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Permit • CITY OF TIGARD MASTER PERMIT 1 :: : ::- COMMUNITY DEVELOPMENT Permit #: MST2011 -00168 .TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/12/2012 Parcel: 2S110BA10500 Jurisdiction: Tigard Site address: 14222 SW 119TH PL Subdivision: 2010 -004 PARTITION PLAT Lot: 2 Project: Treehill Partition, Lot 2 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 943 sf Basement. 0 sf Left 5 Parking Spaces: 0 Height: 24 Bathrooms: 5 Second 1490 sf Garage: 655 sf Front: 20 Smoke Dwelling Units. 1 Third: 1222 sf Right: 5 Detectors: Yes Total. 3655 sf Value: $407,481.32 Rear: 15 PLUMBING Sinks 1 Water Closets: 5 Washing Mach: 1 Laundry Trays. 1 Rain Drain. 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs /Showers: 5 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 7 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 Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 7 201 -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 3655 Owner: Contractor: JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION Required Items and Reports (Conditions) FOUR D CONSTRUCTION CO INC 12600 SW 72ND AVE #200 1 Ersn Cntrl 503 - 681 - 4444 12600 SW 72ND AVE #200 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 - 639 -2639 PHONE 503 - 639 -2639 FAX: 503 -624 -0239 Total Fees: $21,010.18 . 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. • NTION: •r - =•n law r-• ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0%1-0010 rough OAR 9 ?.-0• -009+. o may obtain a copy of the rules or direct questions to OUNC by calling 503.232. =87 or 1.800.332.2344. Issu d By: / ■■. Itk ./ / Permittee Signature: . , _ . _ _ !. ie'" . Call 503.639.4175 by 7:00 a.m. for the next available inspec ion date. I 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. N II CITY OF TIGARD MASTER PERMIT I 2 COMMUNITY DEVELOPMENT Permit #: MST2011 -00168 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/12/2012 Parcel: 2S110BA10500 Jurisdiction: Tigard Site address: 14222 SW 119TH PL Subdivision: 2010 -004 PARTITION PLAT Lot: 2 Project: Treehill Partition, Lot 2 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 943 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 5 Second: 1490 sf Garage: 655 sf Front: 20 Smoke Dwelling Units: 1 Third: 1222 sf Right: 5 Detectors: Yes Total: 3655 sf Value: $407,481.32 Rear: 15 PLUMBING Sinks: 1 Water Closets: 5 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs /Showers: 5 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 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: 7 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =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 addl 500 sf: 7 201 -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 8 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 3655 Owner: Contractor: JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION Required Items and Reports (Conditions) FOUR D CONSTRUCTION CO INC 12600 SW 72ND AVE #200 1 Ersn Cntrl 503 - 681 -4444 12600 SW 72ND AVE #200 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503- 639 -2639 PHONE: 503- 639 -2639 FAX: 503- 624 -0239 Total Fees: $21,010.18 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 OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .1987 or 1.800.332.2344. Issued By `' _ _ ' e _....12.- Prmittee Signature: ` 1"......4-149 Call 50 a� 7:00 a.m. for the next available Inspection date. 71-A, This permit card shall b: : • 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. ` _ , �., `J)2 Cl 1 1 '£' # , � '�+, r '� 'mo 's t �y 1 n o z's. - r., ;: . 1 , Yw e -4- e IORO , . Cit Tigard y of Tigar cC 2 8 Race _ „ • 'S G P 2 8 2011 Date/B 1� . � �m i r� `e7 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ra ° ' `' Phon': 503.718.2439 Fax: 503.598. J Q... Date/B : r � I ` .. / _ r Inspection Line: 503 ' i 1 O TIGARD Date Reap""" orris: TIGARD g Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: " j Supplemental Information -t'+ g i New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the : - ,wk ^; �`7 ,, , ,, , t ; n ., v work indicated on this application. r� Valuation: $ P 1 - and 2- family dwelling El Commercial/industtial , ❑ Accessory building ❑ Multi - family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms: £2 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 \ o Job site address: \Lk gam "akke C \ New dwelling area: 3 106- square feet City/State /ZIP: T \v 012_ 9 - S Garage /carport area: 6.65- square feet ( 222. Suite/bldg. /apt. no.: Project name: 'IT,/ vzii_ ' • \\ Covered porch area: (t�S square feet /At Cross street/directions to job site: C:ac_m—r�e- ( l 1t I h+ el Deck area: 3 1 at square feet el/V3 l Other structure area: I .,3 (d square feet �4 REQUIRED DATA: COMMERCIAL;USE „,,,.1,:,, ® , ',5`` Subdivision: 1 J•„ g41( Lot no.: 2 Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 1{ 1 2 (( Valuation: S Existing building area: square feet New building area: square feet PIt ,)PI * 1f) ,,, : ;',..f x. ANT. Number of stories: Name: \ e\ - Q ,#L La. k s 0.. Type of construction: Address: la 6 15z.4 S, , ' 1 l i ci-via St a 4 7,9' (y Occupancy groups: City/State /ZIP: I i 7 �„ r 9 0 (L 7 fig- Existing: Phone: ( St) ) 63 1 - a l b S l Fax: (5t 3) 6, 4 - 63 `f New: t '�.� -;�; ' �•• fi V ', 34a,Y .. "�' ' , „' ” o 1 " ,, ., „, : � aS °,;,.0 t 1 io @7 ., a 1 , ice •• " «'o . .:, >d Business name: IT 9_ t v,Sksr v.`�a t ^ , Structural plan review fee (or deposit): /� Contact name: I � ,k Address: 14� 9a �a 3 El FLS plan review fee (if applicable): (TO o$i ti co Total fees due upon application: City/State/ZIP: T r d r, O., ` q-aa 3 c., 4,1 Phone: (9,3 ) 63 ^...11.. 39 - F :: (g) ) l...'{ _ c 3 Amount received: � q P a ' r' t E -mail: 4(.3 3 1 1 ' r r ` d d : '''''',.., roof-top , , ,.. C Commercial and residential prescriptive installation of ' ' ` _: roof -top mounted Photo Voltaic Solar Panel Sytem. .=sex_ ....- �.s��j,�,�,tt��- .a..,. ^ + , ...�... . i,.. ...,_..1 ` ��?.n? : � "�,..<.�._�' .. .:,�.t. Business name: G o ,r�,{..1 6 N Submit two (2) sets of roof plan with connection details B and -fire department access, along with the 2010 Oregon Address l b 1X) sr. q-,,),._-4' A,re _s trt k •e �Z Solar Installation Specialty Code checklist. _ City /State /ZIP: --r-ii,,,,,) Permit Fee (includes plan review b � and administrative fees): $180 Phone: ( 3 ),6 3 r „ A 3 Fax: ( �3 ) 4„,D - A - 7 State surcharge (12% of permit fee): $21.60 CCB lic.: 3f J Total fee due upon application: 41.60 Authorized signature: 4 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 4$(7, . f - , Date: et/,?-8/11 * Fee methodology set by Tri -County Building Industry Service Board. I: \ Building \Permits\BUP- RESPeimitApp.doc 02/ 24/2011 440- 4613T(11/02 /COM/WEB) This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form.and the information it provides helps the review process and response to your project. City of Tigard Buildin g Division TIGARD TRANSMITTAL LETTER TO: -0-64 DATE WM: DEPT: BUILDING DIVI ON FEB 2 8 2012 CITY OF TIGARD FROM: - Ak S}ln 7--PM 11 BUILDING DIVISION COMPANY: Al 9. C.11.wc tA. J-1, bv- PHONE: • Cs �-ab - If i(q v B '- ' � • RE: /1/aA2 ) //9. - A--- l rale /6 (SiteA ss)) I / (Permit Number) eiek LPL 141 7- -7 A.) 4..p • (Project name or subdivision name and lot numb(r) c . ATTACHED ARE THE FOLLOWING ITEMS: • Copies: I Description: I Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (exp in): REMARKS: --/--v1.4... c e ./ 1..e-4-¢/e,- . • FOR OFFICE USE ONLY outed to e it Te hnician: Date: c 5 - o 1' / ) Initial ' f Fees Due: Ye ❑ No Fee Description: Amount Due: 655f of i,►t I4- $ dCZ, $o $ Special �� Instructions: Reprint Permit (per ' .: 'e ❑ No ❑ D • ne A. slicant Notifies. :ate: 1 , • u, ; r Initi. s• ■ 1: \Building\ Forms \TransmittalLetter - Revisions.doc 02/08/2011 Electrical 'Permit Application CEIVED � FOR OFFICE USE ONLY • • City of Tigard Date/B : 9 Re // PermitNo.: ��j�1(�/� -G�l� E n 13125 SW Hall Blvd., Tigard, OR 97223 p Plan Review q Phone: 503.718.2439 Fax: 503.598.196( EP `� 2011 Date : Received Other Permit: dp (v,ecav -etilJ 2 TIGARD Inspection Line: 503.639.4175 Date Ready/By: kris: H See Page 2 for . Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information P l 47e,! :' ', 4 i "+^ a ,as' �a rD.I Y I, - °, f' a ' " r F.� �u v -. �4 TY PE` OF kD , ` . PLAN REVIEW s.i r» ry ,.3: rte, �. 1� , �:�sa -ter ,-wa a ,r,�_a� , . � �' -., x .sb , � ., s. _. zg , ; < , .. � ..m. �.. . ,... �', e � a .. . , RI 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. ;' 4 , SATEPORY OF, CONSTRU%19 i ,1i rf i - .0.7 mgr . 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 ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or 'mss O-SITE ORMATION AND LO . ION �'° Emergency system. larger separately derived system. E,? _ , N ,1 , u ' JB - ,, INF , g _., , e:A ,ae� , ,, >:, . . ... ,. ❑ Addition of new motor load of ❑ "A ", "E ", `1 -2 ", `I -3 ", Job no.: Job site address: 1 )-,�. a g%., \ 10 Six or or more. occupancy. \ 4 C.L ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP \� �,,.a, o 61-7--g3 ❑ Health -care facilities. ❑ Supply voltage for more than ` ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: 1Y� ❑ Service or feeder 600 amps or more. > ' FEE 'sSCHEDULE ' tft V Cross street/directions to job site: / k \ et PA . Description I Qty. I Fee. I Total I * New residential single- or multi- family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 1 168.54 1 Subdivision: - 1 - 4 ,, e \ \\ Lot no.: Q. 4 Ea. add'l 500 sq. ft. or portion "7 33.92 'Z ? .44- 1 Tax map /parcel no Limited energy, residential § -.1, aDESGRIPTIcON O1 dWclita „ ;; Itt � (with above sq. ft.) i 75.00 "7.S 2 _ S ` 1 \ Limited energy, multi -family R W ' S S\ ( - tr� �-1 �V..S wC — residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 75 00 2 �„ \ , 200 amps or less 100.70 2 1(5 \ L E��n c v' ® - , O . W WIVER" , , L L - • TENANT ,'' , : W , - ,., 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: ,\ v� 2-.\,.\ C.,..ir -1 -v, 601 amps to 1,000 amps 301.04 2 Address: l,..bc Sw \ ( �, r � g� ,)41,1 Over 1,000 amps or volts _ 552.26 2 d V ' " Temporary services or feeders installation, alteration, and /or City /State /ZIP: 1I O.xcl of ql' 3 relocation Fax: ( ).6.?,-1--- 200 amps or less 59.36 I Phone: ( 6D3) i_ >i°3� 9.3 6 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with e.... V W A PPLICPT� °'` " egi i ' rr � C ON T A ` CT PER "'" "MA " e' above service or feeder fee, 7 42 2 fx, I x ® 11 A A < �g , . u ._ .. , k . . _ _�... > §P.- z Z' ° each branch circuit Business name: J ` CsIv. Siov B. Fee'for branch circuits without service or feeder fee, first 56.18 2 Contact name:,ti branch circuit 1 Each add'I branch circuit 7.42 2 Address: ` 7 66.6 p Stj . t Cam, Miscellaneous (service or feeder not included) Each manufactured or modular City /State /ZIP: (q� OK 9` ( 3 - dwelling, service and/or feeder 67.84 2 JJ Reconnect only 67.84 2 Phone: (�3) X39 — ab�l Fax: : (S'n ) c.„7-1 — Pump or irrigation circle 67 84 2 E Sign or outline lighting 67.84 2 (?"" 2"'t Vi e . "" „ b _,"' ^:r, ,, f .°', t _ CON11.ACTOR °, , , i y,a; Signal circuit(s) or limited - energy Business name: panel, alteration, or extension. Page 2 2 � ,tNt+`� -t ( -�-'�' .C- Each additional inspection over allowable in any of the above Address: P g ` 4 `1-S 1 • 4Oe4 (.44449.4. S� Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: t ` - _ n r 1 v Investigation (1 hr min) 66.25/ hr l S V�(i7 171` 91_ a� Industrial plant (1 hr min) 78.18/ hr Phone: (S-D3 )61.4 _ c' t1 ii Fax: (�3 ).Gii If _ '9 -'"i • inspections for which no fee is 90.00 / hr l specifically listed (' /A hr min) CCB Lic.: Electrical Lic.: ' Suprv. Lic.: . „ELECTRiCAL PERM IT FEES,�"r >) 4s . • ts�s��� 3'��I�� f: 5 Suprv. Electrician signature, required: (7/74.419.7 Subtotal: 6 1 - €)C.) , c(13 Plan review (25% of permit fee): Print name: CA`-+t t � Date: / State surcharge (12% of permit fee): �7? 0 7 TOTAL PERMIT FEE: 53 e 7 0) Authorized signature: pe ( / Q �� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: b owte,I 3 `n--e- Date: 7 /s,T/ // • Number of inspections allowed per permit. I ' \ Building \Permits \ELC- PermitApp.doc 07/01/10 r 440- 4615T(11/05 /COM/WEB t -. Mechanical Permit Application FOR OFFICE USE O NLY City of Tigard �1 R e ceived 9 � _�� DateBy: p H, l ��J Permit No • „ , „ / .. i u 13125 SW Hall Blvd., Tigard, OR 972 s+. '. i D ate /By: Plan Review 61.0e / / -2 /,� Phone: 503.718.2439 Fax: 503.598.19i)i Other Permit. �1 D TIGARD Inspection Line: 503 ` -' G Il + t 1. 11 Date Ready/By: luris • See Page 2 for Internet: www.tigard - or.gov C N otified /Method: Supplemental Information AlCiN TYPE OFt WR , 0, - :, COMLt.FEE* SCHEDLE -USE CHECICLIST °° >` , - ,. b ,.0 ' " - , , _ ' . . w '' O a ff h - - - ., ERCTAmi ___. U . _, ��,,tt��`` Mechanical permit fees* are based on the value of the work ® New construction ❑ Addition /alteratiWiltep acement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. r ark" _ i -...� m^`**,; a >. Y a a`�&' ,. , 4` �^ Value ` � ' j' a CATEGORY OF CONSTRUCTION � ,� 4' < k 1 RESIDENTIAL E QIIIPMEkI / SYSTEMS a✓ ,, X 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total . i v 4t p w i a"Y 'w`" ah"'''" e 4Y" : "� ° Heating/cooling: *, , „. 1 ' t JOB,SITE INFORMATIONi AND LO @ATION t p I, i i ; 5 w Air conditioning Job site address: \g--k. aaD 5w I te1�'' � (requires site plan showing placement) 46.75 Furnace 100,000 BTU (ducts /vents) k, 46.75 City /State /ZIP: '`j pf, q� 3 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name:T,(-� CCv t r Heat pump (requires site plan showing placement) 61.06 _ Cross street/directions to job site: 6' off- 1 i l M� e , ot Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision:- ,, 1t I Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances: 4 , . , DESGRI T N O PTP IOoI WORK .:m rVnif :C "� .. Water heater 23.32 ie lNe :,. ts' � :4 ,. aw n. , . >.a ,_ E _ �-x . x ekii, s . _ r 'L° ; xz s � _ -.<.. , .; ". ., ,. Q. Jl1i v Gas fireplace 33.39 \\ �V1C� K O. I Flue vent for water heater or gas fireplace _ 23.32 Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 it . ' ®PRORERTY OWNER w _ ®TENANT r� ' ,, y4 Chimne /liner /flue /vent 23.32 . v ,a., - , ,-0.,,, *- ,�*. ,-,:.. 2i ., A „ ..> Other: 23.32 Name: r Kd 4k.,, w- ( Environmental exhaust and ventilation: Address: 6, y ,,,, �-,4 �L gt,._ ii 0 Range hood /other kitchen equipment k 33.39 City /State /Z1P: Ti-e5 o L 9fia33 Clothes dryer exhaust \ 33.39 Single -duct exhaust (bathrooms, Phone: (s-b-� ) 1,'31 - Fax: (,s-b3) (.,a r tQ31 toilet cojpartments, utility rooms) /0 23.32 t q2 a -, ; ® APPLIC i ' , t " CONTACT'PE Attic /crawlspace fans 23.32 Business name: AT a CA � � r Other: 23.32 Fuel piping: Contact name: C \�Slh ,^ $14.15 for first four; $4.03 for each additional _ Address: l2b�o "7� Su , ' e_ S a l �� P etc. l ���I p Gas heat pump City /State /ZIP: 1 e>•rCJ b4- 19 Wall /suspended /unit heater Phone: (+yp, )<, -,x Fax:: (g$3 ) (3-,-.) 1-D031 Water heater I Fireplace E -mail: , x c o , 'S' 3`"�..r T ae� ;i �a ' a "' ' ' . i�;� q ,? Range P I r,h„ s,- i �� . f t e 1 „ONTRACTOR /� ' ' :rte -” " r. i e � , Barbecue ..�rJ?.; .L ,. � 4. �wu as s� <b ., . �,c -v,,, . zoews s.,v e>. „ €a R.�+z:�., ^�-, .� a-,- r o ,,,n,, � Business name: (2 M ,A¢a.. Clothes dryer (gas) Other Address. r O , r ` - D - `\ \\ 'y; MECHANICAL PERAtITiFEES* e- , < ;� City /State /ZIP: \'lr7•f btt 'II- 6t) `'3? _ Minimum permit fee ($90.00) Phone: ( 3 ) k,, z _: $ e Fax: (sb3) L3 - 6ay Plan review (25% of permit fee) CCB lie.: `a,l.-t'- •'�. State surcharge (12% of permit fee) — 0 , � .(` • TOTAL PERMIT FEE S 3 ��� te..) kie, Phis permit application as es if a permit is not obtained within 180 Authorized signature: days safter r it t has been accepted as complete. Print name: u • ` _ Date: O ` l- I u Fee methodology set by Tri -County Building Industry Service Board I\ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -4617T ( I /02 /COM /WEB) i Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received Q /� �/ Mr a011 �� Date/By: 7 0 Peit No.: tm l a 13125 SW Hall Blvd., Tigard, OR 97 3 Plan Review L� n 0 �, / Date Er II Phone: 503.718.2439 Fax: 503.598.19 0 Date/By: Permit No.: K c ^ Inspection Line: 503.639.4175 E �� F 2 O 2 01 I Date Read B Janis: ® See Page 2 for TIGARD Internet: www.tigard-or.gov �/�� •�,7��( Notified/Method: Supplemental Information a' .o- �'Ti " +iv5 lJi +?� *1 �sF -':" f Z ,� 4 T "6 Fn?'4J' Y , 9 Ab, 3,A .s�b3°?v '; < B M ' :, , ;; WT e ,, <. 7- 7 a , 4TYPE g O F sfWO * r . , I ` ° r? FEE*�S r fi6tr L E ` ' ( .!',.4,,,A c n�viso ® New construction For spec information use checklist. Description Qty. 1 Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) ,. 7`,N" k SFR (1) bath 312.70 F -'" ° C OFACONSTRUCTIONN r ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi- family � SFR (3) bath 500.32 522 32__ . Each additional bath/kitchen , 25.02 04. ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 f - , 4 1 � : ... � *dli ITE I AI t p. LO : a z. `4IZ' Site utilities: � :. Job site address: , q a -� a s \ \29 e \ Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP. � ck DC- ( Footing drain (no. linear ft.: _) Page 2 Suite/bldg. /apt. no.: Project name:weR, C L ` ' I Manufactured home utilities 50.03 Cross street/directions to job site: ao . / l \ c=k . K� ,1 Manholes 18.76 Rain drain connector 1 18.76 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: _) Page 2 Subdivision:- Cam`` Lot no.: n, Fixture or item: Backflow preventer i 31.27 Tax map /parcel no.: "' y ° a ;:tf ' `D TWO ;Ni - Backwater valve 12.51 (� Clothes washer , 25.02 s""S�` � 5 , Dishwasher ‘ 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ''''''''4'', f� r �a c i P , '' ��� �„ g o Ex ansi tank 12.51 ® PR OPERTY OWNER �/ `- tTENANT P \ l� , Fixture /sewer cap 25.02 \ Name: ` �n.S c�i"lb r^ Address: Floor drain /floor sink/hub 25.02 �� Sw �� J e 5 ✓ Garbage disposal 25.02 City /State /Z;P'-'k' by... e 9.- 3 Hose bib 1 25.02 Phone: (so3 ) 03 -Q6 j e t Fax: ( b ) t. _00,31 Ice maker 1 12.51 Rgit �` a P �N �" ;�"a. _ a 1 i r r t" Inter tor/ rease tra 25.02 ..,. � APLICAT �, °.' ,. r.> ,., ., . 4,iL CONTACT P ,3, P g P al- �+ ` Medical gas (value: $ ) Page 2 Business name: " C v v.s ��..,1 2 ,ov. ti,,� Primer 12.51 Contact name: a 6„,....4.t. Roof drain (commercial) 12.51 Address: b00 5s ' 1 e i �t) Sink/basin/lavatory 25.02 City /State /ZIP: -F 3 ,„4 6 e gi- 3 Solar units (potable water) 62.54 Phone: (Sb3 )(39 -0(,31 Fax: :(S') ) - .0,1-ba3 Tub /shower /shower pan 5 12.51 E -mail: Urinal 25.02 Water closet S 25.02 ° k .. .. CONTR _ - b_;. ,.k ,., ' ._ ^ n � Water heater 37.52 t' Business name: J 0 S „ I Water piping/DWV 56.29 Address: ` D vX �T14 Other: 25.02 City /State /ZIP: 6 Subtotal , - 7)"‘" lil� No_ ��'� Phone: (513 ) 3 _ i --. Fax: (57)3 ) ' t.( - OS $ d Minimum permit fee: $72.50 CCB Lie.: (pa J 3c . Plumbing Lic. no.: 34- ��(� Q Plan review (25% of permit fee) S tate surcharge (l2% of permit fee) ��, 0T Authorized signature: TOTAL PERMIT FEE (,), ___. cLivi_eifit Print name: This permit appli expires if a permit is not obtained within 180 days P i 3 PALL l Date: 7 /. 7 .7 ((( *Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits\PLMU- PermitApp.doe 10/01/09 440- 4616T(I0/02 /COM/WEB) III " Building Division Development Code Provision Review TIGARD Residential Projects Building Permit No: Ta I 1-60 i l " CWS Service Provider Letter Received: Yes ❑ No ❑ N/A K Routed Plans: (1/ Original Plan Submittal Date: aS 1st Revision Submittal Date: / ❑ 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 alon le only only if approved. Planning Review (contact • IST1'v �« r w le..n at 503 - 718 - ZySL or /crtsd ti and -or. ov g ( _ @ g g ) Land Use Case No. M L P2o0]-- OQ,6 Name TreR.k i 1 I Pct, 411-1 on C Zoning IQ' ' lie Front 2- Rear 1 S Side S Street Side I S Garage -Z C7---"Maximum Building Height 30 Actual Building Height Z--V 1� r , J i Lam' Visual Clearance A L'Easements ' ` C]''Sensitive Lands Type: Aid A/L. V 3/i L Notes: Original Plan: Approved ffr:. Not Approved ❑ Date: r /2-9// Revision 1: Approved ri Not Approved ❑ Date: "" / / g I Revision 2: Approved ❑ Not Approved El Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) ,©Actual Slope: ' 1 Notes: Original Plan: Approved Not Approved ❑ Date: 4 Z /( Revision 1: Approved Not Approved El /0 l� - 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) LN / ty Street Trees © Protected Trees Notes: r 1 / J /, ot ^" J_ S l� ,r? i t Sctd �ti^- A T Co � l Ca✓� r, Oft re CCo" - c-J �� ( i..1 p - /r s -/� { 4,t\� fcc,rJ ic ed „'c l�� e� f-OT,, Lr_ Original Plan: Approved ❑ Not Approved Date: y 3 t? ' Revision 1: Approved 1 Not Approved ❑ Date: /IL 11 ad // 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 : 7 a' Original Plan: Date Sent to Applicant: L Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes fit' No .10/ sf • Date Routed to Building: CCC Page 2 of 2 ,-,. ■1 , x) a% . . ■,i IC (6 i ." iterUlt4,1 .64■ ' -, I, 'Jr , r) I 4..4 cr) ‘ 0, 0 iii r- : g t - ii: ,g ~,< — 1 (f) .1 n_ 3 r2IITI E ZIleg-§ 9 '. i R • m 1 IR "h''' e ia (.3 1 i 1 • ____ . ' 4 flj . ci r„, zt. 1 •-.„1- ..,,„,., 1 1 0-0 ij i .0 / • - . • ■ , :11 7 ' _________ . f 0 0 9 0, .0 I-- Al „ f,E,69,,TO S ''. I .7. - ILI _ RECE I ' I i OF TIGAir CITY BUILDING •- - -- - ___ ___ __ ,CO'LGE , 1 I [ ...._2; q 1..... .:: _ .... . . ii r - a - - - -- - - .°- ' - I ''') 1 '''•1 . - , -■ '..1 I CO IL:': /11, 0 0 I ,_ .010c t . f.:1 • 1- - -2 I .. A. _ El I - _ _ j H— _ _ _ _ IIII I _ -i- I , - _ - -- - _ - - -- - - _ 1, ,,,,, ----- --- _-_ ___...._______ ,,,,.._ . i a 0 ,..., I • - - • :-.--_-_-_=- ■> .....--, 01 .41 / it - I i Qi ,,:_z"tr‘YE ... , •.. I I '.- - - - - - - 1 1 ',. ' I I - g • N 21 ',I, -. 1 1 . „ 'I I — - -7- I--". 1 -CI- -------- - . . .. .... .... ,,_ . _.___ . 6f -- , 6 I . ' • .:... \ ,i . • A .) - \I Al ‘,... c.,1 ..4. , A" - ' Y ' s _(_,„ . , .___ 11) ' ;frE" I .#-Zt•Z:9' rt. , , ...., -1 -- q\, - ' .-t ..-- -- ‘ „ 9e, a T. I ) (•,,, cf ....- 4.: --- ....- ,.., :, ,03..„ - °) --i---\ :04,..z.-;,,„ ,), • - . . Mit: ..-'''' I. A' IY-.-.) • '-''' . •-•:\ .< '(-, ' • 1 ■_: '1 i+. ' - A. \ 5. • . ' \ -- , ,....,......,......__....,_,...._....,.....„.,...„................._ .. ._.....___,...._,.._.„.....,___ .,..„...__........._..,......__....._.,,....... . ... _..........,,,.....„._„, __....... ...._ • .4457-026(1 -6-6ie0v 1 q STREET TREE TIGARD CERTIFICATION , owner /a for , (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. PERMIT NO.: �-o ((- 00140 F1 HIE ADDRESS: sw f 17 SUBDIVISION: ( . LOT #: SIGNATURE: _ w . � (OWNER/AGENT) ‘1/4 RECEIVED & VERIFIED BY: DA'1 E: (CITY OF TIGARD) ❑ Tree location verified pe approved site plan. I: \Building \Forms \StreetTreeCertificate 04 /01/2011 ./ Tao /l -ate /6 S' Oregon Residential Specialty Code N1107.2 HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 00 « eK Jurisdiction: Site Address: Raw Su- Vk Subdivision/Lot #: \ e -t \ and/or Map and Tax Lot #: By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) Signature: /' k- � Date: °I R g Owner , eneral Contractor /Authorized A ent /1? Print Name: .0. A 1 ' ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. l: \Bui Id ing\Forms RES- HighEfficiencyLighting.doc 07/0 /1467' c7) — cra ( $ Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, , am the general contractor or the owner- builder at the following address: Site Address: s ,e lame City: Permit #: ao lt — au`b� Subdivision/Lot #: ). 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: / °'(/6 Date: 7( lid General ontractor or Owner - Builder C 1:\ Building\ Forrn \RES- MoistureSensitiveWood.doc 09/25/08