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Permit %B /,� 4iLJ-f Q /6 C� MASTER PERMIT n CITY OF TIGARD IN @ COMMUNITY DEVELOPMENT Permit #: MST2009-00177 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/25/2009 Parcel: 2S112BD09000 4 - Jurisdiction: Tigard Site address: 7812 SW WEBBER LN LN Subdivision: BRITTANY MEADOWS Lot: 26 Project: Brittany Meadows Project Description: New SFR • BUILDING Floor Areas Required Setbacks Required Stories 2 Bedrooms 4 First 854 sf Basement. 0 sf Left 5 Parking Spaces 2 Height 24 Bathrooms. 3 Second 1252 sf Garage: 445 sf Front 15 Smoke Dwelling Units: 1 Third: 0 sf Right 5 Detectors Yes Total sf Value: $232,333 00 Rear 15 PLUMBING Sinks. 1 Water Closets' 3 Washing Mach 1 Laundry Trays 0 Rain Drain' 0 Catch Basins: 0 Lavatones 5 Dishwashers 1 Floor Drains. 0 Sewer Lines: 100 SF Rain Other Fixtures 0 Tubs /Showers: 3 Garbage Disp 1 Water Heaters 1 Water Lines 100 Drains: 1 Bckflw Prevntr. 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers 1 Natural Gas Heat Pump' N Hoods' 1 Other Units 0 Fum <100K 0 Vents 0 Woodstoves 0 Gas Outlets. 5 Fum > =100K: 1 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr 0 Ea add'I 500 sf 3 20 1 -400 amp: 0 201 -400 amp 0 1st W/O Svc/Fdr: Limited Energy 401 -600 amp: 0 401 -600 amp 0 Ea add'l Br Cir. 601 -1000 amp 0 601 +amp- 1000v: 0 1000 +amp /volt 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio 8 Stereo N HVAC' N Security Alarm' N Vaccuum System: N Garage Opener N All Other: N Other Description Ecompasmg N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) MORRIS WESTLUND PACIFIC LIFESTYLE HOMES 16615 MAPLE CIRCLE 11815 NE 99TH ST #1200 LAKE OSWEGO, OR Brush Prairie, WA 98604 PHONE 503 -601 -5041 PHONE 360- 213 -0864 FAX 360 - 574 -6401 Total Fees: $16,147.38 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503 246.6699 or 1.800 332.2344 Issued By: Permittee Signature: 1 � CITY OF TIGARD MASTER PERMIT 1111 • COMMUNITY DEVELOPMENT Permit #: MST2009 -00177 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/25/2009 Parcel: 2S112BD09000 ze s. /s£/L Jurisdiction: Tigard Site address: Subdivision: BRITTANY MEADOWS Lot: 26 Project: Brittany Meadows Project Description: New SFR BUILDING Floor Areas Required Setbacks Required Stones 2 Bedrooms 4 First 854 sf Basement 0 sf Left 5 Parking Spaces 2 Height 24 Bathrooms 3 Second. 1252 sf Garage 445 sf Front: 15 Smoke Dwelling Units 1 Third 0 sf Right: 5 Detectors. Yes Total: sf Value $232,333 00 Rear. 15 PLUMBING Sinks 1 Water Closets: 3 Washing Mach 1 Laundry Trays 0 Rain Drain 0 Catch Basins 0 Lavatories 5 Dishwashers 1 Floor Drains: 0 Sewer Lines. 100 SF Rain Other Fixtures. 0 Tubs /Showers 3 Garbage Disp. 1 Water Heaters. 1 Water Lines. 100 Drains: 1 Bckflw Prevntr 0 MECHANICAL Fuel Types Air Conditioning* N Vent Fans 5 Clothes Dryers 1 Natural Gas Heat Pump N Hoods: 1 Other Units. 0 Fum <100K 0 Vents. 0 Woodstoves 0 Gas Outlets: 5 Furn > =100K: 1 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less 1 0 -200 amp 0 0 -200 amp 0 W/ Svc or Fdr 0 Ea add 500 sf. 3 20 1-400 amp. 0 201 -400 amp: 0 1st W/O Svc/Fdr Limited Energy. 401 -600 amp 0 401 -600 amp. 0 Ea add Br Cir 601 -1000 amp 0 601 +amp -1000v 0 1000 +amp /volt 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo N HVAC: N Secunty Alarm N Vaccuum System: N Garage Opener: N All Other N Other Descnption: Ecompasing N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) MORRIS WESTLUND PACIFIC LIFESTYLE HOMES 16615 MAPLE CIRCLE 11815 NE 99TH ST #1200 LAKE OSWEGO, OR Brush Praine, WA 98604 PHONE 503- 601 -5041 PHONE 360 -213 -0864 FAX 360 -574 -6401 Total Fees: $16,147.38 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days ATTENTION' Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503 246.6699 or 1.800 332 2344 Issued By: nt f IA ‘f 5. f Permittee Signature: . (t ' Building Permit Application Residential RE --- FOR OFFICE USE OE) City of Tigard Date /B : Permit No • 1 . a� „i ° 13125 SW Hall Blvd., Tigard, OR 97223 S E P 0 12009 Plan Review • ' Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permi - _ O); 8 I - I O A It D Inspection Lme 503.639 CITY OF IGARD D. t R .d /B • ® See Page 2 for Internet: www.tigard- or.gov Notifies e thod O Supplemental Information BUILDING DIVISION ' - TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ® New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment,'matenals, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $135,000 ® 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: 4 ❑ Master builder ❑ Other: Number of bathrooms: 2.5 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: 1473•5 SIN ,?Ave t' 79 /a , GfJ f /cQ 4.4) . New dwelling area: 2106 square feet City/State /ZIP: Tigard Garage /carport area: 380 square feet Suite/bldg. /apt. no.: Project name: Brittany Meadows Covered porch area: 15 square feet Cross street/directions to job site: Bonita to 79th Deck area: square feet Other structure area: square feet — REQUIRED- DATA::COMMERCIAL -USE CHECKLIST-- Subdivision: Brittany Meadows Lot no.: 26 Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the.value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 2106 sq ft new single family home with attached two car garage Valuation: $ Existing building area: square feet New building area: square feet - ® PROPERTY OWNER _ I ❑ TENANT Number of stories: Name: Morris Westlund Type of construction: Address: 16615 Maple Circle Occupancy groups: City/State /ZIP: Lake Oswego Existing: Phone: (503)601 -5041 Fax: (503)601 -5042 New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: Pacific Lifestyle Homes, Inc. All contractors and subcontractors are required to be Contact name: Russ Tiedeman licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 11815 NE 99 St, Suite 1200 jurisdiction in which work is being performed. If the City /State /ZIP: 98682 applicant is exempt from licensing, the following reasons apply: Phone: (360) 852 -2827 I Fax: : (360) 574 -6401 E -mail: russt @pacificlifestylehomes.com CONTRACTOR Business name: Same as applicant BUILDING PERMIT FEES* Address: (Please refer to fee schedule) City/State /ZIP: Structural plan review fee (or deposit): 750. O Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: 19 s19- b a q • I d 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: A ll Tom. ��_ Date: € 0 /'� * Fee methodology set by Tn -County Building Industry / Service Board. 1.\ Building \Permits \BUP- RESPermitAppdoe 11/6/07 440-46 I 3T( I I /02/COM/WEB) ' . f -. 'Electrical Permit Application L ' D `- 7 , C ' Qr Ti III a Da 1 Penmt ::: .na zoo 1 ,L. 13125 SW Nail Blvd , Tignd, OR 97223 'c/D ived � I�t.Ia Rcyicl, r . Phone 503.639.4171 Fia 503 598.1960 Other Permit DatJDg _ — Inspection Lin: 503 639 4175 Dale Ready/B;,: 1 to I 0 See Page 2 for • - - Internet +vw+v.ligard- or,gut• Nonfiecllhlethod Supplemental Information TYPE OF WORK -- - - - -- - 7 I __ PLAN REVIEW - - ® New construction ❑ .Addition /alt ^raiton /repincemm�l I I'I•_. se cI c k an ILn ;.p,,i (subrou 2 sets of plants whim checked below) ❑ Service or feeder -100 aelns or inure ❑ Building over three stories ❑ Demolition ❑ Other: where the OctILIbht taut( carnal ❑ Manias and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps it 150 volts or ❑ I looting buildings less to ground, or caceeds 14.000 ❑ Commercial -use agricultural [Y! I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps For all taller installations. buildings ❑ Multi - family Q Master builder ❑ Other: ❑ lint pomp. ❑ Installation of KVA or - -! ❑ Emergency system. larger separately derived syIlcnl JOB SITE INFORMATION AND LOCATION I L] Addumu of no, motor lo id of ❑ " ,.• ..I_� Job no.: I Job site address: f LW IoW _ 71/ ^ ,r 1011P or more. oc - -.— __ - - a _ - - -�_ I SIN or Inore leoldetiCal non 0 Recreational +chicle park; City /State /ZIP: Tigard. OR ❑ health -cart fac,6ue.. G Supply voltage for more than i I Ilooaldous locations 600 volts nominal Suite/bldg. /apt. no.: Project name: Brittany Meadows L7 Service cm (ceder 600 amity or [note. -- -- -- FEE SCHEDULE Cross street/directions to ob site: Bonita to 79thi -- On. err 7,rwl 1 - ni't n - - �— - - -- 7'c;i residential single or multi- family dwelling unit. Includes attached 1,nrage. Subdivision: Brittany Meadow's - I ,,t no l 1, 0 00 sq. 0. or less _ I -15.15 •t 5. - - -- T:1.add'l500ss _ 0. or portion 33.40 100, 1 Tax map /parcel no.. Limited energy, residential 75 00 I 2 K DESCRIPTION OF WORK - (with above stk n.) _ -- — -- 1, I Limiled enemy, nu lti- family -- i — Single family new construction ?5 dU 2 rt:manual (with above ste 0.1 _� I L ' Services or feeders intitnlintlon, alteration, and/or relocation 200 a ;ape or less I 80 30 I 2 ® PROPERTY OWNER ❑ TENANT 1 "276F to -100 crop= - 106.85 2 Name: Morris Westlund - r � il01 amps to 600 amps 160.60 2 Gill amps to 1,000 amps 240 60 Address: 16615 Maple Circle Over LOCO imps or oohs 454.65 2 City /Stott /ZIP: Lake Oswego, OR Temporary services or feeders installation, alteration, and /or relocotnn _ __ Phone: (503)601 -5041 I Fax: (503)601 -5042 17-7, 00 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps m 400 ;:ups 100,30 intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 maps _ 133 75 _ Brnneh circuits _ new, alteration, or extension, per panel Owner signature: Date: -- -- -- - - --- A Fcc for branch circuits with Fe APPLICANT El ,CONTACT PERSON above service or feeder fee, G.h5 -- cacti branch circwt - Business name: Pacific Lifestyle Homes 13 Fee for brunch circuits without service or feeder fee. Contact name: Russ Tiedemun 46 85 _ first branch circuit Address: 11815 NE 99 St., suite 1200 Each ;WW1 branch circuit 6.65 2 -- - -- - -- - I M15ce)lancons (sOr or feeder not included) City /State /ZiP. Vancouver, WA 93682 ! �aci1 manuiiielwed 01 modular -- c+adtir',sr1 ^,ccnnc'or(cyder 90.90 3 Phone (360) 213 -0864 Fax: : (360) 574 -6401 ' -- __ J ___ - - - RL•conncci only 66.35 2 E -mail: russt@pacificlifestylehomes.com - - Pump or imgation tarctc 53.40 _ CONTRACTOR - I Sign or outline fighting - 53.40 - SJgncl citeuit(s) or limited Business name: Garter Electric energy panel, aherntion, or Address: 2920 SE Brookwood Ave, Suite A extension Describe Page 2 '- City /State /ZiP: l{illsboro,OR 97123 Erich additional insucclion over allowable in any of the above - - Per inspection T 61.50 Phone: (s(1 °� ) ( rr C '2 — F I C "z15 62.50 - i -' hrvcsli[!atiun perhour( hr n,m) CCB Lie.: 121159 Electrical Lie.- - 4 -30 • / S 'r-s ;..hic : 3707-5 Industrial plant per hour 73 75 � - 1',177 ,3A - -- -- ELECTRICAL RICAL PERMIT FEES Suprv. Electrician signature, required: :y 9r r' F - - - -- - ' : v _ Subtotal Print name: C n ( ! � r /! rl Dult: �} - Plan review (25 o1'permit fee): �� N r 1 -�.{ /�' I �4 �� / 0 State surchrugc (12r)6 of permit lee): Authorized signature ' � -- //-- ��--�� TOTAL PERMIT FEE. ��•••'' l'Iris permit application expires If u permit Is not oUlnd within IIID Print name: �� f • S / /f Date / / � g - do }s after It Iris been accepted at complete. ' Number of in•.pct buns allowed per permit I!IluildmCtl'cnuiist :LC•t'cnmtApp tnr 55/1 I ill - 16157(I I , 05 I CO\I OF11 Mechanical P.ermit °Application I:ol2 orrice usu: ()NIA City of Tigard R eceived Permit No - Date/By m • 2 ` 4 • . q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit I I G A It D Inspection Line 503.639.4175 Date Ready/By. Jura: ® See Page 2 for Internet: www.tigard -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: $ ® 1 -and 2-family dwelling RESIDENTIAL-EQUIPMENT / SYSTEMS' FEES* y g ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist. Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION = Heating/cooling Job site address: 14 SW °' 1St 2 d 8 t � Air conditioning heat pump q (requires site plan showing placement) 14.00 City/State /ZIP: Tigard, OR Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 1 17.90 17.90 Suite/bldg. /apt. no.: Project name: Brittany Meadows Gas heat pump 14.00 Cross street/directions to job site: Bonita to 79th Duct work 10.00 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. 14.00 Subdivision: Brttany Meadows Lot no.: 26 Flue/vent for any of above 6.80 ? Other. 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater ( 10.00 10,01) Gas fireplace 1 10.00 fb, CO Single Family New Construction Flue vent for water heater or gas 1 fireplace 10.00 Log lighter (gas) 10 00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ® PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 10.00 Other: 10.00 Name: Morris Westlund Environmental exhaust and ventilation Range hood/other kitchen Address: 16615 Maple Circle equipment I 10.00 1040 City/State /ZIP: Lake Oswego, OR Clothes dryer exhaust I 10.00 jD.OV Single -duct exhaust (bathrooms, Phone: (503- )601 -5041 Fax: (503)601 -5042 toilet compartments, utility rooms) 5 6.80 NOD ❑ APPLICANT 0 CONTACT PERSON . Attic /crawlspace fans 10.00 Business name: Pacific Lifestyle Homes Other. 10.00 Fuel piping Contact name: Russ Tiedeman $5.40 for first four; $1.00 for each additional Address: 11815 NE 99th St. Suite 1200 Furnace, etc. 5,q0 Gas heat pump City/State /ZIP: Vancouver, WA 98682 Wall/suspended/unit heater Phone: (360) 213 -0864 Fax: : (360) 574 -6401 Water heater I Fireplace I E -mail: russt @pacificlifestylehomes.com Range - CONTRACTOR ., - , Barbecue Business name. , (. t Li • • ui Clothes dryer (gas) • Other: Address: 22100 NE 237`" Ave , ' MECHANICAL PERMIT FEES* City/State /ZIP: Brush Prairie, WA 98604 Subtotal Minimum permit fee ($72 50) Phone: (360) 803 -4876 Fax: (360) 883 -2969 Plan review (25% of permit fee) CCB lic.: 173524 State surcharge (12% of permit fee) TOTAL PERMIT FEE Authonzed signature �/� — � This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name:js Tc 4� Date: O * Fee methodology set by Tn -County Building Industry Service Board 1 \Buddmg\Permas\MEC- PermnApp.doc 01/19/07 44 461 (1I /02 /COM/WEB) Plumlaing Permit Application Building Fixtures i= :. L FOR OFFICE USE ONLY City of Tigard S EP 0 9 2009 Received �f /�/+� �7 Date/By. Permit No • I t f• f2OO4 '�JI 1 I N a 13125 SW Hall Blvd., Tigard, OR 97223 v 0 Phone: 503 639.4171 Fax: 503 598 1 9607, i i, ' != ' i c P Review ., i�� p TE GARI)Date/By. Other Permit No. Inspection Line: 503 639.4175 l t 1= r i r �; . ' � ale.Ready / By• Juns. ® See Page 2 for TIGARD Internet. www.ti ard - or. ov PL ANNING / .ENCI NEE g g Notified/Method. Supplemental Information -. TYPE OF,' WORK FEE* ,SCHEDULE ® New construction ❑ Demolition For special information use checklist. Descnption I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 O I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 El Accessory building El Multi-family SFR (3) bath 399.00 39q ❑ Master builder El Other: Each additional bath/kitchen 45 00 Fire sprinkler ( sq. ft.) Page 2 . JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 7g/A co,,,, lom8a 40 Catch basin or area dram 16.60 City/State /ZIP: Tigard, OR Drywell, leach line, or trench dram 16.60 Suite/bldg. /apt. no.: I Project name: Brittany Meadows Footing drain (no. linear ft.: _ ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Bonita to 79th Manholes 16.60 Ram drain connector 16.60 Sanitary sewer (no linear ft.: _ ) Page 2 Storm sewer (no. linear ft.: _ ) Page 2 Subdivision: Brittany Meadows I Lot no.: 26 Water service (no. linear ft.: _ ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 " " " • DESCRIPTION • OF: WORK" - . Backflow preventer Page 2 Single Family New Construction Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ® PROPERTY OWNER I ❑ TENANT Drinking fountain 16 60 Ejectors /sump 16 60 Name: Morris Westlund Expansion tank 16.60 Address: 16615 Maple Circle Fixture/sewer cap 16 60 City/State /ZIP: Lake Oswego, OR Floor drain/floor sink/hub 16.60 Phone: (503)601 - 5041 Fax: (503)601 - 5042 Garbage disposal 16.60 ® APPLICANT + CONTACT PERSON - Hose bib 16.60 Ice maker 16.60 Business name: Pacific Lifestyle Homes Interceptor /grease trap 16 60 Contact name: Russ Tiedeman Medical gas (value: $ ) Page 2 Address: 11815 NE 99 St., Suite 1200 Primer 16.60 City/State /ZIP: Vancouver, WA 98682 Roof drain (commercial) 16 60 Sink/basin/lavatory 16.60 Phone: (360) 213 - 0864 Fax: : (360) 574 Tub /shower /shower pan 16.60 E - mail: russt @pacificlifestylehomes.com Urinal 16.60 CONTRACTOR ' Water closet 16.60 Business name: Malmedal Plumbing Water heater 16 60 Address: PO Box 207 Other: City/State /ZIP: Banks, OR 97106 Subtotal Minimum permit fee: $72 50 Phone: (503) 324 - 0759 Fax: (503) 324 - 0580 Residential backflow minimum permit fee: $36 25 CCB Lic.: 102535 Plumbing Lic. no.: 4509 JP Plan review (25% of permit fee) Authorized signature: ( m 1/ t 1 ( L 1 Q �,�` 1 Qi� State surcharge (12% of permit fee) V" TOTAL PERMIT FEE Print name: Russ Tiedeman Date: 9/1/09 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1 \Budding \ Permits \ELME - PermitApp doc 12/27/06 440- 4616T(10/02 /COM/WEB) F CITY OF TIGARD • SITE PLAN REVIEW BUILDING PERMIT NO.: 1157 00 (77 PLANNING DIVISION: Required Setb Q Approved ❑ Not Approved Side: S Street Side: Front. _.LC Ga age: ? Rear: Visual Clearance: [ Approved ❑- Not Approved Maximum Building Height SS feet , CWS Service Provider Letter Required: ❑ Yes ❑ No ❑ Received i ti : Date: `1/3 /o' ENGINEERIN DEPART ENT: Actual Slope:% Opproved ❑ Not Approved Site PI • A roved ❑ Not Approved By: IJZ. VJ Date: CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO: Street Trees: Approved ❑ Not Approved Protectec es: el Approved S Not , By: J / Date: / L Notes: _ Xt4" - tic e lotibi isyre. $7JC•, IktJ • • City Of Tigard; Oregon • 13125 Si Hall Blvd. • Tigard, OR 97223 • V Wednesday, December 16, 2009 << TIGARD, Pacific Lifestyle Homes 11815 NE 99th St., #1200 Brush Prairie, WA 98604 RE Transportation Development Tax (TDT) Refund. Permit No. MST2009 -00177 for 7812 SW Webber Ln. Brittany Meadows At the time the above building permit was issued you paid a Transportation Development Tax (TDT) fee of $4,599.00. Effective December 1, 2009, Washington County approved a Temporary Discount on TDT charges and has made that discount retroactive to July 1, 2009. The enclosed check represents a refund to you of the difference between your original TDT payment for your project and the new Temporary Discount charge. The amount of the credit refund is $920.00. Please call me at 503 - 718 -2426 if you have any questions. A t Shields Permits /Projects Coordinator 503- 718 -2426 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 I ° City of Tigard T I G A RD Accela Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Accela System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Pacific Lifestyle Homes, Inc. DATE: 12/10/09 11815 NE 99 St., #1200 Brush Prairie, WA 98604 REQUESTED BY: Dianna Howse AMS TRANSACTION INFORMATION: Receipt #: 175345 Case #: MST2009 -00177 Date: 09/25/09 Address /Parcel: 7812 SW Webber Ln. Pay Method: Check Project Name: Brittany Meadows EXPLANATION: Refund amount discounted for TDT per Washington County. - RE _ _ .: Pi � :;Fee' l escri tion :From Receipt Revenue Account >No: Refund ,.., ' >Exam p le:: 4 UILD 1 P.ermit Fee: 'Exainple::.2'.45'- 0000 - 432000 , , . $;Amount .. TDT - Transportation Development Tax 4050000 -43320 $920.00 TOTAL REFUND: $920.00 APPROVALS: If under $,5002 . Professional Staff If under $7,500 Division Manager If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board 1 . •...,, Refund Request Reviewed: Date: -? ..`, y _ B a7 ' Case Refund Processed: Date: ��` �B,G� A By: ,if•" e *- -7 7r 1: \Building \ Refunds \RefundRequest.doc 04/13/09 CITY OF TIGARD RECEIPT . 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD f r • Receipt Number: 176350 - 12/18/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID M ST2009 -00177 $ - 920.00 Total: $- 920.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check —402-149 4:7 DHOWSE 12/18/2009 . $- 920.00 Payor: ..Keystone-Deaelepment-- ( f r c:� G / : u r . . - d�G •, - /' " .S ,Vu • Total Payments: $- 920.00 Balance Due: $920.00 Page 1 of 1 "'--• '�:; CITY OF TIGARD RECEIPT • _ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARti. /,.,.(. rk' •, Receipt Number: 175345 - 09/25/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID • MST2009 -00177 Building Permit 2300000 -43104 $1,372.77 MST2009 -00177 Water Quantity - Res 5200000 -43122 $275.00 MST2009 -00177 CDC Plan Review, RES 1003100 -43112 $46.00 MST2009 -00177 CDC Plan Review, RES - LRP 1003100 -43117 $6.00 MST2009 -00177 12% State Surcharge - Building 1003100 -24001 $164.73 MST2009 -00177 Metro Const. Excise Tax - Residential 2300000 -24011 $278.80 Use MST2009 -00177 Tig -Tual School CET - Residential 2300000 -24102 $2,106.00 MST2009 -00177 Park - Single Family Unit . 4250000 -43300 $5,370.00 ^`y MST2009 -00177 TDT - Transportation Development Tax 4050000 -43320 $4,599.00 <_ MST2009 -00177 Erosion Control 1003100 -22002 $88.00 MST2009 -00177 Erosion Plan Review CWS 1003100 -22003 $28.60 MST2009 -00177 Erosion Plan Review COT 2300000 -43102 $28.60 MST2009 -00177 SFR - Baths 2300000 -43101 $399.00 MST2009 -00177 12% State Surcharge - Plumbing 1003100 -24001 $47.88 MST2009 -00177 Furnaces >= 100K BTU 2300000 -43102 $17.90 MST2009 -00177 Duct Work 2300000 -43102 $10.00 MST2009 -00177 Water Heater 2300000 -43102 $10.00 MST2009 -00177 • Gas Fireplace 2300000 -43102 $20.00 MST2009 -00177 Range Hood /Other Kitchen 2300000 -43102 $10.00 MST2009 -00177 Clothes Dryer Exhaust 2300000 -43102 $10.00 MST2009 -00177 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $34.00 Utility Rooms) MST2009 -00177 Fuel Piping 2300000 -43102 $6.40 MST2009 -00177 12% State Surcharge - Mechanical 1003100 -24001 $14.20 MST2009 -00177 Permit Fee - Elect (per dwelling unit) 2200000 -43103 $278.75 MST2009 -00177 12% State Surcharge - Electrical 1003100 -24001 $33.45 MST2009 -00177 Plan Review 2300000 -43106 $142.30 Total: $15,397.38 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 2560 LSELLERS 09/25/2009 $15,397.38 Payor: Pacific Lifestyle Homes, Inc. Total Payments: $15,397.38 Balance Due: $0.00 Page 1 of 1 C SW WBBiR L 1��I y ,:, ..„ * ,, W . o ■ - 1—> .. „a A® Ai w a 5= ` - z . U C'V 7 0,..., Q ` ' R a� 3 X50' -2 H C) °— CZ.:Z , / • 2 Lot 2 6 L. . -... ..,...•.. ... 4 , 584. SF ;�'....�..,.:.; :.. 1111 I N • �..�e r 518SFD�(ve ' N co •. . �F9,p4,. 1 oo E-4 • N . - . I a 1 � - o0 013 I \ .. - • ., ...; i ra ,.. .,. : .... 1 ,, 4, 2" Caliper _ i „ \ DRAIN BT 80 SF Patio R. YANCEY • IMP Trident Maple . _ , (Q _ � � \ viis, 1 \ 10/03/07 N N � �, RavrsaD in 1 \\ ., ./ m Lot Coverage Area = 28% \ .m 161 158 / / Lot SF= 4584 63 .12' �� /' - House SF= 1280 \ / Impervious Area= 594 SF � � PCB „rte \\I 1. . . - - A / HEATH. YF BACI�FL ®vV 27345 `- , . 111111r INC• dNEW ❑ EXISTING ' . .. BACKFLOW ASSEMBLY TEST REPORT . ❑.REMOVED . . PROPERTY /22 e/ _ �' ` CI REPLACEMENT OWNER: / _f L G/ 1/ /e /Y "�E FIONE: . • MAILING ' / 2 $ - r " / - r• l ADDRESS: 7" A �j L �/ �7 CITY - 77 -- p !iv -C/7 - STATE /• _ ZIP f s ASSEMBLY r/ ADDRESS: STREET ❑ R.P.B.A. , D.C.V.A.. ❑.R.P.D.A. ❑ D.C. .D D.A.. ❑ P.V.B.A. ❑ S.V.B.A. ❑ A.V.B.. ❑ AIR GAP SIZE: LJH MAKE: O ' MODEL:? ° WATER PURVEYOR: „75----- 7 � /' 7 Cy NUMBER: �1� 7/ 72_ ASSEMBLY v .714 / - r • LOCATION: � "�� ' REDUCED PRESSURE ASSEMBLY P.V.B.A. / S.V.B.A INITIAL TE T ' DOUBLE CHECK AIR CHECK PASSED NI CHECK = PRESS DROP (A) CHECK #1 INLET FAILED ❑ _ ITE OPENED ATVE (B)ITIGHT ,0�3 OPENED AT: PRESS DROP MIN 2 PSID PSID DATE: �/ RESULTS BUFFER (LEAKED ❑ PSID PSID / / / 5 ` " /�f /[' '" A - B = I CHECK #2 zi MIN 3 PSI #2 RELIEF VALVE (TIGHT] _ DID NOT FAILED SYSTEM - PASS ❑ FAIL ❑ (LEAKED PSID OPEN ❑ ❑ PSI COMMENTS REPAIRS AND /OR . PARTS . 1 REDUCED PRESSURE ASSEMBLY P. V.B.A. /S. V.B.A. AFTER REPAIRS NI CHECK D.C.V.A. TEST PRESS DROP (A) CHECK #1 DATE: RELIEF ( OPENED AT PRESS DROP AFTER OPENED (8) TIGHT 0 PSID / / ' REPAIRS WW2 PSID SUFFER ( CHECK #2 A -B �,,.a ITIGHT ❑ PSID PSID PSID PASSED ❑ IN COMPLETING AND SUBMITTING THIS TEST REPORT. THE TESTER CERTIFIES THAT THE ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE WITH ALL APPLICABLE RULES AND REGULATIONS � OF THE ATER SYSTEM, AND STATE REGULATIONS. GAUGE CALIBRATION DATE /2 D E TOR -METER READING _ 3275 ' TESTER SIGNATURE CERT N David B Heath X h OR 1 0039 / 20473 TESTERS NAME PRINTED PO Box 1565 Sherwood OR 97140 (5B3) GAUGE II 53 TESTERS ADDRESS Heath Backflow Inc. • PHONE N - • COMPANY NAME _ - - SERVICE RESTORED REPORT RECEIVED BY:. (REPRESENTATIVE OF OWNER) WHITE - Water System Copy PINK - Customer Copy ' YELLOW - Tesler Copy • - • Oregon Residential Specialty Code N1107.2 HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: Jurisdiction: 0 Sr taxi- aovv Ccry of 776/4-124N Site Address: 78 iZ 6JIERRE1t 4 ,E Subdivision/Lot #: 812 arAw1Y ev►FAbotol uo; 24 and/or Map and Tax Lot #: • By my signature below, I certify that a minimum of fifty (50) percent of the permanently installed lighting fixtures in the above mentioned building have been installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. (Oregon Residential Specialty Code N1107.2) Signature: , Date: � - - ner /General tractor /Authorized Agent Print Name: Sc a RA 1,j61 1 ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this requirement. The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per input watt. 1:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWEE y"GEMENT FORM I, SGo7T Lj R/9 ay , am the general contractor or the owner- builder at the following address: Site Address: N12 LJERRE2 LA0E City: 7I6A2b c 1 Permit #: MST Zooci - oor7 - 7 • Subdivision/Lot #: Bear» i7 , iE 1DO JS 26. and /or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture - sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: G/ Date: ,y - -/p era! Contra or Owner - Builder I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 STREET TREE CERTIFICATION I, Scar f /AA4- , Owner /Agent for P,AciFic uFEsry hipi (PLEASE PRINT) (PERMIT 1- (OLDER) Do hereby certify that the following location meets City of Tigard land use and development standards for street tree installation. ADDRESS: 7Ri2_ W I ' A.)F SUBDIVISION: gR inF s LOT: 26 SIGNATURE: DATE: / _,y_, O WI%NER /AGENJ) RECEIVED BY: DATE: (CITY OF TIGARD) I: \Building \Forms \StreetTreeCertificate 01/19/07