Permit � i CITY OF TIGARD MASTER PERMIT
ilh • :'� = COMMUNITY DEVELOPMENT Permit #: MST2012 -00053
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/03/2012
Parcel: 2S109AB 17400
Jurisdiction: TIGARD
Site address: 13234 SW WILMINGTON LN
Subdivision: HIGHLAND HILLS ESTATES Lot: 3
Project: Highland Hills, Lot 3
Project Description: New SF
6/21/2012: REPRINTED to add fire sprinklers.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1328 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 1826 sf Garage: 606 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3154 sf Value: $352,289.06 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 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
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
Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
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: 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 & 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 3154
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: $20,138.79
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 - - - set forth in OAR
952- 001 -0010 through 0 R 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. : a :. 32.2344
Issued By: Permittee Signature: /i
—d'—
Call 603.639.4176 by 7:00 a.m. for the next available Inepectio
This permit card shall be kept in a conspicuous place on the job site until co ',,.1 = n of the project.
Approved plans are required on the Job site at the time of each inspection.
FOR OFFICE USE ONLY - SITE ADDRESS: /A,22 / 4)/L '1 /4G7 /V
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 • COMMUNITY DEVELOPMENT DEPARTMENT
lig Transmittal Letter
T I (..; A It I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: D NFL.., DATE RECEIVED:
DEPT: BUILDING DIVISION RECEVED
, I JUN 0 6 2 01 2
FROM: ,Jos ti �/I k
CITY OF TIGABD
COMPANY: *)\ k ; v 4 1 BUILDING DIVISION
PHONE: S °3 - 34? ( ^ ?3 By
RE: 1323`1 S,ti w 'UT c Z AD d'S - S
(Site Address) / J (Permit Number)
[A q ,4 (4 L-1
(Prof t n e or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: I 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.
/ to Other (explain): 5 i 'ik I D ( c,1,.r •
REMARKS: cr < !Se{ (4?
FOR OFFICE USE ONLY
Routed to Pe it Technician: Date: Initials:
Fees Due: Yes ❑ No Fee Description: Amount Due: •
�QE �`P/1,�1l�.l.P2 (��rr� $ o /69.40
47 . 1.4 2C $ ao . 53_
/tiro P2oe . // Y/7 {' (Apr) $ i co
///lo /doe. /1 (521p) $ Al, oo _. 40
Special TaTgC ; tea 0. 9-5° ) Il
Instructions: �,/
Reprint Permit (per PE): r!e es ❑ No Done 4 V
Applicant Notified: 7 S# D ate: ( /yi,/ L Initials —
1:\Buildin Forms \TransmittalLetter - Revisions.doc 05/25/2012
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT
Permit #: MST2012 -00053
T I G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/03/2012
Parcel: 2S109AB17400
Jurisdiction: TIGARD
Site address: 13234 SW WILMINGTON LN
Subdivision: HIGHLAND HILLS ESTATES Lot: 3
Project: Highland Hills, Lot 3
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1328 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 31 Bathrooms: 3 Second: 1826 sf Garage: 606 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3154 sf Value: $352,289.06 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs /Showers: 4 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
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
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, 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 +amplvolt: 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 3154
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: $19,791.59
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. AT - : . • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 -0010 through OA' 9 10 -00 • : You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.
Iss• •d By: 16_ ''' . -.t " 1__!_I Permittee Signature:
— Call 603.639.4175 by 7:00 a.m, for the next available inspe on d
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 e
Residential i f( C) 9, FOR OFFICE USE ONLY
City of Tigard ®� Date /3 : J ®/a 'I PermitNo.: t-N A94,2 .0065-
. q 13125 SW Hall Blvd., Tigard, OR 97223``A� G
C �`�` �S Plan Rev 1 � �
- N
Phone: 503.718.2439 Fax: 503.598.196 O ff{ �� Date/B : Other Permit:
f ! G n !t 17 Inspection Line: 503.639.4175 G Date Rea - ®
y: See Page 2 for
Internet: www.tigard - or.gov G \ 'oh r f� ) HAI� od: Is ME Supplemental Information
TYPE OF WORK / REQ ❑RID DATA: l- AND 2- FAMILY DWELLING
® 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
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: 3�JZ o f
El Accessory building ❑ Multi - family Number of bedrooms: 4
El builder ❑ Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 13234 SW WILMINGTON LANE New dwelling area: 3154 square feet
City /State /ZIP: TIGARD /OR/97224 Garage /carport area: 606 square feet
Suite/bldg. /apt. no.: Project name: HIGHLAND HILLS Covered porch area: 7o square feet (z
Cross street/directions to job site: BULL MOUNTAIN TO 133 TO 134Th Deck area: 300 square feet ( 3
Other structure area: 3 square feet ?'
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: HIGHLAND HILLS I 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
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:
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
City /State /ZIP: LAKE OSWEGO /OR/97035
Total fees due upon application:
Phone: (503) 381 -3753 I Fax: : (503) 214 -8524 Amount received: # 7 DC'
E -mail: JOSHKELS03 @GMAIL.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial • • s residential prescriptive installation of
CONTRACTOR roof -top mounter 'hotoVoltaic Solar Panel System.
Business name: MISSION HOMES NW Submit two (2) sets 1 oof plan with connect' • • • etails
Address: PO BOX 1689 and fire department acce . long with ti. 110 Oregon
Solar Installation Specialty • . • • list.
City /State /ZIP: LAKE OSWEGO /OR/97035 Permit Fee (includes ..n revr- $180.00
and . • - istrative fees):
Phone: (503) 381 -3753 Fax: (503) 214 -8524 _ State surcharge (12% of permit fee): 21.60
CCB lic.: 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: 3/17/201.-
* Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building \Permits \BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(I 1 /02 /COM/WEB)
0.3/17.12011 13:12 5034636863 CONNECTIONS ELECTRIC #2190 P.002/002
wk... I L., 11 IV • TLII111 ivy.. I I TV I. L
, Electrical Permi Application $ 803.11 101; t l I( I. t' .1: ()NI.
City of Tigard !3125 SW C ti0 '.- Rer�a , �
JIen1;114.,Tigard.OR
( Phon .04- -0<22 I
es. 8.2139 Far 503.59L1960 ` vV ,�Cje� �'�:∎ ,, Ma
inspection Lino: 503..4175 �` 1 :: -" - s e ep. z mr
I;,Ai, 639 � 1� F ero
Inland: cumMW,ti$erd.or g0v C �G9 SePP lemaaat tnrormalion • 1-7= TYPE OF WORK � )3 . .. .... ' .. .. . :.:. i'YEW . ' .. ..
, )Newcottspuation CI Addilion/altaation/Wement chase cheek a ti rpm *Any 04 ileelso pleas %Mema • • •
p Demolition Omer. ` _ OSentoor Waal mops ermaa fa 01(441 stodge-
Hero the saws eidi eulmeal 13 towards.
I y�5` • y I ich ":%..: meads 10,000 amps of ISO ions or Whaling buildup. .
�' >! lea to wound, or emceadd 14.000 DC oatmerm skne sadiaakwxl
1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building sales far all olher Metoiwlaaa. 1wOdiaga
o Multl-Pamti ❑ Master builder CI Omer: D Piro pump. q lasiUetlon of7a EVA or
' '• JOB si IC INFORMATION AND LOCATION D Addition ►ao row m - war a .w �
0 Additionthawmotor load of 0 "A *,•0', ~14:`1
Job uo.: Job site address: t3 Z3(f ScAl J / ;.�j - /ate OS hi r m hienild a is. C> realooll veld* mkt. City/Stato/ZIP: `f o °l . • / Diteal h -era Whim. r1 SuppIredose Ian mare then
fa limetdoes letetimv. 600 volts nominal.
/
SuileibldgIapt. no.: I Project name: I.(1 a 00, .0 i.} u vf D Service or tecaortre° ame err owe.
• Cross street/directions !Nob efle: &v I I f1400441 /'D / 33 r/ .; � ��� p
I sleigh- or multi- milt dwelli,>gMelt.
Includes sunhat swap.
3ubdNision: }4467 f f f-t/curs I Lanus.: 9
0004 It.orles MN 168.54 [ :. iU
b. edd'i SOO e4. It or Fenian in AN l� J ll
'fix map/parcel no.: 'e;: , . .• n
_ RIttlaN OF WoliK • • ! y5A0 'MOO DBSC
. Limped ooergy, multi rollY ■ 75.00 mil
NEW SINGLE FAMILY residealial with above • • tL
• Services orfeedera inat*Qa*ion alters ion and/or relocation
' 200am'• or tea MI 101130 IQ
® PROPERTY OWNER r 0 ftwANP ' - 701 • • •. 1o400 , • • NE l3a.56 111111111111E1
• 401 10600. NM 20034 d
Name: MISSION HOMES NW . 6oi emu w Low anws In 201.04 EI
• Address: PO BOX 1689 Ora t.tr00amps at wtu 11.11 55126 _ 0
City/Witt/21P: LAKE OSW1ZOt)IOIi /97035 Temporary services or hulas letaltat1on, alteration, and/or
_ re! Ion
Phone: (503)381`3753 I Fax: (503)214.1524 ' 200 amps or leas NM 59.56 IIIMII11
Owner installation! This InstalhNon is being made on property that I own which is not zoo am tA400amps l2S08
Intended for sale, lease, runt, or exchange, according to ORS 447, 449, 670, and 701. 401 nch I mops .r II
Br 401
einr+tuttuit amps s— alteration or extension , .r ,.nel
Owner aipalure: Date: A. Fee Sr bread) chants web II 742 MI
.' ® A Q CONTACTPFdlSON ebovotandcerettlederRa
each brendt alreait
BUSIIlt33 neme MISSION BOWS NW : .00 - woolen- , 1
minium se
undo err feeder he, tint
Contact name: JOSH KELSO 13 •• • Gi10 &
. - • ' Each.dd'I branch circuit r 7.42
Address: PO BOX 1689 N . e a : sows service or cinder no Included
Cit SIaWZ h: LAKE OSWEGO/OR/9703S — - 6714 II
pboae: ( ) 361.3753 I : (50 3) 214.8534 ' 6i aa
.I: 9f17! MI 6754 0
E•trlatl :1OSHKELSO3@GMMI.,COM SI, ' or wpm( liehting — 67.84 � EI
OONIEACTOA Sspot _ spot etrcuit(s) or Italittci4MY m
Business name: CONNECTIONS EI.ECTEIC �: or . ee faa
]tech additional edioa Over allowable is an of the above
Address. 4675 PORTLAND RD NE {% 7134 'wilonni • . • • -i • . (t hr min) NI 66.25/ hr
- lased! ation (I in min) 11111111=3 • NI
. City /State/ ZIP: SALEM /OR/9730S $ t41... pe.,.41 3 Indusedel plant (I hr mia) 11111113153 r 111
Phone: (303)390.1914 [ Fex: (Ma ) 4{43-6,65 3 • . . ens 1 ..
. no ' 90.0olbr .111
e • - Mall listed hr min
CC8 Lie.: 65444 Elcoaleal Lie.: 24.248C Sapty. Lie.: 3eitts ELECTRICAL PZBMU PUPS
Sabwatt: iramun
Suprv. Electrician si$ualurn, required: Plan roles a 5% of ' mull Ice . iiiMIIM
Date:
Stale son lame (1246 otpgmtii ice): ���
Printname: a�Co'vt� rt�.,1 �� - =mu. Maar R.E: i A i
• Authorized signanme " ) penult epplicatimn expires If. pencil is eel a Idled withta 180
' dap aria Ithas ben scat lmd a eemplela
Nat name: OM: • Number orta sp:41one aimed per panel
timdldlernr ulp£Lc.wn n Appdoo 001111) 404031111/01/COMMA
•
Mechanical Permit A licatio V FOR OFFICE USE ONLY
Received
III City of Tigard� 1� /
13125 SW Hall Blvd., Tigard, � Date/By: _ - � l , P No.: ij , ..
0 Plan Review
Phone: 503.718.2439 Fax: 503. 98.191�� GOr* DateBy: Other Permit l/l.�a_ j�
T I G A R D Inspection Line: 503.639.4175 �\$\`' Date Ready/By: Juris: 61 See Page 2 for
Internet: www.tigard or.gov G (* �l Notified/Method: Supplemental Information
G
TYPE OF "" V COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
® New construction ❑ Addition /alteration/replacement 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
Job site address: 13234 SW WILMINGTON LANE (requires site plan showing placement) 1 46.75
Furnace 100,000 BTU (ducts/vents) 1 46.75
City /State /ZIP: TIGARD /OR/97224 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.: 3 Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater I 23.32
NEW SINGLE FAMILY Gas fireplace 1 33.39
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 I 33.39
City/State /ZIP: LAKE OSWEGO /OR/97035 Clothes dryer exhaust I 33.39 II�
Single -duct exhaust (bathrooms, � 23.32 Ilk, b0
Phone: (503)381 -3753 Fax: (503)214 -8524 toilet compartments, utility rooms) Q
•
® 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. 1 l 4, (5
Gas heat pump
City /State /ZIP: LAKE OSWEGO/ OR/97035 Wall /suspended/unit heater
Phone: (503) 381 -3753 Fax: : (503) 214 -8524 Water heater I
Fireplace 1
E -mail: JOSHKELSO3 @GMAIL.COM Range l
CONTRACTOR Barbecue 1 A--.o
/
Business name: ADVATNAGE HEATING & AIR CONDITIONING, LLC
Clothes dryer (gas)
Other:
Address: 2355 HYACINTH MECHANICAL PERMIT FEES*
City /State /ZIP: SALEM /OR/97301 Subtotal 7CI .77
Phone: (503) 393 -5315 Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 7 f , /� State surcharge (12% of permit fee) �Z . Z )
�' - TOTAL PERMIT FEE 3 q3,
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'MEC- PermitApp.doc 09/09/10 440.46t7T (I1102/COM/WEB)
P l um bing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard tfft A� Date/By: / 3 /1 / Permit No.: �Or,a',
C • 13125 SW Hall Blvd., Tigard, OR 9 23 1�' ��
III
Plan Review
Phone: 503.718.2439 Fax: 503.598.196W- `S� DateBy: Other Permit No. 4/0/3 -04005C
Inspection Line: 503.639.4175
TI GARD Q Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov
S ' Notified/Method: Supplemental Information
TYPE OF WORK �1W FEE* SCHEDULE
® New construction ❑ Dem o lition 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
0 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
ID Accessory building ❑ Multi- family SFR (3) bath 1 500.32 .(56r
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler (3154 sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13234 SW WILMINGTON LANE Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City/State /ZIP: TIGARD /OR/97224 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.: 3 Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 1 25.02
NEW SINGLE FAMILY Dishwasher I 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
0 PROPERTY OWNER I 0 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
0 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 Fax: : (503) 214 -8524 Tub /shower /shower pan 4 12.51
E -mail: JOSHKELSO3 @GMAIL.COM Urinal 25.02
CONTRACTOR Water closet 3 25.02
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 r 3G
Phone: (503) 545 -3601 Fax: (360) 695 -5031 Minimum permit fee: $72.50
CCB Lic.: 168129 tl I 9I i y Plumbing Lic. no.: QP7rj Plan review (25% of permit fee)
1111 State surcharge (12% of permit fee) 6o. 0 4-
Authorized signature ■11111 TOTAL PERMIT FEE 560, 3i,
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.
1:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440 -4616T(I0 /02/COM/WEB)
. A ktLt
5 e ° Building Division U ,1 — 3
Development Code Provision Review
TIGARD Residential Projects
Building Permit No: 1`"l') 1 ao1 a Coos 3
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: 2 � l i a I O
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 rev 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 l if approved. ,/�
Planning Review (contact / � at 503 - 718 - ° or @tigard - or.gov)
La d Use Case No. Name
Zoning K.7
Setbacks:
Front I Rear 16
J / ide C Street Side 1 0 Garage eV
li Maximum Building Height Actual Building Height 31
O Visual EllEasements , r /
IG Sensitive Lands Type: N l R
Notes:
Original Plan: Approved k7 Not Approved ❑ Date: 3//31 /;
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)
. ,13 Actual Slope: cr cyo
Notes:
Original Plan: Approved Not Approved ❑ Date: 3 t 3 /Z-
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
•
(Review Continues on Page 2)
Page 1 of 2
City �rborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
, treet Trees
Protected Trees
Notes:
Original Plan: Approved Not Approved ❑ Date: yfyrz,-
� PP PP
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 7J No ❑
Date Routed to Building: A
•
•
•
•
•
Page 2 of 2
\I ?V
101 1 3 2012
\ / TREE r CM - SD \AS O
-,f STREET TREE Va.–
♦- ACER, Rubrum "Red Sunset Maple"
S.W. WILMINGTON LADE
1
T
c a.) . r . ,_c_ . ?utours,_i rimm, 53.0
4 n ° . .
° " D "tir
o' 1
J, V 1 ° c e g
°
i � 4
C ENT REDI I
ENTRY J
GARAGE
I
1 /SILVERWOOD
�////�
/ / / /LS_- Z3rsil
I .
�/ ��
i SETBACKS:
GARAGE = 20'
: LOT 3 I BUILDING =15'
1 4.703 SF. I PORCH = 12'
50.01+' GI ' D " 4"E''¢ SIDE YARD = 5'
51-1- - - - - 5 STREET SIDE YARD = 10'
� STREET TREE
Sitep fan
_
SCALE : 1"=20'
PLAN NAME: CON AC l :
Phone-503-381-3753
DRAWN: BKE ✓ ✓��L , ` , b .//� n n
PLOT: 3/12/12 � I OT 3 mission Homes NW , LAC.
SCALE: i•••
1/4".1'-0"
STREET TREE
TIGARD CERTIFICATION
I, A,U cbJk , owner/ agent for P'l;ss 140 rya ,
(PLE PRINT) (PERMIT HOLDER)
do hereby certiji 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.: Ms - =51
HIE ADDRESS: k'Y13'1 SGJ wilh;K44c,,,, I
SUBDIVISION: V‘9 1.4 LOT #: 3
SIGNATURE: lea ,! L / DA•IE: 9- -
(0 ER /AGENT)
RECEIVED &
VERIFIED BY � _ . DA1 E: /d
(CITY OF TIGARD)
❑ Tree location verified per -.proved site plan.
I: \Boil rms \StreetTreeCertificate 05/30/2012
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Jurisdiction:
n st. aol), -ocbS3
Site Address:
131 N (AU &; �n 1 r V1 In
Subdivision/Lot #: 1
141111
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: 0-4/4( Date: 9--K—(1 wn /General ractor /Authorized Agent
Print Name: A A 4 c .11 cy
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:\ BuildingWorms \RES- HighEfficiencyLighting.doc 07/01/08
. ,
Oregon Residential Specialty Code 8318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, AAli 'c.IL , am the general contractor or the owner- builder
at the following address:
Site Address: 15),3 S u , (J� ( n3- w ,
City: +; 1°' A
Permit #: N►S;• )o 1 - oas 3
Subdivision/Lot #: N ai il.
and/or
Map and Tax Lot #: 3
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: c • S I i
Gene I Contractor or Owner - Builder
I:\Building\Form\RES- MoistureSensitiveWood.doc 09/25/08