: Date B Rte to Bid. Admin: Date l00� B c1�.� Refund Processed: Date h77 e B i — Invoice Processed: Date By Permit Canceled: Date By Parcel Tag Added: Date By Receipt # /4274,6 DateS/25 /// Method C e.L. Amount $ ,T /e 6 , erel l: \Buildin \forms \Re 1 cc.v 07/26/07 3 5 - v Ln A457 -00oia& M1 STREET TREE CERTIFICATION I, t l k 01,5 , owner/ agent for • Q, (PLEASE PRINT (PERMIT HOLDER) • do hereby certify that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. 135 (0 3 l 3s' 7 Zr S1 I E ADDRESS: SUBDIVISION: g7,s9, �r C_ ..__. - ... LOT #: /r a ' _ SIGNATURE: % DATE: / 4 ' / 1 (018'NER /AGE \t RECEIVED & • VERIFIED BY: DA! b: ie. �« / � OF TIGARD) ✓' I Tree location verified pe a proved site plan. \Buddrr mot 2010 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS A16 r 2 - Permit No.: 00 Jurisdiction: Site Address: ✓ }3 * o t 5572 13 55 0 4 ... 136 _,.._ Subdivision/Lot i1: and/or Map and Tax Lot g: 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 NI 107.2) Signature: Date: ¢ " �' ' �r Ow ec`General ContractonAuthorized Agent Print Name: I /( (A ► ,.�' 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 t 'i3u3IdingW Forms RLti -I Iighl.rTicienc}l ighnngdoc 07/01/06 Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM 1, 0 J r am the general contractor or the owner - builder at the following address: Site Address: ISSCP , 35 City: __ „t Permit #: Subdivision/Lot #: and/or r 2,6 0O0-6'{> 000 45 Map and Tax Lot #: 000 +fir / 000 C - 7 - 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. S i g n a t u r e : _ Date: / U - 6 ” Ge: I Contractor or Owner- Builder - f ViuildingTorm1R1c5 -Moi urc.Sen5lhve'.Voxi doc 09/25'08