Permit CITY OF TIGARD Q ZS Z MASTER PERMIT
Ip
' COMMUNITY DEVELOPMENT Permit #: MST2012 -00192
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/11/2012
Parcel: 2S 109AB 17600
Jurisdiction: TIGARD
Site address: 13272 SW WILMINGTON LN
Subdivision: HIGHLAND HILLS ESTATES Lot: 5 • .
Project: Highland Hills, Lot 5
Project Description: New SF. 10/25/12, reprinted to add fire sprinklers.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 991 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 1322 sf Garage: 413 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2313 sf Value: $260,165.84 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: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins. 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value. 1
Drywell- Trench Drain: ,0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
' Ea add'l 500 sf: 4 201 -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 2313
Owner: Contractor:
MISSION HOMES NW MISSION HOMES NORTHWEST LLC Required Items and Reports (Conditions)
PO BOX 1689 PO BOX 1689 1 Ersn Cntrl 503 - 639 -4175
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503 - 381 -3753 PHONE: 503 -381 -3753
FAX: 503- 214 -8524
Total Fees: $18,809.69
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 0 952- 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: 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.
•
FOR OFFICE USE ONLY - SITE ADDRESS:
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 0 COMMUNITY DEVELOPMENT DEPARTMENT
IN Transmittal Letter
_ FG Alt D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
I/ �`� OCT 172012
FROM: J o5i
CITY OF TIGARD
� ,, ' I BUILDING DIVISION
COMPANY: �,�I�l,c CC; �r� 4-DAAe.c v
PHONE: So - ?f3 1 " C By:
RE: I)2 T1 S ') w (l,/, I (i . MST 2 / C°/ 2
(Site Address) (Permit Number)
r ect name or s ubdivis i on nam d lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: 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:
FOR (�Iy I/E USE ONLY (3)9
Route• .s• - - hnician: Date: //2 //y Initials:
Fee • rer ❑ No Fee Description: Amount Due:
-•■ $ /': 'o
$ dro . 35
$
Speci. • 0729 f187• YS
structions:
' e.rint Permi (per PE): /r Yes ❑ No -Done
A.. i . - b stifled: Date: i , ., ,A_ (44 w/ Initials: (___
c0 lit ts -t i i = ^ r .=e20 :{ _ -
- o_- d -1 � � j
I:\ Bu ilding\ Forms \Transmittal Letter- Revisions.doc ' /25/2012
— ;7 J
CITY OF TIGARD MASTER PERMIT
II a COMMUNITY DEVELOPMENT Permit#: MST2012 -00192
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/11/2012
Parcel: 2S109AB17600
Jurisdiction: TIGARD
Site address: 13272 SW WILMINGTON LN
Subdivision: HIGHLAND HILLS ESTATES Lot: 5
Project: Highland Hills, Lot 5
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 991 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 30 Bathrooms: 3 Second: 1322 sf Garage: 413 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2313 sf Value: $260,165.84 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
0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 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 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: 4 201 -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 2313
Owner: Contractor:
MISSION HOMES NW MISSION HOMES NORTHWEST LLC Required Items and Reports (Conditions)
PO BOX 1689 PO BOX 1689 1 Ersn Cntrl 503 - 639 -4175
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503- 381 -3753 PHONE: 503- 381 -3753
FAX: 503 - 214 -8524
Total Fees: $18,619.74
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. ENTIO . Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 01 -0010 through • • R • : -' . 1- 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.81e .2344.
Issu By: ' / / f[ - 44 -rQ-k / Permittee Signature:
- Call 503.639.4175 by 7:00 a.m. for the next available Inspectlo • •/1 111111111111."—
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 FOR OFFICE use ONLY
City of Tigard Received
q 13125 SW Hall Blvd., Tigard, OR 97223 ��
C g P lan Review t• Other P ermit � ��.2 /�,�, / /'
Phone: 503.718.2439 Fax: 503.598.1960 JUL 2 5 2012 DateBv: If I/ I '�/ C:�fir 6t
///-/ s
1 I G A IZ D Inspection Line: 503.639.4175 Date Ready/By: G p Juris: ® See Page 2 for
Internet: www.tigard - or.gov CrrYOFT.G� Notified/Method:O / i� 4 /, Z Supplemental Information
BUILDING 1 G �VI DIVI SI OAI �/ p // �l
TYPE OF WORK REQUIRED 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.
® I- and 2- family dwelling ❑ Commercial /industrial Valuation: 0 2,60
❑ Accessory building ❑ Multi- family Number of bedrooms: 4
❑ Master builder ❑ Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 13272 SW WILMINGTON LANE New dwelling area: 2313 square feet
City /State /ZIP: TIGARD /OR/97224 Garage /carport area: 413 square feet
Suite/bldg. /apt. no.: Project name: HIGHLAND HILLS Covered porch area: aa square feet
Cross street/directions to job site: BULL MOUNTAIN -TO 133 TO 134 Deck area: square feet e t7(
• Other structure area: 7 72‘ square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: HIGHLAND HILLS - . Lot no.: 5 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
NEW SINGLE FAMILY Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: MISSOIN HOMES NW Type of construction:
Address: PO BOX 1689 - Occupancy groups:
City /State /ZIP: LAKE OSWEGO /OR/97035 Existing:
Phone: (503)381-3753 Fax: (503)214 -8524 - New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: MISSION HOMES NW (Please refer lo fee schedule)
Structural plan review fee (or deposit):
Contact name: JOSH KELSO
Address: PO BOX 1689 FLS plan review fee (if applicable):
Total fees due upon application:
City/State /ZIP: LAKE OSWEGO /OR/97035 /�
Amount received:
Phone: (503) 381 -3753 Fax: : (503) 214-8524
E -mail: JOSHKELS03 @GMAIL.COM PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System.
Business name: MISSION HOMES NW ' Sub •'t two (2) sets of roof plan with connectio • etails
and fire . .artment access, along with th• : I Oregon
Address: PO BOX 1689 Solar Installa . • secialty Co, - -c list.
‘,....City/State/ZIP: LAKE OSWEGO /OR/97035 Permit Fee ' 1 .. • .r- plan review $180.00
- -. and adminis t . ' e fees):
Phone: (503) 381 -3753 Fax: (503) 214 -8524 State surcharge (12% of permit -- • $21.60
CCB lit.: 186849 Total fee due upon application: $201.60
Authorized signatu . This permit application expires if a permit is not o tained
within 180 days after it has been accepted as complete.
Print name: JOSH KELSO Date: 7/24/2012 * Fee methodology set by Tri -County Building Industry
Service Board.
- I:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440 -4613T(I l /02 /COM/WEB)
Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of Tigard Received e
g JUL q D : ' A �� PermitNo.:�/� . , .. f /.
1
q 13125 SW Hall Blvd., Tigard, OR 97223 ` 5 Z�� "'
C Plan Review iL, � �
Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit No. 44 �
I G A R D Inspection Line: 503.639 ((;jj �( �� tii�lp Date Ready/By: Juris: El See Page 2 for v
Internet: www.tigard - or.gov BUILDING DIVISION 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 (l) bath 312.70
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
El Accessory building SFR (3) bath 1 500.32
ry g ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler (2313 sq. ft.) Pagc 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13272 SW WILMINGTON LANE Catch basin or area drain 18.76
City /State /ZIP: TIGARD /OR/97224 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: HIGHLAND HILLS Manufactured home utilities 50.03
Cross street/directions to job site: BULL MOUNTAIN TO 133 TO 134TH Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: HIGHLAND HILLS I Lot no.: 5 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 1 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: MISSION HOMES NW Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: PO BOX 1689
Garbage disposal 1 25.02
City /State /ZIP: LAKE OSWEGO /OR/97035 Hose bib 2 25.02
Phone: (503)381 -3753 Fax: (503)214 -8524 Ice maker 1 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: MISSION HOMES NW Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: JOSH KELSO
Roof drain (commercial) 12.51
Address: PO BOX 1689 Sink/basin/lavatory 6 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
Water closet 3 25.02
CONTRACTOR
Water heater I 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
Phone: (503) 545 -3601 Fax: (360) 695 -5031 Minimum permit fee: $72.50
CCB Lic.: 168129 Plumbing Lic. no.: Plan review (25% of permit fee) -
State surcharge (12% of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: JOSH KELSO Date: 7/24/2012 This permit application expires it a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I:\Building\Permits\PLMU- PermitApp.doc 10/01/09 440-4616T(I0/02 /COM/WEB)
Mechanical Permit Application , FOR OFFICE USE ONLY
I' iii-i i , , e
City of Tigard �> d y. ila 12. l ^ ^ Permit No.: / i l _
°. 13125 SW Hall Blvd., Tigard, OR 97223 "Plan Review
I C Phone: 503.718.2439 Fax: 503.598.1960 I 1 1l p C 1e /g y . Other Permit: 6c,0•2..(9--00/615
TI G A IZ D Inspection Line: 503.639.4175 .2 S II �te Ready/By: Juris: 10 See Page 2 for
Internet: www.tigard or.gov N otified/Method: Supplemental Information
. i , '
TYPE OF WORK
B UILDIN�Di l lJ ISIO AI 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: 13272 SW WILMINGTON LANE (requires site plan showing placement) I 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.: 5 Flue /vent for any of above 23.32
' Other: 23.32 _
Tax map /parcel no.: - - Other fuel appliances: ,
DESCRIPTION OF WORK Water heater 1 23.32
'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
' 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 - '1 • 33.39 "
503 381 -3753 - ' - F ax: 503 214 -8524 Single-duct comp rtm ents (bathrooms,
Phone: '
( ) ( ) toilet compartments, utility'rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: MISSION HOMES NW Other: _ 23.32
. Fuel piping: '
Contact name: JOSH KELSO - S14.15.for first four; $4.03 -for each additional .
Address: PO BOX 1689 Furnace; etc.
I •
Gas heat pump '
City/State /ZIP: •LAKE OSWEGO/ OR/97035 Wall /suspended/unit heater '
Phone: (503) 381 -3753 Fax: : (503) 214 -8524 Water beater _ I .
Fireplace - 1- " '
E -mail: JOSHKELSO3 @GMAIL.COM Range I
CONTRACTOR Barbecue 1
•
Business name: ADVANTAGE HEATING & AIR CONDITIONING, LLC Clothes dryer (gas)
Other: ' • '
Address: 2355 HYACINTH MECHANICAL PERMIT FEES*
- City /State /ZIP: SALEM /OR/97301 Subtotal .
Phone: (503) 393 -5315 Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee) .
CCB Iic.:. i /I 1.4a - , - State surcharge (12% of permit fee) •
TOTAL PERMIT FEE
Authorized SlgnatUr 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: 7/24/2012 • Fee methodology set by Tri -County Building Industry, Service Board
' l:\ Building \Permits\MEC- PermitApp.doc 09/09/10 - 4404617T (I1 /02 /COM/WEB)
03/17/2011 13:12 5034636863 CONNECTIONS ELECTRIC #2190 P.002/002
.nw.. I,. LVI I IV.7L'Im nu. I ITV I. L
Electrical Permit Application END r 01: c I rl. I l I t' .l: O,`;, .1
City of Tigard R .' ... , t►crmgNo t —oo/ ,
�
. r. 13125 SW Rail Blvd, Tigard. OR 97283
JUL 2 5 2012 0 2 �olo�- oo/ • •
• ' ( Phone: SO3.718.2439 roe: 503.591.1960
• , , ; , ,. , ; , , laaPoc2�a UN; 503,639A 173 CITY O TIGARD - • - r.r -� y
h 11"": "AVAigrrcd -M8Dt MIMING WING DIVISIO . LV otl a mnh fed4
. T Y P E O F W O R K .. . • . .. .... • .....:,:.(..:, ;AN I YIEW .
• G New co auction CI Addilion/altefadonheplacement Flake davit a0 thatapply (sonnet l sets oTpleas wikenicheckedbetoy): Om •
PI penlolilion Other, _ „ de feeder 400 mops or moos ° sood�ba rd
. 9- P0•�ai! H y � - : i,,: , -- meads 10,000 taps al ISO W u or Q Floatingbe114th 0.
0 and 2 Ibmil dwells 0 Commerolnl/industrial 0 Accessory building am to 4 or exceeds hallo oss. Q (oeameeoht one eddCOta,cat
y � ry' aa�ps �lralla,hartagaldrio.ra. Ming.
• _Q Multi- fhmily ❑ Master builder 0 Other: 0 Pire Fuqua Q ms.aatton of7S KVA or
_ ' ' 301) 191TE IAFoilaIATtON AND LOCATION G 1no oew WM& lover m ° 1 W. "i deems
C1 MINOR atom motor load of Q "A ^,rte, 1� - '1•3".
Yob na.: +cob she address: J 37_ Z S ' J w I G M / N O M ' U i . Miser M O O alid013411 O a k a .
City/State/UP: 7, g Igo 4 �2 3-2 2Y 1 a lean, A 600
ipirceuve no ame a a�eeeth6e
Suile/bldgIapt. no I Project name: �{ }� l U, S O Salto or hake 600 maps a mare.
• • Cross street/directions la job elle: 8,/r,c, /y1o1,�✓ ) -fa / 3 3 7 14 /7 y 1 b«eriorfa ' ... :' tar• - I ` oa: I run •
Ncw fetid Witt Angle Or main dwelling unit.
Ineludei atlaehed prase.
Subdivision: I #64.4) (LL,S J Lot no.: s 10044• It or Iola / 168.54 4
a&
, 1 lI , .63'1300 eq. tt. or penpen= ; 4. 33.92 1
-' reskuo
- del / 75.00 2
_ D$SCRiP17GQN OF *rag a — Lammed .net , m 7100 2
N SINGLE FAMILY r iallwiih above at Il)
Services or feeders installation alteration. andlar relocation
200 carpe or las 100.70 L 2
®1 'RO PEan O WNIR � 0 *Kerr • 201 nape1o400amps 133.56 2
Nnsna: MISSION HOMES NW '' 401 amps to 600 aegis 200.34 2
601 amps m 1,000 amps 301.04 2
• Address: PO BOX 1689 Oyer 1,000 any or rota 1 552.26 a
• City/State/2W: I.AI OsVy)sot]VOBJ97035 Temp U a'y' ets or realm am Madan, aluradon, and/ar
Phone: (503)381.3753 Fax: (503)214 4524 • 200 amps or lass 59.36 1
Owner installation: btslafelion is being made on propetty that f own which is not 201 male 4400 amps 128.08 2
401 lded for sale, lease, rent, or exchange, aecordiag to ORS 447, 449, 670, end 701. 1along amps - t . 168.54 oa
13raneb elr+chhits -new, diirallOn, or exte»slo0, .,fir toe!
• Owner signature: bate: A. Fee ibr broth CM OS WI: . 2 AFrUCANT Q CONTACT PF SON• - above Ioivloe Or Rader (be. 7A2 _ 2
each tan* circuit
Dusincss aarrle Ml&SION ROM>$S Pi Vi B new leooch circuits valise
envies or feeder he, ran 56.18 2
Contact nacre: JOSH KEL.SO brooch circuit --
. Each idd'I WW1 circus 7.42 2
Address: PO BOX 1689 • A e}lageous jservitc or lbeder_ nor )ac1adcd) laroaikir CjfyIStawZOP: LAKE OSWEGO/OR/97035 rivagihg. service anther feeder 67 84 a
•
Moo: (503) 381.3753 l : (503)!1 :024 Reconnect only OM 2
E.mal LSOa@GMAlE«COM Pomp or irrigation bo lS itnX 6.8 2
- Si g n or oudlno ltgihtlng
CO11r1'BACIOR - Sipml ctccuil(a) or Ualiled.emergy
Business name: CONNECTIONS ELECTRIC Paael,attention. orexteaaioa_ Pes
, Each Additional inspection (Wee allowable is any crow above
Address! 4675 Pe)RT2.AND RD IVE { , ?Say Additional inspatiOn (l hr min) - 66.251 hr
SALEM/OR/97305 mr oti(t I min) 66ss/la
. City/Slate/ZIP:
�� 0 ���� lr�ur�lplaat(lhr 7838/hr
• Phone: (503) 390.7914 i Fax: (S ) '434% 3 Yrapcctloes for which no Ro is _ 90.00/0 •
snotirimlly listed in hr min)
CCa Uc : 65444 Electrical Lk.: 24.4$C Sups!. Lk.: 3e ICs Vurraicsualurdri PEPS
•
• Sabtol:
Suprv. Electrician sigaaturo. Mulled: �N � = Pion review 5%or p mhh Ice .
pk
. Print name: o • : � 'ate. St ssrcherae (12%04111M11 Y
TOTAL maw FM
A u t h o r i z e d signati Ibli pro separative esptrea ifs p icon it eel • deed winds 180
Print man= r aw: y/ /i2 - • Number of tmpo o a ttoa allowed per permit. F a caaplvlr. •
•
$ IOMMulPtf MIELC,ronchAppeloc 07/011W 4.46PTOIAVCOMMIIP
e ° Building Division
Development Code Provision Review
T I G A R D Residential Projects
Building Permit No: H ao t a i 9
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A xi
Routed Plans:
Original Plan Submittal Date: 7 451/
1st 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 � �" at 503 -718 or /_ @tigard- or.gov)
Land Use Case No. Name
Er Zoning ? 1
Er Setbacks:
ront / c Rear /' Side # Street Side / ° Garage
l Maximum Building Height ,Si' Actual Building Height 32
[ ( Visual Clearance
L asements
LY Sensitive Lands Type:
Notes: (97 � / m✓I (Q /Jie al Gdr- S
Original Plan: Approved Not Approved ❑ Date: - 713 P / /
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)
Zr Actual Slope: 9 cyo
Notes:
Original Plan: Approved Not Approved ❑ Date: 1
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
ti f City borist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
P eet Trees
• Protected Trees
Notes:
l • -
I Original Plan: Approved � Not Approved ❑ Date: g ./ bk
Revision 1: Approved ❑ Not Approved ❑ Date:.
Revision 2: Approved ❑ Not Approved ❑ Dater
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 ��'. ❑
Date Routed to Building: // e
9
•
•
•
•
1
r 3
r l
'1 ri
Ir J
Page 2 of 2
RECEIVED
JUL:
S.W. WILMINGTON LANE _ _ �G�
B
i ' I
` two' NW
1 co _. - ' ^ � fir
2 +{{ 1 e
I OVERED G DRIVEWAY 1 ��,
���� ` ENTRY e • . ,i n ,�:t ein
� GARAGE/ W�11
C
1 1,:, -
.
, i . - 4 Lv --I: r Ir I
/. I 1 • _,c
A.,:i 1
1
-e i , LOT 5 I
I I ' • 5 SF. 1
'�
�J 1--tr 5 0.00' _ _ 1
i , FMS �t T7 SE BACKS:
G� ' GARAGE = 20'
BUILDING =15'
PORCH = 12'
SIDE YARD = 5'
51 Tr ^ Red 5w►rc.4 A4°'pk . STREET SIDE YARD = 10'
�� ;��. STREET TREE
Ztell'n '-r
i s Ste 1
\ - -- -- -vii
7,7 . " =20'
PLAN NAME: CON i AC is
Phone-503-381-3753
2313 F 03 -21485
DR4U1N: BKE
PLOT: 1/2/12
� n � j /7 f
//�� i T r, I LOT ITlissio HOMES NW , LLC.
bGALE: i••. 1
1/4 " =1' -m"