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Permit 1 1,1 a CITY OF TIGARD iy MASTER PERMIT s COMMUNITY DEVELOPMENT y P ermit #: MST2011 -00213 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012 Parcel: 2S110BA10600 Jurisdiction: Tigard Site address: 14238 SW 119TH PL Subdivision: 2010 -004 PARTITION PLAT Lot: 3 Project: Treehill Partition, Lot 3 Project Description: New SF. 4/25/12, adding continuous loop fire srinkler system. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 854 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26.5 Bathrooms: 4 Second: 1332 sf Garage: 830 sf Front: 20 Smoke Dwelling Units: 1 Third: 1581 sf Right: 5 Detectors: Yes Total: 3767 sf Value: $423,425.08 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains. 0 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: 6 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: 8 201 -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 3767 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 -629 -2639 PHONE: 503 -639 -2639 FAX: 503 -624 -0239 Total Fees: $21,991.34 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 acco • 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. ATTEN N: Oregon aw requires you to follow the rules adopted by the Oregon Utility Notification Center. hose rules are set forth in OAR 952 -001 -0010 ro gh OAR 952- 0 .19e. Y.. ay obtain a copy of the rules or direct questions to OUNC by calling • .232.19: o .800.332.2344. Issued By: /4�/ i / Al Permittee Signature: ' /�=�, 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. 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. UPI City of Tigard Buildin g Division TIGARD TRANSMITTAL LETTER TO: 14) DATE DEPT: BUILDING DIVISION REM?. ' ED MAR 15 2012 • CITY OF TIGD FROM: U.,S"))1'J BUILDING DIVIS ON COMPANY: JJ g C S� RAJ PHONE: SC)) (-P., - By: 67 RE: /Lfg, 3 St,J . 1/9 * /4. /y § ( l - C� )-( (Site Address) (Per it Number) 11,, 1 106,r ;-fi& /o 3 r ojectname or subdivision name a lo t n 376 2 ATTACHED ARE THE FOLLOWING ITEMS: Copies: 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 (explain): p r\ kr p t o n/1 REMARKS: FOR OFFICE USE ONLY Routed to e 1 Technician: Date: Initials: Fees Due: es ❑ No Fee Description: Amount Du 5,7 4? $ e9)03, $ ?' `? $_ . Special $ c a? / l9 Instructions: Reprint Permit (per PE): 11 Yes ❑ No ❑ Done Applicant Notified: , ,l ate: Initials: 1:\Building\ Forms \TransmittalLetter - Revisions.doc 02/08/2011 W CITY OF TIGARD MASTER PERMIT e� ! COMMUNITY DEVELOPMENT Permit #: MST2011 -00213 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012 Parcel: 2S110BA10600 Jurisdiction: Tigard Site address: 14238 SW 119TH PL Subdivision: 2010 -004 PARTITION PLAT Lot: 3 Project: Treehill Partition, Lot 3 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 4 First: 854 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26.5 Bathrooms: 4 Second: 1332 sf Garage: 830 sf Front: 20 Smoke Dwelling Units: 1 Third: 1581 sf Right: 5 Detectors: Yes Total: 3767 sf Value: $423,425.08 Rear: 15 PLUMBING Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 6 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs /Showers: 3 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: 6 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: 8 201 -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 3767 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 - 629 -2639 PHONE: 503 - 639 -2639 FAX: 503 - 624 -0239 Total Fees: $21,730.16 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 cosy of the ru - or direct questions to OUNC by calling 503. .6 2.1987 or 1.800.332.2. Issued By: __ •- Permittee Signature: i . ■ ■ 0) Call 50.14 "•'" 5 by 7:00 a.m. for the next available inspection da.9. 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. , ! :t>ial FOR OFFICE USE ONE City of Tigard 2 0 201 • I Received , per mit No. �� .-00.9/ • O Date/B : /2 A0 / _ M a l� /, II 13125 SW Haft. 74 it. `„ y 3 - P� Oy Plan Review Phone: 50 t a, i� 7 t � • 1i 1 • Cj Date/B : M ee Inspection raf �� Other Perni �� !7 nspect .0 ' ' . Date Rd 1 ` " + ate e TIGARD Y =Y n �� See Page2 for r.gov Notitied/Method: � ` • Internet: www.tigard- o a ^ /, ' / Supplemental Information J TYPE OF WO P 1 REQUIRED DATA: I AND 2 FAI►fltY DW'I'ELLING' New construction [d Demolition Permit fees* are based on the value of the work performed. -t I Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the f CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: S 4-a77 4- ; q; -El ' 1- and 2- family dwelling ❑ Commercial /industrial ✓ ❑ Accessory building ❑ Multi - family Number of bedrooms: Master builder 111 Other: Number of bathrooms: 1 3 ,,3 JOB SPPE INFORMATION AND LOCATION Total number of floors: 3 i � Job site address: 1 to Kg S ,,_, � � l New dwelling are: 37e7 square feet City /State; "LIP: �Of_ 4 1.1" :" ? .-- S � 4 1.1" :" ? .-- S _ Garage /carport area: s feet ( k' 1 Suite/bldg. /apt. no.: I 1 Project name:, \N62,(2.,\ c,\.\. Covered porch area ) square feet [3"37--- Cross street/directions to job site: *\��ctuckck 1 Deck area: 33L square feet 6 Other structure area: - square feet 26/5 REQUIRED DATA: COMMERCIAL - USE CHECKLIST I hnbdivis;on_ `�e kt■k\\ Lot no.: 3 I Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tux map: parcel no.- equipment, materials, labor, m erhead. and the profit for the I �� , - -- ` D _ DESCRIPTION OF WORK work indicated on this application. —� ___. �K bl� �11p� Valuation: 5 Existing building area: square feet 1, i New building area: square feet I ❑ PROPERTY OWNER ❑ TENANT Number of stories: 1, Name 946. (-o YxSk`rv■CAN -01n Type of construction: � Address: 1 // -I \00o s4' 1-r _ tt ,9 Stxil # D-00 i Occupancy groups: i V� City /State /ZIP: T ,/ �[ ! —' %0 , + �o - t)(_ 1� �'3�3 � Existing: � i � h one : ( S6'3 1 31- a (03 1 ' Fax. ( vta3 ) ! �- c.. 37 New: ❑ APPLICANT ❑ CONTACT PERSON _ _ —^ BUILDING PERMIT FEES* Business name: ^� (Please refer to fee schedule) - \7 - - - - - Structural plan review fee (or deposit): q Contact name: vnt %AsCl v N . /� FLS plan review fee (if applicable): Address: t.34, 5,..4 - 1"� tR s,,,1,, '- c�-023 F Total fees due upon application: City /State /ZIP: a� l Amount received: 0 256' oo Phone: (c )6, 7 - 46 1 I Fax: : (Sb) - 03 S9 i E g fi PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* �� Y3tvx{ w vi— Commercial and residential prescriptive installation of f. ,tom , : , , , ,.',4: CORACTOR ,, •� .�: NT roof -top mounted Photovoltaic Solar Panel System. Business name: ' Submittwo (2) of roof plan with connectis I • tails ST Caw t. �'°"� he vs and fire department . • ess, along wit. - 110 Oregon 1. Address: (� e o 9 S, ice( /1 t P s k E t-� • Solar Installation Specia . . • c ecklist. City /State /ZIP: j 1 ,„,,c � _� Permit Fee (incl • pl. eview $180.00 ��a 3 ail .eministrative Phone: ( 4 ) 2 6 . 1) (r, 3`j - �1� s'7 1 Fax: (S'L3) L'-/ " ate 7 State ■ 3 arge (12% of permit fee): , $21.60 CCB lic.: 310 Total tee due upon application: $201.60 Authorized signature: / ■ l This permit application expires if a permit is not obtained _ L ` V within 180 days after it has been accepted as complete. 1 Print name: �+ 13 Date: * Fee methodology set by Tri- County Building Industry 1� t� in / Service Board. I:\ Building \Permits \BUP- RESPetmitApp.doc 02/24/2011 440- 4613T(I l /02 /COM /WEB) I Electrical Permit 'on $. FOR OFFICE USE ONLY Received .� City v 0'�� DateB { : R i Permit No.. / I / 2 . 1 . 13125 SW Hall Blvd. T ar e� Plan Review Pho 503.718.24391,', Vaaxx(-'65 5 ' .. P � O Date/B : Other Permit: / / -�/ 7 Inspection Line: 503.639.4175 1 � ,�- �� C Date Ready / By: Sufis: ®See Page 2 for TIGARD Internet: i • "g t ARD ,� Notified/Method: Supplemental Information . m s ' _ .: e F WQRI ;\ c1 . ; . .. . . . ,PI ► Tt K., 1 ` . P f1, ,'; ;; ' .N New construction ❑ Addition /alteration e r acement 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 0 Other: __ _ where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. 1 and 2 family dwelling ❑ Commercial /industrial El Accessory building less so ground, f a exceeds alla ons, ❑Commercial -use agricultural Sgi Y g amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: L[' 3 0 S W \`ok q\ _ , Six or or more. occupancy. 1 \ ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP57 wi j (AL 6t9-.?"") ❑ Health -care facilities. ❑ Supply voltage for more than 1 ❑ Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: Project name: 'T•K2sL \l ❑ Service or feeder 600 amps or more. {� ` FEE SCHEDULE Cross street/directions to job site: t \l�1iv"1 °t'-t' /_ a, Description I Qty. I Fee. I Total I t � New residential single- or multi - family dwelling unit. Includes attached garage. �sr�. \A1� '3 1,000 sq. ft. or less i I 168.54 4 Subdivision. Lot no.: /+` Ea. add'I 500 sq. 0. or portion Zy 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) - Limited energy, multi - family ‘p tie k �l (��e residential (with above sq. ft.) 75.00 2 ` _ , N Services or feeders installation, alteration, and /or relocation 10 - Q-S ' - _ \4 11J - ,t" ---s 200 amps or less 100.70 2 ❑ PROPERTY OWNER ` ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447. 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑_ CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: '.&'" v CS ,Sk 0 B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: prws�� branch circuit Each add'I branch circuit 7.42 2 Address: E W `ai ( e StM� �' Miscellaneous (service or feeder not included) `` ' f Each manufactured or modular City/State /ZIP: TtGLur 1 / �'Q a (1- - -?' % dwelling, service and/or feeder 67.84 2 Phone: Fax: : Reconnect only 67.84 2 (�3 ) ��'� �� ( _09.3 Pump or irrigation circle 67.84 2 E - mail: p - • _* Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: panel, alteration, or extension. Page 2 2 J � XO � 4 Each additional inspection over allowable in any of the above Address: P + il S � s ._. Additional inspection (1 hr min) 66.25/hr i b Investigation (I hr min) 66.25/ hr City/State /ZIP: t 1',. 6,, o t w s _ . a -f-14.1 Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Inspections for which no fee s s �� —S �� Fax: ( ) b - I f hih f i specifically hsted� %: hr min CCB Lic.: I. s tx Electrical Lic.: 39 _,t Suprv. Lic.: Lic 60S .it .0114-6'34,i �,�'I;t 46 90.00 / hr , a; c4 ii Subtotal: Sum. Su. Electrician signature, required: Plan review (25% of permit fee): Print name: ± Date: /. / i / State surcharge (12% of permit fee): Authorized signature: n l 1 TOTAL PERMIT FEE: Y:e..41Y This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Z(xAfl Date: („„ la a- i 1 • Number of inspections allowed per permit. l \ Building \Pennits\ELC- PermitApp.doc 07/01/10 440- 4615T(I t /05 /COM/WEB Mechanical Perm' tkicti FOR OFFICE USE ONLY Ili City of Tigar 4 1 Received Date/By: / R n oir,4 A / PermitNo.: / w 13125 SW Hall Blvd., Tield, r+' r7 Plan Review !/t = Phone: 503.718.2439 t 8. 9 6 11 0 ( � Date/By: Other Permit: r , T e /�� ao! 73 TI G A RD Inspection Line: 503.639.4175 ,T , v� \ Date Ready/By: Juris: See Page 2 for , Internet: www.tigar r' vor A_ � V . O� Notified/Method: Supplemental Information BU1LD ,, ' ,..,0& , T WORK � _ COi�IMERCIAf .-FEE* SCHEDULE - USECHFCKLIST �` i r � Mechanical permit fees* are based on the value of the work A New construction ❑ Addition/alteration/rgj .. 40 performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: '?,' mechanical materials, equipment, labor, overhead, profit. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 191 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: tt t�Ay » 1 \ ° l am C \emu (requires site plan showing placement) 46.75 C'tty /State /ZIP. ,', v & c A-W-3 Furnace 100,000 BTU (ducts vents) , 46.75 L Furnace 100,000+ BTU (ducts /vents) 54.91 t 1V-�' Suite/bldg./apt. no.: Project name !�v srR Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: `^ °A / a� Duct work 23.32 " l 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 1 a Lot no.: Flue /vent for any of above 23.32 1 Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater t 23.32 1� Gas fireplace 1 33.39 A.e,`� � \ \ (,,„,,r4,4-,..(2 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 ❑ PROPERTY OWNER 1=1 TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation: Address: Range hood /other kitchen equipment ' 33.39 City /State /ZIP: Clothes dryer exhaust i 33.39 Single -duct exhaust (bathrooms, Phone: ( I Fax: ( ) toilet compartments, utility rooms) la 23.32 13132-- APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23,32 Business name: -`I- R11r' kftnv \ 1" Other: 23.32 JJ Fuel piping: Contact name: $14.15 for first four; $4.03 for each additional Address: ( ma,► I� R („ o a� Furnace, etc. \� Sw ✓ 'C Gas heat pump City /State /ZIP: -T-;1 0 t 1 3-.. -s Wall /suspended/unit heater Phone: ( Tit.3 ) 3 Fax:: (' 3 ) b�`f - 3 7 Water heater I a � q Fireplace E mail:. va h Y ) ,rts avxr '4 -V , 1/4._... I Range CONTRACTOR Barbecue, • Business name: t 1 M O ,) � Clothes dryer (gas) '2 �'"' Other: Address: e D* 6t>,C. 1 1t,.. s ' '„ CAL ,t: a.,'. ).. -, ",r City/State /ZIP: tc, ()AC 1-009 Subtotal �J Minimum permit fee ($90.00) Phone: (S3) b31- g y 91 Fax: ('Sp3) L3 I. _ Sayy Plan review (25% of permit fee) CCB lie.: pit 3 -. State surcharge (12% of permit fee) , TOTAL PERMIT FEE j 3, 2...`3 Authorized signature: �� This permit application expires if a permit is not obtained within 180 � /�iltif' 0.44 K1 days after it has been accepted as complete. Print name: Ort ALt W L Date: 1„7, a, / / I I * Fee set by Tri County Building Industry Service Board I:a Building \Permits'MEC- PermitApp.doc 09/09/10 4 4G ITT (1I /02/COM/WEB) N Plumbinz Permitlication aildin o + FOR OFFICE rise ONLY l�l�' Of 1�� 11 `1 C i DaceiB / I Permit No. Q�/�2,�1? • 131 vS�d 1 1I Tigard, OR 97223 Plan Review O �df / . /1 J � g Plan Review m Phonb`.'"503.7I843', s Jx: 503.598. i,,k %'\' Date/By: Other Permit No.: :� ��`�1 7^ T t GA RD Inspeetiv ..�y� Date Ready /By: Juris: ® See Page 2 for ` Int w 1<<i W . _ • NAIR -` e tJNotified/Method: Supplemental Information New construction '' A 1 TYPE OF WORK v F� ` FEE* SCHEDULE...'' ❑ De L t G� For special information use checklist ( h �, �� Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Othe .0 New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 1 312.70 a 1 - and 2-family dwelling SFR (2) bath 437.78 y g ❑Commercial /industrial SFR (3) bath 1 500.32 f jQ:31, ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 1. 25.02 - ZS, 0 r] Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: ,�'��t 5 , 4 ` \' q 1 ,e.,< Catch basin or area drain 18.76 T��( d Ot, C D oting leach line, linear trench drain 18.76 City /State /ZIP: Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name:cs,f,ejt,\A Manufactured home utilities 50.03 Cross street/directions to job site: WIy\,,kw /1,6\ I etOkikx kk Manholes 18.76 Rain drain connector 1 18.76 Sanitary sewer (no. linear ft.. _) \ Page 2 Storm sewer (no. linear It _) \ Page 2 Water service (no. linear ft.: _) i 1 Page 2 1 Subdivision:'1, , Lot no.: 3 Fixture or item: Tax map /parcel no.: Backflow preventer 1 31.27 DESCRIPTION OF WORK Backwater valve 12.51 �� Clothes washer , 25.02 \ \I -� i�2 A� A 0 V Dishwasher \ 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain /floor sink/hub 25.02 Address: Garbage disposal 1 25.02 City /State /ZIP: Hose bib I 25.02 Phone: ( ) Fax: ( ) Ice maker 1 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: ,'� (2..40,\ l ., u\k,kl.0 r Medical gas (value: $ ) Page 2 Contact name: ,� Ch, Primer 12.51 Roof drain (commercial) 12.51 Address: \ Op S W 1-4 f J Q � I Sink/basin/lavatory 25.02 City /State /ZIP:q, gcx.ic b a 7 ��a Solar units (potable water) 62.54 Phone: (SUS ) f Sl _ a(o g Fax:: (.a3) -6 g Tub /shower /shower pan 4 12.51 Urinal 25.02 E - mail: ; -1e ", ' ' ak■". Y P \ \k‘r &L&N.L , c ov._• �( CONTRACTOR Water closet 1 25.02 Water heater 1 37.52 Business name: p o ,., , , , „�0J Water i m WV 56.29 Address: (t Ai is 5 Sw KQ. ,v44 h LJ0...._4 Other: 25.02 City/State /ZIP: Qmricke„.ok v et la 1 Subtotal ) (g . �,}- 45 Minimum permit fee: $72.50 Phone: (ST; $\u_�9�. � Fax: U ) CCB Lie.: ts`1 B Plumbing Lic. no.: e fo - S )� Plan review (25% of permit fee) 1 State surcharge (12% of permit fee) Authorized signature: /7��,E TOTAL P FEE Print name: (� n �L K 1 _ ` S 0 / � !!! Date: a - I 1 This permit application expires if a permit is not obtained within 180 days after x L �L (G ' it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Permits\PLMU- PermnApp.doc 10/01/09 440- 46I6T(10 /02/COMIWEB) ,A4s g c5 // ?',2. IN Building Division r- 4-47/17-1 °� '°�" NI g Development Code Provision Review T i c n k Residential Projects Building Permit No: H _T c oil coo P. ( 3 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A jit Routed Plans: // Original Plan Submittal Date: /A40 (// 1sL Revision Submittal Date: ❑ Site Plan Only 2 ^d 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 /(5 � at 503 718 WSI. or 1C0-164.44 @ tigard- or.gov) Land Use Case r loit y 1407-00004 Name 'Cr t4.�..6 R Pq.t I7 h on 'Zoning (C ' 111/Setbacks: Front 2 Rear `J Side Jam' Street Side 1 S Garage � 'Jl Z„ ' / Maximum Building Height ,3 D Actual Building Height 361 ? 2 y2 12/ Visual Clearance L!( Easements ? 0 Lands Type: at, de, Notes: • s a •El r$44#4 . C7 K.. ' /J /. !Q. f t i /t t - A... .4. a k. iv... 11 - No • # yy c.La - kJr. Original Plan: Approved if 1/41/IL. Not Approved )Z1 Date: 14 2. 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) la Actual Slope: Notes: Original Plan: Approved ❑ Not Approved ❑ Date: ` Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 Cityis orist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) b i treet Trees t(s Protected Trees Notes: Original Plan: Approved / Not Approved ❑ Date: / /rp .�o/ Revision 1: Approved ❑ Not Approved ❑ Date: / / 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 //&L� f 4 J A- V Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Appli nt Okay to Issue Permit: Yes N ❑ • Date Routed to Building: • Page 2 of 2 b t ,: -41:.''''. ' ,,,, I It / ‘40 444, . MARK STEWART T_ DESIGN /� ■ $ REC • IVED 7 DEC 3 2011 r�iiT� l 341 NW 9T14 )4�VlEY OF IGARD PORTLAND, cg JH7pd DIVISION (503) 88513311 P t (503) 519.4132 F wwwmarkstewart.com t r...... -1. fb i N 02 E i 1 1 I' 4.75' � ' �I -i 9I - I ( i in ° , „ 7) �I .9 -I i m DI 01 0; b1 .0 Q el C . N 88 46 13 N' I m I m m ; m s 1 at I O o Q I �j 133.47' 367 , -- - L- -- -}- - -- -_ _ N48 3. W mI n vi � - n iil to C: �� i 1 133.47 - _ -_t__ - - } - I m , _ _ - J 35a�' y g I ��- I i 1 I T / 36'-6' I I I � I I 1 .4111114446,44‘ 9,-11 1 1 - - I ---i -I- 1 i 1 4 Mh tL�R ! - - -�- - / I I Q1 /: j 11 -t'll 0� 'I) d) I I 441 l i i i I A Stock -iome Plans Ill I �GF- a 369.0 ' i i p Custom Desfgn . , O I PARCEL # Builder Marketing Q /� — I I Interior Design l t, 39 _�• ( L , Since 1982 rte• ..d A 7 l - --- I - MF. • 370 .0' I I � Thaw+ plena and u,. a«lgr ++we+ _ 1 _ ! , sr� copy x�d and Ler j t 4 .'a. MsWrt and Mark. A t a Aawolatr 1+14. 2006 1 43' 2 . i �� ; a ' I , Important Dfsalosurs IIf� I f J�J I kb Please Roads 1 , ■ — " - I nt The Mane you hive P.dr..d arc - I I for . construction of CM hone only. _ — � II I i r -- - 61'I -1' I wb troll ` 4ww� � plane.o.,,,:n — +--_ — —I-- — — II ' � N 08 ° 46'16 P W I I I the c w,le 6e ,t a Mom -- I 1 � ! -. --L-- _ - ---4-- - _ --�- ■ - ► L .n ropy ed end n • a kelaewa q 1 l I I I __ . I -- i w Ivd�al onpyt�a 4w w raprod�ee 1 i , 173.68 I I i I + - - ---Z _ _ � sr.... Mirk wera a .bweale. Iii ` ,n r V Q Q 1 i I I I I I 011 hely prwecw ANY vaatwn of iu • . ,p n 9 t I 354ID' Dopy lgleed deelgre and pa.e n m ^ N 0 ea 7 r. w w j of i i i e rr1 rn M nn 0 In gibed t o. one ON m nd a within r the ooNa of the govorn j rNdfatcc. Hark Menem I a.eeoat.e take. No teepon'aM'J her th nra.e nos of IN* pan to Any code or Any building T REE HILL '� PARCEL #3 - SITE PLAN CO TROTH CONSTRUCTION PARCEL #3 SCALE: 1/16 " =1'-0" ,,.�. TREE TREE HILL llviNONANOVSYBER 07, 2011 milcia CTT' 4,5 I I - 3 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: -oti — 00 (3 - 13 Site Address: '.4a 3s? Sw 1 ° r ' JA � 3 Subdivision/Lot #: ' 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 Sp cialty Code N1107.2) Signature: Date: 7// 7 /42 g 2r/lconttactorrized Agent • Print Name: Ati S � 120 ORSC Section NI 107.2. 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:\ Building \Forms RES- HighEfficiencyLighting.doc 07/01/08 /v( Sar 1 - o-oa i 3 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, \ M-.TA ( -t u-c \ In , am the general contractor or the owner- builder at the following address: Site Address: '`A.a .?(( S«.) l k.4: City: G-V Permit #: 3011 —oc W3 Subdivision/Lot #: Tv, I and/or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918 - 480 -0140, I am notifying the building official that I am.aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture- sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: Date: 7 /(7//c? //a General C ntractor or Owner - Builder !` I: \Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 jfri 5; �� /— I 3 • STREET TREE T[GARD E TIFI A TIO C R C N , owner / agent for -11 60 tee)- „(„ (PLEASE PRINT) (PERMIT HOLDER) do hereby certifr 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.: 31t —aoal3 SI1 E ADDRESS: (37 s u- / l' 12(a,,e SUBDIVISION: Tv- e"-- It; if LOT #: 3 SIGNATURE: � � DA1 E: i/i // OWNER/AGENT) RECEIVED & VERIFIED BY: DATE: 7/B/ (CITY OF TIGARD) ❑ Tree location verified per ' 'proved site plan. I: \Building \Forms \StreetTreeCertificate 04/01/2011