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Permit
w 1 11 1 111 o Community Development ��V 5 Request for Permit Action 1 * (1 TIGARD 0 � 4 1 PRp • \ (OF c S\014 TO: CITY OF TIGARD OD" Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: © Owner ❑ Applicant ❑ Contractor ❑ City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) Le5enck N Orele S Mailing Address: 1 2-1 S 5 S■ 0ci -t►-. Pw ue .4 100 City/State/Zip: PaYt -la.r, d , o v2. 9 1 2 2-3 Phone No.: ` r - (020 - Bo 80 P PLEASE TAKE ACTION FOR THE ITEMS) CHECKED (1): (f;IP LI❑ CANCEL PERMIT APPLICATION. i e) f , � 0 REFUND PERMIT FEES (attach receipt, if available). 4 � ,9' D I G (� ) ❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). I � � 1 '' /( I P ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). ! t' r Permit #: VAST 200 - 00 P34- 1,0 /i 5k, ' P 't. Site Address or Parcel #: 1„...x m- 1 1/440 % \4dzi-k- Sw W lI.W41- C *- Ele W pel Project Name: A L ry l.&T C-R.E Subdivision Name: WAL mu T CREEK Lot #: 4 tD EXPLANATION: — rsigx. '? 0;= Fob ,.,.s /o ,f& >, c4.--c1ot C) Signature: Date: 3 rt,A t 2.009 Print Name: SzOff Refund Policy I. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to Sys Admin: Date By Rte to Bldg Admin: Date By Refund Processed: Date ^/ /� By Invoice Processed: Date By Permit Canceled: Date / By Parcel Tag Added: Date By Receipt # Date Method Amount $ I: \Building \Forms \RegPemvtAction.doc Rev 07/26/07 • • T L I E, 1■■ March 3, 2009 City of Tigard ��, : a 13125 SW Hall Boulevard �— Tigard, OR 97223 LEGEND Voucher Request HOMES q RE: Walnut Creek TIF Credit Voucher for Lot #46 This is a request to use a portion of our remaining TIF Credit Voucher for the Walnut Creek subdivision. When the permit for Lot #46, 14124 SW Walnut Creek Way (permit #MST2008 -00034) was issued on February 2nd, I neglected to bring in the Credit Voucher paperwork. I would like to have this credit applied retroactively and either receive a check or have the funds applied towards a future permit. Please contact me at 503 -620 -8080 x211 if there are further questions. rP Thank You lD /p (` ° e• i3 O1 taus ,r `� Design Department Manager � �� � D 1 Voice • 503.620.8080 Fax • 503.598.8900 12755 SW 69th Ave., Suite 100 Portland, Oregon 97223 www.LegendHomes.com L /L /LUU7 CITY OF TIGARD Fees Associated With 1:09:26PM 1111 e • 13125 SW Hall Blvd. TIGARD Tigard, OR 97223 503.639.4171 Case #: MST2008 -00034 . Fee Start End Revenue Created Type Date Date Dept Description Account Number By Date Amount Due BPLC 1/1/1990 12/31/2020 [ BUPPLN] PIn Rv Deposit 245- 0000 - 433000 BLD 4/8/2008 750.00 0.00 CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC PIn Rev 100 - 0000 - 433060 LS 4/21/2008 46.00 46.00 LRPI 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 LS 4/21/2008 6.00 6.00 PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 LS 4/21/2008 399.00 399.00 PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270 - 0000 - 450000 LS 4/21/2008 5,215.00 5,215.00 TIFM 7/1/2002 12/31/2020 [TIF -MT] TIF Mass Tr 210 - 0000 - 448005 LS 4/21/2008 240.00 240.00 BPLD 1/1/1990 12/31/2020 [BUPPLN] PIn Rv Balance 245- 0000 - 433000 LS 4/21/2008 123.15 123.15 RDRT 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245- 0000 - 432000 LS 4/21/2008 1,343.30 1,343.30 . .t1 12/31/2007 12/31/2020 [TAX] Build 12% State Surchrge 100 - 0000 - 207020 LS 4/21/2008 161.20 161.20 MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245- 0000 - 229202 LS 4/21/2008 270.63 270.63 BCET 3/1/2008 12/31/2020 [BEACET] Beaverton School CET 245- 0000 - 229204 LS 4/21/2008 2,171.00 2,171.00 MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245- 0000 -431010 LS 4/21/2008 97.30 97.30 SUR2 12/31/2007 12/31/2020 [TAX] MEC 12% State Surcharge 100 - 0000 - 207020 LS 4/21/2008 11.68 11.68 SUR3 12/31/2007 12/31/2020 [TAX] PLM 12% State Surcharge 100 - 0000 - 207020 LS 4/21/2008 47.48 47.48 ELCF 1/1/1990 12/31/2020 [ ELPRMT] ELC Permit 220 - 0000 - 431510 LS 4/21/2008 278.75 278.75 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100 - 0000 - 207020 LS 4/21/2008 33.45 33.45 ELRP 1/1/1990 12/31/2020 [ELPRMT] ELR Permit 220-0000-431510 LS 4/21/2008 75.00 75.00 SUR5 12/31/2007 12/31/2020 [TAX] ELR 12% State Surchrge 100 - 0000 - 207020 LS 4/21/2008 9.00 9.00 EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100 - 0000 - 207307 LS 4/21/2008 88.00 88.00 ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn PIn Rv CWS 100 - 0000 - 207308 LS 4/21/2008 28.60 28.60 ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pin Rv COT 245- 0000 - 433010 LS 4/21/2008 28.60 28.60 TIFR 7/1/2002 12/31/2020 [TIF -R] TIF Resident 210- 0000 - 448001 BLD 6/5/2008 2,960.00 2,960.00 r '2 1/1/1990 12/31/2020 [ BUPPLN] Addl Pln Rv 245- 0000 - 433000 BLD 2/2/2009 62.50 62.50 Total Due: $13,695.64 OCqOd6 ' $(1 �/ 5 .loS� Page 1 of 1 CaseFees..rpt CITY OF TIGARD "" " 11 1 0 Fees Associated With ' & . 1:17:47PM 13125 SW Hall Blvd. QO - - 4 a �� TIGARD Tigard, OR 97223 503.639.4171 Case #: MST2008 -00034 Fee. Start End • Revenue Created Type Date Date Dept Description Account Number By Date Amount Due BPLC 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Deposit 245- 0000 - 433000 BLD 4/8/2008 750.00 0.00 CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC Pln Rev 100- 0000 - 433060 LS 4/21/2008 46.00 0.00 LRPI 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 LS 4/21/2008 6.00 0.00 PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245- 0000 - 431000 LS 4/21/2008. 399.00 0.00 PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270- 0000 - 450000 LS 4/21/2008 5,215.00 0.00 TIFM 7/1/2002 12/31/2020 [TIF -MT] TIF Mass Tr 210- 0000 - 448005 LS 4/21/2008 240.00 0.00 BPLD 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Balance 245- 0000 - 433000 LS 4/21/2008 123.15 0.00 ►' DRT 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245- 0000 - 432000 LS 4/21/2008 1,343.30 0.00 . Al 12/31/2007 12/31/2020 [TAX] Build 12% State Surchrge 100 - 0000 - 207020 LS 4/21/2008 161.20 0.00 MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245- 0000 - 229202 LS 4/21/2008 270.63 0.00 BCET 3/1/2008 12/31/2020 [BEACET] Beaverton School CET 245- 0000 - 229204 LS 4/21/2008 2,171.00 0.00 MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245- 0000 - 431010 LS 4/21/2008 97.30 0.00 SUR2 12/31/2007 12/31/2020 [TAX] MEC 12% State Surcharge 100- 0000 - 207020 LS 4/21/2008 11.68 0.00 SUR3 12/31/2007 12/31/2020 [TAX] PLM 12% State Surcharge 100 - 0000 - 207020 LS 4/21/2008 47.48 0.00 ELCF 1/1/1990 12/31/2020 [ELPRMT] ELC Permit 220 - 0000 - 431510 LS 4/21/2008 278.75 0.00 SUR4 12/31/2007 12/31/2020 [TAX] ELC 12% State Surcharge 100- 0000 - 207020 LS 4/21/2008 33.45 0.00 EL RP 1/1/1990 12/31/2020 [ELPRMT] ELR Permit 220-0000-431510 LS 4/21/2008 75.00 0.00 SURS 12/31/2007 12/31/2020 - [TAX] ELR 12% State Surchrge 100 - 0000 - 207020 LS 4/21/2008 9.00 0.00 EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100- 0000 - 207307 LS 4/21/2008 88.00 0.00 ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100- 0000 - 207308 LS 4/21/2008 28.60 0.00 ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245- 0000 - 433010 LS 4/21/2008 28.60 0.00 TIFR 7/1/2002 12/31/2020 [TIF -R] TIF Resident 210- 0000 - 448001 BLD 6/5/2008 2,960.00 0.00 '2 1/1/1990 12/31/2020 [BUPPLN] Addl Pln Rv 245- 0000 - 433000 BLD 2/2/2009 62.50 0.00 Total Due: $0.00 • Page 1 of 1 CaseFees..rpt •. C, • ■ IC March 3, 2009 cut RECEIVED i I City of Tigard g (• = Tigard, O Hall 23ulevard MAR 0 4 2009 • LEGEND CITY OFTIGARD Voucher Request BUILDING DIVISION Ho ME • RE:. Walnut Creek TIF Credit Voucher for Lot #46 . • This is a request to use a portion of our remaining TIF Credit Voucher for the Walnut Creek subdivision. When the permit for Lot #46, 14124 SW Walnut Creek Way (permit . #MST2008- 00034) was issued on. January 28 I neglected to bring in the Credit Voucher paperwork. I would like to have this credit applied retroactively and either receive a check or have the funds applied towards a future permit. Please contact meat 503 -620- 8080 x211 if there are further questions. Thank You • . • Steve L cas Design Department Manager - • • • • • • • • • Voice • 503.620.8080 • Fax • 503.598.8900 • • 12755 SW 69th Ave., Suite 100 . Portland, Oregon 97223 www.LegendHomes.com e . • CITY OF TIGARD Credit No.: 20 '7 - R i;4- f Date Issued: 7/27/07 Engineering A I � Authorization 'L �.. Date: 7/27/07 TRAFFIC IMPACT FEE CREDIT VOUCHER Land Use Casefile No.• SUB2005 -00025 In accordance with Ordinance 379 (Washington County Traffic Impact Fee Ordinance) Matrix Development Corporation (name of developer) is entitled to $ 77,736.38 in Traffic Impact Fee Credits that can be applied to TIF charges for development on lot(s) 1 -54 of the Walnut Creek Development. The use of TIF credits are subject to the rules and limitations of the TIF Ordinance which are listed on the back of this voucher. WARNING: This voucher must be presented at the time of issuance of the building permit, or if deferral was granted, issuance of an Occupancy Permit. Director 7 ' . Date Permit Numbers Lot Numbers Credit Used Balance Beginning Balance $ 77,736.38 /00 P sf /�I G L' ef's d.`r,;) ,:r f f` c . b� : , y, 94, - : ' F 'tW. , {v /,,-,,f • A r;f:2 f c -te.24 e ,. i ,c c og ; G / 97 Y P e Si' ' G•.j,' 41.12)64;) Ais 2 a✓ t {tt /1., / C hr 4 - � t ,:. fre . e 4' /�. 4/2O � /1 .?t� e7 z'�`.x ✓ : /e , Ye -7', C ..54' 1,144, G° i s et 1M c) fipsTawa a o'iq re ? Au). 6 . 4 -7 IN • /)ST�a.) -61:060 /% 3, ?w . uc 55 5,3G • 38 677 . BY • , rn - ctsc37 LiT S 3Ro.Go 55 . a•-, - Balance carried forward to TIF Credit No. • Ordinance 379 provides for an expiration 10 years from authorization. login \viola\tif09.1 RESIDENTIAL PERMIT APPLICATION REVIEW Permit No.: MST2008 -00034 Site Address: 14157 SW Walnut Creek Way Subdivision: Walnut Creek Lot No.: 013 Contact Name: Steve Lucas Business: Legend Homes Street: 12755 SW 69th Ave., Suite #100 City: Portland State: OR Zip: 97223 As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and plans have been reviewed to determine if it is complete and if the plans are deemed "simple" or "complex" as defined in ORS 455.467 and 455.469. The application is complete. The application is incomplete for the following reason: ❑ The submitted plans will be reviewed; however, a permit cannot be issued until the above information is reviewed and /or approved. ❑ The submitted plans cannot be reviewed until the above information has been submitted and /or approved. ❑ The plans are deemed "simple ". • The plans are deemed "complex ". Signature: /7ie.- //i4 ;J Oo Name: Brandon Shaw Dat Title: Plans Examiner Phone: 503 - 718 -2425 E -Mail: BrandonS @tigard - or.gov I• \ Building \Norms \RI?ti- I'crmitAppRcvw -Blank doc 1/18/07 Cr • , • Date Permit Numbers Lot Numbers Credit Used Balance Beginning Balance 55 I4/4. 4/43-- 1157*.06 - ooi6V 4 Balance carried forward to TIF Credit No. • Ordinance 379 provides for an expiration 10 years from authorization. , , r a C I TY OF TIGARD MASTER PERMIT PERMIT #: MST2008 -00034 ' COMMUNITY DEVELOPMENT DATE ISSUED: 2/2/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104BB - 12900 SITE ADDRESS: 14124 SW WALNUT CREEK WAY ZONING: R - 25 SUBDIVISION: WALNUT CREEK LOT: 046 JURISDICTION: TIG PROJECT: WALNUT CREEK Project Description: New SF. BUILDING REISSUE: REDWOODA STORIES* 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 912 sf BASEMENT. of LEFT* SMOKE DETECTORS' Y TYPE OF USE. SF FLOOR LOAD: 50 SECOND 1,259 sf GARAGE' 417 sf FRONT: PARKING SPACES . TYPE OF CONST 5N DWELLING UNITS* 1 THIRD sf RIGHT* VALUE' OCCUPANCY GRP' R3 BDRM: 225,527 70 4 BATH 3 TOTAL 2,171 sf REAR: PLUMBING SINKS. 1 WATER CLOSETS. 3 WASHING MACH: 1 LAUNDRY TRAYS 1 RAIN DRAIN: 100 TRAPS. LAVATORIES 4 DISHWASHERS: 1 FLOOR DRAINS. SEWER LINES 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS' 3 GARBAGE DISP. 1 WATER HEATERS: 1 WATER LINES 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 4 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS 5 CLOTHES DRYER: 1 NAT FURN > =100K. 1 UNIT HEATERS HOODS 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES. VENTS* WOODSTOVES. GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS 1 0 - 200 amp. 0 - 200 amp: W /SVC OR FDR. PUMPHRRIGATION' PER INSPECTION* EA ADD'L 500SF. 4 201 - 400 amp. 201 - 400 amp* 1st W/O SVC /FDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY 1 401 - 600 amp 401 - 600 amp* EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR. 601 - 1000 amp. 601 *amps- 1000v: MINOR LABEL: 1000. amp /volt : PLAN REVIEW SECTION Reconnect only. >=4 RES UNITS* SVC/FDR> =225 A.. > 600 V NOMINAL CLS AREA/SPC OCC• ELECTRICAL - RESTRICTED ENERGY A SF RESIDENTIAL B COMMERCIAL AUDIO R STEREO* VACUUM SYSTEM* AUDIO & STEREO: FIRE ALARM* INTERCOM /PAGING: OUTDOOR LNDSC LT. BURGLAR ALARM* OTH: ALL - ENCOMP BOILER: HVAC' LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER* CLOCK: INSTRUMENTATION. MEDICAL: OTHR• HVAC• DATA/TELE COMM: NURSE CALLS. TOTAL It SYSTEMS. This permit is subject to the regulations contained In the Tigard Owner: Contractor: Municipal Code, State of OR Specialty Codes and all other applicable LEGEND HOMES MATRIX DEVELOPMENT CORPORATION laws All work will be done in accordance with approved plans This 12755 SW 69TH AVE 12755 SW 69TH AVE #100 permit will expire if work is not started within 180 days of issuance, or SUITE 100 TIGARD, OR 97224 if the work is suspended for more than 180 days ATTENTION PORTLAND, OR 97223 Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080 You may obtain copies of these rules or direct Phone: 503 620 - 8080 Contact #: PRI 503 620 - 8080 questions to OUNC by calling 503 246 6699 or 1 800 332 2344 FAX 503 - 598 - 8900 Reg #: LIC 55151 TOTAL FEES: $ 14,445.64 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 / n Issued : (K___....7 /' t� Permittee Signature : eraLi.-- Call 503.639.4175 by 7:00 a.m. for an inspection that business da . 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. v oc..-b \ -O t3 Building Permit Application FOR OFFICE USE ONLY City of Tigard Received fn 4., Permit No �' 'aag„, 0*. II ° 13125 SW Hall Blvd., Tigard, OR 97 t (( , c:,,,,,,, l �' a Date/F3 Review - ` �r I� _( Phone 503 639.4171 Fax 503 598 `,�' ' \ ! t• °" L Date/B Other Permit Inspection Line. 503 639 4175 ► 4 . ' Date Ready /By ^^ n J uns ® See Attached Checklist for TIGARD °Y V�' /n�lfJ. Internet www tigard -or gov pc • t t t N. Fy n hod Supplemental Information try�� jt�S I O�� '7/ ' TYPE O F W1%: II %1`N : L� t' , � ' / REQUIRED DATA: 1- AND 2- FAMILY DWELLING ® New construction ❑ Demolition Permit fees* are based on the value of the work performed � Pte' Indicate the value (rounded to the nearest dollar) of all El El r> Addition/alteration /replacement Other: i� � I equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION $'°19 240 work indicated on this application ® I- and 2- family dwelling ❑ Commercial /industria , A 4 C ,---. Valuation 5234,346.87 building 0 >P , . •� °� ,. Number of bedrooms: 4 A ccesso ❑ Accessory g ❑ Multi- family O 0 „, 1; 1,�n ® Master builder ❑ O uvi `D1,�Eb Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors• 2 Job site address44451 -SW Walnut Creek Way 141214 1 n u 0 rev talti. New dwelling area: 2,274 square feet City /State /ZIP: Tigard, OR 97223 Garage /carport area 421 square feet Suite /bldg. /apt. no.: Project name: Walnut Creek Covered porch area: square feet Cross street/directions to job site: Barrows and Walnut Deck area: 150 square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision Walnut Creek 1 Lot no W Permit fees* are based on the value of the work performed Tax map/parcel no.:-.2S404.13.13-9600. 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. Valuation: $ Existing building area: square feet New building area: square feet Z PROPERTY OWNER ❑ TENANT Number of stories: Name: Legend Homes Type of construction: Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups: City /State /ZIP: Portland, OR 97223 Existing. Phone: (503)620 -8080 Fax: (503)598-8900 New: Z APPLICANT ❑ CONTACT PERSON NOTICE Business name: Legend Homes V ii! 41,40). ' IUr 3--)we Iv All contractors and subcontractors are required to be Contact name: Steve Lucas pfW/ S;I't- fe e ,-- r licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address • 12755 SW 69 Avenue, Suite #100 l /I v 1 , t/ rq z jurisdiction in which work is being performed If the City /State /ZIP: Portland, OR 97223 v ( i }� ��%�' + applicant is exempt from licensing, the following reasons apply Phone: (503) 620- 8080 x211 Fax: : (503) 598 -8900 E -mail: slucas @legendhomes.com CONTRACTOR BI:VI:\ 1ION 1)1 ".V 17.LU1'i \117.N 1_ (.(_)KL'UK ;\ 1 IUN BUILDING PERMIT FEES* A ,12755 SW 69 � AVE STE 10(1 (Please refer to fee schedule) Ci — PORTLAND OR 97223 Structural plan review fee (or deposit): — P1 620 -$0$0 I'. \X:503- 598 -8900 FLS plan review fee (if applicable) _„ — Pt (,(,13 #55151 /\ b 7� se-e-- C( ��( Total fees due upon application: Amount received: Authorized signature: - This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Steve Lucas Date: 4/08/08 * Fee methodology set by Tri- County Building Industry Service Board I \Building\Permits\BUP- PermitApp doe 03/21/06 440- 4613T(I I /02 /COM/WEB) 'FROM :GARNER ELECTRIC FAX NO. :5036427925 Sep. 26 2007 11:17AM P1 FROM : FAX NO. :5036818648 Sep. 26 2007 10:06AM P2 Elgctrica1 permit Applicaiio�n I i City of Tigard - MINE : 4 / / 13175 SW Hall Blvd., Tigard, OR 97323 Other p� L -r. ' Phone: 503.639,4171 FAR: 5031 o toadylBy 398.1960 Inspection Lime 503.639.4175 Internet www.ngard- or.gov melee obedr nn t l m t a (a 3 ea a,pa e ) 1E1 New construction Additioe/altaratiodreplascmprit Mambo or Leader 400 amps ar mole 0 Building over thno sloriea. Demolition ❑ Other: ,wbn,e it. weilahtr *tat memos el Mamas and boatyards exoeeas ;MOO amps nt ISO volts or 0lemon bafldlags. .teas to erected, or moods 1000 0 CommeroinFaee aarlouaaral 1■ end 14anlly dwelling Comtnerd1 tllndu1trial ❑ Accessory building amps for all other imanliaaa+e. building., ❑ Mnhi-fami I El Master b4ijdet ■ Other. �Ptle Cl I smer s lea of731<VA or D fI Y eta 1arBer separately dsr1 d system ,., -.• " - :.a . - ' t1 M ofemmotor load of [] "n ", "ft ", "I ". "1.S ", Job no.; Job site addreeta psis ar mare residential mica ❑ Recreational vehicle parka. p HeW1A oars IDoi1UN1, O qtr voltage fur , mwro than Cl ,S 1P: Tigard, OR 97223 ' 1 4 1 2 y lA1c �dk . Q IIMNtInce Itevaitma, volts ltage f 6 Wa lnut Crook v ■ i11 ac or 6eeder 600 amps or mare. Suita/hl(lglapt no.: Project name ...— - ;•! : 6'i;':,,`,.!.• '::: ; : ...' I In.).Y N a Cross rca/directions to job site; Barrows pied Walnut - ' `�i'� � . Now redden . al • or mulladMmlly dwelling unit. . % . _ falladea numbed garage, . I [,ot no,: , $ t U/ 1 �p� R °9' a I 145.15 145. I5 4 Subdivision: Walnut Creak ` . addi 500 e. or portico 33 l.3.______- •� l Tax n»tplpuruel n4,; n n.n 4 oa Arsr, !J led Ometgy, il l k 1 7500 • 75.00 2 '1 i(ivhhabovesq 8.) Limited energy, mu 75 -00 2 lres tdentl!l (e 4th above s4. It) - - Services 8i installation, alteration, endiur relocatio 200 amps or loss I. 80.30 2 IIIIMIIIIIIIIIIINIIIIIIMIIIIIIIIIIIIIIIIIMIIII 201 amps to 46 -- I 0515 0515 5 2 401 amps to 60 s teps 160.60 2 Name: Legend Homes i _ 6d1 amps to 1.000 amps 210.60 2 Address; 127$5 SW 69th Avenue, Spite #1p0 i � Oren 1,000 !Oulu or volts . 454.65 2 ^" City/State/ZIP: Portland, OR 97323 '1'tnnporAry servloee or feeders InstaMtI n, alteration, aedlor re ncatlen 200 amps or less 66.85 1 Phone: (303)620 - 608D ! ( Fax: (503)590490D 1 , 2 l tempo to 400 amps 100,30 a Owner installation: This installation IS being made on propony that own which is opt to 599 amps 133.75 2 intended for sale, lease, rent, or exchange. according t0 ORB 447, 4 49, 670, and 701. ' aeb circuits _ n alteration, Or stanlfl9n,perPanel . .- , Qw ai5flR re: Date: A.Fee fbr branch circuits with 'above service or feeder fee, 6, 65 2 lark branch circuit it Business Hama: Legend Homes _ B!Fee for branch circuits without service or Plater lye, 46.85 2 Contact name. Stove Lome ? first Mande circuit add'I branch circuit 6.65 2 Address: 12755 SW 69th Avenue, Suite ttib0 M 110o11anoDUi (servlee or f eder not included) . - City/State/ZIP: Portland, 011 97223 ! manufactured or modular 90.90 2 1 dwell : . w ( ' - -;, Phone: (503) 6204000 x211 : hex; : (503) 59 NIS00 Raalmeet Only 66.89 2 n dhometl.e0m or irrigation circle 33.40 2 Earlsll: due st n or outline lighting Y . 53.40 2 Signal circuity) m limited- Business name: Garner Electric _ energy panel, alteration, or � I earbawi0n. Describe: Page 2 2 Addre88; l9VIr 247 Avenue #A _ . City/State/ZIP; tlllisbaro, R O 97123 l � bleb additional iusgectIon over allowable in oof the above Pot Inapoatloa 62,50 „ Rhona: (503) 6484552 1 Fax: (. I . 643 -74x6 1110oatfeatlon per hour (1 br min) ' 62.40 ' CC141,1o.: 121159 Electrical L1a.1 t Su , , Lie.: 37074 In" ' ` • jam hour 73.75 Suprv. Electrician signature, required: / 3uneo +1: 53. l f pout review (IS% of er oyil foe): /1411, Print name: Cheek Garner Y • State surcharge (8% of permit fee): s.S.3o Authorized signature: TOTAL PERMIT FEE: '3 Z. o ,..�,,.,. 'Ib;e posit separation orptrea Ifs permit fs eve obtained .. Print name: D • O g days after It Is“ be ncceptrd as eornpaeto. I tilusober ofimpaotioneatbw 1WTp,andi. • ..- �..rW.. I•.Yw,l,,,vo I 'Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: ;KESI�.fTa IA.L�W R%WMV— ;b = , Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ® Audio and Stereo Systems* ® Burglar Alarm ® Garage Door Opener* ® Heating, Ventilation and Air Conditioning System* ® Vacuum Systems* ❑ Other: .COIVI.ME:I C ` WfORB' aa ga'* ;: Fee for each commercial $75.00 system (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling LI Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I \Building\Pcrmits\ELC- PermiApp doc 03/23/06 Mechanical Permit Application FOR O FFICE USE ONLY • ' Received /' City of Tigard Date/By ( 5 / Permit No '.y'5 „ ' _ a}3 - a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone 503.639 4171 Fax. 503 598 1960 Date/By Other Permit T I GARD Inspection Line: 503 639 4175 Date Ready /By Juns ® See Page 2 for Internet• www ugard -or gov 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* ® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist ❑ Multi - family ® Master builder ❑ Other Description Qty Ea Total ' . " ' JOB SITE INFORMATION 'AND LOCATION • • , . Heating/cooling °14157 SW Walnut Creek Way A Air conditioning or heat pump Job site address. 14157 ILA 1 Zk l& , f\ u l V , 'I (requires site plan showing placement) 14 00 City /State /ZIP• Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) I 14 00 14 00 Furnace 100,000+ BTU (ducts /vents) 17 90 Suite/bldg. /apt. no.: Project name: Walnut Creek Gas heat pump 14 00 Cross street/directions to job site Barrows and Walnut Duct work 14 00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14 00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10 00 Subdivision: Walnut Creek Lot no.: 0A' to Flue /vent for any of above N 1N,, 10.00 '7*-A4. Other 10 00 Tax map /parcel no.: 291'0481375 Other fuel appliances DESCRIPTION OF .WORK Water heater 1 10 00 10 00 ' Gas fireplace 1 10 00 10 00 Flue vent for water heater or gas fireplace N I., 10 00 — 2tr.t9- Log lighter (gas) 10 00 Wood /pellet stove 10 00 Wood fireplace /insert 10 00 ® PROPERTY OWNER Chimney/liner/flue/vent 10 00 _ , ❑ TENANT Other. 10 00 Name: Legend Homes Environmental exhaust and ventilation Address: 12755 SW 69th Avenue, Suite #100 Range hood/other kitchen equipment I 10.00 10.00 City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust I 10 00 10 00 Single -duct exhaust (bathrooms, Phone: (503)620 -8080 Fax: (503)598 -8900 toilet compartments, utility rooms) 5 6 80 34 00 ® APPLICANT ' ❑ CONTACT PERSON Attic /crawlspace fans 10 00 Other 10 00 Business name: Legend Homes Fuel i rn Pp g Contact name: Steve Lucas $5.40 for first four; $1.00 for each additional Address 12755 SW 69th Avenue, Suite #100 Furnace, etc I Gas heat pump . City /State /ZIP: Portland, OR 97223 Wall /suspended/unit heater Phone: (503) 620 - 8080 x211 Fax. (503) 598 -8900 Water heater I Fireplace I E-mail slucas @legendhomes.com Range 1 5 40 ' CONTRACTOR ' Barbecue Business name: Tri County Temp Control Clothes dryer (gas) Other Address: 13150 Clackamas River Drive • MECHANICAL PERMIT FEES *; City /State /ZIP: Oregon City, OR 97045 Subtotal -12 "t9 Phone: (503) 557 -2220 Fax: (503) 557 -0919 Minimum permit fee ($72 50) Plan review (25% of permit fee) CCB lic.: 72623 State surcharge (8% of permit fee) '9'89'• TOTAL PERMIT FEE -119 -N Authorized signature: ,,e - -- This permit application expires if a permit is not obtained within ISO g days after it has been accepted as complete. Print name: Steve Lucas Date: 4/08/08 • Fee methodology set by Tn- County Building Industry Service Board I \Bwldmg\Permits'.MEC- PermiApp doc 04/06/06 440 -46t7T (11/02 /COM/WEB) 09/26/2007 09:55 5036679891 WOLCOTT PLUMBING F'AI*. 021 172 FROM : FRX NO. :5036818648 Sep. 26 2007 09158AM P2 F1umbfin e r m i 1 Afplieatlo1 t i i i t i t I it 1 t,' O• T riee ' (,v7 � ff J' l No.: ,P1 S {/U 011.C) All ev ( - ' City of Ti axd Dm/0 /0 re L7 13129 3W Hall Sint, Tigard, OR 97223 1, amt.' "' 1 Planet 503.639,4171 Nita: 5033911,1960 t other remit No.: nupexdon Lino. 503.639.4175 ' ' f: ) internet: www.lisard -atgoY +1 :"1 6 1 i ' I.: I, , :i' ' i;l11 ra1 II i 111 ai ! 3 ® Now consWCd01t ❑ Demolition For • , road n not ehooldlm. - D -... , io •u . , Ha. Total ❑ Addhlion /albuation/rtipineentent 0 Other New 1- 2- family dwellinlp (Includes 100 iL for each utility connection) ,,,i: ,'j I',1 ,1 , ' 1 t" ' ' SPR(I)bath L__ , 299.20 ® 1- and 2411mily dwelling ❑ CommcrclaVlndusirial SFR (2) bath 390,00 1] Accessory building q Multi- (drnily bath 1 399,00 399.00 Each additional buth/kitehen 45.00 ® Master builder ❑ Other Fire sprinkles sq. ) Page 2 51 '' 'l r : '' 1 , '' , , ) 1 . , . 1 , ' '.1 . . c. :hi Site utilities 1 , is 1, r L .� , +I � . sa Job site addre�as._- e k "( II 2. .1 4 , Catch Nein or area drain _ NICEIMMIIII Clty/9tate/ZiP: Tigard, OR 9'1'233' , _ S Drywall, leach line, or trench drain 16.60 otina drain (no. linear R.: ,„,__) Page 2 Suite/bldg./apt dg apt no.: I Project trop: %_ nut Creek Manufactured home utilities 110,00 Cru;n+ street/directions to job Rite: rinrrows and Walnut Mtinh01e9 16.60 - Rain drain connector 16.60 Sanitary sewer (iw. linear R: ,__ j Page 2 Storm sewer (nn linear ft.: ) Page 2 Subdivision! Walnut Creek I I ut nu. :1 ! p We service (no. linear k.: ) Page 2 ... Fixture or Item Tax map/parcel no Absoiptlon valve �� 16.60 ii _ . (I r , ', ,.h ,a HI.. ro : . . .`.I; , . it HaakflOW LirCVCit r .�., Page 2 It Backwater valve 16.f,0 • Clothes washer _ 16.60 Dlshwasher 16.60 1 . ® lhlnkingibu11U1ie 16,60 c i i J '! . 1 hi 1 I Ejeailt6/$nmp 16.60 S . . Name: Legend Homes _. Rxpenaion tank 16.60 Address: 12755 SW 69th Avenue, Suite 1/1n0 _ Fixture/sower asp 16.60 City/State/ZIP: Portland, OR 1/7223 Float drnWfioor sink/hub 16.60 Phone: (S03)620.9080 Fax: (503)599 -8900 Garbage disposal 16.60 16 ill 1 :i r .. 1,1 ii '' /II l, Ks= .1 ,1 ..,, a Hose bib GO Ice rnidsrx Business name: Legend gluon lolerceptar /grease trap 16.60 Contact name: Steve Lama Medical gm (value: $ _„..) Page 2 Address: 12755 SW 69th Aten+ae, Suite #100 Primer 16.60 Diu/State/ZIP: Portland, OR ',177813 Roof drain (comtneroisi) 16.60 Phone: (503) 620. 8080x211 I Fax:: (503) 598-59C10 Sink/basin/lavatory 16.60 Tub /shower/showar pan 16.60 E-mail: ahicnagilegendhamea.cem Urinal 16.60 I y Water close •— . 16.60 T3txcintvs mono: Wolcott PIUmhing Water heater 16.60 Address: l DqS to • 14.,5 -1-crr i Qo t USY4) t��i i CRhar Clty /3tatei nr -o l� Cr l - C, t 9'70(00 ___----_ Subtotal 399,00 Mi n i mum perm f ee: 871.50 Phone: (053) 667 -1781 Fax: (5113) 667 - 9119'! Residential beak/low minimum permit !be: $36.25 Celt Lie.: 112220 Phmtbl lg Liu. nn.: x1•924P19 Plan rovlow (25% of permit Poe) - _ State sureharge Authorized sigenture: rr)0L� ' W .,4_,. TOTAL PERMIT P$k .480115. Print name: Gloria Haws � T I Date: r�i0e, 't'h ts permit application expires If a per,nit in not obtnined within f 180 days after it has been accepted as complete. "Foe methodology act by Td- County fluliding Industry Service Hoard, I :0aaaU PmmlulPtM- POrndIApp.duo oeOl+od 440.1916T(IOaVCOWWBa) FIXTURE UNIT WORKSHEET - WATER METER Contractor Name Legend Homes Billing Address 12755 SW 69 Avenue #100, Portland, OR 97223 Address of New Meter 7- SW Walnut Creek Way 1U124V Lot #' L4 i Subdivision Walnut Creek Please fill in the number of each fixture as detailed on the plans, then multiply quantity by the point value given to arrive at the point total. Add all point totals together for total fixture unit points. Fixture Unit Quantity Point Value Point Total Bar Sink 0 X 1 = 0 Bidet 0 X 1 = 0 Clotheswasher 1 X 4 = 4 Dishwasher 1 X 1.5 = 1.5 Hose Bib 1 X 2.5 = 2.5 Hose Bib, each Adt'l 1 X 1 = 1 Kitchen Sink 1 X 1.5 = 1.5 Laundry Sink 0 X 1.5 = 0 Lavatories 4 X 1 = 4 Water Closet, 1 .6 GPF 3 X 2.5 = 7.5 Bathtub /Whirlpool 1 X 4 = 4 Shower Stalls 1 X 2 = 2 Bath/Shower Combo 1 X 4 = 4 Under 34= Over 34 = 1" Total Fixture Points 32.0 Meter Size 3/4" Meter Cost ****************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** FOR OFFICE USE ONLY Fixture Count Verified with Plumbing Permit Meter # • Receipt # Emp. Name Revised 10/09/2007 RESIDENTIAL PERMIT APPLICATION REVIEW Permit No.: MST2008 -00034 tg,e,v■SeCG .- 2 8 . O° Site Address:. 11157 SW Walnut Creek Way LRi n e re.e \ Subdivision: Walnut Creek Lot No.: JAI L (9 , RQV \ZR • 2 8 - OS Contact Name: Steve Lucas Business: Legend Homes Street: 12755 SW 69th Ave., Suite #100 City: Portland State: OR Zip: 97223 As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and plans have been reviewed to determine if it is complete and if the plans are deemed "simple" or "complex" as defined in ORS 455.467 and 455.469. g The application is complete. ❑ The application is incomplete for the following reason: ❑ The submitted plans will be reviewed; however, a permit cannot be issued until the above information is reviewed and /or approved. ❑ The submitted plans cannot be reviewed until the above information has been submitted and /or approved. ❑ The plans are deemed "simple ". The plans are deemed "complex ". Signature: Name: Brandon Shaw Datd Title: Plans Examiner Phone: 503 - 718 -2425 E -Mail: BrandonS @tigard - or.gov I• \ Building \ Forms \RES- PcrmitAppRcvw- Blank.doc 1/18/07 PLOT PLAN 1/2 2109 Lo r 004 WALNUT CIREEK 14124 SW WALNUT CREEK WAY NE I SECTION 4, T. 25, R.1 W, W.M. RECEIVED ,• . 20• -0" CITY OF TIGARD JAN 2 8 2009 WASHINGTON COUNTY, OREGON �+'� � IL i-4 G END - . - ,,; :> -.: BUILDING DIVISION ON �� A II 0IVI , i IIIGI 12755 S8 68h Ave. OFFI (505) 2 80 -8080 1 � 11 i111 SOITE 100 PAR CE (505) 598 -8900 PORTLAND, OR. 97223 CCB/ 55151 W W W SV WALNUT S RE ' Iii F_ ---K WAY . / UB \: ■Y` i r • / . L� I� : .. I { I • C R STREET TREE: ... \ \ : +. ,, ! ' a \SIDEWALK CHANTICLEER PEAR 2 "Caliper _ 23 2 OT — —` 1 \ 0 233.01 \ '.. N I I S' FU E 1 1 235∎ 10.39' • \ '' '1.' ` 2340' 1 @ 1 I A i' � 1 232.8' ! Li' .E 53' \ 1 0 1- a �- LOT LOT @I� 1 �o /' 46/ 45 - di r- 9 °v C �FT W - - - - - -- WATER LINE Z1 \ REDWpOD A ;VI-) 233 R FIN. FL • 236.0./ ..ti I- SS - - SANITARY SEWER GA FLR�234.2 SD STORM DRAIN I R isl o EROSION FENCE 1 e 1 - q OF STREET 236 1 8.50' 1 © WATER METER \ /4 5.00' Q MANHOLE 231- ` - e ~ � 355l _ - I 234 a CATCH BASIN 238! 4 6 y ~ - - ----- -- 23 ?, PROPOSED 239- - - - - 236 1L1 `a8 - 1 - --- - , 44 50 - STREET TREES 24PJ - ` - - � - - - -�- 23� a STREET LIGHT LOT 6 5 88 IS'2 E 000 - w FIRE HYDRANT 39 -4 L mT N N ' PROVIDE EROSION CONTROL FENCE rn Oq .k i y,� ' to U S Q -1--c fY1 PER COMMUNITY EROSION PLAN L c.) A- t 3 -}- v Lo k LI 0. SETBACKS : FRONT YARD = 15 FEET GARAGE = 20 FEET REAR YARD = 15 FEET SIDE YARD = 4 FEET STREET SIDE YARD = 10 FEET CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: n1F.a2 C10O724 PLANNING DIVISION: Required Setbacks: [Approved ❑ Not Approved Side: 4 Street Side: '_ Front. ,, G , � ' Rear: ts Visual Clearance: G rip ed ❑ Not Approvee Maximum Building Height 21. tc t CWS Service Provider Letter .:.; fired: ❑ Yes ❑ No 44-4-414/ ❑ Received B) : JA.1.-,4) Date: / f gfOe1 ENGINEERING DEPARTMENT: Actual Slope: % ,.Approved ❑ Not Approved Site PIa Approved 0 t proved By: Duce: • , Notes: at CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: mgT2c1c18 •0O Street Trees: Ed Approved ❑ Not Approved Protected Trees: f Approved Approved By: 7,964 ir Date: 30 07 Notes: • P . .or PLAN RECEIVED 40S LOT #013 WALNUT GREEK APR • III CITY OF rGA D 14151 SW WALNUT CREEK WAY BUIWINO ! IV;SiCN NE 1 /4 SECTION 4, T.2S, R.IW, W.M. 1' • 20 -0• CITY OF TIGARD _ . WASHINGTON COUNTY, OREGON CITY OF TIGARD - SITE PLAN REVIEW ARBORIST NOTES BUILDING PERMIT NO: - 1) For Walnut Creek Subdivision, the standard tree protection area is 15 -feet from the back of each lot to the property Street Trees: Approved ❑ Not Approved line fence (highlighted in purple). Protected Trees: , ❑ N Approved 2) Just prior to deck construction, the tree protection fencing By: � ' c 7i y� Date` 1 1 / 5 0( should be adjusted to allow for deck construction within Notes: ( • / -- .. ,..., -" the standard tree protection area (red line illustrates adjustment). t 3) Fence adjustments should be made under the supervision 1 P of the project arborist, and placement of 11 Q p ) p protection fencing should be verified by the arborist prior to deck construction. a i= 4) Deck construction should be conducted by hand and no to CC7"ltL' equipment is allowed within the tree protection area. 0) Decks will be built on pier blocks and concrete footings measuring approximately 18 "x18 "x18" are needed to hold 9 88 E the pier blocks in place; excavation for footings should be 46 ter P la n conducted by hand - digging. The location of concrete , N footings will be adjusted to avoid root impact as feasible. 2 356 • 1 , Iy m I0 , I When root impact is unavoidable, roots less than 2- Inches 4 . PECK °...s"t , I;,� SA' in diameter may be cut clean to the edge of excavation - �I .o _ .' V c with a pruning saw or pruning shears; if the roots are � 1 pr ` 72!] larger than 2- inches in diameter, work should temporarily 31._ L �/ ; � i 1 1. 28-C-)(2 38 -_ stop so that the project arborist may be contacted for 2 /1 �' • 23v additional recommendations. No storage or stockpiling of f f materials within the protection area; concrete for footings `/ �' F '236 should be mixed In a wheel barrow on site. LOT 12 � u ' I 'L OT ' 13 / � , 1 ' 1 • / /% /.3'4"4x1'/ Q REDWOODW" 1 // ' C• - "Pi • 4/22/08 '� ',// riti:LR•23W ; . ' ! 9 1 2 LOT 14 Mot!IE. Holeu Ql • '% // ' / e C errifre Arborist, ISA PN -6145A 71 � !/ / \ 71 Forest Biologist, PBS Environmental , ,, / , \ W — —WATER LINE ) 1 SS SANITARY SEWER SD STORM DRAIN IDA • ./ •• 1 6 0 EROSION FENCE .. ./ .. 'k 4OFSTREET 1 Q' WATER METER i . 2341F 1 q , !n , I - STREET TREE • 0 MANHOLE 8 FUE CHANTICLEER PEAR . S ::'1926' E. / / 2^ Cau Q CATCH BASIN SIDEWALKA , • . '' ° •' 4 •_ ' �' - a per • P ROPOSED - tt.-f--i __ ■ STREET TREES e 1 i. E4 STREET LIGHT_ • . \\ \ CURB lir FIRE HYDRANT 1 \ 1•y0 i i \ PROVIDE EROSION I I \ SS \ \ CONTROL FENCE SW �.___ —_ \ _ T u PER COMMUNITY SW I UJALNUT q� W EEK y EROSION PLAN SD / SETBACKS : co 1 FRONT YARD • 15 FEET ra 0.1 4 GARAGE • 20 FEET e' REAR T ARD . 15 FEET SIDE YARD . 4 FEET STREET SIDE YARD • 10 FEET • • CITY OF TiGA SITE PLAN REVIEW RD - T BUILDING PERMIT NO.: N Approved PLANNING Baas: DIVISION:_ e Approved 0 Required Setb Street Side: Rear: -- Side: i G ge� Not Approved ��n +. I e Approved ❑ Clearance: f eet ::• < :u►um� Building Height. 29._ Yes CI No S rvice provider Letter Required: El I Re eived ' Date: `f a- DEPARTMENT. 0 Approved � v(u S ope: ° Approved Not App Actual 5rApproved l Slope: �'— /0 � Site Plan: pa e: . t3 k v ' Notes; CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2008 -00034 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2/7009 7009 Phone: (503) 639 -4171 I�I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 2/17/2009 TIME: 7 :00AM PAGE: 3 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK . LOT #: (1 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: Nevv SF. OWNER: LEGEND HOMES, PHONE #: 50620 -8Q80 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: • 503- 620 -t1080 Inspection Request Scheduled For: Date: 2117/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 606 Poi:I /beam mechanical 080570 -02 503. 209-3370 N Corrections /Comments /Instructions: • 5/ARTIAL APPROVAL CANCEL NO ACCESS ❑ FAIL `/ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: / D Phone #: (503) 718 - Z * p � ) . 1 CITY OF TIGARD BUILDING DIVISION ,,..A . PERMIT #: mm008_00034 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2/2009 Phone: (503) 639-4171 ,.._ ,i ilil' , Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 2/17/2009 TIME: 7:OOAM PAGE: 4 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: 046 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503-620.8080 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 603-620-8000 Inspection Request Scheduled For: Date: 2/17/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 225 Pot/ham structural 080570-01 503-209-3370 N Corrections/Comments/Instructions: 1 A rARTIAL APPROVAL AP 1/ D CANCEL _ NO ACCESS n FAIL ri CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: 1 Date: Z/1 0 Z-6616/ Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION " PERMIT #: i, ST200 000 9 13125 SW Hall Blvd., Tigard, OR 97223 A b X DATE ISSUED J 12009 Phone: (503) 639 -4171 d 1 ,, A, "T O Inspection Requests (24 Hrs.): (503) 6394175 �'_ 0 °11M1 / D� � INSPECTION WORKSHEET FOR DATE: ; ?9I2O09 TIME: 7 :OOAM PAGE: 12 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: 046 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503520 -8030 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 503-620.8080 Inspection Request Scheduled For: Date: 21912009 Pour Time: 40 Code # Inspection Description Confirm # Contact # Message 210 Foundation wells 08041:01 50,3-209-3370 N Corrections /Co ments /Instructions: ki ----- b i k__./ ------- U 1:d C L' 150 ,`12_.- 4 - PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ��(/`( /// Date: �� / � 1 Phone #: (503) 718- 0 / �� P C= ` CITY OF TIGARD - BUILDING DIVISION . PERMIT #: M I700f3 -000:4 13125 SW Hall Blvd., Tigard, OR 97223 1 DATE ISSUED: 2 12001 Phone: (503) 639 -4171 , ;A�� Inspection Requests (24 Hrs.): (503) 639 -4175 /2c7 INSPECTION WORKSHEET FOR DATE: 2/5/2009 TIME: 7 :OOAM PAGE: 1 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: 046 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION:. New SF. OWNER: LEGEND HOMES, PHONE #: 503 - 240000 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 603 Inspection Request Scheduled For: Date: 2/5/2009 Pour Time: 40 6 Code # Inspection Description Confirm # Contact # Message 1 / . 0 S ,/ 205 Footing 00033t.3 01 503.209-3370 N � f V Corrections /Comments /Instructions: ate \.6 w v C - . - Cr 6 — a" ........ IN lbk;3 ❑ PARTIAL APPROVAL ❑ CANCEL \:, \= : .... xis.'-:'' ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ..,._ • \� �" Date: *; Phone #: 503 718- �`I Inspector: ( ) CITY OF TIGARD BUILDING DIVISION qDP PERMIT #: MST2000 -00034 13125 SW Hall Blvd., Tigard, OR 97223 l) 42,40 a 2AATE ISSUED: 7 /::?()(19 Phone: (503) 639 -4171 / 1 1 Inspection Requests (24 Hrs.): (503) 639 -4175 ��' 1 �! 4 INSPECTION WORKSHEET FOR DATE: 7717/2009 TIME: 7:OOAM PAGE: 13 SITE ADDRESS: 14124 SW WALNUT CREEK K WAY CLASS OF WORK: SUBDIVISION: WALNtJ CREEK LOT #: 04 TYPE OF USE: . PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503- 620 -80110 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 503 62(3.0080 Inspection Request Scheduled For: Date: 7117/ 2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post /berm plumbing 0180569 -01 503 - 667 -17t31 N Corrections /Comments / Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: c b Phone #: (503) 718 - R± CITY OF TIGARD ` BUILDING DIVISION \‘'... P #: P+liaf 700i 0003 13125 SW Hall Blvd., Tigard, OR 97223 D D E ISSU {aQ(jQ Phone: (503) 639 -4171 1,, ,i , ���il 1 Inspection Requests (24 Hrs.): (503) 639 -4175 �� INSPECTION WORKSHEET FOR DATE: 7111/2009 TIME: 7 : QOfiM PAGE: 14 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: Q46 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503- 620 -8080 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 503 -620 -8080 Inspection Request Scheduled For: Date: 2/11/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 0804130.02 503 -9f.9 -4631 N Corrections /Comments/ Instructions: 7 I 1 k rSj 45-1 -- T ,- ��_07— "CiNi2-42..._ _____iz t a,..___{._ G Le -.. 1---)_QA G1 /u a1L Pf ,.s_ ) 45)‘ - i)r ____ __ 12 PASS ,! RARTIA PROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ‘ 2,--- Date: 2 1 V Phone #: (503) 718 - ?'4-1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST?00l3 -00034 13125 SW Hall Blvd., Tigard, OR 97223 / , DATE ISSUED ''.0./2009 Phone: (503) 639 -4171 ' ^ . I +i ' ' Inspection Requests (24 Hrs.): (503) 639 -4175 ..'! 1I.. 7 j INSPECTION WORKSHEET FOR DATE: 2/11/2009 TIME: 7 :00AM PAGE: 13 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: 046 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503-620-0080 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 503-620-8000 Inspection Request Scheduled For: Date: 7!11/1003. Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 08048 +3 03 503.969 -4631 N Corrections /Comments /Instructions: e 3 /r 2 - c 54 -9 ; c ->\ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: `' ` J Date: -2,7, / Phone #: (503) 718- CITY OF TIGARD " • BUILDING DIVISION (j PERMIT #: ly1ST20g0- 000`:i4 13125 SW Hall Blvd., Tigard, OR 97223 I DATE ISSUED: Phone: (503) 639 -4171 • '�I,.. � `v \ Inspection Requests (24 Hrs.): (503) 639 -4175 `__ l INSPECTION WORKSHEET FOR DATE: 2/11/2009 TIME: 7 :00AM PAGE: 12 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: f)46 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF, OWNER: LEGEND HOMES, PHONE #: 503 - 6201:3080 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: .50:. 620.13080 Inspection Request Scheduled For: Date: 2/11/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain 080488- L14 503.969-4631 N Corrections /Comments /Instructions: - 5 " Q--(AA 4(\_..e v Q-------SL_ - tAL 3 6 PASS PARTIAL APPROVAL ❑CANCEL n NO ACCESS _ FAIL (l CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED V& � Date �/ ` YO / Phone #: (503) 718 - >V-2-f-( CITY OF TIGARD _ BUILDING DIVISION 1)1( PERMIT #: MST200i3.O0034 13125 SW Hall Blvd., Tigard, OR 97223 t ATE ISSUED: 7,J2 09 Phone: (503) 639 -4171 , Inspection Requests (24 Hrs.): (503) 639 -4175 `'I �.. '. f INSPECTION WORKSHEET FOR DATE: 2111/2009 TIME: 7:OQAM PAGE: 11 SITE ADDRESS: 14124 SW WALNUT CREEK WAY CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: 06 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF. OWNER: LEGEND HOMES, PHONE #: 503-620 -8080 CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 503 - 620 -80130 Inspection Request Scheduled For: Date: 7/11/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 ;anii: ry sewer 00Q480 -05 503. 969.4631 . N Corrections /Comments/ Instructions: (, -(---- C A ' ii C v\,e_s? SLizIL _ ( 7 c -N---6 ' = I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED d �/ �I Inspector: Date: Z1 \ Phone #: (503) 718 - 7.-y- T 2 - I CITY OF TIGARD --- . . ---- - BUILDING DIVISION y g . DAT M„. 13125 SW Hall Blvd., Tigard, OR 97223 , Phone: (503) 639-4171 Nlilt O --- / Inspection Requests (24 Hrs.): (503) 639-4175 ..--_-_- --- INSPECTION WORKSHEET FOR DATE: 2/11/2009 TIME: 7:00AM PAGE: '15 SITE ADDRESS: 14124 SW WALNUT CREEK WAY . CLASS OF WORK: SUBDIVISION: WALNUT CREEK LOT #: ()4 TYPE OF USE: PROJECT NAME: WALNUT CREEK DESCRIPTION: New SF. OWNER: LEGEND OMES PHONE #: 503-620-8090 H, CONTRACTOR: MATRIX DEVELOPMENT CORPORATION PHONE #: 503-620-8090 Inspection Request Scheduled For: Date: 2111/2009 Pour Time: Code # Inspection Description Confirm # Contact # Mes ge itilt 310 • Crawl drain 080488-01 503-969-4631 Y Corrections/Comments/Instructions: SS 42E El PARTIAL APPROVAL El CANCEL fl NO ACCESS Ell FAIL r7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED t‘•■ Inspector: Date: c i f ? 2__ Phone #: (503) 718- yz- 4 / ----- e 'ran ,‘6-7r)/.. c /-�( & 21 - t-,rct,M � +N Ilii ' I q CITY MASTER PERMIT COMMUNITY DEVELOPMENT DATE ISSUED: 4/25/2008 00033 T,i6ARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133AD-15400 SITE ADDRESS: 11161 SW SUMMER LAKE DR ZONING: R -7 SUBDIVISION: SUMMER LAKE LOT: 035 JURISDICTION: TIG PROJECT: BELL Project Description: Addition. 7/24/08 ADDED (1) bathroom vent fan. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 288 st BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: 5 VALUE: 30,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 288 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER: NAT FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 0 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAUPANEL: IN PLANT: MANU HM /SVCIFDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO P. STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CHRISTOPHER & CATHERINE BELL VIAL & PHAM LLC laws. All work will be done in accordance with approved plans. This 11161 SW SUMMERLAKE DR 7145 SW VARNS ST permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: 503 - 524 - 8579 Contact #: PRI 503 - 597 - 2425 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 297 -2428 Reg #: LIC 167458 TOTAL FEES: $ 1,201.76 REQUIRED ITEMS AND REPORTS Issued By v i r j Permittee Signature : ' ' - 7 C■/ Call I .•39.4175 by 7:00 a.m. for an inspection that business day. 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. JUL/23/2008/WED 04:02 PM THERMAL FLO FAX No, 5035709064 P. 002/002 - , . . . ,... .. .. .... . . . Mechanical Permit Application - • • • ... .. . • . . • i OFFICE I.ISE ONLY.. . .. . . : . .,., City of Tigard Received ....., Date/By: f , eti PermitN.:ifft579w3 • , ' - .1 13125 SW Hall Blvd., Tigard, OR 97223 Ili : , Pho Plan Review • ' . . ne; 503.639.4171 Fax: 503.59t9S Other Permit! Date/By: Inspection Line: 503.639.4175 TIGARD Date Reacly/By: Juris: 0 See Pogo 2 for Internet: www.tigard-ong ° Notified/Method: r::6 Supplemental Information 9 ; ; ; F:!,,,,, , 4• , i;,;.-,, ,, ,;; , •7, , i;,',;••.:;;;:,i , ,•.7:::.. , ., , v,:::,..,e.! . .:4t:t ..kiii;e4 • '10 ' '41eolkimig ' ' El New construction )SrAddition/alteAopl • • - , ,A Mechanical permit fees"' are based on the value of the work 0 Demolition 0 Other G.\ I;) performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor,overhead. and profit. :,;:5];-.i;,8:;i:;i,::::,'.:!.;;;;.i;'4:;.,'.•;;‘.;';,`•,!'6:'irOAtigi3:6*.*:9*.)4.WM,i3O,0j:i;igP!•J'!.:';:::;;:'4;1k.!:,;,:i:;;!;!:;!::.;:i;!; „, ,, , . „„ s ., ,., ?' 111e: ,, I . Xl and 2 dwelling 1:1 Commercial/indUStrial 0 Accessory building For special inforniat ion We checklist. El Multi 0 Master builder 0 Other: Description Qry. 1 Ea. Total ... „ ... ..... ...,, ... ., ,.„„ .,. — „. „..-. .!;F:i: Heating/cooling Air conditioning or heat pump Job site address: ("1677-(74ilnec/age", -J,,-,, Lregia_es siesjan_arztin r I acer_b_p_ r_Ls_____10 14.00 City/State/ZIP: 770, 04 97'2 g Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,0004- BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: Project name: 4 21/ ,i- Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hy hot water system 14,00 - Residential boiler (radiator or ThOi7 id 60 0 f------- hydronic) Unit heaters (fuel not electric), 14.00 in-wali. in-duct. suspended etc. . 14.00 Flueivent for any of above 6.80 Subdivision: 1 :. no.: Other' • 10.00 Tax map/parcel no.: Other fbel appliances W ater heater 10.00 I :.::;.:;:;:c::::;:::,..!•,.::iJI ,-,,,, - ---.,:' ,. - , .-4!-L.-.!g.,:.......,---,p4LIZzon . :::: . ; , .".!,"0:!.r:Y.:.-t . -!....! , .!.. , ".'.71..:r!.r Gas fireplace 10.00 ._ 4 6arlovoat-----,. Flue vent for water heater or gas _ 14li7i A 0 ) ., fireplace Log lighter (zits) I 0.00 1 0.00 Re CtOd& ilid/L - / - 0 it/gieg/t4 . .. Wood/pellet stove . 10.00 A 7 7 -- 14 ,,, e ,b _ 00 -- 0-p Wood fireplace/insert 10.00 !V'!!''" 744jo A iir iti ::::::. rrid ,,1:il;•;:;,,, 6 *k'',.. ChinineWlineriflueivent 10.00 ..,—„„;„:gittt. :,q,„, . . . .. .0.• •••••: 4:13tv:tolV;! ,.,, .!::.. Pr.',‘.(•7 ,,,.1, •■•• ,,, ... , . , ....:;;J:.. other 10.00 Name: _12/a/ '1i1ten 6,8,, Environmental exhaust and ventilation • . Range hood/other kitchen • Address: equipment City/State/ZIP: Clothes dryer exhaust 10.00 , Single-duct exhaust (bathrooms, . f Phone: ( ) Fax: ( ) toilet compartments, utility rooms) I 6.80 Co c7 ::11 ' 04.0...:A ; • 1 ,R1 1 1 ' i!14i1!11 : ;2 1 k 000ii Anicicravits fans 10.00 Other: 10.00 1 Business name: . Fuel piping - Contact name: A 4 1 . . $5.40 for first four; $1.00 for each additional • — r , / Furnace. etc. Address: 06 j / I Gas heat pump City/State/ZIP: V Wall/suspended/unit heater ---- i - • Phone: ( ) Fax: : ( ) Water heater - Firepla E-mail: bi ce eorla Range . . '• :,;`,.il Barbecue Business name: 7 er 0 .,Thc. ----- --- Fi . Clothes dryer (gas) . Otlier: Address: 1 te, (9 • ( r // '' 11:4 . . , ' . .. ::•• ::.:. - ' '''i ! '''' 4 ' !: ' :',:. 34b1U1416;;Cti*.EIlil/IIT I ftli.Sk : ' . " City/State/ZIP: 1,11- / / it /1 zef- Subtotal 67 • ge2 Phone; Or Fa 4 0 )b O•' - .00 , Minimum permit fee (S72.50) Plan review (25% of permit fee) CCB lie.: 15/04.1. — State surcharge (12% of pennit fee) d WI- TOTAL PERMIT FEE Ti 491 Authorized signatur. / /120,41 . This permit application expires If a permit is not obtained within 180 days niter It has been accepted as complete. Print name:lye ir e Date: 7- , • Fee methodology set by Tri-Counly Building industry Service Board Ili a 'CITY OF TIGARD MASTER PERMIT PERMIT #: MST2008 -00033 COMMUNITY DEVELOPMENT DATE ISSUED: 4/25/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133AD-15400 SITE ADDRESS: 11161 SW SUMMER LAKE DR ZONING: R - 7 SUBDIVISION: SUMMER LAKE LOT: 035 JURISDICTION: TIG PROJECT: BELL Project Description: Addition. BUILDING REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 288 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: 5 VALUE: 30,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 288 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: NAT FURN >=100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: Mu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADDL INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FOR: 0 PUMP/IRRIGATION: PER INSPECTION: EA AMYL 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 1 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAL/PANEL: IN PLANT: MANU HM /SVC/FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC/FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: . ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable CHRISTOPHER & CATHERINE BELL VIAL & PHAM LLC laws. All work will be done in accordance with approved plans. This 11161 SW SUMMERLAKE DR 7145 SW VARNS ST permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503 - 524 - 8579 Contact #: PRI 503 - 597 - 2425 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. FAX 503- 297 -2428 Reg #: LIC 167458 TOTAL FEES: $ 1,194.14 REQUIRED ITEMS AND REPORTS / Issued By : _ j _ - . � Permittee Signature i ■•• Call 503.639.4175 by 7 :00 a.m. for an inspection that business da . 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. - m : Cis' It-e5 a( l Ol( (,rrl(:i: 1'sl: ()NIA I of Tigard � � Received Aa g 71 Permit No :: , ' . _ Ill -lag ° 13125 SW Hall Blvd., Tigard, OR 972 Plan Review 0 Phone: 503.639.4171 Fax: 503. OD DateBv: Li - o24`or Other Permit: Tic; It a A Inspection Line: 503.639.4175 a Q- h � (� Date Ready/By: ii . � len M s: See Page 2 for Internet: www.tigard - or.gov r � `' .-c \ (3I Notifi ,..: -f 2 10 /' , Supplemental Information l O� ' ��S � i w Wit% ._ // TYPE OF WO � R QUIRED D � : 1- AND 2- FAMILY DWELLING ❑ New construction ❑ ' r . 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. ® m I. and 2- family dwelling ❑ Comercial industrial Valuation: $30,000 ❑ Accessory building ❑ Multi- family Number of bedrooms: n/a` ❑ Master builder ❑ Other: Number of bathrooms: tt/a JOB SITE INFORMATION AND LOCATION Total number of floors: 1 Job site address: 11161 Sw Summer Lake Dr. New dwelling area: 288 square feet City/State /ZIP: Tigard, OR 97223 Garage /carport area: n/a square feet Suite/bldg. /apt. no.: Project name: Bell Residence Addition Covered porch area: n/a square feet Cross street/directions to job site: Scholls Ferry Rd. Deck area: n/a square feet (Close to Mcdonald's) Other structure area: n/a square feet . . REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Summer Lake Subdivision I Lot no.: 35 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 1S133AD -15400 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. Lower level addition. Extending the kitchen and family room, and dining room Valuation: $ area to make larger. Located on the back side of home. Existing building area: square feet New building area: ' square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Christopher and Catherine Bell Type of construction: Address: 11161 SW Summer Lake DR. Occupancy groups: City/ State/ZIP: Tigard, OR 97223 Existing: Phone: (503)524 -8579 Fax: ( ) New: ® APPLICANT ❑ CONTACT PERSON NOTICE lke. Business name: All contractors and subcontractors are required to be Contact name: Cathy Bell licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 11161 Sw Summer Lake Dr. jurisdiction in which work is being performed. If the City/State/ZIP: Tigard, OR. 97223 applicant is exempt from licensing, the following reasons apply: Phone: (503) 524 -8579 I FTOR ax :: ( ) E -mail: catbells@verizon.net CONTRAC �.Q Business name: Vial & Pham, LLC. Construction and Development BUILDING PERMIT FEES* Address: 7145 SW. Varnes St. (Please refer to fee schedule) A City/State/ZIP: Tigard, OR. 97223 Structural plan review fee (or deposit): FLS plan review fee (if applicable): n Phone: (503) 597 -2425 Fax: (503) 597 -2428 • ` .0 I t � Total fees due upon application: l' , CCB lic.: 167458 71 1 Amount received: -g r Atuthomrtdsegnature' This permit application expires if a permit is not obtaine Y within 180 days after it has been accepted as complete. ■ i dege ._ 4 P L / , Da t e: � � �U / Fee methodology set by Tri- County Building Industry Ce...:re Rno..l J • ' (, `Plumbing Permit Application . Building Fixtures FOR OFFICE USE ONLY __ _ Re ceived • +�, �y� City of Tigard y h P e rmit No.: /72 5 pr.(� `�` e., Date/By: �/ ! � � q 13125 SW Hall Blvd., Tigard, OR 97223 �� Plan Review l IN C • Phone: 503.639.4171 Fax: 503.598.1960 j DateBy: Other Permit No.: Inspection Line: 503.639.4175 Q Date Ready/By: !aria: 65 See Page 2 for aF.S9C T I G A R D Internet: www.tigard- or.gov `)O Notified/Method: Supplemental Information I FEE* SCHEDULE TYPE OFW �� b i1^.� Itk ❑ New construction ❑ DemolittbO ` `�j0 `�" For special information use checklist - �'��,� Description I Qty. I Ea. I Total ® Addition /alteration/replacemetlt ❑ Ok4Nr ISP New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTR1 T TION SFR (1) bath 249.20 ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 11161 Sw Summer Lake Dr. Catch basin or area drain 16.60 City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Bell Residence Addition Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Seholls Ferry Rd Manholes 16.60 (Near McDonald's) Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 • Storm sewer (no. linear ft.: _) Page 2 Subdivision: Summer Lake Subdivision I Lot no.: 35 Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: IS133AD -15400 Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 Lower level addition to kitchen, family and dining area. Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: Christopher and Catherine Bell Expansion tank 16.60 Address: 11161 SW Summer Lake Dr. Fixture /sewer cap 16.60 City/State /ZIP: Tigard, OR 97223 Floor.drain /floor sink/hub 16.60 Phone: (503)524 -8579 Fax: ( ) Garbage disposal I 16.60 ® APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker / 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Cathy Bell Medical gas (value: $ ) Page 2 Address: 11161 Sw Summer Lake Dr. Primer 16.60 City /State /ZIP: Tigard, OR 97223 Roof drain (commercial) 16.60 Phone: (503) 524 -8579 Fax:: ( ) Sink/basin / lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: catbells@verizon.net Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: p 0 cot I,. , (Z 6 o `f-e ( S�-,/ , c Water heater 16.60 Address: 33 00 VV (,J ($ S . Ave 4 21 3 Other: City/State/ZIP: ra r l q ,, e 3 0 (. 1 7 2 2 Subtota Minimum permit fee: $72.50 . Phone: (c--D_ )5 33 01/441 t3 Fax: (So 3 ) 7 1 c-(..4 ci a ° Residential backflow minimum permit fee: $36.25 CCB Lie.: I O g S© q Plumbing Lic. no.: 26 7 76. P. Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: " L7- TOTAL PERMIT FEE - Print name: 6 e a A-- Date: 1 -/ -2 - This permit application expires if a permit is not obtained within J 180 days after it has been accepted as complete. *Fee methndnlnov get by Tri- County Ruildino Industry Service Round ‘ if to_ Vi A"pTON`bc . har a Permit Application ifillelp Washington Cou % 74r' w c6 washini oI us Phone: 503- 846 -3470 Fax: 503- 846 -3993 ' 1 " ,rs• -4 155 N. 1 AV, Suite =51 -1 �( - ;W , \S \'+• Inspection Request Line: 503- 846 -3699 ' of Hillsboro, OR 97124 �` C) Hillsboro, Land Use Approval: 0 .0 Project #: Permit #:/7)S77CXf8 - Uc 3 t' : il?.3; "��, •• - T:y •:,, : .•4 fPEYOF_IWARK g= ` : ; t, ;" _ ::.:' .. :3 . s ;; : : : .t COMMERCIAL; FEE. SCHEDUL.E ^ -4USE dCHECKLIST '`=;:.', :'. m ❑ New construction P4ddition/alteration/replacement Mechanical permit fees are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, ❑ Demolition ❑ Other. • equipment, labor, overhead, and profit. :: r:: , p.' ;.; ..' ?CATEOORi'40F:1CONSTRUCTIOr4 !.'.,'4�..i ::..t ;:' ~' '` • '. !' Value: S ( and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 9RESIDENTIAL EOUIPMENTTiSYSTEMS FEES " ' O Multi- family ❑ Master builder ❑ Other: For special fulbrmarion use checklist. ,!::'a;.` 7 iJOB 'SITE.JINFORMATION sAND;tL•'OOATION / •= �'; '. : ' ;: Description I Qty. I Ea. Total Job site address: /) f(Q / s ) Su „, m Y ke. br- H eatinWcooling Furnace, incl. ductwork, vent, and liner 8.50 City/State/ZIP: Tie' a r)1 i Q e- R L n 2,23 / Air conditioner (site plan required) 8.50 Suite/bldg /apt. no.: Project name:& Iii des, �1.ehGe, Heat pump (site plan required) 8.50 s dt' lf� Duct work. alterations and additions I 8.50 Re Cross street /directions to job site: Hydronic piping system 8.50 � Boiler, incl. vent** State Permit Required 1 f(f ad Gas heaters/unit n in-wall, in-duct, 'S c ` otf t/S I r suspended, etc. not t inn cl. . vent. 830 Other. I' Other fuel appliances Subdivision: 5/4 tmm•e- bekt I Lot no.: 3 5 • Waterheater 8.50 Tax map/parcel no.: 15 I a 3 A- E) - 15 Li 00 Gas fireplace/insert/stove 8.50 " `' } :f y a` -; DESCRIP..TION E - *Hier „ . . ,igc Gas log/log lighter 8.50 - • Pool or spa heater, la'ln• 8.50 Low erg LE-t,wi ( CtC(d ►`'"d I fiD Wood/pellet stove/insert 8.50 ba c lc cif hey u. Irc-- Wood fireplace 8.50 Chimney/liner /flue/vent w/o appliance 8.50 Oil tanks/gas/diesel generators • 8.50 Other. ;. m y :: 0,4 Environmental exhaust and ventilation a.:,... ra, 1= 1 .? ROF 'OWNERi¢,r>,�:na r ? '. :. / ,y,� Range hood/other kitchen tchen equipment � 8.50 Name: CJ1Y b S "1 l n ` t �� .4 Cat Y1.&Y ( tYl1. ' )e Dr ' Clothes dryer exhaust 8.50 Address: i l l (a- ( 50,) S&t m vet. -i 1..."4, h e_ D y Single -duct exhaust (bathrooms, toilet compartments, utility rooms) 8.50 City/State/Z1P: - r A ) O g._ 9'7 22;; Attic/crawispace fans 8.50 Phone: (5 Q 3) S 2 .4- 257, I ( ) Whole house ventilation or Radon Fax: mitigation • 8.50 :' x` Y ,c. 4r r: �� ,1C 40:WAN'!--w': pt5 t3 ; t,. , .; v ;Pi Other: ther. .`1."�' r� r"� :" ; ,��1,f�M1': ✓, 9 :;P-'�:; 1` ..`�"�.. v � ' ' bwr � ,, , �l.• d��.. . Business name: Fuel piping S8.50 for first four, S1.00 for each additional Contact name: f /t Furnace By outlet II Address: - / %, 0 ' Wall/suspended/unit heater By outlet fi ,`,/ Water heater By outlet a City /StnteJZIP: R ace/log lighter /gas log By outlet s Phone: ( ) j I Fax: ( ) Range By outlets 5,0.50 E -mail: & t iC ( . Fier/IL C Barbecue By oudet fl � v - Clothes dryer By outlet a • 'CONTRACTOR • :: . .. - Other: Business name: • ... , j j al G i G ;MECHANICAL'PERMIT.FEES _ • Address ` /. !. Subtotal S �� � `D, P:9 Minimum permit fee Sb0 .09 5 / �j City/State/ZIP: /02 / fi at 91 2f' Plan review (65% of permit fee) S Phone:g ) 6711 00¢ Fax: /03} &lO' g State surcharge(12 %of permit fee) S I./dire66 ArniQlciO .m6e COm' TOTAL PERMIT FEE S E- trratl. ✓ { , J / G/ This permit application expires If a permit is not obtain within 180 CCB lic.: /5/841 I City or metro lic.: 7 3' days after it has been accepted as complct (, 2-0 Authorized • Site plan required for an outdoor unit UUUUUU d •• State Building Codes Division's approval required signature: - Printname:gjetee Co)X' /j 1 Datee -N-eig 440- 4617T (10/07 /COM/WEB) ' ,r tec rival Permit Application IOR of i ici- USE ONLY _ _ . 0 l - -- Received City of Tigard � V Date/By: y R' iY /7j Permit No.: m ��� j3 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 0 Q Other Permit: Ph one: 503.639.4171 Fax: 503.59 r i: Date/By: T I G n R D Inspection Line: 503.639.4175 4 r p late Ready/By: Juris: ® See Page 2 for Internet: www.tigard- or.gov r ` i ^'� , e, ' otified/Method: Supplemental Information TYPE OF WOR IW \ \1 PLAN REVIEW ❑ New construction ® Ad dition/alteratio Ola a !lent 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 ❑ Commercial /industrial ❑ 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 ", "l -2 ", "1 -3 ", Job no.: Job site address: 11161 Sw Summer Lake Dr. looslP or more. occupancy. ❑ 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: Bell Residence Addition ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Scholls Ferry Rd. Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. (Near McDonald's) Includes attached garage. Subdivision: Summer Lake Subdivison Lot no.: 35 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: ISI33AD -15400 Ea. add'1500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75 00 2 Lower level addition to kitchen , family room, dinning areas. residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: Christopher and Catherine Bell 401 amps to 600 amps 160.60 2, 601 amps to 1,000 amps 240.60 2 Address: 11161 Sw Summer Lake Dr. Over 1,000 amps or volts 454.65 2 City/State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or relocation Phone: (503)524 -8579 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: 3/�/(�� A. Fee for branch circuits with ® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: Cathy Bell without service or feeder fee 46.85 2 first branch circuit Address: 11161 Sw Summer Lake Dr. Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Tigard OR 97223 Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: (503) 524 -8579 Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: /J r •e /� /�� Signal panel, alteration, or circuit(s) or limited - energy panel Address: 4" 9 �� (ai 66� t � � extension. Describe: Page 2 2 City/State /ZIP: R8�/...&te,W v g 9 7 , / 9 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (5621) $" /5 2 9 2 2 , Fax: (.5CS (3 6 ('J `7 Investigation per hour (1 hr min) 62.50 CCB Lic.:6 Electrical Lic., 6-/efe--._Suprv. Lic.34 Industrial plant per hour 73.75 • Fl LECTRICAL PERMIT FEES Suprv. Electrici a Si! . �1 re, require / I Subtotal: Print name: e AO e --6 _ Date z_o/00' Plan review (25% of permit fee): State surcharge (12% of permit fee): Authorized signature: � `/ - TOTAL PERMIT FEE: Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • H )TO 8 - oco 3 3 4 ' J JLI APR 0 2 200$ " By CleanWate� services RE:Li • •. clear. Ai 4 6 � P 1 CWS FHIeNumber • S9-Scr I $- OOO 947 B Jurisdiction Pad-go Property Information: (example 1S234AB01400) Owner Information: / �,/ . Taxlot ID(s): I S l 33 n 1 5400 Name: l ' F' I r I.S�D pee -C z 1 ►' �•'I�! Ulm t , Company: f Address: I I 1 ICI S,l) .5u rY1 rYet( j ICL 16L - fir a Site Address: I I (LD, OLl � c m rnef I�A � r l 2 � . TI ct rc� OZ. 1 7 � r Phone /Fax: '6 q 7 2M `7 r)D3' - 7 �17CCf �Q Nearest Cross Street -) r h o l I S Fe rlry E -mail: ca.} be Os 0, Ulf rz ry e n C — Development Activity: Check all that apply Applicant I rmation: f_ Addition to Single Family Residence (rooms, deck, garage) — Name: ( a YY7 G'L S G beDVP.� Lot Line Adjustment ❑ Minor Land Partition ❑ Company: Residential Condominium ❑ Commercial Condominium ❑ Address: Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial ❑ Phone /Fax: / Other E -mail: Will the project involve any off -site work: YES ❑ NO Unknown ❑ Location and description of off -site work: Additional comments or Information that may b,e,Teded to understand your project: This application does NOT replace the need for Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEQ 1200 -C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document, and to the best of my knowledge and belief, this information is true, complete, and accurate. ( / Print/Type Name: firtM`1e.r1 fl.2- L t. Print/Type Title: ho me_ o ne.-r Signature: r. Date: 3j31/ 0 2' FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, State, and federal law. r: Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s) are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT O - ERVICE PROVIDE - ETTER IS REQUIRED. Reviewed By: V /9�Q Date: c/ a 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 M.1-16 Phone: (503) 681 -5100 • Fax: (503) 681 -4439 • www.cleanwaterservices.orti Revised: May 9, 2007 • • 1 --- . � y_O° 10'015 /16 % 9'5 I/8" I4' -6' 5'0' J o I • A Z008 el ° i m C' C3 - ;;r C y �t� Jj PROPRTY LIN g o� „,,/ / ,,,u,ri? F : ' MC l..11%;'..Sr,.;N / d\ 1 1\ 1 \ \ ii il I FIP I In 4' -6' 20'-0° I4' -O° 5' -6' in EXISTING NORTH ELEVATION / EXISTING EAST ELEVATION SCALE: I /e" = I' -a' SCALE: I/8" = I' -0" . / - ° t - ... _ • , � ,�� i y � ad - ! Sw VTaii { 4r - - ' 94 • & ! : - s. Sno tho in . ._ 2 to I _ _ : : sir \ w 44'-O° i c „tea. - AREA OF WORK / / • 23' -0° 12' O 9'-O' I . ; t 4, i I ` 2' M MAIN FLOOR ONLY i I r -2 , /z• - as...-:, 1—_—_::::77-' N CM 5'-0" 9,,o;!'' g S sc T.: r.--- �� . , Ill O� t ,._ - sw, I.... k.d 51' - -_- 1 I I- . -9 . Q (TIG2STORY • � . m:,w. �,""°" i Q BUILDING ` � _ °` —.. r, . -- Summer.._ co a N �I F--- F. .. y? &Ammar Lein summ.r sn,n�ndriict- __= ! L _ 1i t N c _:._ I .J r N J _ . _ � _ _ Lake Summer \ ;LtesLCr LI CO AD! Q I II —6 nry!n i S '+ ems ` 4 4, - . ... _ ._s.W,m,..0r sNMaeWK'd a °� r d I: DRAWN BY: '------\\ VICINITY MAP HOA PHAM DRIVEWAY co REV. DATE: m EXISTING MAIN FLOOR PLAN CI SCALE: I/8" = I' TY D •RE AUG -13 -2007 O o" BUILDING PERMIT OF NO: TIGAR /79- � SITE �T�� — Gt�ViEW �r N SHEET TITLE • N Street Trees: isr Approved ❑Not Approved _L_ DRAWING INDEX Protected Trees: Approved ❑ Not Approved L�• SITE PLAN / 5W 5UMMERLAKE DRIVE A01 - SITE / EXISTING Notes: .•,. EXISTING SITE PLAN A02 - PROPOSED PLANS Revision 00 SCALE: I/8" = I' -a' NOT TO µ A03 - FOUNDATION, 1ST FLOOR & ROOF FRAMING ---,-- A' SHEET # N S1 - STRUCTURAL DETAILS A01 • CITY OF TIGARD SITE PLAN RE VIEW BUILDING PERMIT NO.: 015/0.1--, Not Approved PLANNING ba,ks: DIVISION: ❑ ve Required e Setbafks: Street Side: Rear Side: � 5 Ga • ge: Not Approved ,p 7 r :� o ►,�. � ce A oved ❑ i'leijrance: •ht feet ❑ No Yes See ic Provider er L uired: 0 Received 1 , 5c�v +tee Pr der Letter ReQ 11.1-/-01 Date: 4k(f�0k •` N IN DEPARTME ❑ Not Approved Ac Actual e: % ' Approved i N ot Approved A ctual n: &APProv e: t Site Plan: Date: 4