Permit CITY OF TIGARD MASTER PERMIT
111
a • COMMUNITY DEVELOPMENT Permit #: MST2011 00107
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2012
Parcel: 2S109AB18100
Jurisdiction: TIGARD
Site address: 13185 SW HOODVISTA LN
Subdivision: HIGHLAND HILLS Lot: 10
Project: Highland Hills, Lot 10
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1469 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24.5 Bathrooms: 3 Second: 1951 sf Garage: 496 sf Front: 22.5 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3420 sf Value: $375,664.23 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 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: 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
Drywell- Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea addl 500 sf: 6 201 -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 - 2 3420
Owner: Contractor:
MISSION HOMES NW MISSION HOMES NORTHWEST LLC Required Items and Reports (Conditions)
PO BOX 1689 PO BOX 1689 1 Ersn Cntrl 503 - 681 - 4444
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503- 381 -3753 PHONE: 503 - 381 -3753
FAX: 503 - 214 -8524
Total Fees: $19,541.96
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 s= • - OAR
952- 001 -0010 through OAR 952- 001 -0090. You m- obtain a copy o e rules o =ct questions to OUNC by calling 503.232.1987 or 1.800.332.2
Issued B . - _ i�_ Permittee Signature: -
Call 5u 7:00 a.m. for the next available Inspection ! . -_ '
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.
I. .
Building Permit Application
Residential FOR OFFICE USE ONLY
Cl of Tigard Rece '�yt
%�
�' g DateB : . i e r j
13125 SW Hall Blvd., Tigard, OR 97220 Plan Revie p
Phone: 503.718.2439 Fax: 503.598.19 p % `l� 0 DateB : or /� I all Permit / „„al:, •
"I [GAIL U Inspection Line: 503.639.4175 `\ f► Date Rea. y : y: Jarig: Ed See Page 2 for
Internet: www.tigard- or.gov ,v � Notifi ed/Method: �1 Supplemental Information
OV s tC3' I re) - for ti- •
TYPE OF WORK c SAG REQUIRED DATA: l- AND 2- FAMILY DWELLING
® New construction ❑ De ton 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
CATEGORY OF CONSTRUCTION work indicated ois application.
® I- and 2- family dwelling ❑ Commercial/industrial Valuation: �i 2
❑ Accessory building ❑ Multi- family Number of bedrooms: 4
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 13185 SW HOODVISTA LANE New dwelling area: 3420 square feet
City /State /ZIP: TIGARD /OR/97224 Garage /carport area: 4%,1zt" square feet
Suite/bldg. /apt. no.: . Project name: HIGHLAND HILLS Covered porch area: (? 5 1C square feet ( 16-1
Cross street/directions to job site: BULL MOUNTAIN TO 133 TO 134 Deck area: Z606 1 ;quare feet 14.61
Other structure area: 1, b feet 2.A .
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: HIGHLAND HILLS Lot no.: 10 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.
NEW SINGLE FAMILY Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: MISSOIN HOMES NW Type of construction:
Address: PO BOX 1689 Occupancy groups:
City /State /ZIP: LAKE OSWEGO /OR/97035 Existing:
Phone: (503)381 -3753 Fax: (503)214 -8524 New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: MISSION HOMES NW (Please rejerto fee schedule)
Structural plan review fee (or deposit):
Contact name: JOSH KELSO
FLS plan review fee (if applicable):
Address: PO BOX 1689
City /State /ZIP: LAKE OSWEGO /OR/97035 Total fees due upon application: 4
Phone: (503) 381 -3753 Fax: : (503) 214 -8524 Amount received: 't( 750 �
E -mail: JOSHKELS03 @GMAIL.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
Business name: MISSION HOMES NW Submit two (2) se of roof plan . connection details
and fire department a . . • with the 2010 Oregon
Address: PO BOX 1689 Solar Installation Special ode c e •
City /State /ZIP: LAKE OSWEGO /OR/97035 Permit Fee (incl -.es plan review $180.00
and a. inistrative fees):
Phone: (503) 381 -3753 Fax: (503) 214 -8524 _ State surchar : (12% of permit fee): $21.60
CCB lie.: 186849 To : fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: JOSH KELSO Date: * Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(l 1/02 /COM/WEB)
03/17/:011 13:12 5034636863 CONNECTIONS ELECTRIC #2190 P.002/002
RIM.. 11. LVII IV.TL •V. I ITV I. L
, F . l e c t r l e a l Permit Application 4 c 1 1 i c t ) 4 v 1 1 1 l 1. ( J . \
City of Tigard (p / L'' Na.: w; ,/ /�la 7
13125 SW Rall Mod., Tigard, OR 972 1 •,
kl r Moto 503,2182439 r'elc 503.501.1960 ` �. .:.. Oder Permit: o'iW/L2.o / / —WO?
lospectioa lino; 503.6394115 N� i... Ti- : '' - See r.6ez tor
Internet: 'WA W.ti$Drd -Or gD ' t ��) C Supplemental tnformolion
(=,=" ' ' - • TM OF WORK . 6`C \ N .. .. • • .. : .:. r : X1,41Pr,RE'V 'W . • . .
D New consbuotion 0 Addilion/alterationitep t• Nous dock .0 uw *poly (wf mti lees a pW41 trains oboe
O & Moo or fads 400 otos or move aDailding oar lAroemotion.
• � Demolition Other. _ _ Malian sod
� •,�, r►11ero the imitable ma eva'eet ❑ boatyards.
'7 9.Qg p0#17 4 1:4 ,166 : : exceeds 10,000 a a1150 We or C1 Floating MAUNA
0 I and 2 - family dwelling 0 Canlnercir /Induatdal 0 Accessory building broil l CI I t+l'us° egdc°Iaua1
❑ Mult1 -thud rL ❑ Master builds ❑ Other: 0 W pump. q laaauatonor75 KvA or
d01) SRB' I$WORit1�1'1'IOTI AND LO A7'tON 13141104900 Vilm large' p * &dyed system.
EI Addition ofaawmotorloador C " A^, "11", "1,2 - .` -3",
yob no.: Job site address: l 3 ($� ,S. U ( ocgikf ,{, p g �or mo ro s msilmeial node. O itserealood soblale mks.
Cily/StatolZlP: I t o - q 2 Z y Q CI lholdaeare Roma** Winans. p d 0 vat2 fra mare than
Built/bldg./apt. no.: Project name: 4-p,', -/ O service or Roder 600 owe or mot.. -
,
Cross �I :VIE i1I.6'• : .
ss street/4irectiomsto�ob 7 ' 1 1,0 /3 ai " :
: berm own= �� L I
Nov rceIdedtial Slag c- or multbramily dwelling obit.
Includes outbid garage.
Subdivision: 1 Lot no.: /Q IA00e4• It• or lets 168.54 rr:., lr1
se,. e641300 sr" 3 or portion (p 33.92 • 03, = 9
Tax mep/perGol no.: •• Pr. eaarDr, n Fa 75.00 '75500 a
DESCRIPTION OF WORK' • - •. orals above • .i .
NEW SINGLE FAMILY LWO above • . IL ■ 7540 Me
Servlec* or feeders installation er'.r:oo, ondAst relocation
200 • • or ltse i00.70 — jA
Ca Pito aT 1C OtiYNBR O Zfd1U111T1' ' - 201 . •. 10400 ' M 13316 IIIIIIIII 1E1
401 ,• - 10 600. ME 20034 - d
Name: MISSION HOMES NW' 601 emp.lo 1,000 erfiPs M 301.04 • 9
Address: PO BOX 1689 Over t,000 mops woohs IIIII 552.26 — 0
City/State/2.M Stlue/ZIl?• LAKE OSVyEt9WOJt/97035 Temporary eUV$res or recast; inealtadon, alteration, and/or
r • ,;,; Ion
Phone: (501)381.3753 Fa: (503)2!.4•8524 • 200 amps or Isar 11111 506 MINH
Owner installation: b siallalion is being made on property that 1 own which is not 201 woao emus 1x5. NEM Ell
Intended for sale, lease, runt, or exchange, according to ORS 447, 449, 670, and 701. 4012 to 399 amps
11111111EZEI CI
Branch circuits —new alteration or extension •r . erne!
Owner a(gaatune: _ Date: A Fee thr blanch dram yid/ 111 7A2
14 ArrLICAN)i I 0 comm. PERSON. . w ebove climb
Business Remo: MISSION >St7M NW " o o ay r I liallill
Contact name: JOSH KELSO
writs err fender are. arm b . otrauu
Rash add'I brand! circuit r 7.42 NM 9
Address! e 1 111., e : sous service or Feder no tattadat
ti a 1: • r •l:... 67.64 El
IY 52 "� 67.84 IIIII
' ' 1 n• Si „ erelawlighting MIN 6704 El
ColaraAcitils slow cirlalie(e) or IImIled.edetgY ErgIIIIIIIIFI
Susi= name: CONNECT101 ELlEcTitIC .,-, . :. iv, ore:dension•
Rash addWanal , • reams over allowable is an of she above
Address! 4675 I ► s. Additional '• • - , • , (lbrmir0 MN 6625/hr MINE NI
tareauptiaa (t hr min) Mill ILEMI r
_ I 1 , sakes..— •• Industrial plant (l hr min) :
phone: oa3)aspial4 Pax: ,.. • '^ • no ' N 9000114
I • - • hee listed iv rain
CCB I.ic.: 65444 EiccK1ea1 We.: 2444K Suptv. Lie.: Wills ELECTRICAL mum PEES
— Mont IGEWPM- II
Suprv. Blecirician signaturo, required: Phu, review r 3% of , •milt ice .
Print name: , .. _ Date: State sarcharae (1254 otpcpmil (ce): 1- 6:l
------ TL. AL PERMIT FEE: 0/1D�
Authorized signature'' • Wan appllranen 01 es If. pencil is eel 0 • abed edibles ISO
Print Remo: 1 Date: Soya ear It has boo servpW as complete. � OS 4 fry — Number Grimm/WI eased Per poma
1.i5 loVeroboli -ramlUtP000 07/0U10 44e- ea1/T1111ealGObirtvap
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard W Received Re
�
/) AWN' �l �/ Permit No.: t _
• 13125 SW Hall Blvd., Tigard, OR 97223 � DPlan y
' view / A
0 . Phone: 503.718.2439 Fax: 503.598.19 � NV
Date/By: Other Permit: / totao W FS."'
T t G A a D Inspection Line: 503.639.4175 N V Date Ready/By: runs: Page www.tigard or.gov J � 4 ®Se Pa e 2 for
Noti fied/Method: Supplemental Information
O V
TYPE OF WORK 1 v COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
® New construction ❑ Addition/alteration/repla ent performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning Al
.e site address: 13185 SW HOODVISTA LANE (requires site plan showing placement) 1 46.75 - t I ' •
City /State /ZIP: TICARD /OR/97224 Furnace 100,000 BTU (ducts/vents) 1 46.75 4
Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: HIGHLAND HILLS Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: BULL MOUNTAIN TO 133 TO 134TH 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: HIGHLAND HILLS Lot no.: 10 Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 1 23.32 - 2-3.3Z
NEW SINGLE FAMILY Gas fireplace 1 33.39 "3-3,
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 ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: MISSION HOMES NW Environmental exhaust and ventilation:
Address: PO BOX 1689 • Range hood/other kitchen
equipment 1 33.39 �3,51
City /State /ZIP: LAKE OSWEGO /OR/97035 Clothes dryer exhaust I 33.39 3•
503 81 -3753 F ax: 503 214 -8524 Single -duct exhaust (bathrooms,
Phone: //
( ( ) toilet compartments, utility rooms) h 23.32 ( b.(CO
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: MISSION HOMES NW Other: 23.32
Fuel piping:
Contact name: JOSH KELSO $14.15 for first four; $4.03 for each additional
Address: PO BOX 1689 Furnace, etc. I 14.16
Gas heat pump
City /State /ZIP: LAKE OSWEGO/ OR/97035 WalUsuspended/unit heater
Phone: (503) 381 -3753 Fax: : (503) 214 -8524 Water heater 1
Fireplace 1
E -mail: JOSHKELSO3 @GMAIL.COM Range 1
CONTRACTOR Barbecue 1 4,
Business name: RITE -WAY HEATING & AIR Clothes dryer (gas)
Other:
Address: 33505 SW TUALATIN VALLEY HWY MECHANICAL PERMIT FEES*
City/State /ZIP: HILLSBORO /OR/97123 Subtotal 35 i , 77
Phone: (503) 693 -3161 Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 71242 State surcharge (12% of permit fee) A- ... 'Z (
�' TOTAL PERMIT FEE ' 3
Authorized signature: days p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: JOSH KELSO Date: • Fee methodology set by Tri County Building Industry Service Board
I:1BuildinglPermits1MEC- PermitApp.doc 09/09/10 440- 4617T(I1 /02/COM/WEB)
•
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard O ~ Re 6. A9 Permit No.: t/ v/ -, ( 7
• 13125 SW Hall Blvd., Tigard, OR 97 Plan Review /
C Phone: 503.718.2439 Fax: 503. ' ). I 42 1;1 % CS Other Permit No.:2 (. - (�'� f
v '� f� S. 0 DateBy:
,(1,
"I I G A R D Inspection Line: 503.639.4175 \ � G �v Date Ready/By: orris: ® See Page 2 for
Internet: www.tigard or.gov Q~ �,`� Notified/Method: Supplemental Information
TYPE OF WORK ��,, FEE* SCHEDULE
® New construction ❑ Demolit For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
O 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
Accessory building SFR (3) bath 1 500.32 sj 772-_-- ❑ ry g ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler (3420 sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13185 SW HOODVISTA LANE Catch basin or area drain 18.76
City/State /ZIP: TIGARD /OR/97224 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: I Project name: HIGHLAND HILLS Manufactured home utilities 50.03
Cross street/directions to job site: BULL MOUNTAIN TO 133 TO 134TH Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: HIGHLAND HILLS I Lot no.: 10 Fixture or item:
Tax map /parcel no.: Backtlow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02
NEW SINGLE FAMILY
Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
0 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: MISSION HOMES NW Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: PO BOX 1689
Garbage disposal 1 25.02
City/State /ZIP: LAKE OSWEGO /OR/97035 Hose bib 2 25.02
Phone: (503)381 -3753 Fax: (503)214 -8524 Ice maker 1 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: MISSION HOMES NW Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: JOSH KELSO
Roof drain (commercial) 12.51
Address: PO BOX 1689 Sink/basin/lavatory • 7 25.02
City /State /ZIP: LAKE OSWEGO/OR/97035 Solar units (potable water) 62.54
Phone: (503) 381 -3753 I Fax: : (503) 214 -8524 Tub /shower /shower pan 3 12.51
-
E -mail: JOSHKELS03 @GMAIL.COM Urinal 25.02
Water closet 3 25.02
CONTRACTOR
Water heater 1 37.52
Business name: S & B PLUMBING Water piping/DWV 56.29
Address: 10601 EVERGREEN HWY Other: 25.02
City/State /ZIP: VANCOUVER/WA/98664 Subtotal S-66, ?
Phone: (503) 545 -3601 Fax: (360) 695 -5031 Minimum permit fee: $72.50
CCB Lic.: 168129 Plumbin: Lic. no.: j Plan review (25% of permit fee)
'� 7 ///s1 State surcharge T L P ERMIT EE . Q • 3
Authorized signature: TOTAL PERMIT FEE' 1..[1
Print name: JOSH KELSO Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
•Fee methodology set by Tri -County Building Industry Service Board.
I: \Building\Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(I0 /02/COM/WEB)
\ . '. -7/6" eiva- iL
1 1 4 ■ Building Division
•
r - i 1z i Development Code Provision Review
Residential Projects .
•
•
Building Permit No: \H 5r0 / / — 6 0 l o7
CWS Service Provider Letter Received: Yes ❑ No lir N /A' ❑
Routed Plans:
Original Plan Submittal Date: 1p /? - /// '
1st Revision Submittal Date: ❑ Site Plan Only
2 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 (1) 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 , 503 - 718 -�or
o .511,4 @tigard- or.gov)
Land Use Case No. &(I DOD_r"ODG��L . -- L .lm ({ot1CLIQ41- t ttli "--c. CS?Kti
t 3 Zoning tZ, "
Qr Setbacks /
f Front / J Rear f Side S Street Side i. 0 Garage .c2 •
lJ. Maximum Building Height �Actual Building Height r�-•
ri/ Visual Clearance
. g/Easements 5 I PSD, P Sff Sensitive Lands Type: 1r
Notes: 4- bti .4,2L.i' gb PA." ' C/, 40 ff�fr- _
Original Plan: Approved ! / Not Approved / Date: WV / (
Revision 1: Approved Not Approved ❑ . Date: 7 r /151 1
• Revision 2: Approved ❑ Not Approved ❑ Date: f
Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov)
" Actual Slope: e
•
Notes:
Original Plan: Approved Not Approved ❑ Date: *L_____t
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
•
(Review Continues on Page 2)
Page l of 2
ix
City Arborist Review (contact Todd Prager at 503- 718 -2700 or todd @ tigard - or.gov)
r1 treet Trees
Protected Trees
Notes: -
Original Plan: Approved Not Approved ❑ Date: 7//
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 :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes N ❑
Date Routed to Building: // /
a
1
•
Page 2 of 2
i
Building`Permit Applicati I n!,
Residential FOR OFFICE USE ONLY
City of Tigar R eceived / ' Permit No.: y , ,/,,....604) ° 13125 SW Hall Blvd., Tigard, OR 9722'(1` qqpp Plan Review
.71 C '� Y �0`` Date/B : Other Permit:
Phone: 503.718.2439 Fax: 503.598.19::.
I' I G \ It f1 Inspection Line: 503.639. ``� Date Read yBy: runs: ® See Page 2 for
Internet: www.tigard or.gov J Notified/Met Supplemental Information
VI CI - TYPE OF WORK -I % v c i REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® New construction
❑ De \\ ton 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
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1- and 2- family dwelling ❑ CommerciaUindustrial
Valuation: $243,000
❑ Accessory building ❑ Multi - family Number of bedrooms: 4
El builder ❑ Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 13185 SW HOODVISTA LANE New dwelling area: 3420 square feet
City /State /ZIP: TIGARD /OR/97224 Garage/carport area: 466 square feet
Suite/bldg. /apt. no.: Project name: HIGHLAND HILLS Covered porch area: square feet
Cross street/directions to job site: BULL MOUNTAIN TO 133 TO 134" Deck area: 0 square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: HIGHLAND HILLS Lot no.: 10 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.
NEW SINGLE FAMILY Valuation: $
Existing building area: square feet
New building area: square Teet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name: MISSOIN HOMES NW Type of construction:
Address: PO BOX 1689 Occupancy groups:
City /State /ZIP: LAKE OSWEGO /OR/97035 Existing:
Phone: (503)381 -3753 Fax: (503)214 -8524 New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: MISSION HOMES NW (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: JOSH KELSO
FLS plan review fee (if applicable):
Address: PO BOX 1689
Total fees due upon application:
City /State /ZIP: LAKE OSWEGO /Oft/97035
Phone: (503) 381 -3753 Fax: : (503) 214 -8524 Amount received:
E-mail: JOSHKELS03 @GMAIL.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
Business name: MISSION HOMES NW Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: PO BOX 1689 Solar Installation Specialty Code checklist.
City /State /ZIP: LAKE OSWEGO /OR/97035 Permit Fee (includes plan review $180.00
and administrative fees):
Phone: (503) 381 -3753 Fax: (503) 214 -8524 State surcharge (12% of permit fee): $21.60
CCB lie.: 186849
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: JOSH KELSO Date: * Fcc methodology set by Tri - County Building Industry
Service Board.
I:\ Building \Permits\BUP - RESPermitApp.doc 02/24/2011 440- 4613T(1 1 /02 /COM /WEB)
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STREET TREE
TIGARD CERTIFICATION
I, A r11 Q711t owner / agent for M 4.s o v )4n P s ,
(PLEASE PRINT (PERMIT HOLDER)
do hereby cert 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.
PERMITNO.: M5 -30011 - 00 161
SI"1E ADDRESS: 1`3 \S S E-\cc, 1
SUBDIVISION: \-\,5‘4\„,,,,A 14,1 \; LOT #: 1�
SIGNATURE: G� „�,� DA
E: 7--1- \ �
6s (WNER /AGENT)
RECEIVED &
VERIFIED BY: DALE:
E:
(CITY OF TIGARD)
❑ Tree location verified per approved site plan.
1: \Buildikrms \StreetTreeCertificare 04/01/2011
i •
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Jurisdiction:
M5}* )
Site Address: -
I i sr C c. it) N .0 i •
Subdivision/Lot #: i;5 1 1, I' S
and/or � C,•
Map and Tax Lot #: 1 0
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: � r f Date: 3
Own /General Co ractor /Authorized Agent
Print Name: f n 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.
I:\ Building \Forms\RES - HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code 8318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, fah d b be J , am the general contractor or the owner- builder
at the following address:
Site Address:
City:
Permit #:
°C; I G 1
Subdivision/Lot #: j, In �^„� I4 1
►c�
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: G��� / Date:
Gene at ontractor or awner- Builder
1:\Building\Form\RES- MoistureSensitiveWood.doc 09/25/08