Permit 1
i
n CITY OF TIGARD 7;1 ® MASTER PERMIT
l '1 a '• COMMUNITY DEVELOPMENT Permit #: MST2012 -00031
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2012
Parcel: 2S 109AB 12600
Jurisdiction: Tigard
Site address: 14188 SW ALPINE CREST WAY
Subdivision: ALPINE VIEW Lot: 7
Project: Alpine View, Lot 7
Project Description: New SF. 9/24/12, reprinted to correct address from 14178 to 14188 SW Alpine Crest Way.
/
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1024 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1697 sf Garage: 462 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2721 sf Value: $305,128.80 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
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: 5 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 Tem 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: 5 201 -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 2721
Owner: Contractor:
LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports (Conditions)
12013 NE 99TH ST #1650 2103 NE 129TH ST 1 Ersn Cntrl 503- 681 -4444
VANCOUVER, WA 98682 VANCOUVER, WA 98686
PHONE: PHONE: 360- 258 -7900
FAX: 360 - 258 -7901
Total Fees: $18,807.62
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, ATTE N: on law requires you to follow the rules adopted by the Oregon Utility Notifi ion Center. Those rules are set forth in OAR
952- 001 -00 through OAR 5 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by ing 503.232.1987 br 1.800.332.2344.
Issued B : if/MA[. a Permittee Signal de(
Call 503.639.4175 by 7:00 a.m. for the next available inspecU�n 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.
CITY OF TIGARD MASTER PERMIT
al
COMMUNITY DEVELOPMENT Permit #: MST2012 -00031
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2012
Parcel: 2S 109AB 12600
Jurisdiction: Tigard
Site address: 14178 SW ALPINE CREST WAY
Subdivision: ALPINE VIEW Lot: 7
Project: Alpine View, Lot 7
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1024 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1697 sf Garage: 462 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2721 sf Value: $305,128.80 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 Rein 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: N 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: 4
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add'I 500 sf: 5 201 -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 2721
Owner: Contractor:
LENNAR NORTHWEST INC LENNAR NORTHWEST INC Required Items and Reports (Conditions)
12013 NE 99TH ST #1650 2103 NE 129TH ST 1 Ersn Cntrl 503 - 681 - 4444 .
VANCOUVER, WA 98682 VANCOUVER, WA 98686
PHONE: PHONE: 360 -258 -7900
FAX: 360 - 258 -7901
Total Fees: $18,807.62
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 • •• - .ce with approved plans. This permit will expire if work is not started within 180 days of issue ,
. if work is suspended for more the 180
days. A •" NTION: Or- s •n law requires you to follow the rules adopted by the Oregon Utility Notificatio ;0 - . Those ru =s are et forth in OAR
952 -00 -0010 through OAR • •2- - , ) 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503 r : or 1 : 1 . . 44
� / _ •
Issued 7 - . P e rmittee Signature: IL -...,
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 Application �� .
•
Residential �� �� �A Received
FOR OFFICE USE ONLY
C
. City of Tigard ` ,) ` ` .. DateB : 4 , .i J� Permit No.: �J �`
71
° 13125 SW Hall Blvd., Tigard,OR 972 �' Plan Review NIF
Phone: 503.718.2439 Fax: 503.598.1960 `� ( cN ■ 4' i ' z2 Other Permit: Q��.2 6
, DateBy: ACE TIGARD Inspection Line: 503.639.4175 �i� Date Ready :y: Juris: 0 See Page 2 for :
Internet: www.tigard- or.gov � C. l ` �CV Notified/Method: Ty.-(, Supplementallnformition
. , TYPE OF WORK 'REQUIRED DATA 1- AND 2-FAMILY ,DWELL,
ew 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.
and 2-family dwellin g ❑ Commercial /industrial Valuation: $ �L.J5I rz,
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑Other: Number of bathrooms: S ..._../
' ; JOB SITE INFORMATION AND LOCATION, . : Total number of floors: Z
Job site address: fi 1-i! f � 3 A , u9 , .41/ Ntveiz•as, 14 New dwelling area: z721 square feet
City /State /ZIP: -Roars"-, / ®17 97 $41 Garage /carport area: 1 0 0 2, , square feet
Suite/bldg. /apt. no.: Project name: /ye iiecj Covered porch area J* square feet (en
Cross street/directions to job site: /3„ in e.... D area: square feet (Q2
Other structure area p 3 square feet
: REQUIRED DATA COMMERCIAL -USE CHECK4.,IST .
Subdivision: t /rAte l/itPli l Lot no.: -9 Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
. ' • . DESCRIPTION OF WORK ' ' " . ' work indicated on this application.
Valuation: $
Existing building area square feet
New building area: square feet
, P11OPERTY OWNER . - ,❑ TENANT . - Number of stories:
•
Name: Le,# ,42 )1 /..h Br 606,6+ I19G • Type of construction:
Address:.. /d . A). F2 14574 Ls.,. is �. Occupancy groups:
'.. City/State/ZIP:prnteck &,eit g.5 f $4 g,6 Existing:
Phone: (7 -7,59= 79 Fax: (%9) �ai New: •
.APPLICANT ❑ CONTACT PERSON.' ' - BUILDING PERMIT FEES* . : k
1 (Please refer to fee schedule) •
Business name:�Q� /12 'new 6(. ; iG.% Structural plan review fee (or deposit):
Contact name: �r lrht-
N FLS plan review fee (if applicable):
Address: v . A - Z-. ,e%' c ` O --
/lazy? Total fees due upon application: W
City /State /ZIP: e jveixe,t_
9g6?.-g Amount received: 11 76) •
Phone: 940 7542-2q Fax: : (300) z52---7
HOTOVOLTAIC SOLAR PANEI SYSTEM FEES*
E-mail
�'Grd' ®�P , r�rn C_ ��e, Commercial and residential prescriptive installation of
CONTRACTOR roof -top mount.' 'hotoVoltaic Solar P. • System.
Submit two (2) sets %f roof plan w' connection details
Business name:
._41 II i. L L i/ / - A G • and fire department a ess, al' : with the 2010 Oregon
N Address: -.2 iv ) Z9 'az, 0 ' Solar Installation S.eci.. ode checklist.
City /State /ZIP: L� /t`ue,16/1,- Gj .76� Permit Fee ..e .lanrevie $180.00
,� / j any , iministra:ve fees :
ft Phone: (�3 ) � - .2.9 Fax: (mo � ) D 19,91 State surch• • %of perm fee): $21.60
CCBlic.:`
Total fee due upon application: $201.60
Authorized signature:
di A ` This permit application expires if a permit is not obtained
j
Date: within 180 days after it has been accepted as complete.
Print name: r ��� dL * Fee methodology set by Tri -County Building Industry •
?„,...ei/rti !J/Cj �� �i� Service Board
1: \Building\ Permits \BUP- RESPermitApp.doc 02 /24/2011 4404613T(l 1 /02 /COM/WEB) •
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• . V.
Electrical Permit Application .c FOR OFFICE USE ONLY
City of Tigard Date/B , EM PcrmitNo.: , �� --/L1,.. v 13125 SW Hall Blvd., Tignrd,OR 223 Plan Review
111 G Phone: 503.718.2439 Fax: 503.598.19 8 „j `� ��' � '
Date/By: Other Permit: o'ik,,e_go42-cee):3G7
TI G A R D Inspection Line: 503.639.4175 �'` !uric . Dale Ready/By: ® See Page 1 for
Interact: www.tigard-or.gov ((^� 9 V'C1G I . S ,p Notified/Method: I Supplemental Information
TYPE OF Wf n �X� ` PLAN REVIEW
gNew construction ❑ Addition /altericraiplacemcnt Please check nil that apply (submit a scts of plans udlems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
. ❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
p itl- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps Torah other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: CI Piro pump. ❑ Installation of 75 KVA Cr
❑Amergon
JOB SITE INFORM/ • n LOCATION of new system. ' separately
V,.' E', "1-", derived system.
_ ['Addition ne motor load of ❑ "A ", "E ", "1- 2 ", "1 -3 ",
E . • I00HP or more. occupancy.
Job no.: . I Job site address: _ Ars . - . ( � ; ❑ Six or more residential units. ❑ Recreational vehicle parks.
ra City /State/ZIP: Ill iiiel / e 9 7 ❑ Health -care facilities. ❑ Supply voltage for more than
r ' ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt.no.: V I Project name: ['Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Oty, I Pm. I Total I •
New residential single- or multi-family dwelling unit.
Bl // ,41 , �� , /, C ) Includes attached garage.
Subdivision: — � � / Vt; V;(641V I no.: l Lotno.: /s] 1,000 sq. ft. orlcss 168.54 ,a.
Tax map/parcel Ea. add'I 500 sq. ft. or portion 33.92 b 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq. R.) V 75.00 - 2
L t�
Limited energy, ill a b o v e s
C`� s , l ! / /// � /� rcicesorleedeabovese,.[t.) 75.00 2
s � ` Services or feeders Installation, nitcrallon, anrUor relocation
200 amps or less 100.70 2
J PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: L Fit //(/A/' Mie 77//e/E -VN/! . 601 amps to 1,000 amps 301.04 2
Address: 07//),,? NEm? St - 5 -/e, /6)O Over 1,000 amps or volts 552.26 _ 2
J Temporary services or feeders installation, alteration, and/or
City /State/ZIP: /z Re, yer, 1f1 9f /,f 4 relocation
Phone: 10 0 ) Q 2 5 1-_,.. 79 2 p I Fax: (96 ),26-g... 79/1 / 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on properly 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 ex tension, per panel
Owner signature: . . _ Date: A. Fee for branch circuits with
g APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: L2P 4 - 0lem, r B. Fee for branch circuits without
service feeder or eeder fcc, first
56.18 2
Contact name: gl i,,tee ifiet;/ /ye- branch circuit
1 Each add'1 branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Cit / State/ZIP: Each manufactured or modular 67 84 2
y dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
/ Pump or irrigation circle 67.84 2
E - mail: ell r f r?r'i 4 n'!,l//,,'a47 e �1Wil '7Y'e f'4/11 Sign or outline lighting 67.84 2 -
`CONTRACfOR Signal circuit(s) or limited- energy
Business name: L4. C panel, alteration, or extension. Page 2
l /I /i 7�7/ / !r/ri��� 1 �" /P� /G Each additional inspection over allowable In any of the above
Address: 5-6/ ,? SA- /36. A s9 Additional inspection (I hr min) 66.25/ hr
City/Slate /ZIP: y fJ Investigation (1 hr min) 66.25/ hr
O!'7 -/ , . l �� Industrial plant (h hr min) 78.18/ hr
Phone: ( ) 7G 7— .c�,2 I Fax: 523) 7�, `/ 2 Inspections for which no fee is 90.0W hr
specifically listed ('h In min) ,
CCB Lie.: /4,2:34.,f Electrical Lie.: 3'33,26 I Suprv. Lie.: 33 9es- ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 0 _ 4 k - •, Q • Subtotal: , A13,
Plan review (25% of permit fee): _
Print name: _pen il/5 hie/et I Date: Stale surcharge (12 %ofpermit fee): 41.$5
;- � • TOTAL PERMIT FEE: 6 7 7 °2
Authorized signature: 6.4...:4 f ` mil • T his permit nppllcalion expires if o permit is not obtained within 180
days after It has been accepted as complete.
Print name
/ �' iiG` : , Da • Num ber of inspections allowed per pennit.
I: 01oitdiag■PermildELC-PamtlApp.doe 07/01/10 440-06157(1 I/OS/COWivE.a
Mechanical Permit Application Q,x.. FOR OFFICE USE ONLY
City of Tigard � Y ti0 Re Date ceived °2 J. a
v
13125 SW Hall Blvd., Tigard, OR 9722 �3
C Phone: 503.718.2439 Fax: 503.598.1960 0 G �� Other Permit: Au Q ..e2,36 ?
T I G D Inspection Line: 503.639 O� `� �5� D at e R ea d y B y: Surfs: ® See Page 2 for
Internet: www.tigard - or.gov al ��� Notif i ed/Method: Supplemental Information
TYPE OF WORK ���Q COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
' Mechanical permit fees* are based on the value of the work
w 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*
d 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
/ti J SITE INFORMATION AND LOCATION Heating/cooling:
7 Air conditioning
Job site address: t 6 r iA •
. �14a / ,.yl t � Q � w q ,r (requires site plan showing placement) 46.75
n '7 "" V/ Furnace 100,000 BTU ( ducts/vents) t 46.75
City/State /ZIP: !
�g q4e v 1 / ' 7 ZZ Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: 40iwe p >teu/ Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 6.- rit 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: 0r,, �I� r Lot no.: Flue /vent for any of above 23.32
n C� ��� Other: 23.32
Tax map /parcel o.: Other fuel appliances:
DESCRIPTION OF WORK Water heater ( 23.32
Gas fireplace r 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
El-PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name:Z, 04/2- 21d7 z ..g V Environmental exhaust and ventilation:
u � /I Range hood/other kitchen
Address:
j, %vfi / 2,7 6""T/Z equipment 1 33.39
City /State /ZIP emu• cA.`L G - ( 6 6 ',� Clothes dryer exhaust 33.39
/ Single -duct exhaust (bathrooms,
Phone: (AO Z - - 79 s7 Fax: (. 1: j - 779/ toilet compartments, utility rooms) 23.32 11 t 1
pit:C1
111-134 0 CONTACT PERSON Attic /crawlspace fans 23.32
Business name:Ge�� ji 7/bzZ. i Lt i � ��, - Other: 23.32
� Fuel piping:
Contact name: C /� o/z bee k h t $14.15 for first four; $4.03 for each additional
9 ( <. 7 y
Furnace, etc. ( (A,1.-
Address: �f / i 7 Gas heat pump
City/State/ZIP: j, vIe t, /./i_ L(�� 9 ' Wall /suspended/unit heater
Phone: t mg- 7gt" v Fax: : (tea) 7r55? 's .79;" / Water heater
Fireplace i
E -mail: ` • /'Yl iz''J/�6 -h'tT & G°AJi Peat- I er arY7 Range I .
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: " I;Zi (1 7 6 1.2 Other:
Address: / '3 is-z9 , e i a , „ 5 /7 ! 1444 X2 , MECHANICAL PERMIT FEES*
City/State /ZIP: (1)/z_ q 0/0 e9 ` � 9 Subtotal 7300./9
9
,� ✓✓ Fax: Minimum permit fee ($90.00)
Phone:
(, 7 57- Z Z L� e ft > �7 fl Plan review (25% of permit fee)
CCB lie.: 7 2 a 2... State surcharge (12% of permit fee) al, t 2
• as71._ TO TAL PERMIT FEE '1737. nature: ,g� / This permit application expires if a permit is not obtained within 180
Authorized si g ��4v v[ days after it has been accepted as complete.
Print name: me ki, / g I Datepe�.34,2_, • Fee methodology set by Tri- County Building Industry Service Board
I:\ BuildingTermits \MEC•PermitApp.doc 09/09/10 4404617T(I1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation:- , Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 2
' Plumbing Permit Application .
Building Fixtures V FOR OFFICE USE ONLY *.$C � Received 4 4_ City of Tigard �� � 'L
Date/By: 3 1,- Permit No.:A Q.t� ix_ ow31
C o 13125 SW Hall Blvd., Tigard, OR 97223 I q: S
P� Review
Revw J/
Phone: 503.718.2439 Fax: 503.598.,1960 KV- �S. Date/By: Other PermitNo.:6e0Q�/ ". ,
Inspection Line: 503.639.4175 c' �l� Date Ready/By: Suns: ® See Page 2 for
T I G A R D Internet: www.tigard - or.gov , S .e*-' Notified/Method: Supplemental Information
TYPE OF WOR NiV . FEE* SCHEDULE
w 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 (1) bath 312.70
L d 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
SFR (3) bath I 500.32 5.b•32--
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
/if/1g JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or • Job site address:L D ae� . ! .v ' /iL�l/ p2 �� area drain 18.76
City/State /ZIP: U Ci Proje � $6 Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt. no.: Project name: 6 Q� °
" //ll/
J G/�C � / IJ
G� Manufactured home utilities 50.03
Cross street/directions to job site: /U rya ' Manholes 18.76
Rain drain connector 18.76
• Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
0 Water service (no. linear ft.: , ) Page 2
1 Subdivision:/ , e (/.�„[�GJ I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
O.-PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
f� Fixture /sewer cap 25.02
Name: eyny�,� cn ,i e s _�/r�G
/� Floor drain /floor sink/hub 25.02
Address:
!^ /0 C , l7� �/LQ e � Garbage disposal 25.02
City/State /ZIP: v t�i4.eaw a <_ 956 V.g Hose bib 25.02
Phone: ( �5j -...79d� Fax: (U,p) 255y , -790/ Ice maker 12.51
APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name LBO f A. �� G � � _ Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: az ..29 M v ht. Roof drain (commercial) 12.51
Address: ? /( ' 3 n 9„ ... _ /2.4 o� ,QPCi7 Sink/basin/lavatory 25.02
City/State /ZIP: / A dB-fe�� give.- 744. Solar units (potable water) 62.54
Phone: ('' 45 2 $_ 7y 7 / tii:ax: ( Z5
) - Q� Tub /shower /shower pan 12.51
E- mai1: L..0- 'CJ `.41a..A� /,ht LeiallSlsr?. �� Urinal 25.02
✓ C �Watercloset 25.02
CONTRACTOR
Water heater 37.52
Business name: 7ne/ff91dAzL- �/t fit ! S I ' s, p p g/D
Water i in WV 56.29
Address: p , D . A 7_0.7 Other: 25.02
City /State /ZIP: /ZCGNIZ / (0/i, g'7 /e,6 Subtotal '.'32 _
Phone: (5� 2. 4 -_ e 9-75-z? Fax: (60 • 7_5( 19,5157Q Minimum permit fee: $72.50
Plan review (25% of permit fee)
CCB Lie.: JO 2. s Plumbing Lic. no.: 1,../2 ^ / f �
0 9 ‘,r 1----
State surcharge (12% of pennit fee) G• Authorized si TOTAL PERMIT FEE 5 0 , .3 f Print name: d' ,,� yn�°�An , Dater /431 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\PI.MU- PermitApp.doc 1 0/01 /09 440- 4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
•
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. . Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1" 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54 7,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' 37.52
Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
and including $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * . , Plan Review for Plumbing Installations
Quantiy by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace./ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font ❑ Any new commercial building with water service 2" and
greater, except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
- Jacuzzi/Whirlpool -
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918- 780 -0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher. Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918 -780 -0040.
Drinking Fountain •
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: - 2"
3 " Isometric or Riser Diagram
- 4 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non - food that meet the qualifications above.
Disposal: - Domestic food related
- Commercial food related
- Industrial food related
Ice MachiRefrig. Drains Comments regarding fixture work:
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non -food related
- Bradley
- Com/Serv/Util food related
- Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor p
WaterCloset Toilet plumbing permit can be issued.
Urinal _
Other Fixtures:
I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2
c.e4,1-L L- 7
1,1 ° Building Division
Development Code Provision Review
T I G A R D Residential Projects
Building Permit No: M ST---01? CX D J /
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: 0 P /
1st Revision Submittal Date: /7 /r ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review (contact I�CC at 503 - 718 - or _sk[ @ti or.
Land Use Case o. S.I o2erUa' a0 4 /Name i a rn( t 114
Zoning e
l2Setbacks: /
Front 6 Rear !.C Side C Street Side /0 Garage Ve
0/Maximum Building Height gj Actual Building Height -Lt
12/ Visual Clearance
D/ asements ' t Piker
IV/Sensitive Lands Type: NI IK
Notes:
Original Plan: Approved Not Approved ❑ - Date: • ag 0-
Revision 1: Approved Not Approved ❑ Date: Effi
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
Actual Slope: /
Notes:
Original Plan: Approved Not Approved ❑ Date: /
Revision 1: Approved% Not Approved ❑ Date: IZ
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
TfrStreet Trees
ad Protected Trees
f
Notes: ccJ . L. fi tEn tn, V o4 J 1:4...-“, � ,R :t-:* trjoi t v o+
so,.
Original Plan: Approved —❑ Not Approved I/ Date: a c y Do / a -
Revision 1: Approved Lid Not Approved ❑ Date: /,do /a-
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: t'
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Appli nt
Okay to Issue Permit: Y s No r4( 2.
Date Routed to Building. /.�il
•
•
Page 2 of 2
R EC,E 0
•
c . APR 1 2012
�, 1 �: "n
rt ? If ` LI .C-'
LOT COVERAGE I t
LOT AREA 5030 SQ. FT. S
BUILDING COVERAGE t -wir
2272 SQ. FT. = 45.1%
IMPERVIOUS AREA 412 SQ. FT. /
•
E
. . ` PRIVATE STREET 4
b I
1 l ,. '.. — . . '. . ..
16 7 25.E
,te e.- -iee�� eEr,.
Ahlt � `;�" ) LOT 7'♦!
E
acLONE FEN _ L� � � , \� Ill II fN .
�,� 0
1 1 I �, D t `rc w�uvr
4
1 `\. 1 /
L
• 1 1 \ ` ♦�
\♦ ��♦ ♦ . 0.
0
♦ \ \
\ ni
/ ♦ ♦ ♦ GARAGE S `— \ —
o V _ \-_-_-_-_-_-_-----
- _ 81L1
II
\ .
L 1L i 5. 9 ' smEwAuc I' _
`� 1` , PLANTER STRP *e �,
OCCOMINI MO
SW ALPINE CRESTS WAY %\
LEGAL DESCRIPTION
SUNTEl HOME DESIGN, INC. IS NOT LOT 7 — ALPNE VIEW 11111 \-LW
LIABLE FOR THE ACCURACY OF THE SW ALPINE CRESTS WAY w �r'p
N. R
TOPOGRAPHY INFORMATION IS TIGARD, OR
THE SOLE RESPONSIBILITY OF THE
FE: KM ROI
Btu TO NERFY ALL SITE LEGEND
CONDITIONS. INCLUDING ANY FILL
Cit.
PLACED THE r
E SITE AND INFORM iy . 7 DOGWOOD STREET TREE " `el
+
OWNERS OF ANY POTBNIT1AL FED MODIFICATIONS. MODFlCATION S. "►�""M0121171
STREET TREE
CERTIFICATION
I . iIM,G�►/ &�� owner /a agent or L&iv" Hcws 5
C � , g f
(PLEASE PRINT) (PERMIT HOLDER)
do hereby certiO 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 � q___— Ci" ) 3 L
SI"1 E ADDRESS: 5I41 pvocrfts-ki4,--
r-
SUBDIVISION: L o c c .,r e i LOT #. 7
SIGNATURE: l l✓: 5' /Z! I, Z
( �R GENT) DA
RECEIVED & •
VERIFIED BY: (--/ - DA"lE: pi-26-12- ( %' OF TIGARD) _
❑ Tree location verified per app " ved site plan.
/
I: \Building \Forms \StreetTreeCertificate 05/30/2012
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
��i�3
Permit No.
gcr C Z I Jurisdiction: /
Site Address:
/CS C 51A/ A .1•1
Subdivision/Lot #: -
and/or
Map and Tax Lot #: (di-7
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 eff ac 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)
1
Signature: Date: fl
Owner /General Contractor /Authorized Agent
Print Name:
Yl
I 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:\ BuildingTorms \RES- HighEtliciencyLighting.doc 07/01/08
Oregon Residential Specialty Code 8318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, if/KR/An/ i tA0A4 G , am the general contractor or the owner- builder
at the following address:
Site Address: S C 41 �� to.),
City: 5 6
Permit #: R51_ 2) ( Ls_ C 3 t
Subdivision/Lot #: A 1p ' v\
and/or
Map and Tax Lot #: LA-7
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:
General Contractor or wner- u der
I: \Building\Form\RES- MoistureSensitiveWood.doc 09/25/08