Loading...
Permit CITY OF TIGARD MASTER PERMIT Is COMMUNITY DEVELOPMENT Permit #: MST2012 -00134 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/04/2012 Parcel: 2S114BA17600 Jurisdiction: TIGARD Site address: 9633 SW FERN HOLLOW CT Subdivision: FERN HOLLOW Lot: 2 Project: Fern Hollow, Lot 2 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 897 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1203 sf Garage: 380 sf Front: 15 Smoke Dwelling Units: 1 Third: 0 sf Right: 4 Detectors: Yes Total: 2100 sf Value: $234,855.96 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: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 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 Temp SrvclFeeders 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: 3 201 -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 Ecom asin Other: N Other Description: P 9 BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R -3 2100 Owner: Contractor: COMMUNITY FINANCIAL CORP RIVERSIDE HOMES LLC Required Items and Reports (Conditions) ATTN JOHN SATTERBERG 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503- 639 -4175 412 A ST #150 BEAVERTON, OR 97006 LAKE OSWEGO, OR 97034 PHONE: PHONE: 503 -645 -0986 FAX: 503 -690 -2942 Total Fees: $17,551.03 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through • • R 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: � f4s.I - �� Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection da e. • 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. -, 'w Building Permit Applicatio r:P r; Residential " ^ � I'OR OFFICE USE ONLY City of Tigard J 18 2012 INIIME • 13125 SW Ball Blvd.. Tigard. OR 97223 Plan Re, C pp� �� �, '7 Other Permit Qae(1 - 1P Phony. 503.715.2439 Pax: 503.598❑AT OFT IGA Dateriv; , 'I'I G \ RI) Inspection 1_ine: 503.639 ®�� 11p DING yy�� , � Date Rea ,. ty: s , „ • - s ® See Page 2 far Internet: %tine- ttgard- or.eov ��11 ® 1\1ia t,',�yfe� tall• Kotiliied \ {ethad:/ ����, SupplcncnalInformation S P 1 n� G L A � n <. , IIt� T '� =�' -r � T� D;2 = CAi1iIJtil' °-UVU LY: iN6: .: OF. E �U DA A.l A ' :i Q Ki New construction ❑ Demolition Permit fees* are based on the value of the work performed. a Indicate the %alue (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment. materials. labor. overhead. and the profit for the 6 ;_ ;, sq - dC;° : =r'n c = tv • indicated on this application. - work tcd � Ih s a I icaut '. r .;. '; .A OT.'CONSTRUGTION':%, < y`- � ;t<i� :' ,' ,,, , ?- r ,_ PP r.>. , ., ._. ...,., a.., ..., ..•. . �. .'r� ... ....,_ a.. a.• r. a.. �x'_., v. r, ...._..... x. ..�•:�)..;..nr,. .......,.Y:l,:,._ /�- Eli- and 2- family dwelling Valuation: $ L3� CI 7 s +1 , ❑ Commercial/industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: 5 t ❑ Master builder ❑ Other: Number of bathrooms: 2.5 (' ':.` '.° ;r_`w f�, ''a: floors: 2 ;=,;; ':] Of '- 51TE'INFORTKIATdUN;`'ANU. lQ'CATION`.;�,2;� .�: �� • `: ,: :. ,..- ,,,1�•:. _._ ._...,.. _ r'. ire. . -;. - ..r�.....��:>.Y... -_, .i(.r.�.j:' + }FJ .,J :Y Cx; �'�� � Total number of Job site address: 9633 SW Fern Hollow Ct New dwelling area: 2100 square feet City/State/ZIP: Tigard, OR 97224 Garage/carpon area: 380 square feet Suite/bldg. /apt. no.: I Project name: Fern Hollow Covered porch area: 83 square feet 1203 Cross street/directions to job site: Deck area: NA ° �7 �1 square feet Other structure area: 2 square feet - '' R Q' IR,I D.DATi1: ?; "§iRv)ERCI'ALIDS `C1IECk11ST7z< Subdivision: Fern Hollow I Lot no.: 2 Permit fees* are based on the value of the woe): performed. ` 'fax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all ,,:,,, : a,,:..� ;, ,:,= equipment, materials, labor, overhead, and the profit for the , - :' _' t DERPTIOO '< , A , ,, . - r ;/,,, , ,,, o indicated _ W ° " - r;' .t work it cated on this application. t Valuation: $ Existing building area: square feet New building area: square feet ' .C:d.:= - '.r': __ Pa ;'h:' - •�.1 - �,,(y ':��T- �,rS,a:J:': -.; �ti y.xv� :y'c. ,1. ;St�� " }'1 ti:.;y:V; y " R tiitTYo 'NE$- .�. ��,.�"I.` : - i. ' ,: Illi�. EAJI*N7_t:::;s -' -:�,.. Number of stories: Name: Riverside Homes, LLC Type of construction: Address: 17933 NW Evergreen Pkwy, Suite 370 • Occupancy groups: City/State/ZIP: Beaverton, OR 97006 Existing: Phone: ( 503)645 -0986 Fax: (503)690-2942 New. • ;: : s:: _.: f -: :.i*�.: -.>,'�•�- ;,,iii. ��a'Ai: `u?•; ='� _ :_F- 'a:,`3r•;s� -'r :' - 1 Q�� >`r; � .:c.t : . �]- ��© NTrAC `[` ;114 NG'7':RltTil ':1:1 =�` t� ._::.e . ;,, �` �r':'e:o ._ _.• _.:_, -,3�} z _•_.,r. ,.'_,�- �. - „c_._�, ••,: -•> t_ r., � �” ��tiZ %'�'�'`.,T % � _rp 1 'i.`. �ntw.. s...h` -'., 1r`. =: .; �, o��ti Business name: Riverside Homes, LLC ;. . i- " -_ f1-s iriliai lly'ro ieie.g ie`} .�% :';�:�''i:- ;3' L indsay A dams Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): Address: 17933 NW Evergreen Pkwy, Suite 370 Total fees due upon application: City/State/ZIP: Beaverton, OR 97006 Phone: ( 503) 645 -0986 I Fax: : (503 )690 -2942 r- Amount received: v.. E-mail: LAdams @Riversidehome.com � _ a.7o o 1;A c o L .'i ni. e ._, , . i rz: ` .r < , N , ,, g , „ a-• e.; ; ;; xy ; ,,, •:.,.•. 4 .;, sf` : ;x . : ; { , p ? _ ;y , Coinniercial atid residential prescriptive installation of .- .:.I:' `: = =, :,r 'Sy 'fAii .- 1 is . -,, ,- c *Y s -S f r• i1•iOtL %.r:.'�,�i0.:.rd•_t +, s� ? '.-:'a..., roof -top mounted Photovoltaic Solar Panel System. Business name: Riverside Homes, LLC Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: 17933 NW Evergreen Pkwy, Suite 370 Solar Installation Specialty Code checklist. Fee (includes plan review Beaverton, OR 97006 P ermit F end administrative fees): $180,00 Phone: ( 503)645 -0986 Fax: ( 503)690 -2942 State surcharge (12% of permit fee): $21.60 CCI3 lie.: 189148 Total fee due upon application: $201.60 C ' � This permit application expires if is not obtained Authorized signature P PP P P \\\///VVV within 180 days after it has been accepted os complete. Print name: Lindsay Adams I Date: • Fee methodology set by •fn- County Building Industry Service Board. I.\ Building \Permits113UI'- RESPcrmitApp doe 02/24/2011 440 -461311 I I /02 /COMM'EB) 1 4 - MOO Plumbing Permit AnnlicL CE IVED Building Fixtures Fills (1FFI( 1: l'SE ONLY City of Tigard JUN 18 2012 Received e < Q MA- rirfa- Permit No.: S `golf_(0 /3ie III , , • 13125 SW Hall Blvd., Tigard, OR 97223 Phone 503.718.2434 Fax somroF TIG - D Date/By: Otber Permit No.: 4. a- /0040 1- IGnit1) Inspection Line: 503.639.417 of / � t ,- ^' DueResdy1By. lurk I Ste Pogo 2for Internet: ttnvw.ligatdor,gov UIl DIINO LiViSIvii Notified/Method: So..tementalInformation RI New construction ❑ Demolition For sped at lnfommUon use checklist Description I Qty. I Ea. i Total 0 Addition /alteration/replacement ❑ Other: Newt- 2- family dwellings (includes 100 ft. for each utility connection) -- _ tprryrj7 Tai 'a 1 tjt 1litnta) SFR(1)bath 312.70 ® 1- and 2- family dwelling 0 Conlmercial/industrial SFR (2) bath 437.78 ❑ Accessory balding ❑ Multi - family SPR(3)bath 1 500.32 �.��_ 1:1 Master builder Each additional bath/kitchee 25.02 ❑ Other: Fire sprinkler( sq. R) Page 2 -'- - - a t 61 -1-)' I:1I N . (e ) 1,9 (r) -- r'o sI,)r irC- 4 c) - - Site utilities: Job site address: 9633 SW Fern Hollow Ct Catch basin or area drain 18.76 Dmtitil, leach line, or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain (no. linear R: _) Page 2 Suite/bldg./apt. no.: I Project name: Fern Hollow Manufactured home utilities 50.03 Cross streeUdireaions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sower (no. linear it: _) Page 2 Storm sower linear ft: _) Paget Waterservice (no. linear 8.: ^) Page 2 Subdivision: Fern Hollow I Lot no.: 2 Fixtareor item: Tax map /parcel nn.: Backilow preventer 3127 - - - -J) tc(il ylt):1ta) it) Backwetervelvo 12.51 -- - - -. CIOth washes 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 TRY)" I I` o) °A1'i _ i . _ v - t , Expansion tank a - .. .. ' ' 12.51 Name: Rivers .e • omes, Fixture/sewer cap 25.02 Address: 17933 NW Evergreen Pkwy, Suite 370 Floor drainMoorsirtk/hub 25.02 City/State/ZIP: Beaverton, OR 97006 Ho aiaposai 25.02 Hose b bi b 25.02 Phone: (503)645 -0986 Fax: (503)690 -2942 Icomaker 12.51 __ 1 ) . r e t - - • t , --1 z (✓ -i; G ,,, ; ..1i 1 - 1., i) - intercepter/grease trap 25.02 Business name: Riverside Homes, LLC Medical gas (value:S) Paget Contact name: Lindsay Adams Primer 12.51 Address: 17933 NW Evergreen Pkwy, Suite 370 Re 15 Sink /basln/iavatory 25.0.0 2 City/State/ZIP: Beaverton, OR 97006 Solar units (potable water) 62.54 Phone: (503)645 -0986 I Fax:: 503 )690 -2942 TubWahowerhhowerpan 12.51 B -mall: LAdams@Riversidehome.com Urinal 25.02 Water closet 25.02 Water heater 37.52 Business name: H &H Mechanical Waterpiping/DWV 36.29 Address: 5757 SW Willow Lane - Olha: 25.02 City/State/ZIP: ‘ Illweu le, • - ' 6 Subtotal Phone: (503) 975 -9787 Fax: (503)659 -2979 Minimum pamit fee 572.50 cee Lie.: 178122 Plumbing Lie. oo.: PB414 Plan review (25% of pennit fee) State surcharge (12%%ofpermit fee) Authorized signature: ....,..111PS . I TOTAL PERMIT FEE I • //, 'fhb pelmet application expires if a permit b eei obUlred within 180 days ,� �` Date: after It has been accepted n complete. Fee methodology not byTrl-County Building Industry Service Bosrd. LABoadui Peso tOP1MU.PamltAppdoo 1091109 440-4616T(I001./COoVWCa) Mechanical Permit Annlien ' ^ � :a � 'b A Received 01'1'1y', l. I SE. .0 City of Tigard il ti� „ '.- , Date/By: , / Permit No.: 4r e, ^ CV • 13125 SW Hall Blvd., Tigard, OR 97223 • Plan R Phone 503.718.2439 Fax: 503.598.1960 J U N 1 8 2012 Dme/By: °tom Patnit j -! • DO/ Tic A t i t) inspection Line: 503.639.4175 Date Reedy�By. 3wa /v Internet: www.tigard•or,gov See Page2lor CCPI! / Notified/Method: Supplemental lnrorrastioe ? t , l axn' .� D rP :... .:.:•:'d:...,,;: .:- "s (l 8 1 1 :.:. ; .:. T,?',.., . s....� :.... .. ..., . � ie�iOtAG'F£BR�SC • . .... ......:. � 13►.. . _ ... � ...� , . HEDI!w.4,Ai5E'CkECICa.ST<:' °. ® N New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work ❑ N ewo construction CI Other: perforated. Indicate the value (rounded to the nearest dollar) of all mechanical materials. equipment, labor. overhead, and profit. .....:........:.. , ,CAT£CORY.;.OF CONSTRUCT a tee: :a :.;tFSWEN IA /S1 f E }tS E6± ; `.1'.` ixi I- and 2- family dwelling ❑ Commercial/industrial ❑ Actesso building ng For sycclallpforrnar/pn use checklist. ❑ Multi - family 0 Master builder ❑ Other. Description I Qty. I Fa. , Total i . ?i=:: :)..2-E ?'.;;i" OBjSITL INFO MATJON' ' r � ;: = ; .'a ;,;:a <r : : Heatin �) let AN))�1OCA Q Air condit Job site address: g 9633 SW Fern Hollow Ct Immures site plan showing placement) 46.75 Clty/StaterLlP: Tigard, OR 97224 Furnace 100,000 BTU (duen,v ) 46.75 Furnace 100,000+ BTU (duur ins) 54.91 Suite/bldg. /apt. no.: I Project name: Fern Hollow Hem pump (requires site plan showing placement) 61.06 Cross so to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (mdiatoror hydronic) 23.32 Unit heaters (fuel-type, not electric), in -wall, in -duct suspended, etc. 46.75 Subdivision: Fern Hollow I Lot no.: 2 Flue/vent for any of above 23.32 Tax map/parcel no Other: 23,32 Other fuel appliances: .. . ri;, . . . , . . :........ ...........: .2e W* ... AN >`OF. WORK -. - Writer heater ....__ , - .- .....�;�'.. _,..:a,::,. _.,.- „.:.�........;•:�:...... 1 23.32 Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Lop fielder (fan) '23.32 Wood/tiellet stove 33.39 Wood freplaoelinserrt 23.32 . ,I. ; w Rgifi IIOP.ER. r rOW�I ii+ : - : SI llY _ ;,.; � ,�.::: � Cl inn lli e 23.32 -t•, -�• ey ucly _,. _..,._ , . ..�,._ .._.._. - ��a:r�� ..��,..,, ,.,,:. <�...:- �il�,:T�A� , :•j:;; ' Other: 23.32 Name: Riverside Homes, LLC Eavitronmeotal exhaust and ventilation: Address: 17933 NW Evergreen Pkwy, Suite 370 Range hootUother.kitchen equipment 33.39 City /State/ZIP: Beaverton, 'OR 97006 Clbthes diver exhaust 33,39 Phone: ( 503) 645 -0986 Fax: ( 503) 690 -2942 Single -duct exhaust (bathrooms, ,� � toilet compartments, utility rooms) 23.32 .:,_.. s:l_. ,..._�.._54tI:r :sYt c- t�:'.�s, . . Attic%rawlstmcefans 23.32 >3usin ss me: Riverside LLC Other. - _ 23.32 Fuel piping: Contact name: Address: 17933 NW: Ever reen P S14.15 for first four. 54.03 for each additional g kwy, Suite 370 Famace.etc. .1 Gas City/State/ZIP: Beaverton, OR 97006 WI /ste pump naed/unithoats Phone: ( 503).645 - 0986 I Fax: : (503)690 -2942 -Welustrspe; heater _ I E -mail: LAdami@RIVersidehome.com Fircpleco I i::!`i`'l -' ;''`J �- .',�%�'!.c `+C�'+'� ...., - �'f< - f,S.<.'`'; < a;5':.'� a= r7”' ^(r'ni.`t: �•:t< 1 ... i�}lJ. r 5►!. ., .- - ;e .� :3,'? >'- 3.",.. <:a :iR„�::...�f. 3 ':�2 % Barbecue Business name: Arideiserf Heating, Inc • Clothes dryer Ws) Address: 6463 Dawn • Ave Ot 1 _ City /Statd S obtotal zIP: Lake Oswego, OR 97035 "" Phone: ( 503)841 -074 I Fax: (503)536 -6615 Minimum permit fee (S90.00) Plan review (25% of *mit fee) CCB )ic.: 168214 State surcharge (12% of perlrllt fee) TOTAL PERMIT FEE Authorized signature: This permit spoliation expiroNa'permit Is nut obmtaedwrithin /Bo days after It has been emoted is complete. ( Print name: Art Andersen I Date: i7 `' t. 1 • Fee methodology set by Tri•County Building Industry Service Boyd I: 1BuAdinplPermiulE hC•PermilAypdoe 03107/12 ITr(11102/('OMVWEB) Electrical Permit Applica C ' ! 41 rotz orrice us ONLY City of Tigard „JUN 18 2012 AM� t'emdtN°.: 5 , , wr.1 . = 13125 SW Hall Blvd., Tigard, OR 97 3 plan Review — Phone: 503.718.2439 Fax: 503.59 Dar . Other Pennit:S)Q ea 41. _I I r A R D Inspection Line: 503.639.4175 1 1' i� OF TIG� l F �i D B 1A 1 Date Ready/13y. Jam ® See Page 2 for Internet: wwwAigard-or.gov OI � D ING DI DIVISION Notified/Method: Supplemental Information TYPE OF WORK l � PLAN REVIEW ® New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w!nen6 checked below): ❑ Serves or feeder 400 amps or more ❑ Budding 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 ® I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps road other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of KVA or JOB SITE INFORMATION AND LOCATION 0 Etmmeigmrry system. separately . larger sarately derived system. ❑ Addition of new motor load of ❑ "A ", "E", "1.2 ", - 1 - 3 . ', Job no.: Job site address: 9633 SW Fern Hollow Ct 100HP or more occupancy. ❑ Six a more residential units. ['Recreational vehicle parks. City /State/ZIP: Tigard, OR 97224 ❑ Health facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Sui tc/bldgJapt no.: Project name: Fern Hollow ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: - Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Fern Hollow I Lot no.: 2 1 .000 sq. ft. or less 1 168.54 4 En. add'I 500 sq. ft. or poni°n 7j 33.92 1 Tax map/parcel no.: Limited energy, residential I 75 00 2 DESCRIPTION OF WORK (with above sq. R) Limited energy, multi- family 75.00 2 residential (with above sq. ft.) , Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2_ RI PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: Riverside Homes, LLC 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: NW Evergreen Pkwy, Suite 370 Over 1,000 amps or volts 552.26 2 city /Stale/ZIP: Beaverton, OR 97006 Temporary services or feeders Installation, alteration, and /or relocation Phone: ( 503)645 -0986 Fax: ( 503)690 -2942 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that 1 own which is not 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 extension, per panel Owner signature: Date: A. Fee for branch circuits with If APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch citcuil Business name: Riverside Homes, LLC B. Fee for branch circuits wfthnnr service or feeder fee, first Contact name: Lindsay Adams branch circuit 56.I8 2 Each add'l branch circuit 7.42 2 Address: 17933 NW Evergreen Pkwy, Suite 370 Miscellaneous (service or feeder not included) City /State/ZIP: Beaverton, OR 97006 d wellin , sfrvic a or modular 67.84 2 r dwelling, service and/or feeder Phone: ( 503)645 -0986 I Faxc:: ( 503)690 -2942 Reconnect only 67.84 2 E -mail: LAdams @Riversldehome.com Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuits) or limited-energy Business name: Western Cascade Electric panel, alteration. or extension. Page 2 _ 2 Each additional inspection over allowable in any of the above Address: 8900 SW Bumham St. G18 Additional inspection (1 hr min) 66.25/ hr - City/State/ZIP: ligard, OR 97223 Investigation (I hr min) 66.25/hr Industrial plant (I hr min) 78.18/ hr Phone: ( 503) 521 -0000 I Fax: (503 )521 - 8876 Inspections for which no fee is specifically listed ('A hr min) 90.00/ hr cCB Lie.: 153415 I Electrical Lic.: 34 -616C I Suprv. Lic.:* .. . • .ELECTRICAL PERMIT: : .. • . Suprv. Electrician signature, requited: r Subtotal: Plan review (25% of permit fee): Print name: Jeff Evens Date: `' Z S tatesurcharge(12%ofpermitfee): Authorized signature: /I/ TOTAL PERMIT FEE: This permit application expires it a permit is cot obtained within 180 Print name: Jeff Evens i I Date: h KI I — • days after it has been accepted as complete. 7 Number of inspections allowed per permit. 1.1Bn dmgSPermils\ELC- PnmdApp doe 01/01/10 440.4615f(O INS/COM/WEB 1,1 ° Building Division Development Code Provision Review T I G A R D Residential Projects Building Permit No: f `r a01 - 00 ) 3 �I CWS Service Provider Letter Received: Yes ❑ No ❑ N/A 5 Routed Plans: Original Plan Submittal Date: ( -1 6 - 17 -- 15t Revision Submittal Date: ❑ 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 1L , i.. at 503-718- 2M 3 or @tigard- or.gov) Land Use Case No. 5' ri 9Q(-, - i l Name Zoning Pf Setbacks: , / ront (5 Rear t'r" Side r J / Street Side ID Garage 2. Maximum Building Height 3( Actual Building Height z.9 p' Visual Clearance 0 Easements Sensitive Lands Type: I` rk Notes: Original Plan: Approved O Not Approved ❑ Date: 6 _z Z / 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) Afr Actual Slope: Notes: Original Plan: Approved Not Approved ❑ Date: 6 Z S l z, Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 Citty Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) t Street Trees Iff Protected Trees Notes: Original Plan: Approved El Not Approved ❑ Date: 6 'Poi) 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: YesNo ❑ Date Routed to Building: / / // ' Page 2 of 2 ,.. 9633 SW Fern Hollow Ct �° • L - _. - - _ + - 2100 A RIGHT ∎ 10.0o 5/17/2012 / — — " 7 K' r `, "1.- i JUN 1 8 2012 I - • '' •\ ; " \,)\ 2 .`33'-i ��\ i r ;! : ::: :y'...: ..u, „.:.J: co \ \ i I • / X 36' / . ” , \ ��� L �/,'1 / `" .e ' I 1.00 4k%.11`, r/ '2`J1 � (. 4 � / c Cam. �.� \ ' \\ 1� �o io �/ \ I • 5; -\ S5 �i�,.. 25.00 fi , , t A � 0 / , ' �Et, /• � ' � / /' `er `• / ✓ � -" 0 sTRE L ;40 .) ` � � / ear 7Or 1 : \ j C) RISE O / \\ \ • \ � \ 0 AP \ \ 1 20' 10' 0 20' k / r \ E ' �i \ 0 0 . \ SCALE: 1" = 20' v Qi \ G\ ' 10.00' 9, MINIMUM FRONT YARD :10 FEET (S) y\ 20.00' ' r MINIMUM SIDE YARD: 4 FEET (E) — — — 0 F\ MINIMUM SIDE YARD:5 FEET (W) / MINIMUM REAR YARD: 10 FEET (N) 3 r. MINIMUM GARAGE: 25 FEET / ..! P.U.E.: 10 FEET r,� i D • , `� � ��0iP" a ff4 FER ROLL • W 4 . , TIGARD, OREGON DESIGN GROUP INC. oxeaoH LOT 2 14025 Sw FARMINGTDN RD (.' 4 16' 0 ` 1 G site 270 I. o�a� Project No. RVR001 Dote: 05/11 /12 1 of Z BEAVERTON, OR 97005 (503)644.4628 ExamES 12•31.13 I Scale: 1" = 20' Drawn By. KRF P lra N l,'3 Y f. ICZoinr v . Air & Duct Leakage Affidavit 4 , 0 / ti Permit #: IA J a t 0i t House address or lot number: Z q 6 3 3 y W ,C34. r [ ((o t.,) c+- City: 1 ty 64-- Zip: Cond. Floor Area (ft2): 210 0 Average Ceiling Height: $. S Air Leakage test; Maximum Air Leakage: (6ACH x V / 60) = 1f1' CFM @50 Pa Measured Air Leakage: I c3 CFM @50 Pa -- ( ✓ a , 5 5 Baseline: ^ I Pa Ring (circle one if applicable): Opee> 3 Windy? Yes No Air Handler in conditioned s ace? yes no Air Handler present during test ye no Circle Test Metho Leakage to Outside Total Leakage Maximum duct leakage: Post Construction, total duct leakage: (floor area x .08) = CFM @50 Pa Post Construction, leakage to outdoors: (floor area x .06) = 1 6 CFM@50 Pa Rough -In, total duct leakage with air handler installed: (floor area x .06) = CFM @50 Pa Rough -In, total duct leakage with air handler not installed: (floor area x .04) = CFM @50 Pa Test Result / 1 0 CFM @50Pa r"Q 54 Ring (circle one if applicable): Open 1P3 Duct Tester Location: gEiVrw. Pressure Tap Location: le - i 1 IA) y OW ( 1 I certify that these air leakage rates are accurate and determined using standard ODOE protocol. Company Name: Westside D sulation Technician: K le Chase ■••0" / Technician Signature: Date: II Z3 - STREET TREE TIGARD CERTIFICATION I R"' sib 04I% S , owner/ agent for ?ivecilDe (PLEASE PRINT) (PERMIT HOLDER) do hereby certify 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.: AA sr . 2-O tZ- 00134 ST1 E ADDRESS: q X33 Si FERJ ' SUBDIVISION: fE 1 e.11 LOT #: 2 — SIGNATURE: A S.LQjer DA 1 E: l C- 2-4°-1.2 / (OWNER /AGENT) RE CEIVED d� VERIFIED BY DA"1 E: I f -7,6 l _ Or ❑ Tree location verified per approved site plan. I:\ Building \Forms \StreetTreeCertificate 05/30/2012 Oregon Residential Specialty Code N1107. HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: titsr 2otz D01 3L{ Jurisdiction. ' -r Site Address: 63'3 S ‘Psi Fe 124.1 t•t5w dr Subdivision/Lot #: FE¢ -3 «cI, w 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: V 1(11:3* tOe tADA,Ata Date: 2- I Z Owner /General Contractor /Authorized Agent Print Name: C FI.VVe-CIDE Mi 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. 1:\Building\Forms\RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318. MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, lc 1 r/ERs i t c \ IC r �.L L , am the general contractor or the owner- builder at the following address: Site Address: FRry City: Permit #: _A/IS V ovv. Subdivision/Lot #: l .r L 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: all – M `" Date: ►° 1; - 1. 7— - General Contractor or Owner - Builder I:\Building\Form\RES- MoistureSensitiveWood.doc 09/25/08