Permit CITY OF TIGARD MASTER PERMIT
111
C • COMMUNITY DEVELOPMENT Permit #: MST2012 00061
Date Issued: 04/12/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109DA18700
Jurisdiction: Tigard
Site address: 12734 SW WILLOW POINT LN
Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 116
Project: Arlington Heights No. 3, Lot 116
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1410 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 29.5 Bathrooms: 3 Second: 1675 sf Garage: 460 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3085 sf Value: $347,412.40 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 4 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: 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
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 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 +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 3085
Owner: Contractor:
STONE BRIDGE HOMES STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
4230 GALEWOOD ST SUITE 100 16869 SW 65TH AVE # 505 1 Ersn Cntrl 503- 681 -4444
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 2 Geo tech report prior to
footing inspection
PHONE: 503- 387 -7577 PHONE: 503- 387 -7577
FAX: 503- 387 -7615
Total Fees: $20,013.53
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 i . _ 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. • TENTION: Orego 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 OAR 952 -• 01 -'' • • may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/ i k e "
Issue• By: _ ..l_ ■�• 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.
Building Permit Applicatio
,DE CEIVED Received Residential MAR 2 8 2012 2 /�G FOR 01 l'lci i;s1. ()N1.1 City of Tigard OF TIGARD Date/By: .' O p i ! Permit No.: J 7 7l �- J
N. • 13125 SW Hall Blvd., Tigard, OR Pl R ev i ew, i •
IF DIVISION Date/By: l0 1 Other Permit: /� /alpha
I-1 ` ii l Inspection Line: 503.639.4175 Date Read . J \ Jam: I ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: . 1 /( // i I Supplemental Information
�Ni)I
ce (42 uYRE
TYPE OF WORK REQ D DATA: 1- 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 El
Valuation: ' 347 12,40 •
❑ Accessory building ❑ Multi - family Number of bedrooms:
4
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATIOON AND LOCATION 1 - , Total number of floors: 2
Job site address: 1t7 cm Wi WOW 1 6 New dwelling area: °701iS square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: 46 0 square feet
Suite/bldg. /apt. no.: I Project name: Arlington Heights Covered porch area: ' V o square feet 1
Cross street/directions to job site: Deck area: 2U 0 square feet 1+10
Other structure area: '!54 square feet X
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Arlington Heights I Lot no.: no b 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 Residential Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Stone Bridge Homes Type of construction:
Address: 4230 Galewood St, Suite 100 Occupancy groups:
City/State /ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7577 Fax: (503)387 -7616 New:
❑ APPLICANT ❑ CONTACT PER3bN NOTICE
Business name: SEE ABOVE All contractors and subcontractors are required to be
Contact name: Deirdre Britt licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E -mail: dbritt@stonebridgehomesnw.com
CONTRACTOR
Business name: SEE ABOVE BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: 173318 Total fees due upon application:
Amount received: 7.€0/
Authorized signature: "---reiZ"—QA5911 This permit application expires if a permit is not obtained
S R�� I
within methodology 180 days after it has been accepted as complete.
Print name: 1 Date: 2,6, .1 Z • Fee methodology y set by Tri- County Building Industry
Service Board.
I:\Building\Permits\BUP -RES PermitApp.doc 10/01/09 440 -4613T(11 /02 /COM/WEB)
• - RECEIVED
Electrical Permit Application FOR OFFICE USE ONLY
MAR 2 2012
eB ,
City of Tigard Received eceived �j �/ Permit No.: 5r�4a z wo ,
;, 13125 SW Hall Blvd., Tigard, OR 9�iITY OF TIGARD Plan Review �Q /a�,��
Phone: 503.639.4171 Fax: 503.��I�,g9JNG DIVISION Date/By: Permit:
f I G.t r D Inspection Line: 503.639.4175 Date Ready/By: Juris: la See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
® 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.
CATEGORY OF CONSTRUCTION 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 ❑ CommerciaVindustrial ❑ Accessory building 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 ", "I -2 ", "I -3 ",
Job no.: '¢tri Job site address: r27154 SW MOW P°S"4T 100HP or more. occupancy.
❑
0 Six or more residential units. Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Arlington Heights ['Service or feeder 600 amps or more.
job site: Description FEE SCHEDULE
Cross street/directions to
J I Q4•• I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Arlington Heights Lot no.: //6 1,000 sq. ft. or less L 168.54 I1 (.8, 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 2.63.57, 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) ( 75.42f> 75.Qe, 2
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name: Stone Bridge Homes 401 amps to 600 amps 200.34 2
601 amps to 1;000 amps 301.04 2
Address: 16869 SW 65th Avenue #505 Over 1,000 amps or volts 552.26 2
City/State /ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)387 -7577 Fax: (503)387 -7615 200 amps or less 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
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 ex tension, per panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT i ❑ CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: SEE ABOVE B. Fee for branch circuits
without service or feeder fee,
Contact name: Deirdre Britt first branch circuit 56.18 2
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: dbritt@stonebridgehomesnw.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: City Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: 55568 SW Schaltenbrand Lane extension. Describe: Page 2 2
City/State /Z1 P: Sherwood, OR 97140 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (971) 404-1714 Fax: (503) 625 -3052 Investigation per hour (1 hr min) 66.25
CCB Lic.: 42422 I Electrical Lic.: 26 -289C Suprv. Lic.: 35925 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: ifkl{-7 • QC:,
C Print n ame: Chuck Friesen Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: �' TOTAL PERMIT FEE:0Q. LA
Print name: Date: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Pemtits \IiLC•PemitApp.doc 10/01/09 4404615'f(11 /05 /COMIWI /B
Plum bin . Permit A • • licat' • '
Site Utilities . I OIt OFFICE- I(. 1 SE'' ONLY. , .
City of Tigard o y 4 a /A- ' a''''' 2012. boon
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 5(13.718.2439 Fax: 503.598.1960 Date/0y: Other Permit No.:
I. I G A k D Inspection Line: 503.639.4175 Dale Rurdy/By: weir . 0 Sec Page 2 for
Internet: www.tigard-or.gov �� D Notified/Medmd: Supplemental Information
TYPE OF WORK j`j y 1L FEE' SCHEDULE
El New construction ❑ De�qqt ioq For special fnformarion use checklist J V Id 1 2 2012 Description I Qty. I Ea I Total
❑ Addition /alteration /replaceinent ❑la!Other: [�1C New 1- 2- family dwellings (includes 100 ft. for each utility connection)
OF CONS 61111. meth's Tii'rlAR') SFR (t) bath 312.70
g � i han (ai/ItRI Y U�J SFR (2) bath 437.78
® ! - and 2-family dwellin t
-
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other; Fire sprinkler (_sq. IL) Page 2
JOB ME INFORMATION AND LOCATION Site utilities:
Job site address: 1''1 WILIAM/ 'PONT (,N1 Catchhasirlorarcadrain 18.76
Drywell, leach line, or trench drain 18.76
City /State/ZIP: Tigard
Fooling drain (no. linear ft.: __,) Page 2
Suite/bldg. /apt. no.: Project name: Arlington Heights Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
' Rain drain connector 18.76
Sanitary sewer (no, linear ft.: ___) j Page 2
. Storm sewer (no. linear ft.: ,,,_) Page 2
_ -_- Water service (no, linear ft.: ) Page 2
Subdivision: Arlington Heights . I Lot no.: MO - Fixture or Item:
Tax map/par el I .., Backtlow preventer 31.27 -�
•DESCRIPfi )N-4 WORK Backwater valve 12.51
Clothes washer 25.02
single family residence
( .
I . Dishwasher 25.02
A _ !_ a I Drinking fountain 25.02
/ i Ejectors/sump 25.02
i
PROPERTY WNER ❑ TENANT Expansion tank 12.51
Name: Stone Bri e Fixture/sewer ca p, 25.02__
Floor drain/floor sinklhub 25.02
Address: 430 Galewood St, Suite 100 Garbage disposal 25.02
City /State/Z1P: Lake Oswego, OR 97035 I lose bib 25.02
Phone: (503)387 -7577 Fax: (503)387 -7615 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap ' 25.02
Business name: SEE ABOVE Medical gas (value: $ _) Page 2
Contact name: Deirdre Britt - Primer 12.51
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower putt 12.51
E - mail: dbritt@stonebridgehomesuw.com Urinal 25.02
CONTRACTOR
Water closet , 25 -02 -
• Water heater 37.52
Business name: Max Plumbing Water piping/DWV 5629
Address: PO. Box 5597 Other: 25.02
I City /State/Z1P: Beaverton Oregon Subtotal
Phone: (971) 275 0198 Fax: ( ) Minimum permit.fee: $72.50
CCB Lie.: 194644 Plumbing Lie. no.: PB1083 Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signature: (/' ..e.....n.... TOTAL PERMIT FEE _
I Print name: Jason lb Date:
This permit application expires If a permit h not obtained within'18U days
after it has been accepted as complete.
"Fee methodology sal by Tri- Couniy.Building Industry Service Board.
t: \nailding \PvmtuV',\tu- PermiIApp.dm 10/01/09 441..46ta1( IaiOLCOMWF9)
i
I
r .
Mechanical Permit ApplicaCEIVED
Received
City of Tigard �,A Dat /By: �� I Permit No.: �a ®/ /
13125 SW Hall Blvd., Tigard, OR 97220AR 2 8 2012 O w [
Phone: 503.639.4171 Fax: 503.598.1960 DateBy:1eW
II Other Permit: 6 to 4
Inspection Line: 503.639.4175 CITY OF TIGARD
l Y Y S Date Read B Juris: l See Pa e for
�d
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK 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.
CATEGORY OF CONSTRUCTION Value: $
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
Job site address: /2734 6W W ! W� s/ �4/ Dai1/41 E Air conditioning
(requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) f 46.75
Suite/bldg. /apt. no.: I Project name: Arlington Heights Furnace 100,000-F BTU (ducts/vents)
Heat pump 54.91 61.06
Cross street/directions to job site: 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
I /, _ Flue /vent for any of above 23.32
Subdivision: Arlington Heights Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater t 23.32
Gas fireplace 33.39
New, Single Family Residential 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 I Chimney/liner /flue /vent 23.32
❑ TENANT Other: 23.32
Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation
Address: 16869 SW 65 Avenue #505 Range hood /other kitchen
equipment 33.39
City/State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms, w r
Phone: (503)387 -7577 Fax: (503)387 -7616 toilet compartments, utility rooms) Y' 23.32 I ,
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name: same as above
Fuel piping
Contact name: Deirdre Britt $14.15 for first four; $4.03 for each additional
Address: Furnace, etc. I 14,11-7
Gas heat pump
City/State/ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax :: ( ) Water heater
Fireplace
E - mail: dbrittta�stonebridgehomesnw.com Range
CONTRACTOR Barbecue
Business name: Comfort Zone Clothes dryer (gas)
Other:
Address: 1032 NW Corporate Drive MECHANICAL PERMIT FEES*
City/ State/ZIP: Troutdale, OR 97060 Subtotal SZA ,(
Phone: (503) 667 -5595 I Fax: (503) 491 -8252 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 110091 State surcharge (12% of permit fee) 812,
TOTAL PERMIT FEE 3 3,2
Authorized signature: This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: David Heldstab I Date: . Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Pcrmils\MEC- PennitApp.doc 10/01 /09 440- 4617T(I1 /02/COM/WEB)
Plumbing Permit App WED
Building Fixtures relit Owlet? USE ONLY
MAR 2 8 2012
City of Tigard Received - l
� Permit No.: �/ - 006
13125 SW Hall Blvd., Tig �_��gg ,. rti)
Plan a� /
Re
111 0
MA 150. ' i Plan Review er n_ 5
Phone: 503.639.417 ] 184 55993. " ` 8• Other Permit No.: , � -O � Inspection Line: 503.631M 5,DING ION D ate Ready/By: I (. A R 1> y/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition 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 (I) bath 312.70
® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath I 500.32 yj G?9, a1L
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /Z7 Sw wit ow Pa /Nr toulE Catch basin or area drain 18.76
City/State/ZIP: Tigard, OR 97223 Drywall, leach line, or trench drain 18.76
Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: I Project name: Arlington Heights Manufactured home utilities 50.03
Cross street/directions to job site: 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: Arlington Heights I Lot no.: fib Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer .. 25.02
New, Single Family Residential Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Stone Bridge Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 16869 SW 65 Avenue #505
Garbage disposal 25.02
City/State/ZIP: Lake Oswego, OR 97035 Hose bib 25.02
Phone: (503)387 -7577 Fax: (503)387 -7615 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: SEE ABOVE Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Deirdre Britt Roof drain (commercial) 12.51
Address: Sink/basin /lavatory 25.02
City/State /ZIP: Solar units (potable water) 62.54
Phone: ( ) I Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: dbritt@stonebridgehomesnw.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Jardine Plumbing Water piping/DWV 56.29
Address: PO Box 186 Other: 25.02
City/State /ZIP: Estacada, OR 97023 Subtotal
Phone: (503)351 -8532 Fax: (503) 6302882
3 _, ,45 Minimum permit fee: $72.50
Plan review (25% of permit fee)
CCB Lic.: 108747 Plumbing Lic. no.: 93-11 A
State surcharge (12% of permit fee) C, 01\
Authorized signature: -j\
ti (/ TOTAL PERMIT FEE Z, �'
Print name: Ja Jardine Date: This permit application expires if a permit is not obtained within 180 days
y after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1:1Building\Pennits\PLMU- PermitApp.doc 10 /01 /09 440- 461 6r(10 /02 /COM /WEl3)
aA /? 5s, f 1
11 11111 • ° Building Division /a759 `0 U371L .0 A
Development Code Provision Review
T i c e ii Residential Projects
Building Permit No: ' l S 1 (90 /9 4 f
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A 7(
Routed Plans: � a � / � ! r
Original Plan Submittal Date: b
1st 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 (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 alo left on • proved.
Planning Review (contact 1 4JLafveal\ at 503 - 718 -a V5 - Z or /C,,✓iszi•e, @tigard - or.gov)
Land Use Case No. 5rkd3 2 a -waol Name Arts . 3 � n �. ... 1 l f No•
0• Zoning 12 -7
El--Setbacks: .
Front / 5 Rear IS Side _ S Street Side it, Gar se
El. Maximum Building Height 3 .3 Actual Building Height 2 fYZ-
t Visual Clearance
• Easements
Ca/Sensitive Sensitive Lands Type: Cm- 15 S fja i A J4,.8• r c. f"
Notes:
Original Plan: Approved MI Not Approved ❑ Date: 3 /7.R f/ Z
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)
zf Actual Slope: ZO
Notes:
Original Plan: Approved Not Approved ❑ Date: -5 2-0 12-
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City orist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
r treet Trees
Protected Trees /
Notes: ra a W
t_
� ,c fuc- - . t- sperm, CN pwk, 7 11
Original Plan: Approved r
Not Approved X Date: 1J .X$4 4.
Revision 1: Approved Not Approved 0 Date: '3 3 V - ?Q /-
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 :
f. I • Gti� ` t �v .•
Original Plan: Date Sent to Applicant: •
Revision 1: Date Sent to Applicant •
Revision 2: Date Sent to App • ant
Okay to Issue Permit: Yes • ■ o W.... .
Date Routed to Building: •
V .1/
Page 2 of 2
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. III •
City of Tigard
_ Buildin g Division
TIGARD
TRANSMITTAL LETTER
TO: a DAT Ili' a- , .., . -MED
DEPT: BUILDING DIVISION t L IV
APR 4 2012
CITY OF TIGARD
FROM: BUILDING DIVISION
COMPANY: 2L -:j(1 _ LA M---1
PHONE: CC)Wilii41 By:
RE: j,7 bi cA r (f J Aim -r ('N, a , — . .
( Addresg) ' ernut `um ' er
Lo f /(6. 4 ^ 4, A. . -,S L-
(Project name or subdivision name and lot number)
■
ATTACHED ARE THE FOLLOWING ITEMS: •
Copies: I Description: I 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.
Other (explain): /
REMARKS: ����f L—
ie a1 S`-c f�T a..c.. dl - r
FOR � FF CE USE ONLY
Routed to Permit Technici Date: 4l ►b ( lrZ Initials: ; i
Fees Due: ❑ Yes Ejf 14o Fee Description: Amount Due:
$
•
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes I ❑ No ❑ Done
Applicant Notified: Date: Initials:
1:\Building\ Forms \TransmittalLetter - Revisions.doc 02/08t201I
1
STONEBRIDGE 7 � *EmJEri O
HOMES i� 1../...0 d lO : 118
i °i s o eisaa t o$sooiv 0/4 600 MAR 29 2012 DATE: 3/29/12
(1908)887 •71977 PROPERTY:ARLINGTON HEIGHTS
CITY OF IG'A 1D TIGARD
BUILDING DIVISION COUNTY: WASHINGTON- COUNTY
SCALE: 1' =20'
12134 SW WILLOW OPTION 11 ELEVATION
POINT LANE ,,,
36' fi Alpp 366 ' % E ': , i A ,
SIDEWALK _ 3 62 iltil
EL•368
CON. - . i 360
w e' F UE DEL
It 1
R - I 58
- - 6 1
1 364 -,.... � 356
- 354
04'
`a 23'8' i b ' - m'
352
0 ' 4 .
; '
P c FE 36415
1 -10 352
9
22'XI
DES D
O I5' SPE- — — " — — — — — — — — — — — -5' SDE '0
n
M
' 348
4.
EL. 55103' " J •
SILT FENCE
LEGEND
LOT COVERAGE iiii
LOT AREA: 5,484 SQ. FT. —STREET W TREES:
P
BUILDING AREA: 2,050 SQ. FT. PARKKWAY MAPLE
PERCENTAGE: 31%
���
'�--� —RETAINING WALL
NOTES:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
THEY MAY RETAINING ARY AND BE SUBJECT LOCATIONS CI- IANGE.ARE ESTIMATES. LOT 0 116
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES, 5/484 8Q. FT.
STREETLIGHTS, AND OTHER SITE CONDITIONS.
Oregon Residential Specialty Code R318.
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, s� �Q I mo_ , am the general contractor or the owner- builder
at the following address:
Site Address: ci S J
City: 1 cz
Permit #: vvvs Z Cep (cD
Subdivision/Lot #: , �►L � � I_ �1 —
and/or W �
Map and T Lot : / l /'
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: ' l 2 "
General Contractor or Ow ilder
I:\Building\ Form \aES- MoistureSensitiveWood.doc 0925/08
}
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Jurisdiction:
msf Zol z 0006 / 1, 3Q. r
Site Address: l Z 7 3 / j 5 (") ) ) Oki P
Subdivision/Lot #: • A1/\-
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 Ni 107.2)
Signature: Date: l � J
Owner /General Contractor /Autd Agent
Print Name: b � V / SQ
' 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\ Forrns \RES- HighEfficiencyLighting.doc 07/01/08
. a ,
STREET TREE
TIGARD CERTIFICATION •
I, ��� ✓q, I ,..� - z , owner/ a ent or 5 N-e,,3r; � .e-
g f 10C/3
(PLEASE PRINT) (PERMIT HOLDER)
do hereby certift 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.:-j -- 2o1Z (c)OL
HIE ADDRESS: 1 Z `? 30 5 10j fo
SUBDIVISION: P L v : lam- ' V V LOT #: ) ��
SIGNATURE: DA1E: �)Z'
(• .% R/AGENT)
RECEIVED &
VERIFIED BY: _ " DA'1 E: 7 7 .)
1 (CITY OF TIGARD)
. ❑ Tree location verified pe approved site plan.
I:\ Building \Forms \StreetTreeCertificate 05/30/2012
..111 Lt '.1Lll1
•
Energy Trust New Homes r cH
( :ertrfied Residential Air Duct System ENERGY STAR ENERGY TgR '?)!
EnergyTrust
. rr ("re mi. Inc
(• C omnpa>, info _ rmatior� " W''',7
co, _/ C_+ _-1 L „L1�
Technician (� � D:t(
Combusti Applia$Ce •Zone.( Z
/G7 734 S(.►i Vain Zone Zune 2, if applks
(•It % WWI' O((hit'• WUU -1 PojhT Ls/ - - - -- P
Li;isclinr (W R I Kim off) _ Pa p,;,
INIET I(AZ Pressure (sniiirac•1 -- — —
baseiiue lions CAL W RT outside) _ _ _ ___ Pa Pa
,. ,
Duct Leakage (fiH out onestickeipet,puctsystem)_
Description of Area System Serves SI r
( 'until. Floor Area System Serves (ti-) - _`- -___.—
[J yes gnu Air I lundler in conditioned space?
y ttzes (] nu . . lr Handler present during lest''
ft "yes" for either, then ncrxinuun CFM is 75 CFM(050 Pa or
floor area x 0.06 CFM a),50 Pa. whichever is greater.
If "no' for both, then maximum CFM is 50 CFM(0,50 L'a or
Flour area a 0.04 _____ _._ (: FM (t:!),50 Pa, whichever is greater.
Test iVlethod: El Leakage to Outside or l l r,tal Leakage
'i cst Result . .. 3_ _. _. ._.- - -._—_ C � C • FM�_•i _ _J, S UPa
I'uu Pressure Pa Gauge type: ❑ DG -3 or L )G -700
. ) % � �
king (circle one) Open I ;r 3
Duel Blaster Location / 51- Ha or I ' _ f- 1.,11,
Pressure 'lap Location ./ ST L 4 1-1....
147 57 c7oo ( ..•,<<s;%. emh §:�. .