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Permit CITY OF TIGARD MASTER PERMIT !E • ' COMMUNITY DEVELOPMENT Permit #: MST2012 -00227 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/30/2012 Parcel: 1S 136CA08900 Jurisdiction: TIGARD Site address: 11049 SW LEGACY OAK WAY Subdivision: WHITE OAK VILLAGE Lot: 10 Project: White Oak Village, Lot 10 Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 690 sf Basement: 0 sf Left: 3 Parking Spaces: 0 Height: 32 Bathrooms: 3 Second: 950 sf Garage: 193 sf Front: 10 Smoke Dwelling Units: 1 Third: 520 sf Right: 3 Detectors: Yes Total: 2160 sf Value: $232,946.80 Rear: 13 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 0 Drains: Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Dra Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Drywell- Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0-200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 3 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All 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 2160 Owner: Contractor: WESTLAND INDUSTRIES INC WESTLAND INDUSTRIES Required Items and Reports (Conditions) 11036 SW LEGACY OAK WAY 12670 SW 68TH AVE STE #400 1 Ersn Cntrl 503 - 639 - 4175 TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 -572 -0746 PHONE: 503 - 780 -0626 FAX: 503- 598 -9081 Total Fees: $17,590.65 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 • • - • , with approved plans. This permit will expire if work is not started within 180 days of is • -nce, • if work is suspended for more the 180 days. A r ENTION: Ore• • law requires you to follow the rules adopted by the Oregon Utility Notific• ion Center. Those rules are set forth in OAR 952 -001 1010 t T ough OAR 9 2 -• • -• • • You may obtain a copy of the rules or direct questions to OUNC by calling 63.232.1987 • r .23• Issued B . ` Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available in - • ection date. This permit card shall be kept in a conspicuous place on the Job site until completion of the p oject. Approved plans are required on the job site at the time of each inspection. Building Permit Applical Residential . EIVED FOR OFFICE USE ONLY .. _ ° City of Tigard 3 �'. ' I U 2012 Received p ` Date/By: C r / l /9 - I Pennit No.: "7: e 2 3 - 13125 SW Hall Blvd., Tigard,, Plan Review / q C1 bI Other Pennit: ��/2 Phone: 503.718.2439 Fa i I . : MD iIGARD Date /B 41 � ' ]uric: 0 See Pape 2 for TI GARD Inspection Line: 503.639.4 I LDINGDV ON Date Ready /By: Supplemental Information Internet: www.tigard- or.gov YISIO Notified /Method: 0 1 °oke al AM -4 /e/aN'[I2 TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING � ❑ Demol Permit fees* are based on the value of the work performed. [� �Iew construction Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the ❑ Addition /alteration/replacement ❑ Other: work indicated on this application. CATEGORY OF CONSTRUCTION - L� UV Valuation: $ Z� (� [ 1- and 2- family dwelling ❑ Commercial /industrial , Number of bedrooms: ❑ Accessory building ❑ Multi- family d Number of bathrooms: , `,5 El Master builder ❑ Other: JOB SITE INFORMATION AND LOCATION Total number of floors: / l New dwelling area: r /1 V square feet Job site address: /l9(� S0/ ofc y Q - / . / 7293 Garage/carport area: / y3 square feet 52O City/ State/ZIP: -176. �-�''� &,4- g' 3 Suite/bldg. /apt. no.: Project name: / O `f /C 4. fish- Covered porch area: IV/ square feet C fc, Cross street/directions to job site: Deck area: square feet Vil-0 „ff Other structure area: Z3-5 j square feet 3__ REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: /.a f(e U G 4.. Lot no.:l Permit fees* are based on the value of the work performed. p Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: /s' / 36 CSI 0 t� 6 equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. _ ! l Valuation: $ /�� �� �,�/ S /'4` 4/4 �� � Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone: ( ) / Fax: ( ) New: (jJ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: /JC r � //J _/A:/f) ,/ '7 72 4 5 /At Structural plan review fee (or deposit): Contact name: /206 4 eso'2 / .ham 5 Ve /Xt- FLS plan review fee (if applicable): Address: �� 7 ` j 57,,) 6,9 721- �!! �� Total fees due upon application: City/State/ZIP: -------•- 6 /2 9 7 z 23 9 Amount received: Phone: (0_3) 5-7.2_.-671/6 I Fax: 6.03 ) 6.---906( t PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E- mail: .. .;;-i J raei 2 .6 064* /z , CSI /i/ Commercial and residential prescriptive installation of CONTRACTOR /ff `� roof -top mounted PhotoVoltaic Solar Panel System. � �l�i`-i `� • Submit two ar sets of roof plan with connection details Business name: and nd fire department access, along with thn 20 e 2010 Oreg c r3 Solar Installation Specialty Code checklist. Address: � - 2-6,7 0 �j�� C j? T� Permit Fee (includes plan review $180.00 City/State /ZIP 1 7 �� and administrative fees): 17 Phone: �) I Fax: ( 9 , v -���} I State surcharge (12% of permit fee): $21.60 CCB lie.: , t )`) Total fee due upon application: $201.60 This permit application expires if a permit is not obtained Authorizes • •�ei _ � within 180 days after it has been accepted as complete. Fee methodology set by Tri-County Building Industry nt nan1 y c- 6 ,r Date: .7/ . ( '� Service Board. 1• \R;,ilrlino \Pe n s \BUP- RESPennitAnp.doc 02/24/2011 440- 4613T(I1 /02 /COM /WEB) Plumbing Permit Applicatio 'ED • .,, , Building Fixtures A (IG FOR OFFICE USE ONLY City of Tigard 3 U 2012 D g gd/ . r Permit No.W OT`1o / a-Gb?„9'7 a 13125 SW Hall Blvd., Tigard, 0 9 'YOFTI Plan Review Other Permit Nn.: Lap /a_�r�3 C '. Phone: 503.7182439 Fall 509 D ate/By. 2 for TIGAitD InspectionL;ne: 503.639.4175 G DIVISION DateReadyBy: row I 1 SeePa�hrllnformation Internet www.tigard - orgov Notified/Method • TYP1 OF IOW • BEE ; SCHE 11JLE For special infounation use checklist C New construction ❑ Demolition Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other New 1-2-family dwellings (includes 100 ft for each utility connection) CATSGORY•OF'CONSTRUCTIOK :`:. -; : • •--- - SFR (1) bath L t 312.70 • � 437.78 SFR (2) bath 111...L- 2- family dwelling ❑ Commercial/industrial q 500.32 SFR (3) bath ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder - ❑ Other: Fire sprinkler ( _ sq. ft.) Page 2 • - . JOB S1TE.INBORMATIOJF A1) LOCA.TON . Site utilities: r r - u9 Catch basin or area drain 18.76 Job site address: /f, ,-- ir trench drain 18. City/State/ZIPP: ] 't . i , l �lhr � Footing drain (no. linear $: __) Page 2 Suite/bldg. /aptno.: Project name: I r 41 ; • l 2? Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 1836 Rain drain connector 18.76 Sanitary sewer (no. linear 1: j Page 2 Storm sewer (no. linear ft: _, / Page 2 Water service (no. linear $: _) 1 I Page 2 Subdivision: (( a Ili,. L Lot no.: k, Fixture or item: Tax map /parcel no.: /5 17, J�� Backflow preventer 31.27 ; e. 0 y t `t' 12.51 a Backwater valve DESCRIP OF W • RK • Clothes washer 25.02 ,./ i "-*._/.' y / . D" <4Z.C� 'i1 /IJ"G 471 Dishwasher �( 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 • ❑ PROPERTY OWNER t] TENANT Expansion tank 12.51 • Fixture/sewer cap 25.02 Name: -- Floor drain/floor sink/hub Address: - Garbage disposal i 25.02 City/State/ZIP: Hose bib 7- 25.02 Phone: ( ) Fax: ( ) Ice maker ( 12.51 rE APPLICANT ❑ • CONTACT PERSON Interceptor/grease trap 25.02 Business name: i F A6 f et Medical gas (value: $ ) Page 2 /=�i� Primer 12.51 Contact name: t i 3. / Vi r C Roof drain (commercial) 12.51 Address: 6 js � /y Ag Sink/basin/lavatory 25.02 City /State /ZIP: et i' Oi-- / Solar units (potable water) 62.54 Tub/shower /shower pan 12.51 Phone: ((Sin gti _ N2io Fax:: ( -9 Urinal 25.02 E-mail: ye 1 [aJ i - , iAl 1C I . 1 _ IA 25.02 Water closet CONTRACTOR Water heater i 37.52 Business name: /60 i t..-4‘,/4 J (r 11 h L Water pipmg/DWV 5629 Address: - er- Alp j Other. 25.02 City/State/ZIP: 41 ■ d 4 -01) Subtotal rte( Minimum permit fee: $72.50 Phone: ( • ) Fax: ( ) �� Plan review (25% of permit fee) CCB Lic.: / l it s , Plumbing Lic. no.: 3 4 - A S State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE p ir �1M et This permit application expires if a permit is not obtained within 180 days Print nam i t _ . I ( Date: 1 • • alter it has been accepted as complete *Fee methodology set by Tri- County Building Industry Service Board. L\ Building \Permits\PLMU- PerndtApp.doc 10/01/09 440 .4616T(10102 /COM1Win) Mechanical Permit Applicatio FOR OFFICE USE ONLY City of Tigard Date/By: ■ MO Permit No.: N ti '}..ee2a 74 't 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit: 4,010/A- 4 00/g3 Phone: 503.718.2439 Fax: 503.598.1960 _AUG 2012 3 Q Date/By: T14JtRD In Line: 503.639.4175 Date Ready/By: runs: H See Page 2 for Internet: www.tigard or.gov CITYOFTIGgDn Notified/Method: Supplemental Information BUILD[NC� � TYPE OF WORK COMMERCIAL FEE* SCHEDULE - iJSE:CHKLIS ECI Mechanical permit fees* are based on the value of the work • Tew 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: $ • . CAT OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES *' • [ 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family 0 Master builder 0 Other: Description Qty. 1 Ea. 1 Total Heating/cooling: • JOB Sl INFORMATION AND LOCATION Air conditioning Job site address: /fJj � 11 ment) 46.75 (requires site plan showing place s �ssL� � Furnace 100,000 BTU (ducts/vents) ents) 46.75 City/State /ZIP: i ( ') f 7 ' Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: Project name: CU-i (N. V i 1 E l't Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: i- v 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 Flue /vent for any of above 23.32 Subdivision: (itwri. r - / f -�' Lot no.: /O Other: 23.32 Tax map /parcel no.: f - 13( lift 4 e 6 Other fuel appliances: DESCRIPTION OF WORK Water heater t 23.32 Gas fireplace 33.39 /? e)]: j ®a/ ;- a ' 5 t ft. Flue vent for water heater or gas � / ` "` ` tom • fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney/liner /flue /vent 23.32 ❑ PROPERTY OWNER ❑ TEN Other. 23.32 Name: • Environmental exhaust and ventilation: Range hood/other kitchen i Address: equipment t 33.39 City/State /ZIP: Clothes dryer exhaust f 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 5 23.32 Attic/crawlspace fans 1 23.32 APPLICANT • ❑CONTACT PERSON 23.32 Other: Business name: A . ` . V• . Fuel piping: Contact name / • � P ` 'i , / 1 $14.15 for first four; $4.03 for each additional Furnace, eta I Address: t 6 P`) Gas heat pump City/State /ZIP: 1L t � Walllsuspended/unitheater Crn 525 Phone: ) Y1 2,,_ ( 1 bb : ( � F 9 ? f Water heater � f , / r /� /1, Fireplace I. E- mail: -q� e. lq'j'{ITF .(- >� r� J ` • - `' i1 - A Range i `- CONTRACTOR Barbecue Business name: 1 e' 4 f _ ■� ��r.� �M • 61 ' T7 )(i Other. 1 Address: r MECHANICAL PERMIT FEES* • Subtotal City/State /ZIP: Q C6 Minimum permit fee ($90.00) Phone: ( c02-; Fax: ( ) Plan review (25% of permit fee) CCB lic.: i 1 q 7 /) A1[ State surcharge (12% of permit fee) `� f TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. t * Fee methodology set by Tri -County Building Industry Service Board Print name: 1'r Date:. .� n • )� 440.4617T(t1 /02/COM/WEB) Electrical Permit App1i + 'i,i ` :r. EIVED FOR OFFICE USE ONLY ve Received 1 Permit No.: 9 City of TigaTigard D 4- / - r,9D /2l 7 Ill = ° 13125 S Hall Blvd., Tigard,01 M233 0 2012 Plan Review Other Permit . l o/ j /g3 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: runs: l7 SeePage2for T1GARD Inspection Line: 503.639.417EnI' / �'�IGARD DateReadyBy: I Supplemental Information Internet www.tigard - or.g SIO *' N B UILDINGDIVI. Pt : _ P»v .. - TYPE OF WOR - - : - . • . - . Please check all that apply (submit 2 sets of plans wfitems checked below): New construction ❑ Addition/alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. exceeds 10,000 amps at 150 volts or ❑ Floating buildings. CATEGORY OF. CONSTRUCTION. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ['Fire pip ❑installation of 75 R:VA or • El Mult - family ❑ Master builder ❑ Other: 0 Emergency system. larger separately derived system. • JOB SITE INFORMATION AND LOCATION . , • . ❑ Addition of new motor load of GI "A" , "E ", "12 ", "1 -3 ", 100HP or more. occupancy. Job no.: • Job site address: PY9,it L - -t f O l ❑ Six or more residential units. ❑ Revehicle packs. / et? 7.-2...% Health -care locations. ❑ Supply voltage for more than City / State/ZIP: 7 i�� ❑ Hazardous locations. 600 volts nominal. Suite/bldgJapt no.: Project name: f � ❑ Service or feeder 600 amps or more. . /,�lT - y (/ �� FEB SCHEDULE • Cross street/directions to job site: Descripti I Qty. I Fee. I Total 1 . New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: 011-g �� L.'r Lot no.: Id 1,000 sq. ft or less I 168.54 4 / � 13d �f} p d 7 � Ea. add'1500 sq. ft orportion -5 33.92 1 Tax ma p P arce no.: / U Limited energy, residential 75.00 2 DESCRIPTION OF WORK. v (with above sq. ft) Limited energy, multi - family 75.00 2 .1)5 rG � /l 5 // fig residential (with above sq. ft) 7 �/V /- JG/'/J � 1T�1 $ or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 201 am to 400 amps 13356 2 ❑ PROPERTY OWNER ❑ 'TENANT 401 amps to 600 amps 200.34 2 Name: - 601 amps to 1,000 amps 301.04 2 • Address: Over 1,000 amps or volts 55226 2 Temporary services or feeders installation, alteration, and/or City /State /ZIP: relocation 200 amps or less 59.36 1 Phone: ( ) Fax: ( ) 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 16554 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with above service or feeder fee, • 7.42 2 APPL 0 CONTACT PERSON each branch circuit r- B. Fee for branch circuits without Business name: � rL1/�1 �/QU57"c2/� s service or feeder fee, fast 56.18 2 Contact name: gob A flasd.(] /j ,,- 7/,�D2, branch circuit E ach addl branch circuit 7.42 2 Address: /d - 6 «7I 5 A9- Aft✓ $U ire- 4 7 Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City / State/ZIP: • / ©e - 6 / 7 7,3 3 dwelling, service and/or feeder 67.84 Reconnect only 2 Phone 5 ) t 1 7L�[,� Fax:: (�0 j )�j� g / Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy 2 • c panel, alteration, or extension. Page 2 Business name: GG e_ ( r o e / O ,I 1' 5 Each additional inspection over allowable in any of the above Address: / f3 5f, ,23 ! Additional inspection (I hr min) 6625/ hr Investigation (1 hr min) 6625/ hr City/State/ZIP: - Ain&sCe./.5 : ' #d& ,9 7(9,e ` Industrial plant (1 hr min) 78.18/ hr Phone: Cs) ) 35 — 6 /eq Fax: ( g7 'i) 7 E - 01.60 Inspections for which no fee is 90.00 / hr specifically listed (% hr min) CCB Lic.: it ( 9._ Electrical Lic.: 26. VC Suprv. Lic.:= . f S ELECTRICAL PERMIT FEES 1'' Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: --- / Dater •1,b a I 1,,,O'' State surcharge (12% of permit fee): TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: - Date: * Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 07/01 /10 440 -4615T(11 /05 /CONU"EB 1111 ° Building Division Development Code Provision Review T I G A ►t D Residential Projects Building Permit No: N )r.90/ CWS Service Provider Letter Received: Yes ❑ No ❑ N /A" Routed Plans: d Original Plan Submittal Date: D( 1st Revision Submittal Date: ❑ Site Plan Only 2 °d Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) 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 uhery I Ca. ()es at 503 -718- ?437 or C* er1-1 C.- @tigard- or.gov) Land Use Case No. - Pt) era -0 Name I411k I ikl•A9'P it Zoning R - t?. "P D Setbacks: Front I t, Rear i 3 7 Side 3 e4^ Street Side — Garage ?© Maximum Building Height 35 Actual Building Height p r Visual Clearance ciit Easements • 0 Sensitive Lands Type: N/A • Notes: + S: de yQiei. v ) / e« Ok-a7 b/G X 1 0 -1- o-- Original Plan: Approved, Not Approved ❑ - Date: . 1 — y 1 a 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) .l f Actual Slope: l J Notes: Original Plan: Approved,Z Not Approved ❑ Date: * Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 cAOtvN n City Arborist Review (contact : _ _ ! ! ` : _ : ^ = : ) ,n Street Trees S . Protected Trees Notes: Original Plan: Approved tie Not Approved ❑ Date: ` r' y - Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or abert @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 Applic nt Okay to Issue Permit: Yes Date Routed to Building: 4 ? Page 2 of 2 ■ ‚ Ti ' III Z NOM _....l Wire How Mil SE Mi'v■it Ave SITE PLAN NOTES: a,:t CA 9.771,2 A n � min.. R(T =rCOUnZCS.I L ALL EXCESS GRADING MATERIAL TO BE EXPORTED TO AN APPROVED DISPOSAL \ 13 I 1��3 2 \ A 111_ 10 11/32" LOCATION. �f 2. ALL FILL AREAS 1s- UNDER GARAGE BOORS, SIDEWALKS, DRIVEWAYS, ETC.. TO BE V J (� COMPACTED GRANULAR FILL. V J N R THERE 3. D ILLL 9TIRUCTURE. OVER EXCAVATION TO PROVIDE CONCRETE FORMING ALL EE 0.0 ' n e N 4. PROVIDE COUNTY /CITY APPROVED SEDIMENT FENCING AROLND EXCAv4TED AREA O 3•mm LL EE. � •m 1 1 1 1 PRIOR TO EXCAVATION AND CCNSTRUCTIOK la I (, I W/-) T -� PLYWD �I v O SAN. SEWER LINE I Z y 5. PROVIDE COUNTY /CITY APPROVED STABILIZED GRAVELED CONSTRICTION ENTRANCE OV R ye s W/ Q O Cn Ll PRIOR TO EXCAVATION AND CONSTRIGTIONL H M 4 -- O P .V.G. WATER MAIN 6. STOCKPILES MUST BE COVERED WITH OR PLASTIC 96IEEtING BETWEEN 2 n CAL > V c OCTOBER I AND B 30. CAMBRIDGE ^ B 4 ix 1. CONTRACTOR/ SUB-CONTRACTOR TO VERIFY C LOA7101J OF ALL UTILITIES PRIOR TO 1 X � 1 _.l EXCAVATION AND CONSTRUCTION. TREE 8. Bcu1D4RY AND TOPOGRAPHY INFOrd1ATION NA9 BED -I'1 PROVIDED TO SKYLINE FIOI•IES N. �3.: PLAN 3044 A � '6'" z = p DESIGN DE9 INC. SKYLINE HOI'IE9 AND DESIGN. INC., IN WILL NOT BE HELD LIABLE FOR THE \ Q ACCURACY CF THIS INFORMATION. IT 15 THE SOLE RESPONSIBILITY OF THE CONTRACTOR 2 SQ. FT \ /OWNER TO VERIFY ALL 917E CONDITIONS INCLUDING FILL PLACED ON SITE. 0 1- N 3 ED FRi I —\ r / i 5. TOPOGRAPHY ELEVATIONS WERE COLLECTED FROM ACTUAL SITE SURVEY. N N �. `X �� 1 � _ = Cl _, (y I0. ELEVATION LEGEND: _ O }—{ ' ` ,L EE• EXISTING GRADE ELEVATION / qo CON 0 N v h' FE. FINAL GRADE ELEVATION I�X , FIN. � FFE• FINISHED FLOOR ELEVATION ��ll 1 V G A er p fRf VE a ~ / 11V- 1' II. PROVIDE A MINIMUM GRAVEL BASE UNDER ALL DRIvEWAT AREAS. c� 12. PROVIDE A 4' MINIM3M GRAVEL BASE UNDER ALL SIDEWALK AND PATIO AREAS. 2 2. 18 1 Q N R UN G. PIPE ALL 9TO1 DRAINAGE FROM THE BUILDING TO A COUNTY /CITY DISPOSAL % W/ F1 r2E RA T=2 PLYWD. _ GA LINE _ FONT /CONNECTION. 1 \/ j �' ■�\ I,yA ■ / 14. MAXIMUM SLOPE OF CUTS AND FILLS TO BE TWO (2) HORIZONTAL TO ONE (I) J` - x VERTICAL FOR BUILDINGS. STRUCTURES, FOUNDATIONS, AND RETAINING WALLS. , 3. �1 B. PROVIDE AND MAINTAIN FINISH GRADE WITH POSITIVE DRAINAGE AWAY FROM EE. 0.0' EE. 0. 01 STRUCTURE ON ALL SIDES WITH A ELOPE OF 5' MINIMUM IN 10 -0'. IMPERVIOUS AREA'S: n \ n \ 11 i• 160 S0. FT. DRIVEWAYS 13'-0" 0 20'4?) 1/32 IS S0. FT. PORCH 32 SO. FT. WALK FIN. OOF 100 PATIO 10 -1 150 50. FT. OVERHANGS 825 50. FT. BUILDING COVERAGE 1,286 TOTAL SQ. FT. IMPERVIOUS AR ) :IN .PI.ATE LOT I1�ORMATION: EROSION CONTROL PLAN LOT AREA: 1,880 SC. FT. PLAN ff�- 0 IMPERVIOUS COVERAGE: 1.286 SC. FT. BUILDING COVERAGE: 61 % COVERED STOCKPILES �� WOODEN CURB RAMP DRAWN: No . : 1-2 34 -204 T.F. BUILDING HEIGHT: APPROX---- 31' -0' DATE: MIN. BUILDING SETBACKS: I1.5' FRONT, S REAR. 3' SIDES. `SALE' x SEDIMENT FENCE 0 CATCIH BASIN PROTECTION FILE: 3054 - 0 s 3 j CONSTRUCTION ENTRANCE N. B. . COVER ALL AREAS OF BARE LOT 10 PLOT SOIL UNTIL PERMANENT LANDSCAPE PLAN 15 IN PLACE WHITE OAK VILLAGE D WORK STAGING/ MATERIAL STORAGE TIGARD, OR a 7 I FIN. ROOF 0 0 O. . ri a Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, 46 /✓D asD /l) , am the general contractor or the owner- builder at the following address: Site Address: RC // 54 / O M4- y City: Permit #: A5T — a607-7 Subdivision/Lot #: / l 1 � /� ? , �� /07-- and/or # /O l�" (y ��-- U/ Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture - sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: ;` Date: 3 (— /3 � IF al Contractor or Owner- Builder I:\Building\Form RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: fr72 _ n7 7 Jurisdiction: e - 7 - 6 fe z Site Address: / /D � �f c L c y Z(X Subdivision/Lot #: U� / f a �'� // /L,G4 .i and/or Map and Tax Lot #: By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) 411 A Signature: W'• Date: 3 - / / 3 er /Genera Contractor /Authorized Agent Print Name: AAio ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. I:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 STREET TREE 2.. TIGARD CERTIFICATION I, / 4z/0,72,0,v , r owner/ a ent o ArcriWO a �_ri2(ES , g f (PLEASE PRINT) (PERMIT HOLDER) do hereby certin that the following location meets City of Tigard land use and development standards for street tree installation and is consistent with the approved site plan. PERMIT NO.: M$7O/? SIT E ADDRESS: //aq y aebt %/ ay SUBDIVISION: G / f/L_GIK-f_____ LOT #: l O SIGNATURE: DATE: 3-/ (OWNER/AG RECEIVED & VERIFIED BY: � DATE: j_ c- (3 (CITY OF TIGARD) ❑ Tree location verified per proved site plan. I: \Building\ Forms \StreetTreeCertificate 05/30/2012 Program Use Only ; Form 640S FastTrack ID Completion Certification —Site Inspection Energy rust New Homes Program — Single Family Data check by of Oregon (initials) To be completed by verifier Portland Energy Conservation, Inc. (PECI) is a Program Management Contractor for Energy Trust of Oregon. First Inspection Second Inspection Date: 1 -3 -12 Verifier Name: preston kuckuck Date: 3 -1 -13 Verifier Name: preston kuckuck Incentive Payee Company Name: Builder or Company: Westland industries Contact Name: Performance Testing Company: Fireside Home Solution Technician Name: Site Information Development Lot Number: REM/Rate SCO Project ID: Name: white oak 10 File #. (required roject is project ENERGY STAR Site Address: 11049 SW white oakiaage cit Tigard State OR Zip: ❑ Unattached ❑ Attached Number of Stories: l c Total Building Square Footage: 2183 Number of Bedrooms 3 sement ❑ None ❑ Full Basement ❑ Half Basement XXJ Crawlspace Type ❑ Garage/basement combo ❑ Slab on grade ❑ Other Electric Provider [ PGE ❑ PAC ❑ Other: Gas Provider l NWN ❑ CNG ❑ Other: Electric Meter Number: 27123604 Gas Meter Number: (must apply to permanent meter) (must apply to permanent meter) 42400215 Additional Project Information (please mark all that apply) ❑ Code plus Best Practices (meets minimum Best Practice requirements with improvements above code) Ig Path 1 EPS Best Practices ❑ Path 2 ENERGY STAR ❑ Envelope Upgrade ❑ Ducts & HVAC Equipment Inside © Equipment Upgrade ❑ Path 3 ENERGY STAR with ducts inside ❑ Path 4 Performance Plus with ducts inside ❑ Path 5 Advanced Performance ❑ Zonal Electric Efficient ['Advanced Electric Resistance ❑ Solar Electric (PV) ❑ Solar Water Heating (SWH) ❑ Small Wind Renewable ❑ Solar Ready Electric (SRPV) ❑ Solar Ready Water Heating (SRWH) Energy ❑ Qualifies for Solar Ready Incentive (must attach checklist) Solar Installer: Name: Company: Low Income ❑ Yes ® No Does this project qualify as Low Income? (must provide documentation from builder) Accessory ❑ Yes © No Is this home an ADU? Dwelling Unit ❑ Yes `X No Is the ADU separately metered? If so, provide meter numbers above Other ❑ Earth Advantage — Certification Level: Certifications ❑ LEED -H - Certification Level: ❑Other (please specify): Form 640S v10 120101 Page 1 of 3 Return completed form to: Energy Trust New Homes Program —Single Family 100 SW Main Street, #1600 *Portland, Oregon 97204 1.877.283.0698 o Fax 1.855.575.4315 newhomes @energytrust.org Form 640S .i■ Completion Certification —Site Inspection EnergyTrust New Homes Program—Single Family of Oregon To be completed by verifier Portland Energy Conservation, Inc. (PECI) is a Program Management Contractor for Energy Trust of Oregon. Verification Type Actual Value Equipment Details & Notes Category Insulation Flat Ceiling R- 49 Insulation Type: bib Framing Type: Vaulted Ceiling R- 38 Insulation Type: Batt ❑ Standard Scissor Truss R- Insulation Type: Intermediate Above Grade Walls R- Insulation Type: bib ❑ Advanced 23 Framing Below Grade Walls R- Insulation Type: 30 Size: Floor Over Unheated Space R- Insulation Type: bait Floor Over Garage R- Insulation Type: Slab Floor (unheated) R- ❑ Full Slab ❑ Perimeter Doors Door R- Windows Windows U- • SHGC: 3 0 Window Frame Material: vinyl Skylights U- SHGC: Window Area (Glazing) % Total window area: Lighting Indoor and Outdoor 80 % # fixtures: 32 # of ENERGY STAR fixtures or CFLs: 26 Appliances ENERGY STAR Dishwasher N1 Yes ❑ No EF Cooling Air Conditioning SEER: Btu /Hr: None Primary Heat Fireplace AFUE: 95.5 Brand: fraser johnston Outdoor Unit (for heat nil Source Gas Furnace pumps) ❑ Electric ❑ Boiler HSPF: Model #: TG9S060A 1 OM P 11 A Model #: a Gas Heat Pumps: SEER: Serial #: W 1 h2121767 ❑ Other: ❑ Air Source (ducted) COP: Btu /Hr: 60,000 Serial #: ❑ Mini Split (ductless) ❑ Ground Source Location: ECM: ❑ Yes tI No Heat pump commissionin ❑ Radiant Floor Heat � C report attached or commissioning ❑ Cadets Electronic Air Cleaner: ❑ Yes Ej No cond confirmation for ground ❑ Zonal Backup fuel: ❑ Electric ❑ Gas ❑ Other source heat pumps that ❑ Other: space X manufacturer's start up procedure was performed 0 Additional notes on primary heating: Notes on secondary heating: Water Heater ❑ Storage Gallons: Brand: ❑ Electric K®(Tankless Rinnai A=I Gas EF: 82 Model #: RI., 751 Location: Serial #: Dg.ca- 066309 cond space Btu /Hr: 180,000 Form 640S v10 120101 Page 2 of 3 Return completed form to: Energy Trust New Homes Program — Single Family 100 SW Main Street, #1600 • Portland, Oregon 97204 1.877.283.0698 • Fax 1.855.575.4315 newhomes@energytrust.org /o Lf S i,< « Lt 6-4c/ c/4-tC Form 640S 7 / \ Completion Certification —Site Inspection EnergyTrust New Homes Program — Single Family of Oregon To be completed by verifier Portland Energy Conservation, Inc. (PECI) is a Program Management Contractor for Energy Trust of Oregon. Verification Type Actual Value Equipment Details & Notes Category Ventilation Energy Trust Mechanical ❑ Exhaust Meets Energy Trust Mechanical Ventilation Requirements System Ventilation Requirement ❑ Supply /Yes ❑ No {Exhaust & Supply Cycler ❑ Heat Recovery ERV/HRV Model #: Ducts ❑ Ducts Inside % ducts inside: Ducts in Conditioned Space If claiming incentives for ducts inside, check one of the following: +Ducts Tested ❑ Visual Inspection per RTF specs Duct Insulation R- 8 Duct Location 50 attic 50 cond space Duct Sealing w/Mastic Paste Yes ❑ No Performance Testing & Duct System Information Ducts Duct leakage must not exceed 0.06 CFM @50 x floor area, or 75 CFM @50, whichever is greater. When tested without the air handler, leakage must not exceed 0.04 CFM @50 x floor area, or 50 CFM @50, whichever is greater �Multiple tests may be required. }}y( Duct Cubic Feet Per Minute Duct Leakage Air Handler In [? Yes Air Handler Present Q Yes Leakage: (CFM) @ 50Pa: 119 ass ❑ Fail Conditioned Space ❑ No During Test ❑ No Fan Pressure ❑ DG3 Fan Ring Type ❑ 0 ❑ 2 Leakage Test Total Leakage Gauge 1](DG700 Pressure: (check one) ❑ 1 3 Method ❑ Leakage to Outside Duct Blaster Pressure Tap Location: Bath Area Tested: 2183 Location: Main return Whole House Air Changes per Hour Envelope Tightness Cubic Feet Per Minute Leakage: (ACH) @ 50Pa: 3.8 ff Pass ❑ Fail (CFM) @ 50Pa: 1 270 House Volume: 19647 09213 Practices Requirements «1( requirements tiMgeb2611206:Doeigiali Energy Performance Score) • Thermal Enclosure Checklist Complete i] Pass ❑ Fail Thermal Enclosure Checklist attached? ❑ Yes • Insulation Quality Inspection Performed In Yes ❑ No 4 (complete insulation verification section below) • Approved Mechanical Ventilation Installed I] Yes ❑ No 4 (complete mechanical ventilation section below) • Zonal Pressure Relief — All zones comply XJ Yes ❑ No If no, state reason for failure: • Combustion Appliance Zone Testing Net CAZ Pressure: Pa If not applicable, please explain: Dv (required) Forced air system operation must not depressurize Combustion Appliance Zone (CAZ) by more than 3 Pascals (Pa.) *AII shaded sections are required for Best Practices. Applications will not be processed without these sections completed. Technical Compliance Options (please list all that apply) If any values on this form do not meet Builder Option Package (BOP) requirements, please indicate which Technical Compliance Option(s) allow the variance and explain which component was traded. TCO #: Explanation: Additional Notes: Signature By my signature below, I certify that I have performed the tests as described, that the form is complete, and that all information on the form is accurate. Verifier Verifier D ate: Signature: Preston Kuckuck Name: Preston Kuckuck 3 -1 -13 Red Tag Inspection (if needed): Signature: Name: Date: Form 640S v10 120101 Page 3 of 3 Return completed form to: Energy Trust New Homes Program —Single Family 100 SW Main Street, #1600 a Portland, Oregon 97204 1.877.283.0698 • Fax 1.855.575.4315 newhomes @energytrust.org